Objectives: This study evaluated sex differences in physical activity levels, anthropometric parameters, strength–endurance performance, and acute physiological responses to high-intensity strength–endurance exercise in emergency medical services students. Methods: Participants included 36 male and 23 female students aged 19–29 years. Body composition was assessed using bioelectrical impedance analysis. Physical activity was measured using the International Physical Activity Questionnaire, and strength–endurance performance was assessed with the 3-Minute Burpee Test (3-MBT). Blood pressure, heart rate, oxygen saturation, perceived exertion, and handgrip strength were recorded before and after the 3-MBT. Results: Men reported significantly higher PA levels than women (1963 vs. 1367 MET·min/week, p < 0.001). Women had a significantly higher percentage of body fat (31.0% vs. 19.4%, p < 0.001). Men completed more 3-MBT cycles than women (44 vs. 33 cycles/3 min, p < 0.001), whereas the between-sex difference in mean heart rate was not significant after Benjamini–Hochberg correction (170.2 vs. 162.2 bpm; adjusted p = 0.075). Systolic blood pressure was higher in men before and after the test (p < 0.001 and p = 0.004, respectively) and increased significantly in both sexes (p < 0.001). Oxygen saturation and handgrip strength decreased significantly after the 3-MBT in both groups (p < 0.001). Conclusions: Men demonstrated greater strength–endurance performance than women, although both sexes were classified as having “poor” performance according to established 3-MBT normative values. Men reported higher physical activity, whereas women had a higher body fat percentage. These findings demonstrate sex-based differences in physical activity, body composition, and strength–endurance performance among paramedic students.
Background: The aging population in Portugal requires interventions such as multicomponent exercise to maintain the functionality of older adults. The aim of this exploratory pilot study was to investigate preliminary changes in body composition, physical fitness, quality of life and satisfaction with life following a low-frequency multicomponent exercise program delivered in two different community-based contexts (conventional exercise room and Snoezelen room). Methods: This study followed a non-randomized quasi-experimental methodology based on participant preference and logistical availability. Following the baseline assessment, participants self-selected their participation context. Participants who chose to participate in the exercise intervention were assigned to either the Snoezelen Room Group or the Exercise Room Group according to their preference, whereas participants who did not participate in either intervention because of personal preference or logistical constraints formed a non-participating comparison Control Group. The final sample comprised 27 older women: Snoezelen Room Group (n = 14), Exercise Room Group (n = 7), and Control Group (n = 6). The intervention consisted of a 12-week multicomponent program (1 session/week, 45–60 min) carried out in different environments. Body composition, functional physical fitness, quality of life and satisfaction with life were assessed before and after the intervention. Results: The primary between-group analysis of change scores (Δ = post−pre) identified significant differences for body mass (H(2) = 9.516, p = 0.009), with a significant Bonferroni contrast between the Snoezelen and Exercise Room Groups (1 vs. 2; adjusted p = 0.008). For Back Scratch, the Δ-based omnibus test was also significant (H(2) = 7.398, p = 0.025), with Snoezelen differing from the Exercise Room Group (1 vs. 2; adjusted p = 0.020). For quality of life, the Δ-based omnibus test was significant (H(2) = 11.356, p = 0.003), with significant contrasts between Exercise Room and Control Groups (2 vs. 3; adjusted p = 0.003). Secondary between-group analyses at specific time points also identified differences in post-intervention bone mass (H(2) = 8.460, p = 0.015; 1 vs. 2, adjusted p = 0.026; 2 vs. 3, adjusted p = 0.038), muscle mass (H(2) = 7.748, p = 0.021; 1 vs. 2, adjusted p = 0.034), Back Scratch (H(2) = 7.947, p = 0.031; 1 vs. 2, adjusted p = 0.031; 2 vs. 3, adjusted p = 0.050), and 6-Minute Walk (H(2) = 9.015, p = 0.011; 1 vs. 2, adjusted p = 0.012). Conclusions: The findings suggest that a low-frequency multicomponent exercise program may be feasible in community social centers; however, the observed within-group changes and exploratory between-group differences should be interpreted cautiously given the non-randomized design, small sample size, and baseline differences. Larger controlled studies are needed to determine whether the exercise environment contributes to differential outcomes.
