Exercise prescription to improve clinical practice on cancer patients suffering chemotherapy-induced peripheral neuropathy undergoing treatment: a systematic review

This document aims to summarize and analyze systematically the current body of evidence about the effects of specific exercise proto- cols on physical function, balance control and quality of life in patients with peripheral neuropathy (PNP) induced by chemotherapy. Methods: Systematic Review, Literature survey Specific terms were identified for the literature research in MEDLINE, Scopus, Bandolier, PEDro, and Web of Science. Only studies pub- lished in peer-reviewed journals written in English language were considered. Four manuscripts were classified as eligible with 88 total participants, with an average of 57.1 years old. Quality appraisal classified two studies as high quality investigations while two with low quality. Results were summarized in the following domains: \u201cCIPN symptoms\u201d, \u201cStatic balance control\u201d, \u201cDynamic balance control\u201d, \u201cQuali- ty of life and Physical function\u201d. Results Specific exercise protocols were able to counteract common symptoms of chemotherapy-induced peripheral neuropathy (CIPN) during chemotherapy treatments. Significant improvements were detected on postural control. Additionally, patients\u2019 quality of life and inde- pendence were found ameliorated after exercise sessions, together with reductions on altered sensations and in other peripheral neu- ropathy symptoms. Combined exercise protocols including endurance, strength and sensorimotor training showed larger improvements. Conclusions Exercise prescriptions for cancer patients undergoing chemotherapy with CIPN symptoms should be recommended since these exercise interventions appeared as feasible and have been demonstrated as useful tools to counteract some common side effects of chemother- apeutic agents

Reliability of an isometric and isokinetic strength testing protocol of the knee and ankle in young adults

Background: Isokinetic dynamometers are becoming very common in assessing muscle strength and pathology, both in research and clinical practice, but for most of those devices reliability studies are still needed to support their extended use. The aim of this study is to assess the test-retest reliability also in health adults. Methods: Thirty adults (13 male and 17 females; mean age 25.4 ± 2.7 years) were recruited among University students. They participated to two testing sessions (7 day apart) in which they performed isokinetic and isometric strength assessment of the knee and ankle flexion and extension. Results: All variable showed an Intra-class correlation coefficient higher than 0.7 (isometric knee extension 0.96; isokinetic knee extension 0.96; isokinetic knee flexion 0.97; isometric ankle right flexion pl and flexion do 0.75-0.96; isometric ankle left flexion pl and flexion do 0.78-0.97; isokinetic ankle right flexion pl and flexion do 0.88-0.73; isokinetic ankle right flexion pl and flexion do 0.88-0.85) and paired-sample t-test showed no significant difference. Moreover, most of the recorded values were included within the upper and lower limits of agreement. Conclusion: Multi-joint evaluation system is a reliable device to assess knee and ankle isokinetic and isometric strength among healthy adults

Nordic Walking promoted weight loss in overweight and obese people: A systematic review for future exercise prescription

The aim of this systematic review was to analyze the effect of Nordic Walking (NW) on anthropometric parameters, body composition, cardiovascular parameters, aerobic capacity, blood sample, and glucose tolerance in overweight and obese subjects. The main keywords "Nordic Walking" or "Pole Walking", associated with either "obese", "obesity", "overweight", or "weight loss" were used on the online database MEDLINE, PubMed, SPORTDiscus and Scopus. Additionally, references of the studies included were screened to identify eligible articles. Applying the inclusion and exclusion criteria, ten manuscripts were considered as eligible for this review. The results of the studies were categorized in several domains with regard to "anthropometric parameters and body composition", "cardiovascular parameters and aerobic capacity", and "blood sample and glucose tolerance". The results showed positive effects on the anthropometric parameters, body composition, cardiovascular parameters, blood sample, and glucose tolerance. The greatest improvements were observed in supervised and high weekly frequency of NW interventions. NW could be considered as an effective modality through which to involve the obese in physical activity. For weight loss, NW should be prescribed 4-5 times per week, at least 60 min per session, preferably combined with diet control

Effect of exercise on cardiometabolic health of adults with overweight or obesity: Focus on blood pressure, insulin resistance, and intrahepatic fat—A systematic review and meta‐analysis

This systematic review examined the impact of exercise intervention programs on selected cardiometabolic health indicators in adults with overweight or obesity. Three electronic databases were explored for randomized controlled trials (RCTs) that included adults with overweight or obesity and provided exercise‐training interventions. Effects on blood pressure, insulin resistance (homeostasis model of insulin resistance, HOMA‐IR), and magnetic resonance measures of intrahepatic fat in exercise versus control groups were analyzed using random effects meta‐analyses. Fifty‐four articles matched inclusion criteria. Exercise training reduced systolic and diastolic blood pressure (mean difference, MD = −2.95 mmHg [95% CI −4.22, −1.68], p < 0.00001, I2 = 63% and MD = −1.93 mmHg [95% CI −2.73, −1.13], p < 0.00001, I2 = 54%, 60 and 58 study arms, respectively). Systolic and diastolic blood pressure decreased also when considering only subjects with hypertension. Exercise training significantly decreased HOMA‐IR (standardized mean difference, SMD = −0.34 [−0.49, −0.18], p < 0.0001, I2 = 48%, 37 study arms), with higher effect size in subgroup of patients with type 2 diabetes (SMD = −0.50 [95% CI: −0.83, −0.17], p = 0.003, I2 = 39%). Intrahepatic fat decreased significantly after exercise interventions (SMD = −0.59 [95% CI: −0.78, −0.41], p < 0.00001, I2 = 0%), with a larger effect size after high‐intensity interval training. In conclusion, exercise training is effective in improving cardiometabolic health in adults with overweight or obesity also when living with comorbitidies

