2.1 Literature search results
This study retrieved a total of 1,770 relevant documents (38 from Wipu, 69 from CNKI, 132 from Wanfang, 52 from PubMed, 25 from Embase, 280 from Web of Science, 402 from Cochrance, and 8 from other sources), and duplicates were eliminated. There were 85 published documents, and 738 documents were eliminated by reading the titles and abstracts (preliminary screening) (656 articles and 82 reviews were eliminated based on the titles and abstracts). After reading the full text and re-screening, 49 randomized controlled articles were screened out. Based on the research objects, intervention measures, Due to incomplete trial design and outcome indicators, 36 articles were excluded, and 13 articles were finally included, including 8 Chinese articles (Chang B et al. 2016, Lu H Y et al. 2020, Li L et al. 2016, Zhang X L et al. 2019, Liu L et al. 2015, Chang B et al. 2018, Qin K M et al. 2018, Wang H Z et al. 2017), 5 English documents (Rosety et.al. 2013, Rafiee et.al. 2016, Mohamma et.al. 2019, Andersenet. al. 2022, Safarinejadet. al. 2019), as shown in Fig. 1.
2.2 Basic characteristics of included literature
Among the 13 documents included in this study, most were consistent with single-arm studies (including 1 intervention), and the subjects were male young people and healthy male rats. The intervention measures include three different types of aerobic training: low, medium and high, and there are large differences between the research protocols. Among them, the intervention time ranges from 40min to 120min, and the intervention period ranges from 6 weeks to 60 weeks, as shown in Table 2.
Table 2
Basic characteristics of single-arm studies included
First author
|
years
|
sample size
T/C
|
Age (M ± SD, years)
T/C
|
Interventions
|
measure time
|
Outcome indicators
|
Rosety(6)
|
2013
|
30/30
|
T:36.2 ± 3.5
|
C:35.7 ± 4.0
|
Home Treadmill Training
|
40min/time, 3 times/week, 14 weeks
|
①②③
|
Rafiee(7)
|
2016
|
100/50
|
20-60years old
|
high intensity sports
|
not indicated, not indicated, 6 months (24 weeks)
|
①⑧
|
Mohamma(8)
|
2019
|
12/12
|
Not shown
|
aerobic training
|
27m/min, 60min, 10 weeks
|
③④⑤⑥
|
Andersen(9)
|
2022
|
18/19
|
T:37
|
C:45
|
Moderate intensity aerobic exercise
|
Not shown, 150min/week, 52 weeks
|
①③⑤⑥⑧
|
Safarinejad(10)
|
2009
|
143/143
|
T:28 ± 9
|
C:27 ± 9
|
high intensity running
|
120min/time, 5 times/week, 60 weeks
|
①③⑤
|
Chang B(11)
|
2016
|
6/6
|
Not shown
|
Aerobic treadmill training
|
26m/min-60min/day, 6 days/week, 8 weeks
|
③⑤
|
Lu H Y(12)
|
2020
|
9/8
|
Not shown
|
Treadmill training
|
60min/time, 6 days/week, 8 weeks
|
③⑤
|
Li L(13)
|
2014
|
10/10
|
Not shown
|
Swimming
|
60min/time, 6 times/week, 10 weeks
|
⑤⑥⑦
|
Zhang X L(14)
|
2019
|
3/4
|
Average age 19 years old
|
Aerobic exercise
|
50min/time, 6 days/week, 6 weeks
|
③⑤⑥
|
Liu L(15)
|
2015
|
10/10
|
Not shown
|
Aerobic exercise
|
1h/day, 6 days/week, 8 weeks
|
①⑥⑦
|
Chang B(16)
|
2018
|
6/6
|
Not shown
|
Aerobic exercise
|
60min/time, not specified, 8 weeks
|
⑤⑥
|
Qin K M(17)
|
2018
|
10/8
|
Not shown
|
aerobics swimming
|
60min/time, 6 times/week, 10 weeks
|
⑦
|
Wang H Z(18)
|
2017
|
30/30
|
20–35 years old
|
Aerobics jogging
|
1h/day, not indicated, 6 months
|
②⑦
|
Note
T = test group, C = control group; ① sperm concentration ② sperm quality (DNA fragmentation index, reactive oxygen species and total antioxidant capacity) ③ sperm motility ④ sperm morphology ⑤ total sperm number ⑥ active sperm number ⑦ necrotic sperm number ⑧ sperm volume
2.3 Bias assessment of included literature
According to the Cochrane risk of bias assessment chart in Fig. 2, we can see that low risk bias accounts for the most part, followed by unknown risk bias, but there is still a possible high risk of bias in the included studies. The risk of bias was further analyzed through the risk of bias summary diagram. Since the subjects of this study were selected from two parts for analysis, male youths had certain exercise risks during the intervention and were required to sign an informed consent form during the intervention. Therefore, 6 documents were clear. It shows that a single-blind trial was used, and 8 literature reports were blinded to the experimenters. The experimenters in 6 studies were all involved in the measurement and experimental intervention, so they were evaluated as high-risk bias; 13 documents were randomized controls, 3 of which were randomized controlled trials. Describe the method of concealing the allocation of subjects, which is evaluated as low risk of bias; 0 documents reported complete data on outcome indicators, so they were evaluated as low risk of bias; 13 studies had no suspicious selective reporting, so they were evaluated as low risk of bias ; In terms of other biases, one document had a source of bias, 4 had no source of bias, and 8 studies did not have sufficient information to make a judgment, so all studies were evaluated as low-risk assessments. In terms of literature quality assessment, the overall quality of the 13 documents was relatively high, with 12 documents rated as grade A, 1 as grade B, and 0 as grade C (see Fig. 2).
