Search Results (136)

Colorectal cancer (CRC) remains a leading cause of cancer morbidity and mortality worldwide, especially in older adults where frailty complicates treatment outcomes. Multimodal prehabilitation—comprising nutritional support, physical exercise, and psychological interventions—has emerged as a promising strategy to enhance patients’ resilience before CRC surgery. Clinical studies demonstrate that prehabilitation significantly reduces postoperative complications, shortens hospital stays, and improves functional recovery. Nutritional interventions focus on counteracting malnutrition and sarcopenia through tailored dietary counseling, protein supplementation, and immunonutrients like arginine and glutamine. Physical exercise enhances cardiorespiratory fitness and muscle strength while modulating immune and metabolic pathways critical for surgical recovery. Psychological support reduces anxiety and depression, promoting mental resilience that correlates with better postoperative outcomes. Despite clear clinical benefits, the molecular mechanisms underlying prehabilitation’s effects—such as inflammation modulation, immune activation, and metabolic rewiring—remain poorly understood. This review addresses this knowledge gap by exploring potential biological pathways influenced by prehabilitation, aiming to guide more targeted, personalized approaches in CRC patient management. Advancing molecular insights may optimize prehabilitation protocols and improve survival and quality of life for CRC patients undergoing surgery. Full article

We examined the physiological demands of trained rowers across four exercise intensity domains (considering the effects of weight category and sex). Twenty-four trained rowers (12 lightweight and 12 heavyweight) performed 7 × 3 min incremental bouts on a Concept2 rowing ergometer (30 W power increases and 60 s rest intervals). Performance, cardiorespiratory and metabolic responses were continuously assessed throughout the experimental protocol to characterize internal load across progressive exercise intensities. Statistical analyses included a repeated measures ANOVA test and independent t-tests (p ≤ 0.05). Heavyweight rowers exhibited greater absolute anaerobic energy production in the severe domain (41.25 ± 10.39 vs. 32.54 ± 5.92 kJ) (p = 0.02), higher peak metabolic power (up to 1.57 ± 0.30 vs. 1.48 ± 0.30 kW) (p = 0.001) and greater total energy expenditure (up to 277.52 ± 51.23 vs. 266.69 ± 51.59 kJ) (p = 0.001) than lightweight rowers, whereas the latter showed comparable relative cardiorespiratory responses to heavyweights. With respect to sex differences, males demonstrated higher oxygen uptake (from ~43–59 vs. ~34–48 mL·kg⁻¹·min⁻¹) (p = 0.001), ventilation (from ~78–146 vs. ~49–99 L·min⁻¹) (p = 0.001), metabolic power (from ~1.1–1.7 vs. ~0.7–1.0 kW) (p = 0.001) and energy expenditure (from ~193–305 vs. ~119–209 kJ) (p = 0.001) across all intensity domains. However, blood lactate levels and anaerobic energy contributions were similar between sexes. These findings demonstrated that domain-based physiological profiling effectively differentiates internal responses among rowers by weight category and sex. Heavyweights showed greater absolute energy output, while lightweights demonstrated higher metabolic efficiency. Males had elevated cardiorespiratory and metabolic values, but relative bioenergetic responses were similar across groups. These findings support individualized training based on physiological profiles. Full article

Wheelchair tennis (WT) is a Paralympic sport designed for athletes with physical impairments. Assessing physical fitness characteristics using appropriate field-based tests and standardized protocols is essential for individualized training, injury prevention, and performance monitoring. However, there is currently limited information on which field-based tests are most suitable and how they should be applied in WT athletes, resulting in inconsistency across studies and practical use. Establishing a standard operating procedure (SOP) enables replicable, cost-effective testing routines that improve data consistency and comparability. We conducted a scoping review to synthesize the existing evidence on field-based physical fitness assessment in WT athletes and to propose a structured SOP for these tests. A comprehensive search was conducted in three electronic databases—NLM PubMed, Web of Science, and Scopus—using predefined keywords and Boolean operators. The inclusion criteria were limited to peer-reviewed, English-language original articles focusing exclusively on field tests in WT athletes. Studies with other populations, reviews, and abstracts were excluded. Eleven studies met the eligibility criteria. This scoping review identified various field tests assessing key fitness components, including cardiorespiratory endurance, muscle strength, agility, and body composition. The most frequently employed tests were the 20 m sprint test, isometric handgrip test, spider test, Illinois Agility Test, and skinfold thickness. These findings highlight the lack of standardized fitness assessments in WT. The proposed SOP offers a practical step toward consistent, replicable, and relevant evaluation in these athletes. Full article

