Med Sci Sports Exerc [JOURNAL]
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200 papers
Performance Prediction and Athlete Categorization using the Anaerobic Power Reserve Framework in Rowing.
Rappelt L, Donath L, Wiedenmann T … +3 more , Micke F, Mühlenhoff S, Held S
Med Sci Sports Exerc · 2026 Apr · PMID 41348913 · Publisher ↗
PURPOSE: With the Olympic rowing distance reduced to 1500 m for 2028, the anaerobic power reserve framework has been proposed to evaluate anaerobic performance and differentiate physiological profiles. This study investi...
PURPOSE: With the Olympic rowing distance reduced to 1500 m for 2028, the anaerobic power reserve framework has been proposed to evaluate anaerobic performance and differentiate physiological profiles. This study investigated performance predictions and athlete profiles using the anaerobic power reserve framework and related physical performance measures. METHODS: Thirty-one female (simulated 2000-m performance [power output during 2000-m trial (P2k)] = 285.1 ± 36.0 W) and 63 male (P2k = 422.8 ± 62.2 W) (sub-)elite German rowers completed tests for maximal oxygen uptake ( ), maximal lactate accumulation rate, peak power output (PPO), power at (MAP), at 2 mmol·l -1 (P2) and 4 mmol·l -1 blood lactate (P4), and P2k. Backward stepwise regression models were used to predict P2k, and the model's performance was evaluated via a k -fold cross-validation approach. Commonality analyses and Lindeman, Merenda, and Gold (LGM) metrics were used to assess predictor contribution, while k -means clustering based on the power reserve ratio (PRR = PPO·MAP -1 ) was used to identify athlete subgroups. RESULTS: For P2k prediction, P4, PPO, and in females (average results from k -fold cross-validation: R2 = 0.90, root mean squared error = 9.3 W, mean absolute error = 6.3 W), and P4, MAP, and PPO in males (R 2 = 0.93, root mean squared error = 16.2 W, mean absolute error = 12.6 W) showed excellent model fits. Commonality analyses revealed ~90% shared variance contributions among predictors. K -means clustering identified sprint-type (females: PRR ≥ 1.52; males: PRR ≥ 1.66) and endurance-type rowers (females: PRR ≤ 1.43; males: PRR ≤ 1.62) along the PRR continuum. CONCLUSIONS: Key predictors for P2k highlight the interplay between the aerobic and anaerobic systems. Moreover, the distinct sprint - and endurance-type clusters emphasize the physiological diversity among rowers, even among athletes with similar performance outcomes. Longitudinal PRR assessments may support talent identification and tailored training strategies.
Exercise Above Critical Power Elicits Greater Post-Exercise Hypotension than Heavy Exercise Performed to Task Failure.
Lei TH, Bai SJ, Perry B … +6 more , Mündel T, Kondo N, Fujii N, Wang IL, Peng M, Goulding RP
Med Sci Sports Exerc · 2026 May · PMID 41347448 · Publisher ↗
BACKGROUND: We have previously shown that critical power (CP) is a key threshold determining the magnitude of post-exercise hypotension (PEH); however, whether this finding depended upon 1) the attainment of task failure...
BACKGROUND: We have previously shown that critical power (CP) is a key threshold determining the magnitude of post-exercise hypotension (PEH); however, whether this finding depended upon 1) the attainment of task failure or 2) could be augmented by increasing exercise duration above CP remained unclear. PURPOSE: To determine 1) whether a similar magnitude of PEH would occur after exhaustive heavy versus supra-CP exercise, and 2) whether the magnitude of PEH depended upon exercise duration above CP. METHODS: Eighteen healthy participants (14 males and 4 females) performed 3 criterion trials involving exercise performed to task failure at power outputs that elicited exhaustion in either 6 min ( WR6 ), 12 min ( WR12 ), or at a heavy intensity (50%ΔGET-CP, halfway between the gas exchange threshold [GET] and CP) and all were followed by 60 min of seated recovery. RESULTS: Although time to exhaustion was greatest in 50%ΔGET-CP (2606 ± 732 s) versus WR12 (790 ± 67 s) and WR6 (397 ± 42 s, P < 0.001), the magnitude of PEH, as indicated by the change in mean arterial pressure (MAP) from baseline ( WR6 vs 50%ΔGET-CP: -12.9 ± 3.3 mm Hg vs -9.4 ± 3.6 mm Hg; WR12 vs 50%ΔGET-CP: -12.8 ± 3.7 mm Hg vs -9.4 ± 3.6 mm Hg, main effect P < 0.01) was greater in WR6 and WR12 than 50%ΔGET-CP (all P < 0.05). However, the changes in MAP were not different between WR6 and WR12 ( P = 0.90). CONCLUSIONS: These findings reinforce the notion that CP is a key threshold determining the magnitude of PEH. Specifically, the magnitude of PEH after exhaustive supra-CP exercise remained greater than heavy exercise when the heavy bout was performed to task failure.
Long-Term Pulmonary Rehabilitation Enhances Cerebral Oxygenation, Functional Capacity, and Psychological Health in Idiopathic Pulmonary Fibrosis.
Kritikou S, Zafeiridis A, Markopoulou A … +10 more , Boutou A, Zacharias A, Rampiadou C, Kounti G, Gkalgkouranas I, Kastritseas L, Chloros D, Stanopoulos I, Pitsiou G, Dipla K
Med Sci Sports Exerc · 2026 Apr · PMID 41347399 · Publisher ↗
INTRODUCTION: Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease characterized by exertional dyspnea, desaturation, and exercise intolerance. Desaturation may contribute to cerebral hypoxia during exercise...
