Search Results (491)

The purpose of this study was threefold: (a) to analyze differences in mean force, impulse, mean concentric and eccentric velocity, and peak concentric velocity across six repetitions of the flywheel deadlift exercise, with a particular focus on the first repetition initiated from zero momentum; (b) to explore relationships between these kinetic and kinematic variables and one-repetition maximum (1-RM) performance in the free-weight deadlift; (c) to examine the effects of different flywheel inertial loads on the relationships among mean force (MF), impulse, time under tension (TUT), and velocity, with the aim of identifying the most valid and reliable parameter for flywheel load prescription. Thirteen resistance-trained men (24.7 ± 5.0 y; 82.2 ± 11.7 kg; 1-RM deadlift: 174 ± 24 kg) performed six repetitions of the flywheel deadlift against six inertial loads (0.025 to 0.145 kg∙m²) on a kBox 5 device. Results showed that although the first repetition had 25–30% lower mean concentric velocity and 7–11% lower mean force compared to subsequent repetitions (p < 0.001), it exhibited 4–8% higher impulse due to the 14–20% longer time under tension. MF, velocity, and impulse in the first repetition showed moderate-to-strong correlations with 1-RM (r = 0.58 to 0.85, p < 0.05), particularly at the two higher inertia loads. MF plateaued at moderate inertia loads, while impulse and TUT increased linearly with increasing inertial load and demonstrated the strongest and most consistent relationships with inertial load (r = 0.99 ± 0.01 and 0.97 ± 0.02, p < 0.001), enabling individualized flywheel training prescription. This study highlights the distinct value of the first repetition in flywheel deadlifts and its practical value for both assessment and training. Also, it suggests that impulse and TUT may be used as simple and practical flywheel exercise prescription variables. Full article

Background/Objectives: This case represents the successful treatment of cervical spine injury from high-speed rear-impact motor vehicle collision and abnormal cervical kyphosis with left arm radiculopathy, utilizing conservative spine care rehabilitation methods. This patient was treated with a multimodal treatment approach integrating a cervical spine extension traction protocol. Subject and Methods: A 50-year-old male with a history of motor vehicle collision presented with left arm radiculopathy, as well as cervical and upper thoracic spine pain. Notably the cervical spine presented with kyphotic deformity. The patient presented, after a being struck during a rear-end motor vehicle collision, with neck, upper back, and left arm radiculopathy. Prescription medication and traditional chiropractic care proved ineffective for substantive symptom and quality-of-life improvement. Treatment frequency was three times per week for eight weeks using the Chiropractic Biophysics^® protocol of mirror image (MI^®) postural exercise, spinal adjustment, and cervical spinal traction. On completion of in-office care, the patient was treated monthly, performed home care at least three times per week, and was re-examined at one year. Results: Final examination after eight weeks of care showed significant improvement in cervical lordosis (21.8 degrees), resulting in reduced cervical kyphosis. The patient completed outcome indices before, during, and 12 months after cessation of active care, all indicating improvement. Conclusions: This case report demonstrates both subjective and objective improvement in cervical spine kyphosis and attendant symptoms. The successful treatment of chronic pain, peripheral weakness, and radiculopathy with long-term follow-up using CBP care is documented as well. The treatment was designed to improve sagittal balance and reduce radiographic abnormalities evincing spinal misalignment. Administration of subjective, objective, and health-related quality-of-life outcome indices during, following, and 12 months post-treatment are suggestive of long-term efficacy of Chiropractic BioPhysics^® (CBP) treatment methods. Larger studies are needed to substantiate this given the limitations of a case report. Full article

