Use of Artificial Intelligence in the Identification and Diagnosis of Frailty Syndrome in Older Adults: Scoping Review.

BACKGROUND: Frailty syndrome (FS) is one of the most common noncommunicable diseases, which is associated with lower physical and mental capacities in older adults. FS diagnosis is mostly focused on biological variables; however, it is likely that this diagnosis could fail owing to the high biological variability in this syndrome. Therefore, artificial intelligence (AI) could be a potential strategy to identify and diagnose this complex and multifactorial geriatric syndrome. OBJECTIVE: The objective of this scoping review was to analyze the existing scientific evidence on the use of AI for the identification and diagnosis of FS in older adults, as well as to identify which model provides enhanced accuracy, sensitivity, specificity, and area under the curve (AUC). METHODS: A search was conducted using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines on various databases: PubMed, Web of Science, Scopus, and Google Scholar. The search strategy followed Population/Problem, Intervention, Comparison, and Outcome (PICO) criteria with the population being older adults; intervention being AI; comparison being compared or not to other diagnostic methods; and outcome being FS with reported sensitivity, specificity, accuracy, or AUC values. The results were synthesized through information extraction and are presented in tables. RESULTS: We identified 26 studies that met the inclusion criteria, 6 of which had a data set over 2000 and 3 with data sets below 100. Machine learning was the most widely used type of AI, employed in 18 studies. Moreover, of the 26 included studies, 9 used clinical data, with clinical histories being the most frequently used data type in this category. The remaining 17 studies used nonclinical data, most frequently involving activity monitoring using an inertial sensor in clinical and nonclinical contexts. Regarding the performance of each AI model, 10 studies achieved a value of precision, sensitivity, specificity, or AUC ≥90. CONCLUSIONS: The findings of this scoping review clarify the overall status of recent studies using AI to identify and diagnose FS. Moreover, the findings show that the combined use of AI using clinical data along with nonclinical information such as the kinematics of inertial sensors that monitor activities in a nonclinical context could be an appropriate tool for the identification and diagnosis of FS. Nevertheless, some possible limitations of the evidence included in the review could be small sample sizes, heterogeneity of study designs, and lack of standardization in the AI models and diagnostic criteria used across studies. Future research is needed to validate AI systems with diverse data sources for diagnosing FS. AI should be used as a decision support tool for identifying FS, with data quality and privacy addressed, and the tool should be regularly monitored for performance after being integrated in clinical practice.

Inter-rater and intra-rater reliability of the extended TUG test in elderly participants.

BACKGROUND: To analyse the reliability, variance and execution time of the Extended Timed Up and Go (Extended TUG) test in three age groups of elderly participants (G1: 55-64 years; G2: 65-74 years; G3: 75-85 years). METHODS: An analytical cross-sectional study of 114 recruited participants (63 women) of average age 70.17 (± 7.3) years was undertaken. Each participant performed the Extended TUG three consecutive times, with a rest break between tests of 120 s. Both the intragroup and intergroup reliability of the measurements in the Extended TUG were analysed. RESULTS: The reliability of the Extended TUG test is excellent for the first and second decades but drops down to good for the third decade. Specifically, intragroup reliability ranged from 0.784 for G3 to 0.977 for G1 (G2 = 0.858). Intergroup reliability, compared with intragroup reliability, was slightly lower, ranging between 0.779 for G3 and 0.972 for G1 (G2 = 0.853). CONCLUSION: The reliability of the Extended TUG test progressively decreases with increasing age, being excellent for the younger age groups and good for the oldest age group.

Effectiveness of a muticomponent workout program integrated in an evidence based multimodal program in hyperfrail elderly patients: POWERAGING randomized clinical trial protocol.

