Med Sci Sports Exerc [JOURNAL]
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200 papers
Moderate-to-Vigorous Physical Activity and Cerebral Small Vessel Disease in Older Adults with Type 2 Diabetes: A Cross-Sectional Study.
Sugimoto T, Ando T, Saji N … +6 more , Omura T, Uchida K, Yokoyama Y, Onoyama A, Shinozaki M, Sakurai T
Med Sci Sports Exerc · 2026 Mar · PMID 41872726 · Publisher ↗
PURPOSE: Cerebral small vessel disease (SVD) is prevalent in older adults with type 2 diabetes and contributes to an elevated risk of cognitive decline. Although physical activity (PA) is a potentially modifiable factor...
PURPOSE: Cerebral small vessel disease (SVD) is prevalent in older adults with type 2 diabetes and contributes to an elevated risk of cognitive decline. Although physical activity (PA) is a potentially modifiable factor in SVD prevention, previous findings remain inconsistent, particularly regarding activity intensity. This study aimed to investigate the association between accelerometer-measured PA and SVD severity in older adults with type 2 diabetes. METHODS: This cross-sectional study analyzed 66 adults aged ≥70 years with type 2 diabetes. PA was objectively measured using a tri-axial accelerometer over 14 days. Time spent in sedentary behavior (≤1.5 metabolic equivalents [METs]), light-intensity PA (LPA; 1.6-2.9 METs), and moderate-to-vigorous PA (MVPA; ≥3.0 METs) were assessed. Lacunes, cerebral microbleeds, enlarged perivascular spaces, and white matter hyperintensities were evaluated using brain magnetic resonance imaging. The total SVD score (range, 0-4) was calculated, and participants were categorized into either mild (score 0-1) or moderate-to-severe (score 2-4) groups. To estimate the odds of having moderate-to-severe SVD associated with a hypothetical reallocation of 10 min of sedentary time to either LPA or MVPA, multiple logistic regression analysis using an isotemporal substitution model was performed. RESULTS: Of the 66 participants, 29 (43.9%) had moderate-to-severe SVD. A hypothetical reallocation of 10 min from sedentary time to MVPA was associated with lower odds of moderate-to-severe SVD (odds ratio, 0.78; 95% confidence interval, 0.61-1.00; p = 0.047). LPA exhibited no significant association. CONCLUSIONS: Engaging in MVPA is associated with lower SVD severity in older adults with type 2 diabetes.
Aerobic Fitness and Health-Related Phenotypes: A Two-Stage Phenome-Wide Mendelian Randomization Study.
Fornara E, Hernández MH, Fernández-Sanlés A … +9 more , Hernando-Redondo J, Camps-Vilaró A, Polo-Alonso S, Lassale C, Dégano IR, Elosua R, Schröder H, Marrugat J, Hernáez Á
Med Sci Sports Exerc · 2026 Jul · PMID 41851812 · Full text
PURPOSE: We investigated potentially causal associations between genetically predicted aerobic fitness and multiple health phenotypes using a two-stage phenome-wide Mendelian randomization (MR) study. METHODS: Geneticall...
PURPOSE: We investigated potentially causal associations between genetically predicted aerobic fitness and multiple health phenotypes using a two-stage phenome-wide Mendelian randomization (MR) study. METHODS: Genetically determined aerobic fitness, as operationalized by Cai et al., served as the exposure instrument. We screened 712 health-related phenotypes as outcomes using publicly available European-ancestry genome-wide association studies (GWAS) summary statistics from OpenGWAS (Discovery GWAS n > 5000), prioritizing non-UK Biobank/non-FinnGen datasets for Discovery when available and selecting an independent GWAS for validation. Associations were estimated using the MR-Robust Adjusted Profile Score method, controlled for multiple testing (5% false discovery rate) and unaffected by violations of MR assumptions (directional concordance between discovery and validation; no evidence of horizontal pleiotropy across inverse-variance weighted, MR-Egger, weighted-median, and weighted-mode methods; negative control analysis on hair color). RESULTS: We identified 108 discovery associations, of which 34 remained valid and statistically significant after validation. Higher genetically determined aerobic fitness was associated with lower lacunar stroke risk, lower arterial stiffness, higher heart rate variability, lower diastolic blood pressure, more favorable anthropometric measures, lower use of antidiabetic drugs, lower asthma risk, lower C-reactive protein, higher bone mineral density, favorable liver function biomarkers, favorable platelet-related traits, multiple blood count-derived hematological cell indices and counts, as well as higher years of schooling. Adverse associations were confined to atrial fibrillation, valvular heart disease, and systolic blood pressure. CONCLUSIONS: Genetically determined aerobic fitness is linked to a broad pattern of favorable cardiometabolic, inflammatory, musculoskeletal, respiratory, hepatic, and hematological phenotypes, alongside a narrow set of potential cardiovascular hazards.
Alterations in Muscle Contractile Properties, Structure, and Function During 10-Day Bed Rest, Post-Recovery, and Following COVID-19 Lockdown.
Boštjan Š, Fabio S, Martino F … +3 more , Elena M, Rado P, Marco NV
Med Sci Sports Exerc · 2026 Mar · PMID 41851769 · Full text
PURPOSE: Tensiomyography detects early hallmarks of bed-rest-induced atrophy. We aimed to identify early tensiomyography alterations in six muscles during a 10-day bed rest (BR10), followed by a 30-day recovery period (R...
