Search Results (767)

Background/Objectives: Sports-related concussions can result in prolonged symptoms and deficiencies in stability and balance. Effective and standardized rehabilitation protocols remain limited. This case report introduces a novel balance training program using virtual reality and force plate technology to address persistent post-concussion symptoms. Methods: A 20-year-old National Collegiate Athletic Association (NCAA) Division I football player with a history of multiple concussions and balance-related symptoms completed a 10-week intervention. The program utilized a multi-axis force platform and immersive visual tasks to train vestibular, oculomotor, and proprioceptive systems. Each weekly session consisted of seven tasks progressing in difficulty, which were completed three times per session. Performance was measured by the percentage of time a digital cursor remained within task boundaries using the distribution of their center of mass. Symptom self-reports were also recorded. Results: Cumulative mean performance improved from 75.87% in the first session to 91.67% in the final session. All individual template scores increased, including those on the most complex template, which rose from 55.76% to 80.20%. The patient also reported reduced dizziness, disorientation, and improved functional balance across the 10-week period. Conclusions: This virtual-reality-based balance training program shows promise in resolving persistent post-concussion symptoms. Its objective measurement, engaging format, and ease of use suggest potential for broader application in concussion rehabilitation. Full article

This cross-sectional study investigated whether elite female World Tour cyclists have a specific gut microbiome compared to non-athlete female controls, potentially resulting from the unique physiological and dietary demands of high-level endurance cycling. Fourteen female cyclists and thirteen matched controls provided fecal samples during a period of reduced training (off-season cycling). The samples were analyzed using 16S rRNA gene sequencing and short-chain fatty acid (SCFA) quantification. The results revealed significant differences in microbiome composition. The cyclists showed a higher abundance of Bacteroidota (72.7% vs. 15.3%) and a lower abundance of Firmicutes (22.1% vs. 62.5%) compared to the controls, along with reduced alpha-diversity (Shannon index, p < 0.05). Fiber-fermenting families such as Lachnospiraceae and Ruminococcaceae were depleted, consistent with a carbohydrate-focused and relatively low-fiber diet. Interestingly, fecal SCFA levels did not differ, suggesting functional adaptation of the microbiome. These findings indicate that the elite female cyclists may have developed a “performance-adapted” gut microbiome. However, due to the cross-sectional design, causality cannot be established, and the long-term health implications remain uncertain. Full article

Background/Objectives: This study investigated how phase-specific dietary strategies and weight regulation influence gut microbiota composition and diversity in competitive weightlifters. Particular emphasis was placed on integrating energy intake, macronutrient clustering, and weight fluctuations across distinct training phases. Methods: Thirteen competitive weightlifters were recruited, with 10–12 contributing complete data per phase. Fecal and dietary samples were collected during the preparation, competition, and transition phases. Gut microbiota was profiled via 16S rRNA gene sequencing, and alpha/beta diversity was analyzed using QIIME2. K-means clustering based on caloric/macronutrient intake identified dietary patterns. Taxonomic differences were assessed using DESeq2, and microbial structures were compared across training phases, weight classes, and weight-change categories. Results: Overall phylum- and genus-level profiles and diversity indices remained stable across training phases, indicating community-level resilience. However, specific genera varied with dietary and physiological factors. Enterococcus was higher during the preparation phase, whereas Lactobacillus was enriched during the competition and transition phases as well as in the high-calorie cluster. Lightweight and heavyweight athletes also showed distinct microbial structures, and pre- and post-competition weight changes were associated with shifts in selected taxa. Notably, the low-calorie group exhibited higher Shannon diversity than the high-calorie group (p = 0.0058), with Lactobacillus dominance contributing to reduced evenness in high-energy diets. Conclusions: Despite overall microbial stability, dietary energy availability and body-weight regulation modulated specific taxa relevant to performance and recovery. By integrating dietary clustering, weight-class comparison, and pre- and post-competition weight changes, this study provides novel insight into the microbiota of resistance-trained athletes, a population underrepresented in previous research. Despite the modest sample size and single-season scope, this study offers new evidence linking dietary strategies, weight regulation, and gut microbiota in weightlifters, and highlights the need for validation in broader cohorts. Full article

