High-definition trans cranial direct current stimulation and its effects on cognitive function: a systematic review.

High-Definition Transcranial Direct Current Stimulation (HD-tDCS) is focal and improves higher mental functions. Due to the lack of published evidence, we conducted this review on the effect of HD-tDCS on cognitive functions in healthy and diseased individuals. We performed an electronic-data and gray-literature search to obtain the relevant studies for the review. The two distinct literature searches obtained a total of 468 studies. Out of these, a total of 12 studies were conducted on higher mental functions, and of these, two were on disordered consciousness, five were on memory, two were on speech, two were on cognition, and one was on execution. We submitted nine studies with control group to methodological quality assessment using the PEDro Scale. Remaining three studies underwent quality assessment by Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group. We found that anodal HD-tDCS stimulation is significantly effective in treating disordered consciousness and improving memory, speech, cognition, and execution.

Cross-Cultural Adaptation of the Godin-Shephard Leisure-Time Physical Activity Questionnaire for Arabic Population and Testing its Psychometric Properties.

BACKGROUND Physical activity during leisure time is essential to promote health, owing to the decreased physical activity in mechanized working environments. The present study aimed to cross-culturally modify the Godin Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) into Arabic and to assess its psychometric properties. MATERIAL AND METHODS We conducted this study in various standardized stages. At each stage, the corrections were made by an expert committee. In the initial stage, the English version of the GSLTPAQ was translated into Arabic and then back-translated into English. In the second stage, we ensured the content validity by collecting the opinion of 10 professionals in the medical field. Finally, in the third stage, the Arabic version was applied to the Saudi population to check its test-retest reliability, face validity, internal consistency, and concurrent validity. RESULTS For the Arabic version of the GSLTPAQ, we evaluated the content validity by involving 10 experts, and it was found to be excellent. The scale was applied to 150 office workers in the university to assess psychometric properties. The scale showed remarkable internal consistency (0.99) and high test-retest reliability (0.88). We evaluated the concurrent validity by comparing it with the Copenhagen City Heart Study Leisure Time Physical Activity Questionnaire, and it was shown to have an excellent validity of 0.86 (<0.001). CONCLUSIONS After conducting the careful process of translations, we adapted and created the Arabic version of the GSLTPAQ. It was found to have excellent content validity, test-retest reliability, internal consistency, and concurrent validity.

Promoting healthy lifestyles using information technology during the COVID-19 pandemic.

In this pandemic era there exist a relationship between a sedentary lifestyle during lockdown with periods of anxiety and stress among the population. Moreover, the population with chronic disease will be vulnerable to the ill effects of a physically inactive lifestyle. Besides, social media platforms and technological advances also appear to be another potential tool for promoting health and wellbeing, however, the capability of these interventions during the pandemic era is largely unknown. To explore the possible role of technological advances and social media platforms as an alternate tool in promoting a healthy living style during the COVID-19 era. The studies with the predefined criteria were used to synthesize information regarding the opportunities and challenges. Studies delivering lifestyle intervention using social media platforms, technologies for health promotion were considered for the review. The studies included to synthesize evidence were randomized controlled trials, systematic reviews and meta-analysis. Database like Medline, Scopus, and Science Direct were searched independently by two reviewers. A total of 17 studies were included in the review, Internet and lifestyle modification n = 2, mHealth and lifestyle modification n = 3, Social media and lifestyle modifications n = 3, technology adoption for lifestyle modification n = 4, and hazards = 5. Technology and social media-based interventions appear to be a promising technique for promoting health and wellbeing and it is the only effective method for delivering an intervention during a pandemic situation. However, there also appears a need for the development of guidelines for social media usage to prevent probable hazards.

Revisiting pulmonary rehabilitation during COVID-19 pandemic: a narrative review.

There has been an apparent association between the risks of complications with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with a history of existing chronic respiratory diseases during the pandemic of coronavirus disease 2019 (COVID-19). SARS-CoV-2 poses a severe risk in cardiopulmonary management. Moreover, chronic respiratory diseases may further amplify the risk of morbidity and mortality among the afflicted population in the pandemic era. The present review outlines the importance of pulmonary rehabilitation (PR) in persons with chronic respiratory diseases (Chronic obstructive pulmonary disease (COPD) and Asthma) during the COVID-19 era. In this context, amongst the population with a pre-existing pulmonary diagnosis who have contracted SARS-CoV-2, following initial medical management and acute recovery, exercise-based pulmonary rehabilitation (PR) may play a crucial role in long-term management and recovery. The energy conservation techniques will play a pragmatic role in PR of mild to moderate severity cases to counter post-COVID-19 fatigue. Moreover, there is also an urgent need to effectively address post-COVID-19 anxiety and depression, affecting the PR delivery system.

