Physiologia

Background/Objectives: Previous studies have shown that excess body weight influences plantar pressure. However, the specific impact of Body Mass Index (BMI) on dynamic pressure distribution during different phases of walking, as well as its effect on load symmetry between the feet, requires further investigation. This study aimed to evaluate the effects of varying BMI categories on dynamic plantar pressure, spatiotemporal gait parameters, and load symmetry. Methods: A retrospective analysis of pre-existing records from 300 adults (2017–2025) classified as normal weight, overweight, and obese was conducted. Dynamic plantar pressure, contact time, and gait speed across four stance phases were assessed using baropodometric platforms. Bilateral differences were evaluated via the symmetry index (SI). Results: Overweight and obese individuals exhibited higher plantar pressures and prolonged contact times, particularly during the forefoot contact phase (FFCP) ($p$ < 0.001). Gait speed decreased inversely with BMI across all phases. Despite these kinematic adaptations, BMI-related load asymmetry occurred only during the initial contact phase (ICP) ($p$ < 0.001), restoring stability in subsequent phases. Conclusions: Excess body mass is associated with targeted mechanical overload of the forefoot rather than uniform stress across the foot. To manage inertia and maintain symmetry, individuals with high BMI may adopt spatiotemporal strategies that reduce speed and extend double support, potentially prioritizing stability over propulsive efficiency. These findings suggest that orthotic interventions for individuals with high BMI may benefit from prioritizing forefoot offloading, although prospective studies are needed. Full article

Background/Objectives: Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD) is a frequent complication of chronic kidney disease, characterized by altered bone mineral density and mineral–hormonal metabolism. Therapeutic exercise may help attenuate these alterations, but evidence remains limited. This systematic review and meta-analysis evaluated the effects of therapeutic exercise on bone mineral density and mineral–bone and hormonal biomarkers in adults with CKD, focusing on CKD-MBD-related outcomes. Methods: Following a PROSPERO-registered protocol (CRD420251245021), Scopus, PubMed, Cochrane Central Register of Controlled Trials CENTRAL, and Web of Science were searched from inception to January 2026. Randomized controlled trials, including pilot randomized controlled trials, comparing therapeutic exercise with usual care or non-exercise control conditions in adults with CKD were included. Methodological quality and risk of bias were assessed with the PEDro scale and RoB 2, respectively. Results: Six studies involving 398 participants were included. Most interventions lasted 22 to 24 weeks and used resistance or combined aerobic and resistance exercise across inpatient and outpatient settings. Qualitative synthesis suggested improvements in femoral neck and lumbar spine bone mineral density and favorable biomarker changes. The assessed outcomes included femoral neck and lumbar spine BMD, calcium, phosphorus, sclerostin, PTH, FGF23, and klotho. Meta-analysis showed significant effects favoring therapeutic exercise for bone mineral density (MD = 0.05; 95% CI: 0.03 to 0.06; p < 0.00001; I² = 39%), mineral and bone-related biomarkers (SMD = 0.71; 95% CI: 0.42 to 0.99; p < 0.00001; I² = 75%), and hormonal biomarkers (SMD = 1.32; 95% CI: 0.88 to 1.77; p < 0.00001; I² = 85%). Conclusions: Therapeutic exercise may have beneficial effects on bone mineral density and selected mineral and hormonal biomarkers in adults with CKD. However, confidence in these findings is limited by the small number of studies, differences in CKD stage and exercise protocols, methodological limitations, risk of bias, and substantial heterogeneity in several pooled analyses. No definitive conclusions can currently be drawn regarding the optimal exercise modality, dose, or effects across CKD stages. Full article