Background/Objectives: High-intensity interval training (HIIT) can optimize recovery by complementing the low cardiovascular fitness intensities typically achieved in stroke rehabilitation programs. Skating exercise is an HIIT workout developed based on ice skating movements, and we investigated the effects of this exercise on the cardiorespiratory fitness of elderly patients with minor stroke. Methods: Participants aged 65 or older with a National Institutes of Health Stroke Scale score of 3 or lower were recruited. This study was designed as a randomized controlled trial, in which the intervention group engaged in skating exercises following HIIT, while the control group underwent moderate-intensity continuous training (MICT). Both groups of participants performed either HIIT or MICT for 20 min per day, four times a week, over three months. Results: A total of 34 elderly patients with minor stroke were recruited, with an average age of 70.7 years. For three months, no fall-down injuries or adverse cardiovascular or cerebrovascular events were reported among patients undergoing HIIT or MICT. Both the intervention and control groups showed significant increases in the measures of aerobic capacity after the intervention. However, the patients in the intervention group exhibited significantly greater improvements in peak oxygen uptake, ventilatory threshold, and peak MET (p = 0.005, p = 0.002, and p = 0.024, respectively). Additionally, the Berg Balance Scale (BBS) scores and the skeletal muscle mass index showed significantly greater enhancements in the intervention group compared to the control group (p = 0.032 and p = 0.032). Conclusions: In conclusion, skating exercise could be a safe and effective HIIT protocol for elderly people who have experienced a minor stroke. Full article

This study investigated physiological differences in cardiorespiratory and metabolic performance parameters between professional football players from top- (TR) and mid-ranked teams (MR) in the Serbian Super League. A total of 55 male outfield players (TR: n = 29; MR: n = 26) were assessed in March 2022 using a maximal multistage treadmill protocol and lactate analysis. The key cardiorespiratory variables included maximum oxygen uptake (VO₂max), heart rate at the anaerobic threshold (HR AT), and recovery heart rate metrics, while the metabolic variables focused on lactate concentrations and efficiency indices. The results indicate that the TR players achieved significantly lower HR AT values (162 ± 10.26 vs. 168.77 ± 7.28 bpm; p = 0.017) and demonstrated superior second-minute recovery (%Re 2′: 66.62 ± 14.08% vs. 34.53 ± 9.13%, p < 0.001). In contrast, the MR players exhibited higher VO₂max (62.65 ± 4.48 vs. 60.06 ± 3.29 mL/kg/min; p = 0.017) and greater cardiorespiratory efficiency scores. The lactate parameters were comparable between the groups, except for the metabolic efficiency index (Index ME), which were favorable among the TR players (p = 0.011). These findings highlight that while MR players possess higher aerobic capacity, TR players demonstrate superior physiological recovery and metabolic control, reflecting adaptations to different tactical demands and match intensities. The results offer practical implications for individualized training design and performance monitoring in elite football settings. Full article

