Background: Acute aerobic exercise leads to positive physiological adaptations within the central nervous system. These findings inspired research on potential cognitive benefits following acute aerobic exercise. The effects of acute aerobic exercise on subsequent cognitive performance, by far, have been the most researched for interference control, a subcomponent of executive function. The results of primary studies on the effects of acute aerobic exercise on subsequent interference control performance are inconsistent. Therefore, we used meta-analytic methods to pool available effect sizes, and to identify covariates that determine the magnitude of exercise-induced interference control benefits.Methods: Medline, PsycINFO, and SPORTDiscus were searched for eligible records. Hedges' g corrected standardized mean difference values (SMDs) were used for analyses. Random-effects weights were used to pool effect sizes. Moderator analyses were conducted using meta-regressions and subgroups analyses. Covariates that were here tested for moderation included parameters of the applied exercise regimen (exercise intensity and exercise duration), characteristics of examined participants (age and fitness), and methodological features of existing research (type of control group, familiarization with test procedure, type of test variable, delay between exercise cessation, and testing).Results: Fifty studies, with data from 2,366 participants, were included in qualitative and quantitative synthesis. A small, significant beneficial effect of acute aerobic exercise on time-dependent measures of interference control was revealed (k = 49, Hedges' g = −0.26, 95%CI: −34 to −0.18). Effect sizes from time-dependent measures of interference control varied widely and heterogeneity reached statistical significance (T2 = 0.0557, I2 = 28.8%). Moderator analyses revealed that higher exercise intensities (vigorous intensity and high-intensity interval training), also participants at younger or older age, and participants who are familiar with the testing procedure prior to the experiment, benefitted most from acute aerobic exercise. However, noticeable heterogeneity remained unexplained within specific subgroups (high-intensity interval training, preadolescent children, and active and supervised control group).Conclusion: Acute aerobic exercise improves subsequent interference control performance. However, the covariates exercise intensity, participants' age, and familiarization with testing procedure determine the magnitude of that effect. Methodological features were not found to influence the magnitude of effects. This dismisses some doubts that exercise induced benefits for interference control performance are scientific artifacts. The fact that large heterogeneity remained unexplained in some subgroups indicates the need for further research on covariates within these subgroups. It should be noted that effect sizes for all analyses were small.
Dolutegravir (DTG) is widely recommended within three-drug regimens. However, similar efficacy and tolerability have also been achieved with DTG within two-drug regimens in clinical trials. This study evaluated the real-world effectiveness and discontinuations in people living with HIV-1 (PLHIV) switching to DTG with lamivudine (3TC) or rilpivirine (RPV). MethodsThis was a one-arm meta-analysis utilizing data from a systematic literature review. Data from real-world evidence studies of DTG + RPV and DTG + 3TC were extracted, pooled and analysed. The primary outcome was the proportion of patients with viral failure (VF; ≥ 50 copies/mL in two consecutive measurements and/or ≥ 1000 copies/mL in a single measurement) at week 48 (W48) and week 96 (W96). Other outcomes included virological suppression (VS; < 50 copies/mL) and discontinuations (W48 and W96). Estimates were calculated for VF, VS as per snapshot (VSS) and on treatment analysis (VSOT), and discontinuations. ResultsPooled mean estimates of VF for DTG + 3TC and DTG + RPV were 0.8% [95% confidence interval (CI): 0.4-1.3] and 0.6% (95% CI: 0.0-1.6), respectively, at W48. VSS rate at W48 was 85.0% (95% CI: 82.3-87.5) for DTG + 3TC regimen and 92.4% (95% CI: 85.0-97.7) in the DTG + RPV regimen. The DTG + 3TC and DTG + RPV regimens led to discontinuations in 13.6% (95% CI: 11.1-16.2) and 7.2% (95% CI: 2.1-14.4) of patients, respectively, at W48. Similar results were observed at W96. ConclusionsTreatment with DTG + 3TC or DTG + RPV in clinical practice provides a low rate of VF and a high rate of VS when initiated in virologically suppressed PLHIV with diverse backgrounds.
