Objective: This study aimed to compare and rank the effect of hypoxic practices on maximum oxygen consumption (VO₂max) in athletes and determine the hypoxic dose-response correlation using network meta-analysis.Methods: The Web of Science, PubMed, EMBASE, and EBSCO databases were systematically search for randomized controlled trials on the effect of hypoxc interventions on the VO₂max of athletes published from inception until 21 February 2023. Studies that used live-high train-high (LHTH), live-high train-low (LHTL), live-high, train-high/low (HHL), intermittent hypoxic training (IHT), and intermittent hypoxic exposure (IHE) interventions were primarily included. LHTL was further defined according to the type of hypoxic environment (natural and simulated) and the altitude of the training site (low altitude and sea level). A meta-analysis was conducted to determine the standardized mean difference between the effects of various hypoxic interventions on VO₂max and dose-response correlation. Furthermore, the hypoxic dosage of the different interventions were coordinated using the “kilometer hour” model.Results: From 2,072 originally identified titles, 59 studies were finally included in this study. After data pooling, LHTL, LHTH, and IHT outperformed normoxic training in improving the VO₂max of athletes. According to the P-scores, LHTL combined with low altitude training was the most effective intervention for improving VO₂max (natural: 0.92 and simulated: 0.86) and was better than LHTL combined with sea level training (0.56). A reasonable hypoxic dose range for LHTH (470–1,130 kmh) and HL (500–1,415 kmh) was reported with an inverted U-shaped curve relationship.Conclusion: Different types of hypoxic training compared with normoxic training serve as significant approaches for improving aerobic capacity in athletes. Regardless of the type of hypoxic training and the residential condition, LHTL with low altitude training was the most effective intervention. The characteristics of the dose-effect correlation of LHTH and LHTL may be associated with the negative effects of chronic hypoxia.

This study aimed to separately compare and rank the effect of various living-low and training-high (LLTH) modes on aerobic and anaerobic performances in athletes, focusing on training intensity, modality, and volume, through network meta-analysis. We systematically searched PubMed, Web of Science, Embase, EBSCO, and Cochrane from their inception date to June 30, 2023. Based on the hypoxic training modality and the intensity and duration of work intervals, LLTH was divided into intermittent hypoxic exposure, continuous hypoxic training, repeated sprint training in hypoxia (RSH; work interval: 5–10 s and rest interval: approximately 30 s), interval sprint training in hypoxia (ISH; work interval: 15–30 s), short-duration high-intensity interval training (s-IHT; short work interval: 1–2 min), long-duration high-intensity interval training (l-IHT; long work interval: > 5 min), and continuous and interval training under hypoxia. A meta-analysis was conducted to determine the standardized mean differences (SMDs) among the effects of various hypoxic interventions on aerobic and anaerobic performances. From 2,072 originally identified titles, 56 studies were included in the analysis. The pooled data from 53 studies showed that only l-IHT (SMDs: 0.78 [95% credible interval; CrI, 0.52–1.05]) and RSH (SMDs: 0.30 [95% CrI, 0.10–0.50]) compared with normoxic training effectively improved athletes’ aerobic performance. Furthermore, the pooled data from 29 studies revealed that active intermittent hypoxic training compared with normoxic training can effectively improve anaerobic performance, with SMDs ranging from 0.97 (95% CrI, 0.12–1.81) for l-IHT to 0.32 (95% CrI, 0.05–0.59) for RSH. When adopting a program for LLTH, sufficient duration and work intensity intervals are key to achieving optimal improvements in athletes’ overall performance, regardless of the potential improvement in aerobic or anaerobic performance. Nevertheless, it is essential to acknowledge that this study incorporated merely one study on the improvement of anaerobic performance by l-IHT, undermining the credibility of the results. Accordingly, more related studies are needed in the future to provide evidence-based support. It seems difficult to achieve beneficial adaptive changes in performance with intermittent passive hypoxic exposure and continuous low-intensity hypoxic training.

This study aims to compare, through quantitative analysis, the effectiveness of different endurance training types on increasing lower limb strength and muscle cross-sectional area (MCSA) in concurrent training. This systematic literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) [PROSPERO ID: CRD42023396886]. Web of Science, SportDiscuss, Pubmed, Cochrane, and Scopus were systematically searched from their inception date to October 20, 2023. A total of 40 studies (841 participants) were included in this meta-analysis. MCSA analysis showed that, compared to resistance training alone, concurrent high-intensity interval running training and resistance training and concurrent moderate-intensity continuous cycling training and resistance training were more effective (SMD = 0.15, 95% CI = −0.46 to 0.76, and SMD = 0.07, 95% CI = −0.24 to 0.38 respectively), while other modalities of concurrent training not. Lower body maximal strength analysis showed that all modalities of concurrent training were inferior to resistance training alone, but concurrent high-intensity interval training and resistance training showed an advantage in four different concurrent training modalities (SMD = −0.08, 95% CI = −0.25 to 0.08). For explosive strength, only concurrent high-intensity interval training and resistance training was superior to resistance training (SMD = 0.06, 95% CI = −0.21 to 0.33). Different endurance training types have an impact on the effectiveness of concurrent training, particularly on lower limb strength. Adopting high-intensity interval running as the endurance training type in concurrent training can effectively minimize the adverse effects on lower limb strength and MCSA.

