Search Results (880)

Background/Objective: Caffeine has demonstrated ergogenic effects across various doses (2–9 mg·kg⁻¹). However, aerobic responses to caffeine vary substantially, with time-trial performance ranging from ~–3% to +16%. Given that higher doses may increase adverse effects without clear additional benefits, this review examined the effects of low (≤3 mg·kg⁻¹), moderate (4–6 mg·kg⁻¹), and high (>6 mg·kg⁻¹) caffeine doses on time-trial performance. Methods: A systematic review and meta-analysis of randomized, placebo-controlled trials was conducted using PubMed, Embase, and Virtual Health Library databases. Eligible studies included healthy adults (18–59 years) acutely ingesting oral anhydrous caffeine before aerobic time-trial tests, with performance outcomes measured exclusively as time-to-completion variables. Data were pooled using standardized mean differences (SMDs) and 95% confidence intervals under random-effects models, and risk of bias was assessed using the Cochrane Risk of Bias tool. Results: Forty-eight studies (689 participants) met the inclusion criteria. Both low and moderate caffeine doses significantly reduced time-trial completion time relative to placebo. Low doses produced a standardized mean difference of −0.27 (95% CI: −0.44 to −0.11; p = 0.001), whereas moderate doses resulted in an SMD of −0.52 (95% CI: −0.77 to −0.28; p < 0.0001). No studies evaluating high caffeine doses (>6 mg·kg⁻¹) and reporting time-to-completion outcomes met the inclusion criteria. Subgroup analyses demonstrated similar ergogenic effects in both trained and highly trained individuals consuming moderate caffeine doses. Conclusions: This is the first meta-analysis specifically focused on aerobic time-trial performance to suggest that pre-exercise ingestion of low caffeine doses (1.3–3 mg·kg⁻¹) may enhance endurance performance by reducing time-trial completion time. Notably, the use of moderate caffeine doses (4–6 mg·kg⁻¹) appears to produce a more consistent ergogenic effect. Full article

Objective: Sodium–glucose cotransporter 2 (SGLT2) inhibitors, particularly empagliflozin, have attracted considerable attention because of their cardiovascular benefits beyond glycemic control. However, the interaction between empagliflozin and exercise-induced physiological cardiac remodeling in healthy individuals remains insufficiently understood. This study investigated the effects of different swimming exercise protocols (anaerobic, aerobic, and endurance), administered alone or in combination with empagliflozin, on cardiac structure and electrophysiology. Methods: Thirty-six male Sprague–Dawley rats were randomly assigned to six groups (n = 6 per group): anaerobic (An), aerobic (Ae), endurance (En), and the corresponding exercise groups combined with empagliflozin (An + Empa, Ae + Empa, and En + Empa). Empagliflozin was administered by oral gavage at a dose of 15 mg/kg/day for 30 days. Transthoracic echocardiography, electrocardiography (ECG), and gastrocnemius electromyography were performed at baseline and at the end of the study to assess cardiac remodeling, heart rate, and neuromuscular function. The study was carried out over a 30-day intervention period following ethics committee approval on 24 July 2024. Results: No significant between-group differences were observed in echocardiographic parameters before the intervention. On day 30, significant differences were identified among the groups in interventricular septal thickness at end-diastole (IVSd) (p = 0.027), left ventricular internal diameter at end-diastole (LVIDd) (p = 0.009), and end-diastolic volume (EDV) (p = 0.014). Bonferroni-corrected post hoc analysis showed that the aerobic exercise plus empagliflozin group differed from several exercise-only groups, particularly in parameters related to ventricular size and filling volume, including LVIDd and EDV (p < 0.008). On day 30, electrocardiographic repolarization-related parameters, including QT, QTc, JT, and Tpeak–Tend intervals, also differed significantly among the groups (all p < 0.05). In post hoc analysis, the anaerobic exercise group showed significant differences in QT and JT intervals compared with the aerobic and endurance groups (p < 0.008). In the anaerobic protocol, empagliflozin was associated with a reduction in heart rate compared with the corresponding control group (p = 0.019). No significant between-group differences were observed in EMG findings. Conclusions: Different exercise protocols induce distinct patterns of adaptation in cardiac structure and electrophysiology in healthy rats. Empagliflozin (15 mg/kg/day) may modulate exercise-induced cardiac responses in a modality-dependent manner; the most pronounced echocardiographic effects were observed in the aerobic protocol, whereas the effect on heart rate was observed in the anaerobic protocol. These findings highlight the need for longer-term and mechanistic studies to further clarify the effects of SGLT2 inhibitors on physiological cardiac remodeling. Full article

