Craniopharyngioma-related hypothalamic obesity (CHO) has become a key issue in postoperative management of craniopharyngioma. Modified low calorie diet and exercise interventions have been found by some studies to be effective in relieving CHO, and suggested to be used as non-pharmacological treatments for weight management of craniopharyngioma patients. However, there are few relevant studies in China. We reviewed the latest developments in prevalence, hazards and risk factors as well as diet and exercise interventions towards CHO, in order to improve the outcomes and quality of life of CHO patients. In addition, we put forward recommendations on comprehensively improving the quality of life of CHO patients, such as making efforts to value CHO clinically, carrying out prospective studies on weight control in CHO, and developing rigorous diet and exercise interventions.

Regular physical activity is a cornerstone of diabetes management, and more precise guidance on exercise prescriptions is needed in children and adolescents with diabetes due to the complexity of glycemic changes, however, there are relatively few guidelines for this population. As the continuous exploration of experts and scholars in this field, after five years, the International Society for Pediatric and Adolescent Diabetes (ISPAD) updated its guidelines on exercise for children and adolescents with diabetes in 2022. The guidelines target the service population more precisely to the children and adolescents with type 1 diabetes and provide comprehensive guidance from the perspectives of exercise types, exercise timing, blood glucose fluctuations during exercise, insulin adjustment and nutritional supplementation. This article interprets the main contents and key updates of the 2022 ISPAD guidelines, aiming to provide more scientific exercise prescriptions for children and adolescents with diabetes in China.

The prevalence of overweight and obesity has been increasing yearly and become a global public health problem with a range of consequences causing widespread concern. Weight loss can reduce the incidence of type 2 diabetes, cardiovascular risk, and all-cause mortality. The most common approaches of weight loss are drug therapy, surgery and lifestyle interventions including diet and exercise, however, exercise intervention remains the healthiest and most fundamental approach of weight loss. Exercise can reduce cellulite, increase muscle mass and improve metabolism. The combination of exercise and other weight loss approaches can reduce adverse reactions and produce better results. Continuing exercise after weight loss can also effectively prevent rebound and maintain weight loss effects. This paper reviews the definition, mechanism, effect, and management of "exercise is the foundation of weight loss", and provide a reference for weight loss through exercise in the context of the experience of Zhongda Hospital.

Heart rate variability (HRV) is commonly used to evaluate the short-term prognosis of coronary artery diseaseas a well-known non-invasive indicator of cardiac autonomic function. Percutaneous coronary intervention (PCI) is a commonly usedsuigical treatment of coronary artery disease, however, major adverse cardiac event (MACE) such as malignant arrhythmias and recurrent myocardial infarction are common after suigical treatment. Although dual antiplatelet therapy (DAPT) can reduce the occurrence of MACE to a certain extent, it is prone to be complicated with gastrointestinal bleeding, and unable to consistently improve the prognosis of PCI. Ocular acupuncture can effectively reduce the duration and frequency of chest pain, and exercise therapy can enhance the function of heart and blood vessels. The application of ocular acupuncture and exercise combination therapy (OAECT) after PCI remains to be explored.

To investigate the effect of OAECT on postoperative heart rate variability and prognosis of patients treated with PCI.

A total of 32 CHD patients after PCI with moderate and low risk attending Hospital of Chengdu University of Traditional Chinese Medicine were selected and randomly divided into the OAECT group and drug treatment group in a 1∶1 allocation ratio. Patients in the OAECT group received OAECT in addition to DAPT, patients in the drug treatment group received DAPT alone, patients in both 2 groups completed the 2-week intervention. The data of patients was collectedas follows: (1) Baseline indicators: gender, age, height, weight, blood pressure, respiratory rate, interval between onset and intervention, education level, occupation, severity of coronary artery disease, and number of underlying diseases. (2) Main indicators: HRV within 24 h after PCI and on the day of the end of 2-week intervention, including the standard deviation of all normal to normal RR intervals (SDNN) , standard deviation of all 5-minute RR intervals (SDANN) , mean of the standard deviation of all NN intervals for all 5-min segment of 24 hours (SDNN index) , root mean square of difference between adjacent NN intervals (rMSSD) , percent of NN50 in the total number of NN intervals (PNN50) , high frequency (HF) , low frequency (LF) low frequency/high frequency (LF/HF) values. Prognosis at 2, 4, and 8 weeks after the intervention assessed by MACE, including cardiac or all-cause deaths, malignant arrhythmias such as ventricular tachycardia and ventricular fibrillation, severe heart failure, recurrent myocardial infarction, repeat PCI and chest pain recorded by telephone and outpatient consultations. (3) Secondary indicators: C-reactive protein (CRP) , N-terminal pro B type natriuretic peptide (NT-proBNP) , creatine kinase isoenzyme (CK-MB) , high-sensitivity troponin I (hs-TnI) . (4) Safety indicators: the occurrence of complications after PCI such as subcutaneous hematoma, skin lesions, muscle soreness, respiratory abnormalities and stroke, all the outcome indicators were measured within 24 hours after PCI and on the day of the end of 2-week intervention.

There was no significant difference in LF/HF, SDNN, SDANN, SDNN index, LF, HF, RMSSD and PNN50 between the 2 groups (P>0.05) . There were significant differences in LF/HF, SDNN and SDANN (P<0.05) .CRP was higher in the drug treatment group than OAECT group after 2 weeks (P<0.05) ; there was no significant difference in NT-proBNP, CK-MB and hs-TnI between the 2 groups (P>0.05) . The incidence rates of MACE and adverse reactions in the OAECT group were lower than DAPT group (P<0.05) .

OAECT is more effective than drug treatment in improving HRV with a lower incidence rate of MACE and better prognosis for patients after PCI.

Adolescent idiopathic scoliosis (AIS) is a progressive three-dimensional skeletal deformity that affects spinal mobility and trunk symmetry. It was previously believed that AIS was not accompanied with pain, but recent studies have shown that approximately 31.5% of the patients complain of low back pain, which may due to factors such as paravertebral muscle imbalance and fatigue.

To observe morphological changes of paravertebral multifidus muscles at the top of the main curvature after high energy laser therapy (HILT) combined with physiotherapy scoliosis specific exercise (PSSE) in AIS patients with low back pain by using musculoskeletal ultrasound. and evaluate the clinical effect of treatment on the correction of paravertebral muscle imbalance.

A total of 30 patients with AIS RigoE1 admitted to the Scoliosis Correction Center of the Fifth Hospital of Harbin from December 2020 to December 2021 were selected for a randomized single-blind controlled trial and divided into the experimental group (n=15) and control group (n=15) , the experimental group was treated with HILT combined with PSSE, and the control group was only treated with HILT. Musculoskeletal ultrasound, visual analogue scale (VAS) scores, range of motion of the patient's lumbar joints and Roland-Morris lumbar spine dysfunction questionnaire (RDQ) were performed before and 4 weeks after treatment in both groups. Pearson correlation analysis was used to investigate whether there was a correlation between the changes in the multifidus muscles after treatment and the treatment effect.

