Search

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]

Background: While a substantial body of work postulates that adaptation (response-shift effects) may serve to hide intervention benefits, much of the research was conducted in observational studies, not randomized-controlled trials. This scoping review identified all clinical trials that addressed response shift phenomena, and characterized how response-shift effects impacted trial findings. Methods: A scoping review was done of the medical literature from 1968 to 2021 using as keywords "response shift" and "clinical trial." Articles were included if they were a clinical trial that explicitly examined response-shift effects; and excluded if they were not a clinical trial, a full report, or if response shift was mentioned only in the discussion. Clinical-trials papers were then reviewed and retained in the scoping review if they focused on randomized participants, showed clear examples of response shift, and used reliable and valid response-shift detection methods. A synthesis of review results further characterized the articles' design characteristics, samples, interventions, statistical power, and impact of response-shift adjustment on treatment effect. Results: The search yielded 2148 unique references, 25 of which were randomized-controlled clinical trials that addressed response-shift effects; 17 of which were retained after applying exclusion criteria; 10 of which were adequately powered; and 7 of which revealed clinically-important response-shift effects that made the intervention look significantly better. Conclusions: These findings supported the presumption that response shift phenomena obfuscate treatment benefits, and revealed a greater intervention effect after integrating response-shift related changes. The formal consideration of response-shift effects in clinical trials research will thus not only improve estimation of treatment effects, but will also integrate the inherent healing process of treatments. Key points: This scoping review supported the presumption that response shift phenomena obfuscate treatment benefits and revealed a greater intervention effect after integrating response-shift related changes. The formal consideration of response-shift effects in clinical trials research will not only improve estimation of treatment effects but will also integrate the inherent healing process of 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]

Exergaming is a combination of exercise and gaming. Evidence shows an association between exercise and cognition in older people. However, previous studies showed inconsistent results on the cognitive benefits of exergaming in people with cognitive impairment. Therefore, this study aims to examine the effect of exergaming intervention on cognitive functions in people with MCI or dementia. A systematic literature search was conducted via OVID databases. Randomized controlled trials (RCTs) examined the effect of an exergaming intervention on cognitive functions in people with MCI or dementia were included. Subgroup analyses were conducted according to the type of intervention and training duration. Twenty RCTs with 1152 participants were identified, including 14 trials for MCI and 6 trials for dementia. In people with MCI, 13 studies used virtual-reality (VR)-based exergaming. Those who received VR-based exergaming showed significantly better global cognitive function [SMD (95%CI) = 0.67 (0.23–1.11)], learning and memory [immediate recall test: 0.79 (0.31–1.27); delayed recall test: 0.75 (0.20–1.31)], working memory [5.83 (2.27–9.39)], verbal fluency [0.58 (0.12–1.03)], and faster in executive function than the controls. For people with dementia, all studies used video-based exergaming intervention. Participants with exergaming intervention showed significantly better global cognitive function than the controls [0.38 (0.10–0.67)]. Subgroup analyses showed that longer training duration generated larger effects. The findings suggest that exergaming impacts cognitive functions in people with MCI and dementia. Cognitive benefits are demonstrated for those with a longer training duration. With technological advancement, VR-based exergaming attracts the attention of people with MCI and performs well in improving cognitive functions. [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]

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]

Parents of children with developmental disabilities are susceptible to mental health problems. Mindfulness-based and acceptance and commitment therapy (ACT)-based interventions can improve their mental well-being. This review examined the effectiveness of mindfulness-based and ACT-based interventions in improving mental well-being and mindfulness among parents of children with developmental disabilities. Six electronic databases were searched, resulting in the inclusion of ten studies published between 2014 and 2020. Meta-analysis was conducted using the random-effect model. The results suggest that mindfulness-based and ACT-based interventions were effective in decreasing parental stress, anxiety and depression, however, the effectiveness of these interventions in increasing parental mindfulness was inconclusive. Based on these findings, we discussed considerations for implementing interventions and identified areas which warrant further research. [ABSTRACT FROM AUTHOR]

