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"Govindasamy, Karuppasamy"
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Effect of music therapy on sleep quality in elderly: A systematic review and meta-analysis
2025
Sleep disturbances are common among older adults, affecting up to 50% of this population and significantly impacting quality of life and health outcomes. Music therapy has been proposed as a non-pharmacological intervention to improve sleep quality in this population, but evidence regarding its effectiveness remains inconsistent across individual studies. Therefore, this systematic review and meta-analysis aims to synthesize available evidence on the effectiveness of music therapy interventions for improving sleep quality in elderly adults..
We conducted a systematic review and meta-analysis following PRISMA guidelines. Major databases were searched for studies evaluating music interventions for sleep quality in adults aged 50 + years. Randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) were included. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool for RCTs and the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for non-RCTs. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using both common effect and random effects models. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
The initial search retrieved 473 articles from electronic databases. After removing duplicates and screening, 10 studies (6 RCTs, 4 non-RCTs) published between 2010 and 2023 with 602 participants met inclusion criteria and were included in the meta-analysis. The random effects model showed significant improvement in sleep quality with music therapy (SMD: -0.79; 95% CI, -1.25 to -0.33; P < .001). Substantial heterogeneity was observed (I² = 79%; Q = 42.54; P < .001). Subgroup analysis revealed significant benefits in RCTs (SMD: -0.59; 95% CI, -1.11 to -0.07) but not in non-RCTs (SMD: -1.08; 95% CI, -2.36 to 0.19). Sensitivity analyses confirmed the robustness of findings, and no publication bias was detected. GRADE assessment indicated very low certainty of evidence for both RCTs and non-RCTs due to risk of bias concerns and substantial heterogeneity.
Music therapy demonstrates significant improvement in sleep quality among older adults; however, the very low certainty of evidence based on GRADE assessment suggests caution in clinical recommendations. Future research should address methodological limitations, particularly regarding bias in outcome measurement and intervention implementation, to provide more definitive evidence for clinical practice guidelines.
Journal Article
Heart rate variability in female soccer players, before, during, and after a COVID-19 positive test
2025
The purpose of this study is to examine the impact of COVID-19 infection on heart rate variability (HRV) in female soccer players, with a focus on identifying changes in autonomic regulation before, during, and after a COVID-19 positive test. Seven elite female soccer players (age: 20.14 ± 6.41 years, height: 162.43 ± 4.32 cm, weight: 51.73 ± 5.65 kg) were included in the analysis after consistently recording their HRV during the specified period. Morning HRV measures were completed using photoplethysmography via the HRV4 training smartphone application, a validated tool for field-based monitoring, along with self-reported data. The players were tracked for at least 30 consecutive days before testing positive for COVID-19 using a polymerase chain reaction (PCR) test. They were also requested to record their HRV while they had COVID-19 until a negative PCR result was obtained. The study presents data on RMSSD, LnRMSSD and HR for the 30 days prior to COVID-19, as well as for the 3 days (day − 3), 2 days (day − 2), and 1 day (day − 1) leading up to COVID-19. Also, data for the first 5 days following a positive COVID-19 test are included. The results of this study indicated that LnRMSSD measurements were significantly lower 2 days (day − 2) and 1 day (day − 1) before the onset of COVID-19, as well as during the first four days following a positive COVID-19 test, compared to baseline. In addition, RMSSD measurements were significantly lower during the first 4 days after a positive COVID-19 test, while resting heart rate was significantly higher during the first and second days following a positive COVID-19 test, compared to baseline. Our findings suggest that reductions in LnRMSSD, reflecting decreased parasympathetic activity, may serve as early indicators of COVID-19 infection in elite female soccer players, potentially allowing for pre-symptomatic detection through daily HRV monitoring.
