Search Results (613)

Background/Objectives: MicroRNAs (miRNAs) are key regulators of skeletal muscle adaptation; however, the extent to which exercise modulates the miRNA biogenesis pathway remains poorly understood. To investigate the impact of acute and chronic high-intensity exercise on components of miRNA biogenesis, and whether such changes are reflected in miRNA expression across stages of their biogenesis, we performed secondary analyses of muscle biopsy samples from two previously published studies. Methods: Muscle biopsies were analyzed from the following protocols: nine men and eight women pre- and 3 h post- a bout of high-intensity interval cycling exercise (HIIE), and eleven men and eight women pre- and post- a 6-week period of high-intensity interval training (HIIT) or non-exercise control. mRNA expression of components of miRNA biogenesis including Drosha, Exportin-5, Dicer, and Ago2 were assessed following HIIE using RT-qPCR and their protein abundance was measured following HIIT using Western blotting. Primary (pri-miR-133a1, -133a2, -133b) and mature (miR-133a-3p, -133a-5p, -133b) miRNA expression were quantified following HIIT. Results: An acute bout of HIIE significantly decreased Drosha mRNA (p < 0.05) and resulted in a reduction in Dicer mRNA that approached significance (p < 0.10). Following 6 weeks of HIIT, no significant changes were detected in the protein abundance of Drosha, Exportin-5, Dicer, or Ago2. HIIT did not alter miR-133 expression at either the primary or mature transcript level across all isoforms. Conclusions: This study highlights the complexity of miRNA regulation in skeletal muscle and underscores the need for further research examining the temporal and mechanistic control of miRNA biogenesis in response to exercise. Full article

Skeletal muscle plasticity is modulated by a delicate equilibrium between reactive oxygen species (ROS)-mediated signaling and oxidative distress. Although excessive oxidant accumulation impairs excitation–contraction coupling, accelerates fatigue, and contributes to muscle dysfunction, transient and compartmentalized ROS signals are now recognized as important modulators of mitochondrial biogenesis, metabolic remodeling, proteostasis, and tissue repair processes after contractile stress. This review synthesizes the biphasic nature of redox biology in exercise physiology, interpreting this duality through the paradigm of hormesis. We discuss modality-specific redox responses associated with endurance, resistance and high-intensity interval training, emphasizing that adaptive outcomes depend not on global redox shifts, but on spatiotemporally confined signaling cascades within specific nanodomains. Furthermore, we evaluate the controversial role of antioxidant supplementation, highlighting evidence that high-dose or poorly timed antioxidant intake attenuates specific exercise-induced adaptive responses. We further discuss how aging and chronic disease narrow the adaptive redox window by impairing mitochondrial quality control, inflammatory resolution, and recovery capacity. This paradigm supports a precision exercise strategy in which training modality, intensity, recovery, and nutritional interventions are aligned to preserve adaptive redox signaling while avoiding cumulative oxidative injury. Full article

Heart failure (HF) remains a major global health challenge, necessitating accurate yet accessible diagnostic tools. While the left ventricular ejection fraction (LVEF) is the primary metric for classifying HF into preserved (HFpEF), mid-range (HFmrEF), and reduced (HFrEF) phenotypes, conventional imaging modalities such as echocardiography are resource intensive. In contrast, the electrocardiogram (ECG) offers a low-cost, non-invasive alternative for continuous cardiac assessment. This paper proposes a multi-algorithm artificial intelligence (AI) framework for automated HF phenotype classification using high-resolution ECG signals from 303 patients with chronic heart failure from the MUSIC cohort. After preprocessing (normalization, bandpass filtering), we employed a hybrid approach combining the Pan–Tompkins algorithm for robust R-peak detection with the NeuroKit2 toolbox for the precise delineation of P, Q, S, and T waves. ECG recordings were then segmented using an adaptive beat-centric windowing strategy. From the segmented beats, we extracted a comprehensive set of temporal, morphological, and energy-based features, including RR, QRS, and QT intervals, along with P-wave, QRS-complex, and T-wave energies. These features were used to train and evaluate several ensemble machine learning models—Random Forest, XGBoost, CatBoost, LightGBM, and a stacking classifier—using a stratified 70–15–15 train–validation–test split with 5-fold cross-validation. The LightGBM model achieved the highest performance with a test accuracy of 98.45%, an AUC of 0.9989, and a macro F1-score of 0.9804, outperforming other ensembles and the stacking classifier. The results demonstrate that an AI-driven analysis of ECG-derived morpho-energy features can serve as a reliable, non-invasive screening tool for the accurate and early discrimination of HF phenotypes, potentially supporting clinical decision making and improving patient management in resource-limited settings. Full article

