Search Results (176)

Background: Metabolic syndrome (MetS) leads to alterations in cardiac autonomic control that can be detected from electrocardiogram (ECG)-derived markers, particularly when the cardiovascular system is challenged during an oral glucose tolerance test (OGTT). Methods: In this paper, we present an automated framework for MetS identification using RR intervals and heart rate variability (HRV) features extracted from 12-lead ECG recordings acquired during the five OGTT stages in 40 male participants (15 with MetS, 10 controls, and 15 endurance-trained marathon runners). RR intervals were first derived using a multilead Pan-Tompkins approach with fusion-based validation. From these RR series, HRV descriptors were computed from time-domain statistics (RR mean, SDNN, rMSSD, pNN50), spectral indices (VLF, LF, HF, LF/HF), and nonlinear measures (SD1, SD2, SampEn, DFA-${\alpha }_1$). Conventional HRV analysis revealed pronounced physiological differences between groups: MetS subjects exhibited reduced parasympathetic activity, reflected by lower rMSSD and SD1, lower HF power, and higher LF/HF ratios, whereas marathoners showed greater vagal modulation, higher HF power, and increased signal complexity. Healthy controls showed an intermediate autonomic profile. Using RR sequences and HRV descriptors (256 samples per stage), we trained three multimodal classifiers: a CNN-MLP model with a softmax output, a CNN-MLP model with an SVM head, and a CNN + LSTM-MLP + SVM architecture. Results: All models achieved strong discriminative performance, with accuracies ranging from 0.92 to 0.95, F1-macro values from 0.92 to 0.95, and macro-AUC values from 0.96 to 0.97. The CNN-MLP model achieved the best overall performance, whereas the CNN + LSTM-MLP + SVM model showed strong class discrimination, particularly for endurance athletes, while maintaining competitive recall for MetS. Conclusions: These findings support the feasibility of ECG-based autonomic assessment as a complementary non-invasive approach for early metabolic risk detection in clinical and preventive cardiometabolic screening settings. Full article

Background: We aimed to (i) identify the factors associated with performance in non-elite runners, (ii) present the terms and definitions/attributes used to characterize runners, and (iii) identify how performance has been operationalized. Methods: Our search was conducted using the databases PubMed, Web of Science, Medline Ovid, Cochrane, PsycInfo, Scielo, Scopus, and SportDiscus in October 2023 and updated in February 2026. Original articles that assessed factors associated with performance in non-elite runners competing in distances ranging from 5 km to ultramarathons were included. The findings were summarized by race distance. The Joanna Briggs Institute Analytical Cross-Sectional Studies critical appraisal tool was used for quality assessment. Results: A total of 4151 studies were identified, and 66 studies were included in the final selection. “Recreational” and “athletes” were the most used terms, and finish time was the most common indicator of performance. Performance decline was influenced by arm circumference and mid-axillary skinfold thickness, smoking, body mass index, alcohol consumption, and weather characteristics. Training variables, physiological determinants, and social variables were positively related to performance. Conclusions: The field struggles with a lack of clarity regarding the nomenclature and criteria used to categorize runners. The relevance of a predictor differs according to race distance, with physiological aspects becoming less important at higher distances (i.e., marathon and ultramarathon). Full article

Marathons are one of the ultimate challenges of human endeavor. As a consequence of the growing passion of amateur runners for this discipline, a strong need has been shown for counselling during the preparation and for advice on how to manage their efforts during the race. This monitoring should be based on parameters collected during the race and correctly interpreted. Multifractality parameters, which have proved their relevance in many other areas of signal processing, are natural candidates for this purpose. This paper shows that, due to the extreme irregularity of the data, the previously used multifractal techniques cannot be applied in this context, in contrast with the recently introduced parameters based on the weak scaling exponent, which require no a priori assumptions for their use; these parameters yield new classification parameters in the processing of physiological data captured on marathon runners. The comparison of their values reveals how marathon runners handle variations in the irregularity of their races and therefore gives a new insight on the way that runners of different levels conduct their run; therefore, this study shows that the use of these parameters offers a promising tool in order to give advice on how to improve performances. Full article

