Velten L, Prado RCR, Conforti ALP
… +3 more, Andreatta MV, Ferreira Reis CB, Leite RD
Int J Sports Med
· 2026 Mar · PMID 40840539
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The effects of estradiol and progesterone fluctuations during the menstrual cycle (MC) on strength and fatigue remain unclear. This study investigated their impact on peak torque and fatigue in isokinetic tests. Eleven s...The effects of estradiol and progesterone fluctuations during the menstrual cycle (MC) on strength and fatigue remain unclear. This study investigated their impact on peak torque and fatigue in isokinetic tests. Eleven strength-trained women performed five knee extensions and flexions to assess maximum peak torque, rating of perceived exertion (RPE), and rating of perceived pain (RPP). A separate protocol of 60 repetitions was used to evaluate peak torque, total work, percentage of work fatigue, RPE, RPP, and blood lactate concentration before and after exercise. MC phases were determined using a combination of calendar tracking, urinary ovulation tests, and serum hormone analysis. A one-way repeated-measures analysis of variance, followed by Bonferroni's post hoc tests and effect size calculations (partial eta-square), analyzed differences across six MC phases. No significant differences were observed in peak torque, RPE, or RPP during knee extension and flexion (>0.05). Similarly, fatigue parameters assessed during the 60-repetition test showed no significant variation across MC phases (>0.05). However, blood lactate concentrations were significantly higher postexercise than preexercise (<0.05). These findings suggest that strength performance and muscle fatigue are not influenced by hormonal fluctuations across the MC in strength-trained women.
Braghieri HA, Silva GO, Farah BQ
… +4 more, Parmenter BJ, Kanegusuku H, Ritti Dias RM, Correia M
Int J Sports Med
· 2026 Mar · PMID 40840538
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This systematic review/meta-analysis aimed to evaluate the effects of resistance exercise on ambulatory blood pressure (ABP). PubMed, Web of Science, Scielo, Embase, and Scopus databases were searched for crossover/contr...This systematic review/meta-analysis aimed to evaluate the effects of resistance exercise on ambulatory blood pressure (ABP). PubMed, Web of Science, Scielo, Embase, and Scopus databases were searched for crossover/controlled trials of resistance exercise in adults compared to a control group/condition from inception until May 2025. Mean differences with 95% confidence intervals were calculated (<0.05 significant). Risk of bias was assessed by the Cochrane risk-of-bias tool for randomized trials. Twenty-six studies were included: 18 acute (immediate, short-term, including 351 participants) and 8 chronic (long-term, including 356 participants), with mostly unclear/high risk of bias. Acutely resistance exercises led to lower 24-hour diastolic blood pressure (BP) in subjects with chronic diseases (-1.15 mmHg;-2.08,-0.22; =0.020), and lower daytime diastolic BP in healthy participants (-0.77 mmHg,-1.51,-0.03; =0.040). Chronically resistance training lowered 24-hour systolic (-3.99 mmHg;-7.59,-0.39; =0.030) and diastolic BP (-1.52 mmHg;-2.67,-0.37; =0.009) and daytime systolic/diastolic BP in subjects with chronic diseases (Systolic:-5.53 mmHg;-8.83,-2.23; =0.001; Diastolic:-1.86 mmHg;-3.11,-0.61; =0.003). In conclusion, resistance exercise promotes modest reductions in ABP, especially among individuals with chronic diseases. The most consistent effects were observed for 24-hour and daytime systolic and diastolic BP. Acute reductions were smaller and limited to daytime diastolic BP.
