scholarly journals Acute and Long-Term Effects of Attentional Focus Strategies on Muscular Strength: A Meta-Analysis

Sports ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 153
Author(s):  
Jozo Grgic ◽  
Ivan Mikulic ◽  
Pavle Mikulic

This review aimed to perform a meta-analysis examining the following: (a) acute effects of adopting an internal focus vs. external focus of attention on muscular strength; and (b) long-term effects of adopting an internal focus vs. external focus of attention during resistance training on gains in muscular strength. We searched through five databases to find eligible studies. Random-effects meta-analyses of standardized mean differences were conducted to analyze the data. Ten studies were included. In the meta-analysis for the acute effects, there was a significant positive effect of external focus on muscular strength (standardized mean difference: 0.34; 95% confidence interval: 0.22, 0.46). In the meta-analysis for the long-term effects, there was no significant difference between training with an internal focus and external focus on muscular strength gains (standardized mean difference: 0.32; 95% confidence interval: –0.08, 0.73). In the subgroup analysis for lower-body exercises, we found a significant positive effect of training with an external focus on muscular strength gains (standardized mean difference: 0.47; 95% confidence interval: 0.07, 0.87). In summary, our findings indicate an acute increase in muscular strength when utilizing an external focus of attention. When applied over the long-term, using an external focus of attention may also enhance resistance training-induced gains in lower-body muscular strength.

2020 ◽  
Vol 44 (5) ◽  
pp. 341-354
Author(s):  
Saeed Shahabi ◽  
Kamran Bagheri Lankarani ◽  
Seyed Taghi Heydari ◽  
Maryam Jalali ◽  
Sulmaz Ghahramani ◽  
...  

Background: Lateral elbow tendinopathy, also known as “tennis elbow” or “lateral epicondylitis,” is a common disease leading to pain in the lateral side of the elbow and disability during hand gripping. A counterforce brace is one of the most conventional treatments. However, its effects on outcomes remain inconclusive. Objectives: To investigate the effects of counterforce braces on pain in subjects with lateral elbow tendinopathy. Grip strength was reviewed as a secondary outcome. Study design: Systematic review and meta-analysis of randomized controlled trials. Methods: PubMed, Embase, Scopus, Web of Science, CENTRAL, PEDro, ProQuest, RECAL, and RehabData were searched from January 1, 1995, through June 15, 2019. Results: Seventeen studies were included with a total of 1145 participants. A small improvement in pain over the short term (standardized mean difference −0.02; 95% confidence interval: −0.85 to 0.80) and a moderate-to-large improvement in pain in subjects 45 years or younger (standardized mean difference −0.86; 95% confidence interval: −2.45 to 0.72) in favor of the brace versus physiotherapy interventions were found. In contrast, over the long-term physiotherapy interventions (standardized mean difference 1.17; 95% confidence interval: −0.00 to 2.34), wrist splint (standardized mean difference 0.35; 95% confidence interval: −0.07 to 0.76), and laser therapy (standardized mean difference 0.58; 95% confidence interval: −0.44 to 1.59) had better effects on pain improvement versus the brace. Conclusion: The results indicated that physiotherapy interventions compared to counterforce braces have better effects, especially over the long-term. However, counterforce braces may have better effects on pain in younger people (<45 years old) over the short term (<6 weeks). Clinical relevance The results suggest that counterforce bracing is a reasonable strategy to alleviate pain over the short term. However, the subgroup analysis suggests that factors such as age may have a role in their effectiveness.


2019 ◽  
Vol 7 ◽  
pp. 205031211983111 ◽  
Author(s):  
Jaqueline Santos Silva Lopes ◽  
Aryane Flauzino Machado ◽  
Jéssica Kirsch Micheletti ◽  
Aline Castilho de Almeida ◽  
Allysiê Priscila Cavina ◽  
...  

Given the practicality and low cost of using elastic resistance in training for different populations and its effectiveness in a range of outcomes, a comparison with conventional devices could clarify and quantify the benefits provided by both mode. To compare the effects of resistance training with elastic devices (tubes and Thera-Bands) and conventional devices (weight machines and dumbbells) on the outcome muscular strength. A search was performed in the databases PubMed/MEDLINE, EMBASE, PEDro (Physiotherapy Evidence Database), and CENTRAL (Cochrane Central Register of Controlled Trials) from the earliest records up to 20 December 2017. Data were pooled into a meta-analysis and described as standardized mean difference with a 95% confidence interval (registration number: CRD42016042152). Eight studies were included. The results of the meta-analysis demonstrated no superiority between the methods analyzed for upper limb (standardized mean difference = −0.011; 95% confidence interval = −0.40, 0.19; p = 0.48) or lower limb muscular strength (standardized mean difference = 0.09; 95% confidence interval = −0.18, 0.35; p = 0.52). Elastic resistance training is able to promote similar strength gains to conventional resistance training, in different population profiles and using diverse protocols.


