Physiotherapy Regimens in Esophagectomy and Gastrectomy: a Systematic Review and Meta-Analysis

Abstract Background Esophageal and gastric cancer surgery are associated with considerable morbidity, specifically postoperative pulmonary complications (PPCs), potentially accentuated by underlying challenges with malnutrition and cachexia affecting respiratory muscle mass. Physiotherapy regimens aim to increase the respiratory muscle strength and may prevent postoperative morbidity. Objective The aim of this study was to assess the impact of physiotherapy regimens in patients treated with esophagectomy or gastrectomy. Methods An electronic database search was performed in the MEDLINE, EMBASE, CENTRAL, CINAHL and Pedro databases. A meta-analysis was performed to assess the impact of physiotherapy on the functional capacity, incidence of PPCs and postoperative morbidity, in-hospital mortality rate, length of hospital stay (LOS) and health-related quality of life (HRQoL). Results Seven randomized controlled trials (RCTs) and seven cohort studies assessing prehabilitation totaling 960 patients, and five RCTs and five cohort studies assessing peri- or postoperative physiotherapy with 703 total patients, were included. Prehabilitation resulted in a lower incidence of postoperative pneumonia and morbidity (Clavien–Dindo score ≥ II). No difference was observed in functional exercise capacity and in-hospital mortality following prehabilitation. Meanwhile, peri- or postoperative rehabilitation resulted in a lower incidence of pneumonia, shorter LOS, and better HRQoL scores for dyspnea and physical functioning, while no differences were found for the QoL summary score, global health status, fatigue, and pain scores. Conclusion This meta-analysis suggests that implementing an exercise intervention may be beneficial in both the preoperative and peri- or postoperative periods. Further investigation is needed to understand the mechanism through which exercise interventions improve clinical outcomes and which patient subgroup will gain the maximal benefit.

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P-OGC46 Physiotherapy Regimens in Esophagectomy and Gastrectomy: a Systematic Review and Meta-analysis

British Journal of Surgery ◽

10.1093/bjs/znab430.174 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Karina Tukanova ◽

Swathikan Chidambaram ◽

Nadia Guidozzi ◽

George Hanna ◽

Alison McGregor ◽

...

Keyword(s):

Hospital Mortality ◽

Cohort Studies ◽

Lower Incidence ◽

Respiratory Muscle ◽

Postoperative Morbidity ◽

Exercise Intervention ◽

Meta Analysis ◽

Postoperative Rehabilitation ◽

Exercise Interventions ◽

The Impact

Abstract Background Esophageal and gastric cancer surgery are associated with considerable morbidity, specifically postoperative pulmonary complications (PPC), potentially accentuated by underlying challenges with malnutrition and cachexia affecting respiratory muscle mass. Physiotherapy regimens aim to increase the respiratory muscle strength and may prevent postoperative morbidity. This meta-analysis aims to assess the impact of physiotherapy regimens following esophagectomy or gastrectomy. Methods An electronic database search was performed in MEDLINE, EMBASE, CENTRAL, CINAHL and Pedro databases. A meta-analysis was performed to assess the impact of physiotherapy on the functional capacity, incidence of PPC and postoperative morbidity, in-hospital mortality rate, the Length of Hospital Stay (LOS) and the Health-Related Quality of Life (HRQoL). Results Seven RCTs and 7 cohort studies assessing prehabilitation totalling 960 patients, and 5 RCTs and 5 cohort studies assessing peri- or postoperative physiotherapy with 703 total patients, were included. Prehabilitation resulted in a lower incidence of postoperative pneumonia and morbidity (Clavien-Dindo score >II). No difference was observed in functional exercise capacity, and in-hospital mortality following prehabilitation. Meanwhile, peri- or postoperative rehabilitation resulted in a lower incidence of pneumonia, a shorter LOS and better HRQoL scores for dyspnea and physical functioning, while no differences were found for the QoL summary score, global health status, fatigue and pain scores. Conclusions Our meta-analysis shows that implementing an exercise intervention may be beneficial in both the preoperative and peri- or postoperative period. Further investigation is needed to understand the mechanism through which exercise interventions improve clinical outcomes and which subgroup of patients will gain the most benefit.

