Clinical effects and biological mechanisms of exercise on lumbar disc herniation.

Lumbar Disc Herniation (LDH) is a syndrome in which lumbar disc degeneration, rupture of the annulus fibrosus, and herniation of the nucleus pulposus irritate and compress the nerve roots and cauda equina, resulting in the main manifestations of lumbar pain and/or lower extremity pain. There is evidence in various clinical areas that exercise is effective in treating LDH, and exercise intervention for more than 2 weeks reduces disease activity in LDH. However, the mechanism of exercise's action in reducing disease activity in LDH is unclear. In this article, we first summarize and highlight the effectiveness of exercise in treating LDH and provide guideline recommendations regarding exercise type, intensity, frequency, and duration. Then, we integrate the existing evidence and propose biological mechanisms for the potential effects of exercise on neuromechanical compression, inflammatory chemical stimuli, and autoimmune responses from the perspective of LDH pathogenesis as an entry point. However, a large body of evidence was obtained from non-LDH populations. Future research needs to investigate further the proposed biological mechanisms of exercise in reducing disease activity in LDH populations. This knowledge will contribute to the basic science and strengthen the scientific basis for prescribing exercise therapy for the routine clinical treatment of LDH.

The effect of mobile phone task and age on gait: A systematic review and meta-analysis.

Objective: Mobile phone usage while performing postural-locomotor tasks is everyday activity across persons of all ages in various environmental contexts and health conditions. However, it is also an important factor contributing to accidents. To lower the risk of pedestrian accidents, this meta-analysis aimed to examine how mobile phones affect pedestrian gait and identify how mobile phone tasks and participant age affect gait differently. Methods: Electronic database searches were performed in The Cochrane Library, PubMed, and Medline. Two examiners evaluated the eligibility and quality of included studies using the Downs and Black checklist. The mean differences (MD) or standardized mean differences (SMD) were calculated for each outcome. Subgroup analyses were used to compare the differential effects of mobile phone task and participant age on gait. Results: Among 22 eligible studies, 592 participants in 10 countries were analyzed in this meta-analysis. The overall meta-analysis showed that using a mobile phone significantly decreased pedestrian gait velocity (SMD = -1.45; 95% CI: -1.66 to -1.24; p < 0.00001; I2 = 66%), step length (SMD = -1.01; 95% CI: -1.43 to -0.59; p < 0.00001; I2 = 82%), and stride length (SMD = -0.9; 95% CI: -1.19 to -0.60; p < 0.00001; I2 = 79%), significantly increased pedestrian step time (SMD = 0.77; 95% CI: 0.45 to 1.08; p < 0.00001; I2 = 78%), stride time (SMD = 0.87; 95% CI: 0.69 to 1.06; p < 0.00001; I2 = 24%), step width (SMD = 0.79; 95% CI: 0.34 to 1.24; p = 0.0006. I2 = 75%), double support time (SMD = 1.09; 95% CI: 0.86 to 1.31; p < 0.00001; I2 = 42%), and double support (%gait cycle, %GC) (MD = 2.32; 95% CI: 1.75 to 2.88; p < 0.00001; I2 = 26%). Conclusion: In summary, the effects of mobile phone tasks and participant age on gait were inconsistent. Our study found that resource-intensive tasks (texting and reading) significantly reduced gait velocity, and step time; however, small resource-intensive tasks (calling, talking, and dialing) did not affect these outcomes. In contrast to young adults, step length and step time were not affected by mobile phone use in older adults. Tips: Pedestrians should consider using a mobile phone in their daily lives according to the application scenarios (walking environment, the complexity of mobile phone tasks, pedestrians' task processing abilities, etc.) as appropriate to avoid dangerous accidents. Systematic Review Registration: identifier CRD42022358963.

Meta-Analysis of the Effect of Different Exercise Mode on Carotid Atherosclerosis.

