Med Sci Sports Exerc [JOURNAL]
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200 papers
Step Counts and Stepping Intensity Among U.S. Adults: National Health and Nutrition Examination Survey 2011-2014.
Shreves AH, Maylor B, Hyde ET … +11 more , Chan S, Harper C, Hayes HA, Acquah A, Hong HG, Keadle SK, Saint-Maurice PF, Wolff-Hughes DL, Fulton JE, Doherty A, Matthews CE
Med Sci Sports Exerc · 2026 Apr · PMID 42002910 · Publisher ↗
OBJECTIVES: To characterize stepping in a nationally representative sample of U.S. adults by age, sex, and race and ethnicity. METHODS: Step counts are a simple, scalable metric of physical activity associated with lower...
OBJECTIVES: To characterize stepping in a nationally representative sample of U.S. adults by age, sex, and race and ethnicity. METHODS: Step counts are a simple, scalable metric of physical activity associated with lower mortality and chronic disease risks. However, nationally representative estimates of step volume and intensity across demographic groups remain limited. We analyzed data from U.S. adults aged ≥20 years in NHANES 2011-2014 who wore a wrist accelerometer for seven days. Stepping metrics derived from the OxWearables machine-learning algorithm, including daily steps, peak 30-minute cadence, and self-selected cadence. We estimated survey-weighted means and the prevalence of meeting age-specific thresholds associated with substantial reductions in mortality risk (≥9,000 steps/day for adults <60 years; ≥7,000 steps/day for adults ≥60 years) in previous meta-analyses. RESULTS: Adults (N=8,762, mean age 48 years [SD 17]; 52% female) averaged 8,818 steps/day (95% CI: 8,676-8,961). 51% of steps were accumulated <2-minute bouts and 28% from ≥5-minute bouts. Males took more steps than females. Hispanics had higher step counts than other racial and ethnic subgroups. Peak and self-selected cadence converged in older adults. 48.6% of adults <60 years obtained ≥9,000 steps/day, and 44.8% of ≥60 years obtained ≥7,000 steps/day. CONCLUSIONS: Nearly half of U.S. adults achieved step counts associated with substantially lower mortality risk, with differences by age, sex, race, and ethnic groups. We provide benchmarks for population surveillance and can inform strategies to promote step-based activity. These findings could guide future efforts to promote stepping as physical activity among the least active adults.
Classifying Endurance Runners by Kinematics Strengthens Relationships of Muscle-Tendon Unit Function with Running Economy and Performance.
Eihara Y, Kinoshita M, Jotoku K … +3 more , Maeo S, Kanehisa H, Isaka T
Med Sci Sports Exerc · 2026 Apr · PMID 41992483 · Publisher ↗
PURPOSES: Running kinematics and sex may alter the primary muscle and tendon demands for propulsion and shock absorption, potentially modifying how muscle-tendon unit (MTU) function relates to the energy cost of running...
PURPOSES: Running kinematics and sex may alter the primary muscle and tendon demands for propulsion and shock absorption, potentially modifying how muscle-tendon unit (MTU) function relates to the energy cost of running and performance. This study examined whether clustering runners by running kinematics strengthens these relationships and how they differ by sex. METHODS: One hundred twenty endurance runners (60 females) underwent assessments of MTU function, including slow (30°/s) and fast (180°/s) isokinetic knee extension (KE) and flexion (KF) torque and performance in countermovement, drop, and rebound jumps. These variables were summarized using principal component analysis. Running kinematics and energy cost of running were assessed at 11 km/h and 80% of vV̇O2max, and the season's best time (World Athletics [WA] score) was recorded. Runners were clustered via k-means based on foot strike angle and KE/KF range of motion. Stepwise regression analyses tested whether MTU-related associations differed between cluster-specific and whole-cohort models. RESULTS: K-means identified three or four clusters per sex at each running velocity condition. In whole-cohort analyses for each sex, only weak to fair correlations were found between MTU function and either energy cost (r = -0.204 to 0.267) or WA score (r = -0.276 to 0.175). Clustering significantly (P < 0.05) strengthened these relationships in a cluster-specific manner (adjusted R2 = 0.159 to 0.595). This pattern was more evident at 80% of vV̇O2max, particularly in male clusters. Across conditions, MTU-related variables were selected in a greater proportion of female clusters (57.1%) than male clusters (31.2%). CONCLUSIONS: Kinematic-based clustering strengthens sex- and cluster-specific associations of MTU function with the energy cost of running and performance, supporting more individualized performance enhancement strategies.
Gait-Specific Pulmonary Oxygen Uptake Kinetics During Gait Transitions Reflect the Energetics of Walking and Running in Humans.
Fujita M, Horiuchi M, Fukuoka Y
Med Sci Sports Exerc · 2026 Apr · PMID 41975652 · Publisher ↗
PURPOSE: Human terrestrial locomotion involves a transition between walking and running. While the energetics of steady-state walking and running have been well characterized, cardiac, ventilatory, and gas exchange kinet...
