Muscle Exercise Research Articles

The 24-hour molecular landscape after exercise in humans reveals MYC is sufficient for muscle growth.

A detailed understanding of molecular responses to a hypertrophic stimulus in skeletal muscle leads to therapeutic advances aimed at promoting muscle mass. To decode the molecular factors regulating skeletal muscle mass, we utilized a 24-h time course of human muscle biopsies after a bout of resistance exercise. Our findings indicate: (1) the DNA methylome response at 30 min corresponds to upregulated genes at 3 h, (2) a burst of translation- and transcription-initiation factor-coding transcripts occurs between 3 and 8 h, (3) changes to global protein-coding gene expression peaks at 8 h, (4) ribosome-related genes dominate the mRNA landscape between 8 and 24 h, (5) methylation-regulated MYC is a highly influential transcription factor throughout recovery. To test whether MYC is sufficient for hypertrophy, we periodically pulse MYC in skeletal muscle over 4 weeks. Transient MYC increases muscle mass and fiber size in the soleus of adult mice. We present a temporally resolved resource for understanding molecular adaptations to resistance exercise in muscle ( http://data.myoanalytics.com ) and suggest that controlled MYC doses influencethe exercise-related hypertrophic transcriptional landscape.

Effect of chest expansion resistance exercise and respiratory muscle stretching on respiratory function and gait endurance in patients with stroke.

Limited chest expansion and asymmetry in the respiratory muscles after a stroke lead to poor ventilation and reduced physical performance. To determine the effect of chest expansion resistance exercise and respiratory muscle stretching on respiratory function and gait endurance in patients with stroke. Thirty stroke patients were randomly assigned to a chest expansion resistance group (CERG), a respiratory muscle stretching group (RMSG), and a control group (CG). CERG and RMSG received chest expansion resistance and respiratory muscle stretching, respectively, 3 times a week for 8 weeks. Respiratory function, respiratory muscle strength, and gait endurance were measured before and after the intervention period. The experimental groups, CERG and RMSG, showed significant improvements in respiratory function variables (p < .05). For respiratory muscle strength variables, maximal inspiratory pressure (MIP) in the CERG and maximal expiratory pressure (MEP) in the RMSG showed significant changes compared to the CG (p < .05). Both CERG and RMSG also showed significant improvements in the 6MWT compared to the CG (p < .05). Chest expansion resistance exercise would be a more effective method, while both chest expansion resistance exercise and respiratory muscle stretching are helpful in improving respiratory function and gait endurance.

Fucoidan from Undaria pinnatifida Enhances Exercise Performance and Increases the Abundance of Beneficial Gut Bacteria in Mice

Fucoidans, known for their diverse biological properties such as anti-inflammatory, antiviral, antitumor, and immune stimulatory effects, have recently gained attention for their potential benefits in exercise endurance, muscle mass, and anti-fatigue. However, the mechanisms by which fucoidans enhance exercise performance are still unclear. To investigate these effects, we administered 400 mg/kg/day of fucoidan extract derived from Undaria pinnatifida to 64 C57BL/6J mice over 10 weeks. We evaluated changes in running activity, mitochondrial-related gene expression in skeletal muscle, and alterations in the intestinal microbiome. Our results showed that fucoidan supplementation significantly increased daily running distance and muscle mass by 25.5% and 10.4%, respectively, in mice on a standard chow diet, and with more modest effects observed in those on a high-fat diet (HFD). Additionally, fucoidan supplementation led to a significant increase in beneficial gut bacteria, including Bacteroides/Prevotella, Akkermansia muciniphila, and Lactobacillus, along with a notable reduction in the Firmicutes/Bacteroidetes ratio, indicating improved gut microbiome health. Mechanistically, fucoidan supplementation upregulated the mRNA expression of key genes related to mitochondrial biogenesis and oxidative capacity, such as COX4, MYH1, PGC-1α, PPAR-γ, and IGF1, in both standard chow and HFD-fed mice. Our findings suggest that fucoidan supplementation enhances exercise performance, improves muscle function, and positively modulates the gut microbiome in mice, regardless of diet. These effects may be attributed to fucoidans’ potential prebiotic role, promoting the abundance of beneficial gut bacteria and contributing to enhanced exercise performance, increased muscle strength, and improved recovery.

