Effects of Combined Cognitive and Exercise Interventions on Poststroke Cognitive Function: A Systematic Review and Meta-Analysis

Objective. We investigated combined cognitive and exercise interventions in the literature and summarized their effectiveness in improving poststroke cognitive impairment (PSCI). Data Sources. Electronic databases and trial registries were searched from their inception until July 2020. Study Selection. Trials were collected with the following study inclusion criteria: (1) patients over 18 years of age who were diagnosed with PSCI; (2) combined cognitive-exercise interventions, regardless of the order of the two types of interventions or whether they were administered simultaneously; (3) any control group studied at the same time that was deemed acceptable, including no intervention/routine care, delayed intervention, sham intervention, and passive training; (4) the use of any validated cognitive neuropsychological test to evaluate cognitive function; and (5) clinically administered random trials with controls. Data Extraction. Five randomized controlled trials met the inclusion criteria. Two reviewers independently assessed the eligibility of the full texts and methodological quality of the included studies using the Cochrane risk of bias tool. Inconsistent results were resolved by additional discussion or decided by a third examiner, if necessary. Data Analysis. Meta-analysis demonstrated that the combined interventions had a significant effect on executive function and working memory [Stroop test (time), standardized mean difference SMD = 0.42 , 95% confidence interval (CI): 0.80–0.04, p = 0.02 ; Trail Making Test, SMD = 0.49 , 95% CI: 0.82–0.16, p = 0.004 ; Forward Digit Span Test, SMD = 0.91 , 95% CI: 0.54–1.29, p ≤ 0.001 ]. While it was impossible to conduct a meta-analysis of global cognitive function and other cognitive domains, individual experiments demonstrated that the combined interventions played a significant role in global cognition, reasoning ability, logical thinking, and visual-spatial memory function. Conclusions. Our analyses demonstrated that the combined interventions had a significant effect on the improvement of PSCI, particularly in terms of executive function. However, the moderate risk of bias in the included trials and the small number of relevant studies indicated a need for more uniform diagnostic and evaluation criteria, and larger trials would provide stronger evidence to better understand the effectiveness of the combined interventions. This trial is registered with trial registration number INPLASY202160090.

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Efficacy of Different Types of Exercise on Cognitive Function in People With MCI or Dementia: A Network Meta-Analysis

Innovation in Aging ◽

10.1093/geroni/igaa057.938 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 293-293

Author(s):

Qiaoqin Wan ◽

Xiuxiu Huang ◽

Xiaoyan Zhao ◽

Bei Li ◽

Ying Cai ◽

...

Keyword(s):

Executive Function ◽

Cognitive Function ◽

Cognitive Dysfunction ◽

Meta Analysis ◽

Memory Function ◽

Controlled Trials ◽

Exercise Interventions ◽

Exercise Treatment ◽

Different Types ◽

Global Cognition

Abstract With the accelerating progress of population aging, cognitive dysfunction is becoming increasingly prevalent. Exercise, as a promising non-pharmaceutical therapy, showed favorable effects on cognitive function. But which type is the most effective exercise treatment is still unclear. This study compared the efficacy of different types of exercise interventions based on network meta-analysis and aimed to explore the optimal exercise treatment for cognitive decline. The electronic databases of PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, SPORTDiscus, PsycInfoy, and OpenGrey were searched from inception to September 2019. We only included randomized controlled trials that examined the effectiveness of exercise interventions in people with MCI or dementia. Primary outcomes were global cognition, executive function and memory function. Standard mean difference (SMD) and its 95% confidence interval (CI) were calculated to estimate the effect sizes. Finally, 73 articles with 5748 participants were included. The results showed all kinds of exercise interventions were effective on global cognition and resistance exercise was probably the most effective exercise treatment to prevent the decrease of global cognition (SMD=1.05, 95%CI 0.56-1.54), executive function (SMD=0.85, 95%CI 0.21-1.49) and memory function (SMD=0.32, 95%CI 0.01-0.63) for people with cognitive dysfunction. Subgroup analysis revealed multi-component exercise showed more favorable effects on global cognition (SMD=0.99, 95%CI 0.44-1.54) and executive function (SMD=0.72, 95%CI 0.06-1.38) in people with MCI. In conclusion, resistance exercise tended to be the optimal exercise type for people with cognitive dysfunction, especially for people with dementia. And multi-component exercise also should be recommended for people with MCI.