2.4 Meta-analysis
2.4.1 Overall effect test
A total of 13 papers covering 54 studies were included in this study, as detailed in Table 3, including 7 animal experiments and 6 healthy human experiments. The total number of study subjects was 723 (human: 600, animal: 123). After the heterogeneity test, the results showed (see Fig. 3) that there was a high degree of heterogeneity among the studies (2 = 602.36, I2 = 91%, p < 0.00001), so the random effects model was used for the meta-analysis. According to the results of the study, the combined effect size was d = 0.37 with a 95% confidence interval of (0.15, 0.59), P > 0.05, indicating that there was no significant difference. Therefore, animals and healthy males can be considered as the same cohort for comparative study analysis. In the forest plot (see Fig. 3), the horizontal line of the 95% confidence interval for the standardised mean difference (SMD) of the effect of exercise on spermatozoa is located to the right of the null line. The results show that the intervention of exercise on spermatozoa is effective.
Table 3
Overall effect test of the impact of exercise on sperm
|
Number of studies
|
Subject
|
Homogeneity test
|
Double tailed test
|
Effect size and 95% confidence interval
|
χ2
|
P
|
I2
|
Z
|
P
|
|
random effects model
|
13
|
732
|
602.36
|
P<0.00001
|
91
|
3.32
|
P = 0.0009
|
0.37(0.15, 0.59)
|
This meta-analysis included more than 10 documents, which can be tested for bias. As shown in Fig. 4: the scatter points are evenly distributed and basically symmetrical on the left and right, indicating no publication bias.
In the meta-analysis results of this study, due to the small sample size, the data cannot be accurately obtained. This study read and sorted out 13 documents, and then compared the data extracted from the categories of healthy male youth and animal experiments with the data related to this article; due to There is significant heterogeneity among the outcome indicators in each study. In this regard, further measures need to be taken to explore the source of heterogeneity; due to different intervention content, intervention period, intervention time, intervention cycle, intervention frequency, intervention recipients Differences in the subject groups may affect the intervention effect, and subgroup analysis is needed to explore whether these factors are sources of heterogeneity. Therefore, this conventional Meta was used to conduct analysis and research based on different intervention exercise intensity contents. The different intervention contents in this study were subgroup analyzed by different levels of aerobic exercise types (low, medium, and high), so three different levels of aerobic exercise were defined. Low-intensity aerobic exercise: 1.6 < 3METs, 20 < 40VO2max, 40 < 55%HRmax, 20 < 40%HRR (Physical exercise (usually aerobic exercise) that can not cause an obvious change of breathing rate and that intensity can be last ≥ 60min); moderate-intensity aerobic exercise: 3 < 6METs, 40 < 60VO2max, 55 < 70% HRmax 40 < 60%HRR (Physical exercise (usually aerobic exercise) that can be performed while maintaining a conversation uninterrupted and that intensity can sustain 30–60min); high-intensity aerobic exercise: ≥9METs, ≥ 85VO2max, ≥ 90% HRmax, ≥ 85%HRR (An intensity that usually cannot last more than 10min).
2.4.2 Conventional Meta-analysis of the Effect of Different Levels of Aerobic Exercise Intervention on Sperm in Subjects as Healthy Men
In the literature data extraction of the subject group as healthy male youths, only conventional Meta-analysis was performed because the number of sperm quality, sperm morphology, number of active sperm, and number of necrotic sperm included in the study for the three indicators was too small for reticulated Meta-analysis due to the categorization and analysis by indicator.
