What Is Known from the Existing Literature about Hypopressive Exercise? A PAGER-Compliant Scoping Review.

Introduction: Hypopressive exercise (HE) can be viewed as a mind-body activity, characterized by the integration of breath control and stretching postures. Proponents of HE claim that this type of training can offer potential therapeutic or health benefits. To date, there is no existing comprehensive published overview on HE. This scoping review aims to map and summarize the current literature reporting data on HE and identify key knowledge gaps and future research directions. Methods: This review considered studies that report on the immediate, short-, or long-term practice of HE regardless of condition, sex, age, and/or level of practice or physical condition. Any context or setting was considered for inclusion. This review was performed in accordance with the methodological framework proposed by the Joanna Briggs Institute and by Arksey and O'Malley. MEDLINE, CINAHL, SPORTDiscus, Scopus, and Web of Science were searched from inception up to July 2023. Literature was mapped following the Patterns-Advances-Gaps-Evidence for Practice Recommendations framework to identify patterns and inform practice. Results: In total, 87 studies were identified that reported on the following themes: (1) therapeutic application of a short- or long-term HE programs (n = 56); (2) physiologic and physical responsiveness to a short- or long-term HE programs (n = 22); (3) psychologic and behavioral response to a short-term HE program (n = 14); and (4) acute or immediate physiological responses (n = 21). Literature gaps included poor methodological design, incomplete reporting of intervention, lack of male participants, and exploration of muscle groups distinct from the pelvic floor and abdominal muscles. Discussion: There is a need for high-quality randomized controlled trials, adherence to reporting guidelines on exercise, and the use of active control groups to verify clinical significance, the dose response, and health applications of HE.

Assessment of Integrative Therapeutic Methods for Improving the Quality of Life and Functioning in Cancer Patients-A Systematic Review.

Background: Cancer rehabilitation represents a series of measures adopted for the recovery of psychological, emotional, social, and financial functioning in the case of cancer patients. The purpose of this study is to identify the main elements of therapeutic management in the field of medical rehabilitation, as well as integrative, complementary medicine and holistic approaches that can be performed on the oncological patient. Methods: This systematic literature review follows the methodology outlined in the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" ("PRISMA") statement, which is an internationally recognized and widely accepted standard. Results: Active rehabilitative therapies offer therapeutic options for improving the functioning and quality of life of oncological patients; these therapies comprehensively address both the physical and psychological aspects of the disease. This review also includes the latest novelties and nanotechnologies applied in oncological rehabilitation, for example, drugs (or supplements) inspired by nature. Conclusions: Physical and rehabilitation medicine, mostly using stimulating therapeutic methods, was recently added to the list of contraindications in the management of oncological patients, both as an approach to the pathological concept itself and as an approach to the main clinical consequences and functional aspects of oncological therapies. Integrative, complementary medicine presents an important therapeutic resource in the case of oncological patients. Advanced studies are needed in the future to further ascertain the role of these therapies.

Lumbar Paravertebral Muscle Pain Management Using Kinesitherapy and Electrotherapeutic Modalities.

BACKGROUND: Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence and evolution of low back pain. METHODS: The purpose of this paper is to highlight the physiological and functional changes in young adults with painful conditions of the lumbar spine, after using exercise therapy. The study was of the longitudinal type and was carried out over a period 6 months in an outpatient setting. The rehabilitation treatment included electrotherapeutic modalities and kinesitherapy. RESULTS: The results obtained when evaluating each parameter, for all moments, show statistically significant values in both groups. The results obtained regarding the relationship between the therapeutic modalities specific to rehabilitation medicine and low back pain are consistent with those reported in studies. CONCLUSIONS: Depending on the clinical-functional status of each patient, kinesitherapy can accelerate the heart rate and increase the blood pressure and oxygen saturation of the arterial blood, values that can later return to their initial levels, especially through training.

Efficacy of trigger point injection therapy in noncardiac chest pain: A randomized controlled trial.