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Association of Thyroid Function With Suicide Ideation/Attempt -A Systematic Review and Meta-analysis

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1680 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A824-A825

Author(s):

Freddy Jean Karlo Toloza Bonilla ◽

Yuanjie Mao ◽

Lakshmi P Menon ◽

Gemy Maria George ◽

Madhura Borikar ◽

...

Keyword(s):

Suicidal Ideation ◽

Thyroid Function ◽

Suicide Ideation ◽

Meta Analysis ◽

Risk Of Bias ◽

Control Group ◽

Thyroid Disorders ◽

Thyroid Function Tests ◽

Inclusion Criteria ◽

The Mean

Abstract Background: Thyroid disorders are very prevalent and could affect virtually the entire human body, including cognitive and psychiatric domains. However, the relationship between thyroid dysfunction and suicide is still controversial. Material and Methods: A systematic review and meta-analysis was conducted to describe the association of thyroid function with suicide ideation/attempt in adults. A comprehensive search from databases’ inception (MEDLINE, EMBASE, Cochrane, PsycINFO, PsycArticles, PSYNDEX and Scopus) to July 20, 2018 was conducted with no language restrictions. We included studies that reported mean values and standard deviation (SD) of thyroid hormone levels [Thyroid-stimulant hormone (TSH), free T4 (FT4), free T3 (FT3), total T4 (TT4), and total T3 (TT3)] in patients with suicide ideation/attempt compared with controls. Four reviewers worked independently and in duplicate for assessment of inclusion criteria, data extraction, and assessment of risk of bias. The mean value and SD of the thyroid function tests were used to calculate the mean difference for each subgroup. Random-effects models for meta-analyses were applied. Results: Overall, 2278 articles were identified, and 13 observational studies met the inclusion criteria. These studies involved 2651 participants, including 817 participants diagnosed with suicidal ideation/attempt. Group sizes of patients with suicide ideation/attempt ranged from 7 to 122 participants with mean age ranging from 23 to 49 years. Control group sizes ranged from 8 to 464 participants with mean age ranging from 24 to 50 years. Two studies included only women, two studies included only men, and 9 studies included both (% female range: 29 to 78%). Patients with suicide ideation/attempt had lower levels of FT3 (-0.19 pg/mL; P=0.04) and TT4 (-0.23 µg/dL; P=0.05) compared to controls. There were no differences in TSH, TT3 or FT4 levels between groups. In a subgroup analysis comparing current suicidal ideation vs current suicidal attempt vs history of suicidal ideation/attempt with the control group, there were no differences in any of the thyroid function tests. None of the included studies compared rates of overt/subclinical thyroid disease among groups. The overall risk of bias of the included studies was low-to-moderate. Conclusions: There is scarce evidence regarding the association of thyroid disorders and suicide. We found statistically significant lower thyroid hormone levels in patients with suicidal ideation/attempt. The clinical implications of this finding remain unknown and further research is needed to evaluate the association of thyroid disorders with suicide.

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Effect of exercise on myosteatosis in adults: a systematic review and meta-analysis

Journal of Applied Physiology ◽

10.1152/japplphysiol.00738.2020 ◽

2020 ◽

Author(s):

