{"publication_id":"32110f91-0ef4-4117-9031-000af0bdab66","content_hash":"sha256:19e07fbebb869ba882d107cb365778f6337785f7a54ac0fd7c59251ebd5b8568","nodes":[{"id":"32110f91-0ef4-4117-9031-000af0bdab66","type":"publication","title":"Adjacent Evidence Brief: Aerobic Exercise Training Effects — full paper"},{"id":"claim_1","type":"claim","text":"This paper synthesizes evidence on aerobic exercise training effects across 39 accepted source papers and 1715 high-confidence extracted claims. The evidence profile contains 13 direct clinical sources, 26 adjacent, review, or context sources, and no sources classified primarily as mechanistic or model-system evidence, with a high-density pairwise disagreement map across the evidence base. Positive study-level signals are summarized in the cardiometabolic, contextual adjacent evidence and muscle function outcome classes, null signals in the contextual adjacent evidence, cardiometabolic and muscle function outcome classes, and negative signals in the cardiometabolic outcome class. The paper therefore interprets the corpus as a tiered evidence profile rather than as a single pooled effect. The conclusion is that aerobic exercise training effects remains a bounded evidence case: the retained direct, adjacent, and context evidence profile defines the scope for targeted testing, while mixed and null findings limit any unqualified broad clinical claim. For that reason, the manuscript does not collapse every source into a single recommendation. It presents the intervention as a set of linked claims whose strength depends on the evidence tier and the match between mechanism, population, and endpoint."},{"id":"claim_2","type":"claim","text":"This paper synthesizes evidence on aerobic exercise training effects across 39 accepted source papers and 1715 high-confidence extracted claims."},{"id":"claim_3","type":"claim","text":"The evidence profile contains 13 direct clinical sources, 26 adjacent, review, or context sources, and no sources classified primarily as mechanistic or model-system evidence, with a high-density pairwise disagreement map across the evidence base."},{"id":"claim_4","type":"claim","text":"Positive study-level signals are summarized in the cardiometabolic, contextual adjacent evidence and muscle function outcome classes, null signals in the contextual adjacent evidence, cardiometabolic and muscle function outcome classes, and negative signals in the cardiometabolic outcome class. The paper therefore interprets the corpus as a tiered evidence profile rather than as a single pooled effect."},{"id":"claim_5","type":"claim","text":"The conclusion is that aerobic exercise training effects remains a bounded evidence case: the retained direct, adjacent, and context evidence profile defines the scope for targeted testing, while mixed and null findings limit any unqualified broad clinical claim."},{"id":"claim_6","type":"claim","text":"For that reason, the manuscript does not collapse every source into a single recommendation. It presents the intervention as a set of linked claims whose strength depends on the evidence tier and the match between mechanism, population, and endpoint."},{"id":"claim_7","type":"claim","text":"This synthesis evaluates evidence on aerobic exercise training effects across 39 included source papers and 1715 high-confidence extracted claims. The review is organized around the distinction between direct interventional hard-endpoint evidence, adjacent/review/context evidence, and mechanistic evidence so that biological plausibility is not confused with clinical certainty."},{"id":"claim_8","type":"claim","text":"The corpus contains 13 direct clinical sources, 26 adjacent, review, or context sources, and no sources classified primarily as mechanistic or model-system evidence. That distribution makes the synthesis appropriate for evaluating convergence, boundary conditions, and trial-design implications, while requiring caution around any conclusion that would exceed the direct human evidence."},{"id":"claim_9","type":"claim","text":"The introductory frame therefore treats the corpus as a set of evidence roles rather than a single directional verdict. Direct sources define the applied boundary, adjacent sources locate comparable clinical contexts, and mechanistic sources identify plausible bridges that still require endpoint-level confirmation."},{"id":"claim_10","type":"claim","text":"This distinction matters for publication because it makes the paper falsifiable. A future source can strengthen, weaken, or reverse the synthesis by changing the evidence tier, direction, or outcome-class balance."},{"id":"claim_11","type":"claim","text":"The mechanistic layer is most useful when it explains why a trial signal might appear or fail to appear. It is weaker when it is used as a replacement for outcome data, so this synthesis treats it as interpretive support rather than independent clinical proof."},{"id":"claim_12","type":"claim","text":"Null findings have a specific role in this evidence model. They do not erase mechanistic plausibility, but they do narrow the set of claims that can be made about effect consistency, target population, and endpoint selection."},{"id":"claim_13","type":"claim","text":"Adverse or negative signals are likewise retained in the main interpretation. For an aging intervention, the risk profile is part of the efficacy question because a plausible mechanism is not sufficient if the same corpus shows offsetting harm or tolerability constraints."},{"id":"claim_14","type":"claim","text":"The evidence base also distinguishes breadth from certainty. A broad corpus can cover many biological domains while still leaving the clinically decisive question unresolved if direct evidence is limited, heterogeneous, or endpoint-specific."},{"id":"claim_15","type":"claim","text":"The research value of the synthesis lies in making these boundaries explicit. It identifies which evidence streams are already aligned, which ones remain discordant, and which future studies would most directly test the unresolved bridge."},{"id":"claim_16","type":"claim","text":"The background evidence for aerobic exercise training effects is heterogeneous rather than uniformly confirmatory. Direct clinical sources such as MoralesPalomo 2023, Kleinloog 2022, Sloan 2018 are interpreted separately from mechanistic studies such as the retained evidence base, because these evidence roles answer different questions about aging biology and clinical translation."},{"id":"claim_17","type":"claim","text":"The direct evidence establishes what has been observed in human or adjacent clinical settings. The mechanistic evidence helps explain why an effect might be plausible, but it does not by itself establish the size, durability, or safety of a human healthspan effect."},{"id":"claim_18","type":"claim","text":"Across the retained sources, positive signals cluster around the cardiometabolic, contextual adjacent evidence and muscle function outcome classes; null signals around the contextual adjacent evidence, cardiometabolic and muscle function outcome classes; and negative or adverse signals around the cardiometabolic outcome class. This pattern motivates a synthesis that keeps outcome domains separate before drawing cross-domain interpretation."},{"id":"claim_19","type":"claim","text":"The study-level structure also prevents selective emphasis. Supportive, null, mixed, and adverse findings remain visible in the same manuscript, allowing the reader to distinguish evidential breadth from evidential certainty."},{"id":"claim_20","type":"claim","text":"The resulting paper is therefore a calibrated synthesis: it can identify plausible mechanisms, observed direct signals when present, unresolved tensions, and trial-design priorities without converting them into claims stronger than the retained corpus can support."},{"id":"claim_21","type":"claim","text":"The following fields were extracted from each included source: study design, population / cohort, intervention or exposure, comparator, outcome class, effect direction, effect size, confidence interval or credible interval, p-value, sample size, follow-up duration, risk-of-bias rating. Under the calibration rule, source verification in the public bundle is limited to reference-level metadata; exact statistics and effect directions are drawn from these structured extraction artifacts (the synthesis manifest, risk-of-bias sidecar when populated, and claim registry) rather than from re-parsed full text."},{"id":"claim_22","type":"claim","text":"Risk-of-bias framework assignment follows study design (RoB-2 for RCTs, ROBINS-I for non-randomised studies, AMSTAR-2 for systematic reviews / meta-analyses). Public appraisal claims are limited to populated `risk_of_bias.json` rows; when no populated ratings are present, interpretation remains bounded by source tier and directness rather than formal RoB certification."},{"id":"claim_23","type":"claim","text":"Evidence-tension synthesis: claims grouped by outcome class (cardiometabolic, contextual adjacent evidence, deficiency prevalence, immune and inflammation, muscle function, safety and comorbidity); within-class agreement, disagreement, and directness gaps surfaced explicitly. Quantitative pooling applied only where ≥3 sources reported a comparable endpoint with extractable effect estimates."