PURPOSE: Human terrestrial locomotion involves a transition between walking and running. While the energetics of steady-state walking and running have been well characterized, cardiac, ventilatory, and gas exchange kinetics during gait transitions remain poorly understood. METHODS: In this study, we used a sinusoidally changing speed of locomotion to investigate cardiac, ventilatory and gas exchange kinetics (beat-by-beat heart rate [HR], breath-by-breath pulmonary ventilation [VE], CO2 output [VCO2], and O2 uptake [VO2]) as well as step frequency adjustment across three gait conditions: walking (Walk), running (Run), and the walk-run transition (WRtrans). In each condition, the treadmill speed was varied sinusoidally in a range of mid-speed ± 1.5 km•h -1 with two different frequencies: the periods of 2 and 5 min. RESULTS: The VO2 in the WRtrans condition was intermediate between walking and running, whereas the amplitude of the VO2 in the WRtrans was significantly greater than in the other two condition (both p < 0.001). The VO2 and HR response during running was significantly delayed, as showing larger phase shifts, compared to walking. Notably, the observed VO2 response in the WRtrans closely matched the estimated VO2 response, reconstructed from the amplitude and phase shift values individually obtained in the Walk and Run conditions. Additionally, the average step frequency of all participants abruptly increased at gait transition and remained constant during the running phase of the WRtrans condition. CONCLUSIONS: These results suggest that: (i) the VO2 kinetics during gait transitions reflect the integration of walking- and running-specific VO2 energetic responses, and (ii) gait transitions are accompanied by adjustments in step frequency and length that are consistent with energetically optimal locomotor patterns.
Initiation, Maintenance, and Discontinuation of Habitual Exercise and Perceived Sleep Restfulness: A Population-Based Cohort Study.
Miyagi H, Fukuda H, Yamamoto K
Med Sci Sports Exerc · 2026 Apr · PMID 41975651 · Publisher ↗
PURPOSE: Sleep restfulness is a simple yet meaningful indicator of sleep health. Although physical activity is known to influence sleep, it remains unclear how initiating, maintaining, and discontinuing physical activity...
PURPOSE: Sleep restfulness is a simple yet meaningful indicator of sleep health. Although physical activity is known to influence sleep, it remains unclear how initiating, maintaining, and discontinuing physical activity affect sleep restfulness. METHODS: We analyzed longitudinal data from 702,007 Japanese adults who underwent annual health checkups in 2021 and 2022. Participants with prior diagnoses of sleep disorders or with sufficient sleep restfulness at baseline were excluded. Sleep restfulness and physical activity were assessed using a standardized self-administered questionnaire as part of the health checkups. Physical activity was examined in two domains: daily physical activity and regular exercise. Odds ratios (ORs) and 95% confidence intervals (CIs) for improvements in sleep restfulness were calculated according to the initiation, maintenance, and discontinuation of physical activity. RESULTS: Regular exercise showed consistent associations across initiation (adjusted OR [95% CI], 1.37 [1.34-1.40]), maintenance (1.23 [1.21-1.25]), and discontinuation (0.94 [0.92-0.97]). In contrast, daily physical activity did not show consistent associations in initiation (1.24 [1.22-1.26]), maintenance (1.00 [0.99-1.01]), and discontinuation (1.07 [1.05-1.09]). CONCLUSIONS: This large-scale epidemiological study demonstrates that regular exercise is strongly associated with enhanced perceived sleep restfulness. The findings suggest that initiating regular exercise may contribute to improved sleep restfulness and that maintaining an exercise habit may help enhance perceived sleep restfulness even among individuals who already exercise regularly but feel insufficient restfulness.
Cycling Cleat Positioning Influences Achilles Tendon Strains, but at What Energetic Cost?
Firminger CR, Asmussen MJ
Med Sci Sports Exerc · 2026 Apr · PMID 41975639 · Publisher ↗
INTRODUCTION: Patellar and Achilles tendinopathy are overuse injuries associated with repetitive strain and often arise following sudden increases in exercise intensity or volume. As such, interventions that reduce tendo...
INTRODUCTION: Patellar and Achilles tendinopathy are overuse injuries associated with repetitive strain and often arise following sudden increases in exercise intensity or volume. As such, interventions that reduce tendon strain may represent effective methods for reducing overuse injury risk in this at-risk population of novice cyclists. One potential intervention is through the anterior/posterior positioning of the cycling cleat. METHODS: Ten recreational athletes, who were all novice cyclists, cycled on a stationary cycle ergometer at three cleat positions (neutral, 20 mm anterior, 20 mm posterior), four power outputs (150 W, 200 W, 250 W, 300 W) and two rider positions (seated, standing) for a total of 24 conditions. Motion capture and plantar pressure data were collected, and peak Achilles and patellar tendon strains were obtained using musculoskeletal modelling. Metabolic output for each condition was also modelled using a combination of musculoskeletal modelling and a previously published metabolic model. RESULTS: Peak Achilles tendon strain was significantly reduced with a posterior cleat position compared to a neutral (p = 0.047) and anterior (p < 0.001) position during both standing and seated cycling. However, peak patellar tendon strain (p = 0.928) and modelled metabolic output (p = 0.778) were not influenced by cleat position. CONCLUSIONS: Cycling with a 20 mm posterior cleat position represents an effective intervention for reducing the risk of developing Achilles tendinopathy without concurrently increasing patellar tendon strain and sacrificing performance.
