Impact of air pollution on the health of the older adults during physical activity and sedentary behavior: A systematic review.

BACKGROUND: Air pollution, in addition to presenting health risks, can impact the practice of physical activity (PA) and sedentary behavior (SB) in older adults. This study analyzed the impact of air pollution on the health of older adults during PA and SB, through a systematic review. METHODS: A keyword and reference search was performed in PubMed, SCOPUS, SPORTDiscus, and Web of Science. Predetermined selection criteria included study designs: interventions or experiments, retrospective or prospective cohort studies, cross-sectional studies and case-control studies; population: older adults aged 60 years or older; exposures: specific air pollutants (particulate matter (PM), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), sulfur dioxide (SO2), black carbon (CN), ultrafine particles (PU), nitrogen oxides (NOx) and biomass fuels) indoors and outdoors; and outcomes: physical activity and/or sedentary behavior. RESULTS: The beneficial effects of PA were attenuated or harmed in 11 studies, showing negative impacts on the health of the older adults, mainly by PM2.5 pollutants. On the other hand, in 10 studies the effects of PA were greater than the negative effects of air pollutants, with a greater frequency in relation to PM2.5. In general, even the articles presenting controversial results suggest that practicing PA in polluted environments is more favorable to the health of older adults than remaining in SB. DISCUSSION AND CONCLUSIONS: On the one hand, air pollution negatively impacted the health of the older adults during PA practices, while on the other hand, PA can mitigate the negative effects of pollutants on the health of older adults during the practices. Evidence shows that practicing PA in environments with low concentrations of pollutants can provide gains and reduce health risks. Remaining in SB in environments with high levels of air pollution worsens the health of older adults.

Effects of different protocols of physical exercise on fibromyalgia syndrome treatment: systematic review and meta-analysis of randomized controlled trials.

Physical exercise has been used as a form of treatment for fibromyalgia, however, the results indicate the need for further investigations on the effect of exercise on different symptoms. The aim of the study was to synthesize and analyse studies related to the effect of exercise in individuals with fibromyalgia and provide practical recommendations for practitioners and exercise professionals. A search was carried out in the Web of Science, PubMed, and Scopus databases in search of randomized clinical trials (RCT) written in English. A meta-analysis was performed to determine the effectiveness of different types of exercise on the fibromyalgia impact questionnaire (FIQ), and the protocol period and session duration on the pain outcome. Eighteen articles were eligible for a qualitative assessment and 16 were included in the meta-analysis. The exercise showed large evidence for the association with a reduction in the FIQ (SMD - 0.98; 95% CI - 1.49 to - 0.48). Protocols between 13 and 24 weeks (SMD - 1.02; 95% CI - 1.53 to - 0.50), with a session time of less than 30 min (SMD - 0.68 95% CI - 1.26 to - 0.11) or > 30 min and < 60 min (SMD - 1.06; 95% CI - 1.58 to - 0.53) presented better results. Better results were found after combined training protocols and aerobic exercises. It is suggested that exercise programs lasting 13-24 weeks should be used to reduce pain, and each session should last between 30 and 60 min. In addition, the intensity should always be carried out gradually and progressively.PROSPERO registration number CRD42020198151.

Clinical applicability of infrared thermography in rheumatic diseases: A systematic review.

Rheumatic Diseases (RD) are a class of disorders of the musculoskeletal system, including different conditions, and are considered a major cause of disability among the population. RD do not have an objective and quick diagnosis and are sometimes challenging. In this way, Infrared Thermography (IT) could represent a fast and effective tool to detect essential information for diagnosing RD. Thus, the aim of this systematic review was to summarize and describe the clinical applicability of IT in RD. This innovative systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD42020214601). The risk of bias assessment was performed using the Cochrane tool. The PubMed, EMBASE, Science Direct, Web of Science, CINAHL, and SciELO databases were searched from their inception to June 2021. In total, 476 studies were identified and 12 studies met the inclusion criteria. The main RD analyzed were Raynaud's Phenomenon (RP), Scleroderma, Osteoarthritis (OA), Rheumatoid arthritis (RA), and localized juvenile scleroderma. The assessment protocols were similar in terms of acclimatization time, distance between the camera and the individual, temperature, and ambient humidity. Evidence demonstrates that infrared thermography is an effective tool to assess the health status of individuals with rheumatic diseases, producing clinical information relevant to diagnosis and treatment.

