Background: Functional fitness has evolved from a niche training methodology into an influential movement in contemporary exercise science, sports performance, and the fitness industry. Among the competitive formats that have recently emerged, Hyrox® has become a prominent standardized model of hybrid fitness competition. This review aimed to critically synthesize the available evidence on the development of Hyrox® and its physiological demands, psychological characteristics, and performance determinants. Methods: Given the limited evidence available, a narrative review was conducted. PubMed, Scopus, and Web of Science were searched for original and review articles investigating Hyrox® athletes or participants. The evidence was synthesized across three major domains: physiology, psychology, and performance determinants. Results: Eleven studies were included, comprising eight original articles and three review articles. The available evidence indicates that Hyrox® imposes sustained high metabolic and per-ceptual demands, with functional stations eliciting particularly elevated blood lactate concentrations. Running capacity consistently emerged as the strongest determinant of overall performance. Psychological, recovery, sleep, and injury-related aspects remain insufficiently investigated. Conclusions: Hyrox® represents a promising research model for hybrid fitness because of its standardized competition format and rapidly growing international participation. However, the evidence base remains limited and is pre-dominantly derived from observational studies and analyses of publicly available competition data. Controlled interventions, longitudinal monitoring, and physiological, biomechanical, and psychosocial investigations are required to support evidence-based recommendations for athlete preparation and competition.

This study aimed to examine variations in mood states, gastrointestinal symptoms, and kidney function in non-drug-free amateur bodybuilders across four peri-competition timepoints: 7 days before competition, competition day, 7 days after competition, and 14 days post-competition. The study was characterized as an exploratory longitudinal study with repeated measures. Nine amateur bodybuilders (median age: 30 years) participated in the study. Athletes were assessed at four moments using validated mood and gastrointestinal symptom scales, anthropometric measurements, and biochemical analyses. Blood biomarkers included glucose, urea, creatinine, cystatin C, and glomerular filtration rate. Body mass was recorded at each timepoint to evaluate changes in energy balance. Some mood-related items showed significant changes across the peri-competition phases, including variations in tension, fatigue, anger, and vigor. Body mass increased after the contest, indicating a positive energy balance during recovery. Although group-level biochemical markers remained largely stable, individual analyses revealed relevant fluctuations in glucose, urea, creatinine, and cystatin C. Glomerular filtration rate was lower on the contest day compared to follow-up assessments. The findings highlight the variability in psychological and physiological markers observed in amateur bodybuilders during peri-competition phases, such as mood disturbances, kidney function variations, and post-competition increases in body mass. Coaches and practitioners should closely monitor athletes throughout contest preparation to better support performance, health, and recovery.

Background/Objectives: Long COVID (LC) has been linked to fatigue, exercise intolerance, and autonomic dysfunction, but sex-stratified data on cardiovascular responses to maximal exercise-an essential component of personalized medicine-are scarce. This study aimed to examine hemodynamic, autonomic, and functional responses during and up to 24 h after a cardiopulmonary exercise test (CPET) in young adults with and without Long COVID (LC). Methods: In this cross-sectional study, we assessed 38 physically active adults, who were allocated into four subgroups stratified by clinical condition (LC or control) and biological sex: control-female (CON-F; n = 10), LC-female (LC-F; n = 10), control-male (CON-M; n = 10), and LC-male (LC-M; n = 8). Outcomes included systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), cardiac output (CO), total (TPR) and peripheral vascular resistance (PVR), pulse wave velocity (PWV), augmentation index (AIx@75), and heart rate variability (HF, LF, LF/HF), assessed at rest, peak effort, recovery (1, 3, 5, 10, 30, and 60 min), and through 24 h ambulatory blood pressure monitoring (ABPM) after CPET. Results: SBP increase appropriately during exercise, with higher peaks in males (p < 0.01), and returned to baseline within 5 min across all groups. HR recovery was preserved; however, LC-F showed lower values than CON-F at 3, 5, and 10 min (126 vs. 144 bpm, p = 0.020; 119 vs. 136 bpm, p = 0.020; 94 vs. 109 bpm, p = 0.011), though all groups normalized by 60 min. PWV, AIx@75, TPR and PVR exhibited expected sex-related patterns without LC-related impairments. HRV indices showed transient post-exercise shifts (HF↓, LF↑, LF/HF↑). Ambulatory monitoring confirmed preserved circadian modulation, with normal systolic dipping (11-13%) and no abnormal nocturnal patterns. Conclusions: Young physically active adults with LC showed preserved hemodynamic, autonomic, and vascular responses during and after maximal exercise. These findings contribute to personalized medicine by showing that individualized, sex-stratified cardiovascular assessments reveal no clinically relevant impairments in this population, supporting tailored clinical decision making and exercise prescription.

