Search Results (978)

Survival rates in pediatric cancer have increased substantially over recent decades. However, children and survivors frequently experience treatment-related alterations in physical function, body composition, bone health, and metabolic regulation. Chemotherapy, glucocorticoid exposure, physical inactivity, nutritional imbalance, and inflammatory and neuroendocrine disturbances may contribute to reduced lean mass, decreased bone mineral density, sarcopenic obesity, and long-term cardiometabolic risk. This narrative review critically summarizes current evidence on multimodal exercise and nutritional interventions in pediatric oncology, with particular attention to their effects on physical function, body composition, nutritional status, and metabolic health. Literature searches were conducted in PubMed, Scopus, and Web of Science up to April 2026, combining contextual evidence with studies evaluating combined exercise and nutritional strategies. Current evidence suggests that structured and supervised exercise, particularly resistance and combined aerobic–resistance training, is feasible and safe, and may improve cardiorespiratory fitness, muscle strength, functional capacity, and body composition. Nutritional care should be individualized, prioritizing adequate protein intake, micronutrient status, periodic reassessment of energy requirements, and body composition rather than relying on BMI alone. Nevertheless, available findings remain limited by small sample sizes, heterogeneous protocols, variable supervision, inconsistent outcome assessment, and limited long-term follow-up. Integrating exercise, nutrition, and regular monitoring into pediatric oncology care may help mitigate treatment-related functional and metabolic complications. Future studies should prioritize adequately powered randomized trials, standardized intervention protocols, objective monitoring of exercise intensity, harmonized body composition and functional outcomes, and longer follow-up to define clinically applicable multimodal care models. Full article

Physical inactivity and declining health-related physical fitness among college students are growing global public health concerns. High-intensity interval training (HIIT) is a time-efficient strategy to improve multiple components of health-related physical fitness. Emerging evidence suggests that exercise timing may influence physiological responses and adherence through circadian rhythm regulation; however, its feasibility in college settings, particularly in China, remains unclear. This study aims to evaluate the feasibility and preliminary effectiveness of an eight-week time-specific HIIT programme among Chinese college students, and to compare outcomes between morning and evening training. In this mixed-methods feasibility randomized controlled trial, approximately 72 students with low physical activity levels and intermediate chronotype will be randomly assigned to a morning HIIT group, evening HIIT group, or control group. Intervention groups will complete three HIIT sessions per week for eight weeks. Primary outcomes include feasibility indicators (recruitment, retention, adherence, and data completeness). Secondary outcomes assess changes in body composition, cardiorespiratory fitness, muscular strength, endurance, and flexibility. Quantitative data will be analysed using descriptive and repeated-measures methods, while qualitative interviews will be thematically analysed. Findings will inform the feasibility and design of future large-scale trials and contribute to chrono-exercise research in college populations. Full article

Evidence remains limited on the interconnections between developmental coordination disorder (DCD), health-related physical fitness—including body composition, flexibility, strength of lower body, and cardiorespiratory fitness—and objectively measured physical activity (PA) in school-aged children. This study aimed to (1) examine differences in physical fitness and PA between children with and without DCD and (2) investigate whether physical fitness functions as a mediator in the association between DCD and PA in school-aged children. Sixty-three children aged 6.5–8 years (12 DCD, 19.05%) who provided valid data were enrolled. Mediation analysis was conducted using the PROCESS macro for SPSS. Flexibility significantly mediates the relationship of DCD to vigorous PA (VPA) (effect = 3.202, bootstrap SE = 1.682, 95% bootstrap CI = 0.463, 7.078), as well as DCD to moderate-to-vigorous (MVPA) (effect = 5.194, bootstrap SE = 2.903, 95% bootstrap CI = 0.434, 11.778). Additionally, there was a significant mediating effect of lower muscle strength on the relationship between DCD and VPA (effect = −1.943, bootstrap SE = 1.297, 95% bootstrap CI = −5.112, −0.021), and DCD and counts per minute (CPM) in axis 2 (effect = −34.388, bootstrap SE = 20.212, 95% bootstrap CI = −80.819, −1.353). The findings highlight flexibility and lower-body strength as potential mechanisms underlying the association between DCD and PA participation. These factors may represent candidate intervention targets; however, their roles require confirmation in larger samples and longitudinal designs. Full article