Robinson Ramírez-Vélez ◽

Yasmin Ezzatvar ◽

Mikel Izquierdo ◽

Antonio Garcia-Hermoso

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Exercise Group ◽

Muscle Quality ◽

Control Group ◽

Inclusion Criteria ◽

Exercise Interventions ◽

Randomized Controlled ◽

Populations At Risk ◽

Muscle Attenuation

Muscle tissue typically contains only small amounts of adipose tissue, and the excess deposition of adiposity is considered a pathological phenomenon termed myosteatosis. Several studies have assessed the effects of exercise alone on the severity of myosteatosis, and some studies have reported promising results. We performed a systematic review and meta-analysis to investigate the effects of exercise interventions on myosteatosis (i.e., lipid infiltration and muscle attenuation). Studies were identified through a systematic search of three databases and limited to randomized controlled trials (RCTs) focused on evaluating the effect of exercise interventions on lipid infiltration and/or muscle attenuation in adults. Thirteen studies met the inclusion criteria and twelve were included in the meta-analysis (n = 465, 84.7% women). The volume of lipid infiltration was decreased in the exercise group compared to the control group (Hedges'g = -0.45 95% confidence interval [CI] -0.74 to -0.16, p = 0.008, I2= 0%), and the degree of muscle attenuation was increased (Hedges'g = 0.67 95% CI 0.22 to 1.13, p = 0.009, I2= 59.3%). Based on meta-regression analyses, there were no significant effects of mean age at baseline (lipid infiltration, β=-0.008 95% CI, -0.035 to 0.019; p=0.495; muscle attenuation, β=-0.013 95% CI, -0.036 to 0.011; p=0.248) and intervention duration (lipid infiltration, β=-0.008 95% CI, -0.028 to 0.010; p=0.311; muscle attenuation, β=-0.018 95% CI, -0.050 to 0.014; p=0.230) on the effect sizes estimates. Overall, our findings indicate that exercise can significantly improve muscle quality in populations at risk of developing obesity - and sarcopenia-related disability.

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Effect of Tai Chi on Cognitive Function among Older Adults with Cognitive Impairment: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/6679153 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Renjun Gu ◽

Yujia Gao ◽

Chunbing Zhang ◽

Xiaojuan Liu ◽

Zhiguang Sun

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Decline ◽

Tai Chi ◽

Digit Span ◽

Meta Analysis ◽

Control Group ◽

Clinical Dementia Rating

Background. Cognitive decline occurs in all persons during the aging process and drugs can only alleviate symptoms and are expensive. Some researches demonstrated that Tai Chi had potential in preventing cognitive decline while others’ results showed Tai Chi had no influence on cognitive impairment. Therefore, we conduct a systematic review and meta-analysis to assess the efficacy and safety of cognitive impairment patients practicing Tai Chi. Methods. A comprehensive literature search was carried out in multiple databases, including PubMed, Cochrane, MEDLINE (Ovid), Web of Science, Embase, Scopus, PsycInfo (Ovid), CKNI, Wan Fang, VIP, SinoMed, and ClinicalTrails, from their inception to 1 July 2020 to collect randomized controlled trials about practicing Tai Chi for patients with cognitive impairment. Primary outcomes included changes of cognitive function and secondary outcomes included changes of memory functions. Data were extracted by two independent individuals and Cochrane Risk of Bias tool version 2.0 was applied for the included studies. Systematic review and meta-analysis were performed by RevMan 5.3 software. Results. The results included 827 cases in 9 studies, of which 375 were in the experimental group and 452 were in the control group. Meta-analysis showed that Mini-Mental State Examination WMD = 1.52, 95% CI [0.90, 2.14]; Montreal Cognitive Assessment WMD = 3.5, 95% CI [0.76, 6.24]; Clinical Dementia Rating WMD = −0.55, 95% CI [−0.80, −0.29]; logical memory delayed recall WMD = 1.1, 95% CI [0.04, 2.16]; digit span forward WMD = 0.53, 95% CI [−0.65, 1.71]; and digit span backward WMD = −0.1, 95% CI [−0.38, 0.19]. No adverse events were reported in the included articles. Conclusion. There is limited evidence to support that practicing Tai Chi is effective for older adults with cognitive impairment. Tai Chi seems to be a safe exercise, which can bring better changes in cognitive function score.

