Search Results (8,062)

Background/Objectives: Melatonin (MEL) promotes sleep and recovery, while caffeine (CAF) enhances alertness and performance. Despite their common use among athletes, their potential interaction remains underexplored. This study examined the effects of MEL and CAF, administered separately or in combination, on sleep, physical performance, physiological, biochemical, and perceptual responses in trained males. Methods: In a randomized double-blind placebo-controlled crossover study, fourteen trained males (22.4 ± 2.9 years) underwent four conditions, designed to isolate the effects of each substance and their interaction: (1) PLA + PLA: placebo before sleep and placebo in the morning; (2) PLA + CAF: placebo before sleep and caffeine (3 mg·kg⁻¹) in the morning; (3) MEL + PLA: melatonin (6 mg) before sleep and placebo in the morning; and (4) MEL + CAF: melatonin before sleep followed by caffeine in the morning. One hour after the morning ingestion, participants performed the 5 m shuttle run test (5mSRT). Blood samples were collected pre- and post-exercise to assess markers of muscle damage (creatine kinase, lactate dehydrogenase, aspartate aminotransferase, and alanine aminotransferase) and inflammation (C-reactive protein). Peak heart rate (HR_peak) and rating of perceived exertion (RPE) were recorded throughout the test. Sleep was assessed only during the night following melatonin or placebo ingestion. Results: No differences were observed in sleep parameters between conditions (p > 0.05). Total distance in the 5mSRT increased following MEL + CAF and PLA + CAF conditions compared with PLA + PLA. Moreover, MEL + CAF reduced muscle damage and inflammation markers compared with PLA + PLA, MEL + PLA, and PLA + CAF conditions (p < 0.05). Conclusions: The ingestion of nocturnal MEL and next-day CAF was associated with improvements in certain high-intensity exercise performance outcomes, along with changes in muscle damage and inflammation. Full article

Background: Artificial intelligence (AI) has shown promise in the interpretation of electrocardiograms (ECGs) using signal-based deep learning models. In parallel, large language models (LLMs) have gained increasing visibility in clinical practice, including exploratory applications in ECG analysis. Whether a general-purpose LLM can meaningfully discriminate cardiovascular disease from athlete ECGs during PPS remains unknown. We aimed to evaluate the diagnostic performance of a general-purpose LLM for this task. Methods: In this multicentre diagnostic accuracy study, we evaluated a commercially available LLM (ChatGPT, version 5) in 2950 competitive athletes undergoing PPS. All athletes underwent resting 12-lead ECG, with second- and third-line investigations performed when clinically indicated. The reference outcome was confirmed cardiovascular disease after full diagnostic work-up (n = 450, 15.3%). For each ECG, the LLM generated a numeric score (0–100) representing the inferred likelihood of underlying disease using a standardized prompt and without task-specific fine-tuning. Discriminative performance was assessed using receiver operating characteristic (ROC) analysis. Misclassification patterns were analysed according to International ECG Criteria. Results: GPT-derived scores demonstrated a marked floor effect, with a median value of 0 (IQR 0–2) in both diseased and non-diseased athletes and substantial overlap between groups. The area under the ROC curve was 0.52 (95% CI 0.49–0.55), indicating performance close to random classification. At the Youden-derived threshold, 79% of athletes with confirmed disease were incorrectly classified as negative. False-negative cases were predominantly characterized by borderline ECG patterns (82%), and a substantial number of red-flag ECG abnormalities were also missed. Conclusions: In this PPS cohort, a general-purpose LLM used in a naïve configuration showed no clinically meaningful ability to discriminate between cardiovascular disease and athlete ECGs. Without task-specific training or domain adaptation, such models should not be used for diagnostic triage in athlete screening. Full article