Abstract The study aimed to evaluate the metabolic flexibility of sedentary elderly women in response to resistance training (RT) plus photobiomodulation therapy (PBMT) or RT alone, after two months of intervention. Nineteen elderly women were allocated into two groups, RT (n = 9, 68.44 ± 5.27 years old) and RT plus PBMT (RTPT) (n = 10, 69.40 ± 5.21 years old). The RTPT group received the PBMT, while for the RT group, the equipment was turned off. An incremental treadmill test together with a gas analyzer was performed to record variables such as heart rate (HR), oxygen consumption (VO 2 ), carbon dioxide production (VCO 2 ) and power output (PO) at the anaerobic threshold (AT), respiratory compensation point (RCP) and maximal oxygen consumption (VO 2max ), and thus indirectly verify metabolic flexibility. In comparison with baseline RTPT displayed significant differences in VO 2max (pre: 18.32 ± 3.01; post: 21.89 ± 2.35), carbohydrate oxidation (CHox) (pre: 1.54 ± 0.61; post: 2.45 ± 0.91), CHox/FFM (fat-free mass) (pre: 36.12 ± 12.28; post: 55.92 ± 16.74) and energy expenditure normalized to FFM, EE/FFM (pre: 147.00 ± 49.95; post: 227.56 ± 68.08) during maximum effort incremental testing, while the RT group did not demonstrate a significant difference in these variables.The intervention with RT plus PBMT seems to result in a positive impact on metabolic variables in sedentary elderly women when compared with RT alone, making this approach a viable alternative to improve VO 2max , CHox, CHox/FFM and EE/FFM during maximal effort testing. Author summary An aging-related decline in metabolic flexibility may reduce the ability to efficiently use energy during exercise, contributing to lower physical capacity and increased health risks in older adults. Resistance training is widely recommended for elderly populations, but additional strategies may further improve metabolic and physiological adaptations. This study investigated whether combining resistance training with photobiomodulation therapy could improve metabolic responses in sedentary elderly women more effectively than resistance training alone. Participants completed two months of supervised training, and metabolic responses were evaluated during an incremental exercise test. Women who received both resistance training and photobiomodulation therapy showed greater improvements in maximal oxygen consumption, carbohydrate oxidation, and energy expenditure during maximal exercise compared with those who performed resistance training alone. These findings suggest that photobiomodulation therapy may enhance the physiological adaptations associated with resistance training. The results indicate that combining resistance training with photobiomodulation therapy may represent a promising non-invasive strategy to improve exercise metabolism and functional capacity in sedentary elderly women. Further studies with larger samples are needed to confirm these findings and clarify the mechanisms involved.

Introdução. A relação entre o sono e as funções executivas têm sido amplamente investigada, especialmente no contexto esportivo, onde fatores como atenção, memória de trabalho e tomada de decisão são essenciais. Objetivo. Revisar as evidências sobre a influência do sono e do exercício físico nas funções executivas de atletas e praticantes de atividades físicas. Método. Foi realizada uma revisão narrativa da literatura, abrangendo publicações de 2000 a 2024, nas bases SciELO, PubMed e Google Scholar, com foco em artigos nos idiomas português e inglês. Resultados. Os resultados indicam que o sono de qualidade desempenha um papel crucial no desempenho cognitivo e motor, promovendo a consolidação da memória e a recuperação física. Em contrapartida, a privação do sono afeta negativamente o tempo de reação, a atenção sustentada e o desempenho motor. Além disso, o exercício físico regular, especialmente aeróbio, contribui para melhorias nas funções cognitivas, aumentando a neuroplasticidade e a conectividade neuronal. Conclusão. A interação entre sono adequado e prática de exercício físico otimiza o desempenho das funções executivas, sugerindo a necessidade de abordagens integradas para melhorar o rendimento esportivo e a saúde geral.

