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J. Funct. Morphol. Kinesiol., Volume 11, Issue 1 (March 2026) – 130 articles

Cover Story (view full-size image): Walking cadence strongly influences the biomechanical strategies used during locomotion. In this study, healthy adults walked on a treadmill while step cadence was systematically modulated using a metronome. Kinematic and kinetic adaptations were analyzed together with plantar pressure distribution to investigate how cadence changes affect gait mechanics. Increasing cadence altered lower-limb dynamics and redistributed plantar loading patterns, revealing coordinated adjustments in locomotor control. These findings provide insight into how cadence modulation shapes human walking biomechanics and may help inform gait training, rehabilitation strategies, and performance optimization. View this paper
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24 pages, 3449 KB  
Review
Collagen Supplementation on Tendon-Related Structural and Performance Outcomes: A Systematic Review
by Albert Buchalski, Michael Jeanfavre, Colby Altorelli and Gretchen Leff
J. Funct. Morphol. Kinesiol. 2026, 11(1), 130; https://doi.org/10.3390/jfmk11010130 - 23 Mar 2026
Viewed by 13405
Abstract
Background: Tendons adapt to mechanical loading by increasing cross-sectional area (CSA), stiffness, and matrix organization, with structural remodeling critical for both rehabilitation and performance. Collagen supplementation has been proposed to enhance this process by supplying key amino acids for collagen synthesis; however, inconsistent [...] Read more.
Background: Tendons adapt to mechanical loading by increasing cross-sectional area (CSA), stiffness, and matrix organization, with structural remodeling critical for both rehabilitation and performance. Collagen supplementation has been proposed to enhance this process by supplying key amino acids for collagen synthesis; however, inconsistent results across trials have limited its clinical and athletic application. Methods: A systematic review of randomized controlled trials evaluating collagen supplementation in humans was conducted. PubMed, EMBASE, CINAHL, and Web of Science were searched from database inception through May 2025. Risk of bias was assessed using the PEDro scale (≥6/10 classified as good-to-excellent quality). Due to substantial heterogeneity in supplementation protocols, training modalities, and outcome measures, results were synthesized narratively without meta-analysis. Data extraction included collagen type, dose, training modality, intervention duration, and outcome measures. Results: Of 887 unique citations, eight RCTs (n = 257; ages 18–52; 246 M:11 F) met the inclusion criteria. All studies incorporated resistance or plyometric training (3–15 weeks). Three of four studies reported significantly greater increases in tendon CSA in collagen groups versus placebo. Four studies investigated tendon stiffness and Young’s modulus; the two using higher doses (15–30 g/day) demonstrated significant between-group improvements favoring collagen, while lower-dose studies (~5 g) showed only within-group effects. Muscle strength improved with training in all trials, but no additive effects of collagen were observed. One study reported improvements in eccentric rate of force development and deceleration impulse with collagen, though gross explosive metrics (e.g., jump height) were unaffected. Conclusions: Collagen supplementation (15–30 g) with vitamin C (≥50 mg) may enhance tendon remodeling when combined with high-intensity resistance training (≥70% 1 RM). The current literature suggests strong evidence (GRADE A) for increases in tendon CSA and stiffness, strong evidence (GRADE A) against an effect on muscle strength, and conflicting evidence (GRADE C) for muscle cross-sectional area and physical performance. Limitations include small sample sizes, heterogeneous protocols, and short intervention durations. Full article
(This article belongs to the Special Issue The Effects of Resistance Training on Musculoskeletal Health)
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14 pages, 881 KB  
Article
High Tibial Osteotomy for Knee Osteoarthritis with Genu Varum: A Retrospective, Observational Study
by Ana Ramos, Jordi Zafra and Jordi Villalba
J. Funct. Morphol. Kinesiol. 2026, 11(1), 129; https://doi.org/10.3390/jfmk11010129 - 23 Mar 2026
Viewed by 922
Abstract
Background: High tibial osteotomy (HTO) is a joint-preserving alternative for patients with medial compartment knee osteoarthritis (KOA), although its use has declined in recent decades in favor of total knee arthroplasty (TKA). This study aimed to evaluate HTO outcomes in patients treated at [...] Read more.
Background: High tibial osteotomy (HTO) is a joint-preserving alternative for patients with medial compartment knee osteoarthritis (KOA), although its use has declined in recent decades in favor of total knee arthroplasty (TKA). This study aimed to evaluate HTO outcomes in patients treated at a tertiary center over the past decade. Methods: We conducted a single-center, retrospective, observational cohort study of patients with medial femorotibial KOA and genu varum who underwent HTO. Failure was defined as conversion to TKA. A comparative analysis regarding HTO survival was conducted with preoperative variables and KOA stages in the follow-ups up to 5 years. Univariate and multivariate Cox regression models were built to assess their effect on HTO survival time. The Kaplan–Meier method was used to estimate overall and subgroup survival. Disease progression over time was evaluated with the Bhapkar test. In all cases, p < 0.05 was considered statistically significant. Results: HTO was successful in 74.6% of the 63 patients. Age was significantly higher in the failure group (p = 0.006), and each additional year increased the hazard of failure by 8% (95% CI, 1.01–1.16, p = 0.033), although this significance was lost in multivariate analysis (p = 0.104). Kaplan–Meier estimated survival was 76.7% at 5 years, with a median survival time of 10.1 years. KOA stage progression was significant 5 years after HTO (p < 0.001). Conclusions: HTO demonstrated 76.7% survival at 5 years, with radiographic KOA progression over time. The association between age and failure was not maintained after multivariable adjustment. Full article
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18 pages, 1179 KB  
Article
Beyond the Disc: Positional Differences in Morphological and Physical Performance Characteristics Among Male Ultimate Frisbee Players
by Cristian Hernández, María Alejandra Camacho-Villa, Nuria Sánchez-Hernández, Luis Gabriel Rangel Caballero, Jorge Gómez-Camacho, Juan Carlos Saavedra, Jorge Enrique Buitrago-Espitia and Adrián De la Rosa
J. Funct. Morphol. Kinesiol. 2026, 11(1), 128; https://doi.org/10.3390/jfmk11010128 - 22 Mar 2026
Viewed by 749
Abstract
Background: Ultimate Frisbee (UF) is an intermittent team sport with distinct positional roles (cutters and handlers), yet evidence integrating anthropometric, body composition, and physical performance profiles by playing position remains limited. This study aimed to examine positional differences in these variables among male [...] Read more.
Background: Ultimate Frisbee (UF) is an intermittent team sport with distinct positional roles (cutters and handlers), yet evidence integrating anthropometric, body composition, and physical performance profiles by playing position remains limited. This study aimed to examine positional differences in these variables among male UF players. Methods: Forty male players (age: 25.13 ± 3.76 years; 7.0 ± 2.5 years of training experience) participated in this cross-sectional design, including 20 cutters and 20 handlers. Anthropometry, body composition, and dynamic balance variables were analyzed using independent-samples t-tests or Mann–Whitney U tests, as appropriate. Positional differences in somatotype and physical performance were analyzed using a one-way multivariate analysis of variance (MANOVA). Results: No positional differences were observed in general anthropometric variables (p > 0.05). However, handlers exhibited higher body fat percentage (14.32 ± 2.37 vs. 11.95 ± 2.45; p = 0.028), fat mass (11.08 ± 2.51 vs. 8.95 ± 2.67 kg; p = 0.049), and endomorphy (4.15 ± 1.22 vs. 2.99 ± 1.30; p = 0.002) than cutters. In contrast, cutters demonstrated higher speed (20 m sprint: 3.11 ± 0.17 vs. 3.21 ± 0.15 s; p < 0.05), agility (10.16 ± 0.69 vs. 10.69 ± 0.61 s; p < 0.05), and vertical jump performance (Counter Movement Jump: 40.93 ± 6.54 vs. 36.38 ± 4.71 cm; p < 0.05; Abalakov: 46.39 ± 7.88 vs. 40.20 ± 4.68 cm; p < 0.01). No differences were found in intermittent endurance (Yo-Yo Intermitent Recovery Test1): 982 ± 354 vs. 940 ± 348 m), upper-limb power, or dynamic balance. Conclusions: These findings indicate that playing position in UF is characterized by distinct body composition and lower-limb neuromuscular performance profiles, whereas intermittent endurance, upper-limb power, and balance represent shared physical requirements across positions. Full article
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28 pages, 5556 KB  
Article
Evaluating the Effect of the Schroth Method on Sensorimotor Control in Adolescents with Idiopathic Scoliosis: A Controlled Clinical Trial
by Alexandros Kastrinis, Nikolaos Strimpakos, George A. Koumantakis, Dionysios Tzatzaliaris, Marianna Oikonomaki and Zacharias Dimitriadis
J. Funct. Morphol. Kinesiol. 2026, 11(1), 127; https://doi.org/10.3390/jfmk11010127 - 21 Mar 2026
Viewed by 672
Abstract
Background: Adolescent idiopathic scoliosis (AIS) is often associated with central nervous system disorders and deficits in sensorimotor function. While the Schroth method is a common clinical intervention, research evidence regarding its effectiveness in enhancing sensorimotor control remains limited. This study aimed to [...] Read more.
