Cochrane Database of Systematic Reviews最新文献

{"title":"Umbilical cord antiseptics for preventing sepsis and death among newborns.","authors":"Aamer Imdad, Melissa Medina, Chris Cooper, Zulfiqar A Bhutta","doi":"10.1002/14651858.CD008635.pub3","DOIUrl":"https://doi.org/10.1002/14651858.CD008635.pub3","url":null,"abstract":"<p><strong>Rationale: </strong>The umbilical cord, composed of blood vessels and connective tissue, connects the fetus to the placenta during pregnancy. After birth, the remaining cord stump may serve as an entry point for harmful bacteria, potentially leading to serious infection (neonatal sepsis) and death, particularly in low- and middle-income countries (LMICs). Applying antiseptics - substances that prevent the growth of microorganisms on living tissues - may help reduce the risk of infection through the umbilical stump.</p><p><strong>Objectives: </strong>To evaluate the benefits and harms of the application of antiseptics on a newborn's umbilical cord versus no antiseptics for the prevention of morbidity and mortality in infants in low- or middle-income countries (LMICs), and high-income countries (HIC).</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, Embase, LILACS and trial registries in December 2025. We checked reference lists of included studies and/or studies/systematic reviews where subject matter related to the intervention or population examined in this review.</p><p><strong>Eligibility criteria: </strong>We included individual and cluster-randomized controlled trials comparing any antiseptic with no antiseptic applied to the umbilical cord of newborns (0 to 28 days of life), regardless of gestational age, birthweight, delivery setting, or maternal infection risk. We excluded studies involving newborns with congenital malformations, quasi-randomized or observational designs, trials comparing different formulations or concentrations of the same antiseptic, and studies involving only topical antibiotics or antiseptic-antibiotic combinations.</p><p><strong>Outcomes: </strong>Our outcomes were all-cause neonatal mortality, omphalitis, and cord separation time. All the outcomes were measured during the neonatal period (i.e. from birth to 28 days of life).</p><p><strong>Risk of bias: </strong>The risk of bias was assessed by using the Cochrane risk of bias tool (RoB 1).</p><p><strong>Synthesis methods: </strong>Two review authors independently assessed studies for inclusion and evaluated the risk of bias. One review author extracted the data, and a second author verified the extraction for accuracy. We analyzed studies conducted in low- and middle-income countries (LMICs) separately from those in high-income countries (HICs), given the differing baseline risks. Where appropriate, we synthesized results using random-effects meta-analysis. We assessed the certainty of the evidence for each outcome using the GRADE approach.</p><p><strong>Included studies: </strong>We included 18 trials in the review (143,150 participants), two studies are awaiting classification and four studies are ongoing trials. The included studies evaluated antiseptics such as 70% alcohol, 4.0% chlorhexidine (CHX), silver sulfadiazine, and povidone iodine in LMICs. In HIC, the studies evaluated CHX and alcohol.</p><p><strong>Synthesis of results: <","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"3 ","pages":"CD008635"},"PeriodicalIF":8.8,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactive movement- and mindfulness-based interventions for promoting parent-infant bonding in the postpartum period.","authors":"Tessy Boedt, Katleen Van Der Gucht, Noor de Waal, Anne-Catherine Vanhove, Myrthe Boekhorst","doi":"10.1002/14651858.CD016340","DOIUrl":"https://doi.org/10.1002/14651858.CD016340","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of interactive movement- and mindfulness-based interventions compared with standard of care, waitlist control, no intervention, or attention control for promoting parent-infant bonding during the postpartum period (birth to 12 months).</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"3 ","pages":"CD016340"},"PeriodicalIF":8.8,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-clotting factor therapies for preventing bleeds in people with congenital hemophilia A or B.","authors":"Omotola O Olasupo, Noella Noronha, Megan S Lowe, Derek Ansel, Mihir Bhatt, Davide Matino","doi":"10.1002/14651858.CD014544.pub3","DOIUrl":"10.1002/14651858.CD014544.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Management of congenital hemophilia A and B is by prophylactic or on-demand replacement therapy with clotting factor concentrates. The effects of newer non-clotting factor therapies such as emicizumab, concizumab, marstacimab, and fitusiran compared with existing standards of care are yet to be systematically reviewed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effects (clinical, economic, patient-reported, and adverse outcomes) of non-clotting factor therapies for preventing bleeding and bleeding-related complications in people with congenital hemophilia A or B compared with prophylaxis with clotting factor therapies, bypassing agents, placebo, or no prophylaxis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register, electronic databases, conference proceedings, and reference lists of relevant articles and reviews. The date of the last search was 16 August 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;Randomized controlled trials (RCTs) evaluating people with congenital hemophilia A or B with and without inhibitors, who were treated with non-clotting factor therapies to prevent bleeds.