Search Results (224)

Objectives: This study investigated the acute effects of pre-exercise cold-water immersion (CWI) on performance, muscle oxygen saturation, and mechanical muscle tension during calf raise training. Method: Twenty-four trained individuals (5 females, 19 males) were randomly assigned to either a CWI group (5 min at 10 ± 1 °C) or a non-CWI group (no intervention). Both groups performed three sets of standing calf raises to failure using a standardized protocol. Load lifted, repetitions, and rate of perceived exertion (RPE) were recorded. Muscle oxygenation (SmO₂, total hemoglobin) and mechanical muscle properties (frequency and stiffness) were measured before and after each set. Results: The CWI group showed a significantly greater increase in barbell load from set 1 to set 2 compared to the non-CWI group (from 94.5 ± 18.1 kg to 98.0 ± 18.7 kg, p < 0.01). Repetitions decreased and RPE increased across sets in both groups. The non-CWI group exhibited earlier increases in muscle stiffness and frequency, whereas these responses were delayed in the CWI group. Gastrocnemius SmO₂ increased during the protocol in the non-CWI group only. Total hemoglobin change was greater in the CWI group in set 1. Conclusions: These findings suggest that pre-exercise CWI may acutely enhance performance and delay neuromuscular fatigue without negatively affecting perceived effort. Full article

Background/objectives: Multiple systemic treatments are available for metastatic castration-resistant prostate cancer (mCRPC), with unclear safety profiles. This study seeks to describe the safety determined in randomized clinical trials of a systemic treatment for mCRPC and whether safety differs by age. Methods: We utilized individual patient data from industry-funded phase 2/3 trials in mCRPC on abiraterone acetate (AA). Vivli, a clinical trial repository site, was used. One investigator independently performed screening. Relative effects of treatment were assessed with frequencies and odds of serious adverse events (SAEs). The Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was used. Subgroup analysis measured odds of SAEs as modified by age. Results: We identified 14 trials with 4296 patients. The median age of participants was 69 years. Nearly all participants experienced at least one adverse event (98.4% abiraterone, 97.3% standard of care [SOC]). More serious adverse events (grade 3 or 4) and deaths (grade 5) occurred in those receiving SOC (71.8%) compared to abiraterone (64.1%). The most frequent adverse event category was “Musculoskeletal and Connective Tissue Disorders”. The most frequent event types included anemia, back pain, hypertension, fatigue, hypokalemia, and bone pain. The odds of all events were lower in those receiving abiraterone compared to SOC. Odds of a serious musculoskeletal event were lower in older subjects by 22% (OR 0.78; 95% CI 0.63, 0.96). Conclusions: In this IPD meta-analysis, abiraterone acetate provides no greater risk of SAE in those receiving abiraterone than those receiving SOCs. Patients in the RCTs are younger and healthier than those in the general population; consequently, the results of RCTS might not be applied to the general population, especially those under-represented in the RCTs. There is a need to further evaluate abiraterone-related fractures and neuromuscular toxicities (NMTs) as key outcomes to gain insight into risk factors related to these adverse events. A real-world prospective study is warranted to examine the overall risks and benefits associated with treatment. Full article

Padel is a doubles racket sport played on an enclosed court, characterised by intermittent high-intensity efforts, frequent directional changes, and short recovery periods. This study aimed to analyse the evolution of physiological responses and neuromuscular fatigue in amateur padel players according to playing position (Right Side [RS] vs. Left Side [LS]) and match outcome (Win or Lose). A total of 52 padel players (35.6 ± 11.6 years) participated, competing in 13 matches. The mean match duration was 57.2 ± 15.7 min, with an average of 152.0 ± 40.4 points per match. Physiological variables were recorded during each set, and neuromuscular variables (countermovement jump [CMJ] and handgrip strength) were assessed before the match and after each set. No significant differences in physiological load were found between winners and losers or between RS and LS positions. However, differences in handgrip strength were observed at T1 (p < 0.05, d = −0.72) and T2 (p < 0.05, d = −0.59) (post-set testing), with LS players showing higher grip strength. Regarding the progression of physiological responses across the different sets, a progressive increase in cardiovascular load was observed within each subgroup, with significant differences across sets (set 1, set 2, and set 3) in several variables, including HR_peak, HR_avg, zone 1, zone 2, zone 3, and TRIMP_Edwards. No performance decline was observed in CMJ or handgrip strength in any of the groups analysed. These findings suggest that physiological responses increase throughout a match, particularly in the final sets, but no signs of neuromuscular fatigue (CMJ and handgrip) were observed, regardless of match outcome or playing position. These results highlight the need to include high-intensity scenarios and role-specific strategies in training to address the progressive physiological demands and positional differences in match play. Full article