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The impact of exercise interventions concerning executive functions of children and adolescents with attention-deficit/hyperactive disorder: a systematic review and meta-analysis

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01135-6 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Xiao Liang ◽

Ru Li ◽

Stephen H. S. Wong ◽

Raymond K. W. Sum ◽

Cindy H. P. Sit

Keyword(s):

Executive Functions ◽

Children And Adolescents ◽

Attention Deficit ◽

Exercise Intervention ◽

Meta Analysis ◽

Relevant Literature ◽

Moderate Intensity ◽

Exercise Interventions ◽

Positive Effects ◽

The Impact

Abstract Background Previous studies found that exercise interventions have positive effects on executive functions of the general population. However, studies seldom target executive functions of children and adolescents with attention-deficit hyperactivity disorder (ADHD). This study aimed to synthesise empirical studies regarding the effects of exercise interventions on executive functions of children and adolescents with ADHD. Methods A systematic search of the relevant literature was conducted in March 2020 through six electronic databases: CINAHL Complete, Eric, MEDLINE, PsychINFO, SPORTDiscus with Full Text, and Web of Science. Randomised controlled trials/quasi-experimental designs that applied exercise interventions and assessed executive functions through neurocognitive tasks among children and adolescents with ADHD were included. Altogether, 314 studies were identified, from which 31 full texts were independently assessed by two authors for eligibility. Finally, 21 studies underwent systematic reviews and 15 were selected for meta-analysis. Data extraction procedures and risk of bias analysis were conducted by two independent authors using the Physiotherapy Evidence Database (PEDro) scale. Results The findings indicated that exercise interventions improved overall executive functions of children and adolescents with ADHD (SMD = 0.611, 95% CI [0.386 to 0.836], p < 0.01). Exercise interventions had a moderate-to-large positive effect on inhibitory control (g = 0.761, 95% CI [0.376 to 1.146], p < 0.01) and cognitive flexibility (g = 0.780, 95% CI [0.331 to 1.228], p < 0.001). Likewise, during the subgroup analysis, intervention intensity and sessions of exercise (acute vs chronic) significantly moderated exercise intervention rather than intervention type. Conclusions Chronic sessions of exercise interventions with moderate intensity should be incorporated as treatment for children with ADHD to promote executive functions.

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

BMC Cancer ◽

10.1186/s12885-021-07989-0 ◽

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.

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Effects of Exercise Interventions on Weight, Body Mass Index, Lean Body Mass and Accumulated Visceral Fat in Overweight and Obese Individuals: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052635 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2635

Author(s):

Hyun Suk Lee ◽

Junga Lee

Keyword(s):

Body Mass Index ◽

Randomized Controlled Trials ◽

Lean Body Mass ◽

Body Mass ◽

Visceral Fat ◽

Exercise Intervention ◽

Meta Analysis ◽

Controlled Trials ◽

Exercise Interventions ◽

Randomized Controlled

(1) Background: Exercise interventions for overweight and obese individuals help reduce accumulated visceral fat, which is an indicator of cardiometabolic risk, but the effectiveness of these interventions is controversial. The purpose of this meta-analysis was to investigate the effectiveness of exercise interventions in overweight and obese individuals in order to reduce weight, body mass index (BMI), and accumulated visceral fat, and increase lean body mass. (2) Methods: Databases were used to select eligible studies for this meta-analysis. Randomized controlled trials with control and experimental groups were included. The degrees of effectiveness of the exercise interventions were computed to assess the benefits on reducing weight, BMI, and accumulated visceral fat, and increasing lean body mass. (3) Results: Sixteen studies were included in this meta-analysis. Participation in exercise interventions reduced weight (d = −0.58 (95% confidence interval (CI), −0.84–−0.31; p < 0.001; k = 9)), BMI (d = −0.50 (95% CI, −0.78–−0.21; p < 0.001; k = 7)), and accumulated visceral fat (d = −1.08 (95% CI, −1.60–−0.57; p < 0.001; k = 5)), but did not significantly increase lean body mass (d = 0.26 (95% CI, −0.11–0.63; p = 0.17; k = 6)). The average exercise intervention for overweight and obese individuals was of moderate to vigorous intensity, 4 times per week, 50 min per session, and 22 weeks duration. (4) Conclusions: Participating in exercise interventions has favorable effects on weight, BMI, and accumulated visceral fat. Further studies considering different modalities, intensities, durations, and measurements of fatness need to be conducted.

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

BMJ Open ◽

10.1136/bmjopen-2020-038854 ◽

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.