Effect of High-Intensity Functional Training with Basketball on Cardio-Respiratory Fitness and Functional Movement Performance in Obese Adolescents.
Lin L, Hu M, Huang J … +11 more , Liao S, Su C, Fan Q, Chen M, Jiang L, Liang G, Liu Y, Chen Y, Guo X, Zhu W, Gao D
Med Sci Sports Exerc · 2026 Apr · PMID 41941857 · Full text
PURPOSE: The purpose of the current study was to evaluate the potential beneficial effect and efficacy of two distinct high-intensity functional training (HIFT) protocols on cardio-respiratory fitness and functional move...
PURPOSE: The purpose of the current study was to evaluate the potential beneficial effect and efficacy of two distinct high-intensity functional training (HIFT) protocols on cardio-respiratory fitness and functional movement performance in obese adolescents. METHODS: Thirty-three obese adolescents were randomly divided into the HIFT combined with basketball group (HB, n = 11), the HIFT group (n = 11) and the control group (no structured training, n = 11), with a 12-week intervention (3 sessions/week, 45 min/training session). Body composition analysis, pulse wave velocity (PWV), flow-mediated dilation (FMD) measurement, heart rate variability (HRV) assessment, and maximum oxygen consumption (VO2max) test, and functional movement performance test (vertec jump, sitting anterior flexion, T-run, 300-yard shuttle run, Y-balance) were employed to evaluate their fitness. RESULTS: Both interventions significantly reduced body weight, BMI, and fat mass, while increasing water content. Additionally, HIFT could increase the inorganic salt content, protein content, and muscle mass, while decreased BMIz significantly. In terms of cardiovascular parameters, both interventions substantially reduced blood pressure. However, HIFT could decrease the cfPWV. Additionally, both interventions significantly decreased the AIx and AIx@HR75, while improving SEVR and FMD. For HRV indices, both interventions decreased the HR, increased the time domain indices (RMSSD, PNN50, SDNN and NN50) and TP of obese adolescents, while also elevating HF and reduced LF/HF ratio compared to the control group. We also found that both interventions could boost VO2max and functional movement performance. CONCLUSIONS: This study demonstrated HB and HIFT exerted comparable efficacy in improving the body composition parameters, cardiovascular function, and functional movement performance in obese adolescents, possibly by mitigating arterial stiffness, balancing autonomic activity, enhancing respiratory fitness and optimizing hemodynamics.
Response.
Burns S, Chua MT, Sim A … +2 more , Aziz AR, Polglaze T
Med Sci Sports Exerc · 2026 Apr · PMID 41931832 · Publisher ↗
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Is the "Rest" Truly Rest? Cardiovascular Considerations of Blood Flow Restriction Applied During Recovery Periods in HIIT.
Torun A
Med Sci Sports Exerc · 2026 Apr · PMID 41931831 · Publisher ↗
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Comparison of Physical Activity, Fitness and Motor Skills Between Profiles of Sport Participation and Outdoor Time During Nine Years of Childhood.
Luukkainen NM, Côté J, Tolvanen A … +4 more , Sarkkinen E, Niemistö D, Sääkslahti A, Laukkanen A
Med Sci Sports Exerc · 2026 Apr · PMID 41931010 · Publisher ↗
INTRODUCTION: The types of children's physical activity (PA) vary individually and across different ages, yet limited evidence exists what are the combinations of organised sports participation and non-organised outdoor...
INTRODUCTION: The types of children's physical activity (PA) vary individually and across different ages, yet limited evidence exists what are the combinations of organised sports participation and non-organised outdoor time, and how they relate to PA, physical fitness, and motor skills. METHODS: A total of 1,115 Finnish children (50.0% girls) aged 3-14 years were assessed at three time points: T1 (3-8 years), T2 (6-11 years), and T3 (9-14 years) between 2015 and 2023. Organised sports participation and outdoor time were reported by parents at all time points. PA was measured using accelerometers at T2 and T3. Physical fitness was assessed at T3 (20-metre shuttle run, push-ups, and curl-ups), and motor skills at T1-T2 (shortened version of the Test of Gross Motor Development) and T3 (throw-catch and 5-leaps test). Latent class analysis (LCA) identified participation profiles, which were compared using the BCH method in Mplus. RESULTS: LCA identified four distinct participation patterns: 1) multisport with high outdoor time (n = 234), 2) multisport with moderate outdoor time (n = 310), 3) one-sport with low outdoor time (n = 275) and 4) low-sport with high outdoor time (n = 296). Significant differences (p <. 05) were found in the profiles for all outcomes. Children in the multisport with a high outdoor time profile generally showed higher results in moderate-to-vigorous PA (18.0 - 51.5 %), fitness items (-13.6 - 116.2 %), and motor skills (1.1 - 69.0 %) compared to the other profiles. CONCLUSIONS: Children engaging in multisport combined with high outdoor time is associated with higher PA, fitness, and motor skills across childhood.