Background and Objectives: Individuals with chronic obstructive pulmonary disease (COPD) often exhibit some degree of intolerance to physical exercise and several limitations in daily activities. Therefore, the objective of this study was to conduct a scoping review on the characteristics—frequency, intensity, time, and type (FITT)—and the effects of exercise programs on quality of life and functional capacity in individuals with COPD. Materials and Methods: The present review included 21 studies that were scoping-reviewed to describe their main findings and training characteristics. Results: The participants across studies ranged in age from ~39 to 76 years with mild to very severe COPD stages. The results showed that, among all studies, eleven used cardiorespiratory training (e.g., walking or cycling), five used strength training (e.g., exercises with elastic bands or traditional resistance training), and five implemented combined training (i.e., cardiorespiratory and strength exercises). Conclusions: Overall, all training protocols improved aerobic capacity (cardiorespiratory training), strength (resistance training), and both capacities together (combined training). In conclusion, this review provided complementary insights to existing exercise prescription guidelines, particularly concerning cardiorespiratory, strength, and combined training in individuals with COPD. However, the methodologies of the training protocols varied widely, and detailed descriptions of FITT components were often incomplete or lacking clarity, especially regarding the specific exercises used. Future research should include more comprehensive spirometry variables such as forced expiratory volume 1 or forced vital capacity, as these are critical for determining COPD stages. Thus, there is a clear need for more high-quality research with robust methodological design in the context of exercise interventions for individuals with COPD. Full article

Background: Survivors of hematopoietic stem cell transplantation (HSCT) during childhood face significant late effects. This study aimed to map the dietary micronutrient intake of long-term survivors of pediatric HSCT and explore its associations with transplant outcomes, body composition, and physical capacity. Methods: We included 85 long-term survivors of HSCT (median age 30 years) The median time since HSCT was 19.9 years, reflecting a long-term survivor population. Dietary intake was assessed using a 3-day food record. Body composition was measured by DXA, and physical capacity was evaluated through cardiorespiratory fitness and physical performance tests. Results: We observed an inadequate intake of several vitamins and minerals including vitamins A, C, D, E, selenium, and potassium, with a median intake below recommendations. While dietary intake of vitamin D was reduced in patients with chronic graft versus host disease (cGvHD), the occurrence of cGvHD was not associated with overall micronutrient intake. Twelve percent of the participants had reduced skeletal muscle mass and 16% displayed a low bone mass density during DXA scans. These conditions were not related to the micronutrient intake. Likewise, reduced cardiorespiratory fitness and physical performance were unrelated to micronutrient intake. Total energy intake was found to significantly influence micronutrient intake (p = 0.001), explaining 66% of the variation. Conclusions: Long-term survivors of pediatric HSCT demonstrated inadequate intake of multiple micronutrients. These findings suggest that inclusion of comprehensive micronutrient assessment and nutritional guidance should be considered for inclusion in follow-up care protocols. Full article

The global aging trend increases chronic diseases and lowers quality of life. Exercise is vital for physiological, cognitive, and mental health, countering age-related decline. Outdoor multidomain interventions enhance adherence, motivation, and resilience, supporting independence and well-being. Objectives: This paper aimed to apply an outdoor exercise protocol for middle-aged and older people and to study its preliminary effects on cognitive state, body composition, cardiovascular health, physical fitness, physiological function, physical activity, frailty, incidence of sarcopenia, and satisfaction with life. Methods: This protocol describes an eighteen-week, two-pronged, parallel, single-blind randomized controlled trial. This paper complies with the Consort and SPIRIT guidelines. A cohort comprising a minimum of fifty-two older adults from the University for Seniors program will be equally allocated to a multidomain training group (TG) and a passive control group (CG). Intervention: The TG will follow a multidomain outdoor intervention twice a week for a complete duration of 18 weeks, with recommendations for additional autonomous cardiorespiratory training. The supervised sessions will be divided into a 10-min warm-up session focusing on activation and joint mobility, followed by 40 min of resistance training, cardiorespiratory training, and balance and coordination; and it concludes with a 10-min cool-down featuring flexibility, relaxation, and playful emotional intelligence tasks. Cognitive training will be integrated across different parts of the session. Conclusions: This preliminary study aims to explore the feasibility and potential effectiveness of outdoor multidomain training in improving the health of older adults. Importantly, by including late middle-aged adults from the age of 55, this study also aims to explore the potential of preventive strategies initiated before reaching old age. This reflects a broader conceptualization of healthy aging as a lifelong process, where early interventions may help mitigate decline and extend independence into later life. The partnership between health professionals and physical activity fosters independence for older adults, addressing the increasing burden on health services. Full article

