Effectiveness of functional training on cardiorespiratory parameters: a systematic review and meta-analysis of randomized controlled trials

Effects of cardiorespiratory rehabilitation program on submaximal exercise in patients with long-COVID-19 conditions: a systematic review of randomized controlled trials and recommendations for future studies

INTRODUCTION

Long-COVID-19 patients (LC19Ps) often experience cardiovascular and respiratory complications. Cardiorespiratory rehabilitation programs (CRRPs) have emerged as promising interventions to enhance exercise capacity in this population. This systematic review aimed to assess the impact of CRRPs on submaximal exercise performance, specifically the 6-minute walk test (6MWT) outcomes, in LC19Ps through an analysis of available randomized controlled trials (RCTs).

METHODS

A systematic search was conducted in PubMed/Medline and Scopus to identify relevant RCTs. Six RCTs meeting inclusion criteria were included in this review, investigating the effects of CRRPs on 6MWT outcomes in LC19Ps.

RESULTS

The findings from the included RCTs provide compelling evidence supporting the effectiveness of CRRPs in improving submaximal exercise performance in LC19Ps. These results underscore the potential of CRRPs to enhance submaximal exercise capacity and overall functional well-being in this population. However, future research is imperative to determine optimal CRRPs, including duration, intensity, and specific intervention components. Additionally, the long-term sustainability and durability of CRRP-induced improvements warrant further exploration. Future studies should prioritize patient-centric outcomes and address potential implementation barriers.

CONCLUSION

CRRPs show promise in ameliorating submaximal exercise performance among LC19Ps. Further research is needed to refine these programs and ensure their lasting impact on this patient group.

SYSTEMATIC REVIEW REGISTRATION

https://doi.org/10.17605/OSF.IO/HMN38. [Figure: see text].

Impact of cardiorespiratory rehabilitation program on submaximal exercise capacity of Tunisian male patients with post-COVID19: A pilot study

Post-COVID19 patients suffer from persistent respiratory, cardiovascular, neurological, and musculoskeletal health complaints such as dyspnea, chest pain/discomfort, and fatigue. In Tunisia, the potential benefits of a cardiorespiratory rehabilitation program (CRRP) after COVID19 remain unclear. The main aim of this study was to evaluate the impact of a CRRP on submaximal exercise capacity, evaluated through the 6-min walk test (6MWT) data in post-COVID19 Tunisian patients. This was a cross-sectional study including 14 moderate to severe COVID19 patients aged from 50 to 70 years. CRRP was performed after the end of patients’ hospitalization in COVID19 units for extensive or severe extents of COVID19. Dyspnea (modified medical research council), spirometry data, handgrip strength values, 6MWT data, and 6-min walk work (i.e., 6-min walk distance x weight) were evaluated 1-week pre-CRRP, and 1-week post-CRRP. CRRP included 12 sessions [3 sessions (70 min each)/week for 4 weeks]. Exercise-training included aerobic cycle endurance, strength training, and educational sessions. Comparing pre- and post- CRRP results showed significant improvements in the means±standard deviations of dyspnea by 1.79 ± 0.80 points (p < 0.001), forced expiratory volume in one second by 110 ± 180 ml (p = 0.04), 6-min walk distance by 35 ± 42 m (p = 0.01), 6-min walk work by 2,448 ± 3,925 mkg (p = 0.048), resting heart-rate by 7 ± 9 bpm (p = 0.02) and resting diastolic blood pressure by 6 ± 10 mmHg (p = 0.045). In Tunisia, CRRP seems to improve the submaximal exercise capacity of post-COVID19 patients, mainly the 6-min walk distance and work.

Effectiveness and characteristics of physical fitness training on aerobic fitness in vulnerable older adults: an umbrella review of systematic reviews

OBJECTIVES

To present an overview of effectiveness and training characteristics of physical training on aerobic fitness, compared with alternative or no training, in adults aged over 65 years with various health statuses, providing a basis for guidelines for aerobic training of vulnerable older adults that can be used in geriatric rehabilitation.

