Developing and training mental toughness in sport: a systematic review and meta-analysis of observational studies and pre-test and post-test experiments

ObjectiveTo investigate the efficacy of interventions designed to train and develop mental toughness (MT) in sport.DesignSystematic review and meta-analysis.Data sourcesJournal articles, conference papers and doctoral theses indexed in Embase, Scopus, PubMed and SPORTDiscus from inception to 22 November 2019.Eligibility criteria for selecting studiesObservational and pre–post experimental designs on the efficacy of physical and/or psychological interventions designed to promote MT in athletes.ResultsA total of 12 studies, published between 2005 and 2019, were included in the review. A majority of the studies included a sample comprised exclusively of male athletes (54.55%), MT interventions were primarily psychological (83.33%) and most studies measured MT via self-report (75%). The Psychological Performance Inventory (25%), the Mental Toughness Questionnaire-48 (16.67%), and the Mental, Emotional and Bodily Toughness Inventory (16.67%) were the most popular inventories used to measure MT. Methodological quality assessments for controlled intervention studies (k=7), single group pre-test–post-test designs (k=4) and single-subject designs (k=1) indicated that the risk of bias was high in most (75%) of the studies. The meta-analysis involving k=10 studies revealed a large effect (d=0.80, 95% CI 0.30 to 1.28), with variability across studies estimated at 0.56.ConclusionAlthough the findings of this review suggest there are effective, empirically based interventions designed to train MT in sport, practitioners should be aware of the level of validity of intervention research before adopting any of the MT training programmes reported in the applied sport psychology literature.

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What components of smoking cessation care during pregnancy are implemented by health providers? A systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-026037 ◽

2019 ◽

Vol 9 (8) ◽

pp. e026037 ◽

Cited By ~ 2

Author(s):

Gillian Sandra Gould ◽

Laura Twyman ◽

Leah Stevenson ◽

Gabrielle R Gribbin ◽

Billie Bonevski ◽

...

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Data Extraction ◽

Meta Analysis ◽

Self Report ◽

Health Providers ◽

Eligibility Criteria ◽

Reporting Practices ◽

Registration Number ◽

Meta Analyses

BackgroundPregnancy is an opportunity for health providers to support women to stop smoking.ObjectivesIdentify the pooled prevalence for health providers in providing components of smoking cessation care to women who smoke during pregnancy.DesignA systematic review synthesising original articles that reported on (1) prevalence of health providers’ performing the 5As (‘Ask’, ‘Advise’, ‘Assess’, ‘Assist’, ‘Arrange’), prescribing nicotine replacement therapy (NRT) and (2) factors associated with smoking cessation care.Data sourcesMEDLINE, EMBASE, CINAHL and PsycINFO databases searched using ‘smoking’, ‘pregnancy’ and ‘health provider practices’.Eligibility criteria for selecting studiesStudies included any design except interventions (self-report, audit, observed consultations and women’s reports), in English, with no date restriction, up to June 2017.ParticipantsHealth providers of any profession.Data extraction, appraisal and analysisData were extracted, then appraised with the Hawker tool. Meta-analyses pooled percentages for performing each of the 5As and prescribing NRT, using, for example, ‘often/always’ and ‘always/all’. Meta-regressions were performed of 5As for ‘often/always’.ResultsOf 3933 papers, 54 were included (n=29 225 participants): 33 for meta-analysis. Health providers included general practitioners, obstetricians, midwives and others from 10 countries. Pooled percentages of studies reporting practices ‘often/always’ were: ‘Ask’ (n=9) 91.6% (95% CI 88.2% to 95%); ‘Advise’ (n=7) 90% (95% CI 72.5% to 99.3%), ‘Assess’ (n=3) 79.2% (95% CI 76.5% to 81.8%), ‘Assist (cessation support)’ (n=5) 59.1% (95% CI 56% to 62.2%), ‘Arrange (referral)’ (n=6) 33.3% (95% CI 20.4% to 46.2%) and ‘prescribing NRT’ (n=6) 25.4% (95% CI 12.8% to 38%). Heterogeneity (I2) was 95.9%–99.1%. Meta-regressions for ‘Arrange’ were significant for year (p=0.013) and country (p=0.037).ConclusionsHealth providers ‘Ask’, ‘Advise’ and ‘Assess’ most pregnant women about smoking. ‘Assist’, ‘Arrange’ and ‘prescribing NRT’ are reported at lower rates: strategies to improve these should be considered.PROSPERO registration numberCRD42015029989.