Objectives: This study aimed to compare the effects of trigger point injections and stretching exercises in patients with noncardiac chest pain (NCCP) associated with myofascial pain syndrome. Patients and methods: This prospective randomized controlled trial included 50 patients with noncardiac chest pain and trigger points in the pectoralis muscles between October 2019 and June 2020. The patients were randomly assigned to receive trigger point injections into the pectoralis muscles and exercise (n=25; 15 males, 10 females; mean age: 42.8±9.2 years; range, 25 to 57 years) or only perform exercise (n=25; 11 males, 14 females; mean age: 41.8±11.2 years; range, 18 to 60 years). The primary outcome was pain intensity at the first month and three months after the first treatment session, measured using the Visual Analog Scale from 0 to 100. The secondary outcome was the Nottingham Health Profile score. Results: Treatment with stretching exercises and trigger point injection resulted in significant pain reduction compared to stretching exercises alone, and the reduction was persistent at the three-month follow-up (p<0.001). A between-group comparison showed no significant difference in the Nottingham Health Profile (p=0.522). Complications related to the procedure or severe adverse events attributable to treatment were not reported. Conclusion: Trigger point injection combined with stretching exercises is an efficient treatment for noncardiac chest pain related to myofascial pain syndrome compared to exercise treatment alone.

Cardiorespiratory Effects of Yogic Versus Slow Breathing in Individuals with a Spinal Cord Injury: An Exploratory Cohort Study.

Background: An intricate physiological and pathophysiological connection exists between the heart and lungs, which is especially important in individuals with spinal cord injury (SCI). While an exercise intervention may seem the best approach to leverage this relationship, the prior work has shown that, despite numerous health benefits, regular exercise training does not improve cardiorespiratory control in individuals with SCI. Breath training presents an alternative intervention that is uniquely accessible, with yogic breathing directly engaging linked fluctuations in respiration and cardiovascular control. In addition, there is evidence across a range of populations that regular yogic breathing reduces cardiovascular disease risk. It is possible that the chronic decrease in breathing frequency associated with regular yogic breathing, rather than the specific yogic breathing techniques themselves, is the primary contributor to the observed risk reduction. Methods: Therefore, in 12 individuals with traumatic SCI from C4 to T8, the authors compared Unpaced and conventional 0.083 Hz (Slow) paced breathing with various yogic breathing techniques including: (1) inspiratory-expiratory breath holds (i.e., Kumbhaka or "Box Breathing"), (2) extended exhalation (1:2 duty cycle), and (3) expiratory resistance via throat constriction (i.e., Ujjayi). Beat-to-beat heart rate and blood pressure were measured as well as end-tidal CO2 and O2 saturation were measured. Statistical analysis was performed using a one-way repeated-measures analysis of variance with post hoc pairwise t tests corrected for multiple comparisons. Results: As expected, all slow breathing patterns markedly increased respiratory sinus arrhythmia (RSA) compared with Unpaced in all (n = 12) individuals. More importantly, Ujjayi breathing appeared to improve ventilatory efficiency over Unpaced breathing in individuals with SCI by increasing O2 saturation (97.6% vs. 96.1%; p = 0.042) and tended to decrease end-tidal CO2 (32 mmHg vs. 35 mmHg; p = 0.08). While other slow breathing patterns demonstrated similar effects, only Ujjayi improved RSA while increasing heart rate and improving ventilatory efficiency. Conclusions: Hence, slow breathing per se can result in important cardiorespiratory changes, but the yogic breathing practice of Ujjayi, with glottic throat resistance, may hold the greatest promise for improving cardiorespiratory control in individuals with SCI (CTR ID No. NCT05480618).

Rehabilitation Strategies for Wernicke-Korsakoff Syndrome: Physiotherapy Interventions and Management Approaches.

