Comprehensive management of children and adolescents with type 1 diabetes mellitus through personalized physical exercise and education using an mHealth system: The Diactive-1 study protocol.

Introduction: The use of new technologies presents an opportunity to promote physical activity, especially among young people with type 1 diabetes (T1DM), who tend to be less active compared to their healthy counterparts. The aim of this study is to investigate the impact of a personalized resistance exercise program, facilitated by the Diactive-1 App, on insulin requirements among children and adolescents diagnosed with T1DM. Methods and analysis: A minimum of 52 children and adolescents aged 8-18 years, who were diagnosed with T1DM at least 6 months ago, will be randomly assigned to either a group engaging in an individualized resistance exercise program at least 3 times per week over a 24-week period or a waiting-list control group. The primary outcome will be the daily insulin dose requirement. The secondary outcomes will include glycemic control, cardiometabolic profile, body composition, vascular function, physical fitness, 24-hour movement behaviors, diet, and psychological parameters. The usability of the app will also be assessed. Ethics and dissemination: Ethical approval to conduct this study has been granted by the University Hospital of Navarra Research Board (PI_2020/140). Parents or legal guardians of minors participating in the study will provide written consent, while children and adolescents will sign an assent form to indicate their voluntary agreement. The trial's main findings will be shared through conference presentations, peer-reviewed publications, and communication directly with participating families. This study aims to offer valuable insights into the holistic management of children and adolescents with T1DM by utilizing personalized exercise interventions through an mHealth system. Trial registration: NCT06048757.

Incidence of type 1 diabetes mellitus in children and adolescents under 20 years of age across 55 countries from 2000 to 2022: A systematic review with meta-analysis.

AIMS: The aim of this study was to determine the global incidence of type 1 diabetes mellitus (T1DM) in children and adolescents under 20 years of age from 2000 to 2022. MATERIALS AND METHODS: Two reviewers searched three electronic databases (PubMed, Web of Science, and CINAHL) for studies published between January 2000 and November 2022. Pooled estimates of T1DM incidence with a 95% confidence interval (CI) per 100,000 person-years were calculated by country/region, sex, age, and COVID-19 pandemic period (pre-COVID-19 and pandemic). RESULTS: The study included 126 studies from 55 countries and 18 regions. The incidence rate (IR) of T1DM from 2000 to 2022 was 14.07 (95%CI, 12.15-16.29) per 100,000 person-years. Finland and high-income North America had the highest IR, with 56.81 (95%CI, 55.91-57.73) and 28.77 (95%CI, 26.59-31.13) per 100,000 person-years, respectively. The IR was 13.37 (95%CI, 10.60-16.88) per 100,000 person-years in boys and 13.87 (95%CI, 11.51-16.70) per 100,000 person-years in girls. There were statistically significant differences among different age ranges: 0-4 versus 5-9 and 10-14 years old (p < 0.001); 5-9 versus 15-19 (p < 0.001) and 10-14 versus 15-19 years old (p = 0.003). Finally, during the pandemic period (2020-2022), the IR was 24.84 (95%CI, 17.16-35.96) per 100,000 person-years, which was higher but not significant compared with the prepandemic period (2017-2019) of 13.56 (95%CI, 7.49-24.56) per 100,000 person-years (p = 0.090). CONCLUSIONS: The IR of T1DM in children and adolescents under 20 years of age is substantial, especially during the pandemic period, although it varies across regions. More reliable data from additional countries are needed to determine the worldwide incidence of T1DM.

Youth with type 1 diabetes mellitus are more inactive and sedentary than apparently healthy peers: A systematic review and meta-analysis.

AIMS: To conduct a meta-analysis of differences in physical activity, sedentary behaviour, and physical fitness between children and adolescents with type 1 diabetes and their healthy peers. METHODS: The databases EMBASE, PubMed and SportsDiscus were searched for studies. Pooled effects were calculated using random effects inverse-variance models with the Hartung-Knapp-Sidik-Jonkman adjustment. RESULTS: Thirty-five studies were included, comprising a total of 4,751 youths (53% girls, 2,452 with type 1 diabetes). Youth with type 1 diabetes were less physically active (Cohen's d = -0.23, 95%CI - 0.42 to -0.04), more sedentary (Cohen's d = 0.33, 95%CI 0.06 to 0.61), and had lower cardiorespiratory fitness (Cohen's d = -0.52, 95%CI - 0.73 to -0.31) than their healthy peers. This corresponds to -12.72 min/day of moderate-to-vigorous physical activity, 63.3 min/day of sedentary time (accelerometry) and -4.07 ml/kg/min of maximum/peak oxygen consumption. In addition, young people with type 1 diabetes were less likely to meet the international physical activity recommendations than their healthy peers (odds ratio = 0.44, 95%CI 0.31 to 0.62). CONCLUSIONS: Keeping in mind the heterogeneity between studies in the design, population and assessment, our findings show that children and adolescents with type 1 diabetes seem to be less active, more sedentary, and have lower cardiorespiratory fitness levels than their healthy peers.