Outcome of a Physical Rehabilitation Program on Functionality and Impact on Quality of Life in Postoperative Liver Transplant Patients: A Systematic Review

Objectives: To conduct a systematic review of the literature on the outcomes of a physical rehabilitation program on functionality and identify possible impacts on quality of life in patients after liver transplantation. Methods: Controlled clinical trials and observational studies were selected from the PubMed, SciELO, and BIREME databases that "t the PICO (P – population; I – intervention; C – comparison; O – outcomes) question “what are the bene"ts of a physical rehabilitation program on functionality and quality of life outcomes in patients undergoing liver transplantation?” Studies written in English, Portuguese, and Spanish, published in the last 10 years were selected. After selection, the Physiotherapy Evidence Database (PEDro) scale was used to perform the methodological evaluation of the studies. Results and Discussion: A total of "ve interventionist articles were selected, most of which had good methodological quality. Only one study did not associate resistance training with aerobic exercises, but all had signi"cant results regarding increased functional capacity and reduced perception of fatigue after liver transplantation. Conclusion: !e studies indicated that the association of a resistance training program associated with aerobic training is bene"cial in terms of muscle strength gain, exercise capacity, and perception of fatigue.

Association of visceral fat area with early-stage locomotive syndrome across various age groups: a cross-sectional study

The association between visceral fat area (VFA) and locomotive syndrome (LS) has been extensively studied in the older population; however, the association between VFA and early-stage LS (stage 1 [LS1]) remains unclear. In this cross-sectional study, we investigated this association across different age groups. The study involved 1,236 (524 male and 712 female) participants (aged 20–85 years). Multiple regression analysis adjusted for sex, body mass index, skeletal muscle mass index, T-score, exercise habits, smoking status, and alcohol consumption revealed a significant association between LS1 and VFA across all VFA quartiles. The adjusted odds ratio OR for quartiles 2, 3, and 4 was 1.84, 2.68, and 4.12, respectively. The association between LS1 and VFA across the age groups—high VFA (> 73 cm2) and non-older (< 65 years) (OR, 1.87; 95% CI, 1.28–2.72; p = 0.001), low VFA (≤ 73 cm2) and older (≥ 65 years) (OR, 3.16; 95% CI, 1.94–5.14; p < 0.001), and high VFA and older groups (OR, 6.43; 95% CI, 3.98–10.4; p < 0.001)—was significantly stronger than that in the low VFA and non-older group. In summary, our findings suggest that managing VFA through diet and exercise is crucial for preventing LS1 across all age groups.

The Effectiveness Of Physical Therapy And Rehabilitation Approaches In Low Back Pain On Pain Severity And Disability; A Systematic Review

Low Back Pain encompasses nociceptive pain, neuropathic pain radiating to the legs, and nociplastic pain, often classified as non-specific due to central nervous system exaggeration. Globally, Low Back Pain is a leading cause of activity restriction and loss of productivity, significantly impacting finances. Objective; This study aimed to review the efficacy of physical therapy and rehabilitation approaches for LBP, focusing on pain intensity and disability. Materials and Methods; A literature review was conducted in PubMed and Web of Science databases up to January 30, 2024. English studies were required, using keywords: “low back pain,” “pain intensity,” “pain severity,” “disability,” and “physical therapy.” Pain intensity was measured using the Visual Analog Scale (VAS) and Numeric Rating Scale (NRS), including the 11-point Pain Intensity Numerical Rating Scale (PI-NRS). Disability was assessed using ADL, IADL scales, Roland Morris Disability Questionnaire (RMDQ), and Oswestry Disability Index (ODI). Results; Seven study met the inclusion criteria from 665 initial records. Interventions included osteopathic manipulative treatment (OMT), core muscle exercise with interferential current (IFC), cognitive functional therapy (CFT), dry cupping therapy, high-intensity machine-based core muscle resistance training (C-IPU), heat therapy, TENS, pelvic traction, Reiki, dynamic muscular stabilization technique (DMST), and McGill Big 3 (MB3). Sample sizes ranged from 30 to 1090 participants. IFC combined with core muscle exercises significantly reduced pain intensity compared to each method alone, though not statistically significant (p &gt; 0.05). The C-IPU group had greater pain relief (P 0.05). Dry cupping did not outperform sham cupping. CFT reduced absenteeism in the first two years but not later. Reiki showed significant improvement in pain and ADL compared to drug therapy, but not to physiotherapy. Conclusions; Physical therapy interventions effectively alleviate symptoms and improve outcomes in LBP. However, variability in interventions and outcome measures necessitates cautious interpretation. Further research with standardized protocols is essential to understand the effectiveness and optimal duration of physical therapy for LBP. Keywords; low back pain; pain intensity; pain severity; disability; physical therapy