PURPOSE: Tensiomyography detects early hallmarks of bed-rest-induced atrophy. We aimed to identify early tensiomyography alterations in six muscles during a 10-day bed rest (BR10), followed by a 30-day recovery period (R+30), and to compare these changes with those observed after the 50-day COVID-19 lockdown in ten healthy males (22.9±5.0 years). METHODS: Tensiomyography and muscle thickness (assessed by ultrasound imaging) were assessed at baseline, during bed rest, at BR10, R+30, and after the COVID-19 lockdown. Additional assessments included vertical jump performance (force plate), body composition (bioimpedance), physical activity (GPAQ), and lower back pain (VAS). RESULTS: By BR10, participants experienced a 1.9% body mass loss, a 3.8% increase in fat mass, and a 2.4% reduction in muscle mass. While anthropometric parameters returned to baseline by R+30, fat mass increased again by 3.9% post-lockdown. Jump height declined by 10.1% at BR10, returned to baseline at R+30, and remained stable thereafter. Muscle thickness decreased by 7.0% in the vastus lateralis at BR10 and by 10.1% post-lockdown. Tensiomyographic amplitude increased in five leg muscles prior to BR10, recovered at R+30 and increased again after the COVID-19 lockdown, while a reduction was observed in the erector spinae within the first 48 hours, coinciding with reported lower back pain. In the erector spinae, both delay and contraction time decreased during BR10 and post-lockdown, while contraction time of the biceps femoris increased before BR10 and remained elevated post-lockdown. CONCLUSIONS: The observed post COVID-19 lockdown alterations in tensiomyographic parameters followed the same trend as those induced by bed rest, albeit with smaller magnitude. These findings support the utility of TMG as a sensitive and non-invasive method for monitoring muscle responses across different disuse paradigms.
Long-Term Effects of High-Intensity Training following Lung Cancer Surgery - A Five-Year Follow-Up of a Randomized Controlled Trial.
Edvardsen E, Anderssen SA, Borchsenius F … +3 more , Holme IM, Nordsletten L, Skjønsberg OH
Med Sci Sports Exerc · 2026 Mar · PMID 41851742 · Full text
PURPOSE: To evaluate long-term extended effects of 20 weeks of high-intensity training (HIT) performed shortly after lung cancer surgery on physical fitness, muscle mass, pulmonary function, quality of life (QoL), and su...
PURPOSE: To evaluate long-term extended effects of 20 weeks of high-intensity training (HIT) performed shortly after lung cancer surgery on physical fitness, muscle mass, pulmonary function, quality of life (QoL), and survival. METHODS: All participants in the original HIT-trial were invited five years after surgery. Original measures were repeated by the same technician and equipment. All-cause mortality was registered five- and ten years post-surgery. RESULTS: Of 61 patients who completed the 20-week intervention, 40 (66%) were alive at five years, and 32 (80% of survivors; HIT n=15, SoC n=17) completed follow-up testing.No significant between-group difference was observed in the primary outcome, peak oxygen uptake (VO2peak) five years after HIT (adjusted mean difference 1.13 mL·kg -1·min -1, p=0.576). Similarly, there were no between-group differences in physical function, muscle mass, pulmonary function, or QoL. In contrast, a significant sustainable difference in leg-press strength was observed in the HIT-group compared to the SoC-group (23 kg, p=0.048). Regarding survival, five-year survival rates were similar between the HIT-group (67%) and the SoC-group (65%). Although the HIT-group demonstrated a tendency towards longer median post-operative survival (60.0±32.6 months, 95% CI: 43.2-76.8) compared to the SoC-group (43.0±33.5 months, 95% CI: 24.4-61.5), this difference was not statistically significant (p=0.760). At 10 years, no differences in survival rates were observed between the groups. CONCLUSIONS: Twenty weeks of HIT following lung cancer surgery led to a significant effect in leg-press strength after five years, but showed no long-term effects on VO2peak, muscle mass, pulmonary function, QoL, or survival compared to SoC.
Human Performance Across the Extreme- and Severe-Intensity Domains: Insights from Decremental and Priming Exercise Protocols.
Marinari G, Murias JM, Iannetta D
Med Sci Sports Exerc · 2026 Apr · PMID 41843647 · Publisher ↗
PURPOSE: To investigate whether W' in the extreme-intensity domain is smaller, yet linked to the W' predicted by the severe-intensity time series. METHODS: Twelve recreationally active participants (four females) complet...
PURPOSE: To investigate whether W' in the extreme-intensity domain is smaller, yet linked to the W' predicted by the severe-intensity time series. METHODS: Twelve recreationally active participants (four females) completed 1) three extreme-intensity and three severe-intensity constant-power output (PO) trials to establish the PO duration series and to obtain W' within their respective domains (W'EXT and W'SVR, respectively); 2) two decremental protocols from extreme-to-severe (EXT1→SVR3) and from severe-to-severe POs (SVR2→SVR3); 3) one extreme- and one severe-intensity constant-PO trial preceded by priming exercise (EXT1P and SVR2P, respectively); and 4) control extreme- and severe-intensity constant-PO trials. Peak values for oxygen uptake (V̇O2peak), blood lactate concentration ([La-]b-peak), and minute ventilation (V̇Epeak) were also analyzed. RESULTS: W'EXT was significantly smaller than W'SVR (P < 0.001). There was no difference in W' between the composite EXT1→SVR3 and SVR2→SVR3 and SVR3 alone (all P > 0.05). Priming-induced increase in W'EXT and W'SVR was not different (P = 0.401). V̇O2peak, V̇Epeak, and [La-]b-peak were all greater in EXT1P compared with EXT1 (all P < 0.05). CONCLUSIONS: We showed that W'EXT is smaller than W'SVR during cycling. Following task failure during EXT1, more work could be performed at SVR3 until complete depletion of W'SVR. Additionally, heavy-intensity priming exercise increased W'EXT and W'SVR by a similar magnitude. Collectively, these findings suggest that performance within the extreme-intensity domain is limited by mechanisms, at least in part, different from those that limit performance within the severe-intensity domain.