The cross-sectional area of the convex side of multifidus muscles, anterior flexion, left lateral flexion, left rotation and right rotation of the experimental group were higher than those of the control group after treatment (P<0.05) , the cross-sectional area and thickness of multifidus muscles on the concave side, the cross-sectional area and thickness ratios of multifidus muscles on the concave and convex sides, extension after treatment were higher than those before treatment in the experimental group (P<0.05) . VAS scores and RDQ scores after treatment were lower than those before treatment, and anterior flexion, left lateral flexion, right lateral flexion, left rotation and right rotation were higher than those before treatment (P<0.05) in both two groups. The extension after treatment was lower than that before treatment in the control group (P<0.05) . Pearson correlation analysis showed that the cross-sectional area ratio of multifidus muscles on the concave and convex sides was negatively related with right rotation of the lumbar spine after treatment in the experimental group (r=-0.660, P<0.01) , the thickness ratio of the concave and convex sides of multifidus muscles was negatively related with right flexion of the lumbar spine (r=-0.614, P<0.05) .

HILT combined with PSSE can change the morphology of the multifidus muscles on the concave side of the parietal vertebrae of scoliosis, reduce low back pain, increase lumbar spine mobility, reduce lumbar spine dysfunction and improve activities of daily living; the use of HILT alone can effectively relieve low back pain caused by scoliosis, although it has no significant effect on the morphological changes of the multifidus muscles. Balancing the morphology of the multifidus muscles on both sides of the spine has a positive effect on improving the lateral flexion and rotation of the lumbar spine.

Obesity is an increasingly prevalent and costly public health problem. Many people regard exercise as an effective weight loss strategy, even superior to dieting. However, the effectiveness and safety of exercise for weight loss in obese individuals need to be carefully weighed. This paper briefly discusses the view that "Exercise is not the foundation of weight loss" in the combination of evidence-based medicine, from the aspects of mild effect of exercise on weight loss, poor adherence to long-term high-intensity exercise, safety of high-intensity exercise in obese individuals, and the mechanism of poor weight loss effect of exercise.

The prevention and delay of disability is important for promoting healthy aging. Exercise intervention is an efficient strategy for disability prevention. Besides, exercise intervention presents significant therapeutic advantages and broad application prospects due to low cost, low implementation difficulty, high acceptance and wide application scenarios. Therefore, Nursing Group of Chinese Society of Geriatrics, Committee on Geriatric Nursing of Chinese Association of Geriatric Research, China Gerontological Nursing Alliance, National Center of Gerontology, Institute of Geriatric Medicine of Chinese Academy of Medical Sciences jointly developed and published Clinical Practice Guidelines for Exercise Interventions for the Prevention of Disability in Older Adults (2023). According to the methodologies specified in WHO Handbook for Guideline Development, the guidelines finally involve 32 recommendations and 18 clinical issues containing exercise principles, effectiveness and plans of different types of exercise, facilitators and barriers during exercise, aiming to provide a reference for the development and implementation of exercise programs for older adults at risk of disability and standardize clinical practice, thus promoting the gateway to improving physical function of the older adults, reducing the prevalence of disability, improving quality of life, contributing to healthy aging.

Self-management meets the long-term rehabilitation needs of stroke patients and their families. However, there is a lack of relevant evidence, and there is no scientific and standardized self-management program in clinical practice.

To evaluate and summarize the best evidence of self-management in patients with motor dysfunction after stroke.

PubMed, Cochrane Library, Web of Science, Embase, CINAHL, CNKI, Wanfang Data, VIP, Chinese Biomedical Literature Database (CBM), American Heart Association/American Stroke Association (AHA/ASA), World Stroke Organization (WSO), Chinese Stroke Association (CSA), Guidelines International Network (GIN), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), and Yimaitong were searched for relevant research evidence on self-management of patients with motor dysfunction after stroke from inception to July 2022, including guidelines, expert consensuses, systematic reviews, quasi-experimental studies, and randomized controlled studies. Two researchers independently evaluated the quality of the retrieved literature by using the 2017 version of the Appraisal of Guidelines for Research and Evaluation (AGREE Ⅱ) and the 2016 version of the literature evaluation criteria developed by the Joanna Briggs Institute (JBI) Evidence-based Health Care Center, extracted evidence and graded the quality of the evidence to summarize the best evidence of self-management in patients with motor dysfunction after stroke.

A total of 36 studies were involved, including 9 guidelines, 4 expert consensuses, 5 systematic reviews, 5 quasi-experimental studies, and 13 randomized controlled studies, which were summarized in 6 aspects of organization and management, assessment, exercise instruction, health education, psychological support, monitoring and follow-up, and 34 pieces of best evidence.

The evidence of self-management in patients with motor dysfunction after stroke summarized in this study contains 6 aspects: organization and management, assessment, exercise instruction, health education, psychological support, monitoring and follow-up. Healthcare workers should select the best evidence based on the individual situation and needs of patients in the context of clinical practice, and provide personalized self-management interventions for patients, so as to improve their motor function and self-management ability, promoting the recovery of disease.

Limb paralysis is a common sequela of cerebral infarction, which leads to both physical disorders and heavy psychological burden. Recent years have witnessed growing studies on the prognosis of motor function in patients with cerebral infarction, and increasing well-known relevant medical evaluation tools, such as diffusion tensor imaging (DTI) and motor evoked potential induced by transcranial magnetic stimulation (TMS-MEP), which can microscopically assess the structural changes in white matter fiber bundles, and the combined use of them, that is, the combination of neuroanatomy, electrophysiology and neuroimaging, can more accurately assess the level of motor neuron impairment, thereby obtaining a motor function assessment surpassing the assessment based on clinical function indicators in terms of objectivity. We reviewed the prognostic value of DTI and TMS for motor function recovery via detecting and quantifying corticospinal tract degeneration in patients after cerebral infarction, and summarized the prognostic values of commonly used relevant measurement parameters for motor function recovery in hemiplegic patients. We concluded that DTI and TMS-MEP are powerful tools for noninvasively assessing complex structures of brain tissues, which can detect more subtle neural and tissue changes, and the combined use of them can effectively explore the damage pattern of white matter fiber bundles using different analysis methods, contributing to the development of neurological rehabilitation programs and maximum improvement of the long-term prognosis for patients.