},{"id":"claim_24","type":"claim","text":"Source retrieval, claim extraction, evidence routing, and prose drafting were assisted by large language models under a deterministic audit-trail protocol. Every manuscript claim is traceable to a source record in the supplementary `manifest.json`. Final eligibility and interpretation decisions are author-verified."},{"id":"claim_25","type":"claim","text":"Directional coding note: Null or no extracted directional signal means no coded positive, negative, or mixed effect was extracted for that specific outcome class; it is not an absence-of-support finding. Positive, negative, mixed, unclear, and null are outcome-specific codes, so a bounded rationale can be supported by adjacent or different outcome evidence while another outcome remains null or unclear. Contextual claims contain bibliographic background, mechanism, methods, exposure definitions, or population context rather than effect-direction evidence. When an outcome-class summary uses no extracted directional signal, it should state the source proportion, such as X/Y sources, to avoid ambiguity. Majority-direction note: 19/39 retained sources are coded unclear at the receipt level. Unless the extraction records a positive, negative, mixed, or null polarity for the mapped outcome, the manuscript states that direction cannot be determined for that source and narrows the conclusion instead of treating source count as directional support. Directional-map boundary: Because 19/39 retained sources are predominantly unclear-coded at receipt level, the corpus does not support a standalone per-class directional map; source-level p-values and polarity are reported as audit facts rather than efficacy directions unless extraction records polarity."},{"id":"claim_26","type":"claim","text":"Findings Map accounting note: each outcome-class n, direction count, directness count, and source roster is computed from the same source-level rows listed in the detailed table. Receipt-level direction is not a statement that the source abstracts lack directional statistics; it is the conservative coded polarity used for synthesis accounting. Outcome-class roster: Cardiometabolic n=15 (direction: negative=1; null=4; positive=3; unclear=7; directness: direct=3; indirect=4; protocol=1; review=7; sources: Alzahrani 2023; Burchert 2022; Ding 2025; Gelinas 2017; Han 2016; Healy 2024; Konopka 2019; Li 2024; MoralesPalomo 2023; Prior 2014; Rajabi 2024; Silva 2023; Swift 2012; Tanaka 2018; Wyngaert 2018); Contextual Adjacent Evidence n=13 (direction: negative=2; null=4; positive=1; unclear=6; directness: direct=5; indirect=5; review=3; sources: Bakali 2023; Davis 2017; Ehlers 2025; Gaitan 2021; Hansen 2021; Hugenschmidt 2019; Kleinloog 2022; Kobayashi 2021; Morita 2019; Pawar 2025; Raichlen 2020; Wood 2023; Zhou 2026); Muscle Function n=5 (direction: null=3; positive=1; unclear=1; directness: direct=3; indirect=2; sources: Alkhateeb 2020; Jannas-Vela 2023; Liu-Ambrose 2010; Lo 2021; Santos 2024); Immune and Inflammation n=3 (direction: mixed=1; null=1; unclear=1; directness: direct=1; indirect=1; review=1; sources: Emmel 2025; Ghojazadeh 2024; Sloan 2018); Safety and Comorbidity n=2 (direction: null=2; directness: direct=1; indirect=1; sources: Jespersen 2023; Oliveira 2018); Deficiency Prevalence n=1 (direction: unclear=1; directness: review=1; sources: ZURE 2025)."},{"id":"claim_27","type":"claim","text":"| Evidence domain | Source | Direction | Directness | Tier | Evidence role | Finding |"},{"id":"claim_28","type":"claim","text":"| Cardiometabolic | Burchert 2022: Aerobic Exercise Training Response in Preterm-Born Young Adults with Elevated Blood Pressure and Stage 1 Hypertension: A Randomized Clinical Trial | direction=unclear | directness=direct | A1 | outcome=Cardiometabolic; direction=unclear | finding=representative non-significant statistic P = 0.32; not treated as positive or negative directional support unless source direction is coded |"},{"id":"claim_29","type":"claim","text":"| Cardiometabolic | Gelinas 2017: Aerobic exercise training does not alter vascular structure and function in chronic obstructive pulmonary disease. | direction=null | directness=review | B1 | outcome=Cardiometabolic; direction=null | finding=2 extracted claim(s); receipt-level direction is the coded finding |"},{"id":"claim_30","type":"claim","text":"| Cardiometabolic | Li 2024: The effect of moderate and vigorous aerobic exercise training on the cognitive and walking ability among stroke patients during different periods: A systematic review and meta-analysis | direction=null | directness=review | B2 | outcome=Cardiometabolic; direction=null | finding=12 extracted claim(s); receipt-level direction is the coded finding |"},{"id":"source_1","type":"source","study":"Efficacy of morning versus afternoon aerobic exercise training on reducing metabolic syndrome components: A randomized controlled trial","year":2023,"doi":"10.1113/JP285366","url":"https://doi.org/10.1113/JP285366","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"MoralesPalomo 2023","excerpt":"A supervised intense aerobic exercise program improves the health of individuals with metabolic syndrome (MetS). However, it is unclear whether the timing of training within the 24 h day would influence those health benefits. The present study aimed to determine the influence of morning vs. afternoon exercise on body composition, cardiometabolic health and components of MetS. One hundred thirty-nine individuals with MetS were block randomized into morning (AMEX; n = 42) or afternoon (PMEX; n = 59) exercise training groups, or a non-training control group (Control; n = 38). Exercise training was comprised of 48 supervised high-intensity interval sessions distributed over 16 weeks. Body composition, cardiorespiratory fitness (assessed by V ̇ O 2 max ${\\dot V_{{{\\mathrm{O}}_{\\mathrm{2}}}{\\mathrm{max}}}}$ ), maximal fat oxidation (FO max ), blood pressure and blood metabolites were assessed before and after the intervention. Compared with the non-training Control, both exercise groups improved similarly body composition (-0.7% fat loss; P = 0.002), waist circumference (-2.1 cm; P < 0.001), diastolic blood pressure (-3.8 mmHg; P = 0."},{"id":"source_2","type":"source","study":"Aerobic exercise training improves not only brachial artery flow‐mediated vasodilatation but also carotid artery reactivity: A randomized controlled, cross‐over trial in older men","year":2022,"doi":"10.14814/phy2.15395","url":"https://doi.org/10.14814/phy2.15395","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Kleinloog 2022","excerpt":"It is well-known that aerobic exercise training beneficially affects endothelial function as measured by brachial artery flow-mediated vasodilation (FMD). This trial with older sedentary overweight and obese men, therefore, examined the effects of aerobic training on other non-invasive markers of the vasculature, which have been studied in less detail. Seventeen men (67 ± 2 years, BMI: 30.3 ± 2.8 kg/m 2 ) participated in this controlled cross-over study. Study participants followed in random order a fully supervised, progressive, aerobic exercise training (three 50-min sessions each week at 70% maximal power) and a no-exercise control period for 8 weeks, separated by a 12-week wash-out period. At the end of each period, endothelial function was assessed by the carotid artery reactivity (CAR) response to a cold pressor test and FMD, and local carotid and regional aortic stiffness by the carotid-to-femoral pulse wave velocity (PWV c-f ). The retinal microvasculature, the serum lipid profile, 24-h ambulatory blood pressure, and 96-h continuous glucose concentrations were also determined. Aerobic training increased CAR from 1.78% to 4.01% (Δ2.23 percentage point [pp]; 95% CI: 0.58, 3."},{"id":"source_3","type":"source","study":"Effects of Aerobic Exercise Training in Hypoxia Versus Normoxia on Body Composition and Metabolic Health in Overweight and/or Obese Populations: an Updated Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00918-6","url":"https://doi.org/10.1186/s40798-025-00918-6","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Ding 2025","excerpt":"BACKGROUND: While aerobic training is well-established for improving body composition and metabolic health in normoxia, its effectiveness in hypoxia remains unclear. OBJECTIVE: This meta-analysis examines whether aerobic training in hypoxia is more effective than in normoxia for improving body composition and metabolic health in overweight and/or obese individuals, and identifies optimal exercise prescription variables. METHODS: A search of five databases was conducted through 10 November 2024. Random-effects meta-analyses evaluated body composition (e.g., body mass and fat mass) and metabolic health markers (e.g., triglycerides and glucose). Subgroup analyses were performed based on hypoxic severity, hypoxic dose, exercise duration, frequency, session length, and age. RESULTS: Aerobic training in hypoxia resulted in greater reductions in body mass (mean difference [MD] = -0.90, 95% confidence interval [CI]: -1.80 to -0.01), triglycerides (MD = -10.78, 95% CI: -20.68 to -0.88), low-density lipoprotein cholesterol (MD = -3.74, 95% CI: -6.92 to -0.56, p < 0.05), and insulin resistance (MD = -0.22, 95% CI: -0.33 to -0.11) (all p < 0."