Background/Objectives: Carotenoids are pigmented phytochemicals known for their antioxidant properties, known to protect against oxidative damage, especially in the context of intense exercise. The purpose of this paper was to observe and analyze the short-term effects of running a full marathon on skin and plasma carotenoid levels in endurance runners. Methods: This study recruited 24 healthy endurance runners (12 male, 12 female; mean age 37 years) registered for a 26.2-mile marathon. Skin carotenoid (SC) measures were taken via reflection spectroscopy, and plasma carotenoid concentrations (lycopene and β-carotene) were assessed via HPLC at three time points: pre-race, immediately post-race, and 48 h post-race. Changes across time were analyzed using repeated-measures ANOVA. Results: Skin carotenoid levels significantly changed over time, dropping from pre-race to post-race (p < 0.001), reflecting rapid utilization. At 48 h post-race, SC levels rebounded significantly, exceeding baseline measurements (p = 0.019). Plasma lycopene concentrations increased significantly from pre-race to post-race (p = 0.018) and remained elevated at 48 h. Plasma β-carotene concentrations showed no statistically significant change. Conclusions: The significant acute depletion of SC levels immediately following the marathon reflects the rapid utilization of these dermal antioxidants in response to the high oxidative stress generated by intense exercise. The elevation in plasma lycopene may reflect hemoconcentration resulting from intense activity and possible mobilization from tissue stores. The rapid rebound and overshoot in SC levels 48 h after the race are consistent with a recovery pattern of dermal carotenoid levels following acute depletion. Full article

Objective: Resistance exercise can induce muscle damage that impairs sports performance and cellular repair. Myokines, particularly mitochondrial myokines, play an important role in regulating energy metabolism and muscle recovery. The ACTN3 R577X polymorphism, which alters the expression of α-actinin-3 in muscle fibers, may influence myokine responses by modulating exercise adaptation and recovery. Methods: Seventy-five amateur runners (30–55 years) from the São Paulo International Marathon were evaluated. Plasma levels of mitochondrial myokines (BDNF, FGF-21, FSTL, IL-6, apelin, IL-15, musclin, and myostatin) were measured before and after the race and correlated with ACTN3 R577X genotypes. Results: In this study, the genotypic frequencies of the ACTN3 R577X polymorphism were 36% (RR), 39% (RX), and 14% (XX). Plasma concentrations of BDNF, FSTL, FGF-21, and IL-6 increased immediately after running across all genotypes, with no significant differences observed between genotypes. In contrast, plasma levels of myostatin, musclin, IL-15, and apelin decreased during the recovery period only among runners carrying the R allele. Conclusions: Mitochondrial myokine responses to resistance exercise were not substantially different among genotypes of the ACTN3 R577X polymorphism. However, myokines associated with protein breakdown and bioenergetic adaptation were reduced during the recovery period in runners carrying the R allele, which may impact muscle repair and bioenergetic adaptation. Full article

Participation in running events has expanded worldwide, consolidating itself as a form of active leisure and a driver of social and tourism engagement. Although runners’ motivations have been extensively studied, perceived inclusivity, understood as motivation derived from the event’s promotion of equitable participation across gender, age and functional ability, has rarely been examined as a distinct motivational dimension within structural models. This study analyses the motivational structure of participants in the Elche Half Marathon (Spain) and assesses the incremental contribution of inclusivity to traditional motivational frameworks. Based on a sample of 1053 valid responses, a two-stage psychometric and segmentation approach was applied. Exploratory and confirmatory factor analyses (EFA and CFA) were conducted to compare a four-factor model (sport-related hedonism, competition, socialization and digital socialization) with an extended five-factor model incorporating inclusivity. Subsequently, cluster analyses were performed using factor scores derived from each model. The results show that the inclusion of inclusivity improves model fit and increases explained variance, while also generating a more differentiated segmentation structure. The extended model revealed six motivational profiles, some of which displayed continuity with the classical solution, while others were reconfigured when inclusivity was introduced. Overall, the findings indicate that inclusivity functions as a complementary and context-dependent motivational dimension that refines the understanding of participation heterogeneity in running events. Rather than replacing traditional motives, inclusivity contributes incremental explanatory value and enhances the identification of motivational profiles, offering relevant insights for the design and management of mass-participation sporting events. Full article