DESIGN

An umbrella review of systematic reviews that included both randomised controlled trials and other types of trials.

DATA SOURCES

MEDLINE, Embase, CINAHL and the Cochrane Library were searched on 9 September 2019.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

We included systematic reviews reporting on physical training interventions that are expected to improve aerobic fitness, presenting results for adults aged 65 years and older, describing at least one of the FITT-characteristics: Frequency, Intensity, Time or Type of exercise, and measuring aerobic fitness at least before and after the intervention.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers extracted the data and assessed the risk of bias. A narrative synthesis was performed.

RESULTS

We included 51 papers on 49 reviews. Positive effect of training on aerobic fitness was reported by 33 reviews, 11 reviews remained inconclusive and 5 reviews reported no effect. Training characteristics varied largely. Frequency: 1-35 sessions/week, Intensity: light-vigorous, Time: <10-120 min/session and Types of exercise: many. The methodological quality was most often low. Subgroup analyses revealed positive effects for all health conditions except for trauma patients. Exercise characteristics from current existing guidelines are widely applicable. For vulnerable older adults, lower intensities and lower frequencies were beneficial. Some health conditions require specific adjustments. Information on adverse events was often lacking, but their occurrence seemed rare.

CONCLUSION

Physical fitness training can be effective for vulnerable older adults. Exercise characteristics from current existing guidelines are widely applicable, although lower frequencies and intensities are also beneficial. For some conditions, adjustments are advised.

PROSPERO REGISTRATION NUMBER

CRD42020140575.

The Effects of High-Intensity Multimodal Training in Apparently Healthy Populations: A Systematic Review

Background

High-intensity multimodal training (HIMT) is emerging as a popular training method that combines aerobic and resistance training throughout a single exercise session. The current literature is limited by a lack of terminology that broadly encompasses all styles of combined aerobic and resistance training. The magnitude of chronic or long-term (i.e.  ≥ 4 weeks) effects of HIMT participation on aerobic and muscular fitness also remains unclear. Additionally, one of many complex reasons for the growing popularity of HIMT may be attributed to the affective response to exercise, namely levels of enjoyment. However, this concept is not yet well understood across all styles of HIMT. A comprehensive systematic review is required to synthesise the available literature and attempt to provide an operational definition of HIMT to capture the breadth of combined training styles that exist.

Objective

The objective of this systematic review was to determine the chronic effects of HIMT participation on aerobic and muscular fitness and to compare HIMT to established concurrent training methods. Enjoyability and other adherence-related subjective responses were also examined in HIMT participants. This review critically assessed the level of evidence and feasibility of current HIMT guidelines.

Methods

A systematic literature search was conducted on PubMed, Web of Science and SPORTDiscus to identify studies up until March 2021.

Results

A total of 20 studies were included for review. Studies generally reported moderate to large effects on aerobic fitness and subjective responses in favour of HIMT interventions. Mixed outcomes were demonstrated in muscular fitness. These results should be treated with caution due to high risk of bias among included studies.

Conclusions

Few studies have assessed the chronic effects of HIMT participation on aerobic, and musculoskeletal adaptations and subjective responses, in particular exercise enjoyment. Research conclusions are limited by heterogeneity of experimental protocols and outcome measures. Furthermore, the inability of the literature to make adequate comparisons between various styles of HIMT and other concurrent training protocols limits understandings of the efficacy of HIMT.

Registration This systematic review was registered on the Open Science Framework (10.17605/OSF.IO/2RE4B; 26 March 2021).

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-022-00434-x.