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Prevalence of lower airway dysfunction in athletes: a systematic review and meta-analysis by a subgroup of the IOC consensus group on ‘acute respiratory illness in the athlete’

British Journal of Sports Medicine ◽

10.1136/bjsports-2021-104601 ◽

2021 ◽

pp. bjsports-2021-104601

Author(s):

Oliver J Price ◽

Nicola Sewry ◽

Martin Schwellnus ◽

Vibeke Backer ◽

Tonje Reier-Nilsen ◽

...

Keyword(s):

Systematic Review ◽

Female Athletes ◽

Meta Analysis ◽

Respiratory Illness ◽

Self Report ◽

Lower Airway ◽

Future Research ◽

Eligibility Criteria ◽

Objective Testing ◽

Bronchial Provocation

ObjectiveTo report the prevalence of lower airway dysfunction in athletes and highlight risk factors and susceptible groups.DesignSystematic review and meta-analysis.Data sourcesPubMed, EBSCOhost and Web of Science (1 January 1990 to 31 July 2020).Eligibility criteriaOriginal full-text studies, including male or female athletes/physically active individuals/military personnel (aged 15–65 years) who had a prior asthma diagnosis and/or underwent screening for lower airway dysfunction via self-report (ie, patient recall or questionnaires) or objective testing (ie, direct or indirect bronchial provocation challenge).ResultsIn total, 1284 studies were identified. Of these, 64 studies (n=37 643 athletes) from over 21 countries (81.3% European and North America) were included. The prevalence of lower airway dysfunction was 21.8% (95% CI 18.8% to 25.0%) and has remained stable over the past 30 years. The highest prevalence was observed in elite endurance athletes at 25.1% (95% CI 20.0% to 30.5%) (Q=293, I2=91%), those participating in aquatic (39.9%) (95% CI 23.4% to 57.1%) and winter-based sports (29.5%) (95% CI 22.5% to 36.8%). In studies that employed objective testing, the highest prevalence was observed in studies using direct bronchial provocation (32.8%) (95% CI 19.3% to 47.2%). A high degree of heterogeneity was observed between studies (I2=98%).ConclusionLower airway dysfunction affects approximately one in five athletes, with the highest prevalence observed in those participating in elite endurance, aquatic and winter-based sporting disciplines. Further longitudinal, multicentre studies addressing causality (ie, training status/dose–response relationship) and evaluating preventative strategies to mitigate against the development of lower airway dysfunction remain an important priority for future research.

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Environmental, behavioural and multicomponent interventions to reduce adults' sitting time: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-098968 ◽

2018 ◽

pp. bjsports-2017-098968 ◽

Cited By ~ 7

Author(s):

Melissa M Peachey ◽

Julie Richardson ◽

Ada V Tang ◽

Vanina Dal-Bello Haas ◽

Janelle Gravesande

Keyword(s):

