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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Sports Medicine".

Deadline for manuscript submissions: 20 September 2026 | Viewed by 6251

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Special Issue Editors

Dr. Pedro Miguel Forte

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Guest Editor

1. Department of Sports, Higher Institute of Educational Sciences of the Douro, 4560-708 Penafiel, Portugal
2. Research Center for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
3. Department of Sports, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
4. CI-ISCE, ISCE Douro, 4560-708 Penafiel, Portugal
Interests: chronic pain; physical exercise; sports science
Special Issues, Collections and Topics in MDPI journals

Dr. Joana Ribeiro

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Guest Editor Assistant

Department of Sports, Higher Institute of Educational Sciences of the Douro, 4560-708 Penafiel, Portugal
Interests: physical exercise; sports science; psychology

Special Issue Information

Dear Colleagues,

Physical activity and structured exercise are essential components in the promotion of health, the prevention of chronic diseases, and the enhancement of physical and mental well-being. Increasing evidence highlights the effectiveness of exercise interventions across diverse populations, from athletes to individuals with chronic health conditions. Clinical exercise science offers a multidisciplinary approach that integrates assessment tools, biomechanical analysis, and personalized exercise prescription to optimize both health outcomes and performance.

This Special Issue aims to explore the intersection of physical activity, clinical assessment, and real-world health applications. We welcome contributions that investigate the role of exercise in improving cardiovascular and metabolic health, preventing and managing noncommunicable diseases, supporting healthy aging, enhancing immune function, and reducing the incidence of sports-related injuries. Special emphasis will be given to translational and interdisciplinary research that bridges the gap between scientific findings and clinical or community-based interventions.

Topics of interest include, but are not limited to, the following:

Clinical assessment protocols and biomechanical tools in exercise science;
Exercise interventions for chronic disease prevention and management;
Exercise for mental health, quality of life, and healthy aging;
Innovations in exercise prescription and testing models;
Integrative approaches combining exercise with other health disciplines;
Physical activity strategies to enhance sports performance and reduce injury risk.

By bringing together novel research and applied methodologies, this Special Issue seeks to contribute to the development of effective strategies that can inform clinical practice.

Dr. Pedro Miguel Forte
Guest Editor

Dr. Joana Ribeiro
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

clinical exercise science
physical activity
chronic disease prevention
biomechanics
healthy aging
physiology

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Published Papers (6 papers)

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Research

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14 pages, 1575 KB

Open AccessArticle

Effects of a 12-Week Supervised Exercise Program on Quality of Life, Functional Capacity, and Biological Parameters in Women with Breast Cancer: A Prospective Pilot Program

by Gema Barrientos Vicho, Luis Posado-Dominguez, José David Urchaga, Luis Figuero-Perez, Francisco Javier Alves Vas, Belén Cigarral García, Iñaki Pérez Echepare, Rebeca Lozano Mejorada, Joaquín Martín Pena, Monserrat Diaz Martín, Yolanda López-Mateos, Maria Garijo-Martínez, Juan Carlos Redondo-González, Jonathan Roldán-Ruiz, Emilio Fonseca Sánchez and Cesar Augusto Rodríguez Sánchez