Background: Tribulus terrestris L. Zygophyllaceae (TT) is a plant that has been claimed to increase testosterone levels and improve sexual function, particularly erectile dysfunction, with potential benefits for male sexual health. Purpose: This systematic review aimed to evaluate the effectiveness of TT supplementation in improving sexual function and serum testosterone levels in men. Methods: We conducted a systematic review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After searching the literature (n = 162), 52 studies were selected for full-text reading, and 10 studies were eligible for this review, comprising 9 clinical trials and 1 quasi-experimental study (a study without a control). The Jadad score revealed low methodological quality for 50% of the studies. Results: The studies involved 15 to 172 participants (total = 483) aged between 16 and 70 years with different health conditions: healthy men (n = 5), oligozoospermia (n = 1), erectile dysfunction (n = 1), erectile dysfunction associated with hypogonadism (n = 2), and unexplained infertility (n = 1). TT supplementation at doses of 400 to 750 mg/d for 1 to 3 months improved erectile dysfunction in 3 of the 5 studies that assessed this parameter. Eight out of ten studies did not report significant changes in androgen profile following TT supplementation, but the subjects in the neutral studies did not have low androgen levels at baseline. Therefore, only 2 studies showed significant intra-group increase in total testosterone levels, which had low clinical magnitude (60-70 ng/dL) and involved subjects with hypogonadism. Conclusions: TT supplementation has a low level of evidence regarding its effectiveness in improving erectile function in men with erectile dysfunction, and no robust evidence was found for increasing testosterone levels.

Background: Fibromyalgia (FM) is a complex condition characterized by physical and psychological symptoms. The severity of symptoms is attributed to various factors, including body composition. The objective of the present study was to assess the anthropometric profile and body composition of women with FM. Materials and Methods: This is a crosssectional study with 93 women diagnosed with FM, with an average age of 49.0 +/- 9.8 years. Sociodemographic information was collected through a structured questionnaire. To assess the impact of FM on women's health, the Revised Fibromyalgia Impact Questionnaire (FIQR) was used. The assessment of body composition was performed using a tetrapolar electrical bioimpedance, model InBody 570. Results: Average values were found for body weight of 75.6 +/- 14.4 kg, BMI of 29.5 +/- 5.2 kg/m2, body fat percentage of 42.6 +/- 7.0%, skeletal muscle mass of 23.2 +/- 3.0 kg, and waist circumference of 87.4 +/- 11.0 cm. Obesity and overweight accounted for 43.0% and 35.5% of the sample, respectively. Very high body fat percentage (>= 32%) was found in 93.5% of the women. Increased and high risk for metabolic diseases, according to waist circumference, represented 25.8% and 51.6% of the sample, respectively. Conclusion: A high prevalence of overweight and obesity was found in women with FM, with elevated levels of total and abdominal body fat. The findings suggest a substantial increase in the risk of metabolic diseases in this population. Incentives for body fat loss are highly recommended.

OBJECTIVES:Chronic kidney disease (CKD) is associated with several disorders that compromise the physical, mental and social health. The aim of the present study was to investigate the effects of resistance training with cluster-set method (RT-CS) on quality of life (QoL) and depression symptoms in older subjects with CKD. METHOD:The QoL was evaluated by the Short Form Health Survey 36 questionnaire, and depression by the Beck Depression Inventory (BDI). Sixty-eight subjects with CKD on maintenance hemodialysis (age: 57.55 ± 4.06 years) were selected and randomly distributed into a control group without RT (CG, n = 26); traditional RT group (RT, n = 26); and RT cluster-set group (RT-CS, n = 26) with 15 s pause every four repetitions. Subjects completed 24 wk of RT, three times a week, 1 h and 30 min before the hemodialysis session. RESULTS:It was found that both the RT and the RT-CS group improved QoL, while only RT-CS displayed reduced depression symptoms. The minimally clinically important difference revealed that more subjects from the RT-CS were responsive to decrease of depression and functional capacity. CONCLUSION:This highlights the importance of RT-CS as an intervention to mitigate the effects of low QoL and depression in older subjects with CKD.

