ABSTRACT
Walking is a fundamental physical activity with significant health implications. Backward gait training (BGT) has emerged as a novel approach with potential benefits, yet its effects in comparison to traditional forward gait training (FGT) remain uncertain. This systematic review and meta-analysis aimed to evaluate the effects of BGT on body composition, cardiopulmonary fitness, and inflammatory and metabolic markers in adults. A comprehensive search across electronic databases was conducted following the Preferred Publishing Items for Systematic Reviews and Meta-Analyses guidelines. Randomized clinical trials (RCTs) comparing BGT with FGT in adults were included. Methodological quality was assessed using the Cochrane risk-of-bias tool. The certainty of evidence was evaluated using the Grading of Recommendation, Assessment, Development, and Evaluation approach. The analysis included a total of 379 male participants across the studies. The meta-analysis demonstrated significant changes in body composition and inflammatory marker outcomes, which included waist-to-height ratio (standardized mean difference [SMD]-1.18, 95% confidence interval [CI]-1.89-0.48, I2 = 83%, P < 0.01), body mass index (SMD-0.55, 95% CI-0.77-0.32, I2= 0%, P < 0.01), and C-reactive protein (SMD-0.98, 95% CI-1.28-0.70, I2= 0%, P < 0.01). In addition, the qualitative review revealed potential enhancements in cardiopulmonary fitness and metabolic markers following BGT. While the results suggest potential benefits of BGT on body composition and inflammatory markers, the evidence remains limited and heterogeneous. Further robust research with diverse populations, longer intervention periods, and comprehensive outcome assessments is essential to elucidate the true impact of BGT and its utility for promoting overall health and well-being in adults.
ABSTRACT
Background: Type 2 diabetes mellitus (T2DM) often leads to cardiac autonomic neuropathy (CAN), a severe complication affecting cardiovascular health. Exercise training is a proven intervention for improving metabolic control and cardiovascular health in T2DM, but the effects of concurrent exercise training (CET), combining aerobic and resistance exercises, on CAN are not fully understood. Objective: This randomized controlled trial investigates the impact of a structured CET program on cardiac autonomic modulation, metabolic profile, body composition, cardiorespiratory fitness (CRF), and quality of life (QoL) in individuals with T2DM and CAN. Methods: A total of 96 participants, aged 35-70 years, with T2DM and CAN, were randomized into CET (n = 48) and control (n = 48) groups. The CET group engaged in combined aerobic and resistance training three times per week for 13 weeks, while the control group received standard care. Primary outcomes included heart rate variability (HRV) and heart rate recovery (HRR). Secondary outcomes were metabolic profile, body composition, CRF, and QoL, which were assessed using standardized protocols and validated questionnaires. The trial was registered with the Clinical Trials Registry-India (CTRI/2021/09/036711). Results: Significant improvements were noted in the CET group compared to controls. HRV metrics (SDNN, RMSSD, pNN50, TP, LF power, HF power, and LF/HF ratio) and HRR metrics (HRR30s, HRR1, HRR2, and HRR3) all showed significant enhancements (p < 0.01). The CET group also exhibited substantial reductions in fasting blood glucose, postprandial blood glucose, HbA1c, waist circumference, hip circumference, and percentage body fat (p < 0.01). Improvements were observed in lipid profile markers and CRF (VO2max) (p < 0.01). QoL scores improved significantly in the CET group as per the ADDQoL-19 (p < 0.01). Conclusions: CET significantly enhances cardiac autonomic modulation, metabolic profile, body composition, CRF, and QoL in individuals with T2DM and CAN. These findings support the integration of CET into standard T2DM management to improve clinical outcomes and QoL. Further research is needed to explore the long-term benefits and broader applicability of CET in diverse diabetic populations.
ABSTRACT
BACKGROUND: A link between pronated feet (PF) and chronic low back pain (CLBP) has been reported in the literature. However, physical interventions (PI) like physiotherapy and orthotics mainly target the lower back, neglecting the broader biomechanical impacts of PF that affect the feet, ankles, and overall posture. Currently, there is a lack of comprehensive meta-analyses or systematic reviews on this subject. OBJECTIVES: This systematic review with a meta-analysis aimed to evaluate the effects of PI on pain and disability in patients having CLBP with PF. METHODS: From inception until October 15, 2023, Medline/PubMed, Web of Science, and Scopus databases were searched using the desired keywords for randomized control trials (RCTs). The quality of the RCTs was evaluated using the PEDro scale and risk of bias tool. RESULTS: Four studies involving 268 patients were identified, two compared custom-made foot orthoses to non-biomechanical foot insoles, while the other two used exercises. The meta-analysis included four studies for pain and three for disability. The results showed a significant change in pain [-2.43 (95% CI -2.73 to -2.13, p < .001)] and disability of -6.69 (95% CI -8.04 to -5.33, p < .001)]. CONCLUSIONS: This systematic review and meta-analysis of four RCTs elucidates that PI, specifically targeting PF, significantly alleviate pain and reduce disability in patients having CLBP with PF. These findings advocate for integrating foot-based PI within the treatment protocols for patients suffering from CLBP accompanied by PF.
