Search Results (691)

Mobile health (mHealth) apps increasingly capture the physiological, biomechanical, and psychological variables involved in sport training, but the evidence remains fragmented across single-domain reviews, leaving practitioners without a consolidated basis for selecting and deploying these tools across the training process. This scoping review aimed to identify and characterize research on mHealth apps in sport training, focusing on their performance testing, training load and recovery monitoring, technical and skill development, injury screening and prevention, and athlete self-management. It also synthesized evidence regarding their applications, intended purposes, technical characteristics, and the evidence supporting their effectiveness. Five databases (PubMed, Scopus, Web of Science, SPORTDiscus, Embase) were searched from inception to July 2026 for journal articles reporting original empirical data on app research on the sport training process in athletes. Studies involving only the promotion of physical activity or lacking human-subject testing, including commercially available apps without supporting research on their effectiveness, were excluded. Findings were synthesized narratively, and methodological quality was appraised with the Mixed Methods Appraisal Tool. Of 9476 records identified, 111 studies met the inclusion criteria and were inductively classified into ten application categories: sport skill training (n = 26), performance measurement (n = 20), vertical jump measurement (n = 18), self-reported monitoring (n = 12), physiological measurement (n = 12), musculoskeletal screening (n = 10), psychological intervention (n = 5), nutrition (n = 3), anthropometric and maturation screening (n = 3), and tactical and match analysis (n = 2). Most apps relied on built-in smartphone sensors or no sensing at all and used manual or deterministic computation; processing location went unreported in 74.8% of studies, which reflects a reporting gap rather than an architectural profile of the field, and reported that AI or machine learning labels did not track with actual method disclosure. Validation and reliability designs dominated the evidence base (52%), while randomized or controlled effectiveness trials were rare (10%). Apps generally showed good relative validity but limited absolute accuracy against criterion instruments, and wherever apps were deployed longitudinally, adherence rather than accuracy determined their real-world value. mHealth apps now support nearly every stage of sport training and can substitute for laboratory instruments in select, validated use cases, including video-based sprint and jump timing and chest-strap-paired heart-rate variability monitoring. However, the field remains organized around demonstrating measurement accuracy rather than showing that app-guided decisions improve athlete outcomes. A successful pathway for mHealth app development should progress from technical validity, through measurement reliability and responsiveness, to decision rules, and then to practitioner adoption by coaches and athletes, ultimately yielding better athlete outcomes. Full article

Sports cardiologists frequently face the challenge of distinguishing physiological cardiac adaptation to intensive training (“athlete’s heart”) from early or mild cardiac pathology, a dilemma in which both false-positive and false-negative assessments carry meaningful consequences for the athlete. Cardiopulmonary exercise testing (CPET) provides a dynamic, functional complement to structural and electrical assessment, but its value in this specific differential-diagnosis context has not been comprehensively synthesized. This narrative review examines current evidence on CPET in distinguishing athlete’s heart from hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic cardiomyopathy, and thoracic wall deformities such as pectus excavatum, alongside the physiological basis of high exercise capacity in athletes and the athlete-specific reference values now becoming available. Across conditions, peak oxygen uptake alone proved an unreliable discriminator. Ventilatory efficiency, oxygen-pulse kinetics, and the exercise arrhythmic and blood-pressure response appear to carry additional information when interpreted within a multiparametric framework, although the supporting studies are observational, mostly single-centre, and were not designed to compare these variables against one another. Special populations, including veteran athletes, women, and those with congenital heart disease, require dedicated reference data that remain incomplete, and emerging artificial-intelligence-based interpretive tools require athlete-specific validation before clinical adoption. A practical, stepwise diagnostic framework integrating CPET with imaging and shared decision-making is proposed. It reflects the authors’ synthesis of the reviewed evidence rather than a prospectively validated or society-endorsed pathway. Closing the evidence gaps identified here, particularly for underrepresented athlete populations and prospective outcomes data, should be a priority for future research in sports cardiology. Full article