Background: Training planning in military environments is complex due to diverse operational demands and constant exposure to stressors. When combined with high training volumes and insufficient recovery, this can result in physical and mental overload. Regular assessments are crucial to monitor the condition of personnel and adjust training accordingly, though more research is needed to effectively track performance in real operational settings. Objectives: This study aims to monitor neuromuscular and psychological performance in relation to training load in a military school, addressing the research gap in tracking performance in operational settings. Methods: Overall, 27 marines (age: 27.9 ± 4.8 years; height: 178.1 ± 6.3 cm; weight: 79.1 ± 7.8 kg) were monitored over a 13-week academic-military training period to assess neuromuscular performance and psychological fatigue. Results: Laboratory tests included the countermovement jump (p = 0.002), isometric mid-thigh pull (p = 0.001), and handgrip strength for both dominant (p = 0.947) and non-dominant hands (p = 0.665). Field tests involved maximum pull-ups (p = 0.015), push-ups (p = 0.001), and the medicine ball throw (p = 0.334). Psychological evaluation via the POMS questionnaire showed the highest negative mood scores in Tension–Anxiety, Depression–Melancholia, and Fatigue–Inertia, while Vigor–Activity was the highest positive state. RESTQ-Sport results indicated total recovery was 68.9% greater than total stress. Conclusions: Despite improvements in some field tests, no significant neuromuscular gains were observed, likely due to excessive training loads, limited recovery, and sustained stress. Full article

Fatigue in elite soccer is a multifaceted phenomenon involving physical, metabolic, psychological, and neuromuscular stressors that accumulate over training and competition. Traditional monitoring tools, while informative, are often invasive, impractical during play, or fail to provide real-time insights. This narrative review synthesizes sweat-based biomarkers linked to fatigue in elite soccer, with a focus on multi-modal domains (neuromuscular, metabolic, inflammatory, psychological). Using an integrative approach, we reviewed studies published across databases including PubMed, Scopus, and Web of Science that evaluate sweat biomarkers of different types of fatigue in soccer. We identified key candidates—lactate, sodium, cortisol, IL-6, and hypoxanthine—and evaluated their potential in non-invasive monitoring. Youth-specific and female populations remain underrepresented. We also assessed each biomarker’s technological maturity using a sweat-specific Technology Readiness Level (TRL) framework. Based on these findings, we propose a translational framework for practitioners and outline priorities for future research and validation in real-world sport settings. Full article

Background: Functional massage is a soft tissue intervention that combines tissue compression with specific joint movements to enhance muscle function, improve joint mobility and reduce pain. The physical working capacity at the fatigue threshold (PWC_FT) uses surface electromyography to determine the highest exercise intensity that can be sustained indefinitely. The purpose of this study, therefore, was to examine the influence of FM on a multi-joint exercise such as cycle ergometry. Methods: Twelve healthy college-aged men volunteered for the current study. On two occasions, separated by seven days and in randomized order, subjects either completed a 14 min FM on both legs prior to an incremental cycle ergometer test to determine PWC_FT, or rested for 14 min before performing the same cycling test. Results: The paired samples t-tests revealed a significant (p < 0.05) difference for the absolute and relative PWC_FT values between the no-FM and FM conditions. Conclusions: These results indicate that FM may delay the onset of neuromuscular fatigue for whole-body exercise. Full article