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two review authors independently reviewed studies for eligibility, assessed risk of bias, and extracted data for the primary outcomes (bleeding rates, health-related quality of life (HRQoL), adverse events) and secondary outcomes (joint health, pain scores, and economic outcomes). We assessed the mean difference (MD), risk ratio (RR), 95% confidence interval (CI) of effect estimates, and evaluated the certainty of the evidence using GRADE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;Six RCTs (including 397 males aged 12 to 75 years) were eligible for inclusion. Prophylaxis versus on-demand therapy in people with inhibitors Four trials (189 participants) compared emicizumab, fitusiran, and concizumab with on-demand therapy in people with inhibitors. Prophylaxis using emicizumab likely reduced annualized bleeding rates (ABR) for all bleeds (MD -22.80, 95% CI -37.39 to -8.21), treated bleeds (MD -20.40, 95% CI -35.19 to -5.61), and annualized spontaneous bleeds (MD -15.50, 95% CI -24.06 to -6.94), but did not significantly reduce annualized joint and target joint bleeding rates (AjBR and AtjBR) (1 trial; 53 participants; moderate-certainty evidence). Fitusiran also likely reduced ABR for all bleeds (MD -28.80, 95% CI -40.07 to -17.53), treated bleeds (MD -16.80, 95% CI -25.80 to -7.80), joint bleeds (MD -12.50, 95% CI -19.91 to -5.09), and spontaneous bleeds (MD -14.80, 95% CI -24.90 to -4.71; 1 trial; 57 participants; moderate-certainty evidence). No evidence was available on the effect of bleed prophylaxis using fitusiran versus on-demand therapy on AtjBR. Concizumab may reduce ABR for all bleeds (MD -12.31, 95% CI -19.17 to -5.45), treated bleeds (MD -10.10, 95% CI -17.74 to -2.46), joint blee","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"3 ","pages":"CD014544"},"PeriodicalIF":8.8,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early intervention for high-risk smoldering multiple myeloma (SMM).","authors":"Po-Huang Chen, Hong-Jie Jhou, Ching-Liang Ho, Hai-Lun Huang, Cho-Hao Lee","doi":"10.1002/14651858.CD015494.pub2","DOIUrl":"10.1002/14651858.CD015494.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Smoldering multiple myeloma (SMM) represents an intermediate stage between monoclonal gammopathy of undetermined significance (MGUS) and active multiple myeloma. Early identification and intervention for people with high-risk SMM may prevent or delay progression to symptomatic disease. Current evidence on the optimal timing and choice of intervention remains controversial, necessitating a systematic evaluation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the benefits and harms of different early interventions compared to observation alone or placebo in people with high-risk smoldering multiple myeloma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched MEDLINE, Embase, CENTRAL, two clinical trial registries, and conference proceedings up to 1 October 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomized controlled trials (RCTs) comparing early intervention with observation or placebo in adults with high-risk SMM, defined by validated risk stratification models or International Myeloma Working Group criteria. Eligible interventions included monoclonal antibodies, immunomodulatory agents, alkylating agents, and cytokine inhibitors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcome was progression-free survival. Our important outcomes were overall survival, overall adverse events, serious adverse events, and health-related quality of life. We evaluated outcomes at all reported time points, prioritizing the longest available follow-up data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the original Cochrane risk of bias tool (RoB 1) to assess risk of bias in the included RCTs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We conducted meta-analyses using a random-effects model, applying the Hartung-Knapp-Sidik-Jonkman (HKSJ) method for pooled analyses where appropriate. We used hazard ratios (HRs) for time-to-event outcomes, odds ratios (ORs) for dichotomous outcomes, and mean differences (MDs) for continuous outcomes. For each effect estimate, we calculated the corresponding 95% confidence interval (CI). We assessed heterogeneity using I² statistics, and we assessed the evidence certainty using GRADE methodology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included seven RCTs (1096 participants) evaluating four intervention types: a monoclonal antibody (1 trial, 390 participants), immunomodulatory agents (3 trials, 427 participants), alkylating agents (2 trials, 195 participants), and a cytokine inhibitor (1 trial, 85 participants). Follow-up ranged from 29.2 months to 150 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Monoclonal antibodies versus active monitoring Evidence from one large trial suggests that early intervention with daratumumab compared with active monitoring may reduce the risk of disease progression or death slightly (HR 0.49, 95% CI 0.36 to 0.67; 389 participants; low-certainty evidence) and may also reduce the risk of death slightly (HR 0.52, 95% CI 0.27 to 0.99; 389 part","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"3 ","pages":"CD015494"},"PeriodicalIF":8.8,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School