Understanding the direct relationship between skeletal muscle mass and strength in athletes is paramount for optimizing performance. Such a relationship has been poorly investigated in soccer players. In this work, a large number (n = 225) of elite soccer players aged 14-37 years had whole-body (WB) and regional skeletal muscle mass (SMM) estimated from Dual-energy X-ray absorptiometry (DXA) scans, together with maximal isokinetic strength of several muscle groups. Results showed a statistically significant (p < 0.001) correlation between limb SMM or muscle strength and body mass (r = 0.84-0.86; r = 0.61-0.97, respectively) and stature (r = 0.58-0.64; r = 0.61-0.93, respectively), whereas the relationship with age was much more variable. A statistically significant (p < 0.001) correlation was found between SMM and muscle strength across all muscle groups (r = 0.55-0.80). Linear regression showed that SMM explained 30% to 64% of the variance in muscle strength. ANOVA showed that playing position had a statistically significant effect (p < 0.001) on all SMM and muscle strength values. Playing position had a significant effect on relative (normalized per-limb SMM) muscle strength during knee and ankle flexion. This work showed that DXA-measured skeletal muscle mass is associated with the strength of several limb muscle groups in soccer players. This association is of variable strength across muscle groups and is partially modulated by playing position.

Background/Objectives: The relationship between body composition (BC), sarcopenia, and multiple sclerosis (MS) remains poorly understood. A high body mass index (BMI) is associated with a higher risk of MS and brain atrophy. However, limited data are available on BC in patients in the early stages of the disease. This study investigates differences in BC and sarcopenia between early-diagnosed patients with MS (pwMS) and healthy controls (HC), while exploring correlations with brain atrophy and biomarkers of oxidative stress and axonal injury. Methods: This project is part of BPS-ARMS, a cross-sectional study conducted in 2019-2022 at Verona University involving 51 participants aged 18-40 years, diagnosed with MS in the last two years, and currently not taking disease-modifying drugs. Seventeen (69% females) pwMS consented to be enrolled in this sub-study, matched by age and body mass index (BMI) to 17 HC; BC was assessed using Dual-Energy X-ray Absorptiometry (DXA). Collected variables included BMI, fat and lean mass, and sarcopenia index (SI). A brain MRI scan was performed in pwMS between 6 months before and 1 month after inclusion, to assess T2 lesion, normalized brain (NBV), white matter (WMV) and gray matter (GMV) volumes, and presence of gadolinium-enhancing (Gd+) lesions. Biomarker analysis was performed on blood samples collected at baseline. Oxidative stress was assessed as plasma gluthatione (GSH) and gluthatione disulphide (GSSG) levels and STAT1 phosphorylation at Tyr 701 (pSTAT) in peripheral blood cells, while axonal damage was measured as serum neurofilament light chain (NfL) levels. Results: A significantly lower SI was found in pwMS compared to HC (p = 0.038), particularly in female cases. In the pwMS group, WMV was inversely correlated with SI (p = 0.028) and lean body mass (p = 0.016). BMI was inversely correlated with WMV (r = -0.658, p = 0.02). A significant inverse correlation of plasma GSSG level was found with SI (r = -0.546, p = 0.023) and lean mass (r = -0.585, p = 0.014); the ratio of GSH over GSSG (GSH/GSSG) was directly correlated with SI (r = 0.518, p = 0.036) and lean mass (r = 0.568, p = 0.017). Conclusions: Patients with early-stage untreated MS and low-grade disability are more prone to sarcopenia than HC. Moreover, MS subjects with higher BMI show lower brain white matter volume and a lower global brain volume.

The authors advance a situated internalism for adapted sport by linking genealogical analyses of power to the broad internalism value. Constraints are judged not only by what they forbid or allow, but by how they stage a meaningful trial. Call this challengeability: rules are challengeable when they calibrate uncertainty, secure non-dominating reciprocity and embed intrinsic adversity, protecting skill-dependence, fair mutual challenge, and striving and resilience. Extending Elster, the authors distinguish Fundamental Hard (constitutive), Contextual Hard (classification, equipment, comparability) and Soft constraints. Genealogically these devices produce subjects; internally the authors assess their contribution to practice goods and the lived quality of the trial, with cases and governance cues on sustaining excellence without oppression or spectacle.

