Search Results (5,717)

Background/Objectives: Cognitive dysfunction, or “brain fog”, following COVID-19 viral infection is strongly associated with diminished work capacity which disproportionality affects working-age adults. This study examined an existing method of cognitive rehabilitation training applied to adults struggling with workplace functioning and self-efficacy due to post-COVID-19 brain fog. Methods: Nine adults with post-COVID-19 cognitive dysfunction participated in this single arm pilot trial of a severity-adaptive cognitive training program. The participants completed 45–90 h of clinician-delivered cognitive training exercises delivered remotely in 60- to 90-min sessions, two or three times per week. The primary outcome measure was overall workplace self-efficacy with subskills of perceived workplace functioning, perception of cognitive functioning, and perception of home functioning assessed through pre and post surveys and qualitative interviews. The secondary outcome was cognitive function operationalized by an IQ score administered before and after the intervention. Results: The participants achieved significant improvements in workplace self-efficacy and cognition following cognitive training. The main qualitative themes of self-reported improvements were in executive function, health and energy, daily living activities, productivity, and socioemotional functioning. A cross-case synthesis of pre-intervention struggles, and post-intervention improvements revealed subthemes at work or school in cognitive processing and comprehension, memory, executive function, fatigue, emotional distress, confidence in work or academics, and work/academic performance impairment. As a group, the mean gain in IQ score was 10.5 points. Conclusions: This study adds to the growing body of literature examining the possibility of using cognitive rehabilitation for post-COVID-19 cognitive dysfunction impacting workplace self-efficacy and work functioning. Full article

Background: Small-sided games (SSG) and running-based high-intensity interval training (HIIT) are commonly used in soccer conditioning to improve aerobic fitness and performance. Although both modalities induce high cardiovascular stress, their acute neuromuscular, perceptual, and cognitive responses remain incompletely understood when examined within the same cohort. This study compared the acute physical, psychophysiological, and cognitive responses to SSG and Tabata-type HIIT in amateur male soccer players. Methods: Thirty-two male amateur players (n = 32; age: 20.53 ± 1.65 years) completed a counterbalanced within-subject crossover design. Participants performed a 4v4 SSG protocol and a running-based Tabata-HIIT protocol (8 × 20 s, 10 s recovery) on separate days (48 h apart). Countermovement jump (CMJ), squat jump (SJ), 20-m sprint, agility t-test, heart rate, perceived exertion (Borg CR-10), mental effort, and cognitive performance (d2 test) were assessed pre- and post-exercise. Parametric variables were analyzed using 2 × 2 repeated-measures ANOVA (time × protocol; η²p), and non-parametric data were analyzed using Friedman and Wilcoxon tests (r) (p < 0.05). Results: Both protocols elicited similar cardiovascular responses (~90% HR_max). A significant protocol × time interaction was observed for CMJ (p < 0.001), showing a decline after Tabata-HIIT, whereas performance was maintained after SSG. No inter-protocol differences were found for SJ, sprint, or agility. Perceived exertion and mental effort during recovery were higher following Tabata-HIIT (p < 0.05). Cognitive performance improved after both protocols (p < 0.001), with no between-protocol differences. Conclusions: Despite comparable cardiovascular load, Tabata-HIIT was associated with greater acute neuromuscular and perceptual strain, whereas SSG preserved neuromuscular performance. Perceptual and mental responses may therefore differ despite similar physiological intensity, which may inform soccer training prescription. Full article

Background: Older adults are particularly vulnerable to heat related illness due to impaired thermoregulatory responses. Heat acclimation (HA) strategies can mitigate the negative impacts of high environmental temperatures on physiological and perceptual responses. Whilst active HA strategies may prove problematic for older adults, passive approaches such as hot water immersion (HWI) may be more feasible. Methods: This study investigated the effects of four consecutive days of HWI on physiological and perceptual markers in individuals aged over 65 years during moderate exercise. Nine healthy, recreationally active participants (76 ± 5 years) completed two 30 min cycling bouts at 75–80% age predicted HR_max pre- and post-four days of HWI at 40 °C. Measures of average HR, gastrointestinal temperature, skin temperature, thermal sensation, thermal comfort, rate of perceived exertion, power output, and distance covered were recorded during both exercise bouts. Results: Results showed a significant increase in exercise capacity as measured by power output (p < 0.05, 7.45 W) post-intervention, despite no change in ratings of perceived exertion, and reductions in average heart rate (112 ± 3 vs. 109 ± 4 bpm). There were no alterations in gastrointestinal or skin temperature, and ratings of thermal comfort and sensation remained unchanged post-intervention. Conclusions: These preliminary findings provide important new evidence that four days of passive HWI may be a practical and effective method of inducing physiological adaptations in older individuals, which may be of use in interventions to mitigate the negative impact of high environmental temperatures in this population. Full article