Journal Article
Effects of Resistance Training on Sarcopenia Risk Among Healthy Older Adults: A Scoping Review of Physiological Mechanisms
2025
Sarcopenia, characterized by progressive loss of muscle mass and strength, significantly increases health risks in healthy older adults. Resistance training (RT) is believed to counteract sarcopenia through a variety of physiological mechanisms, many of which remain underexplored by public health and physiotherapy professionals. This scoping review aims to consolidate studies that have explored RT programs in mitigating sarcopenia among healthy older adults. A systematic search in four knowledge databases (Web of Science, Scopus, Embase, Cumulative Index for Nursing and Allied Health Sciences Complete) was conducted on 30 April 2024 to consolidate the evidence of RT programs to mitigate sarcopenia risk among healthy older adults. Two reviewers independently screened, consolidated, and synthesized the results based on the Arksey and O’Malley framework. We included 36 studies supporting the RT program for reducing sarcopenia risk among healthy older people. Current evidence, predominantly derived from studies with high selection bias and non-randomized designs, indicates that RT programs may enhance muscle strength in healthy older adults. However, their impact on muscle morphology and mobility appears less pronounced. The dosage and intensity of RT are critical factors influencing these health outcomes. To substantiate the health benefits of RT in healthy older adults and facilitate the translation of research findings into policy-level recommendations, further high-quality, randomized controlled trials are warranted.
Journal Article
Enhancing the efficacy: Aromatherapy as an adjunct to massage for uncomplicated varicose veins
by
Karuppasamy, Govindasamy
,
Kuppusamy, Maheshkumar
,
Ravi, Poornima
in
Aromatherapy
,
Correspondence
,
Edema
2024
According to a recent Cochrane systematic review, the massage techniques move extravascular fluid without disrupting intravascular fluid, which reduces edema [ 5]. Particular attention should be paid to subjects with a history of past contact skin allergies before application of rosemary oil. [...]massage therapy combined with topical rosemary oil application may provide an additional impact for patients with uncomplicated varicose veins, strengthening the multimodal strategy suggested in the original study. [...]we suggest a viable road towards comprehensive patient care is a thorough investigation of the combined effects of yoga, naturopathy, massage therapy, and aromatherapy on uncomplicated varicose vein disease.
Journal Article
Effects of Different Types of High-Intensity Interval Training (HIIT) on Physical Performance in Female Basketball Players—A Systematic Review
by
Stanković, Mima
,
Katanić, Borko
,
Stefanica, Valentina
in
Adaptation
,
aerobic capacity
,
Anthropometry
2025
The aim of this systematic review was to examine the effects of high-intensity interval training (HIIT) on physical performance and body composition in female basketball players. The review followed PRISMA guidelines, and the protocol was registered in the PROSPERO database (registration number: CRD420251006285). A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Google Scholar. Nine studies that met the inclusion criteria were analyzed, with intervention durations ranging from 4 to 12 weeks. Despite differences in protocols, a majority of studies reported improvements in VO2max (6/9), explosive strength (7/9), agility (5/6), and speed (5/6) and reductions in body mass and fat percentage (3/3). These findings highlight HIIT as an effective method for enhancing both aerobic and anaerobic capacities, as well as optimizing body composition. Despite variations in study protocols, HIIT consistently offers improvements in performance, irrespective of training level. The results underscore the importance of HIIT in preparing athletes, not only during the preseason but also throughout the competition period. Coaches should consider integrating HIIT into training programs, adjusting intensity and volume based on the season to optimize performance and prevent overtraining.