Background: Positive effects of acute exercise on cognitive performances in general inspired research that investigated the effects of acute exercise on specific cognitive subdomains. Many existing studies examined beneficial effects of acute exercise on subsequent set shifting performance in healthy adults. Set shifting, a subdomain of executive function, is the ability to switch between different cognitive sets. The results of existing studies are inconsistent. Therefore, a meta-analysis was conducted that pooled available effect sizes. Additionally, moderator analyses were carried out to identify covariates that determine the magnitude of exercise-induced set shifting benefits.Methods: Medline, PsycINFO, and SPORTDiscus were searched for eligible studies. Hedges' g corrected standardized mean difference values were used for analyses. Random-effects weights were applied to pool effects. Potential moderation of the effect of acute exercise on subsequent set shifting performance by exercise intensity, type of exercise, participants' age, and type of control group were examined.Results: Twenty-two studies (N = 1,900) were included into analysis. All aggregated effect sizes ranged from small to moderate. Overall, a small significant beneficial effect was revealed (g = −0.32, 95 % CI −0.45 to −0.18). Heterogeneity of included effect sizes was moderate and significant (T2 = 0.0715, I2 = 46.4%, (p < 0.0016). Moderator analyses revealed a larger average effect in older adults than for studies examining younger adults (−0.42 vs. −0.29). Light exercise (−0.51) led to larger effects than moderate (−0.24) or vigorous exercise (−0.29). Studies testing acute exercise against active control groups showed a noticeably smaller average effect (−0.13) than studies that used passive (−0.38) or cognitive engaging control groups (−0.34). Interestingly, application of resistance or aerobic exercise led to no different average effect sizes (−0.30 vs. −0.32). However, none of the tested covariates reached statistical significance.Conclusion: Acute exercise improves subsequent set shifting performance. However, effect sizes are small, making the relevance for everyday life questionable. The results indicate that older adults benefit more from acute exercise than younger adults do. Light intensity exercise seems most effective while the type of exercise does not seem to influence the magnitude of effects. Research designs with active control groups show the smallest average effect, raising concerns about placebo effects.PROSPERO registration number: CRD42019138799
This systematic review and meta-analysis investigated whether acute aerobic exercise improves subsequent set shifting performance in healthy young individuals. Potential moderation of studies' methodological quality and exercise intensity, as well as the presence of small-study effect was also examined. Studies were identified using electronic databases Medline, PsycINFO, and SPORTDiscus, as well as references of recent meta-analyses and references of included studies. In total, 12 studies were included into qualitative synthesis. Eleven studies that contained data from 1,189 healthy young individuals were eligible for inclusion in the meta-analysis. The effect size of each trial was calculated as bias corrected Hedges' g standardized mean difference. A random-effects model was used to pool outcomes across studies. Sensitivity analysis was conducted to investigate influence of outliers and of studies with mixtures of aerobic and anaerobic exercise. Meta-regression and subgroup analyses were used to examine moderation. A small to moderate significant beneficial effect of acute aerobic exercise on subsequent set shifting performance compared to control (Hedges' g = -.26, 95 % CI -.49 to -.02, p = .03) with large true heterogeneity was revealed (I 2 = 70.9%, Q=44.61, p<.0001). Results became homogenous when two outliers were removed from the analysis (I 2 =0%, Q=6.52, p=.84) while summary effect size estimate stayed comparable (Hedges' g = -.23, 95 % CI -.38 to -.-.08, p = .003). Studies' methodological quality and exercise intensity did not modify effect size estimates. There was no indication of small-study effect detected. This review shows that even healthy young adults, who are at the peak of their physiological and cognitive capacities, show improved set shifting performance following a single bout of aerobic exercise. The results indicate that these effects are not due to methodological shortcomings, exercise intensity, or small-study effect. The results indirectly support the conclusion that these effects are a result of physiological and/or psychological adaptations to the exercise.
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