The aim of the present study was to analyze the effects of whole-body vibration on lower limb muscle architecture, muscle strength, and balance in stroke patients during a period of 3 mos. The inclusion criteria were having had ischemic or hemorrhagic stroke at least 6 mos before the study and a National Institutes of Health Stroke Scale score of greater than 1 and less than 20. The patients were randomly divided into two groups: an experimental group (n = 11, six men and five women; age, 62.4 ± 10.7 yrs; height, 1.64 ± 0.07 m; mass, 69.4 ± 12.9 kg) and a sham group (n = 9, five men and four women; age, 64.4 ± 7.6 yrs; height, 1.62 ± 0.07 m; mass, 75.0 ± 15.8 kg). The experimental group received a whole-body vibration treatment, with an increase in frequency, sets, and time per set during 17 sessions. The sham group performed the same exercises as that of the experimental group but was not exposed to vibration. Outcome variables included the muscle architecture (the rectus femoris, the vastus lateralis, and the medial gastrocnemius), the maximal isometric voluntary contraction of the knee extensors, and the Berg Balance Scale. There were no significant differences between the groups on the primary outcomes of lower limb muscle architecture, muscle strength, and balance. It seems that whole-body vibration exercise does not augment the increase in neuromuscular performance and lower limb muscle architecture induced by isometric exercise alone in stroke patients.

Aims: This systematic review aims to evaluate and summarize findings from published meta-analyses on the effects of regular exercise in patients with peripheral arterial disease (PAD). The review will assess the impact of exercise on functional parameters, health-related quality of life, haemodynamic parameters, physical activity levels, adverse events, and mortality. Methods and results: A systematic search was performed in PubMed, Web of Science, Scopus, and Cochrane Library databases (up to May 2023) to identify meta-analyses including randomized controlled trials that examined the effects of regular exercise in patients with PAD. Sixteen studies, with a total of 198 meta-analyses, were identified. Results revealed with strong evidence that patients with PAD who exercised improved functional and health-related quality of life parameters. Specifically, supervised aerobic exercise (i.e. walking to moderate–maximum claudication pain) improves maximum walking distance [mean difference (MD): 177.94 m, 95% confidence interval (CI) 142.29–213.60; P < 0.00001; I2: 65%], pain-free walking distance (fixed MD: 68.78 m, 95% CI 54.35–83.21; P < 0.00001; I2: 67%), self-reported walking ability [i.e. distance score (MD: 9.22 points, 95% CI 5.74–12.70; P < 0.00001; I2: 0%), speed score (MD: 8.71 points, 95% CI 5.64–11.77; P < 0.00001, I2: 0%), stair-climbing score (MD: 8.02 points, 95% CI 4.84–11.21; P < 0.00001, I2: 0%), and combined score (MD: 8.76 points, 95% CI 2.78–14.74; P < 0.0001, I2: 0%)], aerobic capacity (fixed MD: 0.62 mL/kg/min, 95% CI 0.47–0.77, P < 0.00001, I2: 64%), and pain score (MD: 7.65, 95% CI 3.15–12.15; P = 0.0009; I2: 0%), while resistance exercise improves lower limb strength (standardized mean difference: 0.71, 95% CI 0.29–1.13, P = 0.0009; I2: 0%]. Regarding other outcomes, such as haemodynamic parameters, no significant evidence was found, while physical activity levels, adverse events, and mortality require further investigation. Conclusion: Synthesis of the currently available meta-analyses suggests that regular exercise may be beneficial for a broad range of functional tasks improving health-related quality of life in patients with PAD. Supervised aerobic exercise is the best type of exercise to improve walking-related outcomes and pain, while resistance exercise is more effective to improve lower limb strength.

In order to ascertain whether differing structural mechanisms could underlie blood flow restricted training (BFRT) and high intensity training (HIT), this study had two aims: (i) to gain an insight into the acute variations of muscle architecture following a single bout of two different volumes of BFRT, and (ii) to compare these variations with those observed after HIT. Thirty-five young men volunteered for the study and were randomly divided into three groups: BFRT low volume (BFRT LV), BFRT high volume (BFRT HV) and traditional high intensity resistance training (HIT). All subjects performed a bilateral leg extension exercise session with a load of 20% of one repetition maximum (1RM) in the BFRT groups, whereas the load of the HIT group was equivalent to an 85% of their 1RM. Before and immediately after the exercise bout, ultrasound images were taken from the rectus femoris (RF) and the vastus lateralis (VL). All groups increased their RF (p < 0.001) and VL (p < 0.001) muscle thickness, while the increases in pennation angle were larger in HIT as compared to BFRT LV (p = 0.013) and BFRT HV (p = 0.037). These results support the hypothesis that acute muscle cell swelling may be involved in the processes underlying BFRT induced muscle hypertrophy. Furthermore, our data indicate differing structural responses to exercise between BFRT and HIT.

Pediatric chronic pain is a common public health problem with a high prevalence among children and adolescents. The aim of this study was to review the current knowledge of health professionals on pediatric chronic pain between 15–30% among children and adolescents. However, since this is an underdiagnosed condition, it is inadequately treated by health professionals. To this aim, a systematic review was carried out based on a search of the electronic literature databases (PubMed and Web of Science), resulting in 14 articles that met the inclusion criteria. The analysis of these articles seems to show a certain degree of heterogeneity in the surveyed professionals about the awareness of this concept, especially regarding its etiology, assessment, and management. In addition, the extent of knowledge of the health professionals seems to be insufficient regarding these aspects of pediatric chronic pain. Hence, the knowledge of the health professionals is unrelated to recent research that identifies central hyperexcitability as the primary factor affecting the onset, persistence, and management of pediatric chronic pain.