Background/Objectives: The majority of stroke survivors undergo physical therapy rehabilitation to regain functionality and improve their overall quality of life. Given the wide range of physical therapy modalities and approaches in post stroke cardiovascular fitness rehabilitation, this systematic review and meta-analysis (SR-MA) aims to assess their efficacy as measured by peak oxygen consumption (VO2peak). Methods: Adhering to PRISMA guidelines; a detailed search of the MEDLINE PubMed; Cochrane Library; and Scopus databases was conducted. Results: Thirty-seven studies with a total of 1310 post-stroke patients were included. The aggregated mean VO2 pre-intervention was 15.30 mL/kg/min ([14.09, 16.51], I² = 99.7%), increasing to 17.10 mL/kg/min post-intervention ([15.73, 18.46], I² = 99.8%). The standardized mean difference in VO2 was 1.76 ([1.20, 2.31], I² = 96.9%). Sensitivity analyses in a subset of RCTs revealed that cardiorespiratory rehabilitation demonstrates a statistically significant improvement in VO2peak levels compared to conventional physical therapy. There was a high degree of heterogeneity among included studies (potentially due to the lack of standardized protocols) while Egger’s test (β = 0.32, p = 0.72) and funnel plot inspection were indicative of moderate publication bias with small study effects. Conclusions: Based on the results of this meta-analysis, the increase in VO2peak levels post-interventions ranged from 0.28 to 3.36 mL/kg/min, depending on intervention type. The ideal time to commence aerobic training rehabilitation was found to be six months post-stroke. According to previous studies on cardiovascular diseases, VO2peak can potentially act as a predictor of (a) the efficacy of intervention and (b) the patient’s risk of stroke-recurrence and disability progression. Full article

(1) Background: Individuals with obesity tend to stop exercising after the completion of a structured training program. Thus, the aim of the present study was to assess adherence and body composition, cardiorespiratory fitness, physical activity levels, and physical and mental health after a 12-month exercise program and an 18-month follow-up period in a group of male adults with obesity. (2) Methods: Thirty-four adults with obesity were evaluated before (T0) and after (T3) a 3-month combined training (COMB). After that, they followed a maintenance program with low-intensity aerobic activity for three months. Then, they were recalled for a 6-month training program including thresholds (THR) training until the end of the study (T12). Finally, they participated in a 18-months follow-up period that included suggestions for healthy lifestyles, which ended with assessments (T30). Thus, the assessments were carried out at the beginning and end of the first training protocol (T0 and T3), at the beginning and end of the second training protocol (T6 and T12) and 18 months after the end of the training program (T30). At all time points, body composition (i.e., BMI, fat mass [FM] and fat-free mass [FFM]), physical capacities (i.e., V̇O₂max), and physical habits (i.e., International Physical Activity Questionnaire (IPAQ) and Short-Form 12 (SF-12, for physical, P, and mental, M, indices) were measured. (3) Results: Fifteen out of thirty-four participants (42.8%) (age 42.8 ± 8.1 y) completed this study. At T30, participants increased their V̇O₂max (3.07 ± 0.46 vs. 3.67 ± 0.60 L·min⁻¹, p < 0.001), IPAQ TOT score (396 (2888) vs. 1356 (9144), p = 0.006), and SF12_MI score (41.1 ± 8.9 pt vs. 48.6 ± 11.0 pt) compared to T0. Furthermore, multivariate analysis showed that decrease in BMI was largely associated with the increase in the SF 12_PI questionnaire (0.032). Similarly, the decrease in %FM and the increase in V̇O₂max were related with the increase in IPAQ tot (p < 0.001) and SF 12_MI (p < 0.001) scores. (4) Conclusions: 42.8% (15 out of 34) of the initial participants completed the follow-up test at T30 and maintained higher V̇O₂max values than at T0. Conversely, their physical characteristics returned to baseline. The improvement in V̇O₂max, compared to T0, correlated with maintaining high activity levels and with improved physical and mental well-being. In summary, it is recommended that people with obesity follow a structured physical activity program, as this leads to an improvement in physical capacities and physical and mental well-being. A personalized and monitored approach can lead to greater adherence to treatment and more effective long-term outcomes. Full article