Effects of Exercise in the Treatment of Alzheimer's Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses.

The authors aimed to provide an overview of the evidence on the effects of exercise in people with Alzheimer's disease through a comprehensive review of the existing systematic reviews and meta-analyses. A literature search was performed in CINAHL, Cochrane Library, EMBASE, PubMed, SPORTDiscus, Scopus, and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The AMSTAR-2-Tool was used for the quality assessment. Twenty-three reviews fulfilled the criteria. Most of the reviews investigated the effects of aerobic exercise on Alzheimer's disease symptoms. The largest effects of exercise were seen in terms of improved cognition by multiple exercises. The majority of the reviews were rated as being of moderate quality and none were classified as having high quality. Exercise is an effective way to treat Alzheimer's disease symptoms and has a low incidence of related adverse events. As most reviews were evaluated as low-moderate quality, caution is needed in the interpretation of the results.

Effects of air pollution on health: A mapping review of systematic reviews and meta-analyses.

BACKGROUND: There has been a notable increase in knowledge production on air pollution and human health. OBJECTIVE: To analyze the state of the art on the effects of air pollution on human health through a mapping review of existing systematic reviews and meta-analyses (SRs and MAs). METHODS: The systematic mapping review was based on the recommendations for this type of scientific approach in environmental sciences. The search was performed using PubMed, Web of Science, Scopus, Cinahl, and Cochrane Library databases, from their inception through June 2020. RESULTS: Among 3401 studies screened, 240 SRs and MAs satisfied the inclusion criteria. Five research questions were answered. There has been an overall progressive increase in publications since 2014. The majority of the SRs and MAs were carried out by researchers from institutions in China, the US, the UK, and Italy. Most studies performed a meta-analysis (161). In general, the reviews support the association of air pollution and health outcomes, and analyzed the effects of outdoor air pollution. The most commonly investigated health outcome type was the respiratory (mainly asthma and COPD), followed by cardiovascular outcomes (mainly stroke). Particulate matter (with a diameter of 2.5 µm (PM2.5) and 10 µm (PM10) or less) and nitrogen dioxide (NO2) were the most widely investigated pollutants in the reviews. The general population was the most common sample in the reviews, followed by children, and adults. The majority of the reviews investigated health outcomes of respiratory diseases in children, as well as cardiovascular diseases in all ages. Combining health outcomes and air pollutants, PM2.5 was included in a higher number of reviews in eight health outcomes, mainly cardiovascular diseases. DISCUSSION: The majority of SRs and MAs showed that air pollution has harmful effects on health, with a focus on respiratory and cardiovascular outcomes. Future studies should extend the analysis to psychological and social aspects influenced by air pollution.

Comparisons of Mood States Associated With Outcomes Achieved by Female and Male Athletes in High-Level Judo and Brazilian Jiu-Jitsu Championships: Psychological Factors Associated With the Probability of Success.

