Search Results (1,163)

Introduction: Numerous overuse injuries affecting the lower limbs of elite athletes have been associated with biomechanical alterations in plantar loading of the foot. This study aimed to analyze the plantar pressure distribution in elite male soccer players and its relationship with various morphological and functional factors, including foot type, metatarsal and digital alignment, and on-field position. Material and Method: Dynamic foot pressure measurements were obtained from 21 soccer players who participated in the UEFA Champion League. The participants had an average age of 27 years, with an average height of 180.9 cm, weight of 76.9 kg, and BMI of 23.4. An insole system (BioFoot/IBV) with telemetry transmission was employed to record plantar loading patterns during normal gait and running. Results: During the support or contact phase, the central and medial metatarsal areas exhibited the highest peak pressure under both walking and running conditions. When walking, the right foot exerted 13–60% more pressure on the outer metatarsal and toe areas. The left foot experienced up to 13% more peak pressure in the middle metatarsal area. During running, the total pressure difference between the feet ranged from −8% to +19%. The right foot usually had more peak pressure on the heel and first toe. In players with valgus feet, the pressure in the central metatarsal area increased from 1086 kPa (walking) to 1490 kPa (running), representing a 37% increase. Conversely, in players with cavus-varus feet, the pressure in this central area increased from 877 kPa to 1804 kPa, a 105% increase. Conclusions: Foot morphology and playing position significantly influenced the plantar pressure patterns in elite soccer players. The central metatarsal region bears the highest load, particularly during running, with distinct variations across foot types and field positions. These findings highlight the need for individualized biomechanical assessments to prevent overuse injuries and optimize performance. Full article

Cardiopulmonary exercise testing (CPET) is a gold standard to assess cardiorespiratory fitness (CRF). CRF varied through the lifespan, increasing in children until early adulthood and then gradually declining. Reference values for CPET are used to check whether the child’s CRF falls within the normal range. The differences between directly measured and normative age-adjusted exercise data may suggest pathology and are helpful during the diagnostic process. Deriving reference values for children is particularly challenging. Moreover, many children participate in sports, some at an advanced/elite level, which translates into specific adaptations in CPET. The ATS/ACCP statement on CPET presented a checklist that should be followed when reporting reference values. However, the checklist originally focused on adults. This aggravates the quality of reporting pediatric reference values for CPET, making between-studies comparisons difficult. This review (1) presents a step-by-step protocol to fulfill all requirements from the ATS/ACCP statement in the pediatric population, and (2) summarizes the key challenges in deriving reference values for CPET in children, especially among pediatric athletes. Additional recommendations to enrich the quality of reporting reference values for CPET in pediatric athletes were also discussed. Full article

Endurance exercise is widely recognized for its cardiovascular benefits, including improved longevity and metabolic health. However, excessive endurance training may lead to adverse cardiac adaptations, such as myocardial fibrosis, detected via late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR). This review examines the dual role of myocardial fibrosis in athletes—as a potential risk marker for life-threatening arrhythmias or a benign byproduct of physiological remodeling. While moderate exercise promotes beneficial cardiac hypertrophy, ultra-endurance athletes exhibit a 10–20% increase in ventricular size and mass, alongside elevated cardiac biomarkers post-exercise. Myocardial fibrosis, particularly in the left ventricle (LV), is associated with arrhythmias and sudden cardiac death, especially when presenting as a subepicardial/midmyocardial patchy pattern. Studies report that 22% of athletes with this pattern experienced malignant arrhythmias, underscoring its clinical significance. Conversely, fibrosis may also reflect adaptive remodeling in some cases, complicating its interpretation. The mechanisms underlying fibrosis in athletes remain unclear but may involve repeated cardiac stress, inflammation, or distinct atherosclerotic plaque dynamics. CMR is critical for detecting fibrosis, though differentiating pathological from physiological patterns requires careful clinical correlation. Risk stratification must consider LGE patterns, arrhythmia history, and symptoms. Despite concerns, elite athletes generally exhibit increased longevity, highlighting the complex interplay between exercise benefits and risks. Further research is needed to clarify fibrosis mechanisms, refine diagnostic criteria, and guide management strategies to ensure athlete safety while preserving the advantages of endurance training. Full article

