Search Results (1,383)

Background/Objectives: Lack of objective evidence exists regarding changes in physical function and impact on daily functioning in paediatric post-COVID-19 condition (PPCC). This study aimed to assess exercise capacity, fatigue, and peripheral and respiratory muscle strength in PPCC patients compared with healthy controls. Additionally, the impact of PPCC on domains of daily life was evaluated. Methods: A cross-sectional study was performed. Study variables: exercise capacity (6 min walk test, 6MWT), inspiratory muscle strength (maximal inspiratory pressure, PImax), handgrip strength (handheld dynamometer, HHD), quadriceps femoris muscle thickness (QF MT), rectus femoris muscle thickness (RF MT), rectus femoris cross-sectional area (RF CSA), rectus femoris echo-intensity (RF EI), fatigue (Paediatric Functional Assessment of Chronic Illness Therapy-Fatigue, pedsFACIT-F), and physical activity (Assessment of Physical Activity Levels Questionnaire, APALQ). Results: A total of 115 PPCC patients and 227 healthy controls were included. The PPCC group had lower 6MWT (509.00 ± 86.12, p < 0.001), PImax (68.71 ± 26.23, p < 0.001), HHD (82.84 ± 29.09, p < 0.001), APALQ (7.94 ± 3.14, p < 0.001), pedsFACIT-F (24.51 ± 11.01, p < 0.001), QF MT mid-thigh (33.21 ± 7.99, p = 0.011), and higher RF EI (p < 0.001) vs. controls. Only 37.63% of the PPCC group resumed previous sports, 43.48% were unable to attend school full-time and 28.7% could not participate in after-school activities. Conclusions: Paediatric post-COVID-19 condition patients exhibited significant impairments in terms of physical function, with a high impact on daily functioning. This knowledge is necessary to provide targeted therapeutic interventions. Full article

The circadian rhythm controls the sleep/wake cycle and a wide variety of metabolic and physiological functions. Clock genes regulate it in response to both external and endogenous stimuli, and their expression may change because of aging, leading to an increased risk of health problems. Despite the well-described benefits of physical exercise as a circadian synchronizer, there is a lack of literature regarding the role of chronic exercise intensity in clock gene expression during aging. This article aims to analyze the differential expression of genes that regulate the biological clock under the effects of variable-intensity aerobic swimming training in aging mice, determining whether these exercise regimens interfere with the genomic regulation of the circadian rhythm. For this purpose, the mice were exposed to low- and high-intensity exercise and had their heart and gastrocnemius tissues molecularly analyzed by cDNA synthesis and qPCR to determine the expression levels of the selected genes: Clock, Arntl, Per1, Per2, Cry1, Cry2, and Nr1d1. The results showed that low-intensity exercise, performed at workloads below the anaerobic threshold, significantly changed their expression in the gastrocnemius muscle (p < 0.05), while high-intensity exercise had no statistically significant effects (p > 0.05), with the heart being immune to exercise influence except when it comes to the Per1 gene, for which expression was increased (p = 0.031) by low-intensity exercise. Additionally, both body weight and lactate thresholds had no change during the experiment (p > 0.05), while the maximum supported workload was maintained for high-intensity exercise (p > 0.05) and increased for low-intensity exercise (p < 0.01), with the control group experiencing a decay instead (p < 0.05). Thus, the present study highlights the importance of chronic exercise in modulating clock genes and opens exciting possibilities for circadian medicine, such as improvements in exercise capacity, heart condition, and lipid metabolism for subjects of low-intensity regimens. Full article

The relationship between exercise and immune function has been widely studied, yet findings remain inconsistent regarding how different exercise modalities and intensities influence acute and chronic immunological responses. Previous reviews have often focused on single exercise types or limited outcomes, leaving a gap for an integrated synthesis. This narrative review aims to address this gap by summarizing and comparing immunological effects across aerobic exercise, resistance training, high-intensity interval training (HIIT), blood flow restriction (BFR), isometric exercise, mind–body interventions, and hypoxic training. A structured narrative approach was adopted. Literature published between January 2000 and December 2024 was searched in PubMed, Scopus, and Web of Science. Experimental and observational studies on humans and animal models were included, with study selection and data extraction performed by two reviewers. Findings were synthesized thematically by exercise modality to capture both acute and chronic immune responses. Twenty-four eligible studies were identified. Aerobic and mind–body exercises consistently demonstrated anti-inflammatory and immunoprotective effects, including increased IL-10 production, improved T cell profiles, and reduced inflammatory markers. Isometric training showed favorable modulation of cytokines and T cell balance, while resistance training evidence was limited but suggested cortisol-lowering benefits. HIIT, BFR, and hypoxic exercise produced mixed results, often combining transient pro-inflammatory responses with immunological benefits. Acute and chronic immunological responses to exercise are highly modality- and intensity-dependent. Aerobic and mind–body interventions provide the most consistent benefits, whereas HIIT, BFR, and hypoxic training show variable effects. Further high-quality trials are needed to clarify mechanisms and guide exercise-based immune recommendations. Full article

