Exercise training improves participation in persons with multiple sclerosis: A systematic review and meta-analysis

BackgroundAlthough previous studies have examined the effects of exercise training on other International Classification of Functioning, Disability and Health (ICF) component levels in persons with multiple sclerosis (MS), the effects of exercise training on participation remain unclear. The objectives of this review were to: (1) characterize systematically the use of outcome measures that capture participation in exercise training studies; (2) quantify the effect of exercise training on participation in persons with MS.MethodsA search of 6 electronic databases (CINAHL, SPORTDiscuss, Embase, MEDLINE, Cochrane Central, and Scopus) was conducted to identify controlled and noncontrolled trials involving exercise training and participation in persons with MS. Search strings were built from Medical Subject Headings and CINAHL headings. ICF linking rules were used to identify participation chapters and categories captured. Meta-analysis was used to quantify the effect of exercise training on participation in randomized controlled trials comparing exercise effects to no intervention/usual care.ResultsWe included 49 articles involving controlled and noncontrolled exercise trials in the systematic review of outcome measures. We captured 16 different outcome measures that captured all 9 participation chapters and identified 89 unique participation categories. Across these 16 outcome measures, mobility was the most commonly represented participation chapter, with 108 items. A subsample of 23 randomized controlled trials was included in the meta-analysis. An overall effect of 0.60 (standard error = 0.12, 95% confidence interval: 0.36–0.84, z = 4.9, p < 0.001) was calculated, indicating a moderate, positive effect of exercise training on participation.ConclusionThe current review provides information that can be used to guide the selection of outcome measures that capture participation in studies of exercise training in persons with MS. Exercise training has a positive effect on outcomes that capture participation, providing further evidence for the role of exercise training in promoting and maintaining engagement in everyday life.     

中等强度有氧运动对高血脂患者血脂水平影响的元分析——基于随机对照试验的证据

目的: 评价中等强度有氧运动对高血脂患者血脂水平的影响效果。方法: 检索Google Scholar、PubMed、Web of Science(WOS)、EMBASE、维普、知网和万方数据库中关于中等强度有氧运动干预高血脂患者血脂水平的随机对照试验(RCT),检索期限从各数据库收录时间起至2020年12月。采用Stata 14.0 软件进行meta分析。结果: 共纳入13个RCT,826例患者。与对照组相比,中等强度有氧运动对高血脂患者总胆固醇(TC)(SMD=-0.94,95% CI-0.15~-0.74, P<0.001)、甘油三酯(TG)(SMD=-0.95,95%CI:-1.41~-0.50, P<0.001)、高密度脂蛋白胆固醇(HDL-C)(SMD=0.95(95%CI: 0.79~-1.11,P<0.001),低密度脂蛋白胆固醇(LDL-C)(SMD=-1.36(95%CI:-1.53~-1.19,P< 0.001)水平均有显著影响。结论: 中等强度有氧运动降低了血清中TC总量、TG和LDL-C水平,升高了HDL-C水平。每周6~7次、每次30~90分钟、坚持24~48周的中等轻度有氧运动可以作为高血脂患者改善血脂水平的运动处方。鉴于该研究还存在一定的局限性,仍需高质量的RCT予以论证。     

太极拳对原发性高血压患者降压效果的系统评价与Meta分析

目的：本研究系统评价太极拳运动对原发性高血压患者血压指标的影响并进行Meta分析,以期为临床工作提供较为可靠的参酌依据。方法：收集太极拳对原发性高血压患者血压影响的随机对照试验,应用Cochrane偏倚风险评估工具对纳入研究进行方法学质量评价,Stata15.0软件进行Meta分析。结果：依据排除标准,研究共纳入15篇随机对照试验,其中低、中、高风险文献分别为6篇、8篇和1篇。纳入研究总样本量732个,其中实验组316个,对照组416个。Meta分析发现,实验组对原发性高血压患者收缩压和舒张压的改善效果优于对照组;亚组分析显示,太极拳可明显改善65岁以下患者的收缩压和舒张压;多因素Meta回归分析未能解释研究间异质性的来源,敏感性分析剔除2篇质量较差的文献后,同质性较好。Egger检验显示,太极拳影响收缩压的文献存在显著发表偏倚,影响舒张压的文献无显著发表偏倚。结论：基于现有证据,太极拳对原发性高血压患者收缩压和舒张压的干预是有效的,应在原发性高血压的治疗中得到重视和推广。     

