Purpose: This study aimed to provide comparative evidence on the effectiveness of various lifestyle interventions on body composition management for preschool and school-aged children.
Methods: PubMed (MEDLINE), Embase, CINAHL, and Web of Science were systematically searched for this network meta-analysis. Randomized controlled studies (RCTs) that included children aged 4-12 years with no physical or mental conditions; performed at least 1 type of lifestyle intervention; reported change in body mass index (BMI), BMI z-score, or body fat percentage (BFP); and were published between January 2010 and August 2023 were included.
Results: The final analysis included 91 RCTs with aggregate data for 58,649 children. All interventions were categorized into single-arm approaches (physical activity, diet, and behavioral and informational support) and combined arms approaches (bicomponent and multicomponent treatment). Multicomponent treatment showed significant effectiveness on the reduction of BMI (mean deviation (MD) - 0.49, 95% confidence interval (95%CI): -0.88 to -0.12), BMI z-score (MD = -0.11, 95%CI: -0.18 to -0.04), and BFP (MD = -1.69, 95%CI: -2.97 to -0.42) compared to the usual care condition. Bicomponent treatment also significantly reduced BMI (MD = -0.28, 95%CI: -0.54 to -0.04) and BMI z-score (MD = -0.07, 95%CI: -0.12 to -0.02) compared to usual care.
Conclusion: Interventions targeting multiple lifestyle components achieved greater reductions in children's BMI and BFP. Among single-component approaches, physical activity engagement emerged as the most effective. These findings should guide practitioners in recommending comprehensive lifestyle modifications for children. Moreover, children with higher initial BMI and body fat levels tend to exhibit more positive responses to lifestyle interventions aimed at managing obesity.
Background: Due to its high relevance in sports and rehabilitation, the exploration of interventions to further optimize flexibility becomes paramount. While stretching might be the most common way to enhance range of motion, these increases could be optimized by imposing an additional activation of the muscle, such as mechanical vibratory stimulation. While several original articles provide promising findings, contradictory results on flexibility and underlying mechanisms (e.g., stiffness), reasonable effect size (ES) pooling remains scarce. With this work we systematically reviewed the available literature to explore the possibility of potentiating flexibility, stiffness, and passive torque adaptations by superimposing mechanical vibration stimulation.
Methods: A systematic search of 4 databases (Web of Science, MEDLINE, Scopus, and Cochrane Public Library) was conducted until December 2023 to identify studies comparing mechanical vibratory interventions with passive controls or the same intervention without vibration (sham) on range of motion and passive muscle stiffness in acute (immediate effects after single session) and chronic conditions (multiple sessions over a period of time). ES pooling was conducted using robust variance estimation via R to account for multiple study outcomes. Potential moderators of effects were analyzed using meta regression.
Results: Overall, 65 studies (acute: 1162 participants, chronic: 788 participants) were included. There was moderate certainty of evidence for acute flexibility (ES = 0.71, p < 0.001) and stiffness (ES = -0.89, p = 0.006) effects of mechanical vibration treatments vs. passive controls without meaningful results against the sham condition (flexibility: ES = 0.20, p < 0.001; stiffness: ES = -0.19, p = 0.076). Similarly, moderate certainty of evidence was found for chronic vibration effects on flexibility (control: ES = 0.64, p = 0.043; sham: ES = 0.65, p < 0.001). Lack of studies and large outcome heterogeneity prevented ES pooling for underlying mechanisms.
Conclusion: Vibration improved flexibility in acute and chronic interventions compared to the stand-alone intervention, which can possibly be attributed to an accumulated mechanical stimulus through vibration. However, studies on biological mechanisms are needed to explain flexibility and stiffness effects in response to specific vibration modalities and timing.
Background: The potential of exercise as a concurrent therapy for actively treated primary tumors has been suggested by emerging preclinical and observational studies. However, clinical trials regarding this question are scarce. Therefore, we conducted a randomized controlled trial investigating the effects of aerobic or resistance exercise concomitant to neoadjuvant chemotherapy (NACT) on tumor size.
Methods: In the BENEFIT study (German title: Bewegung bei neoadjuvanter chemotherapie zur verbesserung der fitness), patients with breast cancer scheduled for NACT were randomly assigned to supervised resistance training (RT, n = 60) or aerobic training (AT, n = 60) twice weekly during NACT or to a waitlist control group (WCG, n = 60). The primary outcome, "change in tumor size", as well as the secondary clinical outcomes pathologic complete response (pCR), type of surgery (breast conserving/mastectomy), axillary lymph node dissection (ALND, yes/no), premature discontinuation of chemotherapy (yes/no), and relative dose intensity (RDI) were derived from clinical records. Due to the highly skewed distribution, the primary outcome was categorized. Multiple (ordinal) logistic regression analyses were performed.