Mitochondrial dysfunction is a key factor in the pathophysiology of major depressive disorder (MDD) and treatment-resistant depression (TRD), connecting oxidative stress, neuroinflammation, and reduced neuroplasticity. Physical exercise induces specific mitochondrial changes linked to improvements in mental health. The aim of this paper was to examine emerging evidence regarding the effects of physical exercise on mitochondrial function and treatment-resistant depression, highlighting the clinical importance of the use of mitochondrial biomarkers to personalize exercise prescriptions for patients with depression, particularly those who cannot tolerate standard treatments. Physical exercise improves mitochondrial function, enhances biogenesis and neuroplasticity, and decreases oxidative stress and neuroinflammation. Essential signaling pathways, including brain-derived neurotrophic factor, AMP-activated protein kinase, active peroxisome proliferator-activated receptor-γ coactivator-1α, and Ca²⁺/calmodulin-dependent protein kinase, support these effects. Most studies have concentrated on the impact of low- and moderate-intensity aerobic exercise on general health. However, new evidence suggests that resistance exercise and high-intensity interval training also promote healthy mitochondrial adaptations, although the specific exercise intensity required to achieve this goal remains to be determined. There is strong evidence that exercise is an effective treatment for MDD, particularly for TRD, by promoting specific mitochondrial adaptations. However, key gaps remain in our understanding of the optimal exercise dose and which patient subgroups are most likely to benefit from it (Graphical Abstract). Full article

Long COVID is characterized by persistent symptoms associated with chronic inflammation and oxidative stress. While high-intensity interval training (HIIT) and supplementation with antioxidants such as Triphala have demonstrated individual therapeutic benefits, their combined effects remain unclear. This study aimed primarily to evaluate the effects of an 8-week HIIT program on markers of inflammation, oxidative stress, and exercise-related symptoms in individuals with long COVID, and secondarily to explore whether Triphala supplementation provided additional benefits. A total of 104 participants (aged 18–59 years) were randomized into three groups—control (placebo), HIIT (cycling for 28 min/day, 3 days/week), and combined (HIIT + Triphala, 1000 mg/day)—for 8 weeks. The biomarkers assessed included interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), malondialdehyde (MDA), protein carbonyls, and superoxide dismutase (SOD) activity. Following the intervention, significant reductions in IFN-γ, TNF-α, MDA, protein carbonyls, and rating of perceived exertion were observed in both the HIIT and combined groups (p < 0.05), with no significant differences between the two. SOD activity significantly increased in all groups, including the control group (p < 0.05), with no between-group differences. An 8-week HIIT program appears to be effective in reducing inflammation, oxidative stress, and dyspnea in individuals with long COVID. Triphala supplementation did not provide any additional statistically significant benefit but was safe and well tolerated. Full article

Background: Cancer has a high mortality rate and leaves physical and mental difficulties even after treatment. When it afflicts frail elderly people, it poses a greater burden to them and society. Regular exercise helps to restore the deteriorated health of cancer survivors. The purpose of this study was to compare the effects of a short-term, high-repetition, home-based “exercise snack” program with those of a traditional, continuous, moderate-intensity exercise format on key health outcomes in elderly cancer survivors, including quality of life, cardiorespiratory fitness, and metabolic flexibility. Methods: A short-duration, high-repetition exercise snack group (ESG, n = 17) and a traditional exercise group (TEG, n = 17) were compared after 12 weeks of training. The effects of exercise on quality of life, cardiorespiratory fitness, metabolic flexibility, and blood lipids were measured. Results: Quality-of-life vitality, social functioning, cardiorespiratory fitness VO₂ peak, and high-density lipoprotein cholesterol were improved more in ESG than in TEG (p < 0.05). Metabolic flexibility showed that fat utilization increased and carbohydrate utilization decreased post-training compared to pre-training at VO₂ peak 20 and 40% in both groups (p < 0.05). Conclusions: In both groups, cardiorespiratory fitness was shown along with physical and psychological improvements in quality of life, and the efficiency of metabolic flexibility was also improved. Therefore, short-term, frequent exercise may be an appropriate exercise alternative for elderly people with difficulties. Full article