Background and Objectives: Artificial intelligence (AI) has rapidly emerged as a promising tool for delivering personalized interventions in physical activity, exercise prescription, and weight management. AI technologies may facilitate individualized recommendations, behavioral support, and lifestyle modification through adaptive digital health solutions, although their effectiveness remains to be established across different populations and settings. However, the current evidence remains heterogeneous, and the practical implementation of AI in personalized training and weight management requires further evaluation. This scoping review aimed to summarize the current evidence regarding the application of artificial intelligence for the personalization of training and weight reduction, with particular emphasis on the types of AI technologies used, their reported outcomes, practical applications, and current limitations. Methods: A scoping review was conducted following a structured literature search of studies investigating AI-supported interventions related to physical activity, exercise, dietary behavior, and weight management. Eight studies involving diverse populations, intervention designs, and AI technologies were included. Data were extracted on study characteristics, AI technologies, intervention characteristics, reported outcomes, and research gaps. The literature search was subject to access-based restrictions, including the use of “Free full text” in PubMed and “Open Access” in Web of Science, as well as language restrictions. Results: The included studies investigated a wide range of AI technologies, including conversational chatbots, natural language processing systems, machine learning algorithms, computer vision applications, knowledge-based systems, and large language models. Selected studies reported favorable or modest changes in exercise adherence, physical activity participation, dietary behaviors, user engagement, and weight-related outcomes; however, the magnitude and consistency of these findings varied across studies. Personalized coaching, real-time feedback, and continuous behavioral support were common features of interventions reporting favorable outcomes. However, considerable heterogeneity existed across study designs, participant populations, intervention protocols, AI technologies, and outcome measures, and evidence regarding long-term effectiveness remains limited. The findings should be interpreted in the context of the adopted search strategy, including access-based restrictions and the inability to retrieve eight of 57 reports sought for retrieval, which may have contributed to availability bias. Conclusions: Current evidence suggests that artificial intelligence may have potential as a tool for supporting the personalization of training and weight management interventions, particularly through individualized behavioral support, feedback, and user engagement. However, the available evidence is heterogeneous and does not yet allow firm conclusions regarding the effectiveness or mechanisms of AI-supported interventions. AI should currently be viewed as a complement rather than a replacement for healthcare and exercise professionals. Future large-scale randomized controlled trials with longer follow-up periods and standardized outcome measures are needed to clarify the effectiveness, sustainability, and practical implementation of AI-supported interventions.
Background and Objectives: Running-related musculoskeletal injuries remain highly prevalent among recreational runners, and the absence of population-specific biomechanical reference values limits clinical and sports interpretation in Latin American populations. This study aimed to establish reference values for spatiotemporal and selected running kinematic/mechanical values (initial contact angle, vertical leg stiffness, and vertical oscillation) in healthy adult recreational runners from Barranquilla (Colombia) using three-dimensional motion capture. Methods: A cross-sectional observational study was conducted in 25 healthy adults (13 men, 12 women; mean age 32.7 ± 7.4 years, range 20–47 years). Running biomechanics were assessed using a BTS SMART-DX three-dimensional motion capture system and a Modified Helen Hayes marker model with 30 reflective markers. Participants completed treadmill running trials at 7, 9, 11, and 13 km/h. Key spatiotemporal parameters and global kinematic/mechanical metrics were processed using BTS Smart Clinic software. Reference values were defined using the 10th and 90th percentiles, stratified by sex and running speed, and accompanied by bootstrap 95% confidence intervals. Effects of sex and speed were tested by two-way ANOVA with partial eta squared and Holm-adjusted p values, with a linear mixed-effects model as a robustness check. Results: Motorized treadmill-specific biomechanical reference values (10th and 90th percentiles) were established and stratified strictly by running speed (7, 9, 11, and 13 km/h) and sex. Under the primary linear mixed-effects model, running speed significantly affected all ten evaluated biomechanical variables (all adjusted p < 0.001), including initial contact angle and vertical oscillation, confirming that speed-disaggregated estimates are mandatory for clinical interpretation. Conversely, sex effects were robust to multiplicity adjustment only for flight time and vertical leg stiffness. Compared with a European reference cohort, and after adjustment for sex, age, stature, body mass and speed through the published reference equations, this cohort showed a 6.6% shorter flight time, a 19.0% lower vertical oscillation, a 3.8% shorter stride length, and a 3.1% higher cadence. Conclusions: This study provides the preliminary regional reference database for running spatiotemporal and selected kinematic parameters in a cohort of healthy adult recreational runners from Barranquilla (Colombia). These preliminary values provide a baseline restricted to motorized treadmill running at fixed speeds; while they support standardized treadmill screening and rehabilitation tracking, their direct applicability to overground or self-paced running remains limited and warrants caution.
Background: Patellar tendinopathy is a persistent load-related condition in athletes, and exercise is recommended as first-line care; however, the comparative value of specific tendon-loading prescriptions remains uncertain. This systematic review aimed to synthesize exercise-based interventions for adults with patellar tendinopathy, map reported loading prescription parameters, and estimate comparative effects when sufficiently comparable active-loading data were available. Methods: We conducted a PROSPERO-registered systematic review following PRISMA 2020. MEDLINE/PubMed, Web of Science Core Collection, Scopus, SPORTDiscus, and CENTRAL via Ovid/EBMR Reviews were searched. Two reviewers independently screened studies, extracted data, and assessed risk of bias. The primary outcome was VISA-P/VISA final score. Randomized active exercise/loading comparisons with extractable final-score data were pooled as mean differences on the original 0–100 scale using random-effects restricted maximum likelihood models with Hartung–Knapp adjustment. Results: The searches identified 942 records; 96 full-text reports were assessed and 40 reports were retained for qualitative synthesis. Six active exercise/loading comparisons contributed to the primary comparative synthesis. The pooled mean difference was 5.16 VISA-P/VISA points (95% CI 2.39 to 7.93) in favour of the first-listed intervention, with negligible statistical heterogeneity (tau2 = 0.000; I2 = 0.0%; Q = 3.50, p = 0.624). All contributing studies had some concerns in RoB 2, and GRADE certainty was low. Conclusions: Structured tendon-loading exercise remains central to rehabilitation. The pooled estimate should be interpreted as a small average comparative signal across clinically distinct active-loading contrasts, not as evidence that one specific loading strategy is universally superior.