To investigate the limb-specific blood flow regulation during dynamic bilateral cycling exercise in individuals with traumatic single lower-limb amputation compared to a control group. Seven individuals with single lower leg amputation (AMP) (37 ± 11 years, 11 ± 8 years since amputation) and 7 age-matched controls (Ctrl) (36 ± 10 years) were tested during three 5 min constant workload exercise at 60W, 100W, and 80 V̇ O2), ventilation ( V̇_E ), mean arterial pressure (MAP), heart rate (HR), and cardiac output (CO) were also quantified. AMP exhibited lower FBF in AL compared to WL (60W, − 61 V O2 (p = 0.241), V̇_E (p = 0.124), MAP (p = 0.186), HR (p = 0.360), and CO (p = 0.144) at any workload was detected. Individuals with amputation present considerable limb-specific blood flow regulation during bilateral cycling exercise. Understanding the mechanisms for this interlimb difference may provide important information to improve rehabilitation and training in this population.

Background/Objectives: Exercise and nutrition may be useful strategies in dynapenic and sarcopenic obesity management, but the identification of treatment modalities aimed at improving this condition is still lacking. We compared the effect of a five-month hypocaloric diet plus resistance training (RT) with and without essential amino acids (EAAs) on body composition, physical performance, and muscle strength among older adults with dynapenic obesity (DO). Methods: Older individuals (n = 48) with DO [(BMI ≥ 30 kg/m2 and/or high waist circumference and low handgrip strength (HGS)] were randomized into two double-blind groups (RT without EAAs vs. RT+EAAs). All participants followed a hypocaloric diet (1 g of proteins/kg spread over three meals) and RT for five months. Pre- and post-intervention assessments included the body composition (DXA), Short Physical Performance Battery (SPPB), HGS, one-repetition maximum (1-RM), and maximal isometric torque with an isokinetic dynamometer. Results: Both groups reduced body mass (RT: −4.66 kg; RT+EAAs: −4.02 kg), waist circumference (RT: −4.66 cm; RT+EAAs: −2.2 cm), total fat mass (RT: −3.81 kg; RT+EAAs: −3.72 kg), and compartmental fat mass with no between-group differences. Both groups improved 1-RM strength (33–47%), isometric torque for body mass (RT: 14.5%; RT+EAAs: 10.6%), and functional performance (chair stand (RT: −3.24 s; RT+EAAs: −1.5 s) and HGS (RT: −2.7 kg; RT+EAAs: 2.9 kg)) with no between-group differences. Conclusions: A moderate hypocaloric diet combined with RT improves body composition and physical function in DO participants, but EAA supplementation did not provide additional benefits.

This article explores the concepts of power as articulated in the philosophies of Nietzsche and Spinoza, applying them to the context of adapted sport for athletes with physical disabilities. Nietzsche's notion of the will to power emphasizes surpassing limits and continuous creative self-overcoming, whereas Spinoza's concept of conatus focuses on self-preservation and the enhancement of one's power to act. To narrow the scope and enable an in-depth analysis of the relationship between power and physicality, this study specifically addresses physical disabilities, deliberatery excluding both sensorial and intellectual disabilities. The primary aim is to investigate how these philosophical perspectives can illuminate the subjective experience of physical empowerment and identity formation in athletes with disabilities. The study argues that adapted sport provides a space in which athletes can achieve existential transcendence and self-affirmation by combining rational self-knowledge, inspired by Spinoza's philosophy, with the Nietzschean drive to continually trascend bodily limitations. Through this theoretical synthesis, adapted sport is portrayed as a tangible sphere of personal transformation, growth, and redefinition of bodily potential.