Background: Extensive data exists on external load during training and competition, but a significant gap remains in understanding internal physiological load, particularly in protocols conducted in ecological settings. Given the scarcity of studies on the on-field cardiorespiratory profiles of national-level athletes, especially in Argentine soccer, this study aimed to identify the on-field cardiorespiratory fitness profile of ten highly trained youth field soccer players (13.6 ± 1.3 years old) from both the first league of the Argentine Football Association and members of the national team in their age group category in the current year. Methods: Each athlete performed an on-field cardiorespiratory exercise test (20-m Shuttle Run Test, 20-m SRT) with the COSMED K5 wearable metabolic system (COSMED, Rome, Italy) in dynamic micro-mixing chamber mode. The 20-m Shuttle Run Test involves running back and forth between two lines set 20 m apart, following the pace set by an audio signal. The test starts at a running velocity of 8.5 km·h⁻¹ and increases by 0.5 km·h⁻¹ each min. Results: Mean velocity at maximal oxygen uptake (v$\dot{\mathrm{V}}$O_2max) was 12.3 ± 0.7 km·h⁻¹. The maximal oxygen uptake ($\dot{\mathrm{V}}$O_2max) on-field was 67.1 ± 5.3 mL·kg⁻¹·min⁻¹. The $\dot{\mathrm{V}}$O₂ at the first and second ventilatory thresholds (VT1 and VT2) were identified at 67.0 ± 3.0% $\dot{\mathrm{V}}$O_2max (44.9 ± 3.3 mL·kg⁻¹·min⁻¹) and 84.7 ± 3.7% $\dot{\mathrm{V}}$O_2max (56.8 ± 3.8 mL·kg⁻¹·min⁻¹), respectively. Conclusions: This is a scarce on-field gas exchange assessment, conducted in an ecological context using a portable analyzer with highly trained national-level youth soccer players from the Argentine youth national team, which underlines their cardiorespiratory fitness, showcases their high-performance potential, offers valuable insights into a selective group of players, and provides a reference for larger-scale research on elite youth soccer and the long-term development of aerobic power and capacity. Full article

Background/Objectives: The inspiratory muscles play a fundamental role in cardiorespiratory performance, especially in water sports. The main objective of this study was to investigate the effects of an inspiratory muscle warm-up (IMW) protocol on the performance and respiratory parameters of scuba divers prior to performing two diving tests, one static and the other dynamic. Methods: Eight young, active divers (six men and two women; 26.63 ± 4.67 years of age) volunteered for the study. In two sessions, one using an IMW protocol and the other without IMW, participants performed two underwater tests with a gas tank: a static immersion at the bottom of the pool for 5 min and a dynamic test consisting of swimming underwater for 12 min at 1 m/s. Some cardiorespiratory parameters such as gas expenditure, oxygen saturation (SO₂), heart rate (HR), spirometry, and rating of perceived exertion (RPE) were measured before and after each of the tests. Results: Significant differences were observed in gas expenditure using IMW in both static and dynamic testing (p < 0.05) and in RPE in dynamic testing (p < 0.05). HR values were significantly higher in the pre-dynamic test with IMW and the post-static test with IMW. Finally, with the use of IMW, spirometry values were significantly higher (p < 0.05) in static tests after immersion, whereas in the dynamic test, they were significantly higher before the immersion (p < 0.05). Conclusions: Based on the results of this study, the use of the IMW prior to a dive would be recommended for better overall physical performance, oxygen expenditure, improved pulmonary function, and lower perceived exertion. Full article