Korsakoff syndrome and Wernicke's encephalopathy (WE) show neurological and cognitive deficits. Wernicke-Korsakoff syndrome (WKS) is a compound neurological condition. The cause of this neurological condition could be the consumption of alcohol regularly for a chronic duration. A tailored rehabilitation protocol that focuses on cognitive and physical deficiencies was implemented along with thiamine supplementation for managing a case of a 49-year-old male patient who had a history of high alcohol consumption and was exhibiting typical signs of WKS. After planning a proper physiotherapy plan, it is necessary to look after the patient's progress along with re-evaluation, which reveals notable gains in cognitive function, memory, and functional independence. There is a dearth of research on the impact of physical therapy in managing WKS. The above case report reflects the benefits of combining physiotherapy, cognitive rehabilitation, and balance training to improve patient functionality and independence. Tailored rehabilitation interventions like the Benson relaxation method (BRM), brain gym exercises, Frenkel's exercise, electrical stimulation, sensorimotor training, basic body awareness therapy (BBAT), and gait training can be used to enhance a patient's quality of life. Addressing individual needs is essential in managing WKS, focusing on the importance of comprehensive care beyond cognitive rehabilitation alone.

Effects of hypopressive exercises on pelvic floor and abdominal muscles in adult women: A systematic review of randomized clinical trials.

INTRODUCTION: Hypopressive exercises (HE) are postural and breathing exercises that activate deep muscles in the abdomen and pelvic floor. Despite this, there is still no consensus in the literature on its real effectiveness. The objective was to analyze the effects of HE on the abdominal and pelvic floor muscles in women with or without dysfunctions in these regions. METHODS: This is a systematic review of randomized clinical trials found in the PEDro, PubMed, Cochrane, LILACS, and Embase databases. We include studies that evaluate the effects of HE (with or without other techniques) on the pelvic floor and abdominal region for 8 weeks or more, in women over 18 years old, with or without dysfunction in these regions, with the presence of a control group (active or passive). RESULTS: HE were effective in improving strength, tone, and reducing symptoms of pelvic floor dysfunctions, in magnitude less than (in two studies) or equal (in one study) to the pelvic floor muscle training (PFMT). When HE were performed with PFMT in the same group, no additional benefits were found. Only one study evaluated abdominal muscles activation, where HE were effective in improving postural control and activation of the transversus abdominis muscle. CONCLUSIONS: The HE presented positive results to the evaluated parameters. However, the information is still preliminary and scarce. There are methodological divergences regarding the execution, follow-up and standardization of the method, which could affect the results. According to the existing information, HE cannot yet be reliably indicated for the treatment of the pelvic floor, despite pointing out relevant results in some studies. More randomized clinical trials and long-term studies are needed to analyze the effects of HE not only for pelvic floor, but also for other regions, such as abdominal muscles and related dysfunctions.

Effect of aerobic exercises on patients with chronic mechanical low back pain: A randomized controlled clinical trial.

BACKGROUND: Chronic mechanical low back pain (CMLBP) is one of the most prevalent and costly disorders. Determining its most effective treatment approach is a priority for researchers. PURPOSE: To examine the effects of including aerobic exercise within a conventional therapy regimen for young adults with CMLBP. METHODS: Fifty CMLBP patients (22 males and 28 females) were randomly and equally assigned to one of two groups to receive the prescribed treatment for 8 weeks. The control group received the traditional program only (infrared, ultrasound, burst TENS, and exercises); for the experimental group, an aerobic training program using a stationary bicycle was added. Back pain intensity was the primary outcome. Secondary outcomes included the Oswestry disability index, back extensor endurance measured by the Sorensen test, and physical performance indicated by the back performance scale and the 6-min walk test. A Two-way MANOVA was used for data analysis. RESULTS: Multivariate tests revealed statistically significant effects of group (p = 0.002, partial η2 = 0.182), time (p < 0.001, partial η2 = 0.928), and group-by-time interaction (p = 0.01, partial η2 = 0.149). Univariate group-by-time interactions were significant for back disability (p = 0.043), extensor endurance (p = 0.023) and results of the 6-min walk test (p = 0.023) showing greater improvement in the experimental group. However, back pain intensity and the back performance scale revealed no significant group-by-time interactions. Within-group comparisons were significant for all measured variables in both groups (p < 0.001). CONCLUSION: Although a traditional program of infrared, ultrasound, TENS, and exercises is beneficial for CMLBP treatment, adding aerobic exercises to the program leads to more beneficial outcomes.