Background: Body composition in athletes is characterized by pronounced muscle mass and low body fat (BF). Over and excessive adiposity are thus expected in athletes at higher body mass index (BMI) levels than those suggested by the World Health Organization (WHO). Therefore, we aimed to test the validity of WHO BMI cut-off points for overweight and obesity, respectively (i.e., ≥25 kg/m2 and 30 kg/m2) in young male athletes from different sport disciplines in Italy. Methods: This study includes 622 male young adult athletes of mean age 25.7 ± 4.7 years who were initially categorized according to the WHO BMI classification, and then re-categorized by adiposity status based on total BF% as measured by dual-energy X-ray absorptiometry (DXA). A predictive equation has been developed utilizing multivariable model-building to predict the best BMI cut-offs for identifying overweight and obesity in this population. The agreement between the different classification systems was assessed with the kappa statistic (κ). Results: According to the WHO BMI classification, 451 (72.5%) individuals were of normal weight, 148 (23.8%) were with overweight and 23 (3.7%) were with obesity, but based on the total BF%, 598 (96.1%) were of normal weight, and only 19 (3.1%) were with overweight and 5 (0.8%) were with obesity, revealing a weak agreement between the two classification systems (WHO BMI vs. BF%; κ = 0.169). On the other hand, new BMI cut-off points were identified (BMI ≥ 28.2 kg/m2 for overweight and 33.7 kg/m2 for obesity) and showed good agreement with the BF% classification system (κ = 0.522). Conclusions: The currently used WHO BMI cut-offs are not suitable for determining weight status in young male athletes, and since the newly proposed ones demonstrated a good performance, these should be implemented in new guidelines.

Background/Objectives: In recent years, awareness has been growing regarding the needs of female athletes with physical impairments. Despite the importance from both health and performance perspectives of assessing body composition in this athletic population, there is limited literature focusing on this topic. This study explored whole-body and regional three-compartment body composition in female athletes with a physical impairment to assess the impact of impairment and sex on body composition parameters in this population. Methods: Twenty female athletes with a physical impairment were pair-matched by age with an able-bodied female athlete and a male athlete with a comparable physical impairment. All athletes underwent whole-body scanning with dual-energy X-ray absorptiometry. Results: Female athletes with physical impairments showed body composition changes including higher amounts of fat mass, particularly in the lower body regions. Among athletes with a physical impairment, sex showed an independent effect on whole-body composition, with females showing higher fat mass and lower lean mass and bone mineral content compared with males, especially in the legs. Conclusions: Female athletes with physical impairments had a distinct body composition profile, characterized by sex-specific distribution of body tissue at the regional level. Nutritional and training strategies aimed at optimizing body composition in female athletes with physical impairments should be specifically tailored to meet the needs of this athletic population.

Background/Objectives: Disordered eating (DE) is a wide-spectrum condition, represented by altered eating patterns, behaviors, and attitudes aimed at controlling food intake, body weight, and shape, which does not necessarily satisfy the diagnostic criteria for an eating disorder of clinical severity. DE is frequently reported among athletes, but its prevalence and associated factors have not been fully elucidated. In this study, we intended to assess the prevalence of DE among adult athletes from different sports disciplines in Italy and Lebanon and to identify the factors associated with DE. Methods. A validated questionnaire (Eating Attitude Test [EAT-26]) was administered to determine the prevalence of DE, which was indicated by a score ≥ 17. Sport-related information, such as the type of sport, level of competition, training volume, and years of athletic experience, was also collected. Results: Among the total sample of 881 athletes, 78 were identified as having DE, with a prevalence of 6.1% (7.8% of females and 4.9% of males) in Italian athletes and 21.3% (27.3% of females and 17.0% of males) in Lebanese athletes. In addition, among male athletes, the risk of having DE was more than threefold in those practicing weightlifting or bodybuilding (odds ratio [OR] = 3.23; 95% confidence interval [CI] = 1.03–10.08, and p < 0.05), while females with more athletic experience had almost 10% less risk of having DE (OR = 0.92; 95%CI = 0.86–0.98, and p < 0.05). Conclusions: DE is a prevalent condition among athletes. Therefore, it is crucial that sports federations and committees consider adopting standardized practical guidelines that focus on routinely screening for the early identification of DE in this population and implementing strategies for its timely management. In the future, longitudinal studies are also needed to clarify the impact of DE on athletes’ clinical condition as well as their physical fitness and sports performance.

