Search Results (874)

Background/Objectives: Weight loss and hypermetabolism are negative prognostic factors in amyotrophic lateral sclerosis (ALS). Ketone bodies (β-hydroxybutyrate, βHB) as high-energy substrates may compensate for this energy deficit, since a ketogenic diet (KD) has been shown to increase survival and stabilize body weight in the SOD1 mouse model. In this case series, we tested exogenous ketone salts (KS), ketone esters (KE), and a KD, in patients with ALS and in healthy subjects to identify novel therapeutic interventions for subsequent clinical studies. Methods: KS (KetoForce^® (KetoSports, Frisco, TX, USA)) were tested in healthy subjects (11.7 g and 15.6 g βHB) and patients (15.6 g βHB 3×/day over 3 days). KE (KE4^® (KetoneAid, Falls Church, VA, USA)) containing 10.0 g βHB were applied in healthy subjects (once) and in patients (3×/day over 2 days). For the KD, KetoCal^® 2.5:1 LQ MCT MF Vanilla (Nutricia, Frankfurt, Germany) was applied via percutaneous endoscopic gastrostomy over four weeks. Regular capillary βHB measurements were conducted, and adverse events were recorded. Results: Between January 2021 and March 2025, we treated nine patients with ALS and two healthy subjects at the Department of Neurology of Ulm University, Germany. KE and KS increased βHB temporarily. However, the elevation was more pronounced following KE (maximum 2.2–2.7 mmol/L vs. 0.8–1.2 mmol/L). The KD increased βHB levels continuously with nighttime fluctuations. No adverse events occurred under KE. KS caused diarrhea in 3/5 patients and 1/2 healthy subjects. The KD was well tolerated, with mild gastrointestinal symptoms occurring in all patients. Conclusions: All ketogenic approaches increased βHB blood levels. While the KD and KE provided good tolerability, KS caused significant gastrointestinal side effects. KD seems to be an interesting candidate for future clinical studies, as it prompted a long-term increase in βHB while providing satisfying tolerability. Since maintaining a KD long-term is difficult for oral-feeding patients, KE may constitute a feasible alternative. Full article

Background/Objectives: Traumatic brain injury (TBI) is increasingly understood as a chronic condition, but the role of early post-injury lifestyle behaviors in later cardiometabolic risk remains unclear. We examined whether lifestyle behaviors reported 1 year after injury were associated with the accumulation of common cardiometabolic risk factors by 5 years in the Traumatic Brain Injury Model Systems (TBIMS) National Database. Methods: This retrospective cohort secondary analysis included adults with followed 1-year and 5-year interviews, complete 1-year data on four behaviors, and the complete ascertainment of hypertension, diabetes or high blood sugar, and high cholesterol at both waves. The exposure was a favorable lifestyle count based on not smoking, non-heavy alcohol use, non-obese body mass index, and sports or exercise at least 10 times per month. The primary endpoint was the incident accumulation of at least two new common cardiometabolic conditions between years 1 and 5. The analytic cohort was an observed-data subset defined by follow-up retention, complete behavior data, paired outcome ascertainment, and baseline at-risk status rather than a random sample of all TBIMS participants. Results: Among 10,057 linked participants with followed interviews at both waves, 9593 were adults, 3182 had complete four-behavior exposure data, 689 had complete cardiometabolic ascertainment, and 581 formed the primary at-risk observed-data cohort. The primary endpoint occurred in 39 participants (6.7%). Each additional favorable behavior was associated with lower odds of the primary endpoint in the adjusted model (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.41–0.98; p = 0.040). The results were similar after adjustment for the 1-year Functional Independence Measure cognitive score and in Firth logistic regression. Because the final cohort was selected and the number of primary events was small, the estimates should be interpreted as exploratory and may not generalize to the broader TBI population. Conclusions: More favorable 1-year lifestyle profiles were associated with lower 5-year cardiometabolic risk factor accumulation after TBI. These findings support prevention-oriented follow-up but do not establish causality or validate a prognostic score. Full article