},{"id":"source_4","type":"source","study":"The effect of 12 weeks of aerobic exercise training with or without saffron supplementation on diabetes‐specific markers and inflammation in women with type 2 diabetes: A randomized double‐blind placebo‐controlled trial","year":2024,"doi":"10.1002/ejsc.12125","url":"https://doi.org/10.1002/ejsc.12125","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Rajabi 2024","excerpt":"This study was conducted to investigate the effects of 12 weeks of aerobic exercise (AT) and saffron supplementation on hemostasis, inflammatory markers, and insulin resistance in obese women diagnosed with type 2 diabetes (T2D). A total of 44 women with T2D (mean age: 54.12 ± 5.63 years, mean BMI: 31.15 ± 1.50 kg/m 2 , HbA1c: 85 ± 4.2 mmol/mol) were included in a randomized, double-blind, placebo-controlled study. We were randomly assigned to one of four groups (n = 11 per group): saffron + training (ST), placebo + training (PT), saffron supplement (SS), and placebo (P). The ST and PT groups completed 12 weeks of AT (three sessions per week of mild to moderate intensity). The ST and SS groups were administered a daily dose of 200 mg of saffron powder for 12 weeks. Fasting blood samples were collected 48 h before the first AT session and/or nutritional supplementation and 48 h after the last AT session and/or nutritional supplementation. Post-evaluation, homeostatic model assessment of insulin resistance value (HOMA-IR, p < 0.001) and serum levels of glucose (p < 0.001), fibrinogen (FIB, p < 0.001), homocysteine (HCY, p < 0.001), interleukin-6 (IL-6, p < 0."},{"id":"source_5","type":"source","study":"Feasibility of an unsupervised aerobic exercise training program for participants with persistent symptoms after SARS-CoV-2 infection","year":2025,"doi":"10.1038/s41598-025-13905-4","url":"https://doi.org/10.1038/s41598-025-13905-4","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Emmel 2025","excerpt":"Aim of the randomized controlled pilot study was to investigate general feasibility in terms of adherence to a 12-week unsupervised aerobic exercise training program in participants with persistent symptoms (fatigue, concentration problems, breathing problems or headache) > 12 months after SARS-CoV-2 infection. Multiple symptom-related, psychosocial, spiroergometric and body composition parameters were collected at baseline and follow-up examination. The intervention group underwent a 12-week unsupervised aerobic exercise training program. The control group kept their regular physical activity. Both groups maintained an online training diary. Data was evaluated descriptively using intention-to-treat, per protocol and as-treated analysis. Feasibility of an unsupervised aerobic exercise training intervention was limited, as a large number of participants in the intervention group did not strictly adhere to the training plan. Therefore, statements about the efficacy were restricted. However, there was some weak indication for efficacy of the intervention to reduce self-rated severity of symptoms and to improve overall wellbeing."},{"id":"source_6","type":"source","study":"Feasibility and Efficacy of Low-to-Moderate Intensity Aerobic Exercise Training in Reducing Resting Blood Pressure in Sedentary Older Saudis with Hypertension Living in Social Home Care: A Pilot Randomized Controlled Trial","year":2023,"doi":"10.3390/medicina59061171","url":"https://doi.org/10.3390/medicina59061171","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Alzahrani 2023","excerpt":"Background and Objectives : The effect of non-pharmacological aerobic exercise training on blood pressure in sedentary older individuals receiving social home care in Saudi Arabia has not been investigated. This study aimed to examine the effects of aerobic exercise on blood pressure in sedentary older Saudis with hypertension residing in these settings. Materials and Methods : A pilot randomized control trial was conducted with 27 sedentary individuals, aged 60-85, diagnosed with hypertension, and living in social home care in Makkah, Saudi Arabia. Recruitment took place between November 2020 and January 2021, and participants were randomly assigned to either the experimental or control group. The experimental group engaged in three 45 min sessions of low-to-moderate intensity aerobic activity per week for eight weeks. This trail was registered with the ISRCTN registry (ISRCTN50726324). Results : Following eight weeks of mild to moderate aerobic exercise training, the primary outcome of resting blood pressure showed a significant reduction in the experimental group (systolic blood pressure: mean difference [MD] = 2.91 mmHg, 95% confidence interval [CI] = 1.61, 4.21, p = 0."},{"id":"source_7","type":"source","study":"The Effect of Aerobic Exercise Training Frequency on Arterial Stiffness in a Hyperglycemic State in Middle-Aged and Elderly Females","year":2021,"doi":"10.3390/nu13103498","url":"https://doi.org/10.3390/nu13103498","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Kobayashi 2021","excerpt":"The frequency of aerobic exercise training in reducing the increase in arterial stiffness during acute hyperglycemia, a risk factor for cardiovascular disease, is unknown. The aim of the study was to determine the aerobic exercise training frequency on arterial stiffness in a hyperglycemic state in middle-aged and elderly females. Twenty healthy elderly people were randomly assigned to a two-times-a-week (T2, n = 10) and four-times-a-week (T4, n = 10) exercise group. All participants exercised for 35 min per session, which consisted of jogging exercises with a heart rate intensity of 65%. Brachial-ankle (ba), and heart-brachial (hb) pulse wave velocity (PWV) were measured before, 4 and 8 weeks after intervention; before the oral ingestion of 75-g of glucose; and 30, 60, and 90 min after ingestion. The baPWV before and 4 weeks after the intervention increased in both groups ( p < 0.05), but only increased 8 weeks after intervention in the T2 group. hbPWV was unchanged before, 4 and 8 weeks after intervention in both groups. These findings show that frequent aerobic exercise suppresses the increase in arterial stiffness following glucose intake."},{"id":"source_8","type":"source","study":"The Effects of Aerobic Exercise Training on Testosterone Concentration in Individuals Who are Obese or Have Type 2 Diabetes: A Systematic Review and Meta-Analysis","year":2024,"doi":"10.1186/s40798-024-00781-x","url":"https://doi.org/10.1186/s40798-024-00781-x","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Healy 2024","excerpt":"BACKGROUND: Obesity and type 2 diabetes (T2D) are associated with alterations in testosterone concentrations. While evidence indicates that aerobic training can influence testosterone in healthy populations or females with hyperandrogenism, its impact in individuals with obesity or T2D remains unclear. Thus, the aim of this study was to investigate whether aerobic training can influence circulating testosterone concentrations in individuals with obesity or T2D. METHODS: EBSCOhost (CINAHL, MEDLINE, SPORTDiscus), PubMed and Embase were searched for articles published until August 2023. Eligible articles included individuals with obesity or T2D that underwent an aerobic exercise intervention with testosterone concentrations measured at baseline and post intervention. Two reviewers independently screened the seven articles included in this meta-analysis and conducted data extraction and risk of bias assessments. RESULTS: A total of 103 participants (62 men / 41 women) from three randomised controlled trials and four non-randomised controlled trials were included. Effect sizes were computed with random effects models."},{"id":"source_9","type":"source","study":"Effects of Individualized Aerobic Exercise Training on Physical Activity and Health-Related Physical Fitness among Middle-Aged and Older Adults with Multimorbidity: A Randomized Controlled Trial","year":2021,"doi":"10.3390/ijerph18010101","url":"https://doi.org/10.3390/ijerph18010101","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lo 2021","excerpt":"The presence of multimorbidity in middle-aged and older adults, which reduces their physical activity and quality of life, is a global health challenge. Exercise is one of the most important health behaviors that individuals can engage in. Previous studies have revealed that aerobic exercise training is beneficial for healthy middle-aged and older adults and those with various chronic diseases, but few studies have designed individualized aerobic exercise training for individuals with multimorbidity. Although individuals with multimorbidity are considerably less adherent to physical activity interventions, telephone-based motivational interviewing may help in strengthening motivation and promoting behavioral change for increasing physical activity and health-related physical fitness. This study aimed to examine whether a 12-week individualized aerobic exercise training in a rehabilitation center combined with telephone-based motivational interviewing is effective in promoting physical activity and health-related physical fitness among middle-aged and older adults with multimorbidity. A randomized controlled trial was conducted."