Exercise Prescription Research Articles

Influencing Factors and Implementation Pathways of Adherence Behavior in Intelligent Personalized Exercise Prescription: Qualitative Study.

Personalized intelligent exercise prescriptions have demonstrated significant benefits in increasing physical activity and improving individual health. However, the health benefits of these prescriptions depend on long-term adherence. Therefore, it is essential to analyze the factors influencing adherence to personalized intelligent exercise prescriptions and explore the intrinsic relationship between individual behavioral motivation and adherence. This understanding can help improve adherence and maximize the effectiveness of such prescriptions. This study aims to identify the factors influencing adherence behavior among middle-aged and older community residents who have been prescribed personalized exercise regimens through an electronic health promotion system. It also explores how these factors affect the initiation and maintenance of adherence behavior. We used purposive sampling to conduct individual, face-to-face semistructured interviews based on the Transtheoretical Model (TTM) with 12 middle-aged and older community residents who had been following personalized exercise regimens for 8 months. These residents had received detailed exercise health education and guidance from staff. The interviews were recorded, transcribed verbatim, and analyzed using NVivo software through grounded theory. We then applied the TTM and multibehavioral motivation theory to analyze the factors influencing adherence. Additionally, the relationship between behavioral motivations and adherence was explored. Using the behavior change stages of the TTM, open coding yielded 21 initial categories, which were then organized into 8 main categories through axial coding: intrinsic motivation, extrinsic motivation, benefit motivation, pleasure motivation, achievement motivation, perceived barriers, self-regulation, and optimization strategies. Selective coding further condensed these 8 main categories into 3 core categories: "multitheory motivation," "obstacle factors," and "solution strategies." Using the coding results, a 3-level model of factors influencing adherence to intelligent personalized exercise prescriptions was developed. Based on this, an implementation path for promoting adherence to intelligent personalized exercise prescriptions was proposed by integrating the model with the TTM. Adherence to personalized exercise prescriptions is influenced by both facilitating factors (eg, multibehavioral motivation, optimization strategies) and obstructive factors (eg, perceived barriers). Achieving and maintaining adherence is a gradual process, shaped by a range of motivations and factors. Personalized solutions, long-term support, feedback mechanisms, and social support networks are essential for promoting adherence. Future efforts should focus on enhancing adherence by strengthening multibehavioral motivation, optimizing solutions, and addressing barriers to improve overall adherence.

Influence of Fitness Exercise Recommendations on College Athletes' Mental Health

At present, there are problems in teaching and teachers in colleges and universities, and college physical education and health care students do not get effective exercise, and their physical fitness indexes have decreased and mental health problems have appeared. In this paper, the effect of fitness exercise prescription on the mental health of college physical education students is the research goal, and the purpose and requirements of exercise for the students are analyzed by using questionnaires and experimental research. The effect of different exercise prescriptions on the mental health of physical education and health care students was studied. The results showed that fitness exercise prescriptions had positive effects on the mental health, physical health and hobbies of college physical education and health care students. This study provides theoretical data to support the influence of fitness exercise prescription on the mental health of college physical education and health care students.

The impact of diet and physical activity on the management of Type 1 diabetes mellitus in children

Nutritionists suggest that people with type 1 diabetes mellitus (T1DM) should engage in physical activity in conjunction with healthy diet habits. This study was designed to determine the effect of diet and physical activity on the course of T1DM in children aged 8 to 15 years. Young T1DM patients were enrolled in this quasi-experimental descriptive study at the Sebdou and Maghnia hospitals (wilaya of Tlemcen – north-west Algeria), from December 2018 to March 2019. The study was based on a questionnaire and the prescription of dietary measures and physical exercises. Anthropometric (BMI) and biological parameters (glycaemia, HbA1c) were measured at baseline and at three months of follow up. Comparison tests were performed using statistical software at a significance level of p < 0.05. Thirty T1DM patients were recruited. The sex-ratio was 0.76 and the average age 12.83 ± 1.98 years. BMI, which was 22.36 ± 5.16 kg/m2 at baseline, was improved to 21.72 ± 3.71 kg/m2 after experimentation. Glycated hemoglobin and glycaemia levels also decreased from 9.02 ± 0.80 % and 1.51 ± 1.007 g/L, respectively, at baseline to 7.72 ± 1.01 % and 1.57 ± 0.41 g/L, respectively, at the end of the experimentation. Drug treatment combined with a healthy lifestyle and regular monitoring of biological parameters; improve the quality of life of diabetic children.

