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Time of the day of exercise impact on cardiovascular disease risk factors in adults: a systematic review and meta-analysis.
Sevilla-Lorente, R, Carneiro-Barrera, A, Molina-Garcia, P, Ruiz, JR, Amaro-Gahete, FJ
Journal of science and medicine in sport. 2023;26(3):169-179
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In humans, shifted sleep patterns seem to interfere with several metabolic pathways. Shift work, short sleep duration, exposure to artificial light, inadequate eating time window, and lack of physical activity, are some characteristics of the modern lifestyle that contributes to the occurrence and worsening of cardiovascular disease (CVD). The aim of this study was to analyse the time of the day of exercise-induced effects on CVD risk factors in adults. This study was a systematic review and meta-analysis of twenty-two studies. Results showed that exercise produces an acute reduction of systolic blood pressure independently of the time of the day at which it is performed. Similarly, exercise produces an acute increase in blood glucose independently of the time of the day. Authors concluded that further research is needed to establish whether there is a diurnal variation of exercise on cardiovascular health and how it is related to health status, sex, or the type of exercise.
Abstract
OBJECTIVES To compare the effect of a single bout of morning vs. evening exercise on cardiovascular risk factors in adults. DESIGN Systematic review and meta-analysis. METHODS A systematic search of studies was conducted using PubMed and Web of Science from inception to June 2022. Selected studies accomplished the following criteria: crossover design, acute effect of exercise, blood pressure, blood glucose, and/or blood lipids as the study's endpoint, a washout period of at least 24 h, and adults. Meta-analysis was performed by analyzing: 1) separated effect of morning and evening exercise (pre vs. post); and 2) comparison between morning and evening exercise. RESULTS A total of 11 studies were included for systolic and diastolic blood pressure and 10 studies for blood glucose. Meta-analysis revealed no significant difference between morning vs. evening exercise for systolic blood pressure (g ∆ = 0.02), diastolic blood pressure (g ∆ = 0.01), or blood glucose (g ∆ = 0.15). Analysis of moderator variables (age, BMI, sex, health status, intensity and duration of exercise, and hour within the morning or evening) showed no significant morning vs. evening effect. CONCLUSIONS Overall, we found no influence of the time of the day on the acute effect of exercise on blood pressure neither on blood glucose.
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Effects of multi-domain intervention on intrinsic capacity in older adults: A systematic review of randomized controlled trials (RCTs).
Liao, X, Shen, J, Li, M
Experimental gerontology. 2023;174:112112
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With the increase of age, the physiological reserve of the elderly decreases, which leads to the increase of physical vulnerability and the decrease of anti-stress ability, showing a series of frailty manifestations. Intrinsic capacity (refers to the comprehensive capacity of all physical and mental capacities of an individual) is central to maintaining function in older adults, and maintaining optimal intrinsic capacity is important to promote healthy aging. The aim of this study was to assess randomised controlled trials of multidomain interventions to further validate their effectiveness in the maintenance and enhancement of function in older adults, and to formulate strategies for preventive care and clinical practice. This study was a systematic review and meta-analysis of twenty-five publications. Results showed that multi-domain interventions can improve indicators of vital domains in older adults and integrate to optimise intrinsic capacity (refers to the comprehensive capacity of all physical and mental capacities of an individual) through potential interaction mechanisms. Authors concluded that because older adults may not be able to receive overly complex interventions due to limitations in their integrative abilities, the involvement of older adults and the sustainability of interventions should be considered before implementing them.
Abstract
Intrinsic capacity is central to the maintenance of function in older adults, and maintaining optimal intrinsic capacity is of great importance to promote healthy aging. The purpose of this systematic review and meta-analysis was to analyze the impact of multi-domain interventions on intrinsic capacity in older adults, intervention components, and potential interactions between components. A total of 6740 published articles were screened until August 2022, and the review included 25 randomized controlled trials that analyzed populations, interventions, control groups, and outcomes. The meta-analysis showed improvements in the primary outcome indicators in the intervention group compared to the control group. These included increased scores on the Mini-Mental State Examination as an indicator of cognitive function, decreased scores on the Geriatric Depression Scale (GDS-15) as an indicator of psychological ability and increased scores on the Short Physical Performance Battery (SPPB) as an indicator of physical performance, with only the SPPB indicator analyzed showing greater heterogeneity. Significant improvements were also seen in the secondary indicators Time-to-Walk Test (TUG), gait speed, Chair Stand Test (CST), grip strength values and BMI. There was insufficient data for the Mini Nutritional Assessment (MNA) as an indicator of vitality to conduct a meta-analysis. Studies were of moderate to high quality. The results of this review indicate that multi-domain interventions can maintain the level of intrinsic capacity in older adults and are equally effective in older adults with declining self-care abilities.
