Med Sci Sports Exerc [JOURNAL]
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200 papers
Impact of Burn Injury Size on Critical Environmental Limits during Exercise in the Heat in Young and Middle-Aged Adults.
Cramer MN, Belval L, Huang MU … +1 more , Crandall CG
Med Sci Sports Exerc · 2026 Jul · PMID 41774483 · Publisher ↗
PURPOSE: Burn injuries impair sweating and evaporative heat loss. This project 1) investigated the extent to which the size of a burn injury alters the critical relative humidity (RH crit ) for heat balance during exerci...
PURPOSE: Burn injuries impair sweating and evaporative heat loss. This project 1) investigated the extent to which the size of a burn injury alters the critical relative humidity (RH crit ) for heat balance during exercise-heat stress among burn survivors with injuries spanning ~20% ( n = 9), ~40% ( n = 6), and ~60% ( n = 9) total body surface area (TBSA), and 2) compared RH crit values between burn survivors and 10 noninjured individuals with simulated burns of 20%, 40%, and 60% TBSA. METHODS: Participants cycled (heat production: 192 ± 17 W·m -2 ) in 40°C and 24% relative humidity for 30 min, after which relative humidity increased 3% every 5 min until an upward inflection in esophageal temperature. RESULTS: RH crit averaged 41.3 ± 6.6% and 30.2 ± 3.8% in burn survivors with 20% and 40% injuries, respectively, and averaged 40.7 ± 5.3%, 38.2 ± 4.8%, and 31.73 ± 4.3% in noninjured individuals with 0%, 20%, and 40% TBSA-simulated burn injuries, respectively. There was a significantly higher probability of achieving RH crit sooner (i.e., at a lower relative humidity) with larger actual and simulated injuries up to 40% TBSA ( P < 0.001). Notably, esophageal temperature never reached a stable plateau, and thus RH crit could not be determined, in half of the participants with 40% TBSA actual and simulated injuries, likely reflecting the influence of burn size plus other factors that influence thermolytic capacity. No participants exhibited an RH crit with a 60% TBSA injury (actual or simulated), indicating that 60% TBSA injuries are too large to permit heat balance at even the lower relative humidity tested. CONCLUSIONS: Higher %TBSA injuries lead to lower RH crit values, with no difference between simulated and actual burn injuries.
Driver Cooling Strategies to Mitigate Heat Illness in Motorsports: Physiological Impacts and Recommendations.
Davis AR, Breach-Teji J, Faltus AL … +6 more , Boettcher AE, Gulbransen GD, Marchal S, Pluszczynski GM, Xhaja S, Ferguson DP
Med Sci Sports Exerc · 2026 Jul · PMID 41774482 · Publisher ↗
INTRODUCTION: Each year, over 1 million individuals participate in automobile racing and are at an increased risk of heat illness due to the physical effort to pilot the vehicle while wearing a fire protective suit in a...
INTRODUCTION: Each year, over 1 million individuals participate in automobile racing and are at an increased risk of heat illness due to the physical effort to pilot the vehicle while wearing a fire protective suit in a hot cockpit. To date, there has been no investigation into the various methods advertised to mitigate heat stress in drivers. PURPOSE: This study aimed to evaluate the effectiveness of three driver cooling strategies-cool shirt, helmet blower, and suit blower-during heat exposure, and to determine their impact on thermal stress in a laboratory setting. METHODS: Physically fit participants completed six 60-min cycling trials in a heat chamber (32°C, 80% relative humidity) while wearing full fire-protective racing gear. Trials included five cooling strategies (cool shirt, helmet blower with ambient or cold air, suit blower with ambient or cold air) and a control (no cooling) condition. Core temperature, skin temperature, heart rate, and Physiological Strain Index were recorded. Ambient air trials were discontinued after three participants due to safety concerns. RESULTS: After 60 min of exercise, the suit blower with cold air (34.85 ± 0.11°C) had the lowest ( P < 0.001) skin temperature, followed by the cool shirt (37.99 ± 0.11°C), then the helmet blower with cold air (38.71 ± 0.04°C) and finally the control condition (39.74 ± 0.04°C). Core temperature was the lowest ( P < 0.001) in the suit blower (cold air) condition (37.51 ± 0.04°C), followed by the helmet blower (cold air) condition (38.05 ± 0.04°C), then the control condition (38.32 ± 0.04°C), and finally, the cool shirt condition (38.58 ± 0.04°C). CONCLUSIONS: The suit blower with cold air is the most effective strategy for mitigating thermal strain. helmet blowers also offer substantial benefits, while cool shirts provide limited cooling.
Variations in Ramp Slope Affect the Prediction of W´ from a Single Incremental Test.
Stuer L, VAN Rie K, Boone J … +2 more , Mucci P, Caen K
Med Sci Sports Exerc · 2026 Jul · PMID 41774481 · Publisher ↗
PURPOSE: The purpose of this study was to assess the suitability of ramp incremental (RI) tests with different ramp slopes to predict the work capacity above critical power (CP), which is termed W´. We hypothesized that...