This article proposes an interpretation of pain in Paralympic sport through the lens of the Promethean paradigm as an anthropological and symbolic key for conceptualizing the human condition as structurally non-finite. Drawing on the thought of Nietzsche and Gehlen, it is argued that pain, when consciously embraced in competitive practice, constitutes a transformative gesture of ontological nature: a creative act of subjectivation that, rooted in limitation, expresses the human projective tension. The reflection unfolds through a dialogue between classical myth, philosophical anthropology, and ethnographic insights from Paralympic practice. This context is chosen because it makes visible, in a particularly clear way, how athletes transform vulnerability and suffering into resources for self-formation. The athletic gesture does not merely appear as adaptation, but as an expression of the possibility to shape one's vulnerable body, transforming suffering into a language of the self. The categories of learning-through-suffering (p & aacute;thei m & aacute;thos) and embodied practical intelligence (m & eacute;tis) are proposed as hermeneutic tools to understand action within limitation as a performative and transformative gesture. Finally, an educational reflection is opened: a pedagogy of non-finitude capable of valuing formative pathways that, beyond performance, are grounded in creativity, relationality, and presence. From this perspective, the Promethean gesture is not solely athletic: it is any gesture wherein the human being seeks to bring a form into existence.

Background/Objectives: The body mass index (BMI) is considered a key method for the classification of individuals’ weight status, according to cut-off points proposed by the World Health Organization (WHO); however, the use of this classification is still the subject of debate and criticism. We aimed to evaluate the accuracy of the WHO BMI classification in reflecting true adiposity in the Italian general population. Methods: This cross-sectional study included 1351 adults of mixed gender aged between 18 and 98 years, comprising 19 (1.4%) underweight individuals, 787 (58.3%) normal weight, 354 (26.2%) overweight, and 191 (14.1%) with obesity according to the WHO BMI. After that they were re-categorized according to adiposity based on body fat percentage (BF%) measured by dual-energy X-ray absorptiometry (DXA). The agreement between the two classification systems was tested using the kappa statistic (κ), with the system based on BF% being considered the gold standard. Results: According to the BMI classification, 78.1% of the individuals who were in the normal weight range were correctly classified. However, 53.4% of the overweight group and 68.4% of the underweight group were misclassified according to the BMI, as the majority of those misclassified fell within the normal weight range according to their BF%. Finally, regarding the obesity group, 34% who were classified as having obesity according to the BMI were misclassified, since they were revealed to be only affected by overweight according to adiposity status. Conclusions: Despite the fact that the BMI seems to be reliable in determining body weight status in the normal weight range, over a third of the general population was misclassified, as the current BMI classification appears to inflate the prevalence of underweight, overweight, and obesity among the general population. Accordingly, this may warrant consideration of revising the National Guidelines in Italy related to weight status classification. Healthcare practitioners should be advised not to rely solely on the BMI, and should integrate its use with adiposity measures (i.e., BF%) or alternative surrogate indicators (i.e., waist-based) in routine evaluations, especially in those with a BMI below or above 18.5 kg/m2 or 25 kg/m2.

