scholarly journals Efficacy of Physical Exercise to Offset Anthracycline‐Induced Cardiotoxicity: A Systematic Review and Meta‐Analysis of Clinical and Preclinical Studies

2021 ◽  
Author(s):  
Willeke R. Naaktgeboren ◽  
David Binyam ◽  
Martijn M. Stuiver ◽  
Neil K. Aaronson ◽  
Arco J. Teske ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Exercise ◽  
Clinical Studies ◽  
Animal Studies ◽  
Exercise Intervention ◽  
Ex Vivo ◽  
Meta Analysis ◽  
Voluntary Exercise ◽  
Cochrane Central Register ◽  
Exercise Interventions

Background Physical exercise is an intervention that might protect against doxorubicin‐induced cardiotoxicity. In this meta‐analysis and systematic review, we aimed to estimate the effect of exercise on doxorubicin‐induced cardiotoxicity and to evaluate mechanisms underlying exercise‐mediated cardioprotection using (pre)clinical evidence. Methods and Results We conducted a systematic search in PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Cochrane's and Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk‐of‐bias tools were used to assess the validity of human and animal studies, respectively. Cardiotoxicity outcomes reported by ≥3 studies were pooled and structured around the type of exercise intervention. Forty articles were included, of which 3 were clinical studies. Overall, in humans (sample sizes ranging from 24 to 61), results were indicative of exercise‐mediated cardioprotection, yet they were not sufficient to establish whether physical exercise protects against doxorubicin‐induced cardiotoxicity. In animal studies (n=37), a pooled analysis demonstrated that forced exercise interventions significantly mitigated in vivo and ex vivo doxorubicin‐induced cardiotoxicity compared with nonexercised controls. Similar yet slightly smaller effects were found for voluntary exercise interventions. We identified oxidative stress and related pathways, and less doxorubicin accumulation as mechanisms underlying exercise‐induced cardioprotection, of which the latter could act as an overarching mechanism. Conclusions Animal studies indicate that various exercise interventions can protect against doxorubicin‐induced cardiotoxicity in rodents. Less doxorubicin accumulation in cardiac tissue could be a key underlying mechanism. Given the preclinical evidence and limited availability of clinical data, larger and methodologically rigorous clinical studies are needed to clarify the role of physical exercise in preventing cardiotoxicity in patients with cancer. Registration URL: https://www.crd.york.ac.uk/prospero ; Unique identifier: CRD42019118218.

scholarly journals Remote interventions to improve exercise behaviour in sedentary people living with and beyond cancer: a systematic review and meta-analysis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saïd Ibeggazene ◽  
Rebecca Turner ◽  
Derek Rosario ◽  
Liam Bourke
Keyword(s):  
Systematic Review ◽  
Exercise Intervention ◽  
Meta Analysis ◽  
Exercise Interventions ◽  
Exercise Behaviour ◽  
Cancer Services ◽  
The Social ◽  
Intervention Adherence ◽  
Randomised Controlled ◽  
Exercise Guidelines

Abstract Background The COVID-19 pandemic has forced many cancer services to consider a transition to a remote format of delivery that is largely untested. Accordingly, we sought to perform a systematic review of the effects of remotely delivered interventions to improve exercise behaviour in sedentary adults living with and beyond cancer. Methods Eligible studies were randomised controlled trials comparing a remotely delivered exercise intervention to a usual care comparison in sedentary people over 18 years old with a primary cancer diagnosis. Nine electronic databases were searched from inception to November 2020. Results The review included three trials, totalling 186 participants. Two of the included trials incorporated prescriptions that meet current aerobic exercise recommendations, one of which also meets the guidelines for resistance exercise. No trials reported an intervention adherence of 75% or more for a set prescription that meets current exercise guidelines. Conclusion There is little evidence suggesting that remote exercise interventions promote exercise behaviours or improve physical function in sedentary adults living with and beyond cancer. The development and evaluation of novel remote exercise interventions is needed to establish their usefulness for clinical practice. Given the social response to the COVID-19 pandemic, further research in this area is urgently needed.

scholarly journals Effectiveness of workplace exercise interventions in the treatment of musculoskeletal disorders in office workers: a protocol of a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038854
Author(s):  
Carlos Tersa-Miralles ◽  
Roland Pastells-Peiró ◽  
Francesc Rubí-Carnacea ◽  
Filip Bellon ◽  
Esther Rubinat Arnaldo
Keyword(s):  
Systematic Review ◽  
Musculoskeletal Disorders ◽  
Exercise Intervention ◽  
Meta Analysis ◽  
Office Workers ◽  
Cochrane Library ◽  
Exercise Interventions ◽  
Physical Strength ◽  
Prolonged Sitting ◽  
Randomised Controlled