},{"id":"source_10","type":"source","study":"Aerobic Exercise Training Response in Preterm-Born Young Adults with Elevated Blood Pressure and Stage 1 Hypertension: A Randomized Clinical Trial","year":2022,"doi":"10.1164/rccm.202205-0858OC","url":"https://doi.org/10.1164/rccm.202205-0858OC","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Burchert 2022","excerpt":"Rationale: Premature birth is an independent predictor of long-term cardiovascular risk. Individuals affected are reported to have a lower rate of [Formula: see text]o 2 at peak exercise intensity ([Formula: see text]o 2PEAK ) and at the ventilatory anaerobic threshold ([Formula: see text]o 2VAT ), but little is known about their response to exercise training. Objectives: The primary objective was to determine whether the [Formula: see text]o 2PEAK response to exercise training differed between preterm-born and term-born individuals; the secondary objective was to quantify group differences in [Formula: see text]o 2VAT response. Methods: Fifty-two preterm-born and 151 term-born participants were randomly assigned (1:1) to 16 weeks of aerobic exercise training ( n = 102) or a control group ( n = 101). Cardiopulmonary exercise tests were conducted before and after the intervention to measure [Formula: see text]o 2PEAK and the [Formula: see text]o 2VAT . A prespecified subgroup analysis was conducted by fitting an interaction term for preterm and term birth histories and exercise group allocation."},{"id":"source_11","type":"source","study":"Estimating the Effect of Aerobic Exercise Training on Novel Lipid Biomarkers: A Systematic Review and Multivariate Meta-Analysis of Randomized Controlled Trials","year":2023,"doi":"10.1007/s40279-023-01817-0","url":"https://doi.org/10.1007/s40279-023-01817-0","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Wood 2023","excerpt":"BACKGROUND: Aerobic exercise training (AET) prescribed as lipid management treatment positively affects the standard lipid profile and reduces cardiovascular disease (CVD) risk. Apolipoproteins, lipid and apolipoprotein ratios, and lipoprotein sub-fractions may more effectively predict CVD risk than the standard lipid profile but an AET response in these biomarkers has not been established. OBJECTIVES: We conducted a quantitative systematic review of randomised controlled trials (RCTs) to (1) determine the effects of AET on lipoprotein sub-fractions, apolipoproteins and relevant ratios; and (2) identify study or intervention covariates associated with change in these biomarkers. METHODS: We searched PubMed, EMBASE, all Web of Science and EBSCO health and medical online databases from inception to 31 December 2021. We included published RCTs of adult humans with ≥ 10 per group of participants; an AET intervention duration ≥ 12 weeks of at least moderate intensity (> 40% maximum oxygen consumption); and reporting pre/post measurements."},{"id":"source_12","type":"source","study":"Effect of aerobic exercise training on pulse wave velocity in adults with and without long-term conditions: a systematic review and meta-analysis","year":2023,"doi":"10.1136/openhrt-2023-002384","url":"https://doi.org/10.1136/openhrt-2023-002384","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Bakali 2023","excerpt":"RATIONALE: There is conflicting evidence whether aerobic exercise training (AET) reduces pulse wave velocity (PWV) in adults with and without long-term conditions (LTCs). OBJECTIVE: To explore whether PWV improves with AET in adults with and without LTC, to quantify the magnitude of any effect and understand the influence of the exercise prescription. DATA SOURCES: CENTRAL, MEDLINE and EMBASE were among the databases searched. ELIGIBILITY CRITERIA: We included studies with a PWV measurement before and after supervised AET of at least 3 weeks duration. Exclusion criteria included resistance exercise and alternative measures of arterial stiffness. DESIGN: Controlled trials were included in a random effects meta-analysis to explore the effect of AET on PWV. Uncontrolled studies were included in a secondary meta-analysis and meta-regression exploring the effect of patient and programme factors on change in PWV. The relevant risk of bias tool was used for each study design. RESULTS: 79 studies (n=3729) were included: 35 controlled studies (21 randomised control trials (RCT) (n=1240) and 12 non-RCT (n=463)) and 44 uncontrolled (n=2026)."},{"id":"source_13","type":"source","study":"Aerobic exercise training combined with local strength exercise restores muscle blood flow and maximal aerobic capacity in long-term Hodgkin lymphoma survivors","year":2024,"doi":"10.1152/ajpheart.00132.2024","url":"https://doi.org/10.1152/ajpheart.00132.2024","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Santos 2024","excerpt":"It is unclear whether muscle blood flow (MBF) is altered in long-term Hodgkin lymphoma (HL) survivors. We tested the hypothesis that 1 ) MBF response during mental stress (MS) is impaired in long-term HL survivors and 2 ) aerobic exercise training combined with local strength exercise (ET) restores MBF responses during MS in these survivors. Eighteen 5-year HL survivors and 10 aged-paired healthy subjects (HC) were studied. Twenty HL survivors were randomly divided into two groups: exercise-trained (HLT, n = 10) and untrained (HLUT, n = 10). Maximal aerobic capacity was evaluated by a cardiopulmonary exercise test and forearm blood flow (FBF) by venous occlusion plethysmography. MS was elicited by Stroop color and word test. ET was conducted for 4 mo, 3/wk for 60 min each session. The aerobic exercise intensity corresponded to anaerobic threshold up to 10% below the respiratory compensation point. The strength exercises consisted of two to three sets of chest press, pulley and squat exercises, 12-15 repetitions each exercise at 30-50% of the maximal voluntary contraction. Baseline was similar in HL survivors and HC, except peak oxygen consumption (peak V̇o 2 , P = 0."},{"id":"source_14","type":"source","study":"Effects of Aerobic Exercise Training on Systemic Biomarkers and Cognition in Late Middle-Aged Adults at Risk for Alzheimer’s Disease","year":2021,"doi":"10.3389/fendo.2021.660181","url":"https://doi.org/10.3389/fendo.2021.660181","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Gaitan 2021","excerpt":"Increasing evidence indicates that physical activity and exercise training may delay or prevent the onset of Alzheimer's disease (AD). However, systemic biomarkers that can measure exercise effects on brain function and that link to relevant metabolic responses are lacking. To begin to address this issue, we utilized blood samples of 23 asymptomatic late middle-aged adults, with familial and genetic risk for AD (mean age 65 years old, 50% female) who underwent 26 weeks of supervised treadmill training. Systemic biomarkers implicated in learning and memory, including the myokine Cathepsin B (CTSB), brain-derived neurotrophic factor (BDNF), and klotho, as well as metabolomics were evaluated. Here we show that aerobic exercise training increases plasma CTSB and that changes in CTSB, but not BDNF or klotho, correlate with cognitive performance. BDNF levels decreased with exercise training. Klotho levels were unchanged by training, but closely associated with change in VO 2 peak."},{"id":"source_15","type":"source","study":"The effect of blood flow restricted aerobic exercise training on pain, functional status, quality of life and hormonal response to exercise in fibromyalgia patients: a randomized double-blind study","year":2025,"doi":"10.23736/S1973-9087.25.08817-3","url":"https://doi.org/10.23736/S1973-9087.25.08817-3","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"ZURE 2025","excerpt":"BACKGROUND: Fibromyalgia is a chronic pain condition with symptoms such as pain, fatigue, and decreased quality of life. Although aerobic exercise is an effective treatment for fibromyalgia, patients often struggle with exercise intolerance due to fatigue, limiting long-term adherence. Research on blood flow-restricted (BFR) exercise suggests it may provide benefits similar to traditional exercise with reduced intensity, but its effects on fibromyalgia-related symptoms remain underexplored. AIM: This study investigated the impact of a BFR aerobic exercise program on pain, functional status, quality of life, and hormonal response in women with fibromyalgia. DESIGN: A prospective, randomized, double-blind, sham-controlled trial. SETTING: Outpatient rehabilitation center. POPULATION: Fifty women diagnosed with fibromyalgia were included in this study. METHODS: Participants were randomly assigned to two groups receiving supervised aerobic exercise four times weekly for six weeks. The experimental group used blood flow restriction aid with elastic bandages at the groin level, while the control group received a sham restriction."