Maxillofacial defects impair facial aesthetics and oral function, arising from trauma, tumor resection, or congenital anomalies; however, reconstruction using Computer-Aided Design (CAD) and autologous grafts remains complex and time-intensive, and is associated with donor-site morbidity. Although deep learning (DL) has advanced automated reconstruction, existing models often address isolated tasks, lack integrated multi-scale feature learning, and rely on small datasets. This study proposes the Maxillofacial Implant-generation Network (MaxI-Net), a fast, resource-efficient three-dimensional DL framework for end-to-end maxillofacial defect reconstruction and patient-specific implant generation, with a completion step of cavity filling within the assembly. The model employs a 3D encoder–bottleneck-decoder architecture integrating hybrid dilated convolutions, residual connections, squeeze-and-excitation (SE) blocks, and 3D Convolutional Block Attention Modules (CBAM) with multi-scale feature fusion. It was trained on 921 Cone Beam-Computed Tomography (CBCT) scans, augmented to 11,973 maxillary defect pairs, using Dice loss and Adam optimisation with Automatic Mixed Precision, and benchmarked against UNet, UNETR, SegResNet, and SwinUNETR. MaxI-Net achieved the following: superior Dice Similarity Coefficient (DSC) = 0.778; 95th percentile Hausdorff Distance (HD95) = 3.453 mm; DSC Standard Deviation (SD) = 0.094; 95% confidence interval (CI) for mean DSC: 0.775–0.782). It was statistically validated against all competing architectures via pairwise Wilcoxon signed-rank tests, with significant DSC improvements confirmed across all comparators (p < 0.001) and rank-biserial effect sizes ranging from r = 0.250 against the closest competitor SegResNet* with high efficiency (0.06 s/volume; 9.6 min/epoch). Internal cavity filling of the generated implants was performed as a brief manual post-processing step in Autodesk Fusion 360 prior to biomechanical validation. Biomechanical validation using a finite element analysis (FEA) of polyether–ether–ketone (PEEK) implants (~26.53 g) showed 41% stress reduction under physiological loads (100–400 N), predicting a ~9.2-year lifespan. 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

Muscle oxygen nation impairment, defined as a mismatch between oxygen delivery, distribution, and oxidative utilization in active skeletal muscle, contributes to exercise intolerance and functional decline. Near-infrared spectroscopy (NIRS) has emerged as the leading non-invasive tool for monitoring local muscle oxygenation, but its clinical translation and optimal exercise-based management remain incompletely defined. This scoping review aimed to (1) synthesize the pathophysiology of muscle oxygenation impairment across the oxygen transport cascade, (2) evaluate NIRS-based diagnostic protocols, and (3) review exercise-based interventions targeting muscle oxygenation. The review followed PRISMA-ScR guidelines and was prospectively registered in OSF (DOI: 10.17605/OSF.IO/QW8R3) and PROSPERO (CRD420261365040). PubMed, Web of Science, Scopus, Cochrane CENTRAL, EMBASE, PEDro, and ClinicalTrials.gov were searched through to April 2026. Methodological quality was appraised using the PEDro scale, the Downs and Black checklist, and the Newcastle–Ottawa Scale. A total of 61 studies (2003–2025) were included, with fair-to-good methodological quality (PEDro 3–8, mean 5.3; Downs and Black 15–24, mean 18.6; Newcastle–Ottawa 5–8, mean 6.5). Regarding pathophysiology, muscle oxygenation impairment is a cascade-level phenomenon with four mechanistically distinct phenotypes corresponding to the dominant site of impairment, each with characteristic NIRS signatures. Regarding diagnostic assessment, NIRS has shown value in selected contexts including a validated threshold for peripheral artery disease, but most studies report group-level correlations without deriving receiver operating characteristic curves at validated thresholds, which together with device and calibration heterogeneity limits clinical translation. Regarding exercise-based interventions, adaptations align with the underlying cascade lesion, sprint and high-intensity interval training enhance oxidative capacity, while walking-based and vascular-targeted programs preferentially improve microvascular function. These findings support a unifying framework in which the site of cascade impairment guides diagnostic protocol selection and exercise prescription. The proposed cascade lesion phenotyping schema is hypothesis-generating and requires prospective validation. Full article