Background: Wearable sensing technologies enable continuous monitoring of physiological states in athletes, yet age-related differences in autonomic and mechanical load among professional soccer players remain insufficiently characterized. This study investigated whether heart rate variability (HRV) indices and accelerometry-derived physical load differ between younger and older professional players during routine morning training sessions. Methods: Fourteen male professional soccer players were monitored using a wrist-worn biosensor. Participants were divided into two age groups: Group A (≤23 years, n = 7) and Group B (≥24 years, n = 7). The device was attached at 08:30 and recorded tri-axial acceleration and cardiac signals continuously until 11:30 (≈3 h). Extracted metrics included root mean square of successive differences (RMSSD), percentage of NN intervals differing by more than 50 ms (pNN50), heart rate recovery (HRR), maximum heart rate, and total beat count. Group differences and position-based differences were evaluated. Results: Accelerometry-based physical load showed no significant difference between age groups. In contrast, HRV indices demonstrated age-related divergence: RMSSD was significantly higher in Group A compared to Group B (p = 0.031), suggesting greater parasympathetic activity in younger players. Total beat count was significantly higher in Group B (p = 0.015). pNN50 showed no group difference (p = 0.918). Pre- and post-session HRR did not differ significantly between groups, whereas maximum heart rate was significantly higher in Group A (p = 0.0017). Position-based comparisons revealed no consistent differences across metrics. Conclusions: Although mechanical load was comparable between age groups, autonomic markers—particularly RMSSD—indicated higher parasympathetic modulation in younger professional players. These findings align with established sports physiology literature but provide preliminary evidence derived from real-world data collected in professional soccer athletes using a compact wrist-worn biosensor. The results support the utility of wearable HRV monitoring for age-related physiological profiling in elite sports environments. Full article

Background/Objectives: Ammonia inhalants, commonly known as smelling salts, are widely used in sport as an acute arousal strategy, yet their ergogenic value remains uncertain. This systematic review and three-level meta-analysis examined the acute effects of ammonia inhalation on physical performance and selected psychophysiological outcomes. Methods: Controlled human studies involving healthy adults, physically active individuals, or athletes were included when they compared ammonia inhalation with placebo, sham, or no-inhalation control conditions. Physical performance was the primary outcome, with heart rate and selected subjective responses analyzed as exploratory secondary outcomes. Results: Ten studies were included. The primary analysis showed no statistically significant effect of ammonia inhalation on overall physical performance (k = 47, g = 0.11, 95% CI [−0.06, 0.28]). Heart rate and subjective exertion/fatigue were also not significantly affected. In contrast, subjective activation/arousal increased significantly (k = 9, g = 0.73, 95% CI [0.43, 1.04]), although this finding was based on only two studies. Moderator analyses did not show consistent subgroup differences for performance type, training status, or comparator type, whereas sex-based differences were exploratory and based on limited evidence. Sensitivity analyses suggested that physical performance became significantly improved after removal of influential effects, and power/explosive performance showed a possible benefit; however, these findings should be considered preliminary rather than confirmatory. Conclusions: Overall, ammonia inhalation appears to act primarily as a brief arousal stimulus rather than a consistent ergogenic aid. Potential benefits may depend on task demands, with explosive or repeated high-intensity tasks appearing more plausible targets than maximal strength or precision-based skills. Current evidence remains limited by small samples, heterogeneous protocols, and low certainty. Full article

This study aimed to investigate associations between training load (TL) calculated using the OMNI rating of perceived exertion scale (OMNI-RPE) and heart rate (HR) and velocity-derived measures of TL in non-elite adolescent team sport athletes. Fifty-four athletes participated in the study. The study was separated into two parts. In the Part A, twenty athletes completed both an easy and hard version of a simulated team game circuit outdoors on natural turf to replicate performance parameters often used in training. In part B, thirty-four different athletes completed a competitive team game played outdoors on synthetic/natural turf hockey or soccer pitches. For both Parts A and B, session OMNI TL (sOMNI-TL) was derived as a product of the session OMNI-RPE and session duration, and was correlated to Edward’s Training Impulse (TRIMP) and time spent in 0–25%, 25–50%, 50–70% and >70% peak velocity. Low-to-moderate correlations were observed between sOMNI-TL and Edwards TRIMP (r = 0.18–0.20) and velocity measures (r = 0.05–0.42) for Part A. Larger correlations were observed between sOMNI-TL and Edwards TRIMP (r = 0.53, p < 0.05) and velocity measures (r = 0.36–0.51, p < 0.05) for part B. The hypothesis that sOMNI-TL would show significant, moderate associations with heart rate and velocity-derived training load in both simulated and game conditions was only partially supported, and the results of this study do not support its use as a stand-alone measure in a practical setting. Full article