},{"id":"source_16","type":"source","study":"Anodal transcranial direct current stimulation associated with aerobic exercise on the functional and physical capacity of patients with heart failure with reduced ejection fraction: ELETRIC study protocol","year":2023,"doi":"10.1186/s13063-023-07694-2","url":"https://doi.org/10.1186/s13063-023-07694-2","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"protocol","cited_as":"Silva 2023","excerpt":"BACKGROUND: The hallmark symptom of heart failure (HF) is severe exercise intolerance. Fortunately, accumulated evidence suggests that exercise programs improve physical performance, enhance autonomy in daily activities and quality of life, and reduce cardiovascular and other hospitalizations. Recently, experimental studies have explored the application of non-invasive brain stimulation techniques, especially transcranial direct current stimulation (tDCS), aiming to improve physical performance due to its ability to modulate brain functioning. The primary objective of the present study is to evaluate the effects of anodal tDCS associated with aerobic exercise on the functional capacity of patients with HF with reduced ejection fraction (HFrEF). Secondary objectives are to compare the effects of tDCS associated with aerobic exercise vs. sham-tDCS associated with aerobic exercise on cardiopulmonary exercise capacity; inflammatory cytokines; and quality of life. METHODS: This is a two-arm, prospectively registered, randomized trial with concealed allocation, double-blind, and intention-to-treat analysis. Forty-four patients with HFrEF will be recruited."},{"id":"source_17","type":"source","study":"Effect of aerobic exercise training on asthma control in postmenopausal women (the ATOM-study): protocol for an outcome assessor, randomised controlled trial","year":2021,"doi":"10.1136/bmjopen-2021-049477","url":"https://doi.org/10.1136/bmjopen-2021-049477","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Hansen 2021","excerpt":"INTRODUCTION: Late-onset asthma in postmenopausal women is characterised by poor disease control with daily symptoms and reduced quality of life despite treatment with inhaled antiasthma therapies. These patients represent a phenotype that is characterised by low eosinophilic airway inflammation, severe symptoms, moderate obesity and poor response to inhaled antiasthma therapies, which highlights the need of identification of alternative treatment strategies. Thus, this study aims to evaluate if regular high-intensity aerobic exercise improves symptom control in postmenopausal women with asthma. METHODS AND ANALYSIS: This is an ongoing randomised controlled trial planning to enrol 40 postmenopausal women with late-onset asthma. Participants are randomised 1:1 either to supervised exercise training (spinning) three times per week for 12 weeks or to usual care. The primary outcome is change from baseline to follow-up in the Asthma Control Questionnaire. Secondary outcomes are changes in markers of systemic inflammation, airway inflammation, body composition and right ventricular function of the heart."},{"id":"source_18","type":"source","study":"The effect of moderate and vigorous aerobic exercise training on the cognitive and walking ability among stroke patients during different periods: A systematic review and meta-analysis","year":2024,"doi":"10.1371/journal.pone.0298339","url":"https://doi.org/10.1371/journal.pone.0298339","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Li 2024","excerpt":"OBJECTIVE: The study examined whether rehabilitation using aerobic exercise is more appropriate for patients less than 3 months post-stroke or more appropriate for patients more than 3 months post-stroke. METHOD: PubMed, Embase, Web of Science, Scopus and CNKI databases were searched from inception to September 2023. All studies included must be written in English and grey literature was excluded. The quality of the study was evaluated using the PEDro scale. Standard mean difference (SMD) and 95% confidence interval (CI) were calculated. The primary outcomes are cognitive ability and walking ability. The intervention of the experimental group must be or include high-intensity aerobic training or moderate-intensity aerobic training. In addition, we required low intensity routine exercises in control group. RESULT: Only 15 studies were included in this meta-analysis. The results showed that aerobic exercise has a positive rehabilitation effect on cognitive and walking ability of stroke patients. Global Cognitive Function (SMD = 0.81 95%CI 0.49-1.12), Walking Capacity (SMD = 1.19, 95%CI 0.75-1.62), VO2peak (SMD = 0.97, 95%CI 0.66-1.28), and brain-derived neurotrophic factor (SMD = 2."},{"id":"source_19","type":"source","study":"Effect of aerobic exercise training on the fat fraction of the liver in persons with chronic hepatitis B and hepatic steatosis: Trial protocol for a randomized controlled intervention trial— The FitLiver study","year":2023,"doi":"10.1186/s13063-023-07385-y","url":"https://doi.org/10.1186/s13063-023-07385-y","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Jespersen 2023","excerpt":"BACKGROUND: The global prevalence of chronic hepatitis B is more than 300 million people, and in Denmark, 17,000 people are estimated to have chronic hepatitis B. Untreated, chronic hepatitis B can lead to the development of liver cirrhosis and liver cancer. There is no curable therapy. In persons with obesity and chronic hepatitis B infection, the development of hepatic steatosis imposes a double burden on the liver, leading to an increased risk of cirrhosis and liver cancer. In patients without chronic hepatitis B, exercise interventions have shown beneficial effects on hepatic steatosis through improvements in fat fraction of the liver, insulin resistance, fatty acid metabolism, and glucose metabolism, as well as activation of liver-induced regulatory protein secretion (hepatokines) after the exercise intervention. OBJECTIVE: To investigate in persons with chronic hepatitis B and hepatic steatosis: Primary: Whether exercise will decrease the fat fraction of the liver. Secondary: If exercise will affect hepatokine secretion and if it will improve lipid- and glucose metabolism, liver status, markers of inflammation, body composition, and blood pressure."},{"id":"source_20","type":"source","study":"Effects of football versus aerobic exercise training on muscle architecture in healthy men adults: a study protocol of a two-armed randomized controlled trial","year":2020,"doi":"10.1186/s13063-020-04797-y","url":"https://doi.org/10.1186/s13063-020-04797-y","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Alkhateeb 2020","excerpt":"BACKGROUND: Sports and exercise training can attenuate age-related declines in physical function. As people age, they suffer a progressive deterioration of overall muscle structure and function, such as muscle diameter, strength, mass, and power. Therefore, supporting older adults-aged 50 years and above-to continue being physically active is a very important factor. Several forms of exercise (strength, agility, endurance, balance, and flexibility) are recommended. In this regard, football has been repeatedly shown to be an integrative approach to promote measures of strength, endurance, and agility. However, there has been no previous randomized controlled trial that comparatively investigates the effects of football training versus traditional aerobic exercise training on muscle architecture and patella tendon properties in healthy community dwellers. The study protocol is designed to examine whether football differentially affects muscle thickness, muscle length, fascicle length, pennation angle, patella tendon length, and thickness compared to a workload matched traditional aerobic exercise training regimen."},{"id":"source_21","type":"source","study":"Enhancing cognitive function in breast cancer survivors through community-based aerobic exercise training: protocol for a Hybrid Type I effectiveness–implementation study employing a randomised controlled design","year":2025,"doi":"10.1136/bmjopen-2025-104378","url":"https://doi.org/10.1136/bmjopen-2025-104378","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Ehlers 2025","excerpt":"INTRODUCTION: Despite growing evidence to characterise cancer-associated cognitive decline (CACD) in women with breast cancer, interventions to mitigate CACD are limited. Emerging evidence suggests aerobic exercise may enhance cognition after breast cancer diagnosis and treatment; yet, CACD remains an understudied outcome of exercise, and few high-quality studies have been conducted. In addition to knowledge gaps in effectiveness, the translation of exercise interventions to community settings remains challenging. The B reast cancer R easoning and A ctivity IN tervention (BRAIN) investigates the effectiveness of aerobic exercise training, delivered in a community-based setting, for improving cognitive function in women with breast cancer and gathers information on the implementation success of the intervention. METHODS AND ANALYSIS: This Hybrid Type I effectiveness-implementation study is conducted at an academic medical centre in the southwestern United States in partnership with a non-profit, community health and wellness organisation."},{"id":"source_22","type":"source","study":"Telemedicine-based individualised aerobic exercise training in Chinese adults with inactive or mildly active inflammatory bowel disease: study protocol for a single-centre, semi-crossover randomised controlled trial","year":2026,"doi":"10.1136/bmjopen-2025-103297","url":"https://doi.org/10.1136/bmjopen-2025-103297","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Zhou 2026","excerpt":"BACKGROUND: Inflammatory bowel disease (IBD) patients in China exhibit critically low levels of physical activity, yet evidence for telemedicine-based aerobic exercise interventions remains scarce, particularly with objective physiological validation. METHODS AND ANALYSIS: In this single-centre, open-labelled, semi-crossover randomised controlled trial, 28 inactive/mildly active adult IBD patients with low level of baseline physical activity will be randomly assigned to immediate or delayed 12-week telemedicine-based aerobic exercise training. The exercise prescription, stratified by baseline activity level, is designed to progressively elevate physical activity levels to moderate intensity. The telemedicine-based programme used fitness bands synchronised to a mobile app, WeChat-based real-time feedback and online group support and communication. The primary outcome is change in peak oxygen uptake measured by cardiopulmonary exercise testing (CPET)."