Background: Dietary advice for Paralympic athletes (PAs) with a spinal cord injury (PAs-SCI) requires particular attention and has been widely studied. However, currently, no particular attention has been addressed to nutritional guidelines for athletes with an amputation (PAs-AMP). This study aimed at filling up this gap, at least partially, and compared veteran PAs-SCI with PAs-AMP. Methods: A sample of 25 male PAs (12 with SCI and 13 with AMP), recruited during two training camps, was submitted to the following questionnaires: allergy questionnaire for athletes (AQUA), Nordic Musculoskeletal Questionnaire (NMQ), Starvation Symptom Inventory (SSI), neurogenic bowel dysfunction (NBD), orthorexia (ORTO-15/ORTO-7), alcohol use disorders identification test (AUDIT), and Mediterranean diet adherence (MDS). The PAs were also submitted to the following measurements: dietary Oxygen Radical Absorbance Capacity (ORAC) and intakes, body composition, handgrip strength (HGS), basal energy expenditure (BEE), peak oxygen uptake (VO2peak), peak power, peak heart rate (HR), post-exercise ketosis, and antioxidant response after a cardiopulmonary exercise test (CPET) to voluntary fatigue. Results: Compared to PAs-AMP, PAs-SCI had higher NBD and lower VO2peak (p < 0.05), peak power, peak HR, peak lactate, phase angle (PhA) of the dominant leg (p < 0.05), and ORTO15 (p < 0.05). The latter was related to NBD (r = −0.453), MDS (r = −0.638), and ORAC (r = −0.529), whereas ORTO7 correlated with PhA of the dominant leg (r = 0.485). Significant differences between PAs-AMP and PAs-SCI were not found in the antioxidant response, glucose, and ketone levels after CPET, nor in dietary intake, AUDIT, AQUA, NMQ, SSI, BEE, HGS, and FM%. Conclusions: The present study showed that PAs-SCI and PAs-AMP display similar characteristics in relation to lifestyle, energy intake, basal energy expenditure, and metabolic response to CPET. Based on both the similarities with PAs-SCI and the consequences of the limb deficiency impairment, PAs-AMP and PAs-SCI require personalized nutritional advice.

Background: Muscle and bone show reciprocal interactions and are associated in a muscle-bone unit. The muscle-bone unit has been investigated to a very limited extent in soccer players. The objective of this work was to investigate in detail the muscle-bone unit in male youth elite soccer players. Methods: Bone mineral and lean mass were measured with dual-energy X-ray absorptiometry (DXA). The functional muscle-bone unit (fMBU) and the muscle-to-bone ratio (MBR) were calculated from the DXA output in a sample of players aged 14–19 (n = 193) playing in the youth squads of an Italian Serie A team. Results: Statistically significant (p < 0.05) correlations were found between lean mass variables and bone mineral content and density, also after adjusting for age, body mass, stature, maturity, and ethnicity (White/Black). fMBU and MBR were statistically significantly associated with age, body mass, stature, maturity, and ethnicity. Linear regression showed that body lean mass was the strongest predictor for bone mineral content and density. Age was a statistically significant predictor for fMBU and MBR. Playing position did not show any statistically significant relationship with bone mineral content and density, as well as fMBU or MBR. Centiles for fMBU and MBR were calculated as a reference. Conclusions: This work is the first detailed characterization of the muscle-to-bone relationship in soccer players. It is expected to be of use for sport scientists and the wide community of sportsmen and professionals involved in soccer.

This study was designed to support the tactical decisions of wheelchair basketball (WB) coaches in identifying the best players to form winning lineups. Data related to a complete regular season of a top-level WB Championship were examined. By analyzing game-related statistics from the first round, two clusters were identified that accounted for approximately 35% of the total variance. Cluster 1 was composed of low-performing athletes, while Cluster 2 was composed of high-performing athletes. Based on data related to the second round of the Championship, we conducted a two-fold evaluation of the clusters identified in the first round with the team’s net performance as the outcome variable. The results showed that teams where players belonging to Cluster 2 had played more time during the second round of the championship were also those with the better team performance (R-squared = 0.48, p = 0.035), while increasing the playing time for players from Classes III and IV does not necessarily improve team performance (r2 = -0.14, p = 0.59). These results of the present study suggest that a collaborative approach between coaches and data scientists would significantly advance this Paralympic sport.

IntroductionThis study was planned to assess the association between serve efficacy and match outcome, and to investigate which factors are associated with serve efficacy in high-level male and female Sitting Volleyball players.MethodsThe study sample was comprised of a total of 3,664 serving actions, performed during the 2020 Paralympic Games and the 2022 Sitting Volleyball World Championship. For each serving action, we considered serve efficacy (i.e., Point lost, Negative Serve, Positive serve and Point won), serve zone, type of serve technique, target zone of the serve, type of reception, receiving player and match outcome (i.e., match won, or match lost).ResultsThe Mixed-effects logistic regression model showed that serve efficacy is significantly associated with the match outcome, increasing serve efficacy being associated with increased chances of winning the game. The ratio between the probability of winning and losing the game started at 0.86 for a Point lost and increased to 1.67 for a Point won. Compared to Negative serves, Positive serves were associated with a higher probability that the opponent team would use a low reception rather than a high reception. In turn, a low reception was associated with a higher chance (from 45.1% to 58.3%) of the receiving team committing an error in the side-out phase.DiscussionBased on these results, it is recommended that high-level coaches focus on improving their players' serve efficacy by instructing them on managing risk, avoiding serves to the front zone, and reducing the likelihood of overhead receptions.

