Blood flow restriction (BFR) induces hypoxic and metabolic stress, which may alter afferent feedback and neuromuscular control. However, its acute effects on ankle sensorimotor function remain unclear. The aim of the study was to investigate the acute effects of lower-limb BFR on multidimensional ankle sensorimotor function in healthy adults. Twenty-four participants (12 females, 12 males) completed two conditions in randomized order and a crossover design: BFR at 60% arterial occlusion pressure (AOP) and a control condition (20 mmHg). All measurements were performed during occlusion. Outcomes included joint position sense (active and passive), kinesthesia, static and dynamic balance, lower-limb muscle activation (surface electromyography), and muscle reaction time during sudden ankle inversion. BFR impaired active joint position sense at 20 degrees of inversion (p = 0.011), with no changes at other angles or in kinesthesia. Static balance deteriorated, with increases in sway area (p = 0.017), sway distance (p = 0.029), and sway velocity (p < 0.001), particularly under eyes-closed single-leg stance. Posterolateral reach distance decreased (p = 0.023), accompanied by reduced lower-limb muscle activation. Tibialis anterior muscle reaction time during 30 degrees of inversion in the ankle neutral position was shortened (p < 0.001), whereas peroneus longus muscle responses were unchanged. Acute lower-limb BFR impairs ankle sensorimotor control by reducing proprioceptive accuracy, balance performance, and muscle activation, while shortening reaction time. These findings suggest caution when applying BFR during tasks that require high postural demands or end-range control. Registration number and date: NCT07307339, 12/26/2025.
Cardiac strain and myocardial work indices may provide additional information for performance stratification beyond traditional physiological assessments in martial arts, but their relevance to anaerobic and neuromotor performance remains insufficiently defined. This cross-sectional observational predictive modeling study assessed whether echocardiographic myocardial efficiency indices were associated with performance classification among national-level martial artists. A total of 180 athletes were assessed, and the primary comparative analysis used the top and bottom tertiles of a composite performance score to define higher-performance athletes and a lower-performance internal reference group, respectively, rather than a non-athlete control group. Echocardiographic indices included global longitudinal strain (GLS), global work efficiency (GWE), global wasted work (GWW), and myocardial performance index (MPI). Performance outcomes included Wingate anaerobic power, agility time, reaction time, Balance Error Scoring System (BESS) errors, and Finger-to-Nose Alternation Test (FTNAT) coordination. Higher-performance athletes showed greater peak power than the lower-performance reference group (11.7 ± 1.3 vs. 9.3 ± 1.2 W/kg, p = 0.002), faster agility time (9.0 ± 0.7 vs. 10.6 ± 0.9 s, p = 0.001), and higher technical execution scores (8.4 ± 1.0 vs. 5.6 ± 1.4, p = 0.001). GLS magnitude was greater across myocardial segments, GWE was higher (96.8% vs. 92.1%, p = 0.002), and GWW was lower (9.4% vs. 13.2%, p = 0.003). GLS and GWE were associated with group classification in regression models, while lower MPI values were associated with shorter agility times and fewer balance errors, indicating better performance direction for both outcomes. These findings suggest that cardiac strain and myocardial work indices are associated with anaerobic and neuromotor performance in martial artists; however, longitudinal validation is required before these measures can be considered predictive markers for talent identification or training decisions.