Background: Exercise-induced bronchoconstriction (EIB) is common in athletes, being more frequent in outdoor endurance-based/long-distance sports. We followed a World-Class marathon paddler’s season with recurrent episodes of EIB, which intensified during cold exposure workouts. This unique immunophenotype profile during the season and its variations were reflected in acute and chronic inflammatory markers. Methods: A longitudinal case study was conducted with blood sampling obtained from a single paddler after overnight fasting at three timepoints: T1 (beginning of season, after 15-day rest period), T2 (post-Winter National Championship), and T3 (post-Summer National Championship). Complete blood counts and lymphocyte immunophenotyping were performed using automated hematology analysis and multiparametric flow cytometry. Results: The total numbers of leukocytes (T1: 6.3; T2: 5.0; T3: 5.5 × 10⁹/L), neutrophils (3.1; 2.5; 2.8 × 10⁹/L), and lymphocytes (2.4; 1.8; 2.2 × 10⁹/L) declined between T1 and T2, followed by a partial recovery at T3. In contrast, monocyte counts exhibited the reverse pattern (0.41; 0.62; 0.31 × 10⁹/L). The two T cell subsets (αβ and γδ) remained relatively stable, showing only minor seasonal fluctuations. CD19+ B cells, initially at very low levels, increased steadily as the season progressed (0.05; 0.07; 0.16 × 10⁹/L). During T2, the proportion of memory lymphocytes (CD45RO+) rose, while naive cells (CD45RA+) declined; this trend was subsequently inverted at M3. Although the CD4+/CD8+ ratio varied over time, it consistently stayed below the normal reference range established for healthy controls (0.50; 0.83; 0.60 for T1, T2, and T3, respectively). Conclusions: The immune assessment of the World-Class marathon paddler revealed transient immunosuppression early in the season, marked by reduced neutrophils, a low CD4+/CD8+ ratio, and diminished CD19+ lymphocytes. Over time, immune parameters showed signs of recovery, indicating a temporary imbalance that did not impair the athlete’s physical performance. Conclusions: This case study of an elite marathon kayaker revealed transient immune fluctuations across a competitive season, including early immunosuppression (low neutrophils, CD4+/CD8+ ratio 0.50, and minimal CD19+ B cells) followed by partial recovery mid- and late-season. Despite persistently inverted CD4+/CD8+ ratios suggesting chronic immune dysregulation, the athlete maintained competitive performance, highlighting the temporary nature of these changes and emphasizing that regular immune monitoring can help optimize health and performance in elite athletes. Full article

Football (soccer) is the world’s most widely played sport, but it carries a high incidence of traumatic injuries, particularly to the head, face, and lower limbs. Once regarded as a low-equipment discipline, the role of protective devices has expanded substantially in recent decades, both in injury prevention and in return-to-play strategies. This review provides a comprehensive overview of the historical evolution, typology, and materials of football protective equipment, with additional focus on regulatory frameworks, cultural acceptance, and illustrative cases from elite athletes. Shin guards remain the only mandatory device, yet the use of facial masks, headgear, braces, and orthoses is increasing, particularly following high-profile injuries. Advances in carbon fiber composites, thermoplastics, viscoelastic foams, and additive manufacturing have enabled lightweight, customized devices that balance protection with comfort and adherence. Beyond biomechanics, psychological reassurance, esthetics, durability, and hygiene strongly influence player compliance and perception. Despite this progress, critical challenges remain. Football lacks standardized testing protocols, clear certification pathways, and longitudinal studies on long-term outcomes. Evidence is particularly limited for youth athletes and newer categories of equipment. Looking ahead, the integration of wearable technologies, systematic hygiene and durability testing, and sustainable materials could transform protective gear into multifunctional tools for safety, monitoring, and performance optimization. Protective equipment in football has thus evolved into a multidisciplinary field at the intersection of medicine, engineering, psychology, and regulation. Future advances will depend on stronger collaboration between clinicians, researchers, governing bodies, and manufacturers to ensure safe, effective, and widely accepted protective solutions at all levels of the game. Full article

Background: A sexually active lifestyle is generally associated with positive effects on physical condition and health. However, engaging in sexual activity prior to a sports competition could affect athletic performance. This systematic review examines the current literature on the impact of pre-exercise sexual activity on sports performance, with particular attention paid to its effects on physiological, hormonal, cognitive, and perceptual markers. Method: Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed original studies published within the last 25 years. Eligible studies were randomized or non-randomized controlled design and indexed on PubMed, Scopus, Dialnet, and Cochrane. Additional sources were consulted including a network diagram with Connected Papers^®. Two methodological quality scales, McMaster University Occupational Therapy Evidence-Based Practice Research Group and Physiotherapy Evidence Database (PEDro), were used. The study was registered in PROSPERO (#CRD42023426555). Results: A total of 244 records were identified through the search process, of which 7 studies met the inclusion criteria. The studies involved 117 (115 men) physically and sexually active subjects including 29 elite top athletes. When comparing the sexual activity condition/group (SexG) to abstinence (AbsG), significant (p < 0.05) decreases were observed in average speed and maximum strength. In contrast, non-significant trends towards improvement (p > 0.05) were observed in exercise capacity, reaction time, and muscular endurance. No significant changes (p > 0.05) were found in physiological and hormonal biomarkers and fatigue perception. However, perceived exertion was significantly higher (p < 0.05) in SexG compared to AbsG. Conclusions: Current evidence does not conclusively support the influence of pre-exercise sexual activity on sports performance, or physiological and hormonal biomarkers. However, it could contribute to increased perception of exercise intensity. Full article