ABSTRACT: Brandt, R, Bevilacqua, GG, Crocetta, TB, Monteiro, CBdM, Guarnieri, R, Hobold, E, Flores, LJF, Miarka, B, and Andrade, A. Comparisons of mood states associated with outcomes achieved by female and male athletes in high-level judo and Brazilian jiu-jitsu championships: psychological factors associated with the probability of success. J Strength Cond Res 35(9): 2518-2524, 2019-Moods can be used to predict the performance of athletes in various sports; accordingly, we selected the Brunel Mood Scale (BRUMS) to evaluate mood states of high-level judo and Brazilian jiu-jitsu (BJJ) athletes. The aims of this study were (a) to compare the mood states of high-level female and male athletes in BJJ and judo championships in relation to their performance outcomes and (b) to verify associations between psychological factors and performance in estimating their probability of success. The subjects were 173 grappling athletes (judo, n = 85 and BJJ, n = 88), separated into male (n = 129, 40 winners and 89 nonwinners) and female (n = 44, 23 winners and 21 nonwinners) groups. Each subject's mood state was assessed 60 minutes before the first match using the BRUMS (tension, depression, anger, vigor, fatigue, and mental confusion dimensions). Descriptive and inferential statistics (including logistic regression and variance analysis) were used to evaluate relations between mood states and performance (i.e., winning/losing), with p ≤ 0.05. Analysis showed significant differences between male and female athletes in vigor and fatigue, and differences between male judo and male BJJ athletes in tension, vigor, confusion, and fatigue. Female judo and female BJJ athletes showed significant differences in depression and vigor. Logistic regression revealed that higher levels of anger and tension increased athletes' chances of performing well in a match by 23 and 13%, respectively. In addition, lower levels of depression increased athletes' chances of better performance by up to 32%. Overall, we observed a significant relationship between mood state and sports performance. Thus, coaching staff and athletes should monitor athletes' mood states before competitions to ensure that they are in optimal condition to perform and use psychological interventions to support judo and BJJ preparation.

Effect of Mindfulness Training on Fatigue and Recovery in Elite Volleyball Athletes: A Randomized Controlled Follow-Up Study.

Volleyball is a team sport with high physical and perceptual-cognitive demand, hence, increasing the perception of physical and mental fatigue during a competition. To alleviate fatigue (physical and mental), mindfulness and music have been proposed. The aim of this study was to analyze the effect of mindfulness-based mental versus music training on mental fatigue, physical fatigue, and recovery in elite competitive female volleyball athletes using a randomized two-controlled study with follow-up. Participants were 30 elite female Brazilian volleyball athletes. Athletes were randomly assigned to the following groups: 1) mindfulness-based mental training group (MBMT); 2) music-based training group (MBT); or 3) control group (CG). Three variables were evaluated as follows: 1) recovery based on total quality recovery; 2) mental fatigue visual analog scale; and 3) physical fatigue visual analog scale. Regarding recovery, there was no difference between the MBMT, MBT, and CG groups (p > 0.05). A difference in mental fatigue was noted between MBT and CG at follow-up [F(2,26) = 5.71, p = 0.009; large]. Regarding physical fatigue, there was no difference between the MBMT, MBT, and CG groups (p > 0.05). The mindfulness intervention effectively attenuated the mental fatigue caused by competition in volleyball athletes. These results will assist coaches and staff in providing fatigue management and reinforce the applicability of mental training in sports.

Effects of Physical Exercise on the Expression of MicroRNAs: A Systematic Review.

Silva, FCd, Iop, RdR, Andrade, A, Costa, VP, Gutierres Filho, PJB, and Silva, Rd. Effects of physical exercise on the expression of microRNAs: A systematic review 34(1): 270-280, 2020-Studies have detected changes in the expression of miRNAs after physical exercise, which brings new insight into the molecular control of adaptation to exercise. Therefore, the objective of the current systematic review of experimental and quasiexperimental studies published in the past 10 years was to assess evidence related to acute effects, chronic effects, and both acute and chronic effects of physical exercise on miRNA expression in humans, as well as its functions, evaluated in serum, plasma, whole blood, saliva, or muscle biopsy. For this purpose, the following electronic databases were selected: MEDLINE by Pubmed, SCOPUS, Web of Science, and also a manual search in references of the selected articles to April 2017. Experimental and quasiexperimental studies were included. Results indicate that, of the 345 studies retrieved, 40 studies met the inclusion criteria and two articles were included as a result of the manual search. The 42 studies were analyzed, and it can be observed acute and chronic effects of physical exercises (aerobic and resistance) on the expression of several miRNAs in healthy subjects, athletes, young, elderly and in patients with congestive heart failure, chronic kidney disease, diabetes mellitus type 2 associated with morbid obesity, prediabetic, and patients with intermittent claudication. It is safe to assume that miRNA changes, both in muscle tissues and bodily fluids, are presumably associated with the benefits induced by acute and chronic physical exercise. Thus, a better understanding of changes in miRNAs as a response to physical exercise might contribute to the development of miRNAs as therapeutic targets for the improvement of exercise capacity in individuals with any given disease. However, additional studies are necessary to draw accurate conclusions.

