Search Results (5,349)

Background: The skeletal muscle extracellular matrix (ECM) is critical for muscle force and the regulation of important physiological processes. A growing body of evidence demonstrates that in aging, altered ECM composition profoundly hinders the capacity for muscle adaptation in response to exercise training. We evaluated the pattern of ECM expression in response to exercise training between healthy young participants and patients with chronic obstructive pulmonary disease (COPD), to provide insight into how normal adaptive processes differ under conditions of chronic disease. Methods: Vastus lateralis muscle biopsies from 29 patients (mean ± SD FEV1: 43 ± 16% predicted) and 14 healthy subjects were analyzed before and after an interval exercise training program for myofiber distribution and size. A selection of ECM molecules was quantified using ELISA. Results: Compared to healthy participants, patients exhibited a lower capacity to increase myofiber type I distribution (by 4.7 ± 3.4 vs. 1.3 ± 2.2%) and mean fiber cross-sectional area (by 13.6 ± 3.2 vs. 9.1 ± 1.9%). Exercise training induced a diverse protein expression between the two cohorts in ECMs regulating tissue structure (collagens: up-regulated only in COPD), myogenesis (SPARC: up-regulated only in healthy), necroptosis (tenascin C: up-regulated only in COPD), adherence to muscle-cell precursors (Fibronectin: up-regulated only in healthy) and tissue integrity (biglycan: down-regulated only in COPD). Conclusions: Impaired ECM remodeling may underlie the reduced exercise training muscle adaptation observed in COPD patients. Full article

Background/Objectives: Sports tendinopathy management has traditionally focused on mechanical loading protocols, yet emerging evidence suggests metabolic factors significantly influence clinical outcomes and tissue adaptation responses. The aim was to systematically evaluate the impact of metabolic factors on sports tendinopathy outcomes and assess the effectiveness of advanced rehabilitation approaches that extend beyond traditional mechanical loading protocols. Methods: A comprehensive search across academic papers from Semantic Scholar corpus identified studies investigating metabolic influences and advanced rehabilitation strategies in sports tendinopathy. Inclusion criteria encompassed athletes and active individuals with chronic tendinopathy, interventions targeting metabolic factors or advanced rehabilitation techniques, and validated outcome measures. Risk of bias was assessed using RoB 2 for randomized trials and ROBINS-I for observational studies. Evidence certainty was evaluated using GRADE methodology. Results: Forty studies met inclusion criteria, comprising 5 randomized controlled trials, 9 systematic reviews, and 5 cohort studies. Metabolic syndrome significantly impaired eccentric exercise outcomes in Achilles tendinopathy (F[1,54] = 24.45, p < 0.001). Collagen-derived peptide supplementation combined with eccentric training demonstrated superior pain reduction at rest compared to exercise alone (p < 0.05). Advanced rehabilitation strategies including criteria-based progression, neuroplastic training, and staged loading protocols showed improvements in patient-reported outcomes and functional scores, with some approaches demonstrating superiority over traditional eccentric protocols. Conclusions: Metabolic factors negatively influence sports tendinopathy rehabilitation outcomes, while advanced rehabilitation approaches incorporating metabolic considerations show promise for enhancing treatment effectiveness. Integration of metabolic assessment and targeted interventions may optimize tendinopathy management beyond mechanical loading alone. Full article