Reducing Anxiety and Enhancing Mindfulness in College Students during COVID-19 through WeActive and WeMindful Interventions.

OBJECTIVE: The purpose of this study was to examine the immediate and short-term, sustained effects of two virtual interventions, WeActive, an aerobic and resistance training program, and WeMindful, a mindful exercise, in reducing anxiety and improving mindfulness among college students during the COVID-19 pandemic. METHODS: Participants were 60 students from a large Midwestern university who were randomly assigned to either the WeActive group (n = 36) or the WeMindful group (n = 24). The WeActive group participated in two virtual 30 min aerobic and resistance training sessions per week (WeActive) and the WeMindful group participated in two virtual 30 min mindful exercise sessions per week for eight weeks. All participants completed the Generalized Anxiety Disorder scale and the Five Facet Mindfulness Questionnaire through Qualtrics at three time points: one week prior to (pre-test), one week after (post-test), and six weeks after (follow-up) the intervention. RESULTS: A repeated-measures ANOVA revealed a significant main effect of time on anxiety (F = 7.51, η2 = 0.036, p = 0.001) in both groups. WeActive significantly decreased anxiety scores between the pre-test and follow-up (t = 2.7, p = 0.027) and post-test and follow-up (t = 3.1, p = 0.007), and WeMindful significantly decreased anxiety scores between the post-test and follow-up (t = 0.641, p = 0.028). For mindfulness, there was a significant main effect of time in both groups (F = 3.91, η2 = 0.009, p = 0.025), where only WeMindful significantly increased mindfulness from the pre-test to follow-up (t = -2.7, p = 0.025). CONCLUSIONS: Anxiety decreased significantly in both the WeActive and WeMindful groups and mindfulness increased significantly in the WeMindful group. Furthermore, the decrease in anxiety was sustained in a short-term period following the end of the intervention.

Effects of diverse resistance training modalities on performance measures in athletes: a network meta-analysis.

Background: Jumping ability is one of the necessary qualities for athletes. Previous studies have shown that plyometric training and complex training including plyometrics can improve athletes' jumping ability. With the emergence of various types of complex training, there is uncertainty about which training method has the best effect. This study conducted a meta-analysis of randomized controlled trials of plyometric-related training on athletes' jumping ability, to provide some reference for coaches to design training plans. Methods: We systematically searched 3 databases (PubMed, Web of Science, and Scopus) up to July 2023 to identify randomized controlled trials investigating plyometrics related training in athletes. The two researchers conducted literature screening, extraction and quality assessment independently. We performed a network meta-analysis using Stata 16. Results: We analyzed 83 studies and found that complex training, which includes high-intensity intervals and plyometric exercises, was the most effective method for improving squat jumps (SURCA = 96%). In the case of countermovement jumps a combination of electrostimulation and plyometric training yielded the best results (SURCA = 97.6%). Weightlifting training proved to be the most effective for the standing long jump (SURCA = 81.4%), while strength training was found to be the most effective for the five bounces test (SURCA = 87.3%). Conclusion: Our current study shows that complex training performs more efficient overall in plyometric-related training. However, there are different individual differences in the effects of different training on different indicators (e.g., CMJ, SJ, SLJ, 5BT) of athletes. Therefore, in order to ensure that the most appropriate training is selected, it is crucial to accurately assess the physical condition of each athlete before implementation. Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO/, Registration and protocol CRD42023456402.

Mind-Body Training: A Plausible Strategy against Osteomuscular Chronic Pain-A Systematic Review with Meta-Analysis.