American College of Sports Medicine Position Stand. Resistance Training Prescription for Muscle Function, Hypertrophy, and Physical Performance in Healthy Adults: An Overview of Reviews.
Currier BS, D'Souza AC, Singh MAF … +10 more , Lowisz CV, Rawson ES, Schoenfeld BJ, Smith-Ryan AE, Steen JP, Thomas GA, Triplett NT, Washington TA, Werner TJ, Phillips SM
Med Sci Sports Exerc · 2026 Apr · PMID 41843416 · Full text
PURPOSE: The aim of this overview of reviews was to determine the impact of resistance training (RT) prescription on muscle function and hypertrophy, utilizing evidence synthesis methods. It updates the American College...
PURPOSE: The aim of this overview of reviews was to determine the impact of resistance training (RT) prescription on muscle function and hypertrophy, utilizing evidence synthesis methods. It updates the American College of Sports Medicine 2009 Position Stand, "Progression models in resistance training for healthy adults." DATA SOURCES: Ovid MEDLINE(R) ALL, Ovid Emcare, Ovid Embase, Cochrane Database of Systematic Reviews, EBSCOhost SPORTDiscus, and Web of Science Core Collection current to October 2024. ELIGIBILITY CRITERIA: Eligible systematic reviews synthesized randomized trials of healthy adults (≥18 yr) who completed RT (≥6 wk; range: 6-52 wk), compared with a group that completed no exercise or an alternative RT program, and reported the change in muscle function, size, or physical performance. RESULTS: We synthesized data from 137 systematic reviews (>30,000 participants). Compared with no exercise (control), RT significantly improved muscle strength, size (hypertrophy), power, endurance, contraction velocity, gait speed, balance, and multiple physical function outcomes. Few RT prescription (RTx) variables affected primary adaptations. However, voluntary strength was enhanced by lifting heavier loads (≥80% one-repetition maximum), through a complete range of motion, for 2-3 sets, at the beginning of training sessions, and ≥2 sessions/wk. Muscle hypertrophy was enhanced by higher volumes (≥10 sets/wk) and eccentric overload. Power was enhanced by moderate loads (30%-70% one-repetition maximum), low-to-moderate volume (≤24 repetitions⋅sets), Olympic-style weightlifting, and power RT (fast concentric phase). Power RT enhanced physical function. Training to momentary muscle fatigue, equipment type, exercise complexity, set structure, time under tension, blood flow restriction, and periodization did not consistently impact training outcomes. CONCLUSIONS: Healthy adults should perform progressive RT, with variable prescription consistent with our findings, to improve muscle function, size, and physical performance. Muscle strength, hypertrophy, power, and certain components of physical function can be enhanced by manipulating the RT variables highlighted.
Short-Term Moderately High-Fat Diet Has No Effect on Physical Performance.
Dawson MA, Whitney CC, Ndou TV … +6 more , Karl JP, Margolis LM, Smith TJ, Finlayson G, Gaffney-Stomberg E, Jayne JM
Med Sci Sports Exerc · 2026 Apr · PMID 41843415 · Publisher ↗
PURPOSE: Military personnel and first responders engage in physically demanding activities resulting in high daily energy expenditures, often coupled with inadequate energy intake. Increasing dietary fat for short durati...
PURPOSE: Military personnel and first responders engage in physically demanding activities resulting in high daily energy expenditures, often coupled with inadequate energy intake. Increasing dietary fat for short durations (<6 d) is one strategy to increase energy intake. However, some studies suggest that short-term high-fat diets may impair endurance performance, while other research indicates that longer-term high-fat diets appear to have no effect on performance. METHODS: This randomized crossover study aimed to determine the impact of a short-term moderately high-fat diet (MHF; 40% of total kcal) compared with a standard fat diet (SF; 30% of total kcal) on multiple dimensions of physical performance. Twenty healthy adults (22 ± 5 y, body mass: 80.3 ± 12.2 kg, : 47.9 ± 9.0 mL·kg·min-1] consumed controlled, weight-maintaining, isocaloric, protein-matched MHF and SF diets for 5 d, separated by ≥7 d. To assess physical performance, participants completed vertical jump, 4-mile time trial, and time to exhaustion (85% ) tests and the six-event Army Combat Fitness Test before and immediately after each intervention. RESULTS: Consistent with the experimental design, the MHF diet resulted in a higher proportional energy intake from fat (41 ± 1% vs 30 ± 3%; P < 0.001) and less from carbohydrate (40 ± 1% vs 52 ± 4%; P < 0.001) versus the SF diet, without differences in energy intake (MHF: 2474 ± 297 vs SF: 2493 ± 303 kcal·d-1; P = 0.25). No between-group differences in any performance measure were observed (P ≥ 0.05). CONCLUSIONS: Short-term consumption of a higher-fat diet neither impaired nor meaningfully improved measures of physical performance.
Proteomic Signatures Related to Physical Activity Are Associated with Risks of Future Disease.
Huang S, Long G, Li G … +8 more , Dai S, Li G, He Z, Chen Y, Lu QI, Huang H, Zhang A, Xu C
Med Sci Sports Exerc · 2026 Apr · PMID 41843414 · Publisher ↗
PURPOSE: Physical activity (PA) can lower the risk of developing chronic diseases. However, few studies have examined the proteomic signatures linked to PA, and the role of these signatures in the connection between PA l...