Prolonged endurance exercise performed in hot ambient conditions is associated with an increased prevalence of performance-limiting gastrointestinal perturbations. This study aimed to examine the associations between biomarkers of exercise-induced gastrointestinal syndrome (EIGS) and exercise-associated gastrointestinal symptoms (Ex-GIS) under exertional heat stress (EHS). Fifty-six non-heat acclimated endurance-trained individuals completed 2 h of steady state running at 60% maximal oxygen uptake ($\stackrel{.}{V}{\mathrm{O}}_{2\max }$) with an ambient temperature of 35.1 °C and relative humidity 29.4%. Venous blood samples were collected immediately pre- and post-exercise to quantify plasma concentrations of gastrointestinal epithelial injury and systemic inflammatory biomarkers, whilst gastrointestinal symptoms were recorded at regular intervals throughout the exercise protocol. Spearman’s rank correlation identified moderately significant relationships between interleukin-6 (IL-6) with defecation-bloody stools; interleukin-10 (IL-10) with upper abdominal pain; and IL-10, IL-1 receptor antagonist (IL-1ra), and systemic inflammatory response (SIR) profile with flatulence. Simple linear regression demonstrated that IL-6 explained a small but significant proportion of the variance defecation-bloody stool (adjusted R² = 0.094, p = 0.024); whilst variance in flatulence was independently explained by IL-10 (adjusted R² = 0.138, p = 0.025), IL-1ra (adjusted R² = 0.122, p = 0.033), and SIR-Profile (adjusted R² = 0.112, p = 0.040). These findings suggest that Ex-GIS development is multifactorial in aetiology and pathophysiology, and that symptom reporting alone likely underestimates perturbations to the gastrointestinal tract during EHS. Full article

Breast cancer is the most prevalent malignancy among women. The disease and its treatments often lead to physical and psychosocial impairments, compromising quality of life. While exercise and music-based interventions have individually demonstrated benefits on these symptoms, the advantages of their combination remain unexplored. This study evaluates whether a concurrent exercise program, including aerobic and strength training performed while listening to music based on individual preferences, is more effective than the same exercise program without music in improving self-esteem, body image, cancer-related fatigue, physical function (upper and lower limb strength and cardiorespiratory endurance), quality of life, sleep quality, and intolerance of uncertainty in female breast cancer survivors. A single-blind, two-arm, parallel-group, randomized controlled trial will be conducted including 42 women who completed primary treatment for stage 0–III breast cancer at least six months before enrollment. Participants will be randomly assigned to a music-listening concurrent exercise training group (MLTG), or a no music exercise training group (NMLTG), both performing the same 8-week exercise program. The primary outcome will be self-esteem (Rosenberg Self-Esteem Scale). Secondary outcomes include body image, fatigue, upper and lower limb strength, cardiovascular endurance, quality of life, sleep quality, and intolerance of uncertainty. Measurements will be collected using validated and reliable questionnaires and standardized functional tests at baseline, post-intervention, and at 6 months. Data will be analyzed under the intention-to-treat principle. Music listening, particularly when based on individual preferences and synchronized with movement, may enhance mood and exercise performance while modulating reward-related neural pathways. This trial will provide new evidence on a feasible and low-cost strategy to enhance supportive care and physical and psychosocial outcomes in breast cancer survivors. ClinicalTrials.gov (NCT07045961). Ethics Committee code: 2025-0855. Full article

