Effects of resistance training on C-reactive protein in menopausal and postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.

IMPORTANCE: Menopause is a biological stage associated with increased cardiovascular morbidity and mortality due to changes in sex hormone levels. OBJECTIVE: This systematic review aimed to investigate the benefits and harms of RT in menopausal and postmenopausal women. EVIDENCE REVIEW: We searched PubMed, Embase, CENTRAL, Scopus, and Web of Science from inception to 2021, and clinical trial registries. Randomized controlled trials (RCT) in menopausal and postmenopausal women that compared women undergoing RT programs with a control group were included. The primary outcomes were C-reactive protein level and adverse events; and, the secondary outcomes were lipid profile and waist circumference. Two reviewers independently selected the studies, extracted data, and assessed the completeness of RT programs, risk of bias, and quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach (GRADE). A random-effects model was used. Statistical significance was set at P < 0.05. FINDINGS: Twelve RCTs published from 2012 to 2020 met the inclusion criteria (n = 482). Four follow-up periods were assessed. RT caused reductions in C-reactive protein levels compared to those in the control group in postmenopausal women in the short- to long-term follow-up (mean difference, -0.47 mg/dL; 95% confidence interval, -0.66 to -0.29; P < 0.00001). Furthermore, RT may reduce C-reactive protein levels even at moderate and moderate-to-high intensity ( P < 0.0001 and P = 0.0005, respectively). Similar findings were found for lipid profiles in the short- to long-term follow-up ( P < 0.05). RT may have had little to no effect on waist circumference. The certainty of the body of evidence was assessed as very low and downgraded owing to serious study limitations, inconsistency, imprecision, and publication bias. CONCLUSIONS AND RELEVANCE: There was very low-quality evidence supporting the benefits of RT compared with control for C-reactive protein levels and lipid profile. No benefits were found for the outcome of waist circumference in postmenopausal women with different comorbidities or risk factors. Safety data were scarce. We have little confidence in the results, and the true effect is likely to be substantially different. Further well-conducted and well-reported RCTs are warranted to strengthen the evidence. PROTOCOL REGISTRATION: PROSPERO CRD42020213125.

Effects of Hypopressive Exercise on Posterior Back Chain Kinematics and Pulmonary Function in Professional Female Basketball Players.

CONTEXT: Hypopressive exercise (HE) has been used as an alternative lumbo-pelvic injury prevention program and claimed to be a means of respiratory and flexibility improvement. However, the possible effects of HE on athletic populations and physical performance remain unclear. OBJECTIVE: Examine the effects of a HE program on posterior back chain kinematics, thoracic mobility, pulmonary function, and lower lumbar pain in female basketball players over an 8-week training period. DESIGN: Prospective (1) baseline, (2) midpoint (4 wk), and (3) after 8 weeks. SETTING: Sports field. PARTICIPANTS: A total of 17 professional female basketball players (mean age 20.7 y, SD: 3.50; body mass index, 21.71, SD: 1.69). INTERVENTION: Participants performed 8 HE weekly sessions of 30 minutes. MAIN OUTCOME MEASURES: Back chain kinematics was assessed with the sit and reach and finger to floor test, and back pain was assessed through numerical rating scale. Respiratory parameters were assessed by spirometry and through thoracic mobility. RESULTS: The analysis of variance revealed significant differences between the 3 measurement periods for thoracic mobility (P > .01); forced expiratory volume in the first second (P < .05) while no statistical differences were found for the rest of spirometry outcomes. Significant differences were also revealed between baseline and after the intervention for the sit and reach test (P > .01), peak expiratory flow (P = .01), and forced expiratory volume in the first 25 seconds (P = .04). Also, significant differences between weeks were found in levels of lumbar pain (P = .003) and the finger to floor test (P = .002). CONCLUSIONS: These preliminary findings suggest that a HE program can improve posterior back chain and chest wall kinematics as well as lower lumbar pain levels. However, no gains seem to be observed for the majority of pulmonary variables except for peak expiratory flow and forced expiratory volume in the first seconds.