Efeito do treinamento funcional na dor e capacidade funcional de mulheres idosas

Resumo Introdução: O crescimento da taxa de idosos no mundo pode tornar-se um problema de saúde pública quando estes exibem níveis insuficientes de atividade física, que têm o potencial de aumentar dores crônicas e causar incapacidade funcional. Objetivo: Analisar os efeitos do treinamento funcional na dor e capacidade funcional de mulheres idosas. Métodos: Desenvolveu-se um ensaio clínico controlado não randomizado com 32 idosas, divididas em dois grupos: treino funcional (TF: n = 17) e grupo controle (GC: n = 15). Como indicador da capacidade funcional foi utilizado o Teste de Aptidão Física para Idosos. A dor foi avaliada pelos relatos de sintomas de desconforto musculoesquelético e suas características por meio do Questionário Nórdico de Sintomas Osteomusculares de Dor e Escala visual Analógica de Dor (EVA). O programa de treinamento funcional foi aplicado por 12 semanas em uma frequên-cia de três vezes semanais. Resultados: Verificaram-se efeitos significativos após a intervenção no grupo TF, com redução da dor e aumento da flexibilidade e resistência para membros inferiores e capacidade cardiorrespiratória (p < 0,05). Conclusão: O programa de treinamento funcional em idosas foi efetivo para a melhoria das variáveis de flexibilidade de membros inferiores, percepção de dor, resistência de força de membros inferiores e capacidade cardiorrespiratória.

Effects of functional training on pain and functional capacity in elderly women

Abstract Introduction: The growing rate of elderly people in the world can became a public health problem when they exhibit insufficient levels of physical activity, which can increase chronic pain and lead to functional disability. Objective: To analyze the effects of functional training on pain and functional capacity in elderly women. Methods: A non-randomized controlled clinical trial was conducted with 32 elderly women, divided into two groups: functional training (FT: n = 17) and control group (CG: n = 15). Functional capacity was analyzed using the Physical Fitness Test for the Elderly. Pain was assessed by reports of musculoskeletal discomfort symptoms and their characteristics using the Nordic Musculoskeletal Pain Questionnaire and pain visual analog scale (VAS). The functional training program was applied for 12 weeks at a frequency of three times a week. Results: Significant effects after the intervention in the FT group were observed, with pain reduction, increased flexibility and resistance for lower limbs, and cardiorespiratory capacity (p < 0.05). Conclusion: The functional training program in elderly women was effective in improving the variables of lower limb flexibility, pain perception, lower limb strength resistance and cardiorespiratory capacity.

The safety and effectiveness of rehabilitation exercises on COVID-19 patients: A protocol for systematic review and meta-analysis

BACKGROUND

Corona Virus Disease 2019 (COVID-19) is spreading fast starting late 2019. It mainly affects the human respiratory system. Many reports revealed that rehabilitation exercise can improve respiratory function and relieve the pressure from diseases, but there is no evidence to prove its effects on COVID-19. This protocol of systematic review and meta-analysis will clarify the safety and effectiveness of rehabilitation exercises on different COVID-19 patients.

METHODS AND ANALYSIS

Related studies will be retrieved from Web of Science, Cochrane Library, PubMed, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, Wan fang Database, ClinicalTrials, WHO Trials, and Chinese Clinical Trial Registry. Pre-defined inclusion and exclusion criteria will be used by two researchers independently for extracting data from literatures. Clinical recovery time and effective rates will be assessed as the primary outcomes. Changes of patient's condition, pulmonary function, respiratory function and activity of daily living will be assessed as the secondary outcomes. Fixed effect model will be used for evaluating efficiency. Considering clinical heterogeneity, random effect model will be used for continuous outcomes. Funnel charts, subgroup analysis and sensitivity analysis will be used to explore sources of heterogeneity. Endnote X9.3 will be used to manage data screening. The statistical analysis will be completed by RevMan5.2 and Stata/SE 15.1 software.

RESULT

This study will assess effects and safety for practicing rehabilitation exercises on COVID-19 patients.

CONCLUSION

The conclusion of this study will provide evidence to prove the safety and effectiveness of rehabilitation exercises on COVID-19 patients.