Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials
- Miller, Kyle, Areerob, Pinyadapat, Hennessy, Declan, Gonçalves-Bradley, Daniela, Mesagno, Christopher, Grace, Fergal
- Authors: Miller, Kyle , Areerob, Pinyadapat , Hennessy, Declan , Gonçalves-Bradley, Daniela , Mesagno, Christopher , Grace, Fergal
- Date: 2020
- Type: Text , Journal article
- Relation: F1000Research Vol. 9, no. (2020), p. 1-51
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- Description: Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years. Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12 th, 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups. Results: The systematic review included 81 RCTs, with 69 meeting eligibility for the network meta-analysis ( n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges' g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges' g = -0.06, PrI = -0.91, 0.79), mind-body versus aerobic (Hedges' g = -0.12, PrI = -0.95, 0.72), mind-body versus resistance (Hedges' g = -0.06, PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment. Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults, irrespective of severity. Registration: PROSPERO CRD42018115866 (23/11/2018). © 2020 Miller KJ et al.
- Authors: Miller, Kyle , Areerob, Pinyadapat , Hennessy, Declan , Gonçalves-Bradley, Daniela , Mesagno, Christopher , Grace, Fergal
- Date: 2020
- Type: Text , Journal article
- Relation: F1000Research Vol. 9, no. (2020), p. 1-51
- Full Text:
- Reviewed:
- Description: Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years. Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12 th, 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups. Results: The systematic review included 81 RCTs, with 69 meeting eligibility for the network meta-analysis ( n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges' g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges' g = -0.06, PrI = -0.91, 0.79), mind-body versus aerobic (Hedges' g = -0.12, PrI = -0.95, 0.72), mind-body versus resistance (Hedges' g = -0.06, PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment. Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults, irrespective of severity. Registration: PROSPERO CRD42018115866 (23/11/2018). © 2020 Miller KJ et al.
An examination of physical exercise as an adjunct treatment for depressive symptoms in adults aged 65 years and older
- Authors: Miller, Kyle
- Date: 2020
- Type: Text , Thesis , PhD
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- Description: In light of impending demographic shifts and projected strain on healthcare systems, this thesis set out to progress our putative understanding of the benefits of physical exercise on mental health in older adults aged 65 years and over. Herein, four studies of divergent research design interrogated the current knowledge base relating to the potential benefits of exercise in older adults with depressive symptomology. Study 1 set out to establish preliminary experimental evidence that four years of unsupervised aerobic exercise can improve cardiorespiratory function (determined by VO2max) and health-related quality of life (HRQL) in lifelong sedentary ageing men compared with lifelong exercising athletes. Results demonstrated preliminary proof of concept for exercise-induced benefits on cardiorespiratory function and HRQL in ageing men. Study 2 surveyed community-dwelling older adults (n = 586) to establish a hierarchy of exercise-associated factors to predict depressive symptomology. Contrary to expectation, exercise behaviour did not confer additional antidepressant effect, but was substantially predicted by exercise-induced mood, exercise self-efficacy, and social support (f2 = 0.993). Study 3 pooled evidence from randomised controlled trials (RCTs) to quantitatively compare the treatment effectiveness from aerobic, resistance and mind-body exercise training in older adults with pre-existing clinical depression, whereas Study 4 followed the same methodology in apparently health older adults without pre-existing clinical depression. Using network meta-analytical techniques, both clinical depressed (g = -0.41 to -1.38) and apparently healthy (g = -0.27 to -0.51) older adults demonstrated equivalent effectiveness for aerobic, resistance, and mind-body exercise interventions, with encouraging levels of study compliance. Taken together, these findings encourage personal exercise preference when prescribing either aerobic, resistance, or mind-body exercise as a treatment adjunct for clinical depression and older adults with symptoms thereof. The sum of works herein provide new knowledge to guide exercise prescription for stakeholders in mental health and older adults over 65 years.
- Description: Doctor of Philosophy
- Authors: Miller, Kyle
- Date: 2020
- Type: Text , Thesis , PhD
- Full Text:
- Description: In light of impending demographic shifts and projected strain on healthcare systems, this thesis set out to progress our putative understanding of the benefits of physical exercise on mental health in older adults aged 65 years and over. Herein, four studies of divergent research design interrogated the current knowledge base relating to the potential benefits of exercise in older adults with depressive symptomology. Study 1 set out to establish preliminary experimental evidence that four years of unsupervised aerobic exercise can improve cardiorespiratory function (determined by VO2max) and health-related quality of life (HRQL) in lifelong sedentary ageing men compared with lifelong exercising athletes. Results demonstrated preliminary proof of concept for exercise-induced benefits on cardiorespiratory function and HRQL in ageing men. Study 2 surveyed community-dwelling older adults (n = 586) to establish a hierarchy of exercise-associated factors to predict depressive symptomology. Contrary to expectation, exercise behaviour did not confer additional antidepressant effect, but was substantially predicted by exercise-induced mood, exercise self-efficacy, and social support (f2 = 0.993). Study 3 pooled evidence from randomised controlled trials (RCTs) to quantitatively compare the treatment effectiveness from aerobic, resistance and mind-body exercise training in older adults with pre-existing clinical depression, whereas Study 4 followed the same methodology in apparently health older adults without pre-existing clinical depression. Using network meta-analytical techniques, both clinical depressed (g = -0.41 to -1.38) and apparently healthy (g = -0.27 to -0.51) older adults demonstrated equivalent effectiveness for aerobic, resistance, and mind-body exercise interventions, with encouraging levels of study compliance. Taken together, these findings encourage personal exercise preference when prescribing either aerobic, resistance, or mind-body exercise as a treatment adjunct for clinical depression and older adults with symptoms thereof. The sum of works herein provide new knowledge to guide exercise prescription for stakeholders in mental health and older adults over 65 years.
