PMID- 32671231
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240330
IS  - 2398-502X (Print)
IS  - 2398-502X (Electronic)
IS  - 2398-502X (Linking)
VI  - 5
DP  - 2020
TI  - Measuring the effects of exercise in neuromuscular disorders: a systematic review 
      and meta-analyses.
PG  - 84
LID - 10.12688/wellcomeopenres.15825.1 [doi]
LID - 84
AB  - Background: The benefit and safety of exercise training for patients with 
      neuromuscular disorders (NMDs) has long been a contentious topic. This is, in 
      part, due to recognised challenges associated with rare diseases including small 
      and heterogenous patient populations. We performed a systematic review and 
      meta-analyses to evaluate the effectiveness and safety of interventional exercise 
      and establish minimal clinically important differences (MCID) in outcomes to 
      facilitate clinical interpretation. Methods: We searched six databases from 
      inception to Mar 2018. Aerobic, strength, and combined (aerobic and strength) 
      intervention were eligible. Meta-analyses compared outcomes at baseline with 
      those after at least six weeks (before-after exercise within individuals). A 
      further meta-analysis compared outcomes before-after exercise between groups 
      (exercise training versus usual care). Disease heterogeneity was explored using a 
      random effect model. This study was registered (PROSPERO, CRD42018102183). An 
      interactive database was developed to facilitate full interrogations of data. 
      Results: We identified 130 articles describing 1,805 participants with 35 
      different forms of NMD. Of these studies, 76 were suitable for meta-analyses. 
      Within group and between group meta-analyses detected an increase in peak aerobic 
      capacity (p=0.04), and peak power (p=0.01). Six-minute walk test (p=0.04), 
      sit-to-stand (STS) (repetitions) (p=0.03), STS (seconds) (p=0.04), rise from 
      supine (p=0.008), SF-36 (p=0.0003), fatigue severity (p=<0.0001), citrate 
      synthase (p=0.0002), central nuclei (p=0.04), type 1 (p=0.002) and type II muscle 
      fibre area (p=0.003), were only able to detect change within group meta-analyses. 
      Substantial I (2) statistic heterogeneity was revealed for STS (seconds) ( 
      I(2)=58.5%; p=0.04) and citrate synthase ( I(2)=70.90%; p=0.002), otherwise 
      heterogeneity for all outcomes was low. No study-related serious adverse events 
      were reported nor significant increases in creatine kinase. Conclusions: Exercise 
      training in patients with NMDs appears to cause no harm across a range of 
      outcomes. With the emergence of new therapeutic strategies, defining MCID is 
      vital in informing future clinical trial design.
CI  - Copyright: (c) 2020 Stefanetti RJ et al.
FAU - Stefanetti, Renae J
AU  - Stefanetti RJ
AUID- ORCID: 0000-0001-6402-6435
AD  - Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle Upon 
      Tyne, Tyne and Wear, NE2 4HH, UK.
FAU - Blain, Alasdair
AU  - Blain A
AUID- ORCID: 0000-0002-3712-5283
AD  - Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle Upon 
      Tyne, Tyne and Wear, NE2 4HH, UK.
FAU - Jimenez-Moreno, Cecilia
AU  - Jimenez-Moreno C
AUID- ORCID: 0000-0002-0488-9631
AD  - Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle Upon 
      Tyne, Tyne and Wear, NE2 4HH, UK.
FAU - Errington, Linda
AU  - Errington L
AD  - Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, Tyne and 
      Wear, NE2 4HH, UK.
FAU - Ng, Yi Shiau
AU  - Ng YS
AUID- ORCID: 0000-0002-7591-2034
AD  - Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle Upon 
      Tyne, Tyne and Wear, NE2 4HH, UK.
FAU - McFarland, Robert
AU  - McFarland R
AD  - Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle Upon 
      Tyne, Tyne and Wear, NE2 4HH, UK.
FAU - Turnbull, Doug M
AU  - Turnbull DM
AD  - Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle Upon 
      Tyne, Tyne and Wear, NE2 4HH, UK.
FAU - Newman, Jane
AU  - Newman J
AD  - Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle Upon 
      Tyne, Tyne and Wear, NE2 4HH, UK.
AD  - NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust, Newcastle upon Tyne, Tyne and Wear, NE4 5PL, UK.
FAU - Gorman, Grainne S
AU  - Gorman GS
AD  - Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle Upon 
      Tyne, Tyne and Wear, NE2 4HH, UK.
LA  - eng
GR  - WT_/Wellcome Trust/United Kingdom
PT  - Systematic Review
DEP - 20200504
PL  - England
TA  - Wellcome Open Res
JT  - Wellcome open research
JID - 101696457
PMC - PMC7331112
OTO - NOTNLM
OT  - Neuromuscular
OT  - aerobic
OT  - exercise training
OT  - functional exercise
OT  - minimal important clinical difference
OT  - muscle biopsies
OT  - outcome measures
OT  - strength
COIS- No competing interests were disclosed.
EDAT- 2020/07/17 06:00
MHDA- 2020/07/17 06:01
PMCR- 2020/05/04
CRDT- 2020/07/17 06:00
PHST- 2020/04/23 00:00 [accepted]
PHST- 2020/07/17 06:00 [entrez]
PHST- 2020/07/17 06:00 [pubmed]
PHST- 2020/07/17 06:01 [medline]
PHST- 2020/05/04 00:00 [pmc-release]
AID - 10.12688/wellcomeopenres.15825.1 [doi]
PST - epublish
SO  - Wellcome Open Res. 2020 May 4;5:84. doi: 10.12688/wellcomeopenres.15825.1. 
      eCollection 2020.