Search Results (483)

The gut microbiota can influence tumor immunity and treatment responses through microbial metabolism, intestinal barrier regulation, and immune–inflammatory signaling, but whether exercise engages these mechanisms through the muscle–gut axis remains uncertain. This review integrates evidence from exercise physiology, microbial metabolism, and tumor immunology to examine how exercise-associated host signals may reshape the intestinal ecological niche and microbial function. Three candidate muscle–gut axes are proposed: the myokine–enteroendocrine–substrate delivery–short-chain fatty acid (SCFA) axis, the exercise-associated lactate–microbial cross-feeding–propionate axis, and the muscle-derived endocrine signaling–intestinal epithelial repair–hypoxic niche axis. Separate studies support exercise-associated IL-6/GLP-1/PYY regulation and gastrointestinal transit, lactate entry into the intestinal lumen and lactate-associated microbial remodeling, Veillonella atypica-mediated propionate production, and irisin/apelin-related epithelial repair. Together, these pathways may influence microbial metabolism, barrier homeostasis, and immune–tumor interactions. However, tumor-related links remain incomplete, and none has been validated as a complete causal chain in a single tumor-bearing exercise model. Relatively complete preclinical evidence comes from mouse melanoma, where endurance exercise enhanced microbial folate-dependent one-carbon metabolism and formate output, with microbiota-derived formate promoting CD8⁺ T-cell antitumor activity and immune checkpoint inhibitor efficacy. Regular exercise with an appropriate load and adequate recovery may support microbial and intestinal barrier homeostasis, whereas excessive or prolonged exercise with inadequate recovery may impair barrier integrity. Human evidence remains limited and largely associative and does not establish microbiota-mediated improvements in tumor immunity or treatment responses. These candidate axes therefore require causal validation in tumor-bearing exercise models and prospective human studies. Full article

A fundamental concern for coaches and sport practitioners is developing athlete performance while preserving health and well-being. An emerging topic is that performing in nature-based environments may have more benefits than performing in typical built/indoor environments. However, to understand athlete performance and well-being, it is essential to recognize how performers accommodate (adapt) skills and resources under environmental constraints in pursuit of sport and exercise task goals. This article presents a narrative review to support a hypothesis on the sustained benefits of performing in nature-based environments, with health and well-being as necessary aspects for performance, grounded in the ecological dynamics theoretical framework. We start by discussing: (i) performance in nature-based and indoor environments underpinned by affordance perception; (ii) evidence for the role of nature-based environmental constraints on movement and psychological aspects; (iii) the hypothesis that prolonged engagement with nature-based environments during sport and exercise may promote adaptive skill development, health, and well-being, and may facilitate the transfer of these adaptations to performance in built indoor competitive settings; (iv) the distinct lived experiences (e.g., emotion, well-being) that emerge from exercising in nature-based and built indoor environments; and (v) suggestions on how to include nature-based constraints on sport and exercise training, and future research considerations. Overall, the reviewed theoretical and empirical evidence provides a rationale for the hypothesis that prolonged engagement with nature-based environments during sport and exercise may promote adaptive skill development, health, and well-being, with potential transfer of these adaptations to performance in built indoor settings. Future longitudinal and experimental studies are required to test this hypothesis and determine whether, and under what conditions, these proposed adaptations transfer to performance in built indoor sport settings. Full article

Background/Objectives: Highly branched cyclic dextrin (HBCD) may improve carbohydrate (CHO) availability during soccer-specific intermittent exercise via favorable gastrointestinal properties. Whether co-ingestion with whey protein confers additional ergogenic benefits beyond HBCD alone remains unclear. Methods: Nine male soccer players completed a single-blind, randomized crossover trial (≥7-day washout) with three conditions, Placebo (water), CHO, and isocaloric HBCD plus whey protein isolate (CHOP), during a standardized, ~120-min laboratory-based soccer-specific intermittent exercise protocol (not an actual match). The 500-mL beverage, split into two 250-mL servings, was consumed before exercise and at half-time during the exercise protocol. Respiratory quotient (RQ), substrate oxidation, heart rate, RPE, digestive symptoms, running time, and distance were assessed, with condition effects tested via repeated-measures ANOVA at each cycle. Results: Compared with Placebo, CHO increased RQ (p = 0.042) and carbohydrate oxidation (p = 0.048) while reducing fat oxidation (p = 0.034) at the final cycle, reflecting greater late-exercise CHO utilization without improving endurance performance. Compared with Placebo, CHOP significantly improved both running time (p = 0.019) and running distance (p = 0.025), with no significant difference from CHO on either outcome. RPE was significantly lower in CHOP than in Placebo during the latter stage of exercise (p = 0.016). Conclusions: HBCD ingestion before exercise and at half-time promoted greater late-exercise CHO utilization without increasing cardiovascular or gastrointestinal strain. Co-ingestion of whey protein with HBCD provided ergogenic benefits over Placebo by improving fatigue-limited endurance performance, supporting isocaloric CHOP co-ingestion as a practical nutritional strategy for prolonged soccer-specific intermittent exercise. Full article