2.4.2.1 Sperm quality
In each of the included studies, according to the content of different intervention exercise intensity, the implemented intervention content includes high-intensity aerobic exercise, medium-intensity aerobic exercise, low-intensity aerobic exercise, so it can be analyzed according to the subgroups of different intervention intensity exercise. A total of 120 subjects, 60 in the experimental group and 60 in the control group, were included in 2 papers and 1 study; the results of the conventional Meta-analysis of the effects of different intensity aerobic exercise interventions on sperm quality showed that (see Table 4), the combined value of the effect of medium-intensity aerobic exercise was (SMD = 0.95, 95% CI: 0.42to1.49, P = 0.0005); and that of the effect of low-intensity aerobic exercise was (SMD=-0.95, 95% CI: 0.42to1.49, P = 0.0005). combined value was (SMD=-1.42, 95% CI: -1.99to-0.85, P < 0.00001); the combined effect value was (SMD=-0.23, 95% CI: -2.56to2.10, P > 0.05); and the three groups were heterogeneous in terms of the effect sizes (I2 = 97.2%,Z = 0.20), suggesting that the effect sizes of the study were highly Heterogeneity, in the case for the non-intervention does not have a significant difference (P > 0.05); in the observation of the value of the difference between the groups after the analysis found that compared with the conventional intervention, there is a significant difference between the groups (P < 0.00001). The amount of effect of medium-intensity aerobic exercise was the largest (d = 0.95), followed by low-intensity aerobic exercise (d=-1.42), and the P-value of both intensities of aerobic exercise was < 0.05, which indicated that there was a significant effect of the intervention exercise on the quality of men's spermatozoa. The efficacy of different intensities of interventional exercise in improving sperm quality was consistent, but the high-intensity aerobic exercise intervention was ineffective, which may be due to the small sample size and the inclusion of only one study, and the large heterogeneity was due to the inconsistency of the unit of measurement of the outcome indexes.
2.4.2.2 Sperm morphology
By subgroup analysis of outcome indicators with different intervention exercise intensities, 3 papers and 2 studies were included with a total of 632 subjects, 316 in the experimental group and 316 in the control group. Conventional Meta-analysis of the studies on the effect of different intensities of aerobic exercise interventions on sperm morphology showed (see Table 4) that the combined value of the effect of high-intensity aerobic exercise was (SMD=-0.17, 95% CI: -0.40to0.06, P = 0.15); and the combined value of the effect of moderate-intensity aerobic aerobic exercise was (SMD = 0.31, 95% CI: -1.10to1.72, P = 0.67). The results of the combined effect showed that (SMD = 0.10,95% CI:-0.49to0.68, Z = 0.33); after looking at the values of the differences between groups, the analysis revealed that there was no significant difference at P > 0.05 compared to the conventional intervention, the study showed that the different levels of exercise did not have a significant effect on the status of enhancing sperm morphology, and there was no statistically significant difference between the groups (P > 0.05), the 3 groups were heterogeneous in terms of effect size (I2 = 0%), indicating that the study was homogeneous in terms of effect size. Among them, medium-intensity aerobic exercise produced the largest effect size (d = 0.31), followed by high-intensity aerobic exercise (d=-0.17); and both intensity aerobic exercise P-value > 0.05, indicating that there is no significant effect of intervention exercise on sperm morphology in men, leading to which may be due to a small sample size, no intervention effect of low-intensity aerobic exercise, and inclusion of only 3 articles in the literature.
2.4.2.3 Active sperm count
Among the included studies, a total of 2 documents and 1 study results were included, with a total of 43 subjects, 21 in the experimental group and 22 in the control group. The results of conventional meta-analysis on the effect of different intensity aerobic exercise intervention on active sperm count show (see Table 4), the combined value of the effect of medium-intensity aerobic exercise is (SMD = 0.05, 95% CI: -0.56to0.65, P = 0.88). The heterogeneity of the effect size among the three groups (I2 = 23%, Z = 0.15) shows that the effect size of this study has low heterogeneity and there is no significant difference between the groups (P > 0.05). Research shows that compared with conventional intervention controls, exercise has no statistically significant difference in improving men's active sperm count, and no significant effect is found. The reason for its effect may be that the literature sample is small.
2.4.2.4 Number of necrotic sperm
Through subgroup analysis of different intervention exercise intensities on outcome indicators, 1 article and 0 studies were included, with a total of 60 subjects, 30 in the experimental group and 30 in the control group. Conventional meta-analysis of the effects of aerobic exercise intervention of different intensities on the number of necrotic sperm showed (see Table 4) that the combined effect value of low-intensity aerobic exercise is (SMD=-1.42, 95% CI: -1.99to-0.85, P < 0.00001 ). In the case of non-intervention, there is a significant difference at P < 0.05. Low-level aerobic exercise has a significant statistical difference in improving the number of necrotic sperm in men; compared with conventional intervention, it shows that exercise intervention can improve the number of necrotic sperm in men. No significant effect was found on the number, which may be due to the small number of literature samples.
2.4.3 Conventional Meta-analysis of the Effects of Different Levels of Aerobic Exercise Intervention on Sperm in Subjects as Male Rats
In the literature data extraction for the experiment of the subject group being healthy male rats, only conventional Meta-analysis was performed because the number of sperm morphology and sperm density 2 indicators included in the study was small due to the categorization and analysis by indicator, which did not allow for reticulated Meta-analysis.
2.4.3.1 Sperm morphology
Through subgroup analysis of different intervention exercise intensities on outcome indicators, 1 article and 0 studies were included, with a total of 24 subjects, 12 in the experimental group and 12 in the control group. Conventional meta-analysis of the effects of different-intensity aerobic exercise intervention on sperm morphology shows that (see Table 4), the combined effect value of medium-intensity aerobic exercise is (SMD=-0.74, 95% CI: -1.58to-0.09, P > 0.05) ; Without intervention, P > 0.05 has no significant difference. Research shows that moderate-intensity aerobic exercise has no significant effect on improving sperm morphology. The reason for its effect may be that the sample size in the literature is small or the intervention factors are not classified in detail.
