Effects of high-intensity interval exercise on cardiac troponin elevation when comparing with moderate-intensity continuous exercise: a systematic review and meta-analysis

Natural history of progressive vision loss in Bietti crystalline dystrophy: a model-based meta-analysis

PURPOSE

Bietti crystalline corneoretinal dystrophy (BCD) is an autosomal recessive progressive retinal degenerative disease due to mutations in the CYP4V2 gene. Best-corrected visual acuity (BCVA) is a common primary endpoint in clinical trials for retinal diseases, but the natural history of BCVA loss remains unclear because of the heterogeneity of manifestations in BCD patients.

METHODS

Based on the individual data of untreated BCD patients, a disease progression model was established using the change in BCVA from baseline as an index, and covariates including age of onset, age, duration of disease, baseline BCVA, gender, race (East Asian/non-East Asian), genotype, and family history. Then, based on the final model, the natural disease progression characteristics of BCD were simulated.

RESULT

A total of 14 studies met the inclusion criteria, with a total sample size of 117 cases, including 6 studies (N=80) with East Asian populations and 9 studies (N=37) with non-East Asian populations. The change of BCVA from baseline increased linearly with time, and the disease progression model of BCD was successfully established. BCVA increased by 0.06 logarithm of the minimum angle of resolution (LogMAR) per year in BCD patients. BCVA increased by 0.09 LogMAR per year in patients with BCVA≥0.5LogMAR and disease duration more than 10 years.

CONCLUSIONS

For the first time, we successfully established a BCD disease progression model based on the change in BCVA from baseline. The mean visual acuity loss increased linearly with the progression of the disease. A sharper loss of BCVA may be expected in patients with BCVA≥0.5LogMAR and disease duration ≥10 years.

The effect of exercise intervention on balance and executive function in children with autism spectrum disorder: a meta-analysis

OBJECTIVE

This study primarily evaluated the the effects of exercise intervention on balance and executive function in children with autism spectrum disorder (ASD).

METHODS

Search for eligible studies through four databases, and then proceed with screening. The inclusion criteria are as follows: (1) Children with ASD; (2) Age 3-18 years; (3) Randomised Controlled Trial; (4) The intervention group received exercise training; (5) Conducted pre- and post-test, which include balance and executive function. Use the Cochrane bias risk assessment tool to evaluate the quality of the selected study. Select Standardized Mean Difference (SMD) as the appropriate effect scale index.

RESULTS

Twelve of the selected articles involved 288 males and 108 females. The findings demonstrated that the exercise group (EG) benefited more from the improved balance than its control group (CG) counterpart [SMD = 0.86 (0.56, 1.16), p < 0.05, I2 = 37%]. Furthermore, subgroup analysis revealed that exercise interventions lasting over eight weeks significantly enhanced balance [SMD = 1.19 (0.79, 1.58), p < 0.05, I2 = 17%]. However, exercise interventions lasting less than or equal to 8 weeks did not have a significant impact on balance [SMD = 0.41 (- 0.06, 0.87), p = 0.09, I2 = 0%].

CONCLUSION

Exercise interventions can better improve the balance and behavioural inhibition of children with ASD compared to CG. Nevertheless, physical training prescribed for more than eight weeks led to a more significant improvement in balance than interventions performed for shorter periods.

Exercise Intervention Influences on Sleep and Anxiety in Children with Autism Spectrum Disorder: A Meta-Analyses of Randomized Controlled Trials

Related issues, such as sleep disturbance, are also frequently reported by children with autism spectrum disorder (ASD). This study systematically reviewed the influences of exercise on sleep and anxiety in children with ASD.Search for eligible studies through four databases, and then proceed with screening. The inclusion criteria are as follows: 1) children with ASD; 2) age 3 to 14 years; 3) randomized controlled trial (RCT); 4) the intervention group received exercise training; 5) conducted pre-and posttest, which includes sleep and anxiety. Use the Cochrane bias risk assessment tool to evaluate the quality of the selected study. Select standardized mean difference (SMD) as the appropriate effect scale index, and use Revman 5.4 software to analyze the mean difference of the selected article data.A total of seven studies fulfilled the inclusion criteria and were selected for the meta-analysis. The included studies involved 387 males and 79 females. The results demonstrated that the EXP group benefited from improved sleep (SMD, -1.05 [-1.25, -0.85], p < 0.05, I2 = 27%, p for heterogeneity = 0.22) and anxiety (SMD, -1.14 [-1.56, -0.72], p < 0.05, I2 = 95%, p for heterogeneity < 0.01) than the CON group.According to the findings, physical activities could offer nonpharmacological interventions for improving sleep and anxiety in children diagnosed with ASD. Sports training could also be considered to promote the rehabilitation of children patients with ASD, which might provide valuable insights.