(1) Background: There is increasing evidence showing the health benefits of exercise on carotid atherosclerosis. However, little is known about the different exercise modes for carotid atherosclerosis. This study was designed to perform a meta-analysis of effect of different exercise modes on carotid atherosclerosis so as to provide evidence-based suggestions for the prevention and management of cardiovascular and cerebrovascular diseases. (2) Methods: Six databases were systematically searched to identify randomized trials that compared exercise to a non-exercise intervention in patient with carotid atherosclerosis. We a priori specified changes in cIMT, TC, LDL-C, and HDL-C biomarkers as outcomes. (3) Results: Thirty-four trials met the eligibility criteria, comprising 2420 participants. The main analyses showed pronounced differences on cIMT (MD = -0.06, 95%CI (-0.09, -0.04), p < 0.00001, TC (MD = -0.41, 95%CI (-0.58, -0.23), p < 0.00001), LDL-C (MD = -0.31, 95%CI (-0.43, -0.20), p < 0.00001), and HDL-C (MD = 0.11, 95%CI (0.04, 0.19), p = 0.004), which significantly reduced the risk factors of carotid atherosclerosis disease. In the different exercise modes, the effect was pronounced for aerobic exercise for all outcomes except TC; high-intensity interval exercise also showed significance for all outcomes except TC and HDL-C; aerobic exercise combined with resistance exercise did not affect any outcome except HDL-C; (4) Conclusions: Exercise has a prominent prevention and improvement effect on carotid atherosclerosis. In the perspective of exercise pattern, aerobic exercise and high-intensity intermittent exercise can improve carotid atherosclerosis; however, aerobic exercise has a more comprehensive improvement effect.

Effects of non-invasive brain stimulation on walking and balance ability in Parkinson's patients: A systematic review and meta-analysis.

Objective: To investigate and contrast the effects of non-invasive brain stimulation (NIBS), including repeated transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), on walking and balance ability in patients with Parkinson's disease (PD). Methods: The PubMed, Embase, Medline, Cochrane, CNKI, and Chinese WanFang databases were searched up to June 2022. Quality assessment was performed using the Cochrane Collaboration's risk-of-bias guidelines, and the standardized mean differences (SMD) or mean differences (MD) for each outcome were calculated. Results: Among 32 eligible studies, including 1,586 participants were analyzed in this meta-analysis. The results of the meta-analysis showed that NIBS was effective in improving UPDRS-III scores (MD = -2.07; 95% CI, -2.62 to -1.53; P < 0.00001; I 2 = 6%) and variables associated with the ability of walk such as step width (SMD = 0.35; 95% CI, 0.16-0.55; P = 0.0005; I 2 = 38%), cadence (SMD = 0.3; 95% CI, 0.05 to 0.55; P = 0.02; I 2 = 25%), and 6MWT (MD = 62.86; 95% CI, 39.43-86.29; P < 0.00001; I 2 = 0%). In subgroup analyses across intervention types, UPDRS-III scores (rTMS: MD = -2.54; 95% CI, -3.16 to -1.92; P < 0.00001; I 2 = 0%; tDCS: MD = -1.20; 95% CI, -1.99 to -0.40; P = 0.003; I 2 = 0%) and TUGT time (rTMS: MD = -4.11; 95% CI, -4.74 to -3.47; P < 0.00001; I 2 = 0%; tDCS: MD = -0.84; 95% CI, -1.48 to -0.21; P = 0.009; I 2 = 0%) significantly improved. Moreover, our results also showed that compared to tDCS, rTMS was more significant in improving UPDRS-III scores and TUGT time (p < 0.05). Conclusion: NIBS benefits some walking ability variables but not balance ability in 36 patients with PD. The rTMS significantly improved UPDRS-III scores and TUGT time compared to tDCS. Further studies are needed to determine the optimal protocol and to illuminate effects based on the ideal target brain regions, stimulation intensity, timing, and type of intervention. Systematic review registration: http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022350782.