J. Funct. Morphol. Kinesiol., Volume 10, Issue 4 (December 2025) – 70 articles

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. Full article

Background: Accurate assessment of aerobic capacity is essential for performance monitoring in masters athletes, particularly in high-intensity team sports. The objective of this study was to evaluate the validity and agreement of three indirect maximal oxygen uptake (VO₂max) protocols (Åstrand–Ryhming, YMCA, and Polar OwnIndex Fitness test) against the gold-standard cardiopulmonary exercise testing (CPET) in masters basketball players. Methods: A cross-sectional comparative study included 50 male masters basketball players (aged 51–81 years, M = 64.3 ± 7.9). Validity was determined by comparing results from the three indirect protocols to direct VO₂max measurement via CPET. Agreement was assessed using Pearson correlations (r), systematic error, mean absolute error (MAE), and Bland–Altman limits of agreement. Results: The Åstrand–Ryhming test and YMCA tests showed the closest agreement with CPET (systematic error < 4%, MAE ≈ 17–18%, r > 0.50). The Polar OwnIndex test substantially overestimated VO₂max (mean error ≈ 30%, MAE = 32%). The Åstrand–Ryhming test at low workload yielded the strongest correlation (r = 0.75). Conclusions: The Åstrand–Ryhming and YMCA submaximal tests demonstrated acceptable validity and low systematic bias for estimating VO₂max in masters basketball players, positioning them as practical alternatives to CPET. Conversely, the Polar OwnIndex test showed poor agreement and clinically significant overestimation. These findings support the use of submaximal cycling protocols for fitness monitoring and tailored training prescription in this specific older athlete population. Future longitudinal research is warranted to confirm their ability to track fitness changes over time in this population. Full article

Background: Visual, vestibular, proprioceptive and cutaneous sensory information is important for postural control during quiet stance. When the reliability of one source of sensory information used to detect self-motion for postural control is reduced, there may be a reweighting of inputs within and/or across the remaining sensory systems determining self-motion for postural control. Muscle vibration, which creates an illusion of muscle stretch and a compensatory movement to shorten the vibrated muscle, may be used to determine the weighting of muscle spindle Ia proprioception in postural control. The objective of this study was to determine the effect of vision occlusion on triceps surae (TS) Ia proprioceptive weighting in postural control during quiet stance, utilizing an 80 Hz muscle vibration stimulus and a quantitative measure of the body’s anterior to posterior ground center of pressure (COP) response to TS muscle vibration in subjects standing freely. Methods: Subjects (N = 41; mean (standard deviation), 19.6(2.0) years) were examined as they stood with eyes open (EO) or eyes closed (EC). Ground COP was measured during quiet standing with and without bilateral vibration of the TS muscles. Results: The mean backward COP shift induced by TS vibration was significantly greater during the EC condition compared to EO (EC: −4.93(1.62) centimeters; EO: −3.21(1.33) centimeters; p = 6.85 × 10⁻¹⁰; Cohen’s d = 1.29). Thirty-seven subjects increased, and two subjects decreased their vibration-induced COP backward shift in the EC condition compared to EO, although the magnitude of the change varied. Conclusions: The results support the idea that, for most young subjects, there is an increased triceps surae Ia proprioceptive weighting for postural control during EC stance, possibly due to the need for postural control to depend more on non-visual feedback. Full article

Background: Visual search supports action planning and target selection in daily life. Despite toileting being frequent yet high-risk in rehabilitation, gaze analyses specific to toileting remain limited. This study quantified visual search behavior during the approach phase of toileting. Methods: Twenty inpatients aged 65 years or older in a convalescent rehabilitation ward participated in the study. At the time of hospital admission, their gaze behavior from toilet room entry to arrival at the bowl was recorded using an eye tracker (Tobii Pro Glasses 2). Moreover, we evaluated a toilet-functional independence measure (toilet-FIM), comprising toileting, toilet transfer, and locomotion at discharge. Results: In multiple regression, a longer total gaze time directed towards the toilet seat was associated with a greater toilet-FIM independence (β = 0.446), whereas prolonged gaze to the toilet rim (β = −0.839) and to the right handrail (β = −0.621) were related to lower independence (adjusted R² = 0.715). Conclusions: A toilet seat-oriented gaze implies effective action planning for safe sit-down, whereas toilet rim- or handrail-oriented gazes may reflect responses to visual salience or compensatory visual strategies related to reduced independence. These observations could improve our understanding of older patients’ motor planning and spatial perception in toileting. Full article

Objectives: The aim of this study was to analyze the utilization of the EO SwimBETTER^® (EoLab, Sydney, Autralia) device for measuring kinetic and kinematic variables during 50 m and 200 m freestyle trials. Methods: Ten swimmers (seven males and three females, 20 ± 3.5 years) participated. Each completed three sets of 50 m using EO SwimBETTER^® on non-consecutive days, with a 200 m test performed during the third session after recovery to complete the Critical Swim Speed Test (CSS-T). All tests were conducted at maximal intensity. Results: The results showed high reliability for both kinetic and kinematic parameters. Regarding validity, the EO SwimBETTER^® demonstrated strong agreement with the reference device in measuring stroke frequency (SF). In addition, higher mean force values were found in the 50 m compared with the 200 m trial (Δ% = 8.75%, p = 0.099), suggesting sensitivity of the device to different exertion demands. Conclusions: Based on these findings, the EO SwimBETTER^® appears to be a useful and promising tool for monitoring technical and performance-related variables in swimming, although further research is needed. Full article