IntroductionPhysical inactivity due to changes in our society towards more sedentary behaviours is leading to health problems. Increasing physical activity might be a good strategy to improve physical strength and reduce the prevalence of illnesses associated with prolonged sitting. Office workers exhibit a sedentary lifestyle with short rest periods or even without pauses during the workday. It is important to perform workplace interventions to treat musculoskeletal disorders caused by prolonged sitting and lack of movement adopted on the office setting. This article describes a protocol for a systematic review to evaluate the effectiveness of exercise interventions on office workers in their work environment.Methods and analysisA literature search will be performed in the PubMed, CINAHL Plus, Cochrane Library, Scopus, ISI WoS and PeDRO databases for randomised controlled trials and studies published from 1 January 2010 to 31 July 2020 in English or Spanish. The participants will be office workers who spend most of their work time in a sitting position. The interventions performed will include any type of exercise intervention in the workplace. The outcome measures will vary in accordance with the aim of the intervention observed. The results of the review and the outcomes from the studies reviewed will be summarised with a narrative synthesis. The review protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines.Ethics and disseminationEthical approval is not required. The review outcomes and the additional data obtained will be disseminated through publications and in scientific conferences.PROSPERO registration numberCRD42020177462.

scholarly journals The comparative effectiveness of physical exercise interventions in individuals with chronic non-specific neck pain: protocol for a network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e034846 ◽  
Author(s):  
Rutger MJ de Zoete ◽  
James H McAuley ◽  
Nigel R Armfield ◽  
Michele Sterling
Keyword(s):  
Physical Exercise ◽  
Neck Pain ◽  
Meta Analysis ◽  
Network Effect ◽  
Effect Sizes ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Exercise Interventions ◽  
Meta Analyses

IntroductionNeck pain is a global burdensome problem, with a large proportion of neck pain cases becoming chronic. Although physical exercise is a commonly prescribed treatment, the evidence on the effectiveness of isolated exercise interventions remains limited. Traditional pairwise randomised controlled trials (RCTs) and meta-analyses are limited in only comparing two interventions. This protocol describes the design of a network meta-analysis, which enables a comparative investigation of all physical exercise interventions for which RCTs are available. We aim to systematically compare the effectiveness of different types of physical exercise in people with chronic non-specific neck pain.Methods and analysisNine electronic databases (AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Physiotherapy Evidence Database, PsycINFO, Scopus and SPORTDiscus) were searched for RCTs from inception to 12 March 2019. Titles and abstract firstly, and full-text papers secondly, will be screened by two reviewers. Data will be extracted by two reviewers. The primary outcome measure is effectiveness of the intervention. Methodological quality of included studies will be assessed by two reviewers using the PEDro scale. The overall quality of evidence will be assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, which has been adapted for network meta-analyses. The available evidence will be summarised using a network diagram. A contribution matrix will be presented to allow assessment of direct and indirect evidence. Forest plots will be constructed to visualise effects of all included exercise interventions. Pairwise effect sizes will be calculated by including all evidence available in the network. Effect measures for treatments that have not been compared in a pairwise RCT can be compared indirectly by contrasting effect sizes of comparisons with a common comparator.Ethics and disseminationThis work synthesises evidence from previously published studies and does not require ethics review or approval. A manuscript describing the findings will be submitted for publication in a peer-reviewed scientific journal.PROSPERO registration numberCRD42019126523.

scholarly journals Mesenchymal stromal cells as a therapeutic intervention for COVID-19: a living systematic review and meta-analysis protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Aidan M. Kirkham ◽  
Madeline Monaghan ◽  
Adrian J. M. Bailey ◽  
Risa Shorr ◽  
Manoj M. Lalu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mesenchymal Stromal Cells ◽  
Stromal Cells ◽  
Therapeutic Intervention ◽  
Clinical Studies ◽  
Meta Analysis ◽  
Case Series ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Isolation And Characterization

