Validation of a new tool for the assessment of study quality and reporting in exercise training studies

Smart, Neil A.; Waldron, Mark; Ismail, Hashimah; Giallauria, Francesco; Vigorito, Carlo; Cornelissen, Véronique; Dieberg, Gudrun

doi:10.1097/xeb.0000000000000020

Cited by 346 publications

(304 citation statements)

References 16 publications

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“…Individual studies were assessed using the ‘Tool for assessment of study quality and reporting in exercise’ (TESTEX) 48. TESTEX is a 15-point assessment scale, consisting of five available points for study quality and 10 for study reporting.…”

Section: Methodsmentioning

confidence: 99%

Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis

Hughes¹,

et al. 2017

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Background and objectiveLow-load exercise training with blood flow restriction (BFR) can increase muscle strength and may offer an effective clinical musculoskeletal (MSK) rehabilitation tool. The aim of this review was to systematically analyse the evidence regarding the effectiveness of this novel training modality in clinical MSK rehabilitation.DesignThis is a systematic review and meta-analysis of peer-reviewed literature examining BFR training in clinical MSK rehabilitation (Research Registry; researchregistry91).Data sourcesA literature search was conducted across SPORTDiscus (EBSCO), PubMed and Science Direct databases, including the reference lists of relevant papers. Two independent reviewers extracted study characteristics and MSK and functional outcome measures. Study quality and reporting was assessed using the Tool for the assEssment of Study qualiTy and reporting in EXercise.EligibilitySearch results were limited to exercise training studies investigating BFR training in clinical MSK rehabilitation, published in a scientific peer-reviewed journal in English.ResultsTwenty studies were eligible, including ACL reconstruction (n=3), knee osteoarthritis (n=3), older adults at risk of sarcopenia (n=13) and patients with sporadic inclusion body myositis (n=1). Analysis of pooled data indicated low-load BFR training had a moderate effect on increasing strength (Hedges’ g=0.523, 95% CI 0.263 to 0.784, p<0.001), but was less effective than heavy-load training (Hedges’ g=0.674, 95% CI 0.296 to 1.052, p<0.001).ConclusionCompared with low-load training, low-load BFR training is more effective, tolerable and therefore a potential clinical rehabilitation tool. There is a need for the development of an individualised approach to training prescription to minimise patient risk and increase effectiveness.

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Section: Methodsmentioning

confidence: 99%

Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis

Hughes¹,

et al. 2017

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“…The study quality was assessed according to the TESTex scale [18] with a slight modification as subject blinding is unlikely in exercise training studies, so maximum possible TESTex score was 15 (see online suppl. table S3).…”

Section: Methodsmentioning

confidence: 99%

The Effect of Exercise Training Intensity on Quality of Life in Heart Failure Patients: A Systematic Review and Meta-Analysis

Ostman

Jewiss

Smart³

2016

Cardiology

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Objectives: To establish if exercise training intensity produces different effect sizes for quality of life in heart failure. Background: Exercise intensity is the primary stimulus for physical and mental adaptation. Methods: We conducted a MEDLINE search (1985 to February 2016) for exercise-based rehabilitation trials in heart failure using the search terms ‘exercise training', ‘left ventricular dysfunction', ‘peak VO₂', ‘cardiomyopathy', and ‘systolic heart dysfunction'. Results: Twenty-five studies were included; 4 (16%) comprised high-, 10 (40%) vigorous-, 9 (36%) moderate- and 0 (0%) low-intensity groups; two studies were unclassified. The 25 studies provided a total of 2,385 participants, 1,223 exercising and 1,162 controls (36,056 patient-hours of training). Analyses reported significant improvement in total Minnesota living with heart failure (MLWHF) total score [mean difference (MD) -8.24, 95% CI -11.55 to -4.92, p < 0.00001]. Physical MLWHF scorewas significantly improved in all studies (MD -2.89, 95% CI -4.27 to -1.50, p < 0.00001). MLWHF total score was significantly reduced after high- (MD -13.74, 95% CI -21.34 to -6.14, p = 0.0004) and vigorous-intensity training (MD -8.56, 95% CI -12.77 to -4.35, p < 0.0001) but not moderate-intensity training. A significant improvement in the total MLWHF score was seen after aerobic training (MD -3.87, 95% CI -6.97 to -0.78, p = 0.01), and combined aerobic and resistance training (MD -9.82, 95% CI -15.71 to -3.92, p = 0.001), but not resistance training. Conclusions: As exercise training intensity rises, so may the magnitude of improvement in quality of life in exercising patients. Aerobic-only or combined aerobic and resistance training may offer the greatest improvements in quality of life.

