{"id":"https://openalex.org/W4412988893","doi":"https://doi.org/10.1016/j.ijnsa.2025.100398","title":"Effects of exercise therapy in patients with pancreatic cancer: A systematic review and meta-analysis","display_name":"Effects of exercise therapy in patients with pancreatic cancer: A systematic review and meta-analysis","publication_year":2025,"publication_date":"2025-08-05","ids":{"openalex":"https://openalex.org/W4412988893","doi":"https://doi.org/10.1016/j.ijnsa.2025.100398","pmid":"https://pubmed.ncbi.nlm.nih.gov/40822250","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/12355156"},"language":"en","primary_location":{"id":"doi:10.1016/j.ijnsa.2025.100398","doi":"https://doi.org/10.1016/j.ijnsa.2025.100398","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.ijnsa.2025.100398","pdf_url":null,"source":{"id":"https://openalex.org/S4210240685","display_name":"International Journal of Nursing Studies Advances","issn_l":"2666-142X","issn":["2666-142X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-20","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Nursing Studies Advances","raw_type":"journal-article"},"volume":null,"type":"review","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1016/j.ijnsa.2025.100398","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5067245187","display_name":"Mizuki Sekino","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I130830085","display_name":"Fukushima Medical University","ror":"https://ror.org/012eh0r35","country_code":"JP","type":"education","lineage":["https://openalex.org/I130830085"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Mizuki Sekino","raw_affiliation_strings":["School of Nursing, Fukushima Medical University, Fukushima, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Nursing, Fukushima Medical University, Fukushima, Japan","institution_ids":["https://openalex.org/I130830085"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5049201693","display_name":"Takuya Fukushima","orcid":"https://orcid.org/0000-0001-7075-9264","observed_orcids":["https://orcid.org/0000-0001-7075-9264","https://orcid.org/0000-0001-9422-2875"]},"institutions":[{"id":"https://openalex.org/I126884977","display_name":"Kansai Medical University","ror":"https://ror.org/001xjdh50","country_code":"JP","type":"education","lineage":["https://openalex.org/I126884977"]}],"countries":["JP"],"is_corresponding":true,"raw_author_name":"Takuya Fukushima","raw_affiliation_strings":["Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan","institution_ids":["https://openalex.org/I126884977"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5066910827","display_name":"Katsuyoshi Suzuki","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210088324","display_name":"Shizuoka Cancer Center","ror":"https://ror.org/0042ytd14","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210088324"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Katsuyoshi Suzuki","raw_affiliation_strings":["Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan","institution_ids":["https://openalex.org/I4210088324"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5019746159","display_name":"Keiichi Osaki","orcid":"https://orcid.org/0000-0003-0600-9690","observed_orcids":["https://orcid.org/0000-0003-0600-9690"]},"institutions":[{"id":"https://openalex.org/I4210133417","display_name":"Matsushita Memorial Hospital","ror":"https://ror.org/03ycmew18","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210133417"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Keiichi Osaki","raw_affiliation_strings":["Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital, Osaka, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital, Osaka, Japan","institution_ids":["https://openalex.org/I4210133417"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Ikumi Yokoyama","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I130830085","display_name":"Fukushima Medical University","ror":"https://ror.org/012eh0r35","country_code":"JP","type":"education","lineage":["https://openalex.org/I130830085"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Ikumi Yokoyama","raw_affiliation_strings":["School of Nursing, Fukushima Medical University, Fukushima, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Nursing, Fukushima Medical University, Fukushima, Japan","institution_ids":["https://openalex.org/I130830085"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Kazuko Katagiri","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I130830085","display_name":"Fukushima