Search Results (1,103)

Background/Objectives: Multifactorial prevention of falls in persons with dementia has minimal or non-significant effects. Personalised prevention is recommended. We have previously shown that gait speed, basic activities of daily living (ADL), and depression (high Cornell scores) were independent predictors of falls in persons with mild and moderate cognitive impairment. This study explored person-specific risks of falls related to physical, mental, and cognitive functions and types of dementia: Alzheimer’s disease (AD), vascular dementia (VD), mixed Alzheimer’s disease/vascular dementia (MixADVD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB). Methods: The study used data from “The Norwegian Registry of Persons Assessed for Cognitive Symptoms” (NorCog). Differences between the dementia groups and predictors of falls, gait speed, ADL, and Cornell scores were analysed. Results: Among study participants, 537/1321 (40.7%) reported a fall in the past year, with significant variations between dementia diagnoses. Fall incidence increased with age, comorbidity/polypharmacy, depression, and MAYO fluctuation score and with reduced physical activity, gait speed, and ADL. Persons with VD and MixADVD had high fall incidences and impaired gait speed and ADL. Training of physical fitness, endurance, muscular strength, coordination, and balance and optimising treatment of comorbidities and medication enhance gait speed. Improving ADL necessitates, in addition, relief of cognitive impairment and fluctuations. Relief of depression and fluctuations by psychological and pharmacological interventions is necessary to reduce the high fall risk in persons with DLB. Conclusions: The fall incidence and fall predictors varied significantly. Personalised interventions presuppose knowledge of each individual’s fall risk factors. Full article

Long-range underwater gliders (LRUGs) have emerged as essential platforms for sustained and autonomous observation in deep and remote marine environments. This paper provides a comprehensive review of their developmental status, performance characteristics, and application progress. Emphasis is placed on two critical enabling technologies that fundamentally determine endurance: lightweight, pressure-resistant hull structures and high-efficiency buoyancy-driven propulsion systems. First, the role of carbon fiber composite pressure hulls in enhancing energy capacity and structural integrity is examined, with attention to material selection, fabrication methods, compressibility compatibility, and antifouling resistance. Second, the evolution of buoyancy control systems is analyzed, covering the transition to hybrid active–passive architectures, rapid-response actuators based on smart materials, thermohaline energy harvesting, and energy recovery mechanisms. Based on this analysis, the paper identifies four key technical challenges and proposes strategic research directions, including the development of ultralight, high-strength structural materials; integrated multi-mechanism antifouling technologies; energy-optimized coordinated buoyancy systems; and thermally adaptive glider platforms. Achieving a system architecture with ultra-long endurance, enhanced energy efficiency, and robust environmental adaptability is anticipated to be a foundational enabler for future long-duration missions and globally distributed underwater glider networks. Full article

Background/Objectives: Senior nurses in Taiwan shoulder layered responsibilities shaped by professional roles, gendered expectations, and family duty. Although Taiwan faces a persistent shortage of experienced clinical nurses, limited research has explored how long-serving nurses sustain identity and commitment across decades of caregiving. This study examines how senior staff nurses understand their journeys of becoming—and remaining—nurses within a culturally and emotionally complex landscape. Methods: Interviews were conducted between May 2019 and September 2023 in locations chosen by participants, with most sessions face-to-face and others undertaken via video conferencing during COVID-19. This narrative inquiry involved in-depth, multi-session interviews with five female senior staff nurses born in the 1970s to early 1980s. Each participant reflected on her life and career, supported by co-constructed “nursing life lines.” Thematic narrative analysis was conducted using McCormack’s five-lens framework and Riessman’s model, with ethical rigor ensured through reflexive journaling and participant validation. Results: Three overarching themes emerged: (1) inner strength and endurance, highlighting silent resilience and the ethical weight of caregiving; (2) support and responsibility in relationships, revealing the influence of family, faith, and relational duty; and (3) role navigation and professional identity, showing how nurses revisit meaning, self-understanding, and tensions across time. Participants described emotionally powerful moments, identity re-connection, and cultural values that shaped their paths. Conclusions: These narratives offer a relational and culturally embedded understanding of what it means to sustain a career in nursing. Narrative inquiry created space for reflection, meaning-making, and voice in a system where such voices are often unheard. Identity was not static—it was lived, reshaped, and held in story. Full article

