Mind–Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: A Systematic Review and Meta-Analysis

Mind–Body Physical Activity (MBPA) in educational settings is one possible preventive strategy for ameliorating stress-related physiological health parameters. The objectives of this study were to conduct a systematic review of the literature with meta-analyses on the effects of MBPA on stress-related physiological health markers in primary, secondary, and higher education students. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the search for peer-reviewed articles published in English was conducted in PubMed, EBSCOhost, PsychInfo, Scopus, and Cochrane Library databases. Criteria for inclusion consisted of empirical studies targeting the student population (primary, secondary, higher education), studies examining the effectiveness of an MBPA intervention, studies including a control or comparison group (pre-test/post-test studies excluded), studies targeting physiological marker outcomes such as heart rate, blood glucose, cortisol, and blood pressure, and finally, studies examining interventions implemented within educational settings. Twenty-six interventions were eligible for the review and quantitative synthesis, which comprised a total of 1625 participants, with 783 students serving within the control/comparison group. There were statistically significant and large pooled effects for MBPA effectiveness for lowering heart rate (Hedges’ g = −1.71, 95% Confidence Interval (CI): −2.43, −0.98), cortisol (Hedges’ g = −1.32, 95% CI: −2.50, −0.16), and systolic and diastolic blood pressure (Hedges’ g = −1.04, 95% CI: −1.53, −0.58). These effects tended to be stronger in older students compared to younger students. Most analyses were characterized as having high heterogeneity and only 10 of the 26 studies were characterized as good quality (38.4%). MBPA interventions may have a positive impact on specific physiological health markers in students, especially in students within higher education. However, higher-quality research is needed in this area.

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Effectiveness of adult community-based physical activity interventions with objective physical activity measurements and long-term follow-up: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-034541 ◽

2020 ◽

Vol 10 (5) ◽

pp. e034541

Author(s):

Charlotte Wahlich ◽

Umar A R Chaudhry ◽

Rebecca Fortescue ◽

Derek G Cook ◽

Shashivadan Hirani ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Meta Analysis ◽

Risk Of Bias ◽

Cochrane Library ◽

Community Based ◽

Intervention Effects ◽

Meta Analyses

ObjectiveTo identify randomised controlled trials (RCTs) of physical activity (PA) interventions with objective PA outcomes in adults and to evaluate whether intervention effects were sustained beyond 12 months.DesignSystematic review and meta-analysis.Data sourcesSeven databases (Medline, Embase, PsycINFO, Web of Science, Cochrane library, CINAHL (Cumulative Index of Nursing and Allied Health Literature) and ASSIA (Applied Social Sciences Index and Abstracts)) were searched from January 2000 until December 2019.Eligibility criteriaRCTs reporting objective PA outcomes beyond 12 months with community-based participants aged ≥18 years were included; those where controls received active interventions, including advice to increase PA levels, were excluded.Data extraction and synthesisTwo independent reviewers completed extraction of aggregate data and assessed risk of bias. Meta-analyses used random-effects models at different follow-up points. Primary outcomes were daily steps and weekly minutes of moderate-to-vigorous PA (MVPA).ResultsOf 33 282 records identified, nine studies (at generally low risk of bias) were included, five in meta-analyses with 12 months to 4 year follow-up. We observed 12 month increases for intervention vs control participants in steps/day (mean difference (MD)=554 (95% CIs: 384 to 724) p<0.0001, I2=0%; 2446 participants; four studies) and weekly MVPA minutes (MD=35 (95% CI: 27 to 43) p<0.0001, I2=0%; 2647 participants; four studies). Effects were sustained up to 4 years for steps/day (MD=494 (95% CI: 251 to 738) p<0.0001, I2=0%; 1944 participants; four studies) and weekly MVPA minutes (MD=25 (95% CI: 13 to 37) p<0.0001, I2=0%; 1458 participants; three studies).ConclusionsThere are few PA interventions with objective follow-up beyond 12 months, more studies are needed. However, this review provided evidence of PA intervention effects beyond 12 months and sustained up to 4 years for both steps/day and MVPA. These findings have important implications for potential long-term health benefits.PROSPERO registration numberCRD42017075753.