Background: Total trapeziometacarpal (TMC) joint arthroplasty has emerged as a surgical option for selected patients with TMC osteoarthritis. The HORUS® prosthesis (Evolutis, France) is a novel uncemented modular implant featuring a threaded screw-in trapezial cup coated with porous titanium and a PEXEL-E liner (vitamin E-infused cross-linked polyethylene) with a semi-retentive articulation. The purpose of this study was to report preliminary clinical and radiographic outcomes of total TMC joint arthroplasty using the uncemented HORUS® prosthesis at 6-month follow-up. Methods: Eleven patients (8 women, 3 men; mean age 63.6 ± 10.1 years) with Eaton-Littler stage II–III TMC osteoarthritis and at least 6 months of unsuccessful conservative treatment underwent total TMC joint arthroplasty using the HORUS® prosthesis. All procedures were performed by a single surgeon through a dorso-radial approach. Clinical outcomes were assessed preoperatively and at 15 days, 1, 3, and 6 months postoperatively using the Visual Analogue Scale (VAS), QuickDASH questionnaire, and Kapandji opposition score. Standardized radiographs were assessed at 1, 3, and 6 months for component position, periprosthetic radiolucency, cup migration/loosening, and stem subsidence. Results: One intraoperative trapezial fracture (1/11; 9.1%) required conversion to trapeziectomy with suspension arthroplasty; this patient was excluded from the prosthetic outcome analysis. In the remaining 10 patients, mean VAS decreased from 8.7 ± 1.1 preoperatively to 0.3 ± 0.7 at 6 months, mean QuickDASH decreased from 66.2 ± 11.3 to 14.5 ± 7.6, and mean Kapandji score increased from 5.8 ± 0.8 to 9.2 ± 0.6. One minor postoperative complication occurred (flexor tendinopathy of the third and fourth digits at 4 weeks). No dislocation, infection, or radiographic evidence of component migration, stem subsidence, or periprosthetic radiolucency was detected during the 6-month observation period. Conclusions: In this small preliminary series, the HORUS® prosthesis was associated with marked short-term improvements in pain, disability, and thumb opposition. These data should not be interpreted as evidence of long-term implant survival or a reduced risk of loosening because the cohort was small and follow-up was limited to 6 months. Larger comparative studies with longer follow-up are required to assess durability, implant-related complications, and revision risk.
Background: Work-related musculoskeletal disorders impose substantial global burdens. Although Pilates is a recognized biopsychosocial intervention, a quantitative synthesis evaluating its occupational efficacy remains limited. Objective: To compute the pooled effect sizes of workplace Pilates interventions on musculoskeletal pain intensity, functional disability, muscular endurance, and health-related quality of life (QoL). Methods: Twelve randomized controlled trials (14 reports) involving diverse occupational cohorts were analyzed. Data dependency was resolved via outcome aggregation. Random-effects models calculated pooled effect sizes (Hedges’ g), 95% confidence intervals (CI), and 95% prediction intervals (PI). Risk of bias was assessed using RoB 2. Results: The meta-analysis demonstrated a moderate, statistically significant reduction in functional disability (g = −0.660, 95% CI [−1.091, −0.229], p = 0.011). Conversely, pooled estimates for pain intensity (g = −0.461, p = 0.360), muscular endurance (g = 1.354, p = 0.223), and QoL (g = −0.146, p = 0.815) were non-significant. Substantial heterogeneity was observed (I2: 32.02–98.25%), and all prediction intervals crossed the null, indicating high uncertainty regarding future effects. Conclusions: Workplace Pilates consistently mitigates functional disability, but current evidence does not support significant pooled improvements in absolute pain, endurance, or QoL. This divergence between functional recovery and pain reduction aligns with biopsychosocial frameworks, suggesting improved work capacity despite variable pain relief. Given the high heterogeneity and wide prediction intervals, findings must be interpreted cautiously, highlighting the need for rigorously standardized trials.