2.4.3.2 Sperm density
Among the various included studies, a total of 3 papers were included with the results of 2 studies with a total of 60 subjects, 30 in the experimental group and 30 in the control group. Conventional Meta-analysis of the effects of different intensity aerobic exercise interventions on sperm density showed (see Table 4) that the combined value of the high-intensity aerobic exercise effect was (SMD = 0.78, 95%CI:-0.14to1.70,P = 0.10), the combined value of the moderate-intensity aerobic exercise effect was (SMD = 0.74, 95% CI: -0.17to1.66, P = 0.11), the combined low-intensity aerobic exercise effect was (SMD = 0.50, 95% CI: -0.84to0.91, P = 0.94), and the composite effect was shown to be (SMD = 0.50,95% CI: -0.02to1.03).The 3 groups were heterogeneous in terms of the effect sizes (I2 = 23%, Z = 1.90),suggesting that the effect sizes of the study had low heterogeneity; in the case of the non-exercise intervention, there was no significant difference between the groups (P > 0.05). Compared to the conventional intervention control group, the study showed no statistically significant difference in the improvement of sperm density by exercise and no significant effect was observed, which may be due to the low number of studies that led to the effect.
Table 4
List of moderated effect tests for meta-analysis of sperm impact of exercise interventions
Outcome indicators
|
Reports (articles)
|
Heterogeneity test
|
Use model
|
merge
|
Subgroup analysis indicators
|
merge
|
Subgroup difference P value
|
I2 value
|
P value
|
effect size
|
95%CI
|
P value
|
effect size
|
95%CI
|
P value
|
(1)Sperm quality
|
2
|
97
|
<0.00001
|
random
|
-0.23
|
-2.56to2.10
|
0.85
|
high
|
NA
|
NA
|
NA
|
<0.00001
|
middle
|
0.95
|
0.42–1.49
|
0.0005
|
Low
|
8.23
|
2.39–14.07
|
<0.00001
|
(2) Sperm morphology
|
3
|
91
|
<0.0001
|
random
|
0.10
|
-0.49-0.68
|
0.74
|
high
|
-0.17
|
-0.40-0.06
|
0.15
|
0.51
|
middle
|
0.31
|
-1.10-1.72
|
0.67
|
Low
|
NA
|
NA
|
NA
|
(3) Active sperm count
|
2
|
23
|
0.25
|
fixed
|
0.05
|
-0.56-0.65
|
0.88
|
high
|
NA
|
NA
|
NA
|
NA
|
middle
|
0.05
|
-0.56-0.65
|
0.88
|
Low
|
NA
|
NA
|
NA
|
(4)Number of necrotic sperm
|
1
|
NA
|
NA
|
random
|
-1.42
|
-1.99–0.85
|
<0.00001
|
high
|
NA
|
NA
|
NA
|
NA
|
middle
|
-1.42
|
-1.99–0.85
|
0.08
|
Low
|
NA
|
NA
|
NA
|
(5) Sperm morphology
|
1
|
NA
|
NA
|
fixed
|
-0.74
|
-1.58-0.09
|
0.08
|
high
|
NA
|
NA
|
NA
|
NA
|
middle
|
-0.74
|
-1.58-0.09
|
0.08
|
Low
|
NA
|
NA
|
NA
|
(6) Sperm density
|
3
|
0
|
0.42
|
fixed
|
0.50
|
-0.02-1.03
|
0.06
|
high
|
0.78
|
-0.14-1.70
|
0.10
|
0.42
|
middle
|
0.74
|
-0.17-1.66
|
0.11
|
Low
|
0.03
|
-0.84-0.91
|
0.94
|
Note
NA means no comparison display. (1) Sperm quality, (2) Sperm morphology, (3) Active sperm count represents humans; (4) Necrotic sperm count, (5) Sperm morphology, and (6) Sperm density represent rats. High: high-intensity aerobic exercise; medium: moderate-intensity aerobic exercise; low: low-intensity aerobic exercise.
2.5 Network Meta Analysis
In the extraction of literature data on healthy male youths as the subject group, the network meta analysis based on the type of exercise intervention degree has few branches, which will lead to the lack of credibility of the experimental results. Therefore, the network meta analysis is conducted based on different exercise intervention contents. Analysis.
Based on the traditional meta-analysis, the network meta-analysis included a total of 54 studies (31 studies on healthy people and 23 animal experiments), including 723 samples. In the relationship between various intervention measures, the dots represent the exercise intervention method, the area of the dots represents the size of the sample, and the line between the dots represents the direct comparison between the two types of exercise. The thicker the line, the greater the number of studies. many. If there is no connection between the two interventions, it means that there is no direct comparison, and network meta analysis can be used to make indirect comparisons.