Background: Adolescent idiopathic scoliosis (AIS) is often associated with central nervous system disorders and deficits in sensorimotor function. While the Schroth method is a common clinical intervention, research evidence regarding its effectiveness in enhancing sensorimotor control remains limited. This study aimed to evaluate the impact of the Schroth method on sensorimotor control and quality of life (QoL) in AIS patients. Methods: Sixty female participants (mean age 13.4 years) with Cobb angles between 10° and 45° were divided into an intervention group (n = 30), receiving Schroth exercises and bracing for 10 weeks, and a control group (n = 30), receiving bracing alone. Outcome measures included static and dynamic balance, spine lateral flexion joint position sense (JPS), upper-limb functional proprioception, and the GR-BSSQ Brace questionnaire. Results: Statistical analysis using two-way mixed ANOVA revealed significant Group × Time interactions across several parameters. The Schroth group showed significant improvements in static and dynamic balance, with ellipse area reduction (p = 0.005) and reduced Fukuda test distance (p = 0.007), respectively. Significant enhancements were noted in spine lateral flexion JPS (Bilateral p = 0.008) and upper-limb proprioception (Bilateral p = 0.000). Furthermore, the intervention group reported a significant improvement in QoL scores compared to the control (p = 0.000). Conclusions: The findings demonstrate that the Schroth method was associated with enhanced sensorimotor control, supporting its use as a targeted approach to improve functional outcomes in individuals with AIS. These results highlight the clinical value of the method, beyond spinal curve correction. Full article
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17 pages, 1529 KB  
Article
A 3D-Printed Home-Based Arthroscopic Simulator Improves Basic Surgical Skills: A Prospective Comparative Multicentre Study
by Marco Montemagno, Luigi Zaffarana, Flora Maria Chiara Panvini, Ludovico Lucenti, Alessandra Di Nora, Egidio Avarotti, Angelo Di Giunta, Gianluca Testa and Vito Pavone
J. Funct. Morphol. Kinesiol. 2026, 11(1), 126; https://doi.org/10.3390/jfmk11010126 - 21 Mar 2026
Viewed by 380
Abstract
Objectives: Arthroscopic surgery requires complex visuospatial coordination and psychomotor skills, which are traditionally acquired through mentorship and cadaveric training. High-fidelity simulators are effective but often costly and inaccessible. This study evaluates the technical effectiveness of a novel home-based 3D-printed arthroscopic simulator (“Arthrozero”) [...] Read more.
Objectives: Arthroscopic surgery requires complex visuospatial coordination and psychomotor skills, which are traditionally acquired through mentorship and cadaveric training. High-fidelity simulators are effective but often costly and inaccessible. This study evaluates the technical effectiveness of a novel home-based 3D-printed arthroscopic simulator (“Arthrozero”) for improving basic arthroscopic skills among orthopedic residents. Methods: Thirty-three orthopedic residents (25–36 years) from two Italian university centers were randomized into three groups: ZERO (Arthrozero training), ARTHRO (real arthroscope training), and CONTROL (theoretical session). Training was performed on a FAST-like workstation through four progressively complex tasks. Performance metrics included task completion time, number of looks down, and skill progression during a final Shoulder Challenge (SHO-CHA) assessment. A web-based Likert questionnaire evaluated participant satisfaction and perceived educational value. Results: Both ZERO and ARTHRO groups demonstrated significant improvement across training sessions (p < 0.05) for all tasks, while the CONTROL group showed minimal gains. In the SHO-CHA assessment, mean completion times were 394.1 ± 140.7 s (ZERO), 456.1 ± 123.2 s (ARTHRO), and 745.5 ± 190.7 s (CONTROL) (p < 0.01). No significant difference was observed between ZERO and ARTHRO groups (p = 0.276). Conclusions: The home-based Arthrozero simulator demonstrated improvements in basic arthroscopic skill performance, suggesting that it may represent an accessible training tool to support early arthroscopic skill acquisition alongside traditional training methods. Full article
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15 pages, 568 KB  
Article
Effects of Higher Dietary Protein Intake on Isokinetic Muscle Performance in Older Adults with Type 2 Diabetes Mellitus
by Stavroula Kalyva, Dionysia Argyropoulou, Panagiotis Koulouvaris, Charilaos Tsolakis, Gerasimos Terzis, Tzortzis Nomikos, Nickos D. Geladas, Anastasios A. Theodorou and Vassilis Paschalis
J. Funct. Morphol. Kinesiol. 2026, 11(1), 125; https://doi.org/10.3390/jfmk11010125 - 19 Mar 2026
Viewed by 448
Abstract
Background: Type 2 diabetes mellitus (T2DM) is linked to accelerated losses in muscle function. The aim of the present investigation was to evaluate the effect of chronic higher-protein intake on isokinetic knee performance in the older adults with type 2 diabetes mellitus [...] Read more.
Background: Type 2 diabetes mellitus (T2DM) is linked to accelerated losses in muscle function. The aim of the present investigation was to evaluate the effect of chronic higher-protein intake on isokinetic knee performance in the older adults with type 2 diabetes mellitus (T2DM). Methods: Thirty adults (15 men and 15 women) aged 60–80 years with non-insulin-treated T2DM and sarcopenia-related deficits were randomized for 12 weeks to a higher-protein diet (1.2–1.5 g·kg−1·day−1) or a recommended protein diet (0.8–1.0 g·kg−1·day−1), with meal plans designed to maintain body mass. Protein was increased mainly through Mediterranean-style protein sources while diet was monitored using repeated 3-day recalls. Isokinetic knee extensors and flexors peak torque (angular velocity 60°/s) was assessed at baseline and at week 6 and at the end of the 12th week of intervention. Fatigability (20 maximal contractions at an angular velocity at 180°/s) and DXA body composition were assessed at baseline and at the end of the 12th week of intervention. Data were analyzed using two-way repeated-measures ANOVA with repeated measures on time (2 groups × 3 time points), followed by post hoc analysis when significant difference was occurred. Results: Thirty participants completed the trial. Energy intake and body mass remained stable in both groups. At the end of week 12, peak torque declined in the control group (p < 0.05) but remained stable in the higher-protein group. The fatigue index worsened over time in controls but was preserved in the higher protein group, resulting in a significant group d7 time interaction at week 12 (p < 0.05) (post hoc between-group difference at week 12, p < 0.05). Fat-free mass and blood pressure did not change. In fat mass, a decrease was observed with higher protein intake, whereas it remained stable in the control group. Conclusions: Higher protein intake for 12 weeks preserved knee muscle performance in older adults with T2DM without weight gain, supporting dietary protein optimization to counter functional decline. Full article
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17 pages, 1221 KB  
Review
A Systematic Review of the Factors Associated with Performance in Non-Elite Runners
by Mabliny Thuany, Mayara Silva, Matheus Fernandes, Beat Knechtle, Katja Weiss, Thomas Rosemann, Thayse Natacha Gomes, Ramiro Rolim and Marcos André Moura dos Santos
J. Funct. Morphol. Kinesiol. 2026, 11(1), 124; https://doi.org/10.3390/jfmk11010124 - 18 Mar 2026
Viewed by 668
Abstract
Background: We aimed to (i) identify the factors associated with performance in non-elite runners, (ii) present the terms and definitions/attributes used to characterize runners, and (iii) identify how performance has been operationalized. Methods: Our search was conducted using the databases PubMed, [...] Read more.
Background: We aimed to (i) identify the factors associated with performance in non-elite runners, (ii) present the terms and definitions/attributes used to characterize runners, and (iii) identify how performance has been operationalized. Methods: Our search was conducted using the databases PubMed, Web of Science, Medline Ovid, Cochrane, PsycInfo, Scielo, Scopus, and SportDiscus in October 2023 and updated in February 2026. Original articles that assessed factors associated with performance in non-elite runners competing in distances ranging from 5 km to ultramarathons were included. The findings were summarized by race distance. The Joanna Briggs Institute Analytical Cross-Sectional Studies critical appraisal tool was used for quality assessment. Results: A total of 4151 studies were identified, and 66 studies were included in the final selection. “Recreational” and “athletes” were the most used terms, and finish time was the most common indicator of performance. Performance decline was influenced by arm circumference and mid-axillary skinfold thickness, smoking, body mass index, alcohol consumption, and weather characteristics. Training variables, physiological determinants, and social variables were positively related to performance. Conclusions: The field struggles with a lack of clarity regarding the nomenclature and criteria used to categorize runners. The relevance of a predictor differs according to race distance, with physiological aspects becoming less important at higher distances (i.e., marathon and ultramarathon). Full article
(This article belongs to the Section Athletic Training and Human Performance)
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18 pages, 2918 KB  
Review
A Narrative Review of Shockwave Therapy in Plantar Fasciitis
by Yunfeng Sun, Caterina Fede, Xiaoxiao Zhao, Federico Giordani, Hannes Müller-Ehrenberg, Carmelo Pirri and Carla Stecco
J. Funct. Morphol. Kinesiol. 2026, 11(1), 123; https://doi.org/10.3390/jfmk11010123 - 17 Mar 2026
Viewed by 1181
Abstract
This narrative review synthesizes evidence from 108 studies to provide the first comprehensive overview of extracorporeal shockwave therapy (ESWT) for plantar fasciitis across three key domains. First, assessment methodologies were evaluated, identifying 36 distinct tools classified into six categories, including pain (with the [...] Read more.