Background: Climbing and strength training are among the most popular types of sports among recreational athletes. However, many newcomers quickly lose motivation and abandon training due to a lack of visible and athletic progress. Hence, we assessed whether a 6-week combined structured gym and climbing training could improve arm muscle strength and size. Methods: We recruited 25 healthy recreational athletes (14 [56.0%] females, age = 20.4 ± 1.7 years, BMI = 21.8 ± 1.7 kg·m⁻²). Most participants trained several times per week (N = 12, 48.0%), and training sessions lasted between 1 and 2 h (N = 11, 44.0%). Most athletes rated their current fitness level as “very good” (N = 15, 60.0%). Subjects performed two gym sessions and two climbing training sessions per week and avoided other training for 6 weeks. We measured the time of bar hang, handgrip strength, and forearm circumference before and after 6 weeks. Results: Hanging time increased from 55.3 ± 3.2 s to 60.9 ± 31.3 s (t(24) = 6.68, p < 0.001). Right handgrip strength increased from 31.6 ± 8.4 N to 34.3 ± 7.6 N (t(24) = 5.58, p < 0.001). Left handgrip strength increased from 29.4 ± 9.9 N to 31.0 ± 9.8 N (t(24) = 4.62, p < 0.001). Right forearm circumference increased from 24.6 ± 1.5 cm to 25.4 ± 1.7 cm (t(24) = 9.04, p < 0.001). Left forearm circumference increased from 24.6 ± 2.0 cm to 25.1 ± 2.1 cm (t(24) = 5.94, p < 0.001). All the relationships remained significant when stratified between males (p < 0.001–0.003) and females (p < 0.001–0.008). Conclusions: A 6-week training intervention consisting of structured climbing and strength training induces significant improvements in grip strength and the appearance of arm muscles in recreational athletes. Amateurs could benefit even from shorter training mesocycles, as a 6-week window to see visible progress. Full article

Background: Aerobic and resistance training have acute effects on blood pressure (BP) in peripheral arterial disease (PAD). However, the combined effect of both exercises in a single session is still unknown. The aim of this study was to analyze the effects of a single exercise session combining walking and circuit-based training on BP in patients with PAD. Methods: Participants with PAD (n = 13; 65.0 ± 10.2 years; 76.9% male) underwent a supervised exercise therapy (SET) intervention (312 sessions, 24 sessions/patient) that included 15–30 min of walking, followed by 15 min circuit-based training. Clinic systolic (SBP) and diastolic (DBP) were recorded 5 min before and after each exercise session. Longitudinal changes were analyzed using repeated-measures analysis of variance (ANOVA) and categorical changes in blood pressure levels were evaluated with chi-square tests. Results: After each exercise session, clinic SBP decreased 4.87 mmHg (p < 0.001) and clinic DBP decreased 2.11 mmHg (p < 0.001). Furthermore, there were no differences between the initial stage of training (1–10 sessions) and late (14–24 sessions) for each time that SBD or DBP were measured. Conclusions: After an acute exercise session, both clinical SBP and DBP decreased in patients with PAD compared to pre-exercise values. However, no additional reductions in clinical BP were observed when comparing early (sessions 1–10) and late (sessions 14–24) stages of the full SET intervention. Full article

Objectives: This research paper proposes an innovative framework for developing adaptive and dedicated rehabilitation strategies based on the perceptions of specialists in sports rehabilitation (RT), sports training (AR) and with mixed expertise (RT+AR) regarding advanced resistance training methods, including Effort-Based Training (EBT-3/7), Cluster Training (CT), Rest-Pause Training (RPT) and Post-Activation Potentiation (PAP). The aim of this paper was to develop a tailored strategy for rehabilitation programs, grounded in a targeted selection of training methods, short-term periodization and exercises structured around key training variables such as frequency, intensity and volume. Methods: In order to reach this objective, a quantitative research method is proposed, aiming to identify the experts’ opinion on the way of managing and integrating Unilateral Resistance Training Exercise (URTE). Data processing and analysis were conducted by means of specific tests supplied by the SPSS Statistics for Windows (version 20.0, IBM Corp., Armonk, NY, USA)Results: The findings indicate that EBT-3/7 is perceived as the most effective method for rehabilitation with minimal injury risk, whereas CT and PAP are associated with performance benefits but higher perceived injury risk. RT+AR specialists reported more frequent use of these methods and higher perceived effectiveness. Additionally, they demonstrated superior operational and dynamic capabilities compared to single-domain specialists. Conclusions: According to specialists’ opinions, URTE is effective for post-injury rehabilitation, with combined rehabilitation and training expertise enhancing utilization, perceived effectiveness and implementation of personalized, performance-oriented strategies. Full article

Objectives: The present study analyzes the effects of a high-intensity interval training (HIIT) program based on the Tabata method on physiological and psychological variables in contemporary dancers (n = 10) and sedentary individuals (n = 8), who performed a 10-week protocol, with sessions of self-loading exercises structured in intervals of 20 s of effort and 10 s of rest three times a week. Methods: Parameters of body composition, muscle strength, aerobic and anaerobic capacity, heart rate variability, as well as perceptions of health, anxiety, stress, sleep quality, and levels of physical activity and sedentary lifestyle were evaluated. Results: The results showed that no significant changes occurred in most body composition variables, except for visceral fat, where group differences were observed (F = 5.66, p = 0.030, η²ₚ = 0.261). In the indicators of strength and power, the dancers improved the height and relative power of the jump (F = 5.996, p = 0.026, η²ₚ = 0.273), while the sedentary ones increased the strength of the handgrip (p = 0.023). In terms of functional performance, both groups significantly increased anaerobic endurance (F = 10.374, p = 0.005, η²ₚ = 0.393), although no changes were recorded in maximal oxygen consumption or heart rate variability (p > 0.05). On a psychological level, improvements in healthy lifestyle habits and a decrease in the trait anxiety variable were evidenced in dancers (p = 0.023), while in sedentary participants no relevant effects were found. Conclusions: In conclusion, the Tabata protocol may represent an efficient and complementary strategy to enhance strength, anaerobic power, and psychological well-being, particularly among dancers. The observed improvements suggest potential benefits related to movement quality, injury prevention, and general physical conditioning. Full article

