Search Results (1,631)

Background/Objectives: Urinary incontinence (UI) is a prevalent health condition with a negative impact on quality of life (QoL). Exercise therapy (ET), specifically, pelvic floor muscle training (PFMT), is recommended as a first-line conservative treatment for UI during pregnancy, childbirth, and the postpartum period. This study evaluated the effects of ET on the management of postpartum UI. Methods: A systematic search was conducted to identify clinical trials and randomized controlled trials including women over 18 years with postpartum UI. All included studies used ET as the main intervention. Studies were excluded if UI symptoms were attributable to factors outside the urinary tract or if participants had concomitant pathologies. Results: From 298 records screened, four trials were included. Three trials reported statistically significant improvements in UI outcomes, while findings for pelvic floor function and QoL showed greater heterogeneity. One trial found that supervised PFMT was associated with greater improvements in urinary symptoms (BFLUTS), vaginal pressure (18.96 mmHg (SD: 9.08)), and endurance (11.32 s (SD: 3.17)) compared to unsupervised training. Another trial using electromyographic biofeedback with electrical stimulation reported a continence rate exceeding 70% on the 20 min pad test, with improvements in perceived burden (VAS), symptoms (UDI), and QoL (IIQ). A third trial combining PFMT with infrared physiotherapy showed improvements in pelvic floor function (PFIQ-7, PFDI-20), urodynamic parameters, urine loss, and QoL (GQOLI-74). In the remaining trial, within-group improvements were observed, with no statistically significant between-group differences. Conclusions: ET appears to be beneficial for postpartum UI, with a moderate certainty of evidence. While the greatest benefits are observed with supervised PFMT, the diversity of comparators, and the risk of performance bias limit definitive conclusions regarding its superiority. Given the short-term follow-up, it remains unclear whether the results are influenced by the spontaneous recovery trajectory in the postpartum period and if these effects are sustained in the long term. Full article

Background/Objectives: Pulmonary rehabilitation (PR) is a cornerstone treatment for patients with chronic obstructive pulmonary disease (COPD), yet not all patients achieve clinically meaningful benefits. Evidence on the determinants of short- and long-term responses from real-world settings remains limited. The aim of this study was to quantify response rates to outpatient PR and identify baseline factors associated with achieving minimal clinically important differences (MCIDs) in the walking capacity 6 min walk test [6MWT] or endurance shuttle walk test [ESWT] and patient-reported outcomes (St. George’s Respiratory Questionnaire [SGRQ] or COPD Assessment Test [CAT]) at 10 weeks and 1-year follow-up. Methods: In this retrospective cohort study, data from a PR database (2002–2019) at Copenhagen University Hospital Hvidovre were analysed. Patients with COPD and complete data on one functional outcome ([6MWT] or [ESWT]) and one patient-reported outcome ([SGRQ] or [CAT]) were included. Multinomial regression models assessed associations between baseline variables and response categories. Results: Among 922 patients, 52% achieved clinically meaningful improvement following PR, and 47% of responders maintained these gains at 1 year. Response rates declined over time. Higher baseline symptom burden (CAT and SGRQ) and walking capacity showed mixed associations with short-term response. Younger age was the most consistent predictor of both short- and long-term responses, while higher baseline FEV₁ was associated with sustained improvement at 1 year. Conclusions: Approximately half of patients with COPD benefit clinically from PR, with sustained improvements in nearly half at 1 year, and response is associated with baseline age, symptom burden, and functional capacity, underscoring the need for a more individualised approach to care. Full article