Background: Anterior cruciate ligament (ACL) injuries are increasing in young athletes and many are related to non-contact, spontaneous mechanical fatigue-related ruptures. The objective of this narrative review is to identify and synthesize the anatomical, histological, physiological, and biomechanical basis of extracellular matrix (ECM) factors that contribute to ACL injuries and suggest ways to decrease their occurrence. Methods: The primary investigator searched PubMed, Web of Science, and Google Scholar database titles and abstracts using search phrases with Boolean operators: “anterior cruciate ligament” OR “ACL”, OR “cranial cruciate ligament” AND “disease”; “anterior cruciate ligament” OR “ACL”, OR “cranial cruciate ligament” AND “spontaneous rupture” OR “non-contact injury”; and “anterior cruciate ligament” OR ACL, OR cranial cruciate ligament” AND “crosslink”, “collagen” OR “extracellular matrix”; and “anterior cruciate ligament” OR “ACL”, OR “cranial cruciate ligament” AND “microtrauma”, OR “sudden” OR “fatigue failure”. The primary investigator and a sports orthopedic surgeon reviewed titles and abstracts of diverse evidence sources. From these identified sources, the study team performed full text reviews, selected contributing articles, performed Strength of Recommendation Taxonomy (SORT) grading, and synthesized the following themes: A Hostile Environment, ACL Strain, and Poor Nutrient Delivery; Accumulative ACL Microtrauma and Mechanical Failure; The ACL Differs From Other Ligaments; Collagen, the ECM, and ACL Mechanobiology; Crimps and ACL ECM Stretch; Crosslinks Improve ECM Mechanical Properties; The Delicate Collagen Synthesis and Degradation Balance; Exercise Training and the ACL; Can Nutraceuticals Help Restore the Balance?; Training Induced ACL Hypoxia; Estrogen and the Female Athlete; Counting Pitches or Counting Collagen Fiber Ruptures; and Restoring A Positive Anabolic–Catabolic Collagen Balance. Results: Regular exercise training within a physiologically safe loading range is vital to ACL ECM health. However, low or moderate evidence suggested that poor blood supply, slow metabolism, and a hypoxic environment may unbalance anabolic and catabolic homeostasis. Active rest and recovery concepts that prevent youth baseball shoulder and elbow injuries may help prevent non-contact ACL injuries. Conclusions: More prescriptive active rest and recovery intervals and neuromuscular control training may restore the anabolic–catabolic balance that increases mature crosslink density and improves ACL ECM strength. Confirmatory studies are needed to better establish therapeutic intervention mode(s), timing, dosage, and frequency optimization. Full article

Background: Asymptomatic structural joint abnormalities are prevalent among athletes, yet studies on their multi-joint distribution and comparisons with low-activity controls remain lacking. This article evaluated the prevalence and characteristics of asymptomatic structural abnormalities across joints in collegiate athletes compared with controls using 3.0-T MRI. Methods: The cross-sectional study enrolled 53 asymptomatic elite collegiate athletes (high physical activity, HPA) and 84 healthy volunteers (low physical activity, LPA) aged 18–25 years. All participants were asymptomatic with no history of joint trauma or surgery. Generalized estimating equation (GEE) logistic regression was employed to identify independent risk factors for joint abnormalities after evaluation. Results: A total of 666 joints were analyzed. Participants with at least one joint abnormality were significantly more common in the HPA group than LPA group (49.1% vs. 6.0%, p < 0.001). At the joint level, overall abnormality prevalence was 13.5% versus 2.2%, respectively. In the HPA group, knee joints were the most frequently affected (24.2%), predominantly involving meniscal lesions. Shoulder pathologies consisted exclusively of supraspinatus tendon lesions (6.8%), while ankle abnormalities were primarily bone marrow edema (5.9%). GEE analysis identified high physical activity (adjusted OR = 5.23; 95% CI: 1.55–17.71; p = 0.008) and elevated BMI (adjusted OR = 1.09 per kg/m²; 95% CI: 1.03–1.15; p = 0.001) as independent risk factors. Conclusions: Asymptomatic abnormalities are highly prevalent and demonstrate intra-individual clustering across multiple joints. MRI-based surveillance represents a promising strategy for early risk identification and injury prevention. Full article