BACKGROUND: Short-term and mid-term comparison of the efficacy of a multimodal program that incorporates a therapeutic workout program, medication review, diet adjustment and health education, in comparison to the standard medical practice in the improvement of the neuromuscular and physiological condition. Furthermore, it is intended to analyse the maintenance of these effects in a long-term follow-up (12 months) from the onset of the intervention. METHODS: A randomized clinical trial of elderly frail patients drawn from the Clinical Management Unit "Tiro de Pichón", Health District of Malaga, will be included in the study (after meeting the inclusion / exclusion criteria) will be randomized in two groups: a control group that will undergo an intervention consistent of medication review + diet adjustment + health education (regular workout recommendations within a complete advice on healthy lifestyles) and an experimental group whose intervention will consist of a multimodal treatment: therapeutic workout program+ medication review+ diet adjustment + health education. The sociodemographic, clinical and tracing variables will be reflected at the beginning of the study. In addition, the follow-up variables will be gathered at the second and sixth months after the beginning of the treatment and at the third and sixth months after the treatment (follow-up). The follow-up variables that will be measured are: body mass index, general health condition, fatigue, frailty, motor control, attention- concentration- memory, motor memory, spatial orientation, grip strength, balance (static, semi-dynamic), gait speed and metabolomics. A descriptive analysis of the sociodemographic variables of the participants will be conducted. One-Factor ANOVA will be used for the Within-Subject analysis and as for the Between-Subject analysis, the outcome variables between both the groups in each moment of the data collection will be compared. DISCUSSION: A multimodal program that incorporates a therapeutic workout program, medication review, diet adjustment and health education may be effective treatment to reduce the functional decline in elderly. The results of the study will provide information on the possible strengths and benefits in multimodal program in elderly. TRIAL REGISTRATION: ClinicalTrials.gov NCT02772952 registered May 2017.

Reliability and criterion-related validity with a smartphone used in timed-up-and-go test.

BACKGROUND: The capacity to diagnosys, quantify and evaluate movement beyond the general confines of a clinical environment under effectiveness conditions may alleviate rampant strain on limited, expensive and highly specialized medical resources. An iPhone 4® mounted a three dimensional accelerometer subsystem with highly robust software applications. The present study aimed to evaluate the reliability and concurrent criterion-related validity of the accelerations with an iPhone 4® in an Extended Timed Get Up and Go test. Extended Timed Get Up and Go is a clinical test with that the patient get up from the chair and walking ten meters, turn and coming back to the chair. METHODS: A repeated measure, cross-sectional, analytical study. Test-retest reliability of the kinematic measurements of the iPhone 4® compared with a standard validated laboratory device. We calculated the Coefficient of Multiple Correlation between the two sensors acceleration signal of each subject, in each sub-stage, in each of the three Extended Timed Get Up and Go test trials. To investigate statistical agreement between the two sensors we used the Bland-Altman method. RESULTS: With respect to the analysis of the correlation data in the present work, the Coefficient of Multiple Correlation of the five subjects in their triplicated trials were as follows: in sub-phase Sit to Stand the ranged between r = 0.991 to 0.842; in Gait Go, r = 0.967 to 0.852; in Turn, 0.979 to 0.798; in Gait Come, 0.964 to 0.887; and in Turn to Stand to Sit, 0.992 to 0.877. All the correlations between the sensors were significant (p < 0.001). The Bland-Altman plots obtained showed a solid tendency to stay at close to zero, especially on the y and x-axes, during the five phases of the Extended Timed Get Up and Go test. CONCLUSIONS: The inertial sensor mounted in the iPhone 4® is sufficiently reliable and accurate to evaluate and identify the kinematic patterns in an Extended Timed Get and Go test. While analysis and interpretation of 3D kinematics data continue to be dauntingly complex, the iPhone 4® makes the task of acquiring the data relatively inexpensive and easy to use.

A systematic review and cluster analysis approach of 103 studies of high-intensity interval training on cardiorespiratory fitness.