Background/Objectives: Contemporary sport-related concussion management has shifted from prolonged rest toward early, symptom-limited activity and a staged return-to-sport strategy. The Amsterdam framework provides an essential safety hierarchy but does not fully operationalize how clinicians should manipulate exercise dose, task complexity, recovery, and interacting rehabilitation domains within each stage. This Perspective proposes neuroperiodization as a constrained, criterion-based load-prescription framework nested within the Amsterdam strategy. Framework Development: The framework distinguishes prescribed external load from internal response, including symptom change and duration, heart rate, rating of perceived exertion, task quality, confidence, and delayed recovery. Clinical decision-making is organized through a repeated cycle of assessment, prescription, monitoring, adaptation, and reassessment. Proposed Framework: Neuroperiodization supports the concurrent but controlled development of aerobic, cervical, vestibular–ocular, neuromotor, cognitive–motor, and sport-specific capacities. Progression remains subordinate to medical clearance, clinical findings, symptom response, and sport-specific risk. Conclusions: Neuroperiodization should be regarded as a conceptual clinical framework rather than a validated rehabilitation protocol or an alternative return-to-sport clearance pathway. It integrates Amsterdam consensus recommendations, evidence-informed extrapolations, and author-proposed elements and requires population-specific adaptation and prospective evaluation. Full article

Primary dystrophin deficiency, caused by X-chromosome mutations within the DMD gene, encompasses a continuous clinical spectrum of neurological, muscular, and cardiac disorders known as dystrophinopathies that exhibit profound phenotypic variability driven by specific mutation profiles and epigenetic factors. This comprehensive review analyzes the clinical and molecular characteristics of seven primary classifications: Duchenne muscular dystrophy (DMD), a severe childhood myopathy caused by a complete absence of the protein that leads to loss of ambulation and fatal cardiorespiratory failure in youth; Becker muscular dystrophy (BMD), a milder variant with partial protein deficiency that preserves walking capabilities into adulthood and prolongs life expectancy; pseudometabolic dystrophinopathic syndrome, featuring exercise intolerance, cramps, and recurrent rhabdomyolysis that mimics metabolic diseases; asymptomatic dystrophinopathy, representing the mild end of the spectrum identified incidentally through chronically elevated creatine kinase levels; brain dystrophin-related syndrome, where the disruption of distal isoforms like Dp140 and Dp71 results in neurodevelopmental and neuropsychiatric comorbidities such as ADHD, autism, and intellectual disability; X-linked dilated cardiomyopathy (XLDCM), a cardiac-selective condition causing severe heart failure and arrhythmias while sparing skeletal muscle function; and female dystrophin-related syndrome, distinguishing between familial carriers—who can manifest symptoms due to skewed X-chromosome inactivation—and rare sporadic females who develop an exceptional, severe, Duchenne-like phenotype due to cytogenetic accidents such as Turner syndrome or chromosomal translocations. Ultimately, advancements in molecular testing (NGS and WGS) have significantly optimized diagnostic precision, proving essential for implementing early cardioprotective care, accurate genetic counseling, and the development of future tissue-specific targeted gene therapies. The present study also discusses the psychosocial impact that the disease has on patients. Full article