Journal Article
Physiological Differences in Cardiorespiratory and Metabolic Parameters Between Football Players from Top- and Mid-Ranked Teams in the Serbian Super League
by
Prvulovic, Nikola
,
Radakovic, Radivoje
,
Martinovic, Dejan
in
Anaerobic threshold
,
elite performance
,
Endurance
2025
This study investigated physiological differences in cardiorespiratory and metabolic performance parameters between professional football players from top- (TR) and mid-ranked teams (MR) in the Serbian Super League. A total of 55 male outfield players (TR: n = 29; MR: n = 26) were assessed in March 2022 using a maximal multistage treadmill protocol and lactate analysis. The key cardiorespiratory variables included maximum oxygen uptake (VO2max), heart rate at the anaerobic threshold (HR AT), and recovery heart rate metrics, while the metabolic variables focused on lactate concentrations and efficiency indices. The results indicate that the TR players achieved significantly lower HR AT values (162 ± 10.26 vs. 168.77 ± 7.28 bpm; p = 0.017) and demonstrated superior second-minute recovery (%Re 2′: 66.62 ± 14.08% vs. 34.53 ± 9.13%, p < 0.001). In contrast, the MR players exhibited higher VO2max (62.65 ± 4.48 vs. 60.06 ± 3.29 mL/kg/min; p = 0.017) and greater cardiorespiratory efficiency scores. The lactate parameters were comparable between the groups, except for the metabolic efficiency index (Index ME), which were favorable among the TR players (p = 0.011). These findings highlight that while MR players possess higher aerobic capacity, TR players demonstrate superior physiological recovery and metabolic control, reflecting adaptations to different tactical demands and match intensities. The results offer practical implications for individualized training design and performance monitoring in elite football settings.
Journal Article
Seasonal Changes in Body Composition, Jump, Sprint, and Agility Performance Among Elite Female Handball Players
2025
Assessing physical fitness throughout the entire season can provide valuable insights for designing effective training programs to enhance handball performance. Therefore, the aim of this study was to investigate seasonal changes in body composition, jump, sprint, and agility performance among elite female handball players. This study involved fourteen elite female handball players (age 21.98 ± 1.22) who participated in the Serbian Handball Super League and the European Handball Federation (EHF) European Cup during the 2022/23 season. Within the framework of seasonal changes, five measurements were made. Players were tested for height, weight, BMI, body fat and muscle mass percentage, jump performance (CMJ, CMJA, SJ, CMJ right, CMJ left), linear sprint (5 m, 10 m, 20 m), and agility performance (zig-zag and slalom). Repeated measures ANOVA revealed no changes in body composition parameters during the season. Among the five jump performance tests, a significant change was observed only in the CMJ left test, where better values were achieved in the fourth and fifth measurements compared to the initial measurement. In sprints over 5 and 10 m, significant changes were noted between specific measurement points, while no differences were observed in the 30-m sprint. For agility, differences were recorded in four out of five tests, with the best performances in the Zig-Zag tests observed in the third measurement, while in other tests, the best results were most often recorded in the second and fifth measurements. These results indicate that body composition remained stable, while performance improvements were specific to certain physical capacities and time points during the season. These findings can help coaches design targeted strength and agility training aligned with key performance periods, emphasizing short sprints and agility with/without the ball, rather than focusing on body composition changes. However, this study is limited by its small sample size and single-season scope, which may affect the generalizability of the results.
Journal Article
Group Aerobic Exercise Improves Body Composition and Lipid Profile in Young Women with Elevated BMI: A Randomized Controlled Trial
2025
Sedentary behavior among young women is increasingly associated with adverse metabolic and cardiovascular outcomes. The aim of this randomized controlled trial was to evaluate and compare the effects of three structured group fitness programs on anthropometric parameters, body composition, and lipid profile in overweight young women (N = 111, age 18–25, BMI ≥ 25). Participants were assigned to mix aerobics (E1, n = 27), kickbox aerobics (E2, n = 28), step aerobics (E3, n = 27), or a control group (C, n = 29). Each intervention lasted 12 weeks, with sessions conducted three times per week, each lasting 60 min. The results were analyzed using repeated measures ANOVA. Significant reductions were observed in body weight (−4.8 kg in E1, p < 0.01), waist circumference (−5.3 cm in E1, p < 0.001), and body fat percentage (−3.6% in E1, p < 0.01). High-density lipoprotein (HDL) increased by 7.4 mg/dL (p < 0.01), while low-density lipoprotein (LDL), total cholesterol, and triglycerides decreased by 12.1 mg/dL, 18.6 mg/dL, and 19.4 mg/dL, respectively (all p < 0.01). The most pronounced overall improvements were found in the mix aerobics group. In contrast, the control group showed significant deterioration in most variables, including a 2.1 kg weight gain and a 6.3 mg/dL increase in total cholesterol (p < 0.05). These findings confirm the superior effectiveness of mix aerobics as a non-pharmacological intervention to improve body composition (notably through reductions in body weight, fat percentage, and waist circumference) and cardiovascular biomarkers (such as increased HDL and decreased LDL, total cholesterol, and triglycerides) in young overweight women. Compared to kickboxing and step aerobics, mix aerobics consistently achieved the greatest improvements across all measured parameters, making it the most comprehensive and effective option among the three programs tested.