Results: Overall, there was no significant difference in post-intervention tumor size between RT or AT and WCG. However, there was a significant effect modification by hormone receptor (HR) status (pinteraction = 0.030). Among patients with HR+ tumors, results suggest a beneficial effect of AT on tumor shrinkage (odds ratio (OR) = 2.37, 95% confidence interval (95%CI): 0.97‒5.78), on pCR (OR = 3.21, 95%CI: 0.97‒10.61); and on ALND (OR = 3.76, 95%CI: 0.78‒18.06) compared to WCG. The effects of RT were slightly less pronounced. For HR-subtypes, beneficial effects on RDI were found for AT (OR = 3.71, 95%CI: 1.20‒11.50) and similarly for RT (OR = 2.58, 95%CI: 0.88‒7.59). Both AT and RT had favorable effects on premature discontinuation of chemotherapy (OR (no vs. yes) = 2.34, 95%CI: 1.10‒5.06), irrespective of tumor receptor status.
Conclusion: While there was no significant effect on the primary outcome in the overall group, aerobic and resistance exercise concomitant to NACT seem to beneficially affect tumor shrinkage and pCR, reduce the need for ALND among patients with HR+ breast cancers, and prevent low RDI among patients with HR- breast cancers. These results warrant confirmation in further trials.
Purpose: This study aimed to assess the influence of older vs. younger age and previous anterior cruciate ligament (ACL) injury on resting serum cartilage oligomeric matrix protein (sCOMP(tpre)) concentration, on immediate load-induced sCOMP kinetics after a 30-min treadmill walking stress (∆_sCOMP(tpost)), and on the dose-response relationship between ambulatory load magnitude and ∆_sCOMP(tpost).
Methods: A total of 85 participants were recruited in 4 groups (20-30 years: 24 healthy, 23 ACL-injured; 40-60 years: 23 healthy, 15 ACL-injured). Blood samples were collected immediately before and after a walking stress at 80%, 100%, or 120% bodyweight (BW) on 3 test days and analyzed for sCOMP concentration. Linear models were used to estimate the effect of age, knee status (unilateral ACL injury, 2-10 years prior), and sex on sCOMP(tpre), ∆_sCOMP(tpost), and the dose-response between ambulatory load magnitude and ∆_sCOMP(tpost).
Results: We found that sCOMP(tpre) was 21% higher in older than younger participants (p < 0.001) but did not differ between ACL-injured and healthy participants (p = 0.632). Also, ∆_sCOMP(tpost) was 19% lower in older than younger participants (p = 0.030) and increased with body mass index (p < 0.001), sCOMP(tpre) (p = 0.008), and with 120%BW (p < 0.001), independent of age, ACL injury, or sex.
Conclusion: Age but not prior ACL injury influences resting sCOMP and load-induced sCOMP. The dose-response relationship between ambulatory load magnitude and load-induced sCOMP changes is not affected by age, ACL injury, or sex. A better understanding of systemic sCOMP and the role of its mechanoresponse for the understanding of osteoarthritis pathophysiology and monitoring intervention efficacy may require knowledge of individual cartilage composition and tissue-level loading parameters.
Background: Preparticipation examinations (PPEs) are unstandardized screening tools routinely used to collect an athlete's baseline health information prior to the start of a new competitive season. However, many PPEs include minimal and often nonspecific questions related to the health concerns of female athletes. A lack of female athlete specific health questions could result in missed red flags and subsequent injury or illness. As such, the objectives of this scoping review were to (a) determine what female athlete specific health questions currently exist in PPEs in the scientific literature to prevent injury and illness, and (b) map the results against the health domains outlined in the International Olympic Committee (IOC) consensus statement supplement on the female athlete.
Methods: We searched Embase, Scopus, CINAHL, Medline Ovid, and SPORTDiscus from inception to December 2022. Any study with female athlete specific health PPE questions or recommendations for questions (i.e., menstrual health, eating habits, musculoskeletal health, etc.) was included. Three reviewers independently screened titles and abstracts, followed by full text articles for eligibility and data extraction, with conflicts resolved by a third-party reviewer. Extracted data were summarized into 3 determined groupings.
Results: Of the 1356 studies screened, 41 were included in this study. Forty studies (98%) included questions/recommendations related to menstrual health. Thirty-one studies (76%) had questions/recommendations concerning disordered eating/eating habits. Twenty-four studies (59%) referred to body weight/image, and 16 studies (39%) referred to musculoskeletal health. No studies included questions on all IOC female athlete health domains.
Conclusion: There is currently a gap in female athlete specific health content included in PPEs. A more comprehensive, standardized PPE with a focus on inclusion of female athlete specific health questions and considerations should be developed to improve health and optimal participation of female athletes around the world.
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