IntroductionThe Movement Quality Assessment for Athletes (MQA-A) was recently developed, however, the reliability of its scoring procedure is yet to be determined. Thus, the aim of this study was to determine the intra-rater and inter-rater reliability, agreement between live and video scoring methods and measurement error of the MQA-A.MethodsThe athletic movement quality of 50 adolescent athletes (age: 16.1 ± 0.6 years, mass: 81.7 ± 6.1 kg, height: 173.9 ± 10.5 cm) was measured using the MQA-A by two experienced raters, both live and via video. Intra-rater reliability was determined using the movement quality scores of a single rater, inter-rater reliability was determined for live and video scores and agreement between live and video scoring methods were assessed.ResultsIntra-rater reliability and inter-rater reliability for video and live scoring methods was evident (ICC ≥ 0.90, Kw: 0.39–0.90). There was preliminary evidence for agreement between live and video scoring (ICC = 0.86, Kw: 0.61–0.82).DiscussionThus, the MQA-A offers a reliable tool for measuring athletic movement quality in adolescent athletes.
PurposePhysically Active Learning (PAL) integrates purposeful movement into academic instruction and has been associated with improved student learning and health outcomes in school settings. However, evidence supporting PAL implementation in higher education is limited. This mixed-methods pilot study evaluated university educators' experiences of the TransformUs Higher Ed PAL program and explored perceived changes in teaching practice, competence, confidence, willingness, and PAL implementation.MethodsEducators from eight disciplines, including Law, Speech Pathology, Occupational Therapy, Nursing and Theology, at one Australian university participated in the intervention. Post-intervention semi-structured interviews (n = 10) were analysed using an inductive–deductive thematic approach informed by the Capability, Opportunity, Motivation–Behaviour (COM-B) model. Pre- and post-intervention surveys (n = 10) assessed perceived competence, confidence, willingness, barriers, and student outcomes associated with PAL, while implementation checklists (n = 6) described patterns of PAL implementation.ResultsEducators reported increased psychological capability, enhanced motivation driven by improvements in student engagement, and highlighted the importance of practical, social, and institutional support for successful PAL implementation. Qualitative findings demonstrated that educators embedded PAL across diverse teaching contexts and described meaningful shifts in their teaching practices, student engagement, and professional identity. Survey findings indicated improvements across all five PAL implementation constructs, with educators reporting greater willingness, competence, confidence, and perceived student outcomes, alongside fewer perceived barriers to implementing PAL. Implementation checklists showed that educators consistently planned for PAL integration, while embedding PAL into assessment remained the most challenging aspect of implementation.ConclusionsTransformUs Higher Ed appears to be an acceptable professional learning approach for supporting PAL implementation in higher education. Although findings should be interpreted cautiously due to the small sample, they provide a strong rationale for larger multi-institutional studies incorporating observational and student-level outcomes to evaluate effectiveness, sustainability, and scalability.
IntroductionHYROX is a rapidly growing fitness competition combining eight 1-km running intervals with eight functional fitness stations. This study investigated the epidemiology and markers of health problems in HYROX athletes.MethodEighty-nine HYROX athletes (56 female) completed the ‘Oslo Sports Trauma Research Center Questionnaire on Health Problems’ (OSTRC-H2) weekly for 12 weeks, alongside exposure reporting and a baseline questionnaire. In an exploratory analysis, potential risk markers (age, sex, previous injury and HYROX experience) for cumulative injury severity were examined using negative binomial regression with an exposure offset.ResultsThe mean weekly response rate was 62%. The pooled weekly prevalence of any health problem was 30% (95% CI 24% to 37%), with a substantial-problem prevalence of 18% (95% CI 13%–24%). Injury incidence was 14.4 (95% CI 11.1–18.4) per 1,000 h, with a time-loss incidence of 6.4 (95% CI 4.3–9.2); injuries attributed to HYROX training accounted for two thirds of episodes (9.6 per 1,000 h). Overuse injuries accounted for 73% of injuries. The knee was the most frequently injured region (22% of episodes) and, with the lower leg, carried the greatest burden; the elbow ranked third for burden on the basis of four episodes, two of them persistent, while shoulder injuries were near-absent. Previous injury carried the largest rate ratio for cumulative severity, at 2.60 (95% CI 1.00–6.75), an interval also compatible with no association.ConclusionsHealth problems were common in HYROX athletes and dominated by overuse injuries. The burden was led by the lower limb, consistent with the sport's running load, with a possible elbow contribution from two persistent injuries and a near-absence of shoulder problems, a combination that may distinguish the profile from other extreme conditioning programme training but which rests on few cases. Only half of problems involved time-loss, so missed-training-day surveillance understates the burden. Previous injury is a candidate risk marker requiring confirmation in larger cohorts.
