Search Results (294)

The ongoing secular changes in human movement development means that an assessment of primitive reflexes is now required not only in disabled but also in neurotypical children. This study had three aims: (1) presenting the TASHUN test battery as suitable for the assessment of primitive reflex activity in normal children and child athletes; (2) analyzing reflex characteristics of neurotypical children; (3) verifying validity and reliability of tests. Spearman’s rank correlation and ROC analysis were used for validation. Intraclass Correlation Coefficient and RM ANOVA analyzed reliability. The test on 242 schoolgirls has demonstrated that retained primitive reflexes are present in almost every individual (84.7–95.7%). Correlations showed strong positive association, with all values exceeding 0.8, and ROC analysis demonstrated excellent predictive strength (AUC values over 0.9). Interobserver reliability showed excellent agreement (ICC values above 0.9). No significant offset was present among the scoring by evaluators. Therefore, testing for primitive reflexes is necessary in neurotypical children in order to obtain a realistic image about the physiology of reflexes and their role in motor development. Our screening could be useful for practicing sport professionals, researchers and academics, to identify deficiencies, to further explore reflexes and to train future PE teachers and trainers. Full article

Sport injury recognition is rapidly evolving with the integration of new emerging technologies. This systematic review aims to identify and evaluate technologies capable of detecting injuries during sports participation. A comprehensive search of PUBMED, Sport Discus, Web of Science, and ScienceDirect was conducted following the PRISMA 2020 guidelines. The review was registered on PROSPERO (CRD42024608964). Inclusion criteria focused on prospective studies involving athletes of all ages, evaluating tools which are utilised to identify injuries in sports settings. The review included research between 2014 and 2024; retrospective, conceptual, and fatigue-focused studies were excluded. Risk of bias was assessed using the Critical Appraisal Skills Program (CASP) tool. Of 4283 records screened, 70 full-text articles were assessed, with 21 studies meeting the final inclusion criteria. The technologies were grouped into advanced imaging (Magnetic Resonance Imaging (MRI), Diffusion Tensor Imaging (DFI), and Quantitative Susceptibility Mapping (QSM), with biomarkers (i.e., Neurofilament Light (NfL), Tau protein, Glial Fibrillary Acidic Protein (GFAP), Salivary MicroRNAs, and Immunoglobulin A (IgA), and sideline assessments (i.e., the King–Devick test, KD-Eye Tracking, modified Balance Error Scoring System (mBESS), DETECT, ImPACT structured video analysis, and Instrumented Mouth Guards (iMGs)), which demonstrated feasibility for immediate sideline identification of injury. Future research should improve methodological rigour through larger, diverse samples and controlled designs, with real-world testing environments. Following this guidance, the application of emerging technologies may assist medical staff, coaches, and national governing bodies in identifying injuries in a sports setting, providing real-time assessment. Full article

As mental health has gained prominence in recent years, elite ice hockey players have shared their experience of psychological problems, including adverse alcohol use, anxiety, depression, distress, eating disorders, and sleep disturbances. Mental health remains a sensitive issue for ice hockey players, as stigma, a strong hockey culture, lack of mental health literacy, and negative past experiences with seeking help constitute barriers to seeking support. This scoping review aims to identify the psychological factors contributing to elite ice hockey players’ well-being. After screening the titles and abstracts of three databases within a 2002–2025 timeframe, a total of 517 articles were retrieved. Seventeen articles targeting ice hockey athletes over 14 years of age competing at an elite level were selected. Three main categories emerged from the included studies: anxiety and depressive symptoms, motivational variables, and coping strategies at different career stages. Factors such as retirement, concussions, social support, parenting style, task-approach goals, and task-oriented behavior were influential components to the well-being and mental health of elite ice hockey players. Using the Lazarus and Folkman model, the identified psychological factors may help athletes and various actors surrounding them to better understand athletes’ well-being. Full article