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A meta-analysis on the effect of telemedicine on the management of attention deficit and hyperactivity disorder in children and adolescents

Journal of Telemedicine and Telecare ◽

10.1177/1357633x211045186 ◽

2021 ◽

pp. 1357633X2110451

Author(s):

Maryam Bemanalizadeh ◽

Maryam Yazdi ◽

Omid Yaghini ◽

Roya Kelishadi

Keyword(s):

Cognitive Function ◽

Meta Analysis ◽

Risk Of Bias ◽

Clinical Effects ◽

Inclusion Criteria ◽

Phone Calls ◽

Computerized Training ◽

Symptom Domains ◽

Training Programmes ◽

Almost All

Introduction This study aims to report the effect sizes of telemedicine treatments on the symptom domains of paediatric ADHD. Methods In this systematic review and meta-analysis, electronic databases, i.e. PubMed, Scopus, Web of Science and Embase, were searched for articles published up to December 2020. The inclusion criteria were as follows: children or adolescents diagnosed for ADHD or other hyperkinetic disorders; randomized controlled trials (RCTs); efficacy established with parents and teachers or self-rating scales at least for one of the following domains: inattention, cognitive function, hyperactivity, hyperactivity/impulsivity or oppositional behaviours. The risk of bias was assessed using the Cochrane risk of bias tool for RCTs. Results From 310 records reduced to 228 after removing duplicates, overall 12 studies were fulfilled our inclusion criteria. They consisted of 708 participants (358 with telemedicine intervention and 350 controls). The telemedicine interventions varied from computerized training programmes with phone calls to videoconferencing programmes, virtual reality classrooms or games. The most applicable method consisted of computerized training programmes with phone calls. Pooling results of all studies with available data on each subscale showed a significant effect of telemedicine on inattention/cognitive function (standardized mean difference (SMD) = 0.26, 95% CI: 0.16, 0.36), hyperactivity/impulsivity (SMD = 0.29, 95% CI: 0.06, 0.52), and oppositional behaviours (SMD = 0.72, 95% CI: 0.24, 1.20) subscales in ADHD. Almost all studies had an overall unclear risk of bias. The source of outcome assessment (parents, teachers or self-report questionnaire) was addressed as a potential confounding factor. In almost all symptom domains, the satisfaction from the treatment was higher in parents than in teachers. Conclusions The clinical effects of telemedicine on the treatment of ADHD showed a small effect size for inattention/cognitive function, hyperactivity/impulsivity and oppositional behaviours.

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Effect of consumption of animal milk compared to infant formula for non-breastfed/mixed-fed infants 6–11 months of age: a systematic review (protocol)

BMJ Open ◽

10.1136/bmjopen-2020-046370 ◽

2021 ◽

Vol 11 (2) ◽

pp. e046370

Author(s):

Aamer Imdad ◽

Julie Melissa Ehrlich ◽

Joseph Catania ◽

Emily Tanner-Smith ◽

Abigail Smith ◽

...

Keyword(s):

Systematic Review ◽

Infant Formula ◽

Breast Feeding ◽

Meta Analysis ◽

Risk Of Bias ◽

World Health ◽

Control Group ◽

Breastfed Infants ◽

Evaluation Approach ◽

Animal Milk

IntroductionPrevalence rates of breastfeeding remain low even though the World Health Organization (WHO) and the American Academy of Pediatrics recommend exclusive breast feeding for the first 6 months of life in combination with appropriate complementary feeding beyond six 6 months of age. There have been several studies that address the implication of drinking animal milk and/or infant formula on children’s health and development when breast feeding is not offered during the first year of life. Vast improvements have been made in infant formula design, which may increase its benefits compared with animal’s milk. The objective of this review is therefore to synthesise the most recent evidence on the effects of the consumption of animal milk compared with infant formula in non-breastfed or mixed breastfed infants aged 6–11 months.Methods and analysisWe will conduct a systematic review and meta-analysis of studies that assessed the effect of animal milk compared with formula or mixed-fed (breastmilk and formula) on infants aged 6–11 months. The primary outcomes of interest include anaemia, gastrointestinal blood loss, weight for age, height for age and weight for height. We will include randomised and non-randomised studies with a control group. We will use the Cochrane risk of bias tools to assess the risk of bias. We will use meta-analysis to pool findings if the identified studies are conceptually homogenous and data are available from more than one study. We will assess the overall quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.Ethics and disseminationThis is a systematic review, so no patients will be directly involved in the design or development of this study. The findings from this systematic review will be disseminated to relevant patient populations and caregivers and will guide the WHO’s recommendations on formula consumption versus animal milk in infants aged 6–11 months.Trial registration numberCRD42020210925.