Road running tourism events continue to grow worldwide and are increasingly leveraged by destinations seeking diversification and seasonality reduction. This study examines the motivational structure of participants in the 2025 Half Marathon Magaluf (Mallorca, Spain)—a mature Mediterranean resort undergoing tourism repositioning—and analyses how motivation-based segments relate to socio-demographic, sporting and tourism behaviours. Data were collected through a self-administered online survey (N = 306). An Exploratory Factor Analysis (EFA), followed by a Confirmatory Factor Analysis (CFA), validated a five-factor motivational structure: sport-related hedonism, socialisation, personal challenge, inclusiveness and digital interaction. A k-means cluster analysis identified five distinct segments—Digital Enthusiasts, Inclusive Enjoyers, Socializers, Hedonic Achievers and Inclusivists—each exhibiting differentiated patterns in Experience-Use History (EUH), origin, gender, and running-club membership. Notably, Socializers recorded the longest stays, Inclusive Enjoyers were overrepresented among first-time visitors, and Digital Enthusiasts and Hedonic Achievers included a higher share of international runners. These findings expand traditional motivational models by incorporating inclusiveness and digital interaction as emerging drivers and offer actionable recommendations for event organisers and destination managers seeking to enhance overnight stays and support destination repositioning strategies. Full article

Background/Objectives: Running is one of the most popular physical activities worldwide and have been widely studied in relation to performance and injury prevention. In addition to measurements conducted under standardized laboratory conditions, inertial measurement units (IMUs) allow for the assessment of biomechanical parameters in real-world settings—particularly during endurance runs. The aim of this study was to investigate how running a half-marathon under field conditions affects exertion and various biomechanical parameters, as measured using IMUs. Methods: Twenty runners completed a half-marathon on a flat, even-surfaced walkway at a self-selected, constant pace corresponding to a brisk training run. In addition to lower limb biomechanics, heart rate (HR) and ratings of perceived exertion (REP) were also recorded. Results: A significant increase in both HR and RPE was observed toward the end of the half-marathon, indicating the presence of fatigue during the later stages of the run. The biomechanical results further demonstrate that this fatigue was associated with increased peak tibial acceleration, peak angular velocity in the sagittal plane of the foot, and peak rearfoot eversion velocity, while foot strike angle, stride frequency, and stride length remained unchanged. Furthermore, a progressive increase in ground contact time and a decrease in flight time were observed over the course of the run, resulting in an increased duty factor. Conclusions: These findings highlight the value of IMU-based assessments for detecting fatigue-related biomechanical changes during prolonged runs in real-world conditions, which may contribute to early identification of overload and inform injury prevention strategies. Full article

Background: Sleep is essential for athletes’ physical performance and recovery. However, strenuous exercise has the potential to increase inflammation and worsen sleep. This study evaluated the effect of probiotic supplementation on self-reported sleep quality, daytime sleepiness, and inflammatory profile 24 h after a marathon. Methods: 27 marathon male runners were divided into the Probiotic group (Probiotic n = 14) or the Placebo group (Placebo n = 13). The Probiotic group consumed 1 × 10¹⁰ CFU of Lactobacillus acidophilus, 1 × 10¹⁰ CFU of Bifidobacterium lactis + 5 g/day maltodextrin for 30 days prior to the marathon. The Placebo group received a sachet of 5 g/day maltodextrin during the same period. Sleep and inflammatory status were assessed before supplementation, before the marathon, and 1 h and 24 h after the marathon. Data were analyzed using Statistic 13.3 and expressed as mean ± standard deviation. Tukey’s post hoc test was followed by a two-way ANOVA with repeated measures. The level of significance was set at p ≤ 0.05. Results: In the Placebo group, daytime sleepiness, sleep latency, and global sleep score increased 24 h after the marathon, while total sleep time and sleep efficiency decreased. In the Probiotic group, daytime sleepiness, sleep latency, and global sleep scores were lower 24 h after the marathon compared to the Placebo group. Total sleep time and sleep efficiency were higher in the Probiotic group compared to the Placebo group 24 h after the marathon. IL-1β and TNF-α concentrations decreased compared to Basal in both groups. IL-1β levels were lower 24 h after treatment compared to pre-treatment in the Placebo group. IL-6 was lower 24 h after the marathon in both groups. LPS concentrations were lower 1 h and 24 h after the marathon in the Probiotic group compared to the Basal group. There was no difference in cytokines and LPS between the groups. Conclusions: Supplementation with Lactobacillus acidophilus and Bifidobacterium lactis for 30 days changes self-reported sleep and reduces LPS concentration after the marathon. Full article