Effect of Exercise Intervention on Chemotherapy-Induced Peripheral Neuropathy Symptoms in Cancer Patients: A Meta-analysis.

Exercise has been widely used to improve chemotherapy-induced peripheral neuropathy symptoms in cancer patients in recent years; however, there is insufficient evidence to support the effectiveness of exercise intervention in cancer patients. This review aims to comprehensively evaluate the effectiveness of exercise intervention in the management of chemotherapy-induced peripheral neuropathy symptoms in cancer patients and to explore effective exercise intervention characteristics by comparing the effects of different exercise prescriptions. Ten databases were systematically searched from published up to May 2024. The studies that met the inclusion criteria were included. The risk of bias was assessed using the Cochrane Collaboration tool. The statistical analyses were performed in Stata 17.0. A total of 21 studies with 775 participants were included. The pooled results showed that exercise significantly reduced the severity of chemotherapy-induced peripheral neuropathy symptoms; relieved neuropathic pain; enhanced balance function, muscle strength, physical flexibility, and physical endurance; and improved the quality of life of cancer patients with chemotherapy-induced peripheral neuropathy, both compared with patients in the usual care group and with patients' baseline symptoms before exercise. However, no significant improvement in fear of falling was observed. Exercise is an effective way of managing chemotherapy-induced peripheral neuropathy symptoms. The patient's age, exercise cycles, and frequency can affect the effect of the intervention. Oncology nurses can significantly manage chemotherapy-induced peripheral neuropathy symptoms in cancer patients through exercise intervention. Further research is necessary to explore the most suitable characteristics of exercise intervention to achieve optimal intervention effectiveness.

A Practice Guide for Physical Therapists Prescribing Physical Exercise for Older Adults.

Physical activity and exercise are protective factors for physical and cognitive decline in older adults, but recent studies reveal that a large percentage of this population do not practice exercise at the levels recommended by international guidelines. The frequency, intensity, type, time, volume, and progression (FITT-VP) principles are a widely used method for prescribing physical exercise, allowing the development of a personalized exercise program that meets the needs of each individual. This masterclass is intended to serve as a professional application tool for physical therapists who prescribe physical exercise for older adults. We present a section for each FITT-VP principle to facilitate handling these principles individually when prescribing exercise for this population. Review of the scientific literature and international guidelines on the prescription of physical exercises for older adults. Aerobic, mobility, resistance, balance, and flexibility exercises, as well as functional training, should be included in an exercise program for older adults, which should be progressed using different methods for each of the exercise modalities. An exercise program for older adults should integrate different exercise modalities. Exercise progression should be performed following the FITT-VP principles and some specific progression factors recommended for each exercise modality. Considering the challenge faced by clinicians in designing a viable exercise program for older adults that responds to international recommendations, with this masterclass we hope to help physical therapists to plan an exercise program that is feasible and at the same time, responds to the expected needs of this population.

Cadence-based energy expenditure in able-bodied male people comparing cadence-based energy expenditure and oxygen cost indices in able-bodied male people.