Background: Sleep is a critical recovery mechanism for athletes, supporting hormonal regulation, muscle repair, and cognitive function. Dual-career athletes are particularly vulnerable to sleep disruption, which may impair performance and stress regulation. This study examined the effects of a 14-day sleep hygiene intervention protocol (SHIP) on aerobic and anaerobic performance, as well as anticipatory cortisol responses, in university-level soccer players. Methods: Thirty athletes (females: n = 14, 22.1 ± 3.3 y, 157.8 ± 6.0 cm, 53.5 ± 3.9 kg, males: n = 16, 21.5 ± 1.7 y, 167.5 ± 5.9 cm, 62.7 ± 5.4 kg) completed the Pittsburgh Sleep Quality Index (PSQI), provided pre-test salivary cortisol samples, and performed the Yo-Yo Intermittent Recovery Test Level 1 (YYIR1) and Repeated Anaerobic Sprint Test (RAST) before and after the intervention (adhering daily to 10–18 individualized sleep hygiene). Results: The SHIP significantly reduced sleep latency (p = 0.04) and increased sleep duration (p = 0.03), and PSQI scores (p < 0.001) in both sexes. Females showed marked increases in sleep duration (p = 0.002), while males showed improved latency (p = 0.07). Five behaviourally coherent clusters derived from the SHIP adherence explained a substantial proportion of variance (74.99%). Stimulant and metabolic regulation, and bedroom light and thermal environment control consistently predicted sprint and physiological outcomes (p < 0.05). Anticipatory cortisol decreased before both tests (p = 0.03–0.04). YYIR1 performance improved for the full cohort (p = 0.001). RAST times slowed slightly (p = 0.02), though fatigue index improved (p = 0.05). Conclusions: A short-term SHIP effectively enhanced sleep, reduced physiological stress, and improved key performance outcomes in collegiate athletes. Full article

The growing participation in competitive and recreational sports has increased the clinical relevance of Sports Cardiology, particularly for athletes with borderline or ambiguous findings during cardiovascular screening. Advanced imaging is essential to differentiate physiological cardiac remodeling from early or subclinical cardiomyopathy. Cardiovascular magnetic resonance (CMR) has emerged as the reference standard for comprehensive assessment of cardiac morphology, function, and myocardial tissue characterization. Beyond conventional cine imaging and late gadolinium enhancement (LGE), parametric mapping techniques (including native T1, T2, and extracellular volume (ECV) quantification) enable quantitative and reproducible evaluation of diffuse fibrosis, edema, and low-grade inflammation that may precede overt structural disease. In athletes, physiological remodeling may overlap with pathologic phenotypes, posing diagnostic and prognostic challenges. Accurate interpretation requires integration of volumetric and functional measurements with the athlete’s training profile and electrocardiographic features, using population-specific reference values to avoid misclassification of adaptive changes as pathological. This narrative review provides a clinically oriented overview of CMR in athletes, focusing on typical findings, advanced tissue characterization, and emerging techniques such as myocardial strain analysis, right ventricular-focused imaging, and 4D flow. Technical challenges, standardization issues, and future directions are discussed. Multiparametric CMR is increasingly recognized as a key tool for improving diagnostic accuracy, refining risk stratification, and supporting clinical decision-making in athletes with suspected cardiomyopathy or ventricular arrhythmias. Full article

