Esports performance relies on in-game, cognitive, and physiological capacities. Its growing professionalization has led to increasing interest in structured out-of-game training interventions as part of performance-support strategies for elite players. However, the feasibility and effects of such interventions in world-class professional players remain unexplored. The present exploratory ecological study examined the implementation of high-intensity interval training (HIIT) and cognitive-motor training (CMT), together with training-related changes in in-game performance, executive functions, and cardiovascular outcomes, under competitive-season constraints in professional League of Legends (LOL; n = 5) and Valorant (VLR; n = 5) players. Data were collected at the team training facility in Berlin, Germany, between May and July 2024. Both interventions could be implemented during the competitive season, with 100.00
Soccer practitioners routinely use external load (EL), internal load (IL) and fitness measures to monitor players; however, the same monitoring variable may be interpreted as training load (TL), performance, or athlete capacity depending on its purpose and reference. The conceptual problem addressed in this review is therefore not the absence of definitions for EL, IL, or fitness status, but rather the lack of an integrated interpretative structure explaining how these established constructs should be differentiated when evaluating soccer physical performance. This conceptually focused narrative review therefore aims to clarify the distinction between TL, physical performance output, physiological response, and athlete fitness capacity, and to integrate these established concepts within an interpretative framework for soccer training and monitoring. The framework does not propose match demands, physiological responses, or fitness status as replacements for the established concepts of EL, IL, and fitness. Rather, it organizes their interpretation according to three related questions: what external output did the athlete produce, what physiological response accompanied that output, and what does the relationship between output and response indicate about the athlete’s capacity to perform?. By separating the purpose for which monitoring variables are interpreted, the framework aims to support practitioners in selecting appropriate measures and aligning training prescription with either physiological adaptation targets or the external performance demands that players are required to reproduce in competition.
Cold-water immersion (CWI) is widely used after strenuous exercise, but review-level findings vary by outcome, comparator, recovery window, population, and protocol. Reuse of the same primary studies across reviews can also exaggerate apparent consistency. We searched PubMed, Web of Science, SPORTDiscus, Cochrane Library, Embase, and Scopus from inception to 30 January 2026 for systematic reviews, meta-analyses, and network meta-analyses of post-exercise CWI. Fourteen reviews were included. Primary-study overlap was quantified using the corrected covered area (CCA) overall and for outcome-specific study-to-review mappings. Because overlap was high and review-level estimates were statistically dependent, we did not perform second-order meta-analysis. Source-verified estimates were synthesized in a structured, overlap-aware format. Methodological quality was assessed with AMSTAR 2. Of the 14 included reviews, 13 provided quantitative estimates, whereas one review provided narrative evidence on heart rate variability (HRV). Overall CCA was 12.68
While long-term psychosocial health in football players has been extensively studied, little is known about cognitive and mental health during early sport retirement. This study examined the association between football participation factors and self-reported cognitive and mental health among recently retired collegiate players. Participants in the Concussion Assessment, Research, and Education (CARE) Consortium (n = 627; mean age = 25.0 ± 1.7) completed surveys across 26 United States universities (2014–2021) within 5 years of collegiate exit. Measures included Quality of Life in Neurological Disorders—Cognitive Domain (Neuro-QoL), Patient Health Questionnaire (PHQ-9), SF-12 Mental Component Summary (MCS), and Satisfaction with Life Scale (SWLS). Univariate and multivariable regression models evaluated the effects of lifetime concussion history, playing position, and years of football participation on outcome scores. Proportions exceeding clinical score thresholds were also compared across exposure groups. Per univariate analyses, participants reporting three or more concussions had significantly worse scores across all instruments than those without concussion history, and a higher proportion exceeded clinical thresholds for all measures except life satisfaction. In adjusted models, the 3+ concussion group endorsed higher PHQ-9 scores than the non-concussion group (B: 1.53, SE: 0.52, p = 0.014). An interaction between position and concussion was observed for Neuro-QoL scores, with agility players reporting lower scores than hybrid players in those with 1–2 concussions. Greater lifetime concussion history was associated with poorer self-reported psychosocial health among recently retired collegiate football players. Targeted clinical screening and early intervention may benefit those with multiple concussions as they transition to post-athletic careers.
Abstract Background Interlimb asymmetries (ILA) have been associated with an increased risk of injury and decreased athletic performance. However, despite the growing number of training interventions targeting ILA, their comparative effectiveness relative to general strength and conditioning approaches has not yet been systematically reviewed. Objective This systematic review aimed to compare the effectiveness of asymmetry-focused training interventions versus general training programs in reducing ILA and improving physical performance in athletic populations. Specifically, it sought to compare individualized training programs that first identify the weaker limb during pre-testing and subsequently prescribe a greater training stimulus to that limb with general training protocols that apply the same training stimulus to both limbs, as well as unilateral approaches with bilateral training strategies. Methods Following PRISMA 2020 guidelines, a systematic search was conducted in Web of Science, PubMed, and SPORTDiscus up to April 2025. Eligible studies involved healthy athletes (aged 12–30 years) who completed ≥4-week lower-limb training interventions that either applied a greater stimulus to the weaker limb (e.g., starting sets with the weaker side or adding volume) or used unilateral training approaches that applied the same training stimulus to both limbs regardless of baseline ILA values. To be included, studies were required to assess both pre-to-post changes in ILA and at least one physical performance outcome. The risk of bias was assessed using a modified Cochrane tool. Results Eleven studies comprising 297 athletes met the inclusion criteria. Reductions in ILA were more consistent in asymmetry-focused and unilateral training groups compared to general and bilateral training groups, respectively. Most interventions also led to improvements in physical performance, with asymmetry-focused and unilateral protocols typically producing greater gains in single-limb tasks, although bilateral training showed more favourable effects in bilateral tasks. However, variability in training protocols and outcome measures across studies limits the generalizability of these findings. Conclusion Asymmetry-focused strategies, such as starting unilateral exercises with the weaker limb or increasing its training volume, appear to be more effective for reducing ILA than non-individualized unilateral training. These approaches are practical, safe, and potentially beneficial in athletic settings. However, further high-quality research is needed to confirm their superiority over non asymmetry-focused unilateral or bilateral training and to establish clear guidelines for their implementation. Registration PROSPERO-CRD420251023232.