The half-time period in soccer provides a potentially important window to implement short-duration interventions aimed at maintaining second-half performance. However, passive rest has been associated with a decline in subsequent physical and technical performance. While re-warm-up strategies are well studied, little is known about the efficacy of technology-based, passive recovery modalities, device-supported interventions that require minimal active movement or physical exertion from the athlete, during half-time intervals. This study examined whether percussive therapy, electrical muscle stimulation, and pneumatic compression can mitigate second-half performance decline in male adolescent soccer players. Forty-three academy-level players (17.5 ± 0.6 years) completed a simulated soccer protocol including the Loughborough Soccer Pass Test (LSPT), repeated 20-meter sprints, and completed Total Quality of Recovery (TQR) assessments before and after half-time. Participants were randomized into one of four intervention groups during the 15-minute half-time interval: Passive Rest (CON), Percussive Therapy (Theragun Pro; TG), EMS (PowerDot; PD), and Pneumatic Compression (RecoveryAir; COMP). Linear mixed-effects models assessed Time × Condition interactions for performance and recovery outcomes. Passive half-time rest led to significant deterioration in technical skill, sprint performance, and perceived recovery (p < .05) for the control group. TG and PD significantly improved technical performance (LSPT scores) compared to the control group (d = 0.65 and 0.72, respectively; p < .01). Furthermore, TG and COMP were effective at maintaining 20-meter sprint times (d = 0.58 and 0.49; p < .01), whereas the control group experienced significant slowing. Perceived recovery (TQR) scores significantly declined in the CON group from First Half to Second Half (16.5 ± 2.2 to 11.1 ± 2.3. However, this decline was significantly attenuated in all intervention groups: TG (17.5 ± 1.9 to 14.2 ± 1.9), PD (17.3 ± 1.9 to 15.1 ± 1.9), and COMP (17.6 ± 1.9 to 15.9 ± 2.0). Short-duration passive interventions during half-time can mitigate performance decline in adolescent soccer players. TG and EMS appear most effective for preserving technical skills, while COMP may support perceived recovery. These findings highlight practical strategies for optimizing in-game performance and inform evidence-based half-time protocols.
Landing tasks are a major contributor to knee injuries in sport. While biomechanical determinants of knee joint loading have already been studied, less attention has been given to the role of inter-segmental timing during sport-specific landings. This study aimed to examine both biomechanical and temporal predictors of knee joint loading during horizontal and vertical phases of stop-jump landings. Thirty-three male volleyball and basketball players performed stop-jump tasks while lower-limb kinematics, kinetics, patellar tendon forces, and anterior tibial shear forces were calculated. Statistical Parametric Mapping and Linear Mixed Models were used to identify phase-specific differences and predictors of knee loading. Inter-segmental timing, quantified as foot-contact delay between body segments, emerged as a significant predictor of knee joint loading across conditions. This finding extends previous work by highlighting inter-segmental timing as an additional factor influencing knee joint loading alongside established biomechanical predictors such as displacement velocity, body mass, and knee range of motion. Horizontal landing phases showed a stiffer strategy compared to vertical phases, with reduced joint range of motion (40-83%) and increased knee valgus. These differences were associated with higher anterior tibial shear (121%) and patellar tendon (156%) forces. These results may be particularly relevant in sport situations where landings are not fully planned and can be altered by external perturbations such as opponents' deceiving actions.
To evaluate the effects of aerobic exercise (AE) versus resistance training (RT) on cardiometabolic health-related outcomes in patients with type 2 diabetes mellitus and concurrent obesity (diabesity). Systematic review and meta-analysis of randomized controlled trials (RCTs). PubMed, Web of Science, Scopus, ScienceDirect, Cochrane Library, and Google Scholar databases were searched from inception up to April 2026. RCTs comparing AE and RT for a minimum duration of two weeks. Participants were adults with diabesity. A total of 23 RCTs qualified, involving 1, 184 patients (58/42 women/men ratio; age range: 30-70 years; body mass index: 32.1 ± 6.6 kg/m2). AE appears to be more efficacious than RT in reducing fasting blood glucose (mean differences (MD) = -0.89 mmol/L, 95% CI: -1.62 to -0.16; I2 = 0%) and increasing cardiorespiratory fitness (MD = 1.78 mL/kg/min, 95% CI: 0.38 to 3.18; I2 = 66%). However, AE led to a greater increase in body fat (MD = 0.34%, 95% CI: 0.10 to 0.57; I2 = 1%) and less fat-free mass retention (MD = -0.86 kg, 95% CI: -1.46 to -0.26; I2 = 37%) compared with RT. For selected cardiometabolic health-related outcomes, including anthropometrics, blood lipids, and hemodynamics, no statistically significant between-group difference was detected. The overall certainty of the evidence across outcomes ranged from high to very low, with most being moderate. In adults with diabesity, AE appears to provide greater benefits for FBG and CRF, whereas RT appears more favorable for preserving FFM and improving BF. For the majority of cardiometabolic outcomes, the two modalities exhibit analogous effects. The present findings support a goal-directed and complementary approach to exercise prescription, as opposed to a one-modality-fits-all model, for the improvement of cardiometabolic health in patients with diabesity.