As the acceleration of urbanization and population aging in China, the prevalence of various chronic diseases among residents is increasing, the prevention and control of various chronic diseases in the medical care and public health fields are becoming more and more severe. As one of the important treatment modalities, physical activity referral schemes (PARS) have achieved remarkable results in the prevention and treatment of chronic diseases abroad, among which PARS in Australia has become a model for "treatment + co-treatment". This study overviews the formation and development of PARS in Australia comprehensively, summarizes and analyzes its implementation experience. It is recommended to build a sharing and interaction mechanism of general practice and sports co-treatment in China in the context of the current development situation of medical care and sports rehabilitation in China from the following aspects: building a referral structure with general practice as the core, promoting the synergistic governance of general practice and sports co-treatment; improving the personnel training system of general practice and exercise physiology, accelerating the training of medical exercise and health coaches; promoting the innovation of the service system, accelerating the construction of scientific process of general practice and sports co-treatment; exerting the advantages of the Internet vigorously to build a data and information platform of general practice and sports co-treatment.

Previous studies on the benefits of aerobic exercise mainly focus on the impact of aerobic exercise on long-term cardiovascular health and outcomes, namely regular aerobic exercise can improve arterial stiffness, while some studies point out that high blood sugar increases arterial stiffness.

To investigate the immediate effect of aerobic exercise on arterial stiffness in people with different blood glucose levels.

This study selected individuals who had participated in the 6th follow-up physical examination of the Kailuan Study during 2018—2020 and participated in the 5th national physical fitness surveillance in 2020 and completed their brachial-ankle pulse wave conduction velocity (baPWV) measured before and after the secondary load test of the power vehicle bicycle in four subordinate enterprises of Kailuan Group. Epidemiological survey result were collected: general information (age, hypertension, hyperlipidemia, history of antihypertensive drugs, etc.) , anthropometric indicators〔systolic blood pressure (SBP) , diastolic blood pressure (DBP) , etc.〕and biochemical indicators (fasting blood glucose, etc.) . baPWV measured in the secondary load test of the power vehicle bicycle (used as the aerobic exercise) was used as an indicator of upper and lower limb arterial stiffness. baPWV-related indicators〔SBP, DBP, mean arterial pressure (MAP) , heart rate (HR) , baPWV, metabolic equivalent (MET) , maximal oxygen uptake (VO₂max) , etc.〕before and after the test were expressed using a unified form, for example, pre- and post-test baPWV were recorded as baPWV1 and baPWV2, respectively, and its pre- and post-test difference was denoted as ?baPWV. The epidemiological survey result and BAPWV-related data were compared between fasting blood glucose (FBG) quartile groups〔Q1 (n=220) : <5.00 mmol/L; Q2 (n=240) : 5.00-<5.40 mmol/L; Q3 (n=230) : 5.40-<5.81 mmol/L; Q4 (n=234) : ≥5.81 mmol/L〕. Generalized linear regression model was used to evaluate the association of FBG with pre- and post-test baPWV.

A total of 924 eligible cases were enrolled, with an average age of (36.9±7.7) years. FBG quartile groups had statistically significant differences in mean age, hyperlipidemia and hypertension, history of using antihypertensive drugs, mean SBP, DBP, FBG, high sensitivity C-reactive protein, triglyceride, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol (P<0.01) . HR2 was found to be statistically significant higher than HR1 in groups Q1, Q2 and Q3 (P<0.01) . The baPWV2 was found to be statistically significant higher than baPWV1 in Q1, Q2, Q3 and Q4 groups (P<0.01) . SBP1, DBP1, MAP1 and baPWV1 significantly differed across the groups, and so did SBP2, DBP2, MAP2 and baPWV2 (P<0.01) . Compared with baPWV1, baPWV2 decreased by an average of 36.0 cm/s in people with different blood glucose levels. The generalized linear regression model showed that after adjusting for confounding factors, the ?baPWV level in group Q1 was lower than that in group Q4〔B (95%CI) =-18.96 (-36.96, -0.96) , P=0.04) 〕.

Aerobic exercise can immediately improve the degree of arterial stiffness, but the effect can be weakened by high blood sugar. Clinicians should design aerobic exercise programs according to the personal features of populations to improve arteriosclerosis and delay vascular aging.

During the containment of COVID-19, the traditional face-to-face interventions conducted at the rehabilitation center were plagued by many limitations, while internet-based interventions can overcome the limitations of geographic location, working hours and transportation, with less medical costs.

To examine the effects of internet-based interventions on knowledge, attitude/belief and practice (KAP) toward rehabilitation exercises, physical activity (PA) level, and exercise compliance inpatients after PCI.

The subjects were 76 patients who received their first PCI in Department of Cardiology, Tangshan Gongren Hospital from November 2021 to June 2022. They were randomly and equally divided into two groups to receive either internet-based intervention with routine nursing (experimental group) or routine nursing (control group) . Before and three months after the intervention, the Rehabilitation Exercise Knowledge-Belief-Practice Scale for Patients with Coronary Heart Disease (REKBPCHD) , the International Physical Activity Questionnaire-Short Form (IPAQ-SF) , and Patients' Exercise Log were used to assess the KAP level, PA level, and exercise adherence, respectively. The impact of network intervention on exercise adherence in patients after PCI by univariate Logistic regression analysis.

After 3 months of intervention, a significant increase was found in the average total score of REKBPCHD, and the average scores of the knowledge dimension, attitude dimension and practice dimension of the scale in the experimental group (P<0.05) , and the increase was more notable than that in the control group (P<0.05) . Moreover, both post-intervention low PA level and total PA level in the experimental group were higher than those in the control group (P<0.05) . Both post-intervention low PA level and total PA level were higher than the baseline levels in the experimental group (P<0.05) . The post-intervention exercise compliance of experimental group were higher than that in the control group (P=0.003) . Univariate Logistic regression analysis showed that the risk of non-adherence to exercise in the experimental group was relatively lower than that in the control group〔OR=0.143, 95%CI (0.034, 0.594) , P=0.007〕.

Theinternet-based intervention can effectively improve the KAP level toward rehabilitation, PA level, and exercise adherence in patients after PCI.

Many randomized controlled trials (RCTs) about motion style acupuncture in the treatment of acute nonspecific low back pain (ANSLBP) have been published recently, but there is no new systematic evaluation for effectiveness and safety of this treatment in ANSLBP.

To systematically evaluate the effectiveness and safety of motion style acupuncture in treating ANSLBP by meta-analysis.

RCTs, crossover studies or cohort studies about effectiveness and safety of motion style acupuncture in treating ANSLBP were retrieved in electronic databases of CNKI, CBM, Wanfang Data, VIP, PubMed, the National Library of Medicine, Embase and the Cochrane Central Register of Controlled Trials from inception to March 25th, 2021. Revman 5.3 was used to complete the Meta-analysis.