Robotic-Assisted Gait Training Effect on Function and Gait Speed in Subacute and Chronic Stroke Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: The review is intended to provide the effectiveness of robotic-assisted gait training (RAGT) for functional gait recovery in poststroke survivors through a systematic review and to provide evidence for gait speed improvements through the meta-analysis of randomized controlled trials (RCTs). SUMMARY: In this systematic review, PubMed, Web of Science, Wiley Online Library, Science Direct, Science Robotics, Scopus, UpToDate, MEDLINE, Google Scholar, -CINHAL, EMBASE, and EBSCO were reviewed to identify relevant RCTs. Articles included in the study were thoroughly examined by 2 independent reviewers. The included RCTs were having a PEDro score between 6 and 8 points. The initial database review yielded 1,371 studies and, following further screening; 9 studies finally were selected for systematic review and meta-analysis. Out of the 9 studies, 4 were on chronic stroke and 5 were on subacute stroke. The meta-analysis of gait speed showed an effect size value ranging between -0.91 and 0.64, with the total effect size of all the studies being -0.12. During subgroup analysis, the subacute stroke total effect size was identified as -0.48, and the chronic stroke total effect size was noted as 0.04. Meta-analysis revealed no significant differences between RAGT and conventional gait training (CGT). Key Messages: Our systematic review revealed that the RAGT application demonstrated a better or similar effect to that of CGT in a poststroke population. A meta-analysis of gait speed involving all the studies identified here indicated no significant differences between RAGT and CGT. However, the subanalysis of chronic stroke survivors showed a slight positive effect of RAGT on gait speed.

Cervical proprioception and its relationship with neck pain intensity in subjects with cervical spondylosis.

BACKGROUND: Cervical proprioception is critical in the maintenance of posture and movements, so its assessment in different cervical conditions has gained importance in recent clinical practice. Studies reporting this assessment in subjects with cervical spondylosis (CS) have not previously been investigated. The goals of the study are (1) comparison of joint position error (JPE) in subjects with CS to healthy control group. (2) Correlation of neck pain intensity to cervical proprioception in patients with CS. METHODS: In a Cross-sectional study, 132 subjects with CS and 132 healthy age-matched control subjects were evaluated for cervical JPE with the cervical range of motion device. The subjects were blindfolded and repositioned their heads to a target position, which was determined by the examiner previously and their repositioning accuracy (absolute error in degrees) was measured in the frontal (flexion and extension) and transverse planes (left rotation and right rotation). The CS subjects resting neck pain intensity was assessed using visual analog scale (VAS). RESULTS: CS subjects showed statistically significantly larger JPEs compared to healthy control subjects in all the directions tested (flexion - 95% CI = 2.38-3.55, p < 0.001, extension - 95% CI =3.26-4.33, p < 0.001, left rotation - 95% CI = 2.64 - 3.83, p < 0.001, right rotation - 95% CI = 3.77-4.76, p < 0.001). The mean JPE errors in the CS group ranged from 6.27° to 8.28° and in the control group ranged from 2.36° to 4.48°. Pearson's correlation coefficient showed a significant and positive relationship between neck pain intensity and cervical proprioception (p ≤ 0.001). CONCLUSIONS: Proprioception is impaired in subjects with CS when compared to healthy control group. Higher pain intensity was associated with greater cervical JPE in patients with CS.

Effects of Aerobic Exercise on Vibration Perception Threshold in Type 2 Diabetic Peripheral Neuropathy Population Using 3-sites Method: Single-blind Randomized Controlled Trial.

