Effectiveness of telehealth-based exercise interventions on pain, physical function and quality of life in patients with knee osteoarthritis: A meta-analysis.
Journal of clinical nursing. 2022
OBJECTIVE The objective of the study was to evaluate the effectiveness of telehealth-based exercise intervention on pain, physical function and quality of life in patients with knee osteoarthritis. DESIGN A systematic review and meta-analysis of randomised controlled trials (RCTs). METHODS Six databases (PubMed, Embase, Cochrane Library, CINAHL, PEDro and Web of Science Core Collection) were searched for relevant randomised controlled trials published from database inception to 3 June 2021. Reviewers independently screened the literature, extracted data and used the Cochrane Collaboration Risk of Bias Tool for quality assessment. A meta-analysis and subgroup analyses, stratified by control condition, intervention duration and delivery type, were conducted by Revman 5.4. The study was reported in compliance with PRISMA statement. RESULTS A total of 9 independent RCTs with 861 participants were included. The meta-analysis showed that the telehealth-based exercise interventions significantly reduced pain in KOA patients (SMD = -0.28, 95% CI [-0.49, -0.08], p < .01) and produced similar effects to controls in terms of physical function and quality of life. Subgroup analysis revealed that telehealth-based exercise interventions were superior to the use of exercise booklet and usual care in terms of pain and physical function and were similar to face-to-face exercise treatment; a long-term (>3 months) intervention and the use of web and smartphone APPs to deliver exercise interventions were associated with better pain relief and physical function. CONCLUSIONS Telehealth-based exercise intervention is an effective strategy for KOA management during the COVID-19 epidemic, and it is significantly better than usual care in reducing knee pain and improving physical function and was able to achieve the effects of traditional face-to-face exercise treatment. Although the duration and type of delivery associated with the effect of the intervention have been identified, patient preference and acceptability need to be considered in practice.
Review on fate and bioavailability of heavy metals during anaerobic digestion and composting of animal manure.
Waste management (New York, N.Y.). 2022;:75-89
Anaerobic digestion and composting are attracting increasing attention due to the increased production of animal manure. It is essential to know about the fate and bioavailability of heavy metals (HMs) for further utilisation of animal manure. This review has systematically summarised the migration of HMs and the transformation of several typical HMs (Cu, Zn, Cd, As, and Pb) during anaerobic digestion and composting. The results showed that organic matter degradation increased the HMs content in biogas residue and compost (with the exception of As in compost). HMs migrated into biogas residue during anaerobic digestion through various mechanisms. Most of HMs in biogas residue and compost exceeded relevant standards. Then, anaerobic digestion increased the bioavailable fractions proportion in Zn and Cd, decreased the F4 proportion, and raised them more than moderate environmental risks. As (III) was the main species in the digester, which extremely increased As toxicity. The increase of F3 proportion in Cu and Pb was due to sulphide formation in biogas residue. Whereas, the high humus content in compost greatly increased the F3 proportion in Cu. The F1 proportion in Zn decreased, but the plant availability of Zn in compost did not reduce significantly. Cd and As mainly converted the bioavailable fractions into stable fractions during composting, but As (V) toxicity needs to be concerned. Moreover, additives are only suitable for animal manure treated with slightly HM contaminated. Therefore, it is necessary to combine more comprehensive methods to improve the manure treatment and make product utilisation safer.
Potential harms of supplementation with high doses of antioxidants in athletes.
Journal of exercise science and fitness. 2022;(4):269-275
Vigorous exercise generates large amounts of reactive oxygen species (ROS) as a result of the consumption of large volumes of O2 in athletes, causing some athletes to consume antioxidants in the erroneous belief that this will counteract the damaging effects of ROS. There is currently no convincing evidence to support the benefits of antioxidant supplementation in acute physical exercise and exercise training. On the contrary, exogenous antioxidants prevent some physiological functions of free radicals that are needed for cell signaling, causing higher dosages of antioxidants to hamper or prevent performance-enhancing and health-promoting training adaptation such as mitochondrial biogenesis, skeletal and cardiac muscle hypertrophy, and improved insulin sensitivity. However, there remains the perception that antioxidants can counterbalance oxidative stress and benefit exercise adaptation and performance in athletes. It is likely that the negative effects of high doses of antioxidant supplementation exceed their potential benefits. We discuss some proposed pathways of potential side effects of exogenous antioxidant supplementation in athletes.
