To assess the effects of pain neuroscience education (PNE) on patients with fibromyalgia in terms of pain intensity, fibromyalgia impact, anxiety, and pain catastrophizing. A systematic review with meta-analysis of randomized controlled trials was conducted. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated with RStudio software (RStudio, Boston, MA) for relevant outcomes and were pooled in a meta-analysis with the random effects model. A total of eight studies were included. The meta-analysis showed statistically significant differences in pain intensity with a moderate clinical effect in seven studies at the post-intervention assessment (SMD: –0.76; 95% CI: –1.33 to –0.19; P < 0.05) with evidence of significant heterogeneity (P < 0.05, I² = 92%), but it did not show statistically significant differences in fibromyalgia impact, anxiety, and pain catastrophizing (P > 0.05). With regard to the follow-up assessment, only the fibromyalgia impact showed significant improvements, with a very small clinical effect in nine studies (SMD: –0.44; 95% CI: –0.73 to –0.14; P < 0.05) and evidence of significant heterogeneity (P < 0.05, I² = 80%). After the application of a sensitivity analysis with the PNE face-to-face interventions, the meta-analysis showed a significant decrease in pain intensity, with a moderate clinical effect at the post-intervention and follow-up assessments without evidence of significant heterogeneity (P < 0.05, I² = 10%). There is low-quality evidence that in patients with fibromyalgia, PNE can decrease the pain intensity in the post-intervention period and the fibromyalgia impact in the follow-up period. However, it appears that PNE showed no effect on anxiety and pain catastrophizing.

Objective: To assess the available evidence on the effectiveness of high‐intensity interval training (HIIT) in addition to first‐choice cancer treatment on cardiorespiratory fitness (CRF), quality of life (QoL), adherence, and adverse effects of HIIT in patients with cancer or cancer survivors.Methods: An umbrella review and meta‐meta‐analysis (MMA) was performed. A systematic search was conducted in MEDLINE, EMBASE, Cochrane Database, CINAHL, Scopus, SPORTDiscus, and Web of Science until August 2021. Article selection, quality assessment, and risk of bias assessment were performed by two independent reviewers. The MMA were performed with a random‐effects model and the summary statistics were presented in the form of forest plot with a weighted compilation of all standardized mean differences (SMD) and corresponding 95% confidence interval (CI).Results: Seven systematic reviews were included. Regarding CRF, the addition of HIIT to cancer treatment showed statistically significant differences with a small clinical effect, compared with adding other treatments (SMD = 0.45; 95% CI 0.24 to 0.65). There was no significant difference when compared with adding moderate‐intensity continuous training (MICT) (SMD = 0.23; 95% CI −0.04 to 0.50). QoL showed positive results although with some controversy. Adherence to HIIT intervention was high, ranging from 54% to 100%. Regarding adverse effects, most of the systematic reviews reported none, and in the cases in which they occurred, they were mild.Conclusion: In conjunction with first‐choice cancer treatment, HIIT has been shown to be an effective intervention in terms of CRF and QoL, as well as having optimal adherence rate. In addition, the implementation of HIIT in patients with cancer or cancer survivors is safe as it showed no or few adverse effects.

The purpose of this study was to assess the current evidence for the effects of neural mobilization (NM) treatments. Three umbrella reviews with meta–meta-analyses (MMAs) were conducted to determine the effects of NM on pain intensity and disability in people with musculoskeletal disorders and on mechanosensitivity in participants who were asymptomatic. The study used the grading criteria proposed by the Physical Activity Guidelines Advisory Committee to assess the quality of evidence. One MMA revealed a statistically significant moderate effect on pain intensity (standardized mean difference [SMD] = −0.75; 95% CI = −1.12 to −0.38) but with evidence of heterogeneity (Q = 14.13; I² = 65%). The study found a significantly large effect of NM on disability (SMD = −1.22; 95% CI = −2.19 to −0.26), again with evidence of heterogeneity (Q = 31.57; I² = 87%). The third MMA showed a statistically significant moderate effect of NM on mechanosensitivity (SMD = 0.96; 95% CI = 0.35 to 1.57), with no evidence of heterogeneity (Q = 2.73; I² = 63%). For all examined outcomes, the quality of evidence was limited. Overall, the results indicated that although NM treatment had a moderate to large beneficial clinical effect on pain intensity and disability in people with musculoskeletal disorders and on mechanosensitivity in individuals who were asymptomatic, the quality of evidence was limited. Neural mobilization treatments showed positive results on the pain intensity and disability in patients with musculoskeletal conditions. Neural mobilization could be integrated into the physical therapy management, although more research is needed.