OBJECTIVEST: The purpose of this study was to examine the effects of 8 wk of moderate intensity aerobic exercise on vibration perception threshold (VPT) in type 2 diabetic peripheral neuropathy (DPN). METHODS: Single blind parallel group randomized controlled trial was done in a tertiary center. Stratified block randomization was used for selecting participants. A total of 87 individuals participated in the study. After final randomization, there were only 47 individuals in the control group and 37 in the study group. The exercise group training was carried out in the range of 40% to 60% of heart rate reserve as an adjunct to this rating of perceived exertion (scale ranging from 6 to 20) before, during, and postexercise. For the control group, standard medical care, education for foot care, and diet (same as the experimental group) were given. Both the groups were assessed at baseline and wk 8. RESULTS: On comparison of results for control and study group using repeated measures of analysis of variance for VPT measures for 3 sites (great toe, medial malleoli, first metatarsal phalanx), there was a significant difference between the 2 groups (df1, df2 = 1,63; F = 8.56; P < .001) for both lower limbs. CONCLUSIONS: Aerobic exercises have an augmentative effect on vibratory sensations of the peripheral nerves, which implicates an attenuating effect on DPN in type 2 diabetes.

Effectiveness of robotics in improving upper extremity functions among people with neurological dysfunction: a systematic review.

PURPOSE: The primary focus of this review was to find out the effectiveness of robotics in improving upper extremity functions among people with neurological problems in the arena of physical rehabilitation. MATERIAL AND METHODS: Two reviewers independently scrutinized the included studies. The selected studies underwent quality assessment by Physiotherapy Evidence Database (PEDro) scale. Randomized Controlled Trial (RCT) having a score of four or more were included in the review. A search was conducted in PUBMED, MEDLINE, CINAHL, EMBASE, PROQUEST, science direct, Cochrane Library, PEDro and Google Scholar. RESULTS: A total of 202 studies were identified. After removal of duplication, inclusion and exclusion criteria's n = 23 studies were included in the review process. For analysis, only the primary outcome measures of the studies were taken into account. Studies finally included in analysis were n = 21. The included studies were 19 in stroke, 1 in cerebral palsy (CP) and 1 study in multiple sclerosis (MS). No RCTs were reportedly found in spinal cord injury (SCI), Parkinson and motor neuron disease (MND). CONCLUSIONS: Studies related to stroke showed a clear definiteness in the improvement of upper extremity functions. On the contrary, there still remains a need for quality trials in CP, MS to establish the efficacy of robotics in upper extremity rehabilitation.

Comparison of Anti-Microbial Effects of Low-Level Laser Irradiation and Microwave Diathermy on Gram-Positive and Gram-Negative Bacteria in an In Vitro Model.

Background and Objectives: The aim of this study was to compare the effects of low-level laser therapy and continuous microwave diathermy on the growth of Gram-negative and Gram-positive bacteria and to establish their efficacy as an alternative therapeutic modality. MATERIALS AND METHODS: Laser fluence of 13 Joules (J)/cm2, 18 J/cm2 and 30 J/cm2 were used against several bacterial strains. Microwave dosages of 25, 50 and 100 watts (W) were used, respectively. RESULTS: A significant difference between the three groups was observed using repeated analysis of variance (RANOVA) (F value: 0.74, and p value: 0.001). The Greenhouse-Geisser correction (GG) revealed significant results for laser irradiation alone. However, effect size calculation showed effects with microwave diathermy as well as laser fluence. CONCLUSIONS: Low-level laser therapy appears to be an effective modality of treatment when compared with continuous microwave diathermy on the Gram-negative and the Gram-positive bacterial strains tested. Microwave diathermy revealed large and medium effects on the bacterial cell counts with dominant effects on Gram-negative strains.

Effect of moderate-intensity aerobic exercise on glycosylated haemoglobin among elderly patients with type 2 diabetes & peripheral neuropathy.

Aerobic exercise has been known to improve glycosylated haemoglobin (HbA1c) levels and insulin sensitivity in patients with type 2 diabetes mellitus (T2DM). The present study was undertaken to evaluate the effect of eight week moderate-intensity aerobic (heart rate reserve 40-60%) exercise on glycaemic control in elderly patients with T2DM and diabetic peripheral neuropathy (DPN). The participants (n=87) were randomly assigned to an eight-week programme by a computer-generated random number table to the study or control group, respectively. There were 47 participants in the control group and 40 participants in the study group after randomization. There was a significant difference in the mean values of glycated haemoglobin (HbA1c) at baseline and 8th week between the two groups. Moderate-intensity aerobic exercise of eight weeks duration helped in achieving enhanced glycaemic control in the T2DM patients with DPN.

Postural sway in diabetic peripheral neuropathy among Indian elderly.