Background/Objectives: Caffeine is a well-established ergogenic aid in many strength- and endurance-based sports, but its efficacy in sport climbing remains underexplored despite the sport’s unique physical demands on grip strength, power, and muscular endurance. Therefore, this study examined the acute impact of a low caffeine dose (3 mg/kg) on climbing-specific performance, including pull-up and grip tests, in intermediate-advanced climbers. Methods: In a triple-blind, randomized, crossover design, thirteen male climbers (age: 28.2 ± 8.6 years) completed two experimental trials (caffeine vs. placebo). Performance was assessed via a pull-up one-repetition maximum (1RM) and power test at various loads, a pull-up muscular endurance test, and grip tests including maximum dead-hang time, maximum dead-hang strength, and rate of force development (RFD). Results: Caffeine did not significantly enhance performance in any measured variable. While a non-significant increase in peak power was observed at 80% 1RM (+8.0%, 95% CI: −0.232 to 0.304, p > 0.05, g = 0.348), effects at other loads and on pull-up endurance were trivial based on effect size (e.g., repetitions: +3.3%, 95% CI: −3.30 to 4.37, p = 0.292, g = 0.061). For grip metrics, caffeine was associated with a modest reduction in endurance time (+7.4%, p = 0.162, g = 0.171) and a slight increase in maximum strength (+2.4%, p = 0.060, g = 0.120). RFD was unaffected (p > 0.169, g < 0.13). Despite the lack of objective improvement, participants reported significantly greater subjective feelings of strength, energy, and alertness with caffeine (p < 0.05). Conclusions: A 3 mg/kg dose of caffeine, while altering psycho-physiological state, did not elicit statistically or practically meaningful ergogenic effects on pull-up or grip performance in climbers. Higher doses or sport-specific performance tests should be investigated in future research. Full article

Understanding the long-term effectiveness of warm-up strategies is essential for enhancing neuromuscular performance in youth soccer players. This study examined the long-term effects of integrating squat exercises into the final phase of the warm-up over nine weeks on sprint, jump, change-of-direction (COD), and aerobic performance in youth soccer players. Twenty-four male U17 players were randomly assigned to either a squat-based warm-up (experimental group [EG]) or a rondo-based warm-up (control group [CG]). The EG trained twice weekly using 3–4 sets of 4–12 repetitions at progressively increasing intensities (50–85% of 1-RM). Performance was assessed pre- and post-intervention using 10 and 30 m sprint, squat jump (SJ), countermovement (CMJ), standing long jump (SLJ), 5-jump (5JT), T-half (COD), and VAMEVAL tests. The EG showed small to large significant gains in sprint (10 m: −2.21%, Cohen’s d [d] = 1; 30 m: −1.6%, d = 0.58), jumping (SJ: +9.29%, d = 1.23; CMJ: +12.08%, d = 1.83; SLJ: +7.14%, d = 0.8; 5JT: +2.33%, d = 0.32), and COD (−1.41%, d = 0.32), while aerobic endurance showed no significant change (p > 0.05). The CG showed no significant improvements (p > 0.05). Overall, integrating brief, progressive squat exercises at the end of warm-ups twice weekly led to chronic improvements in explosive neuromuscular performance, with minimal impact on aerobic endurance. Full article

Background/Objectives: Sarcopenia is an age-related decline in muscle mass and strength, reducing mobility and functional independence and increasing the risk of falls. Non-pharmacological interventions remain the most effective strategies to prevent or delay its progression, with exercise recognized as the primary approach. Virtual reality (VR)-based training has recently emerged as a promising tool to promote physical activity; however, its application among the oldest-old individuals remains underexplored. This is a randomized controlled pilot study to evaluate the effects of VR-based intervention using the game “Beat Saber” on muscle strength and selected physical performance indicators related to sarcopenia risk in older adults. Methods: Thirty-eight residents (mean age: 87.2) of a long-term care facility were randomly assigned to either a VR group or a control group. The VR group participated in 12 supervised VR-based training sessions of 20 min per session, three times per week for four weeks. Handgrip strength, the arm curl test, 30-s chair stand, a 2-min step-in-place test, and an 8-foot up-and-go test were assessed before and after the intervention. Results: Linear mixed-model analyses revealed significant group-by-time interactions for upper- and lower-limb strength (handgrip, arm curl, chair stand; p < 0.05), favoring the VR group. Agility and endurance (8-foot up-and-go, 2-min step-in-place) showed no significant interactions. In the VR group, the 30-s chair stand performance correlated positively with the arm curl and the 2-min step-in-place tests results, while handgrip strength correlated with the arm curl performance. In the control group, the 30-s chair stand test results correlated strongly with the 8-foot up-and-go and 2-min step-in-place tests, but no significant correlations were found for handgrip strength. Conclusions: The findings indicate short-term functional benefits of VR exercise among the oldest-old adults. VR-based training appears to be an effective and well-tolerated method to enhance physical performance in individuals aged 80 and older and may represent a valuable strategy for improving functional performance indicators associated with sarcopenia risk in adults aged 80 years and older. Full article