- Description: Doctor of Philosophy
Physiotherapy for freezing of gait in Parkinson's disease: a systematic review and meta-analysis
- Miller, Kyle, Suarez-Iglesias, David, Seijo-Martinez, Manuel, Ayan, Carlos
- Authors: Miller, Kyle , Suarez-Iglesias, David , Seijo-Martinez, Manuel , Ayan, Carlos
- Date: 2020
- Type: Text , Journal article
- Relation: Revista De Neurologia Vol. 70, no. 5 (Mar 2020), p. 161-170
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- Description: Introduction. Freezing of gait (FOG) is one of the most severe symptoms associated with Parkinson's disease (PD). Physiotherapy treatment could be an effective strategy for treating FOG, but no systematic review has been carried out in this regard. Aim. To identify the characteristics, methodological quality, and main outcomes of the studies that have analyzed the effects of physiotherapy interventions in FOG up to date, by performing a systematic review and a meta-analysis. Patients and methods. Four electronic databases were searched in order to find randomized controlled trials that provided information regarding the effects of any kind of physiotherapy treatment on FOG. The methodological quality of the included investigations was assessed by means of the PEDro scale. Results. Twelve studies were identified for inclusion into the qualitative analysis, with four randomized controlled trials included in the final meta-analysis. The quality of the trials was generally good. Those physiotherapy modalities including cues were more effective for treating FOG than traditional physiotherapy approaches. The meta-analysis indicated that physiotherapy interventions had a significantly greater impact on FOG than control comparisons. Conclusions. Physiotherapy treatment, especially those modalities including visual and auditory cueing, should be prescribed to PD patients with FOG. Future studies including PD patients with cognitive impairment and FOG objective measurement tools are need to complete the existing scientific evidence.
- Authors: Miller, Kyle , Suarez-Iglesias, David , Seijo-Martinez, Manuel , Ayan, Carlos
- Date: 2020
- Type: Text , Journal article
- Relation: Revista De Neurologia Vol. 70, no. 5 (Mar 2020), p. 161-170
- Full Text:
- Reviewed:
- Description: Introduction. Freezing of gait (FOG) is one of the most severe symptoms associated with Parkinson's disease (PD). Physiotherapy treatment could be an effective strategy for treating FOG, but no systematic review has been carried out in this regard. Aim. To identify the characteristics, methodological quality, and main outcomes of the studies that have analyzed the effects of physiotherapy interventions in FOG up to date, by performing a systematic review and a meta-analysis. Patients and methods. Four electronic databases were searched in order to find randomized controlled trials that provided information regarding the effects of any kind of physiotherapy treatment on FOG. The methodological quality of the included investigations was assessed by means of the PEDro scale. Results. Twelve studies were identified for inclusion into the qualitative analysis, with four randomized controlled trials included in the final meta-analysis. The quality of the trials was generally good. Those physiotherapy modalities including cues were more effective for treating FOG than traditional physiotherapy approaches. The meta-analysis indicated that physiotherapy interventions had a significantly greater impact on FOG than control comparisons. Conclusions. Physiotherapy treatment, especially those modalities including visual and auditory cueing, should be prescribed to PD patients with FOG. Future studies including PD patients with cognitive impairment and FOG objective measurement tools are need to complete the existing scientific evidence.
Nordic walking for overweight and obese people : a systematic review and meta-analysis
- Sanchez-Lastra, Miguel, Miller, Kyle, Martínez-Lemos, Rodolfo, Giráldez, Antón, Ayán, Carlos
- Authors: Sanchez-Lastra, Miguel , Miller, Kyle , Martínez-Lemos, Rodolfo , Giráldez, Antón , Ayán, Carlos
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Physical Activity and Health Vol. 17, no. 7 (2020), p. 762-772
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- Description: Background: Nordic walking (NW) is a potentially beneficial exercise strategy for overweight and obese people. To date, no reviews have synthesized the existing scientific evidence regarding the effects of NW on this population. This systematic review and meta-analysis aimed to identify the characteristics, methodological quality, and results of the investigations that have studied the effects of NW in overweight and obese individuals. Methods: Six electronic databases were searched up to June 2019 for studies that examined the effects of NW on people with a body mass index ≥ 25 kg/m2. The methodological quality of the included randomized controlled trials was retrieved from the physiotherapy evidence database or evaluated using the physiotherapy evidence database scale. Results: Twelve studies were included in the review. The investigations were mostly good-to-fair methodological quality. NW groups had a significant improvement on parameters such as fasting plasma glucose, abdominal adiposity, and body fat compared with the baseline, but no significant improvements were found when compared with control groups. Conclusions: NW can potentially lead to improvements in parameters related to major health outcomes in overweight and obese people. The lack of control for confounding variables in the analyzed studies prevents further elaboration on its potential benefits. © 2020 Human Kinetics, Inc.