This narrative review synthesizes evidence from 108 studies to provide the first comprehensive overview of extracorporeal shockwave therapy (ESWT) for plantar fasciitis across three key domains. First, assessment methodologies were evaluated, identifying 36 distinct tools classified into six categories, including pain (with the Visual Analog Scale being the most frequently used), function (most commonly the Foot Function Index), plantar fascia thickness, and other measures. Second, treatment protocols were analyzed, revealing commonly applied parameters of 2000 impulses per session and an energy flux density of 0.2 mJ/mm2 or 3.0 bar. Third, the comparative status of ESWT relative to other interventions was examined. Across 18 alternative treatments, corticosteroid injections, platelet-rich plasma (PRP), dextrose prolotherapy, laser therapy, and ultrasound were the most frequently compared modalities. ESWT and comparator interventions demonstrated differential advantages across specific outcomes; however, these findings cannot be directly translated into clinical recommendations, due to the limitations of the available evidence. By consolidating fragmented data, the present review clarifies the current research landscape and provides a foundational reference to support outcome evaluation and individualized treatment selection. Full article
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14 pages, 653 KB  
Review
Gastrocnemius Recessions in the Management of Chronic Recalcitrant Plantar Fasciopathy—A Systematic Review
by Gianmarco Gemini, Antonio Mazzotti, Elena Artioli, Laura Langone, Federico Sgubbi, Alberto Arceri, Gianmarco Di Paola, Simone Ottavio Zielli and Cesare Faldini
J. Funct. Morphol. Kinesiol. 2026, 11(1), 122; https://doi.org/10.3390/jfmk11010122 - 17 Mar 2026
Viewed by 553
Abstract
Background: Chronic Recalcitrant Plantar Fasciopathy (CRPF) is resistant to conservative treatments and has historically been managed with Open Plantar Fasciotomy (OPF). This systematic review aims to evaluate the role of the Gastrocnemius Release Procedures (GRPs) in treating CRPF, focusing on its indications, [...] Read more.
Background: Chronic Recalcitrant Plantar Fasciopathy (CRPF) is resistant to conservative treatments and has historically been managed with Open Plantar Fasciotomy (OPF). This systematic review aims to evaluate the role of the Gastrocnemius Release Procedures (GRPs) in treating CRPF, focusing on its indications, surgical techniques and clinical outcomes. Methods: A systematic literature search was conducted following PRISMA guidelines using MEDLINE, Cochrane and Scopus. Studies pertinent to the topic were screened, and those that reported clinical outcomes of GRPs in patients with CRPF were retrieved. The quality assessment was carried out using the Newcastle–Ottawa Scale. Results: Eighteen studies met the inclusion criteria, analyzing a total of 901 patients with a mean follow-up of 27.8 months. Indications for performing GRPs subsisted if conservative treatment failed to relieve pain and if Isolated Gastrocnemius Contracture (IGC) was present. All GRPs significantly reduced pain, with Visual Analogue Scale (VAS) scores decreasing from a mean of 7.3 pre-operatively to 2.56 post-operatively (64.93% reduction). American Orthopaedic Foot & Ankle Society (AOFAS) scores improved from 50.1 to 84.7 on average. Ankle dorsiflexion increased by an average of 7.75°. Patient satisfaction was high, with an average rate of 85% (range 61.6% to 100%). Minor complications were reported but resolved in most cases. Conclusions: Indications for performing GRPs still need to be clarified, and the best surgical technique remains to be defined. Nevertheless, the GRP seems to offer sustained pain relief and functional improvement in patients with CRPF. Full article
(This article belongs to the Collection Advances in Rehabilitation and Injury Management)
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13 pages, 7333 KB  
Article
Cadaveric and Ultrasound-Guided Evaluation of Two Needling Approaches Targeting the Pectoralis Minor Muscle: A Pilot Feasibility Study
by José L. Sánchez-Sánchez, Pedro Belón-Pérez, Xavier Grevol-Coll, Miguel Robles-García, Gustavo Plaza-Manzano, César Fernández-de-las-Peñas and Laura Calderón-Díez
J. Funct. Morphol. Kinesiol. 2026, 11(1), 121; https://doi.org/10.3390/jfmk11010121 - 16 Mar 2026
Viewed by 538
Abstract
Background: The pectoralis minor muscle can be a source of musculoskeletal-related chest pain by contributing to thoracic outlet syndrome. Needling interventions applied to chest wall muscles have an inherent risk of puncturing sensitive structures, e.g., the pleura. Objective: The objective of [...] Read more.
Background: The pectoralis minor muscle can be a source of musculoskeletal-related chest pain by contributing to thoracic outlet syndrome. Needling interventions applied to chest wall muscles have an inherent risk of puncturing sensitive structures, e.g., the pleura. Objective: The objective of this study was to preliminarily investigate the safety and accuracy of two needling approaches targeting the pectoralis minor muscle. Methods: A pincer- and flat-needle approach targeting the pectoralis minor muscle was conducted in five Thiel-embalmed cadavers and 10 healthy volunteers by an experienced and a novice clinician. The needle was inserted until the clinician considered that the pectoralis minor muscle was reached. Each clinician conducted 10 needle insertions with each approach. In cadavers, the accuracy of needle placement was identified with both ultrasound imaging and anatomical dissection. In healthy volunteers, needle placement accuracy was evaluated with ultrasound imaging. Results: Accurate needle penetration of the pectoralis minor muscle was 80–90% and 40–70% for experienced and novice clinicians, respectively, with the pincer approach. One pleural puncture was observed in one cadaver specimen with this approach by the novice clinician. Accurate needle penetration of the pectoralis minor muscle was 100% and 90% for experienced and novice clinicians, respectively, with the flat approach. The novice clinician required 3.5 times longer to perform the flat approach than the experienced clinician. Conclusions: The results of this pilot feasibility study suggest that a pincer-needle approach seems to be less accurate than the flat-needle approach and substantially more error-prone for a novice clinician, which, in a clinical context, could pose a potential risk of pneumothorax based on the pleural puncture observed in one cadaver specimen. In contrast, our preliminary results revealed that the flat-needle approach could have better accuracy and safety, particularly when performed under real ultrasound guidance. Full article
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25 pages, 729 KB  
Perspective
Aquaticity as a Latent Dimension of Aquatic Performance: Conceptual Framework and Application to Breath-Hold Diving
by Ivan Drviš, Dario Vrdoljak, Nikola Foretić and Željko Dujić
J. Funct. Morphol. Kinesiol. 2026, 11(1), 120; https://doi.org/10.3390/jfmk11010120 - 16 Mar 2026
Viewed by 348
Abstract
Sports performance in aquatic environments is governed by biomechanical, physiological, neuromuscular and perceptual–mental constraints that differ fundamentally from those encountered on land. As a result, athletes with comparable general physiological or motor capacities may achieve markedly different performance outcomes in aquatic sports. Within [...] Read more.
Sports performance in aquatic environments is governed by biomechanical, physiological, neuromuscular and perceptual–mental constraints that differ fundamentally from those encountered on land. As a result, athletes with comparable general physiological or motor capacities may achieve markedly different performance outcomes in aquatic sports. Within functional kinesiology and sport science, aquatic performance is still frequently interpreted through isolated physiological, biomechanical, or technical variables, which limits both explanatory depth and applied relevance. This Perspective article introduces aquaticity as an integrated latent construct representing a multidimensional determinant of sports performance specific to the aquatic environment. Aquaticity is conceptualized as a functional framework that modulates how general physiological and motor capacities are expressed under aquatic constraints, integrating key domains of exercise physiology, sport biomechanics, neuromuscular control, energetic regulation, and perceptual–mental stability. The relative contribution of these domains is considered discipline-specific and dependent on task and environmental demands. Breath-hold diving is presented as a particularly suitable model for examining aquaticity, as apnea and hypoxic–hypercapnic stress amplify interactions between physiological regulation, neuromuscular control, and biomechanical efficiency. Training and diagnostic tasks performed in real aquatic settings are interpreted as manifest indicators of aquaticity, enabling ecologically valid athlete monitoring and performance assessment. Within this framework, energetic aquaticity is highlighted as a central functional sub-construct linking metabolic regulation, movement efficiency, and neural control during performance under respiratory constraints. The proposed conceptual framework has important implications for functional kinesiology, sport biomechanics, exercise physiology, and applied athlete monitoring in aquatic sports. Aquaticity is advanced not merely as a descriptive concept, but as a unifying framework that can guide future experimental research, discipline-specific diagnostics, individualized training design, and safety-oriented performance assessment in aquatic environments. Full article
(This article belongs to the Special Issue The Effects of Aquatic Activities on Health and Mobility)
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20 pages, 321 KB  
Article
Association Between Upper Extremity Function and Independence in Activities of Daily Living in Individuals with Motor-Incomplete Tetraplegia: An Exploratory Cross-Sectional Study
by Eleanna Strongylou, Dimitra Karadimitri, Maria Moutzouri, Magdalini Stamou, Christina-Anastasia Rapidi, Yannis Dionyssiotis, Eleni Moumtzi-Nakka and Vasiliki Sakellari
J. Funct. Morphol. Kinesiol. 2026, 11(1), 119; https://doi.org/10.3390/jfmk11010119 - 16 Mar 2026
Viewed by 947
Abstract
Background: Spinal cord injury (SCI) is a leading cause of chronic disability. Loss of upper extremity (U.E.) function is central to limitations, in mobility, postural control, transfers, and self-care. The aim of this exploratory pilot study was to investigate whether self-reported UE function [...] Read more.