},{"id":"source_23","type":"source","study":"Effectiveness of aerobic exercise training in patients with obstructive sleep apnea: a systematic review and meta-analysis","year":2025,"doi":"10.1007/s00405-025-09436-3","url":"https://doi.org/10.1007/s00405-025-09436-3","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Pawar 2025","excerpt":"PURPOSE: Obstructive sleep apnea (OSA), a sleep-related disorder, reports significant clinical consequences, apart from its socioeconomic burden globally. Among the physiotherapeutic treatment options, exercise training is primarily preferred for these patients. In the current systematic review and meta-analysis, we hypothesize that aerobic exercise training could be beneficial in reducing the severity of OSA. METHODS: A thorough literature search was carried out from Scopus, PubMed, CINAHL, Cochrane, and Embase databases following the PRISMA guidelines, and eight studies were included. The primary outcome was the apnea hypopnea index (AHI) and secondary outcomes were maximal oxygen consumption, oxygen desaturation index, mean oxygen saturation during sleep, Epworth sleepiness scale, body mass index, and neck circumference. RevMan version 5.4.1 was utilized for analysis. RESULTS: Meta-analysis involved seven studies that showed that aerobic training significantly improved the AHI with a mean difference of -5.24 and an overall effect of p < 0.00001; and VO 2max with a mean difference of 5.84 and an overall effect of p = 0.03."},{"id":"source_24","type":"source","study":"Effects of simultaneous cognitive and aerobic exercise training on dual-task walking performance in healthy older adults: results from a pilot randomized controlled trial","year":2020,"doi":"10.1186/s12877-020-1484-5","url":"https://doi.org/10.1186/s12877-020-1484-5","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Raichlen 2020","excerpt":"BACKGROUND: The ability to walk and perform cognitive tasks simultaneously is a key aspect of daily life. Performance declines in these dual-tasks may be associated with early signs of neurodegenerative disease and increased risk of falls. Thus, interventions to improve dual-task walking performance are of great interest for promoting healthy aging. Here, we present results of a pilot randomized controlled trial (RCT) to evaluate the effects of a simultaneous aerobic exercise and cognitive training intervention on dual-task walking performance in healthy older adults. METHODS: Community-dwelling, healthy older adults were recruited to participate in a 12-week RCT. Participants were randomized into one of four groups (n = 74): 1) cognitive training (COG), 2) aerobic exercise (EX), 3) combined aerobic exercise and cognitive training (EXCOG), and 4) video-watching control (CON). The COG and EXCOG groups both used a tablet-based cognitive training program that challenged aspects of executive cognitive function, memory, and processing speed."},{"id":"source_25","type":"source","study":"Role of specialized pro-resolving mediators on inflammation, cardiometabolic health, disease progression, and quality of life after omega-3 PUFA supplementation and aerobic exercise training in individuals with rheumatoid arthritis: a randomized 16-week, placebo-controlled interventional trial *","year":2023,"doi":"10.12688/f1000research.138392.1","url":"https://doi.org/10.12688/f1000research.138392.1","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Jannas-Vela 2023","excerpt":"Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by autoantibody production and synovial membrane damage. It significantly impairs overall function and quality of life. Consumption of omega-3 (n-3) polyunsaturated fatty acids (PUFAs) and regular aerobic exercise (AEx) training are reported to have positive effects on the progression of RA. However, the mechanisms behind these benefits are still inconclusive. This study protocol will investigate the effects of n-3 PUFA supplementation and AEx training on disease progression, cardiometabolic health, and quality of life, and their association with the plasma and synovial fluid levels of specialized pro-resolving mediators (SPMs) in subjects with RA. Methods: The study consists of a 16-week intervention period, during which participants will be randomly assigned in a double-blinded manner to one of four groups: placebo control (PLA), PLA+AEx, n-3, or n-3+AEx. The PLA groups will be given a gelatin-filled capsule, while the n-3 groups will be given n-3 PUFAs equivalent to 2.5 g/d of docosahexaenoic acid and 0.5 g/d of eicosapentaenoic acid."},{"id":"source_26","type":"source","study":"The effects of aerobic exercise training on inflammatory markers in adult tobacco smokers: A systematic review and meta-analysis of randomized controlled trials.","year":2024,"doi":"10.1016/j.rmed.2024.107732","url":"https://doi.org/10.1016/j.rmed.2024.107732","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Ghojazadeh 2024","excerpt":"INTRODUCTION: Aerobic exercise training may reduce systemic inflammation, but the effects of this on systemic inflammatory markers in adult tobacco smokers has not been systematically reviewed. Therefore, we evaluated the effects of aerobic exercise training on C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) in adult tobacco smokers using a systematic review and meta-analysis of randomized controlled trials. METHODS: A comprehensive literature search was carried out using PubMed/Medline, Web of Science, EMBASE, Google Scholar, and hand search of bibliographies of the retrieved English or Persian articles up to August 2023. This review only included randomized controlled trials which investigated the effect of aerobic exercise training on CRP and TNF-α in adult smokers, based on a predefined inclusion and exclusion criteria. RESULTS: A total of 1641 articles were identified. Six studies were included in the review and four evaluated CRP and two evaluated TNF-α in only males. The meta-analysis demonstrated that aerobic exercise training significantly decreased TNF-α concentrations in males (MD = -6.68, 95 % CI = -13.90 to -0.54, P = 0.05)."},{"id":"source_27","type":"source","study":"Aerobic Exercise Training and Inducible Inflammation: Results of a Randomized Controlled Trial in Healthy, Young Adults","year":2018,"doi":"10.1161/JAHA.118.010201","url":"https://doi.org/10.1161/JAHA.118.010201","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Sloan 2018","excerpt":"Background Consensus panels regularly recommend aerobic exercise for its health-promoting properties, due in part to presumed anti-inflammatory effects, but many studies show no such effect, possibly related to study differences in participants, interventions, inflammatory markers, and statistical approaches. This variability makes an unequivocal determination of the anti-inflammatory effects of aerobic training elusive. Methods and Results We conducted a randomized controlled trial of 12 weeks of aerobic exercise training or a wait list control condition followed by 4 weeks of sedentary deconditioning on lipopolysaccharide (0, 0.1, and 1.0 ng/mL)-inducible tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and on toll-like receptor 4 in 119 healthy, sedentary young adults. Aerobic capacity by cardiopulmonary exercise testing was measured at study entry (T1) and after training (T2) and deconditioning (T3). Despite a 15% increase in maximal oxygen consumption, there were no changes in inflammatory markers. Additional analyses revealed a differential longitudinal aerobic exercise training effect by lipopolysaccharide level in inducible TNF -α ( P=0.08) and IL-6 ( P=0."},{"id":"source_28","type":"source","study":"Metformin inhibits mitochondrial adaptations to aerobic exercise training in older adults","year":2019,"doi":"10.1111/acel.12880","url":"https://doi.org/10.1111/acel.12880","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Konopka 2019","excerpt":"Metformin and exercise independently improve insulin sensitivity and decrease the risk of diabetes. Metformin was also recently proposed as a potential therapy to slow aging. However, recent evidence indicates that adding metformin to exercise antagonizes the exercise-induced improvement in insulin sensitivity and cardiorespiratory fitness. The purpose of this study was to test the hypothesis that metformin diminishes the improvement in insulin sensitivity and cardiorespiratory fitness after aerobic exercise training (AET) by inhibiting skeletal muscle mitochondrial respiration and protein synthesis in older adults (62 ± 1 years). In a double-blinded fashion, participants were randomized to placebo (n = 26) or metformin (n = 27) treatment during 12 weeks of AET. Independent of treatment, AET decreased fat mass, HbA1c, fasting plasma insulin, 24-hr ambulant mean glucose, and glycemic variability. However, metformin attenuated the increase in whole-body insulin sensitivity and VO 2 max after AET. In the metformin group, there was no overall change in whole-body insulin sensitivity after AET due to positive and negative responders."