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Objective: Rheumatoid arthritis and age are associated with high sarcopenia risk. Exercise is an effective treatment for preventing muscle mass loss in older adult populations. It remains unclear whether exercise affects muscle mass in people with rheumatoid arthritis. Thus, this meta-analysis investigated the effect of exercise on muscle mass gain in patients with rheumatoid arthritis. Data sources: PubMed, EMBASE, the Cochrane Library, the Physiotherapy Evidence Database (PEDro), the China Knowledge Resource Integrated Database, and Google Scholar were systematically searched until June 2021. Methods: The present study was conducted according to the guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Randomized controlled trials (RCTs) that reported the effects of exercise on muscle mass for rheumatoid arthritis were identified. The included RCTs were subject to meta-analysis and risk of bias assessment. Subgroup and random-effects meta-regression analyses were performed to identify any heterogeneity ( I2) of treatment effects across studies. Results: We included nine RCTs with a median PEDro score of 6/10 (range: 4/10–8/10). The weighted mean effect size for muscle mass was 0.77 (95% CI: 0.30–1.24; P = 0.001; I2 = 77%). Meta-regression analyses indicated that the disease duration significantly explained variance of treatment effects across studies (β = −0.006, R2 = 69.7%, P = 0.005). Conclusions: Exercise therapy effectively increased muscle mass in patients with rheumatoid arthritis. Treatment effects may be attenuated in those who have had rheumatoid arthritis for a relatively long time.
Chun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. Exercise therapy for sarcopenia in rheumatoid arthritis: A meta-analysis and meta-regression of randomized controlled trials. Clinical Rehabilitation 2021, 1 .
AMA StyleChun-De Liao, Hung-Chou Chen, Shih-Wei Huang, Tsan-Hon Liou. Exercise therapy for sarcopenia in rheumatoid arthritis: A meta-analysis and meta-regression of randomized controlled trials. Clinical Rehabilitation. 2021; ():1.
Chicago/Turabian StyleChun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. 2021. "Exercise therapy for sarcopenia in rheumatoid arthritis: A meta-analysis and meta-regression of randomized controlled trials." Clinical Rehabilitation , no. : 1.
Older adults with knee osteoarthritis (KOA) are at high risk of sarcopenia. Protein-rich nutritional composition supplementation (PS) combined with resistance exercise training (RET) improves muscle gains and facilitates physical activity in older adults. However, whether PS augments the effects of RET on muscle mass and PA in patients with KOA remains unclear. Therefore, this study identified the effects of PS on sarcopenic indices and PA in older women with KOA subjected to an RET program. Eligible older women aged 60–85 years and diagnosed as having KOA were randomly assigned to either the experimental group (EG) or the control group (CG). Both groups performed RET twice a week for 12 weeks. The EG received additional PS during this period. Outcome measures included appendicular lean mass index, walking speed, physical activity, and scores on the Western Ontario and McMaster Universities Osteoarthritis Index—WOMAC). All measures were tested at baseline and after intervention. With participant characteristics and baseline scores as covariates, analysis of variance was performed to identify between-group differences in changes in all outcome measures after intervention. Statistical significance was defined as p< 0.05. Compared with the CG, the EG achieved greater changes in appendicular lean mass index (adjusted mean difference (aMD) = 0.19 kg/m2, p< 0.01), physical activity (aMD = 30.0 MET-hour/week, p< 0.001), walking speed (aMD = 0.09 m/s, p< 0.05), and WOMAC global function (aMD = −8.21, p< 0.001) after intervention. In conclusion, PS exerted augmentative effects on sarcopenic indices, physical activity, and perceived global WOMAC score in older women with KOA through 12 weeks of RET.
Chun-De Liao; Yi-Hung Liao; Tsan-Hon Liou; Ching-Ya Hsieh; Yu-Chi Kuo; Hung-Chou Chen. Effects of Protein-Rich Nutritional Composition Supplementation on Sarcopenia Indices and Physical Activity during Resistance Exercise Training in Older Women with Knee Osteoarthritis. Nutrients 2021, 13, 2487 .
AMA StyleChun-De Liao, Yi-Hung Liao, Tsan-Hon Liou, Ching-Ya Hsieh, Yu-Chi Kuo, Hung-Chou Chen. Effects of Protein-Rich Nutritional Composition Supplementation on Sarcopenia Indices and Physical Activity during Resistance Exercise Training in Older Women with Knee Osteoarthritis. Nutrients. 2021; 13 (8):2487.
Chicago/Turabian StyleChun-De Liao; Yi-Hung Liao; Tsan-Hon Liou; Ching-Ya Hsieh; Yu-Chi Kuo; Hung-Chou Chen. 2021. "Effects of Protein-Rich Nutritional Composition Supplementation on Sarcopenia Indices and Physical Activity during Resistance Exercise Training in Older Women with Knee Osteoarthritis." Nutrients 13, no. 8: 2487.