Background: Spinal cord injury (SCI) is a leading cause of chronic disability. Loss of upper extremity (U.E.) function is central to limitations, in mobility, postural control, transfers, and self-care. The aim of this exploratory pilot study was to investigate whether self-reported UE function is associated with independence in activities of daily living (ADLs) in people with motor-incomplete tetraplegia. Methods: Eleven (n = 11) individuals with motor-incomplete tetraplegia (AIS C–D; neurological levels C4–T1; injury duration ≥ 1 year), recruited through convenience sampling from five specialist rehabilitation centres, participated in an exploratory cross-sectional pilot study designed to generate hypotheses rather than test them. U.E. function was assessed using the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire, selected for its ability to capture pain and task-related functional difficulty in the elbow, wrist, and hand; its application in this neurological population is considered exploratory. Independence in ADLs was evaluated using the Spinal Cord Independence Measure III (SCIM III). Given the small sample, all analyses were primarily descriptive and along with bivariate associations (Spearman correlations). Regression findings are reported strictly for exploratory purposes. Results: The median age was 50 years (interquartile range [IQR] 43–55). A strong negative correlation was observed between PRTEE total score and SCIM III (rs = −0.76). In an exploratory univariate analysis, each 1-point increase in PRTEE total score was associated with a 1.3-point lower SCIM III score (β = −1.3, 95% CI −2.34 to −0.26, p = 0.02). Age also showed a positive association (β = 1.31, 95% CI 0.04 to 2.58, p = 0.05) with SCIM III; however, this finding is highly likely to reflect a statistical artefact of the small and unrepresentative sample. Multivariable regression was not conducted as a primary analysis due to insufficient statistical power. All findings should be treated as strictly exploratory and hypothesis-generating. Conclusions: Self-reported U.E. function appears to be associated with ADL independence in motor-incomplete tetraplegia. U.E. capacity may contribute to functional tasks requiring postural stability and mobility-related activities, but no predictive inferences can be made from this underpowered, convenience sample. Future studies with larger cohorts and performance-based measures are needed to confirm these preliminary observations and clarify the role of U.E. function in rehabilitation planning. Full article
12 pages, 494 KB  
Article
Neuromuscular Profile of CrossFit® Athletes: Part 1—Isometric and Ballistic Performance
by Diego A. Alonso-Aubin, Ester Jiménez-Ormeño, César Gallo-Salazar, Verónica Giráldez-Costas, Diana Ruiz-Vicente, Sara Zafra-Díaz, Francisco Areces-Corcuera and Carlos Ruiz-Moreno
J. Funct. Morphol. Kinesiol. 2026, 11(1), 118; https://doi.org/10.3390/jfmk11010118 - 15 Mar 2026
Viewed by 422
Abstract
Background: CrossFit® has gained widespread popularity as a high-intensity training modality, yet evidence describing neuromuscular performance characteristics in this population remains limited. This study aimed to evaluate isometric and ballistic strength profiles in trained CrossFit® athletes and to identify sex-based [...] Read more.
Background: CrossFit® has gained widespread popularity as a high-intensity training modality, yet evidence describing neuromuscular performance characteristics in this population remains limited. This study aimed to evaluate isometric and ballistic strength profiles in trained CrossFit® athletes and to identify sex-based differences in absolute and relative neuromuscular performance. Methods: Seventy-two athletes participated (41 males and 31 females) participated in the study, completing two maximal isometric mid-thigh pull (IMTP) tests and three countermovement jump (CMJ) tests within a single testing session. Assessments were conducted using a dual force plate system (Hawkin Dynamics, Westbrook, ME, USA). Results: In the IMTP, males exhibited substantially higher absolute isometric force outputs, including peak force (3059 ± 576 vs. 1899 ± 324 N; p < 0.001) and relative peak force (36.34 ± 6.74 vs. 30.99 ± 4.41 N/kg; p < 0.001). Rates of force development were also greater in males for both early (0–50 ms: 7665 ± 5420 vs. 4001 ± 3021 N/s; p < 0.001) and late phases (0–250 ms: 5350 ± 1832 vs. 3035 ± 886 N/s; p < 0.001). However, no significant sex differences were detected in time to peak force (2.31 ± 1.27 vs. 1.94 ± 1.04 s) or dynamic strength index (0.72 ± 0.12 vs. 0.73 ± 0.12 a.u.). In ballistic performance using CMJ, males achieved higher jump height (0.33 ± 0.07 vs. 0.23 ± 0.05 m; p < 0.001), jump momentum (215 ± 27.9 vs. 131 ± 19.1 kg·m/s; p < 0.001), and modified reactive strength index (0.46 ± 0.11 vs. 0.32 ± 0.08 a.u.; p < 0.001). Relative propulsive and braking forces were also moderately greater in males. Notably, sex differences were reduced when variables were normalized to body mass or peak force, indicating comparable relative neuromuscular function across sexes. Conclusions: These findings provide descriptive neuromuscular performance data for CrossFit® athletes and show that sex-based differences primarily reflect disparities in absolute force-production capacity rather than intrinsic neuromuscular efficiency. Such insights may support more precise, evidence-informed, and sex-specific training prescriptions to optimize performance. Full article
(This article belongs to the Special Issue Biomechanical and Neuromuscular Perspectives in Resistance Training)
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26 pages, 869 KB  
Review
Factors Related to the Etiology of Hallux Abducto Valgus: A Systematic Review
by Marta María Moreno-Fresco, Stephen Mizzi, Pedro V. Munuera-Martínez and Priscila Távara-Vidalón
J. Funct. Morphol. Kinesiol. 2026, 11(1), 117; https://doi.org/10.3390/jfmk11010117 - 13 Mar 2026
Viewed by 690
Abstract
Background: The origin of hallux abducto valgus (HAV) is considered to be multifactorial; however, evidence regarding the factors involved in its development is scattered and often contradictory. Understanding the factors that contribute to the onset of HAV is crucial for informing both prevention [...] Read more.
Background: The origin of hallux abducto valgus (HAV) is considered to be multifactorial; however, evidence regarding the factors involved in its development is scattered and often contradictory. Understanding the factors that contribute to the onset of HAV is crucial for informing both prevention and clinical management strategies. This review aims to explore the etiological factors associated with the development of HAV. Methods: A literature search was conducted in PubMed, Embase, Web of Science and Scopus. The search included observational studies that investigated etiological or risk factors related to the development of HAV. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklists, and the level of evidence was classified according to the Oxford Centre for Evidence-Based Medicine (OCEBM). Results: A total of 36 observational studies (20 cross-sectional and 16 case–control) were included, involving 14,500 participants, predominantly females. Genetic evidence indicated strong familial aggregation and variants in collagen- and extracellular matrix-related genes as potential hereditary determinants. The most consistent biomechanical factors were first-ray hypermobility, abnormal foot pronation and reduced activity of the abductor hallucis muscle. Additionally, female sex, older age and prolonged use of narrow or inadequate footwear were identified as recurring predictive variables. Overall, the findings support a complex etiological model based on the interaction of intrinsic and extrinsic factors. Conclusions: The development of HAV appears to be determined by the interaction of genetic, structural and biomechanical factors that alter first-ray stability and forefoot function. Current evidence supports a multifactorial etiological model with a strong hereditary component and higher susceptibility in women. Longitudinal studies employing standardized methods are needed to establish causal relationships and quantify the relative contribution of each factor. Full article
(This article belongs to the Section Functional Anatomy and Musculoskeletal System)
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18 pages, 1822 KB  
Article
Measuring Plantar Flexor Voluntary Activation and Maximal Voluntary Contraction in a Portable, Seated Method: A Validity and Reliability Study
by Molly E. Coventry, Andrea B. Mosler, Paola T. Chivers, Brady D. Green, Ebonie K. Rio and Myles C. Murphy
J. Funct. Morphol. Kinesiol. 2026, 11(1), 116; https://doi.org/10.3390/jfmk11010116 - 10 Mar 2026
Viewed by 436
Abstract
Background: Voluntary activation testing quantifies the ability of the motor nervous system to produce maximal force. Laboratory assessment of ankle plantar flexor voluntary activation is common, but field testing in practical settings is limited by equipment portability. We aimed to compare plantar [...] Read more.