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Association between serum visfatin levels and psoriasis and their correlation with disease severity: a meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211002381 ◽

2021 ◽

Vol 49 (3) ◽

pp. 030006052110023

Author(s):

Qian Zou ◽

Jiawei Si ◽

Yatao Guo ◽

Jiayu Yu ◽

Huijuan Shi

Keyword(s):

Body Mass Index ◽

Meta Analysis ◽

Severity Index ◽

Cochrane Library ◽

Control Group ◽

Inclusion Criteria ◽

Subgroup Analyses ◽

Mean Differences ◽

The Cochrane Library ◽

Psoriasis Severity

Objective To determine the association between serum visfatin levels and psoriasis and to evaluate the correlation between serum visfatin levels and the severity of psoriasis. Methods The electronic databases PubMed®, Embase® and the Cochrane Library were searched for articles published from inception to 1 May 2020. Data were extracted and then standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated for pooled estimates. Results A total of 11 studies met the inclusion criteria and were included (448 patients diagnosed with psoriasis and 377 controls). This meta-analysis demonstrated that patients with psoriasis had significantly higher levels of visfatin than the controls (SMD = 0.90, 95% CI 0.52, 1.28). Subgroup analyses showed that differences in serum visfatin levels between the patient group and the control group were associated with ethnicity, Psoriasis Area and Severity Index (PASI) and body mass index. Additionally, a meta-analysis of correlations showed that visfatin levels in patients with psoriasis were positively correlated with PASI ( r = 0.51, 95% CI 0.14, 0.75). Conclusions This meta-analysis showed that serum visfatin levels in patients with psoriasis were significantly higher than those in the controls and a positive correlation between serum visfatin levels and psoriasis severity was observed.

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Effects of Supervised Multimodal Exercise Interventions on Cancer-Related Fatigue: Systematic Review and Meta-Analysis of Randomized Controlled Trials

BioMed Research International ◽

10.1155/2015/328636 ◽

2015 ◽

Vol 2015 ◽

pp. 1-13 ◽

Cited By ~ 44

Author(s):

José Francisco Meneses-Echávez ◽

Emilio González-Jiménez ◽

Robinson Ramírez-Vélez

Keyword(s):

Systematic Review ◽

Resistance Training ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Risk Of Bias ◽

Controlled Trials ◽

Exercise Interventions ◽

Training Interventions ◽

Randomized Controlled ◽

Cancer Related Fatigue

Objective. Cancer-related fatigue (CRF) is the most common and devastating problem in cancer patients even after successful treatment. This study aimed to determine the effects of supervised multimodal exercise interventions on cancer-related fatigue through a systematic review and meta-analysis.Design. A systematic review was conducted to determine the effectiveness of multimodal exercise interventions on CRF. Databases of PubMed, CENTRAL, EMBASE, and OVID were searched between January and March 2014 to retrieve randomized controlled trials. Risk of bias was evaluated using the PEDro scale.Results. Nine studiesn=772were included in both systematic review and meta-analysis. Multimodal interventions including aerobic exercise, resistance training, and stretching improved CRF symptoms (SMD=-0.23; 95% CI: −0.37 to −0.09;P=0.001). These effects were also significant in patients undergoing chemotherapyP<0.0001. Nonsignificant differences were found for resistance training interventionsP=0.30. Slight evidence of publication bias was observedP=0.04. The studies had a low risk of bias (PEDro scale mean score of 6.4 (standard deviation (SD) ± 1.0)).Conclusion. Supervised multimodal exercise interventions including aerobic, resistance, and stretching exercises are effective in controlling CRF. These findings suggest that these exercise protocols should be included as a crucial part of the rehabilitation programs for cancer survivors and patients during anticancer treatments.