AIMS: This study aims to systematically review the systematic reviews and meta-analyses examining the effect of high-intensity interval training (HIIT) protocols on improving cardiorespiratory fitness (CRF) and to characterize the main patterns of HIIT modalities using clustering statistical procedures to examine their potential differences on improving CRF. Finally, we aimed to develop a comprehensive guideline for reporting HIIT protocols. METHODS AND RESULTS: A systematic review was conducted on PubMed and Web of Science from their inception to 31 October 2022 for systematic reviews and meta-analysis aimed at assessing the effect of HIIT on CRF in the entire study population. The Assessment of Multiple Systematic Reviews 2 tool was used to evaluate the risk of bias of each review. Additionally, a principal component analysis testing the data adequacy for the factor solution through the Kaiser-Meyer-Olkin procedure test was conducted. Once the number of factors was identified, in order to identify data patterns according to the main characteristics of the HIIT protocols, a two-step cluster analysis was conducted. Nineteen systematic reviews and/or meta-analyses comprising 103 studies were included. Clustering of systematic reviews and meta-analyses identified three HIIT modalities ('HIIT-normal mixed', 'HIIT-long running', and 'HIIT-short cycling') underlying the interventions across the included studies. Similar effectiveness in increasing CRF among the three HIIT modalities was observed. Subgroup analyses showed no significant differences in CRF by sex, weight status, study design, and baseline physical activity level (P > 0.05), but differences were observed by age group, and exercise intensity indicator was used in the HIIT programmes (P < 0.05). CONCLUSION: All three HIIT modalities produced significant improvements of CRF, although some modalities showed greater changes for some specific age groups or intensity indicators.

In this review, including data from more than 100 individual studies, 3 patterns of high-intensity interval training (HIIT), 'HIIT-normal mixed', 'HIIT-long running', and 'HIIT-short cycling', were characterized using a cluster analysis approach. Independently of the sex, weight status, study design, and baseline physical activity level, all three proposed HIIT modalities improved cardiorespiratory fitness (CRF). However, for the age group of 20­44 years, the 'HIIT-long running' reported greater improvement in CRF than 'HIIT-short cycling'. Additionally, the heart rate as an intensity indicator reported higher CRF in 'HIIT-long running' compared with 'HIIT-normal mixed'. A HIIT reporting guideline is provided to address the lack of information on HIIT protocols and provide transparency among studies.

Does Physical Exercise Enhance the Immune Response after Vaccination? A Systematic Review for Clinical Indications of COVID-19 Vaccine.

BACKGROUND: Stimulating protective immunity with vaccines appears to be the most promising option for providing widespread moderate to high protection against COVID-19 in people over the age of 18. Regular exercise improves the immune response, transmitting possible benefits against virus infections. The aim of this review is to study the effects of physical activity on vaccine injections, helping to develop new recommendations for COVID-19 vaccination campaigns. METHODS: A comprehensive review of the existing literature was undertaken using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The internal quality of the studies was assessed according to the Physiotherapy Evidence Database (PEDro) scale. The outcomes analyzed were antibody titer, the level of lymphocytes CD4, CD8, InterLeukin 6 (IL6), leukocytes level, the visual analogue scale (VAS) for overall pain rating, arm and forearm circumferences and volume of oxygen (VO2) peak. RESULTS: Fourteen articles were selected for the analysis. The majority of studies were randomized controlled trials (RCT) (n = 8) and controlled trials (CT) (n = 6). According to PEDro, the 'fair' category (n = 7) was the most represented, followed by 'good' (n = 6) and 'excellent' (n = 1). Physical training showed a positive effect on antibody titers of the vaccine; yet, different variables seem to influence antibody titers: higher new vs. old antigen in the vaccine, higher in younger vs. older individuals, and higher in females vs. males. After exercise, when analyzing variables of direct response to the vaccine, such as the amount of CD4, IL-6 and leukocytes, higher levels were observed in the patients who performed physical exercise compared to the control group. In the same way, better results were observed in physiological variables such as VO2 and limb circumferences, or subjective variables such as pain, which showed better results than the control group. CONCLUSIONS: The immune response (antibody titers) depends on age, gender and the intensity of physical activity: long-term protocols at moderate intensity are the most recommended. All of these aspects also have to be carefully considered for the COVID-19 vaccination.