Background/Objectives: One of the pillars of optimal footballer performance is the gradual preparation of the body for physical exertion in terms of intensity. The aim of this study was to evaluate the impact of a structured warm-up and cool-down program on flexibility, perceived fatigue, and injury prevention in young football players. Methods: Participants were 60 junior football players (U17), with a mean age of 16.5 ± 0.5 years, mean height of 172.5 ± 6.7 cm, and mean body mass of 70.2 ± 6.4 kg. The participants were assigned to experimental (EXP; n = 30) and control (CON; n = 30) groups during 8 mesocycles. A 4-week training stimulus was applied in parallel, consisting of an author-designed exercise routine with a profiled intensity (warm-up and cool-down parts) for the EXP group and standard exercises for the CON group. Selected variables (motor, endurance, injuries) were assessed before, during, and after the intervention. Additionally, the profile of selected correlations was analysed. Statistical analysis was performed using t-tests with a significance level set at p < 0.05. Results: In the EXP group (post-test), a significant improvement in flexibility was observed in the forward trunk flexion test (d = 1.13 cm; p < 0.001; d_c2 = 1.05). Simultaneously, participants reported lower levels of subjective fatigue (RPE = 6.86 ± 0.82 points) compared to the CON group (p = 0.016; d_c = 0.46) and demonstrated fewer injuries during the annual cycle (0.97 ± 0.83 vs. 1.33 ± 0.66; p = 0.026; d_c = 0.48). Both groups showed a strong negative correlation between flexibility and the number of injuries in the annual cycle, training experience and the number of injuries, as well as training experience and RPE (all r_p > −0.50). A strong positive correlation was found between RPE and the number of injuries (r_p > 0.60). Conclusions: The results demonstrate that the structured warm-up and cool-down program significantly improved flexibility, reduced perceived fatigue, and decreased injury occurrence in the participants. Full article

Background and Objectives: Evidence on motor performance in children with autism spectrum disorder (ASD) is scarce and inconsistent. The association of motor impairments with autism severity and intelligence remains insufficiently studied. We aimed to examine motor performance parameters in children with ASD compared with typically developing (TD) peers. Materials and Methods: In this cross-sectional study, a convenience sample of 26 children with ASD, aged 4–10 years, was recruited from specialized centers in KSA, alongside 27 age- and sex-matched TD children. For the ASD group, severity (Childhood Autism Rating Scale, CARS-2) and intelligence quotient (Stanford–Binet Intelligence Scale, SB5) were extracted from medical records. CARS-2 score was utilized to categorize children with ASD into two groups (mild-to-moderate and severe groups). All study children were assessed for gross and fine motor skills using the Movement Assessment Battery for Children-2 (MABC-2), balance, muscle strength, endurance, and flexibility. Results: ASD groups recorded significantly lower scores in all MABC-2 component areas when compared to the TD group (p < 0.001). Aiming and catching percentile was significantly lower in the severe ASD group compared to the mild-to-moderate group (p = 0.05). Furthermore, children with ASD exhibited increased hypermobility, predominantly at the elbow joints, reduced grip strength, shorter distance in the modified 6 min walk test, and lower standing long-jump performance (p < 0.001) when compared to TD group; however, no significant difference was recorded between the ASD groups. Spearman correlation revealed that aiming and catching was negatively correlated with autism severity (CARS-2) (r = −0.38, p = 0.05) and positively with IQ (r = 0.51, p = 0.03). Aiming and catching was positively correlated with grip strength (r = 0.55, p = 0.003), endurance (r = 0.58, p = 0.002), and jump distance (r = 0.44, p = 0.03), while balance was positively correlated with grip strength (r = 0.44, p = 0.02). Conclusions: Children with ASD exhibit significant impairments in gross and fine motor performance compared with TD peers, accompanied by hypermobility, reduced strength, and diminished endurance. Notably, aiming and catching ability correlated with both IQ and autism severity as well as specific motor parameters, suggesting its potential as a clinical marker of motor–cognitive interaction in ASD. Full article