Medical University","ror":"https://ror.org/012eh0r35","country_code":"JP","type":"education","lineage":["https://openalex.org/I130830085"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Kazuko Katagiri","raw_affiliation_strings":["School of Nursing, Fukushima Medical University, Fukushima, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Nursing, Fukushima Medical University, Fukushima, Japan","institution_ids":["https://openalex.org/I130830085"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5034096063","display_name":"Shinichiro Morishita","orcid":"https://orcid.org/0000-0002-4841-948X","observed_orcids":["https://orcid.org/0000-0002-4841-948X"]},"institutions":[{"id":"https://openalex.org/I130830085","display_name":"Fukushima Medical University","ror":"https://ror.org/012eh0r35","country_code":"JP","type":"education","lineage":["https://openalex.org/I130830085"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Shinichiro Morishita","raw_affiliation_strings":["Department of Physical Therapy, School of Health Science, Fukushima Medical University, Fukushima, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Physical Therapy, School of Health Science, Fukushima Medical University, Fukushima, Japan","institution_ids":["https://openalex.org/I130830085"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5021970593","display_name":"Naoko Sato","orcid":"https://orcid.org/0000-0002-1562-0486","observed_orcids":["https://orcid.org/0000-0002-1562-0486"]},"institutions":[{"id":"https://openalex.org/I130830085","display_name":"Fukushima Medical University","ror":"https://ror.org/012eh0r35","country_code":"JP","type":"education","lineage":["https://openalex.org/I130830085"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Naoko Sato","raw_affiliation_strings":["School of Nursing, Fukushima Medical University, Fukushima, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Nursing, Fukushima Medical University, Fukushima, Japan","institution_ids":["https://openalex.org/I130830085"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5049201693"],"corresponding_institution_ids":["https://openalex.org/I126884977"],"apc_list":{"value":2930,"currency":"USD","value_usd":2930},"apc_paid":{"value":2930,"currency":"USD","value_usd":2930},"fwci":0.2005,"has_fulltext":true,"cited_by_count":2,"citation_normalized_percentile":{"value":0.23182527,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":95,"max":96},"biblio":{"volume":"9","issue":null,"first_page":"100398","last_page":"100398"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10178","display_name":"Cancer survivorship and care","score":0.9922000169754028,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10178","display_name":"Cancer survivorship and care","score":0.9922000169754028,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10231","display_name":"Pancreatic and Hepatic Oncology Research","score":0.0034000000450760126,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10352","display_name":"Physical Activity and Health","score":0.0005000000237487257,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/pancreatic-cancer","display_name":"pancreatic cancer","score":0.9570000171661377},{"id":"https://openalex.org/keywords/exercise-therapy","display_name":"exercise therapy","score":0.9990000128746033},{"id":"https://openalex.org/keywords/quality-of-life","display_name":"quality of life","score":0.8050000071525574},{"id":"https://openalex.org/keywords/physical-functioning","display_name":"physical function","score":0.9890000224113464},{"id":"https://openalex.org/keywords/muscle-strength","display_name":"muscle strength","score":0.9950000047683716},{"id":"https://openalex.org/keywords/resistance-training","display_name":"resistance training","score":0.9599999785423279},{"id":"https://openalex.org/keywords/aerobic-exercise","display_name":"aerobic exercise","score":0.9929999709129333},{"id":"https://openalex.org/keywords/chemotherapy","display_name":"chemotherapy","score":0.5350000262260437},{"id":"https://openalex.org/keywords/chemoradiotherapy","display_name":"chemoradiotherapy","score":0.8209999799728394},{"id":"https://openalex.org/keywords/exercise-capacity","display_name":"exercise capacity","score":0.7559999823570251},{"id":"https://openalex.org/keywords/cancer-rehabilitation","display_name":"cancer rehabilitation","score":0.40700000524520874}],"concepts":[{"id":"https://openalex.org/C95190672","wikidata":"https://www.wikidata.org/wiki/Q815382","display_name":"Meta-analysis","level":2,"score":0.8529044389724731},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.583098292350769},{"id":"https://openalex.org/C2780210213","wikidata":"https://www.wikidata.org/wiki/Q212961","display_name":"Pancreatic