PURPOSE: Physical activity (PA) can lower the risk of developing chronic diseases. However, few studies have examined the proteomic signatures linked to PA, and the role of these signatures in the connection between PA levels and future disease risk remains unclear. This study aimed to investigate whether proteomic signatures indicative of PA are associated with the risk of developing common chronic diseases and to explore their role as statistical links in the relationship between PA levels and disease development. METHODS: We used data from a subcohort of UK Biobank participants. PA intensity data were collected from accelerometers worn by each participant. Plasma proteomics results were obtained through Olink analysis. The risks of developing each primary chronic disease were evaluated for types of PA and their associated proteomic signatures, adjusting for age, sex, ethnicity, socioeconomic status, lifestyle factors, and key measurement time-lag covariates. RESULTS: Based on the UK Biobank, we identified significant differences among the proteomic signatures of accelerometer-measured light PA, moderate-to-vigorous PA, and total PA. The main enriched pathways of these proteomic signatures included cell adhesion, cell migration, and immune response. Higher levels of accelerometer-measured PA and their associated proteomic signatures correlated with a lower risk of developing cardiometabolic disorders, cancers, psychological or neurological disorders, and respiratory diseases. CONCLUSIONS: Our findings show that PA and PA-related proteomic signatures are statistically associated with lower risks of chronic diseases. Further analyses identified proteins that were correlated with both PA and disease risk. These results need to be confirmed through longitudinal studies involving diverse populations.
Cold-Water Immersion Impairs Power Earlier than Strength Through Time-Dependent Reductions in Intramuscular Temperature in Human Dorsiflexor Muscles.
Malekzadeh R, Richards AJ, Vaziri A … +3 more , Laham R, Paris MT, Cheng AJ
Med Sci Sports Exerc · 2026 Apr · PMID 41843413 · Publisher ↗
INTRODUCTION: We aimed to investigate the time- and intramuscular temperature-dependent changes in neuromuscular function throughout 1 h of cold-water immersion (CWI) at 10°C. It was hypothesized that acute CWI (<30 min)...
INTRODUCTION: We aimed to investigate the time- and intramuscular temperature-dependent changes in neuromuscular function throughout 1 h of cold-water immersion (CWI) at 10°C. It was hypothesized that acute CWI (<30 min) would not affect neuromuscular function due to limited reductions in intramuscular temperature, whereas prolonged CWI (>30 min) would impair muscle contractility by drastically reducing intramuscular temperature. METHODS: Twelve healthy participants (nine males and three females) partook in a randomized crossover design study involving 1-h CWI at 10°C of their lower leg, with three experimental visits consisting of 1) 1-h CWI at 10°C (CWI-only), 2) nonfatiguing exercise followed by 1-h CWI at 10°C to mimic the use of postexercise CWI (Ex + CWI), and 3) passive muscle preheating followed by 1-h CWI at 10°C (Heat + CWI). Skin temperature, intramuscular temperature, and neuromuscular function were periodically assessed in the dorsiflexors throughout the 1 h of CWI. RESULTS: Decreased peak power was observed after 10 min of CWI, CWI-only (50.3 ± 16.0%, P < 0.05), Ex + CWI (55.0 ± 18.3%, P < 0.05), and Heat + CWI (62.0 ± 16.8%, P < 0.05), whereas maximal isometric torque decreased after ≥30 min of CWI, CWI-only (81.1 ± 9.1%, P < 0.05), Ex + CWI (86.6 ± 14.3%, P < 0.05), and Heat + CWI (88.7 ± 10.0%, P < 0.05). Decreases in M-wave peak-to-peak amplitude, 50-Hz torque, and postactivation potentiation were only evident following prolonged CWI (P < 0.05). CONCLUSIONS: These results highlight that peak power is more sensitive to reductions in intramuscular temperature than maximal isometric strength, reflecting a time- and temperature-dependent effect on skeletal muscle function.
The Effects of Vitamin K2 on Recovery from Muscle-Damaging Resistance Exercise in Young and Older Adults: The TAKEOVER Randomized Controlled Trial.
Lithgow H, Johnston L, Ho F … +8 more , Dunning E, Nakada S, Celis-Morales C, Hunter AM, Lees JS, Mark PB, Quinn TJ, Gray SR
Med Sci Sports Exerc · 2026 Apr · PMID 41843412 · Full text
PURPOSE: Vitamin K2 supplementation has emerged as a strategy to enhance recovery and modulate postexercise physiological responses. This study aimed to assess the effects of vitamin K2 on recovery from muscle-damaging e...
PURPOSE: Vitamin K2 supplementation has emerged as a strategy to enhance recovery and modulate postexercise physiological responses. This study aimed to assess the effects of vitamin K2 on recovery from muscle-damaging exercise in young and older adults. METHODS: Healthy young (18-40 yr) and older (65+ yr) adults were randomly assigned to either vitamin K2 (menaquinone-7, MK-7, 240 μg/d) or placebo (cellulose) for 12 wk in this double-blind randomized controlled trial. Before and after supplementation, knee extensor maximal torque, functional ability, muscle soreness, and systemic blood markers of muscle damage and inflammation were measured before (0 h) and 3, 24, 48, and 72-h postexercise. Data were analyzed using regression and mixed models. RESULTS: Seventy-one participants (35 young and 36 older) completed the study, with 12 wk of vitamin K2 supplementation increasing circulating MK-7 levels (P-value <0.001). There were no supplement × time effects for any variables. Significant supplement × time × older age interaction effects were noted for electromechanical delay (EMD) (P-value = 0.03), electromyography root mean square (RMS) (P-value = 0.01), interleukin-6 (IL-6) concentrations (P-value <0.001), and creatine kinase (CK) levels (P-value = 0.02). In older adults, after 12 wk, EMD appeared lower at all time points and RMS higher postexercise in the vitamin K2 group. No clear pattern in IL-6 or CK was observed, but at 72-h postexercise CK was lower in older adults in the vitamin K2 group. CONCLUSIONS: Vitamin K2 supplementation had no effect on muscle strength, physical function, muscle soreness, or inflammatory responses in the recovery period after a bout of resistance exercise. Effects of supplementation were observed on EMD, RMS, IL-6, and CK by age and warrant further investigation.