(1) Background: Chronic pain, which affects more than one in five adults worldwide, has a negative impact on the quality of life, limiting daily activities and generating absences from work. The aim of the present review is to analyze the efficacy of mind-body therapies as therapeutic strategies for patients with chronic pain. (2) Methods: A systematic review with a meta-analysis was carried out, searching PubMed, Scopus, and Web of Science databases using specific keywords. We selected studies that included mind-body therapies as the primary intervention for older adults with chronic pain. The methodological quality of the articles was assessed using the PEDro scale. (3) Results: Of the 861 studies identified, 11 were included in this review, all of which employed different mind-body therapies as an intervention. The selected studies measured chronic pain as the main variable. (4) Conclusions: This review highlights the value of mind-body exercises in reducing chronic pain in older adults, suggesting their integration as a non-pharmacological therapeutic alternative that improves the quality of life, promoting a holistic approach to pain management.

Effect of traditional Chinese fitness exercises on bone mineral density in postmenopausal women: a network meta-analysis of randomized controlled trials.

We aimed to evaluate the clinical efficacy of five traditional Chinese fitness exercises (Baduanjin, Taijiquan, Wuqinxi, Yijinjing, and Liuzijue), as well as their efficacy when combined with drug therapy, in the treatment of decreased bone mineral density in postmenopausal women. Methods: This study strictly followed the evaluation guidelines of PRISMA and followed the "PICOS" principle outlined in the Cochrane Handbook. We performed a systematic search on Web of Science, Springer Link, Scopus, EMBASE, EBSCO, PubMed, the Cochrane Library, CNKI, Wanfang, CBMdisc, and the VIP Database, and we targeted RCTs studying the effect of TCE on BMD in postmenopausal women published prior to September 2023. The quality of the literature and the risk of bias of the included studies were assessed according to ROB2 and GRADE criteria, and data analysis was performed using Stata 14. Results: A total of 33 RCTs (3658 post-menopausal women) were included. Network meta-analysis showed that Taiji (SMD=0.72, 95% CI: 0.22, 1.21, P<0.01) and Yijinjing (SMD=0.51, 95% CI: 0.03, 0.99, P<0.05) were significantly superior to conventional rehabilitation in lumbar BMD. In terms of improvement of femoral neck BMD, Baduanjin (SMD=1.63, 95% CI: -3.58, 6.85, P<0.001) and Taiji (SMD=0.46, 95% CI: 0.14, 0.79, P<0.05) had statistically different outcomes to conventional rehabilitation. Regarding Ward's triangle BMD, Taiji (SMD= 0.32, 95% CI: 0.14, 0.50, P< 0.05) had statistically different outcomes to conventional rehabilitation. The results of the SUCRA probability ranking showed that Baduanjin + drug interventions achieved the most significant improvement in lumbar BMD (SUCRA=83.6%) and femoral neck BMD (SUCRA=90.2%). Taiji + drug interventions most effectively improved Ward's triangle BMD (SUCRA=86.0%). In terms of traditional Chinese fitness exercises alone, Taiji was the most effective in improving lumbar BMD (SUCRA=64.4%) and Ward's triangle BMD (SUCRA=46.8%), and Baduanjin was the most effective in treating femoral neck BMD (SUCRA=89.9%). Conclusion: Traditional Chinese fitness exercises can significantly improve the BMD levels of postmenopausal women. Taiji, Yijinjing, and Baduanjin combined with medication showed better intervention effects overall. However, due to the limitations of the number of studies and sample sizes of individual interventions, definitive conclusions need to be verified by more high-quality studies.

The effects of yoga and progressive muscle relaxation exercises on premenstrual syndrome: a randomized controlled trial.