Collegiate student-athletes are particularly vulnerable to food insecurity (FI). Prevalence rates range from 9.9% to 65%, although research is limited among this population. Background/Objectives: The challenge of balancing academic and degree progression requirements with training and competition demands can increase the risk for FI among student-athletes. Furthermore, insufficient funds for food has been reported for student-athletes living both on campus and off campus. Methods: This qualitative study employed a phenomenological design and constructivist theoretical framework to explore the experiences of athletic trainers, sports dietitians/nutritionists, and other professionals working with student-athletes in identifying and addressing FI among student-athletes via a series of online focus groups. Results: Participants (n = 27, 12 public colleges) had ≥7 years of collegiate athletics work experience, and most had been in their current position for <3 years. Five approaches to FI screening emerged; specifically, no screening, screening varies by team/sport, informal screening, dietitian screening, and formal screening. Emerging social determinants of FI included financial challenges, competing priorities, cultural/societal impacts, limited life skills, and the food environment. All these factors precipitated on a systems level, including individual, team/athletic department, and university/societal tiers. Conclusions: Athletic department and university policies and budgetary decisions emerged as potential antagonists of food security among student-athletes. FI mitigation strategies for student-athletes must go beyond simply addressing individual factors. Obtainment of food security among collegiate student-athletes requires system changes at the team/athletic department and university tiers. Full article

This study investigated the percentage of iron deficiency anemia (IDA) and iron deficiency (ID) among 71 elite female athletes at a Japanese university and assessed their dietary habits. IDA was identified in 9.9% (n = 7) of participants, and only 22.5% (n = 16) self-reported dietary practices aimed at preventing or managing ID/IDA. Notably, 52.1% (n = 37) of the athletes exhibited IDA or ID but lacked an appropriate dietary approach. Moreover, even among those who reported an intentional dietary approach to the prevention or management of ID/IDA, the intake of iron- and vitamin C-rich foods was insufficient, limiting the effectiveness of their efforts. These findings highlight a gap between awareness and effective practice, indicating that many female athletes in Japan, despite being at elevated risk, do not follow evidence-based dietary strategies for preventing or treating ID/IDA. Targeted nutritional education and routine screening of iron status are strongly recommended for this population. Full article

Endurance training induces significant cardiac remodeling, with evidence suggesting that prolonged high-intensity exercise may increase the risk of atrial fibrillation (AF). However, physiological responses differ by event type. This review compares AF-related markers in marathon and ultramarathon runners, focusing on structural adaptations, inflammatory and endothelial biomarkers, and the incidence of arrhythmias. A systematic analysis of 29 studies revealed consistent left atrial (LA) enlargement in marathon runners linked to elevated AF risk and fibrosis markers such as Galectin-3 and PIIINP. In contrast, ultramarathon runners exhibited right atrial (RA) dilation and increased systemic inflammation, as indicated by elevated high-sensitivity C-reactive protein (hs-CRP) and soluble E-selectin levels. AF incidence in marathoners ranged from 0.43 per 100 person-years to 4.4%, while direct AF incidence data remain unavailable for ultramarathon populations, highlighting a critical evidence gap. These findings suggest distinct remodeling patterns and pathophysiological profiles between endurance disciplines, with implications for athlete screening and cardiovascular risk stratification. Full article

Background: ESC sports classification in 2020, based on cardiac morphological adaptations, may not fully reflect also the variations in functional parameters of athletes. This study aims to characterize CPET-derived physiological parameters in elite athletes according to the ESC classification and evaluate whether this morphological classification also corresponds to a functional categorization. Methods: Elite athletes underwent pre-participation screening before the 2023 European Games and 2024 Olympic Games. Athletes were classified into four categories (skill, power, mixed and endurance). CPET was performed on a cycle ergometer using a ramp protocol, with measurements of VO₂ max, heart rate, power output and ventilatory efficiency. Results: We enrolled 1033 athletes (46.8% females; mean 25.6 ± 5.2 years old) engaged in skill (14.1%), power (33.2%), mixed (33.3%) and endurance (19.4%) disciplines. O₂ pulse showed an incremental significant increase (p < 0.0001) among sport categories (skill 14.9 ± 3.8 mL/beat; power 17.5 ± 4.6 mL/beat, mixed 19 ± 4.3 mL/beat and endurance 22.7 ± 5.8 mL/beat). The lowest ${\dot{\mathrm{V}}\mathrm{O}}_2$max was observed in skill disciplines (36.3 ± 7.9 mL/min/kg) whilst endurance ones showed the highest values (52.4 ± 9.7 mL/min/kg) (p < 0.0001). ${\dot{\mathrm{V}}\mathrm{O}}_2$max was higher in power compared to mixed (42 ± 7.7 mL/min/kg vs. 40.5 ± 5.8 mL/min/kg, p = 0.005) disciplines with an overlapping amount between some mixed and power disciplines. No differences were found for VE max (p = 0.075). Conclusions: Our study provided values of CPET parameters in elite athletes. Significant differences in CPET parameters were observed among different sports disciplines, with endurance athletes showing the highest absolute and relative values in all parameters. An overlap amount was noted between mixed and power categories, especially for relative maximal oxygen consumption. Full article

