We investigated the influence of resistance exercise (RE) with different intensities on HbA1c, insulin and blood glucose levels in patients with type 2 diabetes (T2D). Diabetes trials that compared RE group with a control were included in meta-analysis. Exercise intensities were categorized into low-to-moderate-intensity and high-intensity subgroups. Intensity effect on glycemic control was determined by meta-regression analysis, and risk-of-bias was assessed using Cochrane Collaboration tool. 24 trials met the inclusion criteria, comprised of 962 patients of exercise (n = 491) and control (n = 471). Meta-regression analysis showed decreased HbA1c (p = 0.006) and insulin (p = 0.015) after RE was correlated with intensity. Subgroup analysis revealed decreased HbA1c was greater with high intensity (−0.61; 95% CI −0.90, −0.33) than low-to-moderate intensity (−0.23; 95% CI −0.41, −0.05). Insulin levels were significantly decreased only with high intensity (−4.60; 95% CI −7.53, −1.67), not with low-to-moderate intensity (0.07; 95% CI −3.28, 3.42). Notably, values between the subgroups were statistically significant for both HbA1c (p = 0.03) and insulin (p = 0.04), indicative of profound benefits of high-intensity RE. Pooled outcomes of 15 trials showed only a decreased trend in blood glucose with RE (p = 0.09), and this tendency was not associated with intensity. Our meta-analysis provides additional evidence that high-intensity RE has greater beneficial effects than low-to-moderate-intensity in attenuation of HbA1c and insulin in T2D patients.

This study examined the effects of exercise intervention on the quality of life (QoL), social functioning (SF), and physical functioning (PF) of breast cancer survivors, and identified the responsible and optimal exercise characteristics for amelioration of outcomes. Randomized controlled trials (RCTs) that adopted exercise intervention and measured the QoL, SF, and PF of breast cancer patients were included. We used meta-analysis to calculate the pooled effect, and meta-regression to identify the responsible exercise characteristics (type, frequency, duration, and time). Subgroup analysis assessed the optimal “time of session” for an improved QoL. The Cochrane risk-of-bias tool was used to determine the quality of studies. In the systematic review, we included 26 RCTs with a total of 1892 breast cancer patients, whilst 18 trials were considered for meta-analysis (exercise = 602; control = 603). The pooled effect showed that exercise intervention substantially improved the QoL (standardized mean difference (SMD) = 0.35; I² = 61%; 95% confidence internal (CI): 0.15–0.54; p = 0.0004), SF (SMD = 0.20; I² = 16%; 95% CI:0.08–0.32; p = 0.001), and PF (SMD = 0.32; I² = 32%; 95% CI:0.20–0.44; p < 0.00001). Meta-regression analysis showed that improved QoL was associated (p = 0.041) with the “time of session”. More specifically, sessions conducted for medium-time (>45 to ≤60 min; p = 0.03) and longer-time (>60 to 90 min; p = 0.005) considerably improved the QoL, whilst shorter-time (≤45 min; p = 0.15) did not. To summarize, exercise interventions improved the QoL, SF, and PF of breast cancer survivors, where the “time of session” appeared to be crucial for an effective improvement in the QoL.

Background/Purpose: Resistance exercise (RE) is known to improve cardiovascular health, but the role of RE variables on arterial stiffness is inconclusive. In this systematic review and meta-analysis, we investigated the influence of RE and its intensities on arterial stiffness measured as pulse wave velocity (PWV) in young and middle-aged adults.Methods: Web of Science, PubMed/MEDLINE, Scopus, EMBASE, Cochrane Library, ScienceDirect, CINAHL, Wiley Online Library, and Google Scholar were searched for relevant studies. RE trials that reported PWV data, and compared with respective controls were included. The Cochrane Collaboration tool was used to assess the risk of bias.Results: Data were synthesized from a total of 20 studies, involving 981 participants from control (n = 462) and exercise (n = 519) trials. The test for overall effect (pooled outcome) showed RE intervention had no effect on arterial stiffness (SMD = −0.09; 95% CI: −0.32, 0.13; P = 0.42), but risk of heterogeneity (I²) was 64%. Meta-regression results revealed a significant correlation (P = 0.042) between RE intensity and PWV changes. Consequently, the trials were subgrouped into high-intensity and low-to-moderate-intensity to identify the effective RE intensity. Subgroup analysis showed that low-to-moderate-intensity significantly decreased PWV (SMD = −0.34; 95% CI: −0.51, −0.17; P < 0.0001), while high-intensity had no effect (SMD = 0.24; 95% CI: −0.18, 0.67; P = 0.26). When trials separated into young and middle-aged, low-to-moderate-intensity notably decreased PWV in young (SMD = −0.41; 95% CI: −0.77, −0.04; P = 0.03) and middle-aged adults (SMD = −0.32; 95% CI: −0.51, −0.14; P = 0.0007), whereas high-intensity had no effect in both age groups.Conclusions: Our findings demonstrated that RE intensity is the key variable in improving arterial stiffness. Low-to-moderate-intensity can prescribe as an effective non-pharmacological strategy to treat cardiovascular complications in young and middle-aged adults.