Background: Neurofeedback training has emerged as a promising tool for enhancing performance by targeting specific brain activity patterns linked to motor skills, decision-making, and concentration. This study aimed to explore the associations between neurofeedback outcomes and football-specific performance metrics, including anthropometric, physical, technical, and tactical dimensions. Methods: A quasi-experimental design was used to examine the effects of a six-week neurofeedback training program on motor skills, tactical decision-making, and physical performance in young women’s football players (n = 8, aged 14–18). Participants underwent 30-min sessions three times a week targeting sensorimotor rhythms (SMRs) in the 12–15 Hz range within virtual football scenarios. Pre- and post-intervention assessments included anthropometric measures, neurophysiological evaluations, Loughborough Soccer Shooting Test (LSST), and Yo-Yo Intermittent Recovery Test Level 1 (YYIR1). Tactical decision-making was evaluated with a FUT-SAT-based instrument, and biological maturity was estimated using the Mirwald equations. Results: Statistical analyses using Pearson’s correlations revealed significant associations between neurofeedback outcomes, motor efficiency indices (MEIs), decision-making (DM), and football performance metrics. Correlation coefficients ranged from 0.504 to 0.998, with p-values from 0.010 to <0.001, indicating significant associations across physical, technical, and tactical dimensions. Conclusions: This study highlights the beneficial impact of neurofeedback on football performance in young female athletes. Full article

Background: Basketball performance is highly dependent on morphological and neuromuscular traits, especially during adolescence, when rapid growth and maturation generate marked sex-based differences. However, limited data are available on Latin American players’ performance. This study aimed to compare the anthropometric characteristics, body composition, somatotype, and neuromuscular performance of male and female Colombian U-15 national basketball players. Methods: The sample consisted of thirty-seven players (20 males, 17 females; mean age: 14.8 ± 0.4 years) during the preparatory phase of the 2022 South American U-15 Championships. Anthropometry and body composition were evaluated following ISAK standards, and somatotype was calculated using Carter and Heath’s method. Neuromuscular performance included countermovement and squat jumps, bilateral handgrip strength, and isometric knee extensor and flexor peak torques. Between-sex differences were examined using t-tests, Welch’s tests, or Mann–Whitney U tests. The effects of sex on body composition, somatotype, and neuromuscular outcomes were assessed using MANOVA. Results: Males had higher muscle mass, lower adipose mass, and greater limb lengths than females (p < 0.01). No sex differences were observed in BMI, waist or hip circumference, or quadriceps strength. Regarding neuromuscular performance, males exhibited higher handgrip strength, hamstring torque (absolute and relative), and jump performance than females. Conclusions: Males showed greater muscle mass, strength, and jump performance, whereas females displayed higher fat levels and endomorphy than males. These findings provide useful data for optimizing training load prescriptions, guiding targeted strength programs, and developing sex-specific strategies for injury prevention and talent identification in adolescents. Full article

Objectives: The aim of this study was to investigate the acute physiological effects of the BS on CPF and chest wall volumes in healthy individuals, comparing two body positions: supine and 45° trunk inclination. Methods: Observational, analytical, and cross-sectional study conducted with 14 healthy individuals (7 males) who underwent the BS in two different body positions. CPF, tidal chest wall volumes and the contribution of thoracoabdominal compartments were assessed using Optoelectronic Plethysmography. Statistical analyses included two-way ANOVA and Bonferroni post hoc tests, with a significance level of 5%. Results: A significant increase in CPF was observed after the BS in the inclined position (p < 0.05), with no relevant changes in the supine position. Tidal chest wall volumes also increased in both positions, with a more pronounced effect in the 45° inclination (p < 0.05). The volume increase was predominantly thoracic, with a ventilatory redistribution favouring the pulmonary rib cage compartment, especially in the inclined posture. Conclusions: The BS produced immediate beneficial physiological effects in healthy individuals, with greater efficacy in the inclined position, enhancing expiratory flow and thoracic ventilation. These findings support the clinical applicability of BS as a physiotherapeutic strategy even in populations without respiratory dysfunction. Full article

Background: Tendon structure is related to the magnitude of load and its management, rather than directly predicting pain incidence. Although pain symptoms frequently persist until they severely impact performance, function, and tendon structure, professional basketball players often manage patellar tendon pain alongside high training and competition loads. The aim of this study was to investigate patellar tendon structural adaptations over 8 months of training and competition in professional female and male basketball players. Methods: The primary outcome of this study was defined as the change in the percentage of echo-type II structure from baseline to 8 months. A prospective cohort study was conducted where 43 professional basketball players (20 male, 23 female) were followed during 8 months of training and competition. A bilateral patellar tendon ultrasound tissue characterization (UTC) scan was conducted, and jumping leg (jumping/non-jumping), presence of pain (yes/no), and exposure time (hours) were recorded at baseline, and at 4 and 8 months in the competitive season. Results: The mid-tendon exhibited negative adaptations (decreased alignment), represented by echo-type II, after 8 months of competition (left; p = 0.001; ES = 2.16; right; p = 0.001; ES = −1.35). Positive adaptations (increased alignment], were observed in echo-types III (p = 0.004; ES = −1.04) and IV (p = 0.001; ES = −0.15), after 4 and 8 months. Tendon structure showed differences between female and male professional basketball players throughout the 8 months (echo-type II; p = 0.00; ES = 0.34). Conclusions: The study demonstrated that the tendon structure undergoes significant adaptations, supporting the concept that the patellar tendon adapts to compensate for areas of structure disorganization. Female professional basketball players appeared to maintain a more organized tendon structure than their male counterparts. Jumping leg and presence of pain did not show significant differences in tendon structure over the study period. This research has significant implications for elite sport, as a better understanding of tendon load capacity throughout a competitive season is needed. Full article

