scholarly journals Nutritional interventions to improve muscle mass, muscle strength, and physical performance in older people: an umbrella review of systematic reviews and meta-analyses

2020 ◽  
Author(s):  
Evelien Gielen ◽  
David Beckwée ◽  
Andreas Delaere ◽  
Sandra De Breucker ◽  
Maurits Vandewoude ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Muscle Mass ◽  
Physical Performance ◽  
Systematic Reviews ◽  
Evidence Based ◽  
Umbrella Review ◽  
Belgian Society ◽  
Nutritional Interventions ◽  
Meta Analyses

Abstract Context Sarcopenia is a progressive and generalized skeletal muscle disorder associated with an increased risk of adverse outcomes such as falls, disability, and death. The Belgian Society of Gerontology and Geriatrics has developed evidence-based guidelines for the prevention and treatment of sarcopenia. This umbrella review presents the results of the Working Group on Nutritional Interventions. Objective The aim of this umbrella review was to provide an evidence-based overview of nutritional interventions targeting sarcopenia or at least 1 of the 3 sarcopenia criteria (ie, muscle mass, muscle strength, or physical performance) in persons aged ≥ 65 years. Data sources Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed and Web of Science databases were searched for systematic reviews and meta-analyses reporting the effect of nutritional supplementation on sarcopenia or muscle mass, strength, or physical performance. Data extraction Two authors extracted data on the key characteristics of the reviews, including participants, treatment, and outcomes. Methodological quality of the reviews was assessed using the product A Measurement Tool to Assess Systematic Reviews. Three authors synthesized the extracted data and generated recommendations on the basis of an overall synthesis of the effects of each intervention. Quality of evidence was rated with the Grading of Recommendations Assessment, Development and Evaluation approach. Data analysis A total of 15 systematic reviews were included. The following supplements were examined: proteins, essential amino acids, leucine, β-hydroxy-β-methylbutyrate, creatine, and multinutrient supplementation (with or without physical exercise). Because of both the low amount and the low to moderate quality of the reviews, the level of evidence supporting most recommendations was low to moderate. Conclusions Best evidence is available to recommend leucine, because it has a significant effect on muscle mass in elderly people with sarcopenia. Protein supplementation on top of resistance training is recommended to increase muscle mass and strength, in particular for obese persons and for ≥ 24 weeks. Effects on sarcopenia as a construct were not reported in the included reviews.

scholarly journals Wake up and smell the coffee: caffeine supplementation and exercise performance—an umbrella review of 21 published meta-analyses

2019 ◽  
Vol 54 (11) ◽  
pp. 681-688 ◽  
Author(s):  
Jozo Grgic ◽  
Ivana Grgic ◽  
Craig Pickering ◽  
Brad J Schoenfeld ◽  
David J Bishop ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Systematic Reviews ◽  
Exercise Performance ◽  
Methodological Quality ◽  
Muscle Endurance ◽  
Umbrella Review ◽  
Caffeine Ingestion ◽  
Quality Of Evidence ◽  
Meta Analyses

ObjectiveTo systematically review, summarise and appraise findings of published meta-analyses that examined the effects of caffeine on exercise performance.DesignUmbrella review.Data sourcesTwelve databases.Eligibility criteria for selecting studiesMeta-analyses that examined the effects of caffeine ingestion on exercise performance.ResultsEleven reviews (with a total of 21 meta-analyses) were included, all being of moderate or high methodological quality (assessed using the Assessing the Methodological Quality of Systematic Reviews 2 checklist). In the meta-analyses, caffeine was ergogenic for aerobic endurance, muscle strength, muscle endurance, power, jumping performance and exercise speed. However, not all analyses provided a definite direction for the effect of caffeine when considering the 95% prediction interval. Using the Grading of Recommendations Assessment, Development and Evaluation criteria the quality of evidence was generally categorised as moderate (with some low to very low quality of evidence). Most individual studies included in the published meta-analyses were conducted among young men.Summary/conclusionSynthesis of the currently available meta-analyses suggest that caffeine ingestion improves exercise performance in a broad range of exercise tasks. Ergogenic effects of caffeine on muscle endurance, muscle strength, anaerobic power and aerobic endurance were substantiated by moderate quality of evidence coming from moderate-to-high quality systematic reviews. For other outcomes, we found moderate quality reviews that presented evidence of very low or low quality. It seems that the magnitude of the effect of caffeine is generally greater for aerobic as compared with anaerobic exercise. More primary studies should be conducted among women, middle-aged and older adults to improve the generalisability of these findings.