In this study, university students with premenstrual syndrome (PMS) were evaluated for their responses to the practices of yoga and progressive muscle relaxation (PMR) to combat PMS, and the depression, anxiety, and stress associated with it. A total of 68 students participated in a randomized controlled trial. They were divided into four parallel groups: a yoga intervention group (n = 17), a PMR intervention group (n = 17), a yoga and PMR intervention group (n = 17), and a control group (n = 17). Data were collected between April 2022 and June 2022, from students who practiced only yoga, who practiced only PMR, and who practiced both yoga and PMR. A Personal Information Form, the PMS Scale, and the Depression, Anxiety, and Stress Scale were used as measurement tools. The yoga and yoga + PMR groups had lower scores for the PMS Scale in the posttest than the other groups (p < .05). Depression, anxiety, and stress sub-dimension mean scores were lower in the yoga, PMR + yoga, and PMR groups compared to the control group (p < .05). The results suggest that yoga and PMR interventions are beneficial non-pharmacological treatments for PMS, depression, anxiety, and stress.Clinical Registration Name, Registration Number, Registration Date: The Effects of Yoga and Progressive Muscle Relaxation Exercises on Premenstrual Syndrome, NCT05396976, April 5, 2022.

Effects of traditional Chinese exercises in fibromyalgia syndrome: A meta-analysis of randomized controlled trials.

OBJECTIVES: To explore the efficacy and safety of five traditional Chinese exercises (TCEs) in patients with fibromyalgia syndrome (FMS). METHODS: The PubMed, Embase, Scopus, ProQuest, Web of Science, Cochrane, CNKI, WanFang, and VIP databases were comprehensively searched for randomized controlled trials (RCTs) related to TCEs published from inception until February 2023. Standardized mean differences (SMD) and 95% confidence intervals (CI) were used to determine the combined effects of the intervention, and the Cochrane risk-of-bias assessment tool and Review 5.2 software were used to assess methodological quality. The data were extracted and analyzed by the Stata15.0 random effects model. RESULTS: Nineteen RCTs including 1315 participants were included in the analysis. The studies were found to be heterogeneous (I2 =86.2, P = 0.000), and thus a random effects model was used to combine the data. The results showed that traditional Chinese exercises had potentially beneficial effects on reducing pain (SMD =-0.66,95% CI [-1.08, -0.25], P = 0.002), improving sleep (SMD = -0.35,95% CI [-0.68,0. 01], P = 0.041) and relieving depression (SMD= -0.24,95% CI [-0.47, -0.02], P = 0.034) in FMS patients. However, no significant effects were found on improved quality of life (SMD =-0.20,95% CI [-0.48,0.09], P = 0.176). CONCLUSIONS: TCEs can improve pain, sleep quality and depression in patients with FMS and are safe. However, they do not improve the quality of life significantly. Further large-scale, high-quality, and multi-center RCTs are required to verify the efficacy of TCEs.

Dry Needling Versus Manual Therapy for Patients With Mechanical Neck Pain: A Randomized Controlled Trial.

OBJECTIVE: To compare the short- and intermediate-term effects of dry needling to manual therapy on pain, disability, function, and patient-perceived improvement in patients with mechanical neck pain. DESIGN: A single (therapist) blinded randomized controlled trial. METHODS: Seventy-eight patients (mean ± SD age, 50.74 ± 13.81) were randomly assigned to one of the 2 groups: (1) dry needling and therapeutic exercises (DN + Exercises) and (2) manual therapy and therapeutic exercises (MT + Exercises). Both groups received 7 treatment sessions over a maximum of 6 weeks. Outcome measures, collected at baseline, 2 weeks, discharge (7th treatment session), and 3 months after discharge, were as follows: Neck Disability Index (NDI), numeric pain-rating scale (NPRS), Patient-Specific Functional Scale (PSFS), global rating of change (GROC), Fear-Avoidance Belief Questionnaire (FABQ), and Deep Neck Flexor Endurance Test (DNFET). Data were analyzed with mixed-model analysis of covariance (ANCOVA), using pretest scores as covariates, and a Mann-Whitney U test for GROC scores. RESULTS: The ANCOVA revealed significant group-by-time interaction for all variables. Significant between-group differences, favoring MT + Exercises, were observed at all 3 time points on the NDI (2 weeks: F1,446 = 172.68, P≤.001, [Formula: see text] = .27; discharge: F1,446 = 254.15, P≤.001, [Formula: see text] = .36; and 3 months: F1,446 = 339.40, P≤.001, [Formula: see text] = .43). Results for the MT + Exercises group exceeded recommended minimal clinically important difference for all variables, at all follow-up points. CONCLUSION: MT + Exercises was more effective, both in the short term and intermediate term, than DN + Exercises in reducing pain, disability, and improving function in patients with mechanical neck pain. J Orthop Sports Phys Ther 2024;54(4):1-12. Epub 29 January 2024. doi:10.2519/jospt.2024.12091.