Aging and osteoarthritis are associated with high risk of muscle mass loss, which leads to physical disability; this loss can be effectively alleviated by diet (DI) and exercise (ET) interventions. This study investigated the relative effects of different types of diet, exercise, and combined treatment (DI+ET) on muscle mass and functional outcomes in individuals with obesity and lower-limb osteoarthritis. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of DI, ET, and DI+ET in patients with obesity and lower-extremity osteoarthritis. The included RCTs were analyzed through network meta-analysis and risk-of-bias assessment. We finally included 34 RCTs with a median (range/total) Physiotherapy Evidence Database score of 6.5 (4–8/10). DI plus resistance ET, resistance ET alone, and aerobic ET alone were ranked as the most effective treatments for increasing muscle mass (standard mean difference (SMD) = 1.40), muscle strength (SMD = 1.93), and walking speed (SMD = 0.46). Our findings suggest that DI+ET is beneficial overall for muscle mass in overweight or obese adults with lower-limb osteoarthritis, especially those who are undergoing weight management.
Shu-Fen Chu; Tsan-Hon Liou; Hung-Chou Chen; Shih-Wei Huang; Chun-De Liao. Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials. Nutrients 2021, 13, 1992 .
AMA StyleShu-Fen Chu, Tsan-Hon Liou, Hung-Chou Chen, Shih-Wei Huang, Chun-De Liao. Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials. Nutrients. 2021; 13 (6):1992.
Chicago/Turabian StyleShu-Fen Chu; Tsan-Hon Liou; Hung-Chou Chen; Shih-Wei Huang; Chun-De Liao. 2021. "Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials." Nutrients 13, no. 6: 1992.
Osteoarthritis is one of the leading causes of disability. Total knee arthroplasty (TKA) is a surgical intervention for patients with severe osteoarthritis. Post TKA rehabilitation is crucial for improving patient’s quality of life. However, traditional rehabilitation has only focused on physical function; a systemic analysis of other dimensions such as social participation and environmental factors of post TKA rehabilitation is lacking. The aim of this study was to develop a core set from the International Classification of Functioning, Disability and Health (ICF) to create a comprehensive rehabilitation program for patients with osteoarthritis post TKA. Before the Delphi-based consensus process, a literature review process was performed for related ICF categories selection. We used a three-round Delphi-based consensus among 20 physical therapists with orthopedic rehabilitation expertise in a university-based hospital. A five-point Likert scale was used to rate the importance of each item. The consensus of ratings was analyzed using Spearman’s rho and semi-interquartile range indices. The ICF core set for post TKA rehabilitation was determined based on a high level of consensus and a mean score of ≥4.0 in the third Delphi-based consensus round. The ICF core set comprised 32 categories, with 13 regarding body function, four regarding body structures, nine regarding activities and participation, four regarding environmental factors, and two regarding personal factors. Our ICF core set for post TKA rehabilitation can provide information on effective rehabilitation strategies and goal setting for patients post TKA. However, further validation and feasibility assessments are warranted.
Shih-Wei Huang; Yi-Wen Chen; Reuben Escorpizo; Chun-De Liao; Tsan-Hon Liou. Development International Classification of Functioning, Disability and Health Core Set for Post Total Knee Replacement Rehabilitation Program: Delphi-Based Consensus Study in Taiwan. International Journal of Environmental Research and Public Health 2021, 18, 1630 .
AMA StyleShih-Wei Huang, Yi-Wen Chen, Reuben Escorpizo, Chun-De Liao, Tsan-Hon Liou. Development International Classification of Functioning, Disability and Health Core Set for Post Total Knee Replacement Rehabilitation Program: Delphi-Based Consensus Study in Taiwan. International Journal of Environmental Research and Public Health. 2021; 18 (4):1630.
Chicago/Turabian StyleShih-Wei Huang; Yi-Wen Chen; Reuben Escorpizo; Chun-De Liao; Tsan-Hon Liou. 2021. "Development International Classification of Functioning, Disability and Health Core Set for Post Total Knee Replacement Rehabilitation Program: Delphi-Based Consensus Study in Taiwan." International Journal of Environmental Research and Public Health 18, no. 4: 1630.
Introduction: Knee osteoarthritis (KOA) is associated with an increased risk of sarcopenia, and aging-related muscle deterioration continues after total knee replacement (TKR). Low skeletal muscle mass index may influence postoperative rehabilitation outcomes. Through this study, we aimed to investigate the impact of preoperative sarcopenia on clinical outcomes after postoperative rehabilitation in older Asian adults. Methods: A total of 190 older adults (39 men, 151 women) were enrolled from two previous trials and were classified as having no sarcopenia, class I sarcopenia, or class II sarcopenia according to definitions provided by the Asian Working Group for Sarcopenia (AWGS) and the European Working Group on Sarcopenia in Older People (EWGSOP). All patients were retrospectively analyzed before (T0) and after (T1) TKR rehabilitation and 10 months after surgery (T2). The outcome measures included the timed up-and-go test (TUGT), gait speed (GS), timed chair rise (TCR), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and physical difficulty (WOMAC-PF). With patient characteristics and T0 scores as covariates, an analysis of variance was performed to identify intergroup differences in changes of all outcome measures at T1 and T2. Results: According to the definitions of both the AWGS and EWGSOP, patients with class I and class II sarcopenia exhibited minor changes in TUGT, GS, TCR, and WOMAC-PF at T1 and T2 (all p < 0.05), compared with those without sarcopenia. For patients classified as having sarcopenia based on AWGS and EWGSOP definitions, no significant intergroup differences in WOMAC pain score was observed at T1 or T2 (all p > 0.05). Conclusions: Sarcopenia independently had negative impacts on the treatment effects of rehabilitation on physical mobility but not on pain outcome after TKR in older adults with KOA.
