Harms Of Exercise Research Articles

Exercise and Cognitive Function in Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Efficacy and Harms.

People living with chronic kidney disease (CKD) are at higher risk of cognitive impairment. Exercise may improve cognitive function. This systematic review and meta-analysis of randomized controlled trials (RCTs) was completed to determine the efficacy and harms of exercise in improving cognitive function in people living with CKD. A systematic literature review identified RCTs of people with any stage of CKD, with an intervention that exercised large-muscle groups, and with a validated outcome measure of cognitive function. First, harms were analyzed. Then a random-effects meta-analysis was completed with subsequent planned subgroup analyses to investigate heterogeneity between CKD stages and treatments, between different exercise types, durations and intensities, and between different outcome methodologies. Finally, quality of evidence was rated. Nineteen trials randomized 1160 participants. Harms were reported on 94 occasions in intervention groups vs. 83 in control. The primary analysis found that exercise had a small but statistically significant effect on cognition in CKD (effect size (ES) = 0.22; 95% confidence intervals (CI95) = 0.00, 0.44; P = 0.05). However, the quality of evidence was rated as low. Subgroup analyses found that type of exercise moderated the effect on cognition (χ2 = 7.62; P = 0.02), with positive effects only observed following aerobic exercise (ES = 0.57; CI95 = 0.21, 0.93; P = 0.002). Across the spectrum of CKD, exercise had a small but positive and clinically meaningful effect on cognitive function and did not appear to be harmful. Aerobic exercise was particularly beneficial. However, results must be interpreted cautiously due to the low quality of evidence. Nevertheless, care teams may choose to recommend aerobic exercise interventions to prevent cognitive decline. Researchers should design unbiased studies to clarify what intensity and duration of exercise is required to maximize efficiency of such exercise interventions.

Harms of exercise training in patients with cancer undergoing systemic treatment: a systematic review and meta-analysis of published and unpublished controlled trials.

Exercise is recommended for people with cancer. The aim of this study was to evaluate the harms of exercise in patients with cancer undergoing systemic treatment. This systematic review and meta-analysis included published and unpublished controlled trials comparing exercise interventions versus controls in adults with cancer scheduled to undergo systemic treatment. The primary outcomes were adverse events, health-care utilization, and treatment tolerability and response. Eleven electronic databases and trial registries were systematically searched with no date or language restrictions. The latest searches were performed on April 26, 2022. The risk of bias was judged using RoB2 and ROBINS-I, and the certainty of evidence for primary outcomes was assessed using GRADE. Data were statistically synthesised using pre-specified random-effect meta-analyses. The protocol for this study was registered in the PROESPERO database (ID: CRD42021266882). 129 controlled trials including 12,044 participants were eligible. Primary meta-analyses revealed evidence of a higher risk of some harms, including serious adverse events (risk ratio [95% CI]: 1.87 [1.47-2.39], I2=0%, n=1722, k=10), thromboses (risk ratio [95% CI]: 1.67 [1.11-2.51], I2=0%, n=934, k=6), and fractures (risk ratio [95% CI]: 3.07 [3.03-3.11], I2=0%, n=203, k=2) in intervention versus control. In contrast, we found evidence of a lower risk of fever (risk ratio [95% CI]: 0.69 [0.55-0.87], I2=0% n=1109, k=7) and a higher relative dose intensity of systemic treatment (difference in means [95% CI]: 1.50% [0.14-2.85], I2=0% n=1110, k=13) in intervention versus control. For all outcomes, we downgraded the certainty of evidence due to imprecision, risk of bias, and indirectness, resulting in very low certainty of evidence. The harms of exercise in patients with cancer undergoing systemic treatment are uncertain, and there is currently insufficient data on harms to make evidence-based risk-benefits assessments of the application of structured exercise in this population. There was no funding for this study.

Exercise interventions for adults with cancer receiving radiation therapy alone.

Exercise interventions for adults with cancer receiving radiation therapy alone.

What are the benefits and harms of exercise for women with dysmenorrhea?

What are the benefits and harms of exercise for women with dysmenorrhea?

Effectiveness of non-pharmaceutical interventions to prevent falls and fall-related fractures in older people living in residential aged care facilities – a systematic review and network meta-analysis protocol

Background: Preventing falls and fractures from falls in residents of aged care facilities are an eminent public health goal. Evidence on the effectiveness of non-pharmaceutical methods to prevent falls and fall-related fractures in residential aged care facilities (RACFs) is unclear. This review aims to assess and rank the effectiveness of the most common fall- and fracture prevention strategies of non-pharmaceutical nature in RACFs.Method: This systematic review with network-meta-analysis follows the guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P). We will conduct the systematic literature search across the medical databases MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials (CENTRAL). We will conduct pairwise meta-analyses with a random effects model. When appropriate, we will construct a network graph and conduct network meta-analyses within a Bayesian framework for all outcomes and interventions. Bayesian network meta-analysis (random effects models) will be used to compare the relative effectiveness of the different interventions under investigation.Conclusion: Our review should provide a broader picture of the evidence of benefits and harms of exercise and other non-pharmaceutical interventions in fall- and fracture prevention in residents of residential aged care facilities (RACFs). Findings will benefit public and individual health by contributing in the beneficence of multidisciplinary care of institutionalized seniors through optimization of fall- and fracture prevention programs.Registration: Protocol registration: PROSPERO 2018 CRD42018116446; Registration on 28 November 2018.

What are the benefits and harms of exercise for adults with rheumatoid arthritis of the hand?

What are the benefits and harms of exercise for adults with rheumatoid arthritis of the hand?