Hip Adductor Muscle Forces During Strength Training and Rehabilitation Exercises.
Collings TJ, Horsman A, Hams AH … +6 more , McGill A, Watts D, Hambly MJ, Barrett RS, Diamond LE, Bourne MN
Med Sci Sports Exerc · 2026 Apr · PMID 41931009 · Publisher ↗
BACKGROUND: The hip adductors are crucial for athletic performance and injury prevention; however, the most effective exercises for targeting specific muscles are unknown. This study aimed to rank strength training and r...
BACKGROUND: The hip adductors are crucial for athletic performance and injury prevention; however, the most effective exercises for targeting specific muscles are unknown. This study aimed to rank strength training and rehabilitation exercises based on individual hip adductor muscle forces and describe associated muscle fiber lengths, velocities, and activation ranges. METHODS: Fifteen injury-free participants performed 8 common hip adductor exercises: squat, deadlift, sumo deadlift, step up, lateral slide, lying leg lift, and Copenhagen adduction exercise (short- and long-lever). Three-dimensional kinematics, ground reaction forces, and surface electromyography (EMG) were used as inputs to an EMG-assisted neuromusculoskeletal model to estimate adductor brevis, longus, and magnus (pubofemoral/ischiocondylar), and gracilis muscle forces. Exercises were grouped into three 'tiers' using k-means clustering based on peak normalized muscle forces. Fiber lengths, fiber velocities, and activations were also compared between exercises. RESULTS: Copenhagen long-lever was Tier 1 for all adductor muscles. Copenhagen short-lever was Tier 1 for adductor brevis and longus. Deadlift and sumo deadlift were Tier 1 for adductor magnus ischiocondylar and gracilis, while step up and squat were Tier 1 for adductor magnus (ischiocondylar). Lateral slide was Tier 2 for all muscles. Lying leg lift was Tier 2 for adductor brevis and longus and Tier 3 for adductor magnus and gracilis. Squat was Tier 2 for adductor longus, adductor magnus (pubofemoral), and gracilis. Step up was Tier 2 for gracilis and Tier 3 for adductor brevis, longus, and magnus (pubofemoral). CONCLUSIONS: Copenhagen adduction exercise produced the highest forces across most hip adductor muscles. High adductor magnus (ischiocondylar) forces were generated during hip extension-oriented exercises. These rankings may guide exercise selection and load progression/regression for performance, injury prevention, and rehabilitation.
Acute Aerobic Walking Exercise Induces Changes in Thalamic Resting-State Connectivity in Persons with Multiple Sclerosis.
Sandroff BM, Motl RW, Nauman H … +4 more , Wells GE, Wender CLA, Boukrina O, Wylie GR
Med Sci Sports Exerc · 2026 Apr · PMID 41931006 · Publisher ↗
INTRODUCTION: Examining the effects of acute or single bouts of exercise on brain networks can identify underlying mechanisms for improving cognition in multiple sclerosis (MS). This paradigm informs the design and deliv...
INTRODUCTION: Examining the effects of acute or single bouts of exercise on brain networks can identify underlying mechanisms for improving cognition in multiple sclerosis (MS). This paradigm informs the design and delivery of chronic exercise training, particularly aerobic walking exercise training, as a mechanistic approach for treating cognitive impairment in MS. OBJECTIVES/AIMS: The current within-subjects, repeated-measures design compared the acute effects of 20-minutes of moderate-to-vigorous aerobic treadmill walking exercise (TM) with 20-minutes of moderate-to-vigorous aerobic overground walking exercise (OG) on thalamic resting-state functional connectivity (RSFC) in 24 persons with MS. METHODS: Participants completed 2 experimental conditions (20 minutes of moderate-to-vigorous TM and 20 minutes of moderate-to-vigorous OG) in a randomized, counterbalanced order. Thalamic RSFC was measured immediately before (pre-) and after (post-) each condition using 3T MRI. The primary analyses involved a seed-based approach to examine between-condition differences in pre-to-post thalamic RSFC changes. RESULTS: Between-condition differences in pre-to-post thalamic RSFC changes were observed in 19 brain regions. OG significantly increased RSFC between the thalamus and regions associated with higher-order cognitive functioning relative to TM (e.g., middle frontal gyrus, cingulate cortex, superior medial gyrus; d>0.72). TM significantly increased RSFC between the thalamus and regions associated with visuo-perceptual processing relative to OG (e.g., precuneus, insula, angular gyrus; d>0.75). CONCLUSIONS: This study provides the first empirical evidence that single bouts of aerobic walking exercise induce changes in thalamic RSFC across several regions that are important for cognition in MS, and this differed based on multisensory input associated with OG versus TM. Such evidence provides important insight into potential mechanisms for why aerobic walking exercise might improve cognition in persons with MS.