Youth soccer requires an integrated approach combining technical–tactical, physical, and psychological components to enhance performance and long-term engagement. Although Repeated Linear Sprint Training (LRST) and Repeated Change of Direction Speed (RCOD) training are widely used to improve fitness, direct comparisons of their effects on physical performance and perceptual responses in adolescent players remain limited. This study compared the effects of an 8-week LRST versus RCOD training program on physical performance, perceived exertion, and enjoyment in youth soccer players. Twenty-six male players were randomly assigned to an LRST group (n = 13) or an RCOD group (n = 13). Both groups completed two weekly sessions of their assigned training in addition to regular soccer practice. Pre- and post-intervention assessments included acceleration and sprint speed, change-of-direction (COD) performance (T-Half Test [THT], Illinois Agility Test [IAT]), lower-limb power (Five-Jump Test [5JT], Squat Jump [SJ], Countermovement Jump [CMJ]), and endurance-intensive fitness. Enjoyment and session-RPE were recorded after each training session. Both groups improved across all physical measures (main effect of time, p < 0.0001). Significant time × group interactions favored RCOD for THT (~1.6%), IAT (~1.1%), 5JT (~2.3%), CMJ (~5.2%), and SJ (~6.3%), with no overall main effect of group. Enjoyment was consistently higher in the RCOD group (p < 0.0001), while session-RPE did not differ between groups. In youth soccer, both LRST and RCOD effectively enhance physical performance. However, RCOD appears more effective for improving pre-planned COD and explosive performance while eliciting greater enjoyment without increasing perceived exertion. Incorporating structured RCOD training alongside linear sprint work may represent a practical strategy to optimize physical development and sustain player engagement. Full article

Aim: To investigate the effect of a 6-week sport-specific BET intervention on cognitive and physical performance in elite orienteering athletes. Methods: A single-arm cross-over study with an initial 6-week control period (CON) followed by a 6-week brain endurance training (BET). Thirteen Danish national team orienteering athletes participated in the study. CON athletes adhered to planned physical, cognitive, and technical training. BET athletes added 20 min of route choice assessment (RCA) training after each weekly aerobic training session. The 30 min Stroop color-word task and a sport-specific RCA task evaluated general and sport-specific cognitive performance. A submaximal (1000 m) and a maximal (5000 m) running test were also conducted. Endpoints were assessed pre and post CON and post BET. Results: Average time used per RCA task was 1.4 ± 0.4 s lower following BET (27%) (p = 0.009) compared with no change after CON. Similarly, the total number of correct Stroop answers increased by 13.8 ± 5.21 points (2%) after BET with no change after CON. RCA time use declined steeply from session 1–7, whereafter average time use plateaued. Running performance did not differ significantly between periods. Conclusion: BET improved sport-specific performance and aspects of general cognitive performance, and may effectively improve cognitive parts important for elite orienteering performance. Full article