All the finally enrolled 17 articles used a design of RCT, including 1 226 patients, and 610 of them were treated with motion style acupuncture (observation group) , and other 616 patients were treated with positive control, blank control, placebo acupuncture or dummy acupuncture (control group) . Meta-analysis showed that, compared with controls treated with Western medicine, the observation group had significantly lower post-treatment VAS score〔MD=-1.54, 95%CI (-2.43, -0.65) , P=0.000 7〕, and Roland-Morris Disability Questionnaire (RMDQ) score〔MD=-3.08, 95%CI (-4.92, -1.24) , P=0.001〕, and significantly higher post-treatment ROM of lumbar vertebra〔MD=-1.42, 95%CI (-1.62, -1.22) , P<0.000 01〕and overall response rate〔RR=1.27, 95%CI (1.19, 1.35) , P<0.000 01〕, but there was no significant difference in post-treatment ODI score between the two groups〔MD=-5.11, 95%CI (-19.12, 8.91) , P=0.48〕. Compared with controls treated with dummy acupuncture, the observation group had significantly lower post-treatment VAS score〔MD=-1.70, 95%CI (-2.05, -1.35) , P<0.000 01〕and RMDQ score〔MD=-3.06, 95%CI (-4.50, -2.70) , P<0.000 01〕. Compared with controls treated with physical therapy, the observation group had significantly lower post-treatment VAS score〔MD=-1.60, 95%CI (-2.06, -1.14) , P<0.000 01〕and RMDQ score〔MD=-3.00, 95%CI (-4.31, -1.69) , P<0.000 01〕. Compared with controls treated with Tuina, the observation group had significantly lower post-treatment VAS score〔MD=-1.50, 95%CI (-1.65, -1.35) , P<0.000 01〕, and significantly higher overall response rate〔RR=1.19, 95%CI (1.09, 1.30) , P=0.000 1〕. Only one RCT reported that the incidence of adverse events in observation group was 13.33% (4/30) during treatment.

Available documentary evidence showed that, motion style acupuncture can effectively relieve the pain and lumbar dysfunction, and improve the ROM of lumbar vertebra and overall response rate in patients with ANSLBP, with high safety, but which still needs to be confirmed by more high-quality, large-sample RCTs.

Upper limb motor dysfunction is a common complication after stroke that seriously affects daily living skills of patients. As a common neuroelectrohysiological technique, repetitive transcranial magnetic stimulation (rTMS) has a good effect on post-stroke upper limb motor dysfunction. However, there is still no practice-based evidence on the selection of modalities of rTMS.

To evaluate the clinical efficacy of four rTMS modalities in post-stroke upper limb motor dysfunction by a network meta-analysis.

Randomized controlled trials (RCTs) about rTMS for treating upper limb motor dysfunction after stroke were searched with subject words combined with free words as searching terms in PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, Wanfang Data, and VIP from inception to February 2022, supplemented by references from retrospective meta-analysis. Two researchers performed literature screening, data extraction, and quality evaluation separately. RevMan 5.0 and Stata 16.0 were used for statistical analysis.

A total of 17 RCTs with 790 cases were included. Six interventions were involved: high frequency-rTMS (HF-rTMS), low frequency-rTMS (LF-rTMS), intermittent theta burst stimulation (iTBS), continuous theta burst stimulation (cTBS), sham stimulation and conventional therapy. Network meta-analysis results showed that HF-rTMS and LF-rTMS had better effects on increasing the FMA-UE score than sham stimulation and conventional therapy (P<0.05). cTBS increased the FMA-UE score more significantly than conventional therapy (P<0.05). LF-rTMS increased the MBI and BI scores more notably than sham stimulation and conventional therapy (P<0.05). HF-rTMS and LF-rTMS reduced the MEP latency more significantly than sham stimulation (P<0.05). The SUCRA ranking of the six interventions in terms of increasing the FMA-UE score showed the following: LF-rTMS (79.9%) >cTBS (75.3%) >HF-rTMS (71.1%) >iTBS (45.8%) >sham stimulation (20.2%) >conventional therapy (7.7%). The SUCRA ranking of decreasing the MAS score revealed the following: iTBS (77.0%) >LF-rTMS (64.1%) >cTBS (61.0%) >HF-rTMS (38.0%) >sham stimulation (30.6%) >conventional therapy (29.2%). The SUCRA ranking of increasing the MBI and BI scores showed the following: LF-rTMS (96.4%) >iTBS (74.9%) >HF-rTMS (38.6%) >sham stimulation (30.7%) >conventional therapy (9.4%). The SUCRA ranking of reducing the MEP latency showed the following: HF-rTMS (80.0%) >LF-rTMS (78.9%) >conventional therapy (58.8%) >iTBS (24.9%) >sham stimulation (7.5%) .

The available evidence indicates that, among four modalities producing better effects than sham stimulation and conventional therapy, namely LF-rTMS, HF-rTMS, iTBS, and cTBS, LF-rTMS was superior to the other three in improving upper limb motor function and daily living skills of stroke patients, iTBS performed best in decreasing upper limb muscle tension, and HF-rTMS did best in intervening the corticospinal excitability.

Exercise is one of inexpensive and effective interventions for the prevention and treatment of postmenopausal osteoporosis, but relevant pieces of evidence are wide-ranging and fragmented, and there is no standardized and comprehensive exercise guidance program on clinic.

To screen and assess the evidence of exercise interventions for postmenopausal osteoporosis, then summarize the best pieces.

We systematically searched clinical practice guidelines, clinical decisions, evidence summaries, expert consensuses and systematic reviews regarding exercise interventions for postmenopausal osteoporosis in databases of BMJ Best Practice, Up To Date, DynaMed, National Institute for Health and Care Excellence, Guidelines International Network, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, webs of Registered Nurses' Association of Ontario, International Osteoporosis Foundation, Royal Osteoporosis Society, National Osteoporosis Foundation, Royal Australian College of General Practitioners, American College of Obstetricians and Gynecologists, Society of Obstetrics and Gynaecologists of Canada, Medlive, JBI, Cochrane Library, CINAHL, Web of Science, PubMed, Embase, CNKI and SinoMed from inception to January 2022. All relevant evidence was summarized and extracted according to the theme. Appraisal of Guidelines for Research and Evaluation (AGREEⅡ) was used to evaluate the quality of the guidelines, Critical Appraisal for Summaries of Evidence (CASE) was used to evaluate the quality of clinical decisions, the authenticity assessment tool of the expert consensus of the JBI Evidence-Based Health Care Center in Australia (2016 edition) was used to evaluate the quality of expert consensuses, the Australian JBI Evidence-based Health Care Centre System Evaluation Methodology Quality Evaluation Tool (2016 edition) was used to evaluate the quality of the systematic reviews.

A total of 18 studies were included, including seven guidelines, two clinical decisions, four expert consensuses and five systematic reviews. Twenty-two pieces of evidence were extracted, involving five aspects: pre-exercise assessment, exercise type, exercise intensity and time, health education and precautions.