Impact of exercise intervention with or without curcumin supplementation on body fat composition, glucose, and lipid metabolism in obese adults: A meta-analysis

This study was carried out to systematically review and evaluate the influence of exercise with and without curcumin on body fat composition, glucose, and lipid metabolism in obese adults. Search for eligible studies through four databases, and then proceed with screening. The inclusion criteria are as follows: (1) obese adults; (2) randomized controlled trial (RCT); (3) classified the exercise intervention with curcumin supplementation as the exercise with curcumin (CU) group and without curcumin supplementation as the exercise without curcumin (EX) group; (4) Conducted pre- and post-training assessments, which include body fat composition, glucose and lipid metabolism parameters. Use the Cochrane bias risk assessment tool to evaluate the quality of the selected study. Select standardized mean difference (SMD) as the appropriate effect scale index, and use Revman 5.4 software to analyze the mean difference of the selected article data with a 95% confidence interval (CI). A total of seven studies fulfilled the inclusion criteria and were selected for the meta-analysis. The included studies involved 72 males and 111 females, where 94 belonged to the EX group and 89 from the CU group. The CU group benefited more from the reduced Fat% (SMD, 2.18 [0.12, 4.24], p < 0.05, I2 = 0%, p for heterogeneity = 0.98) than the EX group. The study demonstrated that the combined exercise intervention with curcumin supplementation significantly reduced Fat% in obese adults compared with exercise without supplementing curcumin.

Effects of breaking up prolonged sitting via exercise snacks intervention on the body composition and plasma metabolomics of sedentary obese adults: a randomized controlled trial

Obesity resulting from long-term sedentary a significant threat to human health. This study explores the effects of exercise snack intervention on body composition and plasma metabolomics in sedentary obese adults. Participants in the snack group were subjected to 4 days of sprint exercises by stair-climbing per week for 12 weeks. Systemic and regional fat mass, epicardial adipose tissue (EAT), abdominal visceral (AVFA) and subcutaneous (ASFA) fat area and plasma metabolomics data were measured before and after intervention. A higher improvement of EAT, AVFA and ASFA in the snack group compared to that in the control group, with a significant interaction effect (p < 0.05). The key differential metabolites between the two groups include isoleucine, glycine and serine. The proposed exercise snack effectively reduced the amount of AVFA and EAT. The change in body composition may be associated with the altered pathways of isoleucine, glycine, and serine metabolism.

The Effect of Low-Intensity Interval Exercise with Blood Flow Restriction on Plasma Cardiac Troponin: A Cross-Design Trial

BACKGROUND

Low-intensity training with blood flow restriction (BFR) training could induce endurance adaptations, its impact on myocardial markers is still unclear compared to training without BFR. Consequently, the influence of low-intensity interval exercise with and without BFR and high-intensity interval exercise (HIIE) on cardiac troponin was determined in this study.

METHODS

Twelve physically active males between 18 and 26 years volunteered as participants. The participants completed 3 exercise tests in random order, which included 40% VO2max low-intensity cycling without BFR (group L), 40% VO2max low-intensity cycling with BFR set at 60% limb occlusion pressure (LOP) (group B), and 80% VO2max high-intensity cycling without BFR (group H). Participant muscle oxygen, blood flow, oxygen uptake, heart rate (HR), perceived exertion (RPE) rating, and pain levels were determined before and after exercise, after cuff inflation, and pre- and post-each exercise. Moreover, before each protocol, immediately after the exercises, and 3-4 hours after each exercise, elbow vein blood samples were collected to evaluate lactate (LA) and high-sensitivity cardiac troponin T (cTnT).