Background: Secondary multiple organ dysfunction syndrome (MODS) has an excessively high fatality rate. The mechanisms by which sepsis and systemic inflammatory response syndrome (SIRS) induces organ dysfunction and their characteristic pathological findings and biomarkers are not fully understand. Methods: We examined 24 autopsy cases with secondary MODS and peripheral blood (PB) from 467 patients with SIRS and MODS. Results: PB cytology (presence of large scavenger receptor A-positive (SRA⁺) cells and an SRA index >30), systemic capillary injury, pulmonary symptoms (accumulation of neutrophils and platelet thrombi, alveolar epithelial injury and edema) and cardiac symptoms (accumulation of neutrophils and platelet thrombi, capillary injury and contraction band necrosis) were assessed for all of the cases. The 467 patients were classified into group A (negative for large SRA⁺ cells), group B (positive for large SRA⁺ cells, and SRA index <30) and group C (positive for large SRA⁺ cells, and SRA index >30). Group C patients exhibited a significantly lower survival rate (p < 0.001). Conclusions: It was concluded that: (1) the simultaneous presence of large SRA⁺ cells and an SRA index >30 appear to play a central role in the development of secondary MODS, and could be a useful predictor of poor prognosis in patients with SIRS or MODS; (2) the essential histopathological lesion associated with secondary MODS pathogenesis is systemic capillary injury; and (3) the PB, lung and heart findings mentioned above are characteristic morphological findings suggestive of secondary MODS; (4) a possible mechanism for the development of secondary MODS was proposed. Full article

Objective: This study investigated the effects of three chronic stress exposure models (permanent elimination, forced swimming, and food and water deprivation) on bone oxidative stress, structure, and metabolism in vivo. Methods: Adult rats were exposed to different stress conditions, while control animals were maintained under standard laboratory conditions. Bone morphological and histological parameters, oxidative stress biomarkers, antioxidant defense system, and mineral concentrations were assessed. Results: Stress exposure resulted in significant reductions in body weight, femur weight, and femur length compared to controls. A marked increase in oxidative stress biomarkers was observed in bone tissue, including lipid peroxidation, reactive oxygen species, hydroperoxides, hydrogen peroxide, protein carbonyls, and advanced oxidation protein products. In contrast, antioxidant defenses, including enzymatic activities and levels of glutathione, non-protein thiols, and vitamin C, was significantly decreased. Bone calcium and phosphorus levels were reduced, whereas their plasma concentrations were increased following stress exposure. Histological analysis confirmed the biochemical alterations, suggesting that chronic stress can disrupt bone integrity via oxidative mechanisms. Conclusions: These findings highlight the need for strategies to control and reduce stress-related disorders to maintain skeletal health under various chronic stress conditions. Full article

Calcium (Ca²⁺) and magnesium (Mg²⁺) are essential divalent cations whose homeostasis is essential for cardiovascular, muscular and metabolic function. Absolute or relative imbalances between Ca and Mg can lead to cardiovascular, metabolic and neurological pathologies. Ionized calcium (Ca²⁺) is a biologically active fraction of plasma calcium that is tightly regulated by protein binding, phosphate complexation, magnesium modulation and acid–base status. Ionized calcium plays a central role in multiple physiological processes and is strongly influenced by plasma pH, phosphate concentration and magnesium levels. However, the combined effects of these parameters are difficult to evaluate intuitively because of their nonlinear interactions. In this study, a numerical simulation framework was used to explore how simultaneous variations in pH, phosphate and magnesium may influence ionized calcium under typical physiological plasma conditions as a phenomenological framework linking ionic equilibrium with viscosity-dependent flow parameters under well-mixed plasma conditions. The simulations reveal phenomenological changes in which concurrent increases in pH and phosphate or reductions in magnesium produce disproportionately large decreases in ionized calcium. Within the physiological ranges examined, the results also indicate a region of relative stability for ionized calcium corresponding to Ca/Mg ratios close to 3, while this value should be interpreted as an emergent feature of the modeled parameter space rather than a universal physiological constant. These findings illustrate the importance of considering multiple electrolyte interactions simultaneously when evaluating calcium homeostasis and may provide a conceptual framework for further experimental investigation. Full article