Background: Balance is a key ability in rhythmic gymnastics, affecting not only technical performance but also the aesthetic and expressive quality of routines. Standard tests often do not reflect the real demands of the sport, where gymnasts must simultaneously maintain stability, manipulate apparatus, and follow the musical rhythm. Therefore, there is a need for a specific test that combines motor and cognitive challenges to provide a precise and reliable assessment of athletes’ functional abilities. Methods: The study involved 12 girls with an average age of 9 years. Participants underwent anthropometric measurements and were tested using standard motor tests as well as a specific balance test for rhythmic gymnasts (BTRG). Test reliability was assessed using a test–retest procedure, and construct validity was evaluated through factor analysis in comparison with existing balance tests. Results: The BTRG demonstrated high reliability (ICC = 0.96; CV = 6.4%; SEM = 0.18) and the ability to distinguish gymnasts from different programs. Factor analysis confirmed that the BTRG effectively measures specific balance in accordance with theoretical expectations. Conclusions: The new test provides a potentially valid and reliable tool for assessing specific balance in rhythmic gymnasts and maybe useful in the training process, athlete evaluation, and talent development; however, these finding should be interpreted with caution as they are preliminary and derived from pilot study. Full article

Ventricular repolarization abnormalities are among the most frequent electrocardiographic findings in pediatric athletes undergoing cardiovascular screening, yet their clinical significance remains a major source of diagnostic uncertainty. While most of them represent benign expressions of training-induced cardiac remodeling and developmental maturation, selected patterns may constitute the earliest phenotypic manifestation of cardiomyopathies or primary electrical disease. Distinguishing physiological adaptation from early pathology is therefore essential to prevent both sudden cardiac events and unnecessary restrictions on sports participation. This review integrates contemporary international electrocardiographic interpretation criteria with emerging pediatric evidence to provide a clinically oriented framework for evaluation and risk stratification of ventricular repolarization abnormalities in pediatric athletes. Early repolarization and anterior T-wave inversion are commonly benign when occurring within recognized age- and ethnicity-specific patterns and in the absence of symptoms, concerning family history, or structural abnormalities. Conversely, lateral or inferolateral T-wave inversion, atypical ST-segment morphology, complex ventricular arrhythmias, and abnormal imaging findings represent red flags requiring comprehensive investigation, including multimodality imaging when indicated. Due to the dynamic electrophysiological evolution during adolescence, longitudinal reassessment is crucial. A structured, risk-based approach integrating electrocardiographic features, demographic/familial context, clinical evaluation, imaging findings, and follow-up provides a pragmatic strategy to optimize risk detection while safeguarding appropriate athletic participation in young athletes. Full article

This study examined the effects of a 16-week periodized resistance training program on the strength, power, and body composition of elite collegiate cheerleaders. Thirteen female athletes from a nationally top-ranked university team completed a structured program comprising hypertrophy and strength/power phases. Performance testing at pre-, mid-, and post-intervention included one-repetition maximum (1RM) assessments for the front squat, power clean, and shoulder press, as well as measurements of body mass, lean body mass, and body fat percentage. All strength measures improved significantly across the intervention (front squat: +14.0%, power clean: +17.7%, and shoulder press: +18.3%). Body fat percentage decreased by 6.7%, and lean body mass increased by 2.6%, while total body mass remained statistically unchanged. These results demonstrate that periodized resistance training can elicit meaningful improvements in performance and body composition without increases in body mass. Moreover, the final post-intervention 1RM values—1.43× body mass for the front squat, 1.11× for the power clean, and 0.73× for the shoulder press—offer preliminary benchmarks for the strength performance of high-level collegiate cheerleaders. Full article

Judo, as a weight-category combat sport, exposes young athletes to body mass pressures that may foster abnormal eating behaviours. Building on a companion study that documented the prevalence and sex-specific characteristics of abnormal eating behaviours in this cohort, this secondary analysis aimed to identify training-related predictors of eating behaviours in young Polish judo athletes, examine body image satisfaction as a mediator, and assess whether patterns observed in elite adult athletes apply to younger populations. The participants were 150 athletes (70 girls, 80 boys) aged 12–17. Eating behaviours were assessed using the Three-Factor Eating Questionnaire (TFEQ-13) and the Test of Eating Situation Style (TSJ); training characteristics, pre-competition weight control, and appearance satisfaction were examined through hierarchical regression, mediation analysis, latent profile analysis, and two-way ANOVA. Training-related factors—including tenure, session frequency, competitive level, and pre-competition weight control—showed no significant associations with eating behaviours. However, in a subsample of N = 136 athletes, relative weight grouping predicted dietary restraint (p = 0.015, η²p = 0.066), with athletes in the heaviest tertile reporting higher restriction; lower appearance satisfaction was associated with greater restraint (p = 0.031, β = −0.192), independently of sport-mandated weight control; females demonstrated higher emotional eating across instruments (p < 0.001). These findings suggest that body image and weight classification may be more strongly associated with eating behaviours than training demands, highlighting the need for body image interventions and the monitoring of athletes near weight category boundaries. Full article

