Effects of Plyometric Jump Training on the Reactive Strength Index in Healthy Individuals Across the Lifespan: A Systematic Review with Meta-analysis.

BACKGROUND: The reactive strength index (RSI) is meaningfully associated with independent markers of athletic (e.g., linear sprint speed) and neuromuscular performance [e.g., stretch-shortening cycle (SSC)]. Plyometric jump training (PJT) is particularly suitable to improve the RSI due to exercises performed in the SSC. However, no literature review has attempted to meta-analyse the large number of studies regarding the potential effects of PJT on the RSI in healthy individuals across the lifespan. OBJECTIVE: The aim of this systematic review with meta-analysis was to examine the effects of PJT on the RSI of healthy individuals across the lifespan compared with active/specific-active controls. METHODS: Three electronic databases (PubMed, Scopus, Web of Science) were searched up to May 2022. According to the PICOS approach, the eligibility criteria were: (1) healthy participants, (2) PJT interventions of ≥ 3 weeks, (3) active (e.g., athletes involved in standard training) and specific-active (e.g., individuals using heavy resistance training) control group(s), (4) a measure of jump-based RSI pre-post training, and (5) controlled studies with multi-groups in randomised and non-randomised designs. The Physiotherapy Evidence Database (PEDro) scale was used to assess the risk of bias. The random-effects model was used to compute the meta-analyses, reporting Hedges' g effect sizes (ES) with 95% confidence intervals (95% CIs). Statistical significance was set at p ≤ 0.05. Subgroup analyses were performed (chronological age; PJT duration, frequency, number of sessions, total number of jumps; randomization). A meta-regression was conducted to verify if PJT frequency, duration, and total number of sessions predicted the effects of PJT on the RSI. Certainty or confidence in the body of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Potential adverse health effects derived from PJT were researched and reported. RESULTS: Sixty-one articles were meta-analysed, with a median PEDro score of 6.0, a low risk of bias and good methodological quality, comprising 2576 participants with an age range of 8.1-73.1 years (males, ~ 78%; aged under 18 years, ~ 60%); 42 studies included participants with a sport background (e.g., soccer, runners). The PJT duration ranged from 4 to 96 weeks, with one to three weekly exercise sessions. The RSI testing protocols involved the use of contact mats (n = 42) and force platforms (n = 19). Most studies reported RSI as mm/ms (n = 25 studies) from drop jump analysis (n = 47 studies). In general, PJT groups improved RSI compared to controls: ES = 0.54, 95% CI 0.46-0.62, p < 0.001. Training-induced RSI changes were greater (p = 0.023) for adults [i.e., age ≥ 18 years (group mean)] compared with youth. PJT was more effective with a duration of > 7 weeks versus ≤ 7 weeks, > 14 total PJT sessions versus ≤ 14 sessions, and three weekly sessions versus < three sessions (p = 0.027-0.060). Similar RSI improvements were noted after ≤ 1080 versus > 1080 total jumps, and for non-randomised versus randomised studies. Heterogeneity (I2) was low (0.0-22.2%) in nine analyses and moderate in three analyses (29.1-58.1%). According to the meta-regression, none of the analysed training variables explained the effects of PJT on RSI (p = 0.714-0.984, R2 = 0.0). The certainty of the evidence was moderate for the main analysis, and low-to-moderate across the moderator analyses. Most studies did not report soreness, pain, injury or related adverse effects related to PJT. CONCLUSIONS: The effects of PJT on the RSI were greater compared with active/specific-active controls, including traditional sport-specific training as well as alternative training interventions (e.g., high-load slow-speed resistance training). This conclusion is derived from 61 articles with low risk of bias (good methodological quality), low heterogeneity, and moderate certainty of evidence, comprising 2576 participants. PJT-related improvements on RSI were greater for adults versus youths, after > 7 training weeks versus ≤ 7 weeks, with > 14 total PJT versus ≤ 14 sessions, and with three versus < three weekly sessions.

Global differences in lung function by region (PURE): an international, community-based prospective study.

BACKGROUND: Despite the rising burden of chronic respiratory diseases, global data for lung function are not available. We investigated global variation in lung function in healthy populations by region to establish whether regional factors contribute to lung function. METHODS: In an international, community-based prospective study, we enrolled individuals from communities in 17 countries between Jan 1, 2005, and Dec 31, 2009 (except for in Karnataka, India, where enrolment began on Jan 1, 2003). Trained local staff obtained data from participants with interview-based questionnaires, measured weight and height, and recorded forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). We analysed data from participants 130-190 cm tall and aged 34-80 years who had a 5 pack-year smoking history or less, who were not affected by specified disorders and were not pregnant, and for whom we had at least two FEV1 and FVC measurements that did not vary by more than 200 mL. We divided the countries into seven socioeconomic and geographical regions: south Asia (India, Bangladesh, and Pakistan), east Asia (China), southeast Asia (Malaysia), sub-Saharan Africa (South Africa and Zimbabwe), South America (Argentina, Brazil, Colombia, and Chile), the Middle East (Iran, United Arab Emirates, and Turkey), and North America or Europe (Canada, Sweden, and Poland). Data were analysed with non-linear regression to model height, age, sex, and region. FINDINGS: 153,996 individuals were enrolled from 628 communities. Data from 38,517 asymptomatic, healthy non-smokers (25,614 women; 12,903 men) were analysed. For all regions, lung function increased with height non-linearly, decreased with age, and was proportionately higher in men than women. The quantitative effect of height, age, and sex on lung function differed by region. Compared with North America or Europe, FEV1 adjusted for height, age, and sex was 31·3% (95% CI 30·8-31·8%) lower in south Asia, 24·2% (23·5-24·9%) lower in southeast Asia, 12·8% (12·4-13·4%) lower in east Asia, 20·9% (19·9-22·0%) lower in sub-Saharan Africa, 5·7% (5·1-6·4%) lower in South America, and 11·2% (10·6-11·8%) lower in the Middle East. We recorded similar but larger differences in FVC. The differences were not accounted for by variation in weight, urban versus rural location, and education level between regions. INTERPRETATION: Lung function differs substantially between regions of the world. These large differences are not explained by factors investigated in this study; the contribution of socioeconomic, genetic, and environmental factors and their interactions with lung function and lung health need further clarification. FUNDING: Full funding sources listed at end of the paper (see Acknowledgments).

Bone marrow contribution to eosinophilic inflammation

Allergen-induced bone marrow responses are observed in human allergic asthmatics, involving specific increases in eosinophil-basophil progenitors (Eo/B-CFU), measured either by hemopoietic assays or by flow cytometric analyses of CD34-positive, IL-3 alpha-positive, and/or IL-5-responsive cell populations. The results are consistent with the upregulation of an IL-5-sensitive population of progenitors in allergen-induced late phase asthmatic responses. Studies in vitro on the phenotype of developing eosinophils and basophils suggest that the early acquisition of IL-5 alpha, as well as the capacity to produce cytokines such as GM-CSF and IL-5, are features of the differentiation process. These observations are consistent with findings in animal models, indicating that allergen-induced increases in bone marrow progenitor formation depend on hemopoietic factor(s) released post-allergen. The possibility that there is constitutive marrow upregulation of eosinophilopoiesis in allergic airways disease is also an area for future investigation.