Background: The Functional Movement Screen™ (FMS™) is an assessment of human movement that may signal potential deficits that could predispose an otherwise healthy person to injury risk. FMS™ scores are well reported in both athletic and adult samples. However, to date, there has been no comprehensive systematic review and meta-analysis of FMS™ data among school-aged children and adolescents. Objective: We aimed to systematically review and analyse functional movement proficiency of children and adolescents, specifically when assessed using the FMS™, and to establish initial normative values for the FMS™ in this population group and to further estimate differences in functional movement proficiency between the sexes, by school level (i.e., between primary and secondary school-level children and adolescents), and based on differences in child and adolescent body mass index (BMI). Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, prospective studies were identified from searches across eight databases (MEDLINE, SPORTDiscus, CINAHL, Web of Science, EMBASE, ERIC, PsychINFO and PubMed), without any date restrictions, up to December 2020. The primary meta-analysis estimated the overall FMS™ score for school-aged children and adolescents across published studies. An additional three subgroup meta-analyses estimated comparisons for FMS™ data with school level, sex, and BMI across published studies. FMS™ data were meta-analysed using a number of different meta packages (Schwarzer et al. in Meta-Analysis with R, 1st ed, Springer International Publishing, Berlin, 2015), available in R Studio. Results: A total of 19 articles were included in the systematic review. Meta-analysis revealed a weighted FMS™ mean score of 14.06, with a standardised Tau value of 0.56, signalling a moderate-to-large degree of variability in FMS™ means between studies. The difference in FMS™ means between samples of males (weighted FMS™ mean 13.91) and females (weighted FMS™ mean 14.56) was compatible with a possible small effect size (standardised mean difference − 0.27). The variability in FMS™ means between studies was approximately five times greater in samples of secondary school children (factor difference in Tau values 5.16). The final meta-regression identified a negative association between BMI and FMS™ scores (r = − 0.42), which signalled a moderate-to-large difference in FMS™ scores between healthy weight and overweight children/adolescents. Conclusion: This systematic review and meta-analysis represents a novel and important synthesis of published FMS™ data from groups of children and adolescents. The study signals possible sex- and age-related differences in FMS™ scores, as well as a clear negative relationship between BMI and functional movement proficiency. More longitudinal research is needed to better understand the developmental trajectory and the effects of maturation milestones on FMS™ proficiency. Additional research is also needed to identify the types of interventions that could improve functional movement proficiency among 'at risk' groups, who are susceptible to functional movement deficiency, and whether changes in body composition mediate the relationship between these interventions and the improvement of FMS™ scores. [ABSTRACT FROM AUTHOR]

Background: While chronic exercise training has been demonstrated to be an effective non-pharmacological treatment for chronic low back pain (CLBP), there has been a relative lack of evidence or clinical guidelines for whether a posterior chain resistance training programme provides any benefits over general exercise (GE). Objectives: To determine if chronic posterior chain resistance training (PCRT), defined as exercise programmes of ≥6 weeks duration focused on the thoracic, lumbar and hip extensor musculature, is more effective than GE in improving pain, level of disability, muscular strength and the number of adverse events in recreationally active and sedentary individuals with CLBP. Methods: Four electronic databases were systematically searched from 25 September 2019 until 30 August 2020. Using the Joanna Briggs Institute (JBI) Critical Appraisal Tools checklist for randomized controlled trials (RCTs), articles were critically appraised and compared against the inclusion/exclusion criteria. Standardized mean difference (SMD), risk difference (RD) and confidence interval (CI) were calculated using Review Manager 5.3. Results: Eight articles were included, with a total of 408 participants (203 PCRT, 205 GE). Both PCRT and GE were effective in improving a number of CLBP-related outcomes, but these effects were often significantly greater in PCRT than GE, especially with greater training durations (i.e. 12–16 weeks compared to 6–8 weeks). Specifically, when compared to GE, PCRT demonstrated a greater reduction in pain (SMD = − 0.61 (95% CI − 1.21 to 0.00), p = 0.05; I2 = 74%) and level of disability (SMD = − 0.53 (95% CI − 0.97 to − 0.09), p = 0.02; I2 = 52%), as well as a greater increase in muscle strength (SMD = 0.67 (95% CI 0.21 to 1.13), p = 0.004; I2 = 0%). No differences in the number of adverse events were reported between PCRT and GE (RD = − 0.02 (95% CI − 0.10 to 0.05), p = 0.57; I2 = 72%). Conclusion: Results of the meta-analysis indicated that 12–16 weeks of PCRT had a statistically significantly greater effect than GE on pain, level of disability and muscular strength, with no significant difference in the number of adverse events for recreationally active and sedentary patients with CLBP. Clinicians should strongly consider utilizing PCRT interventions for 12–16 weeks with patients with CLBP to maximize their improvements in pain, disability and muscle strength. Future research should focus on comparing the efficacy and adverse events associated with specific PCRT exercise training and movement patterns (i.e. deadlift, hip lift) in treating this population. Trial registration: PROSPERO CRD42020155700. [ABSTRACT FROM AUTHOR]