Objective: The purpose of this exploratory study was to examine mean differences, reliability, and agreement between CP and W′ derived from a 3MAT performed after an ICT and values obtained during a standalone 3MAT performed on a separate day. Methods: Ten recreationally trained cyclists and triathletes completed four laboratory visits, including an ICT followed by a 3MAT after 30 min of recovery (same-day condition) and a standalone 3MAT performed on a separate day. CP and W′ were derived from both conditions and compared using paired t-tests and Bland–Altman agreement methods. Results: No systematic differences, but limited individual-level agreement were observed between same-day and separate-day conditions for CP (mean difference: 1.72 ± 36.5 W) or W′ (mean difference: 0.99 ± 5.9 kJ), with trivial to small effect sizes. Peak VO₂ values were also not significantly different across testing conditions (p = 0.483). However, Bland–Altman analysis revealed wide limits of agreement for both CP (−69.8 to 73.3 W) and W′ (−10.7 to 12.7 kJ), indicating substantial variability at the individual level. Conclusions: Although same-day testing does not introduce systematic bias in CP or W′ estimation, the wide limits of agreement suggest that these protocols are not interchangeable for individual monitoring. Same-day testing may be appropriate for group-level assessments but should be used with caution when applied to individual athlete monitoring. Full article

Background: New Zealand blackcurrant (NZBC) is an anthocyanin-rich supplement with reported ergogenic effects in endurance exercise; however, its effects in resistance-trained adults remain largely unexplored. Objective: This study aimed to examine whether seven days of low- or high-dose NZBC supplementation improves resistance exercise performance, anaerobic capacity, and cognitive function in resistance-trained adults. Methods: Twenty resistance-trained adults completed a randomized, double-blind, placebo-controlled crossover trial with four conditions: no-capsule control (CON), placebo (PL), low-dose blackcurrant (LDBC; 250 mg·day⁻¹), and high-dose blackcurrant (HDBC; 600 mg·day⁻¹), each for seven days. Outcomes included bench press and leg press 1RM, total lifting volume, Tendo-derived bench press power, 30 s Wingate performance, Stroop Color–Word Test scores, readiness, perceived exertion, hemodynamic responses, and adverse events. Results: LDBC and HDBC increased bench press 1RM versus CON and PL, with increases versus CON of +3.33 kg (ES = 0.72; p = 0.005) and +2.34 kg (ES = 0.49; p = 0.041), respectively. Leg press 1RM was higher in PL, LDBC, and HDBC versus CON, with the largest effects observed for LDBC (+37.2 kg, ES = 1.33; p < 0.001) and HDBC (+25.8 kg, ES = 1.11; p < 0.001). Leg press total lifting volume was substantially higher with LDBC (+2627 kg, ES = 1.56; p < 0.001) and HDBC (+1025 kg, ES = 0.74; p = 0.004) versus CON. Bench press volume showed no significant overall treatment effect (p > 0.05). For Tendo-derived power, HDBC exceeded PL for peak (+79.5 W; p = 0.006) and mean power (+46.2 W; p = 0.026). Wingate outcomes did not differ across conditions (all p > 0.05). LDBC exceeded PL on Stroop Color, Color–Word, and total scores (all p < 0.05); HDBC exceeded PL on Color–Word only. Hemodynamic responses and adverse events were comparable across all conditions. Conclusions: Short-term NZBC supplementation improved selected resistance-exercise and cognitive outcomes, with the strongest evidence observed for outcomes that exceeded both CON and PL. The PL response relative to CON suggests that non-specific capsule, expectancy, repeated testing, or period effects may have contributed to some of the lower-body improvements; therefore, placebo-controlled contrasts should be emphasized when interpreting NZBC-specific efficacy. Wingate performance was unaffected, and both doses were well tolerated over the short-term supplementation period. Full article