Background. Myasthenia gravis is an autoimmune neuromuscular disease characterized by fatigue of striated muscles due to impaired neuromuscular transmission. Mitochondrial dysfunction, according to published data, contributes significantly to metabolic abnormalities, oxidative stress and, as a consequence, the persistence of inflammation. MicroRNAs, which are post-transcriptional regulators of expression, are able to contribute to the aberrant functioning of mitochondria. In this study, with the aim of searching for biomarkers at the level of circulating microRNAs and proteins, the expression of three microRNAs was analyzed and the concentration of mitochondrial proteins was measured in the blood plasma of patients with myasthenia gravis (n = 49) in comparison with healthy volunteers (n = 31). Methods. Expression analysis was performed by RT-PCR, mathematical data processing was carried out using the Livak method, and protein concentration was determined by enzyme immunoassay. Results. Our plasma expression analysis revealed a statistically significant increase in hsa-miR-194-5p expression (Log10 Fold Change = 1.46, p-value < 0.0001) and a statistically significant decrease in hsa-miR-148a-3p expression (Log10 Fold Change = −0.65, p-value = 0.02). A statistically significant decrease in plasma COQ10A concentration was also found (0.911 [0.439; 1.608] versus 1.815 [1.033; 2.916] for myasthenia gravis and controls, respectively, p-value = 0.01). Conclusion. Our data suggest hsa-miR-148a-3p and hsa-miR-194-5p, as well as COQ10A, as potential biomarkers of mitochondrial dysfunction in myasthenia gravis. Full article

This study aimed to investigate the effects of mental fatigue on physical and cognitive performance (lower-limb power, isometric and handgrip strength, and psychomotor vigilance). Twenty-two physically active young adults (12 males, 10 females; M_age = 20.82 ± 1.47) were randomly assigned to either a Mental Fatigue (MF) or Control group (CON). The MF group showed a statistically significant (p = 0.019) reduction in non-dominant handgrip strength, declining by approximately 2.3 kg (about 5%), while no such change was observed in the CON group or in dominant handgrip strength across groups. Reaction time (RT) was significantly impaired following the mental fatigue protocol: RT increased by 117.82 ms, representing an approximate 46% longer response time in the MF group (p < 0.001), whereas the CON group showed a smaller, non-significant increase of 32.82 ms (~12% longer). No significant differences were found in squat jump performance, indicating that lower-limb explosive power may be less affected by acute mental fatigue. These findings demonstrate that mental fatigue selectively impairs fine motor strength and cognitive processing speed, particularly reaction time, while gross motor power remains resilient. Understanding these effects is critical for optimizing performance in contexts requiring fine motor control and sustained attention under cognitive load. Full article

(1) Background: Fatigue impacts neuromuscular performance, especially in endurance sports like rowing. The aim is to explore how continuous workload affects explosiveness and fatigue progression. This study examines acute fatigue during repeated race events by assessing vertical jump height, force output, and subjective fatigue over three consecutive days at the 2024 Hungarian National Rowing Championships. (2) Methods: Nine rowers (five women, four men; mean age 20.17 ± 1.73 years) competed in multiple 2000 m races over three days. Lower limb explosiveness was measured via countermovement jump (CMJ) using a Kistler force plate, pre- and post-race. Heart rate data were recorded with Polar Team Pro^®. Subjective fatigue was assessed using the ‘Daily Wellness Questionnaire’. (3) Results: We found a significant difference in the pattern of the medians of the force exerted by males during the jump between the results of the Thursday preliminaries (ThuQ_Me = 13.3) and the second final (ThuF2_Me = −75.5). Women showed no notable changes. (4) Conclusion: Repeated high-intensity races induce neuromuscular fatigue in men, reflected in reduced explosiveness and increased subjective fatigue. Future research should incorporate biochemical markers to deepen the understanding of fatigue mechanisms. Full article