Objective: Village Health Volunteers (VHVs) are vital to Thailand’s primary healthcare, yet many face high risks for non-communicable diseases (NCDs). This preliminary study aimed to implement health empowerment theory-based personalized health promotion for individuals in the NCD-risk group. Methods: The preliminary mixed-methods study implemented a 6-month empowerment-based health promotion program for 21 VHV leaders (mean age 62.43 ± 7.28 years) at risk for NCDs. The intervention integrated laboratory data, behavioral and qualitative focus-group insights, and quantitative anthropometric data obtained via bioelectrical impedance analysis (BIA). Results: Participants’ exercise adequacy significantly improved after the intervention, increasing from 8.3% to 61.9% (p = 0.03). BIA revealed a physiological shift toward improved energy homeostasis, including decreased body weight, reduced visceral fat area, and increased muscle hydration. While biochemical markers did not reach statistical significance, clinically favorable downward trends were observed in median HbA1c (8.0% to 7.3%) and LDL cholesterol (141.8 to 119.0 mg/dL), alongside stable renal and liver function. Qualitative thematic analysis identified four primary domains of impact: sustainability and systemic advocacy, personal transformation, broad competence acquisition, and enhanced social capital. Participants reported a marked increase in self-efficacy, transitioning from inactive beneficiaries to active health advocates. This change was largely driven by mastery experiences, such as visible improvements in body composition and functional health literacy. Conclusions: The empowerment program significantly improved physical activity and body composition while fostering the social capital and health literacy necessary for community leadership, suggesting that personal health mastery is a critical precursor to effective systemic advocacy and long-term sustainability in community-led health programs. Full article

Population aging has markedly increased the burden of cancer in older adults, in whom frailty, sarcopenia, and reduced physiological reserve limit tolerance to treatment and worsen clinical outcomes. Aging is accompanied by progressive functional decline and by biological processes such as cellular senescence, characterized by irreversible cell cycle arrest, chronic low-grade inflammation, and impaired immune surveillance. The accumulation of senescent cells and the persistence of a senescence-associated secretory phenotype contribute to tissue dysfunction and generate a microenvironment that favors tumor initiation and progression. Physical exercise has been associated with attenuation of inflammation, improvements in metabolic and immune function, and with lower levels of senescence-related biomarkers. Although aerobic exercise has been extensively studied in this setting, resistance training holds relevance for older adults due to its capacity to counteract sarcopenia, preserve muscle strength and power, and sustain functional independence. Structured and periodized approaches to resistance exercise may further enhance these benefits by delivering targeted stimuli aligned with age-related physiological deficits. Block strength training (BST), a periodized model that concentrates training adaptations into sequential phases of maximal strength, power, and muscular endurance, has demonstrated consistent improvements in functional performance and reductions in frailty risk in community-dwelling older adults. BST improves physical function. It may also influence biological processes related to aging and cancer; however, mechanistic evidence specific to BST remains to be established. We hypothesized that the exercise in block as a targeted, a structured and physiologically grounded resistance training intervention highlights the potential of BST to promote functional aging and healthy. In the case of cancer biology, and the environment near to tumour, the relationship between aging mechanisms in older adults and controlled exercise effects are currently in advance, but mechanistic trials are still lacking. Finally, we propose a novel training method, structured and personalized, that could impact different clinical outcomes in older patients with cancer. Full article