Background/Objectives: Evidence for herbal ergogenic aids remains uncertain, and ashwagandha trials span heterogeneous performance domains. This review evaluated oral Withania somnifera supplementation on exercise performance and explored participant-, outcome-, formulation-, and supplementation-related moderators. Methods: PubMed, Web of Science, Cochrane Library, Embase, and SPORTDiscus-EBSCO were searched from inception to 1 April 2026. Eligible randomized controlled trials compared oral ashwagandha with placebo or control conditions and reported objective exercise-performance outcomes. Dependent effects were synthesized using restricted-maximum-likelihood three-level random-effects models; 95% prediction intervals, GRADE certainty ratings, subgroup analyses, and dose/duration meta-regressions were reported. Results: Thirteen trials involving 599 participants contributed 79 effect sizes. Samples were mainly young adults or athletes; reported ages included one 18–40-year trial and one late-adolescent athlete cohort aged 17.4 ± 1.7 years. Trial-level sex composition was four male-only, one female-only, three mixed-sex, and five incompletely reported cohorts. Ashwagandha improved overall exercise performance on average (Hedges’ g = 0.47, 95% CI [0.25, 0.69], p < 0.001; I² = 60%; 95% prediction interval [−0.40, 1.33]), but the prediction interval crossed zero. Exercise type was the clearest moderator (P_between = 0.006): evidence was most consistent for aerobic endurance (g = 0.54, 95% CI [0.22, 0.85], p = 0.002), whereas strength effects were positive but uncertain and power or muscular endurance evidence remained sparse. Dose analyses were hypothesis-generating; 500–600 mg/day was the most evidence-supported extract-dose range. Conclusions: Oral ashwagandha may improve selected exercise-performance outcomes, particularly aerobic endurance, but benefits are not uniform across contexts. Future trials should be preregistered, adequately powered, double-blind, formulation-standardized, sex-stratified, and include rigorous blinding checks, mechanistic endpoints, adverse-event monitoring, and sport-specific performance tests. Full article

Thai rice varieties, including Hom Pathum (Pathumthani fragrant rice) and Tubtim Chumphae rice, contain bioactive compounds with potential antioxidant properties. In this study, their acute effects on glycemic response, cardiac autonomic function, endurance performance, and oxidative stress were investigated in healthy adults. In a randomized crossover design, two independent cohorts of healthy adults were enrolled. A total of 50 participants completed two separate experiments (n = 25 per experiment), in which they consumed 140 g of control jelly, Hom Pathum rice jelly, and Tubtim Chumphae rice jelly in a randomized order on separate occasions. In Experiment 1, blood glucose (BG) was measured at baseline and every 30 min for 120 min, while insulin concentrations were assessed at baseline and after 120 min. In Experiment 2, participants performed treadmill exercise at 60% VO₂peak to volitional exhaustion, and exercise-induced oxidative stress was evaluated following exercise. Postprandial BG responses differed significantly among interventions. At 30 min, BG concentrations were lower following Hom Pathum and Tubtim Chumphae rice jellies compared with the control jelly (p < 0.001 and p = 0.002, respectively), and these reductions were maintained between 60 and 120 min, with Tubtim Chumphae rice generally demonstrating greater glycemic attenuation (p < 0.05). The BG area under the curve was significantly lower following both rice jellies than following the control jelly (p ≤ 0.005). No significant differences were observed in insulin concentrations, HOMA indices, heart rate variability, or blood pressure among interventions. Both rice jellies improved endurance performance compared with the control condition (p < 0.05), whereas post-exercise malondialdehyde concentrations were significantly reduced only following Tubtim Chumphae rice consumption (p = 0.049). These findings suggest that acute consumption of Thai rice-based jellies, particularly Tubtim Chumphae rice jelly, may attenuate postprandial glycemic responses and enhance endurance performance, with Tubtim Chumphae rice additionally demonstrating potential to reduce exercise-induced oxidative stress. However, these findings reflect short-term physiological responses in healthy adults and should be interpreted cautiously pending further mechanistic and long-term investigations. Full article