Background/Objectives: Caffeine is a widely used ergogenic aid; however, evidence regarding its effects on neuromuscular and metabolic responses during resistance training remains limited. Therefore, this study aimed to analyze the effects of caffeine supplementation on blood glucose concentration and neuromuscular activation, assessed through electromyographic activity, during a muscular endurance test. Methods: Eleven resistance-trained men (25.7 ± 5.9 years) participated in this randomized, double-blind, crossover trial. Six laboratory visits were conducted, including one-repetition maximum (1RM) and maximal voluntary isometric contraction (MVIC) testing in the bench press exercise. From the second visit onward (baseline; BL), participants completed a 24 h dietary recall (24hDR), pre- and post-exercise blood glucose assessments, and a muscular endurance test performed at 80% of 1RM until concentric failure, while electromyographic activity was recorded from the clavicular and sternal portions of the pectoralis major, triceps brachii, and anterior deltoid. From the third visit onward, participants received one of the following randomized interventions 60 min before testing: low-dose caffeine (LC = 3 mg·kg⁻¹), high-dose caffeine (HC = 6 mg·kg⁻¹), low-dose placebo (LP = 230 mg), or high-dose placebo (HP = 460 mg). Results: There was an increase in the number of repetitions in all conditions vs. BL, with no significant differences (p > 0.05). Electromyographic activity did not differ between conditions (p > 0.05). Blood glucose decreased post-test in BL and placebo conditions (p < 0.05) but remained stable with caffeine (p > 0.05). Conclusions: Low and high doses of caffeine did not significantly affect muscular endurance performance or neuromuscular activation. However, caffeine supplementation appeared to attenuate the post-exercise decline in blood glucose concentration following exercise performed to concentric failure. Full article

Objective: The purpose of this exploratory study was to examine mean differences, reliability, and agreement between CP and W′ derived from a 3MAT performed after an ICT and values obtained during a standalone 3MAT performed on a separate day. Methods: Ten recreationally trained cyclists and triathletes completed four laboratory visits, including an ICT followed by a 3MAT after 30 min of recovery (same-day condition) and a standalone 3MAT performed on a separate day. CP and W′ were derived from both conditions and compared using paired t-tests and Bland–Altman agreement methods. Results: No systematic differences, but limited individual-level agreement were observed between same-day and separate-day conditions for CP (mean difference: 1.72 ± 36.5 W) or W′ (mean difference: 0.99 ± 5.9 kJ), with trivial to small effect sizes. Peak VO₂ values were also not significantly different across testing conditions (p = 0.483). However, Bland–Altman analysis revealed wide limits of agreement for both CP (−69.8 to 73.3 W) and W′ (−10.7 to 12.7 kJ), indicating substantial variability at the individual level. Conclusions: Although same-day testing does not introduce systematic bias in CP or W′ estimation, the wide limits of agreement suggest that these protocols are not interchangeable for individual monitoring. Same-day testing may be appropriate for group-level assessments but should be used with caution when applied to individual athlete monitoring. Full article

Background: Exercise adaptation is increasingly recognized as an immunometabolic process driven by coordinated interactions among inflammatory signaling, mitochondrial regulation, metabolic homeostasis, and recovery-associated physiology. Within this framework, NLRP3 inflammasome activation and PPARD-mediated metabolic signaling have emerged as biologically relevant pathways potentially involved in exercise-induced physiological adaptation. However, the contribution of regulatory genetic variations linking these pathways remains poorly characterized. Objective: To synthesize current evidence regarding the integration of NLRP3- and PPARD-related pathways in exercise immunometabolism and adaptive physiological responses to exercise, with particular emphasis on the regulatory variants NLRP3 rs10754558 and PPARD rs2267668 as potential contributors to interindividual variability in exercise adaptation. Methods: A structured narrative review complemented by exploratory systems-level in silico analyses was conducted using the PubMed, Scopus, and Web of Science databases until March 2026. Evidence related to exercise physiology, inflammatory regulation, metabolic adaptation, and exercise-associated phenotypes involving the NLRP3 and PPARD pathways was evaluated. Complementary analyses included functional annotation, protein–protein interaction network analysis, and pathway enrichment using STRING, Reactome, KEGG, Gene Ontology, and other publicly available genomic databases. Particular attention was given to the functional and regulatory context of rs10754558 and rs2267668 within the interconnected inflammatory and metabolic pathways relevant to exercise adaptation. Results: The reviewed evidence identified recurrent interactions among the inflammatory and metabolic pathways involved in exercise adaptation and recovery. NLRP3 rs10754558 and PPARD rs2267668 were identified as candidate regulatory variants potentially positioned at the interface between inflammatory responsiveness and metabolic flexibility, providing a biologically plausible framework for understanding the interindividual variability in exercise adaptation. Exploratory system-level analyses identified recurrent associations among inflammatory signaling, mitochondrial function, energy-sensing pathways, and metabolic regulation. These findings primarily reflect the functional annotations and system-level pathway associations identified through exploratory analyses. Conclusions: Current evidence supports a systems-level physiological framework in which inflammatory and metabolic pathways interact dynamically during exercise adaptation and recovery. NLRP3- and PPARD-related pathways, including the candidate regulatory variants rs10754558 and rs2267668, may contribute to interindividual variability in exercise-associated physiological responses and represent promising targets for future hypothesis-driven investigations in exercise immunometabolism, exercise genomics and precision exercise medicine. Full article