Abstract Background Mesenchymal stromal cells (MSCs) have significant immunomodulatory and tissue repair capabilities, mediated partly by conditioned media or through secreted extracellular vesicles (MSC-EVs). Infection with SARS-CoV-2 can cause mild to life-threatening illness due to activated immune responses that may be dampened by MSCs or their secretome. Many clinical studies of MSCs have been launched since the beginning of the global pandemic, however, few have been completed and most lack power to assess efficacy. Repeated systematic searches and meta-analyses are needed to understand, in real time, the extent of potential benefit in different patient populations as the evidence emerges. Methods This living systematic review will be maintained to provide up-to-date information as the pandemic evolves. A systematic literature search of Embase, MEDLINE, and Cochrane Central Register of Controlled Trials databases will be performed. All clinical studies (e.g., randomized, pseudorandomized and non-randomized controlled trials, uncontrolled trials, and case series) employing MSCs or their secretome as a therapeutic intervention for COVID-19 will be included. Patients must have confirmed SARS-CoV-2 infection. Study screening and data extraction will be performed in duplicate. Information concerning interventions, patient populations, methods of MSC isolation and characterization, primary and secondary clinical and/or laboratory outcomes, and adverse events will be extracted. Key clinical outcomes will be pooled through random-effects meta-analysis to determine the efficacy of MSCs and their secreted products for COVID-19. Discussion Our systematic review and subsequent updates will inform the scientific, medical, and health policy communities as the pandemic evolves to guide decisions on the appropriate use of MSC-related products to treat COVID-19. Systematic review registration PROSPERO CRD 42021225431

The Effects of Physical Exercise on Tumor Vasculature: Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Mário Esteves ◽  
Mariana P. Monteiro ◽  
Jose Alberto Duarte
Keyword(s):  
Systematic Review ◽  
Physical Exercise ◽  
Clinical Studies ◽  
Meta Analysis ◽  
Tumor Vasculature ◽  
Tumor Growth Rate ◽  
Tumor Perfusion ◽  
Tumor Vascularization ◽  
Risk Of Cancer ◽  
Present Systematic Review

AbstractA wealth of evidence supports an association between physical exercise, decreased tumor growth rate, and reduced risk of cancer mortality. In this context, the tumor vascular microenvironment may play a key role in modulating tumor biologic behavior. The present systematic review and meta-analysis aimed to summarize the evidence regarding the effects of physical exercise on tumor vasculature in pre-clinical studies. We performed a computerized research on the PubMed, Scopus, and EBSCO databases to identify pre-clinical studies that evaluated the effect of physical exercise on tumor vascular outcomes. Mean differences were calculated through a random effects model. The present systematic review included 13 studies involving 373 animals. From these, 11 studies evaluated chronic intratumoral vascular adaptations and 2 studies assessed the acute intratumoral vascular adaptations to physical exercise. The chronic intratumoral vascular adaptations resulted in higher tumor microvessel density in 4 studies, increased tumor perfusion in 2 studies, and reduced intratumoral hypoxia in 3 studies. Quantitatively, regular physical exercise induced an increased tumor vascularization of 2.13 [1.07, 3.20] (p<0.0001). The acute intratumoral vascular adaptations included increased vascular conductance and reduced vascular resistance, which improved tumor perfusion and attenuated intratumoral hypoxia. In pre-clinical studies, physical exercise seems to improve tumor vascularization.

Fresh Osteochondral and Chondral Allograft Preservation and Storage Media: A Systematic Review of the Literature

2021 ◽  
pp. 036354652110168
Author(s):  
Suzanne M. Tabbaa ◽  
Farshid Guilak ◽  
Robert L. Sah ◽  
William D. Bugbee
Keyword(s):  
Systematic Review ◽  
Clinical Studies ◽  
Animal Studies ◽  
Storage Time ◽  
Ex Vivo ◽  
Inclusion Criteria ◽  
Osteochondral Repair ◽  
Storage Solutions ◽  
Key Variables ◽  
And Storage