Decreased number of satellite cells-derived myonuclei in both fast- and slow-twitch muscles in HeyL-KO mice during voluntary running exercise

BackgroundSkeletal muscles possess unique abilities known as adaptation or plasticity. When exposed to external stimuli, such as mechanical loading, both myofiber size and myonuclear number increase. Muscle stem cells, also known as muscle satellite cells (MuSCs), play vital roles in these changes. HeyL, a direct target of Notch signaling, is crucial for efficient muscle hypertrophy because it ensures MuSC proliferation in surgically overloaded muscles by inhibiting the premature differentiation. However, it remains unclear whether HeyL is essential for MuSC expansion in physiologically exercised muscles. Additionally, the influence of myofiber type on the requirement for HeyL in MuSCs within exercised muscles remains unclear.MethodsWe used a voluntary wheel running model and HeyL-knockout mice to investigate the impact of HeyL deficiency on MuSC-derived myonuclei, MuSC behavior, muscle weight, myofiber size, and myofiber type in the running mice.ResultsThe number of new MuSC-derived myonuclei was significantly lower in both slow-twitch soleus and fast-twitch plantaris muscles from exercised HeyL-knockout mice than in control mice. However, expect for the frequency of Type IIb myofiber in plantaris muscle, exercised HeyL-knockout mice exhibited similar responses to control mice regarding myofiber size and type.ConclusionsHeyL expression is crucial for MuSC expansion during physiological exercise in both slow and fast muscles. The frequency of Type IIb myofiber in plantaris muscle of HeyL-knockout mice was not significantly reduced compared to that of control mice. However, the absence of HeyL did not affect the increased size and frequency of Type IIa myofiber in plantaris muscles. In this model, no detectable changes in myofiber size or type were observed in the soleus muscles of either control or HeyL-knockout mice. These findings imply that the requirement for MuSCs in the wheel-running model is difficult to observe due to the relatively low degree of hypertrophy compared to surgically overloaded models.

To contract or not to contract: should we use pelvic floor muscle exercises in the treatment of dyspareunia

Pelvic floor physiotherapy incorporates pelvic floor muscle (PFM) exercises (PFMEs), i.e. various tasks involving contraction and relaxation. These are widely used as an integral part of conservative treatment for different pelvic health conditions (e.g. urinary incontinence). Currently, there is a debate about the adoption of PFMEs for pelvic pain conditions, specifically dyspareunia. The prevailing belief within both the physiotherapy community and wider social media platforms is that PFMEs for dyspareunia are not appropriate and may even be harmful. The aim of this study was to investigate the role of PFMEs in the treatment of dyspareunia, including an exploration of potential mechanisms through which these exercises may alter its symptoms. Specifically, the authors addressed the following questions: What is the rationale for PFMEs in dyspareunia? What are the documented side effects, if any? What are the outcomes following PFMEs? A list of relevant studies was compiled from extensive searches conducted for the purpose of other reviews performed by the authors, and additional, complementary searches utilizing a combination of keywords associated with dyspareunia, physiotherapy and PFMEs. The inclusion criteria were any studies discussing and investigating the use of PFMEs, such as (but not limited to) repeated contractions or hold contractions as a sole intervention or as part of multimodal treatment. Data were extracted and narratively synthesized to identify arguments advocating for and against PFMEs in the treatment of dyspareunia. Part of the narrative analysis included 10 studies involving women with different types of dyspareunia, such as vulvodynia, postpartum dyspareunia, dyspareunia related to menopause and dyspareunia in cancer survivors. Pelvic floor muscle exercises were implemented as a main intervention or as a part of multimodal physiotherapy. All of the studies reported positive results favouring interventions involving PFMEs across various outcomes, such as pain intensity, sexual function, symptom severity and inconvenience, and PFM morphometry and function. None of the studies reported any side effects following interventions incorporating PFMEs. These exercises may have multiple applications in the treatment of dyspareunia. It appears essential to consider PFMEs as a multifaceted intervention that can be adapted in various forms for diverse objectives that extend beyond simple strengthening. Contrary to prevailing beliefs, PFMEs have been widely incorporated in research studies that have reported positive outcomes and demonstrated the safety of the interventions implemented.