INTRODUCTION: Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease characterized by exertional dyspnea, desaturation, and exercise intolerance. Desaturation may contribute to cerebral hypoxia during exercise, and in turn, to exercise intolerance. Although pulmonary rehabilitation (PR) has been shown to improve functional capacity and symptom management, it remains unclear whether these benefits are partially mediated by improved brain oxygenation. PURPOSE: To evaluate whether a 12-month PR program enhances cerebral oxygenation during exercise in patients with IPF. Secondary outcomes included exercise capacity, cognitive function, depression/anxiety, and physical activity levels. METHODS: Sixteen patients with IPF (68.7 ± 6.4 yr), on antifibrotic therapy, completed a 12-mo supervised PR intervention involving aerobic, resistance, flexibility, and breathing exercises. Pre- and post-intervention assessments included spirometry, cardiopulmonary exercise testing, cerebral oxygenation via near-infrared-spectroscopy, Mini-Mental State Examination, Hospital Anxiety/Depression Scale, and International Physical Activity Questionnaire. RESULTS: After the PR intervention, cerebral oxygenated hemoglobin (O 2 Hb mean-response ) during exercise was higher ( P = 0.04) compared with pre-PR exercise testing. Isowork O 2 Hb responses (at 50% and 75% of pre-PR peak workload) were significantly elevated ( P = 0.006). The PR intervention resulted in improved VO 2 peak ( P = 0.01), cardiopulmonary exercise testing duration, and peak workload ( P = 0.02). Hospital Anxiety/Depression Scale anxiety/depression scores decreased ( P = 0.01; P < 0.001); the Mini-Mental State Examination was not significantly changed ( P = 0.054). Physical activity levels increased from "low" to "moderate" ( P < 0.001). Training-induced cerebral oxygenation improvements were significantly correlated with improvements in exercise capacity (VO 2 peak % predicted , r = 0.54, P = 0.03; Workload peakr = 0.54, P = 0.03) and mMRC. ( r = 0.63, P = 0.01). CONCLUSIONS: A 12-month PR program enhanced cerebral oxygenation during exercise, improved exercise capacity, physical activity levels, and psychological well-being of IPF patients. Importantly, our findings suggest a potential association between improved cerebral oxygenation and enhanced exercise capacity in IPF.
Effects of Sex and Obesity on Lipid Metabolism during Low-Intensity Exercise and Postexercise Period.
Costa DN, Jensen MD
Med Sci Sports Exerc · 2026 May · PMID 41347395 · Publisher ↗
BACKGROUND: Whether there are sex and obesity differences in fat oxidation and free fatty acid (FFA) mobilization during low-intensity exercise is unclear. METHODS: We studied 21 (nine females) participants without and 2...
BACKGROUND: Whether there are sex and obesity differences in fat oxidation and free fatty acid (FFA) mobilization during low-intensity exercise is unclear. METHODS: We studied 21 (nine females) participants without and 24 (16 females) with obesity during 5 h of treadmill walking (~2 mph). We measured energy expenditure (EE) and substrate oxidation (indirect calorimetry) and FFA-palmitate kinetics and oxidation with isotopic palmitate infusions ([U- 13 C]palmitate and [1- 14 C]palmitate or [9,10- 3 H]palmitate). Skeletal muscle samples were collected at 1.5 and 5 h of exercise and 24 h after exercise. We calculated fatty acid (FA) oxidation, palmitate rate of disappearance (Rd), and intramyocellular triglyceride-derived palmitate fractions during exercise. RESULTS: At rest, EE was 1.24 ± 0.23 kcal/min, with FA oxidation contributing 49 ± 13% of total EE. During exercise, FA oxidation accounted for 73 ± 8% of EE, and was not different between males and females ( P = 0.34). Plasma FFA-palmitate concentrations were greater in females than males ( P = 0.003), mean palmitate Rd and plasma palmitate clearance were not different ( P = 0.32 and 0.14, respectively). Plasma FFA-palmitate Rd was correlated with EE ( r = 0.49, P = 0.001), with a proportionally greater Rd response in females ( P < 0.001). Although absolute plasma FFA-palmitate oxidation rates were comparable between sexes, the percent contribution of FFA-palmitate oxidation to EE was greater in females ( P = 0.001). During exercise, intramyocellular triglyceride-palmitate fraction amounts remained stable. CONCLUSIONS: Lipid oxidation during low-intensity exercise is similar in males and females, independent of obesity, although next-day values were greater in participants with normal weight. EE correlates with plasma palmitate disappearance rates, but is proportionally greater in females. The contribution of plasma palmitate oxidation is greater in females than in males during low-intensity exercise.
Aquatic Exercise Training in Warm versus Cold Water in Elderly Patients with Type 2 Diabetes.
Suksom D, Suntraluck S, Panthong S … +1 more , Tanaka H
Med Sci Sports Exerc · 2026 Apr · PMID 41347373 · Publisher ↗
INTRODUCTION: Older adults with type 2 diabetes face increased risks of macrovascular and microvascular complications. Aquatic exercise offers a joint-friendly alternative in this population. However, the influence of wa...
INTRODUCTION: Older adults with type 2 diabetes face increased risks of macrovascular and microvascular complications. Aquatic exercise offers a joint-friendly alternative in this population. However, the influence of water temperature on exercise outcomes remains unclear. PURPOSE: This study compared the effects of warm-water versus cold-water aerobic exercise on physical fitness, glycemic control, and vascular function in elderly patients with type 2 diabetes. METHODS: Thirty-two sedentary older adults (60-75 yr old) with type 2 diabetes were randomized into warm-water (36°C; n = 16) or cold-water (20°C; n = 16) cycling exercise groups, training three times per week for 12 wk. RESULTS: Fifteen participants in the warm-water group and 12 in the cold-water group completed the study. Both groups demonstrated improvements in peak aerobic fitness, glycosylated hemoglobin, lipid profiles, pulse wave velocity, flow-mediated dilation, and skin microvascular function ( P < 0.05). Warm-water exercise produced greater improvements in all indices of foot microvascular reactivity than the cold-water group. Warm-water training additionally improved isometric leg strength, trunk flexibility, plasma nitric oxide, and reduced oxidative stress ( P < 0.05), while cold-water exercise led to reductions in blood pressure ( P < 0.05). CONCLUSIONS: Both warm- and cold-water aerobic exercise effectively improved both macro- and microvascular functions and metabolic health in older adults with type 2 diabetes. However, warm-water exercise conferred extra benefits in muscle strength, flexibility, and oxidative stress, while cold-water exercise reduced blood pressure.