Chun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. Impact of sarcopenia on rehabilitation outcomes after total knee replacement in older adults with knee osteoarthritis. Therapeutic Advances in Musculoskeletal Disease 2021, 13, 1 .
AMA StyleChun-De Liao, Hung-Chou Chen, Shih-Wei Huang, Tsan-Hon Liou. Impact of sarcopenia on rehabilitation outcomes after total knee replacement in older adults with knee osteoarthritis. Therapeutic Advances in Musculoskeletal Disease. 2021; 13 ():1.
Chicago/Turabian StyleChun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. 2021. "Impact of sarcopenia on rehabilitation outcomes after total knee replacement in older adults with knee osteoarthritis." Therapeutic Advances in Musculoskeletal Disease 13, no. : 1.
Aging and osteoarthritis (OA) are associated with a high risk of muscle mass loss, which can lead to physical disability. This study investigated the effectiveness of protein supplementation combined with exercise training (PS + ET) in improving muscle mass and functional outcomes in older adults with lower-limb OA. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) on the effectiveness of PS + ET in older adults with hip or knee OA. Meta-analysis and risk of bias assessment of the included RCTs were conducted. Six RCTs were included in this systemic review; they had a median (range/total) Physiotherapy Evidence Database (PEDro) score of 7 (6–9) out of 10, respectively. Five RCTs that enrolled patients who underwent total joint replacement were included in this meta-analysis. The PS + ET group exhibited significant improvements in muscle mass (standard mean difference [SMD] = 1.13, p < 0.00001), pain (SMD = 1.36, p < 0.00001), and muscle strength (SMD = 0.44, p = 0.04). Our findings suggest that PS + ET improves muscle mass, muscle strength, and functional outcomes and reduces pain in older adults with lower-limb OA, particularly in those who have undergone total joint replacement.
Chun-De Liao; Yen-Tzu Wu; Jau-Yih Tsauo; Pey-Rong Chen; Yu-Kang Tu; Hung-Chou Chen; Tsan-Hon Liou. Effects of Protein Supplementation Combined with Exercise Training on Muscle Mass and Function in Older Adults with Lower-Extremity Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Trials. Nutrients 2020, 12, 2422 .
AMA StyleChun-De Liao, Yen-Tzu Wu, Jau-Yih Tsauo, Pey-Rong Chen, Yu-Kang Tu, Hung-Chou Chen, Tsan-Hon Liou. Effects of Protein Supplementation Combined with Exercise Training on Muscle Mass and Function in Older Adults with Lower-Extremity Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Trials. Nutrients. 2020; 12 (8):2422.
Chicago/Turabian StyleChun-De Liao; Yen-Tzu Wu; Jau-Yih Tsauo; Pey-Rong Chen; Yu-Kang Tu; Hung-Chou Chen; Tsan-Hon Liou. 2020. "Effects of Protein Supplementation Combined with Exercise Training on Muscle Mass and Function in Older Adults with Lower-Extremity Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Trials." Nutrients 12, no. 8: 2422.
(1) Background: Knee osteoarthritis (KOA) and aging are associated with high sarcopenia risk; sarcopenia may further affect outcomes after total knee replacement (TKR). Elastic resistance exercise training (RET) limits muscle attenuation in older adults. We aimed to identify the effects of post-TKR elastic RET on lean mass (LM) and functional outcomes in overweight and obese older women with KOA by using the brief International Classification of Functioning, Disability and Health Core Set for osteoarthritis (Brief-ICF-OA). (2) Methods: Eligible women aged ≥60 years who had received unilateral primary TKR were randomly divided into an experimental group (EG), which received postoperative RET twice weekly for 12 weeks, and a control group (CG), which received standard care. The primary and secondary outcome measures were LM and physical capacity, respectively, and were linked to the Brief-ICF-OA. The assessment time points were 2 weeks prior to surgery (T0) and postoperative at 1 month (T1; before RET) and 4 months (T2; upon completion of RET) of follow-up. An independent t test with an intention-to-treat analysis was conducted to determine the between-group differences in changes of outcome measures at T1 and T2 from T0. (3) Results: Forty patients (age: 70.9 ± 7.3 years) were randomly assigned to the EG (n = 20) or CG (n = 20). At T2, the EG exhibited significantly greater improvements in leg LM (mean difference (MD) = 0.86 kg, p = 0.004) and gait speed (MD = 0.26 m/s, p = 0.005) compared with the CG. Furthermore, the EG generally obtained significantly higher odds ratios than the CG for treatment success for most Brief-ICF-OA categories (all p < 0.001). Conclusions: Early intervention of elastic RET after TKR yielded positive postoperative outcomes based on the Brief-ICF-OA. The findings of this study may facilitate clinical decision-making regarding the optimal post-TKR rehabilitation strategy for older women with KOA.
Chun-De Liao; Yen-Shuo Chiu; Jan-Wen Ku; Shih-Wei Huang; Tsan-Hon Liou. Effects of Elastic Resistance Exercise on Postoperative Outcomes Linked to the ICF Core Sets for Osteoarthritis after Total Knee Replacement in Overweight and Obese Older Women with Sarcopenia Risk: A Randomized Controlled Trial. Journal of Clinical Medicine 2020, 9, 2194 .
AMA StyleChun-De Liao, Yen-Shuo Chiu, Jan-Wen Ku, Shih-Wei Huang, Tsan-Hon Liou. Effects of Elastic Resistance Exercise on Postoperative Outcomes Linked to the ICF Core Sets for Osteoarthritis after Total Knee Replacement in Overweight and Obese Older Women with Sarcopenia Risk: A Randomized Controlled Trial. Journal of Clinical Medicine. 2020; 9 (7):2194.