scholarly journals Efficacy of perioperative immunonutrition in visceral surgery: an umbrella review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053851
Author(s):  
Karem Slim ◽  
Flora Badon ◽  
Charles-Hervé Vacheron ◽  
Chadli Dziri ◽  
Thomas Marquillier
Keyword(s):  
Systematic Reviews ◽  
Surgical Site Infections ◽  
Visceral Surgery ◽  
Hospital Length Of Stay ◽  
Bibliographic Databases ◽  
Measurement Tool ◽  
Published Data ◽  
Umbrella Review ◽  
Meta Analyses

IntroductionImmunonutrition (IN) is generally used before major visceral surgery with the intent to reduce postoperative complications, especially infectious ones. However, the conclusions of published meta-analyses are conflicting. The purpose of this review is to synthesise the data of published systematic reviews on the effectiveness of IN.Methods and analysisThis protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols guidelines. This is an umbrella review of systematic reviews comparing IN (delivered orally 5–7 days preoperatively) with normal diet or isocaloric isonitrogenous feeding before visceral surgery performed on any of several viscera (colorectum, stomach, pancreas, liver, oesophagus). We search the systematic reviews included in the main bibliographic databases. To assess the efficacy of IN, several outcomes will be considered: the main outcome is infectious complications (surgical site infections, pulmonary infections or urinary infections) and secondary outcomes are overall morbidity, hospital length of stay and mortality. Identified reviews will be screened by two independent assessors. The methodological quality of relevant included reviews will be assessed using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) instrument. The data extracted from included reviews will be synthesised using the r-Metafor package considering separate groups according to the viscus of interest. Publication bias will be evaluated, and subgroup analyses will be performed according to the quality of studies and preoperative nutritional status.Ethics and disseminationAn umbrella review based on published data from systematic reviews needs no ethical approval. Furthermore, no patient will be involved in the review. Once terminated, the review will be submitted for publication in an open access journal to ensure wide dissemination of the findings.PROSPERO registration numberCRD42021255177.

scholarly journals Evidence of Rehabilitative Impact of Progressive Resistance Training (PRT) Programs in Parkinson Disease: An Umbrella Review

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
T. Paolucci ◽  
S. Sbardella ◽  
C. La Russa ◽  
F. Agostini ◽  
M. Mangone ◽  
...  
Keyword(s):  
Resistance Training ◽  
Muscle Strength ◽  
Parkinson Disease ◽  
Systematic Reviews ◽  
Cochrane Library ◽  
Progressive Resistance Training ◽  
Umbrella Review ◽  
Positive Effects ◽  
Meta Analyses ◽  
Progressive Resistance

Parkinson disease (PD) is a chronic neurodegenerative condition that leads to progressive disability. PD-related reductions in muscle strength have been reported to be associated with lower functional performance and balance confidence with an increased risk of falls. Progressive resistance training (PRT) improves strength, balance, and functional abilities. This umbrella review examines the efficacy of PRT regarding muscular strength in PD patients. The PubMed, PEDro, Scopus, and Cochrane Library databases were searched from January 2009 to August 2019 for systematic reviews and meta-analyses conducted in English. The populations included had diagnoses of PD and consisted of males and females aged >18 years old. Outcomes measured were muscle strength and enhanced physical function. Eight papers (six systematic reviews and meta-analyses and two systematic reviews) were considered relevant for qualitative analysis. In six of the eight studies, the reported severity of PD was mild to moderate. Each study analyzed how PRT elicited positive effects on muscle strength in PD patients, suggesting 10 weeks on average of progressive resistance exercises for the upper and lower limbs two to three times per week. However, none of the studies considered the postworkout follow-up, and there was no detailed evidence about the value of PRT in preventing falls. The possibility of PRT exercises being effective for increasing muscle strength in patients with PD, but without comorbidities or severe disability, is discussed. Overall, this review suggests that PRT should be included in rehabilitation programs for PD patients, in combination with balance training for postural control and other types of exercise, in order to preserve cardiorespiratory fitness and improve endurance in daily life activities.

scholarly journals Pearls for Interpreting Neurosurgical Systematic Reviews and Meta-Analyses: Lessons From a Collaborative Effort

Neurosurgery ◽  
2020 ◽  
Vol 87 (3) ◽  
pp. 435-441 ◽  
Author(s):  
Victor M Lu ◽  
Christopher S Graffeo ◽  
Avital Perry ◽  
Michael J Link ◽  
Fredric B Meyer ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Evidence Based Medicine ◽  
Lessons Learned ◽  
Evidence Based ◽  
Cranial Neuralgia ◽  
The Individual ◽  
Meta Analyses ◽  
Based Medicine ◽  
Over Time