Statins’ effects on cardiorespiratory fitness (CRF) and their interaction with exercise training remain unclear in older adults with dyslipidemia. This cohort study enrolled nine hundred and eighty-one older adults with dyslipidemia who underwent one of three interventions: (i) multicomponent exercise training (MEX; n = 298; 74% females), (ii) daily statin monotherapy (ST; n = 178; 65% females), or (iii) combined treatment with statins and multicomponent exercise training (STMEX; n = 505; 79% females). CRF, functional status, and lipid profile were assessed at baseline and after 24 months. After follow-up, statin therapy reduced CRF by 4% in women (p < 0.001), but not in men. The statin groups also showed reduced upper- and lower-limb strength in both sexes. Exercise alone significantly improved CRF (women: 27% vs. men: 21%, p < 0.001) and functional status, regardless of sex. The combined treatment significantly increased women’s CRF, whereas men showed an attenuated CRF benefit (women: 27% vs. men: 1%, p < 0.001). Our findings suggest sex-specific patterns in the effects of statin therapy on CRF in older adults with dyslipidemia. Statin therapy was associated with lower CRF over time in women, but not in men, whereas multicomponent exercise training may reverse these effects. Full article

Background/Objectives: Breast cancer survivors differ from non-cancer populations in that cancer treatment commonly induces declines in physical fitness (PF) that are relevant to treatment tolerance, recovery, and survivorship outcomes. However, PF assessment methods vary widely across interventional studies. This scoping review aimed to map and characterize objective PF assessments used in interventional research among breast cancer survivors. Methods: Following PRISMA-ScR guidelines, PubMed, MEDLINE, EMBASE, Web of Science, KoreaMed, KCI, ClinicalTrials.gov, and Google Scholar were searched through November 2024. Interventional studies enrolling adult female breast cancer survivors and reporting at least one objectively measured PF outcome were included. Results: Of 9697 records identified, 316 studies met the inclusion criteria. Most interventions were exercise-based (83.2%) and conducted in the post-treatment phase (56.4%). Across the 316 studies, 557 PF domain records were identified because a single study could report more than one PF domain. Muscular strength accounted for the largest proportion of PF domain records (n = 222, 39.9%), followed by cardiorespiratory fitness (n = 190, 34.1%), flexibility (n = 100, 18.0%) and physical function (n = 45, 8.0%). Assessment method records showed that field-based walking test, strength test, shoulder range of motion test and balance tests were commonly used within their respective domain. Substantial heterogeneity in protocols, timing, and reporting limited comparability across studies. Conclusions: PF assessments are widely used in interventional breast cancer survivorship research but remain unevenly distributed across domains and treatment phases. More standardized and clearly reported PF assessment methods are needed to improve comparability and support future survivorship research. Full article

Background/Objectives: In the school setting, high-intensity interval training (HIIT) has emerged as a time-efficient strategy to improve children’s physical fitness; however, different implementation modalities have not been compared. The aim of this study was to compare the effects of an individual versus paired HIIT protocol based on functional bodyweight exercises on physical fitness-related and anthropometric outcomes in primary school children. Methods: Sixty-one children (11.6 ± 0.3 years) participated in a 10-week experimental study with three parallel groups: individual HIIT (EG1, n = 21), paired HIIT (EG2, n = 20), and a control group (CG, n = 20). Although both HIIT groups performed the same bodyweight functional exercises, in EG2 the exercises required coordinated movement between the partners. The HIIT protocol was integrated into the warm-up of Physical Education (PE) classes twice per week (Tabata-type protocol; 8 × 20 s/10 s/≤8 min per session). Body composition, muscular strength, and cardiorespiratory fitness (estimated VO₂max) were assessed at pre- and post-test, along with a rating of perceived exertion (1–10 scale) and enjoyment/motivation (1–5 scale) across several sessions (1, 7 and 14). Data were analyzed using pre-post comparisons, ANOVA, and ANCOVA models adjusted for baseline values. Results: Body fat percentage decreased in all groups. The individual HIIT group showed within-group improvements in VO₂max (+5.3%, p < 0.001), handgrip strength (+10.1%, p = 0.003), and standing long jump (+4.1%, p = 0.033), with moderate-to-large effect sizes, whereas the paired HIIT group showed smaller and statistically non-significant changes. Between-group comparisons suggested a tendency toward greater improvements in VO₂max and handgrip strength in the individual HIIT group compared with the paired group, although the overall ANOVA for VO₂max was not statistically significant. Perceived exertion declined over time in the paired group but remained relatively stable in the individual group. Conclusions: A low-volume HIIT program performed individually was associated with improvements in several physical fitness outcomes in schoolchildren. In contrast, paired execution showed smaller and mostly non-significant changes, together with a progressive reduction in perceived intensity. Full article