Background and Objectives: This study aimed to compare acute changes in body composition parameters following marathon (42.195 km) and ultramarathon (61 km) runs in trained male athletes, with particular focus on hydration dynamics and metabolic stress. Materials and Methods: Sixteen male amateur endurance runners were assigned to two groups: marathon (n = 8) and ultramarathon (n = 8). Body composition was assessed at three time points pre-race, immediately post-race, and 24 h post-race using bioelectrical impedance analysis. Measurements included body weight (BW), body mass index (BMI), total body water (TBW), total body fat (TBF), lean body mass (LBM), right arm fat (RAF), left arm fat (LAF), right leg fat (RLF), left leg fat (LLF), and torso fat (TF). Results: Both groups exhibited significant reductions in BW and BMI post-race (p < 0.05), with more pronounced changes observed in the ultramarathon group. Partial restoration of these metrics occurred within 24 h, primarily due to glycogen resynthesis and fluid retention. TBW remained stable immediately post-race but increased notably during recovery, particularly in ultramarathon runners, suggesting more effective hydration responses. Muscle and fat-free mass changes were minimal but more favorable in the ultramarathon group. Both total and regional fat percentages declined significantly post-race in both groups, with ultramarathon runners showing greater reductions. Conclusions: Endurance running induces short-term but substantial alterations in body composition, with ultramarathon participation eliciting more pronounced metabolic and fluid balance responses. These findings highlight the importance of race-specific nutritional and hydration strategies tailored to event type and duration. Full article

Accurate and continuous tracking of athletes is essential to meet the infotainment demands and health and safety requirements of major marathon events. However, the current ability to track individual athletes or groups at mass sporting events is severely limited by the weight, size and cost of the equipment required. In marathons, Radio Frequency Identification (RFID) technology is typically used for timing but can only provide accurate tracking at widely spaced intervals, relying on heuristic and interpolation algorithms to estimate runners’ positions between measurement points. Alternative IOT solutions, such as Low Power Wide Area Network (LWPAN), have limitations in terms of range and require dedicated infrastructure and regulation. Therefore, we analyzed the potential use of smartwatches as accurate and continuous tracking devices for athletes, assessing battery consumption during tracking and standby drain, achievable GPS tracking accuracy and the update rate of data transfer from the device in urban environments. The 4G LTE battery drain is different from non-urban areas. Analysis of standby usage is necessary as devices need to conserve power for tracking. We programmed an application that allowed us to control the modalities of acquisition and transmission intervals, integrating advanced logging and statistics at runtime, and evaluated the achievable results in major marathon events. Our empirical evaluation at the Frankfurt, Athens and Vienna marathons with three different types of smartwatch tracking platforms showed the validity of this approach, while respecting some necessary limitations of the tracking settings. Median battery drain was 5.3%/h in standby before race start (σ 1.5) and 16.5%/h in tracking mode (σ 3.29), with an actual update rate varying between 19 and 57 s on Wear OS devices. The average GPS offset to the track was 4.5 m (σ 8.7). Future work will focus on integrating these consumer devices with existing time and tracking infrastructure. Full article

Trail running is a demanding endurance sport where performance prediction models often rely on laboratory testing or pre-race data, limiting their practical application. This study presents a real-time predictive model for marathon and ultra-trail races, based on variables recorded during the race, including uphill/downhill pace-times, terrain difficulty coefficients, and partial rankings. A total of 947 runners from the ‘Trail Valle de Tena’ event (Spain) were analyzed to develop equations that estimate total race time using only the first third of the race. The model incorporates weighted time (WT_n), pacing variability (WTV_n,n+2), and checkpoint percentile rank (CPR_n), showing strong predictive power (adjusted R² > 0.95) across sexes and race modalities. These variables reflect the runner’s ability to both overcome elevation and maintain consistent pacing, offering insights into fatigue management and performance optimization. The model enables coaches and athletes to monitor race progression, adjust strategies in real time, and potentially reduce injury risk through better control of effort intensity. Unlike laboratory-based models, this approach is fully applicable in field conditions and does not require prior testing. Further validation in similar endurance events is recommended to confirm its utility as a practical tool for training and competition planning. Full article