Walking is a fundamental aspect of daily life and exercise, with clinical benefits for cardiovascular health and muscle strength. However, accurately measuring energy efficiency during walking poses challenges due to equipment and spatial constraints. In this study, we proposed the cadence-based energy expenditure index (cEEI) and analyzed its correlation with the previously proposed index for measuring energy expenditure under various gait conditions. We enrolled 15 healthy participants and conducted an experimental protocol on a treadmill to measure the following energy expenditure-related indices: oxygen cost index (OCI), energy expenditure index (EEI), and cEEI. The participants underwent stages of walking at different speeds and inclinations that comply with the modified Bruce protocol, whereas their heart rate, oxygen uptake, and cadence were recorded. Participants showed significant increases in heart rate, oxygen uptake, and cadence with higher walking speeds and inclinations. Correlation analysis revealed strong associations between cEEI and OCI, especially during walking conditions. Bland-Altman plots and interclass correlation coefficient analysis demonstrated a favorable agreement between cEEI and OCI, outperforming EEI. In conclusion, this study proposes cEEI as a reliable metric for estimating energy expenditure during walking by proving a strong correlation and agreement with OCI across various gait conditions. This suggests the potential for cEEI to provide real-time, individualized feedback on energy expenditure during walking, facilitating more personalized exercise prescriptions.NEW & NOTEWORTHY We proposed cEEI as a reliable metric for estimating energy expenditure under various walking conditions. Its demonstrated accuracy and potential for real-time individualized feedback could revolutionize personalized exercise prescriptions for diverse sexes and age groups, as well as individuals with disabilities requiring real-time physical monitoring and home care.

A Multicenter Home-based Prehabilitation Intervention in Kidney Transplant Candidates.

Frailty is a modifiable risk factor for morbidity and mortality among kidney transplant (KT) candidates. We previously demonstrated that an 8-wk center-based exercise intervention is associated with improved frailty parameters in patients with advanced chronic kidney disease. This study aimed to adapt the intervention for home-based delivery and examine its feasibility, safety, and acceptability in a multicenter cohort of KT candidates. We conducted a prospective pilot study between January 2021 and November 2023 involving KT candidates from Mayo Clinic in Minnesota and Baylor St. Luke's Medical Center in Texas. Adults approved for KT who were (1) frail or prefrail by the Physical Frailty Phenotype and/or (2) had a Short Physical Performance Battery score ≤10 were enrolled. The exercise intervention consisted of an individualized exercise prescription provided by a Mayo Clinic exercise physiologist followed by 8 weekly phone calls. Feasibility was assessed via retention rates, adverse events were recorded, and acceptability was assessed via survey. Baseline characteristics of the 15 enrolled participants included a median age of 64 y, 73.3% were men, and 73.3% were of White race. Sixty percent of participants completed the intervention. No unanticipated adverse events occurred. Most participants strongly agreed that the exercise intervention was beneficial to their overall health. This pilot study demonstrates that a home-based 8-wk exercise intervention is a promising prehabilitation strategy in KT candidates and provides important preliminary data for future larger, randomized studies.

Effect of Exercise-Based Cardiac Rehabilitation on Patients With Chronic Heart Failure After Transcatheter Aortic Valve Replacement: A Randomized Controlled Trial.

The objective of this study was to assess the effect of exercise-based cardiac rehabilitation (CR) with individualized exercise prescription in patients with chronic heart failure (HF) undergoing transcatheter aortic valve replacement (TAVR) in a randomized controlled trial. A total of 60 patients with chronic HF who received TAVR treatment were randomly divided into the control group (n=30) and exercise training (ET) group (n=30). The control group was treated with conventional rehabilitation, and the ET group was given personalized exercise-based CR based on a cardiopulmonary exercise test (CPX). The CPX parameters, echocardiography, 6-minute walk test distance, and quality of life were evaluated in the two groups. All patients who completed symptom-restricted CPX showed no complications. After the 12-week rehabilitation period, the levels of anaerobic threshold, peak oxygen uptake, peak oxygen pulse, peak power, left ventricular ejection fraction, and 6-minute walk test distance in the ET group were significantly higher than those in the control group (P<.05). Scores on the Minnesota Life with Heart Failure Questionnaire in the ET group were lower than those in the control group (P <.05). Exercise-based CR significantly improves cardiopulmonary function, exercise tolerance, and quality of life in patients with chronic HF who undergo TAVR.

High-Intensity Interval Training for Cancer Patients: A Review of Key Considerations for Exercise Prescription.