DeVecchis M, Reed C, Ladlow P
… +4 more, Behan FP, McKay G, Bell V, O'Sullivan O
Int J Sports Med
· 2026 Apr · PMID 40825364
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Osteoarthritis (OA) is a common, multi-factorial and -aetiological condition, causing pain, disability and reduced function. Post-traumatic OA (PTOA) is more common in younger populations, especially after anterior cruci...Osteoarthritis (OA) is a common, multi-factorial and -aetiological condition, causing pain, disability and reduced function. Post-traumatic OA (PTOA) is more common in younger populations, especially after anterior cruciate ligament (ACL) or meniscal injury. Identifying those at increased risk of PTOA using molecular, imaging and biomechanical biomarkers is a research priority. This systematic review aims to identify functional tasks used to assess knee kinematics and kinetics at least a year from injury, describe any differences found between the injured and uninjured contralateral and control knees and identify associations with PTOA. Searches were performed on Medline, CINAHL and EMBASE, with reference lists reviewed. The initial search yielded 2504 studies, with six more detected from reference lists. Thirty-three studies involving 1251 participants (=737 injured, all ACL, mean age 25.1, 49.9% male, 1-13 yr post-injury) were included. Studies included the following dynamic tasks: landing (=25), jumping (=3), cutting (=5) or squatting (=3). Overall, reductions in knee flexion and extension angles and moments, increased knee valgus and energy absorption were demonstrated in injured knees. However, this was inconsistent across studies, with data heterogeneity preventing direct comparison and meta-analysis. Changes in biomechanics are present from 1-year post-injury, persisting for several years; however, consensus regarding core outcome sets is required.
Int J Sports Med
· 2026 Jan · PMID 40825328
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World Aquatics rules require only part of the swimmer's head to break the surface each breaststroke cycle. We aimed to assess the impact of breathing every one or two cycles in breaststroke on energy cost (C) and related...World Aquatics rules require only part of the swimmer's head to break the surface each breaststroke cycle. We aimed to assess the impact of breathing every one or two cycles in breaststroke on energy cost (C) and related bioenergetic variables. Fifteen swimmers completed a 6-week intervention to learn the new breathing pattern, followed by a 5×200-m step test (0.05-m∙s increments, 30-s rest) in both patterns. Oxygen consumption (VO) and blood lactate ([La]) were measured to calculate energy expenditure ( ) and C. Linear and exponential regressions were computed between and velocity. Paired -tests and ANCOVA were applied, controlling for World Aquatics points and age. [La] peak, VO peak, , and C were lower at some intensities when breathing every cycle. Adjusted analyses showed higher with breathing every two cycles at steps 1, 2, and 5. Linear and exponential regressions showed strong associations for both breathing patterns ( =0.74 vs. 0.72, respectively). Individual regressions showed similar patterns in some swimmers, while others differed. Breathing every two cycles elicited higher bioenergetic responses at steps 1, 2, and 5 and did not prove effective during incremental 200-m efforts when compared to the traditional breathing pattern.
Int J Sports Med
· 2026 Apr · PMID 40816297
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This systematic review aims to determine whether exercise timing influences different health indicators. The search, conducted until May 2025 across PubMed, Web of Science, EBSCO, China National Knowledge Infrastructure,...This systematic review aims to determine whether exercise timing influences different health indicators. The search, conducted until May 2025 across PubMed, Web of Science, EBSCO, China National Knowledge Infrastructure, and Wanfang databases, reviewed 2,937 articles. This review included randomized controlled trials in English that explored exercise timing for various populations, excluding unspecified exercise timing, animal studies, and low-quality articles. A total of 43 studies with 3,543 participants were included. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and study characteristics and results were tabulated. Current evidence suggests that exercise timing may differentially impact health dimensions: afternoon exercise may improve metabolism in metabolic disorders; postdinner exercise might enhance blood glucose control for type 2 diabetes; premeal exercise could reduce appetite for overweight and obese individuals; evening exercise may improve sleep quality for sleep disorders but may negatively affect early chronotypes; morning exercise may enhance athlete performance, while afternoon exercise may promote the recovery of ordinary individuals; and morning exercise should be approached cautiously in cardiovascular risk groups. However, contradictions in some dimensions highlight the need for further rigorous research to solidify implications for exercise prescriptions. The study protocol was prospectively registered on PROSPERO (ID: CRD42024595984).