Effectiveness of Blood Flow Restriction on Functionality, Quality of Life and Pain in Patients with Neuromusculoskeletal Pathologies: A Systematic Review.

BACKGROUND: Blood flow restriction is characterized as a method used during exercise at low loads of around 20-40% of a repetition maximum, or at a low-moderate intensity of aerobic exercise, in which cuffs that occlude the proximal part of the extremities can partially reduce arterial flow and fully restrict the venous flow of the musculature in order to achieve the same benefits as high-load exercise. OBJECTIVE: The main objective of this systematic literature review was to analyze the effects of BFR intervention on pain, functionality, and quality of life in subjects with neuromusculoskeletal pathologies. METHODS: The search to carry out was performed in PubMed, Cochrane, EMBASE, PEDro, CINHAL, SPORTDiscus, Trip Medical Database, and Scopus: "kaatsu" OR "ischemic training" OR "blood flow restriction" OR "occlusion resistance training" OR "vascular occlusion" OR "vascular restriction". RESULTS: After identifying 486 papers and eliminating 175 of them due to duplication and 261 after reading the title and abstract, 50 papers were selected. Of all the selected articles, 28 were excluded for not presenting a score equal to or higher than 6 points on the PEDro scale and 8 for not analyzing the target outcome variables. Finally, 14 papers were selected for this systematic review. CONCLUSIONS: The data collected indicate that the blood flow restriction tool is a therapeutic alternative due to its effectiveness under different exercise modalities. The benefits found include decreases in pain thresholds and improvement in the functionality and quality of life of the neuro-musculoskeletal patient during the first six weeks. However, the results provided by this tool are still not clear for medium- and long-term interventions.

Descriptive analysis of post-stroke patients in a neurological physical therapy unit.

Introduction: Physical therapy (PT) is the mainstay treatment in functional recovery after suffering a stroke. It is important in the acute phase of hospitalization after a stroke and later in the ambulatory phase. Patients and methods: The present study aimed to analyze the data provided by the clinical history (CH) of people with stroke (pwS) who received PT treatment in order to establish a "preferential patient profile" (PPP) that may benefit more from an early PT treatment. This was an observational, descriptive, and cross-sectional study. A total of 137 pwS who had been treated with PT were selected. Information provided age, gender, stroke type and localization, and start and end dates of the different PT treatments. A descriptive analysis of the variables was conducted using absolute frequencies and percentages for the qualitative variables. Student's t-test or the Mann-Whitney U-test was used to determine the relationship between the time and variables "stroke type," "outpatient," and "occupational therapy." The Kruskal-Wallis H-test was applied for the "localization" variable. Results: Of the entire sample, 57.7% were men, 65% had an ischemic stroke, and 48.9% had a stroke on the left side. The patients with hemorrhagic stroke had an increased number of hospital PT sessions (p = 0.01) and were younger (59.58 years) than patients with ischemic stroke (65.90 years) (p = 0.04). Discussion and conclusion: Our results do not show significant differences between the persons < 65 years and the number of outpatient physiotherapy sessions performed, although the resulting values are close to significance. Our results suggest that the PPP is a young person, with a hemorrhagic and left or bilateral stroke.

Phonophoresis through Nonsteroidal Anti-Inflammatory Drugs for Knee Osteoarthritis Treatment: Systematic Review and Meta-Analysis.