Background and Objectives: The objectives of this review were as follows: to measure changes in renal biomarker levels before, immediately after, and 24 h post-marathon; to identify promising biomarkers for the diagnosis of acute kidney injury; and to describe the temporal patterns of biomarker dynamics in relation to the marathon. Materials and Methods: Studies of marathon runners reporting AKI-related biomarkers were included. Four databases (PubMed, EMBASE, Web of Science, and LILACS) were searched. Data on study design, participant characteristics, and biomarker values (pre-, post-, and 24 h post-race) were extracted, and a random effects meta-analysis was performed. Risk of bias was assessed with the National Heart, Lung, and Blood Institute pre–post tool. Results: The study showed significant increases in most biomarkers immediately after the marathon compared to baseline values. The largest increases were observed in Tissue Inhibitor of Metalloproteinases-2* Insulin-like Growth Factor Binding Protein-7 (TIMP-2*IGFBP), copeptin, urinary Liver-type Fatty Acid Binding Protein (L-FABP), urinary Monocyte Chemoattractant Protein-1 (MCP-1), IGFBP-7, urinary Chitinase 3-like Protein 1 (YKL-40), and TIMP-2, suggesting that these biomarkers are promising candidates for future research. Several patterns of biomarker evolution were observed: some increased without decreasing even at 24 h after the marathon; others increased post-marathon and decreased at 24 h while remaining above baseline; some increased after the marathon and then fell below baseline at 24 h. Conclusions: Marathon running causes significant increases in kidney injury biomarkers, with different patterns of evolution. Full article

Background/Objectives: Soluble ST2 (sST2) has gained recognition as a clinically relevant biomarker across a spectrum of inflammatory, cardiovascular, and respiratory conditions. However, the lack of assay standardization raises concerns about result comparability across platforms and studies. Methods: This study systematically evaluated serum sST2 concentrations measured with two ELISA systems—DuoSet and Quantikine—produced by the same manufacturer (R&D Systems, Minneapolis, MN, USA). Results: Using archived serum samples from healthy volunteers and marathon runners, we identified marked discrepancies: serum sST2 concentrations using the DuoSet recombinant standard were on average 4.3-fold higher than those using Quantikine (median 308.3 [106.6–608.6] vs. 71.5 [41.8–115.6] ng/mL). On the pre-coated Quantikine plate, using the DuoSet recombinant standard increased calculated concentrations 4.3-fold compared with the native Quantikine standard (median 308.3 [106.6–608.6] vs. 71.5 [41.8–115.6] ng/mL). On the manually coated DuoSet plate, the DuoSet standard yielded higher medians than the Quantikine standard (8.0 [5.6–11.3] vs. 5.0 [3.7–7.4] ng/mL). Furthermore, between-lot variability within the same ELISA platform resulted in concentration shifts from 0.09 [0.07–0.10] ng/mL (2016) to 1.17 [0.81–3.23] ng/mL (2023) using the same sample. Previously published studies also exhibited wide inter-study variability among healthy cohorts. Conclusions: These findings emphasize that current ELISA systems for sST2 are not standardized and that cross-study comparisons should be interpreted with caution. Until universal standardization is implemented, sST2 should primarily be used for within-study comparisons. This variability may limit the reliability of longitudinal sST2 assessment even in clinical settings. Full article

Congenital agenesis of the tensor fascia lata (TFL) muscle is an extremely rare anomaly, with very few reports in the literature and unclear clinical significance. We report the incidental finding of unilateral TFL agenesis in a 25-year-old male physician who had been enrolled as a healthy control in a muscle MRI study on genetic myopathies. Imaging demonstrated a complete absence of the right TFL with mild compensatory hypertrophy of the ipsilateral rectus femoris, while the contralateral side and all other muscles appeared normal. The subject had no history of neuromuscular disease, exhibited only a subtle waddling gait, and had previously completed the New York Marathon in 4 h and 16 min without symptoms. Laboratory tests, including creatine kinase, were within normal limits. Thirteen years later, he remains in good health, continues regular sports activities, and has not developed pain or functional impairment. This case emphasizes that TFL agenesis may remain clinically silent and compatible with high levels of physical activity. Nevertheless, awareness of such anomalies is important, as compensatory mechanisms might predispose to long-term biomechanical imbalance, and recognition on imaging can prevent misinterpretation or unnecessary investigations Full article