Objectives: This study aimed to analyze the effects of varying antagonist volume in upper-body supersets on mechanical (lifting velocity), metabolic (blood lactate), and perceptual (perceived exertion) variables. Methods: A randomized crossover study was conducted in which 14 resistance-trained men performed three strength training conditions. In the control condition (CTR), participants performed four sets of bench press with 8 repetitions at their 12-repetition maximum load, whereas in the experimental conditions, a prone bench pull was performed immediately after the bench press using 33% (SS1) or 66% (SS2) of the individual’s maximum possible repetitions. Lifting velocity, lactate concentration, and perceived exertion were measured. Repeated-measures ANOVA or Friedman test was applied to compare conditions, with Bonferroni-corrected post hoc tests and effect sizes reported. Results: Despite a progressive decrease in mean set velocity (p < 0.001) and fastest set velocity across sets (p = 0.014) in the agonist exercise (i.e., bench press), these variables did not significantly differ between conditions. The only difference observed was a lower mean set velocity during the prone bench pull in the SS2 condition compared to the SS1 condition (p = 0.011). Perceived exertion also increased across sets (p < 0.001), with no differences between protocols. Blood lactate concentration, measured before the final set, was significantly higher in SS2 compared to CTR (p = 0.003) and SS1 (p < 0.001), indicating a greater metabolic load during training. Conclusions: Agonist–antagonist supersets allow for reduced training time without negatively impacting acute mechanical performance in the agonist exercise. Low-fatigue configurations (SS1) in the secondary exercise do not significantly increase lactate levels, while moderate-fatigue configurations (SS2) in the secondary exercise increase metabolic load. Full article

Background: The use of knee taping is widely used to enhance stability and landing performance. However, its impact on jumping performance, a key sports performance determinant, remains unknown. Objective: This study aimed to evaluate the effects of knee taping on continuous biomechanics during the countermovement jump (CMJ). Methods: Nineteen recreational female netball players (age 22 ± 2.69 years; height 167.76 ± 7.47 cm; mass 63.32 ± 10.57 kg) performed CMJs under four taping conditions—no tape (NT), rigid tape (RT), dynamic tape (DT), and kinesio tape (KT). All participants completed all four conditions. Continuous biomechanical data were analysed using one-dimensional statistical parametric mapping (SPM1d) with repeated measures ANOVA (p < 0.05). Results: KT significantly reduced time to take-off (from 2.01 ± 0.67 s with NT to 1.26 ± 0.61 s with KT, p < 0.001) and increased modified reactive strength index (from 0.12 ± 0.05 with NT to 0.21 ± 0.06 with KT, p < 0.001). RT increased braking phase velocity compared to NT (−1.53 ± 0.57 m/s vs. −1.69 ± 0.62 m/s, p = 0.01). SPM1d revealed significant kinematic changes across conditions, including reduced ankle flexion and hip flexion with KT, and increased knee rotation with RT and DT. Conclusions: Knee taping modified joint kinematics without enhancing maximal outputs such as power or jump height. KT improved reactive strength indices, suggesting potential benefits for rapid jump performance, while RT and DT mainly altered joint coordination. Full article

Background: Change-of-direction (CoD) ability is critical in karate, yet sport-specific assessment tools are limited. This study aimed to evaluate the reliability and validity of a newly developed karate-specific CoD test for male and female athletes and to examine its relationships with other motor performance measures. Methods: Thirty-six experienced karatekas (20 men: age 20.8 ± 1.8 years, height 1.79 ± 0.05 m, body mass 73.1 ± 10.6 kg; 16 women: age 21.2 ± 1.7 years, height 1.67 ± 0.04 m, body mass 63.5 ± 8.9 kg), all national squad members, participated. Athletes performed the karate CoD test twice to assess test–retest reliability, and completed additional CoD tests (Y CoD, T-half), linear sprint tests, standing long jump, and Y-balance tests to evaluate criterion validity and associations with other motor abilities. Results: The karate CoD test demonstrated excellent reliability (ICC = 0.996), with similar consistency in men and women. Criterion validity was supported by a meaningful correlation with the Y CoD test, but not with the T-half test. Associations with linear sprinting and lower-limb power (standing long jump) were weak or inconsistent, indicating that karate-specific CoD performance is distinct from general physical capacities. Conclusions: The karate CoD test shows good reliability and validity for assessing planned change-of-direction ability in elite karate athletes. Its use should be limited to pre-planned movements and complemented with other tests (e.g., reactive agility, sprinting, jumping, strength) for a fuller performance assessment. Full article

Background: Joint position sense (JPS) is a critical component of proprioception and postural control, especially in older adults, where deficits are associated with increased risk of falls and functional decline. Recent studies have explored smartphone-based digital inclinometers as accessible tools for clinical proprioceptive assessment, but their participant-level reproducibility in institutionalized elderly populations remains unexplored. Objective: We aimed to examine the reproducibility of joint position sense performance in institutionalized older adults, using a smartphone-based inclinometer that has been applied in other populations. Assessing joint position sense with accessible smartphone-based tools may provide practical insights for rehabilitation and functional assessment in older adults. Methods: Thirty-five-year-old or older adults (mean age 85.9 ± 8.19 years) participated in this test–retest study. JPS was assessed using the iPhone^® inclinometer. Participants memorized and attempted to reproduce a 30° forward trunk flexion while standing. The absolute angular error was measured across two sessions, one week apart. Relative and absolute reproducibility were analyzed using intraclass correlation coefficients (ICC 2,1), standard error of measurement (SEM), Smallest Real Difference (SRD), and Bland–Altman analysis. Results: The ICC for the whole sample was 0.839 (95% CI: 0.72–0.91), indicating good reproducibility of participants’ proprioceptive performance. SEM and SRD were 3.65° (33.3%) and 10.1° (92.3%), respectively. Bland–Altman plots showed minimal bias (0.23°) and only 5.71% of values fell outside the 95% limits of agreement. Conclusions: Participants demonstrated moderate-to-good reproducibility in replicating joint position sense, reflecting consistent proprioceptive performance across sessions. This approach demonstrates feasibility for repeated proprioceptive assessment in this population. These findings have potential applications for functional monitoring and fall-prevention programs in institutionalized older adults. Full article