Carmody S, Massey A, Kerkhoffs GM
… +1 more, Gouttebarge V
Int J Sports Med
· 2026 Mar · PMID 40816296
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Full text
The After-Career Consultation (ACC) was developed to empower the physical, mental and social health of retired professional footballers and effectively address their specific health challenges. The objective of this stud...The After-Career Consultation (ACC) was developed to empower the physical, mental and social health of retired professional footballers and effectively address their specific health challenges. The objective of this study was to describe the clinical outcomes (e.g., prevalence of health conditions) and recommendations to retired professional footballers who undertook the ACC. A quasi-experimental study was conducted. Forty-seven retired male professional footballers underwent ACCs. Ten participants had a diagnosis of osteoarthritis (21.3%), 4 (8.5%) met the criteria for a diagnosis of generalised anxiety disorder, 7 (14.9%) met the criteria for a diagnosis of depression and 7 (14.9%) met the criteria for Stage 1 hypertension. Health-related quality of life scores among retired footballers undergoing the ACC were above average compared to the general population. Clinical recommendations were made to participants in relation to their musculoskeletal (=12, 25.5%), cardiovascular (=12, 25.5%), mental (=10, 21.3%) and lifestyle (=20, 42.6%) health. Eleven participants (23.4%) were referred for further investigations, and secondary referral to other specialists was arranged for 4 (8.5%). Participants reported high satisfaction with the ACC. The ACC could complement existing player welfare strategies to provide a well-rounded approach to managing the long-term health of professional footballers throughout the lifespan.
Cardoso P, Tavares F, Loureiro N
… +4 more, Ferreira R, Araújo JP, Reis JF, Vaz JR
Int J Sports Med
· 2026 Jan · PMID 40812361
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Soccer requires athletes to exhibit high levels of acceleration and speed, both of which are crucial for optimal performance. The acceleration-speed (A-S) profile is increasingly utilized to assess these sprinting capaci...Soccer requires athletes to exhibit high levels of acceleration and speed, both of which are crucial for optimal performance. The acceleration-speed (A-S) profile is increasingly utilized to assess these sprinting capacities in soccer, providing in situ insights into an athlete's maximal theoretical acceleration (A0) and speed (S0). This study aimed to investigate the association of external load metrics with A0 and S0 across different age groups in elite academy soccer athletes. One hundred thirty-six athletes, ranging from under-14 to B-team, participated in the study. Training sessions and matches were monitored over a season using Global Navigation Satellite System (GNSS) technology to collect data on the A-S profile and external load metrics. Stepwise regression analysis revealed a positive correlation, in several age groups (under-15, -17, -19, and -23 and B-team), between accumulation of sprint distance (Spr. Dist.) and an increased S0 ( : 0.30-0.52). However, no significant correlation was found between any external load metric and A0. These findings highlight the necessity of individualized training interventions and the inclusion of Spr. Dist. throughout the planning of the training load of young soccer athletes for the improvement of sprint capacity. It may also suggest that acceleration in youth soccer athletes may be influenced by other factors, such as strength training.
Gundersen H, Grendstad H, Rygh CB
… +6 more, Hafstad A, Vestbøstad M, Algerøy E, Smith ORF, Joensen M, Kristoffersen M
Int J Sports Med
· 2026 Feb · PMID 40749734
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Biological maturation and growth influence youth athletes' physical performance during adolescence. However, how this association develops over time remains unclear. Thus, this study examined associations between biologi...Biological maturation and growth influence youth athletes' physical performance during adolescence. However, how this association develops over time remains unclear. Thus, this study examined associations between biological maturity and sprint speed, vertical jumping ability, leg strength, and aerobic capacity between ages 14.1 and 17.4 in youth male soccer players. A total of 103 players were followed. Performance in 40-m sprint, countermovement jump (CMJ), leg press, and maximal oxygen consumption (V̇O) was tested biannually at seven time points. Maturity was estimated using bone age from hand-wrist X-rays. Latent growth modelling examined changes in maturity-performance associations over time. Maturity was significantly ( < 0.05) associated with sprint, CMJ, leg strength (force and power), and V̇O at ages 14.1, 14.7, and 15.3 years. The associations were, however, less significant over time. Specifically, maturity was no longer statistically associated with sprint and CMJ performance at 15.7 years, force and V̇O at 16.4 years, and power at 16.8 years. There were no significant associations at 17.4 years. Biological maturity influences physical capacities during early adolescence, but its impact diminishes as players age. The timing of this decline appears to vary between physical performance domains, with sprint and jump performance stabilizing earlier than muscular strength and aerobic capacity.