Cell culture models are used in cardiovascular research to study molecular pathways associated with endothelial shear stress (ESS). However, previous studies have limited translation from in vivo ESS, especially across exercise intensities. Using the Ibidi pump system, ESS can be replicated in vitro to study exercise-induced changes in protein and gene expression. Currently, there are no standardized protocols describing how to translate exercise-induced ESS from in vivo data to in vitro models. This protocol addresses that gap by integrating human exercise data to generate physiologically relevant ESS from 18 to 60 dyn/cm², replicating rest to high-intensity exercises. We describe the use of the Ibidi pump system to expose human umbilical vein endothelial cells (HUVEC) to exercise-induced ESS from in vivo data, followed by protein (Western blot and immunocytochemistry) and gene (reverse transcription polymerase chain reaction) analysis. The steps include ESS determination at different exercise intensities, culturing HUVEC, Ibidi pump system setup, and molecular analysis. Even though the sample experiment uses a low ESS, representative of low-intensity exercise, this model can be adapted to higher exercise intensities. Potential limitations and solutions are also discussed. Full article

Background: Increased hip-flexion gait (HFgait) has been shown to promote increased aerobic demands by increasing peak swing-phase hip-flexion angles while walking at comfortable speeds. Biomechanically, HFgait produces a gait pattern similar to walking, while removing the flight phase from running and reducing tibial accelerations. We sought to identify knee joint contact forces between HFgait and common exercise modalities, including running, walking, and cycling, across intensity levels. Methods: Ten healthy participants completed two bouts (low and high intensity) of four different exercises: treadmill running, walking, HFgait, and cycling. Tibiofemoral joint compressive force (TCF) was estimated using a static optimization-based approach. Results: Peak TCF was greater in running compared to HFgait, walking, and cycling; greater in HFgait compared to cycling; and greater in walking compared to cycling. The integral of TCF (iTCF) was greater in running compared to cycling, greater in HFgait compared to running, walking, and cycling, and greater in walking compared to running and cycling. Conclusions: HFgait produced lower knee joint loading than running, comparable joint loading to walking, and greater joint loading than cycling. Thus, HFgait may serve as an exercise modality for populations where joint loading is of particular concern, while achieving aerobic demands similar to running or increased functional demands compared to stationary cycling. Full article

Basketball requires high-intensity, multidirectional movements that place significant stress on the ankle joint. Limited dorsiflexion and reduced change-of-direction (COD) ability are associated with impaired movement efficiency and may contribute to injury mechanisms. Isometric training may help address these limitations in professional players. To assess the effects of a season-long isometric intervention program on ankle dorsiflexion and COD performance in professional basketball players. Fourteen professional players (mean age 25.6 ± 3.9 years) completed a season-long isometric intervention program (5 days/week), which included three force-steady sustained running postures and two gym-based exercises performed at 80% maximal voluntary contraction for 15–20 s per repetition (12 reps/set, 3 sets/session). Significant improvements were observed in both ankle dorsiflexion and COD performance. Dorsiflexion increased by 34.0% in the left leg and 19.4% in the right leg (Lunge Test). COD performance in the L-Test improved by 10.0% for the leftwards side and 11.6% for the rightward side from pre- to post-intervention. Isometric training improved ankle dorsiflexion and COD performance in professional basketball players, suggesting potential performance benefits and enhanced movement efficiency in multidirectional tasks. Full article

