Exercise

Efficacy of lifestyle interventions in treating erectile dysfunction: a systematic review and meta-analysis of randomized controlled trials.

Li T, He X, Huang W, Liu G, Feng Q · The journal of sexual medicine · 2026 · n=1477

Erectile dysfunction (ED) is increasingly recognized as a marker of vascular and metabolic health, but the overall effect of lifestyle intervention on erectile function remains uncertain. To evaluate the efficacy of diet- and/or exercise-based lifestyle interventions for improving erectile function in men with ED. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched from inception to December 2025 for randomized controlled trials evaluating lifestyle interventions in adult men with ED. Eligible studies compared exercise-only, diet-only, or combined diet-and-exercise interventions with usual care, standard treatment, or no intervention. The primary analysis assessed change in erectile function using validated International Index of Erectile Function. Risk of bias was assessed with the Cochrane tool, certainty of evidence with GRADE, and pooled mean differences (MDs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models. Prespecifie

Diagnosis and Management of Resistant Hypertension: A Review.

Azizi M, Vongpatanasin W, Fisher NDL, Mahfoud F, Amar L, Kirtane AJ · JAMA · 2026 · n=331

Hypertension, defined as office systolic blood pressure (SBP) 130 mm Hg or greater and/or diastolic blood pressure 80 mm Hg or greater, affects 43.9% of women and 49.5% of men in the US. Approximately 19.7% of patients treated for hypertension have apparent resistant hypertension (blood pressure ≥130/80 mm Hg) despite using 3 or more antihypertensive medications, preferably a renin-angiotensin system blocker, a calcium channel blocker, and a thiazide-type diuretic, at maximally tolerated doses. Approximately 10% of patients treated for hypertension have true resistant hypertension confirmed with home or 24-hour ambulatory blood pressure monitoring to exclude white-coat hypertension (approximately 37.5% of apparent resistant hypertension) and after excluding medication nonadherence (approximately 50%) and secondary hypertension such as primary aldosteronism (approximately 5%-25%). Conditions associated with resistant hypertension include obesity, diabetes, chronic kidney disease

The most effective therapeutic exercises for pain intensity in women with fibromyalgia: A systematic review and network meta-analysis.

Rodríguez-Domínguez ÁJ, Rebollo-Salas M, Chillón-Martínez R, Rosales-Tristancho A, Villa-Del-Pino I, Jiménez-Rejano JJ · Brazilian journal of physical therapy · 2025 · n=2873

Therapeutic exercise (TE) is the only intervention with strong recommendation for fibromyalgia. However, there is controversy as to which type of exercise is the most beneficial. To determine which TE approach is the most effective in reducing pain intensity in women with fibromyalgia. A systematic review was performed with a network meta-analysis (NMA). Six databases were searched from inception until January 2024. Randomized controlled trials (RCTs) evaluating the effects of TE on pain intensity were included in women with fibromyalgia. Methodological quality was assessed using the Physiotherapy Evidence Database scale. The size of the effect and the clinically important difference were determined in the short-term (≤3 months) and long-term (>3 months). Sixty-one studies were identified, of which 51 were included in the quantitative synthesis (n = 2873). Fifteen TE interventions and eight comparison interventions (comparators) were identified. Aquatic exercise (p-score:

Potential application of brain-gut axis-based treatments in Long COVID and ME/CFS: a case-based systematic review.

Kim DY, Youn J, Kang N, Cho SI, Ha IH · Journal of translational medicine · 2026 · n=790

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID share clinical features including persistent fatigue, post-exertional malaise (PEM), and gastrointestinal (GI) dysfunction. Growing evidence implicates brain-gut axis dysregulation, characterized by dysbiosis, neuroinflammation within the central nervous system (CNS), increased intestinal permeability, and microbial translocation in their pathophysiology. However, therapeutic strategies targeting these pathways remain poorly defined. We report a case of post-COVID ME/CFS successfully treated with electroacupuncture (EA)-based deep peroneal nerve stimulation which was employed to potentiate the vagal reflex. Fatigue trajectories were assessed using the Multidimensional Fatigue Inventory over 12 weeks. Based on the case, a systematic review of randomized controlled trials (RCTs) evaluating brain-gut axis-modulating interventions in ME/CFS or Long COVID was conducted. The patient exhibited a significant re

Does exercising during peri- or early post-menopause prevent bone and muscle loss: A systematic review.