Physiotherapists working with pessaries

Pessaries and the physiotherapy profession have evolved over the past 10 years, and pelvic health physiotherapists can now prescribe vaginal pessaries. Pelvic, Obstetric and Gynaecological Physiotherapy (POGP) is developing ways to support members with these skills. Globally, up to 50% of women will suffer from pelvic organ prolapse (POP) (Carroll et al. 2022), and this condition costs the UK National Health Service £45 million every year (PCWHF 2019). The most common symptom is a vaginal bulge. The National Institute for Health and Care Excellence guidelines recommend either doing nothing, or pelvic floor muscle exercises (PFMEs), vaginal pessaries or surgery (NICE 2019). Pessary services are provided in dedicated clinics, usually in general practice or secondary care. There has been an increase in physiotherapists delivering pessary care over the past decade: in 2013, it was reported that 1.4% were part of the pessary workforce compared to 5% in 2020 (Bugge et al. 2013; Brown et al. 2021). Currently, ineffective patient pathways, poor service provision and lack of training are barriers to treatment. Poorly designed patient pathways are frustrating, and women are often required to return to primary or secondary care to get a referral to a pessary clinic. Physiotherapists are well placed to offer a pessary alongside PFMEs since it is part of the range of conservative treatment options. They also build strong a rapport with their patients because of the therapeutic nature of the treatment sessions, and typically, offer longer appointments than postnatal period. A prospective multicentre trial demonstrated the acceptability of and compliance with using a pessary immediately after childbirth irrespective of any pelvic floor dysfunction or mode of delivery (Baessler et al. 2019). The majority of women used the pessary to treat the symptoms of POP. Further work is required to investigate pessary use and the prevention of pelvic floor dysfunction in this cohort of women. The results of the TOPSY [Treatment Of Prolapse with Self-care pessarY] trial (Hagen et al. 2023) highlighted that pessary self-management is cost-effective and reduces complications. This is excellent news because physiotherapists are well placed to teach women pessary self-management because of: generally longer appointments; and the well-established rapport built up over time while teaching PFMEs. Despite women reporting that pessary use during exercise relieves their symptoms, this is an under-researched area. The impact of exercise on POP, and whether there are any protective factors involved that prevent its progression, are not fully understood. There also remains a gap in the evidence with regard to the use of PFMEs and vaginal pessaries. Research proposals are currently in development to address this. A pessary course is being developed by POGP, and this will be launched in 2024 alongside a mentoring programme as part of the pessary accreditation scheme jointly written with the United Kingdom Continence Society. Further governance documents have been created by the Physiotherapists Working with Pessaries subgroup of POGP, including a standard operating procedure, emergency out-of-hours statement, note proformas and template letters (POGP 2024).