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Safety of exercise training in multiple sclerosis: An updated systematic review and meta-analysis.
Learmonth, YC, P Herring, M, Russell, DI, Pilutti, LA, Day, S, Marck, CH, Chan, B, Metse, AP, Motl, RW
Multiple sclerosis (Houndmills, Basingstoke, England). 2023;29(13):1604-1631
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Exercise training represents a rehabilitation-based approach for reversing multiple sclerosis (MS) dysfunction and managing symptoms and should be promoted among persons with MS throughout the disease trajectory. The aim of this study was to quantify the rate of relapse, adverse events (AE) and serious adverse events (SAE) in randomised controlled trials of exercise training in persons with MS. This study was a systematic review and meta-analysis of forty-six exercise interventions. Results showed that in exercise trials with individuals diagnosed with MS, where safety measures were documented, aerobic, strength, or neuromotor exercises conducted under both supervised and unsupervised conditions were deemed safe for those with MS. This conclusion was drawn from two key observations: (1) there were no instances of serious adverse effects reported during exercise sessions, and (2) participants engaging in exercise interventions did not exhibit higher risks of relapse, AE or SAE compared to control participants. Authors concluded that exercise training may be promoted as safe and beneficial to persons with MS.
Abstract
BACKGROUND A review of the safety profile of exercise training in multiple sclerosis (MS) has not been conducted since 2013. OBJECTIVE We undertook a systematic review and meta-analysis of randomised controlled trials (RCTs) of exercise training published since 2013 and quantified estimated population risks of clinical relapse, adverse events (AE) and serious adverse event (SAE). METHODS Articles reporting safety outcomes from comparisons of exercise training with non-exercise among persons with MS were identified. The risk of bias was established from study's internal validity assessed using Physiotherapy Evidence Database (PEDro). Rates and estimated mean population relative risks (RRs; 95% confidence interval (CI)) of safety outcomes were calculated, and random-effects meta-analysis estimated the mean RR. RESULTS Forty-six interventions from 40 RCTs (N = 1780) yielded 46, 40 and 39 effects for relapse, AE, adverse effects and SAE, respectively. The mean population RRs ((95% CI), p-value) for relapse, AE and SAE were 0.95 ((0.61, 1.48), p = 0.82), 1.40 ((0.90, 2.19), p = 0.14) and 1.05 ((0.62, 1.80), p = 0.85), respectively. No significant heterogeneity is observed for any outcome. CONCLUSION In studies that reported safety outcomes, there was no higher risk of relapse, AE, adverse effects or SAE for exercise training than the comparator. Exercise training may be promoted as safe and beneficial to persons with MS.
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Can dementia risk be reduced by following the American Heart Association's Life's Simple 7? A systematic review and dose-response meta-analysis.
Wu, J, Xiong, Y, Xia, X, Orsini, N, Qiu, C, Kivipelto, M, Rizzuto, D, Wang, R
Ageing research reviews. 2023;83:101788
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The American Heart Association (AHA) has defined ideal levels of seven modifiable cardiovascular health (CVH) factors, known as Life's Simple 7, that consist of smoking, physical activity, diet, body mass index, fasting blood glucose, total cholesterol, and blood pressure. Maintaining ideal levels of these factors has been recommended as a prevention strategy against not only cardiovascular diseases but also neurodegenerative disorders, e.g., cognitive decline and dementia. However, studies exploring the beneficial effects of the AHA’s CVH metrics on cognitive outcomes, especially among older populations, have been uncertain, and solid evidence is lacking in this field. This systematic review and meta-analysis aimed to quantify the relationship between the AHA’s CVH metrics and cognitive outcomes. 14 longitudinal studies were included in the meta-analysis. The results showed a considerable effect of a favourable total CVH score on reduced risk of incident dementia in adults aged 70 years or older. When looking at the individual factors, dementia risk can be reduced significantly if older adults achieved the recommended level of physical activity, blood glucose, or total cholesterol. The association with smoking appeared to be borderline, and there was no association between diet, body mass index hazard ratio or blood pressure and dementia risk. The authors concluded that their findings provide evidence that maintaining a favourable level of CVH score, either in mid- or late- life, would substantially reduce the risk of dementia among older adults. Preserving cardiovascular health by quitting smoking, engaging in physical exercise, controlling blood glucose and total cholesterol might be especially effective for forestalling cognitive decline and dementia.
