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    Combined Aerobic and Resistance Training Improves Body Composition, Alters Cardiometabolic Risk, and Ameliorates Cancer-Related Indicators in Breast Cancer Patients and Survivors with Overweight/Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
    (Journal Sports Science & Medicine, 2024) Al-Mhanna, Sameer Badri; Batrakoulis, Alexios; Noor, Norhayati Mohd; Mohamed, Mahaneem; Drenowatz, Clemens; Irekeola, Ahmad Adebayo; Afolabi, Hafeez Abiola
    Breast cancer survivors with obesity are at a high risk of cancer recurrence, comorbidity, and mortality. This review aims to systematically evaluate the effects of combined aerobic and resistance training (CART) on body composition, lipid homeostasis, inflammation, adipokines, cancer-related fatigue, sleep, and quality of life in breast cancer patients and survivors with overweight/obesity. An electronic search was conducted in PubMed, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases from inception up to January 8, 2024. Randomized controlled trials (RCTs) meeting the inclusion criteria were selected for the analysis. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the quality of evidence. A random-effects model was used, and data were analyzed using mean (MD) and standardized mean differences (SMD) for continuous variables with 95% confidence intervals (CI). We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias, and quality of evidence. A total of 17 randomized controlled trials were included in the systematic review involving 1,148 female patients and survivors (mean age: 54.0 +/- 3.4 years). The primary outcomes showed significant improvements in body mass index (SMD -0.57 kg/m(2), p = 0.04), body fat (SMD -0.50%, p = 0.02), fat mass (SMD -0.63 kg, p = 0.04), hip circumference (MD -3.14 cm, p = 0.02), and fat-free mass (SMD 1.03 kg, p < 0.001). The secondary outcomes indicated significant increases in high-density lipoprotein cholesterol (MD -0.05 mmol/L, p = 0.008), natural killer cells (SMD 0.42%, p = 0.04), reductions in triglycerides (MD -81.90 mg/dL, p < 0.01), total cholesterol (SMD -0.95 mmol/L, p < 0.01), tumor necrosis factor alpha (SMD -0.89 pg/mL, p = 0.03), and leptin (SMD -0.63 ng/mL, p = 0.03). Also, beneficial alterations were found in cancer-related fatigue (SMD -0.98, p = 0.03), sleep (SMD -1.17, p < 0.001), and quality of life (SMD 2.94, p = 0.02) scores. There was very low to low confidence in the estimated effect of most of the outcomes. The present findings reveal that CART could be considered an adjunct therapy in supporting the conventional clinical approach observed following exercise. However, further high-quality research is needed to evaluate whether CART would be a valuable intervention to lower aggressive pharmacologic use in breast cancer patients with overweight/obesity.
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    Psychophysiological Adaptations to Exercise Training in COVID-19 Patients: A Systematic Review
    (Hindawi Ltd, 2024) AL-Mhanna, Sameer Badri; Batrakoulis, Alexios; Hofmeister, Martin; Drenowatz, Clemens; Ghazali, Wan Syaheedah Wan; Badicu, Georgian; Afolabi, Hafeez Abiola
    Introduction. Many COVID-19 patients display adverse symptoms, such as reduced physical ability, poor quality of life, and impaired pulmonary function. Therefore, this systematic review is aimed at evaluating the effectiveness of physical exercise on various psychophysiological indicators among COVID-19 patients who may be at any stage of their illness (i.e., critically ill, hospitalized, postdischarge, and recovering). Methods. A systematic search was conducted in PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar from 2019 to 2021. Twenty-seven studies, which assessed a total of 1525 patients, were included and analysed. Results. Overall, data revealed significant improvements in the following parameters: physical function, dyspnoea, pulmonary function, quality of life (QOL), lower limb endurance and strength, anxiety, depression, physical activity level, muscle strength, oxygen saturation, fatigue, C-reactive protein (CRP), interleukin 6 (IL-6), tumour necrosis factor-alpha (TNF-alpha), lymphocyte, leukocytes, and a fibrin degradation product (D-dimer). Conclusions. Physical training turns out to be an effective therapy that minimises the severity of COVID-19 in the intervention group compared to the standard treatment. Therefore, physical training could be incorporated into conventional treatment of COVID-19 patients. More randomized controlled studies with follow-up evaluations are required to evaluate the long-term advantages of physical training. Future research is essential to establish the optimal exercise intensity level and assess the musculoskeletal fitness of recovered COVID-19 patients. This trial is registered with CRD42021283087.
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    The Impact of Various Types of Exercise on Lipid Metabolism in Patients with Type 2 Diabetes and Concurrent Overweight/Obesity: A Narrative Review
    (Annals Applied Sport Science, 2024) Al-mhanna, Sameer Badri; Ghazali, Wan Syaheedah Wan; Batrakoulis, Alexios; Alkhamees, Nouf H.; Drenowatz, Clemens; Mohamed, Mahaneem; Gülü, Mehmet
    Background. Type 2 diabetes mellitus (T2DM) and obesity present substantial challenges to global public health, marked by their widespread prevalence and associated morbidities. The ensuing complications, including cardiovascular disease (CVD), metabolic syndrome, cancer, liver disease, and neurodegeneration, underscore the urgent need for effective preventive measures. Despite this, primary prevention of CVD in individuals with T2DM and obesity remains inadequate. Regular exercise emerges as a pivotal factor in ameliorating various cardiometabolic parameters, yet conflicting findings persist regarding the impact of exercise parameters (frequency, intensity, time, and type) on lipid homeostasis. Objectives. This review scrutinizes the effects of diverse exercise types and parameters on individuals with T2DM and concurrent obesity. A focus is placed on investigating the influence of exercise on conventional lipids, such as LDL-C, HDL-C, TG, total TC, and VLDL-C. The review briefly delves into the mechanisms underlying exercise-induced effects on lipids and lipoproteins. Methods. A literature search was conducted using the PubMed, Scopus, and Google Scholar databases. Results. Regular exercise is instrumental in elevating HDL-C levels while reducing TG, TC, VLDL, and LDL-C concurrently. Exercise mitigates CVD risk, lowers BMI, and enhances insulin resistance, depending on exercise types, volume, intensity, frequency, and duration. Conclusion. Future research must delve into the dose-response effects of real-world exercise programs to guide tailored interventions. This comprehensive understanding should inform clinicians and practitioners, empowering them to prescribe personalized exercise regimens for individuals grappling with compromised metabolic health.