Background: Bioelectrical Impedance Vector Analysis (BIVA) is a qualitative method that standardizes resistance and reactance relative to stature (R/H and Xc/H) and plots them as vectors on an R-Xc graph. This equation-free approach assesses body composition, allowing for the evaluation of hydration status and cellular integrity through tolerance ellipses. This study aimed to systematically map BIVA reference ellipses across general, pediatric, pathological, and athletic populations. Methods: A scoping review was conducted according to PRISMA-ScR guidelines. Five databases were searched. Extracted data included (a) sample characteristics (sample size, age, sex, BMI, country, ethnicity), (b) population type, (c) analyzer specifications, and (d) R/H and Xc/H means, standard deviations, and correlation values. Results: A total of 53 studies published between 1994 and July 2025 were included. From these, 508 tolerance ellipses were identified: 281 for the general population (18–92 years), 133 for children/adolescents (0–18 years), 49 for athletes, and 45 for pathological groups. Studies were primarily conducted in Europe and the Americas, using 11 analyzers with variations in measurement protocols, including body side, posture, and electrode placement. Conclusions: This scoping review categorizes the existing BIVA tolerance ellipses by population type, sex, age, BMI, device used, and measurement protocol. The structured presentation is intended to guide researchers, clinicians, nutritionists, and sports professionals in selecting appropriate reference ellipses tailored to specific populations and contexts. Full article

Objectives: Sports-related concussion (SRC) is mostly associated with contact and combat sports. However, emerging evidence suggest that cyclists are also at risk of repeated concussion injury. Moreover, long-term neurophysiological outcomes in cycling cohorts remain underexplored. This novel study investigated the long-term effect of repetitive concussions in cyclists. Road, mountain biking (MTB), and BMX riders with a history of concussions and self-reported persistent symptoms were assess for neurophysiology and cognitive–motor performance compared to previously concussed cyclists with no ongoing symptoms. Both groups were compared to age-matched with controls. Methods: Using a cross-sectional between-group design, 25 cyclists with a history of concussions (15 symptomatic, 10 asymptomatic) and 20 controls completed symptom reporting, cognitive and balance assessments (SCAT5), sensorimotor testing using vibrotactile stimulation, and neurophysiological assessments via transcranial magnetic stimulation (TMS). Results: Symptomatic cyclists reported a higher number of concussions compared to asymptomatic cyclists (p = 0.041). Cognitive testing revealed large effects (d > 1.0), with impaired concentration in symptomatic cyclists compared to controls (p = 0.005). Motor assessments demonstrated large effects (d > 1.0), with slower tandem gait times (p < 0.001) and greater errors (p = 0.02) in the symptomatic group. Sensorimotor testing indicated slowed simple reaction times (p = 0.001) and poorer temporal order judgement (p = 0.038). TMS showed large effects (d > 1.0) in increased cortical inhibition in the symptomatic group, with prolong cortical silent periods (p < 0.05) and large effects (d > 1.0), and reduced short interval intracortical inhibition (p = 0.001) compared to asymptomatic cyclists and controls. Conclusions: Cyclists reporting persistent symptoms showed greater cortical inhibition and impaired cognitive–motor performance, consistent with findings in contact sport athletes. These results suggest that repeated concussions in cycling carry risk of chronic neurophysiological alterations. Cycling disciplines should consider more rigorous concussion identification protocols and stricter management strategies to mitigate persistent and long-term consequences. Full article

Background: Relative Energy Deficiency in Sport (REDs) results from an imbalance between energy intake and expenditure, leading to low energy availability (LEA) and impairments of physiological and/or psychological functions in female and male athletes. While physical determinants of REDs are well documented, psychological factors such as body image (BI) have received comparatively little attention. The aim of this scoping review was to synthesize the current scientific evidence on the relationship between BI and REDs. Methods: A scoping review examined the current literature, including quantitative and qualitative studies. The scoping review was conducted in April 2025 in PubMed, Web of Science, MEDLINE, SPORTDiscus, APA PsycArticles, APA PsycInfo, CINAHL and OpenDissertations. Studies were included if they examined BI aspects in relation to LEA or REDs in a sporting context, regardless of participants’ gender, age, level or sport. Inclusion criteria were based on the Population—Context—Concept (PPC) framework. Results: Seven studies met the inclusion criteria, covering athletes from various ages, genders, sports, and performance levels. Findings indicate that BI dissatisfaction—manifesting, for example, as a drive for thinness or muscularity, exercise dependence, and disordered eating—represents a relevant psychological factor associated with LEA in both female and male athletes. Conclusions: The relationship between BI and REDs is complex and insufficiently explored. Future research should address this link systematically across sports, performance levels, genders, and age groups. In sports medicine practice, screening tools should systematically incorporate psychological risk factors such as BI disturbances to enable early detection, targeted intervention, and prevention of long-term health consequences. Full article