Background: SARS-CoV-2 infection may impair functional capacity in athletes, while prior vaccination status may be associated with post-infection functional status. However, evidence comparing objective post-infection exercise responses according to vaccination status in elite athletes remains limited. Methods: This study included a total of 220 male athletes with PCR-confirmed SARS-CoV-2 infections: 101 unvaccinated and 119 vaccinated with two doses prior to infection. Cardiopulmonary exercise testing (CPET) was performed 14 ± 1 days after confirmation of SARS-CoV-2 infection and before the athletes returned to full training. A two-way ANOVA was conducted for each CPET variable, using vaccination status and sport as fixed factors. Results: After accounting for the type of sport, vaccinated athletes showed significantly higher VO₂max, VO₂ at VT1, oxygen pulse, heart rate at VT1, and heart rate at VT2, as well as lower VE/VCO₂ values. No significant differences were found for VEmax, HRmax, or heart rate during recovery. The interaction between vaccination status and sport was not significant for the main CPET outcomes, indicating a similar pattern in both sports. Conclusions: These findings suggest that prior vaccination is associated with a more favorable early post-infection physiological profile in professional team-sport players. Full article

Objectives: This study aimed to analyze the placebo effect of caffeine expectancy on interval running performance in moderately trained athletes. Methods: Participants were randomly allocated to one of two treatment sequences (placebo–control or control–placebo) and completed two 5 × 1000-m training sessions on an outdoor athletics track under two conditions: (1) ingestion of a placebo capsule described as containing caffeine (3 mg·kg⁻¹), and (2) a control condition (no ingestion). Running performance (primary outcome), pacing strategy, heart rate, kinematic variables, perceived exertion (RPE), and side effects were recorded. Results: Fourteen participants were randomized and all completed both study periods and were included in the analyses. No statistically significant differences were observed in total session time between conditions (1021.50 ± 114.01 vs. 1017.23 ± 109.08 s, control vs. placebo, respectively; p = 0.270; ES = 0.31). Likewise, no differences were found in pacing strategy, heart rate, rating of perceived exertion, or running kinematics (all p > 0.05). However, participants reported greater feelings of activeness and higher ratings of selected caffeine-related side effects, including increased urine production and sleep disturbances, under the placebo condition. Conclusions: Believing that caffeine had been consumed did not improve interval-running performance, pacing strategy, physiological responses, or running kinematics in trained runners. However, caffeine expectancy altered the perception of some expected caffeine-related side effects. These findings provide limited evidence for an ergogenic placebo effect of caffeine during interval training and highlight the need for further research to identify the conditions under which expectancy effects may influence exercise performance. Full article

Background: Motorsport competition imposes significant psychophysiological demands on athletes, characterized by prolonged cardiovascular strain, high cognitive workloads, and extreme thermal environments. However, scientific literature focusing specifically on the category of single-seater race cars remains lacking. Therefore, the objective of this review was to identify possible physiological demands in Formula drivers to suggest training recommendations and to examine gaps in the literature for future studies. Methods: A narrative literature search was conducted including the following search engines: PubMed/MEDLINE, ScienceDirect, and Google Scholar. All studies until October 2025 were included. Results: A total of eight studies were selected. The limited physiological demands of Formula drivers suggest that professional drivers exhibit specialized physical adaptations. These findings describe high aerobic capacity, elevated sustained heart rates during competition, and targeted musculoskeletal development, particularly regarding neck and upper body strength required to withstand gravitational loads. Conclusions: Although the currently available data provide valuable preliminary insights into the physiological impact of auto racing, the extremely limited and heterogeneous nature of the existing samples prevents definitive conclusions from being drawn. There is an urgent need for future longitudinal research using high-fidelity, category-specific monitoring to establish robust and standardized psychophysiological profiles and provide training recommendations applicable throughout an entire single-seater racing career. Full article