Background/Objectives: Regular physical exercise is strongly recommended for individuals with type 1 diabetes mellitus (T1DM) because of its beneficial effects on cardiovascular fitness, insulin sensitivity, metabolic control, and overall health. Nevertheless, participation in physical activity remains limited, largely due to the fear of exercise-induced hypoglycemia and glycemic instability. Glycemic responses to exercise in T1DM are influenced by the interaction between exercise modality, circulating insulin levels, nutritional status, and diabetes technologies. Continuous aerobic exercise, resistance training, high-intensity interval exercise, and mixed intermittent activities elicit distinct metabolic and hormonal responses, resulting in heterogeneous glycemic trajectories. This narrative review aimed to provide a clinically oriented synthesis of the physiological mechanisms underlying exercise-related glycemic fluctuations in T1DM and to discuss integrated insulin- and carbohydrate-based strategies to support safer participation in physical activity in the context of modern diabetes technologies. Methods: A structured narrative review was conducted using PubMed/MEDLINE, Scopus, and complementary searches in Google Scholar to identify experimental studies, observational studies, systematic reviews, consensus statements, and clinical guidelines focused on exercise-related glycemic responses in individuals with T1DM. Only articles published in English were considered. Evidence was selected and synthesized according to relevance to exercise modality, insulin therapy strategies, carbohydrate management, and diabetes technologies, including continuous glucose monitoring, continuous subcutaneous insulin infusion, and automated insulin delivery systems. The final narrative synthesis was based on 44 selected studies, reviews, consensus statements, and guidance documents considered most relevant to the objectives of this narrative review. Results: Available evidence indicates that continuous moderate-intensity aerobic exercise is most consistently associated with progressive glucose declines and increased risk of hypoglycemia, particularly when performed in the presence of elevated insulin on board. In contrast, resistance exercise and short-duration high-intensity or anaerobic exercise more frequently induce stable glycemia or transient hyperglycemia through adrenergic stimulation and increased hepatic glucose output. Mixed and intermittent exercise modalities often produce more variable responses depending on exercise sequencing, nutritional status, and insulin exposure. Across studies, integrated adjustment of basal and prandial insulin doses together with individualized carbohydrate supplementation emerged as the most effective strategy to reduce exercise-related glycemic instability. Continuous glucose monitoring and insulin pump technologies improved glucose trend awareness and management flexibility; however, physical exercise remains a challenging condition for current automated insulin delivery algorithms and still requires active user-driven decision-making. Conclusions: Exercise management in T1DM should be based on an individualized interpretation of exercise modality, glucose trends, insulin exposure, and nutritional context rather than on fixed glucose thresholds alone. Combining anticipatory insulin adjustments, tailored carbohydrate strategies, and appropriate use of diabetes technologies may substantially reduce glycemic variability and improve confidence toward physical activity participation. Structured education and individualized clinical guidance remain essential to translate physiological knowledge into effective real-world exercise management. Full article

Obesity is a significant risk factor for metabolic diseases and atherosclerotic cardiovascular disease (ASCVD). Exercise exerts beneficial effects partly through myokines secreted by skeletal muscle. This narrative review summarizes current evidence on exercise-induced myokines in obesity. We searched PubMed, Scopus, and Google Scholar up to Jan 2026 using keywords “myokines”, “obesity”, “resistance training”, “aerobic exercise”, and “HIIT”. We focused on six myokines (IL-6, irisin, FGF21, myostatin, apelin, and Metrnl) that are consistently linked to metabolic and cardiovascular health. Key findings are as follows: resistance training effectively increases irisin and decreases myostatin, promoting muscle mass and fat browning; high-intensity interval training (HIIT) induces rapid IL-6 peaks and elevates Metrnl, enhancing anti-inflammatory responses and cardiac function; aerobic exercise improves FGF21 sensitivity and supports long-term metabolic homeostasis. For clinicians and exercise practitioners, a preliminary exercise framework can be suggested based on available human evidence. In obese patients, ≥3 sessions per week of resistance training (60–80% of one-repetition maximum, 8–12 repetitions, 3–4 sets) may be considered to optimize irisin/myostatin balance, combined with ≥150 min per week of moderate-intensity aerobic exercise (50–70% of maximum heart rate) or 75 min per week of HIIT (85–95% of peak heart rate, 4 × 4 min intervals) to improve FGF21 sensitivity and Metrnl levels. These suggestions should be interpreted as hypothesis-generating rather than definitive clinical guidance, given the heterogeneity of included studies and the absence of quantitative synthesis. Nevertheless, they offer a molecular basis for hypothesis-driven precision exercise prescription that requires validation in future prospective studies and randomized controlled trials. Full article