Background: Optimizing training load and recovery is crucial for achieving peak performance in competitive wrestling, a sport characterized by high physical, technical, and psychological demands. Methods: This study compared the effects of two different training programs—one emphasizing high-intensity interval training (HIIT) sessions and the other based on traditional volume-oriented training—on both competitive performance and autonomic regulation measured by heart rate variability (HRV). A total of 24 elite wrestlers were divided into two equal groups, each following a different weekly training regimen over a 3-month period. HRV was recorded using a wearable 3-channel ECG Holter before training, immediately after training, and during recovery phases (up to 2 h post-exercise). HRV parameters were analyzed to assess training-induced stress and recovery status. Competitive performance was evaluated using official national championship scores and ranking positions. Results: Both training programs improved competitive performance, the HIIT-based regimen induced greater short-term suppression of parasympathetic activity (RMSSD: −32% vs. −14%; HF power: −40% vs. −18%) and increased sympathetic dominance (LF/HF: +56% vs. +22%) after training. Wrestlers in the HIIT group achieved a mean competition score of 17.92 ± 4.50 points, compared to 15.08 ± 6.26 points in the volume-oriented group. These acute autonomic shifts may provide a higher readiness for intense and explosive actions, which is advantageous in short and dynamic matches. In contrast, the volume-oriented program induced smaller acute autonomic changes but showed a slower recovery to baseline. Conclusions: These findings suggest that HRV-derived measures can serve as sensitive indicators of training load tolerance, recovery capacity, and stress susceptibility in combat sports athletes. This study highlights the value of integrating HRV monitoring into the periodization of combat training to individualize the load, prevent overtraining, and optimize performance outcomes. Full article

The aim of this study was to explore the prevalence of acute and overuse injuries, as well as risk factors, training load and well-being, in male and female youth padel players. Using a cross-sectional design, data were collected from 104 players (aged 15–20) via a web-based form. Players reported injuries, exposure and rating of perceived exertion (RPE), demographics (age and sex), and perceived well-being. Overuse injury severity was scored per body region (0–25), yielding a total possible score of 125. A total of six acute and 49 overuse injuries were recorded, corresponding to a prevalence of 0.53 injuries per player during a one-week recall period. Most injuries affected the knee, while the foot and lower leg had the highest severity scores (median = 44). Female players reported slightly higher stress levels (median 3) than males (median 2: p = 0.01), though no other well-being or training load differences were found. Injured players had significantly higher total wellness scores, indicating worse well-being, compared to non-injured players (median 10 vs. 9, p = 0.03). In conclusion, overuse injuries, particularly to the knee, were most common. Higher perceived stress and poorer wellness scores may be linked to injury risk, underlining the importance of monitoring well-being in youth padel athletes. Full article

Background: After a warm-up and before the start of sports competition, athletes often take a break. During this break, the effects of the warm-up (e.g., capillary vasodilation) may diminish. The aim of this study was to compare cardiorespiratory responses during high-intensity physical exercise, either preceded or not preceded by post-warm-up breathing, using an additional respiratory dead space volume mask (ARDSv). Methods: The study included 20 trained cyclists. Each participant completed two 3 min tests at an intensity of 110% of their maximal power, determined during a progressive test. A standardised warm-up preceded each 3 min test. Following the warm-up, there was an 8 min passive rest period. During this break, participants either breathed using ARDSv or breathed normally (non-ARDSv). The volume of the ARDSv mask was 1000 mL. Cardiorespiratory parameters were measured during the tests, including mean: oxygen uptake (VO₂av), respiratory exchange ratio (RERav), respiratory rate (RRav), tidal volume (TVav), stroke volume (SVav), and rating of perceived exertion (RPE). Results: VO₂peak was higher in participants breathing using ARDSv compared to non-ARDSv (4.22 ± 0.40 [CI: 4.03–4.41] vs. 3.98 ± 0.42 [CI: 3.79–4.18]; p = 0.002; t = 3.56; d = 0.585). Additionally, RERav (1.08 ± 0.06 [CI: 1.06–1.11] vs. 1.13 ± 0.06 [CI: 1.11–1.16]; p = 0.008; t = 2.96; d = 0.833) and RPE (18.0 ± 1.7 [CI: 17.3–18.8] vs. 18.9 ± 1.1 [CI: 18.4–19.4]; p = 0.009; Z = 2.61; r = 0.583) were lower in participants breathing using ARDSv compared to non-ARDSv. Conclusions: Breathing using ARDSv between warm-up and high-intensity exercise increases oxygen uptake and reduces perceived exertion, likely through peripheral mechanisms. These effects suggest practical applications in competitive sports and provide directions for further mechanistic research. Full article

