Jan Taeymans

The Effect of Exercise on Visceral Adipose Tissue in Overweight Adults: A Systematic Review and Meta-Analysis

Excessive visceral adipose tissue appears to trigger a cascade of metabolic disturbances that seem to coexist with ectopic fat storage in muscle, liver, heart and the ß-cell. Therefore, the reduction of visceral adipose tissue potentially plays a pivotal role in the treatment of the metabolic syndrome. The purpose of this systematic review and meta-analysis is to describe the overall effect of exercise on visceral adipose tissue and to provide an overview of the effect of different exercise regimes, without caloric restriction, on visceral adipose tissue in obese persons. A systematic literature search was performed according to the PRISMA statement for reporting systematic reviews and meta-analyses. The initial search resulted in 87 articles after removing duplicates. After screening on title, abstract and full-text 15 articles (totalling 852 subjects) fulfilled the a priori inclusion criteria. The quality of each eligible study was assessed in duplicate with “The Critical Review Form for Quantitative Studies”. Using random-effects weights, the standardized mean difference (Hedges g) of the change in visceral adipose tissue was −0.497 with a 95% confidence interval of −0.655 to −0.340. The Z-value was −6.183 and the p-value (two tailed) was <0.001. A subgroup analysis was performed based on gender, type of training and intensity. Aerobic training of moderate or high intensity has the highest potential to reduce visceral adipose tissue in overweight males and females. These results suggest that an aerobic exercise program, without hypocaloric diet, can show beneficial effects to reduce visceral adipose tissue with more than 30 cm2 (on CT analysis) in women and more than 40 cm2 in men, even after 12 weeks.

The separation anxiety hypothesis of panic disorder revisited: a meta-analysis.

OBJECTIVE Evidence suggests that childhood separation anxiety disorder may be associated with a heightened risk for the development of other disorders in adulthood. The authors conducted a meta-analysis to examine the relationship between childhood separation anxiety disorder and future psychopathology. METHOD PubMed, PsycINFO, and Embase were searched for studies published through December 2011. Case-control, prospective, and retrospective cohort studies comparing children with and without separation anxiety disorder with regard to future panic disorder, major depressive disorder, any anxiety disorder, and substance use disorders were included in the analysis. Effects were summarized as pooled odds ratios in a random-effects model. RESULTS Twenty-five studies met all inclusion criteria (14,855 participants). A meta-analysis of 20 studies indicated that children with separation anxiety disorder were more likely to develop panic disorder later on (odds ratio=3.45; 95% CI=2.37-5.03). Five studies suggested that a childhood diagnosis of separation anxiety disorder increases the risk of future anxiety (odds ratio=2.19; 95% CI=1.40-3.42). After adjusting for publication bias, the results of 14 studies indicated that childhood separation anxiety disorder does not increase the risk of future depression (odds ratio=1.06; 95% CI=0.78-1.45). Five studies indicated that childhood separation anxiety disorder does not increase the risk of substance use disorders (odds ratio=1.27; 95% CI=0.80-2.03). Of the subgroup analyses performed, differences in comparison groups and sample type significantly affected odds ratio sizes. CONCLUSIONS A childhood diagnosis of separation anxiety disorder significantly increases the risk of panic disorder and any anxiety disorder. These results support a developmental psychopathology conceptualization of anxiety disorders.

Hydration measurements of the stratum corneum: comparison between the capacitance method (digital version of the Corneometer CM 825 ® ) and the impedance method (Skicon-200EX ® )

Measurement of stratum corneum (SC) hydration often involves the use of commercial instruments. The aim of this study was to compare and validate two recent instruments: the Corneometer 825® (digital probe) and the Skicon‐200 EX®.

Muscular activity of different shooting distances, different release techniques, and different performance levels, with and without stabilizers, in target archery