Background: Multiple sclerosis (MS) is the most prevalent neurological disorder in young adults, characterised by physical, psychological and cognitive dysfunction. Exercise training is a safe management strategy. Healthcare providers (HCPs) acknowledge deficiencies in awareness, counselling strategies, and resources that prevent them from promoting and prescribing this effective treatment. We implemented an online evidence-based educational programme and evaluated the effect, acceptability, appropriateness, and feasibility of the programme in improving HCP confidence, knowledge, and attitudes towards remote exercise prescription to persons with MS. Methods: Physiotherapists and exercise physiologists were recruited and received the educational programme (online theory and 16-week experience of prescribing to persons with MS). Participants’ confidence, knowledge and attitudes towards exercise prescription, as well as their professional quality of life, were our primary outcomes—baseline (T1), immediately post-online theoretical learning (T2), post-application with clients (T3; approximately 16 weeks after T2), and at 12-month follow-up (T4). We gathered participants’ acceptability, appropriateness, and feasibility evaluation at T2, T3 and T4. We analysed the effect on primary outcomes using generalised linear mixed models, with secondary and evaluative outcomes analysed as counts and qualitative themes. Results: Of 40 participants who provided baseline data, 24 completed the theoretical programme, and 16 completed the experiential programme. Self-confidence improved significantly (|βs| ≥ 1.27, SEs ≤ 0.31, |zs| ≥ 5.28, ps < 0.001), with large effect sizes (percentage change: 256.8–479.4%). Some theoretical domains framework-based domains have improved, such as beliefs about skills to prescribe evidence-based principles. Participants expressed high satisfaction with the programme and showed increased delivery of implementation behaviour change strategies. Conclusions: An online evidence-based education programme for MS care improved HCPs’ self-confidence, perceived skills and delivery of evidence-based exercise behaviour-based prescription. Full article

Background/Objectives: Aging and a sedentary lifestyle aggravate hypokinetic diseases, compromising the functional capacity of older adults. Thus, the prescription of physical exercise (PE) through mobile applications (MA) has emerged as a remote and personalized alternative. However, there are still gaps in the effectiveness of prescribing physical exercise via mobile apps for older people. This study aimed to analyze the effects of prescribing PE through MAs on the health of older adults. Materials and Methods: This systematic review included studies with older people (≥60 years) that used MAs to prescribe PE, published between 2014 and 2024, in Portuguese or English. The search strategy used the descriptors “older adults,” “physical exercise,” “mobile applications,” and “health,” combined with Boolean operators. The screening followed previously defined eligibility criteria regarding population, intervention, outcomes, and study design. Two independent reviewers extracted data, mediated by a third party in case of disagreement; they screened and extracted data from the PubMed and VHL/Medline databases from 2004 to 2024. Risk of bias was assessed according to levels of evidence, and the results were categorized. Results: Of the 2298 publications initially identified, 7 studies were eligible for this review, totaling 748 participants, predominantly female. The studies included prospective and observational clinical trials with older people suffering from Parkinson’s disease, cardiovascular disease, sarcopenia, and breast cancer. The findings showed favorable effects on adherence to the program (6 studies; n = 654), an increase in PE (5 studies; n = 502), and improvements in functional capacity (4 studies; n = 389), perceived quality of life (5 studies; n = 481), and muscle strength (3 studies; n = 298). Conclusions: The prescription of MA-mediated PE showed positive effects on the health of older people, indicating its viability as a complementary strategy in clinical practice or public health. Full article

Mitochondrial dysfunction is a key factor in the pathophysiology of major depressive disorder (MDD) and treatment-resistant depression (TRD), connecting oxidative stress, neuroinflammation, and reduced neuroplasticity. Physical exercise induces specific mitochondrial changes linked to improvements in mental health. The aim of this paper was to examine emerging evidence regarding the effects of physical exercise on mitochondrial function and treatment-resistant depression, highlighting the clinical importance of the use of mitochondrial biomarkers to personalize exercise prescriptions for patients with depression, particularly those who cannot tolerate standard treatments. Physical exercise improves mitochondrial function, enhances biogenesis and neuroplasticity, and decreases oxidative stress and neuroinflammation. Essential signaling pathways, including brain-derived neurotrophic factor, AMP-activated protein kinase, active peroxisome proliferator-activated receptor-γ coactivator-1α, and Ca²⁺/calmodulin-dependent protein kinase, support these effects. Most studies have concentrated on the impact of low- and moderate-intensity aerobic exercise on general health. However, new evidence suggests that resistance exercise and high-intensity interval training also promote healthy mitochondrial adaptations, although the specific exercise intensity required to achieve this goal remains to be determined. There is strong evidence that exercise is an effective treatment for MDD, particularly for TRD, by promoting specific mitochondrial adaptations. However, key gaps remain in our understanding of the optimal exercise dose and which patient subgroups are most likely to benefit from it (Graphical Abstract). Full article