Brain Lateralization Enhanced by Long-Term Intensive Training and its Resilience to Short-Term Concussion in Elite Athletes.
Cao B, Guo YU, Deng F … +4 more , Chen L, Lu M, Wang J, Huang R
Med Sci Sports Exerc · 2026 Jul · PMID 41839190 · Publisher ↗
BACKGROUND: Brain lateralization, the hemispheric specialization of functional networks, is essential for motor and cognitive functions. However, how intensive athletic training shapes hemispheric organization remains po...
BACKGROUND: Brain lateralization, the hemispheric specialization of functional networks, is essential for motor and cognitive functions. However, how intensive athletic training shapes hemispheric organization remains poorly understood. This study investigated the formation of functional lateralization in elite athletes through long-term intensive training and its potential alteration by external factors, specifically sport-related concussions. METHODS: Resting-state functional magnetic resonance imaging data were collected from 13 world class gymnasts (WCGs) and 14 nonathletic controls. Longitudinal data were collected from 18 soccer players and eight golfers before and after one season, with concussions monitored in the soccer players. Laterality indices of hemispheric integration and segregation (LI int and LI seg ) were calculated to quantify hemispheric differences in information processing for each brain region, and the standard laterality index (LI) was employed to measure hemispheric asymmetry. Associations between laterality indices and neurotransmitter receptor/transporter densities were examined. Postseason changes in these indices were assessed to evaluate the effects of concussion on brain lateralization. RESULTS: The WCGs showed significantly increased LI int in several left-hemispheric regions, including the precentral gyrus, cingulate gyrus, thalamus, superior parietal lobule, and lateral occipital cortex compared with the healthy controls, although no significant differences were found in LI seg . Furthermore, the LI analysis revealed that the WCGs showed higher hemispheric asymmetry in the left precentral gyrus, cingulate gyrus, and thalamus. These laterality indices also were positively correlated with certain neurotransmitters. Similar patterns of enhanced lateralization and neurotransmitter associations were observed in soccer players and golfers. However, no significant changes in laterality indices were observed as a result of concussions sustained during the season. CONCLUSIONS: Long-term intensive training enhances functional integration in the left hemisphere, leading to stable brain lateralization patterns resilient to sport-related concussions.
Cardiometabolic Outcomes of Youth Participating in Organized Sport from Childhood to Early Adolescence.
Hliounakis H, Sanders T, George ES … +1 more , Guagliano JM
Med Sci Sports Exerc · 2026 Jul · PMID 41839188 · Publisher ↗
PURPOSE: The aim is to determine trajectories of youth sports participation and their effect on adolescent cardiometabolic health. METHODS: We included data from waves four, five, and six of the Longitudinal Study of Aus...
PURPOSE: The aim is to determine trajectories of youth sports participation and their effect on adolescent cardiometabolic health. METHODS: We included data from waves four, five, and six of the Longitudinal Study of Australian Children and the intermediary Child Health CheckPoint (CHCP) wave. Participants ( N = 1851) were 12.0 ± 0.4 yr old at the CHCP. We used latent class analysis to identify organized sport trajectories and conducted linear regressions to compare cardiometabolic risk score (CMRS; summative z scores for body mass index, systolic and diastolic blood pressure, high- and low-density lipoprotein cholesterol, triglycerides, and glucose) between classes. Analyses were repeated for team and individual sports participation. Analyses were adjusted for sex, socioeconomic status, and sexual maturity. RESULTS: Four latent classes were identified, including consistent sport participants (65.2%), late uptakes (17.4%), dropouts (7.9%), and nonparticipants (9.6%). Dropouts had significantly worse CMRS ( β = 0.95; 95% confidence intervals (CIs), 0.06-1.85) than nonparticipants. For team and individual sport participation, five trajectories were identified. These included consistent participants in both team and individual sports (31.1%), consistent individual (18.2%), consistent team (18.6%), moving from individual to team (14.9%), and nonparticipants (17.3%). The unadjusted model showed significantly better CMRS for consistent participants in both sports ( β = - 0.62; 95% CIs, - 1.07 to - 0.17) and team sports ( β = - 0.53; 95% CIs, - 1.03 to - 0.04). Secondary outcomes generally showed no statistically significant findings. CONCLUSIONS: Sports dropout in early adolescence is associated with poorer CMRS, while consistent participation in team sport with or without individual sport is associated with better CMRS. Further research exploring associations between cardiometabolic health and sports dropout and strategies to improve youth sport retention should be prioritized.
Multiscale Biomechanical Analysis of Running: Inter- and Intraindividual Variability with Insights into Second Metatarsal Stress.
VAN Waerbeke C, Jacques A, Berton E … +1 more , Rao G
Med Sci Sports Exerc · 2026 Jul · PMID 41839187 · Publisher ↗
PURPOSE: Variability in running plays a crucial role in distributing biomechanical loads and can be consequently associated with injury risk. This study aims to compare the level of variability between several biomechani...