food environment interventions for health and sustainability.","authors":"Anna Leibinger, Nicole Holliday, Carmen Klinger, Xiao Tan, Laura Busert-Sebela, Lukas Schwingshackl, Eva Rehfuess, Solange Durao, Peter von Philipsborn","doi":"10.1002/14651858.CD015882","DOIUrl":"10.1002/14651858.CD015882","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To assess the effects of interventions that change the school food environment on health, nutritional, and educational outcomes in children aged 2 to 19 years, as well as on sustainability outcomes (food waste and greenhouse gas emissions). Secondary objective To examine how the effectiveness of school food environment interventions varies by schooling level, income level of the country, presence of co-interventions, socioeconomic status, sex/gender, and rurality.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"3 ","pages":"CD015882"},"PeriodicalIF":8.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital interventions for improving quality of life and physical function in adults aged 50 and over living with rheumatic and musculoskeletal diseases.","authors":"Ana Rita Henriques, Carolina Andrade, Sofia Silvério Serra, Teresa Costa, Elsa Mateus, Monserrat Conde, Nuno Mendonça, Diederik De Cock, Ana Maria Rodrigues","doi":"10.1002/14651858.CD016341","DOIUrl":"10.1002/14651858.CD016341","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effectiveness of digital health interventions, compared with usual care, non-digital structured intervention, or no intervention, in improving quality of life and physical function among community-dwelling adults (i.e. people living in the community) aged 50 years or over, diagnosed with osteoarthritis, osteoporosis, low-back pain, rheumatoid arthritis, or polymyalgia rheumatica.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"3 ","pages":"CD016341"},"PeriodicalIF":8.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12990293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vagus nerve stimulation to improve post-stroke motor function and activity.","authors":"Gauthier Everard, Ita Daryanti Saragih, Jesse Dawson, Dame Elysabeth Tarihoran, Shailesh M Advani, Huey-Ming Tzeng, Bih-O Lee, Geertruida E Bekkering","doi":"10.1002/14651858.CD015859.pub2","DOIUrl":"10.1002/14651858.CD015859.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;After a stroke, many people experience persistent upper extremity (UE) motor impairments (that is, deficits in strength, coordination, and muscle tone), which can limit activities such as reaching, grasping, and manipulation. Despite conventional rehabilitation, recovery of UE function often remains limited. Vagus nerve stimulation (VNS), applied invasively or non-invasively (transcutaneously), has been proposed as an adjunct to rehabilitation to enhance neuroplasticity and improve motor outcomes after stroke. While early trials have reported mixed findings, the overall effectiveness and safety of VNS interventions in this context are uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the potential benefits and harms of vagus nerve stimulation (VNS) as an add-on treatment to rehabilitate people who have post-stroke UE motor function impairments and activity limitations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched for published trials in the Cochrane Library, MEDLINE, Embase, Scopus, PsycINFO, CINAHL and PEDro. We also handsearched for reference lists and looked for other relevant studies on Google Scholar. We performed the searches up to May 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) that assessed the effect of VNS paired with conventional rehabilitation, compared to conventional rehabilitation alone (or paired with sham VNS) in adults (≥ 18 years) with a first-ever ischaemic or haemorrhagic stroke, at any post-stroke phase.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcomes were UE motor function and the number of participants with at least one serious adverse event (SAE). Our main important outcomes were UE activity and quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;Two review authors independently screened references, selected studies based on eligibility criteria, extracted data, and assessed the risk of bias in each included study using the Cochrane RoB 2 tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;When the studies were sufficiently similar, we synthesised VNS benefits and harms using a fixed-effects model meta-analysis for dichotomous outcomes and a random-effects model for continuous outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 10 studies with a total of 547 participants that met our inclusion criteria. The included studies took place in China, the UK, the USA, and Italy. All studies were published in peer-reviewed journals. Nine were written in English, and one in Chinese. Three studies applied VNS invasively and seven non-invasively (transcutaneously). All interventions were paired with rehabilitation (motor training) and compared with rehabilitation alone. All studies included both men and women. Most treatments were given in outpatient hospital services or health centres. All studies measured outcomes at short-term (six to 12 weeks after treatment), three studies at medium-term (six months after treatment)","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"3 ","pages":"CD015859"},"PeriodicalIF":8.8,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12984006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors predicting adverse perinatal outcomes in women presenting with decreased fetal movements.","authors":"Kristen L Haakons, Samantha Low-Choy, Billie Bradford, Alexander Heazell, Adrienne Gordon, Christine Andrews, Vicki Flenady","doi":"10.1002/14651858.CD016339","DOIUrl":"10.1002/14651858.CD016339","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: Primary objective To identify prognostic factors that predict adverse perinatal outcomes in pregnant women at or beyond 24 weeks' gestation presenting with decreased fetal movements (DFM). Secondary objective To determine the predictive value of DFM prognostic factors in different patients (primiparous versus multiparous; ethnic groups; gestational age and maternal age groups), settings (low- and middle-income versus high-income countries; rural versus urban), and presentations (first versus repeat presentations with DFM; DFM duration).</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"3 ","pages":"CD016339"},"PeriodicalIF":8.8,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retention versus replacement or removal of catheters for people with confirmed or suspected intravascular catheter-related infections.","authors":"Junichi Izawa, Nick Daneman, Neill Kj Adhikari, Robert Fowler","doi":"10.1002/14651858.CD016329","DOIUrl":"10.1002/14651858.CD016329","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects (benefits and harms) of catheter retention (or delayed removal after an initial catheter retention strategy) compared to prompt catheter replacement or removal in people of all ages with a short- or long-term central venous catheter or any arterial catheter, and either (i) catheter-related or -associated infection, (ii) bloodstream infection from an uncertain source or (iii) sepsis from an uncertain source.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"3 ","pages":"CD016329"},"PeriodicalIF":8.8,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-intensity interval training for reducing cardiometabolic syndrome in healthy but sedentary populations.","authors":"Juliette A Strauss, Richard Kirwan, Chathuranga Ranasinghe, Lukas Schwingshackl, Sam O Shepherd, Marty Chaplin, Yanina Sguassero, Jennifer Petkovic, Gemma Villanueva, Kerry Dwan","doi":"10.1002/14651858.CD013617.pub2","DOIUrl":"10.1002/14651858.CD013617.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;The estimated global cost of inactivity is USD (US dollar) 53.8 billion. Exercise is a low-cost, effective, and accessible intervention that can reduce cardiovascular disease risk in sedentary populations. However, nearly one-third of adults do not meet the levels of physical activity recommended by the World Health Organization (WHO). WHO guidelines do not include advice for people who wish to undertake high-intensity interval training (HIIT), because it is unclear whether HIIT is an efficacious and acceptable method for sedentary populations to reduce their risk of cardiometabolic syndrome. As lack of time is the most frequently cited barrier to exercise, and HIIT requires a lower time commitment than moderate-intensity continuous training (MICT), this topic warrants a high-quality, non-biased exploration of the literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of high-intensity interval training (HIIT) on cardiometabolic health in healthy, sedentary adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, Web of Science Core Collection (SCI-Expanded, SSCi, CPCI-S), and two trial registries up to 13 October 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised control trials (RCTs) that compared HIIT with a non-exercise control (comparison 1) or with MICT (comparison 2) over four weeks or longer in healthy adults (aged 18-64 years) who were sedentary at baseline. We excluded studies of athletes, as we were interested in the benefits of HIIT for public health, not for performance. We also excluded studies of people with overweight (body mass index (BMI) 25-29.9 kg/m²) or obesity (BMI ≥ 30 kg/m²) who were recruited as a result of a medical event or diagnosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our main outcomes were cardiorespiratory fitness (measured as maximum oxygen consumption (VO&lt;sub&gt;2max&lt;/sub&gt;) or peak oxygen consumption), systolic blood pressure, waist circumference, waist-to-hip ratio, all-cause mortality, circulating triglycerides, and adverse events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane risk of bias tool (Rob 2) to assess the risk of bias in the RCTs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised results for each outcome using a random-effects meta-analysis. We used GRADE to assess the certainty of the evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;Our review included 58 RCTs (2075 participants). Thirty-five studies evaluated HIIT versus MICT, and 11 evaluated HIIT versus no exercise. Twelve studies evaluated HIIT versus MICT versus another control (e.g. no exercise, walking); we included these studies in both comparisons in our review where possible.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;No studies reported all-cause mortality or adverse events. The certainty of the evidence was downgraded for inconsistency, imprecision, and risk of bias (mainly due to lack of detail on randomisation and ","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"3 ","pages":"CD013617"},"PeriodicalIF":8.8,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}