Effects of exercise in people with haemophilia: An umbrella review of systematic reviews and meta-analyses.

INTRODUCTION: There is considerable evidence to indicate that exercise can have a positive impact on the treatment of people with haemophilia (PWH). However, there is a requirement for in-depth and comprehensive studies. AIM: This study aimed to analyse the evidence regarding the effects of exercise in PWH through an umbrella review of existing systematic reviews and meta-analyses. The secondary objective was to analyse the quality of the evidence. METHODS: This umbrella review followed the PRISMA guidelines and was documented in the PROSPERO registry (CRD42019140785). We searched the PubMed, Web of Science, SPORTDiscus, Scopus, CINAHL and Cochrane Library databases. The methodological quality of the systematic reviews was assessed using AMSTAR 2. RESULTS: Out of a total of 1030 systematic reviews, 10 fulfilled the criteria. Only one study was classified as high quality, and half of the selected studies were classified as low or critically low quality according to AMSTAR 2. Furthermore, most reviews investigated the effects of strength training and aquatic training, with positive results associated with low adverse events. Range of motion, strength and pain were the most investigated variables. All reviews showed overlapping studies. CONCLUSION: Exercise is an effective way to treat haemophilia and has a low incidence of related adverse events. However, caution is needed in the interpretation of the results due to half of the selected reviews showed low or critically low quality and only one have high quality.

Influence of exercise on oxidative stress in patients with heart failure.

Reactive oxygen species play an important role in the pathophysiology of heart failure (HF). In contrast, regular physical exercise can promote adaptations to reactive oxygen species that are beneficial for patients with HF. We completed a systematic review of randomized controlled trials that evaluate the influence of exercise on oxidative stress in patients with HF. Articles were searched in the PubMed, Cochrane, SciELO, and LILACS databases. The search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the included studies was assessed using the Physiotherapy Evidence Database scale. We selected 12 studies with a total of 353 participants. The included patients had a left ventricle ejection fraction of < 52% and New York Heart Association functional class II or III disease. A significant increase was observed in peak oxygen consumption (between 10 and 46%) in the group that underwent training (TG). There was an improvement in the oxidative capacity of skeletal muscles in the TG, related to the positive activity of mitochondrial cytochrome c oxidase (between 27 and 41%). An increase in the expression of the enzymes glutathione peroxidase (41%), catalase (between 14 and 42%), and superoxide dismutase (74.5%), and a decrease in lipid peroxidation (between 28.8 and 58.5%) were observed in the TG. Physical training positively influenced the cardiorespiratory capacity and enhanced the benefits of oxidant and antioxidant biomarkers in patients with HF. High-intensity training promoted a 15% increase in the plasma total antioxidant capacity, whereas moderate training had no effect.

Indoor air quality of environments used for physical exercise and sports practice: Systematic review.