Background: Evidence comparing high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) for obesity remains inconsistent, particularly with respect to cycling-based protocols. Therefore, this meta-analysis aimed to evaluate randomized controlled trials comparing bicycle-ergometer HIIT with cycling-based MICT in adults with overweight or obesity. Methods: PubMed, Scopus, Cochrane Library, and Google Scholar were searched from January 2015 to September 2025; Google Scholar was used as a supplementary source. Eligible studies included adults aged 18–60 years and compared cycling-based HIIT with MICT interventions conducted over a minimum duration of 5 weeks. The primary outcomes were changes in body mass and fat mass. Between-group standardized mean differences (SMDs) were pooled using random-effects models. Results: Nine RCTs involving 394 enrolled participants were included, although analyzable samples varied by outcome. No significant between-group difference was observed for body mass (SMD: 0.04; 95% CI: −0.19 to 0.27; p = 0.710; I² = 0%; τ² = 0.00) or fat mass (SMD: 0.01; 95% CI: −0.23 to 0.26; p = 0.810; I² = 0%; τ² = 0.00). The pooled effects were close to zero and should be interpreted as short-term findings because interventions lasted 5–12 weeks. Conclusion: Current evidence from randomized controlled trials does not demonstrate the superiority of either cycling-based HIIT or MICT for reducing body mass or fat mass in adults with overweight or obesity. These findings do not establish equivalence and should therefore be interpreted with caution, given the small sample sizes, short follow-up, limited dietary control, and possible measurement error in body-composition outcomes. 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

Crossfit^® is a high-intensity interval training modality that combines weightlifting, aerobic exercises, and gymnastics. Although it has gained widespread popularity, it also presents a considerable injury rate without clarity on the extent to which experience categories exhibit distinct temporal patterns. This study identifies the most common injuries and their progression across CrossFit^® categories over 12 months. We defined injury as any Crossfit-related event requiring healthcare consultation and interrupting an athlete’s activity. An observational, longitudinal study was conducted with 102 participants categorized into three groups (n = 34): beginner, scale, and rx. An adapted injury index questionnaire was applied, and descriptive statistics were performed. Results showed that the most frequent injuries affected the shoulder and knee, with variations across the different athlete categories. Beginners exhibited the highest injury rates: knee (56%) and shoulder (35%). The scale group presented a greater concentration of shoulder injuries, whereas rx demonstrated the lowest injury incidence overall. Over the 12-month follow-up, 135 injuries were reported at baseline, decreasing to 116 at six months and 101 at the final evaluation. Dropout rates were 35% among beginners, 12% in the scale group, and 0% in the rx group. Crossfit-related injuries primarily affect the shoulders and knees, with a higher incidence in beginners. Future studies should investigate movement technique, strength, mobility, and limb dominance considering the overhead demands and the associated injury risk, in addition studies should examine training programming too Full article