Abstract
This study aimed to quantify the relationships between the American Heart Association (AHA) Cardiovascular Health (CVH) metrics, namely AHA Life's Simple 7, and cognitive outcomes. We searched PubMed and Embase (January 1, 2010-August 24, 2022) and finally included 14 longitudinal studies (311654 participants with 8006 incident dementia cases). Random-effects meta-analysis and one-stage linear mixed-effects models were performed. Increased CVH score seemed to associate with decreased risk of incident dementia in a linear manner, but this relationship varied by the measurement age of CVH metrics. That is, midlife CVH tended to have a linear association with late-life dementia risk, whereas a J-shaped association was observed between the late-life CVH score and dementia. In addition, late-life dementia risk was reduced significantly if individuals maintained an ideal level of AHA's CVH guidelines of physical activity, fasting plasma glucose, total cholesterol, and smoking. However, our meta-analysis did not show a significant association between CVH score and global cognitive decline rate. Following AHA's CVH guidelines and maintaining CVH at an optimal level would substantially reduce the late-life dementia risk. More research is required to explore the link between a favorable CVH score and cognitive trajectories among cognitively asymptomatic older populations.
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Effects of Different Therapeutic Exercise Modalities on Migraine or Tension-Type Headache: A Systematic Review and Meta-Analysis with a Replicability Analysis.
Varangot-Reille, C, Suso-Martí, L, Romero-Palau, M, Suárez-Pastor, P, Cuenca-Martínez, F
The journal of pain. 2022;23(7):1099-1122
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For individuals who suffer from headaches and migraines, the first treatment option is usually drug based, which has been associated with side effects, dependency, and abuse of medications. Exercise may be of benefit to individuals with headache and migraine, as it can stimulate the release of chemicals in the brain, which are beneficial to coping with pain. The aim of this systematic review and meta-analysis was to determine the effect of exercise in comparison to non-active treatment for pain, frequency of headache episodes, headache duration, quality of life and medication use in individuals with migraine or tension headache. The results showed that both aerobic and strength training were of benefit to the intensity of pain, which resulted in a decrease in medication use. Strength training was marginally better for pain than aerobic exercise, however the research that this was based on was of low quality. It was concluded that exercise could be considered a treatment option for those with migraine and headaches, however the evidence that this was based on was of low quality and so more research is needed before clinical recommendations could be made. This study could be used by healthcare professionals to understand that there may be some benefit of exercise for the management of pain in individuals who have migraines and headaches.
Abstract
The primary aim of this study was to review the effect of exercise in comparison with a non-active treatment on pain intensity, frequency of headache episodes, headache duration, quality of life, medication use, and psychological symptoms, in patients with migraine or tension-type headache (TTH). A systematic search was conducted in various electronic databases to identify all relevant studies: Medline (PubMed), PEDro, EBSCO and Google Scholar. Clinical trials assessing the effects of exercise interventions in patients with primary headaches were selected. Methodological quality was evaluated using the Cochrane Risk of Bias Tool and PEDro scale and qualitative analysis was based on classifying the results into levels of evidence according to the GRADE. 19 studies (2776 participants; 85% female) were included. The meta-analysis showed statistically significant differences in pain intensity for aerobic training in patients with migraine (SMD = -0.65; 95% CI = -1.07 to -0.22, very low certainty evidence) and for strength training in patients with TTH (SMD = -0.84; 95% CI = -1.68 to- -0.01, very low certainty evidence). Statistically significant differences were also found in the medication use (SMD = -0.51; 95% CI = -0.85 to -0.17, low certainty evidence). Low transparency, replicability and high risk of bias were found. Aerobic training has a small to moderate clinical effect on pain intensity and medication use on migraine patients, with very low to low certainty of evidence. Strength training showed a moderate clinical effect with very low quality of evidence in patients with TTH. Exercise could be considered as clinically relevant for the management of patients with primary headaches, but the presence of low certainty of evidence and low transparency and replicability limited its clinical application. PERSPECTIVE This article presents current evidence about exercise interventions in patients with primary headaches, including migraine and tension-type headache. Existing findings are reviewed, and relevant data are provided on the effectiveness of each exercise modality, as well as its certainty of evidence and clinical applicability.