The adoption of wearable sensors for precision training has accelerated in recent years, yet most studies and reviews remain device- or feasibility-centric and lack a field-ready decision framework. This review organizes wearable sensing across four monitoring dimensions—physiological, kinematic, biochemical, and dynamic—and maps them onto three training pillars: physical, technical, and tactical. From the perspectives of athletes and coaches, we operationalize quality control, threshold, and feedback loop to translate measurement into action. We critically appraise key limitations, including signal robustness under high-intensity motion, inter-individual variability and limited model generalizability, cross-device data fusion and latency, battery life and wearability, privacy and data ownership, and limited accessibility beyond elite settings. Looking ahead, we advocate a shift from mere multidimensional measurement to a verifiable, reusable, and deployable precision-training ecosystem that delivers actionable metrics and clear decision support for practitioners. Full article

Objectives: The objective of this study was to separately examine the effects of exercise addiction and the Collagen Type I Alpha 1 Chain (COL1A1) gene rs1800012 G/T polymorphism on injury susceptibility in elite female volleyball players, and to test the hypothesis that the T allele, previously identified as a risk allele, is underrepresented in volleyball players compared to the general population. Methods: The study included 50 professional Turkish female volleyball players with documented injury data, along with 557 Turkish controls, 53 professional Russian volleyball players, and 810 Russian controls. The Turkish participants were enrolled in a case–control study, an injury study, and an exercise addiction study, whereas the Russian participants were enrolled solely in a case–control study. Results: Injured players had significantly higher scores in the Delay of Individual Social Needs and Conflict subscale of the Exercise Addiction Scale compared to their uninjured counterparts (p = 0.036). The random-effects meta-analysis revealed a significantly lower frequency of the COL1A1 T allele in volleyball players compared to controls (pooled OR = 0.63, 95% CI: 0.41–0.96, p = 0.031). Athletes who had not undergone surgery had a significantly higher frequency of the G allele compared to controls (89.2% vs. 78.7%, p = 0.037; OR = 2.23, 95% CI: 1.1–4.7). Among injured athletes, those carrying the GT genotype were significantly more likely to experience prolonged recovery (≥3 months) (57.1%) compared to those with the GG genotype (28.0%, p = 0.017). Conclusions: Exercise addiction and the COL1A1 rs1800012 T allele were associated with a higher incidence of injury in female volleyball players. The T allele was also associated with a longer recovery time following injury. Full article

Background/Objectives: There is a sudden and noticeably increasing focus on naturally found antiplatelet inhibitors that humans can use habitually. Given that athletes receive annual training with periods of recovery that are not always suitably adapted to the workload, this study aimed to explore the association between dietary fat intakes and the indices of blood profiles, concentrating on platelet variables in a sample of high-performance athletes. Methods: The sample encompassed 19.8 ± 2.2-year-old Lithuanian high-performance athletes (n = 82). The assessment of the nutritional profile of study participants was performed using a 3-day food record approach. In laboratory settings, the hematology profile of athletes was assessed via the Nihon Khoden automated hematology analyzer. Results: The recorded mean consumption of energy, carbohydrates, protein, and fat in elite athletes was 49 kcal/kg/day, 5.4 g/kg/day, 1.6 g/kg/day, and 40.3% of energy intake (EI), respectively. The study highlighted the excessive consumption of saturated fatty acids (FA) (13.4–14.3% of EI) and dietary cholesterol (698–982 mg/day). Also, considering that the ideal human omega-6 to omega-3 FA ratio is commonly deemed to be between 1:1 and 4:1, an athlete’s ‘Western diet’ was heavily skewed with a ratio fluctuating from 18.9:1 to 19:4 in favor of omega-6 FA. Furthermore, the study found that the outcomes related to slightly higher levels of blood platelet counts and plateletcrit, however, being within normal limits, were associated with a higher intake of omega-6 FA (adjusted odds ratio (AOR) 9.5, 95% confidence interval (CI) 1.2; 9.9, p = 0.029). A higher platelet-to-hemoglobin ratio as a novel indirect blood-based biomarker pronouncing the potential inflammatory processes in the body revealed the reverse relationship of higher intake levels of dietary omega-3 FA (AOR 6.7, 95% CI 1.3; 12.2, p = 0.029), omega-6 FA (AOR 6.2, 95% CI 2.7; 11.5, p = 0.009), and saturated FA (AOR 8.5, 95% CI 1.5; 9.1, p = 0.020) among elite athletes. Conclusions: The prospect of personalized nutrition targeted at the professional athletes’ segment may provide an innovative opportunity to increase athletes’ capacity to manage the platelet function via diet while stressing the importance of further empirical experimental research in this dynamic and vital biomedical field. Full article