High-intensity interval training (HIIT) performed before, during, and after cancer treatment can attenuate the adverse effects induced by anti-cancer drugs. A clear presentation and rationale of characteristics of HIIT variables is vital to produce the expected HIIT adaptations in cancer patients. However, there are concerns regarding the HIIT protocols used in the cancer literature. The aims were to (1) identify the characteristics of HIIT and the formats that have been prescribed, (2) analyze which anchors have been utilized to prescribe effort and pause intensity, (3) examine characteristics of the physical tests used for HIIT prescription, and (4) identify potential adverse events related to HIIT intervention. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, including PubMed, Scopus, and Web of Science databases. A total of 51 studies were retrieved, and the following results were found: (1) Only 25 studies reported all four essential variables for HIIT prescription [effort intensity (effort duration): pause intensity (pause duration)]. Of these studies, 23 used active pause and employed the following prescription (on average): [84% (116s): 39% (118s)] when percentage of maximal aerobic power (MAP) [maximal/peak oxygen uptake ( O2max/peak)/MAP] was used; [124% (161s): 55% (142s)] when percentage of anaerobic threshold (AT) was used; [83% (230s): 62% (165s)] when maximal heart rate percentage (%HRmax) was used. From these 23 studies, 12 used O2max/peak/MAP (one of the most recommended variables for HIIT prescription). Seven studies adopted the HIIT-long format, and in the remaining five studies, the format was unclear. (2) Twenty-four studies used fractions of O2max/peak or mechanical variables like MAP as anchors for prescribing effort intensity, two studies used AT, 20 studies used fractions of HRmax/heart rate reserve, two studies used rate of perceived exertion (RPE), while one used RPE and % O2peak concomitantly, and two studies utilized RPE/%HRmax concomitantly. Two studies utilized passive resting, 12 studies used % O2peak/%MAP for prescribing pause intensity, four studies used AT, seven studies used %HRmax, one study used %HRmax/% O2peak, and two studies used absolute loads. (3) Ten studies did not report the characteristics of the physical tests employed, two studies used submaximal tests, and 39 studies utilized graded exercise tests. (4) Ten studies did not report if there were adverse events associated with the exercise program, while 34 studies did not report any adverse events. Only 50% of the studies provided all the necessary variables for accurate HIIT prescription, raising concerns about the replicability, comprehension, and effective application of HIIT in cancer patients. Most of the studies that reported all variables appeared to have employed the HIIT-long format. Only a few studies used more individualized anchors (e.g., AT) to prescribe HIIT-long format for cancer patients, which is considered a very heterogeneous population.

Identifying Preferences for Exercise and Sport in Australians With Mild Multiple Sclerosis: Looking Beyond Clinical Characteristics when Implementing Exercise Interventions.

Exercise is a salient component in delaying disability progression in multiple sclerosis (MS). This study considers personal preferences regarding exercise program prescription and the resources needed to facilitate exercise. Cross-sectional study. Community online, Australia. Adults with MS. Participants completed online questionnaires on current exercise and sport, and preferences toward exercise prescription variables, facilitative resource needs, and delivery method. We established preference responses for the entire sample, and separately, we used logistic regression and analysis of variance to compare preferences between participants stratified according to (1) geographical rurality (ie, metro vs rural and remote) and (2) current exercise engagement (ie, active, moderately active, and insufficiently active). Fifty people with a diagnosis of MS completed the survey. Participants had mild disability; most were metro-dwelling (74%) and physically active (58%). Preferences included a program of at least 6 months (70%), where exercise sessions are performed 5 d/wk (38%) at a moderate intensity (50%). Half (50%) of responders wanted to participate in sports for exercise. There was a significant difference in the preference toward higher-intensity exercise in active persons compared with inactive persons. Facilitative resources selected included a behavioral exercise coach (80%) who provides MS-specific information (46%) and behavioral change strategies (41%). Persons with mild MS are interested in participating in various exercises and sports. Encouraging participation will have long-term benefits. We recommend that HCPs and researchers consider individual social factors, in addition to patient symptoms and disability, when designing exercise programs for an Australian MS population.

Maximum Isometric Hip Adduction Squeeze and Abduction Press Strength Values in Men's Rugby Union Players at Select Timepoints Throughout a Competitive Season.