Background: Osteoarthritis has a large and growing burden in an ageing population. Controversy exists in current management, particularly regarding opioid use due to increasing negative effects. Clinicians need guidance on the individual mortality associations for common osteoarthritis treatments when compared to a control. Aims: The aim is to undertake a structured narrative literature review comparing mortality associations for common osteoarthritis management options. Methods: A search strategy (Web of Science 23 September 2024) was performed to identify observational studies which reported all-cause mortality in a treatment group compared to a control. The control group could be either the general population or those with osteoarthritis who were treated with the following: NSAIDs (non-steroidal anti-inflammatory drugs), opioids, paracetamol, GLP-1 RAs (Glucagon-like peptide-1 receptor agonists), hip or knee arthroplasty, or exercise. Articles were screened by two authors, and each included article was assessed for adequate quality using the strengthening the reporting of observational studies in epidemiology (STROBE) framework. Results: Of 2362 studies retrieved, 39 cohort studies met the inclusion requirements. Exercise, compared to no or lower levels of exercise, had ten studies reporting substantially reduced all-cause mortality. GLP-1 RA agonists had two related studies showing all-cause mortality reduction up to 5 years. Mortality following joint arthroplasty followed a multi-phasic response. There was a short-term post-surgical increase in mortality. However, from 90 days post-surgery to 8–11 years, there were significant reductions in mortality. After 9–12 years post arthroplasty, mortality increased and became significantly higher. Opioids were associated with an increase in mortality in 6 out of 7 studies. Inconsistent trends were found for NSAIDs and paracetamol. Conclusions: Exercise and GLP-1 RA prescription are associated with reduced all-cause mortality. Arthroplasty was found to have survival benefit until 9–11 years post-operatively, whereafter mortality then increased. Opioids were found to consistently increase mortality when used for non-cancer pain at all time points. The other common osteoarthritis treatments assessed were not consistently associated with changes in mortality. Full article

Background: Cardiopulmonary exercise testing (CPET) is increasingly recognized as a key tool for evaluating patients with congenital heart disease (CHD). While traditional assessments focus on resting parameters, CPET provides dynamic, integrated insight into cardiovascular, respiratory, and muscular function during exertion. Objectives: This review explores the clinical value of CPET across the spectrum of CHD, with dedicated focus on its applications in both adult and paediatric populations. We analyse the prognostic significance of key CPET parameters—particularly peak oxygen consumption (peak VO₂), ventilatory efficiency (VE/VCO₂ slope), and heart rate dynamics—within distinct anatomical and physiological categories of CHD. Findings: CPET reliably detects exercise intolerance, guides intervention timing, informs exercise prescription, and stratifies risk. Peak VO₂ and heart rate reserve are consistently associated with adverse outcomes across most CHD types. However, the prognostic utility of other variables, such as the VE/VCO₂ slope, varies with pathophysiology—being less reliable in cyanotic lesions like Eisenmenger syndrome. In paediatric patients, CPET must be adapted to growth-related physiological variability and is increasingly used to assess quality of life, functional limitation, and response to therapy. Conclusions: CPET is a powerful, non-invasive tool that should be integrated into routine management of CHD patients across all ages. It enhances risk assessment, supports tailored care, and promotes safe physical activity, ultimately contributing to improved long-term outcomes and quality of life. Full article

Multiple-hops performed horizontally in series effectively assess return-to-play readiness, as they mimic the propulsive and decelerative demands of sports. Movement strategy variables (kinetic variables) offer more insight into injury recovery than outcome-based measures (kinematic variables) like hop distance alone. This study focused on kinematic and kinetic variables to assess asymmetries during triple-hop (3-Hop) and quintuple-hop (5-Hop) tests with 44 male athletes from university sports clubs and teams. The aim was to determine the magnitude and potential direction of asymmetry and compare the sensitivity of kinematic and kinetic variables. Results showed mean kinematic asymmetries below 7.1% (range: 0.00 to 28.9%), while average kinetic asymmetries were as high as 38.8% (range: 0.0% to 95.4%). These findings suggest that kinetic variables are more sensitive in assessing movement strategy, providing more detailed insight into rehabilitation and return-to-play decisions. The study emphasizes the importance of considering both outcome and movement strategy variables in injury recovery. These results have practical applications for clinicians and coaches supporting those in return-to-play scenarios, as well as those addressing performance deficits, therefore offering valuable information to refine exercise prescriptions and athletic program design. Full article