Background/Objectives: Fragility fractures cause disability, independence loss, and death in older adults with osteoporosis. While exercise rehabilitation is recommended, its effectiveness and consistency in improving function, quality of life, and outcomes after a fracture remain uncertain. This study aimed to systematically assess the impact of structured exercise programs on physical function, quality of life, falls, morbidity, and mortality among adults recovering from fragility fractures. Methods: This review and meta-analysis followed PRISMA guidelines, with protocol registration in PROSPERO (CRD42024503933). MEDLINE, PubMed, EMBASE, Cochrane Library, CINAHL, and Web of Science were searched. Randomized controlled trials and quasi-experimental studies including adults (mean age ≥ 50 years) with fragility fractures were eligible if they evaluated structured exercise programs lasting ≥8 weeks compared with usual care or minimal intervention, and reported physical function, quality of life, falls, mortality, or morbidity outcomes. Risk of bias was assessed following the Cochrane Handbook for Systematic Reviews of Interventions guidelines. Primary outcomes comprised physical function, strength, balance, and health-related quality of life. Random-effects meta-analysis was applied where data were comparable. Results: Twenty-six studies with 4142 participants were included (n = 4142; ~80.4% women; mean age ~74.83 years). Interventions were mainly multicomponent (strength, balance, mobility, and functional training). Exercise improved physical function outcomes. At 12 months, pain measured by QUALEFFO-41 decreased (MD −11.61; 95% CI −22.99 to −0.23). Effects on strength, balance, and cognitive outcomes were inconsistent. Conclusions: Exercise-based rehabilitation after fragility fractures may improve physical function and reduce pain, but pooled effects are inconsistent and often highly heterogeneous. Evidence for effects on falls and mortality is sparse and does not support firm conclusions. Physical function measures may be the most practical primary endpoint for evaluating these interventions, interpreted cautiously. Funding: PIGE-0040-2020. Full article

Background/Objectives: Type 2 Diabetes Mellitus (T2DM) is a prevalent metabolic disorder associated with major cardiovascular and metabolic complications. Regular physical activity is recommended for glycaemic management, but barriers such as obesity, joint pain, and impaired mobility may limit participation in land-based exercise. Aquatic exercise may provide a feasible alternative as water buoyancy reduces joint loading while allowing aerobic and resistance training. This systematic review and meta-analysis evaluated the effects of aquatic exercise interventions on glycaemic control in adults with T2DM. Methods: The review followed the PRISMA 2020 guidelines. MEDLINE, Cochrane CENTRAL, Scopus, Web of Science, and IEEE Xplore databases were searched. Randomised and non-randomised longitudinal studies involving adults aged ≥35 years with T2DM participating in structured aquatic exercise programmes were eligible. The primary outcome was glycated haemoglobin (HbA1c). Risk of bias was assessed using RoB 2 and RoBANS 2, and certainty of evidence was evaluated using GRADE. Random-effects meta-analysis calculated mean differences (MDs) with 95% confidence intervals. Results: Eleven randomised controlled trials involving 335 participants were included. Aquatic exercise significantly reduced HbA1c compared with passive control conditions (MD = −0.76%; 95% CI −1.21 to −0.32), although heterogeneity was high. No significant differences were observed between aquatic and land-based exercise interventions. Eight studies used wearable heart-rate monitors to regulate exercise intensity. Conclusions: Aquatic exercise may improve glycaemic control compared with sedentary conditions and yields effects comparable to those of land-based exercise in adults with T2DM. Further high-quality trials are needed to clarify optimal exercise dose–response and evaluate more advanced wearable technologies. Full article

Background/Objectives: Grounded in Self-Determination Theory, this study aimed to translate and validate the Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS), including the Novelty dimension, within the Portuguese exercise context. Given the emerging evidence of novelty as a potential candidate for a basic psychological need, this research examined the psychometric properties and temporal stability. Furthermore, this study explored the nomological validity of these constructs regarding exercise enjoyment and satisfaction with life. Methods: The sample comprised 500 gym-goers (263 females; 237 males), aged between 18 and 65 years (M = 33.76; SD = 12.94). Confirmatory Factor Analysis and Exploratory Structural Equation Modeling were employed to compare the factor structure. Temporal stability was assessed through a test–retest procedure with a four-week interval (n = 50). Results: Exploratory Structural Equation Modeling provided a superior fit to the data (CFI = 0.98; TLI = 0.97; RMSEA = 0.04) compared to Confirmatory factor Analysis, supporting the distinctiveness of the eight dimensions. The instrument demonstrated strong internal consistency (composite reliability ranging from 0.78 to 0.90) and adequate discriminant validity. Path analysis revealed that novelty satisfaction was significantly associated with enjoyment and satisfaction with life. In reverse, novelty frustration was negatively associated with these well-being indicators. Intraclass correlation coefficients (0.75 to 0.83) confirmed robust temporal stability. Conclusions: These findings provide evidence that the Portuguese version of the BPNSFS, including the novelty dimension, is a psychometrically comprehensive instrument for the exercise context. The results support the inclusion of novelty as a relevant psychological need within Self-Determination Theory. Full article