RESULTS

Increased LA was recorded after exercise by the individuals in group H, which was more significant than in group B. Moreover, group B documented a more significant LA increment than group L (P < .05). The peak cTnT of groups B and H after exercise was significantly higher (P < .05). Furthermore, the increase was more significant than the values recorded by group L (P < .05).

CONCLUSION

The present study demonstrated that low-intensity interval exercise combined with BFR could cause cTnT elevations compared to training without BFR. The increase was similar to HIIE protocols.

Managing chronic coronary syndrome: how do we achieve optimal patient outcomes?

INTRODUCTION

Chronic coronary syndrome (CCS) remains the leading cause of death worldwide with high admission/re-admission rates. Medical databases were searched on CCS & its management.

AREAS COVERED

This review discusses phenotypes per stress-echocardiography, noninvasive/invasive testing (coronary computed-tomography angiography-CCTA; coronary artery calcium - CAC score; echocardiography assessing wall-motion, LV function, valvular disease; biomarkers), multidisciplinary management (risk factors/anti-inflammatory/anti-ischemic/antithrombotic therapies and revascularization), newer treatments (colchicine/ivabradine/ranolazine/melatonin), cardiac rehabilitation/exercise improving physical activity and quality-of-life, use of the implantable-defibrillator, and treatment with extracorporeal shockwave-revascularization for refractory symptoms.

EXPERT OPINION

CCS is age-dependent, leading cause of death worldwide with high hospitalization rates. Stress-echocardiography defines phenotypes and guides prophylaxis and management. CAC is a surrogate for atherosclerosis burden, best for patients of intermediate/borderline risk. Higher CAC-scores indicate more severe coronary abnormalities. CCTA is preferred for noninvasive detection of CAC and atherosclerosis burden, determining stenosis' functional significance, and guiding management. Combining CAC score with CCTA improves diagnostic yield and assists prognosis. Echocardiography assesses LV wall-motion and function and valvular disease. Biomarkers guide diagnosis/prognosis. CCS management is multidisciplinary: risk-factor management, anti-inflammatory/anti-ischemic/antithrombotic therapies, and revascularization. Newer therapies comprise colchicine, ivabradine, ranolazine, melatonin, glucagon-like peptide-1-receptor antagonists. Cardiac rehabilitation/exercise improves physical activity and quality-of-life. An ICD protects from sudden death. Extracorporeal shockwave-revascularization treats refractory symptoms.

Application of exercise therapy in patients with chronic kidney disease-induced muscle atrophy: a scoping review

BACKGROUND

The prevalence of muscle atrophy in patients suffering from chronic kidney disease (CKD) presents a significant challenge to healthcare providers, necessitating innovative approaches to management and care. Against this backdrop, this study embarks on a comprehensive review of literature concerning the application of exercise interventions in the nursing care of these patients. Such interventions are critical in addressing the debilitating effects of the condition, which include progressive loss of muscle mass and strength, adversely affecting patient mobility, quality of life, and overall survival. This review aims to identify the specific exercise modalities, contents, outcome indicators, and application effects associated with this intervention, in the context of the complex interplay of metabolic, inflammatory, and hormonal factors contributing to muscle wasting in CKD patients. By examining the efficacy of various exercise interventions, this study seeks to elucidate optimal strategies for mitigating the impact of CKD-induced muscle atrophy, thereby informing clinical practices and improving patient outcomes.

METHODS

According to the method of a scoping review, nine databases (Cochrane, PubMed, EMBASE, Web of Science, ProQuest, Ovid, CNKI, Wanfang Data, and VIP) were searched until September 28, 2023. The included literature was screened, summarized, and analyzed.

RESULTS

A total of 20 pieces of literature were included. Some types include aerobic exercise, resistance exercise, and aerobic combined resistance exercise. The exercise intensity primarily falls within the mild to moderate range, with a recommended frequency of 2 - 3 times a week, lasting 30 - 60 min each time. The types of outcomes encompassed in this study include body composition, functional testing, strength measurements, laboratory examinations, cardiopulmonary function assessments, and patient-reported outcomes. To varying degrees, exercise intervention positively impacts the subjects' physical activity ability, body composition, and skeletal muscle status. Currently, resistance training is the primary type of intervention used for preventing and treating CKD patients induced by muscle atrophy.