PURPOSE: The purpose of this study was to assess the suitability of ramp incremental (RI) tests with different ramp slopes to predict the work capacity above critical power (CP), which is termed W´. We hypothesized that RI tests with a higher slope would underestimate W´, whereas RI tests with a lower slope would provide accurate estimates. METHODS: Thirteen healthy young men (23 ± 3 yr, 180 ± 7 cm, 71.8 ± 5 kg) performed a maximal RI test (30 W·min -1 ), followed by three to five constant work rate (CWR) tests to conventionally determine CP and W´ CWR . Additionally, they performed a slow and fast RI test (10 and 50 W·min -1 , respectively). W´ estimated from the RI tests was calculated as the work performed above CP and referred to as W´ R30 , W´ R10 , and W´ R50 . Each RI test was performed until exhaustion, after which a power output above CP was imposed, which was also maintained until exhaustion to calculate the remaining W´ after the RI test (W´ + ), resulting in total W´ values (W´ T_R30 , W´ T_R10 , and W´ T_R50 ). RESULTS: W´ R30 ( P = 0.018), W´ R10 ( P = 0.006), and W´ R50 ( P < 0.001) significantly underestimated W´ CWR . W´ T_R30 ( P = 0.671), W´ T_R10 ( P = 0.072), and W´ T_R50 ( P = 0.264) were not different from W´ CWR but exhibited a substantial variability. CONCLUSIONS: W´ determination from a RI test resulted in an underestimation compared with values obtained from traditional CWR tests, irrespective of the imposed ramp slope. Although the addition of a supra-CP work bout immediately after termination of the RI test may reduce this underprediction, substantial variability in W´ estimation remain.
Caffeine Increases Core Temperature without Altering Markers of Kidney or Gut Injury after Physical Work in the Heat in Caffeine-Habituated Adults.
Specht JW, Ramirez MR, Quintana A … +7 more , Bailly AR, Peña A, Schmidt E, DE Castro Magalhães F, McKenna ZJ, Schlader ZJ, Amorim FT
Med Sci Sports Exerc · 2026 Jul · PMID 41774477 · Publisher ↗
METHODS: Using a double-blind, crossover design, 14 (6 male) active, caffeine-habituated adults ingested 5 mg/kg of bodyweight (up to 400 mg) of caffeine or placebo 30 min before a 2-h heat trial (35°C dry bulb, 50% rela...
METHODS: Using a double-blind, crossover design, 14 (6 male) active, caffeine-habituated adults ingested 5 mg/kg of bodyweight (up to 400 mg) of caffeine or placebo 30 min before a 2-h heat trial (35°C dry bulb, 50% relative humidity) involving walking (40% peak) and box-lifting. Bodyweight was measured pre- and post-trial. Core temperature (Tcore) and heart rate (HR) were recorded every 10 min. Blood and urine samples were collected pre-, post-, and 1-h post-trial to assess markers of AKI, intestinal injury, and endotoxemia. RESULTS: Caffeine increased peak Tcore (38.2 ± 0.4 vs 38.0 ± 0.3°C; P = 0.02), peak HR (147 ± 18 vs 138 ± 17 bpm; P = 0.02), and bodyweight loss (1.7% ± 1.0% vs 1.5% ± 1.1%, P = 0.04) compared with placebo. There were no differences in markers of AKI (urinary insulin-like growth factor-binding protein 7• tissue inhibitor of metalloproteinase 2, neutrophil gelatinase-associated lipocalin) ( P > 0.05). Serum cystatin C increased from pre- to post-trial in the caffeine (∆0.24 ± 0.43 mg/L, P = 0.03) but not placebo (∆-0.07 ± 0.17 mg/L, P = 0.81) condition, suggesting a reduction in glomerular filtration. There were no differences in markers of intestinal injury (intestinal fatty acid binding protein) or endotoxemia (lipopolysaccharide-binding protein, soluble cluster of differentiation 14) ( P > 0.05). CONCLUSIONS: Caffeine ingestion before work in the heat exacerbated increases in Tcore but did not affect biomarkers of kidney or intestinal injury. Workers performing labor in hot environmental conditions should consider that caffeine during work in the heat may increase the rate of Tcore rise.
Physical Activity Characteristics and Symptoms of Depression: Findings from the Cooper Center Longitudinal Study.
Pavlovic A, Leonard D, Vukovich K … +4 more , Barlow CE, Shuval K, Meernik C, Defina LF
Med Sci Sports Exerc · 2026 Jul · PMID 41774476 · Publisher ↗
PURPOSE: Examine the relationship between physical activity (PA) characteristics and depressive symptoms among community-dwelling adults. METHODS: The study consisted of 38,946 participants (n = 26,378 men, n = 12,568 wo...
