The evidence (rated as low quality) suggested that moderate- and moderate- to high-intensity resistance training improves multidimensional function, pain, tenderness, and muscle strength in women with fibromyalgia. The evidence (rated as low quality) also suggested that eight weeks of aerobic exercise was superior to moderate-intensity resistance training for improving pain in women with fibromyalgia. There was low-quality evidence that 12 weeks of low-intensity resistance training was superior to flexibility exercise training in women with fibromyalgia for improvements in pain and multidimensional function. There was low-quality evidence that women with fibromyalgia can safely perform moderate- to high-resistance training.

Fibromyalgia syndrome, a chronic condition typically characterized by widespread pain, nonrestorative sleep, fatigue, cognitive dysfunction, and other somatic symptoms, negatively impacts physical and emotional function and reduces quality of life. Exercise is commonly recommended in the management of people with fibromyalgia, and interest in examining exercise benefits for those with the syndrome has grown substantially over the past 25 years. Research supports aerobic and strength training to improve physical fitness and function, reduce fibromyalgia symptoms, and improve quality of life. However, other forms of exercise (e.g., tai chi, yoga, Nordic walking, vibration techniques) and lifestyle physical activity also have been investigated to determine their effects. This paper highlights findings from recent randomized controlled trials and reviews of exercise for people with fibromyalgia, and includes information regarding factors that influence response and adherence to exercise to assist clinicians with exercise and physical activity prescription decision-making to optimize health and well-being.

Purpose: End-stage renal disease (ESRD) is a condition affecting multiple physiological systems, leading to a decline in physical function. Effectiveness of therapeutic interventions in people with ESRD has been assessed using various functional and activity outcome measures. The purpose of this study was to determine the relative and absolute reliability of the 6-minute walk test (6MWT), timed sit-to-stand in 30 seconds (TSS30), and maximal and adjusted activity scores (MAS-HAP, AAS-HAP) of the Human Activity Profile (HAP) in people with ESRD. Method: A convenience sample of 25 participants (67.2e14.2 years) was recruited from an outpatient dialysis unit. Relative reliability was determined using the intraclass correlation coefficient (ICC 2,1 ), and absolute test-retest reliability with the standard error of measurement (SEM) and minimal detectable change at the 95% confidence interval (MDC 95 ) statistics, respectively. The test-retest interval was 1 week. Results: Relative reliability (ICC 2,1 ) was 0.93 for both the 6MWT and the TSS30, 0.92 for the AAS-HAP, and 0.76 for the MAS-HAP. Absolute reliability (SEM and MDC 95 ) values for the 6MWT, AAS-HAP, and TSS30 were 28 m and 77 m, 4.1 and 11.4, and 0.9 and 2.6 repetitions, respectively. Conclusions: Our results suggest that the 6MWT, TSS30, and AAS-HAP are reliable physical function and activity outcome measures in people with ESRD. However, the magnitude of the absolute reliability statistics suggests significant within-participant variability on repeat testing in this population.Key Words: end-stage renal disease, Human Activity Profile, reliability, 6-minute walk test, timed-sit-to-stand

Objective. This paper analyzes the effects of resistance training (RT) on metabolic, neuromuscular, and cardiovascular functions in older adults (mean age ≥ 65 years) with type 2 diabetes (T2DM). Research Design and Methods. A systematic review conducted by two reviewers of the published literature produced 3 records based on 2 randomized controlled trials that assessed the effect of RT on disease process measures and musculoskeletal/body composition measures. Statistical, Comprehensive Meta-Analysis (version 2) software was used to compute Hedge's g, and results were calculated using the random effects model to account for methodological differences amongst studies. Results. Largest effect of RT was seen on muscle strength; especially lower body strength, while the point estimate effect on body composition was small and not statistically significant. The cumulative point estimate for the T2DM disease process measures was moderate and statistically significant. Conclusions. RT generally had a positive effect on musculoskeletal, body composition, and T2DM disease processes measures, with tentative conclusions based on a low number of completed RCTs. Thus, more research is needed on such programs for older adults (≥65 years) with T2DM.