Current rehabilitation protocols for transitioning patients to late-stage recovery, evaluating return-to-play (RTP) clearance, and assessing tendon characteristics exhibit significant heterogeneity. Clinicians frequently interpret and apply research findings based on individual philosophies, resulting in varied RTP criteria and performance expectations. Despite medical clearance, patients recovering from Achilles tendon (AT) injuries often exhibit persistent impairments in muscle volume, tendon structure, and force-generating capacity. Inconsistencies in assessment frameworks, compounded by a lack of quantitative data and the utilization of specific metrics to quantify certain strength characteristics (endurance, maximal, explosive, etc.) and standardized protocols, hinder optimal functional recovery of the plantar flexors during the final stages of rehabilitation and RTP. With this in mind, the aim of this integrative review was to provide an overview of AT rehabilitation, with particular critique around mid-stage strengthening and the use of the heel-raise assessment in milestoning rehabilitation progress. From this critique, new perspectives in mid-stage strengthening are suggested and future research directions identified. Full article

Background/Objectives: Physical activity is a cornerstone of diabetes mellitus (DM) management and is strongly recommended in the American Diabetes Association (ADA)’s guidelines. This study aims to investigate the self-reported physical activity levels of individuals with DM in Germany, as well as the barriers and facilitators they encounter. Methods: Individuals with type 1 DM (T1DM) and type 2 DM (T2DM) were asked to fill out an online questionnaire that was partly based on the International Physical Activity Questionnaire (IPAQ). Results: The questionnaire was completed by 338 persons with either T1DM (57.1%) or T2DM (42.9%) (females: 56.2%, males: 42.0%, gender diverse persons: 1.8%) of all age groups (at least 18 years). In total, 80.5% of respondents were aware of the current physical activity recommendations. Among the respondents, 58% reported meeting the recommendations for endurance-type physical activity, while only 30.5% reported meeting those for strength training. The three most frequently cited barriers to physical activity were lack of time, lack of motivation and current state of health. Supporting factors included coverage of costs, availability of exercise programs in close proximity to the patient’s home and target group specific exercise programs. Conclusions: The results imply that many individuals with DM in Germany do not meet ADA’s physical activity recommendations, especially considering that self-reports often overestimate actual behavior. In particular, the actual number of individuals who regularly engage in strength training may be too low. There is a clear need to better communicate the benefits of different forms of physical training and to provide physical activity programs aligned with patients’ individual needs. Full article

This pilot, randomized, double-blind, placebo-controlled trial investigated the effects of branched-chain amino acids (BCAAs)—provided in a 2:1:1 ratio of leucine:isoleucine:valine—combined with exercise on fatigue, physical performance, and quality of life in older adults. Twenty participants (63% female; BMI: 35 ± 2 kg/m²; age: 70.5 ± 1.2 years) were randomized to 8 weeks of either exercise + BCAAs (100 mg/kg body weight/d) or exercise + placebo. The program included moderate aerobic and resistance training three times weekly. Physical function was assessed using handgrip strength, chair stands, gait speed, VO₂ max, and a 400 m walk. Psychological health was evaluated using the CES-D, Fatigue Assessment Scale (FAS), Insomnia Severity Index (ISI), and global pain, fatigue, and quality of life using a visual analog scale (VAS). Significant group x time interactions were found for handgrip strength (p = 0.03), chair stands (p < 0.01), and 400 m walk time (p < 0.01). Compared to exercise + placebo, exercise + BCAAs showed greater improvements in strength, mobility, and endurance, along with reductions in fatigue (−45% vs. +92%) and depressive symptoms (−29% vs. +5%). Time effects were also observed for ISI (−30%), FAS (−21%), and VAS quality of life (16%) following exercise + BCAA supplementation. These preliminary results suggest that BCAAs combined with exercise may be an effective way to improve physical performance and reduce fatigue and depressive symptoms in older adults. Full article