Background: Voluntary activation testing quantifies the ability of the motor nervous system to produce maximal force. Laboratory assessment of ankle plantar flexor voluntary activation is common, but field testing in practical settings is limited by equipment portability. We aimed to compare plantar flexor voluntary activation and maximal voluntary contraction (MVC) using a portable device with a standardised laboratory method and evaluate the test–retest reliability of the portable protocol. Methods: We performed a pseudo-randomised, crossover design. Participants completed two protocols: (1) portable force plate testing and (2) a laboratory-based isokinetic dynamometer. Voluntary activation was assessed using twitch interpolation via tibial nerve stimulation. Differences between protocols were analysed using generalised estimating equations. Reliability was assessed with the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and coefficient of variation (CV). Results: Twenty healthy participants (8 females, 12 males; median age 28.5 years) were included. No difference between protocols was detected for voluntary activation (β = 0.6, p = 0.68). The portable protocol demonstrated good reliability (ICC = 0.85) and low measurement error (SEM = 2.56%, CV = 2.79%). Conclusions: We demonstrated that the portable protocol is a valid and reliable method for assessing plantar flexor voluntary activation. It is suitable for assessing within-subject changes over time and can reduce participant attendance burden for neurophysiological muscle testing. Full article
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10 pages, 930 KB  
Article
The Comparative Effect of Acute Moderate- and High-Dose Citrulline Malate on Resistance Exercise Performance in Trained Individuals: A Double-Blind Randomised Controlled Pilot Trial
by Lewis A. Gough, Rachel Tan, Stephen J. Bailey, Craig Perrin, Charlie J. Roberts and Freya Gibbons
J. Funct. Morphol. Kinesiol. 2026, 11(1), 115; https://doi.org/10.3390/jfmk11010115 - 10 Mar 2026
Viewed by 1971
Abstract
Background: Citrulline malate (CM) supplementation has been shown to improve resistance exercise performance. However, there is limited research on the dose–response effects of CM ingestion. The aim of this study was to investigate a moderate (8 g; CM-MOD) and high (12 g; CM-HIGH) [...] Read more.
Background: Citrulline malate (CM) supplementation has been shown to improve resistance exercise performance. However, there is limited research on the dose–response effects of CM ingestion. The aim of this study was to investigate a moderate (8 g; CM-MOD) and high (12 g; CM-HIGH) dose of CM on resistance exercise performance. Methods: Twelve resistance-trained individuals (7 females, 5 males, age = 24 ± 2 years; body mass = 70 ± 10 kg; height = 172 ± 7 cm) volunteered for this randomised, double-blind, crossover trial. Following a familiarisation trial that consisted of determining one repetition maximum, participants completed barbell bent-over rows and leg presses following acute ingestion of either 8 g CM (CM-MOD), 12 g CM (CM-HIGH), or a placebo 1 h prior to exercise. Each exercise comprised two sets of 10 repetitions (70% one-repetition maximum (RM)) and a third set to exhaustion at 70% 1 RM. Results: The linear mixed-effect model found no significant differences in the completed repetitions between exercise type but did reveal a significant main effect of CM-HIGH on repetitions completed (p = 0.032), which was not found for CM-MOD, and only increases in leg press repetitions were observed (estimated marginal means: placebo = 17; CM-MOD = 19; CM-HIGH = 20). Conclusions: In conclusion, CM-HIGH resulted in small improvements to total repetitions performed during resistance exercise performance and likely only during leg press activity, though the underlying mechanisms remain unclear and further investigation is warranted. Full article
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19 pages, 1655 KB  
Article
Neurofunctional Assessments in Lumbar Spondylosis: Outcomes After Rehabilitation Treatment
by Andreea Ancuta Talinga, Roxana Ramona Onofrei, Ada-Maria Codreanu, Alexandra Laura Mederle, Veronica Aurelia Romanescu, Marius-Zoltan Rezumes, Oana Suciu, Dan-Andrei Korodi and Claudia Borza
J. Funct. Morphol. Kinesiol. 2026, 11(1), 114; https://doi.org/10.3390/jfmk11010114 - 9 Mar 2026
Viewed by 540
Abstract
Background: Lumbar spondylosis is a frequent cause of chronic low back pain, often associated with radiculopathy. Although imaging evaluation is widely used, it does not always reflect the degree of functional impairment of the nerve roots. Electrophysiological assessments, such as nerve conduction [...] Read more.
Background: Lumbar spondylosis is a frequent cause of chronic low back pain, often associated with radiculopathy. Although imaging evaluation is widely used, it does not always reflect the degree of functional impairment of the nerve roots. Electrophysiological assessments, such as nerve conduction studies (NCS) and surface electromyography (sEMG), can provide additional information on neuromuscular function under conservative treatment. Methods: This quasi-experimental study included 60 patients with lumbar spondylosis and 25 healthy subjects, who underwent clinical, imaging, and electrophysiological assessments. NCS and sEMG parameters were assessed in the patient group before and six months after rehabilitation treatment. The control group was assessed only once, at baseline. We analyzed the nerve conduction velocity of the tibial and peroneal nerves and the sEMG activity of the tibialis anterior muscle bilaterally. Statistical analysis used nonparametric tests, Spearman’s coefficient, and Hodges–Lehmann estimates. Results: Compared to the control group, patients presented increased residual latencies and reduced CMAP amplitude and motor conduction velocity values (p < 0.001). After rehabilitation treatment, significant improvements in NCS parameters were observed, with decreased latencies and increased CMAP amplitude and motor conduction velocity bilaterally (p < 0.001). Also, sEMG amplitude and recruitment pattern scores increased significantly at the 6-month follow-up (p ≤ 0.004). Correlations between electrophysiological parameters and the severity of imaging changes were limited, with modest associations for left tibial latencies (ρ = 0.401–0.467; p < 0.050). Conclusions: In patients with lumbar spondylosis, rehabilitation treatment was associated with functional improvements in nerve conduction velocity parameters and muscle activity. Full article
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12 pages, 1154 KB  
Article
The Role of Artificial Intelligence and Professional Expertise in Adapted Physical Activity Prescription for Orthopedic Rehabilitation
by Martina Sortino, Bruno Trovato, Rita Chiaramonte, Antonio Carrera, Marco Sapienza, Federico Roggio and Giuseppe Musumeci
J. Funct. Morphol. Kinesiol. 2026, 11(1), 113; https://doi.org/10.3390/jfmk11010113 - 9 Mar 2026
Viewed by 609
Abstract
Background: Adapted Physical Activity (APA) prescription is a complex decision-making process that integrates clinical guidelines and individual patient characteristics and remains strongly dependent on clinician experience. Generative artificial intelligence (AI) has recently emerged as a potential decision-support tool in exercise prescription; however, [...] Read more.
Background: Adapted Physical Activity (APA) prescription is a complex decision-making process that integrates clinical guidelines and individual patient characteristics and remains strongly dependent on clinician experience. Generative artificial intelligence (AI) has recently emerged as a potential decision-support tool in exercise prescription; however, its interaction with professional expertise is still unclear. This study compared the perceived quality of APA protocols developed by expert professionals, novice professionals supported by AI, and AI operating autonomously across multiple orthopedic conditions. Methods: In this observational cross-sectional study, five real orthopedic prescriptions (scoliosis, low back pain, osteoporosis, high risk of falls, and osteoarthritis) were used to generate three APA protocols per condition: expert professional (EP), novice professional with AI support (NAI), and AI alone. All protocols were created using an identical standardized prompt and anonymized. A multidisciplinary panel of 135 professionals blindly evaluated the protocols using a structured questionnaire assessing effectiveness, safety, appropriateness, clarity, and progression. Overall quality scores were compared using Friedman tests with post hoc Wilcoxon signed-rank tests. Results: Across all conditions, EP protocols achieved the highest quality scores, followed by NAI, while AI-alone protocols consistently received the lowest ratings (all p < 0.05). NAI protocols showed intermediate performance, partially reducing the expertise gap. Post hoc analyses showed that EP protocols received significantly higher rating than AI protocols in all conditions (p < 0.01). NAI protocols received significantly higher rating than AI protocols in most conditions (p < 0.01) except osteoporosis (p = 0.362). Differences between EP and AI were most pronounced for safety (p < 0.01), appropriateness (tailoring p < 0.01), and progression (p < 0.05), whereas EP–NAI differences were smaller and condition-dependent. AI-alone protocols showed greater variability across pathologies. Conclusions: Professional expertise remains the main determinant of APA protocol quality. AI support can improve protocol structure and perceived quality when used by novice professionals but does not replace expert clinical reasoning. AI-generated protocols without human oversight are not yet suitable for autonomous APA prescription, supporting a complementary, expertise-dependent role of AI in exercise programming. Full article
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18 pages, 465 KB  
Article
The Role of Muscle Strength, Physical Activity, Perceived Stress, and Sleep Quality in Patients with Hypertension
by Veronica Potosi-Moya, Ronnie Paredes-Gómez, Shulianna Burgos-Vera and Samantha Báez-Narváez
J. Funct. Morphol. Kinesiol. 2026, 11(1), 112; https://doi.org/10.3390/jfmk11010112 - 6 Mar 2026
Viewed by 597
Abstract
Background: Hypertension is a multifactorial condition influenced by physiological, behavioral, and psychosocial factors. Muscle strength, physical activity, sleep quality, and perceived stress may contribute to blood pressure variability, although their relative influence remains unclear. This study examined associations between systolic blood pressure (SBP) [...] Read more.