Stroke Increases Neuromuscular Fatigability in Females but not Males during Isometric Exercise.
Zhou Z, Schmit BD, Durand MJ … +2 more , Hunter SK, Hyngstrom AS
Med Sci Sports Exerc · 2026 May · PMID 41347372 · Full text
PURPOSE: Females have worse motor-related functional outcomes than males post stroke. However, it is unclear whether stroke affects motor performance such as neuromuscular fatigability differently between sexes. This stu...
PURPOSE: Females have worse motor-related functional outcomes than males post stroke. However, it is unclear whether stroke affects motor performance such as neuromuscular fatigability differently between sexes. This study determined sex differences in the impact of stroke on fatigability. METHODS: Forty-one chronic stroke survivors (23 female, ≥6 months post stroke) and 23 age-matched neurotypical controls (12 female) performed a sustained submaximal (30% of maximum) isometric knee extension contraction with paretic or dominant leg, respectively. Task duration was used to quantify fatigability. Potentiated twitch (Q tw ) and surface electromyography (EMG) were assessed to quantify muscle contractile properties and neuromuscular activation, respectively. Separate two-way analyses of variance (ANOVAs) were performed to determine the main and interaction effects of group and sex on fatigability and neuromuscular measurements. Separate Pearson correlations were performed to explore associations between fatigability and neuromuscular measurements. RESULTS: There was an interaction effect of group and sex on task duration where female stroke survivors had a shorter task duration than neurotypical females (254 ± 121 vs 445 ± 228 s, P < 0.001) whereas this difference was not observed between male stroke survivors (248 ± 132 s) and neurotypical males (260 ± 72 s, P = 0.628). Also, neurotypical females had a longer task duration than neurotypical males ( P = 0.009); however, there were no differences in task duration between male and female stroke survivors ( P = 0.839). Stroke survivors had a shorter task duration than neurotypical controls (251 ± 124 vs 356 ± 193 s, P = 0.008). Males had a shorter task duration than females (253 ± 112 vs 319 ± 186 s, P = 0.027). Stroke survivors had less of a change in Q tw (35 ± 16 vs 51 ± 13% reduction, P < 0.001) and EMG (35 ± 28 vs 98 ± 41% increase, P < 0.001) than neurotypical controls during exercise. Females had less of a change in Q tw (36 ± 14 vs 46 ± 18% reduction, P = 0.020) and EMG (47 ± 39 vs 67 ± 49% increase, P = 0.021) than males during exercise. Within the stroke survivor group, a shorter task duration was associated with less Q tw reduction for female stroke survivors ( r = 0.656, P = 0.001), but a shorter task duration was associated with greater Q tw reduction for male stroke survivors ( r = -0.519, P = 0.039). CONCLUSIONS: Stroke increased fatigability in females but not males during sustained submaximal isometric knee extension exercise. This sex-specific impact of stroke on fatigability is likely due to central versus peripheral mechanisms.
The Effect of Nordic Walking on Knee-Ankle Coordination Patterns in the Sagittal Plane: A Vector Coding Analysis.
Kong T, Lee G, Lee J … +1 more , Kim H
Med Sci Sports Exerc · 2026 Apr · PMID 41343838 · Publisher ↗
INTRODUCTION: Nordic walking, quasi-quadrupedal walking, provides biomechanical benefits to the lower extremities, such as joint load distribution and increased gait speed compared with normal walking. However, limited e...
INTRODUCTION: Nordic walking, quasi-quadrupedal walking, provides biomechanical benefits to the lower extremities, such as joint load distribution and increased gait speed compared with normal walking. However, limited evidence exists regarding how the Nordic walking affects knee and ankle joint kinematic coordination. The purpose of this study was to investigate sagittal plane kinematics and coordination patterns of the knee and ankle joints during walking and Nordic walking. METHODS: Twelve healthy subjects performed five consecutive strides of both conditions while capturing time-series joint kinematics with a smartphone-based motion capture system (OpenCap). Knee-ankle coupling angles were computed and categorized into in-/antiphase and proximal/distal dominance. A paired t test was used to analyze discrete variables, including joint range of motion and the number of coordination phases derived from vector coding. Statistical parametric mapping was used to analyze differences in time-series knee and ankle joint angles. RESULTS: Our results showed that the knee range of motion was significantly smaller in Nordic walking ( P = 0.040), with reduced knee flexion during the early stance phase ( P = 0.001) and push-off to swing phase ( P < 0.001). Ankle plantarflexion increased during early stance phase ( P = 0.001), while ankle dorsiflexion was smaller in mid-stance ( P = 0.002) but greater before push-off ( P = 0.047). Compared with normal walking, Nordic walking exhibited a greater number of antiphase ankle plantarflexion phases ( P = 0.012), and fewer antiphase knee flexion phases ( P = 0.005). CONCLUSIONS: These findings suggest that, in novice adults, the quasi-quadrupedal gait strategy of Nordic walking alters interjoint coordination strategies in a manner distinct from normal walking, particularly by increasing ankle plantarflexion-dominant and decreasing knee flexion-dominant coordination patterns. This study is the first to apply vector coding to Nordic walking, providing new biomechanical insights into its coordination characteristics and potential rehabilitation relevance in novice Nordic walkers.
Longitudinal Associations between Cardiorespiratory Fitness and Cognition in Older Adults: A 10-Year Follow-Up from the Generation 100 Study.