Estrategias de prevención neuromuscular para las lesiones de ligamento cruzado anterior sin contacto en jugadoras de baloncesto. Revisión narrativa / Neuromuscular Prevention Strategies for the Non-Contact Anterior Cruciate Ligament Injury in Female Basketball Players. Narrative Review

Resumen Introducción: La lesión del ligamento cruzado anterior sin contacto tiene una mayor incidencia en las mujeres deportistas en edad adolescente. Las características propias del baloncesto (el salto, el aterrizaje o los cambios de dirección que se producen cada 2.0 a 2.82 segundos) junto con las características biomecánicas y hormonales propias de la mujer (mayor valgo de rodillas, laxitud articular y ciclo menstrual) hace que nos encontremos ante un sector poblacional de especial interés para implementar programas de prevención neuromuscular. El objetivo de este estudio ha sido realizar una revisión bibliográfica para proponer un programa de prevención neuromuscular para las lesiones de ligamento cruzado anterior en mujeres jugadoras de baloncesto. Material y método: La búsqueda se realizó en las bases de datos PubMed, SportDiscus y PEDro entre diciembre 2019-enero 2020. Los descriptores "anterior cruciate ligament", "neuromuscular training", "injury rates", "basketball" y "women" se utilizaron como criterio de búsqueda. Resultados: Se analizaron 20 artículos que fueron seleccionados acorde a los criterios de inclusión: estudios que aporten información sobre factores de riesgo y programas de prevención de la lesión de ligamento cruzado anterior en mujeres sanas, atletas/deportistas. Se clasificó la información obtenida según estrategia o información preventiva aportada. Conclusiones: Un programa de prevención neuromuscular para lesiones de ligamento cruzado anterior sin contacto en mujeres jugadoras de baloncesto debe basarse en cuatro aspectos fundamentales: entrenamiento de fuerza de miembro inferior, pliometría, retroalimentación en el aterrizaje y trabajo central de tronco.

Abstract Introduction: Non-contact anterior cruciate ligament injuries have a higher incidence in adolescent female athletes. The characteristics of basketball (jumping and landing), together with women's biomechanical and hormonal characteristics (greater valgus at the knees, joint laxity, and menstrual cycle), make us find ourselves before a population sector of special interest to implement neuromuscular prevention programs. The objective of this study has been a literature review to propose neuromuscular prevention programs for non-contact anterior cruciate ligament injuries in female basketball players. Material and method: The search was conducted in the PubMed, SportDiscus, and PEDro databases between December 2019 and January 2020. The keywords "anterior cruciate ligament," "neuromuscular training," "injury rates," "basketball," and "women" were used as search criteria. Results: 20 articles selected according to the inclusion criteria were analyzed; these studies provided information on risk factors and prevention programs for common anterior ligament injuries in healthy women and athletes. The information obtained was classified according to the preventive strategy provided. Conclusions: A neuromuscular prevention program for non-contact anterior cruciate ligament injuries in female basketball players should be based on four main aspects: lower limb strength training, plyometrics, feedback on the landing, and central trunk work.