BackgroundBallroom dance remains a contested domain in Philippine higher education, often perceived as formal, outdated, or misaligned with the values and movement preferences of contemporary learners. Within physical education, this creates a need to examine how students' individual interest relates to their study engagement in ballroom-based learning contexts.ObjectiveThis cross-sectional study examined the association between individual interest and study engagement in ballroom-based physical education, using the tripartite model of individual interest comprising positive affect and willingness to reengage, stored utility value, and stored attainment value and knowledge-seeking intentions.MethodsA total of 138 Filipino college students enrolled in PATH-FIT 4 participated in the study. Data were analyzed using partial least squares structural equation modeling (PLS-SEM). Individual interest was first modeled as a reflective-reflective higher-order construct, followed by a dimension-level model examining the separate associations of the three individual interest dimensions with study engagement. An importance-performance map analysis (IPMA) was also conducted to identify the practical relevance of each dimension in relation to study engagement.ResultsThe higher-order model showed that individual interest was positively associated with study engagement and accounted for 49.3% of its variance. In the dimension-level model, stored utility value showed the strongest positive association with study engagement, followed by stored attainment value and knowledge-seeking intentions. Positive affect and willingness to reengage was not significantly associated with study engagement after accounting for the other dimensions.ConclusionThe findings suggest that engagement in ballroom-based PE is linked less to affective enjoyment alone and more to students' recognition of ballroom dance as useful, personally meaningful, and connected to further learning. Positioning ballroom pedagogy around usefulness, self-relevance, cultural meaning, and knowledge-seeking may help PE instructors present dance-based learning as a more purposeful movement experience in Philippine HE.
IntroductionThrowing velocity is a key determinant of offensive success in handball. While the relationship between muscle strength and ball velocity is well-documented, the effectiveness of practical functional indicators, such as the Ballistic Push-up (BPU), remains under-investigated in this sport. This study aimed to analyze the relationship between various upper- and lower-limb strength and power assessments and ball velocity in the standing throw (ST) and the jumping throw with progression (JT).MethodsTwelve university athletes (6 males, 6 females; 22.8 ± 3.7 years) completed a testing battery across six sessions, including: maximal dynamic strength (1RM) in the bench press, bench press power at three intensities (30%, 60%, and 90% of 1RM), seated medicine ball (MB) throw, BPU variations (Standard, Kneeling, and Drop-fall), and the countermovement jump (CMJ). Ball velocity was quantified via 2D kinematic analysis (240 fps) using Kinovea software.ResultsStrong to very strong correlations were observed between bench press variables and throwing performance. The JT showed the most robust associations with 1RM (ρ = 0.842) and peak power at 60% of 1RM (ρ = 0.846). Conversely, the ST correlated more significantly with light-load variables at 30% of 1RM (mean acceleration: ρ = 0.748). The Standard Ballistic Push Up (BPU) and CMJ emerged as significant predictors specifically for the JT (ρ = 0.734 and ρ = 0.748, respectively). Unexpectedly, the seated MB throw showed negative correlations with ball velocity.ConclusionThe findings suggest that JT performance depends on force production at moderate-to-high intensities, while ST is more closely associated with high-velocity, low-resistance capacities. The bench press and BPU are valid and practical functional indicators for monitoring and individualizing strength and power training in handball athletes.