Background: Women with gestational diabetes mellitus (GDM) are vulnerable to oxidative stress, yet limited data exist on the antioxidant potential of their breast milk. This study aimed to evaluate the antioxidant capacity and basic composition of colostrum in women with GDM compared to healthy controls, focusing on total antioxidant capacity (TAC) and enzymatic antioxidants: superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx). Methods: The study included 77 lactating mothers: 56 with gestational diabetes (15 managed with diet/exercise—GDM G1; 41 required insulin—GDM G2) and 21 healthy controls. Colostrum samples were collected on days 3–5 postpartum and analyzed for macronutrients and antioxidant enzymes. To enable comparisons across study groups and to explore associations with maternal characteristics, a range of statistical methods was applied. A taxonomic (classification) analysis was then performed using the predictors that best fit the data: study group membership, maternal hypothyroidism history (from the medical interview), and gestational weight gain. Results: TAC was significantly lower in the GDM G2 group compared to GDM G1 and controls (p = 0.001), with no differences in enzymatic antioxidants. The control group had the highest energy (p = 0.048) and dry matter content (p = 0.015), while protein, fat, and carbohydrate levels did not differ significantly. After dividing the study group into four clusters, based on maternal health factors, including GDM status and thyroid function, TAC levels differed significantly between clusters, with the highest values observed in Cluster 3 (healthy controls without thyroid dysfunction) and the lowest in Cluster 2 (GDM and hypothyroidism). Analysis of colostrum composition revealed significant differences in energy content (p = 0.047) and dry matter concentration (p = 0.011), while no significant differences were found in other macronutrients. Conclusions: Our findings suggest that maternal metabolic and endocrine conditions, such as GDM and thyroid dysfunction, may differentially influence the nutritional and functional properties of colostrum—particularly its antioxidant potential. Full article

People with intellectual disability and visual impairment often have difficulties in accessing leisure events, engaging in cognitive activities, and performing physical exercise. The present study assessed a program aimed at helping six adults with moderate or moderate-to-mild intellectual disability and blindness in each of the aforementioned areas. The program relied on the use of a technology system involving a smartphone, which was supplied with Internet connection and fitted with the Live Transcribe and MacroDroid applications. These applications were set up to (a) enable the participants to use verbal utterances to successfully access preferred songs and comic sketches (leisure events) and answer series of verbal questions (cognitive activity) automatically presented to them, and (b) enable the smartphone to verbally guide the participants’ performance of series of body movements (physical exercise). The program was introduced according to a nonconcurrent multiple baseline design across participants. The intervention was divided into two phases, which included 17–33 and 39–48 sessions, respectively. The results showed that the participants’ baseline performance (without the support of the system) was generally poor. During the intervention with the system, all participants succeeded in accessing the music or comic events available, satisfactorily answering series of questions, and performing series of body movements. The Percentage of Nonoverlapping Data and the Tau (novlap) methods used to compare baseline and intervention performance produced indices of 1 for all participants (confirming the strong impact of the intervention). These results, which need replication to establish their generality, suggest that the technology system might represent a useful tool for helping people like the participants of this study. Full article

Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as a transformative therapy for obesity and type 2 diabetes (T2D) in pediatric populations. This review synthesizes current evidence on efficacy, safety, and knowledge gaps in children and adolescents. Methods: A structured review of randomized controlled trials, extension studies, and mechanistic investigations evaluating GLP-1RAs in pediatric obesity and T2D was conducted. Outcomes of interest included body weight, BMI, body composition, glycemic control, and adverse events. Results: In adolescents, liraglutide and semaglutide consistently produce clinically meaningful reductions in BMI, body weight, and waist circumference, with modest improvements in systolic blood pressure and minimal effects on lipid levels or HbA1c. A newer trial in children 6 to <12 years showed liraglutide reduced BMI compared with placebo, with GI events consistent with prior safety profiles. Weight loss tends to include both fat and lean components; rapid weight loss may impair muscle strength or bone density if resistance exercise and adequate protein intake are not ensured. Risks include micronutrient gaps, misuse, and uncertain long-term effects on growth and puberty. These important considerations remain largely unaddressed in pediatric studies, and adult data can’t be directly extrapolated to children due to developmental, hormonal, and physiological differences. Conclusions: GLP-1 RAs are a promising adjunct to lifestyle therapy for pediatric obesity, but pediatric-specific protocols are needed to safeguard musculoskeletal health, ensure nutritional adequacy, and minimize misuse. Critical gaps remain in pediatric pharmacokinetics, dosing strategies, and long-term developmental safety. Further research is essential to develop evidence-based guidelines for safe and effective pediatric anti-obesity therapy. Full article