Background: Bone health in youth is influenced by both modifiable factors, such as nutrition and physical activity, and non-modifiable factors, such as biological maturation and heredity. Understanding how these elements interact to predict body composition may enhance the effectiveness of early interventions. Importantly, the integration of both supervised and unsupervised machine learning models enables a data-driven exploration of complex relationships, allowing for accurate prediction and subgroup discovery. Methods: This cross-sectional study examined 94 male athletes during the developmental period. Anthropometric, performance, and nutritional data were collected, and bone parameters were assessed using dual-energy X-ray absorptiometry (DXA). Three supervised machine learning models (Random Forest, Gradient Boosting, and Support Vector Regression) were trained to predict Total Body-Less Head (TBLH) values. Nested cross-validation assessed model performance. Unsupervised clustering (K-Means) was also applied to identify dietary intake profiles (calcium, protein, vitamin D). SHAP analysis was used for model interpretability. Results: The Random Forest model yielded the best predictive performance (R² = 0.71, RMSE = 0.057). Weight, height, and handgrip strength were the most influential predictors. Clustering analysis revealed two distinct nutritional profiles; however, t-tests showed no significant differences in TBLH or regional BMD between the clusters. Conclusions: Machine learning, both supervised for accurate prediction and unsupervised for nutritional subgroup discovery, provides a robust, interpretable framework for assessing adolescent bone health. While dietary intake clusters did not align with significant differences in bone parameters, this finding underscores the multifactorial nature of skeletal development and highlights areas for further exploration. Full article

Indoor sports facilities present unique challenges for air quality management due to high crowd densities and limited ventilation. This study investigated air quality in a municipal athletic facility in Komotini, Greece, focusing on concentrations of airborne particulate matter (PM_1.0, PM_2.5, PM₁₀), humidity, and temperature across spectator zones, under varying mask scenarios. Sensing devices were installed in the stands to collect high-frequency environmental data. The system, based on optical particle counters and cloud-enabled analytics, enabled real-time data capture and retrospective analysis. The main experiment investigated the impact of spectators wearing medical masks during two basketball games. The results show consistently elevated PM levels during games, often exceeding recommended international thresholds in the spectator area. Notably, the use of masks by spectators led to measurable reductions in PM_1.0 and PM_2.5 concentrations, because they seem to have limited the release of human-generated aerosols as well as the amount of movement among spectators, supporting their effectiveness in limiting fine particulate exposure in inadequately ventilated environments. Humidity emerged as a reliable indicator of occupancy and potential high-risk periods, making it a valuable parameter for real-time monitoring. The findings underscore the urgent need for improved ventilation strategies in small to medium-sized indoor sports facilities and support the deployment of low-cost sensor networks for actionable environmental health management. Full article

Background/Objectives: This study aimed to examine the effects of an eight-week wearable resistance (WR) training program on jump performance and jump kinematics in experienced senior female volleyball players. It was hypothesised that using WR would increase training load, thereby enhancing vertical jump performance and influencing kinematic movement patterns. Methods: Sixteen competitive female volleyball players (mean age: 23.5 ± 3.24 years; mean weight: 66.8 ± 6.9 kg; mean height: 174.7 ± 5.8 cm) participated in the study. Participants were randomly assigned to either a control group (n = 8) or an intervention group (n = 8) that trained with calf-mounted WR. The intervention group performed supervised resistance training sessions twice per week for eight weeks, totalling 16 sessions. Jump performance was assessed using an Infrared Optical Contact Grid (MuscleLab, Ergotest Innovation AS, Norway), and jump kinematics were measured with the Xsens Link motion capture system (Movella, The Netherlands). Results: The WR group demonstrated a statistically significant improvement in vertical jump height (p = 0.031), with no significant changes in kinematic variables. The control group, however, showed a significant increase in T8–pelvis flexion during the countermovement jump (CMJ) following the intervention period. Conclusions: Eight weeks of WR training can improve CMJ performance in-season among experienced female volleyball players without affecting movement kinematics. Future research should investigate optimal loading strategies and long-term adaptations. These findings suggest that integrating small wearable loads into regular volleyball practice can help athletes maintain and improve explosive performance without disrupting normal training routines. Full article