The effectiveness of hydrotherapy on return to play in sports following hip arthroscopic surgery: a comparative study.

BACKGROUND: The postoperative management of femoroacetabular impingement (FAI) is variable with favourable surgical outcomes. Yet there is no evidence on the efficacy of hydrotherapy in athletes undergoing hip arthroscopy for FAI. The purpose of this study was to evaluate the role and the impact of hydrotherapy on return to sports following hip arthroscopy for symptomatic FAI. METHODS: 2 cohorts of mixed level of athletes from various sports: a hydrotherapy group that followed land-based exercises in combination with hydrotherapy exercises and a control group that followed solely the same land-based exercises. Pre- and postoperative pain and hip-specific outcome scores were completed, and patient satisfaction was rated. RESULTS: A total of 88 hip arthroscopies were included with a minimum of 2 years follow-up; the hydrotherapy group comprised of 36 hips and the control group, 52 hips. There was a significant improvement in time to return to previous performance (HR 1.91, 95% CI, 1.21-3.01; p = 0.005) in the hydrotherapy group compared with the control. The hip-specific scores and patient satisfaction were considerably improved in the hydrotherapy group. CONCLUSIONS: The analysis of our data indicates that the incorporation of hydrotherapy into postoperative rehabilitation for hip arthroscopy for FAI accelerates the return of athletes to their pre-injury performance, since recovery time decreased significantly.

Preoperative respiratory muscle training reduces the risk of pulmonary complications and the length of hospital stay after cardiac surgery: a systematic review.

QUESTIONS: What is the effect of preoperative respiratory muscle training (RMT) on the incidence of postoperative pulmonary complications (PPCs) after open cardiac surgery? What is the effect of RMT on the duration of mechanical ventilation, postoperative length of stay and respiratory muscle strength? DESIGN: Systematic review of randomised trials with meta-analysis. PARTICIPANTS: Adults undergoing elective open cardiac surgery. INTERVENTION: The experimental groups received preoperative RMT and the comparison groups received no intervention. OUTCOME MEASURES: The primary outcomes were PPCs, length of hospital stay, respiratory muscle strength, oxygenation and duration of mechanical ventilation. The methodological quality of studies was assessed using the PEDro scale and the overall certainty of the evidence was assessed using the GRADE approach. RESULTS: Eight trials involving 696 participants were included. Compared with the control group, the respiratory training group had fewer PPCs (RR 0.51, 95% CI 0.38 to 0.70), less pneumonia (RR 0.44, 95% CI 0.25 to 0.78), shorter hospital stay (MD -1.7 days, 95% CI -2.4 to -1.1) and higher maximal inspiratory pressure values at the end of the training protocol (MD 12 cmH2O, 95% CI 8 to 16). The mechanical ventilation time was similar in both groups. The quality of evidence was high for pneumonia, length of hospital stay and maximal inspiratory pressure. CONCLUSION: Preoperative RMT reduced the risk of PPCs and pneumonia after cardiac surgery. The training also improved the maximal inspiratory pressure and reduced hospital stay. The effects on PPCs were large enough to warrant use of RMT in this population. REGISTRATION: CRD42021227779.

Effects of Different Mind-body Exercises in Managing Chronic Pain of Older Adults: A Network Meta-analysis of Randomized Trials.