Bullying victimization, physical inactivity and sedentary behavior among children and adolescents: a meta-analysis.

BACKGROUND: Physical activity and sedentary behavior are related with psycho-social variables among youth, however its relationship with bullying victimization is unclear. The aim of the study was to clarify the associations between physical activity and sedentary behaviors with bullying victimization among children and adolescents. METHODS: Two independent authors searched in four databases. The studies were selected/included only if participants were children and/or adolescents and the relationship between physical activity and/or sedentary behavior with bullying victimization was reported. Random-effects meta-analyses were used. RESULTS: A total of 18 cross-sectional studies (including 386,740 children and adolescents, 51.8% females) were reviewed. Our study found that not meeting the physical activity guidelines (Odds Ratio [OR] = 1.14, 95% confidence interval [CI], 1.04 to 1.23) and excessive sedentary behavior (i.e., 2 h per day or more of screen time) (OR = 1.21, 95% CI, 1.14 to 1.28) were associated with 14 and 21% higher bullying victimization, respectively. Consistent associations were also found when we analyzed specific forms of bullying for sedentary behavior, including traditional and cyberbullying. CONCLUSIONS: The present study establishes the first quantitative framework for understanding the influence of physical activity and sedentary behavior on bullying victimization, and lays the groundwork for future studies and interventions aimed to its promotion. TRIAL REGISTRATION: CRD42018099388 .

Physical activity, screen time and subjective well-being among children / Actividad física, tiempo frente a la pantalla y bienestar subjetivo en niños

BACKGROUND/OBJECTIVE: The aim of the study was to explore the differences between physical activity and/or screen time levels on cognitive (Life satisfaction LS) and affective (Positive affect, PA and Negative affect NA) components of subjective well-being (SWB) in children. METHOD: This cross-sectional study enrolled 1,540 children (1,040 boys, 8-12 years old). LS, PA, NA, physical activity and screen time were assessed with validated questionnaires. RESULTS: Children who reported 3 days per week of physical activity or less had lower LS and PA than counterparts with ≥ 6 days of physical activity per week (p < .05). Participants who reported 2 hours per day or less of screen time had lower NA than counterparts with 4 hours per day or more of screen time (p < .05). Also, children who meet physical activity guidelines have higher LS and PA compared to inactive peers, even with high screen time. In contrast, excessive screen time was also related with NA independent of the level of physical activity. CONCLUSIONS: Our findings suggest that physical activity is related with positive feelings and LS, but does not eliminate the effect of screen time on negative feelings among Chilean children

INTRODUCCIÓN/OBJETIVO: Este estudio explora las diferencias entre la actividad física y/o los niveles de tiempo de pantalla en los componentes cognitivo (Satisfacción de la vida SV) y afectivo (Afecto positivo AP y Afecto negativo AN) del bienestar subjetivo en niños. MÉTODO: Se incluyó a 1.540 niños (1.040 niños, 8 a 12 años). La SV, AP, AN, actividad física y tiempo de pantalla se evaluaron con cuestionarios validados. RESULTADOS: Los niños que informaron 3 días/semana de actividad física o menos tenían menos SV y AP que sus homólogos con 6 días/semana de actividad física o más (p < 0,05). Los que informaron menos de 2 horas por día de tiempo de pantalla tuvieron menos AN que sus homólogos con más o igual a 4 horas por día de tiempo de pantalla (p < 0,05). Además, los niños que cumplen con las pautas de actividad física tienen mayor SV y AP en comparación con los inactivos, incluso con un tiempo de pantalla elevado. Por el contrario, el tiempo de pantalla excesivo también se relacionó con el AN independientemente del nivel de actividad física. CONCLUSIONES: Los hallazgos sugieren que la actividad física está relacionada con emociones positivas y SV, pero no elimina el efecto del tiempo de pantalla en las emociones negativas

Physical activity, screen time and subjective well-being among children.