The Molecular Mechanism of Aerobic Exercise Improving Vascular Remodeling in Hypertension.
Frontiers in physiology. 2022;:792292
The treatment and prevention of hypertension has been a worldwide medical challenge. The key pathological hallmark of hypertension is altered arterial vascular structure and function, i.e., increased peripheral vascular resistance due to vascular remodeling. The aim of this review is to elucidate the molecular mechanisms of vascular remodeling in hypertension and the protective mechanisms of aerobic exercise against vascular remodeling during the pathological process of hypertension. The main focus is on the mechanisms of oxidative stress and inflammation in the pathological condition of hypertension and vascular phenotypic transformation induced by the trilaminar structure of vascular endothelial cells, smooth muscle cells and extracellular matrix, and the peripheral adipose layer of the vasculature. To further explore the possible mechanisms by which aerobic exercise ameliorates vascular remodeling in the pathological process of hypertension through anti-proliferative, anti-inflammatory, antioxidant and thus inhibiting vascular phenotypic transformation. It provides a new perspective to reveal the intervention targets of vascular remodeling for the prevention and treatment of hypertension and its complications.
A Meta-Analysis of High-Intensity Interval Training on Glycolipid Metabolism in Children With Metabolic Disorders.
Frontiers in pediatrics. 2022;:887852
Objective: Metabolic disorders are common among children and adolescents with obesity and are associated with insulin resistance, hyperlipidemia, hypertension, and other cardiovascular risk factors. High-intensity interval training (HIIT) is a time-efficient method to improve cardiometabolic health. We performed a meta-analysis to determine the effects of HIIT on glycolipid metabolism in children with metabolic disorders. Methods: Meta-analyses were conducted to determine the effect of HIIT on glycolipid metabolism markers. Subgroup analysis with potential moderators was explored [i.e., training intensity standard and work/rest time ratio (WRR)]. Results: Eighteen trials involving 538 participants were included. HIIT showed positive effects on glycolipid metabolism, such as triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), blood glucose (BG), blood insulin (BI), and homeostasis model assessment (HOMA)-IR, when compared to the non-training control group (CON); in addition to BG (p = 0.257), the combined results of other indicators have high heterogeneity (p = 0.000). HIIT showed no superior effects when compared to moderate-intensity training (MIT). Subgroup analysis demonstrated that HIIT protocol with a WRR of 1:1 was superior to MIT for reducing TG and LDL-C and used %maximal aerobic speed (MAS) as the exercise intensity was superior to MIT for reducing TG. HIIT protocol used %heart rate (HR) as the exercise intensity was superior to MIT for increasing HDL-C, decreasing BI, and HOMA-IR. Conclusion: HIIT improved glycolipid metabolism in children with metabolic disorders. WRR and training intensity can affect the intervention effects of HIIT. Systematic Review Registration: [https://www.crd.york.ac.uk/], identifier [CRD42021291473].
Effects of caffeine ingestion on physiological indexes of human neuromuscular fatigue: A systematic review and meta-analysis.
Brain and behavior. 2022;(4):e2529
BACKGROUND Caffeine is often used as a stimulant during fatigue, but the standard of characteristic physiological indicators of the effect of caffeine on neuromuscular fatigue has not been unified. The purpose of this systematic review and meta-analysis is to summarize current experimental findings on the effects of caffeine on physiological indexes before and after neuromuscular fatigue, identify some characteristic neuromuscular physiological indexes to assess the potential effects of caffeine. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses are followed. We systematically searched PubMed, Google academic, and Web of Science for randomized controlled trials. We searched for studies on caffeine's (i) effects on neuromuscular fatigue and (ii) the influence of physiological indexes changes. Meta-analysis was performed for standardized mean differences (SMD) between caffeine and placebo trials in individual studies. RESULTS The meta-analysis indicated that caffeine significantly improves voluntary activation (VA) (SMD = 1.46;95%CI:0.13, 2.79; p < .00001), PTw (SMD = 1.11, 95%CI: -1.61, 3.84; p < .00001), and M-wave (SMD = 1.10, 95%CI: -0.21, 2.41; p < .00001), and a significant difference (p = .003) on measures of Peak Power (PP), and insignificant difference on measures of heart rate (HR) (I2 = 0.0, p = .84) and Maximal oxygen uptake (VO2 ) (I2 = 0.0, p = .76). CONCLUSION The analysis showed that caffeine intake had a relatively large effect on VA, potentiated twitch (PTw), M-wave, which can be used as characteristic indexes of caffeine's impact on neuromuscular fatigue. This conclusion tends to indicate the effects of caffeine on neuromuscular fatigue during endurance running or jumping or muscle bending and stretching. The caffeine intake had a big effect on the electromyogram (EMG) and peak power (PP), and its effect role needs to be further verified, this conclusion tends to indicate the effect of caffeine on neuromuscular fatigue during jumping or elbow bending moment movements. HR, VO2 , maximal voluntary contraction (MVC) cannot be used as the characteristic indexes of caffeine on neuromuscular fatigue. This conclusion tends to indicate the effect of caffeine on neuromuscular fatigue during endurance exercise. However, the results of meta-analysis are based on limited evidence and research scale, as well as individual differences of participants and different physical tasks, so it is necessary to interpret the results of meta-analysis cautiously. Therefore, future research needs to explore other physiological indicators and their indicative effects in order to determine effective and accurate characteristic indicators of caffeine on neuromuscular fatigue.