Background/Objectives: The performance of musical wind instruments imposes significant neuromuscular and biomechanical demands on the stomatognathic system. Depending on the mouthpiece type, wind instruments are divided into four classes, which may have distinct impacts on the instrumentalists’ quality of life. This study aimed to evaluate musicians’ self-perception regarding the impact caused by wind instruments practice on oral health-related quality of life (OHRQoL), jaw functional limitations, and chronic pain. Methods: A cross-sectional observational study was conducted among 71 wind instrumentalists (52% female; mean age 24.16 years; mean practice history of 12.8 years) using the Oral Health Impact Profile-14 (OHIP-14), the Jaw Functional Limitation Scale (JFLS), and the Graded Chronic Pain Scale (GCPS). Data were analyzed using the Statistical Package for the Social Sciences (SPSS), with statistical significance set at p < 0.05. Results: Musicians in Class 1 (clarinet/saxophone) and Class 4 (transverse flute) reported the worst OHRQoL and chronic pain scores. Orofacial pain in the jaw, temple, or ear was reported by 66% of the participants. Joint sounds (36%) and closed jaw locking (26%) showed a significant association with female gender; however, this relationship is highly confounded by the strong female clustering in Class 4 (85%) and Class 1 (63%). Behavioral and practice habits significantly influenced outcomes: higher daily study duration (mean 170.31 min), the absence of relaxation exercises, and a willingness to endure physical discomfort for technical progress (73.2%) were significantly associated with lower quality of life and greater functional limitations (mastication and mobility). Performance anxiety, warm-up exercises, and practice intensity peaks showed no significant relationships with OHRQoL. Conclusions: Wind instrument practice severely impacts jaw function and musicians’ well-being. These findings underscore the need for interdisciplinary preventive interventions, including targeted ergonomic training, structured rest protocols, and jaw relaxation exercises, alongside oral public health initiatives that recognize wind musicians as an occupationally vulnerable group. Full article

Background/Objectives: Short-term low-fermentable oligo-, di-, and monosaccharide and polyol (FODMAP) diets can reduce exercise-associated gastrointestinal symptoms (Ex-GIS); however, their effects on the gut microbiome, short-chain fatty acids (SCFAs), and gastrointestinal biomarkers remain unclear. This study explored the effects of 48 h dietary FODMAP manipulation within a high-carbohydrate diet on faecal bacterial and SCFA profiles, and their relationships with exercise-induced gastrointestinal syndrome (EIGS) biomarkers, Ex-GIS, and performance. Methods: Twelve endurance athletes experiencing Ex-GIS were randomly allocated to a 48 h high-carbohydrate (mean ± SD: 12.1 ± 1.8 g∙d⁻¹)–high-FODMAP (HC-HFOD) (54.8 ± 10.5 g∙d⁻¹) and a 48 h high-carbohydrate–low-FODMAP (HC-LFOD) (3.0 ± 0.2 g∙d⁻¹) diet before 2 h of running at 60% $\dot{V}$O_2max, followed by a 1 h distance test (22.9 ± 1.2 °C, 46 ± 8% RH). Baseline faecal samples were collected before exercise trials to determine faecal bacterial and SCFA profiles. Blood samples were collected pre- and post-exercise to determine plasma I-FABP, sCD14, and CRP concentrations. Ex-GIS were recorded every 15 min throughout exercise. Results: Faecal bacterial α-diversity and relative abundance (RA%) at the phylum level were unchanged following both diets, while several family- and genus-level taxa RA% values were changed (p < 0.05), with greater shifts after HC-HFOD. HC-HFOD significantly increased faecal total-SCFA (p = 0.004), acetic (p = 0.002), and butyric (p = 0.028) acid concentrations. Strong positive and negative correlations between bacterial RA% and EIGS biomarkers and Ex-GIS were observed. Strong negative correlations with bacterial RA% and performance were observed. Conclusions: The 48 h HC-HFOD resulted in greater increases in bacterial RA% and SCFA concentrations compared with baseline. Bacterial RA% correlated bidirectionally with EIGS biomarkers and Ex-GIS, alongside strong negative associations with performance. Full article

Background: Citrulline malate (CM) is commonly used as an ergogenic supplement, but its effects on exercise performance and perceived exertion remain uncertain. This systematic review and meta-analysis evaluated the effects of CM supplementation, with attention paid to differences between acute and chronic protocols. Methods: Six databases were searched from inception to August 2025. Randomized controlled trials examining CM supplementation on exercise performance and/or perceived exertion were included. Hedges’ g was synthesized using three-level random-effects models to account for dependent effect sizes. Subgroup and moderator analyses explored supplementation protocol, exercise modality, sex, training status, dosage, and ingestion timing. Risk of bias, small-study effects, sensitivity analyses, and GRADE certainty were assessed. Results: Thirty randomized controlled trials contributed 138 effect sizes from 644 participants. CM supplementation was associated with a small improvement in overall exercise performance (g = 0.16, p = 0.01); however, prediction intervals were wide and statistical power was limited. The pooled effect on perceived exertion was not statistically significant. Current evidence appeared more stable for acute than chronic supplementation, although the protocol subgroup difference remained uncertain. Among acute studies, exploratory subgroup analyses suggested possible benefits for aerobic endurance and short anaerobic tasks, but these findings were not robust across sensitivity analyses. No significant between-subgroup differences were found for sex, training status, dosage, or ingestion timing. GRADE certainty ranged from low to very low. Conclusions: CM supplementation may be associated with small, context-dependent improvements in exercise performance, but current evidence remains limited and uncertain. Reliable dosing, timing, and target populations have not been established. Larger trials with verified supplement composition and standardized protocols are needed. Full article