Whitman PW, Alexander CJ, Kaluta L, Burt LA, Gabel L · Bone · 2025

The highest rate of bone and muscle loss occurs during the menopause transition. Yet, most clinical exercise trials have excluded peri- and early post-menopausal female participants. This systematic review aimed to determine (1) the effects of exercise on bone and muscle health during the menopause transition; and (2) which types of exercise are most effective for preventing bone and muscle mass loss during the menopause transition. Articles were retrieved from five electronic databases (MEDLINE, Embase, CENTRAL, CINAHL, and SPORTDiscus). Inclusion criteria included: (1) randomized controlled trial (RCT); (2) 45-to 60-year-old and peri- or early post-menopausal females; (3) reported bone mineral density (BMD) or lean mass. Six studies met inclusion criteria; two evaluated peri-menopausal and four investigated early post-menopausal female participants. All studies had low quality of evidence, and high risk of bias. Strength training, endurance training, and Tai Chi did not improve are

Balance exercise interventions in Parkinson's disease: A systematic mapping review of components, progression, and intensity.

Wallin A, Franzén E, Studsgaard J, Hansen MB, Johansson S, Brincks JK · Parkinsonism & related disorders · 2025 · n=5335

Rehabilitation in individuals with Parkinson's disease (PD) often includes balance training, but knowledge about optimal training content remains limited. To describe the design, content, delivery, and reporting of balance training for individuals with PD, and furthermore, to map the systematic use and reporting of methods monitoring intensity in balance training interventions for individuals with PD. Six databases were searched. Interventions with at least 50 % of exercises challenging balance control were included. Balance training types (exergaming, multi-modal, sensory-motor integrated, and task-oriented) were categorized based on specific balance exercise components: motor (limits of stability, anticipatory motor strategies, reactive motor strategies, and control of dynamics), sensory (vestibular, visual, and somatosensory systems), and cognitive (dual-tasking in motor or cognitive activities). Training Frequency, Intensity, Time, Type, Volume, and Progression (FITT-VP prin

Update of guideline for diagnosis and treatment of subacromial pain syndrome: a multidisciplinary review by the Dutch Orthopedic Association Part 1: preventive measures, diagnostics, and non-surgical treatment of subacromial pain syndrome.

Lambers Heerspink FO, Veen EJD, Dorrestijn O, Visser CPJ, Leijs MJC, Van Poppel D · Acta orthopaedica · 2026

In 2013, the first clinical practice guideline for subacromial pain syndrome (SAPS) was developed in the Netherlands to support healthcare professionals. SAPS refers to non-traumatic, non-rheumatologic shoulder complaints that are particularly painful during arm elevation. It includes conditions such as supraspinatus tendinosis, calcific tendinitis, and degenerative supraspinatus tears. Over 50,000 patients annually consult orthopedic surgeons for these issues. In response to new evidence and clinical needs, an updated guideline was developed. Part 1 addresses prevention, diagnosis, imaging, and non-surgical treatment. Using a multidisciplinary, evidence-based approach, the guideline aims to answer key clinical questions around SAPS. Initiated by the Dutch Orthopedic Society, the guideline committee identified knowledge gaps through group sessions. Each module was based on a PICO-formatted key question and reviewed by professionals from different fields. The AGREE and GRADE methods we

Update of guideline for diagnosis and treatment of subacromial pain syndrome: a multidisciplinary review by the Dutch Orthopedic Association Part 2: Operative considerations and treatment of various conditions related to subacromial pain syndrome.

Lambers Heerspink FO, Veen EJD, Dorrestijn O, Visser CPJ, Leijs MJC, Van Poppel D · Acta orthopaedica · 2026

In 2013, the first clinical practice guideline for subacromial pain syndrome (SAPS) was developed in the Netherlands to support healthcare professionals. SAPS refers to non-traumatic, non-rheumatologic shoulder complaints that are particularly painful during arm elevation. It includes conditions such as supraspinatus tendinosis, calcific tendinitis, and degenerative supraspinatus tears. Over 50,000 patients annually consult orthopedic surgeons for these issues. In response to new evidence and clinical needs, an updated guideline was developed. Part 2 focuses on supraspinatus tears, biceps tendon pathology, and calcific tendinosis. Using a multidisciplinary, evidence-based approach, the guideline aims to answer key clinical questions around SAPS. Initiated by the Dutch Orthopedic Society, the guideline committee identified knowledge gaps through group sessions. Each module was based on a PICO-formatted key question and reviewed by professionals from different fields. The AGREE and GRAD

FIGO best practice recommendations for the mental health of women at menopausal age.