Related factors associated with fear of hypoglycemia in parents of children and adolescents with type 1 diabetes - A systematic review.
Journal of pediatric nursing. 2022;:125-135
PROBLEM Fear of hypoglycemia is a significant concern for parents of children/ adolescents with type 1 diabetes. Although some studies have explained the parental fear of hypoglycemia, the related factors were yet to be determined. This systematic review aims to identify the related factors of fear of hypoglycemia in the parents of children and adolescents with type 1 diabetes and provide a theoretical basis for further intervention. ELIGIBILITY CRITERIA PubMed, MEDLINE, EMBASE, Scopus, CINAHL, EBSCO, Web of Science, and Cochrane Library were systematically searched from 2010 to 2021. Studies evaluating the fear of hypoglycemia of parents and its associated factors were included. SAMPLE Twenty-three observational articles met the criteria. RESULTS Significant associations were found between fear of hypoglycemia and specific factors, including motherhood, nocturnal hypoglycemia, and the number of blood glucose monitoring. Psychological factors, including anxiety, depression, pediatric parenting stress, mindfulness, self-efficacy, quality of life, and sleep disorders, were conclusive and associations with parental fear of hypoglycemia. CONCLUSIONS Understanding parental fear of hypoglycemia can help parents prevent potential problems in diabetes management, thus promoting children's growth. According to current evidence, effective targeted interventions based on modifiable relevant factors can be developed to reduce the fear of hypoglycemia in parents while maintaining optimal blood glucose control in children/ adolescents. IMPLICATIONS Health professionals should pay more attention to the mental health of parents, and parents should be involved in the care plan and have the opportunity to discuss their fear of hypoglycemia in the most appropriate way to manage type 1 diabetes.
Effects of Exercise on Patients Important Outcomes in Older People With Sarcopenia: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials.
Frontiers in medicine. 2022;:811746
BACKGROUND Many clinical practice guidelines strongly recommend exercise as an intervention for patients with sarcopenia. However, the significance of exercise on patient-important outcomes in older adults with sarcopenia is inconsistent when considering available minimal important differences. To synthesize current systematic review and meta-analyses evidence on the efficacy of exercise on patient-important outcomes in the treatment of sarcopenia in older adults. METHODS We searched MEDLINE, EMBASE, Cochrane Library (Cochrane database of systematic review, CDSR) via OvidSP and Web of science until April 2021 and reference lists. Two independent investigators performed abstracted and title screening, assessed the full text and quality of evidence. This umbrella review included systematic reviews and meta-analyses of randomized controlled trials (RCTs). Eligible reviews aim to evaluate the effect of exercise on patient-important sarcopenic outcomes (muscle or physical function, mortality, and quality of life) in treating sarcopenia in older people. We used the minimally important differences (MIDs) of these outcomes to assess if the effects of exercise matter to patients. RESULTS This umbrella review provided a broad overview of the existing evidence and evaluated the systematic reviews' methodological quality and evidence for all these associations. In older patients with sarcopenia, moderate- to high-quality evidence showed that exercise intervention probably increases walking speed and improved physical performance (measured by TUG test); exercise may increase the muscle strength (grip strength, keen extension strength); but the effect size for grip strength probably too small to achieve patients important changes. Evidence for older people with sarcopenic obesity is limited, and we found the consistent effect of exercise interventions on grip strength and usual walking speed. CONCLUSION Exercise has a positive and important effect on physical performance for older adults with sarcopenia, which supports leaving the current recommendations unchanged. New systematic reviews to summarize the effect of exercise on the quality of life are warranted to fill the current evidence gap.