Sex-specific differences in the prevalence of sarcopenia, dynapenia, and the impact of obesity on muscle strength and quality in patients with chronic kidney disease (CKD) remain underexplored. Background/Objectives: In this cross-sectional study, 78 adults with stage 5 CKD undergoing thrice-weekly maintenance hemodialysis in Brazil (44 men, 34 women; mean ± SD age = 57.55 ± 4.06 years) were assessed. Anthropometry (BMI, waist circumference, waist-to-height ratio), dual-energy X-ray absorptiometry, circulating IL-6, Timed Up and Go, handgrip strength (Jamar ® dynamometer), and muscle quality index (MQI = handgrip/BMI) were obtained. Dynapenia (handgrip < 27 kg men and < 16 kg women) and sarcopenia (1.0 kg/kg for men and 0.56 kg/kg for women) were classified using EWGSOP2-2018 and FNIH thresholds. Results: Compared with reference values, men showed markedly reduced muscle strength and muscle quality (men: handgrip 21.3 ± 5.1 kg; MQI 0.80 ± 0.23 AU) than women. Also, men were 5.1 times more likely to present with dynapenia (88.6%; 95% CI 2.28–11.60) and 3.15 times more likely to present with sarcopenia (75.0%; 95% CI 1.88–5.30) than women. Waist circumference, waist-to-height ratio, BMI, and body fat % correlated inversely with MQI in both sexes (p ≤ 0.01) and with handgrip strength in men (p ≤ 0.01) but not in women. Conclusions: Among hemodialysis patients, men exhibit a substantially higher burden of dynapenia and sarcopenia than women and excess adiposity is independently associated with poorer muscle quality in both sexes. These findings highlight the need for sex-specific screening cut-offs and integrated strategies targeting both muscle dysfunction and central obesity in CKD management.

BACKGROUND AND OBJECTIVES: Currently, there is conflicting evidence regarding both physical activity and exercise in relation to the impact of fibromyalgia (FM). The aim of this study was to correlate levels of physical activity, disease severity, and pain in women with FM. METHODS: This is a cross-sectional study with 93 women diagnosed with FM, with an average age of 49.1±10.3 years. The Revised Fibromyalgia Impact Questionnaire (FIQR) was used to assess the impact of the disease on the women’s health status. To evaluate the level of physical activity, the short version of the International Physical Activity Questionnaire (IPAQ) was used. The Numeric Pain Rating Scale (NPRS) was used to assess the intensity of the participants’ pain. RESULTS: Significant differences were found between the groups in terms of symptom severity (F = 9.471; p<0.001; n2=0.174) and pain intensity (F = 5.074; p=0.008; n2=0.101), which were unfavorable to the sedentary group (p<0.05). Significant inverse correlations were found in assessments of physical activity levels at light and moderate intensities, FIQR and pain (rs = -0.20 to -0.30). CONCLUSION: Sedentary women are severely impacted by the disease and may experience higher levels of pain. Weak to moderate correlations between physical activity levels, disease impact, and pain intensity suggest that engaging in physical activity at light and moderate intensities may be an important intervention in the management of FM.

Abstract Introduction: Resistance training (RT) has shown several benefits for chronic kidney disease (CKD) patients. The affective and perceptual responses to training may influence the initial adherence to the program. Objective: To compare the acute affective and perceptual responses to RT protocols with imposed or self-selected loads in patients undergoing conservative treatment for CKD. Methods: Fourteen elderly (66.7 ± 3.0 years old) with CKD stage 3 or 4 completed two different protocols in a randomized crossover approach: with load at 70% of one maximum repetition (70% 1RM) and self-selected load. The affective valence and rating of perceived exertion (RPE) scales were used between each exercise (total of 10 exercises), and session RPE (sRPE) was measured 30 minutes after the training session. Results: The results demonstrated that when patients self-selected loads, the relative load was lower (~50% 1RM) compared to the protocol with imposed loads. More positive affective responses were found in the session with a self-se-lected load, as well as lower values of RPE and sRPE. Conclusion: The results of the present work suggest that self-selected loads may be an interesting strategy to improve the affective response to RT, and that this is probably mediated by a lower RPE in elderly CDK patients undergoing conservative treatment.