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Application of the Templates TIDieR and CERT Reveal Incomplete Reporting and Poor Replicability of Exercise Interventions for Type 2 Diabetes Mellitus

Current Diabetes Reviews ◽

10.2174/1871525719666210825150957 ◽

2021 ◽

Vol 17 ◽

Author(s):

Claudia Hacke ◽

Janika Schreiber ◽

Burkhard Weisser

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Clinical Practice ◽

Impact Factor ◽

Exercise Intervention ◽

Meta Analysis ◽

Exercise Interventions ◽

Intervention Reporting

Background: Exercise is strongly recommended for the management of type 2 diabetes mellitus (T2DM). However, incomplete intervention reporting in clinical trials limits the replication of exercise protocols. As previously demonstrated by us for exercise and hypertension, the reporting quality might also be insufficient in studies on T2DM and exercise. Objective: To assess completeness of exercise intervention reporting in randomized controlled trials (RCTs) for T2DM. Methods: Two independent reviewers applied the Consensus on Exercise Reporting Template (CERT) and the template for intervention description and replication (TIDieR) to 23 exercise trials obtained from the most recent and frequently cited meta-analysis in current guidelines. The completeness of reporting was evaluated focusing on the F.I.T.T. components (frequency, intensity, time, type). Interrater agreement and associations with publication year and journal impact factor were examined. Results: Mean CERT score was 11/19 (range 5–17), and 8/12 (range 4-12) for TIDieR. F.I.T.T. components were almost completely described, whereas overall completeness of exercise reporting was 60% and 68% (CERT and TIDieR). Replication of each exercise of the respective program was not possible in 52% of interventions. The majority of items had excellent agreement. No associations with publication year or impact factor were found. Conclusion: Exercise interventions were not sufficiently reported in RCTs that currently guide clinical practice in T2DM. Replication in further studies or clinical practice is limited due to poor exercise description. We suggest the use of the more specific CERT for reporting results of exercise interventions. Further refinement for internal diseases is needed to better describe exercise interventions.

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Comparative Efficacy of Seven Exercise interventions for Symptoms of depression in college students: a network of meta-analysis

10.21203/rs.2.13156/v1 ◽

2019 ◽

Author(s):

Shengyu Guo ◽

Fuying Li ◽

Yan Yang ◽

Ling Chen

Keyword(s):

College Students ◽

Depressive Symptoms ◽

Usual Care ◽

Tai Chi ◽

Exercise Intervention ◽

Meta Analysis ◽

Eligibility Criteria ◽

Exercise Interventions ◽

Symptoms Of Depression ◽

Depressed College Students

Abstract Background Depression among college students is common, exercise interventions are valued as one of the most widely prescribed interventions for depressed college students, however, it is especially difficult for university administrators to determine which exercise intervention is most effective, and efficacy of exercise interventions among depressed college students have not been evaluated. Objectives To systematically review and compare the efficacy of Seven Exercise interventions for Symptoms of depression in college students. Method A network of meta-analysis was conducted to fill the objectives. PubMed, Embase databases, and two Chinese language electronic databases WANFANG and CNKI were searched for the related articles. Eligibility criteria Randomized controlled trials comparing the efficacy of Seven Exercise interventions with usual care of college students with depression were included in the review. Main outcomes The Primary outcome of the present study were standardized mean difference(SMD) and the mean change of depressive symptoms. Results 14 trials were identified, including 2010 depressed college students. The result of direct meta-analysis of this review indicated exercise interventions overall had a significantly lower mean depression scores (SMD=-1.13) when compared with usual care. The result of NMA indicated when comparing with badminton intervention, yoga(SMD=-7.7, 95%CI -14 to -0.93) and tai chi (SMD=-9.4, 95%CI -16 to -2.7) can significantly decrease depression scores of the depressed college students. The rank of seven exercise interventions with respect to efficiently decrease symptom of depressed undergraduates was Tai chi > Yoga > Volleyball > Dance > Run> Basketball> Badminton, respectively. Conclusions Tai chi exhibited the highest probability that became the most efficacy intervention among the comparions, and Yoga showed the second most effectiveness to alleviate depressive symptoms of depressed college students, and dance ranks the third, followed by run, volleyball, basketball, badminton respectively.

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The Impact of Accidental Hypothermia on Mortality in Trauma Patients Overall and Patients with Traumatic Brain Injury Specifically: A Systematic Review and Meta-Analysis

World Journal of Surgery ◽

10.1007/s00268-020-05750-5 ◽

2020 ◽

Vol 44 (12) ◽

pp. 4106-4117

Author(s):