Knee osteoarthritis (OA) is the most common joint disease. The administration of nonsteroidal anti-inflammatory drugs (NSAIDs) by phonophoresis is a therapeutic alternative to relieve pain in inflammatory pathologies. The main aim was to analyze the efficacy of the application of NSAIDs by phonophoresis in knee OA. A systematic review and meta-analysis of controlled clinical trials were performed between January and March 2021 in the following databases: Web of Science, Scopus, PubMed, Cinahl, SciELO, and PEDro. The PEDro scale was used to evaluate the level of evidence of the selected studies. The RevMan 5.4 statistical software was used to obtain the meta-analysis. Eight studies were included, of which five were included in the meta-analysis, involving 195 participants. The NSAIDs used through phonophoresis were ibuprofen, piroxicam, diclofenac sodium, diclofenac diethylammonium, ketoprofen, and methyl salicylate. The overall result for pain showed not-conclusive results, but a trend toward significance was found in favor of the phonophoresis group compared to the control group (standardized mean difference (SMD) = -0.92; 95% confidence interval: -1.87-0.02). Favorable results were obtained for physical function (SMD = -1.34; 95% CI: -2.00-0.68). Based on the selected studies, the application of NSAIDs by phonophoresis is effective in relieving the symptoms of knee OA. Future long-term studies are recommended.

Effect of Blood Flow Restriction on Functional, Physiological and Structural Variables of Muscle in Patients with Chronic Pathologies: A Systematic Review.

The main objective of this systematic review of the current literature is to analyze the changes that blood flow restriction (BFR) causes in subjects with neuro-musculoskeletal and/or systemic pathologies focusing on the following variables: strength, physiological changes, structural changes and cardiocirculatory variables. The search was carried out in seven databases, including randomized clinical trials in which therapeutic exercise was combined with the blood flow restriction tool in populations with musculoskeletal pathologies. Outcome variables are strength, structural changes, physiological changes and cardiocirculatory variables. Twenty studies were included in the present study. Although there is a lot of heterogeneity between the interventions and evaluation instruments, we observed how the restriction of blood flow presents significant differences in the vast majority of the variables analyzed. In addition, we observed how BFR can become a supplement that provides benefits when performed with low intensity, similar to those obtained through high-intensity muscular efforts. The application of the BFR technique can provide benefits in the short and medium term to increase strength, muscle thickness and cardiovascular endurance, even improving the physiological level of the cardiovascular system. In addition, BFR combined with low-load exercises also achieves benefits comparable to high-intensity exercises without the application of BFR, benefiting patients who are unable to lift high loads.

Analysis of Structural Characteristics and Psychometric Properties of the SarQoL® Questionnaire in Different Languages: A Systematic Review.

BACKGROUND: Sarcopenia is the gradual and global loss of muscle and its functions. Primary sarcopenia is associated with the typical changes of advanced aging and affects approximately 5-10% of the population. The Sarcopenia and Quality of Life (SarQoL®) questionnaire is composed of 55 items, 22 questions, and is organized into seven domains of quality of life. The main objective of this systematic review was to analyze the structural characteristics and psychometric properties of it, as well as to classify its measurement properties, its methodological quality, and the criteria as good measurement properties of the adaptations and validations made on the SarQoL® questionnaire in different languages. METHODS: A systematic review was carried out in the PUBMED, Web of Science, Cinahl, LatinIndex, and SCOPUS databases. The keywords used were: "SarQoL", "assessment", "sarcopenia", "geriatric", "PROM", "quality of life", and "questionnaire", using the Boolean operator "AND". All articles published up to 15 January 2022 were considered. Methodological quality and psychometric properties were assessed based on the COSMIN guidelines and the guidelines and general recommendations of PRISMA. Documents published in languages other than English were excluded, as well as versions of the SarQoL® published in the form abstracts for conferences when the full text was not available. RESULTS: A total of 133 articles were identified, 14 of which were included. The evaluated questionnaires and the structural characteristics and psychometric properties of each of them were collected. CONCLUSION: The different cross-cultural versions of the questionnaire showed good basic structural and psychometric characteristics for the evaluation of patients with sarcopenia.

Spanish cross-cultural adaptation and validation of the Australian Pelvic Floor Questionnaire in running women.