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Ergogenic Effects of Acute Caffeine Intake on Muscular Endurance and Muscular Strength in Women: A Meta-Analysis.
Grgic, J, Del Coso, J
International journal of environmental research and public health. 2021;18(11)
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Caffeine is a well-documented ergogenic aid. Among the existing studies that have explored this topic, women are largely underrepresented in the data. The aim of this meta-analysis was to evaluate whether the ergogenic effects of caffeine on strength and endurance known to be true for men could also be extended to women. The analysis included studies that used women as participants and found caffeine to have a significant ergogenic effect on both endurance and strength. When a sub-group analysis differentiated between upper- and lower-body exercises independently, only upper-body performance was improved by caffeine ingestion. Based on the current literature, the authors conclude the ergogenic effects that were previously observed in men are also applicable to women. They suggest further investigation as to why the ergogenic effect differs between upper- and lower-body performance.
Abstract
This meta-analysis aimed to explore the effects of caffeine ingestion on muscular endurance and muscular strength in women. Five databases were searched to find relevant studies. A random-effects meta-analysis of standardized mean differences (SMD) was performed for data analysis. Subgroup meta-analyses explored the effects of caffeine on upper-body and lower-body muscular endurance and muscular strength. Eight crossover placebo-controlled studies were included in the review. In the main meta-analysis that considered data from all included studies, there was a significant ergogenic effect of caffeine on muscular endurance (SMD = 0.25; p = 0.027) and muscular strength (SMD = 0.18; p < 0.001). In a subgroup analysis that considered only upper-body exercises, there was a significant ergogenic effect of caffeine on muscular endurance (SMD = 0.20; p = 0.007) and muscular strength (SMD = 0.17; p < 0.001). In a subgroup analysis that considered only lower-body exercises, there was no significant difference between caffeine and placebo for muscular endurance (SMD = 0.43; p = 0.092) or muscular strength (SMD = 0.16; p = 0.109). The main finding of this meta-analysis is that caffeine ingestion has a significant ergogenic effect on muscular endurance and muscular strength in women. The effects reported in this analysis are similar to those previously observed in men and suggest that women may use caffeine supplementation as an ergogenic aid for muscular performance. Future research is needed to explore the effects of caffeine on lower-body muscular endurance and muscular strength in this population.
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The effectiveness of digital interventions for increasing physical activity in individuals of low socioeconomic status: a systematic review and meta-analysis.
Western, MJ, Armstrong, MEG, Islam, I, Morgan, K, Jones, UF, Kelson, MJ
The international journal of behavioral nutrition and physical activity. 2021;18(1):148
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Low physical activity levels are responsible for many non-communicable diseases and a huge cost to health services. Low socioeconomic status is associated with lower physical activity levels and therefore it is important to increase activity amongst this group of people. The use of digital technologies to increase exercise has become popular in recent years, however it is unknown whether they have differing effectiveness depending on the socioeconomic status of the user. This systematic review and meta-analysis of 19 studies aimed to determine whether digital technologies which target physical activity levels are beneficial for those from low socioeconomic status. The results showed that digital interventions targeting activity have differing effectiveness depending on the socioeconomic status, with those from high socioeconomic status benefitting from these interventions, and those from a low socioeconomic status did not. It was concluded that future technologies need to be tailored to target individuals from low socioeconomic status to improve effectiveness. This study could be used by healthcare professionals to understand that digital technologies designed to increase physical activity may not be sufficient for individuals from a low socioeconomic status and extra support and guidance may be needed.