Background and Clinical Significance: This case highlights the management of chronic extensor carpi ulnaris (ECU) tenosynovitis in a patient exposed to non-traditional wrist-loading activities. Exercise therapy rehabilitation is well established in shoulder and knee tendinopathies, although it remains less well described for wrist tendinopathies beyond De Quervain’s disease. Moreover, the patient’s active engagement in non-traditional, wrist-intensive sports such as handstands, slacklining, and yoga may have contributed to the development and persistence of chronic extensor carpi ulnaris (ECU) tenosynovitis. Unlike more common ECU injuries observed in tennis or golf players, this case demonstrates how ECU tenosynovitis can develop in less conventional sports. It adds to the scientific literature by showing that chronic ECU tenosynovitis can be effectively managed through non-surgical rehabilitation tailored to the specific needs of the patient, in particular by using exercise therapy. Case Presentation: The patient presented with chronic left wrist pain, especially during ulnar deviation and resisted ECU testing, following two traumatic events. Examination revealed limited range of motion caused by pain, particularly in flexion, extension, and both ulnar and radial deviations. Ultrasound imaging confirmed ECU tenosynovitis with mild inflammation of other wrist tendons and a small synovial cyst on radio-scapho-lunate level. ECU stability during forearm rotation was confirmed both clinically and by ultrasound.  The diagnosis of chronic ECU tenosynovitis was managed conservatively with a targeted rehabilitation program focused on isometric strengthening and progressive resistance exercises. Over one month, the patient demonstrated marked improvement in wrist strength, pain reduction, and functional capacity, allowing for a gradual return to sporting activities. Conclusions: The main takeaway from this case is that chronic ECU tenosynovitis can be successfully managed through individualized, conservative treatment based on exercise therapy. Early intervention, patient adherence, and rehabilitation tailored to the athlete’s specific demands are crucial for recovery, even in chronic cases, without the need for surgical intervention. Full article

Objectives: To systematically synthesize existing evidence on functional biomechanical tests of the foot and ankle in physiotherapy and sports, focusing on their outcome measures, compatibility with wearable sensor technologies, and psychometric properties. Methods: We performed a systematic review (PRISMA-guided) of PubMed, Web of Science, PEDro, and SPORTDiscus from inception to December 2025. Eligible studies evaluated functional foot/ankle biomechanics in athletes, healthy adults, or adults with musculoskeletal foot/ankle conditions using wearable sensors (e.g., IMUs, wireless pressure insoles). Two reviewers independently screened, extracted data, and appraised methodological quality using the COSMIN Risk of Bias tool, applying property-specific ratings. Heterogeneity precluded meta-analysis; findings were narratively synthesized and tabulated. Results: Twenty full texts were reviewed; four studies (n = 83 participants) met the inclusion criteria. Wearable devices included foot- or trunk-mounted IMUs and wireless pressure insoles. Reported outcomes spanned temporal gait events and inner-stance phases, vertical ground reaction force (vGRF) and centre-of-pressure trajectories, running step rate/stride length, and jump counts in competition. Validity was most frequently assessed: foot-worn IMUs showed millisecond-level agreement with in-shoe pressure references for stance and inner-stance events; pressure insoles demonstrated acceptable agreement with force plates for vGRF/COP alongside fair-to-excellent test–retest reliability; foot- vs. shank-mounted IMUs provided strong agreement for running step rate and stride length; and competition-based jump detection using IMUs achieved high sensitivity. Across studies, reliability indices were inconsistently reported, measurement error (SEM/MDC) was sparse, and MCID was not reported. The COSMIN appraisal ranged from very good/adequate to inadequate, driven primarily by small sample sizes, non-gold-standard comparators, and incomplete psychometric reporting. Full article

This study aimed to evaluate the within-system agreement and interchangeability of real-time and post-processed external load metrics in elite football. Data were collected from 50 official Serie A matches using Dynamix (K-Sport World S.R.L., Pesaro, Italy), the platform for acquiring and standardizing tracking inputs. SmartLive, a real-time monitoring module embedded within Dynamix, was compared with post-processed data from the league-approved optical tracking provider (Hawk-Eye Innovations Limited, Basingstoke, UK) in Serie A. The external load metrics analyzed included total distance covered; distances at speeds exceeding 15, 20, and 25 km·h⁻¹; distances within the 15–20 km·h⁻¹ and 20–25 km·h⁻¹ ranges; distance covered during accelerations > 2 m·s⁻² and decelerations < −2 m·s⁻²; and peak speed. Intraclass correlation coefficients (ICCs) demonstrated excellent agreement across all metrics, with values ranging from 0.929 to 0.999. Bland–Altman analysis revealed small mean differences between systems, indicating strong agreement. Overall, the findings confirm that both real-time and post-processed data are in close agreement across a wide range of performance metrics. Minor discrepancies were observed in intermediate speed zones and acceleration/deceleration events. This study provides the first validation of SmartLive’s within-system agreement with post-processed data, supporting its use alongside post-processed data in elite football environments. Full article