cancer","level":3,"score":0.5711257457733154},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.47313299775123596},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.43319547176361084},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.3682774305343628}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.1016/j.ijnsa.2025.100398","doi":"https://doi.org/10.1016/j.ijnsa.2025.100398","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.ijnsa.2025.100398","pdf_url":null,"source":{"id":"https://openalex.org/S4210240685","display_name":"International Journal of Nursing Studies Advances","issn_l":"2666-142X","issn":["2666-142X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-20","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Nursing Studies Advances","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:12355156","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12355156/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12355156/pdf/","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Int J Nurs Stud Adv","raw_type":"Text"},{"id":"pmid:40822250","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40822250","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International journal of nursing studies advances","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:094af53def7c4dceb03bb0e3d82795d3","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/094af53def7c4dceb03bb0e3d82795d3","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"International Journal of Nursing Studies Advances, Vol 9, Iss , Pp 100398- (2025)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1016/j.ijnsa.2025.100398","doi":"https://doi.org/10.1016/j.ijnsa.2025.100398","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.ijnsa.2025.100398","pdf_url":null,"source":{"id":"https://openalex.org/S4210240685","display_name":"International Journal of Nursing Studies Advances","issn_l":"2666-142X","issn":["2666-142X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-20","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Nursing Studies Advances","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/systematic-review","display_name":"Systematic Review"},{"id":"https://openalex.org/study-designs/meta-analysis","display_name":"Meta-Analysis"}],"awards":[{"id":"https://openalex.org/G6150281387","display_name":"\u60a3\u8005\u306e\u30d5\u30a3\u30b8\u30d3\u30ea\u30c6\u30a3\u3092\u9ad8\u3081\u308b\u9060\u9694\u770b\u8b77\u30b7\u30b9\u30c6\u30e0\u4f75\u7528\u578b\u300c\u81b5\u304c\u3093\u30ea\u30cf\u30d7\u30ed\u30b0\u30e9\u30e0\u300d\u306e\u958b\u767a","funder_award_id":"24K02735","funder_id":"https://openalex.org/F4320334764","funder_display_name":"Japan Society for the Promotion of Science"}],"funders":[{"id":"https://openalex.org/F4320334764","display_name":"Japan Society for the Promotion of Science","ror":"https://ror.org/00hhkn466"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4412988893.pdf","grobid_xml":"https://content.openalex.org/works/W4412988893.grobid-xml"},"referenced_works_count":42,"referenced_works":["https://openalex.org/W1655617308","https://openalex.org/W2012555609","https://openalex.org/W2047683498","https://openalex.org/W2092740524","https://openalex.org/W2093115033","https://openalex.org/W2128621051","https://openalex.org/W2129197203","https://openalex.org/W2138582833","https://openalex.org/W2167571044","https://openalex.org/W2560222145","https://openalex.org/W2581973599","https://openalex.org/W2599228863","https://openalex.org/W2673869653","https://openalex.org/W2756598459","https://openalex.org/W2759262680","https://openalex.org/W2790530831","https://openalex.org/W2898141175","https://openalex.org/W2903623792","https://openalex.org/W2909805827","https://openalex.org/W2946276579","https://openalex.org/W2954926099","https://openalex.org/W2970684805","https://openalex.org/W2981263606","https://openalex.org/W3007075198","https://openalex.org/W3022903699","https://openalex.org/W3042916872","https://openalex.org/W3115719159","https://openalex.org/W3137713649","https://openalex.org/W3142699304","https://openalex.org/W4210973929","https://openalex.org/W4220682241","https://openalex.org/W4229378509","https://openalex.org/W4286587640","https://openalex.org/W4362692224","https://openalex.org/W4389538171","https://openalex.org/W4393935425","https://openalex.org/W4