Systematic Review ◽

Sedentary Behaviour ◽

Meta Analysis ◽

Intervention Group ◽

Self Report ◽

Sitting Time ◽

Qualitative Synthesis ◽

Eligibility Criteria ◽

Environmental Interventions ◽

Multicomponent Interventions

ObjectiveTo examine the overall effectiveness of interventions for reducing adult sedentary behaviour and to directly compare environmental, behavioural and multicomponent interventions.DesignIntervention systematic review with meta-analysis.Data sourcesOvid PsycINFO, Ovid MEDLINE, EBSCOHost CINAHL, EBSCOHost SPORTDiscus and PubMed were searched from inception to 26 July 2017.Eligibility criteriaTrials including randomised controlled trials, quasi-randomised, cluster-randomised, parallel group, prepost, factorial and crossover trials where the primary aim was to change the sedentary behaviour of healthy adults assessed by self-report (eg, questionnaires, logs) or objective measures (eg, accelerometry).ResultsThirty-eight trials of 5983 participants published between 2003 and 2017 were included in the qualitative synthesis; 35 studies were included in the quantitative analysis (meta-analysis). The pooled effect was a significant reduction in daily sitting time of −30.37 min/day (95% CI −40.86 to −19.89) favouring the intervention group. Reductions in sitting time were similar between workplace (−29.96 min/day; 95% CI −44.05 to –15.87) and other settings (−30.47 min/day; 95% CI −44.68 to –16.26), which included community, domestic and recreational environments. Environmental interventions had the largest reduction in daily sitting time (−40.59 min/day; 95% CI −61.65 to –19.53), followed by multicomponent (−35.53 min/day; 95% CI −57.27 to –13.79) and behavioural (−23.87 min/day; 95% CI −37.24 to –10.49) interventions.ConclusionInterventions targeting adult sedentary behaviour reduced daily sitting time by an average of 30 min/day, which was likely clinically meaningful.

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Chasing the Anchor: A Systematic Review and Meta-analysis of Perceptual Anchoring Deficits in Developmental Dyslexia

10.31234/osf.io/amzpj ◽

2020 ◽

Author(s):

Kurt D Shulver ◽

Nicholas A Badcock

Keyword(s):

Systematic Review ◽

Reading Ability ◽

English Language ◽

Prediction Interval ◽

Meta Analysis ◽

Visual Assessment ◽

Individual Performance ◽

Future Research ◽

Significant Heterogeneity ◽

Eligibility Criteria

We report the results of a systematic review and meta-analysis investigating the relationship between perceptual anchoring and dyslexia. Our goal was to assess the direction and degree of effect between perceptual anchoring and reading ability in typical and atypical (dyslexic) readers. We performed a literature search of experiments explicitly assessing perceptual anchoring and reading ability using PsycInfo (Ovid, 1860 to 2020), MEDLINE (Ovid, 1860 to 2019), EMBASE (Ovid, 1883 to 2019), and PubMed for all available years up to June (2020). Our eligibility criteria consisted of English-language articles and, at minimum, one experimental group identified as dyslexic - either by reading assessment at the time, or by previous diagnosis. We assessed for risk of bias using an adapted version of the Newcastle-Ottawa scale. Six studies were included in this review, but only five (n = 280 participants) were included in the meta-analysis (we were unable to access the necessary data for one study).The overall effect was negative, large and statistically significant; g = -0.87, 95% CI [-1.47, 0.27]: a negative effect size indicating less perceptual anchoring in dyslexic versus non-dyslexic groups. Visual assessment of funnel plot and Egger’s test suggest minimal bias but with significant heterogeneity; Q (4) = 9.70, PI (prediction interval) [-2.32, -0.58]. The primary limitation of the current review is the small number of included studies. We discuss methodological limitations, such as limited power, and how future research may redress these concerns. The variability of effect sizes appears consistent with the inherent variability within subtypes of dyslexia. This level of dispersion seems indicative of the how we define cut-off thresholds between typical reading and dyslexia populations, but also the methodological tools we use to investigate individual performance.

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Running and Knee Osteoarthritis: A Systematic Review and Meta-analysis

The American Journal of Sports Medicine ◽

10.1177/0363546516657531 ◽

2016 ◽

Vol 45 (6) ◽

pp. 1447-1457 ◽

Cited By ~ 38

Author(s):

Kate A. Timmins ◽

Richard D. Leech ◽

Mark E. Batt ◽

Kimberley L. Edwards

Keyword(s):