Congenital heart defects represent prevalent malformations requiring complex surgical interventions. Outcomes are influenced by clinical severity, inflammatory response, and complexity of care, highlighting the need for improved risk stratification tools. Objectives: To describe the behavior and distribution of perioperative sTREM-1 concentrations in a pediatric cohort undergoing cardiac surgery, exploratorily stratified by RACHS-1 and TISS-28 severity scores. Methods: A translational cross-sectional study was conducted with 32 children (aged 0–14 years) undergoing surgical correction for congenital heart disease at a Brazilian public referral hospital (2021–2022). Exclusion criteria included genetic syndromes, active infections, or previous cardiac surgeries. Clinical severity was assessed using RACHS-1 (mortality risk) and TISS-28 (care complexity) scores. Serum sTREM-1 levels were measured via ELISA preoperatively and postoperatively. Statistical analysis involved the Shapiro–Wilk normality test, descriptive statistics expressed as medians and interquartile ranges, and Spearman’s rank correlation coefficient to evaluate the relationship between sTREM-1 levels and severity scores, with significance set at p < 0.05. Results: The cohort consisted predominantly of males (56.25%), term infants (93.75%), with 50% presenting cyanosis. RACHS-1 category 3 was most common (34.37%), while TISS-28 category 2 predominated (40.62%). Most patients were discharged (93.75%). Preoperative sTREM-1 levels showed no significant correlation with RACHS-1 (r_s = 0.265; p = 0.143) or TISS-28 scores (r_s = 0.227; p = 0.212). Conversely, postoperative sTREM-1 concentrations significantly and positively correlated with both RACHS-1 (r_s = 0.356; p = 0.045) and TISS-28 categories (r_s = 0.394; p = 0.026), reflecting higher biomarker levels in more severe clinical scenarios. Conclusions: Postoperative sTREM-1 levels correlated significantly with surgical risk and clinical severity, showing higher median concentrations in more severe RACHS-1 and TISS-28 categories. Conversely, no preoperative correlation was observed, suggesting sTREM-1 primarily reflects postoperative inflammatory responses and surgical complexity. Full article

Background: The regulation of inorganic phosphate (Pi) homeostasis is predominantly mediated by the Pi transporters belonging to the SLC34 and SLC20 families of solute carriers. However, not all Pi handling can be explained by these transporters. In this study, we sought to identify novel Pi transporters in accordance with prior findings on inhibition patterns. Methods: We have performed a functional screening of new Pi carriers using the Xenopus laevis oocyte expression system, focusing on the SLC26 family, and corroboration in cell culture. Results: Both SLC26A7 and SLC26A9 have been shown to express sodium-activated Pi uptakes with approximately 200 µmol/L Pi affinity. In both cases, Pi transport is inhibited by increasing pH and by phosphonoformate, arsenate, bicarbonate, sulfate, the chloride channel inhibitor 5-nitro-2-[(3-phenylpropyl)amino]-benzoate, and several transport site and translocation inhibitors of bicarbonate exchangers. In addition, the CFTR inhibitor GlyH-101 and the SLC4 inhibitors DIDS, SITS, and phloretin exhibited partial inhibition of SLC26A9-mediated Pi uptake. The endogenous expressions of both SLC26A7 and SLC26A9 in the renal cell lines LLC-PK1 and MDCK were primarily intracellular, colocalizing with endosomes, lysosomes, and the trans-Golgi network markers. Conversely, plasma membrane expression was found to be minimal. Pi transport in MDCK cells was sodium-independent, but when either SLC26A7 or SLC26A9 was overexpressed, sodium-activated Pi uptake was observed, along with increased expressions of SLC26A7 or SLC26A9 in the plasma membrane. Conclusions: Sodium-activated Pi transport is a novel function of the SLC26A7 and SLC26A9 multifunctional anion transporters. Further research is necessary to ascertain the relevance to Pi homeostasis in vivo. Full article