O' Connor, C, Mc Intyre, M, Delahunt, E, and Thorborg, K. Maximum isometric hip adduction squeeze and abduction press strength values in men's rugby union players at select timepoints throughout a competitive season. J Strength Cond Res XX(X): 000-000, 2024-The purpose of this research was to report hip adduction and abduction strength values in men's rugby union players at select timepoints throughout a competitive season and to examine if differences exist between time of season and hip-testing positions. This cross-sectional repeated measures study design consisted of 15 male rugby union players competing at senior club level. Maximum isometric hip adduction and abduction strength were measured using a ForceFrame in 3 testing positions at specific timepoints: start of preseason (T1), start of competitive season (T2), mid-season period 1 (T3), and mid-season period 2 (T4). At group level, hip adduction strength (N·kg-1) increased from T1 to T2 in all testing positions, with significant increases observed in the 0° hip-flexion short-lever position (p = 0.048), and 45° hip-flexion position (p = 0.032). No significant changes occurred in hip abduction strength (N·kg-1). Hip adduction:abduction strength ratio increased from T1 to T2, with a significant increase observed in the 0° hip-flexion short-lever position (p = 0.008). At individual level, large variations from baseline strength (N·kg-1) were observed between timepoints for hip adduction strength, abduction strength, and adduction:abduction strength ratio. In conclusion, the present study shows increases in hip adduction strength and hip adduction:abduction strength ratio from the start of preseason to the beginning of the competitive season, with no other significant changes in hip strength observed throughout the season. Individual and frequent hip strength monitoring throughout the season and a more individualized exercise prescription approach may be needed for rugby union players, in addition to a more generalized focus on improving adductor and abductor strength.

The impact of high-intensity interval training on insulin sensitivity and quality of life in women with overweight polycystic ovary syndrome

Background Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in women of reproductive age, characterized by menstrual irregularities, hyperandrogenism, and polycystic ovaries. Insulin resistance is central to its pathophysiology, contributing to metabolic disturbances and increased cardiometabolic risks. High-Intensity Interval Training (HIIT) has emerged as a promising intervention to improve metabolic health. Objective This study aimed to investigate the specific effects of HIIT on insulin sensitivity, body composition, metabolic profile, and quality of life in women with overweight PCOS. Methods A retrospective analysis was conducted on 107 female patients with overweight PCOS who were divided into two groups: the Regular Interval Training Group (n = 54) and the HIIT Group (n = 53). Baseline data, including insulin sensitivity, glucose metabolism, body composition, metabolic profile, and quality of life, were measured and compared between the two groups. Results The HIIT Group demonstrated significantly improved insulin sensitivity, reduced fasting glucose levels, lower HOMA-IR index, lower body fat percentage, decreased waist and hip circumferences, improved favorable changes in metabolic profile, and significant improvements in quality of life compared to the Regular Interval Training Group. These findings suggest that HIIT led to beneficial outcomes across various metabolic and clinical parameters in women with overweight PCOS. Conclusion The findings of this study highlight the potential of personalized exercise prescriptions, such as HIIT, in optimizing health outcomes in women with overweight PCOS. The observed improvements in insulin sensitivity, body composition, metabolic profile, and quality of life underscore the promising role of HIIT in addressing the multifaceted implications of PCOS and its associated metabolic and reproductive implications.

Summary of the best evidence for risk stratification of exercise rehabilitation in patients with a cardiac implantable electronic device.