The study investigated the effects of high-intensity interval training (HIIT) on cardiorespiratory fitness, hormonal, and psychological markers in adolescents. Twenty-eight healthy male adolescents were randomized to a HIIT group or a non-training control group. HIIT comprises three sessions per week for 10 weeks, alternating 30 s runs at high-intensity and low-intensity. VO_2max was estimated using the incremental running test. Plasma testosterone and cortisol were assessed by ELISA methods. Depression, anxiety, and stress scores were determined using the Depression Anxiety Stress Scales-21. Data were analyzed using two-way ANOVA with repeated measures. Significant “group × time” interactions were detected for VO_2max, testosterone, cortisol, testosterone-to-cortisol ratio, and stress score, but not for anxiety and depression scores. HIIT resulted in increased VO_2max (p < 0.001, d = 1.04), testosterone (p = 0.005, d = 0.52), and testosterone-to-cortisol ratio (p = 0.008, d = 1.05), and decreased cortisol (p = 0.036, d = 1.09) and stress score (p = 0.020, d = 0.98). Ten-week HIIT resulted in an improvement in physical fitness, steroid hormonal balance, and self-reported stress symptoms, but no changes in depressive and anxiety symptoms in comparison to the control group. The findings should be interpreted with caution due to limitations, including the small sample size and the lack of assessment of sex-related differences. Further research is required to elucidate the topic. Full article

Background/Objectives: Muscle strength is a key determinant of functional capacity in older adults. However, measures such as handgrip strength may not fully reflect multi-joint force production, and the relevance of the Isometric Mid-Thigh Pull (IMTP) for functional and cardiorespiratory outcomes remains unclear. This study examined the associations between IMTP-derived peak force and functional and submaximal cardiorespiratory variables in independent older women. Methods: This cross-sectional study included 21 independent older women (72.6 ± 6.9 years). Maximal isometric strength (IMTP and handgrip), functional performance (TUG, 30-CST, 30-ACT), and submaximal cardiorespiratory variables were assessed. Associations were examined using Pearson’s correlation coefficients with false discovery rate (FDR) correction (q = 5%). Results: Absolute IMTP peak force was significantly related to handgrip strength (r = 0.77; q = 0.001) and PVT1 (r = 0.67; q = 0.007). Relative IMTP peak force was related to relative handgrip strength (r = 0.71; q = 0.002), VO₂VT2 (r = 0.60; q = 0.02), and inversely to COP (r = −0.56; q = 0.03). No significant relationships were observed with TUG, 30-ACT, or most cardiorespiratory variables. Conclusions: IMTP-derived peak force was related to selected neuromuscular and submaximal cardiorespiratory variables, but not to functional performance measures. These findings suggest that the IMTP may provide complementary information on neuromuscular status, although further studies are required. Full article