Objectives: This study aimed to examine the effects of three different warm-up protocols on performance, physiological, and perceptual responses in high-level water polo players. Methods: Ten international-level athletes (Tier 4; mean ± SD: age 22.4 ± 3.53 years; height 1.78 ± 0.06 m; body mass 75.83 ± 6.44 kg) completed three experimental conditions in a randomized, counterbalanced design: dryland, in-water, and combined warm-up. Following each warm-up condition, participants performed the Water Polo Intermittent Shuttle Test (WIST), while performance (distance covered and average speed), blood lactate concentration ([La⁻]), heart rate (HR), tympanic temperature, and rating of perceived exertion (RPE) were assessed. Statistical significance was set at p ≤ 0.05. Results: Players covered greater distances following the in-water (331.5 ± 151.24 m) and combined (358.5 ± 134.06 m) warm-ups compared to dryland (226.5 ± 129.51 m; p < 0.01; ES = 2.00 and 1.53, respectively), with no significant differences between in-water and combined conditions (p = 0.381; ES = 0.29). Physiological responses following the WIST were largely similar between conditions, although [La⁻] was higher in the dryland condition (12.46 ± 4.46 mmol·L⁻¹) compared to the combined condition at 10 min post-exercise (8.66 ± 2.47 mmol·L⁻¹; p = 0.03; ES = 0.80). No differences were found for HR, tympanic temperature, or RPE. Conclusions: These findings suggest that warm-up protocols including an in-water component are more effective than dryland-only routines for optimizing intermittent performance in water polo players. However, combining dryland and in-water exercises does not appear to provide additional benefits compared to in-water warm-up alone. Full article

Background and Objectives: Evidence on the acute effects of caffeine in female team-sport athletes is limited. This study aimed to quantify the acute effects of caffeine on female team-sport athletes across physical performance, sport-specific performance, physiological responses, perceptual responses, and cognitive performance and determine moderators. Methods: PubMed and Web of Science were systematically searched for randomized, placebo-controlled crossover trials of acute, dose-defined caffeine in female team-sport athletes. Effect sizes were expressed as Hedges’ g and synthesized within each domain using a three-level CHE model with CR2 cluster-robust variance estimation and Satterthwaite degrees of freedom; 95% confidence intervals and prediction intervals were reported. Risk of bias (RoB 2), methodological quality (PEDro), and certainty of evidence (GRADE) were assessed. Results: Twenty-six studies were included, comprising 26 randomized, blind, placebo-controlled crossover trials. As a descriptive cross-domain summary, acute caffeine intake showed a small overall effect when all available domains were pooled (Hedges’ g = 0.24, 95% CI 0.13 to 0.35); however, because these domains represent different constructs, domain-specific estimates were considered the primary interpretable findings. For physical performance, caffeine showed a small favorable effect (g = 0.32, 95% CI 0.22 to 0.42), with statistical evidence for repeated sprint ability (g = 0.43), agility or change in direction (g = 0.42), sprint or speed performance (g = 0.39), anaerobic power (g = 0.30), and jumping performance (g = 0.29). For sport-specific performance, the pooled estimate indicated a small favorable effect but did not reach conventional statistical significance (g = 0.36, 95% CI: −0.01 to 0.73). Exploratory sub-indicator analyses, each based on only a few studies, suggested possible favorable directions for sport-specific locomotion or running performance (g = 0.46) and throwing or ball-speed outcomes (g = 0.19), whereas evidence was insufficient for shooting or scoring accuracy. Physiological outcomes were direction-aligned to the value conventionally regarded as favourable for each indicator (i.e., lower heart rate, lactate, and glucose), so that positive values denote the conventionally favourable direction; because the domain aggregates indicators of differing clinical desirability, its pooled value is a descriptive summary only and showed no clear domain-level direction (g = −0.05, 95% CI −0.31 to 0.21). The heart rate submetric showed a statistically detectable difference (g = −0.30), indicating that caffeine increased heart rate, the expected pharmacological response to a stimulant rather than an adverse effect; there were no clear effects on blood lactate or blood glucose. Perceptual responses improved modestly (g = 0.42), largely through reduced rating of perceived exertion (g = 0.35). Cognitive performance, based on only four studies with low degrees of freedom and wide uncertainty, showed a nonsignificant direction (g = 0.37) with no clear evidence for reaction time or cognitive accuracy, and these data should not be interpreted as showing that caffeine improves cognitive performance in female team-sport athletes. Exploratory moderator analyses did not provide statistically reliable evidence of moderation by caffeine dose, timing of intake, formulation or source, sport type, competitive level, habitual caffeine intake, or blinding status. Conclusions: Available evidence most consistently supports small, outcome-specific benefits of acute caffeine for physical performance and reduced perceived exertion. Evidence for sport-specific skills and cognitive outcomes remained uncertain, based on few studies per outcome and not supporting a general benefit. Current data do not support dose-, timing-, formulation-, habitual-intake-, sport-, or population-stratified recommendations. Future trials should be adequately powered, prospectively report menstrual-cycle phase, hormonal-contraceptive use, habitual caffeine intake, and adverse symptoms, and verify the integrity of blinding. Full article