Abstract
BACKGROUND Digital technologies such as wearables, websites and mobile applications are increasingly used in interventions targeting physical activity (PA). Increasing access to such technologies makes an attractive prospect for helping individuals of low socioeconomic status (SES) in becoming more active and healthier. However, little is known about their effectiveness in such populations. The aim of this systematic review was to explore whether digital interventions were effective in promoting PA in low SES populations, whether interventions are of equal benefit to higher SES individuals and whether the number or type of behaviour change techniques (BCTs) used in digital PA interventions was associated with intervention effects. METHODS A systematic search strategy was used to identify eligible studies from MEDLINE, Embase, PsycINFO, Web of Science, Scopus and The Cochrane Library, published between January 1990 and March 2020. Randomised controlled trials, using digital technology as the primary intervention tool, and a control group that did not receive any digital technology-based intervention were included, provided they had a measure of PA as an outcome. Lastly, studies that did not have any measure of SES were excluded from the review. Risk of Bias was assessed using the Cochrane Risk of Bias tool version 2. RESULTS Of the 14,589 records initially identified, 19 studies were included in the final meta-analysis. Using random-effects models, in low SES there was a standardised mean difference (SMD (95%CI)) in PA between intervention and control groups of 0.06 (- 0.08,0.20). In high SES the SMD was 0.34 (0.22,0.45). Heterogeneity was modest in both low (I2 = 0.18) and high (I2 = 0) SES groups. The studies used a range of digital technologies and BCTs in their interventions, but the main findings were consistent across all of the sub-group analyses (digital interventions with a PA only focus, country, chronic disease, and duration of intervention) and there was no association with the number or type of BCTs. DISCUSSION Digital interventions targeting PA do not show equivalent efficacy for people of low and high SES. For people of low SES, there is no evidence that digital PA interventions are effective, irrespective of the behaviour change techniques used. In contrast, the same interventions in high SES participants do indicate effectiveness. To reduce inequalities and improve effectiveness, future development of digital interventions aimed at improving PA must make more effort to meet the needs of low SES people within the target population.
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Comparing Mindful and Non-Mindful Exercises on Alleviating Anxiety Symptoms: A Systematic Review and Meta-Analysis.
So, WWY, Lu, EY, Cheung, WM, Tsang, HWH
International journal of environmental research and public health. 2020;17(22)
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Physical exercise is well known to be beneficial for physical and mental health, and has been proposed as effective treatment for anxiety symptoms. Recent studies have suggested mindful exercises, such as yoga, tai chi, and qigong, may further alleviate anxiety symptoms, compared with traditional exercise. The aim of this review is to compare the effects of mindful and non-mindful exercise on anxiety. A total of 14 studies were included in this analysis. Overall these studies found a significant decrease in anxiety in both mindful and non-mindful exercise. Eight studies found significantly lower anxiety levels in the mindful exercise group compared with the non-mindful exercise group. Based on these results, the authors conclude in general, exercise helps reduce anxiety and mindful exercise seems to be more effective in alleviating symptoms compared with non-mindful exercise. The authors recommend further studies explore the underlying mechanisms of mindful exercise and encourage yoga to be a primary intervention to help reduce overall anxiety.
Abstract
BACKGROUND In recent years, studies and reviews have reported the therapeutic benefits of both mindful and non-mindful exercises in reducing anxiety. However, there have not been any systematic reviews to compare their relative effectiveness for therapeutic application, especially among the non-clinical population. Thus, the aim of this review is to compare the effectiveness between mindful and non-mindful exercise on treating anxiety among non-clinical samples. METHODS Potential articles were retrieved from PubMed, Embase, Academic Search Premier, and PsycInfo. Randomized controlled trials, which involved both mindful and non-mindful exercises as intervention, and the use of anxiety outcome measures were included. RESULTS Twenty-four studies fulfilled the inclusion criteria and were included in our systematic review. In addition, 14 studies provided sufficient data to be included in the meta-analysis. For studies that reported significant group differences at post-assessment, results showed that mindful exercise was more beneficial in reducing anxiety than non-mindful exercise. The meta-analysis reported that yoga was more effective in reducing anxiety than non-mindful exercise. CONCLUSIONS Compared to non-mindful exercise, yoga is shown to be more effective in alleviating anxiety symptoms. It is recommended that yoga could be used as a primary healthcare intervention to help the public reduce anxiety.
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The effect of aerobic exercise on the number of migraine days, duration and pain intensity in migraine: a systematic literature review and meta-analysis.
Lemmens, J, De Pauw, J, Van Soom, T, Michiels, S, Versijpt, J, van Breda, E, Castien, R, De Hertogh, W
The journal of headache and pain. 2019;20(1):16
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In the age group 15–49 years, migraine is the top cause of years lived with disability, magnifying its impact on the working population. The aim of this study was to summarise the literature published after 2004 on the effect of aerobic exercise in patients with migraine on the number of migraine days, attack duration and pain intensity. This study is a systematic review and meta-analysis of six studies. Result indicate that aerobic exercise can reduce pain intensity (20–54%) in patients with migraine (moderate quality evidence). Furthermore, low quality evidence indicates that aerobic exercise can decrease pain intensity or duration of migraine attacks. Authors conclude that there is moderate evidence that aerobic exercise decreases the number of migraine days.