Exercise for patients with major depression: a systematic review with meta-analysis and trial sequential analysis

ObjectivesTo assess the benefits and harms of exercise in patients with depression.DesignSystematic reviewData sourcesBibliographical databases were searched until 20 June 2017.Eligibility criteria and outcomesEligible trials were randomised clinical trials assessing...

Comparative Benefits and Harms of Complementary and Alternative Medicine Therapies for Initial Treatment of Major Depressive Disorder: Systematic Review and Meta-Analysis.

To report the comparative benefits and harms of exercise and complementary and alternative medicine (CAM) treatments with second-generation antidepressants (SGA) for major depressive disorder (MDD). Systematic review and meta-analysis. Outpatient clinics. Adults, aged 18 years and older, with MDD receiving an initial treatment attempt with SGA. Any CAM or exercise intervention compared with an SGA. Treatment response, remission, change in depression rating, adverse events, treatment discontinuation, and treatment discontinuation due to adverse events. We found 22 randomized controlled trials for direct comparisons and 127 trials for network meta-analyses, including trials of acupuncture, omega-3 fatty acids, S-adenosyl methionine, St. John's wort, and exercise. For most treatment comparisons, we found no differences between treatment groups for response and remission. However, the risk of bias of these studies led us to conclude that the strength of evidence for these findings was either low or insufficient. The risk of treatment harms and treatment discontinuation attributed to adverse events was higher for selective serotonin receptor inhibitors than for St. John's wort. Although we found little difference in the comparative efficacy of most CAM therapies or exercise and SGAs, the overall poor quality of the available evidence base tempers any conclusions that we might draw from those trials. Future trials should incorporate patient-oriented outcomes, treatment expectancy, depressive severity, and harms assessments into their designs; antidepressants should be administered over their full dosage ranges; and larger trials using methods to reduce sampling bias are needed.

Exercise motivation in rectal cancer patients during and after neoadjuvant chemoradiotherapy.

Aerobic exercise is safe and feasible for rectal cancer patients during and after neoadjuvant chemoradiotherapy (NACRT), but their motivation to perform such exercise is unknown. Here, we explore the motivational outcomes, perceived benefits and harms, and perceived barriers to exercise during and after NACRT. Rectal cancer patients (n=18) participated in supervised aerobic exercise during NACRT followed by unsupervised exercise after NACRT. Using the theory of planned behavior, we assessed perceived benefits, harms, enjoyment, support, difficulty, and barriers for exercise both during and after NACRT. Patients reported that exercise during NACRT was more enjoyable (p=0.003) and less difficult (p=0.037) than initially anticipated. The most common perceived benefits of exercise during NACRT were cardiovascular endurance (75%), quality of life (75%), and self-esteem (65%). After NACRT, the most common perceived benefits were physical functioning (93%), cardiovascular endurance (86%), and quality of life (79%). The most common perceived harms of exercise during NACRT were fatigue (31%), diarrhea (31%), and skin irritation (24%). After NACRT, the most common perceived harms were fatigue (21%) and hand-foot-syndrome (15%). Side effects from NACRT were the most common exercise barrier during NACRT (88%) whereas lack of motivation was the most common barrier after NACRT (79%). Rectal cancer patients reported aerobic exercise during NACRT to be more enjoyable and less difficult than anticipated despite significant barriers. This positive motivational response may facilitate recruitment and adherence in future interventions. Moreover, rectal cancer patients identified potential benefits and harms that should be closely monitored in future interventions.

In pregnant women, what are the benefits and harms of exercise for treating pelvic and back pain?

In pregnant women, what are the benefits and harms of exercise for treating pelvic and back pain?

Exercise in pregnancy

Key content The physiology of pregnancy and responses to exercise. The benefits of exercise in pregnancy. The potential harms related to exercise in pregnancy. Guidelines and recommendations for exercise in pregnancy. Learning objectives To understand the interaction between the physiology of exercise and pregnancy. To be able to counsel women regarding the benefits and harms of exercise in pregnancy. To recognise longer term benefits of exercise on maternal and fetal health. Ethical issues Consider the variable national recommendations and their impact on pregnant women. Acknowledge the lack of specific research on intensity and nature of exercise.

Exercise in Pregnancy: A Clinical Review.

Context:Health professionals who care for pregnant women should discuss potential health benefits and harms of exercise. Although most pregnant women do not meet minimal exercise recommendations, there are a growing number of physically active women who wish to continue training throughout pregnancy.Evidence Acquisition:A search of the Web of Science database of articles and reviews available in English through 2014. The search terms exercise pregnancy, strenuous exercise pregnancy, and vigorous exercise pregnancy were used.Study Design:Clinical review.Level of Evidence:Level 3.Results:With proper attention to risk stratification and surveillance, exercise is safe for the mother and fetus. Benefits of exercise in pregnancy include reduction in Cesarean section rates, appropriate maternal and fetal weight gain, and managing gestational diabetes. Exercise as a means of preventing gestational diabetes, preeclampsia, or perinatal depression cannot be reliably supported. Overall, the current evidence suffers from a lack of rigorous study design and compliance with physical activity interventions.Conclusion:Research thus far has been unable to consistently demonstrate proposed benefits of exercise in pregnancy, such as preventing gestational diabetes, preeclampsia, or perinatal depression. However, moderate- and high-intensity exercise in normal pregnancies is safe for the developing fetus and clearly has several important benefits. Thus, exercise should be encouraged according to the woman’s preconception physical activity level.

In people with osteoarthritis of the hip, what are the benefits and harms of exercise?

In people with osteoarthritis of the hip, what are the benefits and harms of exercise?