394015555","https://openalex.org/W4399127438","https://openalex.org/W4403535731","https://openalex.org/W4409911460","https://openalex.org/W6636689436","https://openalex.org/W6754669450"],"related_works":["https://openalex.org/W4412480257","https://openalex.org/W4414446017","https://openalex.org/W4389922177","https://openalex.org/W3115719159","https://openalex.org/W3142699304","https://openalex.org/W4213328026","https://openalex.org/W2896216631","https://openalex.org/W2954926099","https://openalex.org/W4362692224","https://openalex.org/W3169550624"],"abstract_inverted_index":{"Introduction":[0],"The":[1,102,125,140,161,318],"reported":[2],"benefits":[3],"of":[4,28,38,52,63,100,107,152,163,193,196,202,236,308,320,346,361,365],"exercise":[5,53,154,226,309,313,325],"therapy":[6,310,326],"in":[7,146,158,171,179,254,305,335],"patients":[8,56,330],"with":[9,57,131,371],"pancreatic":[10,58,92,328],"cancer":[11,59,329],"include":[12],"maintaining":[13],"and":[14,18,25,86,98,109,149,155,174,191,213,220,273,314,338],"improving":[15,233,342],"physical":[16,96,114,234,344],"fitness":[17],"muscle":[19,209,258,276,333],"strength,":[20],"reducing":[21],"treatment-related":[22],"side":[23],"effects,":[24],"enhancing":[26],"quality":[27,99,106,201,235,345],"life.":[29,101,203,347],"However,":[30,348],"the":[31,36,50,82,110,164,216,221,294,297,306,312,336,351,363],"evidence":[32],"remains":[33],"inconclusive,":[34],"necessitating":[35],"integration":[37],"interventional":[39],"studies":[40,148,173,353],"to":[41,48,73,78,137,199],"reach":[42],"a":[43,61,121,150,358],"consensus.":[44],"This":[45],"study":[46,322],"aimed":[47],"elucidate":[49],"effects":[51],"interventions":[54,165],"for":[55,189,225,232,327],"through":[60],"meta-analysis":[62],"randomized":[64,183],"controlled":[65,184],"trials.":[66],"Methods":[67],"A":[68],"literature":[69],"search":[70],"was":[71,105,113,206,230],"conducted":[72,119],"identify":[74],"articles":[75],"published":[76],"prior":[77],"May":[79],"2024,":[80],"using":[81,120,208],"PubMed/MEDLINE,":[83],"Scopus,":[84],"CINAHL,":[85],"PEDro":[87],"databases.":[88],"Search":[89],"terms":[90],"included":[91,128,352],"cancer,":[93],"exercise-related":[94],"terminology,":[95],"function,":[97],"primary":[103],"outcome":[104,112],"life,":[108],"secondary":[111],"function.":[115],"All":[116],"meta-analyses":[117],"were":[118,143,166,278,354],"random-effects":[122],"model.":[123],"Results":[124],"final":[126],"analysis":[127],"6":[129],"studies,":[130],"sample":[132],"sizes":[133],"ranging":[134],"from":[135],"40":[136],"172":[138],"patients.":[139],"intervention":[141,229],"types":[142],"resistance":[144,156],"training":[145,157],"3":[147,159],"combination":[151],"aerobic":[153],"studies.":[160,181],"timings":[162],"after":[167],"surgery":[168],"or":[169,177],"chemotherapy":[170,176],"4":[172],"during":[175],"chemoradiotherapy":[178],"2":[180],"Three":[182],"trials":[185],"used":[186],"European":[187],"Organization":[188],"Research":[190],"Treatment":[192],"Cancer":[194],"Quality":[195],"Life":[197],"Questionnaire-C30":[198],"assess":[200],"Physical":[204],"function":[205],"evaluated":[207],"strength":[210,259,277,334],"measurements":[211],"(isokinetic":[212],"isometric":[214],"strength),":[215],"5-chair":[217],"stand":[218],"test,":[219],"6-min":[222,298],"walk":[223,299],"test":[224,300],"capacity.":[227],"Exercise":[228],"effective":[231],"life":[237],"(standardized":[238,260,280],"mean":[239,261,281],"difference":[240,262,282,304],"=":[241,246,249,263,268,271,283,288,291],"0.41,":[242],"95%":[243,265,285],"confidence":[244,266,286],"interval":[245,267,287],"0.07\u20130.74,":[247],"p":[248,270,290],"0.02).":[250],"In":[251],"addition,":[252],"improvements":[253],"both":[255],"upper":[256,337],"extremity":[257,275],"0.50,":[264],"0.21\u20130.80,":[269],"0.0008)":[272],"lower":[274,339],"observed":[279],"0.35,":[284],"0.14\u20130.56,":[289],"0.0009).":[292],"On":[293],"other":[295],"hand,":[296],"showed":[301],"no":[302],"significant":[303],"effect":[307],"between":[311],"control":[315],"groups.":[316],"Conclusion":[317],"findings":[319,364],"this":[321,366],"indicate":[323],"that":[324],"effectively":[331],"increases":[332],"limbs":[340],"while":[341],"their":[343],"because":[349],"all":[350],"assessed":[355],"as":[356],"having":[357],"high":[359],"risk":[360],"bias,":[362],"review":[367],"should":[368],"be":[369],"interpreted":[370],"caution.":[372]},"counts_by_year":[{"year":2026,"cited_by_count":2}],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2025-10-10T00:00:00"}