Association of Physical Fitness with Leisure Time Physical Activity in Individuals with Spinal Cord Injury

Abstract Background: Physical fitness of persons with spinal cord injury (SCI) is related to their upper limb strength and range of motion. A change in these factors may impact their participation in physical fitness, and consequently leisure time activities. The objective of the study was to examine an association of physical fitness with leisure time physical activity (LTPA) in people with SCI. Materials and Methods: This was a cross-sectional observational study conducted among 30 male and female participants with SCI. Physical fitness and LTPA were assessed using a 6-min push test and physical activity recall assessment for people with SCI, respectively. Spearman’s Rank correlation coefficient was used to estimate the correlation between physical fitness and LTPA in persons with SCI. Results: The mean age of the participants was 33.6 ± 7.73) years. This study found a positive weak to no correlation between physical fitness and LTPA in individuals with SCI (r s = 0.1008) that was statistically nonsignificant (P &gt; 0.596). In this study, 28 (93.33%) participants had good physical fitness, and 19 (63.33%) participants performed LTPA for 20 min or more in a day, whereas 11 (36.67%) performed less than 20 min per day. Conclusion: Though most of the participants had good physical fitness, they performed only exercise-based activities such as walking with orthosis, pushups exercises, and resistance training exercises for upper limb muscles in their leisure time. They did not participate in LTPA such as sports, gardening, swimming, and other recreational activities. Furthermore, studies can be done to understand the perception of physiotherapists and SCI individuals toward the participation of LTPAs.

Effect of kegel pelvic floor muscle exercise on improving urinary disorder in rectum cancer patients after rectal surgery: a randomized clinical trial.

Postoperative urinary dysfunction poses a significant challenge for rectal cancer patients. While pelvic floor muscle training (PFMT) has shown promise in other contexts, its efficacy following rectal cancer surgery remains uncertain. A clinical trial involving 79 rectal cancer patients found that initiating Kegel exercises post-surgery led to significant improvements in urinary symptoms compared to standard care. Adherence to exercises correlated with symptom reduction, with no reported adverse events. We have defined the main outcome of our study as the improvement in urinary function scores post-surgery. Effectiveness is considered as any statistically significant improvement in these scores. Early initiation of Kegel exercises shows promise in alleviating postoperative urinary dysfunction in rectal cancer patients. Further research is needed to optimize postoperative care protocols and enhance patient outcomes.

Development of a spinopelvic complex finite element model for quantitative analysis of the biomechanical response of patients with degenerative spondylolisthesis.

Research on degenerative spondylolisthesis (DS) has focused primarily on the biomechanical responses of pathological segments, with few studies involving muscle modelling in simulated analysis, leading to an emphasis on the back muscles in physical therapy, neglecting the ventral muscles. The purpose of this study was to quantitatively analyse the biomechanical response of the spinopelvic complex and surrounding muscle groups in DS patients using integrative modelling. The findings may aid in the development of more comprehensive rehabilitation strategies for DS patients. Two new finite element spinopelvic complex models with detailed muscles for normal spine and DS spine (L4 forwards slippage) modelling were established and validated at multiple levels. Then, the spinopelvic position parameters including peak stress of the lumbar isthmic-cortical bone, intervertebral discs, and facet joints; peak strain of the ligaments; peak force of the muscles; and percentage difference in the range of motion were analysed and compared under flexion-extension (F-E), lateral bending (LB), and axial rotation (AR) loading conditions between the two models. Compared with the normal spine model, the DS spine model exhibited greater stress and strain in adjacent biological tissues. Stress at the L4/5 disc and facet joints under AR and LB conditions was approximately 6.6 times greater in the DS spine model than in the normal model, the posterior longitudinal ligament peak strain in the normal model was 1/10 of that in the DS model, and more high-stress areas were found in the DS model, with stress notably transferring forwards. Additionally, compared with the normal spine model, the DS model exhibited greater muscle tensile forces in the lumbosacral muscle groups during F-E and LB motions. The psoas muscle in the DS model was subjected to 23.2% greater tensile force than that in the normal model. These findings indicated that L4 anterior slippage and changes in lumbosacral-pelvic alignment affect the biomechanical response of muscles. In summary, the present work demonstrated a certain level of accuracy and validity of our models as well as the differences between the models. Alterations in spondylolisthesis and the accompanying overall imbalance in the spinopelvic complex result in increased loading response levels of the functional spinal units in DS patients, creating a vicious cycle that exacerbates the imbalance in the lumbosacral region. Therefore, clinicians are encouraged to propose specific exercises for the ventral muscles, such as the psoas group, to address spinopelvic imbalance and halt the progression of DS.