Background/Objectives: Exogenous ketone supplementation has been proposed to enhance endurance performance by altering substrate metabolism and sparing muscle glycogen. Prolonged carbohydrate restriction may upregulate ketolytic capacity and could therefore modulate the response to exogenous ketone ingestion. This study investigated the impact of increasing circulating ketone bodies through exogenous ketone supplementation on endurance performance in athletes chronically adapted to a ketogenic diet. Methods: Participants (n = 9 recreationally active males, with ≥1 year of ketogenic adherence) visited the lab four times. The first visit determined their $\stackrel{.}{\mathrm{V}}$O₂max. The second visit accustomed them to test procedures. In a counterbalanced design, visits three and four tested the consumption of a 60 g carbohydrate beverage (CHO), or a beverage comprising 60 g carbohydrate and 0.5 g/kg 1,3-butanediol (CHO + BD). This was followed by a 60 min set-intensity exercise bout, followed by a 16.1 km time trial. Results: βHB significantly increased in the CHO + BD group (rest: 0.72 ± 0.33 mmol/L; post-exercise: 1.69 ± 0.30 mmol/L) compared to CHO (rest: 0.80 ± 0.53; post-exercise: 0.55 ± 0.30) (p < 0.001). There was no significant difference in time trial performance between groups (1606 ± 138 s; 1620 ± 134 s; p > 0.05). During set intensity exercise, there was no significant main effect of supplementation on lactate concentration, substrate oxidation, oxygen consumption at a fixed workload, RPE or heart rate (p > 0.05). However, glucose was significantly lower at minutes 40 and 60 of set intensity exercise in CHO + BD compared to CHO. Conclusions: No significant effect of 1,3-butanediol ingestion on endurance performance was detected in this sample of nine chronically ketogenic male athletes. βHB significantly increased from resting levels; however, time trial performance did not differ between conditions. Given the small sample and limited statistical power, these preliminary findings indicate no detectable ergogenic effect under the present conditions rather than evidence of no effect, and larger studies are warranted. Full article

Firefighters often perform multiple consecutive bouts of high-intensity work in hot environments, which can lead to physiological fatigue and increased health risks. This study examined changes in core temperature, skin temperature, and heart rate during recovery periods following repeated bouts of work in recruit firefighters (n = 10) across a full day of outdoor training. Participants completed four work–rest cycles consisting of firefighting drills performed in full personal protective equipment (PPE), followed by passive recovery after PPE removal. Physiological measurements were recorded one minute prior to recovery and then at 5, 10, and 20 min throughout recovery. Skin temperature and heart rate decreased significantly (p < 0.05) within 5–10 min of recovery in most rounds. However, core temperature required at least 20 min to significantly decline (p < 0.05). These findings suggest that shorter recovery periods may be sufficient for heart rate and skin temperature to return to baseline, whereas longer recovery periods are needed for heat to dissipate from the core, especially as work intensity increases. Thus, standard rehabilitation protocols may be insufficient under more extreme working conditions and should be adjusted accordingly to ensure firefighter safety. Full article

Background/Objectives: This study aims to evaluate the effectiveness of binaural beats (BB) on the autonomic nervous system (ANS), kinesiophobia of reinjury and fitness biomarkers in professional athletes with chronic musculoskeletal injuries. Methods: A total of 54 athletes aged 18–25 years, engaged in open-skill sports and experiencing chronic lower-limb injuries for over three months, will be recruited. They will be randomly assigned to one of three groups: an intervention group, a placebo group, and a control group. All athletes will undergo a 15 min auditory intervention five times per week for four weeks. The intervention group will listen to BB embedded in music at high beta and gamma frequencies (30–100 Hz) with guided instructions. The placebo group will receive placebo BB within the same music framework, while the control group will listen only to the music background. Assessments will be conducted at baseline, immediately post-intervention, and at a 4-week follow-up. The primary outcomes will be kinesiophobia of reinjury, ANS function, and heart rate variability (HRV), assessed using the Tampa Scale of Kinesiophobia (TSK-17), Sympathetic Skin Response (SSR), and HRV analysis, respectively. Secondary outcomes will include sport-related anxiety and pain beliefs, assessed using the Sport Competition Anxiety Test (SCAT-15) and the Pain Beliefs and Perceptions Inventory (PBPI-16), respectively; handgrip strength, assessed using the Hand Grip Test; and fitness-related biomarkers, including maximal oxygen uptake (VO₂max) and blood lactate concentration. Conclusions: These findings may provide evidence supporting BB as a complementary, non-invasive intervention to enhance psychological and physiological rehabilitation in injured athletes. Ethics and Dissemination: The study has received ethical approval and is registered on ClinicalTrials.gov. Findings will be disseminated through peer-reviewed publications, conferences, and academic presentations. Full article