Background: Given the persistent sex-based disparities in anterior cruciate ligament (ACL) injury prevalence and the heightened susceptibility observed during critical stages of development in female academy-level players, it is necessary to enhance the effectiveness of prevention programs, particularly during change of direction (COD). Objectives: This study aims to evaluate whether a multicomponent periodized program modifies three-dimensional knee angular velocity and hamstrings and quadriceps muscle activity during a COD task in under-16 female football players. A secondary objective was to determine whether adaptations differed based on lower limb dominance. Methods: A non-randomized, multicenter controlled trial with a pre–post design was conducted involving 35 players (age: 15.50 ± 1.22), allocated to either an intervention (n = 17) or control (n = 18) group. The intervention group undertook a 12-week multicomponent periodized program within their usual training program whilst the control group undertook their usual training program. The peak and range of thigh and shank angular velocity across three planes, along with the average rectified and peak envelope EMG signals of the Biceps Femoris (BF), Semitendinosus (ST), Vastus Medialis (VM) and Vastus Lateralis (VL), were recorded during the preparation and load phases, using the Change of Direction and Acceleration Test. Three-factor mixed model ANOVAs and non-parametric tests were applied, with statistical significance set at p < 0.05. Results: Post-intervention analysis revealed significant improvements in sagittal and coronal planes shank angular velocities and thigh coronal and transverse plane angular velocities. Muscle activity patterns also improved, particularly in the ST and VM, suggesting enhanced medial stabilization and neuromuscular control. Functional improvements were most evident in the dominant limb. Conclusions: The 12-week multicomponent periodized program effectively modified three-dimensional knee kinematics and muscle activity during a COD task in under-16 female football players. Full article

Background: Only a limited number of studies have examined the effects of short-term, strength–speed-oriented velocity-based training (VBT) on lower-body power in female junior volleyball players and elite female artistic gymnasts. The present study aimed to investigate the impact of a four-week VBT intervention on jump performance and force–velocity characteristics in these athletes. Methods: Seven junior female volleyball players (age: 17.4 ± 0.9 years; height: 179.4 ± 6.5 cm; weight: 74.01 ± 3.5 kg) (top-league team members), and seven elite female artistic gymnasts (age: 17.6 ± 2.9 years; height: 159.6 ± 7.2 cm; weight: 59.3 ± 6.3 kg) (National Team members) completed two weekly training sessions for four weeks, each consisting of four sets of six repetitions of parallel back squats (PBSs) and hip thrusts (HTs). Training loads were regulated using barbell velocity targets (PBSs: 0.46–0.72 m/s; HTs: 0.36–0.60 m/s). Pre- and post-intervention assessments included loaded (15–60% body mass) and unloaded squat jumps (SJs) and countermovement jumps (CMJs) to determine peak power output, jump height, and force–velocity profiles. Results: Volleyball players showed significant improvements in peak power predominantly during loaded SJs (SJ45%: +5.5%, p < 0.01; SJ60%: +5.7%, p < 0.05), whereas gymnasts exhibited greater gains in loaded CMJs (CMJ60%: +7.7%, p < 0.01). In contrast, unloaded SJ and CMJ performances remained largely unchanged for all athletes. Both groups demonstrated a significantly steeper post-intervention force–velocity profile (p < 0.001), indicating an enhanced capacity to produce force at lower movement velocities under external loading. Conclusions: Strength–speed-oriented VBT was effective in improving power production under loaded conditions but had limited transfer to unloaded jump performance. These findings highlight the necessity of subsequent training blocks emphasizing high-velocity, sport-specific movements to optimize explosive performance. Future studies should further investigate low-velocity-loss training protocols as a potential means of enhancing unloaded jump outcomes. Full article

Objective: This study aimed to compare the external load demands of large-sided games, with and without regulatory interruptions, to the average (FOOTmatch) and most demanding scenarios (MDSmatch) observed in official football matches, taking into account players’ pitch positions. Methods: Large-sided training games were implemented with regulatory interruptions (FOOTtask) and without interruptions (MURDtask), during which a coach continuously introduced new balls to maximise effective playing time. GPS data were collected from eight official matches and six training sessions, involving a total of 30 young male football players. Results: MURDtask surpassed FOOTmatch, FOOTtask, and even MDSmatch in distance covered (Effect Size = 0.6–2.5), and equaled MDSmatch in the number of decelerations > 3 m·s⁻². Both FOOTtask and MURDtask exceeded the average match demands in most locomotor external load variables, except for sprinting efforts > 28 km·h⁻¹. However, none of the training games reached the peak values of MDSmatch in high-speed running or high-intensity accelerations and decelerations (>4 m·s⁻²). Positional analysis revealed significantly higher values in MDSmatch for most variables, except for decelerations <−3 m·s⁻². Conclusions: MURDtask is a useful strategy to overload players, but additional tasks are required to replicate high-speed and high-intensity accelerations and decelerations typical of MDSmatch. Full article