This paper extracts the best evidence of exercise intervention for postmenopausal osteoporosis patients from five aspects: pre-exercise assessment, exercise type, exercise intensity and time, health education and precautions. To reduce the risks of falls and fractures and improve quality of life in postmenopausal women with osteoporosis, it is suggested to provide these women with rational exercise guidance developed based on the best evidence.

Maintaining brain health is an advanced goal of healthy ageing. As an important intervention to promote brain health and reduce the risk of cognitive impairment, physical activity is highly recommended in the WHO Guidelines on Risk Reduction of Cognitive Decline and Dementia. However, due to the lack of specific guidance on the types of exercise, amount of exercise and intervention methods, it is difficult to carry out physical activity in the community.

To construct a community-based physical activity intervention program to promote brain health in community-dwelling Chinese residents.

A draft of Community-based Physical Activity Intervention Program Promoting Brain Health (CPAIPPBH) was developed in December 2021 based on the evidence extracted from studies searched systematically after being screened and assessed in terms of quality by two researchers independently, and review results of our research group. Then from February to March 2022, the draft was revised in accordance with the results of a two-round email-based Delphi survey with 13 experts, and response rate, authority coefficient, Kendall's W, weight of each indicator, and the logical consistency of indicators at all levels were calculated, and finally the formal version was developed.

Altogether, 26 out of the 8 943 searched studies were enrolled, from which 27 pieces of evidence were summarized, involving target group and principles of physical activity, type of physical activity, intensity and time of physical activity, effect and relevant evaluation of physical activity, and considerations for physical activity. The draft CPAIPPBH consisted of 6 primary indicators and 32 secondary indicators. The response rate, authority coefficient, and Kendall's W were 100.0%, 0.940, and 0.257 (χ²=123.386, P<0.001), respectively, for the first round of survey, and were 100.0%, 0.925, and 0.275 (χ²=139.548, P<0.001), respectively, for the second round of survey. The final program includes 7 primary indicators (including target group and principles of physical activity, pre-intervention assessment, form of intervention, type of physical activity, intensity and time of physical activity, effect and relevant evaluation of physical activity, and considerations for physical activity, with corresponding weights of 0.213, 0.213, 0.213, 0.066, 0.116, 0.116, 0.066, respectively) and 33 secondary indicators. The consistency ratios of primary and secondary indicators were all <0.100 0.

The CPAIPPBH developed by us has proven to be scientific and practical, which could be used to guide the management of community-based physical activity interventions for brain health by community medical workers.

The association of sedentary behavior and physical activity with bone mineral density (BMD) in Chinese population has been rarely studied in China, and also seldom studied in Asian populations (mainly limited in young children) by foreign countries. Considering there are great discrepancies between foreign populations and Chinese populations in genetics, dietary habits and other aspects, it is necessary to carry out relevant research in China.

To assess the association of sedentary behavior and physical activity with calcaneal BMD in college students, offering a reference for understanding the bone health status of college students, and for preventing osteoporosis in middle-aged and old people.

By use of stratified cluster sampling, 781 college students aged 19-25 years (including 518 females and 263 males) of different grades were selected from a medical university in Guangzhou from January 2021 to March 2022. Demographic and anthropometric characteristics (including sex, age, height, weight, fat mass index and fat free mass index) and lifestyle information (including daily sedentary time, time spent on physical activity in one week, frequency of dairy products, carbonated drinks and tea consumption, calcium supplement, smoking status, alcohol use status) were collected. Calcaneal BMD was measured, and compared across college students by physique and lifestyle. Multiple linear regression and binary Logistic regression were used to investigate the association of sedentary behaviors and physical activity with calcaneal BMD.

The prevalence of normal and abnormal calcaneal BMD in all students was 50.3% and 49.7%, respectively. The prevalence of abnormal calcaneal BMD in female college students (59.4%) is higher than that in male college students (30.4%) (χ²=58.849, P<0.001). The prevalence of abnormal calcaneal BMD varied by daily sedentary time and time spent on physical activity in one week in female students (χ²=6.670, 6.559, P<0.05). After controlling for potential confounders, multiple linear regression analysis and test for trend showed that in female students, the T-score value of calcaneal BMD increased with the decrease of daily sedentary time (β=-0.17), and there was an obvious negative linear trend between them (P_trend=0.011). And the T-score value of calcaneal BMD increased with the increase of time spent on physical activity in one week (β=0.15), and there was an obvious positive linear trend between them (P_trend=0.004). Further analysis based on binary Logistic regression models showed that in female students, sedentary time <4 hours per day was associated with lower risk of abnormal calcaneal BMD compared with sedentary time >8 hours per day〔OR=0.17, 95%CI (0.04, 0.68), P<0.05〕, and 90-150 minutes of physical activity in one week was associated with lower risk of abnormal calcaneal BMD compared with less than 90 minutes of physical activity in one week〔OR=0.66, 95%CI (0.44, 1.00), P<0.05〕.

The prevalence of abnormal calcaneal BMD in female college students is higher than that in male college students. Both sedentary behavior and physical activity are associated with calcaneal BMD in female college students, no correlation found among male college students. Daily duration of sedentary behavior <4 hours and 90-150 minutes of physical activity in one week are associated with lower risk of abnormal calcaneal BMD. Furthermore, the shorter time spent on daily sedentary behaviors, the lower the risk of abnormal BMD.

Both motoric cognitive risk (MCR) syndrome and subjective cognitive decline (SCD) are early stages of cognitive decline in the elderly. MCR syndrome is currently considered as a new effective predictor of preclinical dementia. Identifying the risk factors of dementia in older people with SCD by early MCR syndrome screening is of great significance for reducing the incidence of dementia and related adverse health events in this group.

To investigate the prevalence and influencing factors of MCR syndrome in the elderly with SCD in the community.

A long-term cohort study conducted from January 2019 to January 2022 in a community in Beijing selected 459 cases of the elderly (≥60 years old) with SCD as the study population. SCD was assessed using the memory-related questions in the Geriatric Depression Scale-15 and the Chinese version of Montreal Cognitive Assessment-Basic. The the 6-metre walking test was used to assess gait status. MCR syndrome was defined as SCD in combination with gait decline. A self-designed questionnaire was used to collect the demographic data, physiological factors, psychological factors, lifestyle indicators, psychological factors, nutritional status, conditions of illness and medication history. Stepwise multinomial Logistic regression was used to explore the influencing factors of MCR syndrome.