LE AN, Lydersen S, Brissach DE … +6 more , Håberg AK, Walker TL, Schaumberg M, Berg HH, Stensvold D, Tari AR
Med Sci Sports Exerc · 2026 Apr · PMID 41330544 · Full text
INTRODUCTION: Cardiorespiratory fitness (CRF) is associated with better cognition in older adults. However, the long-term associations between CRF levels and cognitive outcomes remain unclear. This study aimed to investi...
INTRODUCTION: Cardiorespiratory fitness (CRF) is associated with better cognition in older adults. However, the long-term associations between CRF levels and cognitive outcomes remain unclear. This study aimed to investigate the association between baseline CRF, changes in CRF (from baseline to year 1 and year 3) and cognition in older adults. METHODS: We included 770 cognitively healthy older adults (367 females; mean age: 72.0 ± 2 years at baseline) from the Generation 100 Study. All participants had complete data on CRF and important confounding factors (age, sex, educational attainment, and self-rated memory at baseline). CRF was measured directly as peak oxygen uptake using ergospirometry. Cognition was assessed using the Montreal Cognitive Assessment (MoCA) 3-, 5-, and 10 years after baseline. Linear mixed models were used to assess the relationship between CRF at baseline, changes in CRF, and MoCA score over time. RESULTS: The mean MoCA score at 3-, 5-, 10-year follow up was 25.3, 25.0, and 24.8, respectively. Higher baseline CRF predicted 0.06 higher MoCA score at year 3 (95% CI: 0.02-0.09) and 0.07 at year 5 (95% CI: 0.03-0.11) but was not associated with MoCA score at year 10 (β: 0.02, 95% CI: -0.02 to 0.06). Neither 1-year nor 3-year changes in CRF were associated with MoCA scores at any later time points. CONCLUSIONS: Changes in CRF over 1 and 3 years were not associated with cognition in healthy older adults. However, higher baseline CRF was linked to better cognition up to 5 years later, suggesting that achieving and maintaining an age-relative high CRF before entering the 8th decade of life might benefit cognitive aging.
Experimental Evidence for the Independent Modulation of Step Frequency and Duty Factor during Endurance Running.
Patoz A, Perrinjaquet D, Garcia J … +1 more , Malatesta D
Med Sci Sports Exerc · 2026 Apr · PMID 41330479 · Publisher ↗
PURPOSE: Running patterns have been conceptualized as a continuum defined by step frequency (SF) and duty factor (DF), two variables proposed to act as independent axes within a dual-axis framework. However, their experi...
PURPOSE: Running patterns have been conceptualized as a continuum defined by step frequency (SF) and duty factor (DF), two variables proposed to act as independent axes within a dual-axis framework. However, their experimental independence at a fixed speed has not yet been verified. This study aimed to directly test the independence of SF and DF during treadmill running at 11 km·h -1 using a real-time visual biofeedback system. METHODS: Fifteen trained runners performed a preferred baseline trial followed by 16 randomized conditions in which either SF (±6%, ±12%) or DF (±8%, ±16%) was imposed while the other variable was free to vary. RESULTS: SF manipulation did not significantly affect DF ( P = 0.14), with adjustments in contact and flight time occurring in parallel and preserving the ratio underlying DF. In contrast, extreme DF manipulations (±16%) significantly altered SF ( P ≤ 0.03), as opposing adjustments in contact and flight time were insufficient to stabilize step time. CONCLUSIONS: These findings provide the first direct experimental evidence that SF and DF can be modulated independently within a functional range, partly confirming the dual-axis model. Practically, SF and DF represent distinct levers for modifying running mechanics, offering clinicians and coaches flexible strategies for performance optimization.
Longitudinal Tracking of Objective Measures of Cardiorespiratory Fitness, Body Composition, and Physical Activity in Children.
Aoyama T, Hikihara Y, Watanabe M … +4 more , Wakabayashi H, Hanawa S, Lubans DR, Tanaka S
Med Sci Sports Exerc · 2026 Apr · PMID 41289170 · Full text
PURPOSE: Understanding the longitudinal tracking of cardiorespiratory fitness (CRF), adiposity, and moderate-to-vigorous physical activity (MVPA) during childhood is essential for developing effective health intervention...
PURPOSE: Understanding the longitudinal tracking of cardiorespiratory fitness (CRF), adiposity, and moderate-to-vigorous physical activity (MVPA) during childhood is essential for developing effective health interventions. Our study evaluated the tracking of objectively measured MVPA, CRF, and adiposity from early to late elementary school age. METHODS: Participants were recruited through five elementary schools in the Kanto region in Japan. Of the 247 children assessed at baseline in first grade (ages 6-7), 244 participated in a follow-up in fifth grade (ages 10-11). CRF was assessed as peak oxygen uptake (VO 2 peak, mL·kg -1 ·min -1 ) during a progressive treadmill test. Body fat percentage was measured using dual-energy X-ray absorptiometry. MVPA was measured using a triaxial accelerometer worn for 14 consecutive days. RESULTS: Spearman rank correlations indicated high tracking of body fat percentage in boys (ρ = 0.65, P < 0.001) and girls (ρ = 0.61, P < 0.001), and moderate and high tracking of MVPA in boys (ρ = 0.58, P < 0.001) and girls (ρ = 0.63, P < 0.001). CRF showed moderate tracking in boys (ρ = 0.57, P < 0.001), but weaker tracking in girls (ρ = 0.29, P < 0.01). Generalized estimating equations analyses adjusted for height revealed significant tracking for all three indicators, with a weaker tracking pattern for CRF in girls compared with boys: body fat percentage (β = 0.89 in boys, 0.79 in girls, both P < 0.001), MVPA (β = 0.70 in boys, 0.69 in girls, both P < 0.001), and CRF (β = 0.76 in boys, 0.54 in girls, both P < 0.001). CONCLUSIONS: These findings support the need for targeted approaches during the early school years to prevent the consolidation of unfavorable profiles in fitness, adiposity, and physical activity. In addition, population-wide approaches throughout the school-age years may be important in supporting fitness development in girls, given the greater variability observed in CRF.