2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Bi-huan Xiao ◽  
Meihui Shi ◽  
Hongqiang Chen ◽  
Shaoshan Cui ◽  
Yan Wu ◽  
...  

Abnormality of glutathione peroxidase (GPx) is involved in the etiology and pathogenesis of vitiligo. However, the results were controversial.Aim. The purpose of this meta-analysis is to compare the levels of GPx between vitiligo patients and healthy controls.Methods.Relevant published articles were searched according to eligibility criteria. A meta-analysis was conducted to pool estimates of the standardized mean difference (SMD) with 95% confidence interval (CI).Results.Twenty-three studies with a total of 1076 vitiligo patients and 770 healthy controls were included. The pooled meta-analysis showed that patients with vitiligo had equivalent levels of GPx with the healthy controls (SMD = −0.47, 95% CI: −1.03 to 0.08, andp=0.095). Further subgroup analysis showed that the GPx levels of Asian patients or segmental vitiligo patients were, respectively, lower than those of healthy controls (Asian: SMD = −0.47, 95% CI: −1.08 to 0.14, andp=0.001; segmental: SMD = −3.59, 95% CI: −6.38 to −0.80, andp=0.012). Furthermore, the GPx levels in serum/plasma were significantly decreased in either stable or active vitiligo patients, comparing to healthy controls (stable: SMD = −2.01, 95% CI: −3.52 to −0.49, andp=0.009; active: SMD = −2.34, 95% CI: −4.07 to −0.61, andp=0.008).Conclusion. This meta-analysis showed a significant association between low GPx level and vitiligo.


Author(s):  
Haifeng Shen ◽  
Xin Wang ◽  
Yuntao Nie ◽  
Kai Zhang ◽  
Zihan Wei ◽  
...  

Abstract   OBJECTIVES The study aimed to compare the long-term oncological efficacy and perioperative outcomes of patients with locally advanced non-small-cell lung cancers who underwent minimally invasive surgery (MIS) or thoracotomy. METHODS Cochrane Library, PubMed and EMBASE databases, ClinicalTrials.gov and reference lists were searched for relevant studies. Two reviewers independently assessed the quality of the studies. Recurrence-free survival (RFS) and overall survival (OS) and perioperative outcomes were synthesized. Random-effects models were used to summarize hazard ratios (HRs), relative risks and standardized mean differences (SMDs) with 95% confidence intervals (CIs). RESULTS Twenty-three retrospective cohort studies were reviewed with a total of 3281 patients, of whom 1376 (41.9%) received MIS and 1905 (58.1%) received thoracotomy. Meta-analysis showed no significant differences in both RFS (HR, 1.02; 95% CI, 0.89–1.17; P = 0.78) and OS (HR, 0.91; 95% CI, 0.80–1.03; P = 0.15) between MIS versus thoracotomy approaches. Similar results were observed in propensity score matched studies (RFS, HR, 0.94; 95% CI, 0.73–1.20; P = 0.62; OS, HR, 0.96; 95% CI, 0.72–1.30; P = 0.81). No significant difference was found in lymph node clearance and margin positivity. As for perioperative outcomes, MIS was associated with a significant reduction in postoperative complications (relative risk, 0.83; P = 0.01), intraoperative blood loss (standardized mean difference, −0.68; P = 0.007), chest tube drainage (standardized mean difference, −0.38; P = 0.03) and length of hospital stay (standardized mean difference, −0.79; P = 0.002) when compared with thoracotomy. CONCLUSIONS The use of MIS for resectable stage II and III non-small-cell lung cancers is an eligible alternative to conventional thoracotomy without compromising the long-term survival and short-term outcomes.


2021 ◽  
pp. 1357633X2110477
Author(s):  
Ita Daryanti Saragih ◽  
Santo Imanuel Tonapa ◽  
Carolyn M. Porta ◽  
Bih-O Lee