The prevalence of MCR syndrome was 27.2% (125/459) . The elderly in the MCR and non-MCR groups were compared for age, basic activities of daily living (BADL) , instrumental activities of daily living (IADL) , weekly exercise hours, anxiety status, nutritional status, conditions of illness〔hypertension, chronic heart failure, arrhythmia, stroke/transient ischaemic attack (TIA) , multiple lacunar infarction, diabetes mellitus, peripheral vascular disease, cancers, osteoarthritis, history of fracture in the last 2 years, oculopathy, oral disease〕, and medication history, and the difference was statistically significant (P<0.05) . Stepwise multinomial Logistic regression analysis showed that older age〔OR (95%CI) =1.083 (1.034, 1.134) 〕, lower ability to perform BADL〔OR (95%CI) =0.952 (0.914, 0.991) 〕, lower ability to perform IADL〔OR (95%CI) =0.623 (0.486, 0.798) 〕, weekly exercise hours〔OR (95%CI) =0.505 (0.295, 0.864) 〕, anxiety status〔OR (95%CI) =2.442 (1.225, 4.866) 〕, conditions of hypertension〔OR (95%CI) =1.948 (1.086, 3.497) 〕, and conditions of stroke/TIA〔OR (95%CI) =3.154 (1.745, 5.699) 〕were associated with MCR syndrome (P<0.05) .

The prevalence of MCR syndrome was high in older adults with SCD in the community. In view of this, during the MCR syndrome screening in this population, attention should be paid to risk factors such as older age, the ability to perform BADL and IADL, weekly exercise hours, anxiety status, conditions of hypertension, and conditions of stroke/TIA, and support should be provided for these people to control chronic disease and develop a healthy lifestyle, thereby improving their cognitive status.

Sleep disorder is a common complication of stroke with various clinical manifestations. Among them, periodic limb movements in sleep (PLMS) are characterized by repetitive and stereotyped limb movements during sleep. Due to limited clinical date, the pathogenesis of PLMS and their impact on prognosis of stroke are still in the exploratory stage. Studies about the effect of PLMS on sleep in stroke patients are few in worldwide.

To explore the sleep structure of stroke patients with PLMS.

From December 2020 to February 2022, a total of 81 stroke patients with sleep disorders were selected from the Second Affiliated Hospital of Zhengzhou University, in which polysomnography (PSG) was performed. The clinical information and PSG sleep monitoring data of patients were collected. According to the Periodic Limb Movement Index (PLMI) , the patients were divided into non-PLMS patients (control group, PLMI<15 times/h) and PLMS patients (experimental group, PLMI≥15 times/h) . The parameters between two groups were compared. These parameters include awake PLMI, sleep efficiency, proportion of stage N1 sleep in total sleep time, proportion of stage N2 sleep in total sleep time, proportion of stage N3 sleep in total sleep time, REM sleep in total sleep time, sleep apnea hypopnea index (AHI) , sleep latency, arousal index, and periodic limb movement arousal index (PLMAI) . Moreover, the correlation between PLMS and sleep structure and related parameters was analyzed.

There were 42 cases in the control group and 39 cases in the experimental group. The awake PLMI, proportion of stage N1 sleep in total sleep time, proportion of stage N2 sleep in total sleep time, arousal index and PLMAI in experimental group were higher than those in control group (P<0.05) . However, the sleep efficiency and proportion of stage N3 sleep in total sleep time of experimental group were lower than those of control group (P<0.05) . There was no significant difference between two groups in sleep latency, AHI and REM stage sleep in total sleep time (P>0.05) . The results of Spearman rank correlation analysis showed that PLMS was positively correlated with awake PLMI, proportion of stage N2 sleep in total sleep time, sleep latency, arousal index, and PLMAI (r_s values were 0.619, 0.250, 0.271, 0.312, 0.828, respectively; P values were <0.001, 0.024, 0.014, 0.005, <0.001) , which were negatively correlated with sleep efficiency (r_s=-0.345, P=0.002) .

Stroke patients with PLMS have objective sleep disturbance and reduced sleep efficiency, and PLMS may be one of the signs of poor prognosis of stroke.

The pairwise correlation among biased constitution, exercise and health-related quality of life (HRQOL) has been extensively studied, while the relationship among the three has been rarely explored.

To explore the mediating effect of exercise on the relationship of 8 kinds of biased constitution with HRQOL.

By use of convenience sampling, unpaid blood donors and their companions were selected as participants from blood donation cabins and blood collecting vehicles of Beijing Red Cross Blood Center from July to November 2015 and May to September 2016 . The exercise level was obtained by the self-report method. The biased constitution was assessed using the Constitution in Chinese Medicine Questionaire (CCMQ) . The HRQOL was evaluated by the Chinese version of the 36-Item Short Form Health Survey (SF-36) , and a higher score indicates a higher quality of life. Pearson correlation analysis was used to explore the correlation among HRQOL (score of SF-36) , exercise level and 8 kinds of biased constitution. Multiple linear regression model was applied to explore the mediating effect of exercise on the relationship between HRQOL and biased constitution.

A total of 1 828 cases attended the survey, 1 771 of them returned questionnaires, and after excluding 29 who inappropriately (incompletely or illogically) answered questionnaires, the remaining 1 742 cases (95.30%) were included for analysis. The mean SF-36 score of 1 742 subjects was (84.42±12.05) points. And the mean scores of the 8 biased constitution subscales of CCMQ for them were: qi-deficiency: (23.20±14.61) points, yang-deficiency: (20.03±18.12) points, yin-deficiency: (20.87±15.20) points, phlegm-dampness: (19.78±14.65) points, dampness-heat: (21.70±16.57) points, blood-stasis: (17.68±14.08) points, qi-depression: (19.63±15.63) points, specific-diathesis: (15.30±13.62) points. The score of each of the 8 kinds of biased constitution was negatively correlated with HRQOL (r: -0.413 - -0.612, P<0.01) . Except for specific-diathesis type, biased constitution scores were negatively correlated with exercise level (r: -0.072 - -0.176, P<0.01) . Exercise level was positively correlated with HRQOL (r=0.145, P<0.01) . Mediation analysis revealed that, exercise played a significant mediating effect on the relationship between HRQOL and biased constitution except the specific-diathesis type (P<0.05) . And the size of mediating effect in a descending order was 2.13% between HRQOL and phlegm-dampness, 2.05% between HRQOL and yang-deficiency, 1.88% between HRQOL and dampness-heat, 1.55% between HRQOL and yin-deficiency, 1.48% between HRQOL and blood-stasis, 1.37% between HRQOL and qi-depression, 1.16% between HRQOL and qi-deficiency.

Eight kinds of biased constitution (phlegm-dampness, yang-deficiency, dampness-heat, yin-deficiency, blood-stasis, qi-depression, qi-deficiency, and specific-diathesis) negatively affected the HRQOL. Although exercise partially played a role in mediating the relationship of HRQOL with the other 7 types of biased constitution except specific-diathesis, the effect size was generally little.

Microcirculation dysfunction is closely associated with the development of obesity. Exercise intervention could effectively improve the microcirculation in obese people, but the intensity of an exercise intervention schemes often lacks of individualization and precision. FATmax is a precise and individualized exercise intensity determined on the basis of individual fat oxidation rate.