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Accuracy and precision of energy expenditure, heart rate, and steps measured by combined-sensing Fitbits against reference measures: Systematic Review and Meta-Analyses (Preprint)

10.2196/preprints.35626 ◽

2021 ◽

Author(s):

Guillaume Chevance ◽

Natalie M. Golaszewski ◽

Elizabeth Tipton ◽

Eric B. Hekler ◽

Matthew Buman ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Heart Rate ◽

Energy Expenditure ◽

Low Cost ◽

Objective Assessment ◽

Criterion Measure ◽

Battery Capacity ◽

Adults And Children ◽

Meta Analyses

BACKGROUND Although it is widely recognized that physical activity is an important determinant of health there is considerable challenge in assessing this complex behavior. Tools for the objective assessment of the frequency, intensity, and duration of physical activity in adults and children have largely been developed for short-term use within research or public health surveillance environments. However, recent advances in microtechnology, data processing, wireless communication, and battery capacity have resulted in the proliferation of low-cost, non-invasive, wrist-worn devices with attractive designs that can easily be used by consumers to track their physical activity over long periods of time. OBJECTIVE The purpose of the present systematic-review and meta-analyses is to examine, quantify, and report on the current state of evidence for the analytical validity of energy expenditure, heart rate, and steps measured by recent combined-sensing Fitbits. METHODS Systematic-review and Bland-Altman meta-analyses of validation studies of combined-sensing Fitbits against reference measures of energy expenditure, heart rate and steps. RESULTS A total of 52 studies were included in the systematic review. Among them, 41 were included in the meta-analyses, representing 203 individual comparisons between Fitbit devices and a criterion measure (i.e., 117 for heart rate, 49 for energy expenditure, and 37 for steps). Overall, the majority of authors of the included studies concluded that recent Fitbit models underestimate heart rate, energy expenditure, and steps compared to criterion measures. These independent conclusions aligned with the results of the pooled meta-analyses showing an average underestimation of, respectively, -2,99 bpm, -2,77 kcal/min and -3,11 steps/min of the Fitbit compared to criterion measure (results obtained after removing high risk of bias studies). CONCLUSIONS Fitbit devices are likely to underestimate heart rate, energy expenditure, and steps. The estimation of these measurements varied by quality of study, age of the participants, type of activities, and by model of Fitbit. The qualitative conclusions of the majority of studies aligned with the results of meta-analyses. Although the expected level of accuracy might vary from one context to another, this underestimation can be acceptable, on average, for steps and heart rate. Information about energy expenditure however are likely to be too unprecise.

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Impact of carbapenem resistance on mortality in patients infected with Enterobacteriaceae: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-054971 ◽

2021 ◽

Vol 11 (12) ◽

pp. e054971

Author(s):

Ruyin Zhou ◽

Xiangming Fang ◽

Jinjin Zhang ◽

Xiaodong Zheng ◽

Shuangyue Shangguan ◽

...

Keyword(s):

Systematic Review ◽

Comparison Group ◽

Infection Type ◽

Data Extraction ◽

Carbapenem Resistance ◽

Cochrane Library ◽

Risk Of Death ◽

Hospitalised Patients ◽

Meta Analyses ◽

The Impact

ObjectivesTo provide a comprehensive assessment of the impact of carbapenem resistance on mortality among patients infected with Enterobacteriaceae and to explore the source of heterogeneity across studies.DesignThis systematic review was conducted following the guidelines of Cochrane Guidance and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Data sourcesWe conducted a systematic literature search of the PubMed, Embase, Web of Science and Cochrane Library databases to identify relevant studies published between 1 January 1994 and 30 August 2020.Eligibility criteriaWe included primary observational studies published in English that reported the mortality outcomes for hospitalised patients with confirmed infections due to carbapenem-resistant Enterobacteriaceae (CRE) and carbapenem-susceptible Enterobacteriaceae (CSE). Studies with no comparison group or with a comparison group of patients infected with unconfirmed CSE were excluded.Data extraction and synthesisData extraction and assessment of risk bias were conducted independently by two reviewers. The pooled relative risk and risk difference were calculated as effect measures with 95% CIs using a random effects model. The heterogeneity across studies was assessed by Q-statistic and I2 measures.ResultsOf 10 304 studies initially identified, 50 studies were included in the meta-analyses. The results of the meta-analyses showed that carbapenem resistance has a significant positive effect on the probability of death for patients infected with Enterobacteriaceae for any type of mortality outcome. The results of the stratified analysis and meta-regression suggested that the effect of carbapenem resistance on the risk of death varied by infection type, sample size and year of publication.ConclusionsOur results suggested that patients with CRE infection still face a greater risk of death than patients with CSE infection do, and an urgent need to develop new antibiotics and appropriate treatments to reduce the risk of death.PROSPERO registration numberCRD42020176808.