CONCLUSION

Exercise intervention can improve muscle strength, physical function, and quality of life in patients with CKD muscle atrophy. Therefore, patients should be fully informed of the effect of exercise intervention in the treatment of chronic kidney disease-induced muscle atrophy in future, so as to promote the standardized implementation of exercise intervention.

The impact of digital healthcare systems on pain and body function in patients with knee joint pain: a systematic review and meta-analysis

The digital healthcare (DH) system has recently emerged as an advanced rehabilitation approach that promotes rehabilitation training based on virtual reality (VR) and augmented reality (AR). The purpose of this meta-analysis study is to review and assess the impact of DH systems on pain and physical function among patients diagnosed with knee joint pain. Between January 2003 and September 2023, studies that met the listed inclusion criteria were gathered from Scopus, PubMed, Web of Science, and EBSCO databases. The analysis of standardized mean difference (SMD) was carried out with 95% confidence interval (95% CI) (PROSPERO registration number: CRD42023462538). Eight research papers were selected, which collectively involved 194 males and 279 females. The meta-analysis outcomes revealed that DH intervention significantly improved balance (SMD, 0.41 [0.12, 0.69], p < 0.05) and pain level (SMD, - 1.10 [- 2.02, - 0.18], p < 0.05). The subgroup analysis of the pain level showed varied outcomes for the TKA (SMD, - 0.22 [- 0.49, 0.04], p = 0.10) or OA patients (SMD, - 2.80 [- 3.83, - 1.78], p < 0.05) Next, this study found no significant effect of DH intervention on knee joint range of motion (ROM) (SMD, 0.00 [- 0.76, 0.76], p = 1.00) and walking velocity (SMD, 0.04 [- 0.22, 0.29], p = 0.77) in patients with knee joint pain. The meta-analysis review conducted in this study revealed that DH intervention may potentially improve balance among the patients with knee joint pain. It may also alleviate the pain level particularly among OA patients.

The Effects of Combined Exercise with Citrulline Supplementation on Body Composition and Lower Limb Function of Overweight Older Adults: A Systematic Review and Meta-Analysis

The combined exercise with citrulline (CIT) supplementation is a potential adjuvant treatment approach to address the declining body composition and lower limb function of overweight older adults. However, research on this approach is limited. Thus, this study performed a meta-analysis review to explore the effects of combined exercise with CIT supplementation on body composition and lower limb function among overweight older adults. The search strategy and manuscript development of this study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Eligible studies were first searched through four databases (Web of Science, Scopus, PubMed, and EBSCO) from January 2003 until April 2023, followed by screening. The main inclusion criteria for the article selection are as follows: 1) Randomized Controlled Trial studies; 2) Participants aged over 55; 3) Studies involved exercise with CIT supplementation for the experimental group and exercise with Placebo (PLA) supplementation for the control group; 4) Body composition and lower limb function were measured at pre- and post-intervention. Subsequently, the Cochrane risk of bias assessment tool was utilized to evaluate the selected studies' quality. The Standardized Mean Difference (SMD) was chosen as the suitable effect scale index, and the mean differences of the data from the selected articles were analyzed using Revman 5.4 software with a 95% Confidence Interval (CI). A total of seven studies fulfilled the inclusion criteria and were selected for the meta-analysis. The included studies involved 105 males and 198 females, where 157 belonged to the PLA group and 146 from the CIT group. Significant improvements were observed among overweight older adults with CIT supplementation in 6-Minute Walking Test (6MWT) (P = 0.04, I2 = 4%), SMD (95% CI) = -0.28 (-0.54, -0.01), and Lower Limb Strength (LLS) (P < 0.01, I2 = 30%), SMD (95% CI) = -0.38 (-0.65, -0.12) compared to those with PLA supplementation. Combined exercise with CIT supplementation could be an effective non-pharmaceutical intervention to improve the physical function of overweight older adults by increasing their muscle strength.