Background/Objectives: In children, an association exists between muscle and bone, as well as between physical activity and osteogenesis. Impact loading is a factor in increasing bone accrual during growth. In this work, we explored the muscle–bone association in girls exposed to long-term physical activity at different levels of impact loading. Methods: Four groups of girls aged 7–16 were considered. The curricular (C; n = 22) group only had curricular physical activity at school (2 h/w). In addition to curricular physical activity, the girls in the dance (D; n = 21), gymnastics at lower training (GL; n = 14), and gymnastics at higher training (GH; n = 20) groups had 2 h/w, 4 h/w, and 4 h/w < training ≤ 12 h/w additional physical activity, respectively, for at least one year. A visual analysis estimated the respective amounts of impact-loading activity. The bone mineral content (BMC), areal bone mineral density (aBMD), and fat-free soft tissue mass (FFSTM) were assessed with dual-energy X-ray absorptiometry. Results: The results showed that, after adjusting for several confounders, statistically significant correlations were present between muscle mass and several bone mineral variables. A regression analysis confirmed the correlation in the data, and showed the marginal role of other body composition variables and physical activity for predicting BMC and BMD. Conclusion: Skeletal muscle mass is a major determinant of the BMC and BMD of the TBLH, as well as of the Appendicular level, in girls exposed to different amounts of long-term impact-loading physical activity.

AIM:Force expression is characterized by an interplay of biological and molecular determinants that are expected to differentiate males and females in terms of maximal performance. These include muscle characteristics (muscle size, fiber type, contractility), neuromuscular regulation (central and peripheral factors of force expression), and individual genetic factors (miRNAs and gene/protein expression). This research aims to comprehensively assess these physiological variables and their role as determinants of maximal force difference between sexes. METHODS:Experimental evaluations include neuromuscular components of isometric contraction, intrinsic muscle characteristics (proteins and fiber type), and some biomarkers associated with muscle function (circulating miRNAs and gut microbiome) in 12 young and healthy males and 12 females. RESULTS:Male strength superiority appears to stem primarily from muscle size while muscle fiber-type distribution plays a crucial role in contractile properties. Moderate-to-strong pooled correlations between these muscle parameters were established with specific circulating miRNAs, as well as muscle and plasma proteins. CONCLUSION:Muscle size is crucial in explaining the differences in maximal voluntary isometric force generation between males and females with similar fiber type distribution. Potential physiological mechanisms are seen from associations between maximal force, skeletal muscle contractile properties, and biological markers.

Background Aging is characterized by a physiological decline in physical function, muscle mass, strength, and power. Home-based resistance training interventions have gained increasing attention from scientists and healthcare system operators, but their efficacy is yet to be fully determined. Aims to verify the safety, feasibility, and efficacy of a home-based resistance training program delivered by innovative technological solution in healthy older adults. Methods 73 participants (36 females) were randomly allocated to either a control (C) or an intervention (I) group consisting of a 6-months home-based resistance training program delivered through an innovative technological solution, which included a wearable inertial sensor and a dedicated tablet. The safety and feasibility of the intervention were assessed by recording training-related adverse events and training adherence. Body composition, standing static balance, 10-meter walking, and loaded 5 sit-to-stand tests were monitored to quantify efficacy. Results No adverse events were recorded. Adherence to the training program was relatively high (61 % of participants performed the target 3 sessions) in the first trimester, significantly dropping during the second one. The intervention positively affected walking parameters (p < 0.05) and maximal force (p = 0.009) while no effect was recorded on body composition, balance, and muscle power. Conclusions The home-based device-supported intervention was safe and feasible, positively affecting walking parameters and lower limbs' maximal force. This approach should be incentivized when barriers to participation in traditional resistance exercise programs are present.