The quadruple approach in the title refers to four different studies over a period of 3 years. The common factor in these studies is the methodology of the (Brussels) Electromyographic Signal Processing and Analysis System (ESPAS), a hardware and software EMG data acquisition system that has constantly been improved. Therefore, the ESPAS methodology is described extensively (i.e. the electrodes, amplifier, tape-recorder and processing hardware). Experiment 1 investigated muscular behaviour in target shooting, both indoors (18 and 25 m) and outdoors (50, 70 and 90 m). It was found (via iEMG) that a significant increase in activity only exists between 25 and 50 m, and that there is no linear increase of activity with increased distance. No differences in muscular pattern (IDANCO system: Clarys and Cabri, 1988) or activity between the indoor distances and between the outdoor distances were found. Experiment 2 investigated the muscular economy of four string grips: the three-finger grip, two-finger grip, thumb grip and reversed grip. The largest variations in activity were found for the two most unfamiliar grips, i.e. the thumb and reversed grips; however, low iEMG and the rapid precision improvement (over a limited number of shots) suggest that the thumb grip, if practised long enough, might be the most economical technique. Experiment 3 attempted to differentiate muscular activity and a number of performance variables in three different populations of archers--Olympic athletes, National competitors and beginners--in order to obtain feedback regarding improved performance. Apparently, overall muscle pattern, intensities and arrow speed were not discriminatory. The differences found between the groups (or levels of skill) were affected by the ability to reproduce identical patterns and arrow velocities in consecutive shots and by the constancy of neuromuscular control of the M. trapezius, M. biceps brachii and M. extensor digitorum. Finally, Experiment 4 investigated the muscular activity of elite archers shooting at distances of 70 and 90 m with and without stabilizers. Differences in iEMG were not supported by differences in precision. Over time, the low iEMG in shooting without stabilizers increases precision and delays fatigue.

Prognostic respiratory parameters in heart failure patients with and without exercise oscillatory ventilation — A systematic review and descriptive meta-analysis

The purpose of this review was to describe the occurrence of prognostic variables as derived from cardiopulmonary exercise testing (CPET) in patients with heart failure (HF), presenting exercise oscillatory ventilation (EOV) compared to patients without EOV. The effect of EOV on peak oxygen consumption (VO2), minute ventilation/carbon dioxide production (VE/VCO2) slope, oxygen uptake efficiency slope (OUES), rest and peak pulmonary end-tidal carbon dioxide pressure (PETCO2) was meta-analysed. A systematic search strategy was performed in five databases (Pubmed, Cochrane Library, PEDro, Science Direct and Web of Science) assessing 252 articles for eligibility. Nineteen citations met the inclusion criteria totalling 3032 patients with HF (EOV=1111; non-EOV=1921). The risk of bias was assessed by two researchers. Extracted data were pooled using random or fixed effects meta-analysis, if appropriate. The level of significance was set at p≤0.05. Overall, the presentation of EOV significantly indicated aggravated prognostic markers. Subgroup analysis revealed left ventricular ejection fraction (LVEF) and mode of CPET protocol as independent factors, whereas defining EOV significantly influenced the results. A meta-analysis of studies reporting hazard ratios for cardiovascular events demonstrated that HF patients with EOV run a fourfold risk for an adverse event compared to HF patients without EOV. In general, these findings suggest that the presence of EOV in patients with HF is associated with a deterioration of the prognostic CPET parameters. Furthermore, EOV can occur in HF patients with reduced as well as preserved ejection fraction. Further research on defining and assessing EOV in a more accurate and reproducible way is required.

The effect of post-exercise cryotherapy on recovery characteristics: a systematic review and meta-analysis

The aim of this review and meta-analysis was to critically determine the possible effects of different cooling applications, compared to non-cooling, passive post-exercise strategies, on recovery characteristics after various, exhaustive exercise protocols up to 96 hours (hrs). A total of n = 36 articles were processed in this study. To establish the research question, the PICO-model, according to the PRISMA guidelines was used. The Cochrane’s risk of bias tool, which was used for the quality assessment, demonstrated a high risk of performance bias and detection bias. Meta-analyses of subjective characteristics, such as delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE) and objective characteristics like blood plasma markers and blood plasma cytokines, were performed. Pooled data from 27 articles revealed, that cooling and especially cold water immersions affected the symptoms of DOMS significantly, compared to the control conditions after 24 hrs recovery, with a standardized mean difference (Hedges’ g) of -0.75 with a 95% confidence interval (CI) of -1.20 to -0.30. This effect remained significant after 48 hrs (Hedges’ g: -0.73, 95% CI: -1.20 to -0.26) and 96 hrs (Hedges’ g: -0.71, 95% CI: -1.10 to -0.33). A significant difference in lowering the symptoms of RPE could only be observed after 24 hrs of recovery, favouring cooling compared to the control conditions (Hedges’ g: -0.95, 95% CI: -1.89 to -0.00). There was no evidence, that cooling affects any objective recovery variable in a significant way during a 96 hrs recovery period.