Comparative Efficacy of Various Exercise Types on Psychophysiological Outcomes in Colorectal Cancer Survivors: A Network Meta-Analysis.
Batrakoulis A, Perivoliotis K, Courneya KS … +6 more , Schmitz KH, Schwartz AL, Al-Mhanna SB, Liapis N, Tzovaras G, Baloyiannis I
Med Sci Sports Exerc · 2026 Apr · PMID 41289064 · Publisher ↗
PURPOSE: This network meta-analysis aimed to evaluate and rank the comparative efficacy of aerobic training (AT), resistance training (RT), combined AT and RT (CT), and high-intensity interval training (HIIT) primarily o...
PURPOSE: This network meta-analysis aimed to evaluate and rank the comparative efficacy of aerobic training (AT), resistance training (RT), combined AT and RT (CT), and high-intensity interval training (HIIT) primarily on body weight and secondarily on body mass index (BMI), fat-free mass, fasting glucose, fasting insulin, handgrip strength, physical activity, cardiorespiratory fitness, fatigue, quality of life, anxiety, depression, and exercise adherence in colorectal cancer (CRC) survivors. METHODS: MEDLINE/PubMed, Scopus, Web of Science, CENTRAL, and MedRxiv were searched for randomized controlled trials (RCTs) from inception up to July 1, 2025. RCTs published in English comparing exercise to controls (CON) or to another exercise type in CRC patients after colon resection surgery were qualified. RESULTS: Thirty-two studies involving 2001 CRC survivors (51.3/48.7 male-female ratio; mean ± standard deviation: age, 58.0 ± 10.2 years; BMI, 27.1 ± 3.9 kg·m -2 ) were included. HIIT and CT were more effective than CON in improving cardiorespiratory fitness and fasting insulin, respectively. No exercise type was identified as being more efficacious than CON in improving any other outcome measures. Nevertheless, HIIT had the highest probability of being the best exercise intervention for improving body weight, physical activity, cardiorespiratory fitness, and quality of life. AT had the highest likelihood of reducing BMI, fasting glucose, and anxiety. CT had the highest probability of improving fasting insulin, fatigue, depression, and exercise adherence, while RT showed the highest probability of being the most effective exercise type in increasing handgrip strength and fat-free mass. CONCLUSIONS: The current evidence indicates few confirmed benefits of exercise in CRC survivors, suggesting which types of exercise are most promising for a given psychophysiological outcome and may inform further large-scale RCTs of high methodological quality.
Smaller Quadriceps Size Is Associated with Lower Exercise Capacity and Greater Disease Severity in People with Fibrotic Interstitial Lung Disease.
May AK, Holland AE, Hill CJ … +5 more , Bondarenko J, Walsh JR, Morris NR, Hayes K, Dowman LM
Med Sci Sports Exerc · 2026 Apr · PMID 41289006 · Publisher ↗
PURPOSE: Peripheral muscle dysfunction is common in people with fibrotic interstitial lung diseases (ILD). Smaller muscle size may contribute to exercise intolerance in this population, yet this is largely unknown. The p...
PURPOSE: Peripheral muscle dysfunction is common in people with fibrotic interstitial lung diseases (ILD). Smaller muscle size may contribute to exercise intolerance in this population, yet this is largely unknown. The purpose of this study is to investigate if relationships exist between quadriceps muscle size, exercise capacity, disease severity, and dyspnea in fibrotic ILD, and to characterize these relationships based on exertional oxyhemoglobin desaturation. METHODS: In this cross-sectional study, quadriceps cross-sectional area (CSA) and muscle thickness (MT) were measured by B-mode ultrasonography in 45 participants with fibrotic ILD. Relationships between quadriceps muscle size and 6-min walk distance (6MWD), peak workload, endurance time, forced vital capacity (FVC), transfer factor for carbon monoxide (TLCO), demographics, and dyspnea were assessed, with additional subgroup analyses for exertional oxyhemoglobin saturation (SpO 2 ≤ 88%, SpO 2 > 88%). RESULTS: Smaller CSA and MT were associated with lower 6MWD (both r = 0.49, P < 0.01) and peak workload (CSA r = 0.37, P = 0.028; MT r = 0.60; P < 0.001). A smaller CSA was associated with lower FVC ( r = 0.47; P = 0.004). These relationships were stronger in participants who experienced exertional desaturation. There was no significant relationship between muscle size and age, TLCO, or dyspnea. FVC and MT were independently associated with both 6MWD and peak workload. CONCLUSIONS: In fibrotic ILD, those with smaller quadriceps muscle size have lower exercise capacity and worse lung function. This is more apparent in those who experience exertional desaturation. Identifying interventions that preserve quadriceps muscle size in fibrotic ILD would prove beneficial.
Associations of Accelerometer-Determined Sedentary and Physical Activity Behaviors with Heart Failure Biomarkers during Midlife: CARDIA Study.
Pettee Gabriel K, Hornikel B, Dooley EE … +14 more , Chen B, Badon SE, Bhatt AS, Carnethon MR, Jacobs DR, Khan SS, Lima JAC, Reis JP, Schreiner PJ, Shikany JM, Sidney S, Whitaker KM, Sternfeld B, Lewis CE
Med Sci Sports Exerc · 2026 Apr · PMID 41250299 · Full text
BACKGROUND: Few studies have examined the longitudinal associations of accelerometer-based measures of sedentary and physical activity behaviors with subclinical heart failure (HF) in midlife. This is a key gap, given th...