Blood lactate (BLa) concentration is a pivotal biomarker of exercise intensity and physiological stress, which provides insights into athletic performance and recovery. However, traditional lactate measurement requires invasive blood sampling, which presents significant limitations, including procedural discomfort, infection risks, and impracticality for continuous monitoring. Though non-invasive measurements of BLa concentration have emerged, most rely on a single physiological indicator like heart rate and sweat rate, and their accuracy and reliability remain limited. To address these limitations, this study proposes an innovative multi-sensor fusion framework for non-invasive estimation of BLa. By leveraging the inherent multisystem and multidimensional coordination of human physiology during exercise, the framework integrates a range of physiological signals (e.g., heart rate variability and respiratory entropy) and biomechanical signals (e.g., motion data). We proposed a stacking ensemble model that leverages the complementary strengths of these signals and achieved exceptional predictive performance with near-perfect correlation (R² = 0.9661) while maintaining high precision (MAE = 0.1816 mmol/L) and robustness (RMSE = 0.5891 mmol/L). Furthermore, the model’s exceptional capability extends to blood lactate threshold detection with 98.15% classification accuracy, which is a critical metric for training intensity optimization. This approach provides a robust, non-invasive solution for continuous exercise intensity monitoring, demonstrating significant potential for optimizing athletic performance through real-time physiological assessment and data-driven training modulation. Full article

Understanding neuromuscular adaptations resulting from specific training modalities is crucial for optimizing athletic performance and injury prevention. This in silico proof-of-concept study aimed to computationally model and predict neuromuscular adaptations induced by strength and plyometric training, integrating musculoskeletal simulations and machine learning techniques. A validated musculoskeletal model (OpenSim 4.4; 23 DOF, 92 musculotendon actuators) was scaled to a representative athlete (180 cm, 75 kg). Plyometric (vertical jumps, horizontal broad jumps, drop jumps) and strength exercises (back squat, deadlift, leg press) were simulated to evaluate biomechanical responses, including ground reaction forces, muscle activations, joint kinetics, and rate of force development (RFD). Predictive analyses employed artificial neural networks and random forest regression models trained on extracted biomechanical data. The results show plyometric tasks with GRF 22.1–30.2 N·kg⁻¹ and RFD 3200–3600 N·s⁻¹, 10–12% higher activation synchrony, and 7–12% lower moment variability. Strength tasks produced moments of 3.2–3.8 N·m·kg⁻¹; combined strength + plyometric training reached 3.7–4.2 N·m·kg⁻¹, 10–16% above strength only. Machine learning predictions revealed superior neuromuscular gains through combined training, especially pairing back squats with high-intensity drop jumps (50 cm). This integrated computational approach demonstrates significant practical potential, enabling precise optimization of training interventions and injury risk reduction in athletic populations. Full article

High-intensity/sprint interval training (HIIT/SIT) improves aerobic and anaerobic performance, but it is unknown if HIIT/SIT increases strength, muscle mass/size, and muscle endurance (ME). We aimed to determine if HIIT/SIT increases strength, muscle mass/size, and ME. Databases (Ovid Medline, Sport Discus, EMBASE, and CINAHL) and the gray literature (Google Scholar) were searched for original research articles investigating the impact of HIIT/SIT on strength, muscle mass/size, and ME (23 March 2025). The risk of bias (ROB) was assessed via the Cochrane ROB 2 Tool. Meta-analyses were performed when three or more randomized controlled trials compared HIIT/SIT to a common comparator. Fifty-four studies were included (N = 1136). Twenty-five studies had a high ROB, while twenty-nine had some concerns. Standardized mean differences (SMD) (95% CI) of 0.16; (−0.09, 0.40), 0.33; (−0.21, 0.87) were observed for meta-analyses comparing the effect of HIIT/SIT to moderate intensity continuous training (MICT) and non-exercise controls (CON) on FFM, respectively. A meta-analysis comparing the effect of HIIT/SIT to resistance training (RT) on leg press strength yielded a SMD of −0.82; 95% CI: (−1.97, 0.33). HIIT/SIT may induce slightly greater gains than MICT and CON for FFM, while RT is likely superior to HIIT/SIT for improving leg press strength. However, the certainty of evidence is low, and 95% CIs intersect zero for all analyses. Full article