Chicago/Turabian StyleChun-De Liao; Yen-Shuo Chiu; Jan-Wen Ku; Shih-Wei Huang; Tsan-Hon Liou. 2020. "Effects of Elastic Resistance Exercise on Postoperative Outcomes Linked to the ICF Core Sets for Osteoarthritis after Total Knee Replacement in Overweight and Obese Older Women with Sarcopenia Risk: A Randomized Controlled Trial." Journal of Clinical Medicine 9, no. 7: 2194.
Objective To investigate the effect of muscle strength exercise training (MSET) on lean mass (LM) gain and muscle hypertrophy in older patients with lower limb osteoarthritis (OA). Methods A comprehensive search of online databases was performed until April 20, 2019. Randomized controlled trials (RCTs) that reported the effects of MSET on LM, muscle thickness, and cross‐sectional area (CSA) in older patients with OA were identified. A risk of bias assessment and meta‐analysis were performed for the included RCTs. Results We included 19 RCTs with a median PEDro score of 6 (range: 3–7) out of 10. In total, 1195 patients (65% women, 85% with knee OA) with a mean age of 62.1 (range: 40–86) years were analyzed. MSET resulted in significantly higher LM gain (standard mean difference [SMD]: 0.49; 95% confidence interval [CI]: 0.28, 0.71; P < 0.00001) than did the nonexercise controls. Meta‐analysis results revealed significantly positive effects of MSET on muscle thickness (SMD: 0.82; 95% CI: 0.20, 1.43; P = 0.009) and CSA (SMD: 0.80; 95% CI: 0.25, 1.35; P = 0.004) compared with nonexercise controls. No significant effects in favor of MSET were observed for any muscle outcome compared with exercise controls. Five RCTs reported nonsevere adverse events in response to MSET, whereas no RCTs reported severe events. Conclusion MSET is effective in increasing LM and muscle size in older adults with OA. Clinicians should incorporate MSET into their management of patients at risk of low muscle mass to maximize health status, particularly for older individuals with OA.
Chun‐De Liao; Hung‐Chou Chen; Yu‐Chi Kuo; Jau‐Yih Tsauo; Shih‐Wei Huang; Tsan‐Hon Liou. Effects of Muscle Strength Training on Muscle Mass Gain and Hypertrophy in Older Adults With Osteoarthritis: A Systematic Review and Meta‐Analysis. Arthritis Care & Research 2019, 72, 1703 -1718.
AMA StyleChun‐De Liao, Hung‐Chou Chen, Yu‐Chi Kuo, Jau‐Yih Tsauo, Shih‐Wei Huang, Tsan‐Hon Liou. Effects of Muscle Strength Training on Muscle Mass Gain and Hypertrophy in Older Adults With Osteoarthritis: A Systematic Review and Meta‐Analysis. Arthritis Care & Research. 2019; 72 (12):1703-1718.
Chicago/Turabian StyleChun‐De Liao; Hung‐Chou Chen; Yu‐Chi Kuo; Jau‐Yih Tsauo; Shih‐Wei Huang; Tsan‐Hon Liou. 2019. "Effects of Muscle Strength Training on Muscle Mass Gain and Hypertrophy in Older Adults With Osteoarthritis: A Systematic Review and Meta‐Analysis." Arthritis Care & Research 72, no. 12: 1703-1718.
Note: In lieu of an abstract, this is an excerpt from the first page. We thank Chen et al
Chun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. Reply to: "Comment on the Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials, Nutrients 2019, 11, 1713". Nutrients 2019, 11, 2420 .
AMA StyleChun-De Liao, Hung-Chou Chen, Shih-Wei Huang, Tsan-Hon Liou. Reply to: "Comment on the Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials, Nutrients 2019, 11, 1713". Nutrients. 2019; 11 (10):2420.
Chicago/Turabian StyleChun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. 2019. "Reply to: "Comment on the Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials, Nutrients 2019, 11, 1713"." Nutrients 11, no. 10: 2420.
People with sarcopenic obesity (SO) are characterized by both low muscle mass (sarcopenia) and high body fat (obesity); they have greater risks of metabolic diseases and physical disability than people with sarcopenia or obesity alone. Exercise and nutrition have been reported to be effective for both obesity and sarcopenia management. Thus, we aimed to investigate the effects of exercise and nutrition on body composition, metabolic health, and physical performance in individuals with SO. Studies investigating the effects of exercise and nutrition on body composition, metabolic health, and physical performance in SO individuals were searched from electronic databases up to April 2019. Fifteen studies were included in the meta-analysis. Aerobic exercise decreased body weight and fat mass (FM). Resistance exercise (RE) decreased FM and improved grip strength. The combination of aerobic exercise and RE decreased FM and improved walking speed. Nutritional intervention, especially low-calorie high-protein (LCHP) diet, decreased FM but did not affect muscle mass and grip strength. In addition to exercise training, nutrition did not provide extra benefits in outcome. Exercise, especially RE, is essential to improve body composition and physical performance in individuals with SO. Nutritional intervention with LCHP decreases FM but does not improve physical performance.