Appearance-enhancing masticatory muscle exercises and their potential impact on masticatory muscle symptoms: A netnographic study and scoping review

ABSTRACT Objective Videos containing exercises for masticatory muscles to enhance esthetic appearance are published on social media platforms. The aim of the study was to find out the nature of the exercises and whether they could have an impact on the health of the masticatory muscles. Method For the netnography, social media videos of jaw area exercises were collected as material and reviewed. The literature review investigated the effect of voluntary masticatory muscle exercises. Results 71 videos were collected, with none referring to scientific evidence. Muscle exercises found by netnography were isometric exercise of the masseter muscles. The scoping review revealed isometric exercise of the masticatory muscles can cause symptoms in the masticatory system in temporomandibular disorder patients. Conclusion Non-professional masticatory muscle exercises should be considered in the etiology of muscle-related TMD. Dental professionals should to explore social media platforms to be aware of content about dental issues.

Exercise as medicine in hip osteoarthritis: an investigation of exercise type, muscle power and predictive factors (PhD Academy Award)

Exercise as medicine in hip osteoarthritis: an investigation of exercise type, muscle power and predictive factors (PhD Academy Award)

A Study on the Development of Information and Communication Technology-Based Oral Functional Rehabilitation Exercise Program Content for Elderly People.

Background/Objectives: This study was conducted to develop information and communication technology (ICT)-based oral functional rehabilitation exercise (OFRE) program content to effectively improve the oral function of the elderly people. Methods: After selecting evidence-based effective OFRE items through systematic review, the final items were constructed through the validity evaluation of detailed items through an expert Delphi survey. The items were composed in a simple content form that can be performed directly and applied to ICT-based mobile applications. Results: The final content items consisted of an oral functional motor-ability measurement, oral Pilates videos, and games. The first is to measure the maximum opening amount before and after exercise, and the opening amount was designed to be measured by eating the fruit displayed on the screen by opening and closing the lips. The second one consisted of eight exercises in the video, and each exercise was to be performed at least three times a day, with a total of two sets. The third is a salivary secretion function exercise that stimulates the salivary glands to stimulate the user's interest and enable them to perform oral movements on their own. It consists of a lip and respiratory muscle exercise that inflates the cheeks and bursts a balloon, and the image disappears when the word in the image presented on the screen is pronounced correctly. It consists of pronunciation exercises. Conclusions: This content development attempt can be expanded into new convergence research linked to ICT and can be used as basic data when developing related content as part of digital care for the elderly in the future.

Cough-Induced Detrusor Overactivity—Outcome after Conservative and Surgical Treatment

Background/Objectives: The most common variant of mixed urinary incontinence is stress-induced urge urinary incontinence with the correlating urodynamic findings of cough-induced detrusor overactivity (CIDO). This prospective study assessed the clinical outcomes and leakage improvement among patients with CIDO following conservative or surgical treatment. Methods: We included patients with CIDO treated at our tertiary referral center from January 2018 to July 2021 in this prospective cohort study. The detection of a detrusor contraction after a cough was diagnosed as CIDO by urodynamic multichannel testing. All the patients in our study received personalized care, with behavioral therapy and anticholinergic/betamimetic treatment as a first step. If leakage persisted, patients were given a choice between pelvic floor muscle exercises (PFMEs), periurethral bulking or a midurethral sling. The primary outcome was the mean difference in urine leakage in the pad test before and six months after treatment. Results: Thirty-five patients met the inclusion criteria for CIDO and all presented a positive pad test at baseline (mean: 27 g). All 35 patients participated in behavioral therapy and anticholinergic/betamimetic treatment. Twenty-two patients (62.9%) underwent PFME, twelve patients (34.2%) received periurethral bulking, and nine patients (25.7%) received a midurethral sling. After all the treatments, our cohort showed a significant improvement in the pad test (mean: 5.7 g, p &lt; 0.001). The result was more favorable after periurethral bulking than the midurethral sling (p &lt; 0.001). Conclusions: This study shows the effectiveness of conservative treatment as a first step. In cases needing further treatment, bulking agents may be superior to PFME and midurethral propylene slings, offering new perspectives in the field of urogynecology and urinary incontinence.