BackgroundExercise and sleep are modifiable behaviors related to adolescent mental health, but the relevance of specific exercise-frequency categories, participant session duration, and nonlinear sleep duration remains uncertain.MethodsWe analyzed 2,861 adolescents aged 10–19 years from the 2022 China Family Panel Studies. Survey-weighted regression incorporated individual weights, strata, and primary sampling units. Exercise frequency, any exercise participation, participant session duration, and spline-modeled sleep duration were examined in separate models with continuous eight-item Center for Epidemiologic Studies Depression Scale (CES-D8) scores as the primary outcome.ResultsCES-D8 scores differed across exercise-frequency categories (p = 0.002), but the pattern was not monotonic. The largest adjusted difference was observed for once-daily exercise vs. never exercising (B = −1.08; 95% CI, −1.62 to −0.53). Any exercise participation was associated with a modestly lower score (B = −0.57; 95% CI, −1.01 to −0.12), whereas session duration among 2,167 exercise participants was not associated with CES-D8 scores (B per 30 min = 0.004; 95% CI, −0.16–0.17). Sleep duration was nonlinearly associated with CES-D8 scores (overall p < 0.001; nonlinearity p = 0.004); relative to 8 h, scores were higher at 6 h (B = 1.03; 95% CI, 0.55–1.51) and 7 h (B = 0.53; 95% CI, 0.30–0.76). Sensitivity analyses were broadly consistent, and multiple-imputation estimates for exercise participation, exercise-frequency contrasts, and sleep-duration contrasts were similar to the complete-case estimates.ConclusionExercise frequency and sleep duration were modestly associated with depressive-symptom scores, whereas participant session duration showed no clear association. The cross-sectional findings do not establish causality or support a specific exercise prescription.
IntroductionPhysical literacy is a multidimensional construct that integrates physical competence, daily behavior, motivation and confidence, and knowledge and understanding; however, the interpretation of assessment scores may vary across sociocultural contexts. This study aimed to develop age- and sex-specific reference values for the Canadian Assessment of Physical Literacy, second edition (CAPL-2), in Colombian schoolchildren aged 8-12 years.MethodsA cross-sectional multicenter sample of 843 children from the six geographical subregions of Colombia was assessed using the Colombian Spanish adaptation of the CAPL-2. Generalized additive models for location, scale, and shape were fitted separately by sex to estimate smoothed percentiles for the total score and four domains, with age modeled continuously in the location (μ) and scale (σ) parameters. Empirical percentiles were also calculated for selected physical assessment components, and the percentile positions of the original interpretive categories were examined.ResultsPhysical Competence and total scores increased with age and were generally higher in boys, whereas Motivation and Confidence showed greater stability, particularly among boys. Daily Behavior and several physical assessment components also showed higher values in boys, while Knowledge and Understanding showed comparatively small age- and sex-related differences. Importantly, the official interpretive categories occupied markedly different percentile positions across domains.DiscussionThese findings provide contextual reference values that complement the original classification system and allow CAPL-2 performance to be interpreted relative to children of the same age and sex within a geographically diverse Colombian reference sample, without constituting diagnostic thresholds or nationally representative norms.
The integration of artificial intelligence (AI) and genomics in sports science has immense potential in the field by enabling personalised, predictive, and data-driven approaches to enhance athletes' performance and mitigate injury risk. Traditional training models based on generalised protocols may overlook individual variations in training adaptation, recovery, and injury susceptibility. Recent breakthroughs in genomics, wearable technologies, multi-omics profiling, and machine learning have produced new possibilities for precision sports medicine. This review explores the molecular and physiological foundations of athletic performance, highlighting the influence of key genetic polymorphisms, such as ACTN3, ACE, PPARGC1A, and collagen-related genes, on endurance, strength, metabolism, and injury vulnerability. The review additionally analyses the use of AI technologies, including machine learning, deep learning, predictive analytics, and systems biology approaches, in analysing complex physiological, biomechanical, and genomic datasets. The applications of AI-driven individualised training, nutrigenomics, biomarker-guided recovery, wearable sensor technologies, and injury prediction models are thoroughly reviewed. The integration of genomics with AI-driven predictive algorithms may support athlete classification, training optimisation, and assessment of fatigue and musculoskeletal injuries through polygenic risk score and multi-omics analysis. Concerns regarding ethics and legality related to genetic privacy, data security, discrimination, and the misuse of genome technology in sports are also highlighted. Although significant obstacles such as limited reproducibility, small sample numbers, population bias, and difficulties in data integration remain serious limitations, future developments in single-cell omics, digital twins, and real-time biosensing technologies may further contribute to precision sports science and personalised athlete management.