In elite youth soccer, the objective is to identify, develop, and enhance players’ ability to support their progression. During adolescence, players of the same chronological age often show differences in technical, tactical, physical, and psychological performance due to variations in biological maturation. The bio-banding (BB) format tries to reduce these discrepancies by grouping players with maturity-matched peers, promoting development within a maturity-respecting environment. This review synthesizes the effects of BB on soccer-specific performance in comparison to traditional chronological-age (CA) grouping. PubMed, Scopus, Web of Science (Core and Medline), and BASE databases were searched, and experimental studies using crossover, such as those applying both BB and CA in young soccer players, were considered eligible. Eleven experimental studies were included. Most of the investigated outcomes focused on physical performance (n = 9) and technical and tactical characteristics (n = 8), while psychological aspects were less examined (n = 2). Moreover, two studies further assessed how different BB methods influenced the investigated outcomes. The evidence confirms that BB influences youth soccer player characteristics, showing differences compared to CA grouping. BB can be an approach for optimizing individual growth but is not a definitive solution, presenting limits that require careful management, appropriate challenge, and integration with injury prevention and workload monitoring. Further research is needed to clarify its performance-related impact across maturity statuses. Full article

The purpose of this study was to examine sex differences in upper-limb neuromuscular performance in competitive volleyball players across task-specific shoulder positions. Twenty-four athletes (12 males, 12 females) competing at the national level participated in the study. Upper-limb neuromuscular performance was assessed using the Athletic Shoulder (ASH) test performed in three positions (I, Y, and T). Peak force, rate of force development (RFD), and time to peak force were analyzed. A significant main effect of test position and a Test × Sex interaction were observed for peak force (p < 0.05), with males demonstrating higher values than females across all positions. In contrast, no significant sex differences or interaction effects were found for RFD (p > 0.05). For time to peak force, no main effect of test position or interaction was observed; however, post hoc comparisons indicated higher values in males across individual positions. No significant inter-limb differences were detected for any variable. These findings suggest that sex-related differences in upper-limb neuromuscular performance may depend on the specific variable and shoulder position assessed. The results provide preliminary insight into sex-related characteristics of shoulder neuromuscular performance in volleyball players. However, given the cross-sectional design and limited sample size, the findings should be interpreted with caution and cannot be generalized beyond the studied population. Further research is needed to confirm these observations and to explore their potential relevance in applied settings. Full article

Background/Objectives: This study aimed to investigate the occurrence of sport-related concussions (SRCs) in Japanese university sports and to identify factors associated with experiencing multiple SRCs within a single season. Methods: Data were collected through a web-based survey conducted from June to October 2022, focusing on injuries sustained between April 2021 and March 2022. Participants were recruited from universities affiliated with the Japan Association for University Athletics and Sport and were required to be actively participating in sports. Results: Overall, 10,978 participants were analyzed; 195 reported SRCs, whereas 10,783 did not. Athletes who reported SRCs were significantly taller and heavier, had a higher body mass index, and included a higher proportion of male athletes than those who did not report SRCs. SRCs were most frequently reported in rugby football, American football, soccer, and lacrosse. Among athletes with SRCs, those with multiple SRCs tended to be taller and were significantly heavier. They also had a significantly higher proportion of severe first SRCs during the season. Conclusions: SRCs were most frequently reported in rugby football, American football, soccer, and lacrosse, and greater severity of the initial SRC in a season was associated with multiple SRC occurrence. These findings should be interpreted with caution because SRCs were self-reported and not clinically verified, mild cases may have been underreported, and time-loss-based severity may not reflect clinical severity. Full article