2.5.1 Sperm volume
2.5.1.1 Evidence network diagram
Six studies reported sperm volume, and one was a three-arm study involving four types of exercise interventions. The overall evidence network diagram has F as the core, as shown in Fig. 5, which contains a closed loop.
2.5.1.2 Inconsistency test and convergence test
The results of the inconsistency test and convergence test using the node splitting method showed that there was no statistically significant difference between direct comparison and indirect comparison of each two intervention measures in sperm volume (P > 0.05), indicating good consistency.
2.5.1.3 Network Meta analysis and probability ranking
Sperm volume: A network meta-analysis was performed on the included studies, resulting in 10 pairwise comparisons, as shown in Fig. 6. A total of 6 documents reported on sperm volume in exercise intervention, with a sample size of 1118 cases. The results of network meta-analysis showed that home treadmill exercise (MD=-0.14, 95%CI=-0.65, 0.37, P > 0.05), moderate-intensity running exercise (MD = 0.00, -0.23, 0.23, P > 0.05), High-intensity running (MD=-0.01, -0.33, 0.35, P > 0.05), moderate-intensity aerobic exercise (MD=-0.24, -0.94, 0.45, P > 0.05). The research results show that there is no statistical difference in the results of the above exercise methods compared with the conventional control group; the results of pairwise indirect comparisons show that there is no significant difference in the comparison of each exercise method with each other, and there is no statistical significance ( P>0.05).
The ranking of the effectiveness of different exercise intervention methods in improving sperm volume is as follows: home treadmill exercise (SUCRA = 69.6%) > high-intensity running exercise (SUCRA = 45.6%) > conventional control group (SUCRA = 45.2%) > medium Intensity aerobic exercise (SUCRA = 45.1%) > high-intensity physical exercise (SUCRA = 44.5%), the results are shown in Table 5.
2.5.2 Total sperm count
2.5.2.1 Evidence network diagram
Three studies reported total sperm count, one of which was a three-arm study, and the rest were two-arm studies, involving five types of exercise interventions. The overall evidence network diagram has F as the core, as shown in Fig. 7.
2.5.2.2 Inconsistency test and convergence test
The results of the node splitting method showed that there was no statistically significant difference between the direct comparison and the indirect comparison between the two intervention measures in total sperm count (P > 0.05), indicating good consistency.
2.5.2.3 Network Meta analysis and probability ranking
Total sperm count: A network meta-analysis was performed on the included studies, resulting in 15 pairwise comparisons, as shown in Fig. 8. A total of 3 studies reported on the total sperm count in exercise intervention, with a sample size of 675. Network Meta analysis results showed that high-intensity running (MD = 0.25, 95%CI = 0.02, 0.49, P < 0.05) and moderate-intensity running (MD = 0.16, 95%CI=-0.07,0.39, P > 0.05), home treadmill exercise (MD = 0.58, 95%CI = 0.06, 0.1.10, P<0.05), aerobic exercise (MD = 1.70, 95%CI=-0.45,3.85, P>0.05), moderate intensity Aerobic exercise (MD = 0.24, 95%CI= -0.41,0.90, P > 0.05). The results of the study show that when home treadmill exercise is compared indirectly with the conventional control group, high-intensity running exercise, and medium-intensity running exercise, home treadmill exercise has a better effect on increasing the total sperm count. Home treadmill exercise (MD=-0.58, 95%CI=-1.10,-0.06, P < 0.05) has a better effect on increasing the total number of sperm than the conventional control group, high-intensity running (MD=-0.84, 95%CI=-1.40, -0.27, P < 0.05), medium Intensity running exercise (MD = 0.74, 95%CI = 1.31,0.17, P < 0.05) shows that in terms of improving the total sperm count, the above three intervention exercises have statistical differences in the total sperm count (P < 0.05), and the other two There is no statistical difference between the two mutual comparisons, as shown in Fig. 8.
In terms of increasing the total sperm count, the order of probability of the effectiveness of different exercise intervention methods in improving the total sperm count is: aerobic exercise (SUCRA = 91.7%) > home treadmill exercise (SUCRA = 78.5%) > moderate-intensity aerobic exercise(SUCRA = 57.4) > Control group (SUCRA = 44.1%) > Medium-intensity running (SUCRA = 21.4%) > High-intensity running (SUCRA = 6.9%). The results are shown in Table 5.
2.5.3 Sperm motility
2.5.3.1 Evidence network diagram
Six studies reported sperm motility, one of which was a three-arm study, and the rest were two-arm studies, involving four types of exercise interventions. The overall evidence network diagram has F as the core, as shown in Fig. 9, which contains a closed loop.
2.5.3.2 Inconsistency test and convergence test
The results of the node splitting method showed that there was no statistically significant difference between direct comparison and indirect comparison of each two intervention measures in sperm motility (P > 0.05), indicating good consistency.