The aim of the research was to assess how the selected factors could influence the performance of the best horses in dressage, jumping and eventing competitions. The research was based on the Studbook Rankings published by the World Breeding Federation for Sport Horses from 2019 to 2024. Our analysis shows a statistically significant effect of each of the observed factors in at least one discipline. The leading factor in all disciplines was studbook affiliation. The Belgian warmblood, German Sport Horse, Hanoverian, Royal Dutch Sport Horse, Oldenburg and Westphalian studbooks are represented among the significantly best studbooks in all three disciplines. Geldings were statistically highly demonstrably the best in jumping. In eventing, both geldings and stallions were highly significantly better than mares. Significantly, the highest performance was achieved by 11-year-old horses in jumping and by 15-year-old horses in eventing. We have demonstrated a statistical effect of the proportion of thoroughbred genes on performance in dressage. Statistically better performance in a selected elite population of dressage horses was achieved by horses with 20% to 50% thoroughbred genes. Our results confirm the necessity of selecting sport horses based on specialized performance tests and the need for different breeding programs for success in individual equestrian sports. Full article

On behalf of the Strength and Conditioning Society (SCS), we are pleased to present the abstracts submitted for the SCS 8th Annual Meeting. The event was held at the Norwegian School of Sport Sciences in Oslo, Norway, on 8–10 October 2025, and comprised several invited sessions held by international and national speakers on a variety of topics related to biochemistry and exercise physiology, strength and conditioning practices and their application to health, injury prevention, and sports performance. These included strength training in high-performance sports, sport science and training–competition load management in elite environments, biochemistry and exercise physiology and prescription, nutrition and biomechanics, among others. The conference also included practical workshops held by renowned academics and practitioners on eccentric training, change of direction ability, and strength and power training in professional team sports, combat sports, and ergospirometry and exercise prescription in specific populations. Finally, the event disseminated up-to-date strength and conditioning research by providing practitioners and researchers with the opportunity to present their most recent findings. All abstracts presented at the SCS 8th Annual Meeting can be found in this Conference Report. Full article

Background/Objectives: Knee osteoarthritis (OA) is a common degenerative joint disease for which conservative treatments often provide limited long-term benefit. Adipose-derived stromal cells delivered as stromal vascular fraction (SVF) represent a minimally invasive orthobiological approach with potential anti-inflammatory and regenerative effects. This study aimed to evaluate the clinical effectiveness and safety of intra-articular autologous SVF therapy and to explore patient- and treatment-related factors influencing outcomes over one year. Methods: This single-center retrospective study included 48 patients with knee OA Kellgren–Lawrence (KL) grade II–III treated with a single intra-articular injection of autologous SVF between June 2020 and February 2022. Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline and at 3 and 12 months post-treatment. Associations between clinical outcomes and age, sex, body mass index (BMI), OA grade, and administered cell dose were analyzed. Results: Significant improvements were observed in all KOOS domains at 3 months post-treatment (p < 0.001). At 12 months, improvements remained significant across domains, although Symptom scores showed slight attenuation. Higher administered cell dose was associated with greater improvement in KOOS Quality of Life (CFU-F indicators, r_s = 0.41–0.45, p < 0.01) and Sport and Recreation (TNC indicators, r_s = 0.36–0.38, p < 0.05) at 12 months, while younger age predicted greater QoL improvement and normal BMI was associated with better Symptom outcomes. Radiographic OA severity did not significantly influence treatment response, and sex-related differences were minimal. No serious adverse events were recorded. Discussion: SVF therapy was associated with sustained functional improvement and demonstrated a favorable safety profile in patients with moderate knee OA. Although demographic and treatment-related factors showed limited influence, cell dose, BMI, and age may affect selected outcomes. Prospective controlled studies with larger cohorts and longer follow-up are required to optimize patient selection and treatment protocols. Conclusions: These findings suggest that autologous SVF therapy may represent a safe and effective complementary treatment option for patients with moderate knee osteoarthritis seeking alternatives to more invasive interventions; however, these results should be confirmed in prospective controlled studies. Full article