Background: Core stability is a cornerstone of optimum athletic performance, and its reduction is a risk factor for athletic injuries. Evidence has shown that core impairments can alter lower-limb mechanics through the kinetic chains. Additionally, plantar pressure can be influenced by proximal conditions, such as core muscle fatigue. Therefore, this study aimed to investigate the correlation between core endurance and plantar pressure distribution (PPD) during double-leg stance, single-leg stance, and single-leg squat positions in healthy male athletes. Methods: A total of 21 healthy male recreational athletes between 19 and 26 years of age volunteered to participate in this correlational study. The McGill core endurance test was used to measure the endurance of their core flexors, extensors, and lateral flexors. The participants’ PPD was evaluated using the Tekscan Mobile Mat pressure measurement system in three positions (double-leg stance, single-leg stance, and single-leg squat) for both the dominant and non-dominant feet. Results: There was a poor and insignificant correlation (p > 0.05) between the core flexors’, extensors’, and side flexors’ endurance and the peak and total PPD in all the tested positions for both the dominant and non-dominant feet. Conclusions: Core muscle endurance is neither a component that affects nor is affected by the PPD in this study population. Thus, the endurance of core flexors, extensors, and side flexors may not be considered in screening, examination, or intervention for the total and peak pressure during double-leg stance, single-leg stance, and single-leg squat positions for both the dominant and non-dominant feet in the study population. Further similar studies are warranted in various sports and during dynamic tasks to better understand the different dimensions of the studied relationship in athletes. Full article

Objectives: This study aimed to evaluate the efficacy of various nutritional supplements in enhancing endurance performance and subjective thermal perception in athletes exposed to high-temperature environments through a systematic review and network meta-analysis. Methods: A comprehensive search was conducted in PubMed, Embase, Web of Science, Cochrane Library, and EBSCOhost from inception to January 2025. Studies were included if they evaluated the effects of nutritional supplements on either endurance performance or subjective thermal perception in athletes under heat stress. Two independent reviewers screened the literature, extracted data, and assessed the risk of bias. A network meta-analysis was performed using R software (version 4.3.1). The search was limited to English-language publications and employed both MeSH and free-text terms related to “athletes,” “nutritional supplements,” and “exercise performance,” using Boolean operators (AND/OR) to construct the strategy. Results: Twenty-five randomized controlled trials (RCTs) involving 552 participants were included, yielding 22 comparisons: 18 assessed endurance performance, and 11 assessed subjective perception. Standardized mean differences (SMDs) and posterior probabilities (P-scores based on Bayesian ranking) were calculated using random-effects and Bayesian models. Menthol (SMD = −1.83, 95% CI [−3.15, −0.51]; P-score = 71.04%) and taurine (SMD = 0.91, 95% CI [0.08, 1.73]; P-score = 12.75%) demonstrated significant positive effects on endurance. Menthol energy gel showed the greatest improvement in thermal comfort (SMD = 2.14, 95% CI [1.01, 3.26]; P-score = 99.54%). Conclusions: Menthol and taurine appear effective in enhancing endurance in hot environments, while menthol energy gel substantially improves perceived thermal comfort. Future research should apply stricter controls regarding environmental conditions, supplement dosage, and participant characteristics. While individual supplements may offer limited benefits, synergistic combinations may yield greater improvements in performance and comfort. Full article

Elite female tennis players are among those at high risk for developing the Female Athlete Triad (Triad), characterized by three interrelated conditions: energy deficiency/low energy availability, menstrual dysfunction, and low bone mineral density. From 1996 to 2022, the Women’s Tennis Association (WTA) developed and implemented prevention, education, and management plans for female athletes at risk for, or exhibiting symptoms of, the Triad. This article reviews the WTA Triad protocol, developed in 2018 and utilized through 2022, in collaboration with subject matter experts in the Women’s Health and Exercise Laboratory at The Pennsylvania State University. The WTA Triad protocol (1996–2022) includes prevention and management programs implemented by a multidisciplinary Performance Health Team to include screening for “red flags” during annual physicals or upon clinical presentation of a menstrual problem, bone disorder, or nutritional concern; targeted education for players, coaches, and other support team members with handouts and lectures on nutrition and body image to prevent energy deficiency; and a multidisciplinary protocol to guide treatment and return-to-play decisions. Other sport governing bodies can adopt similar multi-layered programs and practices for their athletes, coaches, and support teams to educate, screen, manage, and help to prevent the development of the Triad. Full article

