1
|
Gomes-Neto M, Rodrigues Durães A, Roever L, Magalhães Silva C, Gonzalez Nogueira Alves I, Bernardone Saquetto M, Ellingsen Ø, Oliveira Carvalho V. Effects of Exercise Interventions on Aerobic Capacity in Patients With Heart Failure With Preserved Left Ventricular Ejection Fraction: Systematic Review and Network Meta-Analysis. Cardiol Rev 2024; 32:45-50. [PMID: 35290247 DOI: 10.1097/crd.0000000000000447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Exercise is an important component of rehabilitation care for patients with heart failure with preserved ejection fraction (HFpEF). However, it is unclear which type of physical rehabilitation exercise is most effective. Thus, the aim of this study was to determine the relative effects of different types of exercise interventions on aerobic capacity measured by peak oxygen consumption (VO 2 peak; in mL/kg·min) in patients with HFpEF. We searched different electronic databases until December 2020 for randomized controlled trials that evaluated the effects of different types of exercise interventions on VO 2 peak of patients with HFpEF. Mean difference, standardized mean difference (SMD), and 95% confidence intervals (CIs) were calculated. Fixed and random-effects Bayesian network meta-analysis was used to compare the relative effectiveness of the different exercise interventions. Nineteen studies met the study criteria, including 720 patients. Comparing the physical rehabilitation interventions with usual care (control group), inspiratory muscle training was the highest ranked exercise intervention with an SMD of 3.6 mL/kg·min (95% CI, 2.3-4.8), followed by the group undergoing high-intensity interval training with a significant pooled improvement in VO 2 peak 3.5 (95% CI, 2.6-4.4) and combined aerobic and resistance exercise with an SMD of 3.2 (95% CI, 1.4-5.0). The inspiratory muscle training, high-intensity interval training, and combined aerobic and resistance exercise were the highest ranked physical rehabilitation intervention to improve VO 2 peak. These interventions should be considered as a component in the care of patients with HFpEF. Registration: https://www.crd.york.ac.uk/PROSPERO/ ; Unique identifier: CRD42021256442.
Collapse
Affiliation(s)
- Mansueto Gomes-Neto
- From the Physical Therapy Department, Federal University of Bahia, Salvador, Bahia, Brazil
- Programa de Pós-Graduação em Medicina e Saúde, Federal University of Bahia, Salvador, Bahia, Brazil
- Physiotherapy Research Group, Federal University of Bahia, Salvador, Bahia, Brazil
- Grupo de Estudos em Atividade Física, Brazil
| | - André Rodrigues Durães
- Programa de Pós-Graduação em Medicina e Saúde, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Leonador Roever
- Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil
| | - Cassio Magalhães Silva
- From the Physical Therapy Department, Federal University of Bahia, Salvador, Bahia, Brazil
- Physiotherapy Research Group, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Micheli Bernardone Saquetto
- From the Physical Therapy Department, Federal University of Bahia, Salvador, Bahia, Brazil
- Programa de Pós-Graduação em Medicina e Saúde, Federal University of Bahia, Salvador, Bahia, Brazil
- Physiotherapy Research Group, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Øyvind Ellingsen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, K.G. Jebsen Center for Exercise in Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Vitor Oliveira Carvalho
- Physiotherapy Research Group, Federal University of Bahia, Salvador, Bahia, Brazil
- Grupo de Estudos em Atividade Física, Brazil
- Physical Therapy Department, Federal University of Sergipe-UFS, Aracaju, Sergipe, Brazil
| |
Collapse
|
2
|
Gomes-Neto M, Saquetto MB, Alves IG, Martinez BP, Vieira JPB, Brites C. Effects of Exercise Interventions on Aerobic Capacity and Health-Related Quality of Life in People Living With HIV/AIDS: Systematic Review and Network Meta-Analysis. Phys Ther 2021; 101:6166193. [PMID: 33704496 DOI: 10.1093/ptj/pzab092] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 12/29/2020] [Accepted: 02/22/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Exercise is a recommended component of care for people living with HIV/AIDS; however, it is unclear which type of exercise is most effective. The purpose of this study was to investigate the relative effects of different types of exercise interventions on aerobic capacity measured by peak oxygen consumption (peak VO2) and health-related quality of life (HRQoL) in this population. METHODS For this systematic review and indirect-comparisons meta-analysis (network meta-analysis), different electronic databases were searched up to February 2020 for randomized controlled trials that evaluated the effects of different types of exercise interventions on peak VO2 and HRQoL of people living with HIV/AIDS. Mean differences, standardized mean difference (SMD), and 95% CI were calculated. Fixed- and random-effects Bayesian network meta-analysis were used to compare the relative effectiveness of the different exercise interventions. RESULTS Forty studies met the study criteria, reporting on a total of 1518 patients. When comparing the exercise interventions with usual care (control group) for the peak VO2 outcome, combined aerobic and resistance exercise was the highest ranked exercise intervention with an SMD of 4.2 (95% CI = 2.5 to 5.9), followed by aerobic exercise (SMD = 3.1; 95% CI = 1.4 to 5.1). Compared with aerobic exercise, resistance training, and yoga, combined aerobic and resistance exercise was the best exercise intervention to promote improvement on physical function, general health, mental health, and energy/vitality domains HRQoL. CONCLUSION The combined aerobic and resistance exercise was the highest ranked exercise intervention to improve peak VO2 and HRQoL. Combined aerobic and resistance exercise should be considered as a component of care for people living with HIV/AIDS.