Although white adipose tissue (WAT) serves as a dynamic storage organ that regulates overall metabolism, the molecular impacts of resistance training (RT) on WAT are still not fully understood. Considering that training variables influence RT outcomes, understanding the relationship between exercise volume and WAT remodeling is crucial for elucidating adaptive mechanisms. The hypothesis posits that a higher volume of RT, specifically 8 wk of climbing a vertical ladder for eight sets (RT-8), will lead to more significant positive adaptations in WAT remodeling than a lower volume of four sets (RT-4). The investigation combined histological, molecular (proteomic), and biochemical analyses (electron paramagnetic resonance, zymography, and enzyme-linked immunosorbent assay) with bioinformatics tools. By high-throughput mass spectrometry-based proteomics, we quantified 4,434 proteins in WAT of male rats and revealed that the RT-8 group displayed increased protein abundance associated with lipid transport, fatty acid unsaturation, and lipolysis compared with RT-4. In addition, compared with sedentary controls, RT-8 showed enhanced antioxidant capacity through phase II antioxidant enzymes (thioredoxins, peroxiredoxins, glutathione transferases, and ferritin). In contrast, the RT-4 group did not significantly alter the redox proteome, but selectively upregulated first-line antioxidant defense via the α-Klotho/superoxide dismutase/catalase axis. RT-4 was also associated with a reduction in reactive oxygen species production (superoxide ion and hydrogen peroxide), matrix metalloproteinase-2 activity, and adipocyte cross-sectional area to a similar extent as RT-8, without disrupting redox balance, ubiquitin ligase complex activity, or inflammatory pathways. Our findings contribute to the growing body of literature, suggesting that RT volume is a key determinant of the WAT proteomic signature, with training volume eliciting distinct molecular adaptations.NEW & NOTEWORTHY This study is the first to analyze how resistance training (RT) volume modulates white adipose tissue (WAT) remodeling. RT decreases adiposity index and adipocyte size regardless of exercise volume. Higher-volume RT shows greater abundance linked to phase II antioxidant enzymes and lipolysis pathways. However, inflammatory mediators and redox imbalance may be related to increased volume. Conversely, lower volume induces first-line antioxidant defense through α-Klotho upregulation, revealing that each volume dictates distinct regulatory mechanisms in WAT.

O stiff e a cadeira flexora são dois dos exercícios mais comuns na prescrição do treinamento para os músculos isquiossurais. É sabido que eles proporcionam diferentes tipos de adaptação. Dessa maneira, a utilização de ambos na mesma sessão de treinamento parece ser uma estratégia válida para um desenvolvimento homogêneo dos isquiossurais. Pouco se sabe a respeito da ordem dos exercícios para este grupo muscular. O objetivo do estudo foi comparar o desempenho entre duas sessões de treinamento envolvendo stiff e cadeira flexora com diferentes ordens, para os músculos isquiossurais. Foram recrutados 10 homens treinados, com média de 2,65 ± 1,36 anos de experiência com musculação, realizaram um teste de carga de 10 repetições máximas (RM) na cadeira flexora e stiff. Os voluntários participaram em duas condições no treinamento, separadas por um intervalo de recuperação de no mínimo seis dias: Em uma sessão o stiff foi realizado previamente a cadeira flexora, enquanto na outra a cadeira flexora foi realizada antes do stiff, (os protocolos foram randomizados). O volume total de treinamento (VTT) e o número de repetições foram avaliados em cada sessão. Os resultados destacam que ao iniciar a sessão com a cadeira flexora, não interferiu de maneira significativa o desempenho do stiff (p= 0.102); no entanto, ao iniciar a sessão com o stiff, houve queda significativa no desempenho do número de repetições da cadeira flexora, impactando negativamente o VTT da cadeira flexora e da sessão (p < 0.001) Concluiu-se que iniciar a sessão de treino com o stiff tem um forte impacto negativo no desempenho do número de séries, no VTT da cadeira flexora e consequentemente, no VTT da sessão.