PURPOSE: Variability in running plays a crucial role in distributing biomechanical loads and can be consequently associated with injury risk. This study aims to compare the level of variability between several biomechanical features at different scales of analysis, to investigate the correlations in amplitude and variability between biomechanical features and the second metatarsal stress, and to explore the inter- and intraindividual variability of the stress distribution in the second metatarsal. METHODS: Eight participants looped overground on a 45-m circuit for 30 min, while kinematics, kinetics, and plantar pressure of a stance phase were recorded at each loop. A dynamic finite element model of the foot, driven by muscle forces estimated by a musculoskeletal model, was used to estimate internal loads in the foot. Each variable of interest was classified into a category [ground reaction force (GRF), angles, net joint moments, muscle forces, joint reaction forces, and internal bone stress]. Variability was quantified using the mean standard deviation over the stance phase and compared both within and between these categories. RESULTS: The study revealed that variability across biomechanical domains of analysis lacked a clear relationship, with GRF components showing the lowest variability and joint angles exhibiting the highest. Although second metatarsal stress amplitude correlated strongly with vertical GRF, joint moments, and muscle forces, its variability showed less consistent correlations and was more participant-dependent. Significant inter/intra individual variations in second metatarsal von Mises stress amplitude and variability were observed. CONCLUSIONS: External GRFs and joint kinematics-related quantities, extracted directly from the experimental data, were found to inadequately represent the internal load variability, thus questioning the representativeness of these external features to assess internal stress/load variability.
Neighborhood Social Determinants of Health Patterns and Youth Sports Participation: Evidence from the ABCD Study.
Shih CH, Hayes A, Broadnax M … +1 more , Varangis E
Med Sci Sports Exerc · 2026 Jul · PMID 41839181 · Publisher ↗
PURPOSE: Participation in sports contributes substantially to children's physical health, psychological well-being, and cognitive development. Despite national initiatives to increase youth sports participation, inequiti...
PURPOSE: Participation in sports contributes substantially to children's physical health, psychological well-being, and cognitive development. Despite national initiatives to increase youth sports participation, inequities remain. Socioeconomic disadvantage, racial and ethnic minority status, and other social determinants of health (SDOH) are associated with lower engagement. However, most research addresses isolated factors rather than cumulative neighborhood-level SDOH. This study identified neighborhood SDOH profiles and examined their associations with sports participation. METHODS: Baseline data of 9400 children from 9 to 10 yr in the Adolescent Brain Cognitive Development Study were analyzed. Eighty-two neighborhood indicators spanning seven SDOH domains were aggregated into domain scores, with higher scores reflecting more advantaged conditions. Hierarchical agglomerative clustering identified neighborhood SDOH profiles. Associations between cluster membership and sports participation were examined using regression models adjusted for age, sex, race and ethnicity, parental education, and household income. Outcomes included the total number of sports and qualitative indices by sport skill type (open vs closed) and context (team vs individual). RESULTS: Four neighborhood profiles were identified, ranging from high affluence to urban high-risk environments. Children from disadvantaged clusters participated in fewer sports. Those in the most deprived neighborhoods played approximately 1.5 fewer sports than peers in affluent areas ( P < 0.01) and had reduced odds (open-skill or team sport participation odds ratios approximately 0.35-0.37, P < 0.01). Associations were attenuated after adjustment for individual- and family-level socioeconomic factors, with disparities remaining significant primarily in moderately advantaged and highly socioeconomically deprived neighborhoods. CONCLUSIONS: Distinct neighborhood social conditions are associated with differences in youth engagement in organized sports. These findings underscore the importance of considering structural and community-level factors when examining disparities in youth sports participation.
Effectiveness of Structured Breathwork Interventions on Heart Rate Variability and Heart Rate Recovery Following Maximal Exertion in Tactical Athletes.
Jones ME, Smith G, Acevedo A … +1 more , Melton B
Med Sci Sports Exerc · 2026 Jul · PMID 41839180 · Publisher ↗
PURPOSE: This study investigated the acute effects of two structured breathwork methods on autonomic recovery following maximal exertion. MATERIALS AND METHODS: A randomized control trial was conducted with 62 cadets (44...
PURPOSE: This study investigated the acute effects of two structured breathwork methods on autonomic recovery following maximal exertion. MATERIALS AND METHODS: A randomized control trial was conducted with 62 cadets (44 males and 18 females) assigned to three distinct groups: box breathing (BB), cyclic sighing (CS), or spontaneous breathing control. Participants performed a graded exercise test to assess maximal oxygen consumption (VO 2 ). High-frequency heart rate variability (HF-HRV) and heart rate recovery (HRR) were collected to evaluate autonomic recovery and parasympathetic reactivation. HF-HRV was analyzed at three time points: baseline (Pre), 1-3-min postexercise recovery (Post1), and 4-6-min postexercise (Post2). HRR was measured at 1- and 3-min intervals, analyzing reductions from peak heart rate captured at VO 2max . All analyses were evaluated using a 3 (group) × 3 (time) mixed-design repeated-measures analysis of variance. RESULTS: All groups were comparable in age, weight, height, and body mass index (21 ± 3 yr; 77.4 ± 15.4 kg; 173.1 ± 9.0 cm; 25.7 ± 4.0 kg·m -2 , respectively). HF-HRV revealed significant main effects for time ( F(2,118) = 465.01, P < 0.001, η 2 =0.89), group ( F(2,59) = 8.20, P < 0.001, η 2 =0.22), and time × group interaction ( F(4,118) = 3.54, P = 0.009, η 2 =0.21). Both the CS and BB groups had greater increases in HF-HRV from Post1 to Post2 when compared to spontaneous breathing ( P = 0.001). HRR improved across all participants from 1- to 3-min postexercise with n group level differences ( F(1,59) = 33.51, P < 0.001, η 2 =0.36). CONCLUSIONS: Structured breathwork following maximal exertion significantly accelerated parasympathetic reactivation as reflected by HF-HRV. Both BB and CS offer a simple field-ready intervention aimed to enhance operational readiness for tactical populations through enhancing acute physiological recovery.
Heat Acclimation Training Attenuates Oxidative Stress and Improves Mitochondrial Function to Protect the Heart from Exertional Heat Stroke in Mice.
