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OBJECTIVE:To systematically review the clinical effect of blood flow restriction training on rehabilitation after anterior cruciate ligament reconstruction to provide a reference for clinical practice. METHODS:Databases including CNKI,WanFang,PubMed,Web of Science and EBSCO were searched to collect randomized controlled trials of blood flow restriction training in the intervention of anterior cruciate ligament reconstruction from inception to August 10,2022.Outcomes included knee muscle strength,knee muscle mass,and knee function evaluation,all of which were continuous variables.Two reviewers independently screened the literature and extracted data.Cochrane bias risk assessment tool and Physiotherapy Evidence Database Scale were used to evaluate the bias risk of the included articles.Meta-analysis was then performed using RevMan 5.4 software. RESULTS:A total of 9 publications were included,including 226 subjects,114 in the trial group and 112 in the control group.Meta-analysis results showed that compared with conventional resistance training,the blood flow restriction training group could significantly improve knee muscle strength[SMD=0.54,95%CI(0.29,0.79),P＜0.01],muscle mass[SMD=0.26,95%CI(0.06,0.46),P=0.01]and knee joint function[SMD=1.17,95%CI(0.53,1.80),P＜0.01].Subgroup analysis showed that only when the intervention time was more than 4 weeks,there were significant improvements in knee joint muscle strength[SMD=0.68,95%CI(0.38,0.97),P＜0.01]and muscle mass[SMD=0.38,95%CI(0.09,0.68),P=0.01]. CONCLUSION:Current evidence shows that blood flow restriction training can improve muscle strength and knee function in patients with anterior cruciate ligament reconstruction and reduce muscle atrophy.It is recommended that the postoperative intervention time should be more than 4 weeks to achieve better muscle strength and muscle mass improvement.
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OBJECTIVE:With the increasing aging population,the decline of cognitive ability in older adults has received widespread attention.High-intensity interval training(HIIT)has been applied as an emerging exercise intervention to improve cognitive ability in older adults,but its efficacy is still controversial.This study aimed to investigate the effects of HIIT intervention on cognitive ability in older adults,in order to provide a theoretical basis for its application in improving cognitive ability in older adults. METHODS:Randomized controlled trials regarding the effect of HIIT on cognitive ability in older adults were retrieved from databases including CNKI,WanFang,PubMed,Embase,and Web of Science,from the database inception to November 2022.The Cochrane Collaboration's tool for assessing risk of bias in randomized controlled trials was used to evaluate the methodological quality,and RevMan 5.3 software was used for the Meta-analysis of outcome indicators in the included literature. RESULTS:A total of 8 randomized controlled trials,including 4 high-quality and 4 low-quality studies with 369 participants,were included in the Meta-analysis.Meta-analysis showed that(1)compared with moderate-intensity continuous training(MICT),HIIT could effectively improve the maximal oxygen uptake of older adults[weighted mean difference(WMD)=3.78,95%confidence interval(CI):2.79,4.77,P＜0.000 01].Subgroup analysis showed that with long-term intervention(intervention period≥6 weeks),compared with the MICT group,the HIIT group could significantly improve the executive function[standardized mean difference(SMD)=0.36,95%CI:0.20-0.52,P＜0.000 1)and its sub-function inhibition ability(SMD=0.35,95%CI:0.17-0.52,P＜0.000 1)of older adults.(2)Compared with the control group,the HIIT group could effectively improve the maximal oxygen uptake of older adults(WMD=6.75,95%CI:4.20-9.29,P＜0.000 01),memory(SMD=0.20,95%CI:0.03-0.37,P=0.02),executive function(SMD=0.87,95%CI:0.52-1.22,P＜0.000 01),and its sub-function inhibition ability(SMD=0.89,95%CI:0.46-1.33,P＜0.000 1).Subgroup analysis showed that with long-term intervention(intervention period≥6 weeks),compared with the control group,the HIIT group could effectively improve the executive function(SMD=0.75,95%CI:0.41-1.09,P＜0.000 1),its sub-function inhibition ability(SMD=0.50,95%CI:0.19-0.81,P=0.002),and switching ability(SMD=1.65,95%CI:0.86-2.44,P＜0.000 1).(3)With a single intervention,compared with the control group,the HIIT group could effectively improve the executive function(SMD=1.25,95%CI:0.39-2.11,P=0.004)and its sub-function inhibition ability(SMD=2.40,95%CI:0.87-3.92,P=0.002). CONCLUSION:HIIT can effectively improve the executive function and its sub-function inhibition ability of older adults,but has no improvement effect on memory ability.At the same time,long-term HIIT intervention is superior to MICT in improving aerobic capacity and executive function of older adults.
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Objective To investigate the characteristics of knee kinematics and ground reaction force (GRF), as well as the stress state of cartilage and meniscus in the process of lateral incisions at different cutting angles under expected conditions. Methods Kinematics and GRF data of 14 subjects at 45°, 90° and 135° cutting angle respectively under expected conditions were collected. The knee joint reaction force was obtained through the inverse dynamics calculation of Visual 3D. Based on three-dimensional (3D) finite element model of the knee joint, the contact process at 3 lateral cutting angles was simulated. ResultsUnder expected conditions, there were significant differences in knee joint kinematics characteristics at 3 cutting angles during contact process(P＜0.001), and the knee flexion increased with the cutting angle increasing; the vertical GRF decreased significantly with the cutting angle increasing (P＜0.001), while the horizontal GRF showed the opposite trend; for 3 cutting angles, the peak contact stress of patellar cartilage and femoral cartilage was larger at 90° cutting angle, the peak principal stress at anterior cruciate ligament (ACL) contact point was also larger at 90° cutting angle, and the following was at 135° and 45° cutting angle, respectively; the peak contact stress of lateral femoral cartilage was larger than that of medial femoral cartilage at 3 cutting angles. Conclusions The risk of knee joint injury is higher at 90° cutting angle, and the stress state of knee joint at 135° cutting angles is better than that at 90° cutting angle, and the risk of knee joint injury does not increase with the increase of cutting angle under expected conditions.