BACKGROUND/OBJECTIVE: The aim of the study was to explore the differences between physical activity and/or screen time levels on cognitive (Life satisfaction LS) and affective (Positive affect, PA and Negative affect NA) components of subjective well-being (SWB) in children. METHOD: This cross-sectional study enrolled 1,540 children (1,040 boys, 8-12 years old). LS, PA, NA, physical activity and screen time were assessed with validated questionnaires. RESULTS: Children who reported 3 days per week of physical activity or less had lower LS and PA than counterparts with ≥6 days of physical activity per week (p < .05). Participants who reported 2 hours per day or less of screen time had lower NA than counterparts with 4 hours per day or more of screen time (p < .05). Also, children who meet physical activity guidelines have higher LS and PA compared to inactive peers, even with high screen time. In contrast, excessive screen time was also related with NA independent of the level of physical activity. CONCLUSIONS: Our findings suggest that physical activity is related with positive feelings and LS, but does not eliminate the effect of screen time on negative feelings among Chilean children.

INTRODUCCIÓN/OBJETIVO: Este estudio explora las diferencias entre la actividad física y/o los niveles de tiempo de pantalla en los componentes cognitivo (Satisfacción de la vida SV) y afectivo (Afecto positivo AP y Afecto negativo AN) del bienestar subjetivo en niños. MÉTODO: Se incluyó a 1.540 niños (1.040 niños, 8 a 12 años). La SV, AP, AN, actividad física y tiempo de pantalla se evaluaron con cuestionarios validados. RESULTADOS: Los niños que informaron 3 días/semana de actividad física o menos tenían menos SV y AP que sus homólogos con 6 días/semana de actividad física o más (p < 0,05). Los que informaron menos de 2 horas por día de tiempo de pantalla tuvieron menos AN que sus homólogos con más o igual a 4 horas por día de tiempo de pantalla (p < 0,05). Además, los niños que cumplen con las pautas de actividad física tienen mayor SV y AP en comparación con los inactivos, incluso con un tiempo de pantalla elevado. Por el contrario, el tiempo de pantalla excesivo también se relacionó con el AN independientemente del nivel de actividad física. CONCLUSIONES: Los hallazgos sugieren que la actividad física está relacionada con emociones positivas y SV, pero no elimina el efecto del tiempo de pantalla en las emociones negativas.

The relation of foot morphology to performance in three vertical jumping tasks / Relación entre la morfología del pie y el rendimiento en tres saltos verticales

SUMMARY: The objective of this research is to relate the performance in three vertical jump events with morphological variables of the foot and stature. A total of 177 practitioners of 12 sporting events aged 24.5 ±8.0 years, with 71.01 ±13.00 kg of body mass, 1.71±0.09 m height, and BMI of 24.29±3.24 kg·m-2 were evaluated with an anthropometer in terms of foot length (FL), forefoot width (FW), navicular height (NH), and hindfoot width (HW). These variables were normalized to the height of the subjects. From the footprint record the arch index (AI) was obtained, which indicates the morphology of the medial longitudinal foot arch (MLFA). Performance was evaluated in three vertical jump events: countermovement jump (CMJ), squat jump (SJ), and drop jump (DJ), recording the height reached. FL, FW and HW show a weak positive correlation (r<0.4; p<0.05) with the heights achieved in the three types of jump. The stature is strongly associated with FL, FW and HW (r=0.8; r=0.7 and r=0.6; respectively; p<0.05) and with the height in CMJ, SJ, and DJ (r=0.37; r=0.41 and r=0.32, respectively, p<0.05). The only normalized morphological foot variable that maintained consistency in the correlations analysis was the normalized foot length (NFL) with CMJ (r = 0.2, p<0,05). The subjects whose left foot length was equivalent to 14 % of the stature jumped 27.94 ±6.63 cm, those with 15 % jumped 30.96 ±7.4 cm, and those with 16 % jumped 31.03 ±7.8 cm. FL, FW, HW, and stature are moderately correlated with performance in vertical jump events. However, after discarding the stature of the subjects, only the foot length maintained its relation with performance in CMJ.