Does exercise have a protective effect on cognitive function under hypoxia? A systematic review with meta-analysis

ObjectiveThis study aimed to examine (1) the independent effects of hypoxia on cognitive function and (2) the effects of exercise on cognition while under hypoxia.MethodsDesign: Systematic review with meta-analysis. Data sources: PubMed, Scopus, Web of Science, PsychInfo, and SPORTDiscus were searched. Eligibility criteria for selecting studies: randomized controlled trials and nonrandomized controlled studies that investigated the effects of chronic or acute exercise on cognition under hypoxia were considered (Aim 2), as were studies investigating the effects of hypoxia on cognition (Aim 1).ResultsIn total, 18 studies met our inclusionary criteria for the systematic review, and 12 studies were meta-analyzed. Exposure to hypoxia impaired attentional ability (standardized mean difference (SMD) = –0.4), executive function (SMD = –0.18), and memory function (SMD = –0.26), but not information processing (SMD = 0.27). Aggregated results indicated that performing exercise under a hypoxia setting had a significant effect on cognitive improvement (SMD = 0.3, 95% confidence interval: 0.14 – 0.45, I² = 54%, p < 0.001). Various characteristics (e.g., age, cognitive task type, exercise type, exercise intensity, training type, and hypoxia level) moderated the effects of hypoxia and exercise on cognitive function.ConclusionExercise during exposure to hypoxia improves cognitive function. This association appears to be moderated by individual and exercise/hypoxia-related characteristics.     

The effect of exercise and diet on mental health and quality of life in middle-aged individuals with elevated risk factors for cardiovascular disease.

Mental health and quality of life were assessed before and after a one-year exercise and diet intervention among 219 healthy individuals, aged 41-50 years, with elevated risk factors for cardiovascular disease. The participants were randomized to four groups: diet (n = 55), diet and exercise (n = 67), exercise (n = 54) and no active intervention (n = 43). Quality of life was measured with one eight-item scale and two one-item scales. Mental health was measured by the General Health Questionnaire (30-item version). Depression, anxiety, feelings of competence and self-esteem, coping and social dysfunction were measured using subscales of the General Health Questionnaire. Somatic anxiety was measured by the anxiety subscale of the Symptom Check List-90. Exercise improved the total GHQ scores, perceived competence/self-esteem, and coping as measured by the GHQ subscales. There were no significant effects of diet or exercise on quality of life, depression or anxiety. A high rate of participation in the exercise programme (>70%) was associated with greater improvements in total GHQ scores, anxiety, perceived competence/self-esteem and coping.     

The effect of exercise interventions on resting metabolic rate: A systematic review and meta-analysis

ABSTRACT

The systematic review and meta-analysis evaluated the effect of aerobic, resistance and combined exercise on RMR (kCal·day^-1) and performed a methodological assessment of indirect calorimetry protocols within the included studies. Subgroup analyses included energy/diet restriction and body composition changes. Randomized control trials (RCTs), quasi – RCTs and cohort trials featuring a physical activity intervention of any form and duration excluding single exercise bouts were included. Participant exclusions included medical conditions impacting upon RMR, the elderly (≥65 years of age) or pregnant, lactating or post-menopausal women. The review was registered in the International Prospective Register of Systematic Reviews (CRD 42,017,058,503). 1669 articles were identified; 22 were included in the qualitative analysis and 18 were meta-analysed. Exercise interventions (aerobic and resistance exercise combined) did not increase resting metabolic rate (mean difference (MD): 74.6 kCal·day^-1[95% CI: ?13.01, 161.33], P = 0.10). While there was no effect of aerobic exercise on RMR (MD: 81.65 kCal·day^-1[95% CI: ?57.81, 221.10], P = 0.25), resistance exercise increased RMR compared to controls (MD: 96.17 kCal·day^-1[95% CI: 45.17, 147.16], P = 0.0002). This systematic review effectively synthesises the effect of exercise interventions on RMR in comparison to controls; despite heterogenous methodologies and high risk of bias within included studies.     