BACKGROUND & OBJECTIVES: Diabetic peripheral neuropathy (DPN) is a major complication of type 2 diabetes and have long term complications on the postural control of the affected population. The objectives of this study were to evaluate postural stability in patients with DPN and to examine correlation of Michigan Neuropathy Screening Instrument (MNSI) with duration of diabetes, age and postural stability measures. METHODS: Participants were included if they had clinical neuropathy which was defined by MNSI. Sixty one patients gave their consent to participate in the study and were evaluated on posturography for postural stability measures in four conditions. Repeated measures of analysis of variance (RANOVA) was used to analyze the changes in postural stability measures in different conditions. RESULTS: An increase in mean value of postural stability measures was observed for velocity moment 20.4±1.3, 24.3±2.2, 42.3±20.7, 59±43.03, mediolateral displacement 0.21±0.10, 0.22±0.18, 0.03±0.11, 0.34±0.18, and anteroposterior displacement 0.39 ± 0.09, 0.45±0.12, 0.47±0.13, 0.51±0.20 from EO to EC, EOF, and ECF, respectively. There was a significant difference (P<0.05) in participants with DPN, with greater sway amplitude on firm and foam surface in all the conditions. Moderate correlation of MNSI with age (r=0.43) and postural stability measures were also observed. INTERPRETATION & CONCLUSIONS: Evaluation of postural stability in Indian DPN population suggests balance impairments on either firm and foam surfaces, with greater likelihood of fall being on foam or deformable surfaces among elderly adults with neuropathy (CTRI/2011/07/001884).

Effect of aerobic exercise on quality of life in population with diabetic peripheral neuropathy in type 2 diabetes: a single blind, randomized controlled trial.

OBJECTIVE: To evaluate the effect of 8-week moderate intensity aerobic (heart-rate reserve 40-60%) exercise on neuropathy quality of life in type 2 diabetes. METHODS: A single blind, parallel-group, randomized controlled trial was carried out in a tertiary setting. People with type 2 diabetes were eligible for the study if they had clinical neuropathy which was defined by a minimum score of seven on the Michigan diabetic neuropathy score. Following which, the patients were randomly assigned to an 8-week program by a computer-generated random number tables to intervention or control group. Repeated measure analysis of variance was used for data analysis (p < 0.05 was considered significant). RESULTS: There were 47 participants in the control group and 40 participants in the study group after randomization but 37 from the control group and 29 from the intervention group completed the final analysis. The two groups had a significant difference, pre-post intervention in scores of pain (F = 7, p = 0.01), sensory symptoms (F = 4.60, p = 0.04), restricted activities of daily living (F = 4.97, p = 0.03), disruptions in social relationships (F = 5.43, p = 0.02), specific impact on quality of life (F = 9.28, p < 0.001) overall quality of life (F = 28.72, p < 0.001), and total score (F = 31.10, p < 0.001). Degrees of freedom for all the components were 1, 62. CONCLUSION: Moderate intensity aerobic exercise is cornerstone in improving the quality of life of individuals with peripheral neuropathy in type 2 diabetes.

Closure of chronic non healing ankle ulcer with low level laser therapy in a patient presenting with thalassemia intermedia: Case report.

In this single case study, the possible effect of low-level laser therapy (LLLT) was explored in the form of light emitting diodes on a chronic non-healing wound of 6 months duration in an 18-year-old male patient suffering from thalassemia intermedia. After irradiation, with LLLT dosage of 17.3 J/cm(2) for 8 min for 2 weeks duration followed by proliferative dosage of 8.65-4.33 J/cm(2) for 4 min from 3(rd) week to 6(th) week for 2 min along with antibiotics vancomycin (15 mg/kg) and a combination of amoxicillin and clavulanic acid (1 g). Proliferation of healthy granulation tissue was observed with decrease in score of pressure ulcer scale with complete re-epithelialization eventually LLLT irradiation could be a novel method of treatment for chronic non-healing wound in a thalassemia intermedia patient and an useful adjunct to standard care of treatment of pressure ulcers. It is postulated that LED irradiation augments wound healing with an early closure and no recurrence at the irradiated site even after follow up of 6 months.

Translation, cross cultural adaptation, and validation of Arabic version of Interview administered version of Work Rehabilitation Questionnaire (WORQ).