PURPOSE: Examine the relationship between physical activity (PA) characteristics and depressive symptoms among community-dwelling adults. METHODS: The study consisted of 38,946 participants (n = 26,378 men, n = 12,568 women) who completed a 10-item depression screening assessment, the Center for Epidemiologic Studies Depression Scale (CES-D), and reported PA within the prior 3 months as part of a preventive exam. Intensity of PA reported in metabolic equivalent of task (METs) was assigned based on activity using the Compendium of Physical Activities. Weekly PA volume (MET·min per wk) was calculated as the product of product of intensity (METs) and weekly duration (min per wk) summed across reported activities. Leading type (participants' predominant activity) was classified as aerobic, strength, mixed-endurance (e.g., circuit/interval training, basketball, racket sports, etc.), and flexibility. Diversity of activity was calculated based on Shannon's diversity index using binary logarithms on the proportions of time spent in each reported activity. Depressive symptoms were determined by a CES-D score ≥10. Adjusted odds ratios and 95% confidence intervals were estimated using logistic regression to assess the association between PA characteristics and depression symptoms by sex, adjusted for age, current smoking, alcohol intake, body mass index, glucose, cholesterol, and systolic blood pressure. RESULTS: The mean age ± SD for women and men was 48.3 ± 10.8 and 49 ± 10.1 years, respectively. CES-D score ≥10 was present in 15.4% of women and 9.1% of men. Risk of depressive symptoms was inversely related to all PA characteristics individually and to average intensity and diversity of activity when all PA variables were modeled together. CONCLUSIONS: While all measured PA characteristics were associated with reduced odds of depressive symptoms, the most significant associations were observed for PA intensity and diversity. As such, engaging in a variety of activities, some of which are high-intensity, may be associated with lower odds of depressive symptoms.
Improved Balance and Walking Capacities after Tailored Balance Training with and without Superimposed Sensory Stimulation in Older Adults.
Fabre M, Theodosiadou A, Papavasileiou A … +5 more , Sahinis C, Amiridis I, Patikas D, Baudry S, Lapole T
Med Sci Sports Exerc · 2026 Jul · PMID 41747286 · Publisher ↗
PURPOSE: We investigated the impact of an 8-week tailored balance program, with or without superimposed sensory stimulation (local vibration [LV], and/or transcutaneous electrical nerve stimulation [TENS]), on balance an...
PURPOSE: We investigated the impact of an 8-week tailored balance program, with or without superimposed sensory stimulation (local vibration [LV], and/or transcutaneous electrical nerve stimulation [TENS]), on balance and walking performance in older adults. METHODS: Seventy-five healthy elderly participants (age 79.9 ± 3.9 years) were randomly assigned to one of four groups: postural exercises only ( n = 17), exercises with LV ( n = 19), exercises with TENS ( n = 19), and exercises with LV+TENS ( n = 20). For LV, TENS, and LV+TENS groups, proprioceptive stimulation targeted the triceps surae and tibialis anterior. Participants completed a baseline assessment including the Berg Balance Scale, Short Physical Performance Battery, 6-min walk test, 10-meter walk test, and Timed Up and Go test. A similar assessment was performed 8 weeks later, and after the 8-week tailored intervention, which consisted of two 1-h sessions per week. Balance and walking capacities were finally reassessed 8 weeks after training. RESULTS: In all groups, reliability of the outcome measures was moderate to high between baseline and preintervention values (intraclass correlation coefficients >0.63). Postintervention, linear mixed-effects models revealed significant improvements in Berg Balance Scale and Short Physical Performance Battery scores (53.1 ± 2.4 and 10.9 ± 0.9 vs 54.9 ± 2.4 and 11.5 ± 0.9, P < 0.001), and reduced times for Timed Up and Go test (7.3 ± 1.7 s vs 6.6 ± 1.7 s, P < 0.001) and increased 10-meter walk test velocity (3.6 ± 0.7 m/sec vs 3.4 ± 0.7 m/sec, P = 0.004), with no group differences nor interactions. Benefits were partially maintained 8 weeks after training. The interventions did not affect 6-min walk test performance (525.5 ± 75.1 m vs 527.8 ± 74.1 m, P = 0.143). CONCLUSIONS: Tailored balance exercises alone significantly enhanced postural control and walking capacity in healthy older adults. Additional sensory stimulation provided no extra benefit, suggesting that for healthy older adults without major balance impairments, exercises alone may suffice to achieve meaningful functional improvements.
Variations in Estrogen, Progesterone, and Nocturnal Physiology are not Associated with Performance and Sleep within and between Menstrual Cycles.
Pearson MA, Weakley JJS, Johnston RD … +3 more , Fernandez F, Munteanu G, Halson SL
Med Sci Sports Exerc · 2026 Jul · PMID 41747284 · Publisher ↗
PURPOSE: To investigate performance, recovery, sleep, nocturnal physiology, ovarian hormone concentrations, and menstrual cycle symptoms within and between menstrual cycle phases and establish within-phase reliability of...