Background: Hypertension is a multifactorial condition influenced by physiological, behavioral, and psychosocial factors. Muscle strength, physical activity, sleep quality, and perceived stress may contribute to blood pressure variability, although their relative influence remains unclear. This study examined associations between systolic blood pressure (SBP) and demographic, anthropometric, neuromuscular, behavioral, and psychosocial variables in adults with primary hypertension, with secondary analyses for diastolic blood pressure (DBP) and sex differences. Methods: A cross-sectional study was conducted in 391 adults with hypertension (165 men, 226 women). Predictors included age, body mass index, lower-limb muscle strength, physical activity (GPAQ), sleep quality (PSQI), and perceived stress. Associations were analyzed using correlation analyses and sex-stratified multivariable regression models. Results: In men, SBP correlated positively with age and negatively with lower-limb strength. In women, SBP showed associations with physical activity and perceived stress. Regression analyses indicated that sleep quality and perceived stress were independently associated with SBP in women (adjusted R2 = 0.13), whereas hamstring strength was associated with DBP in men with low explanatory capacity (R2 = 0.05). Moderate-to-high collinearity was observed among strength variables. Conclusions: Blood pressure variability was associated with neuromuscular and psychosocial factors with sex-specific patterns; however, the modest explained variance suggests these factors act as complementary rather than primary determinants. Longitudinal studies are needed to clarify causal relationships. Full article
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15 pages, 668 KB  
Article
Influence of Playing Site and Weekly Training Frequency on Physical Performance in Elite Padel Players
by Adrián González-Jiménez, Diego Muñoz, Adrián Castaño-Zambudio, Bernardino J. Sánchez-Alcaraz and Iván Martín-Miguel
J. Funct. Morphol. Kinesiol. 2026, 11(1), 111; https://doi.org/10.3390/jfmk11010111 - 6 Mar 2026
Viewed by 559
Abstract
Objectives: The physical and physiological characteristics of padel players are essential for appropriate training load prescription; however, this area remains underexplored. Therefore, this hypothesis-driven study aimed to analyse physical and physiological differences in male padel players according to playing side. A secondary objective [...] Read more.
Objectives: The physical and physiological characteristics of padel players are essential for appropriate training load prescription; however, this area remains underexplored. Therefore, this hypothesis-driven study aimed to analyse physical and physiological differences in male padel players according to playing side. A secondary objective was to observe the influence of training volume on these parameters. Methods: Fourteen high-level male players competing in professional circuits or top-level regional competitions participated in this cross-sectional study using directional (one-tailed) testing. Results: Vertical jump performance differed significantly between the countermovement jump (CMJ) and the Abalakov jump (ABK) (p < 0.001), with lower values in the CMJ (40.98 cm) compared with the ABK (46.96 cm). Isometric handgrip strength showed significant inter-limb differences (p < 0.001), with greater force in the dominant hand (49.08 kg) than in the non-dominant hand (44.22 kg). Mean completion time in the agility t-test was 10.40 s (95% CI: 10.06–10.74 s). The Yo-Yo Intermittent Recovery Test showed a mean distance of 404.28 m, corresponding to an estimated VO2max of 50.79 mL·kg−1·min−1. Playing side significantly affected Yo-Yo performance and estimated VO2max (p = 0.036), with higher values in left-side players. Although no significant differences were found in handgrip strength according to playing side. As expected, weekly training frequency did not significantly influence any variable. Conclusions: These findings help characterise the physical and physiological profile of high-level padel players and provide practical reference values to support training prescription and performance monitoring. Full article
(This article belongs to the Special Issue Racket Sport Dynamics)
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16 pages, 3814 KB  
Article
The Role of Hydro-Kinesiotherapy After Intra-Articular Steroid Infiltration in the Management of Juvenile Idiopathic Arthritis: A Non-Randomized Observational Pre–Post Study with Parallel Groups
by Rossana Gnasso, Antonio Picone, Ayda Tavakkolifar, Stefano Palermi, Roberta Naddei, Simona Di Gennaro, Alessandro Nunzio Velotti, Mario Fusari, Tullio Alliegro, Marco Caruso and Maria Alessio
J. Funct. Morphol. Kinesiol. 2026, 11(1), 110; https://doi.org/10.3390/jfmk11010110 - 6 Mar 2026
Viewed by 340
Abstract
Background: Juvenile Idiopathic Arthritis (JIA) is the most prevalent rheumatological disease in childhood. It is classified into seven subtypes, each with specific clinical features. The pathogenesis of JIA involves an increased inflammatory response. Treatment options include pharmacological therapy, patient education, physical therapy, [...] Read more.
Background: Juvenile Idiopathic Arthritis (JIA) is the most prevalent rheumatological disease in childhood. It is classified into seven subtypes, each with specific clinical features. The pathogenesis of JIA involves an increased inflammatory response. Treatment options include pharmacological therapy, patient education, physical therapy, and rehabilitation. Methods: Patients received IAC injections and were subsequently divided into two groups: one group underwent HKT, while the other did not. The effects of HKT were assessed before treatment and one month after the IAC injections and initiation of HKT, using the Child Health Assessment Questionnaire (CHAQ), Visual Analogue Scale (VAS), and the Child Health Questionnaire—Parent Form 50 (CHQ-PF50). Results: Data were analyzed using the t-test. The HKT group showed non-statistically significant improvements in CHAQ and VAS scores compared to the non-HKT group. However, statistically significant differences were observed in the CHQ-PF50, particularly in the self-esteem and pain subscales. Conclusions: Although global differences between groups were not statistically significant, the group that underwent HKT demonstrated better scores, suggesting that HKT may reduce pain and contribute to improved quality of life in children with JIA. Full article
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19 pages, 746 KB  
Article
Position-Specific Kinanthropometric Traits of Professional American Football Players: A Study of Mexican LFA Players
by Luis Gerardo Vázquez-Villarreal, Wiliam Carvajal-Veitía, Gustavo Guevara-Balcázar, Claudia Maceroni, Pedro López-Sánchez and María del Carmen Castillo-Hernández
J. Funct. Morphol. Kinesiol. 2026, 11(1), 109; https://doi.org/10.3390/jfmk11010109 - 5 Mar 2026
Viewed by 1139
Abstract
Background: This cross-sectional observational study aimed to describe the position-specific kinanthropometric characteristics of Mexican professional American football players competing in the 2019–2020 seasons of the Liga de Fútbol Americano. Methods: A total of 189 athletes were assessed following International Society for [...] Read more.
Background: This cross-sectional observational study aimed to describe the position-specific kinanthropometric characteristics of Mexican professional American football players competing in the 2019–2020 seasons of the Liga de Fútbol Americano. Methods: A total of 189 athletes were assessed following International Society for the Advancement of Kinanthropometry standards. Twenty-six anthropometric variables were measured to estimate body composition (five-way fractionation), somatotype, proportionality indices, and tissue-specific masses. Positional differences were examined using ANOVA or Kruskal–Wallis tests with corresponding effect sizes (η2 or ε2). An exploratory stepwise discriminant analysis identified the anthropometric dimensions contributing most to positional differentiation, and classification accuracy was calculated. Results: Offensive and defensive linemen showed the greatest absolute size and higher adipose, muscle, and bone mass compared with other positions. The overall somatotype corresponded to a balanced endomorphic mesomorph (3.8–7.0–0.8), with wide receivers and defensive backs presenting lower endomorphy. The discriminant model identified arm relaxed girth, biiliocristal breadth, and sitting height as the variables contributing most to positional differentiation, achieving a classification accuracy of 57.7%. Given its exploratory nature and the absence of cross-validation, the discriminatory capacity of the model should be interpreted with caution. Somatotype Attitudinal Mean indicated greater interpositional heterogeneity among linemen. Conclusions: This study provides population-specific reference data for Mexican professional American football players, highlighting clear positional morphological characteristics. These findings may support talent identification and positional profiling; however, the exploratory discriminant model and league-specific sample limit generalization to other populations. Full article
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18 pages, 308 KB  
Article
Can We Predict Adductor Strain? A Predictive Analysis of a Major League Soccer (MLS) Cohort Spanning from 2019 to 2022
by Rebecca Davis, Benjamin C. Brewer, Martha Hall and Jill S. Higginson
J. Funct. Morphol. Kinesiol. 2026, 11(1), 108; https://doi.org/10.3390/jfmk11010108 - 5 Mar 2026
Viewed by 521
Abstract
Background: Despite the high prevalence of adductor injury in soccer, there is limited injury-specific predictive modeling to identify common risk factors. The objective of this study was to create an adductor strain prediction model utilizing injury, game, and performance data collected from a [...] Read more.