Pelvic floor dysfunctions are a wide range of disorders in the gynaecological, lower urinary and gastrointestinal tracts that affect the structure and/or function of the pelvic organs. The objective of this study was to carry out a cross-cultural adaptation and a psychometric analysis of the Spanish version of the Australian Pelvic Floor Questionnaire. Observational study divided into two main phases: (1) translation and cross-cultural adaptation and (2) psychometric tests. Women runners from all over the Spanish territory, from different federations, clubs and levels were recruited. Participants: 424 female runners, native Spanish, over 18 years of age and who had been practicing running for more than 6 months. The instruments used in this study were the Australian Pelvic Floor Questionnaire, Female Sexual Function Index, King Health Questionnaire, Quality of Life SF-12 and EuroQoL 5-D. The Spanish version of Australian Pelvic Floor Questionnaire has proven to be an understandable and easy-to-use tool. The general internal consistency of the questionnaire was 0.972 and the intraclass correlation coefficient ranged between ICC 0.596-0.960. The Spanish version of Australian Pelvic Floor Questionnaire is a valid and reliable measure that can be used clinically to assess pelvic floor dysfunctions among the female Spanish population.

Muscle Thickness and Echo Intensity by Ultrasonography and Cognitive and Physical Dimensions in Older Adults.

The purpose of the present study was to investigate the associations between muscle thickness and echo intensity with cognitive and physical dimensions like functional capacity measured in older people. This cross-sectional study involved 20 older adults (15 women and 5 men, mean age ± SD: 85 ± 7 years, body mass index: 25 ± 3 kg/m2) from a geriatric centre in Malaga (Spain). Anthropometric measurements, cognitive assessment with Pfeiffer Short Portable Mental Status Questionnaire and Motor Memory test, Physical Performance with Short Physical Performance Battery, and muscle strength were tested. Additionally, using B-mode ultrasonography, images of wrist flexors, biceps brachii, rectus femoris, vastus lateralis, medial gastrocnemius, and tibialis anterior were captured, and muscle thickness and echo intensity variables were extracted. An association between muscle parameters assessed by ultrasonography and cognitive and physical dimensions were found in older people. Echo intensity was the best predictor in a set of regression models with different muscle parameters and a battery of cognitive and physical tests in older people. Echo intensity adjusted by handgrip strength could be a low cost and ambulatory index and an indirect and reversible indicator of functional capacity.

Effectiveness of Stretching in Post-Stroke Spasticity and Range of Motion: Systematic Review and Meta-Analysis.

Spasticity is one of the most frequent and disabling clinical manifestations of patients with stroke. In clinical practice, stretching is the most widely used physiotherapeutic intervention for this population. However, there is no solid evidence for its effectiveness. The aim of this study was to evaluate the effectiveness of different types of stretching in reducing post-stroke spasticity. Research was carried out until March 2021 in the following scientific databases: PubMed, CINAHL, Scopus, Cochrane Library, Web of Science, and PEDro. The PEDro scale and the Cochrane collaboration tool were used to assess the methodological quality and risk of bias of the studies. Eight articles were selected for qualitative analysis; six of them contributed information to the meta-analysis. No conclusive evidence was obtained on the effectiveness of stretching in terms of treating spasticity and range of motion in patients with stroke. Further research is necessary in order to determine the effectiveness of the use of stretching in this population, considering the different types of stretching (static and dynamic), the time of application, the measurement of the different components of spasticity, and the extrapolation of functional results.

Spanish Questionnaires for the Assessment of Pelvic Floor Dysfunctions in Women: A Systematic Review of the Structural Characteristics and Psychometric Properties.