Background and Objectives: Chronic non-specific neck pain (CNNP) is common among desk-based workers exposed to increased ergonomic risk and is accompanied by functional impairments. This study examined associations between exercise participation and pain intensity, upper-extremity disability, body awareness, and perceived sagittal trunk appearance in this population. Materials and Methods: This cross-sectional study included 250 of 512 screened desk-based workers with CNNP, pain severity ≥4/10, and a Rapid Upper Limb Assessment (RULA) score ≥ 3/7. Physical activity, upper-extremity disability, body awareness, perceived sagittal trunk appearance, and ergonomic risk were assessed using the IPAQ-SF, QuickDASH, Body Awareness Rating Questionnaire (BARQ), KyphoTAPS, and a video-call-based RULA. Results: Participants reporting exercise participation had lower QuickDASH scores (p = 0.003, d = −0.42) and higher BARQ total scores (p = 0.023, d = 0.33) than non-exercisers. BARQ function and awareness scores were higher in this group (p = 0.004 and p = 0.033), while pain severity, perceived sagittal trunk appearance, and ergonomic risk were similar between groups. QuickDASH scores were positively correlated with pain severity (rho = 0.636–0.727) and negatively correlated with BARQ total scores (rho = −0.477). RULA scores showed a weak positive correlation with general neck pain (rho = 0.288) (FDR-adjusted p < 0.002). Exploratory adjusted analyses showed that participants reporting regular exercise participation had lower QuickDASH and higher BARQ total scores than non-exercisers in all models. Participants reporting low-frequency exercise participation had lower QuickDASH scores than non-exercisers only in Model 4. Conclusions: Self-reported exercise participation may be associated with lower QuickDASH scores and higher BARQ total scores in desk-based workers with CNNP and increased ergonomic risk. Because maintaining consistent exercise participation can be challenging in occupational settings, future studies should investigate feasible exercise strategies to address pain-related, functional, and perceptual outcomes among occupational populations exposed to prolonged ergonomic loading. Full article

Background: Frozen shoulder (FS) is a debilitating condition characterized by pain and restricted range of motion (ROM), often leading to prolonged treatment and economic burden. Home exercise programs are effective for FS, so we developed the Defrozen app to support home exercise. This randomized controlled trial (RCT) compared app- versus pamphlet-assisted home exercise programs in patients with FS. Methods: In this RCT, twenty-one patients with FS who received corticosteroid injections were randomized (2:1) to app or pamphlet-assisted home exercise. Baseline assessments were performed, and all participants initiated their assigned home exercise program, which lasted 4 weeks. Outcomes included shoulder ROM, pain intensity (numeric rating scale, NRS), and functional outcomes (Oxford Shoulder Score [OSS] and Quick Disabilities of the Arm, Shoulder, and Hand [QuickDASH] score). Results: Both groups demonstrated significant within-group improvements in ROM measures, NRS, OSS, and QuickDASH scores (p < 0.05). Between-group comparisons using analysis of covariance (ANCOVA) showed significantly greater gains in shoulder abduction (p = 0.023) and internal rotation (p = 0.020) in the app-assisted group compared with the pamphlet group. Conclusions: A four-week app-based home exercise program provides additional benefits in improving shoulder ROM compared with conventional pamphlet-based instruction in FS after corticosteroid injection. Full article

Coffee is widely consumed by physically active individuals and athletes, often with the intention of enhancing alertness, reducing fatigue and supporting exercise performance. Its performance-related effects are primarily attributed to caffeine; however, responses to coffee consumption vary substantially across individuals and type of training. This narrative review examines current evidence on the role of coffee consumption in sport, with particular emphasis on caffeine-related mechanisms, physical performance, fatigue, muscle pain and recovery, as well as factors modifying individual responses, including circadian rhythm, habitual intake and genetic variability. Available evidence indicates that coffee consumption prior to physical activity may support endurance performance, reduce perceived exertion and attenuate muscle pain, particularly during prolonged or demanding exercise and under conditions of sleep restriction or circadian misalignment. In contrast, effects on muscle strength and power performance appear less consistent and more context dependent. Interindividual differences in caffeine metabolism, sensitivity to stimulation and susceptibility to sleep disruption further influence both the effectiveness and tolerability of coffee intake. Emerging findings also suggest that coffee, when consumed in combination with carbohydrates, may enhance post-exercise muscle glycogen resynthesis, a potential benefit of particular relevance for endurance athletes facing limited recovery time. At the same time, evidence regarding non-caffeine bioactive compounds present in coffee remains limited and largely indirect, indicating a modulatory rather than ergogenic role. Overall, coffee should not be regarded as a universally effective ergogenic aid, as its effects may vary according to individual characteristics, training demands and the timing of consumption. Its effective use requires careful consideration of individual characteristics, training demands and timing of consumption, underscoring the importance of personalized strategies in both performance and recovery settings. Full article