BACKGROUND: Accurate assessment tools for work rehabilitation are essential in healthcare settings. Adapting the Work Rehabilitation Questionnaire (WORQ) to Arabic-speaking populations ensures effective evaluation and intervention for individuals with work-related disabilities. OBJECTIVE: To execute a cross-cultural adaptation of interview-administered version Work Rehabilitation Questionnaire -Arabic (WORQ-A) and assess the psychometric properties of WORQ-A in patients with musculoskeletal problems. METHODS: WORQ is mainly intended to assess the work functioning of persons who are involved in vocational rehabilitation. Psychometric properties were scrutinized in the outpatient rehabilitation center. Test-retest reliability was examined with intraclass correlation coefficient (ICC), and internal consistency was evaluated with Cronbach's alpha. The usability of WORQ-A was established in 46 patients with musculoskeletal problems. RESULTS: WORQ-A exhibited exceptional internal consistency (0.93) and a great test-retest reliability (0.87). Regarding usability, the ability to understand the questions and answer choices was established as good. Five percent of the participants encountered minor difficulties with certain words, while the majority found it quite straightforward to choose the correct answers. CONCLUSIONS: The WORQ-A is an effective, consistent, and very easy to administer questionnaire to assess the work-related functions assumed in our study context and the individualities of the sample.

Oblique, forward, and lateral directions reach test distances in young adults, and concurrent validity of these tests with the center of pressure excursion in assessing the limits of stability.

Limits of stability is required to perform functional activities and other advanced tasks of life without losing balance, and assessment of limits of stability is essential in clinical practice. Forward, Lateral, and Oblique direction reach tests are clinical balance tests that assess limits of stability, and these reach distances in various directions may be symmetrical or asymmetrical. The aim was to establish the symmetry between various reach distances on three reach tests and to establish the concurrent validity of oblique, forward, and lateral direction reach test distances with limits of stability measured by the Iso Free machine of TecnoBody company. METHODS: The measurements of oblique, forward, and lateral reach tests and limits of stability excursions of center of pressure were taken in eight directions on Iso Free machine of Techno Body in fifty typical college-going young adults who were recruited through convenience sampling. Pearson correlation test was used to find the relationship between forward, lateral, and oblique direction reaches and limits of stability in forward, lateral, and oblique directions. Regression analysis was used to find the factors influencing the forward, lateral, and oblique reach tests. RESULTS: The reach distances were symmetrical, and out of the three tests, the lateral and oblique direction reach tests have a moderate positive correlation with limits of stability test in lateral and oblique directions with an r-value of 0.569 (p < 0.001) and 0.50 (p < 0.001) respectively. A Significant standardized beta value of 0.49 (p < 0.05) for the oblique direction reach test with total stability limits. CONCLUSIONS: The oblique and lateral direction reach tests are correlated with their respective center of pressure excursion. However, the oblique direction reach test moderately correlated with the total limits of stability scores. Forward reach distances were more in number followed by oblique and lateral reach distances among young Saudi adults.

Photobiomodulation of surgical wound dehiscence in a diabetic individual by low-level laser therapy following median sternotomy.

In this single case study, we attempt to outline the possible effect of low-level laser therapy (LLLT) on delayed wound healing and pain in chronic dehiscent sternotomy of a diabetic individual. The methods that were employed to evaluate changes pre and post irradiation were wound photography, wound area measurement, pressure ulcer scale of healing (PUSH), and visual analogue scale (VAS) for pain. After irradiation, proliferation of healthy granulation tissue was observed with decrease in scores of PUSH for sternal dehiscence and VAS for bilateral shoulders and sternal dehiscence. We found that LLLT irradiation could be a novel method of treatment for chronic sternal dehiscence following coronary artery bypass grafting, as it augments wound healing with an early closure of the wound deficit. Hence, this might be translated into an early functional rehabilitation and decreased pain perception of an individual following surgical complication.

Color Doppler ultrasound in high-low risk pregnancies and its relationship to fetal outcomes: a cross-sectional study.