Background: This study aimed to provide reference values for estimating training intensities in long-distance runners based on progressive incremental tests, considering differences related to sex and performance level. Methods: A total of 1411 endurance-trained runners (819 men and 592 women) completed a standardized treadmill protocol with gas exchange analysis to determine ventilatory thresholds and peak oxygen consumption (VO_2peak). Heart rate (HR) and running speed at each threshold were expressed relative to their peak values. Results: HR at second ventilatory threshold (VT2) occurred at 93.5 ± 2.5% of HR peak, and HR at first ventilatory threshold at 85.1 ± 4.6%. The relative running speeds at VT2 and VT1 corresponded to 87.6 ± 3.9% and 73.9 ± 5.5% of the speed at VO_2peak, respectively. In men, beginners exhibited higher relative HR and VO₂ values at the ventilatory thresholds than elite runners. In contrast, women displayed higher and more stable relative values across performance levels. Conclusions: These findings establish precise, evidence-based reference ranges derived from a large cohort of runners and highlight the need to consider sex and performance level when estimating exercise intensities. Individualized physiological assessment remains essential for accurate training prescription and performance optimization. Full article

Background: This study aimed to investigate the association between occlusal splint use and several key parameters, including body position perception, tongue pressure, temporomandibular joint dysfunction (TMD) severity, jaw functional limitation, and neck muscle endurance. Methods: A total of 157 individuals diagnosed with bruxism were screened, and 52 eligible participants were enrolled and divided into two groups: occlusal splint users (n = 26) and non-users (n = 26). Body position perception was assessed with a digital inclinometer, tongue pressure was measured using the Iowa Oral Performance Instrument (IOPI), and neck muscle endurance was evaluated by the Cranio-Cervical Flexion Test (CCFT). TMD severity and jaw functional limitation were assessed via the Fonseca Anamnestic Questionnaire and Jaw Functional Limitation Scale-20, respectively. Gender-based analyses showed higher TMD severity and mandibular limitation scores in females using occlusal splints than in males. Results: No statistically significant differences were found between the splint and non-splint groups in body position perception, tongue pressure and neck muscle endurance (p > 0.05). However, significant differences were observed in the Jaw Functional Limitation Scale (CFKS) subscales. Splint users reported higher functional limitations in chewing, mobility, and expression compared to non-splint users (all p = 0.000), with small effect sizes (d = 0.23–0.29). Conclusions: Occlusal splint use was not associated with better proprioception, orofacial muscle function, or TMD-related symptoms compared with non-splint users. However, splint users were associated with higher mandibular functional limitation based on CFKS subscale scores. Full article

The growing environmental effect of asphalt pavements has fueled interest in sustainable alternatives including the application of recycled materials and self-healing systems. This research investigates the synergistic possibilities of steel slag aggregates and steel wool fibers in hot-mix asphalt compositions to increase sustainability and let crack healing via electromagnetic induction heating. Using either recycled steel slag or natural porphyritic aggregates, two kinds of AC16 Surf S mixtures with 35/50 bitumen were created incorporating two levels of steel fiber content (2% and 4%). Based on repeated semi-circular bending (SCB) testing following regulated induction heating and confinement, a committed self-healing evaluation plan was developed. The results verified that combinations including recycled steel slag met or outperformed traditional mixes in terms of mechanical behavior. Induction heating successfully set off partial recovery of fracture toughness, with more fiber content and repeated heating cycles producing better healing values. Recovery levels ran from 14.6% to 40%, therefore proving the practicality of this approach. These results encourage the creation of asphalt mixtures with improved endurance and environmental advantages. The research offers both an approved approach for assessing healing and real-world recommendations for the construction of low-maintenance, round pavements utilizing induction-based techniques. Full article