Carbon plate running shoes (CPRS) have significantly advanced running shoe technology, but their orthopaedic impact remains controversial. Remarkably, most running-related overuse injuries affect one leg only, although running is generally considered a symmetrical physical activity. Therefore, this study examined whether CPRS affect biomechanical loading and between-leg symmetry. Twenty-two trained amateur triathletes (13 men and 9 women) participated in a two-day trial. On day 1, ventilatory thresholds (VT1 and VT2) were determined through incremental treadmill testing. On day 2, participants completed five 3-min running trials at three different speeds [90% vVT1, 0.5(vVT1 + vVT2), and 100% vVT2] while wearing four different CPRS models, and their own non-CPRS. Inertial measurement units recorded time-continuous tri-axial tibial accelerations. Results show that peak tibial accelerations and, in parts, also residual shock varied across CPRS models (p < 0.021), but lateral asymmetry remained unchanged (p > 0.361). Interestingly, the findings varied between sexes and exhibited substantial inter-individual effects. These results suggest that increased injury rates possibly associated with CPRS might not be due to altered between-leg asymmetry, but perhaps because of other factors involving residual shock and/or tibial loading patterns during stance phase. Future research should explore these effects across a broader range of CPRS models.
IntroductionIt's important to maintain high propulsive velocity and to avoid severe velocity loss during power-aimed resistance exercises. However, it is hard to measure velocity loss in a timely manner without special devices. This study examined the validity of using ratings of perceived exertion (RPE) as velocity loss marker in power back squat (BS) with different repetition settings.MethodsSeventeen trained males performed three BS tasks with low, medium, and high repetitions at 65% of their one-repetition maximum. RPE, surface electromyography, and concentric velocity were assessed across all conditions. Peak root mean square (RMS) and median frequency (MDF) were calculated from the surface electromyography data.ResultsSignificant effects were observed across experimental conditions for average RPE and average velocity loss, (p < 0.001), while no significant difference was found in average RMS and MDF. As the lifting tasks progressed, significant effects of repetition were observed in RPE, RMS, and MDF (all p < 0.001). When comparing conditions, significant differences were found among the three in RPE and velocity loss (p < 0.001), whereas no significant effect of condition was observed in RMS and MDF.DiscussionRPE was a significant predictor of velocity loss within individuals (p = 0.002), and this relationship could be expressed as an RPE of 3.8 for a 10% velocity loss. These findings indicate a device-free reference that can be incorporated into established RPE-based autoregulation of velocity loss threshold during power BS at moderate load.
The relationship between regional scientific investment and international competitive achievement in handball has never been systematically examined. This scoping review addresses that gap by providing the first globally contextualised synthesis of contemporary handball research, drawing on 205 DOI-indexed, peer-reviewed, English-language studies published between 2020 and 2026 and identified through a PRISMA 2020-compliant search of four major databases (PubMed/MEDLINE, Scopus, Web of Science Core Collection, SPORTDiscus). Evidence was mapped across nine international research regions and six performance-science themes, and a novel Competitive Performance Index (CPI) was constructed from official IHF and EHF records to enable structured comparison between scientific output and senior men's competitive achievement across the same period. Regional analysis reveals four distinct science-performance relationship patterns. Scandinavia (CPI = 40; 16 studies) demonstrates convergence: sustained scientific leadership in injury epidemiology, neuromuscular risk profiling, and load monitoring co-evolves with four consecutive World Championship titles and Olympic gold. The Iberian Peninsula (CPI = 11; 39 studies, the highest volume of any region) and Central-Eastern Europe (CPI = 0; 30 studies) exhibit a leading-indicator pattern, in which scientific investment appears to precede competitive breakthrough by a temporal lag. The German-speaking region (CPI = 7; 28 studies) illustrates how frontier AI-driven performance analytics and youth championship success may function as competitive force multipliers. Western Europe (CPI = 15; 11 studies) demonstrates that strategically concentrated science sustains elite performance without high publication volume. Six thematic pillars structure the evidence base: biomechanics, injury risk and prevention, tactical and match performance, training physiology and conditioning, youth development and maturation, and technology-enhanced analytics. These domains are increasingly interdependent, reflecting a sport entering a phase of genuine scientific maturity. Critical structural gaps persist: approximately 74% of studies are male-only, North America and Oceania are almost entirely absent from the corpus, and the Technology-Enhanced Analytics category (5% of studies) substantially underestimates the true volume of technology-infused research due to the hierarchical classification rule applied. The CPI framework introduced here provides a replicable tool for examining science-performance alignment in handball and, with adaptation, in other team sports.