Background/Objective: Few treatment options improve symptoms and the quality of life of Parkinson’s disease (PD); more treatment choices are needed. This study examined the effectiveness of photobiomodulation therapy (PBMt) combined with exercise to improve PD symptoms and quality of life. Methods: Participants were randomised into Active (n = 32) or Sham (n = 31) PBMt groups. Stage 1 was an 8-week double-blind, randomised, placebo-controlled trial using either active or sham PBMt to the head, back of the neck and abdomen three times weekly at home, followed by a 4-week washout. Stage 2 was 8 weeks of active PBMt for all participants. In Stage 3, participants chose to continue active PBMt treatment (‘continuers’) or receive no PBMt treatment (‘non-continuers’) for up to 48 weeks. Participants continued vigorous exercise throughout the study. Participants were assessed on enrolment and after each stage. The primary outcome measure was timed up-and-go, with a range of secondary motor and non-motor outcomes, including UPDRS. Results: There was no significant difference between the Active and Sham Groups after Stages 1 or 2, apart from minimal increase in MoCA score/cognition (Sham Group) in Stage 1. After Stage 3, continuers showed a significant improvement in the primary outcome measure compared to non-continuers. Anxiety and the motor experiences of daily living (MDS-UPDRS Part II) were also significantly improved, while other outcomes approached significance, including MDS-UPDRS Total score (p = 0.062). Conclusions: As the largest study to date, results add increasing weight to previous clinical trials and highlight potential for at-home, scalable treatment as adjunctive therapy alongside medication and exercise. Full article

Post-activation performance enhancement (PAPE) is an acute performance increase in voluntary exercises induced by a conditioning activity. Due to the scarcity of evidence about the effectiveness of distinct protocols, the aim of this study was to compare the effects of two different flywheel PAPE protocols (half-squat and lunge exercises) on vertical and horizontal jump performance, as well as change-of-direction ability in female amateur footballers (n = 21). Each protocol consisted of 3 sets of 6 repetitions for the half-squat protocol or 10 repetitions for the lunge protocol, with two minutes of passive rest, performed with a conical pulley. Both protocols were followed by rests of two, eight, and twelve minutes for repeated countermovement jump (CMJ), triple hop, and change-of-direction test (modified T-505) testing. The fixed-effect model 2-ways-repeated measures ANOVA showed that there was no significant interaction between time and exercises performed (p > 0.05). There was no significant relationship between exercise specificity and performance in sport-specific tasks. Our results suggest that, within this population, neither flywheel protocol provided measurable PAPE benefits across varied time windows. The findings underscore the importance of strength levels in achieving PAPE benefits and question the specificity of PAPE protocols to targeted sport performance outcomes. Full article

Hypertrophic cardiomyopathy (HCM) is a relatively common global cardiac disease, usually inherited, with complex phenotypes, genetic features, and a natural history. In this study, we constructed atic^−/− zebrafish using the CRISPR/Cas9 gene-editing system and found that atic^−/− zebrafish hearts exhibited HCM symptoms, and atic^−/− zebrafish hearts showed progressive enlargement, eccentric hypertrophy, cardiomyocyte enlargement, and collagen fiber deposition. Echocardiography results also showed that compared with atic^−/− zebrafish hearts, in wild-type zebrafish hearts, the ejection fraction was significantly reduced, shortening fraction was reduced, and ventricular wall thickness was significantly increased. Meanwhile, aerobic exercise intervention in atic^−/− zebrafish showed that aerobic exercise effectively improved the symptoms of HCM and improved cardiac function in atic^−/− zebrafish hearts. Transcriptome sequencing results showed that aerobic exercise improved the symptoms of HCM in atic^−/− zebrafish hearts involving the calcium signaling pathway, Apelin signaling pathway and ECM–receptor interaction. The q-PCR results of key differential genes involved in these pathways further confirmed that aerobic exercise could bring beneficial effects to atic^−/− zebrafish. In conclusion, this study found that the loss of ATIC can lead to hypertrophic cardiomyopathy in zebrafish, and aerobic exercise intervention can effectively improve the hypertrophic pathological characteristics of atic^−/− zebrafish hearts, providing new intervention targets and effective lifestyle interventions for HCM. Full article