Background: Childhood and adolescence represent critical developmental periods characterized by rapid somatic growth, endocrine changes, and the progressive attainment of biological maturity. These maturational processes substantially influence the development of physical fitness, yet are often overlooked when evaluating performance in youth populations. This structured narrative review aims to synthesize current knowledge regarding the relationships between somatic growth, biological maturity, and physical fitness in children and adolescents. Methods: A structured narrative review was conducted by systematically searching PubMed, Scopus, and Web of Science databases for peer-reviewed articles published up to February 2026. Keywords included ‘biological maturation’, ‘physical fitness’, ‘youth’, ‘adolescence’, ‘peak height velocity’, and ‘bio-banding’. Studies were eligible if they examined relationships between biological maturity indicators and physical fitness outcomes in children and adolescents aged 8–19 years. No publication date restrictions were applied, although priority was given to articles from the past 15 years. Results: Evidence consistently indicates that biological maturity substantially influences muscular strength, power, and speed in males; findings among females and for cardiorespiratory fitness are more nuanced and context-dependent. Early-maturing boys typically exhibit superior strength and power performances, whereas findings among girls are more variable. Earlier maturation in girls is frequently associated with increased adiposity, which may attenuate performance in weight-bearing activities. When maturity status is ignored, physical fitness evaluations may misrepresent the capabilities of late-maturing youth and potentially discourage long-term participation in physical activity. Conclusions: Integrating biological maturity into youth fitness evaluation frameworks is essential for accurately interpreting performance data and for providing developmentally appropriate interventions. Three implementation strategies are recommended: (i) adoption of maturity offset or percentage of predicted adult stature as standard covariates; (ii) development of maturity-stratified normative standards; and (iii) implementation of bio-banding in youth sport development. Full article

Allergic Rhinitis (AR) is an IgE-mediated inflammatory disorder that impairs quality of life and systemic function. Following the ‘one airway, one disease’ paradigm, AR-related inflammation often extends to the lower respiratory tract. This randomized controlled trial investigated the effects of an 8-week moderate-intensity aerobic exercise (MOA) program on clinical symptoms, nasal airflow, airway inflammation, pulmonary function, and cardiorespiratory parameters in young adults with physician-confirmed persistent AR. To isolate the exercise effects, all participants discontinued antihistamines, corticosteroids, and leukotriene antagonists before and during the study period. Eighteen participants were allocated to either the MOA group (n = 9), which performed treadmill walking or jogging at 50–60% heart rate reserve three times per week for eight weeks, or a control group (CON, n = 9) that maintained usual daily activities. Clinical symptoms, peak nasal inspiratory flow, fractional exhaled nitric oxide, pulmonary function, heart rate, blood pressure, aerobic fitness, and perceived exertion were assessed at baseline, week 4, and week 8 using standardized procedures. Compared with baseline and the CON group, the exercise intervention resulted in significant reductions in nasal congestion, itching, sneezing, and rhinorrhea, accompanied by increased nasal airflow and reduced airway inflammation. Pulmonary function indices and cardiorespiratory parameters also improved following training. These findings suggest that moderate-intensity aerobic exercise may offer a valuable non-pharmacological approach to support conventional care, potentially enhancing respiratory and physiological outcomes in young adults with persistent AR. Full article

Background: Fibromyalgia is a chronic condition characterized by a complex array of symptoms that impact multiple domains, including physical, psychological, and social aspects of an individual’s well-being. Although home-based adapted physical activity (HAP) interventions represent a promising strategy to improve health-related physical fitness (PF), studies on the topic are still lacking and further research is required. The objective of the present study was to evaluate the impact of participation in a 12-week HAP intervention on health-related PF in adult women with fibromyalgia syndrome (FS). Methods: Participants were women with fibromyalgia (n = 29; 47.1 ± 9.5 yrs) assigned to the 12-week HAP program (n = 17) or wait-list control group (n = 12). Participants completed two weekly circuit-training sessions delivered through an online platform. PF components were assessed through a standardized test battery: 30-s chair stand (lower-body strength), arm curl (upper-body strength), 2-min step (cardiorespiratory fitness), back scratch (flexibility) and 8-foot up-and-go test (agility and balance). Three time-point evaluations were planned: at baseline (T0), after 6 weeks (T1), and after 12 weeks (T2). Linear mixed models were used, and partial eta-squared (η²p) effect sizes were calculated. Results: A significant time × group interaction emerged for upper body strength (p = 0.001; η²p = 0.404), agility (p < 0.001; η²p = 0.569) and cardiorespiratory fitness (p = 0.009, η²p = 0.292). Specifically, from baseline to 12 weeks, the experimental group improved in the arm-curl test (from 15.8 ± 4.5 to 18.9 ± 5.0 repetitions), agility (from 6.6 ± 1.5 to 5.2 ± 1.1 s), and cardiorespiratory fitness (from 69.1 ± 18.8 to 77.2 ± 21.1 repetitions), while the control group showed no meaningful changes. Conclusions: The participation in a 12-week HAP intervention had a positive impact on different components of PF in women with FS, which may have implications for greater physical autonomy and well-being. Full article