The effects of carbohydrate supplementation on immune responses to a soccer-specific exercise protocol

The aim of this study was to determine the effect of carbohydrate (CHO) versus placebo (PLA) beverage consumption on the immune and plasma cortisol responses to a soccer-specific exercise protocol in 8 university team soccer players. In a randomized, counterbalanced design, the players received carbohydrate or placebo beverages before, during and after two 90 min soccer-specific exercise bouts (3 days apart) designed to mimic the activities performed and the distance covered in a typical soccer match. Blood and saliva samples were collected before, during and after the exercise protocol. Plasma lactate concentration increased to approximately 4 mmol x l(-1) at 45 and 90 min of exercise in both treatments (P<0.01). Plasma glucose concentration was significantly lower after 90 min of exercise with ingestion of the placebo than the carbohydrate (PLA: 4.57+/-0.12 mmol x l(-1); CHO: 5.49+/-0.11 mmol x l(-1); P<0.01). The pattern of change in plasma cortisol, circulating lymphocyte count and saliva immunoglobulin A secretion did not differ between the carbohydrate and placebo trials. Blood neutrophil counts were 14% higher 1 h after the placebo trial than the carbohydrate trial (PLA: 4.8+/-0.5x10(9) cells x l(-1); CHO: 4.2+/-0.5x10(9) cells x l(-1); P = 0.06), but the treatment had no effect on the degranulation response of blood neutrophils stimulated by bacterial lipopolysaccharide. We conclude that, although previous studies have shown that carbohydrate feeding is effective in attenuating immune responses to prolonged continuous strenuous exercise, the same cannot be said for a soccer-specific intermittent exercise protocol. When overall exercise intensity is moderate, and changes in plasma glucose, cortisol and immune variables are relatively small, it would appear that carbohydrate ingestion has only a minimal influence on the immune response to exercise.     

体育锻炼延缓老年人认知衰退量效关系的专家共识

检索国内外5个大型电子数据库中关于体育锻炼干预老年人认知功能的随机对照试验,按英国牛津循证医学中心认定的证据水平评价标准,对纳入文献进行分级,统计与分析体育锻炼各变量对认知功能的影响效果,形成体育锻炼延缓老年人认知衰退量效关系的专家共识。结果显示:有氧运动对执行功能的干预效果较好,推荐方案为每周3次,中等强度,每次30~60 min,锻炼周期为12~24周;抗阻运动对执行功能干预效果较好,推荐方案为每周锻炼2次,中、高强度,每次60 min,锻炼周期为24周;多成分运动对整体认知、记忆、执行功能均具有良好的干预效果,推荐方案为每周锻炼3~4次,中等强度,每次30~60 min,锻炼周期为12~24周;中国民族传统体育对整体认知功能干预效果较好,推荐方案为每周锻炼3~5次以上,中等强度,每次锻炼30~60 min,锻炼周期为12~24周。     

The effects of carbohydrate supplementation on immune responses to a soccer-specific exercise protocol

The aim of this study was to determine the effect of carbohydrate (CHO) versus placebo (PLA) beverage consumption on the immune and plasma cortisol responses to a soccer-specific exercise protocol in 8 university team soccer players. In a randomized, counterbalanced design, the players received carbohydrate or placebo beverages before, during and after two 90min soccer-specific exercise bouts (3 days apart) designed to mimic the activities performed and the distance covered in a typical soccer match. Blood and saliva samples were collected before, during and after the exercise protocol. Plasma lactate concentration increased to ~4 mmol.l-1 at 45 and 90 min of exercise in both treatments (P? 0.01). Plasma glucose concentration was significantly lower after 90 min of exercise with ingestion of the placebo than the carbohydrate (PLA: 4.57 +/- 0.12 mmol.l-1; CHO: 5.49 +/- 0.11 mmol.l-1; P? 0.01). The pattern of change in plasma cortisol, circulating lymphocyte count and saliva immunoglobulin A secretion did not differ between the carbohydrate and placebo trials. Blood neutrophil counts were 14% higher 1 h after the placebo trial than the carbohydrate trial (PLA: 4.8 =/- 0.5 x 10 9 cells.l-1; CHO:4.2 +/- 0.5 x 10 9 cells.l-1; P=0.06),but the treatment had no effect on the degranulation response of blood neutrophils stimulated by bacterial lipopolysaccharide. We conclude that, although previous studies have shown that carbohydrate feeding is effective in attenuating immune responses to prolonged continuous strenuous exercise, the same cannot be said for a soccer-specific intermittent exercise protocol. When overall exercise intensity is moderate,and changes in plasma glucose, cortisol and immune variables are relatively small, it would appear that carbohydrate ingestion has only a minimal influence on the immune response to exercise.     