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Exercise and dietary program-induced weight reduction is associated with cognitive function among obese adolescents: a longitudinal study

PeerJ ◽

10.7717/peerj.3286 ◽

2017 ◽

Vol 5 ◽

pp. e3286 ◽

Cited By ~ 6

Author(s):

Chun Xie ◽

Xiaochun Wang ◽

Chenglin Zhou ◽

Chang Xu ◽

Yu-Kai Chang

Keyword(s):

Executive Function ◽

Cognitive Function ◽

Weight Status ◽

Flanker Task ◽

Control Group ◽

Obese Adolescents ◽

School Activities ◽

Combined Exercise ◽

Quasi Experimental ◽

The Relationship

Objective The present study was to determine the effect of a combined exercise and dietary program on cognitive function as well as the relationship between the program-induced weight change and cognitive function alterations. Design The study applies a quasi-experimental design. Methods Fifty-eight adolescents with obese status (body mass index, BMI >28 kg/m2) were assigned to either an experiment (n = 30) or control group (n = 28). Participants in the experiment group received a scheduled program with a specific exercise protocol (two sessions per day, six days per week) and diet plan for four consecutive weeks; the control group was instructed to maintain their normal school activities. The primary outcome measures were anthropometric data and flanker task performance. Results The combined program led to reduced BMI with maintenance of the incongruent accuracy in the experiment group, but the incongruent accuracy decreased in the control group after the four-week period. Additionally, the change in weight status between post- and pre-test measurements was inversely correlated with the change in incongruent accuracy. Conclusion The combined exercise and dietary program resulted in decreased weight and enhanced executive function in the obese adolescents, and the weight alteration may be considered the mediator between the intervention and executive function.

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Effects of recreational sports and combined training on blood pressure and glycosylated hemoglobin in middle-aged and older adults: a systematic review and meta-analysis

10.1101/2021.05.05.21256401 ◽

2021 ◽

Author(s):

Vinicius Mallmann Schneider ◽

Paula de Azevedo Frank ◽

Sandra C. Fuchs ◽

Rodrigo Ferrari

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Glycosylated Hemoglobin ◽

Control Group ◽

Synthesis Methods ◽

Recreational Sports ◽

Middle Aged ◽

Exercise Interventions

Background Combined resistance and aerobic training (CT) is the most suitable form of exercise training to simultaneously improve cardiometabolic profile and functional capacity in middle-aged and older adults. Recreational sports (RS) emerge as an alternative to traditional exercises to improve these outcomes that could be used as a retention and continuity strategy, promoting health benefits associated with pleasure and satisfaction during the physical activity. Objectives The aim was to conduct a meta-analysis on the effects of RS and CT on systolic blood pressure (SBP), diastolic blood pressure (DBP) and glycosylated hemoglobin (HbA1c) in middle-aged and older adults and to compare these exercise interventions to a non-exercising control group (CON). Data Sources A literature search was conducted using the databases at PubMed, COCHRANE and SciELO between July and August 2020. Study Eligibility Criteria Studies that included men and women aged 45 years, healthy or with values of baseline for SBP 130mmHg or DBP 80 mmHg or with type II diabetes, in which the participants performed RS or CT versus CON, and evaluated SBP, DBP and HbA1c. Study Appraisal and Synthesis Methods Two independent reviewers screened search results, performed data extraction, and assessed of methodological quality of studies. Random effects modeling was used to compare pre to postintervention changes in BP and HbA1c from RS and CT versus CON, and the effect size were calculated through the weighted mean difference (MD) with a 95% confidence interval (CI). Conclusions RS and CT are effective exercise interventions to improve blood pressure in middle-aged and older adults. Additionally, CT seems to be an excellent strategy to reduce HbA1c, and future studies are necessary to confirm the effectiveness of recreational sports to improve HbA1c.

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