Yikun Yin

Background: Hypertension is one of the most common chronic diseases worldwide. Brisk walking is regarded as a safe and effective exercise modality for blood pressure reduction; however, its optimal exercise dose remains unclear. This study aims to systematically evaluate the effects of brisk walking on blood pressure in patients with hypertension using a Bayesian meta-analysis, and to determine the dose-response relationship and the optimal exercise dose range. Methods: Randomized controlled trials (RCTs) were systematically searched in China National Knowledge Infrastructure (CNKI), VIP Information (VIP), Wanfang Data, CBM, PubMed, EBSCO (MEDLINE), Embase, the Cochrane Library, and Web of Science from database inception to December 30, 2025. Bayesian hierarchical random-effects models were constructed using the brms, metafor, and dosresmeta packages in R software (version 4.4.3) to perform pairwise comparisons and dose-response meta-analyses. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Results: A total of 17 RCTs involving 1,493 patients with hypertension were included. Brisk walking significantly reduced systolic blood pressure (Hedges’ g = − 0.48, 95% CrI [−0.54 to −0.43]) and diastolic blood pressure (Hedges’ g = − 0.51, 95% CrI [−0.58 to −0.44]), both representing moderate effect sizes. A “U” shaped dose-response relationship was observed for systolic blood pressure, with the optimal dose at approximately 460 MET (Metabolic Equivalent) ⋅ min/week (Hedges’ g = − 1.00, 95% CrI [−1.54 ∼−0.46]), indicating a large effect size. Diastolic blood pressure exhibited a negative dose–response relationship, with the most significant improvement also observed at approximately 620 MET min/week (Hedges ’ g = − 0.55, 95% CrI [−1.06 ∼−0.03]), corresponding to a substantial effect. Conclusion: Brisk walking significantly improves blood pressure in patients with hypertension and demonstrates a precise dose-response relationship. A brisk walking regimen of four sessions per week, ≤ 40 minutes per session, lasting at least 12 weeks, with a total weekly dose of 460–620 MET min/week, is recommended to achieve the most pronounced blood pressure-lowering effects.

Functional ankle instability (FAI) patients often experience restricted ankle dorsiflexion, increased inversion angle, and elevated ground reaction forces during walking, all related to altered kinematics of the talocrural and subtalar joints. This study aimed to investigate the potential positive impact of joint mobilization on FAI patients from a biomechanical perspective. The experimental group (EG, n = 17; Age: 20.06 ± 1.34 years; Height: 1.74 ± 0.07 m; Weight: 69.79 ± 11.20 kg; BMI:22.88 ± 2.63 kg/m²; CAIT:15.59 ± 2.58; M/F: 15/2) received joint mobilization + routine rehabilitation training, while the control group (CG, n = 16; Age: 20.50 ± 0.73 years; Height: 1.73 ± 0.09 m; Weight: 64.59 ± 7.21 kg; BMI: 21.65 ± 2.47 kg/m²; CAIT: 16.75 ± 2.21; M/F: 14/2) only received regular rehabilitation training. Biomechanical tests were performed in both groups after the 4-week intervention. The spatial parameters during walking (including step length, stride length, step width, step time, cadence, step speed, support time, and swing time), ankle flexion and dorsiflexion angle, inversion, and eversion angles, internal and external rotation angles, ankle torque, as well as the vertical ground reaction force were measured before and after the intervention. The results of the two-way ANOVA showed that the main effect of time was significant for step length (P < 0.001), stride length (P = 0.008), step speed (P < 0.001), the sagittal plane angle at touchdown (P < 0.001), maximum dorsiflexion angle (P = 0.005), sagittal plane toe off-ground angle (P < 0.001), peak flexion-dorsiflexion torque (P = 0.033), the first peak vGRF (P = 0.013), and second peak vGRF (P = 0.011). The main effect of Time * Group was significant for step speed (P = 0.044). The EG demonstrated significant improvements in step speed (P = 0.047), maximum dorsiflexion angle (P = 0.047), and the first peak vGRF (P = 0.028) compared to the CG. This study reveals that joint mobilization intervention enhances gait spatiotemporal parameters, kinematics, and kinetics, particularly in step speed, maximum dorsiflexion angle, and the first vGRF peak for the EG compared to the CG. Therefore, the rehabilitation strategy for patients with functional ankle instability should appropriately increase the use of joint movement to promote the functional recovery of FAI patients.