Background: Sports performance indicators are mainly based on male athletes, highlighting the importance of portraying the female reality, particularly in rural contexts. This study aims to characterize sports performance indicators (body composition and physical fitness) of young Portuguese female athletes. Methods: A cross-sectional study was conducted with 124 girls (13.66 ± 1.93 years) participating in federated team sports in a rural region of Portugal. Body composition was assessed using bioelectrical impedance, and physical fitness was evaluated through vertical jump tests (countermovement jump and squat jump), sprint (20 m), agility (T-test), handgrip strength, and cardiovascular endurance (Yo-Yo IR1). Results: Volleyball players are taller; football and basketball players are heavier; football and volleyball players have more fat-free mass than handball players (p < 0.05). Body mass index and % body fat did not differ between sports (p > 0.05). Volleyball players performed better in the countermovement jump (F = 4.146, p = 0.008) and squat jump (F = 7.686, p < 0.001) when compared to basketball, football, and handball players. No differences were observed in the speed or cardiorespiratory endurance tests (p > 0.05). Conclusions: The results revealed that, despite some specific differences between sports, most physical fitness indicators did not differ significantly between sports after controlling for age, menarche, and training experience. These findings suggest that shared contextual limitations in rural regions may take precedence over sport-specific adaptations in the early stages of sports participation. Full article

Ergogenic supplements are becoming increasingly popular in the diet of trained individuals, due to their potential benefits. Ashwagandha (Withania somnifera) is one of the supplements that has recently grown in popularity. Despite growing interest, its scientific background remains limited and sometimes inconsistent. Objective: This overview of systematic reviews aimed to evaluate the effects of Ashwagandha supplementation on sports performance and health-related outcomes. Methods: A systematic literature search was carried out on the following electronic databases: PUBMed, Scopus, Academic Search Complete, SPORTDiscus, Web of Science, and Google Scholar, using the search terms “ashwagandha” and “systematic review” in the title or abstract of the publication in July 2024. The eligibility of the articles was assessed using the PICOS (Population, Intervention, Comparator, Outcomes, and Study Design) approach, and risk of bias was assessed using the AMSTAR-2 checklist. Results: Of the 2388 systematic reviews found, 11 met the inclusion criteria, which included 151 original studies representing 9005 individuals. Findings suggest that Ashwagandha supplementation may improve various aspects of sports performance, such as endurance and muscular strength, as well as health-related outcomes, including anxiety reduction, improved sleep quality, and enhanced sexual function. The most commonly used doses of Ashwagandha supplementation are between 500 mg and 1000 mg a day. Conclusion: While current evidence indicates promising effects of Ashwagandha on physical and psychological parameters, further high-quality randomized controlled trials are needed. Therefore, its use in athletes or healthy individuals should be considered with caution and based on individual needs. Full article

High-speed trains have revolutionized modern transportation with their exceptional speeds, yet the essence of this technological breakthrough resides in the train’s wheels. These components are engineered to endure extreme mechanical stresses while ensuring high safety and reliability. In this paper, we selected the rim and web as representative components of the wheel and conducted a comprehensive and systematic study on their microstructure and mechanical properties. The wheels are typically produced through integral forging. To improve the mechanical performance of the wheel/rail contact surface (i.e., the tread), the rim is subjected to surface quenching or other heat treatments. This endows the rim with strength and hardness second only to the tread and lowers its ductility. This results in a more isotropic structure with improved fatigue resistance in low-cycle and high-cycle regimes under rotating bending. The web connects the wheel axle to the rim and retains the microstructure formed during the forging process. Its strength is lower than that of the rim, while its ductility is slightly better. The web satisfies current property standards, although the microstructure suggests further optimization may be achievable through heat treatment refinement. Full article