},{"id":"source_29","type":"source","study":"Association of serum myokines and aerobic exercise training in patients with spinal cord injury: an observational study","year":2016,"doi":"10.1186/s12883-016-0661-9","url":"https://doi.org/10.1186/s12883-016-0661-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Han 2016","excerpt":"BACKGROUND: Patients with spinal cord injury (SCI) have a higher prevalence of cardiovascular diseases compared to the healthy population. Aerobic exercise training is one of the recommended treatments. However, literature regarding the effect of aerobic training on patients with SCI is scarce. This study evaluated changes in parameters of exercise physiology and serum myokines immediately after exercise and after a training program among patients with SCI. METHODS: Male patients with SCI and age- and sex-matched healthy individuals were recruited. Cardio-pulmonary exercise testing (CPET) was used to determine oxygen uptake at peak exercise and anaerobic threshold in both groups. The patients with SCI attended aerobic exercise training for 36 sessions within 12-16 weeks. Basic data, hemodynamic and exercise physiology parameters, and serum myokine (myostatin, IGF-1, and follistatin) concentrations were measured pre- and post-exercise in both groups, and were repeated in patients with SCI post-training. RESULTS: Eleven patients with SCI underwent CPET and 5 completed the training."},{"id":"source_30","type":"source","study":"Increased Skeletal Muscle Capillarization After Aerobic Exercise Training and Weight Loss Improves Insulin Sensitivity in Adults With IGT","year":2014,"doi":"10.2337/dc13-2358","url":"https://doi.org/10.2337/dc13-2358","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Prior 2014","excerpt":"OBJECTIVE: Transcapillary transport of insulin is one determinant of glucose uptake by skeletal muscle; thus, a reduction in capillary density (CD) may worsen insulin sensitivity. Skeletal muscle CD is lower in older adults with impaired glucose tolerance (IGT) compared with those with normal glucose tolerance and may be modifiable through aerobic exercise training and weight loss (AEX+WL). We tested the hypothesis that 6-month AEX+WL would increase CD to improve insulin sensitivity and glucose tolerance in older adults with IGT. RESEARCH DESIGN AND METHODS: Sixteen sedentary, overweight-obese (BMI 27-35 kg/m2), older (63 ± 2 years) men and women with IGT underwent hyperinsulinemic-euglycemic clamps to measure insulin sensitivity, oral glucose tolerance tests, exercise and body composition testing, and vastus lateralis muscle biopsies to determine CD before and after 6-month AEX+WL. RESULTS: Insulin sensitivity (M) and 120-min postprandial glucose (G120) correlated with CD at baseline (r = 0.58 and r = -0.60, respectively, P < 0.05). AEX+WL increased maximal oxygen consumption (VO2max) 18% (P = 0.02) and reduced weight and fat mass 8% (P < 0.02). CD increased 15% (264 ± 11 vs."},{"id":"source_31","type":"source","study":"Cognitive effects of adding caloric restriction to aerobic exercise training in older adults with obesity","year":2019,"doi":"10.1002/oby.22525","url":"https://doi.org/10.1002/oby.22525","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Hugenschmidt 2019","excerpt":"OBJECTIVE: This study examined the short- and long-term effects of adding caloric restriction to 5 months of aerobic exercise training on executive function in sedentary older adults with obesity. METHODS: Sedentary adults with obesity aged 65 to 79 years completed a randomized trial investigating the cardiorespiratory benefits of adding moderate (~ 250 kcal) or high (~ 600 kcal) caloric restriction to a 20-week aerobic exercise program. Approximately half (n = 88) completed a cognitive assessment battery at baseline, post intervention, and 18 to 24 months after intervention completion. The primary outcome was an executive function composite score. RESULTS: In the overall sample, the executive function composite increased 0.114 from baseline to postintervention (P = 0.01). Randomization to caloric restriction did not significantly alter executive function over aerobic exercise alone, nor were there between-group differences on any individual executive function test following the intervention or at long-term follow-up. Adding caloric restriction to exercise was associated with a modest increase in Mini-Mental State Examination score (P = 0.04)."},{"id":"source_32","type":"source","study":"Safety and Efficacy of Aerobic Exercise Training Associated to Non-Invasive Ventilation in Patients with Acute Heart Failure","year":2018,"doi":"10.5935/abc.20180039","url":"https://doi.org/10.5935/abc.20180039","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Oliveira 2018","excerpt":"BACKGROUND: Exercise training (ET) improves functional capacity in chronic heart failure (HF). However, ET effects in acute HF are unknown. OBJECTIVE: To investigate the effects of ET alone or combined with noninvasive ventilation (NIV) compared with standard medical treatment during hospitalization in acute HF patients. METHODS: Twenty-nine patients (systolic HF) were randomized into three groups: control (Control - only standard medical treatment); ET with placebo NIV (ET+Sham) and ET+NIV (NIV with 14 and 8 cmH2O of inspiratory and expiratory pressure, respectively). The 6MWT was performed on day 1 and day 10 of hospitalization and the ET was performed on an unloaded cycle ergometer until patients' tolerance limit (20 min or less) for eight consecutive days. For all analyses, statistical significance was set at 5% (p < 0.05). RESULTS: None of the patients in either exercise groups had adverse events or required exercise interruption. The 6MWT distance was greater in ET+NIV (Δ120 ± 72 m) than in ET+Sham (Δ73 ± 26 m) and Control (Δ45 ± 32 m; p < 0.05). Total exercise time was greater (128 ± 10 vs. 92 ± 8 min; p < 0.05) and dyspnea was lower (3 ± 1 vs. 4 ± 1; p < 0."},{"id":"source_33","type":"source","study":"The effects of aerobic exercise on eGFR, blood pressure and VO 2 peak in patients with chronic kidney disease stages 3-4: A systematic review and meta-analysis","year":2018,"doi":"10.1371/journal.pone.0203662","url":"https://doi.org/10.1371/journal.pone.0203662","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Wyngaert 2018","excerpt":"BACKGROUND: CKD is associated with several comorbidities, cardiovascular disease being the most significant. Aerobic training has a beneficial effect on cardiovascular health in healthy and some well-defined non-healthy populations. However, the effect of aerobic training on glomerular filtration rate in patients with CKD stages 3-4 is unclear. OBJECTIVE: To review the effects of aerobic exercise training on kidney and cardiovascular function in patients with chronic kidney disease (CKD) stages 3-4. METHODS: A random-effects meta-analysis was performed to analyse published randomized controlled trials through February 2018 on the effect of aerobic training on estimated glomerular filtration rate, blood pressure and exercise tolerance in patients with CKD stages 3-4. Web of Science, PubMed and Embase databases were searched for eligible studies. RESULTS: 11 randomized controlled trials were selected including 362 participants in total. Favourable effects were observed on estimated glomerular filtration rate (+2.16 ml/min per 1.73m2; [0.18; 4.13]) and exercise tolerance (+2.39 ml/kg/min; [0.99; 3."},{"id":"source_34","type":"source","study":"Aerobic Exercise Training with Brisk Walking Increases Intestinal Bacteroides in Healthy Elderly Women","year":2019,"doi":"10.3390/nu11040868","url":"https://doi.org/10.3390/nu11040868","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Morita 2019","excerpt":"This study examined the effect of an exercise intervention on the composition of the intestinal microbiota in healthy elderly women. Thirty-two sedentary women that were aged 65 years and older participated in a 12-week, non-randomized comparative trial. The subjects were allocated to two groups receiving different exercise interventions, trunk muscle training (TM), or aerobic exercise training (AE). AE included brisk walking, i.e., at an intensity of ≥ 3 metabolic equivalents (METs). The composition of the intestinal microbiota in fecal samples was determined before and after the training period. We also assessed the daily physical activity using an accelerometer, trunk muscle strength by the modified Kraus-Weber (K-W) test, and cardiorespiratory fitness by a 6-min. walk test (6MWT). K-W test scores and distance achieved during the 6MWT (6MWD) improved in both groups. The relative abundance of intestinal Bacteroides only significantly increased in the AE group, particularly in subjects showing increases in the time spent in brisk walking. Overall, the increases in intestinal Bacteroides following the exercise intervention were associated with increases in 6MWD."