Khadilkar S, Divakar H, Benedetto C, Genazzani A, Ramos D, Argale E · International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026

Mental health during the menopausal transition requires focused attention to ensure supportive experiences for women. This review presents the International Federation of Gynecology and Obstetrics (FIGO) recommendations and summarizes the evidence, addressing 13 key questions framed by members of the FIGO Committee on Women at Menopausal Age. Although the literature on mental health during menopause is extensive, a gap exists in consolidated best practice recommendations. The FIGO committee members assessed the evidence quality and recommendation strength using a 5-point Likert scale. Over 70% of the experts agreed with a strong recommendation level (score of 5) for eight questions, while five questions were agreed with high and moderate recommendations. Symptoms of anxiety and depression are prevalent during the perimenopause. Menopause-related mental health issues are often overlooked in low- and middle-income countries. Mental health issues impact quality of life, necessitating psyc

Vitamin D in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After COVID-19 or Vaccination: A Randomized Controlled Trial.

Kodama S, Nakata M, Konishi N, Yoshino M, Fujisawa A, Naganuma M · Nutrients · 2026 · n=56

Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) can develop as post-vaccination syndrome (PVS) or Post-Acute Sequelae of SARS-CoV-2 infection (PASC). In our prior retrospective study, most patients with PVS who developed ME/CFS had vitamin D insufficiency or deficiency. We evaluated the efficacy of vitamin D replacement therapy guidance for ME/CFS symptom improvement in patients with vitamin D insufficiency or deficiency. Methods: This open-label randomized controlled trial enrolled 91 participants with ME/CFS as PVS or PASC and serum 25(OH) vitamin D < 30 ng/mL across five clinical sites. Participants were randomized 1:1 to intervention (active vitamin D preparation plus vitamin D replacement therapy guidance: 25 μg daily supplementation, dietary counseling, sun exposure, and exercise) or control (active vitamin D preparation alone) for 12 weeks. The primary endpoint was the change in ME/CFS symptom count from screening to Week 12. Results: Mean sympto

Catheter Ablation vs Lifestyle Modification With Antiarrhythmic Drugs to Treat Atrial Fibrillation: PRAGUE-25 Trial.

Osmancik P, Roubicek T, Havranek S, Chovancik J, Bulkova V, Herman D · Journal of the American College of Cardiology · 2025 · n=212

Obesity is an important risk factor for atrial fibrillation (AF). Nonrandomized studies have shown that weight loss and increased physical activity are associated with AF reduction. The goal of this study was to assess whether treatment based on lifestyle modification (LFM; directed weight loss and physical exercise) in combination with antiarrhythmic drugs (AADs) is noninferior to catheter ablation (CA) in patients with AF and obesity. In a randomized multicenter noninferiority trial, we enrolled patients with paroxysmal or persistent AF and a body mass index (BMI) of 30-40 kg/m2. Patients were randomized to the CA vs LFM+AAD groups in a 1:1 ratio. Seven-day electrocardiographic Holter recordings were performed every 3 months. The primary endpoint was AF freedom during the 12 months after randomization (ie, absence of any AF episode lasting >30 s; the blanking period was 3 months). Secondary endpoints included AF burden, peak oxygen uptake during cardiopulmonary exercise testing,

A randomized controlled pilot trial of low and high arousal resilience interventions for depressive symptoms.

Epel ES, Don BP, Mayer SE, Blades R, Mason AE, Fromer E · Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2025 · n=141

To cope with chronic stress, which can contribute to depression, humans often pursue arousal-reducing activities. Yet, hormetic stressors (intermittent, acute stressors) might also reduce chronic stress. We compared the effects of arousal-reducing and arousal-enhancing interventions on depressive symptoms and perceived stress. Female adults (N = 141; predominantly White, 63%, and Asian, 34%) reporting high perceived stress were randomized to 1 of 4 three-week stress resilience interventions in 2019-2020. Low arousal conditions included mindfulness meditation or slow breathing with warm showers (Control). Hormetic stress conditions included fast paced breathing with cold showers (the Wim Hof Method; WHM) or high-intensity interval training. We assessed depressive symptoms and perceived stress at baseline, postintervention, and 3 months later, and cortisol reactivity to a lab stressor. At postintervention, all 4 groups had decreases in depressive symptoms (15.93%

The Effectiveness of Lifestyle Interventions, Including Exercise, Diet, and Health Education on Symptoms Experienced During Perimenopause: A Systematic Review of Randomized Controlled Trials.