This systematic review, registered in PROSPERO (CRD42025101243), aimed to evaluate how specific badminton shoe design features influence lower-limb biomechanics, injury risk, and sport-specific performance. A comprehensive search in six databases yielded 445 studies, from which 10 met inclusion criteria after duplicate removal and eligibility screening. The reviewed studies focused on modifications involving forefoot bending stiffness, torsional stiffness, lateral-wedge hardness, insole and midsole hardness, sole structure, and heel curvature. The most consistent biomechanical benefits were associated with moderate levels of forefoot and torsional stiffness (e.g., 60D) and rounded heel designs. Increased forefoot bending stiffness was associated with reduced foot torsion and knee loading during forward lunges. Torsional stiffness around 60D provided favorable ankle support and reduced knee abduction, suggesting potential protection against ligament strain. Rounded heels reduced vertical impact forces and promoted smoother knee–ankle coordination, especially in experienced athletes. Lateral-wedge designs improved movement efficiency by reducing contact time and enhancing joint stiffness. Harder midsoles, however, resulted in increased impact forces upon landing. Excessive stiffness in any component may restrict joint mobility and responsiveness. Studies included 127 male-dominated (aged 18–28) competitive athletes, assessing kinematics, impact forces, and coordination during sport-specific tasks. The reviewed studies predominantly involved male participants, with little attention to sex-specific biomechanical differences such as joint alignment and foot structure. Differences in testing methods and movement tasks further limited direct comparisons. Future research should explore real-game biomechanics, include diverse athlete populations, and investigate long-term adaptations. These efforts will contribute to the development of performance-enhancing, injury-reducing badminton shoes tailored to the unique demands of the sport. Full article

Background: Athletes commonly use innovative strategies that aim to enhance their cycling performance. Among them, the effectiveness of non-circular chainrings has been a frequent topic of discussion. This systematic review aims to analyze the physiological and performance effects of using non-circular chainrings in cyclists. Methods: A literature search was conducted on populations ranging from recreational to elite-level athletes, following the PRISMA guidelines. The electronic databases searched were PubMed, Web of Science, Academic Search Complete, Scopus, and SportDiscus, using the search terms (“oval chainring*” OR “non-circular chainring*” OR “elliptical chainring*” OR “asymmetric chainring*” OR “Q-Ring*” OR “eccentric chainring*” OR “chainring*”) AND (cycl*), on 11 May 2025. The risk of bias was assessed using the Cochrane Risk of Bias tool with an extension for crossover studies, indicating some concerns regarding the included studies. Results: The initial search identified 291 research articles, which, after applying the screening criteria, resulted in the inclusion of 18 manuscripts. The results suggest that non-circular chainrings do not appear to improve cycling performance metrics or physiological variables during prolonged efforts; however, it is possible that they enhance the sprinting capacity. Conclusions: While the research remains inconclusive, future studies should further explore the effects of non-circular chainrings on sprinting performance. Full article

Background and Objectives: Vision uses about half of the pathways within the brain, and these anatomical structures are susceptible to injury in concussion. Authors have suggested that subconcussive head impacts, common in soccer, may disrupt visual function. The following study aimed to explore and compare quantitative pupillometry and Vestibular Ocular Motor Screening (VOMS) in female soccer athletes. Materials and Methods: Twenty-six Division 1 female soccer athletes (20.46 ± 2.36 years) received baseline quantitative pupillometry and VOMS measurements. Results: Of the 26 tested athletes, 3 (11.5%) had clinically significant pupillometry findings at baseline. The mean Neurological Pupil Index or NPi, a composite generated from pupillometry, did not vary: 3.9 ± 0.4 (right eye) and 4.0 ± 0.4 (left eye). No difference in NPi was observed compared to the VOMS score (p > 0.05). Kruskal–Wallis H tests were significant in the right eye for constriction percentage (χ²(2) = 17.843, p < 0.001, E² = 0.69) and minimum pupil size (χ²(2) = 7.976, p = 0.019, E² = 0.31). A post hoc Dunn test showed significant differences in constriction percentage and minimum pupil size between low NPi and high NPi groups (p < 0.05). One athlete sustained a concussion. NPi was measured within 24 h and was normal, but VOMS was not (total score = 4). Conclusions: The components of pupillometry need more investigation, and there is a need for agreement on concussion-specific cutoffs for quantitative pupillometry for concussion assessment. The lack of a relationship between quantitative pupillometry and VOMS suggests that these tools evaluate different constructs. Athletes with an NPi < 3.8 had significantly less constriction percentage and larger minimum pupil size than athletes with higher NPi scores. More research should be carried out to determine the usefulness of the NPi score, and perhaps researchers should consider individual pupillometry components. Full article