PURPOSE: To investigate performance, recovery, sleep, nocturnal physiology, ovarian hormone concentrations, and menstrual cycle symptoms within and between menstrual cycle phases and establish within-phase reliability of these measures. METHODS: Twenty naturally cycling, trained female participants (age 27 ± 5 yr) completed a repeated measures study design. Serum estradiol and progesterone concentrations, countermovement jumps, isometric mid-thigh pulls, a repeated 5 km cycle time trial, and two nights of sleep architecture were measured in phases one, three, and four of two menstrual cycles. Sleep and wake measures from activity monitoring, nocturnal heart rate (HR) measures from the Oura Ring, and menstrual cycle symptoms were monitored daily. Statistical analyses included linear mixed models and reliability measures. RESULTS: Estradiol concentrations were significantly lower in phase one versus three, one versus four, and three versus four ( P < 0.001 to 0.04) in both menstrual cycles. Progesterone concentrations were significantly lower in phase one versus four, and three versus four ( P < 0.001) in both menstrual cycles. Symptoms were significantly higher in phase one versus three and four ( P < 0.001) in cycle one only. No significant differences between phases were found for performance, recovery, and sleep in either cycle, except for the nonrapid eye movement stage three (N3%) sleep in cycle two. Nocturnal average HR was significantly lower ( P < 0.001) and HR variability higher ( P < 0.001) in phase one versus four in both cycles. Ovarian hormone concentrations were highly variable within each phase (coefficients of variance 28%-95%), while performance and recovery demonstrated minimal variability in both cycles. CONCLUSIONS: Performance, recovery, and sleep in trained female participants remained consistent despite ovarian hormone fluctuations. Consequently, practitioners should test athletes when convenient, using accurate and reliable assessments rather than synchronizing testing with specific menstrual cycle phases.
The Effects of Neuromuscular Training and Additive Visual Biofeedback on Landing Biomechanics and Sensorimotor Brain Activity in Young Female Athletes.
Slutsky-Ganesh AB, Chaput M, Hogg JA … +18 more , Zuleger TM, Kim H, Diekfuss JA, Anand M, Schille A, Dicesare C, Warren SM, Riehm CD, Schnittjer AJ, Farraye BT, Pierce S, Roe JW, Bennison J, Barber Foss KD, Simon JE, Riley MA, Myer GD, Grooms DR
Med Sci Sports Exerc · 2026 Jul · PMID 41718606 · Publisher ↗
INTRODUCTION: Anterior cruciate ligament injuries are debilitating, often requiring surgical reconstruction and prolonged recovery. Female adolescent athletes are at particularly high risk for anterior cruciate ligament...
INTRODUCTION: Anterior cruciate ligament injuries are debilitating, often requiring surgical reconstruction and prolonged recovery. Female adolescent athletes are at particularly high risk for anterior cruciate ligament injury and display distinct neuromuscular control patterns during jump landing that further increase injury risk. Neuromuscular training (NMT) designed to reduce injury risk can be enhanced with automated movement corrective biofeedback to improve neuromuscular control and landing biomechanics; however, the central nervous system responses to targeted NMT that underlie adaptive biomechanical responses are not well-understood. PURPOSE: This study aimed to identify the effects of NMT on landing biomechanics and task-related brain activity, examine the relationship of changes in these variables, and determine if additive visual biofeedback (augmented versus sham) provides a meaningful impact on injury-related outcomes. METHODS: This study included 55 female middle- and high-school athletes (age mean = 15.73 ± 1.40 yr) who participated in ~6 wk of NMT (3×/wk; 18 sessions), which included up to 12 sessions of additive biofeedback (augmented: n = 28; sham: n = 27). Testing at pre- and post-NMT included a drop vertical jump task to assess landing biomechanics (sagittal and frontal plane hip and knee kinematics and kinetics) and a supine bilateral leg press task during functional magnetic resonance imaging to assess brain activity during a complex sensorimotor movement task. RESULTS: NMT improved landing biomechanics (η 2 range = 0.04-0.41, P s < 0.049) and reduced task-related brain activity in sensorimotor regions ( Prange = 0.015-0.032). Pre-post increases in postcentral gyrus brain activity predicted a reduction in left knee peak abduction moment (odds ratio = 22.61, 95% confidence interval [2.41, 212.21], P = 0.048). Additive biofeedback did not appear to influence outcomes of interest. CONCLUSIONS: NMT improved sensorimotor efficiency and landing biomechanics. However, increased somatosensory activity emerged as a critical predictor of improved landing patterns, highlighting the role of enhanced sensory processing in biomechanical risk-reduction.
Progressive Overload Affects the Magnitude of Muscle Hypertrophy.
Kassiano W, Santos-Melo V, Manske I … +7 more , Lisboa F, Miguel A, Gomes F, Prado A, Stavinski N, Costa B, Cyrino ES
Med Sci Sports Exerc · 2026 Jul · PMID 41718594 · Publisher ↗
PURPOSE: We investigated the influence of progressive overload (PO) on resistance exercise-induced muscle growth. METHODS: Fifty-five untrained young women participated in the study. Each participant's arm was randomly a...