The importance of identifying the key factors for success in high performance sport has been studied for several years. Although the focus during the competition is on the sporting result, it is important to note that the result in sport is preceded by a series of circumstances and factors closely linked to the context of the athlete's preparation process. Therefore, this study aims to identify the potential factors affecting the high-performance sport in a developing country like Colombia from the perception of high-performance coaches. High-performance coaches (HPC) and high-performance directors (HPD) were asked to answer two questionnaires. Descriptive and factorial analyses were performed to identify the decisive factors. Likewise, a one-way ANOVA between groups was performed to assess whether the responses were significantly different. The principal results showed that more than half of the factors identified by developed countries as determinants of success in high performance sport are perceived as weaknesses within the current high-performance system of the emerging country studied. The factors that emerged from this study were Process, Technical and social support, Structure of sports policies, Competition level, and Contractual conditions. This study identifies some factors that have been limiting or facilitating the results of Colombian athletes in elite sports. It also opened new perspectives of research on the field of HPC and HPD, especially inside Latin America Caribbean region and for developing countries more generally.
IntroductionThe aim of the study was to compare the effects of single-task versus dual-task training on dual-task walking performance, prosthetic-limb kinematics, centre-of-pressure behaviour, and health-related quality of life in adults with transtibial amputation.MethodsForty-five participants undertook an eight-week intervention and were randomly allocated to one of three groups: control, single-task training, or dual-task training. Gait variables were obtained from 3D motion capture and force-plate analysis, while health-related quality of life was assessed using a composite measure derived from the WHOQOL-BREF.ResultsTwo-way mixed ANOVA showed that both single-task and dual-task training produced significant improvements in dual-task walk-performance time compared with the control group (p < 0.0001). Positive training effects were also observed for prosthetic-limb step length (p < 0.001), knee and hip joint range of motion (p < 0.05), and anterior-posterior (p < 0.001) and mediolateral (p < 0.01) centre-of-pressure displacement, with dual-task training producing greater improvements than single-task training across all gait variables. Only dual-task training resulted in significant pre- to post-intervention improvements in participants quality of life (p < 0.0001).DiscussionThese findings indicate that an eight-week programme of single- or dual-task training improves walking capability in individuals with transtibial amputation, reflective in improved gait automaticity and more stable, efficient centre-of-pressure transitions from foot strike to push-off in the affected limb. Dual-task training provides additional benefit, producing greater gains across all gait variables and resulting in a significant improvement in perceived quality of life. Future research should examine the long-term transfer of cognitive-motor training to real-world mobility and participation outcomes.
IntroductionGlobal aging and the growing burden of age-related disease have intensified interest in modifiable biomarkers of biological age. α-Klotho, the product of the KL gene, is a pleiotropic anti-aging protein whose circulating (soluble, s-Klotho) form declines with age and is independently associated with all-cause mortality, sarcopenia, cognitive deficit, and cardiovascular events. We conducted a systematic review and meta-analysis of publications from 2015 to 2025 evaluating the effect of exercise training [aerobic, resistance, high-intensity interval training (HIIT), combined] on circulating α-Klotho in adults, with emphasis on individuals aged ≥60 years and patients with chronic kidney disease (CKD), diabetes, and sarcopenia.MethodsA systematic search of PubMed, Scopus, Web of Science, Cochrane CENTRAL, EMBASE, PEDro, and CINAHL (inception–April 2025) identified randomized and quasi–randomized controlled trials (RCTs) reporting serum or plasma α–Klotho measured by enzyme–linked immunosorbent assay (ELISA). A random–effects model (Hartung–Knapp–Sidik–Jonkman correction) was used; effect size was expressed as Hedges' g or mean difference (MD) with 95% confidence intervals (CI), and heterogeneity was assessed by I2.ResultsFourteen RCTs (n = 893; age range 30–94 years) were included. The pooled effect of chronic training (≥12 weeks) on s-Klotho was Hedges' g = 1.20 (95% CI 0.85–1.55; P < 0.0001; I2 = 84%). In patients with CKD, exercise significantly increased Klotho (MD = 158.82 pg/mL; 95% CI 122.33-194.31; I2 = 0%; P = 0.001) and reduced fibroblast growth factor 23 (FGF23) (MD = −102.07 pg/mL; 95% CI −176.23 to −27.91; I2 = 97%; P = 0.001). Resistance training and HIIT showed the most robust modality-specific effects, whereas combined aerobic-resistance programs were the least reproducible. In pre-frail older adults (n = 69, mean age 77 years), 12-week classical resistance, but not power training, significantly increased s-Klotho.ConclusionRegular exercise, particularly resistance training and HIIT, can be considered a consistent stimulus for increasing circulating α-Klotho across diverse adult populations. Circulating s-Klotho is best regarded as a promising biomarker of the biological response to exercise rather than a validated therapeutic target; the 700–1,000 pg/mL range in adults aged ≥60 years is presented only as an observational reference pending prospective validation.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1415238, PROSPERO identifier CRD420261415238.