Currently, corporate social responsibility and environmental/social/governance topics are gaining more relevance in business and finance. Attention to corporate diversity in boards and the workforce is included in this trend. Although most studies focus on executive boards and objective scores, the perception of diversity by employees and its rankability are not fully understood or researched. In this paper, we analyze corporate diversity rankings from the perspective of predictive and prescriptive analytics. Inside predictive analytics, the perceived diversity of a sample of 350 European diversity leader companies is predicted by using three different feature sets (raw financial data, ratios and objective diversity variables) and three machine learning algorithms (K Nearest Neighbors, Logistic Regression, Decision Tree). The best performing algorithm is the Decision Tree, and all three feature sets outperform one random dummy algorithm; the best performing set is the financial ratios set. Inside prescriptive analytics, several rankings involving American companies are intersected and compared in three exercises (studying diversity categorization, ethnic origin and comparing diversity with other unrelated metrics). From these, global rankings were built to search for the best possible agreement among the rankings. These results with both predictive and prescriptive analytics encourage managers to strategize and include diversity in management, as well as employ new technologies in their decision-making processes. Full article

Background: Relative Energy Deficiency in Sport (REDs) results from an imbalance between energy intake and expenditure, leading to low energy availability (LEA) and impairments of physiological and/or psychological functions in female and male athletes. While physical determinants of REDs are well documented, psychological factors such as body image (BI) have received comparatively little attention. The aim of this scoping review was to synthesize the current scientific evidence on the relationship between BI and REDs. Methods: A scoping review examined the current literature, including quantitative and qualitative studies. The scoping review was conducted in April 2025 in PubMed, Web of Science, MEDLINE, SPORTDiscus, APA PsycArticles, APA PsycInfo, CINAHL and OpenDissertations. Studies were included if they examined BI aspects in relation to LEA or REDs in a sporting context, regardless of participants’ gender, age, level or sport. Inclusion criteria were based on the Population–Context–Concept (PPC) framework. Results: Seven studies met the inclusion criteria, covering athletes from various ages, genders, sports, and performance levels. Findings indicate that BI dissatisfaction—manifesting, for example, as a drive for thinness or muscularity, exercise dependence, and disordered eating—represents a relevant psychological factor associated with LEA in both female and male athletes. Conclusions: The relationship between BI and REDs is complex and insufficiently explored. Future research should address this link systematically across sports, performance levels, genders, and age groups. In sports medicine practice, screening tools should systematically incorporate psychological risk factors such as BI disturbances to enable early detection, targeted intervention, and prevention of long-term health consequences. Full article

Background: Elevated global temperatures increase the risk of heat-stroke among athletes exercising in hot conditions. Japanese high school baseball tournaments occur during peak summer, raising concerns regarding heat-related health issues. We examined whether the color of footwear and legwear affects lower-limb temperature, exploring approaches to prevent heat-related health problems. Methods: Eight mannequin legs were fitted with shoes, socks, and baseball stirrup socks in white or black combinations. Plantar and shin surface temperatures were recorded for 120 min on both dirt and artificial turf at wet-bulb globe temperatures above 30 °C and compared across color combinations. Reflectance spectra of shin legwear were also measured. Results: Plantar and shin surface temperatures increased under all conditions. On the dirt field, mannequins wearing all-black gear (shoe, sock, and baseball stirrup sock) exhibited plantar temperatures exceeding 45 °C and shin temperatures over 50 °C. The highest shin temperature occurred with the white shoe/black baseball stirrup sock combination. Temperature increases were smaller for all-white items compared with all-black items. Reflectance spectra showed that white baseball stirrup socks strongly reflected both visible and infrared light. Conclusions: Footwear and legwear color significantly influence lower-limb temperature increases during baseball games in summer heat, especially when wearing all-black items. White gear may help prevent heat-related health problems and improve performance in baseball and other outdoor sports. Full article