Background: Exercise is an effective treatment for asthma, but there is still ongoing debate regarding the most beneficial form of exercise. This study used data from randomized controlled trials to compare and rank the types of exercise that improve asthma-related quality of life (QOL) in patients [total score and four subdomain scores (symptoms, activity limitations, emotional functions, and environmental stimulants)]. Method: This study was meticulously conducted using a rigorous methodology. We included randomized controlled trials of 10 types (two major categories: single-mode exercise and comprehensive-mode exercise) of exercise for the interventional treatment of asthmatics (≥16 years old). The effect size measures were standardized mean differences (SMDs) with 95% credible intervals (CrIs). The confidence of evidence was examined using Confidence in network meta-analysis. The study protocol has been registered with PROSPERO under registration number CRD420251110553. Result: We identified 1,237 citations based on 35 studies involving 3,946 participants. Compared with the control group, all comprehensive-mode exercises (yoga, aerobic combined with breathing or resistance exercise) significantly improved the total score of asthma-related QOL (and four subdomain scores) among participants, and the SMDs [95% Credible Interval (CrI)] ranged between 2.26 (1.63 to 2.90) for Yoga to 1.06 (0.01 to 2.11) for high-intensity interval training (HIIT). Notably, HIIT demonstrated promising trends in improving asthma-related QOL compared to moderate-intensity aerobic exercises ( P -score = 0.58). While Buteyko ( P -score = 0.48) ranked first among various breathing exercises, the differences in efficacy between these methods were mostly small or uncertain. exercise prescription were significant factors affecting the network meta-analysis results. Conclusion: Various comprehensive exercise modes are the best way to improve asthma-related QOL in patients. The exercise period will affect the effectiveness of the rehabilitation program. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251110553 , PROSPERO CRD420251110553.

Objective: This study assessed the blood-pressure effects of various exercise regimens in middle-aged and older adults with type 2 diabetes, considering baseline levels, to clarify dose–response relationships for personalized exercise guidance. Methods: We conducted a dose–response network meta-analysis. Systematic searches were performed in Web of Science, EMBASE, PubMed and Cochrane Library. Baseline blood pressure was modelled as an explanatory variable via meta-regression. Thirty-six eligible RCTs of physical-activity interventions in older adults with type 2 diabetes reporting blood-pressure outcomes were included. Results: In stage 1–2 hypertension, mind–body activities were associated with the greatest systolic blood-pressure reduction and appear to be the most effective intervention based on available evidence. For diastolic blood pressure, combined aerobic-resistance training was effective in stage 1 hypertension. Dose–response analysis indicated that clinically meaningful reductions occur at modest volumes (668 and 657 MET-min/week for systolic and diastolic pressures, respectively), aligning with the lower end of international activity guidelines. Conclusions: Individualized exercise prescription based on baseline blood pressure may offer a useful non-pharmacological strategy for hypertension management in older adults with type 2 diabetes. By quantifying the required activity dose, this work provides an evidence base for integrating structured exercise into precision care for this high-risk population.

Background: Uncertainty persists regarding the dose–response association between exercise exposure and blood pressure (BP) control in chronic kidney disease (CKD). This dose–response network meta-analysis examined whether different exercise modalities and model-estimated metabolic-equivalent exposure levels were associated with changes in systolic BP (SBP) and diastolic BP (DBP). Methods: Exercise dose was estimated as metabolic equivalents of task minutes per week (MET-min/week) from reported session duration, frequency, and intensity. Primary outcomes were changes in SBP and DBP, with exploratory subgroup analyses by dialysis status, baseline BP, and intervention duration. Results: The analysis included 26 randomized controlled trials (1218 participants). Aerobic exercise was associated with lower SBP, with the greatest model-estimated reduction at 880 MET-min/week (MD, −7.73 mm Hg). Resistance and mind–body exercise also showed model-estimated reductions, whereas combined aerobic-resistance training was not statistically significant. Dose–response estimates differed by dialysis status and intervention length, but several subgroup estimates were based on sparse data and wide uncertainty. Evidence certainty ranged from very low to high (CINeMA). Conclusions: Exercise interventions may be associated with BP reduction in CKD, but the identified MET-min/week ranges should be interpreted as exploratory, model-derived estimates rather than validated therapeutic thresholds. Better reported randomized trials are needed to confirm dose ranges, safety, adherence, and tolerability in dialysis and non-dialysis CKD populations.