Chronic pain is a significant and complex health condition characterized by persistent or recurrent pain lasting more than three months. Exercise-based rehabilitation is an effective non-pharmacological intervention, yet its underlying mechanisms have not been fully elucidated. This review systematically maps the molecular pathways of exercise-induced analgesia onto the pathophysiological cascades of chronic pain, aiming to fill a key gap in the current literature. It explores the molecular and cellular mechanisms underpinning the pathophysiology of chronic pain, indicating that the persistence of chronic pain stems from peripheral sensitization driven by inflammatory mediators and central sensitization involving glial cell activation and N-methyl-D-aspartate (NMDA) receptor-mediated neuroplasticity. Exercise can interrupt these pathological cascades through multi-system adaptations, including activation of the endogenous opioid and serotonergic systems activation and anti-inflammation. However, a significant gap remains in translating this mechanistic understanding of chronic pain into optimized, personalized exercise prescriptions, requiring future research into different exercise modalities, sex-specific responses, and the impact of comorbidities. Full article

Background: Type 2 diabetes mellitus (T2DM) is a major global public health challenge. Aerobic exercise (AE) can be a key strategy for non-pharmacological intervention in T2DM through multi-targeted modulation of glucose and lipid metabolism, inhibition of chronic inflammation, and reduction of oxidative stress. This study aims to investigate the current status of AE intervention in T2DM research and analyze its future evolution. Methods: Using the R-based bibliometric software package and the Java-based visualization software CiteSpace and VOSviewer, we analyzed the literature and cited references related to AE intervention in T2DM research included in the Web of Science Core Collection (WOSCC) and China National Knowledge Infrastructure (CNKI) from 2014 to 2024. Results: This study included a total of 882 relevant literature sources (488 of which were indexed in WOSCC and 394 in CNKI). From the perspective of research trends, the number of literature sources on AE interventions for T2DM has shown fluctuating changes over time. In terms of research output, the United States, China, and Canada are at the forefront. It is worth noting that, although China has a relatively high number of published papers, there is still a significant gap in terms of the depth of international collaboration and the presentation of results in top-tier journals. Among researchers, Dai Xia (China) and Riddell MC (Canada) are the scholars with the highest number of published articles in this field. Keyword analysis indicates that mechanisms such as oxidative stress, insulin resistance, inflammatory responses, and glucose metabolism disorders remain core research hotspots. Time-series analysis reveals that the research paradigm in this field has evolved from single exercise methods to comprehensive exercise prescription studies, and multi-dimensional intervention studies combining exercise, diet, and pharmacological interventions are emerging as new research frontiers. Conclusions: This study uses bibliometric methods to visualize and analyze the progress of AE in T2DM intervention research from a broader perspective, providing a scientific overview and macro-level predictions for the research landscape in this field. Full article

Despite the known relevance of punch impact in boxing, limited evidence exists regarding how anthropometric and muscle performance variables contribute to it. This study investigated the relationship between anthropometric characteristics, muscle power and strength performance, and punch impact power in 69 boxing practitioners (mean ± SD age: 27.0 ± 6.1 years). Anthropometric variables (body height (BH), armspan (AS), body mass (BM)) and muscle power and strength tests (countermovement jump (CMJ), one repetition maximum in bench press (1RM BP), and handgrip strength (HS)) were assessed. Punch impact power was assessed with PowerKube (PK), a specific device designed to measure punch impact power. Punch impact power was positively correlated with BH, AS, and BM. Linear regression indicated that BH and AS explained about 36% of the variance in Straight punch impact power and 30–34% in Hook punch impact power. BM showed weaker predictive capacity, explaining 10% of the variance in Straight punch impact power and 11% in Hook punch impact power. When comparing punch impact power differences across groups with varying BH, AS, and BM, it was found that groups with High BH exhibited higher punch impact power than the groups with Low and Medium BH for both Straight and Hook punches. For AS, the High AS group also demonstrated higher punch impact power, with similar trends for BM, where significant differences were observed only between the High and Low BM groups. Additionally, our findings confirm significant relationships between anthropometric characteristics, muscle power, and strength performance. These findings highlight the importance of a comprehensive assessment of anthropometric profiles, alongside muscle power and strength evaluations, to better predict punch impact power. This approach provides valuable insights for boxing training and may also inform exercise programming for the general population. Full article