Thermal Response Patterns Provide Early Sign of Exertional Heat Stroke During Intense Activity.
Atkinson E, Charkoudian N, Driver K … +9 more , Mesite T, Moore C, Galer M, Bursey M, Termini M, Delves SK, King C, Finch P, Buller M
Med Sci Sports Exerc · 2026 Apr · PMID 41917769 · Publisher ↗
OBJECTIVE: Exertional Heat Stroke (EHS) remains a stubborn challenge for active communities globally but is difficult to study in humans since it is a relatively rare occurrence. Severe EHS can lead to long-term organ da...
OBJECTIVE: Exertional Heat Stroke (EHS) remains a stubborn challenge for active communities globally but is difficult to study in humans since it is a relatively rare occurrence. Severe EHS can lead to long-term organ damage and death without rapid treatment. Physiological monitoring may provide early warning that an individual is at risk of EHS. The purpose of this work was to compare heart rate and thermal (skin and core temperature) response patterns of individuals who experienced EHS with others completing the same training event, who did not. METHODS: Heart rate (HR), chest skin temperature (Tsk), three-axis accelerometry, and estimated core temperature (Tect) were collected using a chest-mounted physiological monitor on seven individuals who experienced an EHS (age=22±4yr., ht=1.8±0.1m., wt=86.1±11.3kg., 1-mile run=7:20±0:43., Tr=41.6±0.6°C at collapse) during a loaded military ruck march. Similar data were collected on three controls for each EHS case, matched for age, height, weight and fitness (N=21., age=21±3yr., ht=1.8±0.1m., wt=85.5±10.8kg., 1-mile run=7:09±0:42 min). Each ruck march was divided into four quartiles based on event completion percentage. Mean HR, Tsk, the Gait Instability Index (GINI), and Tect were computed for each quartiles. These profiles were compared between groups by Two-way ANOVA. RESULTS: Tect increased faster over time (p=0.001) in EHS. HR and Tsk showed different patterns over time and were higher in EHS during the second, third and fourth quartile, resulting in a narrower Tsk - Tc gradient in the EHS group. The GINI was higher in EHS only during the fourth quartile. CONCLUSIONS: We report for the first time an early detection method for EHS in prolonged military events, incorporating patterns of HR, Tsk and Tect.
The Association of Handgrip Strength in the Second Trimester with Gestational Hyperglycemia.
Zu P, Xu J, Wang P … +7 more , Bian J, Xu M, Jiang N, Luo W, Yu G, Chen X, Zhu P
Med Sci Sports Exerc · 2026 Apr · PMID 41917766 · Publisher ↗
PURPOSE: While handgrip strength (HGS) is linked to insulin resistance and type 2 diabetes in adults, its association with gestational diabetes mellitus (GDM) is unclear. We aimed to assess associations of second-trimest...
PURPOSE: While handgrip strength (HGS) is linked to insulin resistance and type 2 diabetes in adults, its association with gestational diabetes mellitus (GDM) is unclear. We aimed to assess associations of second-trimester HGS with GDM and glucose metabolism, and to determine its predictive value for GDM. STUDY DESIGN: This prospective cohort study enrolled 1904 pregnant women from Hefei, China. HGS was assessed using a dynamometer at recruitment between 16 and 23 weeks of gestation. Logistic regression models were used to assess the relationship between HGS quartiles and GDM risk, based on standard glucose metabolism outcomes. RESULTS: GDM prevalence was 19.3%. Higher HGS was associated with a lower risk of GDM (P for trend <0.001). Versus the lowest quartile, the highest HGS quartile showed reductions in FPG (-4.8%), 1-h PG (-12.5%), 2-h PG (-11.3%), fasting insulin (-20.2%), and HOMA-IR (-24.8%). The RCS curves demonstrated a significant and linear relationship between HGS and GDM (P value < 0.001). An ROC analysis indicated that adding HGS (cut-off: 24.1 kg) improved the predictive performance for GDM. CONCLUSIONS: Lower second-trimester HGS independently predicts GDM risk and hyperglycemia, supporting its use as an inexpensive initial screening tool in primary care, particularly in resource-limited settings.
Association of Context-specific Sitting time with Healthcare Costs at Midlife: The Northern Finland Birth Cohort 1966 Study.
Akhavan Rad S, Leinonen AM, Korpelainen R … +5 more , Vaaramo M, Kiwanuka F, Ryynänen K, Patja K, Torkki P
Med Sci Sports Exerc · 2026 Mar · PMID 41882810 · Full text
PURPOSE: Prolonged sitting is linked to poor health outcomes; however, its context, particularly work versus leisure, and its economic impact are less understood. This study examined the extent and context of daily sitti...