BACKGROUND: Few studies have examined the longitudinal associations of accelerometer-based measures of sedentary and physical activity behaviors with subclinical heart failure (HF) in midlife. This is a key gap, given that an improved understanding of modifiable factors associated with HF risk may better inform prevention strategies. We hypothesize that more time in light intensity physical activity and/or moderate or vigorous intensity physical activity (MVPA) and less sedentary time will be related to lower levels of HF biomarkers (N-terminal pro B-type natriuretic peptide and high-sensitivity cardiac troponin T [hscTnT]) across midlife. METHODS: Data are from 2494 Coronary Artery Risk Development in Young Adults (CARDIA) participants without clinical HF (58.9% women, 45.7% Black persons, mean [±standard deviation] aged 51.1 ± 7.2 yr at the baseline contributing exam) with at least one occurrence of concurrent valid accelerometer (ActiGraph 7164/GT3X; Ametris; Pensacola, FL) wear and HF biomarkers at the CARDIA year 20, 30 and/or year 35 follow-up examinations. Adjusted linear mixed effects models were used to estimate the associations. Heterogeneity in the associations by the four race-sex groups represented in CARDIA was also examined. RESULTS: In the fully adjusted models, every 5-min higher MVPA was associated with -0.05 (95% confidence interval: -0.09 to -0.01, P = 0.022) lower hscTnT. The associations of sedentary and light intensity physical activity with hscTnT and associations of any accelerometer estimate with N-terminal pro B-type natriuretic peptide were not statistically supported (all P > 0.05). Findings were similar when clinically relevant categories of HF biomarker outcomes were used in the analysis. CONCLUSIONS: Findings address research gaps in the literature and demonstrate the importance of MVPA during the midlife transition for HF prevention before the onset of overt signs or symptoms.
Cerebello-Cerebral Network Dynamic of Basketball Athletes in Motor Control Tasks.
Qi Y, Wang Y, Fang W … +2 more , Li X, DU X
Med Sci Sports Exerc · 2026 Apr · PMID 41223439 · Publisher ↗
PURPOSE: The cerebellum is essential for motor control due to its dynamic interactions with the sensorimotor network (SMN). Within the cerebellum, motor functions are organized into two distinct representations, known as...
PURPOSE: The cerebellum is essential for motor control due to its dynamic interactions with the sensorimotor network (SMN). Within the cerebellum, motor functions are organized into two distinct representations, known as the first motor representation (MRP1) and the second motor representation (MRP2). While long-term training in athletes optimizes motor control, the functional reorganization in the cerebellum and its interaction with the SMN remains unclear. Specifically, the unique contributions of MRP1 and MRP2 to motor expertise remain poorly understood. METHODS: We utilized task-based functional magnetic resonance imaging and dynamic causal modeling to compare 55 elite basketball athletes with 65 nonathlete controls during two general motor tasks: a grip force task focused on upper-limb control and a leg raise task assessing lower-limb postural control. We examined brain activation and effective connectivity across cerebellar and cortical motor regions. RESULTS: No significant differences in regional brain activation were found between the groups. Dynamic causal modeling analysis revealed that, compared with nonathletes, athletes' MRP1 showed a significant stronger bidirectional connectivity with effector regions in both tasks. In contrast, athletes' MRP2 exhibited a significant decreased connectivity with effector regions during the leg raise task. Additionally, there was a nonsignificant trend toward increased connectivity from MRP2 to the motor planning regions of SMN in athletes. CONCLUSIONS: Our findings suggest that the neural signature of expert motor control is better reflected by refined interactions within the cerebello-cerebral circuit, rather than by heightened neural activation. Athletes demonstrate a reorganization of cerebellar modulation, with MRP1 facilitating automatic motor output and MRP2 showing reduced involvement during complex tasks. These results provide new insights into the neural basis of motor expertise and could inform targeted approaches in sports training and neurorehabilitation.
Leisure-Time Physical Activity Trajectories across Adulthood and Cardiometabolic Risk at the Beginning of Late Adulthood: A Prospective Cohort Study.
Savikangas T, Kokko K, Ahola J … +4 more , Kekäläinen T, Kinnunen ML, Reinilä E, Haapala EA
Med Sci Sports Exerc · 2026 Mar · PMID 41191956 · Full text
PURPOSE: Physical activity (PA) is a key strategy in preventing and treating metabolic syndrome (MetS). The purpose is to investigate the associations of leisure-time PA (LTPA) trajectories across adulthood and current P...
PURPOSE: Physical activity (PA) is a key strategy in preventing and treating metabolic syndrome (MetS). The purpose is to investigate the associations of leisure-time PA (LTPA) trajectories across adulthood and current PA with MetS at age 61. METHODS: Participants were 159 Finnish adults (52% women). LTPA frequency was assessed at ages 27, 42, 50, and 61 with a single question. Current PA at age 61 included self-reported vigorous, muscle-strengthening, commuting, and occupational PA. Cardiometabolic risk factors at age 61 included waist circumference, blood pressure, high-density lipoprotein cholesterol, triglycerides, and glucose. MetS was defined based on the Adult Treatment Panel III criteria. LTPA trajectories were conducted using k-means for longitudinal data. RESULTS: Of the three LTPA trajectories found, consistently inactive ( N = 34) and increasingly active ( N = 58) had a higher risk of MetS compared with consistently active ( N = 67) (odds ratio [95% confidence interval]: 3.93 [1.55-10.01] and 2.39 [1.14-4.99], respectively). Only the difference between consistently inactive and consistently active remained statistically significant when the current PA indicators were included in the model. Considering the individual components of MetS, those who were consistently inactive and increasingly active had higher waist circumference, lower high-density lipoprotein, and higher triglyceride levels compared with consistently active. These differences did not remain statistically significant when current PA was included. CONCLUSIONS: Although consistently inactive and increasingly active individuals had higher cardiometabolic risk at age 61 compared with those who were consistently active across adulthood, current PA participation at the beginning of late adulthood attenuated these risks. These findings emphasize the importance of promoting and sustaining PA throughout life to reduce the burden of MetS in the aging population.
Effects of Oral Contraceptives and Biological Sex on Grip Strength and Excitation during Immobilization and Recovery: An Exploratory Clinical Trial.