Salivary Antimicrobial Peptide in Patients With Dementia Before and After Clinical Oral Rehabilitation Programme: A Randomised Controlled Trial.

Emerging evidence suggests a link between salivary metabolite changes and neurodegenerative dementia, with antimicrobial peptides (AMPs) implicated in its pathogenesis. We investigated the effects of a clinical oral rehabilitation programme tailored for dementia patients on salivary flow rate, AMP levels and oral health-related quality of life (OHRQoL). Eligible patients were randomly assigned to either the experimental group (EG; n = 28) or the control group (CG; n = 27). Both groups received a leaflet on oral health. In addition, the EG received an oral care intervention that included individual lessons on oral muscle exercises and oral self-care practices. Saliva samples and OHRQoL data were collected at baseline and follow-up visits. Generalised estimating equation models were used to analyse the changes over time. At the 3-month follow-up, EG showed significantly lower histatin 5 (HTN-5) levels (β = -0.08; effect size [ES] = 0.72) than CG. At 6 months, EG exhibited improved salivary flow rate (β = 0.89; ES = 0.89) and OHRQoL (β = 6.99; ES = 1.31) compared to CG. Changes in salivary flow rate (β = 4.03), HTN-5 level (β = -0.78) and beta-defensin 2 level (BD-2) (β = -0.91) at 3 months predicted improved OHRQoL at 6 months (all p < 0.05). Our clinical oral rehabilitation programme reduced the level of salivary HTN-5, increased salivary flow rate and enhanced OHRQoL in dementia patients. Furthermore, changes in salivary flow rate, HTN-5 level and BD-2 level were associated with improvements in patients' OHRQoL.

308 - Evaluation of the Effect of Pelvic Floor Muscle Exercise During Pregnancy on Sexual Function, Lower Urinary Tract Symptoms and Birth Process

308 - Evaluation of the Effect of Pelvic Floor Muscle Exercise During Pregnancy on Sexual Function, Lower Urinary Tract Symptoms and Birth Process

326 - Involving public and clinician stakeholders to develop a training package for primary care clinicians to support women throughout their lives to do their Pelvic Floor Muscle Exercises for the prevention and management of urinary incontinence.

326 - Involving public and clinician stakeholders to develop a training package for primary care clinicians to support women throughout their lives to do their Pelvic Floor Muscle Exercises for the prevention and management of urinary incontinence.

Effects of group-based versus individual physical exercise programs for knee osteoarthritis: A systematic review and meta-analysis

Background: Knee osteoarthritis (OA) is the most common joint disease worldwide and is associated with a high rate of disability and poor quality of life. However, little is known about the therapeutic effects of group-based versus individual-based physical exercise protocols. Objective: To investigate the effects of individual versus group-based physical exercises on pain intensity and functional outcomes in people with knee OA. Methods: MEDLINE/PubMed, Cochrane, EMBASE, and PEDro databases were searched from the earliest date available to July 2023. Study quality was evaluated using the PEDro scale. Mean difference (MD), standardized mean difference (SMD), and 95% confidence interval (CI) were calculated using a random effect model. Results: Six studies, with 763 patients, met the study criteria. Group-based physical exercises improved pain intensity (VAS 0-100) MD -17.2 (95% CI: -22.2 to -12.3), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale MD -0.54 (95% CI: -1.0 to -0.08), WOMAC function subscale MD -2.1 (95% CI: -4.1 to -0.08) compared to individual modality. No significant difference regarding muscle strength and exercise tolerance was found for participants in the group-based physical exercises compared with individual physical ones. Conclusion: Group-based physical exercise was more successful in reducing pain intensity and functional impairment in patients with knee OA than individual exercise programs. Both group-based and individual physical exercise programs enhanced muscle strength and 6-minute walk distance.