2.5.3.3 Network Meta analysis and probability ranking
Sperm motility: A network meta-analysis was performed on the included studies, resulting in 10 pairwise comparisons, as shown in Fig. 10. A total of 6 studies reported on exercise intervention in sperm motility, with a sample size of 689 cases. The results of network meta-analysis showed that compared with the control group (MD = 1.13, 95%CI = 0.58,1.67, P < 0.05), high-intensity running (MD = 1.46, 95%CI = 0.86,2.05, P < 0.05), Compared with moderate-intensity aerobic exercise (MD = 1.46, 95%CI = 0.86,2.05, P < 0.05) and aerobic exercise (MD = 2.39, 95%CI = 0.43,4.36, P < 0.05), home treadmill exercise, high-intensity running exercise, and aerobic exercise are more effective in improving sperm motility, indicating that two types of exercise intervention (home treadmill exercise, high-intensity running exercise) are statistically better than the control group in improving sperm motility. Difference; pairwise indirect comparison showed that home treadmill exercise was better than the control group, high-intensity running exercise, medium-intensity aerobic exercise, and aerobic exercise. High-intensity running exercise was better than the control group, and aerobic exercise was better than medium-intensity aerobic exercise. Exercise; compared with the control group, high-intensity running exercise, moderate-intensity aerobic exercise, and aerobic exercise, home treadmill exercise can improve sperm motility. The above differences are statistically significant (P < 0.05), and the other differences are not statistically significant. learning meaning.
In terms of improving sperm motility, the order of probability of the effectiveness of different exercise intervention methods in improving sperm motility is: home treadmill exercise (SUCRA = 99.7%) > control group (SUCRA = 72.4%) > high-intensity running exercise (SUCRA = 33.4%) > moderate-intensity aerobic exercise (SUCRA = 33.0%) > aerobic exercise (SUCRA = 11.5%). The results are shown in Table 5.
2.5.4 Sperm concentration
2.5.4.1 Evidence network diagram
Five studies reported sperm concentration, one of which was a three-arm study, and the rest were two-arm studies, involving four types of exercise interventions. The overall evidence network diagram has F as the core, as shown in Fig. 11, which contains a closed loop.
2.5.4.2 Inconsistency test and convergence test
The results of the node splitting method showed that there was no statistically significant difference between direct comparison and indirect comparison of each two intervention measures in sperm concentration (P > 0.05), indicating good consistency.
2.5.4.3 Network Meta analysis and probability ranking
Sperm concentration: A network meta-analysis was performed on the included studies, resulting in 10 pairwise comparisons, as shown in Fig. 12. A total of 5 studies reported on sperm concentration during exercise intervention, with a sample size of 1058 cases. Network Meta analysis results showed that compared with moderate-intensity aerobic exercise, control group, high-intensity running exercise, and moderate-intensity running exercise, high-intensity exercise (MD = 3.31, 95%CI = 2.46,4.15, P < 0.05), moderate-intensity running exercise (MD=-0.38, 95%CI=-0.61,-0.14, P < 0.05) has a better effect on improving sperm concentration, indicating that there are two types of exercise intervention (FXR, MTF) in improving sperm concentration. ) compared with the control group, there is a statistical difference; pairwise indirect comparison shows that high-intensity exercise is better than medium-intensity aerobic exercise, control group, high-intensity running exercise, medium-intensity running exercise, and medium-intensity running exercise is better than the control group group; compared with moderate-intensity aerobic exercise, control group, high-intensity running exercise, and medium-intensity running exercise, high-intensity exercise can improve sperm concentration. The above differences are statistically significant (P < 0.05), and the other differences are not Statistical significance.
In terms of improving sperm concentration, the order of probability of the effectiveness of different exercise intervention methods in improving sperm concentration is: high-intensity exercise (SUCRA = 100.0%) > moderate-intensity aerobic exercise (SUCRA = 62.3%) > control group (SUCRA = 54.7%) > High-intensity running (SUCRA = 30.8%) > Medium-intensity running (SUCRA = 2.2%). The results are shown in Table 5.
2.5.5 Total sperm count
In the literature data extraction where the subject group was rat samples, a network meta-analysis was conducted on the total sperm count of healthy rats according to the type of exercise intervention content.
2.5.5.1 Evidence network diagram
Four studies reported the total number of sperm in rats, generally tending to be 2-arm studies, involving five types of exercise interventions. The evidence network diagram generally has F as the core, as shown in Fig. 13, which does not include closed loops.
2.5.5.2 Inconsistency test and convergence test
The results of the node splitting method showed that there was no statistically significant difference between the direct comparison and the indirect comparison of each two intervention measures in the total number of sperm (P > 0.05), indicating good consistency.