Background and Objectives: Engaging in sports activities presents several benefits but also carries a risk of injury. Performing warm-up exercises may serve as a preventive measure against sports injuries. This study explored how participating in warm-up exercises is associated with complications, subsequent injury frequency, and recovery duration among athletes with a history of sports injuries. Materials and Methods: In this study, we performed cross-sectional secondary analysis of data derived from the 2024 Sports Safety Accident Survey conducted by the Korea Sports Safety Foundation, which is a nationally administered survey based on a structured questionnaire. The survey, conducted from November 2024 to December 2024, targeted 10,000 athletes aged ≥12 years registered in 64 sports nationwide. We utilized the data of 6063 athletes who had experienced sports injuries. The collected data were analyzed using frequency analyses, chi-squared tests, and multivariate logistic regression analyses. This study was conducted as a physical activity epidemiology study to examine associations between warm-up exercise participation and injury outcomes. Results: The likelihood of complications was higher among those who responded “not really” or “neutral” regarding participation in warm-up exercises. The likelihood of injuries was higher among those who responded “neutral” or “somewhat”. Furthermore, the likelihood of prolonged recovery was higher among those who responded “not really”, “neutral”, or “somewhat”. Conclusions: Performing warm-up exercises is an essential measure for athletes with a history of injuries to safely engage in sports activities. Therefore, it is necessary to highlight the importance of warm-up exercises among athletes and to implement a safety management system to encourage consistent performance. Full article

Purpose: Evidence on the safety of single-joint isometric exercises of the lower legs remains limited. Thus, the aims of this study were to examine intraocular pressure (IOP) and retinal vessel responses during a 1 min isometric knee extension task and to assess potential sex-related differences. Materials and Methods: This prospective, parallel-group, quasi-experimental exploratory trial enrolled 43 healthy young adults (22 males and 21 females; age range: 19–35 years), who performed a 1 min sustained maximal-effort isometric knee extension task. The cardiovascular response, IOP, and retinal vessel diameters were assessed. Results: The isometric task increased fatigue, heart rate, systolic blood pressure (SBP), and mean arterial pressure in both sexes (p < 0.05), with males exhibiting a significantly greater rise in SBP than females (p < 0.05). A significant reduction in IOP was observed only in males (p < 0.05). Central retinal arteriolar equivalent decreased in both sexes (p < 0.05), whereas central retinal venular equivalent (CRVE) increased exclusively in females (p < 0.05). Despite the difference in the CRVE response, both sexes exhibited a comparably reduced arteriolar-to-venular diameter ratio (p < 0.05). Conclusions: To sum up, the isometric maximal-effort knee extension exercise increased cardiovascular loads in both sexes, with males showing a greater SBP rise and a reduction in IOP. Although retinal microvascular responses were sex specific, both sexes showed a similar reduction in the arteriolar-to-venular diameter ratio, indicating a consistent shift in microvascular regulation. Full article