The aim of this cross-sectional study was to evaluate the sleep characteristics and behaviours of senior male, senior female, and under 21 (U21) male elite soccer players using athlete-specific questionnaires. During the preseason/early season period, 74 players from the English Premier League (n = 26, age 26 ± 5 y), Women’s Super League (n = 22, age 25 ± 5 y), and English Premier League 2 (n = 26, age 19 ± 1 y) completed the validated Athlete Sleep Screening Questionnaire (ASSQ) to obtain a sleep difficulty score (SDS) and the Athlete Sleep Behaviour Questionnaire (ASBQ) to obtain a global score and individual behaviours. We found that sleep difficulty scores were higher in senior females (5.9 ± 1.9) than senior males (4.1 ± 1.7) and U21 males (4.3 ± 1.2) (p ≤ 0.006), but no severe clinical problems were noted. Global sleep behaviour scores from the ASBQ were worse in senior males (37.9 ± 6.5) and senior females (40.6 ± 7.1) than male U21 players (33.6 ± 4.7) (p ≤ 0.021). Senior players consumed more alcohol and stimulants and felt that travel disrupted sleep; females went to bed thirstier, woke more for the bathroom, and ruminated more prior to sleep (all p < 0.05). In conclusion, senior female players reported more sleep difficulties than male senior and male U21 players. Behaviours such as pre-bed rumination, nutrition, and travel plans could be targeted to improve sleep quality in soccer players. Study limitations include data drawn from a single club in the off-season. Full article

Introduction: Combat sport athletes are exposed to repetitive head impacts yet also develop distinct performance-related brain adaptations. Electroencephalography (EEG) provides millisecond-level insight into both processes; however, findings are dispersed across decades of heterogeneous studies. This mechanistic review consolidates and interprets EEG evidence to elucidate how participation in combat sports shapes brain function and to identify research gaps that impede clinical translation. Methods: A structured search was conducted in March 2025 across PubMed/MEDLINE, Scopus, Cochrane Library, ResearchGate, Google Scholar, and related databases for English-language clinical studies published between January 1980 and March 2025. Eligible studies recorded raw resting or task-related EEG in athletes engaged in boxing, wrestling, judo, karate, taekwondo, kickboxing, or mixed martial arts. Titles, abstracts, and full texts were independently screened by two reviewers. Twenty-three studies, encompassing approximately 650 combat sport athletes and 430 controls, met the inclusion criteria and were included in the qualitative synthesis. Results: Early visual EEG and perfusion studies linked prolonged competitive exposure in professional boxers to focal hypoperfusion and low-frequency slowing. More recent quantitative studies refined these findings: across boxing, wrestling, and kickboxing cohorts, chronic participation was associated with reduced alpha and theta power, excess slow-wave activity, and disrupted small-world network topology—alterations that often preceded cognitive or structural impairments. In contrast, elite athletes in karate, fencing, and kickboxing consistently demonstrated neural efficiency patterns, including elevated resting alpha power, reduced task-related event-related desynchronization (ERD), and streamlined cortico-muscular coupling during cognitive and motor tasks. Acute bouts elicited transient increases in frontal–occipital delta and high beta power proportional to head impact count and cortisol elevation, while brief judo chokes triggered short-lived slow-wave bursts without lasting dysfunction. Methodological heterogeneity—including variations in channel count (1 to 64), reference schemes, and frequency band definitions—limited cross-study comparability. Conclusions: EEG effectively captures both the adverse effects of repetitive head trauma and the cortical adaptations associated with high-level combat sport training, underscoring its potential as a rapid, portable tool for brain monitoring. Standardizing acquisition protocols, integrating EEG into longitudinal multimodal studies, and establishing sex- and age-specific normative data are essential for translating these insights into practical applications in concussion management, performance monitoring, and regulatory policy. Full article