RESUMEN: El objetivo de esta investigación fue relacionar el rendimiento en salto vertical con variables morfológicas del pie y estatura. 177 practicantes de 12 disciplinas deportivas de 24,5 ±8,0 años; 71,01 ±13,00 kg; 1,71 ±0,09 m, e IMC de 24,29 ±3,24 kg•m-2 fueron evaluados con un antropómetro obteniendo longitud de pie (FL), ancho de antepié (FW), altura navicular (NH) y ancho de retropié (HW). Estas variables fueron normalizadas a la estatura. Se midió la huella plantar obteniendo el índice del arco (AI), el cual indica la morfología del arco plantar longitudinal medial (MLFA). El rendimiento fue evaluado en tres pruebas de salto: salto con contramovimiento (CMJ), sentadilla con salto (SJ) y salto desde caída (DJ), registrando la altura alcanzada. FL, FW y HW mostraron una débil correlación positiva (r<0,4; p<0,05) con la altura alcanzada en los tres saltos. La estatura se asocia con FL, FW y HW (r=0,8; r=0,7 y r=0,6; respectivamente; p<0,05) y con la altura en CMJ, SJ y DJ (r=0,37; r=0,41 y r=0,32, respectivamente, p<0,05). La única variable normalizada del pie que mantuvo consistencia en el análisis de correlaciones fue la longitud del pie normalizada (NFL) con CMJ (r=0,2; p<0,05). Los sujetos cuyo pie tiene una longitud equivalente al 14 % de la estatura saltaron 27,94 ±6,63 cm, los que equivalen al 15 % saltaron 30,96 ±7,4 cm y quienes tuvieron un pie equivalente a un 16 % de la estatura saltaron 31,03 ±7,8 cm. FL, FW, HW y la estatura se correlacionan moderadamente con el rendimiento en salto vertical. Sin embargo, después de descartar la estatura de los sujetos, solamente la longitud del pie mantiene su relación con el rendimiento en CMJ.

Physical fitness components in relation to attention capacity in Latin American youth with overweight and obesity.

The aim of the study was twofold: (a) to examine the association between health-related physical fitness and attention capacity in Latin American children and adolescents with overweight and obesity and (b) to test whether body composition outcomes are moderators of this association. A cross-sectional design was used to study 201 overweight/obese participants (12.1 ± 2.1 years of age; 34.3% girls) from Chile (Active-Start study) and Colombia (HEPAFIT study). Body composition, muscular fitness, speed-agility, and cardiorespiratory fitness were evaluated using two similar test batteries (ALPHA and FUPRECOL). Attention capacity was measured by the d2 Test. Linear regression and moderation analyses were conducted. Linear regression analysis revealed an association between muscular fitness (ß = 0.245, P = .015), speed-agility (ß = -0.16, P = .027), cardiorespiratory fitness (ß = 0.331, P < .001) and overall fitness score (ß = 0.210; P = .004) and attention capacity (all analyses were controlled for age, sex, peak height velocity, maternal education, and study setting). Moderation analysis using the Johnson-Neyman technique revealed that the effect of the relationship between muscular fitness score and speed-agility and attention capacity was stronger as fat mass and fat mass index increased. In conclusion, physical fitness components are associated with higher attention capacity in youth with overweight/obesity, but body composition seems to moderate these relationships. Randomized controlled trials in this population would help to better understand whether improvements in different components of physical fitness lead to better attention capacity, especially in youth with excess adiposity.

Exercise program and blood pressure in children: The moderating role of sedentary time.

OBJECTIVES: The aim of the present study was to test a before-school physical activity intervention (Active-Start intervention) on blood pressure in children and examine whether sedentary time moderates the effect of the intervention on blood pressure. DESIGN: Randomized controlled trial. METHODS: The Active-Start intervention comprising 170 children (8-10 years old) from three public schools with low socioeconomic status in Santiago (Chile). The exercise intervention was delivered daily, before starting the first school-class (8:00-8:30 a.m.), for 8 weeks. The intervention was mainly a program of cooperative physical games at moderate-vigorous intensity. Resting systolic and diastolic blood pressure was determined from the average of two measurements at baseline and at the end of intervention. Moderate-to-vigorous physical activity and sedentary time was assessed using a GENEActiv tri-axial accelerometer prior to the program intervention. RESULTS: The Active-Start intervention decreased blood pressure levels in children (p<0.01) but did not change relative to the control group. Johnson-Neyman analysis revealed a significant relationship between the effect of intervention on systolic blood pressure and mean arterial pressure when sedentary time was below, but not at or above, 657 and 659min per day (i.e., the effect of physical exercise disappears), respectively. CONCLUSIONS: The effect of physical activity on blood pressure could disappear in children with excessive sedentary time, which highlights the need to reduce total levels of sedentary time in the day-to-day life of young people in and out of schools.