J. Clin. Med. 2026, 15(4), 1480; https://doi.org/10.3390/jcm15041480 - 13 Feb 2026

Viewed by 448

Abstract

Objective: Physical exercise is an effective supportive strategy in oncology, yet its implementation remains limited, particularly in patients with metastatic breast cancer. This prospective pilot program aimed to evaluate the effects of a 12-week supervised multicomponent exercise program on quality of life, functional capacity, and biological parameters in women undergoing treatment for breast cancer. Methods: Prospective single-arm pilot program. In total, 44 women with early or metastatic breast cancer were enrolled; 29 completed the full intervention and assessments. The program consisted of supervised aerobic, resistance, mobility, and neuromuscular training three times per week. Quality of life was assessed using the EORTC QLQ-C30 questionnaire. Strength, body composition, functional mobility (Functional Movement Screen, FMS), 6 min walk test (6MWT), and laboratory markers (RDW, HDL, and cholesterol profile) were evaluated pre- and post-intervention. Results: Significant improvements were observed in global quality of life (+19.5%, p = 0.002), physical function (p = 0.006), emotional function (p = 0.003), and fatigue reduction (p = 0.007). The FMS total score increased significantly (p = 0.001), and 6MWT distance improved by 110 m (p < 0.001). Biochemical analyses showed a significant reduction in RDW (p = 0.005), a pro-inflammatory marker, and an increase in HDL cholesterol (p = 0.007). The intervention was well tolerated, with no exercise-related serious adverse events and high adherence to the supervised program. Conclusions: A 12-week supervised exercise program is feasible and beneficial for women with breast cancer, including those with metastatic disease. It is associated with improvements in quality of life, functional mobility, and selected markers of systemic inflammation. These findings should be considered exploratory and support the integration of structured exercise into routine oncologic care, pending confirmation in larger controlled studies. Full article

(This article belongs to the Special Issue Advances in Clinical Exercise for Health)

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15 pages, 747 KB

Open AccessArticle

Blood Flow Restriction Training Improves Cardiac Structure and Diastolic Function in Runners with Exercise-Induced Hypertension

by Young-Joo Kim, Jong-Young Lee, Choung-Hwa Park and Han-Soo Park

J. Clin. Med. 2025, 14(21), 7795; https://doi.org/10.3390/jcm14217795 - 3 Nov 2025

Cited by 1 | Viewed by 1670

Abstract

Background/Objectives: Exercise-induced hypertension (EIH) in runners predisposes them to cardiovascular diseases, including myocardial hypertrophy, arrhythmias, and coronary artery disease. Blood flow restriction (BFR) training has been reported to exert non-pharmacological benefits in runners with EIH by improving blood pressure, myocardial workload, and cardiorespiratory fitness. The purpose of this study was to investigate whether changes in myocardial structure and function accompany these effects of BFR training in middle-aged runners with EIH. Methods: Participants who exhibited a maximal systolic blood pressure of ≥210 mmHg during an exercise stress test were assigned either to a BFR training group (BFRTg, n = 15) or to a control group without BFR training (non-BFRTg, n = 14). The BFRTg underwent a two-month BFR training program, performed twice per week for 20 min per session. Cardiac structure and function were evaluated before and after the intervention, and exercise stress test data were obtained from secondary sources of a previous study. Results: Compared with controls, the BFR group showed lower maximal exercise SBP, longer exercise duration, and higher VO_2max. Echocardiography revealed reduced interventricular septal thickness and improved diastolic indices (higher E′/A′, lower E/E′), while systolic function remained unchanged. Conclusions: In conclusion, reductions in septal thickness and improvements in diastolic function induced by blood flow restriction training in runners with exercise-induced hypertension suggest a favorable cardiac adaptation, accompanied by concurrent improvements in exercise blood pressure and cardiorespiratory fitness. Full article

(This article belongs to the Special Issue Advances in Clinical Exercise for Health)

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11 pages, 432 KB

Open AccessProtocol

Association Between Physical Activity Levels and Mortality and Cardiovascular Disease in Chronic Kidney Disease: A Protocol for a Systematic Review and Meta-Analysis

by Silvana Patiño-Cardona, Carlos Pascual-Morena, Maribel Lucerón-Lucas-Torres, Marta Carolina Ruiz-Grao, Elena Moreno-Charco, José Alberto Martínez-Hortelano and Irene Martínez-García