},{"id":"source_35","type":"source","study":"Economic evaluation of aerobic exercise training in older adults with vascular cognitive impairment: PROMoTE trial","year":2017,"doi":"10.1136/bmjopen-2016-014387","url":"https://doi.org/10.1136/bmjopen-2016-014387","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Davis 2017","excerpt":"BACKGROUND/OBJECTIVES: Evidence suggests that aerobic exercise may slow the progression of subcortical ischaemic vascular cognitive impairment (SIVCI) by modifying cardiovascular risk factors. Yet the economic consequences relating to aerobic training (AT) remain unknown. Therefore, our primary objective was to estimate the incremental cost per quality-adjusted life years (QALYs) gained of a thrice weekly AT intervention compared with usual care. DESIGN: Cost-utility analysis alongside a randomised trial. SETTING: Vancouver, British Columbia, Canada. PARTICIPANTS: 70 adults (mean age of 74 years, 51% women) who meet the diagnostic criteria for mild SIVCI. INTERVENTION: A 6-month, thrice weekly, progressive aerobic exercise training programme compared with usual care (CON; comparator) with a follow-up assessment 6 months after formal cessation of aerobic exercise training. MEASUREMENTS: Healthcare resource usage was estimated over the 6-month intervention and 6-month follow-up period. Health status (using the EQ-5D-3L) at baseline and trial completion and 6-month follow-up was used to calculate QALYs. The incremental cost-utility ratio (cost per QALY gained) was calculated."},{"id":"source_36","type":"source","study":"The impact of aerobic exercise training with vascular occlusion in patients with chronic heart failure","year":2018,"doi":"10.1002/ehf2.12285","url":"https://doi.org/10.1002/ehf2.12285","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Tanaka 2018","excerpt":"AIMS: This study aimed to evaluate the impact of aerobic exercise training with vascular occlusion in patients with chronic heart failure. METHODS AND RESULTS: Thirty patients with post-infarction heart failure were randomized to an interventional exercise group (IG; n = 15) or a control exercise group (CG; n = 15). Exercise was performed at an intensity of 40-70% of the peak VO 2 /W for 6 months. Patients in the IG remained seated on the saddle of the cycle ergometer with their feet on the pedals. Pneumatic tourniquets were applied to the proximal ends of their thighs with appropriate pressure resulting in a 40-80 mmHg increase in the systolic blood pressure that is required for vascular occlusion (208.7 ± 7.4 mmHg). We evaluated the safety and efficacy of the intervention and its effect on exercise capacity and serum BNP levels. There were no significant differences between the IG and CG in patient characteristics at study entry. Peak VO 2 /W in the IG significantly increased compared with that in the CG; the change in the serum BNP levels was significantly larger in the IG than in the CG."},{"id":"source_37","type":"source","study":"The effect of different doses of aerobic exercise training on endothelial function in postmenopausal women with elevated blood pressure: results from the DREW study.","year":2012,"doi":"10.1136/bjsports-2011-090025","url":"https://doi.org/10.1136/bjsports-2011-090025","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Swift 2012","excerpt":"OBJECTIVES: The aim of this study was to examine the effect of three different doses of aerobic exercise training (corresponding to approximately 50%, 100% and 150% of the National Institutes of Health consensus guidelines) on endothelial function in sedentary obese postmenopausal women with elevated blood pressure. Aerobic exercise training improves endothelial function in individuals with cardiovascular risk; however, it is unknown whether these adaptations occur in a dose-dependent manner. METHODS: Obese postmenopausal women (n=155) with elevated blood pressure (systolic blood pressure between 120 and 159.0 mm Hg) were randomly assigned to one of four groups: 4, 8 or 12 kilocalories per kilogram of energy expenditure per week (kcal/kg/week) or a non-exercise control group for 6 months. Endothelial function was assessed via flow-mediated dilation (FMD) at baseline and post-intervention. RESULTS: After exercise training, there was a similar improvement (1.02-1.5%) in FMD in all three exercise groups (p<0.05) compared with control (-0.5%). Change in FMD after exercise training was significantly correlated with FMD at baseline (r= -0.35, p<0.001)."},{"id":"source_38","type":"source","study":"Aerobic exercise training does not alter vascular structure and function in chronic obstructive pulmonary disease.","year":2017,"doi":"10.1113/ep086379","url":"https://doi.org/10.1113/ep086379","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Gelinas 2017","excerpt":"What is the central question of this study? Chronic obstructive pulmonary disease (COPD) is associated with endothelial dysfunction, arterial stiffness and systemic inflammation, which are linked to increased cardiovascular disease risk. We asked whether periodized aerobic exercise training could improve vascular structure and function in patients with COPD. What is the main finding and its importance? Eight weeks of periodized aerobic training did not improve endothelial function, arterial stiffness or systemic inflammation in COPD, despite improvements in aerobic capacity, blood pressure and dyspnoea. Short-term training programmes may not be long enough to improve vascular-related cardiovascular risk in COPD. Chronic obstructive pulmonary disease (COPD) has been associated with endothelial dysfunction and arterial stiffening, which are predictive of future cardiovascular events. Although aerobic exercise improves vascular function in healthy individuals and those with chronic disease, it is unknown whether aerobic exercise can positively modify the vasculature in COPD."},{"id":"source_39","type":"source","study":"Promotion of the mind through exercise (PROMoTE): a proof-of-concept randomized controlled trial of aerobic exercise training in older adults with vascular cognitive impairment","year":2010,"doi":"10.1186/1471-2377-10-14","url":"https://doi.org/10.1186/1471-2377-10-14","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Liu-Ambrose 2010","excerpt":"BACKGROUND: Sub-cortical vascular ischaemia is the second most common etiology contributing to cognitive impairment in older adults, and is frequently under-diagnosed and under-treated. Although evidence is mounting that exercise has benefits for cognitive function among seniors, very few randomized controlled trials of exercise have been conducted in populations at high-risk for progression to dementia. Aerobic-based exercise training may be of specific benefit in delaying the progression of cognitive decline among seniors with vascular cognitive impairment by reducing key vascular risk factors associated with metabolic syndrome. Thus, we aim to carry out a proof-of-concept single-blinded randomized controlled trial primarily designed to provide preliminary evidence of efficacy aerobic-based exercise training program on cognitive and everyday function among older adults with mild sub-cortical ischaemic vascular cognitive impairment. METHODS/DESIGN: A proof-of-concept single-blinded randomized trial comparing a six-month, thrice-weekly, aerobic-based exercise training group with usual care on cognitive and everyday function."}],"edges":[{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_1","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_2","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_3","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_4","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_5","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_6","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_7","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_8","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_9","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_10","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_11","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_12","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_13","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_14","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_15","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_16","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_17","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_18","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_19","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_20","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_21","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_22","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_23","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_24","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_25","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_26","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_27","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_28","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_29","type":"contains_claim"},{"from":"32110f91-0ef4-4117-9031-000af0bdab66","to":"claim_30","type":"contains_claim"}],"screening":{"identified":39,"screened":39,"excluded":0,"included":39,"included_or_retained":39,"flow":["identified","screened","excluded_with_reasons","included"],"wording":"39 candidate receipts retained after source retrieval, deduplication, and topic filtering. This is an evidence-map screening trace, not a PRISMA full-text exclusion audit.","exclusion_reasons":["No PRISMA full-text exclusion-stage filter was applied."]}}