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      The influence of acute exercise on bone biomarkers: protocol for a systematic review with meta-analysis


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          Bone is a plastic tissue that is responsive to its physical environment. As a result, exercise interventions represent a potential means to influence the bone. However, little is currently known about how various exercise and participant characteristics interact to influence bone metabolism. Acute, controlled, interventions provide an in vivo model through which the acute bone response to exercise can be investigated, typically by monitoring circulating bone biomarkers. Currently, substantial heterogeneity in factors such as study design, quality, exercise, and participant characteristics render it difficult to synthesize and evaluate the available evidence. Using a systematic review and meta-analytic approach, the aim of this investigation is to quantify the effect of an acute exercise bout on circulating bone biomarkers as well as examine the potential factors that may moderate this response, e.g., variation in participant, exercise, and sampling characteristics.


          This protocol was designed in accordance with the PRISMA-P guidelines. Seven databases (MEDLINE, Embase, Sport Discus, Cochrane CENTRAL, PEDro, LILACS, and Ibec) will be systematically searched and supplemented by a secondary screening of the reference lists of all included articles. The PICOS (Population, Intervention, Comparator, Outcomes and Study Design) approach was used to guide the determination of the eligibility criteria. Participants of any age, sex, training, or health status will be considered for inclusion. We will select studies that have measured the bone biomarker response before and after an acute exercise session. All biomarkers considered to represent the bone metabolism will be considered for inclusion, and sensitivity analyses will be conducted using reference biomarkers for the measurement of bone resorption and formation (namely β-CTX-1 and P1NP). Multi-level, meta-regression models within a Bayesian framework will be used to explore the main effect of acute exercise on bone biomarkers as well as potential moderating factors. The risk of bias for each individual study will be evaluated using a modified version of the Downs and Black checklist while certainty in resultant outcomes will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.


          A better understanding of the bone metabolic response to an acute bout of exercise has the potential to advance our understanding of the mechanisms through which this stimulus impacts bone metabolism, including factors that may moderate this response. Additionally, we will identify current gaps in the evidence base and provide recommendations to inform future research.

          Systematic review registration

          This protocol was prospectively registered in the Open Science Framework Registry ( https://osf.io/6f8dz)

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s13643-020-01551-y.

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          A power primer.

          One possible reason for the continued neglect of statistical power analysis in research in the behavioral sciences is the inaccessibility of or difficulty with the standard material. A convenient, although not comprehensive, presentation of required sample sizes is provided here. Effect-size indexes and conventional values for these are given for operationally defined small, medium, and large effects. The sample sizes necessary for .80 power to detect effects at these levels are tabled for eight standard statistical tests: (a) the difference between independent means, (b) the significance of a product-moment correlation, (c) the difference between independent rs, (d) the sign test, (e) the difference between independent proportions, (f) chi-square tests for goodness of fit and contingency tables, (g) one-way analysis of variance, and (h) the significance of a multiple or multiple partial correlation.
            • Record: found
            • Abstract: not found
            • Article: not found

            GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.

              • Record: found
              • Abstract: not found
              • Article: not found

              brms: An R Package for Bayesian Multilevel Models Using Stan


                Author and article information

                Syst Rev
                Syst Rev
                Systematic Reviews
                BioMed Central (London )
                12 December 2020
                12 December 2020
                : 9
                [1 ]GRID grid.11899.38, ISNI 0000 0004 1937 0722, Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, , University of Sao Paulo, ; Sao Paulo, Brazil
                [2 ]GRID grid.42629.3b, ISNI 0000000121965555, Department of Sport, Exercise and Rehabilitation, , Northumbria University, ; Newcastle upon Tyne, UK
                [3 ]GRID grid.11899.38, ISNI 0000 0004 1937 0722, Food Research Centre, , University of São Paulo, ; Sao Paulo, SP Brazil
                [4 ]GRID grid.430503.1, ISNI 0000 0001 0703 675X, Centre for Women’s Health Research, School of Medicine, , University of Colorado, ; Aurora, USA
                [5 ]GRID grid.268154.c, ISNI 0000 0001 2156 6140, Department of Biostatistics, , West Virginia University, ; Morgantown, USA
                [6 ]GRID grid.11899.38, ISNI 0000 0004 1937 0722, Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina FMUSP, , Universidade de Sao Paulo, ; Sao Paulo, SP Brazil
                [7 ]GRID grid.12361.37, ISNI 0000 0001 0727 0669, Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, , Nottingham Trent University, ; Nottingham, UK
                [8 ]GRID grid.59490.31, ISNI 0000000123241681, School of Health Sciences, , Robert Gordon University, ; Aberdeen, UK
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                Funded by: FundRef http://dx.doi.org/10.13039/501100001807, Fundação de Amparo à Pesquisa do Estado de São Paulo;
                Award ID: 2019/05616-6 & 2019/26899-6
                Custom metadata
                © The Author(s) 2020

                Public health
                exercise,bone,meta-analysis,systematic review
                Public health
                exercise, bone, meta-analysis, systematic review


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