This case study describes the physiological adaptations and performance outcomes of a high-intensity interval training in hypoxia (HITH) intervention in a world-class female Paralympic sprinter during her final preparation for the Paris 2024 Paralympic Games. The participant was a Tier 5, T47 national record-holder in the 400 m. Over an approximately 13-week (≈3-month) period leading up to the Games, she performed HITH on a cycle ergometer, generally twice weekly, in a normobaric hypoxic chamber (FiO2 14.5%, ∼3,000 m). Performance was assessed via periodic anaerobic power tests and official 400-m race times, and 3-min post-set blood lactate concentration was measured after each HITH session. Throughout the intervention, no clear improvement was observed in maximal or mean power output during laboratory tests, and the athlete's 400-m time at the Paralympic Games was consistent with her 2023 season best, indicating performance maintenance. During the intervention, 3-min post-set blood lactate during repeated-sprint sessions conducted within a broadly consistent framework showed an overall downward trend (Set 1: ∼21 to ∼18 mmol·L⁻¹) while mean and peak power were maintained or slightly increased. The HITH intervention was not associated with enhanced maximal power or a faster 400-m time; the reduced blood lactate response is interpreted cautiously and, because potential mechanisms were not directly measured, is offered as a hypothesis of altered lactate kinetics rather than a demonstrated adaptation.
IntroductionDifferences in physical activity or perceived quality of life between dog owners and people without a dog were observed previously. However, the differences between dog pet owners and dog owners participating in dog sports are not well analyzed. Therefore, the aim of this study was to assess the differences in quality of life, dog owner relationship, and physical activity in female dog owners participating in dog sports compared with female dog owners with no dog sports history.MethodsA total of 162 women participated in this study (90 women with regular trainings and competitions in dog sports, 72 women with no trainings or competitions in dog sports). All participants completed an online survey consisting of Monash Dog Owner Relationship Scale, The World Health Organization Quality of Life—Brief, and International Physical Activity Questionnaire—Short Form.ResultsResults show a higher Metabolic Equivalent of Task (MET) moderate physical activity in female dog owners participating in dog sports. A significant correlation between dog trainings (minutes per week) and MET vigorous, MET moderate, and MET total was observed, suggesting a contribution of dog sports participation in higher levels of physical activity. Additionally, in female dog owners participating in dog sports, the quality of life correlated with body mass index (BMI) and dog owner relationship.DiscussionThese findings suggest that dog sports may support an active lifestyle among women, and that among women actively involved in dog sports, the perceived quality of life is positively related to the frequency of shared interactions and the overall strength of the dog owner relationship. This aligns with previous evidence that dog-sport competitors are highly driven by intrinsic motivations, such as the enjoyment of shared activities, and strengthening of the human-animal bond. Future research including objective measures of physical activity, and more diverse samples will allow better understanding the health and well-being implications of participation in dog sports.