Objectives: Shoulder injury prevalence appears to be the highest among all injuries in CrossFit (CF) athletes. Nevertheless, there is no evidence deriving from prospective studies to explain this phenomenon. The purpose of this study was to document shoulder injury incidence in CF participants over a 12-month period and prospectively investigate the risk factors associated with their demographic, epidemiological, and functional characteristics. Methods: The sample comprised 109 CF athletes in various levels. Participants’ data were collected during the baseline assessment, using a specially designed questionnaire, as well as active range of motion, muscle strength, muscle endurance, and sport-specific tests. Non-parametric statistical tests and inferential statistics were employed, and in addition, linear and regression models were created. Logistic regression models incorporating the study’s continuous predictors to classify injury occurrence in CF athletes were developed and evaluated using the Area Under the ROC Curve (AUC) as the performance metric. Results: A shoulder injury incidence rate of 0.79 per 1000 training hours was recorded. Olympic weightlifting (45%) and gymnastics (35%) exercises were associated with shoulder injury occurrence. The most frequent injury concerned rotator cuff tendons (45%), including lesions and tendinopathies, exhibiting various severity levels. None of the examined variables individually showed a statistically significant correlation with shoulder injuries. Conclusions: This is the first study that has investigated prospectively shoulder injuries in CrossFit, creating a realistic profile of these athletes. Despite the broad spectrum of collected data, the traditional statistical approach failed to identify shoulder injury predictors. This indicates the necessity to explore this topic using more sophisticated techniques, such as advanced machine learning approaches. Full article

The purpose of this non-randomized study was to determine the effect of strength training and aerobic interval training on the anaerobic and aerobic power and endurance of young men (assessed by determination of the second ventilatory threshold (VT2)) in non-trained men. Participants (n = 45) were recruited into three groups of 15 each. The first group performed strength training (ST), the second performed aerobic interval training (AIT), and the third group was the control group (CON). In each group, somatic measurements and tests of aerobic (graded test with VT2 determination) and anaerobic capacity (Wingate test) were performed twice (before and after the exercise intervention in the training groups). In the graded test, the level of maximal load (Pmax), maximal oxygen uptake (VO₂max) and intensity and oxygen uptake at VT2 were determined. In the Wingate test, peak power (PP) and mean power (MP) were determined. The exercise intervention in the ST and AIT groups lasted 6 weeks, with three workouts per week. Training in the ST and AIT groups resulted in significant increase in absolute Pmax (p < 0.001, ES = 0.52 and p < 0.05, ES = 0.36), VO₂max (p < 0.001, ES = 0.50 and p = 0.02, ES = 0.55) in the participants. Only AIT was significantly effective in improving oxygen uptake at VT2 (p < 0.04, ES = 0.64), and ST in improving PP. Strength training can be an effective training method in training aerobic and anaerobic capacity (significantly increases Pmax, VO₂max, and PP), while it does not significantly affect work intensity at VT2. Our results suggest that, particularly in anaerobic–aerobic sports, strength training may be a training method that can simultaneously improve both anaerobic power and maximal oxygen uptake. It can also complement endurance training. Full article

Background: Combined cognitive and exercise training improves exercise endurance, including submaximal muscular endurance. Its effects on maximal muscular strength have yet to be determined. Accordingly, we tested the effects of combined training on muscular strength (one repetition maximum, 1RM) and endurance (as many repetitions as possible, AMRAP). Methods: Resistance-trained adults (five males, three females) completed ten sessions (four testing, six training) over 4 weeks. In each testing session, they were assessed for bench press 1RM before they completed AMRAP at 50% of initial 1RM. In each training session, they performed five bench press sets (five repetitions at 80% current 1RM), with each set followed by a hard 5 min cognitive task (Time-Load Dual-Back or Color Multi-Source Interference). Ratings of perceived exertion (RPE) were averaged to provide a session RPE. At the end of each session, participants completed a Psychomotor Fatigue Threshold Test and rated mental fatigue. Results: ANOVAs (four testing sessions) showed that combined training increased 1RM (p < 0.001; averaging 8.0 kg or 11% from sessions 1–4) and AMRAP (p < 0.01; 5.1 repetitions or 22%). Moreover, training increased RPE (p < 0.05; 0.3 or 5%) and decreased mental fatigue ratings (p < 0.001; −1.2 or −49%) but did not affect Psychomotor Fatigue Threshold Test reaction times (p > 0.05; 2 ms or 0%). Conclusions: A 4-week training program that combined high-intensity cognitive and resistance exercise tasks improved maximal and submaximal resistance exercise performance. This pilot study provides preliminary evidence that high-intensity combined training can enhance muscular strength and endurance. Full article