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“…We assessed study quality using the 15-point TESTEX scale [27], which is a validated study quality assessment tool specific to exercise training studies. Median TESTEX score was 10, with two studies scoring 8, three scoring 10 and two studies scoring 12.…”

Section: Assessment Of Study Qualitymentioning

confidence: 99%

Exercise training in heart failure patients with preserved ejection fraction: a systematic review and meta-analysis

Chan¹,

Giallauria

Vigorito

et al. 2016

Monaldi Arch Chest Dis

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Exercise training induces physical adaptations for heart failure patients with systolic dysfunction but less is known about those patients with preserved ejection fraction. This study's aims were to establish if exercise training produces changes in peak VO 2 and related measures, quality of life, general health and diastolic function in heart failure patients with preserved ejection fraction (HFpEF).We conducted a MEDLINE search (1985( to September 1, 2015, for exercise based rehabilitation trials in heart failure, using search terms 'exercise training, heart failure with preserved ejection fraction, heart failure with normal ejection fraction, peak VO 2 and diastolic heart dysfunction'. Eight intervention studies were included providing a total of 174 exercising subjects and 143 control subjects, a total of 317 participants.Peak VO 2 increased by a mean difference (MD) 2.08 mL kg -1 min -1 (95% C.I. 1.51 to 2.65, p<0.00001) in exercise training versus sedentary control, equating to a 17% improvement from baseline. V E /VCO 2 slope was not different between groups, MD -3.10 mL kg -1 min -1 (95% C.I. -7.47 to 1.27, p=0.16); maximum heart rate was significantly increased in exercise groups, MD 3.46 bpm (95% C.I. 2.41 to 4.51, p<0.00001); 6 Minute Walk Distance (6MWT) MD 32.1m (95% C.I. 17.2 to 47.1, p<0.0001); diastolic function; the ratio of early to late filling (E/A ratio) was improved after exercise training MD 0.07 (95% C.I. 0.02 to 0.12, p=0.006); as was filling pressure E/E' ratio MD -2.38 (95% C.I. -3.47 to -1.28, p<0.0001); Deceleration time (D T ) MD -13.2 msec (95% C.I. -19.8 to -6.5, p=0.0001); Minnesota Living with Heart Failure Questionnaire (MLHFQ) MD -6.77 (95% C.I. -9.70 to -3.84, p<0.00001); Short Form-36 Health Survey MD 11.38 (95% C.I. 5.28 to 17.48, p=0.0003). In 3222 patient-hours of training, not a single death was directly attributable to exercise.Exercise training appears to effect several health-related improvements in people with heart failure and preserved ejection fraction.

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Validation of a new tool for the assessment of study quality and reporting in exercise training studies

Abstract: The TESTEX scale is a new, reliable tool, specific to exercise scientists, that facilitates a comprehensive review of exercise training trials.

Cited by 346 publications

References 16 publications

Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis

Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis

The Effect of Exercise Training Intensity on Quality of Life in Heart Failure Patients: A Systematic Review and Meta-Analysis

Exercise training in heart failure patients with preserved ejection fraction: a systematic review and meta-analysis

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