Hierarchical management of sports risk is highly critical to ensure the safety of sports rehabilitation. Early identification, timely prevention and control of sports-related risk factors, and enhanced supervision and guidance can provide a basis for the formulation of sports programmes and the setting of sports monitoring levels. This study aimed to retrieve, evaluate, and integrate evidence for the stratified management of motor risk in patients with a cardiac implantable electronic device (CIED). We searched for evidence according to the "6S" model of evidence-based resources. CNKI, VIP, Wanfang Data, CBM, PubMed, Cochrane Iibrary, CINAHL, EMbase, Web of Science, BMJ Best Practice, Up To Date, and International Guidelines Collaboration Network were searched from inception to February 2024. To search for evidence on stratified management of motor risk in patients with CIEDs, this research includes guidelines, systematic reviews, meta-analyses, expert consensus, clinical decision-making, and randomized controlled trials. After methodological quality evaluation, the evidence was extracted and summarized accordingly. According to the inclusion and exclusion criteria, 16 pieces of evidence were screened, including 5 guidelines, 1 clinical decision-making, 5 systematic reviews, 4 expert consensus, and 1 randomized controlled trial. After reading, extracting, and categorizing, 34 pieces of evidence in 4 areas were identified, namely, screening and assessment of exercise risk in CIEDs, exercise monitoring, implementation of exercise prescriptions, and prevention and management of exercise-related risks. This study provides the best evidence for the prevention and management of exercise risk in patients with CIEDs, clarifies the role of nurses in evaluating, monitoring, and educating patients undergoing motor rehabilitation, and provides a basis for the formulation of clinically feasible rehabilitation programs. PROSPERO, identifier (CRD2024509622).

Understanding factors influencing exercise program adherence for youth with persistent post-concussive symptoms (PPCS)

ABSTRACT Background A significant portion of youth sustain a concussion every year, with around 30% experiencing persistent post-concussion symptoms (PPCS). Research has shown exercising just below the exertion level that provokes symptoms can lead to more rapid recovery. However, youth often struggle to adhere to exercise recommendations following concussion. Methods We conducted structured qualitative interviews (n = 32) with concussed youth and their parents to examine factors influencing motivation to engage in exercise post-concussion. Questions were framed through the lens of Self-Determination Theory (SDT) and Thematic Analysis was used to code and analyze transcripts. Results Four primary factors appeared to motivate youth to exercise after receiving a concussion: 1) social support, 2) accountability, 3) goal setting, and 4) structure. Utilizing the lens of SDT, one could theorize that including social support and accountability helped fulfill the need of relatedness, setting goals helped fulfill the need of autonomy, and providing program structure helped fulfill the need for competence. Conclusions Our results suggest that Self-Determination Theory may be a useful frame for examining exercise adherence post-concussion. Incorporating social support, accountability, goal setting and structure could increase the effectiveness of exercise prescription post-concussion and should be the focus of further study.

Chronotypical influence on eating behaviour and appetite control.

A person's chronotype reflects individual variability in diurnal rhythms for preferred timing of sleep and daily activities such as exercise and food intake. The aim of this review is to provide an overview of the evidence around the influence of chronotype on eating behaviour and appetite control, as well as our perspectives and suggestions for future research. Increasing evidence demonstrates that late chronotype is associated with adverse health outcomes. A late chronotype may exacerbate the influence of greater evening energy intake on overweight/obesity risk and curtail weight management efforts. Furthermore, late chronotypes tend to have worse diet quality, with greater intake of fast foods, caffeine, and alcohol and lower intake of fruits and vegetables. Late chronotype is also associated with eating behaviour traits that increase the susceptibility to overconsumption such as disinhibition, food cravings, and binge eating. Whether an individual's chronotype influences appetite in response to food intake and exercise is an area of recent interest that has largely been overlooked. Preliminary evidence suggests additive rather than interactive effects of chronotype and meal timing on appetite and food reward, but that hunger may decrease to a greater extent in response to morning exercise in early chronotypes and in response to evening exercise in late chronotypes. More studies examining the interplay between an individual's chronotype, food intake/exercise timing and sleep are required as this could be of importance to inform personalised dietary and exercise prescriptions to promote better appetite control and weight management outcomes.

Influence of Baduanjin on cardiopulmonary function in long-term practitioners and beginners.