A systematic review was undertaken to identify lifestyle intervention studies in South Asian migrant populations to determine the effect on the components of the metabolic syndrome. A total of seven studies were identified, of which six focused on educational advice and the seventh on intensive exercise intervention. Four studies were Randomised Controlled Trials of which two studies reported significant reductions in waist circumference. One of these studies focused on home based education with cooperation of the home cook (adjusted waist reduction of 1.9 cm, 95 % CI 0.52-3.3 cm; p = 0.007) and the other entailed an intensive physical activity program (adjusted waist reduction 3.4 cm, 95 % CI 2.0-4.7 cm). The evidence whether lifestyle intervention studies in South Asians can improve components of the metabolic system is not clear. Further lifestyle interventions for South Asians should be culturally adapted, involve friends and family, especially those with cooking responsibilities. [ABSTRACT FROM AUTHOR]

Background: Cardiorespiratory fitness (CRF) among people with severe mental illness (SMI) (i.e., schizophrenia, bipolar disorder, and major depressive disorder) is a critical clinical risk factor given its relationship to cardiovascular disease and premature mortality. Objectives: This study aimed to: (1) investigate the mean CRF in people with SMI versus healthy controls; (2) explore moderators of CRF; and (3) investigate whether CRF improved with exercise interventions and establish if fitness improves more than body mass index following exercise interventions. Methods: Major electronic databases were searched systematically. A meta-analysis calculating Hedges' g statistic was undertaken. Results: Across 23 eligible studies, pooled mean CRF was 28.7 mL/kg/min [95 % confidence interval (CI) 27.3 to 30.0 mL/kg/min, p < 0.001, n = 980]. People with SMI had significantly lower CRF compared with controls ( n = 310) (Hedges' g = −1.01, 95 % CI −1.18 to −0.85, p < 0.001). There were no differences between diagnostic subgroups. In a multivariate regression, first-episode ( β = 6.6, 95 % CI 0.6-12.6) and inpatient ( β = 5.3, 95 % CI 1.6-9.0) status were significant predictors of higher CRF. Exercise improved CRF (Hedges' g = 0.33, 95 % CI = 0.21-0.45, p = 0.001), but did not reduce body mass index. Higher CRF improvements were observed following interventions at high intensity, with higher frequency (at least three times per week) and supervised by qualified personnel (i.e., physiotherapists and exercise physiologists). Conclusion: The multidisciplinary treatment of people with SMI should include a focus on improving fitness to reduce all-cause mortality. Qualified healthcare professionals supporting people with SMI in maintaining an active lifestyle should be included as part of multidisciplinary teams in mental health treatment. [ABSTRACT FROM AUTHOR]

To identify the efficacy of short message service (SMS) reminders in health care appointment attendance. A systematic review was undertaken to identify studies published between 2005 and 2015 that compared the attendance rates of patients receiving SMS reminders compared to patients not receiving a reminder. Each article was examined for information regarding the study design, sample size, population demographics and intervention methods. A meta-analysis was used to calculate a pooled estimate odds ratio. Twenty-eight (28) studies were included in the review, including 13 (46 %) randomized controlled trials. The pooled odds ratio of the randomized control trials was 1.62 (1.35-1.94). Half of the studies reviewed sent the reminder within 48 h prior to the appointment time, yet no significant subgroups differences with respect to participant age, SMS timing, rate or type, setting or specialty was detectable. All studies, except one with a small sample size, demonstrated a positive OR, indicating SMS reminders were an effective means of improving appointment attendance. There was no significant difference in OR when controlling for when the SMS was sent, the frequency of the reminders or the content of the reminder. SMS appointment reminders are an effective and operative method in improving appointment attendance in a health care setting and this effectiveness has improved over the past 5 years. Further research is required to identify the optimal SMS reminder timing and frequency, specifically in relation to the length of time since the appointment. [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]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