A before-school physical activity intervention to improve cognitive parameters in children: The Active-Start study.

The aim of the study was threefold: (a) to test a before-school physical activity intervention (Active-Start) on academic performance, selective attention, and concentration capacity; (b) to test the effect of the Active-Start intervention on anthropometry, body composition, and physical fitness parameters; and (c) whether the physical fitness components are moderators of the effect of the Active-Start program on academic performance, selective attention, and concentration capacity in Chilean children. The Active-Start intervention was a RCT which comprised 170 children (8-10 years old) from three public schools with low socioeconomic status from the city of Santiago (Chile). The exercise intervention was delivered daily, before starting the first school-class (8:00-8:30 am) for 8 weeks. Changes in academic performance, selective attention and concentration capacity, anthropometric, body composition, and physical fitness parameters were measured. The analyses used were mixed regression models for repeated measures over time. No statistically significant changes in attention and concentration capacity were found. However, significant changes were seen in language (0.63; 95% CI 0.49-0.77) and mathematics (0.49; 95% CI 0.32-0.66) performance (P < .001). Also, improvements were seen in fat mass, fat-free mass, muscular, and cardiorespiratory fitness (all P < .05). The Johnson-Neyman technique revealed a significant relationship between the effect of intervention and attention and concentration when change in cardiorespiratory fitness was above, but not below, 3.05 and 0.70 mL/kg/min, respectively. Implementing before-school physical activity programs such as the Active-Start to enhance the cardiorespiratory fitness may benefit attention capacity and academic success among schoolchildren.

Can a before-school physical activity program decrease bullying victimization in disadvantaged children? The Active-Start Study.

BACKGROUND/OBJECTIVE: To test the effectiveness of an 8-week before-school physical activity program to reduce bullying victimization among a group of socially disadvantaged children in the Active-Start study. METHOD: A non-blinded randomized controlled trial was conducted in three public schools classified as highly vulnerable and located in a deprived area of Santiago (Chile). A total of 5 classes participated, totaling 170 fourth grade children. The intervention was delivered before starting the first school-class (8:00-8:30 a.m.). The program lasted for 8 weeks. Primary outcome measurement on bullying victimization was assessed by the CUBE questionnaire at baseline and post-intervention. RESULTS: There was a statistically significant reduction in the probability of suffering physical bullying (OR= 0.18, 95% CI, 0.04-0.82; p= .027) and verbal bullying (OR=0.13, 95% CI, 0.02-0.97; p= .046) after the 8-week program. CONCLUSIONS: Participation in an 8-week before-school physical activity intervention implemented in schools located in a disadvantaged district in Santiago (Chile) resulted in lower levels of bullying victimization among study participants. The Active-Start program may be a feasible and potentially scalable intervention option to improve the climate and pro-sociality environment at schools.

ANTECEDENTES/OBJETIVO: Evaluar la efectividad de un programa de actividad física antes de la escuela de ocho semanas para reducir el bullying en niños en desventaja social del estudio Active-Start. MÉTODO: Se realizó un ensayo controlado aleatorio no ciego en tres escuelas públicas vulnerables y ubicadas en Santiago (Chile), con un total de cinco clases e incluyendo 170 niños de Cuarto Grado. La intervención de ocho semanas se realizó cinco veces por semana antes de comenzar la primera clase (8:00­8:30 a.m.). La medida de resultado primaria fue la victimización por bullying evaluado a través del cuestionario CUBE al inicio y después de la intervención. RESULTADOS: Hubo una reducción estadísticamente significativa en la probabilidad de sufrir bullying físico (OR= 0,18, IC 95%, 0,04-0,82; p= 0,027) y verbal (OR= 0,13, IC 95%, 0,02-0,97; p= 0,046) después del programa de ocho semanas. CONCLUSIONES: La participación en una intervención de actividad física antes de la escuela de ocho semanas implementada en escuelas ubicadas en una comuna desfavorecida en Santiago (Chile) dio lugar a niveles más bajos de victimización por bullying entre sus participantes. El programa Active-Start puede ser una opción de intervención viable y potencialmente escalable para mejorar el clima y el ambiente escolar.