Objective: To calculate the multivessel color Doppler indices in high-risk and low-risk pregnancies and relate these to fetal outcomes. Methods: The investigation involved 60 patients who were pregnant. The patients were separated into groups according to assessment of low and high risk. The patients underwent color Doppler ultrasonography to detect the maternal and fetal blood vessels, and the measured Doppler indices were then analyzed for any association with fetal outcomes. Results: The gestational stages (in weeks) of the participants at the respective times of investigation and delivery were 32.06 ± 2.98 and 36.2 ± 1.78 in the low-risk group and 29.21 ± 1.95 and 29.83 ± 1.86 in the high-risk group. The pulsatility index (PI), resistive index (RI), and systolic/diastolic ratio (SD) decreased with gestation length in the low-risk group, whereas in the high-risk group, these values increased in the uterine and umbilical arteries. With increased gestational stage, MCA-PSV (peak systolic velocity) in the middle cerebral artery (MCA) increased, while PI decreased. Pulsatile and reversal flow of the uterine vein, the vein of Galen, and the umbilical vein were noted in high-risk pregnancies, and these negatively affected the fetal outcome. The fetal venous parameters were more specific and sensitive for predicting an unfavorable fetal outcome than the arterial factors, with a greater negative predictive value. Conclusion: The results of our study indicate that abnormal Doppler indices of the blood vessels in high-risk pregnant patients will result in adverse clinical outcomes. Therefore, the patients can be monitored and managed accordingly using Doppler ultrasonography.

Mediation Effect of Pain on the Relationship between Kinesiophobia and Postural Control: Comparison and Correlations in Individuals with Fibromyalgia Syndrome and Asymptomatic Individuals-A Cross-Sectional Study.

Background: Individuals with fibromyalgia syndrome (FM) usually present with a fear of movement (kinesiophobia), which causes their symptoms to be maintained and exacerbated. Kinesiophobia can significantly impact postural control; ascertaining their association is crucial in evaluating and managing individuals with FM. This study aims to (1) compare postural control between individuals with FM and asymptomatic individuals, (2) estimate the relationship between kinesiophobia and postural control in individuals with FM, and (3) evaluate whether pain intensity mediates the association between kinesiophobia and postural control in individuals with FM. Methods: This study enrolled 92 individuals (mean age: 51.52 ± 7.7 years) diagnosed with FM and 106 asymptomatic individuals (mean age: 50.47 ± 6.6 years). The examiners estimated the fear of movement and the intensity of pain utilizing the Tampa scale of kinesiophobia (TSK) scores and the visual analogue scale (VAS), respectively. The postural control variables included anteroposterior (A-P) sway in mm, medio-lateral (M-L) sway in mm, and ellipse area in mm2. Results: The individuals with FM had impaired postural control compared to the asymptomatic individuals (p < 0.001). Kinesiophobia exhibited mild-to-moderate correlations with the postural control variables (nondominant side: A-P sway: r = 0.48, M-L sway: r = 0.49, ellipse area: r = 0.43. Dominant side: A-P sway: r = 0.41, M-L sway: r = 0.33, ellipse area: r = 0.44). The pain intensity significantly mediated the relationship between kinesiophobia and postural control (p < 0.001). Conclusion: Kinesiophobia showed a significant positive relationship with postural control. The individuals with FM with higher TSK scores had decreased postural control. Pain intensity mediated the relationship between kinesiophobia and postural control. These factors must be considered when evaluating and formulating treatment strategies for people with FM.

Exercise modulates the immune system in cardiorespiratory disease patients: Implications for clinical practice during the COVID-19 pandemic.

BACKGROUND: Patients with cardiorespiratory problems often suffer from systemic inflammation. Stress due to the disease and continuous inflammation can undermine the success of the rehabilitation program. OBJECTIVE: This review has been undertaken primarily to understand the effectiveness of exercise training on the immune system in individuals undergoing cardiorespiratory rehabilitation and its implications for further management during the COVID-19 pandemic. METHODS: Assessors analyzed related studies identified in the MEDLINE, PROQUEST, PUBMED, Cochrane Library, CINAHL, EMBASE, Google Scholar, Physiotherapy Evidence, and Science Direct databases. The studies were divided into groups focused on the effect of exercise on blood leukocytes, the anti-inflammatory effect, and the role of nutrition and exercise in resolving inflammation. RESULTS: Twenty-eight studies were included in this review. The number of studies included in each section was as follows: the effects of exercise training on leukocytes in cardiorespiratory conditions (n = 8), anti-inflammatory effect (n = 6), and the role of nutrition and exercise in resolving inflammation (n = 14). The bias risk assessment showed poor internal validity; most included studies were assigned no and unclear descriptors. CONCLUSIONS: Substantive evidence is presented that emphasizes the role of moderate-intensity exercise in boosting the immune system in patients with cardiorespiratory diseases. Exercise has anti-inflammatory effects that are vital for overall well-being and resolving longstanding inflammation. Individuals with an active lifestyle had a better pathogen immune response than more sedentary individuals. Our findings highlight the current need to investigate the long-term effects of cardiorespiratory rehabilitation programs.