Background and Objectives: Eccentric hypertrophy (EH) represents a common physiological cardiac adaptation in athletes, particularly in endurance disciplines. However, the biological correlates underlying EH and potential sex-specific differences remain poorly understood. This study aimed to investigate clinical, echocardiographic, and biochemical determinants of EH in a large cohort of elite athletes. Materials and Methods: We evaluated 2522 elite athletes undergoing pre-participation screening for Olympic competitions. Athletes were classified according to cardiac geometry into EH or normal geometry (NG) based on echocardiographic parameters. Clinical, anthropometric, echocardiographic, and biochemical variables were compared between groups. Univariate and multivariable logistic regression analyses were performed to identify independent predictors of EH. Results: EH was present in 601 athletes (23.8%) and was more prevalent in endurance sports (51.1% vs. 14.3%, p < 0.0001). Athletes with EH showed greater cardiac chamber dimensions and mass, with preserved systolic and diastolic function. Several biomarkers differed between groups, including higher AST, ALT, CPK, eosinophils, and HDL, and lower creatinine and TSH in EH (all p < 0.01). Following multivariable analysis, lower creatinine (OR 0.28, 95% CI 0.14–0.52, p < 0.0001), higher AST (OR 1.02, 95% CI 1.02–1.03, p < 0.0001), and higher eosinophil count (OR 1.12, 95% CI 1.06–1.20, p < 0.0001) independently predicted EH. The model showed moderate discrimination (AUC 0.72). Sex-stratified analyses showed different biomarker associations with EH in men (creatinine and AST) and women (eosinophils and HDL), with similar model performance (AUC 0.71 vs. 0.73). Conclusions: EH in elite athletes is associated with distinct biological signatures reflecting multiple physiological pathways. Notably, sex-specific patterns emerge, suggesting different mechanisms underlying cardiac adaptation in male and female athletes. Full article

Caffeine is among the most widely used supplements in sports nutrition, with substantial evidence supporting its efficacy for enhancing athletic performance. However, the relevance of pre-exercise caffeine supplementation extends beyond its ergogenic effects. Exercise itself acts as an acute cardiometabolic stressor, eliciting dynamic responses in blood pressure, heart rate, vascular tone, substrate utilization, and glucose regulation. Caffeine may further modify the magnitude, temporal profile, and recovery kinetics of these responses. This focused narrative review examines the acute cardiometabolic responses associated with pre-exercise caffeine supplementation and its potential regulatory effects. It outlines the underlying biological mechanisms, including adenosine receptor antagonism, hemodynamic and vascular pathways, and metabolic and substrate-utilization pathways, while synthesizing current evidence from the literature. Available evidence indicates that the acute effects of caffeine are highly context dependent. In some exercise settings, caffeine may promote lipolysis and fat oxidation; in others, particularly among susceptible individuals or under specific exercise conditions, it may be associated with greater acute cardiovascular or autonomic load, reflected by higher peripheral vascular resistance and blood pressure, altered vascular reactivity, or delayed post-exercise autonomic recovery. Its effects may vary according to dose, timing, supplement form, exercise modality and intensity, training status, habitual caffeine intake, genotype, sex, and hormonal status. Overall, pre-exercise caffeine should not be regarded solely as a uniformly beneficial ergogenic aid, but rather as a physiological modulator that may reshape the acute cardiometabolic milieu during and after exercise. Future studies should integrate hemodynamic, vascular, metabolic, and individual-variability measures over extended observation periods to support more evidence-based and individualized guidance on the appropriate use of pre-exercise caffeine. Full article