Effectiveness of Exercise Therapy in Treatment of Patients With Patellofemoral Pain Syndrome: Systematic Review and Meta-Analysis

Background and Purpose This systematic review and meta-analysis was accomplished to determine whether exercise therapy is an effective intervention to reduce pain and patient-reported measures of activity limitations and participation restrictions (PRMALP) in patients with patellofemoral pain. Data Sources and Study Selection Randomized controlled trials in English and German languages published in the MEDLINE, Physiotherapy Evidence Database (PEDro), International Clinical Trials Registry Platform, and Cochrane databases were searched. Eligibility was assessed in 2 stages. The methodological quality of the studies was rated using the PEDro scale. Data were pooled using random-effects meta-analysis, allowing for variability among studies. For clinical use, overall estimates were re-expressed in the original visual analog scale scores. Significance was set at 5%. Data Extraction and Data Synthesis Fifteen studies, with a total of 748 participants, were included and pooled for the meta-analysis. Six studies compared the effect of exercise therapy with a control group receiving neither exercise therapy nor another intervention. Four studies compared the effect of exercise therapy versus additive therapy, and 5 studies compared different exercise interventions. In both comparisons, exercise therapy resulted in strong pain reduction and improvement of PRMALP effects. Significant short-term effects (≤12 weeks) of exercise therapy were found for pain and PRMALP, whereas long-term effects (≥26 weeks) were observed for PRMALP only. Limitations and Conclusion The 15 studies included in this analysis were of variable quality. Large-scale, high-quality randomized controlled trials are needed to further the evaluation of the possible effects of different exercise therapy modalities on patellofemoral pain. This meta-analysis presents evidence that exercise therapy has a strong pain-reducing effect and decreases PRMALP in patients with patellofemoral pain. However, the question of which exercise modality yields the strongest reducing effect on pain and PRMALP remains unanswered.

Developmental changes and predictability of static strength in individuals of different maturity: A 30-year longitudinal study

Abstract This longitudinal study analyses the development and predictability of static strength and their interactions with maturation in youth. Of 515 children followed annually from age 6 to 18 years, 59 males and 60 females were measured again at age 35. Early, average, and late maturity groups were established. Body height and mass were assessed. Static strength was measured using handgrip dynamometry. Pearson correlations were used as tracking coefficients. From 6 to 12 years of age, no static strength differences were found to exist between the maturity groups of both sexes. Static strength is significantly higher in early than in average and late maturing boys (age 13–16). In girls, a dose–response effect exists (age 11–14). Adult static strength predictability is low in early maturing boys and late maturing girls. It is moderate to high (50–76%) in the other maturity groups up to age 14. Predictors for adult static strength are childhood and adolescent handgrip dynamometry (in females only), medicine ball throw, sit-up, hockey ball throw, and 25-m sprint. Handgrip is a fair predictor of adult static strength at most ages in early and average maturing females; in average maturing males, it is a predictor at age 11. Other indicators of strength (e.g. hockey ball throw) are predictors in males.

Pelvic floor muscle activation and strength components influencing female urinary continence and stress incontinence: a systematic review.

A better understanding of pelvic floor muscle (PFM) activation and strength components is a prerequisite to get better insight in PFM contraction mechanisms and develop more specific PFM‐training regimens for female stress urinary incontinence (SUI) patients. The aim of this systematic review (2012:CRD42012002547) was to evaluate and summarize existing studies investigating PFM activation and strength components influencing female continence and SUI.

Therapy modalities to reduce lymphoedema in female breast cancer patients: a systematic review and meta-analysis

The aim of the present study was to evaluate the effects of compression bandages, sleeves, intermittent pneumatic compression (IPC) and active exercise on the reduction of breast cancer-related lymphoedema (BCRL). A systematic literature search up to the year January 2016 was performed in CINAHL, Cochrane Register of Controlled Trials, Embase, International Clinical Trials Registry Platform (WHO), PEDro and PubMed. Inclusion criteria were (1) RCTs, (2) reported adequate statistics for meta-analysis, (3) English or German language. Exclusion criteria were (1) effects of drugs, hormonal, radiation and surgical procedures, (2) studies with children, (3) non-breast cancers, lower extremity oedema, (4) impact on fatigue only, diets or sexually transmitted diseases, (5) cost-analysis only and (6) non-carcinogenic syndromes or (7) prevention of breast cancer. After scoring the methodological quality of the selected studies, data concerning volume reduction of the oedema swelling were extracted. Thirty-two studies were included in this systematic review. Nine studies were selected for the RCT-based studies and 19 studies were included in the pre–post studies-based random-effects meta-analyses. All conclusions should be taken with precautions because of the insufficient quality of the selected papers. Exercise seems beneficial in reducing oedema volume in BCRL. IPC seems beneficial in helping to reduce the oedema volume in the acute phase of treatment. Compression sleeves do not aid in the volume reduction in the acute phase; however, they do prevent additional swelling.