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Physical inactivity is an independent modifiable risk factor for common chronic diseases.1–4 Exercise is a structured physical activity regimen that targets improvements in health. While the effectiveness of exercise for health promotion and management of diverse chronic disease conditions is well documented, new health conditions continue to surface and the control/management of other chronic conditions remain an ongoing challenge to sports and exercise medicine scientists and clinicians. Research to support exercise as a medical intervention continues to evolve. This edition of BJSM headlines two randomised controlled trials (RCTs) and two reviews that provide new knowledge to support exercise as effective medicine.
Post-COVID-19 conditions… and knees
In an RCT, Longobardi and colleagues demonstrated the effectiveness of a 16-week home-based exercise training programme in severe COVID-19 survivors, including improvements in health-related quality of life and persistent symptoms. (see page 1295) This RCT presents a novel exercise model that is efficacious and safe for adoption as a therapeutic strategy in patients recovering from severe/critical COVID-19. In another RCT, using a randomised controlled equivalence trail design, researchers from Copenhagen, Denmark showed comparable improvements in symptoms and function among patients with patellofemoral pain after undergoing 12-week quadriceps and hip exercise protocols. (see page 1287)
Gleaned from a large-scale pairwise and network meta-analysis of 270 RCTs with a pooled sample size of 15 827 participants, Edwards and colleagues established that various modes of exercise training improve resting blood pressure in hypertensive patients. (see page 1317) In addition, they indicated that isometric exercise training outperforms other exercise modes in reducing both systolic and diastolic blood pressure; a combination of isometric wall squat and running was the most effective for reducing both systolic and diastolic blood pressure. The new findings from this meta-analysis warrant an updated clinical guideline for exercise-based interventions for the treatment and management of hypertension. The second review article is a broad systematic review and meta-analysis led by Dr. Anastasia Vladimirovna from Aberdeen, UK. (see page 1327) This review sheds light on the moderating effects of resistance exercise dose components (intensity, volume and frequency) on common tendinopathies. The authors demonstrate that resistance exercises incorporating higher (external) load versus lower (body mass), and a lesser frequency (defined as less than daily), have superior effectiveness in the management of a range of tendinopathies. These are important findings for clinicians managing competitive athletes or patients with this common but challenging injury.
In pregnancy too!
The editorial ‘Pregnancy and physical activity: facilitating change,’ led by Dr Katherine Marino is a must read. (see page 1285) It reiterates the importance of regular physical activity as an evidence-based intervention to optimise health in pregnant women. The practice of physical activity promotion/facilitation by healthcare professionals remains limited and this must change. This editorial may help close the implementation gap a bit. It details physical activity recommendations during pregnancy and how clinicians can support pregnant women in adopting this healthy behaviour.
We hope you enjoy this edition of BJSM loaded with high-quality research articles and novel findings. Importantly, please incorporate this knowledge into your routine practice, as applicable. Without a doubt, this edition adds to the pool of knowledge that further elevates implementing exercise as medicine for advancements in research and clinical practice…in more ways than one!
Patient consent for publication
Contributors OBAO conceptualised and completed this editorial based on the selected papers for the BJSM issue.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests OBAO is a deputy editor of BJSM.
Provenance and peer review Commissioned; internally peer reviewed.