Systematic Review ◽

Full Text ◽

Meta Analysis ◽

Positive Association ◽

Case Control ◽

Case Control Studies ◽

Eligibility Criteria ◽

Knee Oa ◽

Knee Joint Surgery ◽

Newcastle Ottawa Scale

Background: Osteoarthritis (OA) is a chronic condition characterized by pain, impaired function, and reduced quality of life. A number of risk factors for knee OA have been identified, such as obesity, occupation, and injury. The association between knee OA and physical activity or particular sports such as running is less clear. Previous reviews, and the evidence that informs them, present contradictory or inconclusive findings. Purpose: This systematic review aimed to determine the association between running and the development of knee OA. Study Design: Systematic review and meta-analysis. Methods: Four electronic databases were searched, along with citations in eligible articles and reviews and the contents of recent journal issues. Two reviewers independently screened the titles and abstracts using prespecified eligibility criteria. Full-text articles were also independently assessed for eligibility. Eligible studies were those in which running or running-related sports (eg, triathlon or orienteering) were assessed as a risk factor for the onset or progression of knee OA in adults. Relevant outcomes included (1) diagnosis of knee OA, (2) radiographic markers of knee OA, (3) knee joint surgery for OA, (4) knee pain, and (5) knee-associated disability. Risk of bias was judged by use of the Newcastle-Ottawa scale. A random-effects meta-analysis was performed with case-control studies investigating arthroplasty. Results: After de-duplication, the search returned 1322 records. Of these, 153 full-text articles were assessed; 25 were eligible, describing 15 studies: 11 cohort (6 retrospective) and 4 case-control studies. Findings of studies with a diagnostic OA outcome were mixed. Some radiographic differences were observed in runners, but only at baseline within some subgroups. Meta-analysis suggested a protective effect of running against surgery due to OA: pooled odds ratio 0.46 (95% CI, 0.30-0.71). The I2 was 0% (95% CI, 0%-73%). Evidence relating to symptomatic outcomes was sparse and inconclusive. Conclusion: With this evidence, it is not possible to determine the role of running in knee OA. Moderate- to low-quality evidence suggests no association with OA diagnosis, a positive association with OA diagnosis, and a negative association with knee OA surgery. Conflicting results may reflect methodological heterogeneity. More evidence from well-designed, prospective studies is needed to clarify the contradictions.

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Psychological and Behavioral Impact of Lockdown and Quarantine Measures for COVID-19 Pandemic on Children, Adolescents and Caregivers: A Systematic Review and Meta-Analysis

Journal of Tropical Pediatrics ◽

10.1093/tropej/fmaa122 ◽

2020 ◽

Author(s):

Prateek Kumar Panda ◽

Juhi Gupta ◽

Sayoni Roy Chowdhury ◽

Rishi Kumar ◽

Ankit Kumar Meena ◽

...

Keyword(s):

Systematic Review ◽

Sleep Disturbance ◽

Behavioral Problems ◽

Meta Analysis ◽

Random Effect ◽

Psychological Problems ◽

Psychological State ◽

Eligibility Criteria ◽

Behavioral Abnormalities ◽

Anxiety Depression

Abstract Background During the current ongoing COVID-19 pandemic, psychological problems like anxiety, depression, irritability, mood swings, inattention and sleep disturbance are fairly common among quarantined children in several studies. A systematic review of these publications to provide an accurate burden of these psychiatric/behavioral problems is needed for planning mitigating measures by the health authorities. Methods Different electronic databases (MEDLINE, EMBASE, Web of Science, CENTRAL, medRxiv and bioRxiv) were searched for articles describing psychological/behavioral complications in children/adolescents with/without pre-existing behavioral abnormalities and their caregivers related to the COVID-19 pandemic. Only original articles with/without comparator arms and a minimum sample size of 50 were included in the analysis. The pooled estimate of various psychological/behavioral problems was calculated using a random-effect meta-analysis. Results Fifteen studies describing 22 996 children/adolescents fulfilled the eligibility criteria from a total of 219 records. Overall, 34.5%, 41.7%, 42.3% and 30.8% of children were found to be suffering from anxiety, depression, irritability and inattention. Although the behavior/psychological state of a total of 79.4% of children was affected negatively by the pandemic and quarantine, at least 22.5% of children had a significant fear of COVID-19, and 35.2% and 21.3% of children had boredom and sleep disturbance. Similarly, 52.3% and 27.4% of caregivers developed anxiety and depression, respectively, while being in isolation with children. Conclusion Anxiety, depression, irritability, boredom, inattention and fear of COVID-19 are predominant new-onset psychological problems in children during the COVID-19 pandemic. Children with pre-existing behavioral problems like autism and attention deficit hyperactivity disorder have a high probability of worsening of their behavioral symptoms.