Background/Objectives: Sudden cardiac arrest (SCA) is a major global health concern with high mortality despite advances in resuscitation techniques. Achieving return of spontaneous circulation (ROSC) represents merely the initial step in the extensive rehabilitation journey. This review highlights the critical role of structured, multidisciplinary rehabilitation following ROSC, emphasizing the necessity of integrated physiotherapy, neurocognitive therapy, and psychosocial support to enhance quality of life and societal reintegration in survivors. Methods: This narrative review analyzed peer-reviewed literature from 2020–2025, sourced from databases such as PubMed, Scopus, Web of Science, and Google Scholar. Emphasis was on clinical trials, expert guidelines (e.g., European Resuscitation Council 2021, American Heart Association 2020), and high-impact journals, with systematic thematic analysis across rehabilitation phases. Results: The review confirms rehabilitation as essential in addressing Intensive Care Unit–acquired weakness, cognitive impairment, and post-intensive care syndrome. Early rehabilitation (0–7 days post-ROSC), focusing on parameter-guided mobilization and cognitive stimulation, significantly improves functional outcomes. Structured interdisciplinary interventions encompassing cardiopulmonary, neuromuscular, and cognitive domains effectively mitigate long-term disability, facilitating return to daily activities and employment. However, access disparities and insufficient randomized controlled trials limit evidence-based standardization. Discussion: Optimal recovery after SCA necessitates early and continuous interdisciplinary engagement, tailored to individual physiological and cognitive profiles. Persistent cognitive fatigue, executive dysfunction, and emotional instability remain significant barriers, underscoring the need for holistic and sustained rehabilitative approaches. Conclusions: Comprehensive, individualized rehabilitation following cardiac arrest is not supplementary but fundamental to meaningful recovery. Emphasizing early mobilization, neurocognitive therapy, family involvement, and structured social reintegration pathways is crucial. Addressing healthcare disparities and investing in rigorous randomized trials are imperative to achieving standardized, equitable, and outcome-oriented rehabilitation services globally. Full article

Background: Repeated high-intensity intervals under normoxic (NOR) and hypoxic (HYP) conditions is a training strategy used by athletes. Although different protocols have been used, the effect of longer recovery between repetitions is unclear. In addition, information on the effect of repeated high-intensity intervals on HYP in women is scarce. Aims: To analyse the differences between sexes and between conditions (NOR and HYP) in Repeated Wingate (RW) performance and neuromuscular fatigue in triathletes. Methods: A total of 12 triathletes (men: n = 7, 23.00 ± 4.04 years; women: n = 5, 20.40 ± 3.91) participated in this randomised, blinded, crossover study. In two separate sessions over seven days, participants performed 3 × 30” all out with 7′ of recovery in randomised NOR (fraction of inspired oxygen: ≈20%; ≈300 m altitude) and HYP (fraction of inspired oxygen: ≈15.5%; ≈2500 m altitude) conditions. Before and after RW, vertical jump tests were performed to assess neuromuscular fatigue. Oxygen saturation, power, perceived exertion, muscle soreness and heart rate parameters were assessed. Results: Significant differences were reported between sexes in the parameters of vertical jump, oxygen saturation, RW performance and heart rate (p < 0.05). However, between conditions (NOR and HYP), only differences in oxygen saturation were reported (p < 0.05). No significant differences were reported between conditions (NOR and HYP) in RW performance, neuromuscular fatigue, muscle soreness and perception of exertion. Conclusions: A 3 × 30” RW protocol with 7′ recovery in HYP could have no negative consequences on performance, neuromuscular fatigue and perception of exertion in triathletes compared to NOR, independently of sex. Full article