Background/Objectives: Stress echocardiography (SE) had been recommended by professional societies for assessing patients with suspected angina. SE protocols are variable across hospitals and countries in the recommendation of the cessation of rate-controlling medication (RCMx) prior to SE. Some expert opinion papers recommend the cessation of beta receptor blockers (BBs) and rate-controlling calcium channel blockers 48 h prior to SE to improve the diagnostic accuracy of the test. There is no evidence that the continuation of RCMx can affect the outcome of SE and short-term major adverse cardiovascular events (MACEs). To investigate the efficacy of Dobutamine SE in a cohort of patients where the cessation of rate-controlling medication has not been mandated, we reviewed our data over a one-year period in patients investigated for suspected coronary artery disease (CAD). Methods: A retrospective data analysis was performed on 227 consecutive patients who underwent Dobutamine SE between January 2022 and January 2023 in a single centre. In addition to dobutamine, the protocol allowed the administration of intravenous atropine (maximum dose of 1.2 mg) and a “top up” handgrip exercise at the discretion of the performing cardiologist. We assessed the Dobutamine SE outcome (positive vs. negative), target heart rate (THR, 85% of maximum age predicted), and the achieved peak HR in the two groups with RCMx and without RCMx. We analysed the patients’ characteristics and 12-month outcomes of a combined MACE of death, non-fatal MI, stroke, admission with angina, and unplanned revascularisation. Results: Of the 227 patients, 61% were on No-RCMx (male 40%). Ninety-three percent of the patients on RCMx were on BB and 7% on other rate-controlling medications. The THR was achieved in 74% of the patients with-RCMx and 90% in the without-RCMx groups p = 0.0018. Positive Dobutamine SE was observed in 48% (43/89) of patients on RCMx vs. 28% (39/138) on No-RCMx (p = 0.0022). Patients who did not reach THR 43% (16/37) had positive Dobutamine SE compared to 35% (66/190) who reached THR (p = 0.626). There was no difference between groups in the peak WMSI. Logistic regression analysis showed that being on RCMx was independently associated with positive Dobutamine SE (OR 2.03, 95% CI 1.06–3.91, and p = 0.034). The MACE rate was higher in patients where the THR was not achieved (9/37, 24.0%) vs. where THR was achieved (9/190, 4.7%), p < 0.001, in both the with-RCMx (7/30, 23% vs. 6/66, 9.1%, p = 0.013) and without-RCMx (2/14, 14% vs. 3/124, 2.4%; p = 0.025) groups, respectively. RCMx was independently associated with MACE (OR 3.68, 95% CI 1.227–11.046, and p = 0.020). Conclusions: The use of RCMx proved to be a predictor of both SE and MACE outcomes irrespective of the achieved THR. Our data supports the practice that patients referred for Dobutamine SE on RCMx can continue taking them without impact on the test accuracy. Full article

Background/Objectives: Institutionalized aging is associated with severe physical deconditioning, a high risk of falls, and a pervasive fear of falling. Physical exercise mitigates these factors, but the comparative efficacy of different training methodologies in this specific population remains unclear. The objective of this study was to compare the impact of a multicomponent exercise program versus a dual-task (cognitive-motor) training program on reducing fall risk, decreasing the fear of falling, and improving physical performance in institutionalized older adults. Methods: A randomized, parallel group controlled trial involving 21 older adults residing in a nursing home (Mean age = 83.67 ± 6.17 years). Participants were allocated to either a Multicomponent Group (n = 11) or a Dual-Task Group (n = 10) for a 12-week intervention (2 sessions/week). Fall risk, fear of falling, and global physical performance were assessed at baseline and post-intervention. Results: No significant improvements were observed in fall risk assessment execution time for either group. The Multicomponent Group showed a significant reduction in the fear of falling (−29.1%; 95% CI [−17.27, −1.27], p = 0.025) and a clinically significant improvement in physical performance (+40.9%; 95% CI [1.11, 3.43], p < 0.001), supported by large time effects (FES-I: F(1, 19) = 4.52, η²p = 0.192; SPPB: F(1, 19) = 13.68, η²p = 0.419). The Dual-Task Group achieved no significant changes in these dimensions. Furthermore, a marginally significant time-by-group interaction was observed for physical performance, favoring the multicomponent approach (F(1, 19) = 3.83, p = 0.065, η²p = 0.168 [large effect]). Conclusions: Multicomponent training proved superior in improving physical performance and reducing the fear of falling. In a frail, institutionalized population, the attentional cost demanded by dual-task training appears to limit the physical and psychological benefits of exercise. Full article