The early design courses engage and hone students’ visual, spatial, and communicative skills so that first-year design students begin to understand composition, abstraction, hierarchy, development of process, and representation through experimental, process-driven exercises. Exhibitions have traditionally presented the students’ final work; however, virtual exhibitions allow one to push past the physical studio and present student work as a sustained pedagogical experience. A case study was presented of the development and curation of a speculative gallery-style virtual exhibition for process work by first-year students undertaking Basic Design and a Design Communication course. Rather than falling into the pitfall of functioning as a “digital stand-in for the gallery” approaches were considered where virtual curation becomes an educative space for being literate in the visual, mindful learning, and observer witnessing peer students enculturating themselves into identity. Using a practice-based reflective approach, to examine curatorial decisions (visual sequencing, categorisation, representation, and navigational design), exploring how exhibition design frames beginner work and communicates thinking and process rather than simply “polished” outcomes. It is argued that virtual exhibition, by allowing for prolonged engagement with works, scaling access, and encouraging a visual dialogue among peers, may extend the foundation of design learning. The study contributes to discourse on design pedagogy, digital curation, and the shifting educational place of exhibitions in foundation-level design education. Full article

Neurological disorders drive demand for prolonged upper-limb rehabilitation, yet specialist access is uneven and assessment stays subjective. Marker-based and inertial measurement unit (IMU) systems are accurate but costly and impractical at home, while pose estimation pipelines mostly stop at keypoints, and many process video server-side, raising privacy concerns. We present a markerless pipeline that analyzes monocular RGB video entirely on-device in the browser, so it never leaves the machine. From 33 BlazePose keypoints, it derives five geometric metrics designed to limit body-size dependence—incomplete elbow extension, inter-limb asymmetry, shoulder girdle elevation, lateral trunk lean, and head tilt—compared against empirically calibrated, preliminary thresholds; a finite-state machine segments repetitions, and the flags are pooled into an unvalidated, exploratory quality score. Against an IMU reference over the 0–${62}^{\circ }$ range that the recordings cover, the image-plane angle showed a mean absolute error of ${2.18}^{\circ }$, below the pre-specified $5^{\circ }$ tolerance, a trajectory-averaged bias within $\pm 2^{\circ }$, and Lin’s concordance correlation coefficient of $0.956$; the difference is, however, proportional to the angle—about $4\%$ of the measured value—so the accuracy should not be extrapolated to larger elevations, and because that comparison was made offline, it does not include the timing error of the causal real-time path. On a single seated frontal-plane abduction task, with 18 healthy volunteers simulating the compensations and annotated by two independent clinicians blind to the instructed condition, compensation detection reached a macro-averaged $F_1$ of $0.75$ and $0.72$ against the individual raters. The five signs differ in maturity: near-expert for trunk lean and head tilt, moderate for incomplete elbow extension and inter-limb asymmetry, and weakest for shoulder elevation, which a single frontal view cannot fully disentangle from the abduction motion. Running at 22–30 frames per second on consumer laptops without relying on a discrete GPU, it offers an accessible, privacy-preserving proof-of-concept foundation for home telerehabilitation; generalization beyond this one exercise and effectiveness on genuine post-stroke compensations remain to be established. Full article