Kuo-Jen Hsu; Chun-De Liao; Mei-Wun Tsai; Chiao-Nan Chen. Effects of Exercise and Nutritional Intervention on Body Composition, Metabolic Health, and Physical Performance in Adults with Sarcopenic Obesity: A Meta-Analysis. Nutrients 2019, 11, 2163 .
AMA StyleKuo-Jen Hsu, Chun-De Liao, Mei-Wun Tsai, Chiao-Nan Chen. Effects of Exercise and Nutritional Intervention on Body Composition, Metabolic Health, and Physical Performance in Adults with Sarcopenic Obesity: A Meta-Analysis. Nutrients. 2019; 11 (9):2163.
Chicago/Turabian StyleKuo-Jen Hsu; Chun-De Liao; Mei-Wun Tsai; Chiao-Nan Chen. 2019. "Effects of Exercise and Nutritional Intervention on Body Composition, Metabolic Health, and Physical Performance in Adults with Sarcopenic Obesity: A Meta-Analysis." Nutrients 11, no. 9: 2163.
Aging and frailty are associated with a high risk of lean mass (LM) loss, which leads to physical disability and can be effectively alleviated by protein supplementation (PS) and muscle strengthening exercise (MSE). In this study, the associations between LM gain and PS + MSE efficacy (measured using physical outcomes) in elderly patients with a high risk of sarcopenia or frailty were identified. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) reporting the efficacy of PS + MSE in elderly patients with sarcopenia or frailty. The included RCTs were analyzed using meta-analysis and risk of bias assessment. We finally included 19 RCTs in this meta-analysis with a median (range/total) Physiotherapy Evidence Database score of 7/10 (5-9/10). The PS + MSE group exhibited significant improvements in the whole-body LM (standard mean difference (SMD) = 0.66; p < 0.00001), appendicular LM (SMD = 0.35; p < 0.00001), leg strength (SMD = 0.65; p < 0.00001), and walking capability (SMD = 0.33; p = 0.0006). Meta-regression analyses showed that changes in appendicular LM were significantly associated with the effect sizes of leg strength (β = 0.08; p = 0.003) and walking capability (β = 0.17; p = 0.04), respectively. Our findings suggest that LM gain after PS + MSE significantly contributes to the efficacy of the intervention in terms of muscle strength and physical mobility in elderly patients with a high risk of sarcopenia or frailty.
Chun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. The Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials. Nutrients 2019, 11, 1713 .
AMA StyleChun-De Liao, Hung-Chou Chen, Shih-Wei Huang, Tsan-Hon Liou. The Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials. Nutrients. 2019; 11 (8):1713.
Chicago/Turabian StyleChun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. 2019. "The Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials." Nutrients 11, no. 8: 1713.
Objective:This study determined the clinical efficacy of extracorporeal shockwave therapy and the predictors of its efficacy for knee osteoarthritis.Data Sources:Electronic databases and search engines, namely MEDLINE, PubMed, EMBASE, Cochrane Library Database, Physiotherapy Evidence Database (PEDro), China Academic Journals Full-text Database, and Google Scholar, were searched until 5 March 2019, for randomized controlled trials without restrictions on language and publication year.Review Methods:Eligible trials and extracted data were identified by two independent investigators. The included articles were subjected to a meta-analysis and risk of bias assessment. Outcomes of interest included treatment success rate, pain, and physical function outcomes. A meta-regression analysis was performed to determine the predictors of treatment outcomes following shockwave therapy.Results:We included 50 trials (4844 patients) with a median (range) PEDro score of 6 (5–9). Meta-analyses results revealed an overall significant effect favoring shockwave therapy on the treatment success rate (odds ratio 3.22, 95% confidence interval (CI) 2.21–4.69, P < 0.00001; heterogeneity ( I2) = 62%), pain reduction (standardized mean difference (SMD) −2.02, 95% CI −2.38 to −1.67, P < 0.00001; I2= 95%), and Western Ontario and McMaster Universities Osteoarthritis Index function outcome (SMD −2.71, 95% CI −3.50 to −1.92, P < 0.00001; I2= 97%). Follow-up duration and energy flux density were independent significant predictors of shockwave efficacy.Conclusion:Shockwave therapy is beneficial for knee osteoarthritis. Shockwave dosage, particularly the energy level and intervention duration, may have different contributions to treatment efficacy.
Chun-De Liao; Jau-Yih Tsauo; Tsan-Hon Liou; Hung-Chou Chen; Shih-Wei Huang. Clinical efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a systematic review and meta-regression of randomized controlled trials. Clinical Rehabilitation 2019, 33, 1419 -1430.
AMA StyleChun-De Liao, Jau-Yih Tsauo, Tsan-Hon Liou, Hung-Chou Chen, Shih-Wei Huang. Clinical efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a systematic review and meta-regression of randomized controlled trials. Clinical Rehabilitation. 2019; 33 (9):1419-1430.
Chicago/Turabian StyleChun-De Liao; Jau-Yih Tsauo; Tsan-Hon Liou; Hung-Chou Chen; Shih-Wei Huang. 2019. "Clinical efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a systematic review and meta-regression of randomized controlled trials." Clinical Rehabilitation 33, no. 9: 1419-1430.
