The Effects of Rest on Concussion Symptom Resolution and Recovery Time: A Meta-analytic Review and Subgroup Analysis of 4329 Patients.

BACKGROUND: Numerous individual studies suggest that rest may have a negative effect on outcomes following concussion. PURPOSE: To perform a systematic meta-analysis of the effects of prescribed rest compared with active interventions after concussion. STUDY DESIGN: Meta-analysis; Level of evidence, 4. METHODS: A meta-analysis (using the Hedges g) of randomized controlled trials and cohort studies was conducted to evaluate the effects of prescribed rest on symptoms and recovery time after concussion. Subgroup analyses were performed for methodological, study, and sample characteristics. Data sources were obtained from systematic search of key terms using Ovid Medline, Embase, Cochrane Database of Systematic Reviews, APA PsycINFO, Web of Science, SPORTDiscus, and ProQuest dissertations and theses through May 28, 2021. Eligible studies were those that (1) assessed concussion or mild traumatic brain injury; (2) included symptoms or days to recovery for ≥2 time points; (3) included 2 groups with 1 group assigned to rest; and (4) were written in the English language. RESULTS: In total, 19 studies involving 4239 participants met criteria. Prescribed rest had a significant negative effect on symptoms (k = 15; g = -0.27; SE = 0.11; 95% CI, -0.48 to -0.05; P = .04) but not on recovery time (k = 8; g = -0.16; SE = 0.21; 95% CI, -0.57 to 0.26; P = .03). Subgroup analyses suggested that studies with shorter duration (<28 days) (g = -0.46; k = 5), studies involving youth (g = -0.33; k = 12), and studies focused on sport-related concussion (g = -0.38; k = 8) reported higher effect sizes. CONCLUSION: The findings support a small negative effect for prescribed rest on symptoms after concussion. Younger age and sport-related mechanisms of injury were associated with a greater negative effect size. However, the lack of support for an effect for recovery time and the relatively small overall numbers of eligible studies highlight ongoing concerns regarding the quantity and rigor of clinical trials in concussion. REGISTRATION: CRD42021253060 (PROSPERO).

Impact of anthocyanin-rich whole fruit consumption on exercise-induced oxidative stress and inflammation: a systematic review and meta-analysis.

CONTEXT: Supplementing with fruits high in anthocyanins to reduce exercise-induced oxidative stress and inflammation has produced mixed results. OBJECTIVE: This systematic review and meta-analysis aims to discuss the impact of whole fruits high in anthocyanins, including processing methods and the type and amount of fruit, on inflammation and oxidative stress. DATA SOURCES: PICOS reporting guidelines and a customized coding scheme were used to search 5 databases (SPORTDiscus, Science Direct, Web of Science [BIOSIS], Medline [Pubmed], and the Cochrane Collaboration) with additional cross-referencing selection. DATA EXTRACTION: A random-effects meta-analysis was used to measure effects of the fruit supplements with 3 statistics; the QTotal value based on a χ2 distribution, τ2 value, and I2 value were used to determine homogeneity of variances on 22 studies (out of 807). Outliers were identified using a relative residual value. RESULTS: A small significant negative summary effect across the sum of all inflammatory marker outcomes (P < 0.001) and a moderate negative effect for the sum of all oxidative stress marker outcomes (P = 0.036) were found. Moderator analyses did not reveal significant (P > 0.05) differences between subgrouping variables. CONCLUSIONS: Results indicate that consumption of whole fruit high in anthocyanins can be beneficial for reducing inflammation and oxidative stress.

The effect of physical activity interventions on youth with autism spectrum disorder: A meta-analysis.

The purpose of this meta-analysis was to examine the effect of physical activity interventions on youth diagnosed with autism spectrum disorder. Standard meta-analytical procedures determining inclusion criteria, literature searches in electronic databases, coding procedures, and statistical methods were used to identify and synthesize articles retained for analysis. Hedge's g (1988) was utilized to interpret effect sizes and quantify research findings. Moderator and outcome variables were assessed using coding procedures. A total of 29 studies with 30 independent samples (N = 1009) were utilized in this analysis. Results from meta-analyses indicated an overall moderate effect (g = 0.62). Several outcomes indicated moderate-to-large effects (g ≥ 0.5); specifically, moderate to large positive effects were revealed for participants exposed to interventions targeting the development of manipulative skills, locomotor skills, skill-related fitness, social functioning, and muscular strength and endurance. Moderator analyses were conducted to explain variance between groups; environment was the only subgrouping variable (intervention characteristics) to produce a significant difference (QB = 5.67, P < 0.05) between moderators. While no significant differences were found between other moderators, several trends were apparent within groups in which experimental groups outperformed control groups. Autism Res 2018, 11: 818-833. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Results of the meta-analysis-a method for synthesizing research-showed physical activity interventions to have a moderate or large effect on a variety of outcomes, including for the development of manipulative skills, locomotor skills, skill-related fitness, social functioning, and muscular strength and endurance. The authors conclude that physical activity's standing as an evidence-based strategy for youth with ASD is reinforced.