BACKGROUND: Systematic reviews have the potential to contribute substantially to environmental health and risk assessment. OBJECTIVE: This study aimed to investigate indoor air quality of environments used for physical exercise and sports practice through a systematic review. METHODS: The systematic review followed the PRISMA guidelines and was recorded in the PROSPERO registry (CRD42016036057). The search was performed using the SciELO, Science Direct, Scopus, LILACS, MEDLINE via PubMed, and SPORTDiscus databases, from their inception through April 2017. The search terms used in the databases were {air pollution" OR "air pollutants" OR "air quality"} AND {"physical exercise" OR "physical activity" OR "sport"}. The results of selected studies were divided into 5 categories for analysis: monitoring of air quality in the environment according to international guidelines, indoor-to-outdoor ratio (I/O), air quality during physical exercise, impact of air quality on health, and interventions to improve indoor air quality. RESULTS: Among 1281 studies screened, 34 satisfied the inclusion criteria. The monitoring of pollutants was conducted in 20 studies. CO and NO2 were the most investigated pollutants, and guidelines were discussed in most studies. The I/O ratio was investigated in 12 studies, of which 9 showed a higher concentration of some pollutants in indoor rather than outdoor environments. Among the 34 studies selected, only 7 investigated the impact of indoor air pollution on human health. The population in most of these studies consisted of hockey players. CONCLUSION: Most studies conducted monitoring of pollutants in indoor environments used for physical exercise and sports practice. The earliest studies were conducted in ice skating rinks and the most recent evaluated gymnasiums, fitness centers, and sports centers. The CO, particulate matter, and NO2 concentrations were the most investigated and have the longest history of investigation. These pollutants were within the limits established by guidelines in most studies. Studies that examined the association between air quality documented the adverse effects of pollution. There is a need for more studies focused on the relationship between pollution and health.

Perceived Sleep Quality, Mood States, and Their Relationship With Performance Among Brazilian Elite Athletes During a Competitive Period.

Brandt, R, Bevilacqua, GG, and Andrade, A. Perceived sleep quality, mood states, and their relationship with performance among Brazilian elite athletes during a competitive period. J Strength Cond Res 31(4): 1033-1039, 2017-We described the perceived sleep quality and mood states of elite athletes during a competitive period, and clarified their relationship to athletes' sport performance. Participants were 576 Brazilian elite athletes (404 men and 172 women) of individual and team sports. Mood states were evaluated using the Brunel Mood Scale, whereas perceived sleep quality was evaluated using a single question ("How would you evaluate the quality of your sleep in the last few days?"). Evaluations of mood state and sleep quality were performed up to 60 minutes before national and international sports competitions began. Descriptive and inferential statistics (including logistic regression) were used to evaluate the relationship of sleep quality and mood states with performance (i.e., winning or losing). Athletes typically had good sleep quality and mood states similar to the Iceberg profile (i.e., high vigor and low tension, depression, anger, fatigue, and mental confusion). The Wald test revealed that sleep, anger, tension, and vigor predicted athletes' performance. Specifically, poor sleep quality and low vigor and anger decreased the odds of winning, whereas higher tension increased these odds. The Hosmer-Lemeshow test indicated that the results were sufficiently generalizable. Overall, we observed a significant relationship between sleep and mood states, which in turn both significantly influenced athletes' sports performance. Thus, coaching staff and athletes should monitor athletes' sleep quality before competitions to ensure athletes are in the optimal condition for performance.

Scientific production on indoor air quality of environments used for physical exercise and sports practice: Bibliometric analysis.

INTRODUCTION: In order to minimize adverse health effects and increase the benefits of physical activity, it is important to systematize indoor air quality study in environments used for physical exercise and sports. OBJECTIVES: To investigate and analyze the scientific production related to indoor air quality of environments used for physical exercise and sports practice through a bibliometric analysis. METHODS: The databases Scielo, Science Direct, Scopus, Lilacs, Medline via Pubmed, and SportDiscus were searched from their inception to March 2016. Bibliometric analysis was performed for authors, institutions, countries, and collaborative networks, in relation to publication year, theme, citation network, funding agency, and analysis of titles and keywords of publications. Country, area, and impact factor of the journals were analyzed. RESULTS: Of 1281 studies screened, 34 satisfied the inclusion criteria. The first publication occurred in 1975. An increase in publications was observed in the last 15 years. Most of the studies were performed by researchers in the USA, followed by Portugal and Italy. Seventeen different scientific journals have published studies on the subject, and most are in the area of Environmental Sciences. It was noted that the categories of author keywords associated with "Pollutants," "Sport Environment," and "Physical Exercise" were the most commonly used in most studies. A total of 68% of the studies had at least one funding agency, and 81% of studies published in the last decade had funding. CONCLUSIONS: Our results demonstrate that there is recent exponential growth, driven in the last decade by researchers in environmental science from European institutions.