Decision Support Systems (DSSs) are increasingly shaping high-performance sport by translating complex time series data into actionable insights for coaches and practitioners. This paper outlines a structured, five-stage DSS development pipeline, grounded in the Schelling and Robertson framework, and demonstrates its application in professional basketball. Using changepoint analysis, we present a novel approach to dynamically quantify Most Demanding Scenarios (MDSs) using high-resolution optical tracking data in this context. Unlike fixed-window methods, this approach adapts scenario duration to real performance, improving the ecological validity and practical interpretation of MDS metrics for athlete profiling, benchmarking, and training prescription. The system is realized as an interactive web dashboard, providing intuitive visualizations and individualized feedback by integrating validated workload metrics with contextual game information. Practitioners can rapidly distinguish normative from outlier performance periods, guiding recovery and conditioning strategies, and more accurately replicating game demands in training. While illustrated in basketball, the pipeline and principles are broadly transferable, offering a replicable blueprint for integrating context-aware analytics and enhancing data-driven decision-making in elite sport. Full article

Background: Elite athletes are frequently subjected to high-intensity training regimens, which can result in cumulative physical stress, overtraining, and potential health risks. Monitoring autonomic responses to such load is essential for optimizing performance and preventing maladaptation. Objective: The present study aimed to assess changes in autonomic regulation immediately and two hours after training in athletes, using an integrated framework (combining time- and frequency-domain HRV indices with nonlinear and recurrence quantification analysis). It was investigated how repeated assessments over a 4-month period can reveal cumulative effects and identify athletes at risk. Special attention was paid to identifying signs of excessive fatigue, autonomic imbalance, and cardiovascular stress. Methods: Holter ECGs of 12 athletes (mean age 21 ± 2.22 years; males, athletes participating in competitions) over a 4-month period were recorded before, immediately after, and two hours after high-intensity training, with HRV calculated from 5-min segments. Metrics included HRV and recurrent quantitative analysis. Statistical comparisons were made between the pre-, post-, and recovery phases to quantify autonomic changes (repeated-measures ANOVA for comparisons across the three states, paired t-tests for direct two-state contrasts, post hoc analyses with Holm–Bonferroni corrections, and effect size estimates η²). Results: Immediately after training, significant decreases in SDNN (↓ 35%), RMSSD (↓ 40%), and pNN50 (↓ 55%), accompanied by increases in LF/HF (↑ 32%), were observed. DFA α1 and Recurrence Rate increased, indicating reduced complexity and more structured patterns of RR intervals. After two hours of recovery, partial normalization was observed; however, RMSSD (−18% vs. baseline) and HF (−21% vs. baseline) remained suppressed, suggesting incomplete recovery of parasympathetic activity. Indications of overtraining and cardiac risk were found in three athletes. Conclusion: High-intensity training in elite athletes induces pronounced acute autonomic changes and incomplete short-term recovery, potentially increasing fatigue and cardiovascular workload. Longitudinal repeated testing highlights differences between well-adapted, fatigued, and at-risk athletes. These findings highlight the need for individualized recovery strategies and ongoing monitoring to optimize adaptation and minimize the risk of overtraining and health complications. Full article

Background: Chronic autoimmune thyroiditis, also known as Hashimoto’s thyroiditis (HT) or chronic lymphocytic thyroiditis whose pathophysiology includes both cellular (T-cell mediated) and humoral (B-cell mediated) immune responses, leads to the destruction of thyroid follicular cells and progressive fibrosis of the thyroid gland. While hypothyroidism is a common autoimmune disease, athletes may experience unique challenges related to its diagnosis and management within the context of training programme, competition and anti-doping regulations. In turn, it is known that moderate physical exercise can have a positive effect on the immune system, while excessive exercise can cause unfavourable changes in this system. Therefore, we aimed (1) to identify the interplay between physical activity and autoimmune thyroid disease, (2) to quantify changes in thyroid function associated with physical activity, and (3) to explain the underlying mechanisms of autoimmune thyroiditis in athletes. Methods: The medical database PubMed/MEDLINE was searched in the time period 2004–2025, where 12 publications met the inclusion criteria and were ultimately included for further evaluation according to the RAMESES (Realist and Meta-narrative Evidence Syntheses: Evolving Standards). Results: The reviewed studies have clearly indicated that physical exercise has a beneficial effect on thyroid function, and two studies reported that non-excessive physical exercise leads to a decrease in TPO-Ab concentrations. Conclusions: The beneficial effect of physical exercise on thyroid function and immune response underlines the need for further well-designed studies to formulate specific guidelines for patients with HT, as well as for athletes with autoimmune thyroid disease. Similarly, there is a need to evaluate the prevalence of thyroid hormone use among amateur and professional athletes in order to establish prevention strategies. Full article