Resumo Introdução: A lesão do ligamento cruzado anterior sem contato tem maior incidência em atletas adolescentes do sexo feminino. As características do basquete (salto, aterrissagem ou mudanças de direção que ocorrem a cada 2,0 a 2,82 segundos) juntamente com as características biomecânicas e hormonais da mulher (maior valgo do joelho, frouxidão articular e ciclo menstrual) fazem com que estejamos diante de um setor populacional de especial interesse para implementar programas de prevenção neuromuscular. O objetivo deste estudo foi realizar uma revisão bibliográfica com o objetivo de propor um programa de prevenção neuromuscular de lesões do ligamento cruzado anterior em jogadoras de basquete do sexo feminino. Material e métodos: A busca foi realizada nas bases de dados PubMed, SportDiscus e PEDro entre dezembro de 2019 e janeiro de 2020. Os descritores "ligamento cruzado anterior", "treinamento neuromuscular", "taxas de lesões", "basquetebol" e "mulheres" foram usados como critérios de pesquisa. Resultados: Foram analisados 20 artigos selecionados de acordo com os critérios de inclusão: estudos que fornecem informações sobre fatores de risco e programas de prevenção da lesão do ligamento cruzado anterior em mulheres saudáveis, atletas / esportistas. As informações obtidas foram classificadas de acordo com a estratégia ou informações preventivas fornecidas. Conclusão: Um programa de prevenção neuromuscular para lesões do LCA sem contato em jogadoras de basquete deve ser baseado em quatro aspectos fundamentais: treinamento de força de membros inferiores, pliometria, retroalimentação na aterrissagem e trabalho central.

The effect of exercise training on blood pressure in menopause and postmenopausal women: A systematic review of randomized controlled trials.

The prevalence of hypertension is higher in postmenopausal than in premenopausal women. Regular exercise training has been shown to be effective in addressing hypertension. The aim of this systematic review was to synthesize the effect of exercise training on systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) in menopausal and postmenopausal women. This review was reported according to the PRISMA statement and registered in PROSPERO. The literature search was done in MEDLINE, Embase, Cochrane CENTRAL and ClinicalTrials. Randomized controlled trials involving menopausal and postmenopausal women undergoing exercise training were included. Two blinded reviewers assessed risk of bias in the included studies by using the Cochrane Risk of Bias tool. A random-effects model was used for all analyses. Significance was set at P < 0.05. Compared with the control group, exercise training resulted in clinically significant reductions on SBP (MD -3.43 mmHg; 95% CI, -5.16, -1.71; P < 0.0001), DBP (MD, -2.25 mmHg; 95% CI, -3.40, -1.11; P = 0.0001) and MAP (MD, -3.48 mmHg; 95% CI, -5.84, -1.11; P = 0.004). Aerobic training (AT) did not produce a significant reduction in SBP, DBP and MAP (P >0.05). Combined training (CT) generated larger reductions. Exercise training generated small but clinically relevant reductions in SBP, DBP and MAP in menopausal and postmenopausal women, younger or older than 65 years, with prehypertension or hypertension. AT did not lead to a clinically relevant improvement in blood pressure (BP) in this population. In addition, CT showed the largest reductions in SBP, DBP and MAP.

Effects of a non-pharmacological approach for chronic pain management in patients with haemophilia: efficacy of cognitive-behavioural therapy associated with physiotherapy.

INTRODUCTION: More than half of adult patients with severe haemophilia (PWH) suffer pain daily, with chronic pain (CP) in more than 15% of cases, thereby reducing their quality of life (QoL). However, there are no evidence-based therapeutic guidelines for pain management. AIM: To evaluate the effectiveness of a combined protocol based on psychology and physiotherapy in the improvement of CP self-efficacy in PWH with CP. Secondary outcomes are changes in QoL, emotional status, pain and kinesiophobia. METHODS: In this prospective controlled trial study, recruited patients were allocated either to an experimental group (EG, n = 10) or to a control group (CG, n = 9). EG received interventions over four months: one cognitive-behavioural therapy (CBT) session per month and three home exercise sessions per week. Self-efficacy (Chronic Pain Self-Efficacy Scale), QoL (A36 Hemophilia-QoL), emotional status (Hospital Anxiety and Depression Scale and Rosenberg's Self-esteem Scale), pain (Visual Analogue Scale) and kinesiophobia (Tampa Scale for Kinesiophobia) were assessed at three time points (Week 0, Month 4 and Month 7). The intervention effects were determined with mixed 2-factor ANOVAs. RESULTS: The EG showed a significant improvement (p < .05) in the control of symptoms and pain management scores on the Self-Efficacy Scale, QoL, self-esteem emotional status, pain and kinesiophobia. The intervention effects remained significant (p < .05) over time for pain management, QoL, pain and kinesiophobia. CONCLUSION: The non-pharmacological treatment applied based on CBT and physiotherapy showed to be effective in improving CP self-efficacy, QoL and emotional status, while reducing pain and kinesiophobia in PWH with CP.