Mitochondrial dysfunction is a hallmark of aging and age-related physical decline in people living with HIV (PLWH) who experience accelerated aging. This pilot study investigated the relationships between platelet mitochondrial function, physical performance, and body composition in older, sedentary PLWH compared with older, sedentary HIV-negative controls. Platelets have the potential to act as minimally invasive and easily accessible biomarkers for systemic mitochondrial bioenergetics and may serve as a practical biomarker in aging-related research. We analyzed correlations between mitochondrial parameters, protein levels, and measures of physical performance and body composition in a cohort of predominantly African American men (n = 7 PLWH, n = 7 controls). Body composition was assessed using dual-energy X-ray absorptiometry (DXA), and exercise capacity through VO₂ peak and strength tests. Platelet mitochondrial bioenergetic parameters were measured by oxygen consumption rates (OCR) and extracellular acidification rates (ECAR). Key mitochondrial proteins SIRT3, COXII, DRP1, and OPA1 were evaluated by Western blotting. The PLWH and HIV-negative control groups were similar in age and cardiorespiratory fitness. In PLWH, basal OCR and ATP-linked respiration showed strong positive correlations with VO₂ peak (r = 0.874, p < 0.05 and r = 0.862, p < 0.05, respectively) and negative correlations with BMI (r = −0.856, p < 0.05 and r = −0.849, p < 0.05, respectively). SIRT3 emerged as a potential key player, demonstrating strong positive correlations with basal OCR (r = 0.804, p < 0.05), ATP-linked respiration (r = 0.787, p < 0.05), and VO₂ peak (r = 0.970, p < 0.001), and negative correlations with BMI (r = −0.830, p < 0.05) and fat mass (r = −0.827, p < 0.05) in PLWH. Analyses focused on within-group associations in PLWH because bioenergetic measures were obtained using different Seahorse platforms in PLWH and controls, precluding valid direct quantitative comparisons between groups. Our findings provide evidence for significant associations between platelet mitochondrial bioenergetics, specific mitochondrial proteins (particularly SIRT3), and key physical attributes in older, sedentary PLWH. These preliminary findings suggest that platelets may serve as minimally invasive biomarkers of systemic mitochondrial health, contribute to our understanding of mitochondrial function in HIV-associated accelerated aging, and inform future interventions to enhance mitochondrial function and improve health outcomes in this vulnerable population. However, results should be interpreted cautiously given the small sample size and exploratory design and should be considered hypothesis-generating rather than definitive. Larger, demographically more diverse studies that include HIV-negative controls are needed to validate these associations and determine their clinical relevance. Full article

Background/Objectives: Active surveillance (AS) has become the gold standard for managing men diagnosed with low-risk or favorable intermediate-risk prostate cancer. However, both patients and healthcare providers often face a lack of clear, evidence-based guidance regarding lifestyle choices during this period. This systematic review was designed to determine whether specific lifestyle modifications—including dietary changes, physical activity, weight control, and use of supplements—can tangibly impact oncologic outcomes or improve patient-reported quality of life during surveillance. Methods: The research followed PRISMA protocols, searching PubMed, Cochrane, and Scopus for studies published between 2000 and 2025. The team included diverse methodologies, from randomized controlled trials to qualitative interviews, specifically focusing on men on AS. To ensure high standards, two independent reviewers performed data extraction and quality assessments using CASP tools, and the review was formally registered with PROSPERO. Results: The review synthesized data from over 30 heterogeneous studies. The findings suggest that lifestyle interventions are safe and highly feasible. Physical exercise emerged as the most effective intervention, consistently improving cardiorespiratory fitness and reducing psychological burdens such as fatigue and “PSA anxiety.” While dietary changes and weight loss successfully improved metabolic health markers, they did not show a consistent ability to prevent biopsy upgrading or MRI progression. Similarly, supplements showed only minor, short-term effects on PSA kinetics without providing reproducible oncologic protection. Conclusions: For men undergoing active surveillance, lifestyle interventions may be considered as supportive measures, as they appear feasible and may improve physical fitness, metabolic health, and selected patient-reported outcomes. However, current evidence remains insufficient to demonstrate a consistent effect on biopsy upgrading, MRI progression, or long-term deferral of definitive treatment. Full article