Caffeine withdrawal and high-intensity endurance cycling performance

In this study, we investigated the impact of a controlled 4-day caffeine withdrawal period on the effect of an acute caffeine dose on endurance exercise performance. Twelve well-trained and familiarized male cyclists, who were caffeine consumers (from coffee and a range of other sources), were recruited for the study. A double-blind placebo-controlled cross-over design was employed, involving four experimental trials. Participants abstained from dietary caffeine sources for 4 days before the trials and ingested capsules (one in the morning and one in the afternoon) containing either placebo or caffeine (1.5 mg · kg(-1) body weight · day(-1)). On day 5, capsules containing placebo or caffeine (3 mg · kg(-1) body weight) were ingested 90 min before completing a time trial, equivalent to one hour of cycling at 75% peak sustainable power output. Hence the study was designed to incorporate placebo-placebo, placebo-caffeine, caffeine-placebo, and caffeine-caffeine conditions. Performance time was significantly improved after acute caffeine ingestion by 1:49 ± 1:41 min (3.0%, P = 0.021) following a withdrawal period (placebo-placebo vs. placebo-caffeine), and by 2:07 ± 1:28 min (3.6%, P = 0.002) following the non-withdrawal period (caffeine-placebo vs. caffeine-caffeine). No significant difference was detected between the two acute caffeine trials (placebo-caffeine vs. caffeine-caffeine). Average heart rate throughout exercise was significantly higher following acute caffeine administration compared with placebo. No differences were observed in ratings of perceived exertion between trials. A 3 mg · kg(-1) dose of caffeine significantly improves exercise performance irrespective of whether a 4-day withdrawal period is imposed on habitual caffeine users.     

Effects of exercise by type and duration on quality of life in patients with digestive system cancers: A systematic review and network meta-analysis

BackgroundThere is scant evidence regarding the effects of exercise type and duration on quality of life (QoL) in digestive system cancer (DSC) survivors. We aim to investigate the optimal type and duration of exercise to improve QoL for DSC survivors through a systematic review and network meta-analysis.MethodsA systematic literature search of PubMed, Embase, and Web of Science was performed. Eligibility for study inclusion was limited to studies that were randomized controlled trials involving all kinds of exercise in adult patients with DSCs, and the comparator was in standard care or other types of exercise. The primary outcome was QoL, including general health, physical health, mental health, and role function. Secondary outcomes included cancer-related symptoms such as fatigue, insomnia, depression, anxiety, and duration of hospital stay. The network meta-analyses were performed using a random-effect model.ResultsThe analysis included 32 eligible articles and a total of 2558 participants. Our primary outcome indicated that short-term aerobic exercise significantly enhanced general health (standardized mean difference (SMD) = 0.66, 95% credible intervals (CrIs): 0.05 to 1.30), and also contributed to a better mental health (SMD = 0.38, 95%CrI: –0.05 to 0.81) and role function (SMD = 0.48, 95%CrI: –0.27 to 1.20). Although without significant changes, short-term resistance exercise tended to increase the physical health of patients with DSCs (SMD = 0.69, 95%CrI: –0.07 to 1.50) and effective in alleviating fatigue (SMD = –0.77, 95%CrI: –1.50 to 0.01). Short-term aerobic exercise was related to a lower score of insomnia (SMD = –1.20, 95%CrI: –2.40 to 0.06), depression (SMD = –0.51, 95%CrI: –1.50 to 0.45), and anxiety (SMD = –0.45, 95%CrI: –1.30 to 0.34). All types of exercise related to a trend of declined hospital stays (–0.87 to –5.00 day). Long-term resistance exercise, however, was negatively associated with general health (SMD = –0.33, 95%CrI: –1.70 to 1.00), physical health (SMD = –0.18, 95%CrI: –1.30 to 0.90), and role function (SMD = –1.20, 95%CrI: –2.50 to 0.11).ConclusionThis study suggests that short-term aerobic exercise, with or without resistance exercise programs, enhances QoL (especially for general health) as well as relieves cancer-related symptoms for DSC survivors, while long-term resistance exercise may have negative effects, and thus should be adopted cautiously. These results provide important evidence for the management of DSCs.     