This study evaluated the clinical efficacy of continuous passive motion (CPM) following knee arthroplasty and determined the predictors of effect sizes of range of motion (ROM) and functional outcomes in patients with knee arthritis. A comprehensive electronic database search was performed for randomized controlled trials (RCTs), without publication year or language restrictions. The included RCTs were analyzed through meta-analysis and risk of bias assessment. Study methodological quality (MQ) was assessed using the Physiotherapy Evidence Database (PEDro) scale. Inverse-variance weighted univariate and multivariate metaregression analyses were performed to determine the predictors of treatment outcomes. A total of 77 RCTs with PEDro scores ranging from 6/10 to 8/10 were included. Meta-analyses revealed an overall significant favorable effect of CPM on treatment success rates [odds ratio: 3.64, 95% confidence interval (CI) 2.21–6.00]. Significant immediate [postoperative day 14; standard mean difference (SMD): 1.06; 95% CI 0.61–1.51] and short-term (3-month follow-up; SMD: 0.80; 95% CI 0.45–1.15) effects on knee ROM and a long-term effect on function (12-month follow-up; SMD: 1.08; 95% CI 0.28–1.89) were observed. The preoperative ROM, postoperative day of CPM initiation, daily ROM increment, and total application days were significant independent predictors of CPM efficacy. Early CPM initiation with rapid progress over a long duration of CPM application predicts higher treatment effect on knee ROM and function. The results were based on a moderate level of evidence, with good MQ and potential blinding biases in the included RCTs. An aggressive protocol of CPM has clinically relevant beneficial short-term and long-term effects on postoperative outcomes. II.
Chun-De Liao; Jau-Yih Tsauo; Shih-Wei Huang; Hung-Chou Chen; Yen-Shuo Chiu; Tsan-Hon Liou. Preoperative range of motion and applications of continuous passive motion predict outcomes after knee arthroplasty in patients with arthritis. Knee Surgery, Sports Traumatology, Arthroscopy 2018, 27, 1259 -1269.
AMA StyleChun-De Liao, Jau-Yih Tsauo, Shih-Wei Huang, Hung-Chou Chen, Yen-Shuo Chiu, Tsan-Hon Liou. Preoperative range of motion and applications of continuous passive motion predict outcomes after knee arthroplasty in patients with arthritis. Knee Surgery, Sports Traumatology, Arthroscopy. 2018; 27 (4):1259-1269.
Chicago/Turabian StyleChun-De Liao; Jau-Yih Tsauo; Shih-Wei Huang; Hung-Chou Chen; Yen-Shuo Chiu; Tsan-Hon Liou. 2018. "Preoperative range of motion and applications of continuous passive motion predict outcomes after knee arthroplasty in patients with arthritis." Knee Surgery, Sports Traumatology, Arthroscopy 27, no. 4: 1259-1269.
Aging poses a high risk of lean mass loss, which can be effectively improved through resistance exercise training (RET), or multicomponent exercise training (MET) as well as nutrition supplementation, such as protein supplementation (PS). This study investigated the effects of PS plus exercise training on frail older individuals. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) that reported the efficacy of PS combined with RET or MET in frail older individuals. The included RCTs were analyzed through a meta-analysis and risk-of-bias assessment. We finally included 22 RCTs in the meta-analysis, with a mean (range/total) Physiotherapy Evidence Database score of 6.7 (4–9/10). PS plus exercise training significantly improved the frailty status (odds ratio = 2.77; p = 0.006), lean mass (standard mean difference (SMD) = 0.52; p < 0.00001), leg strength (SMD = 0.37; p < 0.00001), and walking speed (SMD = 0.32; p = 0.002). Subgroup analyses revealed that PS plus MET exert significant effects on frailty indices, whereas PS plus RET further improves lean mass. Our findings suggest that PS plus RET as well as MET is effective in improving frailty status, lean mass, muscle strength, and physical mobility in frail older individuals.
Chun-De Liao; Pi-Hsia Lee; Dun-Jen Hsiao; Shih-Wei Huang; Jau-Yih Tsauo; Hung-Chou Chen; Tsan-Hon Liou. Effects of Protein Supplementation Combined with Exercise Intervention on Frailty Indices, Body Composition, and Physical Function in Frail Older Adults. Nutrients 2018, 10, 1916 .
AMA StyleChun-De Liao, Pi-Hsia Lee, Dun-Jen Hsiao, Shih-Wei Huang, Jau-Yih Tsauo, Hung-Chou Chen, Tsan-Hon Liou. Effects of Protein Supplementation Combined with Exercise Intervention on Frailty Indices, Body Composition, and Physical Function in Frail Older Adults. Nutrients. 2018; 10 (12):1916.
Chicago/Turabian StyleChun-De Liao; Pi-Hsia Lee; Dun-Jen Hsiao; Shih-Wei Huang; Jau-Yih Tsauo; Hung-Chou Chen; Tsan-Hon Liou. 2018. "Effects of Protein Supplementation Combined with Exercise Intervention on Frailty Indices, Body Composition, and Physical Function in Frail Older Adults." Nutrients 10, no. 12: 1916.
Extracorporeal shock wave therapy (ESWT), including radial shock wave (RaSW) and focused shock wave (FoSW) types, is widely used for managing tendinopathies. The difference in efficacy between the 2 shock wave characteristics with different dosage levels remains controversial, and the purpose of this meta-analysis was to examine it for patients with lower extremity (LE) tendinopathy. A comprehensive search of online databases and search engines was performed. This study included randomized controlled trials (RCTs) reporting the efficacy of ESWT in treating LE tendinopathy. The included RCTs were subjected to a meta-analysis and risk of bias assessment. In total, 29 RCTs were included, all of which had a good methodological quality, with a PEDro score of ≥6/10. General ESWT showed significant effects at the immediate follow-up [pain score: standardized mean difference (SMD) = -1.41, 95% confidence interval (CI) = -2.01 to -0.82, P Conclusion ESWT exerted a positive overall effect on pain and function for LE tendinopathy. Shock wave types and dosage levels may have different contributions to treatment efficacy.