Abstract Systematic reviews and meta-analyses in the neurosurgical literature have surged in popularity over the last decade. It is our concern that, without a renewed effort to critically interpret and appraise these studies as high or low quality, we run the risk of the quality and value of evidence-based medicine in neurosurgery being misinterpreted. Correspondingly, we have outlined 4 major domains to target in interpreting neurosurgical systematic reviews and meta-analyses based on the lessons learned by a collaboration of clinicians and academics summarized as 4 pearls. The domains of (1) heterogeneity, (2) modeling, (3) certainty, and (4) bias in neurosurgical systematic reviews and meta-analyses were identified as aspects in which the authors’ approaches have changed over time to improve robustness and transparency. Examples of how and why these pearls were adapted were provided in areas of cranial neuralgia, spine, pediatric, and neuro-oncology to demonstrate how neurosurgical readers and writers may improve their interpretation of these domains. The incorporation of these pearls into practice will empower neurosurgical academics to effectively interpret systematic reviews and meta-analyses, enhancing the quality of our evidence-based medicine literature while maintaining a critical focus on the needs of the individual patients in neurosurgery.

scholarly journals Mapping the Evidence on the Effectiveness of Telemedicine Interventions in Diabetes, Dyslipidemia, and Hypertension: An Umbrella Review of Systematic Reviews and Meta-Analyses

10.2196/16791 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e16791 ◽  
Author(s):  
Patrick Timpel ◽  
Sarah Oswald ◽  
Peter E H Schwarz ◽  
Lorenz Harst
Keyword(s):  
Clinical Outcomes ◽  
Systematic Reviews ◽  
Population Characteristics ◽  
Cochrane Library ◽  
Low Grade ◽  
Umbrella Review ◽  
Eligibility Criteria ◽  
Patients With Diabetes ◽  
Meta Analyses

Background Telemedicine is defined by three characteristics: (1) using information and communication technologies, (2) covering a geographical distance, and (3) involving professionals who deliver care directly to a patient or a group of patients. It is said to improve chronic care management and self-management in patients with chronic diseases. However, currently available guidelines for the care of patients with diabetes, hypertension, or dyslipidemia do not include evidence-based guidance on which components of telemedicine are most effective for which patient populations. Objective The primary aim of this study was to identify, synthesize, and critically appraise evidence on the effectiveness of telemedicine solutions and their components on clinical outcomes in patients with diabetes, hypertension, or dyslipidemia. Methods We conducted an umbrella review of high-level evidence, including systematic reviews and meta-analyses of randomized controlled trials. On the basis of predefined eligibility criteria, extensive automated and manual searches of the databases PubMed, EMBASE, and Cochrane Library were conducted. Two authors independently screened the studies, extracted data, and carried out the quality assessments. Extracted data were presented according to intervention components and patient characteristics using defined thresholds of clinical relevance. Overall certainty of outcomes was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. Results Overall, 3564 references were identified, of which 46 records were included after applying eligibility criteria. The majority of included studies were published after 2015. Significant and clinically relevant reduction rates for glycated hemoglobin (HbA1c; ≤−0.5%) were found in patients with diabetes. Higher reduction rates were found for recently diagnosed patients and those with higher baseline HbA1c (>8%). Telemedicine was not found to have a significant and clinically meaningful impact on blood pressure. Only reviews or meta-analyses reporting lipid outcomes in patients with diabetes were found. GRADE assessment revealed that the overall quality of the evidence was low to very low. Conclusions The results of this umbrella review indicate that telemedicine has the potential to improve clinical outcomes in patients with diabetes. Although subgroup-specific effectiveness rates favoring certain intervention and population characteristics were found, the low GRADE ratings indicate that evidence can be considered as limited. Future updates of clinical care and practice guidelines should carefully assess the methodological quality of studies and the overall certainty of subgroup-specific outcomes before recommending telemedicine interventions for certain patient populations.

scholarly journals Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 6. Systematic Reviews and Meta-Analyses of Observational Studies

2008 ◽  
Vol 5;12 (5;9) ◽  
pp. 819-850
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Evidence Based Medicine ◽  
Observational Studies ◽  
Meta Analysis ◽  
Evidence Based ◽  
Confounding Bias ◽  
Meta Analyses ◽  
Based Medicine