BackgroundSubacromial impingement syndrome (SIS) is a common cause of shoulder pain and functional limitation in overhead athletes, particularly volleyball players. Although corticosteroid injections provide short-term pain relief and mobilization improves shoulder mechanics, evidence comparing their combined effect with mobilization alone in young athletic populations remains limited, particularly with respect to radiological outcomes.ObjectiveTo compare the effects of corticosteroid injection combined with mobilization versus mobilization alone on pain, shoulder function, range of motion, and radiological outcomes in university volleyball players with SIS.MethodsThis prospective randomized controlled trial included 60 male university volleyball players (18–25 years) with clinically diagnosed SIS. Participants were randomly allocated to receive either a single subacromial corticosteroid injection followed by a standardized mobilization program (n = 30) or mobilization alone (n = 30). Outcomes were assessed at baseline, 4 weeks, 8 weeks, and 6 months and included pain intensity (VAS, primary outcome), pain pressure threshold, shoulder range of motion, and functional disability (SPADI) as key secondary outcomes, and radiological measures (coracohumeral interval, supraspinatus tendon thickness, and subacromial bursa thickness) as exploratory outcomes. Intention-to-treat analysis and effect sizes were calculated.ResultsBoth groups demonstrated significant improvements over time; however, the combined intervention group showed significantly greater and earlier improvements in pain, function, and shoulder mobility (p = 0.001). Pain intensity (VAS) decreased significantly more in the combined intervention group, with a between-group mean difference of 2.6 points at 6 months (95% CI: 2.31 to 2.88), favoring the combined group. Pain pressure threshold increased significantly, with a between-group difference of 25.2 kPa at 6 months (95% CI: 8.6 to 41.8). Between-group differences exceeded minimal clinically important difference values for pain and SPADI, with moderate to large effect sizes. Radiological outcomes demonstrated greater increases in the coracohumeral interval and greater reductions in tendon and bursal thickness in the combined group at 6 months.ConclusionCorticosteroid injection combined with mobilization provides superior and clinically meaningful improvements in pain, function, shoulder mobility, and radiological outcomes compared with mobilization alone in university volleyball players with SIS. This multimodal approach appears effective for managing SIS in high-demand overhead athletes. The imaging findings should be regarded as exploratory and supportive of improved subacromial mechanics rather than as evidence of definitive structural recovery.Clinical Trial Registrationidentifier CTRI/2020/06/025692.
BackgroundHypertension remains one of the leading causes of cardiovascular morbidity and premature mortality worldwide, with blood pressure control rates remaining particularly in low- and middle-income countries. In Morocco, the relationship between physical activity levels and blood pressure control among hypertensive adults remains insufficiently documented. Accordingly, this study aimed to estimate the prevalence of uncontrolled blood pressure and determine whether graded physical activity levels were independently associated with blood pressure control among treated hypertensive adults attending Moroccan primary healthcare center.MethodsA cross-sectional study included 612 treated hypertensive adults consecutively recruited during routine follow-up at a primary healthcare center in Kenitra, Morocco, between July and December 2025. Physical activity was assessed using the validated Moroccan IPAQ. Blood pressure was measured, and was interpreted according to the 2023 European Society of Hypertension recommendations. Multivariable logistic regression adjusted for age, sex, income, family history, smoking, salt intake, waist-to-height ratio, diabetes and dyslipidemia, medication adherence, and antihypertensive treatment. Candidate variables were selected at p ≤ 0.20, multicollinearity was assessed using variance inflation factors, and model calibration was evaluated using the Hosmer–Lemeshow test.ResultsThe mean age of participants was 58.5 ± 11.1 years, and 57.0% were women. Of the 612 participants, 36.1% had low physical activity, 39.1% had moderate physical activity, and 24.8% had high physical activity. Overall, 66.0% had uncontrolled blood pressure. Compared with low physical activity, moderate physical activity was associated with 51% lower odds of uncontrolled blood pressure (AOR = 0.49; 95% CI: 0.31–0.77), whereas high physical activity was associated with 69% lower odds (AOR = 0.31; 95% CI: 0.18–0.52). Higher odds of uncontrolled blood pressure were observed among participants aged >60 years, current smokers, those with an elevated waist-to-height ratio or high salt intake, and those with combined diabetes and dyslipidemia.ConclusionGreater physical activity was linked to more favorable blood pressure control among treated hypertensive adults in Morocco. These findings highlight the potential relevance of physical activity to improve cardiovascular outcomes in Morocco.