PURPOSE: We investigated the influence of progressive overload (PO) on resistance exercise-induced muscle growth. METHODS: Fifty-five untrained young women participated in the study. Each participant's arm was randomly assigned to one of the following conditions: 1) PO ( n = 37), 2) nonprogressive overload (N-PO, n = 32), and 3) time-matched nonexercise control (Control, n = 41). The training conditions performed unilateral elbow extension exercise in three sets of 8-12 repetitions, 3 d·wk -1 , for 8 wk. The PO condition increased the load whenever it reached the upper limit of the repetition range, whereas N-PO remained training with the same load and number of repetitions throughout the 8 wk. Triceps brachii (TB) muscle thickness was assessed using ultrasonography at 60% (TB60) and 70% (TB70) of the upper arm length, and the sum of both sites was calculated (∑TB). RESULTS: TB60 muscle thickness increased in both training conditions compared with Control, with greater increases in PO relative to N-PO (PO = 0.40 cm, +21.4% > N-PO = 0.22 cm, +11.3% > Control = 0.02 cm, +1.3%; P < 0.001). TB70 muscle thickness increased in both training conditions compared with Control, with greater increases in PO relative to N-PO (PO = 0.38 cm, +25.0% > N-PO = 0.19 cm, +12.0% > Control = 0.03 cm, +2.5%; P < 0.001). ∑TB increased in both training conditions compared with Control, with greater increases in PO relative to N-PO (PO = 0.79 cm, +22.9% > N-PO = 0.41 cm, +11.6% > Control = 0.05 cm, +1.8%; P < 0.001). CONCLUSIONS: Muscle growth appears to be more pronounced when resistance exercise is progressively overloaded. Notably, training without overload progression is sufficient to induce muscle hypertrophy in young, untrained women. Whether resistance training without increasing overload remains effective in promoting muscle growth when performed for longer periods remains an open question and warrants further investigation.
The Effect of High-Intensity Interval Training on Neuroplasticity-Related Proteins in the Cerebrum of Postnatally Growth-Restricted Mice.
Kim SH, Quinn MA, Ananyev J … +3 more , McPeek AC, Leszczynski EC, Ferguson DP
Med Sci Sports Exerc · 2026 Jul · PMID 41718592 · Publisher ↗
INTRODUCTION: Childhood growth restriction can lead to lasting developmental changes, increasing susceptibility to chronic diseases and neurodegenerative conditions in adulthood. High-intensity interval training (HIIT) e...
INTRODUCTION: Childhood growth restriction can lead to lasting developmental changes, increasing susceptibility to chronic diseases and neurodegenerative conditions in adulthood. High-intensity interval training (HIIT) elevates brain-derived neurotrophic factor (BDNF) levels more effectively than moderate-intensity continuous exercise, supporting neuroplasticity. Building on these findings, this study aimed to determine whether HIIT could enhance neuroplasticity-related protein expression in the brains of postnatally growth-restricted (PNGR) mice. METHODS: Friend leukemia virus B mouse pups born to normal-protein and low-protein-fed dams were cross-fostered at postnatal day (PN) 1 to establish two groups: PNGR mice and control mice (CON). At PN 21, all pups were weaned onto a normal-protein diet and assigned to either a HIIT group (training group [TRD]) or a sedentary group (SED). At PN 45, a maximal exercise performance test was conducted to determine HIIT intensities. Based on these results, mice performed treadmill HIIT 5 d·wk -1 for 4 wk, with alternating intervals of 8 min at 85% and 2 min at 50% of maximal exercise capacity, totaling 60 min per session. At PN 73, all mice were euthanized, and cerebrum tissue was collected for Western blot analysis of BDNF, tropomyosin receptor kinase B, growth-associated protein 43, and synaptophysin protein expression. RESULTS: Despite significant body mass reductions observed in both CON and PNGR groups after HIIT, neuroplasticity-related protein expression did not increase in PNGR mice. The PNGR group exhibited consistently lower tropomyosin receptor kinase B and reduced BDNF and growth-associated protein 43 levels compared with CON mice, indicating a limited neuroplastic response to exercise. CONCLUSIONS: Contrary to expectations, HIIT did not elevate neuroplasticity markers in PNGR mice, highlighting the lasting impact of early-life growth restriction on brain plasticity and suggesting the need for alternative interventions.
Combining Noninvasive Tests of Different Physiological Dimensions Leads to Better Estimation of Muscle Fiber Type Composition in Humans.
VAN DE Casteele F, VAN DER Meulen L, Sablain M … +3 more , VAN Thienen R, Lievens E, Derave W
Med Sci Sports Exerc · 2026 Jul · PMID 41718587 · Publisher ↗
PURPOSE: Muscle fiber type composition is a sports performance determinant, but its use in sports practice is hampered by the invasive muscle biopsy. We aimed to determine the best noninvasive method or combination of su...