Observational studies provide an important source of information when randomized controlled trials (RCTs) cannot or should not be undertaken, provided that the data are analyzed and interpreted with special attention to bias. Evidence-based medicine (EBM) stresses the examination of evidence from clinical research and describes it as a shift in medical paradigm, in contrast to intuition, unsystematic clinical experience, and pathophysiologic rationale. While the importance of randomized trials has been created by the concept of the hierarchy of evidence in guiding therapy, much of the medical research is observational. The reporting of observational research is often not detailed and clear enough with insufficient quality and poor reporting, which hampers the assessment of strengths and weaknesses of the study and the generalizability of the mixed results. Thus, in recent years, progress and innovations in health care are measured by systematic reviews and meta-analyses. A systematic review is defined as, “the application of scientific strategies that limit bias by the systematic assembly, clinical appraisal, and synthesis of all relevant studies on a specific topic.” Meta-analysis usually is the final step in a systematic review. Systematic reviews and meta-analyses are labor intensive, requiring expertise in both the subject matter and review methodology, and also must follow the rules of EBM which suggests that a formal set of rules must complement medical training and common sense for clinicians to integrate the results of clinical research effectively. While expertise in the review methods is important, the expertise in the subject matter and technical components is also crucial. Even though, systematic reviews and meta-analyses, specifically of RCTs, have exploded, the quality of the systematic reviews is highly variable and consequently, the opinions reached of the same studies are quite divergent. Numerous deficiencies have been described in methodologic assessment of the quality of the individual articles. Consequently, observational studies can provide an important complementary source of information, provided that the data are analyzed and interpreted in the context of confounding bias to which they are prone. Appropriate systematic reviews of observational studies, in conjunction with RCTs, may provide the basis for elimination of a dangerous discrepancy between the experts and the evidence. Steps in conducting systematic reviews of observational studies include planning, conducting, reporting, and disseminating the results. MOOSE, or Meta-analysis of Observational Studies in Epidemiology, a proposal for reporting contains specifications including background, search strategy, methods, results, discussion, and conclusion. Use of the MOOSE checklist should improve the usefulness of meta-analysis for authors, reviewers, editors, readers, and decision-makers. This manuscript describes systematic reviews and meta-analyses of observational studies. Authors frequently utilize RCTs and observational studies in one systematic review; thus, they should also follow the reporting standards of the Quality of Reporting of Meta-analysis (QUOROM) statement, which also provides a checklist. A combined approach of QUOROM and MOOSE will improve reporting of systematic reviews and lead to progress and innovations in health care. Key words: Observational studies, evidence-based medicine, systematic reviews, metaanalysis, randomized trials, case-control studies, cross-sectional studies, cohort studies, confounding bias, QUOROM, MOOSE

scholarly journals A Reporting Quality Assessment of Systematic Reviews and Meta-Analyses in Sports Physical Therapy: A Review of Reviews

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1368
Author(s):  
Sung-Hyoun Cho ◽  
In-Soo Shin
Keyword(s):  
Physical Therapy ◽  
Systematic Reviews ◽  
Literature Search ◽  
Reporting Quality ◽  
Risk Of Bias ◽  
Evidence Based ◽  
Reporting Practices ◽  
Review Of Reviews ◽  
Meta Analyses

This review of reviews aimed to evaluate the reporting quality of published systematic reviews and meta-analyses in the field of sports physical therapy using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This review of reviews included a literature search; in total, 2047 studies published between January 2015 and December 2020 in the top three journals related to sports physical therapy were screened. Among the 125 identified articles, 47 studies on sports physical therapy were included in the analysis (2 systematic reviews and 45 meta-analyses). There were several problems areas, including a lack of reporting for key components of the structured summary (10/47, 21.3%), protocol and registration (18/47, 38.3%), risk of bias in individual studies (28/47, 59.6%), risk of bias across studies (24/47, 51.1%), effect size and variance calculations (5/47, 10.6%), additional analyses (25/47, 53.2%), and funding (10/47, 21.3%). The quality of the reporting of systematic reviews and meta-analyses of studies on sports physical therapy was low to moderate. For better evidence-based practice in sports physical therapy, both authors and readers should examine assumptions in more detail, and report valid and adequate results. The PRISMA guideline should be used more extensively to improve reporting practices in sports physical therapy.

scholarly journals Evaluating the Quality of the Iranian Systematic Reviews, Meta-Analyses, and Economic Evaluations in Healthcare from 2005 to 2015

2021 ◽  
Author(s):  
Morteza Arab-Zozani ◽  
Zahra Heidarifard ◽  
Efat Jabarpour
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Time Horizon ◽  
Meta Analysis ◽  
Economic Evaluations ◽  
Evidence Based ◽  
Economic Perspective ◽  
Meta Analyses