Chun-De Liao; Jau-Yih Tsauo; Hung-Chou Chen; Tsan-Hon Liou. Efficacy of Extracorporeal Shock Wave Therapy for Lower-Limb Tendinopathy. American Journal of Physical Medicine & Rehabilitation 2018, 97, 605 -619.
AMA StyleChun-De Liao, Jau-Yih Tsauo, Hung-Chou Chen, Tsan-Hon Liou. Efficacy of Extracorporeal Shock Wave Therapy for Lower-Limb Tendinopathy. American Journal of Physical Medicine & Rehabilitation. 2018; 97 (9):605-619.
Chicago/Turabian StyleChun-De Liao; Jau-Yih Tsauo; Hung-Chou Chen; Tsan-Hon Liou. 2018. "Efficacy of Extracorporeal Shock Wave Therapy for Lower-Limb Tendinopathy." American Journal of Physical Medicine & Rehabilitation 97, no. 9: 605-619.
Shih-Wei Huang; Feng-Chi Hsieh; Li-Fong Lin; Chun-De Liao; Jan-Wen Ku; Dun-Jen Hsiao; Tsan-Hon Liou. Correlation between Body Composition and Physical Performance in Aged People. International Journal of Gerontology 2018, 12, 1 .
AMA StyleShih-Wei Huang, Feng-Chi Hsieh, Li-Fong Lin, Chun-De Liao, Jan-Wen Ku, Dun-Jen Hsiao, Tsan-Hon Liou. Correlation between Body Composition and Physical Performance in Aged People. International Journal of Gerontology. 2018; 12 (3):1.
Chicago/Turabian StyleShih-Wei Huang; Feng-Chi Hsieh; Li-Fong Lin; Chun-De Liao; Jan-Wen Ku; Dun-Jen Hsiao; Tsan-Hon Liou. 2018. "Correlation between Body Composition and Physical Performance in Aged People." International Journal of Gerontology 12, no. 3: 1.
Extracorporeal shock-wave therapy (ESWT), which can be divided into radial shock-wave therapy (RaSWT) and focused shock-wave therapy (FoSWT), has been widely used in clinical practice for managing orthopedic conditions. The aim of this study was to determine the clinical efficacy of ESWT for knee soft tissue disorders (KSTDs) and compare the efficacy of different shock-wave types, energy levels, and intervention durations. We performed a comprehensive search of online databases and search engines without restrictions on the publication year or language. We selected randomized controlled trials (RCTs) reporting the efficacy of ESWT for KSTDs and included them in a meta-analysis and risk of bias assessment. The pooled effect sizes of ESWT were estimated by computing odds ratios (ORs) with 95% confidence intervals (CIs) for the treatment success rate (TSR) and standardized mean differences (SMDs) with 95% CIs for pain reduction (i.e., the difference in pain relief, which was the change in pain from baseline to the end of RCTs between treatment and control groups) and for restoration of knee range of motion (ROM). We included 19 RCTs, all of which were of high or medium methodological quality and had a Physiotherapy Evidence Database score of ≥5/10. In general, ESWT had overall significant effects on the TSR (OR: 3.36, 95% CI: 1.84–6.12, P < 0.0001), pain reduction (SMD: − 1.49, 95% CI: − 2.11 to − 0.87, P < 0.00001), and ROM restoration (SMD: 1.76, 95% CI: 1.43–2.09, P < 0.00001). Subgroup analyses revealed that FoSWT and RaSWT applied for a long period (≥1 month) had significant effects on pain reduction, with the corresponding SMDs being − 3.13 (95% CI: − 5.70 to − 0.56; P = 0.02) and − 1.80 (95% CI: − 2.52 to − 1.08; P < 0.00001), respectively. Low-energy FoSWT may have greater efficacy for the TSR than high-energy FoSWT, whereas the inverse result was observed for RaSWT. The ESWT exerts an overall effect on the TSR, pain reduction, and ROM restoration in patients with KSTDs. Shock-wave types and application levels have different contributions to treatment efficacy for KSTDs, which must be investigated further for optimizing these treatments in clinical practice.
Chun-De Liao; Guo-Min Xie; Jau-Yih Tsauo; Hung-Chou Chen; Tsan-Hon Liou. Efficacy of extracorporeal shock wave therapy for knee tendinopathies and other soft tissue disorders: a meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders 2018, 19, 278 .
AMA StyleChun-De Liao, Guo-Min Xie, Jau-Yih Tsauo, Hung-Chou Chen, Tsan-Hon Liou. Efficacy of extracorporeal shock wave therapy for knee tendinopathies and other soft tissue disorders: a meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders. 2018; 19 (1):278.
Chicago/Turabian StyleChun-De Liao; Guo-Min Xie; Jau-Yih Tsauo; Hung-Chou Chen; Tsan-Hon Liou. 2018. "Efficacy of extracorporeal shock wave therapy for knee tendinopathies and other soft tissue disorders: a meta-analysis of randomized controlled trials." BMC Musculoskeletal Disorders 19, no. 1: 278.