Can a before-school physical activity program decrease bullying victimization in disadvantaged children? The Active-Start Study / ¿Puede un programa de actividad física antes de la escuela disminuir la victimización por bullying en niños desfavorecidos? Estudio Active-Start

Background/Objective: To test the effectiveness of an 8-week before-school physical activity program to reduce bullying victimization among a group of socially disadvantaged children in the Active-Start study. Method: A non-blinded randomized controlled trial was conducted in three public schools classified as highly vulnerable and located in a deprived area of Santiago (Chile). A total of 5 classes participated, totaling 170 fourth grade children. The intervention was delivered before starting the first school-class (8:00-8:30 a.m.). The program lasted for 8 weeks. Primary outcome measurement on bullying victimization was assessed by the CUBE questionnaire at baseline and post-intervention. Results: There was a statistically significant reduction in the probability of suffering physical bullying (OR= 0.18, 95% CI, 0.04-0.82; p= .027) and verbal bullying (OR=0.13, 95% CI, 0.02-0.97; p= .046) after the 8-week program. Conclusions: Participation in an 8-week before-school physical activity intervention implemented in schools located in a disadvantaged district in Santiago (Chile) resulted in lower levels of bullying victimization among study participants. The Active-Start program may be a feasible and potentially scalable intervention option to improve the climate and pro-sociality environment at schools

Antecedentes/Objetivo: Evaluar la efectividad de un programa de actividad física antes de la escuela de ocho semanas para reducir el bullying en niños en desventaja social del estudio Active-Start. Método: Se realizó un ensayo controlado aleatorio no ciego en tres escuelas públicas vulnerables y ubicadas en Santiago (Chile), con un total de cinco clases e incluyendo 170 niños de Cuarto Grado. La intervención de ocho semanas se realizó cinco veces por semana antes de comenzar la primera clase (8:00-8:30 a.m.). La medida de resultado primaria fue la victimización por bullying evaluado a través del cuestionario CUBE al inicio y después de la intervención. Resultados: Hubo una reducción estadísticamente significativa en la probabilidad de sufrir bullying físico (OR= 0,18, IC 95%, 0,04-0,82; p= 0,027) y verbal (OR= 0,13, IC 95%, 0,02-0,97; p= 0,046) después del programa de ocho semanas. Conclusiones: La participación en una intervención de actividad física antes de la escuela de ocho semanas implementada en escuelas ubicadas en una comuna desfavorecida en Santiago (Chile) dio lugar a niveles más bajos de victimización por bullying entre sus participantes. El programa Active-Start puede ser una opción de intervención viable y potencialmente escalable para mejorar el clima y el ambiente escolar

Effects of kinesio taping alone versus sham taping in individuals with musculoskeletal conditions after intervention for at least one week: a systematic review and meta-analysis.

BACKGROUND: Kinesiotaping (KT), has emerged as an interesting and relatively novel method for treating musculoskeletal conditions. To date, none of the systematic reviews with meta-analysis have addressed the efficacy of KT alone (without any other intervention) over sham taping (ST). OBJECTIVE: The present meta-analysis aimed to investigate the effectiveness of KT versus ST in patients with musculoskeletal conditions in interventions lasting at least 1 week on musculoskeletal conditions and functional performance outcomes. DATA SOURCE: Manual and electronic searches (CENTRAL, EMBASE, MEDLINE and PEDro) were conducted using kinesiotaping, strapping, musculoskeletal pain and musculoskeletal conditions. STUDY SELECTION CRITERIA: Randomised controlled trials on adults with a diagnosis of musculoskeletal conditions. DATA EXTRACTION AND DATA SYNTHESIS: Two researchers independently carried out the search and the third author was referred to for arbitration. The methodological quality of the studies using the PEDro scale and GRADE approach. RESULTS: Six RCTs were identified and included in the meta-analysis. When compared with ST in adults with chronic non-specific low-back pain (LBP), KT resulted in superior effects on pain at follow-up, but the pooled pain in the immediate post-treatment period and disability scores (in the immediate post-treatment period and at follow-up) were not significantly different. Generally, all results were supported by low quality evidence according to GRADE criteria. CONCLUSION: Our findings indicate inconclusive and low-quality evidence of a beneficial effect of KT alone over ST in LBP and knee osteoarthritis. Systematic review registration number: PROSPERO CRD42018084151.