2.5.5.3 Network Meta analysis and probability ranking
Total sperm count: A network meta-analysis was performed on the included rat studies, resulting in 15 pairwise comparisons, as shown in Fig. 14. A total of 4 studies reported on the total sperm count of exercise intervention, with a sample size of 85 cases. The results of network Meta consistency analysis showed that aerobic treadmill training (MD = 1.22, 95%CI=-0.07,2.52, P > 0.05), aerobic exercise (MD = 1.20, 95%CI= -0.09,2.48, P>0.05), treadmill training (MD = 0.91, 95%CI=-0.11,1.92, P>0.05), aerobic training (MD = 0.70, 95%CI=-0.13,1.53, P>0.05), swimming Exercise (MD=-0.39, 95%CI=-1.27,0.50, P > 0.05). The research results show that in terms of improving the total number of sperm, there is no statistical difference between the above exercise methods and the conventional control group; compared with swimming exercise, aerobic treadmill training (MD = 1.61, 95%CI = 0.04,3.18, P<0.05) and aerobic exercise (MD = 1.58, 95%CI = 0.02,3.15, P<0.05) are more effective in increasing the total number of sperm, with statistical significance; pairwise indirect comparison shows that aerobic treadmill Training and aerobic exercise are better than swimming, and the above differences are statistically significant. There is no statistical significance in pairwise comparisons between other exercises.
Four studies reported active sperm counts in healthy rats, one of which was a four-arm study and the rest were two-arm studies, involving six types of exercise interventions. The overall evidence network diagram has F as the core, as shown in Fig. 15. Contains three closed loops.
2.5.6.2 Inconsistency test and convergence test
The results of the node splitting method showed that there was no statistically significant difference between the direct comparison and the indirect comparison of each two intervention measures in the active sperm count of rats (P > 0.05), indicating good consistency.
2.5.6.3 Network Meta analysis and probability ranking
Active sperm count: A network meta-analysis was performed on the included rat studies, resulting in 21 pairwise comparisons, as shown in Fig. 16. A total of 4 studies reported on active sperm count in exercise intervention, with a sample size of 96 cases. The results of network meta-analysis showed that compared with the control group, swimming exercise, and high aerobic exercise, aerobic exercise (MD = 3.13, 95%CI = 0.15, 6.11, P < 0.05), swimming exercise (MD=-0.05, 95%CI=-0.05, -0.05, P < 0.05), high aerobic exercise (MD=-0.05, 95%CI=-0.05, -0.05, P < 0.05) have a better effect on increasing active sperm count, indicating that it is improving In terms of active sperm count, the intervention of the above three types of exercise (aerobic exercise, swimming exercise, high aerobic exercise) has statistical differences compared with the control group; pairwise indirect comparison shows that aerobic exercise is better than the control group, swimming exercise, moderate aerobic exercise, swimming exercise is better than high aerobic exercise, and the control group; compared with the control group, swimming exercise, and high aerobic exercise, aerobic exercise can increase the number of active sperm, and the above differences are statistically There is scientific significance (P < 0.05), and the other differences are not statistically significant.
In terms of increasing the number of active sperm, the ranking of the effectiveness of different exercise intervention methods in improving the total number of active sperm is: aerobic exercise (SUCRA = 96.0%) > aerobic training (SUCRA = 69.4%) > moderate aerobic exercise (SUCRA = 61.1%) > Control group (SUCRA = 46.9%) > Low aerobic exercise (SUCRA = 35.0%) > Swimming training (SUCRA = 29.2%) > High aerobic exercise (SUCRA = 12.4%), the results are shown in Table 6 .
2.5.7 Sperm motility
2.5.7.1 Evidence network diagram
Two studies reported on sperm motility in rats, and three of them were two-arm studies involving three types of exercise interventions. The overall evidence network diagram has F as the core, as shown in Fig. 17, which contains three closed loops.
2.5.7.2 Inconsistency test and convergence test
The results of the node splitting method showed that there was no statistically significant difference between direct comparison and indirect comparison of each two intervention measures in rat sperm motility (P > 0.05), indicating good consistency.
2.5.7.3 Network Meta analysis and probability ranking
Sperm motility: A network meta-analysis was performed on the included rat studies, resulting in 6 pairwise comparisons, as shown in Fig. 18. A total of 2 studies reported on the number of active sperm in exercise intervention, with a sample size of 53 cases. The results of network Meta consistency analysis showed that aerobic treadmill training (SMD = 3.13, 95%CI=-0.14,6.40, P > 0.05), aerobic training (SMD = 2.59, 95%CI = 0.85,4.33, P<0.05), treadmill training (SMD = 1.44, 95%CI=-0.60,3.48, P>0.05), indicating that aerobic training is better than the conventional control group in improving sperm motility; aerobic treadmill training, There was no statistical difference in the results between treadmill training and the conventional control group. Pairwise indirect comparison showed that there was no statistically significant difference between each exercise mode, P > 0.05.
In terms of improving sperm motility, the order of probability of the effectiveness of different exercise intervention methods in improving sperm motility is: aerobic treadmill training (SUCRA = 86.0%) > aerobic training (SUCRA = 74.2%) > treadmill training (SUCRA = 35.9%) > control group (SUCRA = 3.9%), the results are shown in Table 6.
2.5.8 Number of necrotic sperm
2.5.8.1 Evidence network diagram
4 studies reported the number of necrotic sperm in rats, 3 of which were 4-arm studies, and the rest were 2-arm studies, involving five types of exercise interventions. The overall evidence network diagram has F as the core, as shown in Fig. 19, which includes three a closed loop.