ABSTRACT
Background: Non-specific chronic low back pain (NSCLBP) presents significant treatment challenges due to its multifactorial nature. Whole-body vibration exercise (WBVE) has emerged as a potential therapeutic modality, offering benefits across various domains, including pain reduction, improved balance, and enhanced quality of life (QoL). The aim of this present systematic review and meta-analysis is to evaluate the effects of WBVE on pain, disability, balance, proprioception, functional performance, and QoL in individuals with NSCLBP. Methods: We comprehensively searched PubMed, Web of Science, Scopus, and CENTRAL databases from October 2023 to January 2024, including RCTs with a PEDro score of ≥5 for high-quality evidence. Outcome measures included pain intensity, Oswestry Disability Index (ODI) score, Roland-Morris Disability Questionnaire (RMDQ) score, balance, proprioception, functional performance (through a progressive iso-inertial lifting evaluation), and QoL (SF-36) in NSCLBP patients. The risk of bias was assessed using ROB-2, and the certainty of evidence for each outcome indicator was analyzed using GRADE. A meta-analysis was conducted using standardized mean differences (SMD) and mean differences (MD) for continuous outcomes. Results: Ten randomized controlled trials fulfilled the inclusion criteria for the systematic review, and nine were suitable for the meta-analysis. The qualitative synthesis revealed WBVE is effective in improving pain, disability, balance, proprioception, and functional performance and QoL. Further, the results of the quantitative review demonstrated WBVE significantly reduced pain [visual analogue scale: SMD = -0.81, 95% CI (-1.11, -0.50), I2 = 0%, p < 0.01], disability [ODI: MD = -3.78, 95% CI (-5.27, -2.29), I2 = 24%, p < 0.01]; RMDQ: MD = -1.43, 95% CI (-2.04, -0.82), I2 = 51%, p < 0.01], balance [SMD = -0.28, 95% CI (-0.52, -0.05), I2 = 0%, p = 0.02], and proprioception [SMD = -4.20, 95% CI (-7.50, -0.89), I2 = 99%, p = 0.01]. Conclusions: This review and meta-analysis indicate that WBVE significantly improves pain, disability, balance and proprioception in individuals with non-specific chronic low back pain. These findings suggest potential benefits of incorporating WBVE into the management strategies for NSCLBP.
ABSTRACT
Objectives: This study aims to investigate the temporal effects of two Kinesio Taping (KT) techniques on lateral gastrocnemius muscle activity, motor neuron excitability, and countermovement jump height in university athletes from hockey, football, basketball, and volleyball. Additionally, it investigates whether the athletes' playing positions-either attacker or defender-influence these outcomes following the KT application. Methods: Forty-eight subjects were randomly assigned to one of three groups: Group A (n = 16), Group B (n = 16), and Group C (n = 16). All groups were further subdivided into attackers and defenders. Adhesive Kinesio tape was applied to the lateral gastrocnemius using the Y-shaped technique for three days. Facilitatory KT was applied from the origin to the insertion of the lateral gastrocnemius, while inhibitory KT was applied from the insertion to the origin. Motor neuron excitability, electromyographic activity, and countermovement jump height were tested at baseline, as well as after KT application, to evaluate if the dependent variables had changed. One-way ANOVA was used for baseline comparison, and mixed ANOVA was applied to assess post-interventional effects on the outcome measures. Results: Significant group effects for lateral gastrocnemius activation were found, measured using percentage of maximum voluntary isometric contraction (% MVIC) average root mean square (RMS). In motor neuron excitability, maximal M-wave (Mmax) was significantly improved in group comparison. Further, there was also a significant increase in countermovement jump height. There was no significant difference in outcome measures based on playing position (attacker and defender). Conclusion: Both KT techniques effectively influenced the lateral gastrocnemius muscle's activity, motor neuron excitability, and jump height when compared with the control group. Additionally, there is no effect of playing position, specifically attacker or defender, on the examined variables following KT application.