Osteoarthritis (OA) is a leading cause of disability worldwide, characterized by progressive joint degeneration driven by extracellular matrix (ECM) breakdown, chondrocyte apoptosis, and chronic low-grade inflammation. Despite the availability of several pharmacological and non-pharmacological interventions, no current therapy effectively halts or reverses disease progression. Physical activity is traditionally recognized as a cornerstone in OA management, improving pain and functional outcomes; however, the molecular mechanisms underlying its beneficial effects remain partially understood. Irisin, a myokine generated by proteolytic cleavage of fibronectin type III domain-containing protein 5 in response to muscle contraction, has recently emerged as a potential regulator of cartilage homeostasis. Experimental evidence indicates that irisin exerts pleiotropic effects by modulating inflammatory and catabolic signaling pathways, promoting anabolic and reparative processes, restoring autophagic and mitophagic flux, and preserving mitochondrial function. These actions collectively contribute to the maintenance of ECM integrity and chondrocyte viability. In vitro and in vivo studies consistently support the protective role of irisin in cartilage biology, highlighting its involvement in the muscle–cartilage axis and its potential as both a biomarker and therapeutic target for OA. This narrative review critically evaluates the chondrocyte-specific mechanisms, receptor uncertainties, experimental-model limitations, analytical challenges, and delivery strategies that currently define the biological and translational relevance of irisin in OA. Particular attention is given to the identification of irisin-mediated signaling pathways in chondrocytes, optimization of delivery strategies, and the definition of exercise regimens capable of maximizing its chondroprotective effects.
Background: Day-to-day movement behavior may influence short-term glycemic variability in adults with type 2 diabetes, but free-living evidence integrating accelerometry with continuous glucose monitoring (CGM) remains limited. Objectives: This study examined whether daily moderate-to-vigorous physical activity (MVPA) and accelerometer-defined sedentary time were associated with 24-h within-day glycemic variability. Methods: In this longitudinal repeated-measures study, 140 adults with type 2 diabetes underwent 14 days of concurrent hip-worn ActiGraph GT3X+ accelerometry and FreeStyle Libre 2 CGM under free-living conditions in Lima, Peru. The primary outcome was a daily CGM-derived coefficient of variation (CV). Linear mixed-effects models separated within-person and between-person components, with Holm adjustment for the two primary within-person associations. Results: The fully adjusted primary analysis included 132 participants and 1728 participant-days. Higher within-person MVPA was associated with a lower daily CV (β = −0.27 percentage points per 10 min/day, 95% CI −0.45 to −0.09; Holm-adjusted p = 0.006), whereas greater accelerometer-defined sedentary time was associated with a higher CV (β = 0.05, 95% CI 0.01 to 0.09; Holm-adjusted p = 0.014). Secondary concurrent analyses showed favorable MVPA and opposite sedentary time associations for time in range, time above range, mean glucose, and glucose standard deviation (all false discovery rate q ≤ 0.018), with no statistically detectable association with time below range. Lagged associations were directionally consistent, but none remained statistically significant after multiplicity correction. Conclusions: Daily MVPA and accelerometer-defined sedentary times were associated with modest differences in within-day glycemic variability and concurrent CGM profiles. These observational findings do not establish causality or a specific exercise dose.
Background: Executive functions (EFs) decline with aging, impacting functional independence. While resistance training (RT) is a promising non-pharmacological intervention, the optimal modality and duration for cognitive benefits remain unclear. Flywheel RT (FRT) imposes greater motor control and attentional demands than traditional RT (TRT), potentially enhancing EFs. Objective: To compare the effects of a 36-week FRT versus TRT program on executive function and serum insulin-like growth factor 1 (IGF-1) levels in healthy older women. Methods: This parallel-group randomized controlled trial allocated 64 older women (overall mean age 66.8 ± 4.6 years; FRT group: 68.0 ± 4.8 years; TRT group: 65.5 ± 4.1 years) to either FRT (n = 25) or TRT (n = 21) for two weekly sessions over 36 weeks. Executive function was assessed using the Victoria Stroop Test (inhibitory control), Digit Span Test (working memory), and Trail Making Test (cognitive flexibility). Serum IGF-1 was quantified via chemiluminescence. Intention-to-treat analyses with ANCOVA were performed. Results: After 36 weeks, both groups showed significant within-group improvements in inhibitory control (mean reduction from pre to post: FRT: 15.2 ± 10.4 to 14.8 ± 7.4 s; TRT: 20.4 ± 11.8 to 15.6 ± 7.3 s; p = 0.028, ηp2 = 0.38) and working memory (Digit Span Forward: FRT: 6.2 ± 1.7 to 7.9 ± 2.0; TRT: 6.7 ± 1.5 to 8.7 ± 1.8; p < 0.001, ηp2 = 0.84). The B/A ratio of the Trail Making Test improved significantly more in the FRT group (73.0 ± 65.2 to 87.5 ± 68.1 s) compared to the TRT group (67.3 ± 54.1 to 137.7 ± 83.6 s; group × time interaction: p = 0.001, ηp2 = 0.13). No significant changes in serum IGF-1 concentrations were observed in either group (FRT: 112.9 ± 25.4 to 115.3 ± 21.3 ng/mL; TRT: 104.7 ± 27.5 to 103.0 ± 28.9 ng/mL; p = 0.88, ηp2 = 0.002). Adherence was high (only 4 out of 46 participants did not complete all 72 sessions), and no severe adverse events were reported. Conclusions: Flywheel training appears particularly effective for enhancing cognitive flexibility, likely due to its higher cognitive-motor demands. The absence of significant changes in circulating IGF-1 suggests that the observed cognitive benefits may not be mediated by systemic endocrine pathways, although this does not exclude the possibility of local central nervous system adaptations or changes in other neurotrophic factors not assessed in this study.