Effects of caffeine on time trial performance in sedentary men

Abstract It is not known if ergogenic effects of caffeine ingestion in athletic groups occur in the sedentary. To investigate this, we used a counterbalanced, double-blind, crossover design to examine the effects of caffeine ingestion (6 mg?·?kg(-1) body-mass) on exercise performance, substrate utilisation and perceived exertion during 30 minutes of self-paced stationary cycling in sedentary men. Participants performed two trials, one week apart, after ingestion of either caffeine or placebo one hour before exercise. Participants were instructed to cycle as quickly as they could during each trial. External work (J?·?kg(-1)) after caffeine ingestion was greater than after placebo (P?=?0.001, effect size [ES]?=?0.3). Further, heart rate, oxygen uptake and energy expenditure during exercise were greater after caffeine ingestion (P?=?0.031, ES?=?0.4; P?=?0.009, ES?=?0.3 and P?=?0.018, ES?=?0.3; respectively), whereas ratings of perceived exertion and respiratory exchange ratio values did not differ between trials (P?=?0.877, ES?=?0.1; P?=?0.760, ES?=?0.1; respectively). The ability to do more exercise after caffeine ingestion, without an accompanying increase in effort sensation, could motivate sedentary men to participate in exercise more often and so reduce adverse effects of inactivity on health.     

Graduated compression stockings: physiological and perceptual responses during and after exercise

The aim of this study was to examine the effect of wearing graduated compression stockings on physiological and perceptual variables during and after intermittent (Experiment 1) and continuous (Experiment 2) running exercise. Fourteen recreational runners performed two multi-stage intermittent shuttle running tests with 1 h recovery between tests (Experiment 1). A further 14 participants performed a fast-paced continuous 10-km road run (Experiment 2). Participants wore commercially available knee-length graduated compression stockings (pressure at ankle 18 - 22 mmHg) beneath ankle-length sports socks (experimental trials) or just the latter (control trials) in a randomized counterbalanced design (for both experiments). No performance or physiological differences were observed between conditions during intermittent shuttle running. During the 10-km trials, there was a reduction in delayed-onset muscle soreness 24 h after exercise when wearing graduated compression stockings (P < 0.05). There was a marked difference in the frequency and location of soreness: two participants in the stockings trial but 13 participants in the control trial indicated soreness in the lower legs. Wearing graduated compression stockings during a 10-km road run appears to reduce delayed-onset muscle soreness after exercise in recreationally active men.     

A single session of resistance exercise does not reduce postprandial lipaemia

This study investigated the effect of a single session of resistance exercise on postprandial lipaemia. Eleven healthy normolipidaemic men with a mean age of 23 (standard error = 1.4) years performed two trials at least 1 week apart in a counterbalanced randomized design. In each trial, participants consumed a test meal (1.2 g fat, 1.1 g carbohydrate, 0.2 g protein and 68 kJ x kg(-1) body mass) between 08.00 and 09.00 h following a 12 h fast. The afternoon before one trial, the participants performed an 88 min bout of resistance exercise. Before the other trial, the participants were inactive (control trial). Resistance exercise was performed using free weights and included four sets of 10 repetitions of each of 11 exercises. Sets were performed at 80% of 10-repetition maximum with a 2 min work and rest interval. Venous blood samples were obtained in the fasted state and at intervals for 6 h postprandially. Fasting plasma triacylglycerol (TAG) concentration did not differ significantly between control (1.03 +/- 0.13 mmol x l(-1)) and exercise (0.94 +/- 0.09 mmol x l(-1)) trials (mean +/- standard error). Similarly, the 6 h total area under the plasma TAG concentration versus time curve did not differ significantly between the control (9.84 +/- 1.40 mmol l(-1) x 6 h(-1)) and exercise (9.38 +/- 1.12 mmol x l(-1) x 6 h(-1)) trials. These findings suggest that a single session of resistance exercise does not reduce postprandial lipaemia.     