Int J Sports Med
· 2026 Apr · PMID 40744098
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Resistance training is an effective strategy for combating geriatric syndromes, including frailty, sarcopenia, and cognitive impairment. Performing instability resistance training (IRT) (e.g., weight-bearing, machine-bas...Resistance training is an effective strategy for combating geriatric syndromes, including frailty, sarcopenia, and cognitive impairment. Performing instability resistance training (IRT) (e.g., weight-bearing, machine-based, or free-weight exercises using unstable surfaces) may provide additional benefits on health outcomes in middle-aged and older adults. With this in mind, we examined the impact of IRT on physical and cognitive functioning (primary outcomes), fall risk, and quality of life (secondary outcomes). We searched three specific databases from inception to October 2024. We included peer-reviewed, randomized trials that analysed the effects of intervention on outcomes of interest among adults aged 50 years or older. Risk of bias and quality of reporting were ascertained using validated checklists. We performed a random-effects meta-analysis using robust variance estimation. 18 studies with participants from Brazil, Spain, Germany, and South Korea (=528, %women: 35-100%) were included in the qualitative review, and 12 studies in the meta-analysis. We found that IRT had a medium-to-large-sized effect on physical and cognitive functioning. Studies had a high quality of reporting but presented significant heterogeneity and low-to-moderate risk of bias. Our findings suggest that IRT is a promising strategy for promoting physical and cognitive benefits in middle-aged and older adults.
de Paulo TRS, Rossi FE, Rossi PAQ
… +2 more, Neves LM, Freitas IF
Int J Sports Med
· 2025 Dec · PMID 40744079
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The use of aromatase inhibitor (AI) therapy in breast cancer survivors (BCS) has been linked to significant and negative changes in body composition and quality of life. However, the long-term effects (9 months) of combi...The use of aromatase inhibitor (AI) therapy in breast cancer survivors (BCS) has been linked to significant and negative changes in body composition and quality of life. However, the long-term effects (9 months) of combined training (CT=resistance plus aerobic training) following the interruption of CT intervention remain unclear in these variables. Thus, the present study aimed to investigate changes in body composition, bone mineral density, and quality of life during a 1-year follow-up period after 9 months of CT in BCS. Participants were randomized into two groups: CT (=18) for 9 months, or control group (=18), with 27 participants (CT=16; control=11) reassessed after the 1-year follow-up. There were significant group×time interactions postintervention, with lower fat mass and fat mass percentage in the CT group. However, after the follow-up period, these values returned to baseline. The CT group shows improvements in quality of life, with higher scores in physical functioning, physical health, social functioning, bodily pain, and vitality compared to the control group. These benefits were maintained after the 1-year follow-up period only in the CT group. This study reinforces the crucial role of consistently maintaining an exercise training program for BCS undergoing AI therapy.
Holtz KA, Lerch B, Zaremski JL
… +5 more, Butler L, Ulman S, Zappa R, Fava A, Oliver GD
Int J Sports Med
· 2026 Jan · PMID 40738124
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The scapula facilitates the windmill pitching motion, providing a stable base for the shoulder muscles to accelerate the humerus. Given the repetitive range of motion facilitated by the shoulder musculature about the sca...The scapula facilitates the windmill pitching motion, providing a stable base for the shoulder muscles to accelerate the humerus. Given the repetitive range of motion facilitated by the shoulder musculature about the scapula, shoulder overuse injuries are a significant concern in softball pitchers. Therefore, we aimed to provide normative values of scapular kinematics during the windmill pitching motion in high school-aged softball pitchers. Kinematic data from 17 high school-aged softball pitchers (15±1 y; 1.7±0.1 m; 72.3±15.0 kg) throwing fastball pitches at regulation distance 13.1 m (43 ft) were obtained using an electromagnetic tracking system synced with motion analysis. Scapular kinematics throughout the windmill pitching motion indicated that the scapula maintains an anteriorly tilted and internally rotated (protracted) position while moving within 5 and 22° in each plane, respectively. Additionally, on average, the scapula remained upwardly rotated throughout the start and top of the pitch, through foot contact, but moved into downward rotation at ball release. Description of scapular biomechanics during the windmill softball pitch is an area that has not been extensively researched. Our data reinforce the significance of the scapula as a dynamic stabilizer of the shoulder and its critical role in the kinematics and kinetics of the fastpitch softball windmill pitch.