Background: There are differing opinions in the literature regarding the optimal treatment modality for adolescents with completely displaced, complex clavicle fractures. This study aims to determine outcome differences between surgical and non-surgical treatment for adolescent Z-type clavicle fractures and to ascertain if differences exist in outcomes between the two interventions. Methods: This was a single-center, retrospective chart review performed at a level 1 trauma center. Inclusion criteria included pediatric patients ages 12 to 16 years who presented with a comminuted, displaced clavicle shaft fracture with a comminuted fragment more than 1 cm in length and were treated either operatively or nonoperatively between January 2019 and December 2022. The outcomes were radiographic union status (i.e., union versus non-union versus malunion), follow-up period, shoulder range of motion, return to athletic activities, and patient reported pain level. Results: Of the 24 patients, 11 were treated surgically and 13 non-surgically. Patients who were treated surgically were more likely to be older (mean 1.5 years, p = 0.039) and have a longer follow-up by 9 months average duration compared to the cohort treated non-surgically (p = 0.0009). There was no significant difference between patient reported pain, radiographic union status, return to athletic activity, or shoulder range of motion between the cohorts. The small sample size and retrospective study design limits the statistical power of our results. Conclusions: The decision between treating these complex fractures operatively versus nonoperatively should be left to a lengthy discussion between the surgeon, parents, and the patient. Full article

The purpose of this longitudinal case report was to assess physical fitness changes in world-class shot put para athletes during six months of training. One male (age: 34.8 years; mass: 96.9 kg; height: 1.79 m; sport class: F42), and one female (age: 45.3 years; mass: 60.1 kg; height: 1.64 m: F54) shot put para-thrower were assessed during a 24-week periodized training program, including strength and power training, throws, and plyometrics. Monthly assessments included competitive shot put throwing performance, the medicine ball throw test, and upper-body maximal strength, while body composition was measured before and after the training period. Shot put throwing performance improved by 10.1% and 1.6% for the male and female athletes, respectively. Similarly, performance in the medicine ball throw test increased by 15.2% and 8.4% for the male and female athletes, respectively. Maximal strength increased by 10.3% (male) and 3.3% (female). Body composition changes included an increased lean mass (2.5%) and reduced sum of six skinfolds (−9.8%) in the male athlete, while the female athlete experienced decreased body mass (−2.5%) and skinfolds (−11.7%). World-class shot put para athletes can improve strength and power through a structured periodized training plan. Monitoring strength and performance indicators monthly effectively tracked training adaptations in elite para athletes. Full article

Background: Student-athletes face the dual challenge of balancing academic and athletic commitments, which may simultaneously promote healthy lifestyle habits while increasing psychosocial and physiological stressors, particularly among female student-athletes. Understanding how these competing demands affect key behavioral (e.g., dietary habits, sleep, and chronotype) and psychological (e.g., body image) factors is essential for supporting their overall well-being. Therefore, this cross-sectional study investigated body dissatisfaction, adherence to the Mediterranean diet, sleep quality, and chronotype in female student-athletes compared to sedentary peers. Methods: Twenty-eight female participants voluntarily participated in the study. Twelve volleyball student-athletes (age 21.6 ± 2.4 years) were assessed during their competitive in-season period, and sixteen non-athlete students with a high sitting time (age 24.0 ± 3.2 years) completed the Mediterranean Diet Adherence questionnaire (PREDIMED), Pittsburgh Sleep Quality Index (PSQI), Morningness–Eveningness Questionnaire (MEQ), and Body Image Dimensional Assessment (body dissatisfaction) to assess their overall well-being. Results: Student-athletes showed significantly (p < 0.05) higher adherence to the Mediterranean diet (PREDIMED: 8.5 ± 1.5 score), although experiencing poorer sleep quality (PSQI: 6.8 ± 3.0 score) compared to non-athlete students with higher sitting times (PREDIMED: 6.7 ± 1.6 score; PSQI: 4.6 ± 2.3 score). Conversely, comparative body dissatisfaction was significantly higher in non-athlete students with a high sitting time (19.4 ± 24.5%) than in student-athletes (5.6 ± 10.5%). No significant differences emerged for chronotype or overall body dissatisfaction. Conclusions: These findings highlight a paradoxical health pattern in female student-athletes who combine healthier eating habits with poorer sleep quality. The results emphasize the importance of comprehensive wellness strategies that integrate dietary habits, sleep hygiene, and psychophysiological factors to better support female student-athletes in managing dual-career demands. Full article