Systematic Review Exercise, Breathwork and Combined Exercise and Breathwork, Acute Interventions for Stress Reduction in Healthy Adults: A Systematic Review and Meta-Analysis

This review's primary analysis compared the relationship between exercise, breathwork and combined interventions in outcome measures that included any reference to acute stress measurements, as outlined in Table 1. Separate subgroup meta-analyses examined the relationship between intervention duration, categorised as short, medium and long and outcome measures. An additional subgroup meta-analysis was conducted to examine the relationship between low, moderate, vigorous and self-moderated exercise intervention intensity and outcome measures. All meta-analyses were conducted using random-effect models (Borenstein & Rothstein, 1999) on pooled studies to compare standardised mean differences between conditions pre-post exercise, breathwork, combined, and controls to compute an estimate Hedges' g ES, along with 95% confidence intervals (CI) for outcome measures. The Hedges' g threshold was set at 0.2 small, 0.5 medium and 0.8 large, along with 95% CI around the estimated ES (differences between intervention and control groups) (Cohen, 1992). An alpha level of P < 0.05 was used to determine significance. All statistics were analysed using Comprehensive Meta-Analysis (V3, Biostat, Englewood, USA) and presented as Forrest plots (where applicable). Heterogeneity between studies was measured using the I2 statistic (Higgins & Thompson, 2002), and the threshold for cut-off percentage points of 25% (low), 50% (moderate) and 75% (high) was used. The risk of publication bias was tested using Egger's regression significance test and funnel plot symmetry/asymmetry (Egger et al., 1997).

本综述的主要分析比较了运动、呼吸练习及综合干预措施与包括急性压力测量在内的结果指标之间的关系，具体内容如表格1所述。针对干预持续时间，即短期、中期和长期，分别进行了亚组荟萃分析，以考察其与结果指标的关系。此外，还进行了额外的亚组荟萃分析，以研究低、中、高强度以及自我调节的锻炼干预强度与结果指标之间的关系。所有荟萃分析均采用随机效应模型（Borenstein & Rothstein，1999）对汇总研究进行比较，以计算条件间标准化均数差，进而估算Hedges' g效应量，并计算结果指标的95%置信区间（CI）。Hedges' g阈值设定为0.2（小）、0.5（中）和0.8（大），同时计算估算效应量的95%置信区间（干预组与对照组之间的差异）（Cohen，1992）。显著性水平的α设置为P < 0.05。所有统计数据均使用Comprehensive Meta-Analysis（V3，Biostat，Englewood，美国）进行分析，并以Forest图（适用时）呈现。研究间的异质性通过I2统计量（Higgins & Thompson，2002）进行测量，阈值设定为25%（低）、50%（中）和75%（高）。通过Egger回归显著性检验和漏斗图对称/不对称性检验（Egger等，1997）来测试发表偏倚的风险。