Context: The number of studies on health is increasing rapidly worldwide and in Iran. Systematic review studies, meta-analyses, and economic evaluation are of great importance in evidence-based decision making because of their standing in the evidence-based pyramid. The purpose of this study was to evaluate the reporting and methodological quality of Iranian systematic reviews, meta-analysis studies and economic evaluations on healthcare. Evidence Acquisition: PubMed and Scopus databases were searched to find considered studies, including systematic reviews, meta analyses and economic evaluations published from 2005 to 2015. Because of the high volume of review studies, 10% of all systematic reviews and meta-analyses were selected as a random sample. Also, all economic evaluations were included. Articles were evaluated using checklists, including PRISMA, AMSTAR and QHES with a maximum score of 27, 11 and 100, respectively. The quality score for each criterion as well as the epidemiological and descriptive characteristics of all articles was determined. Data were analyzed using SPSS V. 16 software. Results: After searching the databases, 1084 systematic reviews and meta-analyses were obtained, 10% of which were included in the study. A total of 41 economic evaluations were also included. The mean scores of systematic reviews and meta-analyses based on PRISMA and AMSTAR checklists were 17.04 (5.35) and 5.42 (1.97), respectively, and 68.21 (12.44) for economic evaluations based on QHES. Only three systematic reviews and meta-analysis articles had recorded protocols and 85% of the studies included the terms “systematic review” and “meta-analysis” in their titles. Only one study had been updated. In addition, 81% of the systematic reviews and meta-analyses were published in specialized journals and 47% in Iranian journals. Financial resources and conflict of interests had been mentioned in 33% and 66% of the studies, respectively. Of the selected studies, 60% had evaluated the quality of the articles and 35% of the studies had assessed publication bias. In economic evaluations, 56% had used CEA analysis, 22% CUA analysis, 12% CBA analysis, and one study had used CMA analysis. Of these studies, 54% were model-based health economic studies and 12% were trial-based. The economic perspective was the health care system in most studies. Forty-four percent of the studies had a short time horizon of one year or less, whereas 33% had a lifetime horizon. Moreover, 68% of the studies showed sensitivity analysis and only 5 included the magnitude and direction of the bias. Conclusions: Overall, the reporting and methodological quality of the selected studies were estimated at a moderate level. Based on these results, it is recommended to adopt strategies to reduce preventable errors in studies. Having a primary plan and protocol and registering it as a systematic review can be an important factor in improving the quality of studies. Economic evaluations should also focus on issues, such as economic perspective, time horizon, available bias, and sensitivity analysis.

scholarly journals Evidence-based umbrella review of cognitive effects of prefrontal tDCS

2020 ◽  
Author(s):  
Luis C Farhat ◽  
Andre F Carvalho ◽  
Marco Solmi ◽  
Andre R Brunoni
Keyword(s):  
Systematic Reviews ◽  
Meta Analysis ◽  
Measurement Tool ◽  
Affective Neuroscience ◽  
Umbrella Review ◽  
Quality Of Evidence ◽  
Neuroscience Research ◽  
Cochrane Database ◽  
Meta Analyses

Abstract Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique, which has been increasingly used as an investigational tool in neuroscience. In social and affective neuroscience research, the prefrontal cortex has been primarily targeted, since this brain region is critically involved in complex psychobiological processes subserving both ‘hot’ and ‘cold’ domains. Although several studies have suggested that prefrontal tDCS can enhance neuropsychological outcomes, meta-analyses have reported conflicting results. Therefore, we aimed to assess the available evidence by performing an umbrella review of meta-analyses. We evaluated the effects of prefrontal active vs sham tDCS on different domains of cognition among healthy and neuropsychiatric individuals. A MeaSurement Tool to Assess Systematic Reviews 2 was employed to evaluate the quality of meta-analyses, and the GRADE system was employed to grade the quality of evidence of every comparison from each meta-analysis. PubMed/MEDLINE, PsycINFO and the Cochrane Database of Systematic Reviews were searched, and 11 meta-analyses were included resulting in 55 comparisons. Only 16 comparisons reported significant effects favoring tDCS, but 13 of them had either very low or low quality of evidence. Of the remaining 39 comparisons which reported non-significant effects, 38 had either very low or low quality of evidence. Meta-analyses were rated as having critically low and low quality. Among several reasons to explain these findings, the lack of consensus and reproducibility in tDCS research is discussed.

Sign in / Sign up

Export Citation Format

Share Document