Int J Sports Med
· 2026 Jan · PMID 40701538
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Osteoarthritis (OA) is considered to be a condition attributable to ageing; however, symptoms can start under 45 years old in one-fifth of patients. Exercise therapy is recommended as first-line treatment in all OA guida...Osteoarthritis (OA) is considered to be a condition attributable to ageing; however, symptoms can start under 45 years old in one-fifth of patients. Exercise therapy is recommended as first-line treatment in all OA guidance; however, uncertainty remains regarding optimal exercise programmes (including strength, aerobic or mind-body interventions) as different populations might respond better to one intervention than another. This review aims to understand the evidence surrounding exercise interventions for OA in younger adults (18-50 years old). An umbrella review methodology was adopted. Individual studies included in 50 systematic reviews (±meta-analyses) published in the last decade were reviewed and those involving participants aged 18-50 were selected. Five papers, from a potential 1046, involved appropriate participants and underwent full-text review. Two were excluded due to pathology and language; therefore, three studies with 265 participants were included. Exercise interventions included strength-based, neuromuscular control and aerobic and were delivered under supervision or via sensor or virtual reality technology. Interventions improved pain, functional, cartilage composition and inflammatory outcomes measures; however, study heterogeneity prevented direct comparison and meta-analysis. There is a clear bias in the literature for an older population, with research and clinical interventions required for a younger adult population with, or at risk of, OA.
Int J Sports Med
· 2026 Feb · PMID 40675174
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Transdermal drug delivery has emerged as an area of significant interest in both pharmaceutical sciences and antidoping research. This narrative review explores the implications of transdermal uptake of substances banned...Transdermal drug delivery has emerged as an area of significant interest in both pharmaceutical sciences and antidoping research. This narrative review explores the implications of transdermal uptake of substances banned in sports, emphasizing its relevance for doping control analysis. The human skin's complex role as both a barrier and a site of drug absorption is examined, alongside studies investigating the transdermal administration of substances on the World Anti-Doping Agency Prohibited List, including approved transdermal formulations and drug candidates. Recent cases demonstrate that (unintentional) dermal exposure of athletes to substances banned in professional sports, e.g., clostebol, can lead to an adverse analytical finding in doping controls. Consequently, studies investigating the detectability and metabolism of transdermally administered doping substances, which might even support identifying the route of exposure, are becoming increasingly important. This review emphasizes the relevance of addressing the skin as a pathway for both intentional doping and unintentional contamination, outlining critical implications for global antidoping efforts and future research priorities.
Teixeira Filho CAT, de Oliveira EVC, Carneiro GR
… +6 more, Vendrame JW, Pizzo Junior E, Da Silva GM, da Silva GO, Brandão GHDS, Vanderlei FM
Int J Sports Med
· 2026 Feb · PMID 40669853
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We sought to evaluate the effects of a low-intensity warm-up with blood flow restriction (BFR) compared to low- and high-intensity warm-up on performance and perceptual responses. A randomized, controlled, crossover clin...We sought to evaluate the effects of a low-intensity warm-up with blood flow restriction (BFR) compared to low- and high-intensity warm-up on performance and perceptual responses. A randomized, controlled, crossover clinical trial was conducted with 33 soccer players, divided into three experimental conditions: warm-up at 30% of VO peak, warm-up at 80% of VO peak, and warm-up at 30% of VO peak combined with BFR at 80% of total occlusion pressure. Vertical jump and sprint tests, muscle pain, perception of effort, discomfort in relation to BFR, and myotonometry were measured before, immediately post, and 10 and 20 minutes post warm-up. No difference was observed between experimental conditions, and no interaction between conditions vs. moments for the performance. In the condition with BFR, there was a difference for the effort perceived and the perception of discomfort in relation to the BFR technique, indicating greater perception of effort and level of discomfort. For myotonometry, differences were found, indicating lower muscle elasticity in the condition with BFR. The low-intensity warm-up with BFR as well as the low- and high-intensity warm-up without BFR resulted in similar performances. Furthermore, although perception of discomfort was greater in the warm-up condition with BFR, it can be attenuated with different BFR protocols.