Introduction: Chronic primary low back pain (CPLBP) is a prevalent condition in primary care and a leading cause of disability and absenteeism worldwide. Multidimensional approaches may be necessary to achieve physical and mental health benefits in individuals with CPLBP. Objective: The BACKFIT randomized controlled trial aims to evaluate the effectiveness of a multidimensional intervention—combining supervised exercise and mindfulness—on pain, physical fitness, mental health, and functional outcomes in individuals with CPLBP. Hypothesis: Both the supervised exercise program focused on motor control and trunk muscle strength (IG1) and the multidimensional intervention combining supervised exercise with mindfulness training (IG2) are expected to produce significant health improvements in individuals with CPLBP. It is further hypothesized that IG2 will yield greater improvements compared to IG1, both immediately post-intervention and at the two-month follow-up. Design: Randomized controlled trial. Setting: Virgen de las Nieves University Hospital, Granada (Spain). Participants: 105 individuals. Inclusion criteria: Previously diagnosed with CPLBP, aged ≥18 and ≤65 years, able to read and understand the informed consent, and able to walk, move, and communicate without external assistance. Exclusion criteria: serious lumbar structural disorders, acute or terminal illness, physical injury, mental illness, and medical prescriptions that prevent participation in the study. Intervention: Individuals will be randomly assigned to a supervised physical exercise group (2 days per week, 45 min per session), a multidimensional intervention group (same as supervised physical exercise group, and mindfulness 1 day per week, 2.5 h per session) or an active control group (usual care, 2 days per week, 45 min per session). The intervention will last 8 weeks. Main Outcome Measures: Primary outcome: pain threshold, perceived acute pain, and disability due to pain. Secondary measures: body composition, muscular fitness, gait parameters, device-measured physical activity and sedentary behavior, self-reported sedentary behavior, quality of life, pain catastrophizing, mental health, sleep duration and quality, and central sensitization. The groups will undergo pre-intervention, post-intervention, and a 2-month follow-up after a detraining period. Statistical Analysis: Both per-protocol and intention-to-treat approaches (≥70% attendance) will be used. Program effects will be assessed via one-way ANCOVA for between-group changes in primary and secondary outcomes. Conclusions: Given the complex nature of CPLBP, multidimensional approaches are recommended. If effective, this intervention may provide low-cost alternatives for health professionals. Full article

Background/Objectives: Central sensitization (CS) is identified as a cause of pain in various musculoskeletal diseases, and breathing pattern disorders (BPDs) are reported to be correlated with chronic pain. This study aimed to analyze the relationship between CS and BPDs through regression analysis. Methods: A cross-sectional study was designed according to the strengthening the reporting of observational studies in epidemiology (STROBE) guidelines. Forty participants with moderate to extreme CS (central sensitization inventory for Koreans; CSI-K ≥ 40) were enrolled, and their respiratory motion (manual assessment of respiratory motion; MARM), respiratory function (self-evaluation of breathing questionnaire; SEBQ), respiratory muscle strength (maximal inspiratory pressure; MIP, maximal expiratory pressure; MEP), pain intensity (numeric pain rating scale; NPRS), pain cognition (Korean version of pain catastrophizing scale; K-PCS), muscle tone and stiffness were measured. Results: Among participants with moderate to extreme CS, 82.5% showed BPDs and 42.5% reported severe pain intensity. Regression analysis revealed significant relationships between respiratory and pain variables. K-PCS demonstrated significant negative relationships with MARM area (β = −0.437, R² = 0.191) and positive relationships with SEBQ (β = 0.528, R² = 0.279). In the subgroup with BPDs, strong regression relationships were found between MARM area and NPRS usual pain (β = −0.486, R² = 0.237) and K-PCS (β = −0.605, R² = 0.366). Multiple regression analysis showed that MARM area and SEBQ together explained 41.2% of variance in pain catastrophizing. The comprehensive muscle stiffness prediction model using CSI-K, K-PCS, and muscle tone showed remarkably high explanatory power (R² = 0.978). Conclusions: In individuals with moderate to extreme CS, respiratory dysfunction was prevalent and significantly predictable through regression models with pain intensity and pain cognition. These quantitative regression relationships between breathing mechanics, pain measures, and muscle properties provide clinical prediction tools and suggest the importance of assessing breathing patterns in CS management. Full article

