The Impact of Exercise Training Interventions on Flow-Mediated Dilation: An Umbrella Review Protocol

Introduction. (Cardio)vascular diseases are among the top causes of death in western societies. The impact of exercise training interventions to improve endothelial-dependent, flow-mediated dilation (FMD) responses has been reviewed extensively. These reviews may differ in their inclusion criteria, exercise type, exercise mode, exercise intensity, specific research questions, and conclusions. Comparing and contrasting these reviews will assist with the determination of optimal exercise programs across healthy and clinical populations.Objectives. We will conduct an umbrella review (or review of reviews) on systematic reviews and meta-analyses that examined the impact of exercise training interventions on peripheral artery FMD. The impact of exercise training design, population or artery studied, FMD methodology, and quality of reviews will be explored.Methods. A database search will be conducted in Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier for systematic reviews and meta-analyses on exercise training and FMD. All reviews must be conducted in adults (≥18 years). No limitation will be placed on the population (disease status, sex, etc.) or type of exercise training. Study quality will be determined using the Joanna Briggs Institute critical appraisal checklist for systematic reviews. Two independent screeners will examine titles, abstracts, full texts of relevant sources, and conduct the quality assessments. The results will be presented narratively and in a tabular format to align with the review objectives.Conclusion. This umbrella review may provide insight into the optimal training program to improve arterial health and act as an agent of change for modifying existing community exercise programs or clinical rehabilitation programs.