Exercise training improves maximum aerobic capacity, in part, through improvements in skeletal muscle function. This study aimed to investigate adaptations to improved aerobic capacity training through non-invasive and non-exhaustive tests of hyperemic muscle blood flow and near-infrared spectroscopy (NIRS) muscle oxygenation kinetics. An experimental study was conducted on 18 participants (age, 28.2 ± 5.3 yr; _absVO_2max, 3.60 ± 0.67 L·min⁻¹). Before and after the intervention of a 6-week of high-intensity interval training (HIIT), participants underwent three tests: (1) a graded cardiopulmonary exercise test; (2) a vascular occlusion test; and (3) a steady-state exercise (SSE) at 60% of PPO. Expired gas analysis, superficial femoral blood flow (occlusion test only) and SmO₂ kinetics were measured. The intervention increased maximal aerobic capacity _absVO_2max (p < 0.001, d = 0.65) and PPO (p < 0.001; d = 0.41). Moreover, steady-state _absVO₂ (p = 0.006; d = 0.37) and HR (p = 0.001; d = 0.65) were reduced. With the cuff test, the SmO₂ desaturation slope increased (p = 0.04; d = 0.52), while peak muscle blood flow (p = 0.02; d = 0.51) and the SmO₂ 10 s reoxygenation rate increased (p < 0.001 d = 1.11; 0.74 ± 0.28 to 1.17 ± 0.45%/s). During steady-state exercise, SmO₂ decreased less (p = 0.02; d = 0.43), and the 10s recovery kinetics rate was slowed (p = 0.01 d = 0.30; 0.28 ± 0.20 to 0.22 ± 0.21%/s). The improvement in VO_2max had a moderate correlation with the SmO₂ recovery rate post-steady-state exercise (p = 0.05, r = −0.54). HIIT changed maximal aerobic capacity alongside improvements in skeletal muscle hyperemic blood flow, SmO₂ post-occlusive reactive hyperemia and SmO₂ post-exercise recovery kinetics. Thus, the findings indicated that non-invasive and non-exhaustive hemodynamic kinetic profiles can monitor adaptations to improved aerobic capacity. Full article

Combined functional training (FT), high-intensity interval training (HIIT) and aquatic exercise may improve health-related fitness in aging populations; however, the influence of baseline adiposity on training responses remains unclear. This study evaluated the effects of a 12-week multicomponent training program on aerobic capacity, body composition, metabolic health, and physical performance in middle-aged and older women and explored whether baseline body fat percentage modulated these responses. Thirty-four women (50–72 years) were assigned to a control group (Ctrl, n = 10) or an exercise group, stratified into normal fat (NF%, n = 10) and high fat (HF%, n = 14). The intervention included three weekly 60 min sessions consisting of HIIT, FT, and aquatic-based interval and resistance exercises, while controls maintained their habitual lifestyle without structured exercise. Significant improvements were observed in VO₂max, skeletal muscle mass, fasting insulin, triglycerides, total cholesterol, HDL cholesterol, and functional performance. Baseline adiposity influenced metabolic adaptations, with greater improvements in the HF% group. These findings suggest that multicomponent training may improve cardiometabolic health and physical performance; however, the results should be interpreted cautiously due to the quasi-experimental design and small sample size. Full article

Background/Objectives: The gut microbiome is a critical regulator of host metabolism, immunity, and the gut–brain axis. Exercise is a promising non-pharmacological modulator of microbial ecology, yet human evidence remains heterogeneous and the translational gap persists. This narrative review synthesizes mechanisms, human and animal evidence, and future directions for the exercise–gut microbiome axis. Methods: PubMed, Scopus, Web of Science, and SID were searched for articles published between January 2000 and February 2025. Keywords included exercise, physical activity, gut microbiome, gut microbiota, short-chain fatty acids, and gut–muscle axis. From 218 initial records, 89 original studies (47 human, 42 animal) met inclusion criteria and were critically appraised. Results: Exercise modulates the gut microbiome via splanchnic hypoperfusion, hyperthermia, altered transit time, and immune-mediated barrier regulation. Moderate-intensity continuous training consistently increases alpha diversity and enriches butyrate-producing taxa (Faecalibacterium prausnitzii, Roseburia hominis) and mucin-degrading Akkermansia muciniphila. High-intensity interval training transiently increases intestinal permeability in untrained individuals but, following adaptation, stimulates butyrate production via lactate cross-feeding metabolism—a recent breakthrough. Effects are transient and reversible upon detraining. Animal models establish causality through fecal microbiota transplantation; human randomized controlled trials demonstrate modest, intensity-dependent, and highly individualistic responses. Emerging evidence supports the gut–muscle axis in sarcopenia and personalized exercise prescription guided by microbiome profiling. Conclusion: Exercise shows promise as a low-cost modulator of the gut microbiome for enriching health-associated taxa and improving metabolic outcomes. Definitive evidence linking exercise-induced microbial shifts to enhanced athletic performance in humans remains lacking. Future research requires diet-controlled randomized controlled trials with ≥12-week interventions, shotgun metagenomics, and mechanistic validation of the gut–muscle axis in humans. Full article