Baduanjin, a traditional Chinese exercise for health enhancement and chronic disease prevention, has been practiced for millennia. However, studies on the exercise intensity of Baduanjin are limited. Most existing studies focus on its general health benefits rather than quantifying its specific intensity levels. This study aims to measure and compare the exercise intensity indices of long-term Baduanjin practitioners and beginners, providing insights into its mechanisms for disease prevention and treatment and supporting the scientific formulation of clinical exercise prescriptions. Twenty healthy adults aged 35-45 years old and the mean BMI was 24.45 were recruited and divided into a beginner group (A group, no prior practice, 10 participants) and a skilled group (B group, practice duration ≥3 years, 10 participants). The Italian Cosmed/K5 wireless portable cardiopulmonary testing system was used to measure indicators during the practice. Within-group analysis revealed statistically significant differences in oxygen consumption (VO2), oxygen consumption per kilogram of body weight (VO2/kg), metabolic equivalent (METs), heart rate (HR), oxygen pulse (VO2/HR), respiratory rate (RR), and minute ventilation (VE) between exercise and resting states in both the B and A groups (P < 0.001). In between-group comparisons, resting HR was significantly lower in the B group compared to the A group (P < 0.01). During Baduanjin practice, significant between-group differences were found in METs, HR (P < 0.01), and RR (P < 0.05), with the A group exhibiting higher values for METs, HR, and RR than the B group. Baduanjin positively impacts cardiovascular function and exercise performance, with long-term practitioners showing significantly better cardiovascular recovery and overall function.

Effect of different training modalities on lipid metabolism in patients with type ii diabetes mellitus: a network meta-analysis

Background/Aims This study to evaluate the effects of different training modalities on blood lipids in type II diabetic patients by Network Meta-analysis, and provide a relevant basis for patients to develop exercise prescriptions to regulate blood lipids. Methods Randomized controlled trials (RCTs) were retrieved from Zhiwang, Wanfang, Wipu, PubMed, EBSCO, Cochrane Library, and Web of Science that were published from the establishment to February 2023. Relevant statistical analyses were performed using Stata 17.0 software and Revman 5.4. Results A total of 35 randomized controlled trials with 2771 patients with type II diabetes were finally included. The results of Network Meta-analysis showed that, compared with the control group, Chinese traditional fitness exercise (CTF), resistance training (RT), and aerobic training (AT) could reduce total cholesterol (TC) levels; CTF, RT, whole body vibration training (WBV), and AT could reduce triacylglycerol (TG) levels; CTF, WBV and AT could increase High-density lipoprotein cholesterol (HDL) levels; CTF, RT and AT could reduce Low-density lipoprotein cholesterol (LDL) levels. SUCRA probability ranking results showed that CTF was the most effective in reducing TC[SMD= −0.57, 95% CI (−0.83, −0.31), p < 0.001], TG[SMD= −0.24, 95% CI (−0.36, −0.12), p < 0.001], LDL[SMD= −0.52, 95% CI (−0.70, −0.35), p < 0.001]; RT was the most effective in increasing HDL[SMD = 0.14, 95% CI (0.03, 0.26), p < 0.05]. Conclusions CTF is more effective in improving TC, TG and LDL levels, while RT is most effective in improving HDL levels.

Time taken to reach treatment for eating disorders in New Zealand.

The significant cost burden of eating disorders (EDs) could be lessened with quicker access to treatment. Little is known about the time it takes to reach treatment. We aimed to examine the time to access treatment in New Zealand. 468 respondents of the Costs of Eating Disorders online survey provided data including demographics; diagnoses; treatment journey, length of time to seek help; time to diagnosis after seeking help; GP referral to a specialist after diagnosis; and waiting time to see an EDs specialist. Half the sample took more than a year to seek help. Those with bulimia nervosa (BN) and binge-eating disorder (BED) took significantly longer to seek help than those with anorexia nervosa and Other EDs. Once participants sought help, half the sample was diagnosed within 1week. GPs referred most participants to an EDs specialist. Of those placed on a waiting list to see an EDs specialist, just under half were seen within 6weeks, with no significant differences by diagnosis in waiting time. Improving the acceptability of seeking help, particularly in those with BN and BED, early recognition of symptoms, and improving treatment pathways are key to minimising longer term impacts.

Does Higher Compliance With American College of Sports Medicine Exercise Prescription Guidelines Influence Exercise Outcomes in Knee Osteoarthritis? A Systematic Review With Meta-Analysis.