Objective: This study aimed to investigate the efficacy of far-infrared (FIR) garments in enhancing recovery following resistance exercise in recreationally active individuals. Methods: Ten recreationally active adults (six females, four males; aged 20.7 ± 3.2 years) completed a resistance exercise protocol and were randomly selected to wear either FIR (n = 5) or placebo (n = 5) tights post-exercise. The FIR garments incorporated Celliant-based fibers emitting wavelengths in the 2.5–20 µm range. The participants’ recovery was assessed using countermovement jump (CMJ) metrics, including their jump height, takeoff velocity, and modified reactive strength index (mRSI), along with their fatigue biomarkers and subjective recovery perceptions. The CMJ performance was tested immediately post-exercise and at 24 and 48 h. Results: The FIR garments led to significant improvements in neuromuscular recovery, with greater increases in the jump height, takeoff velocity, and mRSI observed at 48 h post-exercise (p < 0.05). Notably, the mRSI showed earlier improvements at 24 h. The fatigue biomarkers did not differ between the groups (p > 0.05), suggesting localized rather than systemic recovery effects. The participants in the FIR group reported faster subjective recovery, with a readiness to resume activity perceived within 48 h, compared to slower recovery in the placebo group. Conclusions: FIR garments may enhance neuromuscular recovery and subjective recovery perceptions following resistance exercise, likely by improving the peripheral blood flow, metabolic clearance, and tissue oxygenation. These findings suggest that FIR garments may be effective in enhancing both neuromuscular and perceived recovery following resistance exercise, supporting their potential use as a post-exercise recovery tool. Full article

Whether pattern or amount of daily activity determines neuromuscular properties is the focus of this review. The fast-to-slow conversion of many properties of fast-twitch muscles, by stimulating their nerves electrically with the continuous low-frequency pattern typical of slow motoneurons, argued that muscle properties are determined by their pattern of activity. However, the composition of the motor units (MUs) in almost all muscles is heterogeneous, with the MUs grouped into slow, fast-fatigue-resistant and fast-fatigable types that match corresponding histochemical fiber types. Nonetheless, their contractile forces lie on a continuum, with MUs recruited into activity in order of their size. This ‘size principle’ of MU organization and function applies in normally innervated and reinnervated muscles and, importantly, begs the question of whether it is the amount rather than the pattern of the MU activation that determines their properties. Experimental evidence that uniform daily amounts of ~<0.5, 5%, and 50% ES, converted motoneuron, nerve, and muscle properties to one physiological and histochemical type, argued in favor of the amount of activity determining MU properties. Yet, that the properties were not confined to the expected narrow range argued that factors other than the pattern and/or amount of neuromuscular activity must be considered. These include the progressive increase in the synaptic inputs onto motoneurons. The range of the effects of endurance and intermittent exercise programs on healthy subjects and those suffering nerve injuries and disease is also consistent with the argument that factors other than pattern or amount of neuromuscular activity should be investigated. Full article

Objectives: The objective of this study was to examine the neuromuscular fatigue response to playing in a singles pickleball tournament, as measured by performance on a countermovement jump test (CMJ). We hypothesized that players would exhibit neuromuscular fatigue after the tournament. Methods: Six adult pickleball players (five male and one female, M ± SD: 40.2 ± 10.1 years old, height = 178.7 ± 12.3 cm, body mass = 85.4 ± 16.7 kg) participated in a 15 game singles pickleball tournament. Prior to the tournament, everyone completed the CMJ to assess lower body strength and power on paired Hawkin Dynamics force plates. After the tournament, players repeated the CMJ. Mixed-effects regression modeling was used to examine changes in key outcomes measured from the CMJ. Results: All nine outcomes from the CMJ significantly changed from pre to post-tournament (e.g., means for net impulse increased from 2.32 ± 0.22 to 2.40 ± 0.18 N·s, p = 0.0006; RSImod increased from 0.28 ± 0.07 to 0.33 ± 0.05, p = 0.0001, and propulsive peak power increased from 41.79 ± 6.14 to 44.34 ± 4.70 W/kg, p < 0.0001). All the changes demonstrated improved performance in the CMJ test. Seven out of the nine outcomes demonstrated a large effect size by the partial-eta square statistic, with η²-partial of 0.153–0.487, and three key outcomes (RSImod, propulsive peak power, and propulsive mean power) also demonstrated large effect sizes by the F² statistic (F² of 0.4603–0.9495). Conclusions: Contrary to our hypothesis, participants did not demonstrate significant neuromuscular fatigue. In contrast, they showed significant improvements in CMJ performance. It is possible that adequate rest between games prevented neuromuscular fatigue; alternately, singles pickleball may not provide enough stimulus in the lower body musculature to induce neuromuscular fatigue. Full article