Purpose: Fatigue is one of the most frequent debilitating symptoms reported by people with end-stage renal disease (ESRD) on haemodialysis (HD) therapy. A wide range of underlying abnormalities, including skeletal muscle weakness, have been implicated as causes of this fatigue. Skeletal muscle weakness is well established in this population, and such muscle weakness is amenable to physical therapy treatment. The purpose of this review was to identify morphological, electrophysiological, and metabolic characteristics of skeletal muscles in people with ESRD/HD that may cause skeletal muscle weakness. Method: Electronic databases were searched for relevant literature from inception to March 2010. Inclusion criteria were English language; adult subjects with ESRD/HD; and the use of muscle biopsy, electromyography, and nuclear magnetic spectroscopy ( 31 P-NMRS) techniques to evaluate muscle characteristics. Results: In total, 38 studies were included. All studies of morphological characteristics reported type II fibre atrophy. Electrophysiological characteristics included both neuropathic and myopathic skeletal muscle changes. Studies of metabolic characteristics revealed higher cytosolic inorganic phosphate levels and reduced effective muscle mass. Conclusion:The results indicate an array of changes in the morphological, electrophysiological, and metabolic characteristics of skeletal muscle structure in people with ESRD/HD that may lead to muscle weakness. RÉ SUMÉObjectif : La fatigue est l'un des symptô mes dé bilitants signalé s chez les personnes aux prises avec une insuffisance ré nale chronique au stade ultime avec l'hé modialyse (IRSU/HD). Un large é ventail d'anomalies sous-jacentes, y compris de la faiblesse du muscle squelettique, ont é té mises en cause dans cette fatigue. La faiblesse du muscle squelettique est courante au sein de cette population; une telle faiblesse musculaire peut faire l'objet de traitements en physiothé rapie. L'objectif de cette analyse é tait d'identifier les caracté ristiques morphologiques, é lectrophysiologiques et mé taboliques des muscles squelettiques qui pourraient susciter une faiblesse du muscle squelettique chez les personnes avec IRSU/HD. Mé thode : Une recherche a é té ré alisé e dans les bases de donné es é lectroniques de leur cré ation à mars 2010 afin de ré pertorier la documentation pertinente. Les critè res d'inclusion é taient que ces documents soient en anglais, qu'ils concernent des adultes avec IRSU/HD et que des techniques de biopsie musculaire, d'é lectromyographie et de spectroscopie magné tique nuclé aire ( 31 P-NMRS) avaient é té utilisé es pour é valuer les caracté ristiques des muscles concerné s. Ré sultats : Au total, 38 documents ont é té ré pertorié s et utilisé s. Toutes les é tudes des caracté ristiques morphologiques faisaient é tat d'atrophie des fibres de type II. Les caracté ristiques é lectrophysiologiques incluaient à la fois les changements né vropathiques et myopathiques. Les é tudes des caracté ristiques mé taboliques ont ré vé l...

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Purpose: The primary purpose of this systematic review was to evaluate the anabolic effect of exercise intervention in adults with end-stage renal disease on hemodialysis (HD). The secondary objectives were to evaluate the influences of participant characteristics and exercise parameters on changes in muscle size. Methods: Electronic databases (Cochrane, CINAHL, EMBASE, PEDro, PubMed and SCOPUS) were searched from inception to November 2012. Randomized clinical trials published in English that included adults on HD undergoing an exercise intervention where muscle mass was measured as an outcome were included in this review. Two reviewers independently selected the studies, extracted data, and assessed risk of bias within the included studies. Results were then combined by meta-analysis. The effect of exercises was determined using a standardized mean difference (SMD), expressed as Hedges' g, computed using a random effects model. Results: Seven SMDs extracted from five studies were included for final analysis. Strength training was used in all studies; one study used aerobic and mixed strength and aerobic training with two subgroups of participants. The overall effect of exercise on muscle mass was statistically significant (SMD: 0.272; 95% CI, 0.020-0.525). Conclusions: Our results confirm a small but significant effect of strengthening exercise as an anabolic intervention to increase muscle mass. Exercise training should be included in routine management of people on maintenance HD. Although current results indicate that one in nine people on HD is likely to benefit from exercise intervention, parameters influencing these results require further research.Key Words: bioelectrical impedance; computed tomography scan; dual energy x-ray absorptiometry; exercise; hemodialysis; magnetic resonance imaging; skeletal muscle. RÉ SUMÉObjectif : Cette critique systé matique visait principalement à é valuer l'effet anabolique de l'exercice chez des adultes vivant avec une insuffisance ré nale chronique au stade ultime et suivant des traitements d'hé modialyse (HD). Les objectifs secondaires consistaient à é valuer l'influence des caracté ristiques des participants et des paramè tres de l'exercice sur les changements de la taille des muscles. Mé thodes : On a effectué des recherches dans des bases de donné es é lectroniques (Cochrane, CINAHL, EMBASE, PEDro, PubMed et SCOPUS) depuis leur cré ation jusqu'en novembre 2012. On a inclus des essais cliniques randomisé s publié s en anglais et portant sur des adultes en HD suivant un programme d'exercice au cours duquel on a mesuré la masse musculaire comme ré sultat. Deux examinateurs agissant indé pendamment ont choisi les é tudes, extrait des donné es et é valué le risque de biais dans les é tudes incluses. Les ré sultats ont ensuite é té combiné s par mé ta-analyse. On a dé terminé l'effet de l'exercice au moyen d'une diffé rence moyenne normalisé e (DMN) exprimé e par la mesure g de Hedges, calculé au moyen d'un modè le à effet alé atoire. Ré sultats : Sept DMV extrai...