‘What should I prescribe?’: time to improve reporting of resistance training programmes to ensure accurate translation and implementation

Holden, Sinéad; Barton, Christian J

doi:10.1136/bjsports-2017-098664

Cited by 14 publications

(14 citation statements)

References 7 publications

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“…We analyzed the prescribed exercise dosage and not the actual exercise completed (adherence) which could also explain the lack of a positive dose-response relationship. Generally, this challenge of inadequate intervention reporting is a well-recognized challenge in non-pharmacological interventions 58 , not least in the reporting of exercise program details for patients with knee OA 59,60 . This creates challenges for many types of users of the published research, including clinicians, researches and patients.…”

Section: Dose-responsementioning

confidence: 99%

The relationship between prescribed pre-operative knee-extensor exercise dosage and effect on knee-extensor strength prior to and following total knee arthroplasty: a systematic review and meta-regression analysis of randomized controlled trials

Husted

Juhl

Troelsen

et al. 2020

Osteoarthritis and Cartilage

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Objective: The aim of this systematic review was to evaluate the relationship between prescribed kneeextensor strength exercise dosage in pre-operative exercise intervention and the effect on knee-extensor muscle strength prior to and following TKA. Additional meta-analyses report the effect of pre-habilitation on outcomes prior to and following TKA. Design: A systematic literature search was performed including RCT's evaluating the effect of preoperative exercise prior to and following TKA. Meta-regression analysis was performed to evaluate the dose-response relationship between prescribed exercise dose and the pooled effect, measured as standardized mean difference (SMD). The prescribed exercise dose was quantified using a formula accounting for as many exercise descriptors as possible. Risk of bias in the included trials was assessed using the Cochrane Risk of Bias Tool. Results: Twelve trials with 616 patients were included. Meta-regression analysis showed no relationship between prescribed pre-operative knee-extensor exercise dosage and change in knee-extensor strength neither prior to (slope 0.0005 [95%CI-0.007 to 0.008]) or 3 months following TKA (slope 0.0014 [95%CI-0.006 to 0.009]). Prior to TKA, a moderate effect favoring pre-operative exercise for increase in kneeextensor strength was found (SMD 0.50 [95%CI 0.12 to 0.88]), but not at 3 months following TKA (SMD-0.01 [95%CI-0.45 to 0.43]). Risk of bias was generally assessed as unclear. Conclusion: Meta-regression analysis of existing trials suggests no relationship between the prescribed pre-operative knee-extensor exercise dosage and the change in knee-extensor strength observed prior to and following TKA. Pre-operative exercise including knee-extensor muscle strength exercise increased knee-extensor strength moderately prior to but not 3 months following TKA.

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Section: Dose-responsementioning

confidence: 99%

The relationship between prescribed pre-operative knee-extensor exercise dosage and effect on knee-extensor strength prior to and following total knee arthroplasty: a systematic review and meta-regression analysis of randomized controlled trials

Husted

Juhl

Troelsen

et al. 2020

Osteoarthritis and Cartilage

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“…This is further limited by a poor understanding and knowledge of physical activity guidelines among healthcare professionals [19][20][21], which provides challenges for its integration into sports medicine practice. Indeed, it is not uncommon for healthcare professionals to recommend "strengthening programmes" using 10 or more repetitions per set without a clear indication of the intensity adopted [22,23]. Although most of resistance training modes have demonstrated improvements in strength in inactive/untrained individuals during the first weeks [24], it must be pointed out that "strengthening programmes" and "strength training" are not the same; hence, they cannot be used interchangeably.…”

Section: Introductionmentioning

confidence: 99%

The Benefits of Strength Training on Musculoskeletal System Health: Practical Applications for Interdisciplinary Care

et al. 2020

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“…It is possible that the underpinning evidence for exercise dose in other conditions may be more robust. However, given the broad issues identified in the current review, we suggest this is unlikely and may not be limited to strengthening exercise in RA [ 14 ]. Thirdly, the novel and exploratory nature of this review meant we could not anticipate all of the challenges for grading the quality of the underpinning evidence.…”

Section: Discussionmentioning

confidence: 99%

“…Our results indicate researchers need to improve not only the standard of reporting related to their interventions, but also the evidence they use to justify their decisions about what dose to prescribe. Reporting guidelines like TIDieR and CERT [ 8 , 30 ] should be used to raise standards going forward and as these evolve [ 14 ], could recommend researchers be explicit with type, quality, consistency and applicability of evidence they have used to support each dose parameter. Funders and peer reviewers should take a careful and critical approach when considering how exercise dose has been formulated.…”

Section: Discussionmentioning

confidence: 99%

“…However, relying on these approaches may have methodological limitations. Expert opinion is rated as one of the lowest levels of evidence [ 24 ] and guidelines may lack the necessary detail about what dose to prescribe for a specific clinical population [ 14 ]. The potential impact of not formally testing dose-response and relying solely on the available evidence base is the exercise dose may not be optimised for the clinical population of interest.…”

Section: Introductionmentioning

confidence: 99%

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A systematic review exploring the evidence reported to underpin exercise dose in clinical trials of rheumatoid arthritis

et al. 2020

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We aimed to evaluate the evidence reported to underpin exercise dose in randomised controlled trials (RCTs) using strengthening exercise in RA. We searched six different databases between 1 January 2000 and 3 April 2019. We included RCTs, where a main component of the intervention and/or control used strengthening exercise. Evidence sources cited to underpin dose were judged for their quality, consistency and applicability. Thirty-two RCTs were reviewed. Four (12.5%) piloted the intervention without using dose-escalation designs to determine optimal dose-response. Twenty (62.5%) reported no evidence underpinning dose. Where reported, quality, consistency and applicability of the underpinning evidence was a cause for methodological concern. The majority of RCTs did not report the evidence underpinning dose. When reported, the evidence was often not applicable to the clinical population. Frequently, the dose used differed to the dose reported/recommended by the underpinning evidence. Our findings illustrate exercise dose may not be optimised for use with clinical populations prior to evaluation by RCT.

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‘What should I prescribe?’: time to improve reporting of resistance training programmes to ensure accurate translation and implementation

Cited by 14 publications

References 7 publications

The relationship between prescribed pre-operative knee-extensor exercise dosage and effect on knee-extensor strength prior to and following total knee arthroplasty: a systematic review and meta-regression analysis of randomized controlled trials

The relationship between prescribed pre-operative knee-extensor exercise dosage and effect on knee-extensor strength prior to and following total knee arthroplasty: a systematic review and meta-regression analysis of randomized controlled trials

The Benefits of Strength Training on Musculoskeletal System Health: Practical Applications for Interdisciplinary Care

A systematic review exploring the evidence reported to underpin exercise dose in clinical trials of rheumatoid arthritis

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