Background/Objectives: Chronic ethanol consumption damages erythrocyte membranes, reducing their deformability and disrupting erythropoiesis. Dopaminergic signalling plays an important role in regulating haematopoietic stem cells. However, the impact of genetic alterations in the dopamine system on the functional properties of erythrocytes and their resistance to the toxic effects of alcohol remains understudied. In this study, we evaluated haematological parameters and the sensitivity of erythrocytes to chronic ethanol exposure in DAT-HET rats (heterozygous for the dopamine transporter gene) compared to Wistar rats. Methods: Both lines of rats were subjected to chronic alcoholisation (10% ethanol for six months). Flow cytometry was used to assess reticulocyte production, intracellular esterase activity (cell viability), and membrane lipid asymmetry disruptions. Laser diffraction was used to evaluate osmotic resistance (deformability). Results: The partial knockout of the DAT gene significantly altered the baseline haematological profile, resulting in pronounced leukopenia, moderate thrombocytopenia, moderate erythrocyte macrocytosis, and reduced intracellular esterase activity. The consequences of chronic ethanol consumption in Wistar rats (anaemia, decreased reticulocyte count, increased osmotic rigidity of erythrocytes, and an increased proportion of annexin-positive cells) were similar to those observed in humans, thus confirming the validity of the experimental model. In contrast, chronic alcohol exposure did not significantly influence haematopoiesis parameters or erythrocyte biophysical properties in DAT-HET rats, indicating that even a 50% loss of the dopamine transporter strongly prevented ethanol’s damaging effects on blood cells. Conclusions: The marked contrast between Wistar rats (which develop alcohol-induced anaemia and erythrocyte dysfunction similar to humans) and DAT-HET rats (which remain largely unaffected) demonstrates that dopaminergic signalling plays a previously unrecognised role in determining erythrocyte sensitivity to alcohol toxicity. Full article

Background: Youth with type 1 diabetes (T1D) often show low physical activity levels and a long time spent in sedentary and poor sleep, which may worsen their health. This study aimed to describe baseline movement and sleep patterns in children and adolescents with T1D and compare them with behaviors recorded during a structured summer camp. Methods: Twenty-three participants (13.33 ± 2.13 years) completed physical fitness tests, self-report questionnaires, and 7–8 days of wearable monitoring before camp. During a 10-day diabetes summer camp, participants continued wearing the devices to track physical activity, sedentary time, and sleep. Comparisons between pre- and during-camp periods were performed using paired statistics, and linear regressions examined associations between activity and sleep awakenings. Results: At baseline, device-based monitoring showed low physical activity levels, long sedentary time and poor sleep. Self-reported data confirmed low activity levels and long time spent in sedentary activities, especially screen time. During camp, daily steps increased significantly (p < 0.001), as well as all the physical activity intensities (p < 0.01). Sedentary time decreased significantly (p < 0.001), and sleep duration declined (p < 0.001), but awakenings were shorter (p = 0.005). Baseline sedentary time predicted longer nocturnal awakenings, while greater increases in steps during camp correlated with longer awakenings. Conclusions: Children and adolescents with T1D showed low baseline activity, high sedentary time, and poor sleep. Participation in the structured summer camp appears to be associated with changes in physical activity, sedentary behavior, and sleep patterns. Full article