- Authors: Sanchez-Lastra, Miguel , Miller, Kyle , Martínez-Lemos, Rodolfo , Giráldez, Antón , Ayán, Carlos
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Physical Activity and Health Vol. 17, no. 7 (2020), p. 762-772
- Full Text:
- Reviewed:
- Description: Background: Nordic walking (NW) is a potentially beneficial exercise strategy for overweight and obese people. To date, no reviews have synthesized the existing scientific evidence regarding the effects of NW on this population. This systematic review and meta-analysis aimed to identify the characteristics, methodological quality, and results of the investigations that have studied the effects of NW in overweight and obese individuals. Methods: Six electronic databases were searched up to June 2019 for studies that examined the effects of NW on people with a body mass index ≥ 25 kg/m2. The methodological quality of the included randomized controlled trials was retrieved from the physiotherapy evidence database or evaluated using the physiotherapy evidence database scale. Results: Twelve studies were included in the review. The investigations were mostly good-to-fair methodological quality. NW groups had a significant improvement on parameters such as fasting plasma glucose, abdominal adiposity, and body fat compared with the baseline, but no significant improvements were found when compared with control groups. Conclusions: NW can potentially lead to improvements in parameters related to major health outcomes in overweight and obese people. The lack of control for confounding variables in the analyzed studies prevents further elaboration on its potential benefits. © 2020 Human Kinetics, Inc.
Benefits of pilates in Parkinson's Disease : A systematic review and meta-analysis
- Suarez-Iglesias, David, Miller, Kyle, Seijo-Martinez, Manuel, Ayan, Carlos
- Authors: Suarez-Iglesias, David , Miller, Kyle , Seijo-Martinez, Manuel , Ayan, Carlos
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Medicina-Lithuania Vol. 55, no. 8 (2019), p. 1-14
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- Description: Pilates may be a beneficial method of exercise for people with Parkinson's disease (PD). However, no studies have critically reviewed the scientific evidence in this regard. The purpose of this study was to conduct a systematic review and meta-analysis on the effectiveness of Pilates as a rehabilitation strategy for PD. A systematic search of the electronic databases PubMed, PEDro, Scopus, and SPORTDiscus was conducted to identify studies related to the effect of Pilates on PD. The search timeframe ranged from the inception of each database to March 2019. The search resulted in the identification of four randomized controlled trials (RCTs) and four non-RCT studies. The methodological quality of the investigations ranged from poor to fair. The descriptive analysis of the eight investigations showed that Pilates resulted in beneficial effects on fitness, balance and functional autonomy. A subsequent meta-analysis on the four RCTs indicated that Pilates was more effective than traditional training programmes in improving lower limb function. Pilates can be safely prescribed for people with mild-to-moderate PD. Preliminary evidence indicates that its practice could have a positive impact on fitness, balance and physical function. Its benefits on lower-body function appear to be superior to those of other conventional exercises. Future randomized studies with greater samples are needed to confirm these observations.
- Authors: Suarez-Iglesias, David , Miller, Kyle , Seijo-Martinez, Manuel , Ayan, Carlos
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Medicina-Lithuania Vol. 55, no. 8 (2019), p. 1-14
- Full Text:
- Reviewed:
- Description: Pilates may be a beneficial method of exercise for people with Parkinson's disease (PD). However, no studies have critically reviewed the scientific evidence in this regard. The purpose of this study was to conduct a systematic review and meta-analysis on the effectiveness of Pilates as a rehabilitation strategy for PD. A systematic search of the electronic databases PubMed, PEDro, Scopus, and SPORTDiscus was conducted to identify studies related to the effect of Pilates on PD. The search timeframe ranged from the inception of each database to March 2019. The search resulted in the identification of four randomized controlled trials (RCTs) and four non-RCT studies. The methodological quality of the investigations ranged from poor to fair. The descriptive analysis of the eight investigations showed that Pilates resulted in beneficial effects on fitness, balance and functional autonomy. A subsequent meta-analysis on the four RCTs indicated that Pilates was more effective than traditional training programmes in improving lower limb function. Pilates can be safely prescribed for people with mild-to-moderate PD. Preliminary evidence indicates that its practice could have a positive impact on fitness, balance and physical function. Its benefits on lower-body function appear to be superior to those of other conventional exercises. Future randomized studies with greater samples are needed to confirm these observations.
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