Background and Objectives: Knee arthroplasty often leads to marked postoperative muscle weakness, with strength losses of up to 62% in the first month, contributing to functional impairment and patient dissatisfaction. Blood flow restriction (BFR) training, which combines low-load exercise with partial vascular occlusion, has shown promise in enhancing muscle strength across musculoskeletal conditions and may represent a valuable rehabilitation strategy for this vulnerable population. This review aimed to systematically evaluate the effectiveness and safety of BFR training in improving muscle strength and functional outcomes following knee arthroplasty. Materials and Methods: This systematic review was prospectively registered within PROSPERO (CRD420250652404) and conducted according to PRISMA guidelines. PubMed, Embase, and Cochrane Library were searched through February 2025 for randomized controlled trials (RCTs) investigating BFR training in knee arthroplasty patients. Study selection, data extraction, and risk of bias assessment (RoB 2 tool) were performed independently by two reviewers. Eligible trials reported muscle strength and/or functional outcomes as primary or secondary endpoints. Results: Four RCTs, including 148 patients undergoing total knee arthroplasty (mean age: 67 ± 6.5 years), met the inclusion criteria. All applied preoperative BFR training for 4–8 weeks with heterogeneous protocols. Two trials demonstrated significant improvements in muscle strength (1 RM leg press, 1 RM knee extension; large effect sizes) and functional outcomes (6 min walk test, 30 s sit-to-stand; earlier recovery), favoring BFR. The remaining studies showed no significant between-group differences, though moderate-to-large effect sizes generally favored BFR training. No adverse events were reported. Conclusions: Prehabilitation with BFR training shows considerable potential to enhance early postoperative muscle strength and functional recovery in patients undergoing knee arthroplasty, particularly when compared with usual care lacking structured preoperative intervention. The evidence to date suggests that BFR is a safe and well-tolerated strategy, offering an alternative for patients who cannot perform high-load resistance training. Its favorable safety profile, combined with the potential to accelerate functional recovery, highlights the promise of BFR for reducing rehabilitation costs and healthcare utilization. Nonetheless, larger, high-quality RCTs with standardized protocols and extended follow-up are required to confirm these preliminary findings and establish clear clinical guidelines for their implementation. Full article

Background/Objectives: Impaired angiogenesis and vascular dysfunction are central features of chronic diseases such as cardiovascular disorders, neurodegeneration, and metabolic syndrome. Vascular endothelial growth factor (VEGF) plays a pivotal role in vascular repair and metabolic regulation, yet its responses to exercise remain inconsistently reported. This study aimed to systematically compare the effects of different exercise modalities and doses on VEGF levels across diverse populations. Methods: This review was registered in PROSPERO (CRD42025643709) and followed PRISMA guidelines. PubMed, Web of Science, Embase, and Cochrane Library were searched until 16 January 2025. Eligible studies were randomized or quasi-experimental trials reporting exercise-induced changes in serum/plasma VEGF. Data were extracted and assessed independently using JBI tools. Exercise types were categorized and doses standardized as metabolic equivalents (METs). Network meta-analysis was performed in Stata17.0 (SMD as effect size), with SUCRA used for ranking. Dose–response relationships were examined by meta-regression (remr package), and publication bias was assessed via funnel plots. Results: Twenty-eight studies (N = 1138) were included. In healthy adults, lower-limb resistance training produced the greatest VEGF increase, with benefits observed above ~600 METs-min/week and peaking near 1950 METs-min/week. Among obese individuals, combined aerobic and resistance training under hypoxic conditions showed the highest VEGF response, though dose-specific effects were not significant. In patients with chronic conditions, upper-limb resistance training within 756–950 METs-min/week was most effective, displaying a U-shaped dose–response relationship. No substantial publication bias was detected. Conclusions: The VEGF response to exercise appears to be influenced by both population characteristics and training dosage. High-intensity lower-limb resistance training may provide greater benefits for healthy adults, while obese individuals might experience enhanced responses with combined training under hypoxic conditions. For clinical populations, moderate-dose upper-limb resistance training may be particularly beneficial. Large-scale, long-term trials are needed to further clarify and refine exercise prescriptions targeting VEGF-mediated vascular adaptations. Full article