McNulty KL, Murphy M, Flynn E, Lane A, Muldoon A, Kealy R · Journal of aging and physical activity · 2026

Perimenopause, the transitional period before menopause, is characterized by various physical and psychological symptoms that can impact women's health, well-being, and quality of life. Lifestyle modifications, including exercise, diet, and health education, might help manage these symptoms, but the current evidence is inconsistent. This systematic review aimed to synthesize and identify gaps in existing randomized controlled trials examining the effectiveness of lifestyle interventions on perimenopause symptoms. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four electronic databases (PubMed, CENTRAL, Web of Science, and Scopus) were searched. Two reviewers independently screened the records for eligibility, extracted data, and assessed study quality using a modified Downs and Black checklist and a strategy based on the Grading of Recommendations Assessment Development and Evaluation working group. A total of 25 studies met

Comparative efficacy and safety of non-pharmacological interventions for erectile dysfunction:a systematic review and network meta-analysis.

He X, Li T, Huang W, Liu G, Yang T, Zhang X · Sexual medicine reviews · 2026 · n=1874

Many erectile dysfunction (ED) patients respond inadequately to phosphodiesterase type 5 inhibitors (PDE5is). Non-pharmacological interventions (NPIs) have emerged as potential alternative or adjunct treatments for improving erectile function. This study aimed to evaluate and compare the efficacy and safety of various NPIs for ED through a systematic review and network meta-analysis. Registered in PROSPERO (CRD420251083286), this NMA followed PRISMA guidelines. Eight databases were searched for RCTs through December 2025. Evaluated NPIs included Electrical Stimulation (ES), Exercise, Low-intensity Extracorporeal Shockwave Therapy (Li-ESWT), Acupuncture-Based Therapies (ABT), and Hyperbaric Oxygen Therapy (HOT). Outcomes were the International Index of Erectile Function-5 (IIEF-5), Erection Hardness Score (EHS), Peak Systolic Velocity (PSV) and Adverse Events (AEs). Risk of bias (RoB 2.0) and evidence certainty (CINeMA) were independently assessed. 31 RCTs (1874 participants) were in

Chronic, Noninfectious Diarrhea: A Review.

Singh P, Lee A, Sheth NM, Chey WD · JAMA · 2026

Chronic diarrhea is defined as loose or watery stools lasting longer than 4 weeks and affects approximately 6% to 7% of adults in the US. More than 90% of patients with chronic diarrhea have a noninfectious etiology. The most common causes of chronic, noninfectious diarrhea are irritable bowel syndrome with diarrhea (IBS-D) and functional diarrhea. IBS-D typically presents with recurrent abdominal pain relieved or worsened after defecation. Functional diarrhea is a condition in which more than 25% of bowel movements in the preceding 3 months are loose or watery, but it is not associated with significant abdominal pain. Chronic diarrhea due to a small-bowel source, such as celiac disease or small intestinal bacterial overgrowth, is typically associated with large-volume diarrhea and weight loss, with or without steatorrhea. Celiac disease is an autoimmune condition defined by enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals, and small intest

Methyl-CpG-binding 2 K271 lactylation-mediated M2 macrophage polarization inhibits atherosclerosis.

Chen L, Zhang M, Yang X, Wang Y, Huang T, Li X · Theranostics · 2024

Rationale: Posttranslational modifications of proteins have not been addressed in studies aimed at elucidating the cardioprotective effect of exercise in atherosclerotic cardiovascular disease (ASCVD). In this study, we reveal a novel mechanism by which exercise ameliorates atherosclerosis via lactylation. Methods: Using ApoE-/- mice in an exercise model, proteomics analysis was used to identify exercise-induced specific lactylation of MeCP2 at lysine 271 (K271). Mutation of the MeCP2 K271 lactylation site in aortic plaque macrophages was achieved by recombinant adenoviral transfection. Explore the molecular mechanisms by which motility drives MeCP2 K271 lactylation to improve plaque stability using ATAC-Seq, CUT &Tag and molecular biology. Validation of the potential target RUNX1 for exercise therapy using Ro5-3335 pharmacological inhibition. Results: we showed that in ApoE-/- mice, methyl-CpG-binding protein 2 (MeCP2) K271 lactylation was observed in aortic root plaque macrophage

Exercise-induced endothelial Mecp2 lactylation suppresses atherosclerosis via the Ereg/MAPK signalling pathway.