Knee osteoarthritis (KOA) and age are both associated with an increased risk of lower lean muscle mass (i.e., sarcopenia), which may lead to physical difficulty or functional limitation. Protein supplement (PS) combined with resistance exercise training (RET) improves body composition and strength gains in elder individuals. It remains unclear whether PS augments lean mass and strength gains of older patient with KOA undergoing RET. The purpose of this study is to identify the effect of PS plus RET on body composition and physical function in older women with KOA. Eligible female participants who are older than 55 years old and have a diagnosis of KOA are assigned to either experimental group (PS) or control group (placebo supplement). Both groups receive RET twice a week for a total of 12 weeks. Outcome measures includes analysis of body composition using bioelectrical impedance method, hand and leg strength, lower limb mobility (distance of functional forward reach, duration of single leg stance; timed sit-to-stand test, timed 10-m walk; timed up-and-go test, 30-s timed chair rise), physical activity using International Physical Activity Questionnaire and the Western Ontario and McMaster Universities Osteoarthritis Index score. All measures are tested before (baseline) and after RET (posttest). Analysis of covariance is also performed, using the pretest measures of both groups as the covariates, to test differences in post-test between the two groups. Sixteen patients in the experimental group (mean age 63.4 ± 7.6 y) and 16 in the control group (mean age 62.9 ± 8.7 y) completed the study. A statistically significant improvement of all measures was observed in both groups after intervention (all P < .05), and the experimental group exhibited a significantly superior improvement compared with the control group (P < .05). Combing PS and RET exerted benefits on body composition, muscle strength, and physical capacity in older women with KOA.
C.D. Liao; C.Y. Hsieh. Effects of protein supplement in combination with resistance training on body composition and physical function in middle aged and older women with knee osteoarthritis. Annals of Physical and Rehabilitation Medicine 2018, 61, e480 .
AMA StyleC.D. Liao, C.Y. Hsieh. Effects of protein supplement in combination with resistance training on body composition and physical function in middle aged and older women with knee osteoarthritis. Annals of Physical and Rehabilitation Medicine. 2018; 61 ():e480.
Chicago/Turabian StyleC.D. Liao; C.Y. Hsieh. 2018. "Effects of protein supplement in combination with resistance training on body composition and physical function in middle aged and older women with knee osteoarthritis." Annals of Physical and Rehabilitation Medicine 61, no. : e480.
Chun-De Liao; Jau-Yih Tsauo; Hung-Chou Chen; Tsan-Hon Liou. Reply to RW Morton and SM Phillips. The American Journal of Clinical Nutrition 2018, 107, 1056 -1057.
AMA StyleChun-De Liao, Jau-Yih Tsauo, Hung-Chou Chen, Tsan-Hon Liou. Reply to RW Morton and SM Phillips. The American Journal of Clinical Nutrition. 2018; 107 (6):1056-1057.
Chicago/Turabian StyleChun-De Liao; Jau-Yih Tsauo; Hung-Chou Chen; Tsan-Hon Liou. 2018. "Reply to RW Morton and SM Phillips." The American Journal of Clinical Nutrition 107, no. 6: 1056-1057.
Sarcopenia is associated with loss of muscle mass as well as an increased risk of physical disability in elderly people. This study was aimed to investigate the effect of elastic band resistance training (ERT) on muscle mass and physical function in older women with sarcopenic obesity. A randomized controlled trial with an intention-to-treat analysis was conducted. A total of 56 women (mean ± SD age 67.3 ± 5.1 years) were randomly assigned to the experimental group receiving 12 weeks of ERT and to the control group receiving no exercise intervention. Lean mass (measured using a dual-energy X-ray absorptiometer), physical capacity (assessed using the global physical capacity score), and a 36-item short form questionnaire were conducted at the baseline examination (T0), as well as the 3-month (T1) and 9-month followups (T2). At T1 and T2, the between-group difference was measured in total skeletal mass relative to T0, with mean differences of 0.70 kg (95% CI 0.12–1.28; P < 0.05) and 0.72 kg (95% CI 0.21–1.23; P < 0.01), respectively. Similar results were found in muscle quality, physical capacity, and physical function outcomes. The ERT exerted a significant beneficial effect on muscle mass, muscle quality, and physical function in older women with sarcopenic obesity.
Chun-De Liao; Jau-Yih Tsauo; Shih-Wei Huang; Jan-Wen Ku; Dun-Jen Hsiao; Tsan-Hon Liou. Effects of elastic band exercise on lean mass and physical capacity in older women with sarcopenic obesity: A randomized controlled trial. Scientific Reports 2018, 8, 1 -13.
AMA StyleChun-De Liao, Jau-Yih Tsauo, Shih-Wei Huang, Jan-Wen Ku, Dun-Jen Hsiao, Tsan-Hon Liou. Effects of elastic band exercise on lean mass and physical capacity in older women with sarcopenic obesity: A randomized controlled trial. Scientific Reports. 2018; 8 (1):1-13.
Chicago/Turabian StyleChun-De Liao; Jau-Yih Tsauo; Shih-Wei Huang; Jan-Wen Ku; Dun-Jen Hsiao; Tsan-Hon Liou. 2018. "Effects of elastic band exercise on lean mass and physical capacity in older women with sarcopenic obesity: A randomized controlled trial." Scientific Reports 8, no. 1: 1-13.