David Rösli ◽

Beat Schnüriger ◽

Daniel Candinas ◽

Tobias Haltmeier

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Hospital Mortality ◽

Meta Analysis ◽

Accidental Hypothermia ◽

Trauma Patients ◽

Qualitative Synthesis ◽

Pubmed Database ◽

The Impact

Abstract Background Accidental hypothermia is a known predictor for worse outcomes in trauma patients, but has not been comprehensively assessed in a meta-analysis so far. The aim of this systematic review and meta-analysis was to investigate the impact of accidental hypothermia on mortality in trauma patients overall and patients with traumatic brain injury (TBI) specifically. Methods This is a systematic review and meta-analysis using the Ovid Medline/PubMed database. Scientific articles reporting accidental hypothermia and its impact on outcomes in trauma patients were included in qualitative synthesis. Studies that compared the effect of hypothermia vs. normothermia at hospital admission on in-hospital mortality were included in two meta-analyses on (1) trauma patients overall and (2) patients with TBI specifically. Meta-analysis was performed using a Mantel–Haenszel random-effects model. Results Literature search revealed 264 articles. Of these, 14 studies published 1987–2018 were included in the qualitative synthesis. Seven studies qualified for meta-analysis on trauma patients overall and three studies for meta-analysis on patients with TBI specifically. Accidental hypothermia at admission was associated with significantly higher mortality both in trauma patients overall (OR 5.18 [95% CI 2.61–10.28]) and patients with TBI specifically (OR 2.38 [95% CI 1.53–3.69]). Conclusions In the current meta-analysis, accidental hypothermia was strongly associated with higher in-hospital mortality both in trauma patients overall and patients with TBI specifically. These findings underscore the importance of measures to avoid accidental hypothermia in the prehospital care of trauma patients.

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Comparing the impact of different exercise interventions on fatigue in individuals with COPD: A systematic review and meta-analysis

Chronic Respiratory Disease ◽

10.1177/1479973119894855 ◽

2019 ◽

Vol 16 ◽

pp. 147997311989485 ◽

Cited By ~ 1

Author(s):

Lok Sze Katrina Li ◽

Stacey Butler ◽

Roger Goldstein ◽

Dina Brooks

Keyword(s):

Meta Analysis ◽

Interval Training ◽

Cochrane Library ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Exercise Interventions ◽

Significant Difference ◽

Related Quality ◽

Type Of Exercise ◽

The Impact

To systematically review randomized controlled trials that compared the effectiveness of different types of exercise on the symptom of fatigue in individuals with chronic obstructive pulmonary disease (COPD). MEDLINE, EMBASE, EMcare, PsychINFO, and Cochrane library were searched from inception to October 2018. Studies were included if individuals with COPD were randomized into two or more physical exercise interventions that reported fatigue. Of the 395 full-texts reviewed, 17 studies were included. Fifteen studies reported the impact of exercise on health-related quality of life with fatigue as a subdomain. Reduction in fatigue was observed following endurance, resistance, or a combination of both exercises. There was no significant difference between continuous and interval training ( n = 3 studies, pooled standardized mean difference (SMD) = −0.17, 95% CI = −0.47, 0.12, p = 0.25) or between endurance and resistance training ( n = 3 studies, SMD = −0.35, 95% CI = −0.72, 0.01, p = 0.07) on fatigue in people with COPD. Fatigue reduction is not usually a primary outcome of exercise interventions, but it is frequently a secondary domain. The type of exercise did not influence the impact of exercise on fatigue, which was reduced in endurance, resistance, or a combination of both exercises, enabling clinicians to personalize training to match targeted outcomes.

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A Systematic Review of the Effects of Exercise on Hormones in Women with Polycystic Ovary Syndrome

Journal of Functional Morphology and Kinesiology ◽

10.3390/jfmk5020035 ◽

2020 ◽

Vol 5 (2) ◽

pp. 35

Author(s):

Grei Shele ◽

Jessica Genkil ◽

Diana Speelman

Keyword(s):

Systematic Review ◽

Polycystic Ovary Syndrome ◽

Aerobic Exercise ◽

Exercise Intervention ◽

Polycystic Ovary ◽

Healthy Weight ◽

Ovary Syndrome ◽

Exercise Interventions ◽

The Impact ◽

Androgen Levels

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is characterized by menstrual irregularity and elevated serum androgens, and is often accompanied by insulin resistance. The etiology of PCOS is unknown. Lifestyle interventions and weight loss, where appropriate, remain first-line treatments for women with PCOS. Regular physical activity is recommended for women with PCOS to maintain a healthy weight and cardiovascular fitness. Purpose: To review the evidence for the impact of various exercise interventions on hormone levels in women with PCOS. Methods: A systematic review of original studies indexed in PubMed that utilized an exercise intervention in women with PCOS and reported hormone values pre- and post-intervention. Studies in which the effects of the exercise intervention could be determined were included. Results: Vigorous aerobic exercise improves insulin measures in women with PCOS. Resistance or strength training may improve androgen levels, though additional studies are warranted. Studies with yoga are limited but suggest improvements in androgens. Limited information is available on the impact of exercise on adipokines and anti-Müllerian hormone, warranting further investigation. Conclusions: Recommended guidelines for women with PCOS include vigorous aerobic exercise and resistance training to improve measures of insulin sensitivity and androgen levels.

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