Background/Objectives: This study evaluated carotid baroreflex sensitivity (cBRS) during graded exercise tests to exhaustion in healthy individuals. It aimed to elucidate whether the augmented blood pressure response during heavy- and maximal-intensity dynamic exercise alters carotid baroreflex control of heart rate and contributes to exercise intolerance. Methods: Thirteen healthy males (age 33 ± 2 yrs, body mass 74.6 ± 2.4 kg, and $\dot{V}$O_2max 54.12 ± 1.88 mL·kg⁻¹·min⁻¹) performed a 4 min constant-load cycling exercise at low—(30% PPO), moderate—(60% PPO), high—(80% PPO), and maximal—(100% PPO) intensity, in two experimental conditions: (a) with unrestricted muscle blood flow (no-BFR) and (b) with partial muscle blood flow restriction (BFR). Results: A significant decline in cBRS was observed during the graded maximal exercise test compared to baseline (p < 0.001), accompanied by an upward and rightward relocation of the linear relationship between systolic blood pressure (SBP) and heart rate (HR). However, the magnitude of cBRS reduction was attenuated towards maximum exercise. Application of BFR during exercise exaggerated the blood pressure rise (p < 0.01), the perceptual response (p < 0.001), the exercise-induced cBRS reduction (p < 0.001), and induced a further relocation of the SBP-HR relationship. Additionally, BFR limited the HR increase and resulted in reduced exercise performance compared to the no-BFR condition. Conclusions: These findings suggest that the pronounced increase in blood pressure during heavy- and maximal-intensity exercise may limit further increases in heart rate through arterial baroreflex activation. This may contribute to reduced exercise tolerance, as evidenced by the lower peak power output and attenuated maximal heart rate observed in muscle BFR condition. Full article

Background/Objectives: The combined effects of aerobic exercise and normobaric hyperoxia exposure on skeletal muscle in diabetes mellitus (DM) remain unclear. This study investigated whether their combination influences skeletal muscle capillary and mitochondrial function in diabetic rats. Methods: Seven-week-old male Wistar rats were randomly assigned to the following five groups: control (CON), DM, DM with aerobic exercise (DMEx), DM with aerobic exercise under 30% oxygen exposure (DMEx30), and DM with aerobic exercise under 50% oxygen exposure (DMEx50). Aerobic exercise and normobaric hyperoxia exposure were performed simultaneously in the DMEx30 and DMEx50 groups. Results: Combined aerobic exercise and normobaric hyperoxia significantly improved both capillary density and succinate dehydrogenase (SDH) activity in the soleus muscle, which is predominantly composed of slow-twitch fibers, in diabetic rats. In contrast, the effects were more limited in predominantly fast-twitch muscles, including the extensor digitorum longus and plantaris muscles. Conclusions: Combined aerobic exercise and normobaric hyperoxia may induce beneficial skeletal muscle adaptations in diabetic rats, with more pronounced effects in the predominantly slow-twitch soleus muscle than in predominantly fast-twitch muscles. These findings suggest that muscle fiber-type composition may influence responsiveness to this intervention. This combined approach may contribute to the development of novel exercise-based interventions for DM. Full article

Background/Objectives: This study examined the effects of an eight-week plyometric training programme on jump biomechanics, field-based jump performance, and repeated-jump endurance in 13–14-year-old volleyball players, and explored training-induced changes. Methods: A pre–post controlled experimental design was used. Thirty male volleyball players aged 13–14 years were assigned to an experimental group (EG, n = 15) or a control group (CG, n = 15). The EG completed a structured plyometric programme three times per week for eight weeks in addition to regular volleyball training, whereas the CG continued usual practice. Biomechanical variables were assessed during the Repeated Countermovement Jump test using the BTS Bioengineering G-Walk inertial measurement system, together with field-based jump and repeated-jump endurance tests. Outcomes were analysed using two-way mixed ANOVA (Group × Time). Δ-based correlations were examined using Pearson and Spearman coefficients with false discovery rate correction. Results: Significant Group × Time interaction effects were found for all analysed RCMJ variables (all p < 0.001). Significant interaction effects were also observed for all field-based jump and repeated-jump endurance outcomes (all p ≤ 0.025). The EG showed greater improvements over time than the CG across the principal biomechanical, practical, and endurance-related indicators. Correlation analysis revealed strong associations among the principal RCMJ variables and selected links with field-based and endurance measures. Conclusions: A structured plyometric programme may improve jump biomechanics, jump performance, and repeated-jump endurance in adolescent volleyball players. These findings should be interpreted cautiously because of baseline differences, the modest sample size, and the IMU-derived nature of force- and power-related estimates. Full article