Background: Exercise interacts closely with the circadian system; however, whether long-term training elicits time-of-day-dependent metabolic adaptations in the context of obesity remains unclear. Methods: Male C57BL/6 mice were fed a high-fat diet and trained on a treadmill for 8 weeks during either the early rest phase (ZT3, Zeitgeber time) or the early active phase (ZT15). Sedentary mice served as controls. After the last session, animals were fasted for 4 h and sampled 48–49 h later. Plasma triglycerides (TGs) and glucose, as well as liver and epididymal white adipose tissue (EPI), were analyzed. Results: Plasma TGs showed a significant phase × exercise interaction (F(1, 25) = 5.25, p = 0.0307), with the lowest levels in ZT15-exe (27.22 mg/dL) compared with ZT15-sed (39.47 mg/dL, p < 0.01) and ZT3-exe (41.80 mg/dL, p < 0.01). Hepatic TG content was markedly lower in ZT3 than in ZT15 mice (F(1, 25) = 15.49, p < 0.001), and Oil Red O staining was associated with reduced lipid accumulation in exercised groups (p < 0.05). In EPI, Fasn expression was robustly decreased by exercise (F(1, 25) = 16.43, p = 0.0004, q = 0.0059), indicating long-term suppression of lipogenesis. In the liver, Cpt1a showed significant main effects of both phase (F(1, 25) = 10.11, p = 0.0039, q = 0.0158) and exercise (F(1, 25) = 13.42, p = 0.0012, q = 0.0353), being higher in ZT3 and under sedentary conditions, suggesting a circadian-dominant oxidative advantage in hepatic metabolism. Conclusions: Long-term exercise induced phase-dependent adaptations in lipid metabolism. Active-phase exercise promoted adipose lipid mobilization and lowered plasma TGs, while rest-phase training enhanced hepatic oxidative capacity. These results suggest a “tissue × time” framework of circadian-specific exercise responses, providing hypothesis-generating evidence for optimizing exercise timing in metabolic disorders. Full article

Background: Body surface area is a key determinant of cardiac morphology and function, but it is often underestimated in the interpretation of athlete’s cardiac phenotypes. Aims: This study aimed to assess the role of anthropometric characteristics and whether particularly high vs. low body surface area (BSA) is associated with distinct morpho-functional and cardiometabolic features in elite athletes. Methods: We retrospectively included 2518 Olympic athletes. All underwent a pre-participation screening, including physical examination, ECG, blood analysis, echocardiography, and cardiopulmonary exercise testing. Participants were grouped by sex-specific BSA percentiles: Group A (<5th percentile), Group B (25th–75th), and Group C (>95th percentile). Functional, echocardiographic, and cardio-metabolic parameters were compared among groups. Results: In male athletes, Group C showed higher resting systolic blood pressure (123.8 ± 10.4 mmHg) than Group B (117.4 ± 9.6, p < 0.0001) and Group A (110.4 ± 13, p < 0.0001), and a higher prevalence of dyslipidemia (31.7% vs. 11.1% in Group B and 4% in Group A, p = 0.031). Despite greater LVEDD (59 ± 3 mm in Group C vs. 55 ± 2.9 in B and 51.1 ± 3.1 in A, p < 0.0001) and LV mass (p < 0.0001), functional performance was lower in Group C, with VO₂ max/kg of 35.2 ± 13.2 mL/min/kg vs. 44 ± 7.1 in B, and 47.8 ± 7.3 in A (p < 0.0001). Similar trends were observed in females for morpho-functional parameters, though lipid profiles did not significantly differ among groups (p > 0.05). Conclusions: Anthropometric traits significantly influence the cardiovascular and metabolic phenotype of elite athletes. Our findings support the integration of anthropometric profiling into the routine cardiovascular assessment of athletes, especially those at the extremes of body size, to better interpret physiological adaptations and risk profiles. Full article