Systematic review and meta-analysis of the effects of football heading.

AIM/OBJECTIVE: The objective of this study was to provide a meta-analysis examining the effects of football heading. DESIGN: Meta-analytical review on football heading effects on neurocognitive performance, cognition and symptom reports. DATA SOURCES: Combinations of the key terms were entered into the following electronic database search engines: Cochrane Libraries, PyscARTICLE, PyscINFO, PubMed, ProQuest, SPORTDiscus and Web of Science on 7 July 2016. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: The following inclusion criteria were used to determine eligibility for studies: (1) the study examined and reported on soccer athletes; (2) the population's age, sex and sport position was described; (3) cognitive function, symptoms, balance or other outcomes were quantitatively measured; (4) football heading exposure was quantitatively measured between at least two groups and (5) the study was written in the English language after December 1979. RESULTS: The literature search process identified 467 unique studies. After applying exclusion criteria, 28 studies remained. Included studies had a total of 2288 participants (female participants =933, male participants =1355), aged 13-70 years. The overall results of random effects modelling of football heading were found to be inconclusive across all outcomes, groups and time points. No moderating variables related to methodological, sample or study characteristics were supported in the analysis; age was a potential moderating variable. SUMMARY/CONCLUSIONS: We provide the first meta-analytical review of football heading effects aggregated from multiple studies and extended findings from a recent systematic review of the effects of football heading. Our analysis indicates no overall effect for heading a football on adverse outcomes.

The effectiveness of interventions to increase physical activity among adolescent girls: a meta-analysis.

BACKGROUND: Research has shown that a clear decline in physical activity among girls starting in early adolescence. Therefore, adolescent girls have been identified as a key target population for physical activity behavior change. The quantification of intervention effectiveness for this group has not been previously reported in a meta-analysis, and this therefore was the objective of the current meta-analysis. STUDY SELECTION: Included were interventions in which the main component, or 1 of the components, was aimed at promoting physical activity through behavior change in any setting. Interventions had to include a non-physical activity control group or comparison group, and include a quantitative outcome assessment of physical activity behavior in girls aged 12 to 18 years. DATA SOURCES: Science Direct, PubMed, PsychINFO, Web of Science, Cochrane Libraries, and EPPI Centre databases were searched up to and including May 2013. DATA EXTRACTION AND SYNTHESIS: Forty-five studies (k = 34 independent samples) were eligible from an initial 13,747 references. A random-effects meta-analysis was conducted. RESULTS: The average treatment effect for adolescent girls involved in physical activity interventions was significant but small (g = 0.350, 95% confidence interval 0.12, 0.58, P < .001). Moderator analyses showed larger effects for interventions that were theory based, performed in schools, were girls only, with younger girls, used multicomponent strategies, and involved targeting both physical activity and sedentary behavior. CONCLUSIONS: Interventions to increase physical activity in adolescent girls show small but significant effects, suggesting that behavior change may be challenging. Results suggest some approaches that appear to be successful.

Computerized neurocognitive testing within 1 week of sport-related concussion: meta-analytic review and analysis of moderating factors.

The purpose of this study is to perform a meta-analysis assessing the effects of sport-related concussion as measured by computerized neurocognitive tests (NCT) 1-week post injury. Thirty-seven studies involving 3960 participants between 2000 and 2011 were included. Hedge's g provides an adjusted effect size for smaller sample sizes and was calculated for overall and cognitive task effects, and subgroup analyses were conducted for age, type of NCT, and sport. Concussions had a low negative effect (g = -0.16; p < .001) across all groups, outcomes, and time points. Code substitution (g = -0.27; p < .05), visual memory (g = -0.25; p < .05), processing speed (g = -0.18; p < .05), and memory (g = -0.21; p < .05) tasks demonstrated negative effects for concussion. Younger adolescents had lower (g = -0.29; p < .05) NCT performance than older adolescents (g = -0.01) and college aged athletes (g = -0.11). ImPACT studies (g = -0.19; p < .05) demonstrated a negative effect for concussion as did those involving contact sports (g = -0.20; p < .05). A low to moderate overall effect size of concussion on neurocognitive performance was supported. Subgroup analyses revealed different effect sizes for specific cognitive tasks, types of NCTs, age, and type of sport.

The effectiveness of interventions to increase physical activity among young girls: a meta-analysis.

