The impact of physical exercise on the fatigue symptoms in patients with multiple sclerosis: a systematic review and meta-analysis

Background: Clinical and pre-clinical studies indicate a reduction in seizure frequency as well as a decrease in susceptibility to subsequently evoked seizures after physical exercise programs. In contrast to the influence of exercise after epilepsy previously established, various studies have been conducted attempting to investigate whether physical activity reduces brain susceptibility to seizures or prevents epilepsy. We report a systematic review and meta-analysis of different animal models that addressed the impact of previous physical exercise programs to reduce seizure susceptibility.Methods: We included animal model (rats and mice) studies before brain insult that reported physical exercise programs compared with other interventions (sham, control, or naïve). We excluded studies that investigated animal models after brain insult, associated with supplement nutrition or drugs, that did not address epilepsy or seizure susceptibility, ex vivo studies, in vitro studies, studies in humans, or in silico studies. Electronic searches were performed in the MEDLINE (PubMed), Web of Science (WOS), Scopus, PsycINFO, Scientific Electronic Library Online (SciELO) databases, and gray literature, without restrictions to the year or language of publication. We used SYRCLE's risk of bias tool and CAMARADES checklist for study quality. We performed a synthesis of results for different types of exercise and susceptibility to seizures by random-effects meta-analysis.Results: Fifteen studies were included in the final analysis (543 animals), 13 of them used male animals, and Wistar rats were the most commonly studied species used in the studies (355 animals). The chemoconvulsants used in the selected studies were pentylenetetrazol, penicillin, kainic acid, pilocarpine, and homocysteine. We assessed the impact of study design characteristics and the reporting of mitigations to reduce the risk of bias. We calculated a standardized mean difference effect size for each comparison and performed a random-effects meta-analysis. The meta-analysis included behavioral analysis (latency to seizure onset, n = 6 and intensity of motor signals, n = 3) and electrophysiological analysis (spikes/min, n = 4, and amplitude, n = 6). The overall effect size observed in physical exercise compared to controls for latency to seizure onset was −130.98 [95% CI: −203.47, −58.49] (seconds) and the intensity of motor signals was −0.40 [95% CI: −1.19, 0.40] (on a scale from 0 to 5). The largest effects were observed in electrophysiological analysis for spikes/min with −26.96 [95% CI: −39.56, −14.36], and for spike amplitude (μV) with −282.64 [95% CI: −466.81, −98.47].Discussion:Limitations of evidence. A higher number of animal models should be employed for analyzing the influence of exerciseon seizure susceptibility. The high heterogeneity in our meta-analysis is attributable to various factors, including the number of animals used in each study and the limited number of similar studies. Interpretation. Studies selected in this systematic review and meta-analysis suggest that previous physical exercise programs can reduce some of the main features related to seizure susceptibility [latency seizure onset, spikes/min, and spike amplitude (μV)] induced by the administration of different chemoconvulsants.Systematic Review Registration: PROSPERO, identifier CRD42021251949; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=251949.

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Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

Sensors ◽

10.3390/s21217389 ◽

2021 ◽

Vol 21 (21) ◽

pp. 7389

Author(s):

Irene Cortés-Pérez ◽

Marcelina Sánchez-Alcalá ◽

Francisco Antonio Nieto-Escámez ◽

Yolanda Castellote-Caballero ◽

Esteban Obrero-Gaitán ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Systematic Review ◽

Virtual Reality ◽

Meta Analysis ◽

Simple Observation ◽

High Level ◽

The Impact ◽

Better Than

Patients with multiple sclerosis (PwMS) have a high level of fatigue and a reduced quality of life (QoL) due to the impact of multiple sclerosis (MS). Virtual reality-based therapy (VRBT) is being used to reduce disability in PwMS. The aim of this study was to assess the effect of VRBT on fatigue, the impact of MS, and QoL in PwMS. Methods: A systematic review with meta-analysis was conducted through a bibliographic search on PubMed, Scopus, Web of Science, and PEDro up to April 2021. We included randomized controlled trials (RCTs) with PwMS that received VRBT in comparison to conventional therapy (CT) including physiotherapy, balance and strength exercises, and stretching or physical activity, among others; or in comparison to simple observation; in order to assess fatigue, MS-impact, and QoL. The effect size was calculated using Cohen’s standardized mean difference with a 95% confidence interval (95% CI). Results: Twelve RCTs that provided data from 606 PwMS (42.83 ± 6.86 years old and 70% women) were included. The methodological quality mean, according to the PEDro Scale, was 5.83 ± 0.83 points. Our global findings showed that VRBT is effective at reducing fatigue (SMD −0.33; 95% CI −0.61, −0.06), lowering the impact of MS (SMD −0.3; 95% CI −0.55, −0.04), and increasing overall QoL (0.5; 95% CI 0.23, 0.76). Subgroup analysis showed the following: (1) VRBT is better than CT at reducing fatigue (SMD −0.4; 95% CI −0.7, −0.11), as well as in improving the mental dimension of QoL (SMD 0.51; 95% CI 0.02, 1); (2) VRBT is better than simple observation at reducing the impact of MS (SMD −0.61; 95% CI −0.97, −0.23) and increasing overall QoL (SMD 0.79; 95% CI 0.3, 1.28); and (3) when combined with CT, VRBT is more effective than CT in improving the global (SMD 0.6, 95% CI 0.13, 1.07), physical (SMD 0.87; 95% CI 0.3, 1.43), and mental dimensions (SMD 0.6; 95% CI 0.08, 1.11) of QoL. Conclusion: VRBT is effective at reducing fatigue and MS impact and improving QoL in PwMS.