PURPOSE: Muscle fiber type composition is a sports performance determinant, but its use in sports practice is hampered by the invasive muscle biopsy. We aimed to determine the best noninvasive method or combination of such methods to estimate muscle fiber type composition. We hypothesized that methods measuring different fiber type-specific characteristics, that is, metabolism, power, contractility, and endurance, would complement each other. METHODS: Forty young, healthy, and recreationally-to-competitively trained participants (20 men) underwent noninvasive tests and four muscle biopsies: two in the vastus lateralis and two in the gastrocnemius medialis. The average relative area occupied by type 2 fibers across the biopsies served as the criterion measure (multimuscle FTarea%). On average, this was calculated based on the fiber type of ~5200 fibers and the cross-sectional area of ~1200 fibers per participant. Participants performed 30-m sprints, squat jumps, a Wingate with blood lactate measurements, isometric and isokinetic knee extensions, a maximal ramp incremental cycling exercise, and underwent peripheral electrical stimulation of the quadriceps and a proton magnetic resonance spectroscopy scan to measure muscle carnosine. RESULTS: Multimuscle FTarea% ranged from 21.2% to 60.1%. Many parameters were significantly associated with multimuscle FTarea%, but post Wingate blood lactate concentration showed the strongest correlation (r = 0.67; P < 0.001). A multiple linear regression model with sex, post Wingate blood lactate, peak knee extension torque at 300°·s -1 scaled to upper leg lean mass, average vastus lateralis, and soleus carnosine and singlet contraction time as predictors could explain 68% of the multimuscle FTarea% variance, confirming our hypothesis. CONCLUSIONS: The proposed model, which combines noninvasively measured parameters of metabolism, power, and contractility, can provide a reasonably accurate estimate of vastus lateralis and gastrocnemius medialis fiber type composition.
Compensatory Movement Strategies during the Rearfoot Elevated Split Squat after ACL Reconstruction.
Graham M, Gohil A, Janatova T … +2 more , Johnson D, Noehren B
Med Sci Sports Exerc · 2026 Jul · PMID 41718576 · Publisher ↗
PURPOSE: To compare inter and intralimb compensation strategies between anterior cruciate ligament (ACL)-involved and noninvolved limbs during the rearfoot elevated split squat (RFESS) and examine the influence of trunk...
PURPOSE: To compare inter and intralimb compensation strategies between anterior cruciate ligament (ACL)-involved and noninvolved limbs during the rearfoot elevated split squat (RFESS) and examine the influence of trunk flexion angle on compensation strategy. METHODS: Twenty-five individuals (3.9 ± 0.9 months post-ACL reconstruction) performed RFESS using three-dimensional motion capture and force plates. Joint kinematics, kinetics, and vertical ground reaction forces (vGRF) were analyzed for the lead limb at the bottom position of the RFESS. Internal joint moments were normalized to body mass and vGRF were normalized to body weight. Relative joint contributions were calculated as ([joint moment/total support moment] × 100). Paired samples t tests assessed between-limb differences (adjusted P = 0.0038). Linear regression examined the relationship between trunk flexion angle and compensation strategy. RESULTS: The ACL-involved limb demonstrated both inter and intralimb compensation, reflected by lower vGRF (-7.3%, P < 0.001, d = -1.26) and total support moment (-0.29 N·m·kg -1 , P = 0.002, d = -0.72), alongside a redistribution of demand away from the knee (-12.8%, P <.001, d = -2.81) and toward the hip (+9.8% P < 0.001, d = 2.02) and ankle (+3.2%, P < 0.001, d = 1.10). Greater trunk flexion was associated with higher vGRF (R 2 = 0.52, P < 0.001) but not knee contribution ( P = 0.84). CONCLUSIONS: Inter and intralimb compensation strategies were observed in the ACL-involved limb during the RFESS. Performing the RFESS with a more upright trunk may exacerbate interlimb compensation, promoting offloading of the lead limb. Collectively, these findings suggest that without careful monitoring, the RFESS may be ineffective as a knee extensor strengthening exercise during mid-stage ACL rehabilitation.
Ice Slurry Mitigates Hyperventilation and Cerebral Hypoperfusion, and May Enhance Endurance Performance in the Heat - Erratum.
Katagiri A, Kawai S, Nishiyasu T … +1 more , Fujii N
Med Sci Sports Exerc · 2026 Mar · PMID 41681010 · Publisher ↗
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Prognostic Value of Achilles Tendon Doppler Sonography in Asymptomatic Runners - Erratum.
Hirschmüller A, Frey V, Konstantinidis L … +4 more , Baur H, Dickhuth HH, Südkamp NP, Helwig P
Med Sci Sports Exerc · 2026 Mar · PMID 41681009 · Publisher ↗
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Telomere Length, Cortisol, Body Composition, Hemodynamics and Dance: An Exploratory Analysis In 18-to-83-Year-Olds - Corrigendum.
Med Sci Sports Exerc · 2026 Mar · PMID 41681008 · Publisher ↗
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Medical Care of Transgender Athletes and Policy Implications: ACSM Contemporary Issue Statement.
Marra J, Christensen D, Harper JM … +6 more , Iwamoto SJ, Ryan W, Safer JD, Streed CG, Nokoff NJ, Moreau KL
Med Sci Sports Exerc · 2026 Mar · PMID 41681007 · Publisher ↗
Although transgender and gender diverse people make up 0.6% of the population in the United States, they are underrepresented in sports. Transgender athletes are increasingly visible and subject to widely discrepant poli...