Background: As cardiovascular medicine advances rapidly, the integration of artificial intelligence (AI) has garnered increasing attention. Although AI has been widely adopted in diagnostics, risk prediction, and decision support, its application in exercise-based cardiovascular rehabilitation is still limited, representing a new and promising research frontier. Objective: This scoping review aimed to identify and analyze original studies that have applied AI to exercise-based interventions designed to improve cardiovascular outcomes. Methods: Following the PRISMA-ScR guidelines, PubMed, Scopus, Web of Science, Embase, and IEEE Xplore were searched for articles published between January 2015 and August 2025. Eligible studies were peer-reviewed by human research employing AI (machine learning or deep learning) to deliver, adapt, or monitor an exercise intervention with cardiovascular outcomes. Reviews, diagnostic-only studies, protocols without data, and animal studies were excluded. Non-original works (reviews, protocols), animal studies, and purely diagnostic applications were excluded, ensuring a strict focus on AI applied within exercise interventions. Data extraction focused on study design, AI method, exercise modality, outcomes, and findings. Results: From 2183 records, nine studies met the inclusion criteria (two RCTs, feasibility pilots, and validation studies). Designs included feasibility pilots, randomized controlled trials (RCTs), and validation studies. AI applications encompassed adaptive step goals, reinforcement learning for engagement, coaching apps, machine learning–based exercise prescription, and continuous monitoring (e.g., VO₂ estimation). These AI methods, such as machine learning and reinforcement learning, were used to personalize exercise interventions and improve cardiovascular outcomes. Reported outcomes included blood pressure reduction, improved adherence, increased daily steps, improvement in VO₂max, continuous physiological monitoring, and enhanced diagnostic accuracy. Conclusions: Findings demonstrate that AI has the potential to significantly enhance cardiovascular rehabilitation. It can personalize exercise prescriptions, enhance adherence, and facilitate safe monitoring in home settings. However, the evidence base remains preliminary, with very few RCTs and substantial methodological heterogeneity. Future research must prioritize large-scale clinical trials, explainable AI, and equitable implementation strategies to ensure clinical translation. Full article

Purpose: The aim of this review is to provide an overview of the effects of commonly used dietary supplements on soccer performance and to bridge the gap between scientific evidence and their practical application by practitioners working with elite soccer players. Methods: Relevant literature involving dietary supplement use in soccer players was identified through searches of PubMed, EMBASE, Scopus, and Web of Science. Additionally, insights were gathered from a cross-sectional online questionnaire completed by practitioners (nutritionists, physicians, sport scientists, strength and conditioning coaches, and heads of performance) working with first-division men’s teams across five European leagues. Eligible respondents were over 18 years old with >2 years of experience in elite sport. The 20-question survey, designed on Qualtrics and pilot-tested for content validity, covered practitioner background, beliefs about supplementation, and real-world practices. The study was approved by the Ethical Independent Committee in Genoa, Italy (Ref. 2020/12). Results: Among performance-enhancing supplements, caffeine has been shown to improve endurance, sprint performance, power, and cognitive function, while creatine consistently enhances short-duration, high-intensity efforts. Beta-alanine and sodium bicarbonate help reduce the buildup of acidity in muscles during repeated high-intensity exercise, supporting repeated sprint performance. For hydration and endurance support, dietary nitrates improve blood flow and oxygen delivery to muscles, and glycerol enhances fluid retention in hot environments and during compressed match schedules, where players compete in multiple matches within a short recovery window. Regarding recovery aids, protein and tart cherry supplementation have been shown to accelerate recovery, reduce muscle damage, and support training adaptations. Field insights revealed that creatine and caffeine were widely adopted by practitioners (>90%), with protein powders also commonly recommended (>80%). In contrast, beta-alanine, tart cherry, and dietary nitrates were only partially integrated into daily practice (30%, 32%, and 48.5%, respectively), while sodium bicarbonate (24%) and glycerol (10.5%) were used by a minority. Conclusions: Although scientific evidence provides a strong foundation for the efficacy of dietary supplements, their translation into elite soccer practice is shaped by a range of practical factors, including cultural resistance, taste preferences, gastrointestinal side effects, established team routines, and individual player preferences. These findings highlight the importance of targeted education for players and staff, individualized supplementation plans, and close collaboration between nutritionists, coaches, and medical teams. However, our survey did not directly assess reasons for non-implementation. In addition to practical barriers reported by practitioners, unfamiliarity with current evidence likely contributes to this evidence–practice gap. Full article

Background: The aim of the study was to investigate the effects of a novel two-week dynamic high-intensity interval training (HIIT) protocol, characterized by fixed-load and variable-time intervals (“two times up to ten minutes”), on performance and metabolic adaptations in well-trained cross-country skiers. Methods: Ten qualified skiers (six males, four females) completed six interval training sessions over two weeks. Pre- and post-intervention tests were performed to assess maximal oxygen consumption (VO_2max) and ski speed reached, blood lactate concentration, respiratory gas exchange data, and body weight. Results: Maximal speed at VO_2max increased significantly from 13.5 ± 2.16 to 14.8 ± 1.7 km/h (p = 0.0196; Cohen’s d = 1.06). VO_2max itself was retained (p > 0.05), equivalence testing confirmed stable values within a ±2.8 mL/kg/min margin. Time to reach RER = 1.0 improved significantly across sessions (p = 0.021), indicating enhanced metabolic efficiency. Body weight decreased modestly but statistically significantly by 0.54 kg (p = 0.016). Conclusions: The dynamic HIIT protocol improved maximal performance (speed at VO_2max by 32.9%) and metabolic efficiency in trained skiers without altering VO_2max. These findings support the usefulness of flexible, individualized HIIT models to enhance aerobic endurance, especially for athletes at risk of performance plateaus. Full article

Objectives: Ammonia inhalants (AIs) are commonly used in competition with the assumption that they will increase arousal and reduce the detrimental effects of mental fatigue on performance. However, as the effect of AIs on mental fatigue is unclear, this study investigated (1) whether mental-fatigue-related changes in mood states are associated with reductions in maximal lower-body force production and (2) whether AIs reduce any mental-fatigue-induced changes in performance. Methods: In a randomized, crossover designed study, nine resistance trained males completed two trials, with and without AIs. Profile of mood states, isometric midthigh pull force, and electromyography were measured before and after completion of a 75 min AX-continuous performance test (AX-CPT). For AI trials, AIs were used prior to post-AX-CPT IMTPs. Results: The AX-CPT significantly increased all negative mood subscales, while decreasing vigor (all p < 0.05), resulting in an increase in total mood disturbance (pre-AX-CPT: 27.1 ± 3.17 vs. post-AX-CPT: 64.49 ± 4.01; p = 0.005). Additionally, compared to baseline, force was reduced immediately (1699 ± 345 vs. 1521 ± 324 N; p = 0.009), but not five minutes post-AX-CPT (p = 0.328). Electromyography did not change over time, and no differences between treatments were evident for any of the measures. Conclusions: Mental fatigue, and related mood disturbance, has the potential to acutely reduce lower-body, maximal force. This finding may have implications for athletes competing in strength sports where mental focus, arousal and maximal force production determine optimal performance. However, AIs offer no benefit to alleviating the detrimental effects of mental fatigue. Full article