Background: Despite the high prevalence of adductor injury in soccer, there is limited injury-specific predictive modeling to identify common risk factors. The objective of this study was to create an adductor strain prediction model utilizing injury, game, and performance data collected from a cohort of professional Major League Soccer (MLS) players. Methods: We identified potential risk factors for soft tissue, non-contact adductor strain using a predictive machine learning model framework. Performance and injury data were collected between the 2019 to 2022 seasons of one professional MLS team. We utilized Random Forest (RF) machine learning models with Synthetic Minority Oversampling (SMOTE) to predict soft tissue, non-contact adductor strain injury amongst the cohort. Features chosen to be implemented in the model included injury, game, and performance data. Results: From the four models constructed in this study, the best performing model included Catapult Global Position System (GPS)/Internal Measurement Unit (IMU), strength, injury, and game data using a weekly structure determined by F1 score. Multiple models indicated that not having a previous injury lowers the odds of a future injury in the following week or month. Forwards had greater odds of injury whereas defenders had lower odds of injury. Greater hamstring max force lowered odds of injury whereas a greater amount of change of direction efforts increased the odds of injury in the following week or month. Adductor-to-abductor max strength ratio showed conflicting results regarding the odds of future injury. Conclusions: Through the utilization of RF and SMOTE, we were able to successfully predict adductor injuries in an MLS cohort utilizing injury, game, and performance metrics. Validation in a larger cohort would be highly recommended before utilizing the findings of this study in the design of injury prevention protocols. Full article
18 pages, 3350 KB  
Article
Physical Functional Characteristics of Elite Adolescent and Collegiate Male Soccer Athletes: A Comparative Study Using Medical Check-Ups
by Tingxu Zhang, Hanyan Yan, Ziwen Mu, Ang Ni, Haoxiang Wang, Zhiqiang Han, Kazuhiro Imai and Xiao Zhou
J. Funct. Morphol. Kinesiol. 2026, 11(1), 107; https://doi.org/10.3390/jfmk11010107 - 5 Mar 2026
Viewed by 454
Abstract
Background: Physical functional capacity plays a critical role in sports performance and changes markedly from adolescence to adulthood. This study aimed to compare the physical functional characteristics between adolescent and collegiate soccer athletes. Methods: Fifty elite male soccer athletes (30 adolescents, 20 college [...] Read more.
Background: Physical functional capacity plays a critical role in sports performance and changes markedly from adolescence to adulthood. This study aimed to compare the physical functional characteristics between adolescent and collegiate soccer athletes. Methods: Fifty elite male soccer athletes (30 adolescents, 20 college students) were assessed for joint range of motion, muscle flexibility, dynamic balance, and trunk functional capacity. Results: Adolescent athletes achieved significantly greater general joint laxity score than collegiate athletes (p = 0.01), with significantly greater hip range of motion across all planes (abduction, internal rotation, and external rotation; all p < 0.01). College athletes had significantly lower SLR degree (left: p < 0.01, right: p < 0.05) but significantly greater degrees on passive Ely’s test (p < 0.01) than adolescent athletes. Collegiate athletes delivered significantly superior dynamic balance performance in the Y-balance test, particularly in the posterolateral and posteromedial directions (all p < 0.05). Unexpectedly, trunk functional capacity was significantly lower in collegiate athletes compared with adolescents (p < 0.01). Limb asymmetry was observed in both groups: collegiate athletes showed asymmetry only in the anterior reach direction of the Y-balance test (p = 0.018), whereas adolescents exhibited asymmetry across multiple joints (ankle, hip, hamstrings, and quadriceps; all p < 0.05) and in the posterolateral direction of the Y-balance test (p < 0.01). Conclusions: Adolescent athletes demonstrated significantly superior joint range of motion and lower limb flexibility, whereas collegiate players exhibited better balance performance, indicating distinct functional profiles between the two cohorts, which may be associated with differences in training experience and developmental stages. Full article
(This article belongs to the Section Functional Anatomy and Musculoskeletal System)
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39 pages, 2426 KB  
Review
Machine Learning in Adapted Physical Activity: Clinical Applications, Monitoring, and Implementation Pathways for Personalized Exercise in Chronic Conditions: A Narrative Review
by Gianpiero Greco, Alessandro Petrelli, Luca Poli, Francesco Fischetti and Stefania Cataldi
J. Funct. Morphol. Kinesiol. 2026, 11(1), 106; https://doi.org/10.3390/jfmk11010106 - 4 Mar 2026
Viewed by 960
Abstract
Machine learning (ML) is increasingly influencing the assessment and delivery of movement and exercise, yet its role within adapted physical activity (APA) for individuals with chronic conditions has not been comprehensively synthesized. ML-based approaches have the potential to enhance functional assessment, support individualized [...] Read more.
Machine learning (ML) is increasingly influencing the assessment and delivery of movement and exercise, yet its role within adapted physical activity (APA) for individuals with chronic conditions has not been comprehensively synthesized. ML-based approaches have the potential to enhance functional assessment, support individualized exercise prescription, and facilitate scalable monitoring across preventive, community-based, and long-term adapted exercise settings, particularly in populations characterized by functional heterogeneity and variable responses to exercise. The aim of this narrative review is to synthesize and critically discuss current ML applications relevant to the core professional processes of APA practice. A structured narrative review was conducted using searches in PubMed/MEDLINE, Scopus, and Web of Science, complemented by targeted searches in engineering-oriented sources to capture ML methods not consistently indexed in biomedical databases. The search covered the period in which contemporary ML approaches have been increasingly applied to human movement and exercise research and was last updated in January 2026. Evidence was synthesized thematically into application-oriented domains relevant to APA practice. ML applications in APA include markerless motion and gait analysis, wearable-sensor data processing, balance and fall-risk assessment, and functional classification. Predictive and adaptive models support individualized regulation of exercise intensity, progression, and workload, including remote and hybrid delivery models. Applications span oncology, cardiometabolic, respiratory, neuromuscular conditions, and adapted sport contexts. Ethical, legal, and governance issues, such as algorithmic bias, data privacy, and professional accountability, emerge as central considerations for safe and equitable implementation. ML represents a promising decision-support layer for APA, complementing professional expertise through enhanced assessment, personalization, and monitoring. Its effective integration requires robust validation, interpretability, and responsible governance to ensure that ML augments, rather than replaces, professional judgment in APA practice. Full article
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14 pages, 1113 KB  
Article
Effects of Creatine Monohydrate Gummies on Performance and Body Composition in Female Beach Volleyball Athletes
by Flavia Pereira, Scott C. Forbes, Victor Romano, Paul Christopher, Juan Carlos Santana and Jose Antonio
J. Funct. Morphol. Kinesiol. 2026, 11(1), 105; https://doi.org/10.3390/jfmk11010105 - 4 Mar 2026
Viewed by 3220
Abstract
Background: Beach volleyball is a high-intensity, intermittent sport requiring repeated explosive actions and rapid changes of direction performed on an unstable sand surface. Creatine monohydrate (CrM) supplementation has consistently been shown to enhance short-duration, high-intensity performance; however, evidence in female athletes and [...] Read more.
Background: Beach volleyball is a high-intensity, intermittent sport requiring repeated explosive actions and rapid changes of direction performed on an unstable sand surface. Creatine monohydrate (CrM) supplementation has consistently been shown to enhance short-duration, high-intensity performance; however, evidence in female athletes and sport-specific contexts in beach volleyball remains limited. The purpose of this study was to examine the effects of CrM supplementation delivered in gummy form on physical performance outcomes, body composition, and reaction time in female beach volleyball athletes. Methods: Thirty-two female collegiate and professional beach volleyball athletes completed a 10-week randomized controlled trial and were assigned to either CrM, 5 g·day−1 group (n = 17) or control group (n = 15). Countermovement jump (CMJ) height, change-of-direction speed (CODS), body composition, and reaction time were assessed before and after the intervention. Outcomes were analyzed using mixed-model analyses of variance. Results: Significant Group × Time interactions were observed for CMJ height and CODS, with the CrM group demonstrating improvements in jump height (p < 0.001, ηp2 = 0.34) and faster change-of-direction performance (p = 0.009, ηp2 = 0.21), while the control group showed no improvement or performance declines. Significant Group × Time interactions were also observed for body fat mass (p = 0.024, ηp2 = 0.16), body fat percentage (p = 0.015, ηp2 = 0.18), and total body water (p = 0.038, ηp2 = 0.14). No significant interactions were observed for lean body mass, skeletal muscle mass, total body mass, or reaction time. Conclusions: CrM supplementation delivered in gummy form enhanced selected performance outcomes and helped maintain body composition in female beach volleyball athletes. These findings support creatine gummies as a practical supplementation strategy in this population. Full article
(This article belongs to the Special Issue Sports Nutrition and Body Composition)
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14 pages, 1328 KB  
Article
Measuring Motor Competence in Mid-Adulthood: A Reliable Holistic Test (HOLMOT) Sensitive to Sex and Age Differences
by José Carlos Cabrera Linares, Pedro Ángel Latorre Román and Juan Antonio Párraga Montilla
J. Funct. Morphol. Kinesiol. 2026, 11(1), 104; https://doi.org/10.3390/jfmk11010104 - 28 Feb 2026
Viewed by 481
Abstract
Objective: This study aimed to (i) examine the test–retest reliability of a holistic motor competence test (HOLMOT) in adults aged 30–60 years, and (ii) evaluate its ability to discriminate performance according to sex and age group. Methods: A total of 435 [...] Read more.