Exerkines are released in response to physical exercise and play a key role in promoting health, such as taking part in modulating brain morphology and function. Expression levels of some of them are associated with an increase in neuroplasticity and a decrease in the risk of brain-related diseases such as dementia and depression. Therefore, our objective is to investigate the response of exerkines in healthy individuals and its potential to promote brain health. The search was performed in five databases. Randomized controlled trials of humans and animals of all ages who performed acute and/or long-term exercise and assessed the effects of exerkines were included. Human data were used for quantitative analysis, and animal experiments were included as part of the qualitative analysis. No meta-analyzes were conducted on animal data; preclinical findings are presented solely to contextualize mechanisms and are not used for clinical inference. Eventually, the sample consisted of 3321 individuals, with an age range from 10 to 89 years. Meta-analysis reveals that both acute and chronic exercise induced increases in the brain-derived neurotrophic factor and insulin-like growth factor 1 in older adults. Other exerkines such as cathepsin B and vascular endothelial growth factor have also demonstrated potential power for brain health. In conclusion, physical exercise by altering the levels of exerkines may be a feasible strategy for healthy individuals aiming at healthy aging of the brain. Moreover, it is advisable to analyze additional exerkines or multiple simultaneous applications to assess the cerebral effects during physical exercise. PROSPERO registration number: CRD42023438803. Full article

Background: Weightlifters commonly use upper-extremity high-load training, which encompasses techniques ranging from momentary failure to non-failure. However, little is known about how this training affects posture and core endurance, despite knowing that these factors are risk factors for weightlifting injuries. Therefore, this study aimed to determine the immediate effects of upper-extremity high-load training to momentary failure versus non-failure, using the dumbbell overhead press, on posture and core endurance in recreational collegiate weightlifters. Methods: Fifty recreational weightlifters aged 18–24 with two years of upper extremity resistance training experience were recruited for this study. The participants performed dumbbell overhead press exercises under high-load failure (HL-F) and high-load non-failure (HL-NF) conditions two days after 1RM testing and calculation of the 80% 1RM load. The study analyzed postural changes using photographic data processed in Kinovea, while core endurance was assessed during a prone plank test. Standardized warm-ups, controlled exercise execution, and pre- and post-exercise assessments were conducted to measure core endurance and postural alterations. Results: The thoracic kyphosis angle, together with scapular balance angle and lateral scapular slide distance, increased significantly after HL-F compared to the unloading state, while the craniovertebral angle and prone plank time decreased significantly (p < 0.05). The HL-NF condition showed no statistically significant differences relative to the unloading measurements (p > 0.05). The unloading measurements across testing days were consistent, indicating no carryover effect (p > 0.05). Conclusions: The findings indicate that high-load training to failure adversely affects posture and core endurance, increasing fatigue and potentially increasing the risk of acute injuries. Non-failure training maintains stability, underscoring the importance of strategic program design for achieving optimal performance while minimizing adverse effects. Full article

Background/Objectives: Young women with breast cancer (aged ≤ 40 years) have distinct prognostic characteristics, yet little is known about how modifiable body composition factors influence outcomes in this age group. This study examined whether CT-derived body composition measures could identify thresholds that predict overall survival (OS). Methods: This was a single-center, 10-year, matched case–control study nested within a cohort, utilizing retrospectively collected data. Using an institutional database (2009–2018) and the initial cohort of 112 patients, we performed a subset analysis of patients with stage I–III breast cancer at diagnosis who had available pretreatment CT scans to estimate associations with body composition metrics and OS. The final analytic dataset included 89 individuals (49 survivors and 40 deceased). CT scans at the L3 level were analyzed using Slice-O-Matic software to quantify visceral (VAT), subcutaneous (SAT), intermuscular (IMAT), total adipose tissue (TAT), skeletal muscle density (SMD), skeletal muscle gauge (SMG), and skeletal muscle index (SMI). Cox proportional hazard models determined optimal cutpoints for OS. Multivariable models included adjustments for disease stage and hormone receptor status. Results: The median age was 35 (IQR, 32–38); 47% were White and 37% were Black. The majority (78%) were not Hispanic or Latina. Most (67%) were overweight/obese. Specific thresholds for IMAT index (>2.57), VAT (>31.38), and SMG (<2419.89) were associated with worse survival (all p < 0.05), while no cutpoints were identified for other variables. Conclusions: These findings show that muscle fat infiltration and reduced muscle quality have important prognostic value in young women with breast cancer. Exploratory cutpoints derived from routine staging CT scans may help inform risk stratification and generate hypotheses for targeted nutritional or exercise interventions, but require validation in larger, independent cohorts before clinical application. Full article