Background: Primitive reflex (PR) assessments based on the Institute for Neuro-Physiological Psychology (INPP) framework are increasingly used in developmental and athletic populations. However, the reproducibility of these observer-based assessments remains insufficiently documented. This study investigated the intra- and inter-rater reliability of subjective PR assessments and examined the potential influence of evaluator expertise in elite youth football athletes. Methods: Sixty-nine male youth football players from an elite academy (age: 18 ± 2 years) participated in this study. PR assessments included the Moro reflex, asymmetrical tonic neck reflex, symmetrical tonic neck reflex, and tonic labyrinthine reflex, evaluated using standardized INPP procedures (0-4 ordinal scoring scale). Intra-rater reliability was assessed by an experienced examiner across three testing sessions performed over six months. Inter-rater reliability was evaluated using standardized video recordings independently scored by two novice raters. Relative reliability was assessed using intraclass correlation coefficients (ICCs) with corresponding 95% confidence intervals (95% CIs), while absolute reliability was quantified using the standard error of measurement (SEM) and the minimal detectable change at the 95% confidence level (MDC95). Results: Good to excellent intra-rater relative reliability (ICC = 0.86-0.98; 95% CI = [0.81-0.99]) was observed, with SEM values of 0.1-0.6 and MDC95 values of 0.3-1.7 points. Moderate to excellent video-based inter-rater reliability was found (ICC = 0.69-0.99; 95% CI [0.56-0.99]), with SEM values of 0.1-0.7 and MDC95 values of 0.3-2.0 points. Pairwise comparisons among raters showed moderate to excellent relative reliability (ICC = 0.57-0.99; 95% CI [0.35-0.99]), with SEM values of 0.1-0.5 and MDC95 values of 0.2-1.3 points. Conclusions: Subjective PR assessments performed using the INPP framework demonstrated good to excellent intra-rater relative reliability and moderate to excellent video-based inter-rater relative reliability, together with generally low absolute measurement error in elite youth football athletes. These findings provide preliminary psychometric support for the use of standardized PR assessments in research and applied sport settings.
Background and Objectives: Swimming has sprint and distance events, with current performance often driving selection rather than physiological characteristics of the athlete (e.g., muscle fiber type, blood lactate, etc.), especially among NCAA Division III swimmers, where these characteristics are unknown. We aimed to characterize the differences in estimated muscle fiber types (% fast twitch, %FT) and blood lactate (Blac) response to the maximal anaerobic lactate swim test (MANLT) between collegiate distance and sprint collegiate swimmers. Methods: Twenty-two college-aged (19.7 ± 1.0 yr) DIII swimmers (n = 13 sprint, n = 9 distance) performed an isokinetic muscular fatigue protocol to estimate their %FT, as well as their maximal and minimum Blac values and clearance rate (Blac recovery) (3 and 12 min post) after the MANLT was performed on two separate days (>48 h between). Results: There were no significant differences between sprint swimmers and distance swimmers in maximal Blac levels (11.6 ± 2.5 vs. 10.5 ± 3.4 mM, p = 0.38, d = 0.3), minimal Blac levels (9.3 ± 2.9 vs. 8.3 ± 3.3 mM, p = 0.45, d = 0.3), and percent decreases from 0 to 3 min (0.9 ± 13.1 vs. 9.9 ± 9.5, p = 0.09, d = 0.7), 0-12 min (15.4 ± 15.6 vs. 19.7 ± %, p = 0.52, d = 0.2), and 3-12 min (14.7 ± 12.5 vs. 11.04 ± 11.2%, p = 0.48, d = 0.3) Blac recovery. No significant differences were identified in estimated %FT between sprinters and distance swimmers (52 ± 6.4 vs. 45 ± 10.51, p = 0.056). Both extensor and flexor %FT estimations showed 69.2% and 66.7% accuracy in matching coach-identified event, with their respective estimated fiber type. A positive relation was identified between %FT knee flexor fibers and Blac (r = 0.44) and between %FT knee extensor fibers and Blac (r = 0.48) for all swimmers. Conclusions: This preliminary study suggests that athlete specialization is generally accurate to the physiology of the swimmer, namely anaerobic capacity and estimated fiber type.