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]

Background: Resistance and aerobic exercises are both recommended as effective treatments for people with type 2 diabetes. However, the optimum type of exercise for the disease remains to be determined to inform clinical decision-making and facilitate personalized exercise prescription. Objectives: Our objective was to investigate whether resistance exercise is comparable to aerobic exercise in terms of effectiveness and safety in people with type 2 diabetes. Data sources: PubMed, EMBASE, CENTRAL, CINAHL, and SPORTdiscus were systematically searched up to March 2013. The reference lists of eligible studies and relevant reviews were also checked. Study Selection: We used the following criteria to select studies for inclusion in the review: (i) the study was a randomized controlled trial; (ii) the participants were people with type 2 diabetes aged 18 years or more; (iii) the trial compared resistance exercise with aerobic exercise for a duration of at least 8 weeks, with pre-determined frequency, intensity, and duration; and (iv) the trial provided relevant data on at least one of the following: glycaemic control, blood lipids, anthropometric measures, blood pressure, fitness, health status, and adverse events. Study Appraisal and Synthesis Methods: The assessment of study quality was based on the Cochrane Risk of Bias tool. For effectiveness measures, differences (resistance group minus aerobic group) in the changes from baseline with the two exercises were combined, using a random-effects model wherever possible. For adverse events, the relative risks (resistance group vs. aerobic group) were combined. Results: Twelve trials ( n = 626) were included. Following the exercise interventions, there was a greater reduction of glycosylated hemoglobin with aerobic exercise than with resistance exercise (difference 0.18 % (1.97 mmol/mol), 95 % confidence interval (CI) 0.01, 0.36). This difference became non-significant with sensitivity analysis ( p = 0.14). The differences in changes from baseline were also statistically significant for body mass index (difference 0.22, 95 % CI 0.06, 0.39), peak oxygen consumption (difference −1.84 mL/kg/min, 95 % CI −3.07, −0.62), and maximum heart rate (difference 3.44 beats per minute, 95 % CI 2.49, 4.39). Relative risks for adverse events (all) and serious adverse events were 1.17 (95 % CI 0.77, 1.79) and 0.89 (95 % CI 0.18, 4.39), respectively. Limitations: Most included trials were short term (8 weeks to 6 months), and seven had important methodological limitations. Additionally, the meta-analyses for some of the secondary outcomes had a small number of participants or substantial statistical heterogeneity. Conclusions: Although differences in some diabetic control and physical fitness measures between resistance exercise and aerobic exercise groups reached statistical significance, there is no evidence that they are of clinical importance. There is also no evidence that resistance exercise differs from aerobic exercise in impact on cardiovascular risk markers or safety. Using one or the other type of exercise for type 2 diabetes may be less important than doing some form of physical activity. Future long-term studies focusing on patient-relevant outcomes are warranted. [ABSTRACT FROM AUTHOR]

Study design:Systematic literature review.Objectives:The purpose of this study was to gain a systematic overview of the role of psychological resources in the adjustment to spinal cord injury (SCI).Methods:A systematic literature review was performed. The literature search was conducted in the databases Pubmed, PsycINFO, the Social Sciences Citation Index, the Education Resources Information Center, Embase and the Citation Index of Nursing and Allied Health Literature. The assessed variables, measurement instruments, results and the methodological quality of the studies were extracted, summarized and evaluated.Results:A total of 83 mainly cross-sectional studies were identified. Psychological resources were categorized into seven groups: self-efficacy (SE), self-esteem, sense of coherence (SOC), spirituality, optimism, intellect and other personality characteristics. SE and self-esteem were consistently associated with positive adjustment indicators such as high well-being and better mental health. Interrelations between psychological resources and key rehabilitation outcome variables such as participation were rarely studied. Only a few interventions, which were aimed at strengthening psychological resources were identified. Longitudinal studies suggested that SE, SOC, spirituality and purpose in life were potential determinants of adjustment outcomes in the long term.Conclusion:Research on psychological resources in SCI is broad, but fragmented. Associations of psychological resources with mental health and well-being were frequently shown, while associations with participation were rarely studied. Further development of resource-based interventions to strengthen persons with SCI is indicated. This review can serve as guide for clinical practice and can add to the design of future SCI research. [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]