PURPOSE: Prolonged sitting is linked to poor health outcomes; however, its context, particularly work versus leisure, and its economic impact are less understood. This study examined the extent and context of daily sitting time and its association with annual healthcare costs at midlife in a large Finnish cohort. METHODS: A sample (n=7147) of Finnish adults at the 46-year (46-yr) follow-up point of the Northern Finland Birth Cohort 1966 study was used. Data were collected between 2012 and 2014, including self-reported sitting time (work and leisure) and healthcare costs estimated from self-reported visits to public, private, and occupational primary healthcare services using unit costs based on the Finnish Institute for Health and Welfare. Finally, a generalized linear model (gamma distribution with log link), was used to examine the associations between sitting time and annual healthcare costs. RESULTS: Total sitting time was 7.3 ± 3.3 hours per day (h·d⁻¹), including 4.0 ± 2.2 h·d⁻¹ during leisure and 3.4 ± 2.6 h·d⁻¹ at work. In adjusted GLM analyses, participants in the second quartile of work-related sitting (1.01-3.00 h·d⁻¹) had approximately 20% higher annual primary healthcare costs compared with those in the lowest quartile (p = 0.025). Leisure-time sitting showed no independent association. CONCLUSIONS: In this population-based cohort, work-related sitting, but not leisure-time sitting, was associated with higher annual primary healthcare costs. These findings highlight the potential economic impact of occupational sedentary behavior and suggest that work-related sitting should be considered in future strategies and studies addressing sedentary behavior in workplace settings.
Low-Load Blood-Flow Restricted Resistance Training Improves Finger Flexor Muscle Function in Experienced Climbers: A Randomized Controlled Trial.
Perrin TP, Randy H, Santal P … +11 more , Hugues X, Tourette N, Coudurier M, Guinot M, Cahouet V, Quaine F, Doutreleau S, Vigouroux L, Kerherve HA, Marillier M, Brugniaux JV
Med Sci Sports Exerc · 2026 Mar · PMID 41882800 · Publisher ↗
PURPOSE: Low-load blood flow restriction training (LLBFRT) is a promising modality to improve muscle strength and endurance. In sport-climbing, LLBFRT may prove useful to reduce mechanical stress compared to traditional...
PURPOSE: Low-load blood flow restriction training (LLBFRT) is a promising modality to improve muscle strength and endurance. In sport-climbing, LLBFRT may prove useful to reduce mechanical stress compared to traditional high-load resistance training (HLRT); however, previous climbing studies have failed to induce strength gains with LLBFRT, potentially due to insufficient training stimulus. This study thus aims to examine muscular adaptations to a 5-week finger flexors LLBFRT program until failure, with comparison to HLRT. METHODS: Thirty-six advanced-to-elite climbers were randomly assigned to LLBFRT, HLRT or a control (CON) group. Participants in LLBFRT and HLRT trained twice a week, at ~40% and ~75% of maximal voluntary contraction (MVC) respectively; cuffs were inflated at 60% of limb occlusion pressure in LLBFRT. Rate of perceived exertion, upper-limb discomfort and finger pain intensity were measured during each session. Before and after intervention, finger flexors muscle thickness and strength were determined, while critical force and oxygenation were assessed during a fatiguing test. RESULTS: During training sessions, force-time integral was lower (-19%, p= 0.009) while mean upper-limb discomfort was greater (5±2 vs . 4±2 units, p= 0.028) in LLBFRT vs HLRT. LLBFRT significantly improved finger flexors MVC (+9±8%, p= 0.009) and critical force (+22±15%, p <0.001). These gains were comparable to HLRT (+13±11%, p= 0.006 and +24±21%, p= 0.012, respectively). No significant changes were found in CON. CONCLUSIONS: Despite lower mechanical load, LLBFRT conducted until failure significantly improved finger flexor muscular capacities to a similar extent than HLRT in experienced sport-climbers. This training modality may therefore be of particular interest during overload periods.
Relationship Between Exercise Training-Induced Changes in Oxygen Uptake Kinetics and the Power-Duration Relationship.
Lei TH, Vos L, Wang IL … +4 more , Koga S, Marwood S, Korzeniewski B, Goulding RP
Med Sci Sports Exerc · 2026 Mar · PMID 41875021 · Full text
PURPOSE: This study aimed to determine the relationships between training-induced changes in the variable values of the power-duration relationship (CP and W') and those of pulmonary oxygen uptake (V̇O2) kinetics (the fu...