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Tolerability of statin-based management of patients with a history of statin-associated muscle symptoms: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2021-052341 ◽

2021 ◽

Vol 11 (8) ◽

pp. e052341

Author(s):

Fanny Villoz ◽

Christina Lyko ◽

Cinzia Del Giovane ◽

Nicolas Rodondi ◽

Manuel R Blum

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Mean Difference ◽

Control Group ◽

Cochrane Central Register ◽

Eligibility Criteria ◽

Clinical Issue ◽

Standard Data ◽

Evaluation Approach ◽

History Of

IntroductionStatin-associated muscle symptoms (SAMSs) are a major clinical issue in the primary and secondary prevention of cardiovascular events. Current guidelines advise various approaches mainly based on expert opinion. We will lead a systematic review and meta-analysis to explore the tolerability and acceptability and effectiveness of statin-based therapy management of patients with a history of SAMS. We aim to provide evidence on the tolerability and different strategies of statin-based management of patients with a history of SAMS.Methods and analysisWe will conduct a systematic review of randomised controlled trials (RCTs) and non-randomised studies with a control group. We will search in Data sources MEDLINE, EMBASE, Cochrane Central Register of Controlled Clinical Trials, Scopus, Clinicaltrials.gov and Proquest from inception until April 2021. Two independent reviewers will carry out the study selection based on eligibility criteria. We will extract data following a standard data collection form. The reviewers will use the Cochrane Collaboration’s tools and Newcastle-Ottawa Scale to appraise the study risk of bias. Our primary outcome will be tolerability and our secondary outcomes will be acceptability and effectiveness. We will conduct a qualitative analysis of all included studies. In addition, if sufficient and homogeneous data are available, we will conduct quantitative analysis. We will synthesise dichotomous data using OR with 95% CI and continuous outcomes by using mean difference or standardised mean difference (with 95% CI). We will determine heterogeneity visually with forest plots and quantitatively with I2 and Q-test. We will summarise the confidence in the quantitative estimate by using Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and disseminationAs a systematic review of literature without collection of new clinical data, there will be no requirement for ethical approval. We will disseminate findings through peer-reviewed publications.PROSPERO registration numberCRD42020202619.

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Contrast extravasation and outcome of endovascular therapy in acute ischaemic stroke: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-044917 ◽

2021 ◽

Vol 11 (7) ◽

pp. e044917

Author(s):

Tao Xu ◽

You Wang ◽

Jinxian Yuan ◽

Yangmei Chen ◽

Haiyan Luo

Keyword(s):

Systematic Review ◽

Ischaemic Stroke ◽

Functional Outcome ◽

Endovascular Therapy ◽

Acute Ischaemic Stroke ◽

Data Extraction ◽

Meta Analysis ◽

Poor Functional Outcome ◽

Eligibility Criteria ◽

Contrast Extravasation

ObjectiveContrast extravasation (CE) after endovascular therapy (EVT) is commonly present in acute ischaemic stroke (AIS) patients. Substantial uncertainties remain about the relationship between CE and the outcomes of EVT in patients with AIS. Therefore, we aimed to evaluate this association.DesignA systematic review and meta-analysis of published studies were performed.Data sourceWe systematically searched the Medline and Embase databases for relevant clinical studies. The last literature search in databases was performed in June 2020.Eligibility criteria for study selectionWe included studies exploring the associations between CE and the outcomes of EVT in patients with AIS undergoing EVT.Data extraction and synthesisTwo reviewers extracted relevant information and data from each article independently. We pooled ORs with CIs using a random-effects meta-analysis to calculate the associations between CE and outcomes of EVT. The magnitude of heterogeneity between estimates was quantified with the I2 statistic with 95% CIs.ResultsFifteen observational studies that enrolled 1897 patients were included. Patients with CE had higher risks of poor functional outcome at discharge (2.38, 95% CI 1.45 to 3.89 p=0.001; n=545) and poor functional outcome at 90 days (OR 2.16, 95% CI 1.20 to 3.90; n=1194). We found no association between CE and in-hospital mortality (OR 0.95, 95% CI 0.27 to 3.30; n=376) or 90-day mortality (OR 1.38, 95% CI 0.81 to 2.36; n=697) after EVT. Moreover, CE was associated with higher risks of post-EVT intracranial haemorrhage (ICH) (OR 6.68, 95% CI 3.51 to 12.70; n=1721) and symptomatic ICH (OR 3.26, 95% CI 1.97 to 5.40; n=1092).ConclusionsThis systematic review and meta-analysis indicates that in patients with AIS undergoing EVT, CE is associated with higher risks of unfavourable functional outcomes and ICH. Thus, we should pay more attention to CE in patients with AIS undergoing EVT.