Introduction Telehealth interventions to advance adolescent sexual health have evolved and are being used to promote adolescent sexual health knowledge and healthy sexual behaviors. However, as this area of intervention modality expands, there is a need to pause and examine the effects of telehealth interventions on adolescent sexual health outcomes. Addressing this knowledge gap will inform researchers and practitioners on the current state of evidence of telehealth interventions and inform further intervention development and testing. This study aimed to explore the meta-effects of telehealth interventions on self-efficacy of using condoms, condom use practices, and sexually transmitted infection testing behaviors among adolescents. Methods A systematic review and meta-analysis of randomized controlled trials were conducted. Seven databases (Academic Search Complete, CINAHL, EMBASE, MEDLINE, PubMed, OVID (UpToDate), and Web of Science) were searched for relevant full-text articles from the inception to May 2021. The revised Cochrane risk-of-bias tool for randomized trials was used to assess the methodological quality of the included studies. A meta-analysis was performed using a random effects model to calculate the pooled effects of telehealth interventions for adolescents. Stata 16.0 was used for statistical analysis. Results A total of 15 studies ( N = 5499) that used telehealth interventions with adolescents were included in the analysis. Telehealth interventions were found to increase self-efficacy for condom use (standardized mean difference: 0.22; 95% confidence interval: 0.08–0.36), practice for condom use (standardized mean difference: 0.35; 95% confidence interval: 0.23–0.47), and being screened/tested for sexual transmitted infections (standardized mean difference: 0.61; 95% confidence interval: 0.31–0.92). Discussion Telehealth interventions show promise as effective intervention delivery solutions for improving self-efficacy and certain sexual health behaviors among adolescents. These telehealth strategies could be important alternatives to in-person visits to accessing sexual health information or services near where they live. Future research should consider testing telehealth strategies where there is evidence of impact to move the field forward.


2018 ◽  
Vol 6 ◽  
pp. 205031211880761 ◽  
Author(s):  
Michael Zhang ◽  
David F Jativa

Background: Low plasma levels of vitamin C are associated with adverse outcomes, including increased mortality, in critically ill patients. Several trials have suggested that the administration of intravenous vitamin C in this setting may have beneficial effects, such as reducing the incidence of organ failure and improving survival. However, these studies have generally involved combination therapies consisting of vitamin C along with other antioxidants, confounding the effects of vitamin C alone. The primary objective of this meta-analysis is to investigate the effects of isolated intravenous supplementation of vitamin C in adults with critical illness. Methods: A database search was conducted for studies on the use of intravenous vitamin C in adult patients with critical illness. The primary outcome assessed was mortality at the longest follow-up time available. Secondary outcomes were the duration of mechanical ventilation, duration of vasopressor support, fluid requirements, and urine output in the first 24 h of intensive care unit admission. Results: Five studies (four randomized controlled trials and one retrospective review) enrolling a total of 142 patients were included in this meta-analysis. Compared with controls, the administration of intravenous vitamin C was associated with a decreased need for vasopressor support (standardized mean difference −0.71; 95% confidence interval (−1.16 to −0.26); p = 0.002) and decreased duration of mechanical ventilation (standardized mean difference −0.5; 95% confidence interval (−0.93 to −0.06); p = 0.03), but no difference was found in mortality (odds ratio 0.76; 95% confidence interval (0.27 to 2.16); p = 0.6). Trends were also noted toward decreased fluid requirements and increased urine output. No adverse effects were reported. Conclusion: The administration of intravenous vitamin C may lead to vasopressor sparing effects and a reduced need for mechanical ventilation in the critically ill, without affecting overall mortality. However, these results should be interpreted in light of the limitations of the primary literature and should serve as a preview of upcoming trials in this area.


2017 ◽  
Vol 24 (8) ◽  
pp. 527-539 ◽  
Author(s):  
Dina M Sztein ◽  
Charles E Koransky ◽  
Leah Fegan ◽  
Seth Himelhoch

Introduction Cognitive behavioural therapy has been shown to improve depressive symptoms in adults with mild to moderate depression. To overcome many of the barriers associated with delivering this treatment, attempts have been made to deliver cognitive behavioural therapy via the Internet. The objective of this meta-analysis is to assess whether Internet-based cognitive behavioural therapy delivered to adults with depressive symptoms leads to a reduction in these symptoms as compared to those who receive no therapy. Methods In September 2015, the Cochrane, PubMed and PsycInfo databases were searched; studies were also found through bibliography searches. Studies were included if they were randomized controlled trials published in English between 2005–2015 conducted with adults >18 years of age experiencing mild to moderate depression where study subjects received Internet-based cognitive behavioural therapy, and the control group was placed on a wait-list. The search yielded 257 articles; 14 of these were included in the meta-analysis. Results Internet delivered cognitive behavioural therapy had a medium effect on reducing depressive symptoms at the end of the study period (standardized mean difference: 0.74, confidence interval: 0.62–0.86, p < 0.001). Internet-delivered cognitive behavioural therapy also has a large sustained effect in maintaining reduction of depressive symptoms in follow-up measures done 3–6 months after the conclusion of the therapy (standardized mean difference: 0.83, confidence interval: 0.69–0.99, p < 0.001). There was no publication bias and low heterogeneity. Discussion Cognitive behavioural therapy delivered over the Internet leads to immediate and sustained reduction in depressive symptoms; thus, it may be a good treatment modality for individuals unable or unwilling to access traditional face-to-face therapy.