PURPOSE: This study aimed to determine the relationships between training-induced changes in the variable values of the power-duration relationship (CP and W') and those of pulmonary oxygen uptake (V̇O2) kinetics (the fundamental phase time constant; τVO2, and the slow component amplitude; V̇O2sc). METHODS: Eleven healthy untrained males underwent 2 weeks of severe-intensity exercise training. Before and after training, V̇O2max was assessed via an incremental exercise test on a cycle ergometer, CP and W' were assessed via constant power determination trials, and V̇O2 kinetics were assessed during exercise at a PO 10% above CP (post-training at the same absolute and relative intensity as pre-training). A previously described and validated computer model of the human skeletal muscle bioenergetic system was used to provide further insight into training-induced changes. RESULTS: CP and τVO2were strongly inversely correlated before and after training, and their training-induced changes were also correlated. Computer simulations suggested that increased oxidative phosphorylation activity (kOX) was the main factor determining the training-induced changes in CP and τVO2. Exercise training increased W' and reduced the amplitude of the V̇O2sc, however, the training-induced changes in W' and the V̇O2sc were not correlated. Model simulations suggested that variations in kOX, the accessible phosphate (+creatine) pool (Pacc), and the peak inorganic phosphate (Pi) concentrations attained prior to task failure (Pipeak) could explain the observed training-induced alterations in W' and the V̇O2sc. CONCLUSIONS: The present study suggests that the bioenergetic mechanisms underpinning CP and τVO2are similar, whereas the relationship between W' and the V̇O2sc appears somewhat more complex.
Sex Differences in Physical Activity and Energy Expenditure after Adolescent Concussion.
Smulligan KL, Wingerson MJ, Armento AM … +3 more , Meehan WP, Wilson JC, Howell DR
Med Sci Sports Exerc · 2026 Mar · PMID 41875015 · Publisher ↗
PURPOSE: Sex differences may exist in physical activity (PA) behavior among adolescents. PA is recommended soon after concussion to improve recovery outcomes. Our purpose was to examine sex differences in PA engagement a...
PURPOSE: Sex differences may exist in physical activity (PA) behavior among adolescents. PA is recommended soon after concussion to improve recovery outcomes. Our purpose was to examine sex differences in PA engagement after adolescent concussion. METHODS: Male and female adolescent athletes within 21 days of concussion wore wrist-worn actigraphy devices for one week to quantify three variables: steps/day, caloric expenditure, and resting heart rate (RHR). We used linear mixed models with random slopes and random intercepts for participants to examine sex differences for each outcome over the monitoring period, adjusting for variables that differed between sexes. RESULTS: We enrolled 122 adolescents with concussion: N=62 female athletes (11.4±4.6 days post-injury, age=15.6±1.4 years) and N=60 male athletes (10.9±4.8 days post-injury, age=15.5±1.9 years). After adjusting for symptom severity, body mass index, and anxiety/depression history, female athletes expended fewer calories (β=-336 calories; 95%Confidence Interval [CI]: -553, -159; p<0.001) than males, but daily step count (β=-568 steps/day; 95%CI: -2261, 1124; p=0.51) and RHR (β=3.06 beats/min; 95%CI: -1.97, 8.09; p=0.23) were similar between sexes across the week. Both steps/day (β=353 steps/day; 95%CI: 115, 591; p=0.004) and caloric expenditure (β=38.2 calories; 95%CI: 15.4, 61.0; p=0.001) increased each day for the overall sample, though the rate at which they increased did not significantly differ by sex (sex*time interaction: p=0.10, p=0.07 respectively). CONCLUSIONS: Compared to males, female athletes recorded lower caloric expenditure but similar steps/day and RHR during a one-week monitoring period after concussion. PA and caloric expenditure increased throughout the monitoring week independent of sex, which may reflect improvement in symptoms or a gradual increase in PA based on guidance from their medical provider.
Optimizing Strength and Hypertrophy: The Combined Effect of Intensity and Velocity Loss Thresholds in Bench Press Training.
Pareja-Blanco F, Sánchez-Valdepeñas J, Cornejo-Daza PJ … +1 more , Rodiles-Guerrero L
Med Sci Sports Exerc · 2026 Mar · PMID 41872733 · Publisher ↗
PURPOSE: To analyze the effects of: 1) different relative intensities (%1RM) when matching velocity loss (VL); 2) different VL thresholds when matching %1RM; and 3) the interaction between %1RM and VL on strength gains a...
PURPOSE: To analyze the effects of: 1) different relative intensities (%1RM) when matching velocity loss (VL); 2) different VL thresholds when matching %1RM; and 3) the interaction between %1RM and VL on strength gains and hypertrophy during the bench press exercise. We hypothesized that high-intensity (70-85% 1RM) with a moderate VL (25%) would maximize strength gains, while a high VL (50%) would optimize hypertrophy. METHODS: One hundred and fifty-eight resistance-trained men were randomly assigned to 12 groups following an 8-week bench press training program. Each group was categorized into one of three intensity ranges (40-55% 1RM, 55-70% 1RM, and 70-85% 1RM) and distinguished by the VL allowed per set (0%, 15%, 25%, and 50%). Assessments performed before and after the training program included: (1) cross-sectional area (CSA) of the pectoralis major, (2) maximal isometric strength, (3) progressive loading test, and (4) maximum number of repetitions (MNR), in bench press. RESULTS: Significant "intensity × time" interactions were observed for CSA, 1RM, velocity attained against submaximal loads, and MNR, with 70-85% 1RM producing the greatest gains. Significant "VL × time" interactions were found for CSA, 1RM, and MNR, with VL50 yielding the highest increases in CSA and MNR, while VL25 resulted in the greatest improvements in 1RM. CONCLUSIONS: Bench press training adaptations depend on intensity and VL. High intensities (70-85% 1RM) consistently optimized strength and hypertrophy, while VL modulates outcomes: greater VL (50%) maximized muscle growth and endurance, while moderate VL (25%) produced superior maximal strength gains.