A critical review of the current evidence examining whether resistance training improves time trial performance

A number of reviews have concluded that resistance training is beneficial for improving sports performance despite the inclusion of studies which do not actually measure a performance outcome (i.e. a timed trial). The purpose of this review was to examine only those studies which would allow us to infer the benefits of resistance training on improving time trial performance. Of the nine studies meeting all inclusion criteria only three demonstrated an additive effect of adding resistance training to the current activity-specific training being performed. These three studies demonstrated improvements in either 5 or 10 km time trial among recreationally skilled athletes (i.e. non-elite level time). Previous reviews have included studies which did not include: (1) performance outcomes; (2) control groups; and/or (3) equal volumes of activity-specific exercise among the resistance training and control groups. Presently, there is little evidence that adding resistance exercise to a sport-specific training program will augment time trial performance. While it is difficult to perform such long-term studies assessing the effects of resistance training among time trial athletes, the statement that resistance training is efficacious for improving time trial performance should be tempered until sufficient evidence is presented to support such claims.     

No effect of fluid intake on neutrophil responses to prolonged cycling

Ingesting carbohydrate beverages during prolonged exercise is associated with fewer numbers of circulating neutrophils and attenuated neutrophil functional responses, yet there is little information about the effect of fluid intake alone on immune responses to prolonged exercise. The aim of this study was to examine the influence of regular fluid ingestion compared with no fluid ingestion on plasma cortisol, circulating neutrophil and lipopolysaccharide (LPS)-stimulated neutrophil degranulation responses to prolonged cycling. In a randomized design, nine recreationally active males cycled for 2 h at 65% VO2max on two occasions with either fluid ingestion (lemon-flavoured water, fluid trial) before and during the exercise, or with no fluid intake at all (no fluid trial). Venous blood samples were obtained at rest, immediately after exercise and 1 h after exercise. Immediately after exercise, the plasma cortisol concentration was significantly higher in the no fluid trial than in the fluid trial (592 +/- 62 vs 670 +/- 63 nmol x l(-1), P < 0.05). Circulating numbers of neutrophils increased 4.5-fold (P < 0.01) and LPS-stimulated elastase release per neutrophil decreased 34 +/- 7% (P < 0.01) immediately after exercise; there were no differences between trials. These results suggest that in ambient environmental conditions, fluid ingestion alone has a negligible effect on circulating neutrophil and LPS-stimulated neutrophil degranulation responses to prolonged exercise.     

Time-restricted feeding in young men performing resistance training: A randomized controlled trial†

A randomized controlled trial was conducted to examine eight weeks of resistance training (RT) with and without time-restricted feeding (TRF) in order to assess nutrient intake and changes in body composition and muscular strength in young recreationally active males. The TRF programme consisted of consuming all calories within a four-hour period of time for four days per week, but included no limitations on quantities or types of foods consumed. The RT programme was performed three days per week and consisted of alternating upper and lower body workouts. For each exercise, four sets leading to muscular failure between 8 and 12 repetitions were employed. Research visits were conducted at baseline, four, and eight weeks after study commencement. Measurements of total body composition by dual-energy X-ray absorptiometry and muscle cross-sectional area by ultrasound were obtained. Upper and lower body strength and endurance were assessed, and four-day dietary records were collected. TRF reduced energy intake by ～650?kcal per day of TRF, but did not affect total body composition within the duration of the study. Cross-sectional area of the biceps brachii and rectus femoris increased in both groups. Effect size data indicate a gain in lean soft tissue in the group that performed RT without TRF (+2.3?kg, d?=?0.25). Upper and lower body strength and lower body muscular endurance increased in both groups, but effect sizes demonstrate greater improvements in the TRF group. Overall, TRF reduced energy intake and did not adversely affect lean mass retention or muscular improvements with short-term RT in young males.     