This study addresses the shortcomings of traditional exercise volume assessment methods in dynamic modeling and individual adaptation by proposing a multi-modal data fusion framework based on a spatio-temporal attention-enhanced LSTM neural network for personalized exercise volume optimization in college basketball courses. By integrating physiological signals (heart rate), kinematic parameters (triaxial acceleration, step count), and environmental data collected from smart wearable devices, we constructed a dynamic weighted fusion mechanism and a personalized correction engine, establishing an evaluation model incorporating BMI correction factors and fitness-level compensation. Experimental data from 100 collegiate basketball trainees (60 males, 40 females; BMI 17.5–28.7) wearing Polar H10 and Xsens MVN devices were analyzed through an 8-week longitudinal study design. The framework integrates physiological monitoring (HR, HRV), kinematic analysis (3D acceleration at 100 Hz), and environmental sensing (SHT35 sensor). Experimental results demonstrate the following: (1) the LSTM-attention model achieves 85.3% accuracy in exercise intensity classification, outperforming traditional methods by 13.2%, with its spatio-temporal attention mechanism effectively capturing high-dynamic movement features such as basketball sudden stops and directional changes; (2) multi-modal data fusion reduces assessment errors by 15.2%, confirming the complementary value of heart rate and acceleration data; (3) the personalized correction mechanism significantly improves evaluation precision for overweight students (error reduction of 13.6%) and beginners (recognition rate increase of 18.5%). System implementation enhances exercise goal completion rates by 10.3% and increases moderate-to-vigorous training duration by 14.7%, providing a closed-loop “assessment-correction-feedback” solution for intelligent sports education. The research contributes methodological innovations in personalized modeling for exercise science and multi-modal time-series data processing. Full article

Objective: This study aimed to compare trained male and female athletes regarding physiological, perceptual, and performance variables at ventilatory thresholds (VT₁ and VT₂). Methods: Twenty-four male and nineteen female trained runners (age: 27.9 ± 6.4 vs. 24.4 ± 4.4 years; body mass: 61.8 ± 4.3 vs. 52.6 ± 4.1 kg; height: 174.6 ± 5.8 vs. 165.0 ± 5.0 cm for males and females, respectively) performed a graded exercise test to exhaustion on a treadmill. During the test, oxygen consumption, respiratory exchange ratio, running power output, heart rate, muscle oxygenation, and rate of perceived exertion were analyzed. Sex differences were evaluated with an unpaired-samples t-test. Results: Males exhibited significantly higher respiratory exchange ratios (0.87 ± 0.04 vs. 0.83 ± 0.03; 1.03 ± 0.06 vs. 1.01 ± 0.06) and absolute running speeds (15.00 ± 1.06 vs. 12.42 ± 1.22 km·h⁻¹; 19.04 ± 1.06 vs. 16.32 ± 1.29 km·h⁻¹) at both thresholds (p < 0.05), whereas women showed higher muscle oxygenation in vastus lateralis (60.44 ± 21.21 vs. 26.38 ± 10.21%) and fractional utilization of maximal aerobic speed (93.64 ± 6.44 vs. 91.43 ± 3.21%) at VT₂ (p < 0.01). Also, rate of perceived exertion was similar between sexes at both thresholds. Conclusion: Males showed higher absolute physiological values, while females demonstrated greater fractional utilization at VT₂ and higher muscle oxygenation. No sex differences were observed in rate of perceived exertion. These findings highlight the importance of using ventilatory thresholds in training prescription. Full article