Maillard-Type Protein-Polysaccharide Conjugates and Electrostatic Protein-Polysaccharide Complexes as Delivery Vehicles for Food Bioactive Ingredients: Formation, Types, and Applications.
Gels (Basel, Switzerland). 2022;(2)
Due to their combination of featured properties, protein and polysaccharide-based carriers show promising potential in food bioactive ingredient encapsulation, protection, and delivery. The formation of protein-polysaccharide complexes and conjugates involves non-covalent interactions and covalent interaction, respectively. The common types of protein-polysaccharide complex/conjugate-based bioactive ingredient delivery systems include emulsion (conventional emulsion, nanoemulsion, multiple emulsion, multilayered emulsion, and Pickering emulsion), microcapsule, hydrogel, and nanoparticle-based delivery systems. This review highlights the applications of protein-polysaccharide-based delivery vehicles in common bioactive ingredients including polyphenols, food proteins, bioactive peptides, carotenoids, vitamins, and minerals. The loaded food bioactive ingredients exhibited enhanced physicochemical stability, bioaccessibility, and sustained release in simulated gastrointestinal digestion. However, limited research has been conducted in determining the in vivo oral bioavailability of encapsulated bioactive compounds. An in vitro simulated gastrointestinal digestion model incorporating gut microbiota and a mucus layer is suggested for future studies.
The Effect of Blood Flow Restriction Exercise on Angiogenesis-Related Factors in Skeletal Muscle Among Healthy Adults: A Systematic Review and Meta-Analysis.
Frontiers in physiology. 2022;:814965
BACKGROUND Blood flow restriction (BFR) exercise may be a potential exercise program to promote angiogenesis. This review aims to compare the effects of exercise with and without BFR on angiogenesis-related factors in skeletal muscle among healthy adults. METHODOLOGY Searches were made in Web of Science, Scopus, PubMed, and EBSCO databases from January 2001 to June 2021. Studies were screened, quality was evaluated, and data were extracted. The review protocol was registered at PROSPERO (PROSPERO registration number: CRD42021261367). Standardized mean differences (SMD) of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 2 (VEGFR-2), hypoxia inducible factor 1α (HIF-1α), peroxisome proliferator-activated receptorγcoactivator-1α (PGC-1α) and endothelial nitric oxide synthase (eNOS) were analyzed using Revman 5.4 software with a 95% confidence interval (95% CI). RESULTS Ten studies fulfilled the inclusion criteria with a total of 75 participants for BFR group and 77 for CON group. BFR exercise elicits greater expression of VEGF (heterogeneity test, P = 0.09, I2 = 44%; SMD, 0.93 [0.38, 1.48], P < 0.05), VEGFR-2 (heterogeneity test, P = 0.81, I2 = 0%; SMD, 0.64 [0.08, 1.21], P < 0.05), HIF-1α (heterogeneity test, P = 0.67, I2 = 0%; SMD, 0.43 [0.03, 0.82], P < 0.05), PGC-1α (heterogeneity test, P = 0.02, I2 = 54%; SMD, 0.74 [0.21, 1.28], P < 0.05) and eNOS (heterogeneity test, P = 0.88, I2 = 0%; SMD, 0.60 [0.04, 1.17], P < 0.05) mRNA than non-BFR exercise. In the sub-group analysis, resistance exercise with BFR elicits greater expression of VEGF (heterogeneity test, P = 0.36, I2 = 6%; SMD, 1.66 [0.97, 2.35], P < 0.05) and HIF-1α (heterogeneity test, P = 0.56, I2 = 0%; SMD, 0.51 [0.01, 1.02], P < 0.05) mRNA than aerobic exercise with BFR. CONCLUSION Exercise with BFR elicited more angiogenesis-related factors mRNA expression than exercise without BFR, but not VEGF and PGC-1α protein expression. Therefore, BFR training may be a potential training program to improve vascular function. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021261367].