Sleep Quality, Mood and Performance: A Study of Elite Brazilian Volleyball Athletes.

This investigation analyzed the relationships between sleep quality, mood, and game results in the elite athletes participating in Brazilian volleyball competitions. Participants (n = 277 elite Brazilian volleyball athletes, 214 (77.3%) men and 63 (22.7%) women) completed the Brunel Mood Scale (BRUMS) and reported their subjective sleep perception. Athletes with poor sleep quality reported higher scores for confusion compared to athletes with good sleep quality (p < 0.01, d = 0.43). In addition, athletes who lost their game at the time of evaluation showed higher tension (p < 0.01, d = 0.49) and confusion (p < 0.01, d = 0.32) levels compared to athletes who won their game. A regression analysis demonstrated that for each point increase in the confusion level, there was a 19.7% reduction in sleep quality. Multivariate analysis of variance indicated that athletes who slept well, and won their games, had lower tension levels. Further, our results indicated that the athletes' mood associated with their success in the competitions. Therefore, in a competition, it is important that the athletes show good sleep quality, and use techniques and strategies to ease their mood variations.

What are the Benefits of Exercise for Alzheimer's Disease? A Systematic Review of the Past 10 Years.

To identify and characterize the scientific literature on the effects of exercise on Alzheimer's disease, research was conducted in the following databases: MEDLINE, CINAHL, Web of Science, and Scopus. These MeSH terms--"exercise", "motor activity", "physical fitness", "Alzheimer disease", and its synonyms in English--were used in the initial search to locate studies published between 2003 and 2013. After reading the 12 final articles in their entirety, two additional articles, found by a manual search, were included. Of these, 13 had beneficial results of exercise in Alzheimer's disease. Given the results discussed here, the exercise may be important for the improvement of functionality and performance of daily life activities, neuropsychiatric disturbances, cardiovascular and cardiorespiratory fitness, functional capacity components (flexibility, agility, balance, strength), and improvements in some cognitive components such as sustained attention, visual memory, and frontal cognitive function in patients with AD.

Effects of home-based exercise on the health of patients with fibromyalgia syndrome: a systematic review of randomized clinical trials.

PURPOSE: Analyze the effects of interventions with home-based physical exercise on the health of patients with fibromyalgia and the characteristics of the protocols used. METHODS: This systematic review was registered at PROSPERO and followed the PRISMA recommendations. Searches were performed in six electronic databases. Eligibility criteria for the selection of studies were compiled using the acronym PICOS. Data were extracted and checked in a Microsoft Excel® spreadsheet and the risk of bias was assessed using the Rob 2 tool. RESULTS: The search resulted in seven studies included for analysis. Among them, the most common modality was aerobic exercise. The analyzed outcomes were: pain, quality of life, depression, anxiety, disease severity, physical function, pain catastrophizing, self-efficacy, psychological well-being, sleep quality and somatosensory and temporal discrimination. The effects of home-based exercise are limited, and improvements in pain and quality of life was found. For the other outcomes, the results were inconclusive. Most studies presented some concerns about the risk of bias. CONCLUSION: It is necessary to expand the evidence on home-based exercises for fibromyalgia, as this is the first systematic review on the subject. Subsequent research should focus on methodological rigor and protocol detail, allowing findings to be replicated.

Home-based physical exercise can improve pain and quality of life in patients with fibromyalgia.Among the modalities, combinations of aerobic exercise, resistance training and stretching are recommended.The weekly frequency should be two or three times, with an average duration of 40 minutes.Programs from four weeks onwards may already show improvement in symptoms, but the practice should be maintained in the long term.

Improving Mental Skills in Precision Sports by Using Neurofeedback Training: A Narrative Review.

