Effect of concurrent training on physical performance and quality of life in children with malignancy: A systematic review and meta-analysis

Immediate and short-term effect of physical exercise on BDNF in multiple sclerosis patients: a systematic review and meta-analysis

Low brain-derived neurotrophic factor (BDNF) concentrations have been found in individuals with multiple sclerosis (MS). Physical exercise is an effective strategy for acutely increasing the levels of this neurotrophin in various populations; nevertheless, definitive results are still required for individuals with MS. Thus, this systematic review with meta-analysis aimed to analyze the acute and short-term effects of physical exercise on BDNF concentrations in MS patients. In this pre-registered systematic review (PROSPERO; ID: CRD42024505920), six electronic databases (PubMed-Medline, Scopus, Web of Science, SportDiscus, EbscoHost, and Cochrane) were searched by two independent researchers to identify eligible studies investigating the acute or short-term effects (≤ 3 weeks) of physical exercise sessions on blood concentration of BDNF in MS. Studies that used a sample population with other pathologies or did not provide or specify numerical data on the specified variables were excluded. After applying the inclusion and exclusion criteria, nine studies were included. A total sample of 259 people with MS were analyzed. Effect sizes of outcomes were presented as standardized mean difference (SMD) and 95% confidence intervals (95%CI). The effect estimation was computed using the inverse variance random effects method. Immediately after a session, a significant increase in BDNF was observed (large standardized mean difference (SMD) = 1.52, p = 0.001, I2 = 95). A significant effect (SMD = 0.27, p = 0.05; I2=0%) was found after three weeks of physical training on the BDNF. Our study indicates that physical exercise is an appropriate stimulus to increase BDNF release in MS patients. The acute and short-term increases in this neurotrophin reflect physical exercise's potential and interesting neuroprotective character in populations with neurodegenerative diseases.Trial registration: This study was preregistered in the International Prospective Register of Systematic Review (PROSPERO) with the following registration number: CRD42024505920.

Systematic Umbrella Review and Meta-Meta-Analysis: Effectiveness of Physical Activity in Improving Depression and Anxiety in Children and Adolescents

OBJECTIVE

Depression and anxiety are prevalent and rising in children and adolescents, prompting interest in exercise as a potential therapeutic intervention. The aim of this systematic umbrella review and meta-meta-analysis (a meta-analysis of meta-analyses) was to evaluate the effects of exercise on depression and anxiety symptoms in children and adolescents and to identify the most promising exercise-based approaches.

METHOD

This systematic umbrella review was preregistered (PROSPERO ID: CRD42024533558) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Preferred Reporting Items for Overviews of Reviews (PRIOR) guidelines. A search of 11 databases identified systematic reviews and meta-analyses of randomized controlled trials (RCTs) evaluating the effects of exercise (aerobic, resistance, mind-body exercise) on depression and anxiety symptoms in children and adolescents. Risk of bias was assessed using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) tool, and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. Meta-analyses were conducted to combine effect sizes, using random effects models. Subgroup analyses were performed to examine participant and intervention characteristics.

RESULTS

A total of 21 systematic reviews (n = 375 RCTs, n = 38,117 participants 5-18 years of age) were included. Participants included those with various clinical conditions, including depression, psychosocial disorders, obesity, and cancer, as well as healthy individuals. The pooled analysis found moderate effect sizes favoring exercise for symptoms of depression (standardized mean difference [SMD] = -0.45, 95% CI = -0.59 to -0.31, I2 = 71.37%, p < .01, 180 RCTs, n = 34,490 participants) and anxiety (SMD = -0.39, 95% CI = -0.61 to -0.17, I2 = 68.1%, p < .01, n = 55 RCTs, n = 24,797 participants). Mixed exercise modes and moderate-intensity exercise had the largest effects on depression, whereas resistance exercise was most effective for symptoms of anxiety. Interventions that were <12 weeks were more effective for depression compared with those that were ≥12 weeks. Benefits were generally consistent across populations. The certainty of evidence was moderate for depression and low to moderate for anxiety.