Background: Regulating sensations of fatigue and discomfort while performing maximal endurance exercise becomes essential for making informed decisions about persistence and/or failure during intense exercise. Athletes with a higher effort capacity have competitive advantages over those with a lower one. The microbiota–brain axis is a considered the sixth sense and a modulator of the host’s emotional stability and physical well-being. Objectives: This narrative review aims to explore and evaluate the potential mechanisms involved in regulating perceptions during endurance exercise, with a focus on the possible relationship between the gut microbiota balance and the neural system as an adaptive response to high fatigue chronic exposure. Methods: Electronic databases (PubMed, Web of Science, Google Scholar, and Scopus) were used to identify studies and hypotheses that had documented predefined search terms related to endurance exercise, gut microbiota, the central nervous system, pain, discomfort, fatigue, and tolerance to effort. Results: This narrative review shifts the focus concerning the symbiotic relationship between the gut microbiota, the vagus nerve, the central/enteric nervous system, and the regulation of afferences from different organs and systems to manage discomfort and fatigue perceptions during maximal physical effort. Consequently, the chronicity supporting fatigued exercise and nutritional stimuli could specifically adapt the microbiota–brain connection through chronic efferences and afferences. The present hypothesis could represent a new focus to be considered, analysing individual differences in tolerating fatigue and discomfort in athletes supporting conditions of intense endurance exercise. Conclusions: A growing body of evidence suggests that the gut microbiota has rapid adaptations to afferences from the brain axis, with a possible relationship to the management of fatigue, pain, and discomfort. Therefore, the host–microbiota relationship could determine predisposition to endurance performance by increasing thresholds of sensitive afferences perceived and tolerated. A richer and more diverse GM of athletes in comparison with sedentary subjects can improve the bacteria-producing metabolites connected to brain activity related with fatigue. The increase in fatigue thresholds directly improves exercise performance, and the gut–brain axis may contribute through the equilibrium of metabolites produced for the microbiota. Full article

The interventricular septum is recognized as the first region to undergo remodeling, and a septal bulge is described as an early echocardiographic sign of hypertensive heart disease. Using third-generation microscopic ultrasonography in an animal model, we validated, for the first time, that remodeling originates in the basal septum, presenting as basal septal hypertrophy (BSH), an early imaging biomarker, and subsequently progresses to other regions, leading to tissue dysfunction and heart failure. We have termed this finding the “stress septal sign” (Triple S) because a variety of stress stimuli, such as treadmill exercise or pressure overload from aortic banding in animals, induced BSH, a region with more intensive sympathetic innervation than the mid-apex. This finding also represents a conjunctive point between functional etiologies, such as hypertension, and emotional etiologies that precipitate acute stress cardiomyopathy. Microscopic analysis of the remodeling revealed that hemodynamic stress has a specific effect on cardiac geometry. The Triple S is associated with exercise-induced hypertension and high stress scores in patients with hypertension. Furthermore, three-dimensional segmental remodeling is more effective than cross-sectional measurements for detecting the impact of superimposed multiple stressors. A high-rate pressure product and blood pressure variability in patients exhibiting the Triple S should be managed comprehensively through an integrated approach to stress and hypertension to avoid high mortality in clinical practice. A precise etiologic evaluation of incidentally detected BSH may contribute to the early diagnosis of hypertensive disease. The integrated and timely management of stress and hypertension is important for patients presenting with the Triple S and high stress scores. This management strategy may provide a practical solution for avoiding the adverse hypertensive consequences of global remodeling and maladaptation to superimposed multiple stressors. Full article

Background/Objectives: Heart rate variability (HRV) is a reliable, non-invasive marker of autonomic nervous system function and is often impaired in individuals with metabolic syndrome (MetS). Physical exercise has emerged as an effective strategy to improve autonomic modulation; however, the comparative effects of different training modalities on HRV in individuals with MetS remain unclear. This systematic review and meta-analysis aimed to evaluate the impact of various exercise interventions on HRV and to identify which training types yield the most significant improvements. Methods: A systematic search was conducted in PubMed and Scopus up to April 2025. Eligible studies (n = 16) included adults with obesity and MetS (n = 752) who underwent structured exercise interventions with HRV assessments pre- and post-intervention. Standardized mean differences were calculated using random effects models. Subgroup analyses were performed based on training modality (endurance training [ET], resistance training [RT], high-intensity interval training [HIIT], and concurrent training [CT]). Results: Sixteen studies of moderate to high quality were included, with eleven studies eligible for meta-analysis. ET and HIIT significantly improved time-domain indices (Root mean square of differences of successive R-R intervals —rMSSD—, Standard deviation of the R-R interval series —SDNN—) and frequency-domain parameters (high-frequency —HF—), suggesting enhanced parasympathetic activity. RT showed inconsistent effects, while CT improved long-term HF and total power (TP). Non-linear indices were the least reported due to insufficient data. Conclusions: Physical exercise—particularly ET and HIIT—appears to enhance cardiac autonomic modulation in individuals with obesity and MetS. These findings support incorporating targeted training strategies into clinical practice to optimize cardiovascular health in these populations. Full article