J. Clin. Med. 2026, 15(5), 1983; https://doi.org/10.3390/jcm15051983 - 5 Mar 2026

Viewed by 310

Abstract

Background/Objectives: Chronic kidney disease (CKD) affects almost 800 million people worldwide. Cardiovascular disease is the main cause of death in this population. Although physical activity is fundamental to systemic health, the evidence regarding its impact on the clinical outcomes of CKD populations is inconclusive. This protocol outlines the methodology for a systematic review and meta-analysis aimed at evaluating the association between physical activity and intensity and all-cause mortality, cardiovascular mortality, and cardiovascular disease. Methods: This protocol adheres to PRISMA-P and Cochrane Handbook guidelines and has been registered with PROSPERO (CRD420261302904). A systematic search will be conducted in MEDLINE, Scopus, Web of Science and the Cochrane Library until June 2026. Studies estimating the association between physical activity and all-cause mortality, cardiovascular mortality and cardiovascular disease in populations with CKD will be included. Two independent reviewers will perform study selection, data extraction and quality assessment using the Study Quality Assessment Tool from the United States National Institute of Health tool. The certainty of the evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation tool. Narrative synthesis and random-effects meta-analysis will be conducted to calculate pooled effect estimates. Random-effects meta-analyses will be performed according to the level of physical activity, and meta-regressions will be used to control for the association with major covariates. Ethical approval is not required for this study. Results: The results will provide a comprehensive synthesis of the evidence regarding the use of physical activity as a non-pharmacological intervention to modify CKD progression. Conclusions: The findings will be disseminated through peer-reviewed journals and international conferences. Full article

(This article belongs to the Special Issue Advances in Clinical Exercise for Health)

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17 pages, 1887 KB

Open AccessSystematic Review

The Role of Sleep on Physical and Cognitive Performance of Ultra-Endurance Athletes: A Systematic Review

by Larissa Quintão Guilherme, Bruno Otávio Rodrigues, Carla de Oliveira Barbosa Rosa, Luciano Bernardes Leite, Volker Scheer, Pedro Forte, Helen Hermana Miranda Hermsdorff, Ana Claudia Pelissari Kravchychyn and Helton de Sá Souza

J. Clin. Med. 2026, 15(4), 1398; https://doi.org/10.3390/jcm15041398 - 10 Feb 2026

Viewed by 945

Abstract

Background/Objectives: Sleep is an important factor for recovery and performance in endurance sports, yet its role in ultra-endurance events remains unclear due to extreme physical and cognitive demands and disrupted sleep patterns. This systematic review aimed to analyze the role of sleep in physical and cognitive performance in ultra-endurance athletes. Methods: This systematic review followed PRISMA guidelines. A comprehensive search was conducted in May 2025 across PubMed/Medline, Embase, SPORTDiscus, and Web of Science. Two researchers independently screened, selected, extracted, and assessed data quality using the JBI tools (PROSPERO ID: CRD420251042220). Results: Of 424 articles, 16 met inclusion criteria, totaling data from 1389 athletes. Regarding physical performance, better outcomes were associated with no or less sleep during competition (TST), extended sleep the night before, and increased time in light sleep. In contrast, longer wake time, lower sleep quality, greater sleepiness during competition, and higher sleep efficiency were linked to poorer performance. Cognitive performance was positively associated with pre-race sleep quality and mid-race naps. Conversely, greater accumulated sleep before testing was linked to worse cognitive outcomes. Conclusions: Sleep, particularly total sleep time (TST), plays an important role in ultra-endurance performance, although this relationship may be non-linear and influenced by race context and individual strategies. Pre-race and intra-race sleep strategies such as napping and extended sleep may benefit performance. Further rigorous and longitudinal studies are needed to clarify sleep’s impact on performance and recovery in ultra-endurance contexts. Full article

(This article belongs to the Special Issue Advances in Clinical Exercise for Health)

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16 pages, 430 KB

Open AccessSystematic Review

Acceptance Factors and Barriers to the Implementation of Digital Interventions in Older People with Dementia and/or Their Caregivers: An Umbrella Review

by Ricardo Madeira, Dulce Esteves, Nuno Pinto, Alessandro Vercelli and Maria Vaz Pato