The aim of the study was to investigate the relationship between handgrip strength (HGS), disease impact, and quality of life in women with fibromyalgia (FM). The study is characterized as cross-sectional, and 91 women with FM, with a mean age of 49.37 ± 9.77 years, were assessed for disease impact (FIQR), quality of life (SF-12v2), demographic data, anthropometrics, and HGS. Handgrip strength (HGS) values below 23.1 kg were considered low, and the women were divided into two groups according to HGS: < 23.1 kg and ≥ 23.1 kg. The Student's t-test and Cohen's d were used to compare and estimate the effect size, respectively, between the variables of the groups. Pearson's correlation was used between the variables. Significant differences (p < 0.05) were found between the groups for total FIQR and its function and overall impact domains (d = 0.58, 0.74, and 0.47, respectively), and SF-12v2 physical (d = -0.62) and mental (d = -0.41) components, favoring the group with HGS ≥ 23.1 kg. Significant inverse correlations were found between HGS and total FIQR and domains (r = -0.21 to -0.31). Significant positive correlations were found between HGS and the physical (r = 0.35) and mental (r = 0.29) components of SF-12v2. Women with low levels of HGS exhibited greater FM impact and poorer quality of life, mainly related to the physical aspects of FIQR and SF-12v2. HGS can be used as an aid tool in screening and management, particularly for the physical condition of women with FM.

Gonçalves Dias, W, Benvenutti Bueno de Camargo, J, Volpi Braz, T, Rodrigues Batista, D, Oenning Col, L, Prestes, J, and Ricardo Lopes, C. A comparison between synergist and nonsynergist resistance training schemes in recreationally trained men. J Strength Cond Res XX(X): 000–000, 2025—The aim of the present study was to compare the effects of 2 different resistance training (RT) schemes (synergist [SN] and nonsynergist [NS]) on both muscle strength and hypertrophy outcomes in recreationally trained subjects. The sample included 22 men that were assigned to 2 experimental groups: NS (push/pull and pull/push exercises, n = 12; age: 20.5 ± 2.3 years; total body mass: 75.1 ± 8.2 kg; height: 179.8 ± 7.8 cm; experience in RT: 2.4 ± 1.4 years) and SN (pull/pull and push/push exercises, n = 10; age: 22.1 ± 3.2 years; total body mass: 82.7 ± 11.7 kg; height: 175.0 ± 7.0 cm; experience in RT: 3.2 ± 1.5 years). Muscle thickness assessments of the triceps brachialis, biceps brachialis, pectoralis major, and one repetition-maximum testing in the bench press and lat pull-down exercises were performed before and after the 8-week intervention period. The total load lifted during each week also was calculated. Both groups displayed significant increases in muscle strength and thickness (NS and SN, p < 0.05), with no significant difference observed between the groups for the dependent variables assessed (all p > 0.05). Therefore, the present study suggests that individuals aiming to increase muscle strength and size may benefit from both training schemes, taking into account personal preferences.

PurposeImbalance between Th1 and Th2 cells correlated with increased disease incidence, is well-documented in the older adult. Both acute and chronic exercise induce a transient shift in organic homeostasis, modulating the immune system and impacting the balance between Th1 and Th2 cells. This review investigates the impact of acute and chronic exercise on immune markers of Th1 and Th2 cells in the older adults.MethodsThis study was conducted as a systematic review, following PRISMA guidelines, databases including PubMed, Web of Science, Embase, Science Direct, and Scopus were searched until March 2024, identifying randomized controlled trials and prospective observational studies that examined the effects of acute and chronic exercise on intracellular and surface markers, cytokines, and immunoglobulins in older adults. Studies involving animal subjects, isolated cells, diseased patients, or exposure to medications and drugs were excluded. The quality of the selected studies was assessed using the Cochrane risk of bias tool (ROB2), with data organized and presented in tables and figures.ResultsFourteen studies with 525 participants were included in the analysis. An acute session significantly increased serum IL-4, IL-6, and IL-10 levels immediately afterward, returning to baseline within 1 hour at moderate to high intensities. Chronic exercise at moderate to high intensities reduced serum TNF-α, IL-6, and the CD4/CD8 ratio, while increasing IL-10 levels after 24 weeks. Intracellular, other surface markers and cytokines, and immunoglobulins were not analyzed.ConclusionChronic exercise decreases serum TNF-α and IL-6 levels, lowers the CD4/CD8 ratio, and increases IL-10 after 24 weeks, aiding Th1 and Th2 balance. Acute exercise temporarily increases serum IL-4, IL-6, and IL-10 levels, returning to baseline within an hour, indicating short-term immune modulation of Th1/Th2 balance.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021244426, Identifier CRD42021244426.