We wanted to determine if higher compliance with American College of Sports Medicine (ACSM) exercise prescription guidelines influences exercise outcomes in knee osteoarthritis (OA). We conducted a systematic review. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase up to January 4, 2024, for randomized controlled trials evaluating resistance and/or aerobic exercise for knee OA. Interventions were classified as higher compliance (meeting ≥60% of ACSM guideline recommendations for frequency, intensity, and duration) or lower compliance (meeting <60% of recommendations). Effects on pain and function were evaluated via meta-analysis, stratified by compliance. Twenty-five trials (3,290 participants) evaluated combined resistance and aerobic programs, with no differences in outcomes between those with higher and lower compliance (standardized mean difference [SMD] pain: -0.38 [95% confidence interval (CI) -0.59 to -0.17] vs -0.31 [95% CI -0.45 to -0.16], respectively; SMD function: -0.43 [95% CI -0.64 to -0.21] vs -0.36 [95% CI -0.58 to -0.14]). Sixty-six trials (5,231 participants) evaluated resistance exercise, with no differences between interventions with higher and lower compliance (SMD pain: -0.60 [95% CI -0.81 to -0.39] vs -0.93 [95% CI -1.27 to -0.59]; SMD function: -0.64 [95% CI -0.83 to -0.44] vs -0.85 [95% CI -1.20 to -0.49]). Twelve trials (958 participants) evaluated aerobic exercise, with no differences between interventions with higher and lower compliance (SMD pain: -0.79 [95% CI -1.20 to -0.38] vs -1.00 [95% CI -2.52 to 0.53]; SMD function: -0.83 [95% CI -1.27 to -0.38] vs -0.76 [95% CI -2.02 to 0.50]). Higher or lower compliance with ACSM exercise prescription guidelines did not influence exercise outcomes. Given there was substantial heterogeneity and many publications were at risk of bias, our results should be interpreted with caution.

Effect of diet combined with exercise intervention on tumor necrosis factor α in overweight or obese groups: Based on the exercise dose-response relationship

Background: Chronic low-grade systemic inflammation, often linked to obesity or being overweight, is associated with various complications and an increased risk of disease development. Tumor necrosis factor α (TNF-α) is a key inflammatory factor that significantly impacts various body functions. Objective: 1) To assess whether combined interventions are more effective than single interventions in combining diet and exercise. 2) To assess the effectiveness of exercise dose in different interventions on tumor necrosis factor (TNF-α) levels in obese or overweight patients. Methods: A thorough search was conducted across four electronic databases of randomized controlled trials that focus on exercise or dietary interventions for patients with obesity or overweight. This comprehensive review encompasses data collected up to August 2024. Two independent researchers conducted a thorough evaluation of the literature's quality. Network and dose-response analyses were performed using random effects models to examine the impact of diverse interventions on TNF-α. Results: A total of 19 randomized controlled trials with 1479 patients with obesity or overweight were included. The meta-analysis showed that the hypocaloric diet combined with aerobic training (HDAT) possessed the highest ranking (SMD= -1.00,95%CI -1.51 to -0.49), followed by the hypocaloric diet (HD) (SMD= -0.40,95%CI -0.89 to 0.09), hypocaloric diet combined with resistance training (HDRT) (SMD= -0.48,95%CI- 1.43 to 0.48), and aerobic training combined with resistance training (ART) (SMD= -0.18,95%CI -0.92 to 0.57). Additionally, a notable improvement in TNF-α levels was observed in individuals adhering to a hypocaloric diet in conjunction with exercise when the cumulative exercise volume reached 150 metabolic equivalent of task minutes per week. Conclusion: Based on the GRADE rating guidelines, moderate-quality research evidence indicates that a hypocaloric diet combined with aerobic training (HDAT) is the most effective intervention for enhancing tumor TNF-α levels in individuals with obesity or overweight. Additionally, the dose-response relationship was observed between the total exercise dose and TNF-α levels. Future research should investigate the specific effects of various aerobic exercise modalities on TNF-α levels in obese or overweight patients to develop a more personalized approach to exercise prescription.