This study investigated whether baseline sleep quality influences the effects of a 12-week multicomponent exercise program on sleep quality and physical function in community-dwelling older adults. Twenty-five older adults were classified according to baseline sleep quality using the Pittsburgh Sleep Quality Index into a Good Sleep (GS, n = 8) group and a Poor Sleep (PS, n = 17) group. The exercise program was performed three times per week for 12 weeks, with each 60 min session consisting of warm-up, multicomponent exercise, and cool-down. Outcome measures included sleep quality (PSQI), physical performance assessed by the Short Physical Performance Battery, and health-related fitness tests. A significant group × time interaction was observed for PSQI total score (p = 0.035). The PS group showed a significant reduction in PSQI score (−1.71 points, p < 0.01), indicating improved sleep quality, with favorable changes in subjective sleep quality, sleep latency, use of sleeping medication, and daytime dysfunction. However, the PS group demonstrated significant improvements in gait speed, grip strength, and 2 min walking performance. A significant group × time interaction was observed for the 30 s chair stand test (p = 0.011), with the GS group showing greater improvements in lower-extremity muscular endurance. Baseline sleep quality was associated with the pattern of adaptation to multicomponent exercise. Older adults with poor sleep quality experienced meaningful improvements in sleep, whereas those with good sleep quality showed greater gains in muscular endurance. These findings support the inclusion of sleep assessment when designing individualized exercise interventions for older adults. Full article

Background/Objectives: Canine athletes have a higher energy requirement and are more susceptible to nutrient depletion, electrolyte imbalance, and metabolic stress than sedentary pets. The objective of this study was to characterize the plasma metabolome of American Foxhound dogs following a bout of unstructured exercise. Methods: Thirty-nine adult American Foxhound dogs (32 intact males, 7 spayed females; age: 6.2 ± 3.1 yr; BW: 36.3 ± 5.3 kg) were allotted to a standard performance diet (CTRL) or NUTRO^® Natural Choice^® Adult High Endurance Formula (TEST). After 80 d in the study, blood samples were collected prior to (0 h), and 3 h and 25 h post-exercise (average: 17.7 km run over 2–3 h). Plasma samples of the 10 top performers of each treatment group were analyzed for untargeted metabolite profiling. Results: Of the 566 named metabolites identified, >200 and >185 metabolites were impacted (p < 0.05) by exercise and diet, respectively. Principal component analysis indicated distinct clustering by diet. Random forest analysis highlighted several metabolites having a high degree of predictive accuracy based on diet and exercise, with most related to amino acid, lipid, xenobiotic, and cofactor and vitamin metabolism. Relating to exercise, glycolytic end-products and citric acid cycle intermediates were increased at 3 h post-exercise. Similarly, tocopherols and omega-3 polyunsaturated fatty acids were higher in dogs fed TEST than those fed CTRL during recovery, indicating a lower oxidative stress and anti-inflammatory response. Conclusions: Overall, the data suggest a protective effect (lower susceptibility to oxidative stress and muscle fatigue) of feeding a nutrient-fortified diet for dogs undergoing unstructured exercise. Full article