INTRODUCTION: Mind-body exercises (MBEs) were shown to be effective in managing chronic pain among older adults in several recent studies. However, the differences in the effects of different MBEs remained unclear. OBJECTIVE: To compare the effects of different MBEs in managing chronic pain in older adults. METHODS: Eight databases were searched for studies published between 2012 and 2023, and 14 studies were included in this systematic review and network meta-analysis (NMA). The NMA was performed using R and Metainsight. RESULTS: Results showed that tai chi and yoga were effective in alleviating chronic pain, but their effects were not superior to traditional physical exercises and other MBEs. In addition, none of the MBEs were shown to be effective in mitigating chronic pain-related disabilities. CONCLUSION: Tai chi and yoga can be used for relieving chronic pain in older adults; however, MBE programs alone were not sufficient to mitigate chronic pain-related disabilities.

Effects of Breathing Exercises in Patients With Chronic Obstructive Pulmonary Disease: A Network Meta-analysis.

OBJECTIVE: A network meta-analysis of randomized controlled trials (RCTs) was conducted to compare and rank the effectiveness of various breathing exercises for patients with chronic obstructive pulmonary disease (COPD). DATA SOURCES: We searched PubMed, Web of Science, Embase, and the Cochrane Library databases to determine the articles. STUDY SELECTION: Publications investigating the effect of breathing exercises on exercise capacity (six-minute walk test [6MWT]), pulmonary function (the ratio of the first second forced expiratory volume of forced vital capacity [FEV1/FVC]), quality of life (St George's Respiratory Questionnaire [SGRQ]), inspiratory muscle pressure (maximum inspiratory pressure [PImax]), and dyspnea (Borg scale) were searched. DATA EXTRACTION: Data extracted by 2 researchers were entered into predesigned tables for data extraction. The quality of the literature was assessed using the Cochrane Collaboration's tool. DATA SYNTHESIS: A total of 43 RCTs involving 1977 participants were analyzed. To boost exercise capacity, the top 2 exercises were inspiratory muscle training (75%), Chinese traditional fitness exercises (13%); To improve pulmonary function, the top 2 exercises were Chinese traditional fitness exercises (32%), diaphragm breathing (30%); To raise patients' quality of life, the top 2 exercises were yoga (52%), diaphragm breathing (28%); To increase inspiratory muscle pressure, the top 2 exercises were pursed-lip breathing (47%), Chinese traditional fitness exercises (25%); To improve dyspnea, the top 2 exercises were yoga (44%), inspiratory muscle training (22%). CONCLUSIONS: Various breathing exercises for COPD patients confer benefits that manifest in diverse ways. Pulmonary rehabilitation specialists could administer personalized breathing exercises tailored to each patient's condition to attain optimal therapeutic outcomes.

The effect of progressive relaxation exercises and transcutaneous electrical neural stimulation administered to women delivering via cesarean delivery on pain, breastfeeding success, and comfort levels: A randomized controlled study.

OBJECTIVE: This study aimed to determine the effect of progressive relaxation exercises (PRE) and transcutaneous electrical nerve stimulation administered to women delivering via cesarean delivery on acute pain, breastfeeding success, and comfort levels. METHODS: This is a single-blind, randomized controlled study. This study was carried out in the obstetrics and gynecology clinic of a university hospital affiliated with the Ministry of Health in Turkey between August 20, 2018 and April 15, 2019. A total of 120 participants were randomly assigned to one of four groups, which included a transcutaneous electrical neural stimulation (TENS) group, a PRE group, a combined intervention group, and a control group. Data were collected with a Data Collection Form, The Visual Analogue Scale, The LATCH Breastfeeding Diagnostic Tool, and The Postpartum Comfort Scale. RESULTS: According to the findings of the study, it was determined that pain significantly decreased and comfort increased after having a cesarean delivery in all three intervention groups compared to the control group (p < 0.05). Regarding the breastfeeding success, while there was no statistically significant change in this behavior in the TENS group, it was significantly better in the PRE group and the combined intervention group, where TENS and PRE were administered together (p < 0.05). CONCLUSIONS: According to our study results, we recommend that TENS and PRE should be employed together after a cesarean delivery as safe non-pharmacological methods in pain management, eliminating breastfeeding problems, and increasing comfort.