To compare the effects of aerobic exercise and combined aerobic and resistance exercise at FATmax intensity on improving the microcirculation in obese college students, and to explore the mechanism of action by analyzing the changes in nitric oxide (NO) , endogenous NO synthase (eNOS) , endothelin-1 (ET-1) and endothelial growth factor (VEGF) .

In March, 2021, Sixty-six obese college students were recruited from Hubei University for Nationalities, and equally randomized into sex-matched three groups with different 10-week interventions: aerobic exercise group (performing aerobic exercise at the FATmax intensity, 4 times a week, 60 minutes each time) , combined aerobic and resistance exercise group〔performing combined aerobic and resistance exercise at FATmax intensity, 4 times a week, 60 minutes each time (40 minutes for aerobic exercise and 20 minutes for resistance exercise) 〕, and control group (maintaining their normal living habits) . Body weight, body fat percentage, BMI, microvascular reactivity, transcutaneous oxygen pressure (TcPO₂) , muscle oxygen saturation (SmO₂) , NO, eNOS, ET-1, VEGF and HOMA-IR were tested on March 18 and June 2, 2021, respectively.

The intervention modality and duration had significant interactive effects on body weight, BMI and body fat percentage of three groups (P<0.05) . In particular, the average body weight, BMI and body fat percentage decreased significantly in both aerobic exercise group and combined aerobic and resistance exercise group after the intervention (P<0.05) . What's more, the average post-intervention levels of the above-mentioned three indicators in the two groups were significantly lower than those of the control group (P<0.05) . The intervention modality and duration had significant interactive effects on microvascular reactivity, TcPO₂ and SmO₂ of three groups (P<0.05) . In particular, the average microvascular reactivity, TcPO₂ and SmO₂ increased significantly in both aerobic exercise group and combined aerobic and resistance exercise group after the intervention (P<0.05) . In addition, the average post-intervention levels of the average microvascular reactivity and TcPO₂ in the two groups were significantly higher than those of the control group (P<0.05) . The intervention modality and duration produced obvious interactive effects on NO, eNOS, VEGF and HOMA-IR of three groups (P<0.05) . In particular, the average NO, eNOS, and VEGF increased significantly and HOMA-IR decreased significantly in both aerobic exercise group and combined aerobic and resistance exercise group after the intervention (P<0.05) . Moreover, these two groups showed higher average post-intervention levels of NO and lower average post-intervention level of HOMA-IR than the control group (P<0.05) .

Both 10-week aerobic exercise and combined aerobic and resistance exercise at FATmax intensity could reduce body weight, body fat percentage, BMI and HOMA-IR in obese college students, and the latter may be more effective in improving microvascular reactivity and HOMA-IR. These two modalities of exercise improved microcirculation may be by improving the levels of NO, ET-1, VEGF and other factors.

Aquatic therapeutic exercise is an emerging physical therapy technique, which provides new ideas for improving the motor function and quality of life of patients with stroke. However, it is not clear that the rehabilitation benefits obtained by patients with stroke from aquatic therapeutic exercise, and the levels of methodological quality and evidence quality of relevant studies.

To overview the systematic reviews of aquatic therapeutic exercise in improving the rehabilitation in patients with stroke.

In June 2021, Systematic reviews assessing the effects of aquatic therapeutic exercise in stroke rehabilitation were searched in databases of PubMed, the Cochrane Library, EmBase, CINAHL, Web of Science, CNKI, WanFang Data, CQVIP and SinoMed from inception to June 15, 2021. Two researchers screened systematic reviews according to the inclusion and exclusion criteria and extracted data separately. The methodological quality was evaluated using AMSTAR 2. The reporting quality was evaluated using the PRISMA. The quality of evidence for major outcomes was evaluated using the GRADE system.

A total of 9 reviews were included, 2 of which were in Chinese and 7 were in English. The analysis showed that the methodological quality of 1, 1, and 7 reviews were moderate, low, and extremely low, respectively. The reporting quality of 7 reviews were relatively complete, 1 review had some flaws, and 1 review had a serious information flaw. There were a total of 9 outcome indicators, and 49 bodies of evidence, and the quality of bodies of evidence was mostly low or very low. Aquatic therapeutic exercise improved the balance function, mobility and muscle strength of stroke patients to a certain extent. And the rehabilitation benefits had proven to be more when it was used in combination with dryland trainings.

Aquatic therapeutic exercise has proven to be effective in improving balance function, mobility and muscle strength in stroke patients with good safety. But the overall methodological quality and quality of evidence for major outcomes of included systematic reviews are unsatisfactory. It is suggested that future studies use a larger sample size and an improved design, which will provide evidence-based guidance for clinical management of stroke rehabilitation with aquatic therapeutic exercise.

Cardiopulmonary problems will increase the risk of health harms yet they are often neglected in clinical rehabilitation treatment for stroke patients. In addition, sleep problems also often affect the rehabilitation effect in these patients, while routine drug treatment could not achieve satisfactory effect.

To assess the effect of precisely prescribed exercise on cardiopulmonary fitness and sleep quality in stroke patients.

Sixty-four stroke inpatients were recruited from Rehabilitation Department, Changzhou Dean Hospital from April 2020 to August 2021, and equally randomized into a control group and an experimental group. At baseline, cardiopulmonary fitness was assessed using cardiopulmonary exercise testing (CPET) , and sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI) for both groups. Then control group received 12-week routine rehabilitation training, while experimental group received 12-week routine rehabilitation training plus aerobic exercise precisely prescribed based on baseline CPET parameters. Intra- and inter-group comparisons were made between pre- and post-training major CPET parameters, dyspnea and leg fatigue measured by the Borg Scale and sleep quality.

At the end of training, the experimental group demonstrated higher peak oxygen uptake (VO₂peak) , percentage of predicted peak oxygen uptake (VO₂peak%pred) , peak metabolic equivalent (METpeak) , peak heart rate (HRpeak) , peak load, and anaerobic threshold (AT) , and lower intensity of perceived dyspnea and leg fatigue than the control group (P<0.05) . The above-mentioned eight parameters improved significantly after training in the experimental group (P<0.05) . The experimental group had lower post-training scores of six domains (subjective sleep quality, sleep latency, sleep duration, sleep disturbances, use of sleep medication, daytime dysfunction) and lower post-training total score of PSQI than the control group (P<0.05) . The total score of PSQI and the scores of its seven domains were all lowered significantly when the training was finished (P<0.05) .

The precisely prescribed aerobic exercise by the results of CPET could effectively improve the cardiopulmonary fitness, exercise intensity, exercise endurance, and sleep quality as well as the sense of exercise fatigue in stroke patients.

The level of exercise self-efficacy of lung cancer patients affects the establishment of exercise goals and the belief of overcoming difficulties. Understanding the current situation has a good predictive effect on the exercise behavior of lung cancer patients, but there is no norm for exercise self-efficacy assessment tools for lung cancer patients in China, which makes the measurement results lack of reference standards.