2.5.8.2 Inconsistency test and convergence test
The results of the node splitting method showed that there was no statistically significant difference between direct comparison and indirect comparison of each two intervention measures in the number of necrotic sperm in rats (P > 0.05), indicating good consistency.
2.5.8.3 Network Meta analysis and probability ranking
Necrotic sperm count: A network meta-analysis was performed on the included rat studies, resulting in 15 pairwise comparisons, as shown in Fig. 20. A total of 4 studies reported on the number of active sperm in exercise intervention, with a sample size of 100 cases. The results of network Meta consistency analysis showed that aerobic exercise swimming (SMD = 1.39, 95%CI=-3.66,6.45, P > 0.05), low aerobic exercise (SMD = 0.02, 95%CI=-1.84,1.87, P>0.05), high aerobic exercise (SMD=-0.06, 95%CI=-2.26,2.13, P>0.05), moderate aerobic exercise (SMD=-0.06, 95%CI=-2.40,2.28, P>0.05), swimming (SMD=-0.36, 95%CI=-2.33,1.62, P > 0.05). The research results show that there is no statistical difference between the above exercise methods and the conventional control group in terms of the number of necrotic sperm in rats. Pairwise indirect result comparison showed that there was no statistical significance in the differences between each exercise mode (P > 0.05).
In terms of improving the number of necrotic sperm, the order of probability of different exercise intervention methods in improving the number of necrotic sperm is: aerobic exercise and swimming (SUCRA = 24.1%) > low aerobic exercise (SUCRA = 50.2%) > control group (SUCRA = 50.7%) > High aerobic exercise (SUCRA = 54.9%) > Medium aerobic exercise (SUCRA = 55.4%) > Swimming (SUCRA = 64.7%). The results are shown in Table 6.
Table 5
Probability ranking table of various intervention measures for young men
Interventions
|
sperm volume
|
Total sperm count
|
sperm motility
|
sperm concentration
|
SUCRA/%
|
RANK
|
SUCRA/%
|
RANK
|
SUCRA/%
|
RANK
|
SUCRA/%
|
RANK
|
Moderate intensity aerobic exercise
|
45.1
|
4
|
57.4
|
3
|
33.0
|
4
|
62.3
|
2
|
family treadmill exercise
|
69.6
|
1
|
78.5
|
2
|
99.7
|
1
|
--
|
--
|
high-intensity sports
|
44.5
|
5
|
--
|
--
|
--
|
--
|
100.0
|
1
|
High-intensity running exercise
|
45.6
|
2
|
6.9
|
6
|
33.4
|
3
|
30.8
|
4
|
Moderate intensity running exercise
|
--
|
--
|
21.4
|
5
|
--
|
--
|
2.2
|
5
|
control group
|
45.2
|
3
|
44.1
|
4
|
72.4
|
2
|
54.7
|
3
|
aerobics
|
--
|
--
|
91.7
|
1
|
11.5
|
5
|
--
|
--
|
Note: SUCRA is the area under the curve, RANK is the ranking, The greater the MD of sperm volume, total sperm count, sperm viability, and sperm concentration in this case, the higher the ranking.“–”means not mentioned. |
Table 6
Probability ranking table of intervention measures for male rats
Interventions
|
Total sperm count
|
active sperm count
|
sperm motility
|
Necrotic sperm count
|
SUCRA/%
|
RANK
|
SUCRA/%
|
RANK
|
SUCRA/%
|
RANK
|
SUCRA/%
|
RANK
|
control group
|
19.0
|
5
|
46.9
|
4
|
3.9
|
4
|
50.7
|
3
|
aerobics
|
75.8
|
2
|
96.0
|
1
|
--
|
--
|
--
|
--
|
aerobic training
|
55.7
|
4
|
69.4
|
2
|
74.2
|
2
|
--
|
--
|
swimming training
|
6.4
|
6
|
29.2
|
6
|
--
|
--
|
64.7
|
6
|
low aerobics
|
--
|
--
|
35.0
|
5
|
--
|
--
|
50.2
|
2
|
moderate aerobics
|
--
|
--
|
61.1
|
3
|
--
|
--
|
55.4
|
5
|
high aerobic exercise
|
--
|
--
|
12.4
|
7
|
--
|
--
|
54.9
|
4
|
aerobic treadmill training
|
77.1
|
1
|
--
|
--
|
86.0
|
1
|
--
|
--
|
treadmill training
|
66.0
|
3
|
--
|
--
|
35.9
|
3
|
--
|
--
|
Aerobic exercise swimming
|
--
|
--
|
--
|
--
|
--
|
--
|
24.1
|
1
|
Note: The larger the MD of the total number of sperm, the number of active sperm, and the sperm motility in this example, the higher the ranking; the smaller the MD of the number of necrotic sperm in this example, the higher the ranking; SUCRA is the area under the curve, and RANK is Ranking, – means not mentioned. |