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Individual Resilience Interventions: A Systematic Review in Adult Population Samples over the Last Decade

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147564 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7564

Author(s):

Mafalda Ferreira ◽

António Marques ◽

Paulo Veloso Gomes

Keyword(s):

Systematic Review ◽

Methodological Quality ◽

Meta Analysis ◽

Statistical Significance ◽

Adult Population ◽

Well Being ◽

Eligibility Criteria ◽

Individual Resilience ◽

Literature Searches ◽

Great Heterogeneity

Resilience interventions have been gaining importance among researchers due to their potential to provide well-being and reduce the prevalence of mental disorders that are becoming an increasing concern, especially in Western countries, because of the costs associated. The purpose of this systematic review is to identify the intervention studies carried out in the last decade in adult population samples, evaluate their methodological quality and highlight the trends of these types of interventions. This review was performed using systematic literature searches in the following electronic databases: B-on, PubMed, PsycNet and Science Direct. The application of eligibility criteria resulted in the inclusion of 38 articles, of which 33 were randomized controlled trials and the other five were nonrandomized controlled studies. Although most studies showed statistical significance for their results, these were constrained by the great heterogeneity of the studies, the lack of power of the samples and their fair methodological quality. Therefore, it is important to consolidate the theoretical basis and standardize certain methodologies so that the effects of the interventions can be compared through a meta-analysis.

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Mortality Benefit From the Passive Leg Raise Maneuver in Guiding Resuscitation of Septic Shock Patients: A Systematic Review and Meta-Analysis of Randomized Trials

Journal of Intensive Care Medicine ◽

10.1177/08850666211019713 ◽

2021 ◽

pp. 088506662110197

Author(s):

Moosa Azadian ◽

Suyee Win ◽

Amir Abdipour ◽

Carolyn Krystal Kim ◽

H. Bryant Nguyen

Keyword(s):

Systematic Review ◽

Septic Shock ◽

Fluid Resuscitation ◽

Standard Care ◽

Meta Analysis ◽

Risk Of Bias ◽

Time Interval ◽

Eligibility Criteria ◽

Significant Difference ◽

Passive Leg Raise

Background: Fluid therapy plays a major role in the management of critically ill patients. Yet assessment of intravascular volume in these patients is challenging. Different invasive and non-invasive methods have been used with variable results. The passive leg raise (PLR) maneuver has been recommended by international guidelines as a means to determine appropriate fluid resuscitation. We performed this systematic review and meta-analysis to determine if using this method of volume assessment has an impact on mortality outcome in patients with septic shock. Methods: This study is a systematic review and meta-analysis. We searched available data in the MEDLINE, CINAHL, EMBASE, and CENTRAL databases from inception until October 2020 for prospective, randomized, controlled trials that compared PLR-guided fluid resuscitation to standard care in adult patients with septic shock. Our primary outcome was mortality at the longest duration of follow-up. Results: We screened 1,425 article titles and abstracts. Of the 23 full-text articles reviewed, 5 studies with 462 patients met our eligibility criteria. Odds ratios (ORs) and associated 95% confidence intervals (CIs) for mortality at the longest reported time interval were calculated for each study. Using random effects modeling, the pooled OR (95% CI) for mortality with a PLR-guided resuscitation strategy was 0.82 (0.52 -1.30). The included studies were not blinded and they ranged from having low to high risk of bias using the Cochrane Risk of Bias Tool. Conclusion: Our analysis showed there was no statistically significant difference in mortality among septic shock patients treated with PLR-guided resuscitation vs. those with standard care.

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