Aerobic exercise has been confirmed to improve endothelial function (EF). However, the effect of resistance exercise (RE) on EF remains controversial. We conducted this systematic review and meta-analysis on randomized controlled trials (RCTs) to determine the effect of RE and its intensities on EF. We searched Web of Science, PubMed/MEDLINE, Scopus, and Wiley Online Library, and included 15 articles (17 trials) for the synthesis. Overall, RE intervention significantly improved flow-mediated dilatation (FMD) in brachial artery (SMD = 0.76; 95% CI: 0.47, 1.05; p < 0.00001), which represents improved EF. Meta-regression showed that the RE intensity was correlated with changes in FMD (Coef. = −0.274, T = −2.18, p = 0.045). We found both intensities of RE improved FMD, but the effect size for the low- to moderate-intensity (30–70%1RM) was bigger (SMD = 1.02; 95% CI: 0.60, 1.43; p < 0.0001) than for the high-intensity (≥70%1RM; SMD = 0.48; 95% CI: 0.21, 0.74; p = 0.005). We further noticed that RE had a beneficial effect (SMD = 0.61; 95% CI: 0.13, 1.09; p = 0.01) on the brachial artery baseline diameter at rest (BAD_rest), and the age variable was correlated with the changes in BAD_rest after RE (Coef. = −0.032, T = −2.33, p = 0.038). Young individuals (<40 years) presented with a bigger effect size for BAD_rest (SMD = 1.23; 95% CI: 0.30, 2.15; p = 0.009), while middle-aged to elderly (≥40 years) were not responsive to RE (SMD = 0.07; 95% CI: −0.28, 0.42; p = 0.70). Based on our findings, we conclude that RE intervention can improve the EF, and low- to moderate-intensity is more effective than high-intensity.

Background: Identifying the correlates of exercise behavior is essential to combating physical inactivity as a public health concern. The purpose of this study is to identify the correlates of physical activity among urban Chinese adults under the social-ecological theoretical model in order to facilitate targeted interventions to promote physical activity. Methods: Using the socio-ecological model, we conducted a questionnaire survey among 1459 urban residents in Zhejiang and Shaanxi provinces of China, collecting data on individual demographic factors, sociological factors, environmental perception, and exercise behavior. Binary logistic regression models were employed to analyze the relationships between exercise behavior and socio-ecological factors. Results: Male gender (p < 0.01), advanced age (p < 0.001), higher education level (p < 0.05), living independently from parents (p < 0.05), absence of childcare responsibilities (p < 0.01), residence in a county/prefecture-level city (p < 0.001), favorable neighborhood esthetics (p < 0.001), available greenways/parks (p < 0.001), and family support for exercise participation (p < 0.05) were significantly correlated with an increased likelihood of participating in physical activity. Male gender (p < 0.001), advanced age (p < 0.001), absence of childcare responsibilities (p < 0.05), good neighborhood vegetation (p < 0.01), availability of free neighborhood exercise facilities (p < 0.05), and support from friends for exercise participation (p < 0.01) were significantly correlated with an increased likelihood of engaging in physical activity for more than 150 min per week. BMI, community air quality, traffic safety, public safety, and level of social development were not major correlates. Conclusions: To promote exercise behavior, more attention should be paid to individuals who are female, young, have lower levels of education, bear childcare responsibilities, or reside in provincial capitals in China. Improving the habitat environment and providing convenient and affordable facilities should also be considered. Furthermore, support from family and friends can positively reinforce exercise behavior.