Aim To summarize evidence regarding the effects of oral nutritional supplement on muscle fitness of patients undergoing dialysis. Design A systematic review and meta‐analysis. Review sources Five English databases (CENTRAL, PubMed, EMBASE, CINHAL, and Web of Science) and four Chinese databases (CNKI, WanFang, SinoMed, and VIP) were searched from inception to 31 July 2019 and only randomized controlled trials were included. Review methods Two reviewers independently searched these databases, selected trials, conducted bias assessment, extracted the data. Random‐effects meta‐analysis was conducted to assess the effect size. The predetermined subgroup included type of oral nutritional supplement (a mixture of macronutrients, whey protein, essential amino‐acids, and other nutrients) and intervention duration (over and less than 48 weeks). The subgroup analyses and sensitivity analyses were conducted to explore source of heterogeneity and robustness of results. Results Sixteen studies (910 participants) meeting the inclusion criteria were identified and included in this systematic review. Subgroup analysis showed that supplying a mixture of macronutrients (MD [MD] = 2.36 kg, 95% CI [0.45, 4.26], I2 = 0.00%), an intervention duration of 48 weeks (MD = 4.05 kg, 95% CI [1.43, 6.67], I2 = 0.00%) had some effects on increasing lean body mass. No effects of oral nutritional supplement were found on improving muscle strength or physical performance. Conclusion A mixture of macronutrients and an intervention duration as long as 48 weeks had some significant effects on improving lean body mass of patients undergoing dialysis. No effect of oral nutritional supplement on muscle strength or physical performance were found but with limited evidence. Impact No existing reviews have ever focused on improving muscle fitness of patients undergoing dialysis. This systematic review and meta‐analysis provided evidence of oral nutritional supplement on keeping muscle fitness of these patients and suggested possible type of oral nutritional supplement and intervention duration for clinical practice.

Objectives: The study was aimed to develop and evaluate a lymphoedema selfmanagement behaviour questionnaire (LSMBQ) for breast cancer patients. Methods:The initial version of the behaviour questionnaire was developed based on the framework of self-management and the evidence summary of lymphoedema selfmanagement. Two rounds of expert consultation were conducted to validate the questionnaire's content validity. A cross-sectional survey was then conducted in breast wards of two hospitals in China to evaluate the reliability and validity of this scale. Exploratory structural equation model was used to test the construct validity.T-test was used to analyse the known group validity. Structural equation model was applied to verify the relationship between self-efficacy, social support, and lymphoedema self-management behaviour to test the convergent validity. Also, the internal consistency reliability and test-retest reliability were evaluated.Results: The questionnaire's content validity was satisfactory. There were 22 items included in the LSMBQ for validation and 260 completed the survey. A six-factor structure with good construct validity was identified. The result of t-test verified that patients who knew the risk of lymphoedema and those who received lymphoedema health education had higher scores of lymphoedema self-management behaviours (P < 0.05), indicating that the questionnaire has good known group validity. The fitting results of the structural equation model indicated that the 22-item questionnaire had good convergent validity. Cronbach's alpha coefficients and test-retest reliability for the total questionnaire were 0.910 and 0.875, respectively.

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BackgroundBody composition may influence the prognosis of head and neck cancer (HNC) patients. To find out the most crucial factors in this relationship, we explored the association between body composition and survival.MethodsIn this prospective longitudinal study, HNC patients who underwent radiotherapy (RT) from March 2017 to December 2018 were recruited. The association between body composition and survival was analyzed using Cox proportional hazard regression.ResultsFinal analysis included 316 patients, with a median follow‐up of 34.4 months. Multivariable analysis revealed that weight loss 6 months before RT and body composition changes during RT did not affect the survival outcome. However, patients with low appendicular skeletal muscle mass index (ASMI) before RT exhibited poor overall survival (OS). ASMI before RT was an independent prognostic factor for OS.ConclusionsBody composition loss was common during RT, and ASMI before RT independently influenced the survival outcomes of HNC patients.

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