CONTEXT: Pre-adolescent girls are an important target population for physical activity behaviour change as it may enhance tracking into the crucial period of adolescence. The quantification of intervention effectiveness for this age group of girls has not been previously reported. EVIDENCE ACQUISITION: Studies published in English up to and including August 2013 were located from computerised (MedLine, PsychInfo, Science Direct, Web of Science, EPPI centre databases, and Cochrane Library database) and manual searches. Intervention studies aimed at promoting physical activity, which included pre-adolescent girls aged 5-11 years, and a non-physical activity control/comparison group were included. EVIDENCE SYNTHESIS: A random effects meta-analysis was conducted. The average treatment effect for pre-adolescent girls involved in physical activity interventions was significant but small (g=0.314, p<.001). Moderator analyses showed larger effects for interventions that catered for girls only and used educational and multicomponent strategies. CONCLUSIONS: Interventions to increase physical activity in pre-adolescent girls show small but significant effects, suggesting that behaviour change may be challenging, but results suggest some strategies that could be successful.

Physical activity interventions and depression in children and adolescents : a systematic review and meta-analysis.

CONTEXT: Evidence suggests chronic physical activity (PA) participation may be both protective against the onset of and beneficial for reducing depressive symptoms. OBJECTIVE: The aim of this article is to assess the impact of PA interventions on depression in children and adolescents using meta-analysis. DATA SOURCES: Published English language studies were located from manual and computerized searches of the following databases: PsycInfo, The Cochrane Database of Systematic Reviews and The Cochrane Central Register of Controlled Trials, Trials Register of Promoting Health Interventions (TRoPHI; EPPI Centre), Web of Science and MEDLINE. STUDY SELECTION: Studies meeting inclusion criteria (1) reported on interventions to promote or increase PA; (2) included children aged 5-11 years and/or adolescents aged 12-19 years; (3) reported on results using a quantitative measure of depression; (4) included a non-physical control or comparison group; and (5) were published in peer-reviewed journals written in English, up to and including May 2011 (when the search was conducted). DATA EXTRACTION: Studies were coded for methodological, participant and study characteristics. Comprehensive Meta-Analysis version-2 software was used to compute effect sizes, with subgroup analyses to identify moderating characteristics. Study quality was assessed using the Delphi technique. RESULTS: Nine studies were included (n = 581); most were school-based randomized controlled trials, randomized by individual. Studies used a variety of measurement tools to assess depressive symptoms. The summary treatment effect was small but significant (Hedges' g = -0.26, standard error = 0.09, 95% confidence intervals = -0.43, -0.08, p = 0.004). Subgroup analyses showed that methodological (e.g. studies with both education and PA intervention; those with a higher quality score; and less than 3 months in duration) and participant characteristics (e.g. single-gender studies; those targeting overweight or obese groups) contributed most to the reduction in depression. CONCLUSIONS: There was a small significant overall effect for PA on depression. More outcome-focused, high-quality trials are required to effectively inform the implementation of programmes to reduce depressive symptoms in children and adolescents.

Sedentary behaviour interventions in young people: a meta-analysis.

BACKGROUND: There is increasing concern about the time young people spend in sedentary behaviour ('sitting time'), especially with the development of attractive home-based electronic entertainment. This may have deleterious health effects. PURPOSE: To ascertain, through a meta-analytic review, whether interventions targeted at reducing sedentary behaviours in young people are successful. METHOD: ERIC, MedLine, PsychInfo, SportDiscus and the Cochrane Library databases were searched up to 2010. Titles and abstracts of identified papers were examined against inclusion criteria. Included papers were coded by three researchers. RESULTS: 17 papers, including 17 independent samples (N=4976), met the inclusion criteria and were analysed. There was a small but significant effect in favour of sedentary behaviour reduction for intervention groups (Hedges' g = - 0.192; SE = 0.056; 95% CI = -0.303 to -0.082; p = 0.001). Moderator analyses produced no significant between-moderator results for any of the intervention or study characteristics, although trends were evident. CONCLUSION: Behaviour change interventions targeting reductions in sedentary behaviour have been shown to be successful, although effects are small. More needs to be known about how best to optimise intervention effects.

Tracking of sedentary behaviours of young people: a systematic review.

OBJECTIVE: To review the empirical evidence concerning the strength of tracking of sedentary behaviours from childhood and adolescence. METHODS: Published English language studies were located from computerised and manual searches in 2009. Included studies were prospective, longitudinal studies with at least one sedentary behaviour for at least two time-points, with tracking coefficients reported, and included children (aged 3-11 years) and adolescents (12-18 years) at baseline. RESULTS: Based on data from 21 independent samples, tracking coefficients (r) ranged from 0.08 (over 16 years) to 0.73 (over 2 years) for TV viewing, from 0.18 (boys over 3 years) to 0.52 (over 2 years) for electronic game/computer use, from 0.16 (girls over 4 years) to 0.65 (boys over 2 years) for total screen time, and from -0.15 (boys over 2 years) to 0.48 (over 1 year) for total sedentary time. Study follow-up periods ranged from 1 to up to 27 years, and tracking coefficients tended to be higher with shorter follow-ups. CONCLUSIONS: Sedentary behaviours track at moderate levels from childhood or adolescence. Data suggest that sedentary behaviours may form the foundation for such behaviours in the future and some may track slightly better than physical activity.