Background: Optimal nutrition and training regimens are essential for athletes to maximize performance and recovery. Probiotic supplementation, through the modulation of the gut microbiota, and omega-3 fatty acids, known for their anti-inflammatory properties, may enhance physiological adaptations when combined with targeted training. This study evaluated the effects of probiotics and omega-3 supplementation, alongside ultra-short race pace training (USRPT), on performance metrics in competitive sprint swimmers. Methods: In this double-blind, placebo-controlled study, 60 male sprint swimmers (age: 19.2 ± 3.6 years; height: 182.2 ± 5.2 cm; weight: 81.6 ± 4.4 kg) with a minimum of five years of training experience, were randomly assigned to six groups (n = 10 per group): (1) Control (CON), (2) USRPT only, (3) Placebo + USRPT (PLA + USRPT), (4) Probiotics + USRPT (PRO + USRPT), (5) Omega-3 + USRPT (OMEGA + USRPT), and (6) Probiotics + Omega-3 + USRPT (PRO + OMEGA + USRPT). Over the eight-week intervention, the participants in PRO + USRPT consumed one multi-strain probiotic capsule daily (4.5 × 10¹¹ CFU) and a placebo capsule. Those in OMEGA + USRPT ingested 1000 mg of fish oil after lunch (500 mg EPA and 180 mg DHA per capsule) paired with a placebo capsule. The combined supplementation group (PRO + OMEGA + USRPT) received both probiotic and omega-3 capsules. The PLA + USRPT group consumed two starch capsules daily. The USRPT protocol was implemented across all the training groups, where the swimmers performed 17 sets of 25 m and 12.5 m sprints based on weekly recorded race times. Performance assessments included pre- and post-test measurements of sprint times (50 m and 100 m freestyle), vertical jump tests (both in water and on dry land), and other strength and endurance metrics (reaction time, agility T-test, sprint index, fatigue index, and velocity). Results: The combined intervention of probiotics and omega-3 with USRPT produced the greatest improvements in performance. The PRO + OMEGA + USRPT group reduced 50 m freestyle time by 1.92% (p = 0.002, pEta² = 0.286) and 100 m freestyle time by 2.48% (p = 0.041, pEta² = 0.229), demonstrating significant Time × Group interactions consistent with a synergistic effect. Additionally, the sprint index improved (pEta² = 0.139, p = 0.013) and reaction time decreased (pEta² = 0.241, p = 0.009) in the combined group, indicating enhanced anaerobic capacity and neuromuscular responsiveness compared to single interventions. Conclusions: This study suggests that combining probiotics and omega-3 supplementation with USRPT leads to synergistic improvements in sprint swimming performance, enhancing anaerobic power and recovery beyond what is achieved with individual interventions. This integrated approach may provide a practical strategy for competitive swimmers seeking to optimize their performance. Future studies should incorporate mechanistic markers, longer intervention durations, and diverse athlete populations to clarify further and extend these findings. Full article