Abstract
BACKGROUND In patients with frequent migraine, prophylactic treatments are used. Patients often request non-pharmacological alternatives. One treatment option can be aerobic exercise. The value of aerobic exercise as prophylactic treatment however needs to be determined. METHODS A systematic review and meta-analysis was performed to investigate the result of aerobic exercise on the number of migraine days, duration and pain intensity in patients with migraine. After screening three online databases, PubMed, Cochrane library and Web of Science, using predefined in- and exclusion criteria, six studies were retained. Pooling of data was performed when possible. RESULTS Significant reductions in the number of migraine days after aerobic exercise treatment were found with a mean reduction of 0.6 ± 0.3 migraine days/month. Other outcomes were too variable to pool due to heterogeneity of outcome measurements. Unpooled data revealed small to moderate reductions in attack duration (20-27%) and pain intensity (20-54%) after aerobic exercise intervention. Various exercise intensities are applied. CONCLUSION There is moderate quality evidence that in patients with migraine aerobic exercise therapy can decrease the number of migraine days. No conclusion for pain intensity or duration of attacks can be drawn. Effect sizes are small due to a lack of uniformity. For future studies, we recommend standardized outcome measures and sufficiently intense training programs. TRIAL REGISTRATION CRD42018091178 .
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Impact of implementation intentions on physical activity practice in adults: A systematic review and meta-analysis of randomized clinical trials.
Silva, MAVD, São-João, TM, Brizon, VC, Franco, DH, Mialhe, FL
PloS one. 2018;13(11):e0206294
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Many behavioural interventions have been implemented in order to increase physical activity levels among adults. Despite these efforts, there is often a large gap between setting goals and attaining goals. The aim of this systematic review and meta-analysis was to evaluate the effectiveness of using theory-based strategies on goal attainment in promoting physical activity among adults (specifically implementation intentions or if-then planning). Particular interest was given to the impact of reinforcements during the intervention and follow-up period for coping with obstacles. A total of 13 randomised controlled trials were included. Implementation intentions consisted of two strategies. Firstly, action planning which was designed to increase awareness of possible future situations where behaviours could be achieved. Secondly, coping planning which focused on barriers that might impede the goal behaviour, and ways to overcome these possible barriers. According to the current literature, application of the theory-based goal setting promoted physical activity behaviours, and this was heightened among those who received reinforcement of plans to increase physical activity during the follow-up period.
Abstract
OBJECTIVE The aim of this study was to verify the efficacy of using theory-based strategies on implementation intentions in promoting physical activity (PA) among adults. METHODS This review was conducted in accordance with the PRISMA recommendations. The search was carried out in seven electronic databases (LILACS, PubMed, SciELO, Cochrane, Web of Science) and two searches of the "grey literature" were performed (Openthesis and OpenGrey). Randomized clinical trials (RCT), published up to September 2016, were considered eligible for this study. Two reviewers independently and systematically evaluated the eligibility criteria, and performed data extraction. A meta-analysis was performed for the purpose of comparing the effect between the intervention and control groups. The effect sizes were grouped in two subgroups with the purpose of more accurately verifying the effect caused by reinforcing the implementation intentions strategy, and using the inverse variance statistical method with random effects models to estimate the main effect of the implementation intention strategy on the PA behavior. Heterogeneity among the studies was evaluated by using I-square statistics, and the Jadad scale to evaluate the quality of included papers. RESULTS The search resulted in 12,147 records, of which 13 RCTs were considered eligible for this review. Sample age ranged from 18 to 76 years, and participants had conditions such as medullary lesion, coronary disease, obesity, diabetes mellitus, sedentarism or occupational stress. When the summary of the effect was analyzed in the meta-analysis, the result found in the subgroup with reinforcement of the implementation intentions strategy was 0.25 (IC 95% = 0.05-0.45) in favor of the intervention group. This demonstrated that application of the implementation intentions strategy was capable of increasing PA practice in the participants of these studies, in comparison with others that did not use this reinforcement. CONCLUSION The findings of this review indicated that application of the theory of implementation intentions promoted PA behavior among the adults who received reinforcement of this strategy. The systematic review protocol was registered in the PROSPERO database under the number CRD42018090482.