Background: Body surface area is a key determinant of cardiac morphology and function, but it is often underestimated in the interpretation of athlete’s cardiac phenotypes. Aims: This study aimed to assess the role of anthropometric characteristics and whether particularly high vs. low body surface area (BSA) is associated with distinct morpho-functional and cardiometabolic features in elite athletes. Methods: We retrospectively included 2518 Olympic athletes. All underwent a pre-participation screening, including physical examination, ECG, blood analysis, echocardiography, and cardiopulmonary exercise testing. Participants were grouped by sex-specific BSA percentiles: Group A (<5th percentile), Group B (25th–75th), and Group C (>95th percentile). Functional, echocardiographic, and cardio-metabolic parameters were compared among groups. Results: In male athletes, Group C showed higher resting systolic blood pressure (123.8 ± 10.4 mmHg) than Group B (117.4 ± 9.6, p < 0.0001) and Group A (110.4 ± 13, p < 0.0001), and a higher prevalence of dyslipidemia (31.7% vs. 11.1% in Group B and 4% in Group A, p = 0.031). Despite greater LVEDD (59 ± 3 mm in Group C vs. 55 ± 2.9 in B and 51.1 ± 3.1 in A, p < 0.0001) and LV mass (p < 0.0001), functional performance was lower in Group C, with VO₂ max/kg of 35.2 ± 13.2 mL/min/kg vs. 44 ± 7.1 in B, and 47.8 ± 7.3 in A (p < 0.0001). Similar trends were observed in females for morpho-functional parameters, though lipid profiles did not significantly differ among groups (p > 0.05). Conclusions: Anthropometric traits significantly influence the cardiovascular and metabolic phenotype of elite athletes. Our findings support the integration of anthropometric profiling into the routine cardiovascular assessment of athletes, especially those at the extremes of body size, to better interpret physiological adaptations and risk profiles. Full article

Background: Football performance depends on the integration of physical, technical, and cognitive abilities under constantly changing conditions. In this context, dual-task training combining physical and cognitive demands has emerged as a promising approach to enhance decision-making and game intelligence in youth football players. Objective: The aim of this study was to determine the effects of an eight-week dual-task training programme on physical (speed, strength, and agility), cognitive (working memory, planning, processing speed, and response time), technical (dribbling and short passing), and dual-task performance in U16 football players. Methods: Thirty-two players (age: 14.88 ± 0.65 years; BMI: 20.98 ± 1.79 kg/m²) were randomly assigned to a control group (n = 14) and an experimental group (n = 18). The experimental group completed a dual cognitive–motor training (CMT) programme consisting of 24 sessions (3 sessions/week, 10–15 min each), integrated into regular football practice. Pre-intervention and post-intervention assessments included football skills (dribbling and passing tests), cognitive tests (Wom-Rest and Vismem-Plan), physical tests (countermovement jump, 20 m sprint, and 505 change-of-direction), and a dual-task test (soccer skills and cognitive aptitude test). Results: The experimental group showed significant improvements in all assessed variables, while the control group exhibited no changes or declines in performance. The most notable effects were observed in SoSCAT with visual interference, dual-task cost, and 505 change-of-direction. Conclusions: The findings suggest that integrating brief dual CMT programmes into regular football practice can simultaneously enhance physical, technical, and cognitive performance in youth players. This evidence supports the implementation of dual CMT as an effective and time-efficient tool in talent development programmes. Full article

Background: Previous studies have experimentally investigated and simulated the effects of dynamic hyperinflation on respiratory system resistance variables in populations with different respiratory diseases. However, the acute effects of exercise on these parameters in healthy young adults are unknown; therefore, the objective of this study was to investigate the effects of a submaximal exercise test on the resistance of the respiratory system in healthy adult individuals. Methods: This is an observational study conducted with healthy adults. Fifty healthy volunteers were recruited, of both sexes, over the age of 18, with no previous uncontrolled respiratory diseases and normal spirometry, with an average age of 32.2 ± 11.6 years old and an average BMI of 24.3 ± 3.87 kg/m². The participants underwent an anamnesis, the Impulse Oscillometry Test (IOS) with the variables R5, R20, X5, Fres and AX, followed by the six-minute walk test (6MWT), another IOS measure, immediately after the 6MWT, finishing with a spirometry test. A paired t-test was used for the analyses. Results: Our results showed that the volunteers exhibited a decrease after the 6MWT in the oscillometry parameters R5 (0.35 to 0.32, p = 0.0001), R20 (0.33 to 0.30, p < 0.0001), X5 (−0.13 to −0.10, p < 0.0001), Fres (13.07 to 11.70, p = 0.0042) and AX (0.48 to 034, p = 0.01). In addition, the volunteers walked an average of 623.34 ± 42.6 m in the 6MWT, which represents around 96.6% of what was predicted for this group. Conclusions: Submaximal exercise, as assessed by the 6MWT, acutely reduces respiratory impedance in healthy individuals, which can facilitate moderate-intensity physical activity, preventing sedentary behavior. Full article