Background/Objectives: Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors that increases the risk for cardiovascular disease. Although gait impairments are documented in older adults with MetS, few studies have examined gait biomechanics or the potential for gait-related measures to differentiate metabolic syndrome status in young adults. This study examined whether gait biomechanics, functional gait performance, and muscle strength are associated with MetS risk factors in young adults, and whether these measures predict MetS classification. Methods: Twenty-four young adults meeting criteria for metabolic syndrome (MetS+) and 24 participants without MetS (MetS−) completed cardiometabolic assessments, gait analysis, functional gait testing, and lower extremity isometric strength testing. Multiple linear regression examined associations between gait velocity and MetS risk factors, and binary logistic regression assessed the ability of biomechanical, functional, and strength variables to differentiate MetS status. Results: Compared with matched controls, MetS+ participants demonstrated slower gait velocity, longer stance time, and lower propulsive ground reaction forces. Regression models examining MetS risk factors did not significantly explain variance in gait velocity. Logistic regression indicated that spatiotemporal gait parameters and GRF variables could differentiate MetS classification with fair predictive ability, whereas functional gait performance and strength measures showed limited classification performance. Conclusions: Young adults with MetS demonstrated modest differences in select gait variables, but the MetS risk factors did not show strong relationships with gait velocity in regression analyses. Spatiotemporal gait parameters differentiated MetS+ and MetS− groups but offered limited predictive value. These findings suggest that subtle biomechanical differences may be present early in the progression of MetS, although stronger functional impairments may not yet be detectable in young adults. Full article

Background: Childhood cancer survivors commonly experience long-term treatment effects that impair physical function. Access to in-person physical fitness assessments is often limited by geographic, logistical, and resource constraints. Virtually supervised physical fitness assessments may offer a feasible alternative; however, evidence in this population remains limited. Methods: This study evaluated the feasibility of delivering virtually supervised physical fitness assessments via videoconference for children and adolescents aged 5–18 years following completion of cancer treatment. Assessments evaluated lower-body strength (30 s sit-to-stand), upper-body strength (30 s push-up), mobility (timed up-and-go), balance (single-leg balance), aerobic endurance (two-minute step), and flexibility (sit-and-reach). Pre-defined feasibility benchmarks included recruitment (≥15 participants within three months), assessment completion (≥85% of participants completing all six assessments), individual assessment completion (≥90% of planned assessments completed), technique fidelity (≥85% of assessments performed with correct technique), session duration (≥90% of sessions completed in ≤30 min), safety (no adverse events), and participant satisfaction (qualitative feedback). Results: Twenty-nine participants were enrolled, with 28 completing the virtual assessments. The sample (61% male) had a mean age of 9.8 ± 3.7 years (range 5–16), with acute lymphoblastic leukaemia the most common diagnosis (46%). Recruitment exceeded benchmarks (23 participants within three months). Assessment completion was 92.9% (26/28), individual assessment completion was 98.8% (166/168), and technique fidelity was 90.9%, with the lowest fidelity for push-ups (73.1%). Most sessions were completed within 30 min (92.9%; median 19.5 min, range 15–33). No adverse events occurred. Feedback indicated high satisfaction, highlighting convenience, engagement, and practicality. Conclusions: Virtually supervised physical fitness assessments were feasible, safe, and acceptable for childhood cancer survivors. These findings provide initial feasibility evidence to support further validation and implementation research before broader clinical application. Full article

The purpose of this narrative review was to describe the maximal strength, muscle power, rate of force development, and muscle morphology of athletes across different ski disciplines. Specifically, this review synthesizes evidence on upper- and lower-body maximal strength both dynamically and isometrically, muscle power through jumping performance and rate of force development, and muscle morphology in competitive skiers. Furthermore, it examines how these neuromuscular parameters adapt when resistance-training interventions are incorporated into athletes’ routine training programs. Following a literature search, 30 studies met the inclusion criteria, 18 describing the ski athletes’ characteristics mentioned above and 12 evaluating the effects of resistance-training interventions. Altogether, these studies involved 561 participants, with ages ranging between 14.6 ± 1.1 years and 35 years. Overall, the above characteristics of ski athletes appear to align with sport-specific demands, which vary across ski disciplines. The resistance-training protocols applied in this population are predominantly high-load resistance training and it appears that resistance training may benefit from increased emphasis in ski-specific preparation. However, training programs tailored to the specific demands of each discipline are recommended. Full article