Background and Objectives: Strength deficits are extremely common following anterior cruciate ligament reconstruction (ACLR). These deficits may be further impacted by concomitant meniscus repair during ACLR. However, there remains limited evidence investigating the effect of meniscus repair on lower-limb strength after ACLR, and particularly if there are between-sex differences in strength after ACLR with and without meniscus repair. Therefore, the purpose of this study was to investigate sex-specific differences in meniscus repair during ACLR on quadriceps and hamstring isometric strength. Methods: Eighty-five (37 females; 19.0 ± 6.6 years old) patient charts were retrospectively evaluated after undergoing ACLR. Variables documented included meniscal status, maximal isometric quadriceps and hamstring strength of the operative (OP) and non-operative (NOP) legs. Three separate 3-way [leg (OP vs. NOP) × sex (males vs. females) × meniscus repair status (yes vs. no)] mixed-factorial analyses of variance (ANOVA) assessed differences in quadriceps and hamstring strength, and the hamstring-to-quadriceps strength ratio (H:Q), at an alpha level of p ≤ 0.05. Results: For H:Q there was a sex by meniscus repair status interaction (p = 0.007). Females who underwent meniscus repair had lower H:Q (18.2%) than those without. Females without meniscus repair had a 20.3% greater H:Q than males without meniscus repair. Males had greater quadriceps strength than females (mean difference ± standard error; 0.58 ± 0.28 N∙kg-1) and the NOP leg was stronger than OP for quadriceps (0.34 ± 0.08 N∙kg-1) and hamstring (0.14 ± 0.04 N∙kg-1) strength across sex. Conclusions: These findings suggest that the H:Q ratio differed according to sex and meniscus repair status. Further, there was a between-limb difference for strength in the quadriceps and hamstrings along with sex-related differences in strength. However, meniscus repair status did not influence raw strength values.
Background: Physical and technical development in youth soccer depends on the integration of neuromuscular and small-sided games (SSG) training. However, the influence of training sequence on adaptations remains unclear in prepubertal players. Therefore, this study aimed to compare the effects of performing neuromuscular training before or after SSG on physical fitness and soccer-specific performance in trained prepubertal soccer players. Methods: Twenty-two trained prepubertal male soccer players were randomly assigned to either neuromuscular training followed by SSG or SSG followed by neuromuscular training. Both groups completed a 6-week in-season intervention, including two weekly sessions, with each group performing 3 weeks of neuromuscular training and 3 weeks of SSG training in a different order. Physical fitness (back extensor strength, five-jump test, 10 m sprint, and Yo-Yo IR1) and soccer-specific performance (change of direction with ball and Loughborough Soccer Passing Test) were assessed before and after the intervention. Results: All 22 participants completed the intervention (n = 11 per group). Both groups demonstrated significant improvements over time in most physical fitness and soccer-specific performance variables (p < 0.01). However, significant group × time interactions indicated that the magnitude of improvement was consistently greater when neuromuscular training preceded small-sided games (p ≤ 0.041). Compared with the SSG-before-neuromuscular group, the neuromuscular-before-SSG group achieved larger improvements in back strength (+9.8% vs. +2.7%), five-jump test (+17.1% vs. +10.0%), 10 m sprint (-10.3% vs. -6.3%), Yo-Yo IR1 distance (+35.4% vs. +20.4%), change of direction with ball (-7.4% vs. -1.0%), and Loughborough Soccer Passing Test (-16.0% vs. -7.8%). Conclusions: Training sequence may influence the magnitude of short-term adaptations in prepubertal soccer players. Although both training orders improved performance, performing neuromuscular training before SSG resulted in greater improvements in several physical fitness and soccer-specific performance outcomes. These findings suggest that training order may represent an important factor in youth soccer training design; however, further research is required to confirm the consistency of this sequencing effect and to explore the mechanisms underlying these adaptations.