(1) Background: Frailty is a major geriatric syndrome associated with adverse health outcomes, while direct assessment of cardiorespiratory fitness (CRF) is often impractical in routine clinical settings. This study investigated the association between estimated cardiorespiratory fitness (eCRF) and incident frailty in middle-aged and older adults from three nationally representative aging cohorts. (2) Methods: We analyzed longitudinal data from the Health and Retirement Study (HRS; 2006–2020) in the United States, the English Longitudinal Study of Ageing (ELSA; 2004–2018) in England, and the China Health and Retirement Longitudinal Study (CHARLS; 2011–2018) in China. Participants aged 50 years or older were included. eCRF was calculated using validated sex-specific non-exercise algorithms. Frailty was assessed using a 30-item Frailty Index (FI), and incident frailty was defined as FI ≥ 0.25. Cox proportional hazards models were used to evaluate the association between baseline eCRF and incident frailty. (3) Results: A total of 8152 participants (3982 women and 4170 men) were included in the longitudinal analysis. Each 1-SD increase in eCRF was associated with a lower risk of incident frailty in HRS (HR = 0.60, 95% CI: 0.54–0.68), ELSA (HR = 0.54, 95% CI: 0.46–0.64), and CHARLS (HR = 0.74, 95% CI: 0.63–0.87). Compared with the low-eCRF group, the moderate- and high-eCRF groups had progressively lower risks of incident frailty across all three cohorts, indicating a graded inverse dose–response relationship. Findings were generally consistent across subgroup and sensitivity analyses. (4) Conclusions: Higher eCRF was associated with a lower risk of incident frailty among middle-aged and older adults across three nationally representative cohorts. As an accessible, non-invasive metric, eCRF may be useful for identifying individuals at elevated risk of incident frailty. Full article

Background/Objectives: University life is often accompanied by unhealthy lifestyle behaviors, reduced physical activity, lower fitness levels, and a high prevalence of mental health symptoms. Daily step count has emerged as a practical indicator of habitual physical activity; however, evidence on its association with cardiorespiratory fitness and symptoms of depression, anxiety, and stress in university students remains limited. Therefore, this study examined the association of daily step count with cardiorespiratory fitness and symptoms of depression, anxiety, and stress in university students. Methods: This cross-sectional association study included a convenience sample of 120 students aged 18 to 25 years from a single university. Daily step count was assessed over seven consecutive days using a Xiaomi Mi Band 9. Cardiorespiratory fitness was evaluated with the 20 m shuttle run test, and symptoms of depression, anxiety, and stress were measured using the Depression, Anxiety and Stress Scale-21 Items (DASS-21). Partial correlations, ANCOVA, MANCOVA, binary logistic regression, and restricted cubic spline models were performed after adjustment for sex, age, and socioeconomic status. Results: Higher daily step count was associated with greater cardiorespiratory fitness and with lower symptoms of depression, anxiety, and stress, although the associations with mental health symptoms were weak and not uniform across outcomes. Restricted cubic spline models showed inverse non-linear associations for mental health symptoms, with steeper inverse gradients at lower step-count levels and a tendency to level off at higher volumes, approximately around 9000 steps/day. For cardiorespiratory fitness, the association was positive across the step-count range. Step counts around 7500 steps/day were associated with lower odds of elevated symptoms of depression, anxiety, and stress. Conclusions: A higher daily step count was associated with more favorable mental health symptom profiles and greater cardiorespiratory fitness in this sample of university students. Full article