Although transgender and gender diverse people make up 0.6% of the population in the United States, they are underrepresented in sports. Transgender athletes are increasingly visible and subject to widely discrepant policies regarding their participation in sports. This Contemporary Issues statement reviews topics relevant to the care of transgender athletes, for the providers, trainers, coaches, and others caring for this population. We review: 1) barriers to sport participation, 2) a review of gender-affirming medical and surgical care and the impacts on factors related to sport performance, 3) mental health considerations, and 4) a framework for understanding stressors and resilience. Most of the available data included here are from nonathlete transgender people, with limited data in transgender athletes. More robust data in transgender athletes are needed for future policies.
Team Synchrony Under Fire: Heart Rate Recurrence Reveals a Biosignature of Victory in Elite Esports.
Gu X, Liang X, Zhao S … +2 more , Agudamu, Zhang Y
Med Sci Sports Exerc · 2026 Mar · PMID 41681006 · Publisher ↗
OBJECTIVES: Team success in esports is typically attributed to mechanical skill and tactical execution, yet theoretical models of real-time team coordination remain lacking. This cross-sectional study examined whether te...
OBJECTIVES: Team success in esports is typically attributed to mechanical skill and tactical execution, yet theoretical models of real-time team coordination remain lacking. This cross-sectional study examined whether team-level physiological synchrony, measured via heart rate (HR), predicts competitive success in elite first-person shooter esports. METHODS: HR data sampled at 2 Hz were collected during the 2024 Peacekeeper Elite League Fall Finals. Team-level HR synchrony was quantified using multidimensional recurrence quantification analysis (MdRQA) on 5-s binned HR series. Synchrony metrics were compared between winning and losing teams during pregame and in-game phases using robust linear mixed-effects models. RESULTS: A total of 4.73 million HR samples were analyzed, representing 98.4 h of gameplay. No significant winner-loser differences emerged pregame. During gameplay, however, winners exhibited significantly greater synchrony across multiple MdRQA dimensions. Compared with losers, winners showed higher recurrence rate (+4.18%, Cohen d = 0.71), determinism (+12.0%, d = 0.77), laminarity (+7.03%, d = 0.50), diagonal entropy (+0.95, d = 0.82), vertical entropy (+0.76, d = 0.70), average diagonal line length (+3.0 s, d = 0.67), average vertical line length (+5.3 s, d = 0.78), and maximum line lengths (+73.2 s diagonal, d = 0.52; +45.0 s vertical, d = 0.57). These effects remained significant across 5-s delay embedded models and sensitivity analyses. CONCLUSIONS: Winning teams exhibited more frequent, complex, and sustained HR synchrony during gameplay-suggesting a state of coordinated physiological readiness. These recurrence-based signatures offer a novel biobehavioral marker for training, diagnostics, and team assessment in esports.
High-Load Resistance Training in the First Trimester, a Retrospective Survey: Implications for Exercise Professionals and Obstetrical Providers.
Prevett C, Davenport MH
Med Sci Sports Exerc · 2026 Jun · PMID 41630131 · Publisher ↗
PURPOSE: This study aimed to examine whether individuals engaging in high-load resistance training (RT) make any exercise modifications during the first trimester of pregnancy, and describe pelvic floor health, fertility...
PURPOSE: This study aimed to examine whether individuals engaging in high-load resistance training (RT) make any exercise modifications during the first trimester of pregnancy, and describe pelvic floor health, fertility history, and obstetrical characteristics. METHODS: Individuals <20 wk gestation who regularly engaged in RT during the first trimester were recruited and completed surveys related to preconception and first trimester pelvic health, fertility, menstrual health, relative energy deficiency in sport, and exercise behaviors. Training logs from 3 months preconception, until 12 wk of gestation were obtained from a subset of individuals. RESULTS: Three hundred fifty-nine participants, mean age 32.3 yr (±3.6 yr), completed surveys. From preconception to the first trimester, the frequency of training decreased (4.8 d ± 1.0 d prepregnancy vs 4.0 ± 1.3 d in first trimester, t = 11.45, P < 0.01). Most individuals continued Olympic weightlifting ( n = 127/159, 80%) and core exercises ( n = 214/234, 92%), with over half increasing or maintaining the load of RT ( n = 126/203, 62%). Fatigue and nausea reportedly impacted exercise behavior in 77% of participants. Rates of previous miscarriage were similar to those of the general population. Only 15% of participants were given counseling on exercise after miscarriage (10/68 participants). Ten individuals (3%) reported a miscarriage during enrollment in the current study. Pelvic floor complaints during exercise reduced significantly from preconception to trimester one, irrespective of whether training load was reduced or maintained. Forty-one athletes provided preconception and pregnancy training logs. In this subset of athletes, their working load was maintained from preconception across the first trimester at >75% of estimated one-repetition maximums. CONCLUSIONS: Continued participation of RT in the first trimester was well tolerated by those participating in RT preconception.
Hypertrophic Effects of Single- versus Multi-Joint Exercise: A Direct Comparison between Knee Extension and Leg Press.