CONCLUSION

This meta-meta-analysis finds that exercise reduces depression and anxiety symptoms in children and adolescents. These results suggest that structured exercise programs should be considered as part of comprehensive care approaches.

Exercise prescription prescriptions for frailty improvement in older adults: An evidence-based approach based on the 2024 older adult compendium

OBJECTIVE

This study explored the dose-response relationship of exercise prescriptions for improving frailty in older adults, based on the 2024 Older Adult Compendium. It aims to provide evidence-based support for developing frailty intervention programs and their clinical application.

METHODS

A comprehensive search was conducted in PubMed, OVID, Cochrane Library, Web of Science, and Scopus from inception to November 5th, 2024. Randomized controlled trials (RCTs) related to exercise interventions in older adults were included. Relevant studies meeting the inclusion criteria were selected, and data were extracted for further analysis. The quality of the included studies was assessed. Meta-analysis was performed using R, and the standardized mean difference (SMD) with 95 % confidence intervals (95 % CI) was used to quantify effect sizes.

RESULTS

A total of 16 eligible RCTs comprising 2,716 older adults were included. The meta-analysis revealed that exercise significantly improved frailty among older adults [SMD = -0.81, 95 % CI (-1.25, -0.38), P < 0.001]. However, high-intensity exercise did not demonstrate a significant effect on frailty improvement [SMD = -0.45, 95 % CI (-0.96, 0.06), P = 0.3]. The analysis indicated a nonlinear dose-response relationship between exercise and frailty improvement. The predicted values for frailty improvement at the minimum and maximum exercise doses recommended by the World Health Organization (600 MET-minutes/week and 1200 MET-minutes/week, respectively) were -0.79 (95 % CI [-1.17, -0.41]) and -1.39 (95 % CI [-2.62, -0.15]), respectively.

CONCLUSION

Low- to moderate-intensity exercise significantly improves frailty among older adults, while high-intensity exercise programs are not recommended.

Effects of aerobic exercise on children's executive function and academic performance: A systematic review and meta-analysis

Objective

To investigate the effects of exercise on executive function in children, providing an evidence-based foundation to inform future research in school physical education and health education.

Methods

We searched ten databases: Cochrane Library, Scopus, OVID, Web of Science, PubMed, EBSCOhost, SPORTDiscus, PsycINFO, CNKI, WANFANG DATA, VIP, and SinoMed, and eight articles were included. Applying the revised Cochrane Risk of Bias Tool for Randomized Trials (RoB2), funnel plots and Egger regression analysis were integrated with R meta-analysis to screen for publication bias. The quality of the evidence was appraised using the Grading system.

Results

The included literature contained 2655 participants, with 1308 in the experimental group and 1347 in the control group. The results indicated that the aerobic exercise group considerably improved inhibitory control in children compared to the control group [SMD = 0.29, 95% CI (0.05, 0.54), P = 0.018]; working memory [SMD = 0.25, 95% CI (0.07, 0.42), P = 0.005]; and cognitive flexibility [SMD = 0.36, 95% CI (0.17, 0.54), P < 0.001]. However, the findings indicated that only aerobic exercise interventions extending beyond 50 weeks positively influenced academic performance in children [SMD = 1.19, 95% CI (0.34, 2.04), P = 0.006]. The results of an Egger regression analysis revealed that the p-values for inhibitory control, working memory, cognitive flexibility, and academic performance were more significant than 0.1. The Grade system said that the quality of evidence was all low regarding the level of evidence.

Conclusion

Aerobic exercise enhanced executive function but only aerobic exercise interventions extending beyond 50 weeks demonstrated a significant effect on the academic performance of children. Due to the low quality of evidence presented in this study, additional high-quality randomized controlled trials are needed to confirm these findings.