Minjae Seo

Objectives: This study aimed to compare the effects of facility-based and home-based exercise prehabilitation on postoperative functional capacity and postoperative outcomes in patients undergoing gastrointestinal cancer surgery using a network meta-analysis. Methods: This systematic review and network meta-analysis included randomized controlled trials of exercise-based prehabilitation in patients undergoing gastrointestinal cancer surgery. Facility-based and home-based exercise interventions were compared using random-effects models to evaluate postoperative functional capacity, overall complications, and length of stay. Certainty of evidence was assessed using the CINeMA framework. Results: Nine randomized controlled trials were included. Exercise-based prehabilitation significantly improved postoperative functional capacity compared with control in pairwise meta-analysis (MD = 26.10 m; 95% CI 4.59 to 47.62). In network meta-analysis, facility-based exercise prehabilitation significantly improved postoperative functional capacity compared with control (MD = 24.11 m; 95% CI 2.01 to 46.22), whereas home-based prehabilitation showed no statistically significant effect (MD = 32.12 m; 95% CI −1.70 to 65.93). Conclusions: This study suggests that exercise prehabilitation may be an effective strategy for improving or preserving postoperative functional capacity in patients undergoing gastrointestinal cancer surgery, with facility-based exercise prehabilitation showing more consistent and statistically significant effects.

Purpose Poor sleep is closely associated with obesity and contributes to hormonal dysregulation and weight gain. This meta-analysis aimed to evaluate the effects of nutritional interventions on the sleep quality of individuals with obesity, focusing on strategies, such as calorie restriction, high-protein diets, and plant-based supplementation. Methods A systematic literature search was conducted on PubMed, Embase, Web of Science, and the Cochrane Library, covering publications from inception up to January 2025. Randomized controlled trials (RCTs) assessing nutritional interventions and sleep quality were also included. The risk of bias (ROB) was assessed using Cochrane’s ROB 2 tool, and a meta-analysis was performed using the Comprehensive Meta-Analysis software. The results were reported as odds ratios (ORs) with 95% confidence intervals (CIs), and heterogeneity was evaluated using the I² statistic. Results Eleven RCTs involving 637 participants demonstrated that compared with the controls, the nutritional intervention significantly improved sleep quality (OR = 2.52, 95% CI [1.57, 4.03], P = 0.000). Specific interventions, such as saffron supplementation (OR = 11.10, P = 0.000), showed varying degrees of effectiveness. Long-term interventions (≥ 16 weeks) yielded consistent benefits, whereas moderate heterogeneity was observed (I² = 67.43%, P = 0.027). Conclusion Nutritional interventions, especially those that include calorie restriction, high-protein diets, and plant-based supplementation, have the potential to improve sleep quality in adults with obesity. Long-term interventions (≥ 16 weeks) may offer the most effective benefits.

This study evaluated the effects of exercise interventions on sleep quality and weight loss through a systematic literature review and meta-analysis. A comprehensive literature search was conducted across PubMed, Embase, Web of Science, and the Cochrane Library for publications up to December 2022. Only randomized controlled trials (RCTs) were included in the analysis. The Risk of Bias was assessed using the Cochrane Risk of Bias 2 (ROB 2) tool, and disagreements were resolved by consensus. Data synthesis and meta-analysis were performed using Comprehensive Meta-Analysis Version 4 (CMA version 4) software, with outcomes expressed as pooled effect sizes, odds ratios (ORs), and 95% confidence intervals (CIs). Seven RCTs encompassing 908 participants were analyzed. The meta-analysis indicated a significant improvement in sleep outcomes (OR = 3.93, 95% CI [2.04, 7.56], p < 0.001). The combined aerobic and resistance exercise regimen showed the most substantial effects on sleep quality. Additionally, four of the seven RCTs included in the weight loss analysis indicated a significant improvement in weight loss (OR = 2.58, 95% CI [1.79, 3.71], p < 0.001). Exercise interventions have a strong potential for improving sleep quality and weight loss in adults with obesity. Future studies should focus on developing optimized targeted strategies for sleep enhancement.