Background: Tibial bone stress injury (TBSI) with associated bone marrow edema (BME) is a common and clinically challenging condition in athletes, often requiring prolonged load restriction and delayed return to sport. Evidence for adjunctive interventions that improve both symptoms and MRI-derived recovery remains limited. The aim of this study was to investigate whether adding Functional Magnetic Stimulation (FMS) to standardized rehabilitation improves pain, function, and MRI-derived outcomes over 16 weeks in athletes with MRI-confirmed TBSI. Materials and Methods: Forty athletes with Fredericson grade 2-3 TBSI were randomized to FMS plus rehabilitation (n = 20) or rehabilitation alone (n = 20). Both groups completed a 4-week load-based rehabilitation program, while the FMS group additionally received eight 30 min FMS sessions at 40 Hz. Outcomes were assessed at baseline, 4 weeks, and 16 weeks. The primary outcome was activity-related pain (NPRS), while secondary outcomes included lower-limb function (LEFS-GR), BME extent, and Fredericson grade. Continuous outcomes were analyzed using two-way mixed ANOVA, whereas Fredericson grade was analyzed using an ordinal generalized estimating equation model. The level of statistical significance was set at p < 0.05. Results: Groups were comparable at baseline. Significant group × time interactions favored FMS for NPRS, F(2, 76) = 12.46, p < 0.001, η2p = 0.247; LEFS-GR, F(1.08, 41.09) = 81.56, p < 0.001, η2p = 0.682; and BME extent, F(1.44, 54.85) = 49.33, p < 0.001, η2p = 0.565. At 16 weeks, the FMS group showed lower NPRS scores, higher LEFS-GR scores, and lower BME extent than controls. Fredericson grade also showed a significant group × time effect, Wald χ2(2) = 20.38, p < 0.001. The FMS group had significantly lower cumulative odds of classification in a higher Fredericson grade at 4 weeks (OR = 0.045, 95% CI: 0.012-0.163, p < 0.001), whereas the corresponding difference at 16 weeks remained directionally favorable but did not reach statistical significance (OR = 0.033, 95% CI: 0.001-1.029, p = 0.052). Conclusions: The addition of FMS to load-based rehabilitation was associated with greater clinical and functional improvements, greater reductions in BME extent, and a more favorable longitudinal trajectory in MRI severity classification than rehabilitation alone in athletes with TBSI. However, because the study did not include a sham-FMS condition and participants could not be blinded, the self-reported pain and functional outcomes should be interpreted cautiously. FMS may represent a useful adjunct to structured rehabilitation, although sham-controlled and longer-term studies should determine its effects on return-to-sport progression and recurrence risk.
Objectives: Sided games are commonly used to condition players for the demands of official games (OGs). Therefore, this study aimed to evaluate if different sided games match position-specific locomotor and mechanical OG demands of professional football players. Methods: Twenty-one male professional football players from a second team of a professional football club were monitored during the second half of the 2024/25 season. External load was assessed during OGs and sided games. The latter were categorized by area per player (ApP) as small- (SSG, ApP < 100 m2), medium- (MSG, ApP 100-200 m2) and large-sided games (LSG, ApP > 200 m2). External load was analyzed for total distance (TD), high-speed running (HSR), sprint distance (SPD), and the number of accelerations (ACC) and decelerations (DEC). Players were grouped by position: center backs (CBs), full backs (FBs), central midfielders (CMs), wide midfielders (WMs), and strikers (STs). Results: Across all playing positions (CB, FB, CM, WM, ST), SSGs, MSGs and LSGs elicited significantly higher TD than the OG, except for CM, where no significant differences were observed during SSGs and LSGs. All positions displayed similar HSR during LSGs than OG demands, and some positions also during MSGs (CB, CM, FB) and SSGs (CB). SPD was similar across all positions only during LSGs. ACC and DEC were significantly higher for all positions in SSGs and MSGs than OGs and similar in LSGs. Conclusions: Position-specific OG demands were not statistically from different sided-game formats. ACC, DEC and TD in LSGs met OG demands; however, smaller formats (SSGs, MSGs) overload those variables. In contrast, HSR and SPR load in SSGs and MSGs did not meet OG demands for most positions. For that, coaches should use LSGs, knowing that TD may be overloaded, or supplement SSGs/MSGs with running-based drills for more accurate programming.
Isometric resistance training (IRT) has emerged as a promising non-pharmacological intervention for blood pressure (BP) management. Although current hypertension guidelines primarily recommend aerobic and dynamic resistance exercise, growing evidence indicates that IRT is an effective, feasible, and time-efficient alternative. This narrative review summarizes the current evidence on the efficacy, physiological mechanisms, and clinical applications of IRT. We reviewed randomized controlled trials, systematic reviews, and meta-analyses evaluating the effects of different IRT modalities, including isometric handgrip (IHG), isometric wall squat (IWS), and isometric leg extension (ILE), on BP in normotensive individuals, patients with hypertension, and those with cardiovascular disease. IRT consistently reduces resting systolic BP by approximately 5-8 mmHg and diastolic BP by 3-4 mmHg; these effects may approach those reported with first-line antihypertensive therapy and potentially be equivalent to those of other exercise modalities. These benefits have been demonstrated across normotensive and hypertensive populations and appear largely independent of age, sex, medication use, and the muscle groups involved. Preliminary evidence also supports the feasibility and safety of appropriately prescribed IRT in selected patients with ischemic heart disease and heart failure with preserved ejection fraction. Proposed mechanisms include improvements in endothelial function, nitric oxide bioavailability, autonomic regulation, oxidative stress, arterial baroreflex sensitivity, and myocardial efficiency. IRT has emerged as an effective, safe, and practical adjunct to lifestyle modification for BP control, particularly in older adults and individuals with limited ability to perform conventional exercise. However, current evidence derives from relatively small studies with limited follow-up; further large-scale randomized trials are needed to define the optimal exercise prescription, clarify the underlying mechanisms, and establish the role of IRT in patients with cardiovascular disease.