To establish the norm of Exercise Self-efficacy Scale for lung cancer patients in Anhui Province.

Anhui Province was divided into northern, central and southern regions according to its geographical location. A total of 1 600 lung cancer patients were selected by regional stratified random sampling from January to August in 2021, and Exercise Self-efficacy Scale was used to investigate them, the mean, percentile and demarcation norm of the scale were established.

A total of 1 600 questionnaires were distributed, 1 459 valid questionnaires were recovered, with an effective recovery rate of 91.19%. The total score of Exercise Self-efficacy Scale for lung cancer patients in Anhui Province was (67.66±14.90) , and the score of efficacy expectation dimension was (63.09±18.13) , the outcome expectation dimension score was (73.48±14.10) . In this study, the mean norm of Exercise Self-efficacy Scale for lung cancer patients in Anhui Province was established according to gender and age groups (young group of 19-35 years old, middle-aged group of 36-59 years old, and elderly group of ≥60 years old) . The results of multiple linear regression analysis showed that gender, age, education level, occupation, regular exercise habits, concomitant diseases, hospital level, department, BMI and regional division were the influencing factors for the total score of exercise self-efficacy in lung cancer patients (P<0.05) . Therefore, the classification norm was established based on the above variables. With 5% as the interval, the percentile norm of the Exercise Self-efficacy Scale for lung cancer patients from 5 to 95 was established. With (-s) , (-0.5s) , (+0.5s) , (+s) as the boundary point, the exercise self-efficacy level of lung cancer patients was divided into five states according to the total score of the scale from low to high: very low, low, medium, high and very high.

This study preliminarily constructed the norm of Exercise Self-efficacy Scale for lung cancer patients in Anhui Province, which can provide a reference standard for the study of exercise self-efficacy level of this population, and also provide a theoretical basis for further exploring the influencing factors of exercise self efficacy in lung cancer patients.

As the main cause of death in the world, the morbidity and mortality of cardiovascular diseases are increasing year by year. Chronic inflammation of circulatory system is common in middle-aged and older people, which is closely related to the pathogenesis of various cardiovascular diseases. Dyslipidemia is also one of the age-specific cardiovascular risk factors. Exercise has attracted much attention as an important intervention method, among which resistance training can reduce the risk of cardiovascular diseases in middle-aged and older people, but the regulation effect of inflammation and dyslipidemia is still controversial.

To explore the effect of resistance training on cardiovascular risk factors in middle-aged and older people, and to provide a basis for formulating exercise prescriptions for middle-aged and elderly people.

PubMed, Cochrane, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and VIP Chinese Science and Technology Journal Full-text Database were retrieve by computer for randomized controlled trials on the effects of resistance training on cardiovascular risk factors in middle-aged and older people published from the date of establishment to 2021-08-31. The retrieved literatures were screened and data extracted, including the first author, the year of publication, general characteristics of the study population, resistance training protocols and outcome indicators. The bias risk assessment tool of Cochrane system evaluation manual was used to evaluate the bias risk of literature. Meta-analysis was performed using RevMan 5.3 software, including the statistics of combined effect size, heterogeneity test, sensitivity analysis, and subgroup analysis. Publication bias of included studies was analyzed using Stata 16.0 software, using Egger's test.

Fifteen papers with 476 observations were included. Meta-analysis showed that, resistance training were superior to control group in decreasing C-reactive protein〔SMD (95%CI) =-0.67 (-0.89, -0.46) , P<0.01〕, total cholesterol〔SMD (95%CI) =-0.37 (-0.66, -0.08) , P=0.01〕, triglyceride〔SMD (95%CI) =-0.29 (-0.53, -0.05) , P=0.02〕, low-density lipoprotein cholesterol〔SMD (95%CI) =-0.37 (-0.67, -0.06) , P=0.02〕 and improving high-density lipoprotein cholesterol levels〔SMD (95%CI) =0.33 (0.09, 0.57) , P<0.01〕. Subgroup analysis showed that C-reactive protein and total cholesterol levels were lower in the resistance training group than in the control group at training duration ≤12 weeks, with statistically significant differences (P<0.05) . In both the training intensity of high intensity and the chronic disease population, C-reactive protein levels were lower in the resistance training group than in the control group and high-density lipoprotein cholesterol levels were higher, with statistically significant differences (P<0.05) .

Resistance training has been shown to be effective in reducing cardiovascular risk factors, reducing chronic inflammation and improving dyslipidaemia in the middle-aged and older population.

Smart bracelets are increasingly used in chronic disease management, which help improve patient adherence and motivation to exercise interventions, but more evidence for their long-term effectiveness in patients with type 2 diabetes mellitus (T2DM) in the community needs to be explored.

To develop an intervention model for community-dwelling type 2 diabetes patients using smart bracelets, and to assess its long-term effectiveness in these patients.

From July to August 2018, this study selected 11 community health institutions from 11 districts of Guangzhou (one from each district) as study settings. And from each setting, 10-15 T2DM patients were selected (intervention group), and were compared to sex-matched and age-matched (+/- two years) T2DM patients (control group). The intervention was carried out from September 2018 to August 2019 in two groups, both received standardized health management services provided by the family physician team and underwent the exercise prescribed by an exercise prescriber. The intervention group additionally received health monitoring and management via wearing a smart bracelet, and set personalized exercise challenge goals under the guidance of an exercise prescriber. The score of the Chinese version of Summary of Diabetes Self-Care Activities Measure (SDSCA-C), comprehensive assessment indicators, and attainment rates of key glycemic indicators were compared between the two groups before and after the intervention.

Ninety-two patients in the control group and 144 patients in the intervention group completed one-year intervention and follow-up. After the intervention, the subscale scores of dietary management and foot care management and the total score of SDSCA-C increased notably in the intervention group (P<0.05), but changed insignificantly in the control group (P>0.05). Two groups had no statistically significant differences in all comprehensive assessment indicators at baseline (P>0.05). After one year of intervention, besides a decrease was found in total cholesterol, apolipoprotein A1 and apolipoprotein B in both groups, a reduction was found in waist circumference in the intervention group, and in fasting plasma glucose (FPG), triacylglycerol and low-density lipoprotein cholesterol in the control group (P<0.05) .In terms of the attainment rate of key indicators, the HbA_1c attainment rate increased in the intervention group after intervention (P<0.05), and the post-intervention rate was higher than that of the control group (P<0.05). The FPG attainment rate was higher after intervention in both groups (P<0.05). But the high-density lipoprotein cholesterol attainment rate was lower after intervention in both groups (P<0.05) .

Using a smart bracelet helps people with T2DM maintain self-management behaviors over time and keep their blood sugar at target levels. As dyslipidemia is an important factor affecting blood glucose control, pharmacological interventions should be initiated as early as possible to regulate lipid metabolism disorders in addition to lifestyle modification.