Background/Objectives: Cognitive fatigue and impaired psychomotor function may contribute to reductions in football-specific performance during prolonged match-like activity. This study evaluated cognitive, psychomotor, sprint, and football-specific locomotor responses to multi-ingredient protocols containing taurine, caffeine, and either 300 or 600 mg·day⁻¹ of phosphatidylserine in professional male football players. Methods: In this randomized, triple-masked, placebo-controlled, parallel-group trial, 97 professional male football players were allocated to placebo (PLA, n = 24), taurine plus caffeine (TC, n = 24), taurine plus caffeine plus phosphatidylserine 300 mg·day⁻¹ (TCP-300, n = 24), or taurine plus caffeine plus phosphatidylserine 600 mg·day⁻¹ (TCP-600, n = 25) for 14 days. Taurine and caffeine doses were 1500 mg·day⁻¹ and 200 mg·day⁻¹, respectively. Outcomes included 30 m sprint performance, visual and auditory reaction time, Stroop-task performance, perceived mental fatigue, GPS-derived locomotor variables, and post-intervention first-to-second-half performance-loss indices during a standardized football-specific exercise protocol. Results: The baseline-adjusted ANCOVA demonstrated a significant treatment-group effect on post-intervention 30 m sprint time. After Holm–Bonferroni correction, significant treatment-related effects remained for Stroop reaction time, visual reaction time, and perceived mental fatigue. No statistically significant treatment-related effect was observed for auditory reaction time (unadjusted p = 0.074; Holm-adjusted p = 0.096). During the post-intervention standardized football-specific protocol, baseline-adjusted GPS-derived locomotor outcomes differed significantly between groups. First-to-second-half performance-loss indices also differed between groups, with the smallest post-intervention losses generally observed in TCP-600. Because comparable decline indices were unavailable at baseline, these findings do not represent intervention-related changes in fatigue resistance. Conclusions: Under the present 14-day experimental conditions, the multi-ingredient protocols containing taurine, caffeine, and phosphatidylserine were associated with more favorable selected cognitive and psychomotor outcomes, 30 m sprint performance, and baseline-adjusted GPS-derived locomotor outcomes than placebo. The groups also differed in post-intervention first-to-second-half performance loss during the standardized football-specific protocol. Because corresponding decline indices were not assessed at baseline, these findings do not demonstrate an intervention-related improvement in fatigue resistance. Numerically more favorable values were observed for several outcomes in TCP-600; however, differences between TCP-300 and TCP-600 were modest and not consistently statistically significant, and the study was not specifically powered to establish a dose–response relationship. Because phosphatidylserine was not tested independently, these findings should be interpreted as responses to the combined multi-ingredient supplementation protocols rather than as effects of phosphatidylserine alone. Full article

Background/Objectives: Patients with pre-existing chronic obstructive pulmonary disease (COPD) and/or chronic heart failure (CHF) are a particularly high-risk surgical population in whom postoperative pulmonary complications (PPCs) drive a disproportionate share of morbidity, prolonged stay and mortality. Prehabilitation—the structured optimization of functional reserve during the preoperative interval—has emerged as a proactive, largely non-pharmacological strategy to raise that reserve before the surgical insult. Yet the evidence base is organized predominantly by surgical procedure and enrolled in mixed populations, so the patients with the least physiological reserve—those with established COPD or CHF—remain comparatively understudied. This narrative review takes the comorbidity, rather than the incision, as its organizing axis. Methods: We summarize the pathophysiology that links chronic cardio-respiratory disease to perioperative respiratory failure; appraise the principal non-pharmacological interventions, with the respiratory components (inspiratory muscle training, pulmonary rehabilitation, breathing techniques) as the core and exercise, nutritional, psychological, and smoking-cessation elements as the multimodal context; and re-read the surgical evidence through the lens of the underlying disease. Results: A cross-surgical meta-analysis indicates that preoperative exercise training reduces PPCs (relative risk ≈ 0.52) with no significant difference in effect across surgery type or training modality, supporting a comorbidity-centered rather than procedure-centered framework. We address practical determinants of implementation—timing, patient selection, adherence, home-based and telemonitored delivery, and low-resource applicability—and highlight two cross-cutting problems: heterogeneity of intervention prescription and the lack of standardized PPC definitions. Conclusions: The scarcity of disease-specific evidence is itself the central finding, revealing a mismatch between clinical risk and research investment. Full article