Gross cycling efficiency is not altered with and without toe-clips

The aim of this study was to examine the claim that reductions of 8-18% in submaximal oxygen consumption (VO2) could be due to changing components on a Monark ergometer, from standard pedals without toe-clips or straps (flat pedals) to racing pedals of that era, which included toe-clips and straps (toe-clip pedals). This previously untested assertion was evaluated using 11 males (mean age 22.3 years, s= 1.2; height 1.82 m, s= 0.07; body mass 82.6 kg, s= 8.8) who completed four trials in a randomized, counterbalanced order at 60 rev min(-1) on a Monark cycle ergometer. Two trials were completed on flat pedals and two trials on toe-clip pedals. The Douglas bag method was used to assess VO2 and gross efficiency during successive 5-min workloads of 60, 120, 180, and 240 W. The mean VO2 was 2.1% higher for toe-clip pedals than flat pedals and there was a 99% probability that toe-clip pedals would not result in an 8% lower VO2. These results indicate that toe-clip pedals do not reduce VO2.     

步行锻炼对更年期焦虑症患者生活质量的影响

为了进一步观察步行锻炼对更年期焦虑症患者焦虑水平的影响和步行锻炼对更年期焦虑症患者生活质量的影响。对41例更年期焦虑症患者每天进行30 min以上的匀速步行锻炼,持续2个月,同时给予药物治疗。40例对照组仅进行药物治疗。于开始步行锻炼和药物治疗前以及治疗结束后1周内,分别采用汉密尔顿焦虑量表（HAMA）对两组患者进行焦虑水平评定分析,采用健康调查简易量表（SF-36）评定其生活质量。结果表明：两组HAMA评分均下降,但步行锻炼组下降程度较对照组更显著（P〈0.01）。治疗后两组患者SF-36各维度评分均较治疗前明显提高;治疗后步行锻炼组SF-36大部分项目评分明显高于对照组（P〈0.05）,其中MH的差异具有非常显著性意义（P〈0.01）,但BP的差异无显著性（P〉0.05）。结论：短期步行锻炼能显著改善更年期焦虑症患者的焦虑水平,提高患者的生活质量。     

Effectiveness of psychological intervention following sport injury

With increasing attention given to the development and implementation of psychological interventions during the sport injury rehabilitation process, there is a need to document the effectiveness of these interventions. The purpose of this review was to summarize the empirical findings of the effects of psychological interventions in reducing post-injury psychological consequences and improving psychological coping during the injury rehabilitation process among competitive and recreational athletes. In February 2012, utilizing a comprehensive search strategy, we conducted electronic searches of multiple electronic databases for randomized and nonrandomized control trials that evaluated interventions targeting populations of injured competitive and recreational athletes age 17 years and older. We included interventions that directly intervene on injured athletes' psychological outcomes (e.g., psychological consequences, psychological coping and re-injury anxiety) and utilized psychological strategies including imagery, goal-setting, relaxation, and other common techniques during the post-injury rehabilitation period. Six studies, described in seven peer-reviewed published articles, met study inclusion criteria and were included in this review. Of those studies, two included randomized control trials, two used before and after study designs and two were case study designs. Two interventions utilized guided imagery and relaxation, two interventions utilized goal-setting and one each utilized microcounseling, written disclosure, and acceptance and commitment therapy. Guided imagery/relaxation was shown to be associated with improved psychological coping and reduced re-injury anxiety. Goal setting, however, was not directly associated with the reduction of negative psychological consequences. Other psychological techniques such as microcounseling skills, acceptance and commitment therapy, and written disclosure have demonstrated effectiveness in reducing negative psychological consequences, improving psychological coping, and reducing re-injury anxiety. Our findings suggest a significant need to develop and implement well-designed intervention studies that target improvement of post-injury psychological outcomes in order to assist injured athletes successfully recovery from sport injury.