Collapse
Affiliation(s)
- Mansueto Gomes-Neto
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Fisioterapia, Curso de Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Micheli Bernardone Saquetto
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Fisioterapia, Curso de Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Iura Gonzalez Alves
- Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Bruno Prata Martinez
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Fisioterapia, Curso de Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - João Paulo B Vieira
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Carlos Brites
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| |
Collapse
|
3
|
Gomes Neto M, de Lacerda FFR, Lopes AA, Martinez BP, Saquetto MB. Intradialytic exercise training modalities on physical functioning and health-related quality of life in patients undergoing maintenance hemodialysis: systematic review and meta-analysis. Clin Rehabil 2018; 32:1189-1202. [PMID: 29480025 DOI: 10.1177/0269215518760380] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To determine the effects of different intradialytic exercise training modalities on physical functioning and health-related quality of life of maintenance hemodialysis patients. METHODS We searched MEDLINE, Cochrane Trials Register and CINAHL for controlled trials that evaluated the effects of intradialytic exercise training for maintenance hemodialysis patients and published from the earliest available date to December 2017. Weighted mean difference and 95% confidence interval (CI) were calculated, and heterogeneity was assessed using the I2 test. RESULTS Fifty-six studies met the study criteria, comprising a total of 2586 patients. Compared with no exercise, combined aerobic and resistance exercise resulted in significant improvement in peak VO2 weighted mean difference (5.1 mL kg-1 min-1; 95% CI: 3.4, 6.8 mL kg-1 min-1), depression symptoms (-7.32; 95% CI -9.31, -5.33) and both physical function (10.67 points; 95% CI 1.08, 20.25 points) and vitality (10.01 points; 95% CI 4.30, 15.72 points) domains of health-related quality of life. Resistance exercise alone was significantly associated with improvement in the 6-minute walk test distance (30.2 m; 95% CI 24.6, 35.9 m), knee extensor strength (0.6 N; 95% CI 0.1, 1.0 N) and Physical Component Score of health-related quality of life (9.53 points; 95% CI -3.09, 22.15 points) when compared with control group. Aerobic exercise alone was not significantly associated with aerobic capacity and quality of life improvement. CONCLUSION The results provide support to interventions that combine intradialytic aerobic and resistance exercises to improve physical functioning and quality of life in end-stage renal disease patients undergoing hemodialysis.
Collapse
Affiliation(s)
- Mansueto Gomes Neto
- 1 Physical Therapy Department, Federal University of Bahia (UFBA), Salvador, Brazil.,2 Programa de Pós Graduação em Medicina e Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,3 Physiotherapy Research Group, Federal University of Bahia (UFBA), Salvador, Brazil
| | | | - Antonio Alberto Lopes
- 4 Departamento de Medicina Interna e Apoio Diagnóstico, Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | - Bruno Prata Martinez
- 1 Physical Therapy Department, Federal University of Bahia (UFBA), Salvador, Brazil.,3 Physiotherapy Research Group, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Micheli Bernardone Saquetto
- 1 Physical Therapy Department, Federal University of Bahia (UFBA), Salvador, Brazil.,2 Programa de Pós Graduação em Medicina e Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,3 Physiotherapy Research Group, Federal University of Bahia (UFBA), Salvador, Brazil
| |
Collapse
|
4
|
Parmenter BJ, Dieberg G, Smart NA. Authors’ Reply to Li et al.: “Alternative Statistical Analysis Shows Exercise Training-Induced Improvements in Peak VO2 are Clinically Significant”. Sports Med 2015; 45:767-8. [DOI: 10.1007/s40279-015-0316-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|