BACKGROUND: Pelvic floor dysfunctions affect a third of the adult female population, including a large number of clinical conditions, which can be evaluated through validated questionnaires that inform us of the status and perception of women both objectively and subjectively. The main objective of this study was to review and explain the topics of the validated questionnaires in Spanish on pelvic floor dysfunctions and to review their psychometric properties. METHODS: A systematic review was carried out in the PUBMED and WOS databases. The keywords used were in PUBMED: (((((((("Fecal Incontinence" [Mesh]) OR "Urinary Incontinence" [Mesh]) OR "Pelvic Organ Prolapse" [Mesh]) OR "Pelvic Floor Disorders" [Mesh]) OR "Sexual Dysfunction, Physiological" [Mesh]) OR "Pelvic Girdle Pain" [Mesh]) OR "sexual function" [Title/Abstract]) OR "Prolapse" [Title/Abstract]) AND "Surveys and Questionnaires" [Mesh] AND "Validation" [Title/Abstract] combined with the Boolean operators "AND"/"OR". In contrast, in WOS, a segregated search was carried out with each of the terms of pelvic floor dysfunction together with "Validation" and "Surveys and Questionnaires". All articles published up to 19 November 2021 were considered. Methodological quality was assessed with the COSMIN scale. RESULTS: A total of 687 articles were identified, of which 13 were included. The evaluated questionnaires and the structural characteristics and psychometric properties of each of them were collected. CONCLUSION: The Spanish versions of the questionnaires show good basic structural and psychometric characteristics for the evaluation of patients with pelvic floor dysfunctions and that they resemble other versions of the same questionnaire published in other languages.

Physical Activity Promotion Programmes in Childhood Cancer Patients and Their Impact on Fatigue and Pain: A Systematic Review.

Cancer is one of the main causes of death in children, however, the techniques and interventions applied allow the cure of 80% of diagnosed cases. The aim of this review was to determine the benefits of a health and physical activity promotion programme to reduce pain and fatigue symptoms in children and adolescents with cancer. The databases PubMed, Embase, Scopus, Cochrane, Web of Science and PEDro were searched between December 2020 and January 2021 to elaborate this review, using the keywords child, cancer, exercise, fatigue and pain. The review was preregistered in PROSPERO (ID CRD42021262183). Six studies, out of 937 identified at baseline, were finally included in the review: four randomised controlled trials and two quasi-experimental studies. The total sample size of all the included studies was of 474 participants with very different types of cancer and evolution, and outcome variables were pain, fatigue, physical activity level, self-efficacy and quality of life. A health and physical activity promotion programme seems to improve fatigue in paediatric cancer patients and survivors, but no significant results were found related to pain.

Effectiveness of Global Postural Re-Education in Chronic Non-Specific Low Back Pain: Systematic Review and Meta-Analysis.

BACKGROUND: The aim of this systematic review and meta-analysis was to evaluate the global postural re-education (GPR) program's effectiveness compared to other exercise programs in subjects with persistent chronic low back pain. METHODS: A systematic review and meta-analysis were carried out using PRISMA2020. An electronic search of scientific databases was performed from their inception to January 2021. Randomized controlled trials that analyzed pain and patient-reported outcomes were included in this review. Four meta-analyses were performed. The outcomes analyzed were disability due to back pain and pain. The risk of bias and quality of evidence were evaluated. The final search was conducted in March. RESULTS: Seven trials were included, totaling 334 patients. The results showed improvement in pain measured by Visual Analogue Scale (VAS) (Standardised Mean Difference (SMD) = -0.69; 95% Confidence Interval (CI), -1.01 to -0.37; p < 0.0001), Numerical Pain Scale (NRS) (SMD = -0.40; 95% CI, -0.87 to 0.06); p = 0.022), VAS + NRS (SMD = -1.32; 95% CI, -1.87 to -0.77; p < 0.0001) and function (Roland Morris Disability Questionnaire (RMDQ)) (SMD = -0.55; 95% CI, -0.83 to -0.27; p < 0.0001) after GPR treatment. CONCLUSION: This meta-analysis provides reliable evidence that GPR may be an effective method for treating LBP by decreasing pain and improving function, with strong evidence.

Systematic Review of Therapeutic Physical Exercise in Patients with Amyotrophic Lateral Sclerosis over Time.