Essential tremor (ET) is among the most prevalent movement disorders, causing significant impairment in manual dexterity and daily functioning. Although ET affects individuals across the lifespan, exercise intervention research has focused almost exclusively on older adults, leaving young adults, for whom early intervention may prevent long-term neuromuscular deterioration, critically underrepresented. Furthermore, the effects of strength–endurance oriented exercise combined with task-specific motor activities remain insufficiently explored in any ET population. This quasi-experimental pre-test–post-test study investigated the effects of a 6-week progressive strength–endurance and task-specific exercise program on tremor severity, manual dexterity, and upper extremity functional performance in young adult males with ET (n = 18; mean age: 22.6 ± 4.1 years). The 24-session intervention (four sessions/week) combined proximal upper extremity strength–endurance exercises with seven ADL-specific fine motor tasks. Tremor severity was assessed using the Fahn–Tolosa–Marin Tremor Rating Scale (FTMTRS), manual dexterity using the Nine-Hole Peg Test (NHPT), and upper extremity stability using the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST). The Wilcoxon signed-rank test was used for within-group comparisons, with rank biserial correlation (r) and Cohen’s d reported as effect size indices. Significant pre-to-post improvements were observed across nearly all outcome measures, with medium-to-large effect sizes. Spiral drawing performance improved significantly in five of six conditions (r = 0.47–0.62), with the exception of the Spiral left–B task (p = 0.083). Postural tremor, NHPT (both hands), and CKCUEST also showed significant improvements (r = 0.47–0.73). A composite tremor score, integrating all tremor sub-scores, demonstrated a 14.1% overall reduction (p = 0.001, r = 0.83), providing strong evidence of program-wide effectiveness. Session adherence was 95.8%. To our knowledge, this is one of the first studies to show that a structured strength–endurance and task-specific exercise program was associated with reductions in tremor severity and improvements in upper extremity function, specifically in young adults with ET. These findings support the clinical utility of exercise as a non-pharmacological intervention in this underserved population and highlight the importance of early, targeted intervention during young adulthood. Full article

Background/Objectives: Athletes are characterized by distinct haemodynamic adaptations of the cardiovascular system, including descending aorta haemodynamics, that could influence the diagnosis of coarctation of the aorta. This study aims to evaluate the normal range for the maximum velocity of blood flow in the descending aorta (Vmax-AoDesc) and the predictors of Vmax-AoDesc in apparently healthy athletes without coarctation of the aorta. Methods: We examined 559 asymptomatic healthy athletes with an age of at least 12 years and a tricuspid aortic valve (420 males, age: 29 ± 14 years). We performed evaluations of athletic history, measurements of brachial systolic and diastolic blood pressure, cardiac and aorta ultrasonography and cardiopulmonary exercise testing. Forty athletes were reassessed after a median follow-up of 3.0 (IQR: 2.1) years. Results: The median Vmax-AoDesc was 1.29 (IQR: 0.28) m/s, with a maximum of 2.00 m/s. The Vmax-AoDesc could be independently predicted by age (β = −0.392, p < 0.001), ratio of systole/diastole (β = 0.095, p = 0.023), brachial systolic blood pressure (β = 0.251, p < 0.001), left ventricular stroke volume (β = 0.256, p < 0.001), ascending aorta diameter (β = −0.230, p < 0.001), aortic arch diameter (β = −0.111, p = 0.044) and descending aorta diameter (β = −0.103, p = 0.017). Age accounted for the greatest variability of Vmax-AoDesc (5.8%). Vmax-AoDesc correlated positively with h/week of endurance exercise training (rho = 0.182, p < 0.001) and oxygen uptake at second ventilatory threshold (rho = 0.299, p = 0.001). Vmax-AoDesc did not change significantly during follow-up (p = 0.438). The median change in Vmax-AoDesc was −0.05 (IQR: 0.18) m/s. However, when Vmax-AoDesc was adjusted for all the above-mentioned independent predictors of Vmax-AoDesc apart from age and systolic blood pressure, there was a reduction in adjusted Vmax-AoDesc during follow-up (p = 0.007), indicating a reduction in Vmax-AoDesc with aging. Conclusions: The upper limit of the normal range for Vmax-AoDesc was 2.00 m/s in athletes without coarctation of the aorta. Young age was the most important predictor for the measurement of high Vmax-AoDesc. There was an upregulation of Vmax-AoDesc in athletes with a greater volume of endurance exercise training. Full article