Background: Change-of-direction (CoD) ability is critical in karate, yet sport-specific assessment tools are limited. This study aimed to evaluate the reliability and validity of a newly developed karate-specific CoD test for male and female athletes and to examine its relationships with other motor performance measures. Methods: Thirty-six experienced karatekas (20 men: age 20.8 ± 1.8 years, height 1.79 ± 0.05 m, body mass 73.1 ± 10.6 kg; 16 women: age 21.2 ± 1.7 years, height 1.67 ± 0.04 m, body mass 63.5 ± 8.9 kg), all national squad members, participated. Athletes performed the karate CoD test twice to assess test–retest reliability, and completed additional CoD tests (Y CoD, T-half), linear sprint tests, standing long jump, and Y-balance tests to evaluate criterion validity and associations with other motor abilities. Results: The karate CoD test demonstrated excellent reliability (ICC = 0.996), with similar consistency in men and women. Criterion validity was supported by a meaningful correlation with the Y CoD test, but not with the T-half test. Associations with linear sprinting and lower-limb power (standing long jump) were weak or inconsistent, indicating that karate-specific CoD performance is distinct from general physical capacities. Conclusions: The karate CoD test shows good reliability and validity for assessing planned change-of-direction ability in elite karate athletes. Its use should be limited to pre-planned movements and complemented with other tests (e.g., reactive agility, sprinting, jumping, strength) for a fuller performance assessment. Full article

Background: Only a limited number of studies have examined the effects of short-term, strength–speed-oriented velocity-based training (VBT) on lower-body power in female junior volleyball players and elite female artistic gymnasts. The present study aimed to investigate the impact of a four-week VBT intervention on jump performance and force–velocity characteristics in these athletes. Methods: Seven junior female volleyball players (age: 17.4 ± 0.9 years; height: 179.4 ± 6.5 cm; weight: 74.01 ± 3.5 kg) (top-league team members), and seven elite female artistic gymnasts (age: 17.6 ± 2.9 years; height: 159.6 ± 7.2 cm; weight: 59.3 ± 6.3 kg) (National Team members) completed two weekly training sessions for four weeks, each consisting of four sets of six repetitions of parallel back squats (PBSs) and hip thrusts (HTs). Training loads were regulated using barbell velocity targets (PBSs: 0.46–0.72 m/s; HTs: 0.36–0.60 m/s). Pre- and post-intervention assessments included loaded (15–60% body mass) and unloaded squat jumps (SJs) and countermovement jumps (CMJs) to determine peak power output, jump height, and force–velocity profiles. Results: Volleyball players showed significant improvements in peak power predominantly during loaded SJs (SJ45%: +5.5%, p < 0.01; SJ60%: +5.7%, p < 0.05), whereas gymnasts exhibited greater gains in loaded CMJs (CMJ60%: +7.7%, p < 0.01). In contrast, unloaded SJ and CMJ performances remained largely unchanged for all athletes. Both groups demonstrated a significantly steeper post-intervention force–velocity profile (p < 0.001), indicating an enhanced capacity to produce force at lower movement velocities under external loading. Conclusions: Strength–speed-oriented VBT was effective in improving power production under loaded conditions but had limited transfer to unloaded jump performance. These findings highlight the necessity of subsequent training blocks emphasizing high-velocity, sport-specific movements to optimize explosive performance. Future studies should further investigate low-velocity-loss training protocols as a potential means of enhancing unloaded jump outcomes. Full article