Author(s):  
Bobby Yanagawa ◽  
Derrick Y. Tam ◽  
Kathryn Hong ◽  
Amine Mazine ◽  
Akshay Bagai ◽  
...  

Objective This meta-analysis compares the early echocardiographic outcomes of aortic valve replacement using the two most commonly implanted stented bioprostheses. Methods We searched MEDLINE and EMBASE databases until 2017 for studies comparing Magna or Magna Ease (Edwards Lifesciences, Irvine, CA USA) versus Trifecta (St Jude Medical, St. Paul, MN USA) aortic bioprosthetic valves. A random-effects meta-analysis was performed for the primary outcome of mean gradient on echocardiography and secondary outcomes of effective orifice area, indexed effective orifice area, and in-hospital mortality. Results There were two randomized controlled trial, three matched, and six unmatched retrospective observational studies with 2119 patients [median reported follow-up = 6 months (interquartile range = 6 to 12)]. The Magna/Magna Ease valve was associated with higher early mean gradient (mean difference = 4.09, 95% confidence interval = 3.48 to 4.69, P < 0.0001) and smaller effective orifice area (mean difference = 0.30, 95% confidence interval = −0.38 to −0.22, P < 0.0001). There were no differences in 30-day mortality between Magna/Magna Ease and Trifecta (relative risk = 1.01, 95% confidence interval = 0.41 to 2.50, P = 1.0). Conclusions Trifecta may offer a small hemodynamic advantage compared with the Magna/Magna Ease valve with no differences in early mortality. Long-term follow-up is required to determine whether these differences persist and translate into differences in clinical outcomes.


Author(s):  
Jozo Grgic ◽  
Pavle Mikulic

Several studies explored the effects of attentional focus on resistance exercise, but their analysed outcomes most commonly involved surface electromyography variables. Therefore, the effects of attentional focus on resistance exercise performance remain unclear. The aim of this review was to perform a meta-analysis examining the acute effects of external focus vs. internal focus vs. control on muscular endurance. Five databases were searched to find relevant studies. The data were pooled in a random-effects meta-analysis. In the analysis for external vs. internal focus of attention, there were seven comparisons with 14 study groups. In the analyses for external focus vs. control and internal focus vs. control, there were six comparisons with 12 study groups. An external focus of attention enhanced muscular endurance when compared with an internal focus (Cohen’s d: 0.58; 95% confidence interval (CI): 0.34 and 0.82) and control (Cohen’s d: 0.42; 95% CI: 0.08 and 0.76). In the analysis for internal focus vs. control, there was no significant difference between the conditions (Cohen’s d: –0.19; 95% CI: –0.45 and 0.07). Generally, these results remained consistent in the subgroup analyses for upper-body vs. lower-body exercises. From a practical perspective, the results presented in this review suggest that individuals should use an external focus of attention for acute enhancement of muscular endurance.


2018 ◽  
Vol 88 (4) ◽  
pp. 483-493 ◽  
Author(s):  
Igor Felipe Pereira Lima ◽  
Walbert de Andrade Vieira ◽  
Ítalo de Macedo Bernardino ◽  
Pedro Augusto Costa ◽  
Anderson Paulo Barbosa Lima ◽  
...  

ABSTRACT Objective: To assess the scientific evidence regarding the influence of reminder therapy on plaque index, gingival index, and white spots in patients subjected to orthodontic treatment. Materials and Methods: Randomized clinical trials were searched in the electronic databases LILACS, PubMed, SciELO, Scopus, Web of Science, Embase, LIVIVO, and Cochrane Library. The databases OpenThesis and OpenGrey were used to capture the “gray literature,” preventing selection and publication biases. The risk of bias was assessed by the Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials tool. The software Review Manager was used for the meta-analysis. The heterogeneity among studies was assessed through the I2 statistic. A summary of the overall strength of evidence available was assessed using the Grades of Recommendations Assessment, Development, and Evaluation tool. Results: A total of 332 records were found, from which only 7 articles met the inclusion criteria and were subjected to analysis. Reminder therapy showed improved scores for the plaque index (standardized mean difference = −1.22; 95% confidence interval = −2.03 to −0.42; P = .003) and the gingival index (standardized mean difference = 1.49; 95% confidence interval = −2.61 to 0.37; P = .009). Moreover, there was lower occurrence of white spots (relative risk = 0.53; 95% confidence interval = 0.38 to 0.74; P &lt; .001) when reminder therapy was implemented. Conclusions: According to the existing high-quality evidence, reminder therapy is a valuable strategy and may contribute to the reduction of plaque and gingival indices as well as to the lower occurrence of white spots in patients subjected to orthodontic treatment.


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