Stock MS, Bauerlein HM, Edwards MF … +5 more , Stambaugh KE, Parsowith EJ, Carr JC, Smith-Ryan AE, Richardson RM
Med Sci Sports Exerc · 2026 Apr · PMID 41187315 · Publisher ↗
UNLABELLED: Females often experience greater weakness following immobilization compared with males. Hormonal fluctuations from the menstrual cycle or oral contraceptive (OC) use may contribute to sex differences and resp...
UNLABELLED: Females often experience greater weakness following immobilization compared with males. Hormonal fluctuations from the menstrual cycle or oral contraceptive (OC) use may contribute to sex differences and response variation. PURPOSE: We examined changes in peak and rapid force and surface electromyographic excitation among females using monophasic OC and females not using OC following immobilization and rehabilitation. To examine potential sex differences, a male control group was included. METHODS: Ten males, 10 OC females, and 10 non-OC females (mean ± standard deviation age = 23 ± 3 yr) immobilized their left wrist/hand with a brace for 1 wk, followed by ≥1 wk of rehabilitation. Participants completed grip tests to assess peak force and the rate of force development before and after immobilization and postrehabilitation, with electromyographic signals recorded from the extensor carpi radialis brevis and flexor digitorum superficialis. RESULTS: Grip force declined postimmobilization: males = -17.2 ± 10.3%, non-OC = -22.3 ± 24.7%, OC = -20.7 ± 14.8%. No significant time-group interactions were observed for any dependent variables ( P > 0.05, η² p ≤ 0.084). Time effects showed recovery postrehab across all groups. Rate of force development, particularly at 200 ms, declined posttest and rebounded postrehab. Extensor carpi radialis brevis excitation increased postrehab; flexor digitorum superficialis excitation responses were highly variable across participants. Five participants required >1 wk of rehabilitation (two males, two non-OC, and one OC), suggesting rapid recovery for most. CONCLUSIONS: Males and females in this study exhibited similar declines and recovery in grip force after 1 wk of wrist/hand immobilization, regardless of OC use. These findings suggest that the influence of OC use on neuromuscular outcomes in females undergoing short-term musculoskeletal rehabilitation may be minimal.
Postexertional Symptom Exacerbation after Submaximal Exercise in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Postacute Sequelae of COVID-19.
Berardi G, Janowski A, McNally S … +3 more , Post A, Garg A, Sluka KA
Med Sci Sports Exerc · 2026 Apr · PMID 41185151 · Publisher ↗
PURPOSE: In individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and postacute sequelae of SARS-CoV-2 infection (PASC), physical activity can exacerbate symptoms for days to weeks, referred to as...
PURPOSE: In individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and postacute sequelae of SARS-CoV-2 infection (PASC), physical activity can exacerbate symptoms for days to weeks, referred to as postexertional symptom exacerbation (PESE). This study characterized the trajectory of PESE symptoms before and for 7 d after a submaximal exercise task in individuals with ME/CFS or PASC. METHODS: Individuals with ME/CFS ( n = 30) or PASC ( n = 30) and matched controls ( n = 30) were recruited from a university hospital and the community setting. Participants completed a 25-min moderate-intensity exercise on a whole-body cycle ergometer. The trajectory of eight commonly reported PESE symptoms (physical fatigue, mental fatigue, pain, physical function, flu-like symptoms, gastrointestinal symptoms, sleep dysfunction, and anxiety) before and for 7 d after exercise were analyzed. RESULTS: There was variability in the proportion of those who experienced increased symptoms, ranging from 46/60 reporting physical fatigue to only 18/30 reporting anxiety. There was no change in any of the symptoms across the 7-d period when analyzed individually. An aggregate score of 4-5 symptoms that includes physical fatigue, mental fatigue, physical function, and flu-like symptoms, with or without pain, was more comprehensive in capturing maximal changes in PESE. Changes were greatest during the 72-h postexercise and for those with ME/CFS. The aggregate score shows that 8/30 of individuals with ME/CFS and 12/30 with PASC show minimal to no increase in PESE, while 6-7/30 show increases greater than 3/10 points. CONCLUSIONS: PESE to a clinically relevant exercise task is variable in individuals with ME/CFS and PASC, as submaximal exercise does not exacerbate symptoms for some, while modifications of intensity may be necessary to minimize PESE in others.
The Effect of an Exercise Program on Maternal Health and Birth Outcomes in Sedentary Pregnant Participants with Obesity: Randomized Controlled Trial.
Holmes CJ, Diniz-Sousa F, Sims CR … +10 more , Jansen LT, Martinez A, Dupens A, Turner D, Edwards T, Bellando J, Massey-Swindle T, Diaz EC, Børsheim E, Andres A
Med Sci Sports Exerc · 2026 Mar · PMID 41168681 · Publisher ↗
PURPOSE: This study investigated the effects of a combined aerobic and resistance exercise program on maternal health and birth outcomes in pregnant people with obesity and prior sedentary lifestyle. METHODS: Two hundred...
PURPOSE: This study investigated the effects of a combined aerobic and resistance exercise program on maternal health and birth outcomes in pregnant people with obesity and prior sedentary lifestyle. METHODS: Two hundred sixty-four pregnant people (≥30.0 kg/m 2 ) were randomly allocated to a standard-of-care group (SOC; n = 107) or an exercise group ( n = 157). The intervention consisted of aerobic, resistance, and stretching exercises, 3× per week from the 12 wk of gestation until delivery. A submaximal cardiopulmonary exercise treadmill test was performed at 12 and 24 wk of pregnancy. Biological sample collection, body composition assessment, resting and activity energy expenditure assessment, and depression and stress evaluations were obtained at 12.1 ± 0.5, 24.2 ± 0.7, and 36.0 ± 0.5 wk of gestation. Linear mixed-effect models were used to compare maternal outcomes, while linear and logistic models were used to compare delivery outcomes. RESULTS: The median compliance for exercise sessions attended from the start of exercise (14.0 ± 0.8 wk gestation) to delivery (38.8 ± 1.7 wk gestation) was 61.7%. No significant time × group interactions were found for most maternal outcomes, however, significant time × group interactions were observed in cardiorespiratory fitness outcomes, specifically in grade ( P < 0.001), heart rate ( P = 0.003), workload ( P < 0.001), V̇O₂ ( P < 0.001) during final fitness testing stage corresponding to rating of perceived exertion of 15, and oxygen uptake efficiency slope ( P < 0.001). No significant effects were observed for other maternal health outcome measures, including gestational weight gain, systemic inflammation, and birth outcomes. CONCLUSIONS: Regular physical activity and participation in aerobic and resistance exercise during pregnancy are safe and effective for improving and maintaining physical fitness and activity levels in people with obesity who were previously sedentary.