Primary objectives of neurofeedback training (NFT) are to improve concentration, stress and anxiety management, and performance optimisation. This narrative review examines the role of NFT as a tool to improve mental and cognitive skills of target shooting and archery athletes. Current research discusses how neurofeedback training can act on brain waves by influencing specific EEG frequency bands in order to improve cognitive flexibility. This contribution reports studies that have applied neurofeedback protocols in precision disciplines such as archery and shooting. The results of the studies considered showed that neurofeedback can lead to faster reaction times, more sustained attention, and better emotion management, contributing significantly to athletes' performance. Furthermore, it is emphasised that neurofeedback could be combined with other techniques such as motor imagination to maximise effectiveness in precision sports training. This review emphasises the importance of future studies that focus on the integration of neurofeedback with biofeedback in neuromodulation protocols. Current perspectives and limitations of research in this area are also indicated. Neuromodulation by means of neurofeedback represents a promising strategy to improve the overall mental and cognitive abilities of target shooting and archery athletes with an interesting potential for high-level performance. Future research should focus on integrated approaches and customised protocols to optimise the use of neurofeedback in a precision sports context.

Integrated use of biofeedback and neurofeedback techniques in treating pathological conditions and improving performance: a narrative review.

In recent years, the scientific community has begun tо explore the efficacy оf an integrated neurofeedback + biofeedback approach іn various conditions, both pathological and non-pathological. Although several studies have contributed valuable insights into its potential benefits, this review aims tо further investigate its effectiveness by synthesizing current findings and identifying areas for future research. Our goal іs tо provide a comprehensive overview that may highlight gaps іn the existing literature and propose directions for subsequent studies. The search for articles was conducted on the digital databases PubMed, Scopus, and Web of Science. Studies to have used the integrated neurofeedback + biofeedback approach published between 2014 and 2023 and reviews to have analyzed the efficacy of neurofeedback and biofeedback, separately, related to the same time interval and topics were selected. The search identified five studies compatible with the objectives of the review, related to several conditions: nicotine addiction, sports performance, Autism Spectrum Disorder (ASD), and Attention Deficit Hyperactivity Disorder (ADHD). The integrated neurofeedback + biofeedback approach has been shown to be effective in improving several aspects of these conditions, such as a reduction in the presence of psychiatric symptoms, anxiety, depression, and withdrawal symptoms and an increase in self-esteem in smokers; improvements in communication, imitation, social/cognitive awareness, and social behavior in ASD subjects; improvements in attention, alertness, and reaction time in sports champions; and improvements in attention and inhibitory control in ADHD subjects. Further research, characterized by greater methodological rigor, is therefore needed to determine the effectiveness of this method and the superiority, if any, of this type of training over the single administration of either. This review іs intended tо serve as a catalyst for future research, signaling promising directions for the advancement оf biofeedback and neurofeedback methodologies.

Evaluating the effectiveness of neurofeedback in chronic pain management: a narrative review.

The prevalence and impact of chronic pain in individuals worldwide necessitate effective management strategies. This narrative review specifically aims to assess the effectiveness of neurofeedback, an emerging non-pharmacological intervention, on the management of chronic pain. The methodology adopted for this review involves a meticulous search across various scientific databases. The search was designed to capture a broad range of studies related to neurofeedback and chronic pain management. To ensure the quality and relevance of the included studies, strict inclusion and exclusion criteria were applied. These criteria focused on the study design, population, intervention type, and reported outcomes. The review synthesizes the findings from a diverse array of studies, including randomized controlled trials, observational studies, and case reports. Key aspects evaluated include the types of neurofeedback used (such as EEG biofeedback), the various chronic pain conditions addressed (like fibromyalgia, neuropathic pain, and migraines), and the methodologies employed in these studies. The review highlights the underlying mechanisms by which neurofeedback may influence pain perception and management, exploring theories related to neural plasticity, pain modulation, and psychological factors. The results of the review reveal a positive correlation between neurofeedback interventions and improved pain management. Several studies report significant reductions on pain intensity, improved quality of life, and decreased reliance on medication following neurofeedback therapy. The review also notes variations in the effectiveness of different neurofeedback protocols and individual responses to treatment. Despite the promising results, the conclusion of the review emphasizes the need for further research. It calls for larger, well-designed clinical trials to validate the findings, to understand the long-term implications of neurofeedback therapy, and to optimize treatment protocols for individual patients.