Huang P, Rao Z, Liu S … +7 more , Qu C, Geng X, Zhang J, Gao D, Wu D, Wei Q, Zhao J
Med Sci Sports Exerc · 2026 Jul · PMID 41839179 · Publisher ↗
INTRODUCTION: Exertional heat stroke (EHS) leads to cardiac structural damage and functional impairment. Heat acclimation (HA) training may serve as an effective strategy to prevent and mitigate such damage, yet the unde...
INTRODUCTION: Exertional heat stroke (EHS) leads to cardiac structural damage and functional impairment. Heat acclimation (HA) training may serve as an effective strategy to prevent and mitigate such damage, yet the underlying molecular and cellular alterations remain unclear. METHODS: A C57BL/6N mouse model was used to study EHS-induced myocardial injury and evaluate the cardioprotective effects and mechanisms of HA training. Cardiac injury was assessed via plasma biomarkers, echocardiography, and histopathology, and transcriptomic analysis revealed links among injury, oxidative stress, and mitochondrial alterations. Transmission electron microscopy, O2K respirometry, and redox measurements further elucidated the mechanisms underlying mitochondrial structural and functional changes. RESULTS: EHS was associated with structural damage to myocardial tissue, including myocardial fibrosis, pathological echocardiographic changes, and a substantial elevation of the myocardial injury biomarker (cardiac troponin I). Mitochondrial structural disruption, impaired respiratory capacity, decreased adenosine triphosphate production, and disrupted redox balance were identified as potential contributors to these pathological changes. HA training was associated with attenuated EHS-induced myocardial damage, as evidenced by the amelioration of cardiac dysfunction and histopathological alterations, mitigation of mitochondrial structural damage, restoration of mitochondrial function, and increase in antioxidant capacity. Furthermore, HA training enhanced the thermoregulatory capacity and aerobic endurance of mice under high-temperature conditions. Transcriptomic analysis revealed that biological processes and signaling pathways enriched in differentially expressed genes with mitochondrial dysfunction and oxidative stress. CONCLUSIONS: This work identifies transcriptional alterations and signaling pathways associated with EHS-induced myocardial injury, suggesting pivotal roles for mitochondrial dysfunction and oxidative stress. Additionally, this research provides a theoretical basis and potential intervention targets for the prevention and mitigation of heat stress-induced cardiovascular damage through HA training.
Acute Biochemical Muscle Damage Responses to a Single Session of Whole-Body Electromyostimulation.
Melekoğlu T, Madenci G, Türk A … +3 more , Özdem S, Şentürk SN, Çetinkaya R
Med Sci Sports Exerc · 2026 Jul · PMID 41839178 · Publisher ↗
PURPOSE: This study aimed to investigate the acute effects of whole-body electromyostimulation (WB-EMS) on markers of skeletal muscle damage, renal function, and metabolic stress in sedentary adults. Given increasing rep...
PURPOSE: This study aimed to investigate the acute effects of whole-body electromyostimulation (WB-EMS) on markers of skeletal muscle damage, renal function, and metabolic stress in sedentary adults. Given increasing reports of severe muscle damage after a single WB-EMS session, this study examined the time course and magnitude of biochemical and urinary responses after such an event. METHODS: Twenty-six participants were randomly assigned to a WB-EMS group or a control (exercise-only) group. While both groups completed the same physical exercise protocol, only the WB-EMS group received low-frequency electrical stimulation (40-50 Hz). Venous blood and urine samples were collected at baseline and at 24, 48, and 72 h postexercise. Key biomarkers were measured: creatine kinase, myoglobin, alanine and aspartate aminotransferases, urinary cystatin C, and urinary potassium. Ratings of perceived exertion were also recorded. RESULTS: Despite low perceived exertion (<13), WB-EMS induced statistically significant elevations in serum creatine kinase and myoglobin, peaking at 72 h (1784 U·L -1 and 180.6 ng·mL -1 , respectively), indicating pronounced biochemical skeletal muscle stress. No such changes were observed in the control group. Hepatic enzymes remained within clinical reference ranges, while urinary cystatin C and potassium did not indicate acute kidney impairment. CONCLUSIONS: A single WB-EMS session can elicit marked skeletal muscle damage in previously untrained individuals, even when perceived exertion is low. Although no acute renal dysfunction was observed and the present findings do not indicate a clinical diagnosis of exertional rhabdomyolysis, the magnitude of the biomarker response underscores the physiological strain imposed by initial WB-EMS exposure. Collectively, these findings highlight the importance of careful progression and individualized load management when implementing WB-EMS protocols, particularly in EMS-naive populations.
The Effects of Time-Restricted Feeding and Exercise on Cardiometabolic Health in Sedentary Older Adults: A Randomized Controlled Trial.
Peng L, Chen L, Xia J … +7 more , Zhou J, Shi N, Cheng R, Shu L, Huang J, Hu M, Liao J
Med Sci Sports Exerc · 2026 Jul · PMID 41806970 · Full text
PURPOSE: Exploring preferable lifestyle habits (diet and/or exercise) is essential in improving cardiometabolic health among older adults, who represent the most sedentary than other age populations and generally suffer...