Purpose: We aimed to evaluate the safety and feasibility of a remote electrocardiogram (ECG) monitoring-based cardiac rehabilitation (CR) program during an early postoperative period in patients who underwent cardiac surgery. Methods: Five days after cardiac surgery, patients were referred to a CR department and participated in a low-intensity inpatient CR program while wearing an ECG monitoring device. Prior to discharge, the patients underwent a cardiopulmonary exercise test (CPET) and squat endurance test to determine the suitable intensity and target heart rate (HR) for home-based CR (HBCR). During 2 weeks of the HBCR period after discharge, patients participated in aerobic and resistance exercises. Electrocardiogram data were transmitted to a cloud, where researchers closely monitored them through a website and provided feedback to the patients via telephone calls. Grip strength (GS), 6 min walk distance (6 MWD), EuroQol-5 dimension (EQ-5D), short-form 36-item health survey (SF-36), and Korean Activity Scale/Index (KASI) were measured at three different time points: 5 d post-surgery (T1), pre-discharge (T2), and 2 weeks after discharge (T3). Squat endurance tests and CPET were performed only at T2 and T3. Result: Sixteen patients completed the study, seven (44%) of whom underwent coronary artery bypass graft surgery (CABG). During the study period between T2 and T3, peak VO₂ improved from 12.39 ± 0.57 to 17.93 ± 1.25 mL/kg/min (p < 0.01). The squat endurance test improved from 16.69 ± 2.31 to 21.81 ± 2.31 (p < 0.01). In a comparison of values of time points between T1 and T3, the GS improved from 28.30 ± 1.66 to 30.40 ± 1.70 kg (p = 0.02) and 6 MWD increased from 249.33 ± 20.92 to 387.02 ± 22.77 m (p < 0.01). The EQ-5D and SF-36 improved from 0.59 ± 0.03 to 0.82 ± 0.03 (p < 0.01) and from 83.99 ± 3.40 to 122.82 ± 6.06 (p < 0.01), and KASI improved from 5.44 ± 0.58 to 26.11 ± 2.70 (p < 0.01). In a subgroup analysis, the CABG group demonstrated a greater increase in 6 MWD (102.29 m, p < 0.01) than the non-CABG group. At the end of the study, 75% of the patients expressed satisfaction with the early CR program guided by remote ECG monitoring. Conclusions: Our findings suggest that early remote ECG monitoring-based CR programs are safe and feasible for patients who have undergone cardiac surgery. Additionally, the program improved aerobic capacity, functional status, and quality of life. Full article

Background: Understanding the relationship between physical fitness and body mass index (BMI) is critical for promoting adolescent health, particularly in Saudi Arabia, where cultural norms and rising obesity rates present unique challenges. This study aimed to investigate the impact of BMI, gender, and physical activity levels on lower limb strength and endurance, as measured by the Standing Long Jump (SLJ) and the 1 min Sit-to-Stand (STS) test, respectively. Methods: This cross-sectional study included 100 healthy Saudi adolescents (44 boys, 56 girls) aged 10–18 years. Lower limb strength and endurance were assessed using SLJ (cm) and STS (repetitions/min). Anthropometric measurements included BMI (kg/m²), weight (kg), and height (cm), while physical activity was assessed using the Physical Activity Questionnaire for Adolescents (PAQ-A). Mediation analysis was conducted to examine the potential indirect effects of BMI, PAQ-A score, and age on the relationship between SLJ and STS performance. Results: Boys significantly outperformed girls in both the STS (mean difference = 25.2 repetitions/min; p < 0.001) and SLJ (mean difference = 73.4 cm; p < 0.001). No significant gender differences were found in PAQ-A scores (p = 0.987). A strong positive correlation was observed between SLJ and STS performance (r = 0.768; p < 0.01). BMI was not significantly correlated with SLJ or STS performance. STS repetitions predicted superior SLJ performance both before (β = 0.55, p < 0.001) and after (β = 0.47, p = 0.004) adjustment for BMI, age, PAQ score, and gender. BMI transmitted only a small, non-significant share of this link (indirect β = 0.08, p = 0.122), indicating that the STS–SLJ association is largely direct (model R² for SLJ = 0.84). Conclusions: Explosive lower limb strength and gender were significant predictors of lower-body endurance, whereas BMI showed a limited association with performance. These findings underscore the importance of incorporating gender-specific strategies in adolescent fitness assessments and interventions, with a cautionary interpretation of BMI as a performance indicator. Full article