Objective: This study aimed to (i) examine the test–retest reliability of a holistic motor competence test (HOLMOT) in adults aged 30–60 years, and (ii) evaluate its ability to discriminate performance according to sex and age group. Methods: A total of 435 adults (206 women and 229 men; Mean age: 43.49 ± 7.55 years; Weight: 69.10 ± 9.88 kg; BMI: 23.81 ± 2.42 kg/m2) participated in this cross-sectional study. Motor Competence was assessed using the HOLMOT, a time-based protocol integrating motor-cognitive, locomotor, and manipulative domains. Test–retest reliability was examined in a subsample of 217 participants over a one-week interval using relative (ICC, Pearson’s r) and absolute (SEM, MDC) reliability indices. Sex and age-group differences were analyzed using independent t-tests and analysis of variance. Results: The HOLMOT demonstrated good to excellent reliability for the motor-cognitive (ICC = 0.89), locomotor (ICC = 0.94), and total time (ICC = 0.84) outcomes, with low SEM and MDC values. Reliability was lower for the manipulative section (ICC = 0.44). Men exhibited shorter completion times than women across all sections (p < 0.001), and adults over 50 years showed significantly longer times in the motor-cognitive and locomotor domains (p < 0.05). Conclusions: The HOLMOT is a feasible and reliable tool for assessing motor competence in mid-adulthood, demonstrating sensitivity to sex- and age-related differences and supporting holistic, lifespan-oriented models of motor competence. Full article
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18 pages, 4185 KB  
Perspective
Biomechanical Principles and Techniques—A Systematization for Sport Climbing
by Silas Dech and René Kittel
J. Funct. Morphol. Kinesiol. 2026, 11(1), 103; https://doi.org/10.3390/jfmk11010103 - 28 Feb 2026
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Abstract
Background: Sport climbing, encompassing lead, bouldering, and speed disciplines, has transformed from a niche activity to a widely popular trend, notably after its Olympic debut at the Tokyo Games 2021. This recognition spurred an increase in publications. Despite the emerging scientific interest, [...] Read more.
Background: Sport climbing, encompassing lead, bouldering, and speed disciplines, has transformed from a niche activity to a widely popular trend, notably after its Olympic debut at the Tokyo Games 2021. This recognition spurred an increase in publications. Despite the emerging scientific interest, terminology in climbing textbooks often relies on experiential rather than scientific understanding, leading to inconsistencies. This paper aims to standardize terminology by applying sports science frameworks, including biomechanics, training science, and sports medicine. Methods: The study reinterprets general sports science concepts for climbing-specific applications, proposing a structure of climbing skill that covers physical fitness components, biomechanical principles and techniques (body positioning), and specific components (hand and foot positioning). This integrated approach seeks to establish a coherent nomenclature, facilitating research, training, prevention, and rehabilitation within the climbing discipline. Results: Five primary climbing principles are proposed: optimal wall contact, maintained stability, center of mass shift, movement initiation from the legs and optimal climbing speed. Two technique categories—frontal and rotational—are defined in consideration of the spatial position of the pelvic frontal plane in relation to the wall surface. Each climbing technique can be described by applying the three-phase model of acyclic movements. Principles and techniques both aim to maximize efficiency in moving and resting on the climbing wall. Conclusions: A unified understanding of climbing principles and techniques is vital for progressing research, training programs, prevention strategies, and rehabilitation efforts in sport climbing. Adopting a comprehensive sports science framework promises enhanced clarity and efficacy in climbing practices, benefiting both theoretical analyses and practical applications. Full article
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12 pages, 633 KB  
Article
Comparison of Ventilatory and Metabolic Demands Across Percentage-Based Heart Rate Zones in Firefighters
by Benjamin J. Mendelson, David J. Cornell, Scott D. Brau, Nathan T. Ebersole, Robert J. Flees and Kyle T. Ebersole
J. Funct. Morphol. Kinesiol. 2026, 11(1), 102; https://doi.org/10.3390/jfmk11010102 - 28 Feb 2026
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Abstract
Background: The purpose was to determine the ventilatory and metabolic demands in percentage-based heart rate (HR) zones in active-duty firefighters. Methods: Male career firefighters (n = 48, 38.17 ± 9.02 years, 1.79 ± 0.05 m, 88.27 ± 12.50 kg) completed a maximal [...] Read more.
Background: The purpose was to determine the ventilatory and metabolic demands in percentage-based heart rate (HR) zones in active-duty firefighters. Methods: Male career firefighters (n = 48, 38.17 ± 9.02 years, 1.79 ± 0.05 m, 88.27 ± 12.50 kg) completed a maximal treadmill test while wearing chest strap monitors to measure physiological responses corresponding to Zone 1 (50–59%), Zone 2 (60–69%), Zone 3 (70–79%), Zone 4 (80–89%), and Zone 5 (90–100%) based on age-predicted maximal HR. Aerobic capacity (VO2PEAK, mL·kg−1·min−1), average minute ventilation (VE, L·min−1), and respiratory exchange ratio (RER) in each zone was measured via indirect calorimetry. Linear mixed models determined significant differences in VE, RER, and time in zone (min). Results: Significant relationships emerged between VO2PEAK and average RER in Zone 5 (r = −0.33) and time in Zone 3 (r = 0.45), Zone 4 (r = 0.41), and Zone 5 (r = 0.41). A significant HR zone effect emerged in VE (F = 516.01, p < 0.001) indicating that VE increased as zone intensity increased. After controlling for VO2PEAK, a significant HR zone effect emerged in RER (F = 11.90, p < 0.001), indicating that average RER increased as zone intensity increased. No HR zone effect was found for time in zone (F = 1.18 p = 0.332) after controlling for VO2PEAK. Conclusions: A practical cardiovascular workload measure, such as percentage-based HR zones determined from treadmill testing, have distinct ventilatory and metabolic responses. Higher aerobic capacity is related to greater time spent working in higher HR zones. Full article
(This article belongs to the Special Issue Tactical Athlete Health and Performance, 2nd Edition)
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15 pages, 857 KB  
Review
Vertical Force–Velocity Profiling in Soccer: A Systematic Review of Evidence, Assumptions, and Limitations
by Khairi Salim, El Mouahid Khalid, Chmura Paweł and Rfaki Abderrazak
J. Funct. Morphol. Kinesiol. 2026, 11(1), 99; https://doi.org/10.3390/jfmk11010099 - 27 Feb 2026
Viewed by 716
Abstract
Background: This systematic review critically examined how vertical force–velocity profiling has been used and interpreted in soccer research, with particular attention to methodological limitations and practical constraints. Methods: Following PRISMA guidelines, four databases were searched up to January 2025, and eleven studies met [...] Read more.
Background: This systematic review critically examined how vertical force–velocity profiling has been used and interpreted in soccer research, with particular attention to methodological limitations and practical constraints. Methods: Following PRISMA guidelines, four databases were searched up to January 2025, and eleven studies met the inclusion criteria. Results: Several studies reported statistical associations between vertical F–V variables (particularly Pmax and V0) and jump- and sprint-related outcomes; however, these associations were heterogeneous, task-dependent, and sensitive to modeling assumptions. Age- and maturity-related studies demonstrate progressive increases in F0 and Pmax across developmental stages, explaining much of the inter-individual variability in youth populations. Positional and sex-based analyses reveal distinct neuromuscular profiles, with wide and attacking players displaying more velocity-oriented characteristics, and female players showing lower Pmax values. Indirect links with match-related demands, inferred from positional profiles and external load literature, suggest potential ecological relevance; however, direct evidence linking vertical F–V parameters to match-derived GPS metrics remains limited. Intervention studies show that individualized F–V-based training can modify selected vertical mechanical parameters, but improvements in sprint or match performance are not systematic. Conclusions: Vertical F–V profiling may provide descriptive information under tightly controlled conditions; however, evidence supporting its use for individualized or deficit-based training prescription in soccer remains limited and inconsistent. For this reason, vertical F–V profiling should not be interpreted as a mechanistic model of soccer performance, but rather as a context-dependent descriptive framework with restricted ecological validity. Full article
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