BACKGROUND: the main objective of this study was to analyze the potential short-, medium- and long-term effects of a therapeutic physical exercise (TFE) programme on the functionality of amyotrophic lateral sclerosis (ALS) patients, measured with the Revised Amyotrophic Lateral Sclerosis Functional Scale (ALSFRS-R) scale. METHODS: a systematic review of the PubMed, SCOPUS, Cochrane, Scientific Electronic Library Online (Scielo), Physiotherapy Evidence Database (PEDro), Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDline) databases was carried out. The information was filtered using the following Medical Subjects Heading (MeSH) terms: "Amyotrophic lateral sclerosis", "Physical Therapy", and "Physical and Rehabilitation Medicine". The internal validity of the selected documents was evaluated using the PEDro scale. The study included clinical trials published in the last 5 years in which one of the interventions was therapeutic physical exercise in patients with ALS, using the ALSFRS-R as the main outcome variable and functional variables as secondary variables. RESULTS: 10 clinical trials were analyzed, with an internal validity of 5-7 points. The TFE groups showed significant short-, medium- and long-term differences, obtaining a mean difference of 5.8 points compared to the 7.6 points obtained by the control groups, at six months, measured with ALSFRS-R. In addition, the participants showed significant improvements in functional abilities in the short, medium and long terms. CONCLUSIONS: Therapeutic physical exercise could contribute to slowing down the deterioration of the musculature of patients with ALS, thus facilitating their performance in activities of daily living, based on the significant differences shown by these individuals in the short, medium and long term both in subjective perception, measured with ALSFRS-R, and functional capacities.

Effects of High-Intensity Interval Training on Inflammatory Biomarkers in Patients with Type 2 Diabetes. A Systematic Review.

BACKGROUND: Due to the prevalence and incidence worldwide of type 2 diabetes, and the significant role physical activity plays in these patients, a systematic review has been conducted to find out the effects that high-intensity interval training has on inflammatory biomarkers in subjects with type 2 diabetes. This project aims to determine the effect this training modality has on inflammatory biomarkers, in addition to observing its effects on the values of body composition and determining if this is a more effective, less effective or equally effective alternative to standard aerobic or resistance training. METHODS: A search was conducted in the months of November and December 2020 on different databases: Pubmed, WoS and PEDro. A protocol for this systematic review was registered in PROSPERO (Registration number: CRD42021281186). The studies selected met the previously defined inclusion criteria, and the methodological quality of the papers used was evaluated according to the Downs and Black Checklist. RESULTS: Out of 46 studies found, seven were included. The most relevant data concerning the characteristics of the clinical trials and HIIT characteristics, the values of body composition and the biomarkers under study were extracted from each study. Moreover, the results obtained from the different studies were described. CONCLUSIONS: HIIT could have an effect on inflammatory biomarkers. There is likely to be a relationship between changes in inflammatory profile and fat loss. A controlled diet may be a good complement to reduce the inflammatory profile. Further studies are required to determine whether HIIT is a better, worse or an equivalent alternative to medium-intensity aerobic exercise to improve the inflammatory profile.

Kinematic Mobile Drop Jump Analysis at Different Heights Based on a Smartphone Inertial Sensor.

The purpose of this study was to describe the acceleration variables in a plyometric jump test using the inertial sensor built into an iPhone 4S® smartphone, and the jumping variables from a contact mat. A cross-sectional study was conducted involving 16 healthy young adults. Linear acceleration, flight time, contact time and jump height were measured in a drop jump test from 60 cm and from 30 cm. Greater acceleration values were found in the drop jump test from 60 cm; the same was observed for the values from the contact mat. Multiple regression analysis was performed for each drop jump test: jump height was used as the dependent variable, and the most relevant variables were used as predictor variables (weight and maximum angular velocity in the Y axis for analysis of the drop jump from 60 cm, and weight and maximum acceleration in the Z axis for the drop jump from 30 cm). We found a significant regression model for the drop jump test from 60 cm (R2 = 0.515, p " 0.001) and for the test from 30 cm (R2 = 0.460, p " 0.01). According to the results obtained in this study, the built-in iPhone 4S® inertial sensor is able to measure acceleration for healthy young adults performing a vertical drop jump test. The acceleration kinematic variables are higher in the drop jump test from 60 cm than from 30 cm.