Background: Storage procedures and parameters have a significant influence on the health of fresh osteochondral allograft (OCA) cartilage. To date, there is a lack of agreement on the optimal storage conditions for OCAs. Purpose: To systematically review the literature on (1) experimental designs and reporting of key variables of ex vivo (laboratory) studies, (2) the effects of various storage solutions and conditions on cartilage health ex vivo, and (3) in vivo animal studies and human clinical studies evaluating the effect of fresh OCA storage on osteochondral repair and outcomes. Study Design: Systematic review; Level of evidence, 5. Methods: A systematic review was performed using the PubMed, Embase, and Cochrane databases. The inclusion criteria were laboratory studies (ex vivo) reporting cartilage health outcomes after prolonged storage (>3 days) of fresh osteochondral or chondral tissue explants and animal studies (in vivo) reporting outcomes of fresh OCA. The inclusion criteria for clinical studies were studies (>5 patients) that analyzed the relationship of storage time or chondrocyte viability at time of implantation to patient outcomes. Frozen, cryopreserved, decellularized, synthetic, or tissue-engineered grafts were excluded. Results: A total of 55 peer-reviewed articles met the inclusion criteria. Ex vivo studies reported a spectrum of tissue sources and storage solutions and conditions, although the majority of studies lacked complete reporting of key variables, including storage solution formula and environmental conditions. The effect of various conditions (eg, temperature) and storage solutions on cartilage health were inconsistent. Although 60% of animal models suggest that storage time may influence outcomes and 80% indicate inferior outcomes with frozen OCA as compared with fresh OCA, 75% of clinical studies report no correlation between storage time and outcomes. Conclusion: Given the variability in experimental designs and lack of reporting across studies, it is still not possible to determine optimal storage conditions, although animal studies suggest that storage time and chondrocyte viability influence osteochondral repair outcomes. A list of recommendations was developed to encourage reporting of key variables, such as media formulation, environmental factors, and methodologies used. High-quality clinical data are needed to investigate the effects of storage and graft health on outcomes.

scholarly journals Physical Exercise Improves Heart-Rate Variability in Obese Children and Adolescents: A Systematic Review

2021 ◽  
Vol 13 (5) ◽  
pp. 2946
Author(s):  
Santos Villafaina ◽  
Juan Pedro Fuentes-García ◽  
Juan Luis Leon-Llamas ◽  
Daniel Collado-Mateo
Keyword(s):  
Systematic Review ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Physical Exercise ◽  
Children And Adolescents ◽  
Cardiovascular Health ◽  
Exercise Intervention ◽  
Negative Impact ◽  
Obese Children ◽  
Exercise Interventions

Background: Childhood obesity has negative impact on heart-rate variability (HRV) and, thereby, on the cardiovascular health of children and adolescents. Thus, physical-exercise interventions were proposed to increase HRV. The present systematic review aims to provide an up-to-date analysis of research on the effect of physical-exercise interventions on HRV in obese children and adolescents. Methods: An electronic search of the literature was performed, and 10 articles were included. PRISMA guideline methodology was employed. Results: Physical-exercise interventions predominantly involved aerobic training; however, alternative training programs, including judo or recreational soccer, were found. The duration of intervention ranged from 6 to 24 weeks, with a training frequency of between 2 and 7 times per week. The duration of sessions typically ranged from 40 to 60 min. Conclusions: Results of the included articles indicated that physical-exercise intervention increased the HRV and thereby the autonomic modulation of obese children and adolescents. This is significant, as HRV is associated with cardiovascular health. Such physical-exercise interventions are crucial to reduce weight and improve cardiovascular health in children and adolescents, thereby achieving a sustainable future.

scholarly journals Quality of the reporting of exercise interventions in solid organ transplant recipients: a systematic review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Uma Raje ◽  
Tyler M Saumur ◽  
Fernanda Pesce de Souza ◽  
Sunita Mathur ◽  
Tania Janaudis-Ferreira
Keyword(s):  
Systematic Review ◽  
Exercise Training ◽  
Meta Analysis ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Solid Organ ◽  
Exercise Interventions

Background:Exercise training programs must be described in detail to facilitate replication and implementation. This study aimed to evaluate the quality of exercise training program description in randomized controlled trials (RCTs) involving solid organ transplant (SOT) recipients. Methods: We evaluated 21 RCTs reporting on exercise interventions in SOT recipients that were included in a recent systematic review/meta-analysis conducted by the research team. This previous review investigated the effects of exercise training (versus no training) in adult SOT recipients. Several databases (MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials) were searched from inception to May 2019. Three reviewers independently rated the exercise programs for SOT using the Consensus on Exercise Reporting Template (CERT). Results: Mean score of the CERT was 6/19. None of the RCTs described all items of the CERT. Items of crucial importance, such as adherence, whether the exercise was done individually or in a group, whether there were home program or non-exercise components, and the type and number of adverse events, were either not mentioned or not described in detail. Conclusion: RCTs in exercise in SOT recipients did not satisfactorily report their exercise protocols, which can lead to difficulties in replication by researchers and implementation by clinicians. 

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