Effect of exercise training before and after bariatric surgery: A systematic review and meta-analysis

We aimed to assess the effectiveness of exercise training programs in adults with severe obesity undergoing bariatric surgery. A systematic search of controlled trials published up to October 2019 that assigned participants to either a preoperative or postoperative exercise training group or a nonexercise group was performed. Meta-analyses were conducted using random-effects models. Twenty-two training programs were assessed (18 performed after bariatric surgery). The effect of preoperative exercise training on postsurgery outcomes was reported in only one study. Compared with the control condition without exercise, postoperative exercise training led to higher weight loss (N = 14, mean difference [95% CI] = −1.8 [−3.2; −0.4] kg, P = 0.01), fat loss (N = 9, P = 0.01), increase in VO2max (N = 8, P < 0.0001), and increase in muscle strength (N = 9, P < 0.0001). No significant effect was found on lean body mass (N = 11). Preliminary evidence suggests a beneficial effect of postoperative exercise training on bone mineral density (N = 3, P < 0.001) and weight maintenance after the end of the intervention (N = 2, P < 0.001) but no significant effect on quality of life (N = 2), habitual physical activity (N = 2), or cardiometabolic outcomes (N < 4). In conclusion, exercise training performed after bariatric surgery improves physical fitness and leads to a small additional weight and fat loss and may prevent bone loss and weight regain after bariatric surgery

Effect of exercise training interventions on energy intake and appetite control in adults with overweight or obesity: A systematic review and meta-analysis

This systematic review examined the impact of exercise training interventions on energy intake (EI) and appetite control in adults with overweight/obesity (≥18 years including older adults). Articles were searched up to October 2019. Changes in EI, fasting appetite sensations, and eating behavior traits were examined with random effects meta-analysis, and other outcomes were synthesized qualitatively. Forty-eight articles were included (median [range] BMI = 30.6 [27.0–38.4] kg/m2). Study quality was rated as poor, fair, and good in 39, seven, and two studies, respectively. Daily EI was assessed objectively (N = 4), by self-report (N = 22), with a combination of the two (N = 4) or calculated from doubly labeled water (N = 1). In studies rated fair/good, no significant changes in pre-post daily EI were found and a small but negligible (SMD < 0.20) postintervention difference when compared with no-exercise control groups was observed (five study arms; MD = 102 [1, 203] kcal). There were negligible-to-small pre-post increases in fasting hunger and dietary restraint, decrease in disinhibition, and some positive changes in satiety and food reward/preferences. Within the limitations imposed by the quality of the included studies, exercise training (median duration of 12 weeks) leads to a small increase in fasting hunger and a small change in average EI only in studies rated fair/good. Exercise training may also reduce the susceptibility to overconsumption (PROSPERO: CRD42019157823)

Effect of different types of regular exercise on physical fitness in adults with overweight or obesity: Systematic review and meta‐analyses

This systematic review examined the effect of exercise training interventions on physical fitness in adults with overweight or obesity and compared the effectiveness of different types of exercise training. Four electronic databases were searched. Articles were included if they described randomized controlled trials of exercise training interventions and their effect on maximal oxygen consumption or muscle strength in adults with overweight or obesity. Changes in outcome parameters were analyzed using random effects meta‐analyses for different training types (aerobic, resistance, combined aerobic plus resistance, and high‐intensity interval training). Eighty‐eight articles satisfied the inclusion criteria of which 66 (3964 participants) could be included in the meta‐analyses. All training types increased VO2max (mean difference 3.82 ml/min/kg (95% CI 3.17, 4.48), P < 0.00001; I2 = 48%). In direct comparisons, resistance training was less effective in improving VO2max than aerobic training, HIIT was slightly more effective than aerobic training, and no difference between aerobic and combined aerobic plus resistance training was found. For muscle strength benefits, incorporation of resistance exercise in the training program is indicated. Exercise training increases VO2max and muscle strength in adults with overweight or obesity. Differences between training types should be weighed with other needs and preferences when health professionals advise on exercise training to improve physical fitness

Effective behavior change techniques to promote physical activity in adults with overweight or obesity: A systematic review and meta‐analysis

Multicomponent behavior change interventions are typically used in weight management, but results are largely heterogeneous and modest. Determining which techniques (behavior change technique [BCTs]) are more effective in changing behavior is thus required. This study aimed to identify the most effective BCTs for increasing physical activity (PA) in digital and face‐to‐face behavior change interventions in adults with overweight/obesity. Four databases were searched for eligible studies until October 2019. BCTs were coded using BCTTv1 and MBCT taxonomies. Sixty‐two RCTs were included. Meta‐regressions were performed to explore BCTs' moderating role. Five BCTs showed significant moderator effects on PA in digital interventions: goal setting behavior, goal setting outcome, graded tasks, social incentive, and self‐monitoring of behavior (adjusted R2's = 0.15–0.51). One BCT showed significant moderator effects on PA in face‐to‐face interventions, behavioral practice and rehearsal (adjusted R2 = 0.22). Multivariate and sensitivity analysis generally led to similar findings. Effective BCTs for increasing PA in adults with overweight/obesity in digital and face‐to‐face interventions seem to differ. Evidence suggests that using goal setting, social incentive, and graded tasks might help improve PA in digital interventions while avoiding inconsistent self‐monitoring of behavior. In face‐to‐face interventions, prompting behavioral practice and rehearsal might lead to better PA outcomes. Still, further studies are needed. Implications of the current findings are discussed