Journal Article
Effect of Plant-Based Proteins on Recovery from Resistance Exercise-Induced Muscle Damage in Healthy Young Adults—A Systematic Review
2025
Background: Plant-based protein supplementation in supporting muscle recovery following resistance exercise remains an area of growing interest, particularly among vegan athletes, as a potential alternative to animal-based proteins. This systematic review aimed to evaluate the effectiveness of plant-based proteins on recovery from resistance exercise-induced muscle damage in healthy young adults. Methods: A systematic and comprehensive search was administered in eight databases up to 1 May 2025, identifying 1407 articles. Following deduplication and screening, 24 studies met the eligibility criteria, including 22 randomized controlled trials and 2 non-randomized studies, with the majority from high income western countries. Results: Interventions primarily involved soy, pea, rice, hemp, potato, and blended plant protein sources, with doses ranging from 15 to 50 g, typically administered post resistance exercise. Outcomes assessed included muscle protein synthesis (MPS), delayed-onset muscle soreness (DOMS), inflammatory biomarkers, muscle function, and fatigue. The review findings reaffirm that single-source plant proteins generally offer limited benefits compared to animal proteins such as whey, particularly in acute recovery settings, a limitation well-documented consistently in the literature. However, our synthesis highlights that well-formulated plant protein blends (e.g., combinations of pea, rice, and canola) can stimulate MPS at levels comparable to whey when consumed at adequate doses (≥30 g with ~2.5 g leucine). Some studies also reported improvements in subjective recovery outcomes and reductions in muscle damage biomarkers with soy or pea protein. However, overall evidence remains limited by small sample sizes, moderate to high risk of bias, and heterogeneity in intervention protocols, protein formulations, and outcome measures. Risk of bias assessments revealed concerns related to detection and reporting bias in nearly half the studies. Due to clinical and methodological variability, a meta-analysis was not conducted. Conclusion: plant-based proteins particularly in the form of protein blends and when dosed appropriately, may support muscle recovery in resistance-trained individuals and offer a viable alternative to animal-based proteins. However, further high-quality, long-term trials in vegan populations are needed to establish definitive recommendations for plant protein use in sports nutrition.
Journal Article
Recreational Female Athletes’ Understanding of and Perceived Impact of the Menstrual Cycle on Physical Performance, Mood, and Sleeping Behaviour
2023
This study aimed to examine female recreational (FRC) athletes’ knowledge of the menstrual cycle and their perception of how each phase affects their performance, mood, and sleep. One hundred and sixty-four (n = 164) FRC athletes completed an online survey. The questionnaire employed was based on previously validated questionnaires and consisted of three different sections: (a) knowledge about the menstrual cycle, (b) menstrual cycle symptoms, and (c) menstrual cycle and performance. The results indicated that 70.1% of the surveyed FRC athletes were not knowledgeable regarding the phases of the menstrual cycle, with 55.5% being ignorant of the specific hormones released during the cycle. Furthermore, 37.8% perceived that their performance was sometimes affected during the early follicular phase, with the main symptoms being physical fatigue (17.9%) and a more irritable mood (25.9%). In addition, 19.5% of the FRC athletes reported sleeping disturbances, and 20.4% described changes in sleep quality during menstruation. Lastly, 11.9% of the FRC athletes reported suffering from a combination of mood swings, sleeping problems, bloating or stomach issues, breast tenderness, headaches, and fatigue prior to menstruation. The results of this study provide valuable insights into how FRC athletes experience the menstrual cycle, which can help RC athletes and trainers better understand their needs and support them in achieving optimal performance.
Journal Article