Int J Sports Med
· 2026 Jan · PMID 40664373
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Perturbation training is commonly applied; however, its effects on the peroneal muscle remain underexplored in the female basketball player population. This study aimed to investigate the effects of perturbation-based ne...Perturbation training is commonly applied; however, its effects on the peroneal muscle remain underexplored in the female basketball player population. This study aimed to investigate the effects of perturbation-based neuromuscular training (PNT) on dynamic balance, peroneal muscle strength, endurance, and functional performance in young female basketball players. A randomized controlled trial was conducted with forty young female basketball players. The players were assigned to either a perturbation-based neuromuscular training group (PG) (=20) or a control group (CG) (=20) by simple random allocation. PG received an 8-week neuromuscular training program (two sessions/wk) in addition to routine basketball training, while CG attended routine training only. Dynamic balance, peroneal muscle eccentric strength, endurance, vertical jump (VJ), and side hop (SH) tests were evaluated. Dynamic balance was evaluated with the balance test, and peroneal muscle eccentric strength and endurance were evaluated with the Cybex dynamometer. PG demonstrated significant improvements in dynamic balance (=0.000), VJ (=0.0049), and SH performance (=0.010) after the training program, analyzed with analysis of variance. Peroneal eccentric strength significantly increased in PG (=0.001 right, =0.020 left). Both groups showed improvements in peroneal muscle endurance parameters; however, the PG group improved significantly (=0.004 right, =0.025 left). An 8-week PNT significantly enhances dynamic balance, eccentric eversion strength, and jump performance while contributing to reduced peroneal muscular fatigue in young female basketball players.
Buchwald RL, Buchwald J, Lehtonen E
… +2 more, Peltonen JE, Uusitalo ALT
Int J Sports Med
· 2025 Nov · PMID 40628368
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Overtraining syndrome (OTS) is characterised by persistent fatigue and performance decline, but it currently lacks specific diagnostic criteria and medical coding. Diagnosis is primarily based on a decline in maximal per...Overtraining syndrome (OTS) is characterised by persistent fatigue and performance decline, but it currently lacks specific diagnostic criteria and medical coding. Diagnosis is primarily based on a decline in maximal performance and a subjective feeling of 'staleness', after ruling out other medical conditions. This study aimed to identify physiological and self-reported predictors of OTS by comparing individuals diagnosed with OTS (=110; 2008-2022) with a healthy control group (=447; 2005-2023). Both groups consisted of athletes and recreational exercisers assessed at the Helsinki Sports and Exercise Medicine Clinic (HULA). Data were collected through questionnaires and spiroergometric testing and subsequently analysed using logistic regression, adjusting for age and sex. The results of this study suggest that fatigue, dizziness and shortness of breath, along with decreased maximum oxygen uptake (V̇O2), peak blood lactate value (La) and oxygen uptake at both ventilatory thresholds (V̇O and V̇O), are significant predictors of OTS (<0.05/54). Among reported health conditions, asthma, allergy, anaemia and mental health issues were statistically significant predictors of OTS at the 0.05 level, but not after Bonferroni correction. In conclusion, regular spiroergometric testing and symptom monitoring may support earlier diagnosis and improved management of OTS in athletes and recreational exercisers.
Kim TJ, Jang MH, Han JH
… +2 more, Jung HC, Kim JH
Int J Sports Med
· 2025 Oct · PMID 40623443
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This study aimed to investigate the effect of aerobic exercise under hypoxic conditions (FiO: 14.9%) on post-exercise hypotension compared to normoxic exercise matched for mechanical and physiological intensities. Twenty...This study aimed to investigate the effect of aerobic exercise under hypoxic conditions (FiO: 14.9%) on post-exercise hypotension compared to normoxic exercise matched for mechanical and physiological intensities. Twenty sedentary men completed three exercise sessions using a crossover design: (1) hypoxic exercise at 50% of peak power output, (2) normoxic exercise at 50% of peak power output (normoxic exercise matched for mechanical intensity), and (3) normoxic exercise with heart rates matched for hypoxic exercise. Expired gases and peripheral and muscle oxygen saturation were measured during the exercise. Blood pressure and hemodynamic variables were assessed before and after each exercise session. Hypoxic exercise and normoxic exercise matched for physiological intensity elicited higher heart rate, oxygen consumption, and ventilation compared to normoxic exercise matched for mechanical intensity (<0.05). Hypoxic exercise showed the lowest ventilation efficiency (<0.01) and the most severe systemic and muscle hypoxemia (<0.01) during exercise. Only hypoxic exercise induced significant post-exercise hypotension (-6.9 mmHg; <0.01) with a significant increase in common femoral artery diameter during recovery (<0.05). Our findings suggested that hypoxic exercise significantly enhances post-exercise vasodilation compared to normoxic exercise, resulting in greater post-exercise hypotension. This highlighted hypoxic exercise as a promising strategy for managing hypertension with reduced mechanical stress, particularly beneficial for individuals with low exercise tolerance.