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Effect of leisure-time physical activity in controlling hypertension: a systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2021-056270 ◽

2021 ◽

Vol 11 (12) ◽

pp. e056270

Author(s):

Md Shariful Islam ◽

Md Golam Rabbani ◽

Ammatul Fardousi ◽

Monaemul Islam Sizear ◽

KM Saif-Ur-Rahman

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Data Extraction ◽

Meta Analysis ◽

Cochrane Library ◽

Ethical Approval ◽

Registration Number ◽

Meta Analyses

IntroductionHypertension is a major risk factor for cardiovascular diseases. In 2015, over 1.13 billion individuals worldwide had hypertension. Globally, it results in 10.8 million deaths every year. Around half of the individuals do not continue treatment with medicine to control blood pressure. Physical activity, a non-pharmacological option of treatment, reduces blood pressure. We aim in this research to examine the effect of leisure-time physical activity in controlling blood pressure.Methods and analysisWe will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to conduct this study. We will perform a systematic search in Medline/PubMed, Embase, Scopus, Web of Science, Physical Education Index (ProQuest) and CENTRAL (the Cochrane Library). Both experimental and observational studies will be included. The study population would be people with hypertension. Two reviewers will perform screening of the articles, bias assessment and data extraction independently. We will use the Joanna Briggs Institute Critical Appraisal Tools to assess the risk of bias. We will conduct a meta-analysis if it is applicable.Ethics and disseminationThe results will be published in peer-reviewed journals and presented at relevant scientific seminars and conferences. Ethical approval is not applicable.PROSPERO registration numberCRD42021260751.

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Effects of sedentary behaviour interventions on biomarkers of cardiometabolic risk in adults: systematic review with meta-analyses

British Journal of Sports Medicine ◽

10.1136/bjsports-2019-101154 ◽

2020 ◽

pp. bjsports-2019-101154 ◽

Cited By ~ 6

Author(s):

Nyssa T Hadgraft ◽

Elisabeth Winkler ◽

Rachel E Climie ◽

Megan S Grace ◽

Lorena Romero ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Blood Pressure ◽

Sedentary Behaviour ◽

Vascular Function ◽

Cardiometabolic Risk ◽

Evidence Base ◽

Fat Free Mass ◽

Percentage Body Fat ◽

Meta Analyses

Context/purposeObservational and acute laboratory intervention research has shown that excessive sedentary time is associated adversely with cardiometabolic biomarkers. This systematic review with meta-analyses synthesises results from free living interventions targeting reductions in sedentary behaviour alone or combined with increases in physical activity.MethodsSix electronic databases were searched up to August 2019 for sedentary behaviour interventions in adults lasting for ≥7 days publishing cardiometabolic biomarker outcomes covering body anthropometry, blood pressure, glucose and lipid metabolism, and inflammation (54 studies). The pooled effectiveness of intervention net of control on 15 biomarker outcomes was evaluated using random effects meta-analyses in the studies with control groups not providing other relevant interventions (33 studies; 6–25 interventions analysed).ResultsInterventions between 2 weeks and <6 months in non-clinical populations from North America, Europe and Australia comprised much of the evidence base. Pooled effects revealed small, significant (p<0.05) beneficial effects on weight (≈ −0.6 kg), waist circumference (≈ −0.7 cm), percentage body fat (≈ −0.3 %), systolic blood pressure (≈ −1.1 mm Hg), insulin (≈ −1.4 pM) and high-density lipoprotein cholesterol (≈ 0.04 mM). Pooled effects on the other biomarkers (p>0.05) were also small, and beneficial in direction except for fat-free mass (≈ 0.0 kg). Heterogeneity ranged widely (I2=0.0–72.9).ConclusionsOur review of interventions targeting sedentary behaviour reductions alone, or combined with increases in physical activity, found evidence of effectiveness for improving some cardiometabolic risk biomarkers to a small degree. There was insufficient evidence to evaluate inflammation or vascular function. Key limitations to the underlying evidence base include a paucity of high-quality studies, interventions lasting for ≥12 months, sensitive biomarkers and clinical study populations (eg, type 2 diabetes).PROSPERO trial registration numberCRD42016041742