PURPOSE: Exploring preferable lifestyle habits (diet and/or exercise) is essential in improving cardiometabolic health among older adults, who represent the most sedentary than other age populations and generally suffer from cardiometabolic problems. This study aimed to determine the effects of long-term time-restricted feeding (TRF), exercise training, and their combination on comprehensive measures of cardiovascular functions and multiple auxiliary indicators, and to simultaneously evaluate side effects and adherence. METHODS: Fifty-six sedentary participants (age: 57.6 ± 2.2) were randomly assigned to control (CON; n = 14), exercise (EX; n = 14), TRF (n = 14), and a combinational intervention (EX+TRF; n = 14) group. Participants in each group were instructed to follow their assigned TRF and/or exercise protocol throughout an 8-wk period. The primary outcomes were changes in cardiovascular functions. Secondary outcomes included changes in body composition, metabolic parameters, circulating biomarkers, eating habits, and nutrient intake. RESULTS: After 8 wks, EX (n = 11), TRF (n = 11), and EX+TRF (n = 14) produced significant increase in heart rate variability compared with CON (n = 11) ( P < 0.05); EX and EX+TRF also significantly improved flow-mediated dilation ( P < 0.05). TRF and EX+TRF significantly induced reductions in body fat percentage, lean mass, and total calorie consumption compared with CON ( P < 0.05); EX even induced significant increases in inflammatory biomarkers ( P < 0.05). Three interventions potentially caused adverse events but with no obvious difference; neither TRF nor EX produced superior adherence than the other, but there was lower compliance when counseling them both. CONCLUSIONS: Sedentary older adults could achieve cardiovascular health benefits by choosing either TRF or exercise lifestyle, with no obvious difference in adverse events and adherence.
Evaluating the Effects of the Exercise Is Medicine Program on Biopsychosocial and Behavioral Outcomes in Individuals with Cardiovascular Risk Factors.
Nemati D, Sommer A, Zhao S … +11 more , Williams A, Hauben J, Luthy J, Omar M, Lartey K, Brengartner A, Ojembe N, Paro J, Urse K, Brock G, Joseph JJ
Med Sci Sports Exerc · 2026 Jul · PMID 41791037 · Full text
INTRODUCTION: The benefits of exercise for cardiovascular disease prevention are well established, yet most patients fail to adopt regular exercise despite healthcare provider recommendations. While healthcare provider r...
INTRODUCTION: The benefits of exercise for cardiovascular disease prevention are well established, yet most patients fail to adopt regular exercise despite healthcare provider recommendations. While healthcare provider recommendations provide interpersonal support, exercise adoption requires the development of intrapersonal motivation and the presence of a supportive environment. The Exercise is Medicine (EIM) program utilizes healthcare provider referrals to connect patients with a community that fosters the translation of exercise beliefs into behaviors. The purpose of this study was to examine the biopsychosocial and behavioral outcomes of the EIM program. METHODS: Participants were referred by healthcare providers through electronic medical records. Participants engaged in 16 group sessions and three one-on-one sessions (two before and one after the group sessions) and completed validated measures to assess the biopsychosocial model of health. RESULTS: The EIM program demonstrated significant improvements in biological and behavioral markers. Notably, exercise participation increased by an average of 64.7 min (95% confidence interval [CI]: 46.6 to 82.8). Body mass index decreased by 0.48 units (95% CI: -0.63 to -0.32), while perceived stress scores declined by 1.08 points (95% CI: -1.59 to -0.56). Participants also experienced an improvement in health-related quality of life, with general health scores rising by 5.59 points (95% CI: 4.39 to 6.78). Systolic blood pressure decreased by 2.9 mm Hg (95% CI: -3.9 to -1.9). Additionally, there was a 22% reduction in depressive symptoms ( P < 0.001) and a 9% reduction in perceived stress ( P < 0.001). Increases in exercise time were associated with improvements in key behavioral determinants such as self-efficacy, affective judgment/passion, and tolerance. CONCLUSIONS: Overall, these findings underscore the program's positive impact on cardiovascular health and mental well-being in a real-world community setting.
Effectiveness of a Remote Physical Activity Intervention in Individuals with Alzheimer's Disease and their Caregivers: Results from a Randomized Trial.
Ptomey LT, Helsel BC, Montgomery RN … +9 more , Washburn RA, Sherman JR, Szabo-Reed AN, Vidoni ED, Gorczyca AM, Bodde A, Clina JG, Williams KN, Donnelly JE
Med Sci Sports Exerc · 2026 Jul · PMID 41774485 · Full text
PURPOSE: Individuals with Alzheimer's disease and related dementias (ADRD) and their caregivers often experience reduced physical activity (PA), diminished functional fitness, and heightened health risks. Remotely delive...
PURPOSE: Individuals with Alzheimer's disease and related dementias (ADRD) and their caregivers often experience reduced physical activity (PA), diminished functional fitness, and heightened health risks. Remotely delivered PA interventions may offer scalable and accessible solutions. This study compared a 6-month, group-based dyadic PA program delivered via real-time group videoconferencing (RGV) with an enhanced usual care (EUC) condition on changes in moderate-to-vigorous physical activity (MVPA) and functional fitness among dyads consisting of individuals with ADRD and their caregivers. METHODS: Dyads were randomized to either the RGV or EUC arm. Both arms received wearable activity trackers and twice-monthly individualized support. The RGV group additionally participated in live, thrice-weekly group exercise sessions via videoconference. Outcomes included accelerometer-assessed MVPA and standardized measures of functional fitness. RESULTS: Ninety-nine dyads enrolled, with 90% retention at 6 months. Mean session attendance in the RGV arm was 74% for individuals with ADRD and 69.5% for caregivers. Neither group significantly increased daily MVPA, and there were no significant between-group differences in changes in daily MVPA or sedentary time (all P > 0.05). However, significant within-group improvements occurred in upper-body strength (arm curls) and aerobic capacity (2-minute step test) for both individuals with ADRD and caregivers (all P < 0.05). Compared with EUC, the RGV group showed greater improvements in aerobic capacity among individuals with ADRD (β = 8.97, P = 0.04) and in both arm curls (β = 1.67, P = 0.02) and aerobic capacity (β = 11.3, P < 0.001) among caregivers. CONCLUSIONS: Although MVPA did not increase in the RGV arm, both individuals with ADRD and caregivers demonstrated clinically meaningful gains in functional fitness, supporting the feasibility and benefit of remote dyadic PA programs.
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