The Prevalence of Urinary Incontinence among Adolescent Female Athletes: A Systematic Review.

This review aimed to synthesize the most up-to-date evidence regarding the prevalence of urinary incontinence (UI) among adolescent female athletes. We conducted a systematic review of studies regarding UI in female athletes less than 19 years of age. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRIMSA). The electronic databases of PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science (WOS) were searched between October and November 2020. After blinded peer evaluation, a total of 215 studies were identified and nine were included. Risk of bias was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. This review identified a prevalence of UI in adolescent female athletes between 18% to 80% with an average of 48.58%. The most prevalent sports were trampolining followed by rope skipping. The prevalence of UI among adolescent female athletes practicing impact sports was significantly prevalent. There is a need for further research, education, and targeted interventions for adolescent female athletes with UI.

Feasibility and preliminary efficacy of a hypopressive exercise program on postmenopausal cancer survivors: A pilot study.

BACKGROUND: Cancer-related fatigue (CRF) is a common symptom during and after cancer treatment that negatively affects the patient's quality of life. Exercise is one of the most effective non-pharmacological treatments for CRF. Multimodal exercise therapy programs that include hypopressive exercises, relaxation and myofascial release may be beneficial for CRF. The aim of this pilot study was to evaluate the feasibility and efficacy of a multimodal program on CRF and lower limb functional strength in postmenopausal women diagnosed with cancer. METHODS: 7 postmenopausal women (age = 55.28 years; BMI = 26.05 kg/m2) who had a cancer diagnosis participated in a supervised and progressive 55-min class once per week for 12-weeks. CRF was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Cancer Related Fatigue 12 and lower limb strength was assessed with the sit and stand test. RESULTS: No adverse events were reported during the training period and all participants completed the exercise protocol. There was a significant increase (p = 0.01) in lower limb functional strength (pre: 19.60 (SD = 2.19) vs post: 24.60(SD = 2.19)) with an effect size of d = 2.28 and a decrease in CRF (p = 0.245) (pre: 29.36 ± 24.42; post: 17.85 ± 14.23) with a trivial effect size (d < 0.5). CONCLUSIONS: These preliminary findings indicate that a supervised once per week multimodal program that includes hypopressive exercises for postmenopausal cancer survivors increased lower limb functional strength without exacerbating their CRF. These findings support further randomized trials of hypopressive training programs on patients with cancer.

Effect of a 1-year elastic band resistance exercise program on cardiovascular risk profile in postmenopausal women.

OBJECTIVE: The aim of this study was to investigate the effects of a 1-year progressive resistance training program using elastic bands on cardiovascular profile parameters in sedentary postmenopausal (>12 months' amenorrhea) women. METHODS: This longitudinal prospective experimental study included 38 menopausal women who were randomly divided into two groups: an intervention group (IG, n = 18), who completed a progressive resistance training program with elastic bands over the course of 12 months (six exercises for whole body training, three sets × 10 repetitions), and a control group (CG, n = 20) that did not perform any training. Blood analysis and body composition were determined at baseline and 1 year after intervention. RESULTS: After the 1-year training program, weight, waist circumference, total cholesterol, low-density lipoprotein cholesterol, and C-reactive protein showed a decrease compared with baseline values in the IG, showing a significant (P < 0.05) improvement in cardiovascular profile. Very-low-density lipoprotein, high-density lipoprotein, and triglycerides showed a nonsignificant (P > 0.05) improvement. The CG increased significantly in weight and waist circumference, whereas the rest of the variables remained unchanged. CONCLUSION: One year of progressive resistance training with elastic bands has beneficial effects on anti-inflammatory and anthropometric cardiovascular risk factors in menopausal women, including changes in lipid profile.