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Auricular Acupressure in Patients with Hypertension and Insomnia: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/7279486 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Zhi-Hui Zhao ◽

Yi Zhou ◽

Wei-Hong Li ◽

Zhao-Hui Tang ◽

Ting-Wei Xia ◽

...

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Chinese Medicine ◽

Traditional Chinese Medicine ◽

Comparison Group ◽

Controlled Trials ◽

Efficacy Rate ◽

Randomized Controlled ◽

Auricular Acupressure ◽

Meta Analyses

Objective. The efficacy of auricular acupressure in patients with hypertension and insomnia is controversial. This systematic review aims to explore the effectiveness of auricular acupressure in reducing blood pressure and improving sleep in this population. Methods. We conducted an extensive database search in Cochrane Central Register of Controlled Trials, PubMed, Ovid LWW, Web of Science, Chinese Biomedical Literature Database, China Knowledge Resource Integrated Database, Wanfang Data, and China Science and Technology Journal Database on randomized controlled trials published from inception to November 2019 that compared auricular acupressure with a control or comparison group on blood pressure control and sleep improvement. Two reviewers independently conducted data screening and extraction. Study quality was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analyses were performed on blood pressure, Pittsburgh Sleep Quality Index (PSQI), the efficacy rate of diagnostic and therapeutic criteria for traditional Chinese medicine syndromes (DTCTCMS), and the efficacy rate of guidelines for traditional Chinese medicine (new drug) clinical research (GTCMCR) by Revman 5.3.0. Results. A total of 18 randomized controlled trials with 1685 patients were identified. Compared with a control or comparison group, pooled meta-analyses showed that auricular acupressure significantly improved systolic blood pressure (MD = −15.05, 95% CI (−18.49, −11.61), P<0.00001), diastolic blood pressure (MD = −8.41, 95% CI (−11.33, −5.48), P<0.00001), PSQI (MD = −2.37, 95% CI (−4.64, −0.10), P=0.04), the efficacy rate of DTCTCMS (RR = 1.63, 95% CI (1.16, 2.28), P=0.004), and the efficacy rate of GTCMCR (RR = 1.25, 95% CI (1.12, 1.38)). Conclusions. The results demonstrated a favorable effect of auricular acupressure to reduce blood pressure and improve sleep in patients with hypertension and insomnia. Further studies to better understand the acupoints and intervention times of auricular acupressure are warranted.

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Depression and Objectively Measured Physical Activity: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103738 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3738 ◽

Cited By ~ 2

Author(s):

Vincenza Gianfredi ◽

Lorenzo Blandi ◽

Stefano Cacitti ◽

Mirko Minelli ◽

Carlo Signorelli ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Meta Analysis ◽

Cochrane Collaboration ◽

Protective Role ◽

Cochrane Library ◽

P Value ◽

Meta Analyses ◽

The Cochrane Collaboration ◽

Objectively Measured

Depression is a major contributor to the overall global burden of disease, with high prevalence and relapse rate. Several factors have been considered in order to reduce the depression burden. Among them, physical activity (PA) showed a potential protective role. However, evidence is contrasting probably because of the differences in PA measurement. The aim of this systematic review with meta-analysis is to assess the association between objectively measured PA and incident and prevalent depression. The systematic review was conducted according to methods recommended by the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant papers published through 31 August 2019 were identified searching through the electronic databases PubMed/MEDLINE, Excerpta Medica dataBASE (Embase), PsycINFO, Scopus, Web of Science (WoS), and the Cochrane Library. All analyses were conducted using ProMeta3. Finally, 42 studies met inclusion criteria. The overall Effect size (ES) of depression for the highest vs. the lowest level of PA was −1.16 [(95% CI = −1.41; −0.91), p-value < 0.001] based on 37,408 participants. The results of the meta-analysis showed a potential protective effect of PA on prevalent and incident depression.

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