Current exercise guidelines recommend aerobic types of exercises on most days of the week, supplemented with dynamic resistance exercise twice weekly. Whereas the blood pressure (BP)-lowering effects of a single session of aerobic exercise have been well studied, less is known about the hypotensive effect of a single bout of resistance exercise. To evaluate the transient effect of resistance exercise on BP by means of meta-analytic techniques. A systematic electronic search in Medline, Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), Elton B Stephens Company (EBSCO), EMBASE and SPORTDiscus was completed in March 2015 identifying randomised controlled trials investigating the effect of a single bout of resistance exercise on resting or ambulatory BP in healthy adults. A subsequent meta-analysis was performed. The meta-analysis involved 30 studies, 81 interventions and 646 participants (normotensive (n = 505) or hypertensive (n = 141)). A single bout of resistance exercise elicited small-to-moderate reductions in office systolic BP at 60 minutes postexercise [−3.3 (−4.0 to −2.6)/−2.7 (−3.2 to −2.1) mmHg (CI 95%)], 90 minutes postexercise [−5.3 (−8.5 to −2.1)/−4.7 (−6.9 to −2.4) mmHg (CI 95%)] and in 24–hour ambulatory BP [−1.7 (−2.8 to −0.67)/−1.2 (−2.4 to −0.022) mmHg (CI 95%)] compared to a control session. The reduction in office BP was more pronounced in hypertensive compared to normotensive individuals (p < 0.01), when using larger muscle groups (p < 0.05) and when participants were recovering in the supine position (p < 0.01). A single bout of resistance exercise can have a BP-lowering effect that last for up to 24 hours. Supine recovery and the use of larger muscle groups resulted in greater BP reductions after resistance exercise.
To summarize evidence on the effectiveness of virtual reality games and conventional therapy or no-intervention for fall prevention in the elderly. An electronic data search (last searched December 2016) was performed on 10 databases (Web of Science, EMBASE, PUBMED, CINAHL, LILACS, SPORTDiscus, Cochrane Library, Scopus, SciELO, PEDro) and retained only randomized controlled trials. Sample characteristics and intervention parameters were compared, focusing on clinical homogeneity of demographic characteristics, type/duration of interventions, outcomes (balance, reaction time, mobility, lower limb strength and fear of falling) and low risk of bias. Based on homogeneity, a meta-analysis was considered. Two independent reviewers assessed the risk of bias. A total of 28 studies met the inclusion criteria and were appraised (n: 1121 elderly participants). We found that virtual reality games presented positive effects on balance and fear of falling compared with no-intervention. Virtual reality games were also superior to conventional interventions for balance improvements and fear of falling. The six studies included in the meta-analysis demonstrated that virtual reality games significantly improved mobility and balance after 3–6 and 8–12 weeks of intervention when compared with no-intervention. The risk of bias revealed that less than one-third of the studies correctly described the random sequence generation and allocation concealment procedures. Our review suggests positive clinical effects of virtual reality games for balance and mobility improvements compared with no-treatment and conventional interventions. However, owing to the high risk of bias and large variability of intervention protocols, the evidence remains inconclusive and further research is warranted.
Objective: To perform a systematic review with meta-analyses that evaluates the effectiveness of the Pilates method on the pain and functionality outcome in adults with non-specific chronic low back pain.
1 June 2012 in Best Practice & Research Clinical Rheumatology
Clinical decision-making is complex and based upon accurate evaluation of clinical findings using diagnostic tests and reference standard data. Given that many aspects of dental examination are not direct measures, but rely on indirect measures, it is important for clinicians to understand the basic principles and terms used to assess the accuracy of diagnostic tests and to appropriately evaluate published literature regarding these tests. Luckily, there is a variety of readily available metric systems to assess the quality of diagnostic test studies and to help clinicians better understand evidence-based literature.
To compare the effectiveness of aquatic exercises with patient-education in individuals with knee osteoarthritis. Randomized controlled trial with blinded assessor and intention-to-treat analysis. Aquatic Physiotherapy Centre and Primary Health Care Unit. A total of 60 patients, aged 68.3 (SD = 4.8) with clinical symptoms and radiographic grading (Kellgren–Lawrence 1–4) of knee osteoarthritis were included. An eight-week treatment protocol of aquatic exercise (n = 31) (16 individual sessions, twice a week) and an educational program (group sessions, once a week) (n = 29). Before, after eight-week intervention, and a three-month follow-up with results for the following outcome measures: pain, function, quality of life, functional mobility, and depression. At the end of treatment, the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) functional capacity values reduced in favour of the aquatic exercise group for both the total score MD (mean difference) = –14.2; 95% CI (confidence interval) (−18; −10.5), P = 0.04 and the pain domain MD = −3.8 points; 95% CI (−8.71; −1), P = 0.021. The total score also reduced in the follow-up: MD = −12.3 points; 95% CI (−24.7; −6.1), P = 0.017. No differences were found for the outcomes functional mobility or depression. Aquatic exercise improved pain and function after eight weeks, and function at the three-month follow-up compared to the patient-education program.