Interindividual Variability of Acute Cardiovascular Responses to Low-Load Resistance Exercise with Different Methods of Blood Flow Restriction.
Hammert WB, Kang A, Yamada Y … +4 more , Kataoka R, Sallberg RW, Metcalf EE, Loenneke JP
Med Sci Sports Exerc · 2026 Mar · PMID 41168668 · Publisher ↗
PURPOSE: The aim of the study was to determine if acute cardiovascular responses to low-load resistance exercise with blood flow restriction (BFR) exhibit true and repeatable interindividual variability, and whether resp...
PURPOSE: The aim of the study was to determine if acute cardiovascular responses to low-load resistance exercise with blood flow restriction (BFR) exhibit true and repeatable interindividual variability, and whether responses differ between absolute and relative pressure application methods. METHODS: In a replicate crossover design, 82 healthy adults (21 [3] yr) were randomly assigned to an absolute (100 mm Hg; n = 42) or relative (80% arterial occlusion pressure [~128 mm Hg]; n = 40) pressure group and completed two exercise and two control trials (randomized order). Exercise involved two sets of 30% one-repetition maximum unilateral knee extensions under the assigned pressure, with repetitions individually prescribed as 70% maximum achieved during pretesting. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured pre- and posttrial, and control-adjusted responses were calculated. Within-participant linear mixed models (covariate adjusted) and random-effects meta-analyses quantified interindividual variability, while Pearson correlations assessed reproducibility. RESULTS: BFR exercise increased SBP (18.0 mm Hg), DBP (12.8 mm Hg), and HR (4.5 bpm) versus control (all P < 0.001), with greater increases in SBP (4.9 mm Hg) and DBP (4.1 mm Hg) for the relative group ( P ≤ 0.001). Participant-by-treatment interactions indicated true interindividual variability for all outcomes except HR in the absolute group. Correlations between replicates were significant for all outcomes under relative pressures ( P ≤ 0.018), but only for SBP ( P < 0.001) in the absolute group. CONCLUSIONS: Acute cardiovascular responses to BFR exercise are variable between and reproducible within individuals, particularly under relative pressures. Whether these differences are attributable to BFR or reflect inherent variability to low-load resistance exercise remains unknown.
Does the Choice of Stepping Intensity Metric Influence Dose-Response Associations with Mortality? Analysis on UK Population Cohort Study of 65,253 Adults.
Wei LE, Ahmadi MN, Blodgett JM … +5 more , Aguiar EJ, Biswas RK, Koemel NA, Del Pozo Cruz B, Stamatakis E
Med Sci Sports Exerc · 2026 Mar · PMID 41151011 · Full text
BACKGROUND: Evidence on the potential mortality gain of higher free-living stepping intensity is limited and equivocal, potentially due to the inconsistent usage among various estimation metrics. To estimate the differen...
BACKGROUND: Evidence on the potential mortality gain of higher free-living stepping intensity is limited and equivocal, potentially due to the inconsistent usage among various estimation metrics. To estimate the difference in the association with mortality risk across different stepping intensity metrics, we aimed to compare different metrics in terms of their multivariable-adjusted associations with all-cause, cardiovascular disease, and cancer mortality. METHODS: This cohort study included UK Biobank participants wearing wrist-worn accelerometers. We included eight peak cadence metrics, defined as the highest averaged steps/min across eight different time windows (1-, 5-, 10-, 15-, 20-, 25-, 30-, and 60-min), and two nonpeak cadence metrics including average daily cadence (steps/accelerometer wearing minutes) and purposeful cadence (averaged steps/min for minutes ≥40 steps). For each metric, we first standardized each individual's absolute cadence using (individual's absolute cadence - mean cadence)/standard deviation. We then estimated their dose-response associations using Cox-restricted-cubic-spline models and compared them on overlay plots. RESULTS: Among 65,253 participants (mean age: 61.5 yr [standard deviation: 7.8]; 57% female) followed for 8.0 (median) yr, all peak cadence metrics and the average daily cadence exhibited similar positive dose-response associations with mortality. For example, the medians of the individual-level standardized cadence and hazard ratios (HRs) across peak 1-, 30-, and 60-min cadence were: all-cause mortality, -0.17 steps/min (HR: 0.71 [95% confidence interval (CI): 0.64-0.80]), -0.15 (0.66 [0.59-0.74]), and -0.15 (0.66 [0.59-0.75]), respectively; cardiovascular disease mortality, -0.17 steps/min (HR: 0.63 [95% CI: 0.51-0.78]), -0.15 (0.57 [0.46-0.71]), and -0.15 (0.57 [0.46-0.71]); cancer mortality, -0.17 steps/min (HR: 0.88 [95% CI: 0.75-1.03]), -0.15 (0.89 [0.75-1.04]), -0.16 (0.93 [0.78-1.09]). Purposeful cadence was not associated with mortality (e.g., all-cause mortality: median of the individual-level standardized cadence, 0.59 steps/min; HR, 0.99 [95% CI: 0.86-1.15]). CONCLUSIONS: This study suggested that peak cadence and average cadence metrics can be used interchangeably to quantify the associations of stepping intensity with long-term health outcomes.
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