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The Impact of COVID-19 on College Students’ Physical Activity: A Protocol for Systematic Review and Meta Analysis

10.21203/rs.3.rs-715532/v1 ◽

2021 ◽

Author(s):

Yunxia Ding ◽

Song Ding ◽

Jiali Niu

Keyword(s):

Physical Activity ◽

College Students ◽

Systematic Review ◽

Physical Exercise ◽

Teaching Practice ◽

Assessment Tool ◽

Meta Analysis ◽

Exercise Frequency ◽

Trial Quality ◽

The Impact

Abstract Background: We aimed to conduct a meta-analysis to assess the impact of coronavirus disease 2019 (COVID-19) on college students’ physical activity.Methods: All cohort studies, comparing college students undertaking physical exercise at school before the COVID-19 pandemic and physical exercise at home during the COVID-19 pandemic will be included in this review. We will use index words related to college students, physical exercise and COVID-19 to perform literature searches in PubMed, Medline, Embase and CNKI databases, to include articles indexed as of June 20, 2021 in English and Chinese language. Two reviewers will independently select trials for inclusion, assess trial quality and extract information for each included trials. Primary outcomes are exercise frequency, duration and intensity and associated factors. Based on Cochrane assessment tool, we will evaluate the risk of bias of the included studies. Revman 5.3 will be used for heterogeneity assessment, data synthesis, subgroup analysis, sensitivity analysis and generating funnel-plots.Discussion: The stronger evidence about the impact of COVID-19 on college students’ physical activity will be provided, so as to better guide teaching practice.Systematic review registration: PROSPERO CRD42021262390.

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Impact of aquatic exercise on persons with kidney disease: a systematic review and meta-analysis

Archivos de Medicina del Deporte ◽

10.18176/archmeddeporte.0008 ◽

2020 ◽

Vol 37 (5) ◽

pp. 339-347

Author(s):

D Rodríguez Rey ◽

MA Sanchez-Lastra ◽

C Ayán Pérez

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Kidney Disease ◽

Physical Exercise ◽

Meta Analysis ◽

Scientific Evidence ◽

Aquatic Exercise ◽

The Impact

Objective: Analyze the scientific evidence on the effects that aquatic physical exercise has on people with chronic kidney disease (CKD). Material and method: A systematic review was carried out following the checklist Preferred Reporting Items for Systematic review and Meta-Analysis Protocols, with the objective of locating the largest number of investigations that aimed to identify the effects of the practice of aquatic physical exercise in people with ERC. A search of the PubMed, PEDro, Scopus and Cochrane databases were carried out until March 2019, using the PEDro, CERT, MINORS and NIH scales to determine the methodological quality of the same. Results: Five investigations were located, two of them were randomized control trials, another two studies comparatives and one was uncontrolled. The mean score and the median obtained after applying PEDro scale were 4 and 4 respectively. All the interventions proposed aerobic exercise programs, being generally of short duration and highly supervised, without any adverse effects arising from their practice. In a large part of the studies, significant effects were observed in physical condition, physiological parameters and quality of life, to a lesser extent. The practice of exercise had no significant impact on either the activity of the disease or the perceived pain in patients. Conclusions: Practice of aquatic exercise is beneficial in people with ERC. More longitudinal studies are needed to assess the impact of aquatic exercises as well as its effect and quality of life in long term.

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509 Health-Related Quality of Life in Narcolepsy: A Systematic Review and Meta-Analysis

SLEEP ◽

10.1093/sleep/zsab072.508 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A200-A201

Author(s):

Ragy Tadrous ◽

Deirdre O’Rourke ◽

Julie Broderick ◽

David Mockler

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Systematic Review ◽

General Population ◽

Meta Analysis ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Impact

Abstract Introduction Narcolepsy is a neurological condition that has been associated with considerable detriment to daily life including impaired quality of life, occupational and academic difficulties and adversely affected social and personal relationships. To date, there has been no systematic analysis of the literature regarding health-related quality of life (HRQoL) in Narcolepsy. This systematic review aimed to examine the impact of narcolepsy on HRQoL, measured through standardised HRQoL questionnaires such as the Short Form 36 (SF36). Methods Medline, Embase, Cinahl and Web of Science were searched for studies which investigated HRQoL in adults with narcolepsy. Studies were reviewed independently by two reviewers, and a random-effects meta-analysis was performed. The methodological quality of the included studies was assessed using a modified version of the Joanna Briggs Institute Checklist for Analytical Cross Sectional Studies tool. The impact of study variables and characteristics on HRQoL was assessed using Spearman’s Correlation analyses with adjusted r2 values. Results A total of 30 studies were eligible for inclusion in the review. Additionally, meta-analyses were conducted for the SF36 and the EQ5D. The SF36 meta-analysis identified that the pooled mean scores for the Physical Component Summary (45.91) were less affected than the Mental Component Summary (42.98). The HRQoL of people with narcolepsy was compared to general population norms (US, UK, France and Norway) and to people with chronic diseases including multiple sclerosis, diabetes, and epilepsy. Conclusion People with narcolepsy report significant impairments in HRQoL when compared to the general population and other chronic health conditions including epilepsy, multiple sclerosis, diabetes and hypertension, especially concerning their mental wellbeing. Further research is warranted to identify the longitudinal effects of narcolepsy on HRQoL and to develop a narcolepsy-specific HRQoL tool. Support (if any) This review was completed as part of Mr Ragy Tadrous’ Master of Science (MSc) degree in Trinity College Dublin. This degree was co-sponsored by the Physiotherapy Department in St. James’s Hospital, Dublin.

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