Kinoshita M, Maeo S, Kobayashi Y … +7 more , Eihara Y, Nishizawa N, Kusagawa Y, Sugiyama T, Wakahara T, Kanehisa H, Isaka T
Med Sci Sports Exerc · 2026 Jul · PMID 41630124 · Full text
INTRODUCTION: Single-joint knee extension (KE) and multi-joint leg press (LP) are commonly used exercises to train the quadriceps femoris (QF), the largest muscle group in humans. However, their comparative effectiveness...
INTRODUCTION: Single-joint knee extension (KE) and multi-joint leg press (LP) are commonly used exercises to train the quadriceps femoris (QF), the largest muscle group in humans. However, their comparative effectiveness for inducing QF hypertrophy remains unclear. Furthermore, the specific muscles hypertrophied by LP are not well characterized. This study compared the hypertrophic effects of KE and LP on the QF and other lower-limb muscles. METHODS: Seventeen untrained adults performed KE with one leg and LP with the contralateral leg at 70% of one-repetition maximum, 10 reps/set, 5 sets/session, 2 sessions/week for 12 wk. Magnetic resonance imaging was used to assess pre- and post-training muscle volumes of 17 individual muscles, including the four QF heads, gluteus muscles, hamstrings, and adductors. RESULTS: Muscle volumes of the individual and whole QF significantly increased in both conditions ( P ≤ 0.026), except for the rectus femoris in the LP condition ( P = 0.379). Rectus femoris volume gains were greater for KE than LP (+13.2% vs +1.1%, P ≤ 0.001), but gains in the vasti muscles (+5.0%-7.2% vs +4.4%-6.2%) and whole QF (+7.1% vs +4.9%) were comparable between conditions ( P ≥ 0.319). LP, but not KE, increased volumes of the gluteus maximus (+15.4%) and the adductor magnus (+6.2%) ( P ≤ 0.001). A follow-up experiment using surface electromyography showed that muscle excitation patterns during KE and LP generally mirrored the between-condition hypertrophic differences and similarities observed after the training intervention. CONCLUSIONS: LP induces significant hypertrophy in the gluteus maximus and adductor magnus while producing similar vasti and overall QF growth as KE, indicating that LP is a highly time-efficient exercise. However, KE is essential for effectively targeting the rectus femoris, which may have clinical relevance given its high susceptibility to strain injuries.
Downhill Running Blocks the Mitophagic Flux and Autophagosome-Lysosome Fusion in Rat Soleus Muscle.
Deng H, Zheng S, Li M … +5 more , Zhang D, Yang T, Ma R, Xia Z, Shang H
Med Sci Sports Exerc · 2026 Jun · PMID 41630123 · Publisher ↗
PURPOSE: This study aimed to investigate the effect of downhill running on mitophagic flux and autophagosome-lysosome fusion in rat soleus muscle. METHODS: Sprague-Dawley rats were trained on a treadmill at a speed of 16...
PURPOSE: This study aimed to investigate the effect of downhill running on mitophagic flux and autophagosome-lysosome fusion in rat soleus muscle. METHODS: Sprague-Dawley rats were trained on a treadmill at a speed of 16 m·min -1 and a decline of -16° for 90 min, and the soleus muscle was sampled at 0 h, 12 h, 24 h, 48 h, and 72 h after exercise. Mitochondrial ultrastructural changes were observed by using a transmission electron microscope. Protein levels of Cathepsin D, Vacuolar H + -ATPase (V-ATPase), mitochondrial respiratory complex Ⅰ (NDUFB8), complex Ⅲ (UQCRC2), and microtubule-associated protein 1 light chain 3 (LC3) were determined by Western blot. Mitochondria co-localizations with LC3 and lysosomal-associated membrane protein 2 (LAMP2), syntaxin 17 (STX17) co-localizations with LC3, LAMP2, SNAP29, and vesicle-associated membrane protein 8 (VAMP8), as well as the SNAP29 co-localizations with VAMP8, were measured by immunofluorescence. To assess mitophagic flux in vivo , colchicine or saline was injected intraperitoneally 3 d before exercise, and the protein expression of mitochondrial LC3-Ⅱ was detected by Western blot. RESULTS: After downhill running, mitochondrial structure appeared to be abnormal and contained autophagosomes and autophagolysosomes. The expression levels of Cathepsin D, Vacuolar H + -ATPase, and mitochondrial LC3, as well as the co-localizations of STX17 with LC3 and SNAP29 were significantly higher, whereas the expression levels of mitochondrial NDUFB8, UQCRC2, and LAMP2, along with the co-localizations of STX17 with LAMP2 and VAMP8 were significantly lower than those in the control group. Specifically, mitochondrial LC3-Ⅱ flux was significantly lower following downhill running. CONCLUSIONS: A bout of downhill running may block mitophagic flux by impairing mitophagosome-lysosome fusion, which is accompanied by increased recruitment of STX17 and SNAP29 to autophagosome and reduced co-localizations of STX17 and SNAP29 with lysosomal VAMP8.
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