Wang Y, Chen L, Zhang M, Li X, Yang X, Huang T · Atherosclerosis · 2023

Lactylation, a recently identified post-translational modification (PTM), plays a central role in the regulation of multiple physiological and pathological processes. Exercise is known to provide protection against cardiovascular disease. However, whether exercise-generated lactate changes lactylation and is involved in the exercise-induced attenuation of atherosclerotic cardiovascular disease (ASCVD) remains unclear. The purpose of this study was to investigate the effects and mechanisms of exercise-induced lactylation on ASCVD. Using the high-fat diet-induced apolipoprotein-deficient mouse model of ASCVD, we found that exercise training promoted Mecp2 lysine lactylation (Mecp2k271la); it also decreased the expression of vascular cell adhesion molecule 1 (Vcam-1), intercellular adhesion molecule 1 (Icam-1), monocyte chemoattractant protein 1 (Mcp-1), interleukin (IL)-1β, IL-6, and increased the level of endothelial nitric oxide synthase (Enos) in the aortic tissue of mice. To e

Exercise Mitigates Endothelial Pyroptosis and Atherosclerosis by Downregulating NEAT1 Through N6-Methyladenosine Modifications.

Yang Q, Chen S, Wang X, Yang X, Chen L, Huang T · Arteriosclerosis, thrombosis, and vascular biology · 2023

The benefits of exercise on the cardiovascular system are widely recognized; however, the underlying mechanisms are unknown. Here, we report the effect of the long noncoding RNA NEAT1 (nuclear paraspeckle assembly transcript 1), which is regulated by exercise, on atherosclerosis development after N6-methyladenosine (m6A) modifications. Using clinical cohorts and NEAT1-/- mice, we determined the exercise-mediated expression and role of NEAT1 in atherosclerosis. To investigate the mechanism of epigenetic modification of NEAT1 regulated by exercise, we identified METTL14 (methyltransferase-like 14)-a key m6A modification enzyme under exercise-and found that METTL14 alters the expression and role of NEAT1 through m6A modification and elucidated the specific mechanism of METTL14 in vitro and in vivo. Finally, the NEAT1 downstream regulatory network was investigated. We found that NEAT1 expression was downregulated with exercise and that downregulation of NEAT1 was an important factor in t

Comparing the Effect of Laser Acupuncture Alone or Combined With Pranayama Exercise on Inflammatory Status/Markers in Geriatrics With Allergic Rhinitis

n=60 · NCT05915507 · UNKNOWN · UNKNOWN

Allergic rhinitis (AR) represents one of the most common global health problems with seriously increasing incidence over the last decades.The goal of the treatment of rhinitis is to prevent or reduce the symptoms through reduction of the inflammation of affected tissues. Acupuncture and pranayama yoga exercises had reported a significant improvement in daily symptoms and an increase of symptom-free days in many studies enrolling geriatric patients.

The Effect of Progressive Muscle Relaxation Exercises on Vital Signs, Anxiety And Comfort Level of Patients Undergoing Coronary Angiography

n=70 · NCT06524999 · COMPLETED · COMPLETED

This study aimed to examine the effect of relaxation exercise applied to patients who will undergo elective coronary angiography (CAG) for the first time, on their vital signs, anxiety and comfort levels. The main questions it aims to answer are: 1. Does progressive relaxation exercises affect CAG patients' vital signs. 2. Does progressive relaxation exercises affect CAG patients' anxiety levels. 3. Does progressive relaxation exercises affect CAG patients' comfort levels. Researchers will compare the intervention group with the control group to see if relaxation exercise is effective. Before coronary angiography, patients will undergo a relaxation exercise once. Vital signs, comfort and anxiety level will be evaluated before and after angiography.

Usefulness of Exhaled Breath Condensate and FENO for Evaluation of Markers of Airway Inflammation in Children With Asthma

n=200 · NCT00961155 · UNKNOWN · UNKNOWN

Exhaled breath condensate (EBC) has emerged as a novel noninvasive technique for assessment of airway inflammation, and it provides information on airway lining fluid composition. Traditionally, such assessment relies on invasive diagnostic tools such as bronchial biopsy and bronchoalveolar lavage (BAL) to obtain specimens from the airway but it is very uncomfortable procedure especially for young patients. The aim of this study is to evaluate the effect of allergic disease, disease monitoring and exposure to tobacco smoke on airway inflammation measured by markers in exhaled breath condensate (EBC) in children with asthma allergic to house dust mite. Also, we aim to assess correlations between cytokine concentrations in EBC and clinical characteristic of the patients with exercise-induced bronchoconstriction as another phenotype of asthma.

Multiple Sclerosis Exercise

TRIP Database

TRIP Database provides a search engine for clinical evidence covering various medical topics, including multiple sclerosis and exercise. It aggregates evidence from multiple sources to facilitate evidence-based practice.

Cochrane Library: Obesity

Cochrane

A collection of systematic reviews and meta-analyses synthesizing evidence on interventions for obesity, including diet, exercise, drugs, and surgery.