Background: This study was performed to investigate the influence mechanisms of competitive level and gender on the interval speed characteristics and pacing strategies of 100 m backstroke athletes. Methods: A total of 48 high-level male and female 100 m backstroke athletes were selected from the final rounds of three major competitions between 2023 and 2024. The athletes’ interval speed data across 16 segments were recorded and analyzed using the Dartfish software. Two-way ANOVA and Pearson correlation analysis were used to examine the correlation between interval speeds and total performance, as well as the pacing strategy characteristics of elite backstroke swimmers. Results: For male athletes, significant negative correlations were found between interval speeds and total performance in the 0–25 m, 40–45 m, 65–85 m, and 90–100 m segments (p < 0.05). For female athletes, significant negative correlations were observed in the 0–35 m, 40–45 m, 50–85 m, and 90–95 m segments (p < 0.05). The main effect of competitive level indicated that elite athletes achieved significantly higher interval speeds than sub-elite athletes in several race segments. Moreover, male athletes demonstrated significantly greater standardized speeds across multiple intervals (p < 0.05). Conclusion: (1) Elite athletes demonstrated significantly faster speeds in starts, turns, and the final 50 m sprint compared to sub-elite athletes, indicating higher power output during starts and turns during the race. (2) Male athletes generally exhibited a maximal-effort pacing strategy, as reflected in lower coefficients of variation in speed, while female athletes demonstrated a more balanced pacing pattern. 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

Fencing demands a unique blend of endurance, explosive power, and asymmetric neuromuscular control. This study compared physiological profiles of elite (top 25 nationally ranked, n = 16) and non-elite (positions 26–102, n = 33) Polish male fencers using the Fencing Endurance Test (FET), countermovement jump (CMJ), 5-m sprint, body composition, and heart rate (HR) metrics. FET duration, CMJ-derived explosive power (flight time, reactive strength index), and relative lean mass were also assessed in relation to competitive experience. Quantile regression (age & BMI-adjusted), ROC analysis, and Spearman correlations evaluated group differences. Elite fencers demonstrated superior FET duration (median difference: +1.84 min, p < 0.0001), CMJ performance (e.g., 10.4 W/kg higher peak power, p = 0.014), and relative lean mass (+7.7%, p < 0.001), despite comparable 5-m sprint times. Elite athletes also showed more efficient HR recovery (HRR1) and lower pre-FET resting HR (p < 0.05). Competitive experience correlated strongly with FET endurance (rho = 0.62), CMJ power (rho = 0.42), and lean mass (rho = 0.55). ROC analysis identified FET ≥ 14.3 min, CMJ flight time ≥0.581 s, and ≥10 years of experience as optimal discriminators of elite status (AUCs 0.86–0.90). These findings confirm that elite performance is characterized by superior sport-specific endurance and explosive power, independent of age/BMI. The FET and CMJ emerge as practical tools for monitoring training progress, with identified thresholds serving as benchmarks for elite preparation. Training programs should prioritize individualized development of these traits, acknowledging inter-athlete variability in physiological strengths. Future research should explore sport-specific acceleration metrics and extended FET protocols for elite athletes. Full article

Background/Objectives: This study examined the effects of a six-week eccentric–reactive training program on neuromechanical markers of lateral explosiveness, asymmetry, and stretch-shortening cycle (SSC) efficiency in elite male youth table tennis players. Fourteen national-level athletes (mean age = 16.6 years) were assigned to either an experimental group (EG, n = 7) or a control group (CG, n = 7). EG performed flywheel squats and lateral depth jumps three times per week, while CG maintained regular training. Pre- and post-intervention testing included countermovement jumps, reactive strength index (RSI_DJ), force asymmetry, time-to-stabilization, SSC efficiency, and energy transfer ratio (ETR), measured via force plates, EMG, and inertial sensors. Methods: Multi-dimensional statistical analysis revealed coordinated improvements in explosive power and movement efficiency following eccentric training that were not visible when examining individual measures separately. Athletes in the training group showed enhanced neuromechanical control and developed more efficient movement patterns compared to controls. The analysis successfully identified distinct performance profiles and demonstrated that the training program improved explosive characteristics in elite table tennis players. Results: Univariate ANOVAs showed no significant Group × Time effects for RSI_DJ, ETR, or SSC_Eff, although RSI_DJ displayed a moderate effect size in EG (d = 0.47, 95% CI [0.12, 0.82], p = 0.043). In contrast, MANOVA confirmed a significant multivariate Group × Time interaction (p = 0.013), demonstrating integrated neuromechanical adaptations. Regression analysis indicated lower baseline CMJ and RSI_DJ predicted greater RSI improvements. Conclusions: In conclusion, eccentric–reactive training promoted multidimensional neuromechanical adaptations in elite racket sport athletes, supporting the use of integrated monitoring and targeted eccentric loading to enhance lateral explosiveness and efficiency. Full article