(1) Background: The aim of this study was to conduct a systematic literature review and meta-analysis on the effects of virtual reality (VR) and traditional (TR) physical activity programs, analyzing their impact on the physical, health, and cognitive aspects of participants. The study sought to identify the advantages and limitations of both methods, taking into account previous research and potential areas for future studies. (2) Methods: The study protocol for this systematic review was registered at the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY202530015). The review followed PRISMA guidelines, and studies were selected based on their relevance to the research objectives using the PICOS model criteria. The authors applied a meta-analysis in addition to a systematic review to further ensure the accuracy of the results. Primary outcomes included physical and cognitive performance, while secondary outcomes encompassed participant perceptions and psychological effects. (3) Results: The findings indicate that VR training significantly enhances flexibility, motivation, and cognitive abilities, particularly in populations with limited access to traditional exercise methods. The most pronounced effects were observed in programs lasting 8 to 12 weeks with a moderate to high intensity. In contrast, TR showed superiority in developing strength, endurance, and cardiorespiratory functions. (4) Conclusions: VR offers significant benefits as an adjunct or alternative to TR, especially for individuals with limited resources or physical accessibility. However, variations in methodological approaches, short program durations, and sample heterogeneity highlight the need for further longitudinal research. Standardizing VR training duration and intensity is essential to ensure consistent and reliable outcomes. Full article

This review explores current strategies aimed at reducing complications in gynecologic surgery, focusing on innovations in laparoscopic entry techniques, extraperitoneal lymphadenectomy, and alternative approaches such as gasless laparoscopy. We conducted a comprehensive literature review, including studies and technical descriptions relevant to improved surgical access, lymph node dissection, and overall risk mitigation. Key findings indicate that the individualized selection of entry points—ranging from Palmer’s point in the left upper quadrant to the recently described Jain point—can minimize vascular and bowel injuries, especially in patients with prior abdominal surgeries. Furthermore, extraperitoneal lymphadenectomy appears to lower adhesion formation and bowel handling, potentially decreasing postoperative morbidity in oncologic cases. Gasless laparoscopy may offer comparable surgical outcomes with improved cardiorespiratory stability in high-risk patients, although visualization challenges remain. Overall, the evidence suggests that advanced minimally invasive methods and tailored procedural planning can effectively enhance patient safety and reduce postoperative complications. These approaches, however, demand a high level of surgical expertise, thorough preoperative imaging, and an institutional framework that supports training and ongoing quality monitoring. Continued investigations, including prospective trials and larger sample sizes, are required to validate these findings and further refine protocols aimed at optimizing outcomes in gynecologic surgery. Full article

Background/Objectives: This study sought to evaluate the clinical profile, in-hospital management, prognosis, and survival of patients treated for cardiac arrest using extracorporeal therapy in a third-level Spanish hospital before and after the therapy was protocolised. Methods: This study is a historical single-centre cohort study that was conducted from January 2009 to February 2024. In 2019, an in-hospital extracorporeal reanimation therapy protocol was established in the centre’s Coronary Intensive Care Unit. As a result, the cohort was split into two groups: the Pre-Protocol group (between 2009 and December 2018) and the Post-Protocol group (between 2019 and February 2024). Results: A total of 26 patients were recruited, i.e., 10 in the first cohort and 16 in the second, with acute myocardial infarction being the most prevalent cause in both cohorts. A 30% (3) to 43.65% (7) increase in survival was observed between the two cohorts (p = 0.48), with CPC 1–2 neurological functionality exceeding 85% of cases in both cohorts (p = 0.7). The mean time from cardiac arrest to the application of extracorporeal therapy decreased from 104.1 min to 41.87 min (p = 0.09). The longer duration of ECMO (p = 0.03) and the longer hospital stay (p = 0.002) are due to a higher survival. Conclusions: The results show a trend in improvement outcomes. The small cohort size makes it difficult to draw robust conclusions, but we want to highlight the importance of applying a specific protocol based on standardised patient selection criteria and the establishment of extracorporeal reanimation therapy. Full article