Background: The latissimus dorsi (LD) is a primary muscle involved in pulling exercises used in resistance training, contributing to shoulder extension, adduction and internal rotation, with relevance to athletic performance, injury prevention and rehabilitation as well as to upper-body aesthetics. Aim: to identify which exercise configurations are most consistently associated with greater latissimus dorsi electromyographic (EMG) amplitude. Methods: This SANRA-informed narrative review synthesized surface and high-density EMG evidence across major pulling exercises, for the lat pull-down, pullover, seated row, barbell row, bent-over row and pull-up. Twenty-three eligible studies were included and appraised using a six-criterion methodological checklist. Results: In the lat pull-down, an anterior bar path was the configuration most consistently associated with greater LD EMG amplitude, whereas the effects of grip width were inconsistent. In the seated row, a narrower grip and a lower shoulder-abduction angle were each associated with greater LD amplitude in separate studies; these two variables have not been tested in combination and should not be read as a single validated configuration. Among rowing variants, the inverted row produced the highest LD amplitude in a single, small preliminary study that requires replication. Pull-up variations showed broadly similar LD activation across grip configurations, while the pullover appeared to preferentially activate the pectoralis major rather than selectively target the LD. Conclusions: Current evidence tentatively supports the anterior lat pull-down and, within the seated row, a narrower grip and a lower shoulder-abduction angle (evaluated independently) as the configurations most consistently associated with greater LD EMG amplitude; these findings reflect acute EMG amplitude rather than longitudinal training outcomes and should be treated as an evidence-informed starting point rather than a definitive exercise prescription. Across pulling exercises, the humerus-to-trunk relationship may be a key biomechanical determinant of muscular load distribution.
Background: Rugby union and rugby league are among the most physically demanding contact team sports, in which playing positions impose distinct physical requirements. The aim of the review was to collect and synthesize available data on positional differences in physical fitness between forwards and backs in adult male rugby players. Methods: The systematic review was conducted in accordance with PRISMA 2020 and SWiM guidelines and was prospectively registered in the OSF database (10.17605/OSF.IO/E4Y37). Four electronic databases were searched: PubMed, SPORTDiscus, Web of Science, and Scopus up to June 2026. The search identified 3058 records, which were reduced to 1343 after language and document-type limits and then screened. Eligibility criteria were applied within the PICOs framework. Methodological quality was assessed using JBI Critical Appraisal Checklists and the AXIS tool as a validation instrument. Due to considerable methodological heterogeneity, narrative synthesis with directional meta-synthesis was applied. Results: Thirty-seven studies were included (n > 2000 players; 15 countries; 1996-2025). Forwards achieved higher values of absolute muscular strength and power, body mass, and sprint momentum, whereas backs performed better in sprint tests (10-50 m), maximum sprint velocity, aerobic fitness (VO2max, Yo-Yo IRTL1), CMJ height, and relative power. Following normalization to body mass, positional differences in strength and power were attenuated or reversed. In the only study that isolated the change in direction deficit, no clear positional difference was observed. Conclusions: Body mass appears to be the principal explanatory factor underlying positional differences in absolute strength and power. Position-specific fitness profiles are observable as early as the U20 category and become more pronounced with increasing competitive level. Strength and conditioning coaches should compare positional groups using body mass normalized ratio or, where justified, allometrically scaled measures rather than absolute values.
Background and Objectives: Efficient landing shock attenuation is important for both athletic performance and lower-extremity injury prevention in youth soccer players. Although landing biomechanics and change-of-direction (COD) performance have been widely investigated, the relationship between field-based COD performance and landing impact characteristics remains unclear. This study aimed to examine the relationships between linear sprint performance, COD performance, and landing impact during a standardized single-leg forward drop jump landing task in junior soccer players. Methods: Thirty-six junior soccer players (22 boys and 14 girls; 10-12 years) participated in this cross-sectional study. Linear sprint performance and COD performance were assessed using a 30 m sprint test and a 30 m zigzag run test, respectively. Landing impact was evaluated during a standardized single-leg forward drop jump landing task using a force plate. Body weight-normalized peak vertical ground reaction force (peak vGRF, %BW) was calculated for each trial, and the average of the final five successful trials was used for analysis. Relationships between performance measures and body weight-normalized peak vGRF were examined using Spearman's rank correlation coefficients and partial Spearman correlation analyses adjusted for sex. Results: No significant correlation was observed between 30 m sprint performance and body weight-normalized peak vGRF (ρ = 0.106, p = 0.537). In contrast, 30 m zigzag run performance showed a moderate positive correlation with body weight-normalized peak vGRF (ρ = 0.401, p = 0.015), indicating that poorer COD performance was associated with greater landing impact. This association remained significant after adjustment for sex (partial ρ = 0.474, p = 0.004). Conclusions: These findings suggest that landing impact characteristics may represent one biomechanical factor associated with COD performance. Although the observed association was moderate, field-based COD assessments may provide practical information regarding landing impact characteristics. Future studies should incorporate biological maturation, COD deficit, and additional biomechanical variables to further clarify these relationships.