Cardiovascular and Hematological Responses to Postpartum Sprint Interval Training in Trained Females.
Richard NA, Claydon VE, Koehle MS … +1 more , Coté AT
Med Sci Sports Exerc · 2026 Mar · PMID 41872731 · Publisher ↗
INTRODUCTION: Female athletes, or those in arduous occupations, lack objective guidance on effective and safe rigorous training postpartum. We examined the effectiveness and tolerability of early postpartum sprint interv...
INTRODUCTION: Female athletes, or those in arduous occupations, lack objective guidance on effective and safe rigorous training postpartum. We examined the effectiveness and tolerability of early postpartum sprint interval training (SIT) in healthy recreationally active to international-level female athletes. METHODS: Ten new mothers (7.9±2.4 weeks postpartum, parity 1.6±0.7 children) completed postpartum laboratory testing pre-intervention (PPpre) and post-intervention (PPpost). We measured maximal oxygen consumption (VO2max; metabolic cart), peak cardiac output (Qpeak, inert gas rebreathing), blood volume (BV), plasma volume (PV), and hemoglobin mass (Hbmass, carbon monoxide rebreathing). Between visits, participants completed six weeks of home-based thrice- weekly progressive SIT at 130% of VO2max peak power output (PPO). RESULTS: No adverse events occurred, and 173/180 sessions were completed. Participants breastfed without difficulty throughout the study. VO2max (2.39±0.35 vs 2.75±0.28 L/min p<0.0001) and PPO (233±26 vs 264±23 watts p<0.0001) increased from PPpre to PPpost, whereas Qpeak remained stable (14.6±1.9 vs 14.5±2.0 L/min). Hbmass (611±73 vs 629±79 g), BV (4684±592 vs 4863±573 mL) and PV (2898±416 vs 3005±367 mL) did not increase significantly at PPpost. CONCLUSIONS: As both Qpeak and Hbmass remained stable the increased VO2max likely stems from other physiological adaptations. Additionally, variability in study entry time, combined with cardio-haematological transitions from pregnancy, could account for the nonsignificant changes in haematological and Qpeak results. Breastfeeding may have influenced Q and PV. Six weeks of SIT rapidly improves cardiovascular fitness in previously trained women. Furthermore, in recreational and elite athletes, ergometer cycling SIT is well tolerated, can be started early postpartum, and does not impede breastfeeding.
Adaptation of Neural Common Drive to Motor Units of the Wrist Extensor Agonists in Chronic Lateral Epicondylitis.
Chen YC, Chen Y, Wu CC … +2 more , Hu CL, Hwang IS
Med Sci Sports Exerc · 2026 Mar · PMID 41872728 · Publisher ↗
PURPOSE: Chronic lateral epicondylitis (CLE) arises from overuse and repetitive strain on the extensor carpi radialis brevis (ECRB), particularly prevalent among racquet sport athletes. METHODS: Given the compensatory wo...
PURPOSE: Chronic lateral epicondylitis (CLE) arises from overuse and repetitive strain on the extensor carpi radialis brevis (ECRB), particularly prevalent among racquet sport athletes. METHODS: Given the compensatory workload on a weakened ECRB, this study specified how CLE influences muscle synergy through the neural common drive to motor units (MUs) in both the ECRB and extensor carpi radialis longus (ECRL). Eighteen patients with CLE (49.5 ± 9.2 years) and eighteen healthy participants (48.8 ± 10.4 years) took part in the study. The force dynamics and discharge characteristics of MUs in the agonists were compared between the patient and control groups during a graded force-increasing task. RESULTS: Patients with CLE showed significantly greater task errors (P = 0.005) with smaller mean frequency (MF) of force fluctuations (P = 0.006) than healthy controls. In addition to reduced maximal voluntary contraction (MVC), patients exhibited a lower common drive index (CDI) within the ECRB (P = 0.001) and between the ECRB and ECRL (P = 0.007), with no significant difference observed in the CDI within the ECRL (P > 0.05). The coefficient of variation of the CDI among MU pairs was significantly lower in the patient group for both within the ECRB (CV-CDIECRB) (P < 0.001) and between the ECRB and ECRL (CV-CDIECRB-ECRL) (P = 0.004). Functionally, the size of task errors was negatively correlated with CV-CDIECRB and CV-CDIECRB-ECRL (P < 0.05), while MF of force fluctuations was positively correlated with CV-CDIECRB. CONCLUSIONS: Impaired force control in chronic lateral epicondylitis is associated with altered variability and coordination of common synaptic input, highlighting the relevance of coordination-focused rehabilitation strategies.
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