The construction sector is progressively prioritizing environmental norms owing to its substantial role in carbon emissions from clinker manufacture. Industrial waste materials are increasingly used as alternative constituents in cement-based systems, garnering interest as a sustainable strategy. Ceramic waste powder (CWP), produced in substantial quantities with enduring properties, offers a viable alternative. Nonetheless, its elevated water absorption presents issues, requiring modification procedures such as hydrophobization and the use of nanosilica to enhance performance. This study assessed CWP in both raw and modified forms (ground and hydrophobized) as a partial aggregate replacement in concrete. A silane-derived chemical was employed for hydrophobization, with varying amounts of nanosilica. Recent mortar testing encompassed setting time, flow, and density. Durability was evaluated using capillary water absorption, and flexural and compressive strengths were quantified at 2, 7, and 28 days. Mineralogical and microstructural investigations were conducted utilizing XRD and FTIR to monitor hydration phases and reaction processes. Results indicated that unmodified CWP containing up to 1% (wt) nanosilica enhanced mechanical strength; however, elevated nanosilica concentrations diminished early strength. Hydrophobized CWP samples demonstrated improved early strength with nanosilica levels up to 0.5% (wt), but strength diminished at elevated concentrations. Microstructural analysis confirmed reduced portlandite levels and increased C–S–H production, thereby validating the progress of hydration. The regulated and altered application of CWP with nanosilica can improve mechanical performance and durability while promoting ecological sustainability in cement-based systems. Full article

Background and Objectives: Recent research has highlighted the importance of examining risk factors and their complex interrelationships in the development of lower limb injuries. This study aimed to investigate the direct, indirect, and mediating effects of endogenous neuromuscular and psychological risk factors on the incidence of non-contact lower limb injuries in football players. Materials and Methods: A sample of ninety-seven male football players underwent a structured preseason, on-field assessment. Demographic characteristics, injury history, and athlete burnout were collected through standardized questionnaires. Preseason evaluations included assessments of lower limb flexibility; isometric strength assessment of hamstring, hip abductors, and quadriceps using a handheld dynamometer; hamstring and core endurance; and the single-leg triple hop for distance test. All non-contact lower limb injuries were prospectively recorded throughout the competitive season. Partial Least Squares Structural Equation Modeling (PLS-SEM) method was applied to examine both direct and indirect associations between preseason risk factors and injury incidence. Results: Lower limb strength asymmetries (path coefficient (PC) 0.293, p = 0.004) and previous injuries (PC 0.233, p = 0.015) exhibited the strongest direct effects on the occurrence of new non-contact lower limb injuries. In addition, age acted as a moderating factor, amplifying the effect of lower limb strength asymmetries on injury risk. Moreover, previous injuries demonstrated both direct and indirect effects on neuromuscular characteristics and perceived burnout. Core and hamstring endurance tended to influence new injuries indirectly through strength asymmetries and were significantly affected by hamstring strength (PC 0.248, p = 0.015) and prior injuries (PC −0.207, p = 0.029). Conclusions: Injury prevention strategies should prioritize the improvement of core and hamstring endurance and the reduction in lower limb Strength Asymmetries, particularly among older football players. Furthermore, individualized preventive interventions for athletes with a previous history of injury are strongly recommended. Full article

The validity and accuracy of photoplethysmography (PPG)-based wearable heart rate (HR) monitors remain debatable. This study aimed to determine the concurrent validity of HR records from a wide range of contemporary PPG monitors across the full spectrum of exercise intensities and running conditions. Ten well-trained male endurance athletes performed several incremental maximal aerobic (IMA) tests and high-intensity interval training (HIIT) sessions while wearing a Polar H9 chest strap, as the reference criterion; 16 PPG-based heart rate monitors were tested (Amazfit Fit5; Apple Ultra and SE; Garmin 35, 45, 235, and 935; Polar M200, M430, OH1, Vantage M, Vantage V, Vantage V3, and Verity Sense; Galaxy Watch 5, Suunto 3 Fitness). The results showed excellent ICC (>0.90) versus the reference device across IMA and HIIT tests. Overall, the ICC decreased, and magnitudes of error increased (BIAS, SEM, and CV) as the intensity increased. Moreover, lower ICC values and greater BIAS, SEM, and CV were observed during the HIIT compared to the IMA test. Nevertheless, notable differences between devices were observed in magnitude of errors, accuracy, data loss, and read failures. In conclusion, PPG-based HR monitor validity is device-dependent and therefore exercise data from running training and competitions should be interpreted with caution. Full article