J. Clin. Med. 2025, 14(22), 7974; https://doi.org/10.3390/jcm14227974 - 10 Nov 2025

Cited by 1 | Viewed by 1038

Abstract

Background/Objectives: Digital interventions are essential for dementia care, particularly for older and isolated populations, and provide valuable support for caregivers. This umbrella review aimed to evaluate the acceptability and barriers to implementing the use of digital tools for health monitoring and management in older people with dementia and/or their caregivers. Methods: The review included studies assessing acceptability factors and barriers related to technology use in these groups. A total of 612 studies were identified across three databases. After removing duplicates, 400 articles remained. Following title and abstract screening, thirty articles were selected for full-text evaluation and five met the eligibility criteria for inclusion in this review. These systematic reviews collectively covered 93 primary studies, encompassing 12 to 279 participants with dementia and 11 to 2761 caregivers. Results: Frequently reported factors included self-management support, information access, and enhanced communication, although these were not consistently addressed across all reviews. The most significant barrier was a lack of technical knowledge, which hindered effective use. This gap in knowledge could compromise self-management and potentially increase burden on caregivers. Conclusions: In conclusion, digital interventions offer significant benefits in addressing accessibility challenges and are generally well-received by people with dementia, their caregivers, and healthcare providers. However, addressing the lack of technological proficiency is crucial to ensuring these interventions are effective and do not inadvertently create additional challenges. Practical strategies should include tailored digital literacy training for older adults and caregivers, simplified user interfaces, and ongoing technical support to enhance engagement and long-term adherence. Full article

(This article belongs to the Special Issue Advances in Clinical Exercise for Health)

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19 pages, 1884 KB

Open AccessSystematic Review

Fit Hearts, Better Outcomes? A Systematic Review and Meta-Analysis of Exercise Intensity and Peak VO₂ in Hypertrophic Cardiomyopathy

by Andrija Djuranovic, Jovana Ristic, Milena Antic, Nina Rajovic, Mladen Mirkovic, Djordje Batinic, Milos Maletic, Sevda Ece Kizilkilic, Victoria Zecchin Ferrara, Verica Prodanovic, Suzana Savic, Sanja Mazic and Natasa Milic

J. Clin. Med. 2025, 14(21), 7466; https://doi.org/10.3390/jcm14217466 - 22 Oct 2025

Viewed by 1318

Abstract

Background: This study aimed to systematically review and analyze the available evidence on the safety and efficacy of physical activity (PA) in patients with HCM. Methods: We conducted a systematic search of PubMed, Cochrane, and Web of Science databases up to March 30, 2025. Fourteen studies (4 RCTs) were included in the qualitative synthesis and ten in the quantitative synthesis, totaling 10478 patients. Results: The meta-analysis demonstrated a significant improvement in peak VO₂ in the moderate intensity PA (MIPA) group, with a mean difference of 1.77 mL/kg/min (95% CI: 0.93 to 2.60, I² = 38.2%, p = 0.19), while changes in body mass index were not significant (MD: −0.66 kg/m²; 95% CI: −1.77 to 0.44; I² = 62%; p = 0.07). No significant differences were observed in the occurrence of non-sustained ventricular tachycardia (NSVT) (OR = 1.54, 95% CI: 0.93 to 2.52, I² = 28.3%, p = 0.24), atrial fibrillation (OR = 0.89, 95% CI: 0.77 to 1.03, I² = 28.6%, p = 0.23), or syncope (OR = 1.23, 95% CI: 0.72 to 2.10, I² = 25.6%, p = 0.24) between the MIPA and sedentary group. Additionally, the occurrence of NSVT between the high-intensity PA and MIPA group showed no significant difference (OR = 1.19, 95% CI: 0.60 to 2.36, I² = 0%, p = 0.99). Conclusion: The results suggest that regular exercise does not increase the risk of NSVT, AF, or syncope while enhancing peak VO₂, indicating that regular exercise is safe and beneficial in HCM patients. Full article

(This article belongs to the Special Issue Advances in Clinical Exercise for Health)

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