Background : Hemodialysis (HD) per se is a risk factor for thrombosis. Considering the growing body of evidence on blood -flow restriction (BFR) exercise in HD patients, identification of possible risk factors related to the prothrombotic agent D-dimer is required for the safety and feasibility of this training model. The aim of the present study was to identify risk factors associated with higher D-dimer levels and to determine the acute effect of resistance exercise (RE) with BFR on this molecule. Methods : Two hundred and six HD patients volunteered for this study (all with a glomerular filtration rate of < 15 mL/min/1.73 m(2) ). The RE + BFR session consisted of 50% arterial occlusion pressure during 50 min sessions of HD (intradialytic exercise). RE repetitions included concentric and eccentric lifting phases (each lasting 2 s) and were supervised by a strength and conditioning specialist. Results : Several variables were associated with elevated levels of D-dimer, including higher blood glucose, citrate use, recent cardiovascular events, recent intercurrents, higher inflammatory status, catheter as vascular access, older patients ( > 70 years old), and HD vintage. Furthermore, RE + BFR significantly increases D-dimer after 4 h. Patients with borderline baseline D-dimer levels (400 - 490 ng/mL) displayed increased risk of elevating D-dimer over the normal range ( > 500 ng/mL). Conclusion : These results identified factors associated with a heightened prothrombotic state and may assist in the screening process for HD patients who wish to undergo RE + BFR. D-dimer and/or other fibrinolysis factors should be assessed at baseline and throughout the protocol as a precautionary measure to maximize safety during RE + BFR.

Reis, AL, Deus, LA, Neves, RVP, Correa, HL Reis, TL, Aguiar, LS Honorato, FS, Barbosa, JMS, Araujo, TB, Palmeira, TRC, Simoes, HG, Prestes, J, Sousa, CV, Ide, BN, and Rosa, TdS. Exercise-induced transient oxidative stress is mitigated in Down syndrome: insights about redox balance and muscle strength. J Strength Cond Res 38(3): e125-e34, 2024-This study aimed to evaluate the acute effects of a session of resistance exercise (RE) performed with elastic tubes on the redox balance and inflammatory profile in individuals with Down syndrome (DS). Subjects (n = 23) were allocated into 2 groups: individuals with DS (DS; n = 11) and individuals without DS (WDS; n = 12), who performed an acute RE session. Diagnostic assessment included medical history, anthropometric measures (body height, body mass, body mass index, and body composition assessment), biological collections, muscle strength assessments (handgrip and maximal voluntary isometric contraction tests), and exercises. The redox balance and inflammatory profile were assessed in urine and saliva samples before and after an acute RE session. There were no differences between WDS and DS groups for body composition (p > 0.05). The DS group presented higher values pre and post an acute RE session with elastic tubes for oxidative and proinflammatory markers compared with WDS (p < 0.05). Uric acid values increased from pre-acute RE session to post-acute RE session for WDS (p < 0.0001). No differences were identified within groups for the delta analysis (p > 0.05). Inverse correlations were found between total force and F2-isoprostane, 8OHdG, uric acid, allantoin, IL-6, TNF-alpha, and the TNF-alpha:IL-10 ratio. A positive correlation was found between IL-10 and total force. The DS group presented increased peak force in the knee extension and elbow flexion exercises (similar to 25 and 12%, respectively) but decreases in handgrip strength of similar to 7%. The WDS group showed higher peak force values for knee extension, elbow flexion, and handgrip (similar to 16, 10, and 14%, respectively). The DS group had lower transient elevation of oxidative stress after an acute RE session compared with WDS. Oxidative stress and inflammation responses of DS to an acute RE session with elastic tubes may be insufficient to induce health adaptations for the same relative load compared with WDS.