Excessive exercise without adequate recovery can induce prolonged fatigue, accompanied by skeletal muscle inflammation, oxidative stress, and impaired repair. Bergamot essential oil (BEO), a citrus-derived volatile essential oil, has been reported to have anti-inflammatory and antioxidant activities, but its effects on exercise-induced prolonged fatigue remain unclear. This study investigated the fatigue-relieving effects of long-term inhalation of BEO and its major constituents in a rat model of prolonged exercise-induced fatigue, with emphasis on skeletal muscle regulation. Rats were subjected to progressive exercise loading and exposed daily to BEO or its main components, followed by behavioral, biochemical, histological, transcriptional, and protein analyses. BEO inhalation significantly improved swimming endurance and alleviated fatigue-related physiological disturbances. In skeletal muscle, BEO reduced IL-1β and IL-6 levels, attenuated transcriptional changes in NF-κB/NLRP3-related inflammatory markers, decreased MDA accumulation, and enhanced GSH-Px activity. BEO also modulated muscle repair-related markers by reversing the abnormal elevation of Myod1 and restoring Myog mRNA expression. These effects were accompanied by increased Igf1 expression, restored PI3K protein expression, enhanced PI3K phosphorylation, and increased inhibitory phosphorylation of GSK3β. Overall, BEO alleviated prolonged exercise-induced fatigue by attenuating skeletal muscle inflammation, oxidative stress, and repair-related dysregulation, supporting its potential as a non-oral aromatic intervention for fatigue recovery. Full article

Background/Objectives: Hitting the wall (HTW) is a common and performance-limiting phenomenon in marathon running, traditionally attributed to glycogen depletion and reduced carbohydrate availability. However, the persistence of late-race performance collapse despite advances in fueling strategies suggests that HTW may not be explained by a single metabolic mechanism. Instead, HTW may represent a psychophysiological performance-collapse phenomenon arising from the interaction between physiological strain, perceived exertion, pacing regulation, and the athlete’s capacity to preserve function under prolonged stress. Methods: This narrative review aimed to synthesize the physiological and psychophysiological mechanisms contributing to HTW and to propose an integrative durability-based framework for understanding late-race performance deterioration during marathon running. Results: Current evidence indicates that HTW may emerge from the cumulative interaction of metabolic stress, thermoregulatory strain, dehydration, gastrointestinal dysfunction, neuromuscular fatigue, biomechanical deterioration, perceptual responses, and pacing errors. These stressors may progressively increase perceived effort, impair pace regulation, and reduce the athlete’s capacity to preserve physiological function and sustain the intended race pace. Within this framework, durability represents the ability to resist deterioration in physiological characteristics and performance capacity during prolonged exercise and may help explain why runners with similar fitness levels experience different late-race outcomes. Conclusions: HTW should therefore not be viewed simply as running out of fuel. Rather, it may represent the manifestation of reduced durability and psychophysiological dysregulation arising from multiple interacting stressors during marathon running. Strategies aimed at improving durability through marathon-specific training, optimized fueling, gastrointestinal tolerance, thermoregulatory preparation, neuromuscular resilience, pacing regulation, perceptual awareness, and individualized monitoring may reduce susceptibility to HTW. Full article

Background: The alarming trend of rising depression and insomnia among the world’s population, especially in young adults, demands urgent attention from both clinical and lifestyle medicine perspectives. This study aimed to evaluate whether habitual physical activity (PA) could improve sleep quality and depressive symptoms. It explores whether sleep parameters mediate the relationship between training intensity and depression. Methods: This cross-sectional study examined the relationships between PA, sleep quality, and depression in 349 participants, predominantly young adults, aged 16–54 (Median: 21, Q1–Q3: 20–23). Depressive symptoms and sleep quality were assessed using the Beck Depression Inventory (BDI) and Pittsburgh Sleep Quality Index (PSQI). PA parameters, including training intensity and frequency, were evaluated via a study-specific self-report tool. Mediation effects were assessed utilising Structural Equation Modelling (SEM) to evaluate direct, indirect, and total effects. Results: Higher training intensity and training volume were associated with lower depressive symptoms. Except for the daytime dysfunction domain, the current data did not support sleep as a mediator in the relationship between physical activity and depressive symptoms. Participants with 3–5 years of training experience exhibited lower BDI scores compared to those with less than 12 months of experience. Interestingly, the type of PA did not influence BDI or PSQI scores, suggesting that consistency and intensity are more critical than the kind of exercise itself. Conclusions: Systematic, high-intensity PA, especially for a prolonged period of time, is significantly associated with lower depressive symptoms. The exploratory nature of this study highlights training frequency and intensity as potential factors that need further research. These findings highlight the mind–body connection and demonstrate that PA might be an intervention supporting mental well-being. Full article