Objectives: This study aimed to examine the structure of anthropometric characteristics, motor skills and specific motor skills in young football players. Methods: Study participants (427 male football players) were divided into pre-pioneers (11–13 y), n = 133; pioneers (13–15 y), n = 160; and cadets (15–17 y), n = 134. The entire sample of subjects was evaluated using 13 anthropometric and seven motor variables. The factor structure for each chronological age group was determined using Hotelling’s method. Results: Anthropometric characteristics showed three extracted factors in the pre-pioneers group, four factors in the pioneer group and two factors in the cadet group. Motor skills displayed three factors for the youngest group, two factors for the pioneers and three factors for the cadet group. Four factors were determined for specific motor skills in pre-pioneers, four in pioneers and three in cadet age. Conclusions: This study revealed structural variability and non-uniformity in the latent dimensions across age groups, with the total number of factors fluctuating between two and four. This study revealed two consistent latent dimensions in anthropometric data across all age groups: general morphological parameters and subcutaneous fat tissue. In motor skills, an initial universal factor is separated into central and energetic regulation of movements. Finally, specific motor skills demonstrated a transition from a highly differentiated four-factor structure in younger players toward a more integrated functional system in the oldest cohort, comprising intermuscular coordination, running speed with and without a ball; segmental speed of the lower extremities with a ball; and explosive force in hitting a ball with the foot and head. Full article

Background: Blood flow restriction training (BFRT) is a low-load resistance training modality capable of inducing muscle hypertrophy and strength adaptations that are comparable to traditional high-load resistance training. Beyond athletic performance settings, BFRT has growing relevance for musculoskeletal health, rehabilitation and populations unable to tolerate high mechanical loads. However, substantial inter-individual variability in adaptive responses has been reported. Genetic and molecular factors may partly contribute to this variability and inform more individualised exercise strategies. Other intrinsic and extrinsic factors, including age, sex, training status, nutrition, and protocol-related differences, may also influence adaptive responses. Objective: This scoping review aimed to map available evidence on molecular modulators of adaptation to BFRT and to identify gaps in the literature regarding genetic influences on BFRT responses. Methods: A structured search of PubMed, Web of Science and Google Scholar was conducted till 1 February 2026. Experimental and quasi-experimental studies examining BFRT in relation to genetic polymorphisms, gene expression, and molecular signalling pathways associated with strength and hypertrophy outcomes were included. Primary outcomes were genetic and molecular factors relevant to BFRT adaptation, including genetic polymorphisms, gene expression, and molecular signalling markers. Secondary outcomes included muscle strength, hypertrophy, vascular responses, and related functional outcomes where reported. Study selection and data extraction were conducted according to PRISMA-ScR guidelines. The methodological quality of randomised controlled trials was assessed using the PEDro scale. This scoping review was registered retrospectively in the Open Science Framework on 17 March 2026, after completion of the literature search. Results: From an initial 47 records, only three studies (n = 3) met the inclusion criteria. The included studies reported molecular responses associated with BFRT, including downregulation of proteolytic genes, suppression of myostatin expression, and upregulation of angiogenic markers. Notably, no studies directly examined genetic polymorphism or genotype–BFRT interactions, highlighting a clear need for these studies in this field. Conclusions: This scoping review therefore identifies a critical evidence gap, with genotype-informed BFRT prescription remaining unsupported by the current literature. Limited evidence supports the possible role of BFRT in molecular responses associated with muscle adaptation. Future research should prioritise well-designed studies integrating both genetic and molecular analyses to better understand inter-individual variability in BFRT adaptations. Full article