The presence of wild species in urban areas is becoming increasingly common. In southern Spain, species such as wild boar cause significant damage and problems in human-dominated environments, such as peri-urban areas, sports facilities, and urban parks. Here, we used camera trapping to monitor the entry rates of ungulates (wild boar and red deer) into three golf courses located in urban areas in southern Spain. The courses are surrounded by hunting estates and other non-urban areas where species are controlled through lethal methods. Wild boars are controlled year-round, and red deer are controlled during specific hunting periods. We tested for differences during periods of normal human activity and periods of the COVID lockdown using generalised linear mixed models. We controlled ungulate raids for 2639 trapping nights, obtaining 1093 wild boar and 225 red deer independent events. During the COVID lockdown, wild boar raids on golf courses decreased significantly. Meanwhile, equivalent deer raids increased significantly during the hunting period. The results indicate that certain urban areas where control by firearms is not permitted—such as golf courses—can function as safe zones for wild species. This reserve effect is related to the structure of the urban habitat and the resources it offers in terms of security and food. Full article

Ventricular repolarization abnormalities are among the most frequent electrocardiographic findings in pediatric athletes undergoing cardiovascular screening, yet their clinical significance remains a major source of diagnostic uncertainty. While most of them represent benign expressions of training-induced cardiac remodeling and developmental maturation, selected patterns may constitute the earliest phenotypic manifestation of cardiomyopathies or primary electrical disease. Distinguishing physiological adaptation from early pathology is therefore essential to prevent both sudden cardiac events and unnecessary restrictions on sports participation. This review integrates contemporary international electrocardiographic interpretation criteria with emerging pediatric evidence to provide a clinically oriented framework for evaluation and risk stratification of ventricular repolarization abnormalities in pediatric athletes. Early repolarization and anterior T-wave inversion are commonly benign when occurring within recognized age- and ethnicity-specific patterns and in the absence of symptoms, concerning family history, or structural abnormalities. Conversely, lateral or inferolateral T-wave inversion, atypical ST-segment morphology, complex ventricular arrhythmias, and abnormal imaging findings represent red flags requiring comprehensive investigation, including multimodality imaging when indicated. Due to the dynamic electrophysiological evolution during adolescence, longitudinal reassessment is crucial. A structured, risk-based approach integrating electrocardiographic features, demographic/familial context, clinical evaluation, imaging findings, and follow-up provides a pragmatic strategy to optimize risk detection while safeguarding appropriate athletic participation in young athletes. Full article

The retrofitting of existing stadiums with retractable roof systems presents a complex interdisciplinary challenge, requiring the reconciliation of aged structural capacity with modern performance demands. This paper investigates the engineering design and analysis of a new retractable roof system for the Ningbo (Yinzhou) Tennis Center, a facility originally completed in 2007 and now requiring an upgrade to host higher-tier WTA 500 events. The retrofit is further complicated by increased seismic design requirements and the need to preserve the existing structure. To address these constraints, this study proposes a novel, structurally independent roof system comprising 12 radially deployable units supported by an external single-layer spatial grid and lambda-shaped columns. A multidisciplinary approach integrates structural engineering, mechanical systems, and architectural technology. Key innovations include (1) the selection and detailed modeling of a rack-and-pinion drive mechanism, with a floating engagement design to accommodate dynamic load transfer; (2) a two-stage analytical framework employing both sub-assembly and integrated assembly finite element models to capture the unique mechanical behavior and coupling effects between the new and existing structures; (3) the strategic implementation of circumferential hoop cables to counteract uplift forces and redirect the internal force distribution in the supporting bifurcated columns; and (4) the validation of structural integrity through comprehensive static, stability, and seismic gap analyses, informed by wind tunnel testing. The results demonstrate that the proposed system satisfies all strength, stiffness, and stability criteria under multiple operational states (open, closed, and transitional) and meets the enhanced seismic fortification standards. This research provides a validated theoretical foundation and practical implementation guidelines for this specific stadium retrofit, demonstrating a viable pathway for extending the service life of aging sports infrastructure, with insights that may inform similar urban renewal projects under comparable conditions. Full article

The aim of this study was to investigate older adults’ engagement in sport through the lens of the Positive Development in Sport (PDS), a framework aimed at fostering human growth in sport environments. This qualitative study involved 80 older athletes (M = 71.91 years, SD = 7.91; 45 women) engaged in regular sport practice and four experienced coaches (37–57-years-old). Data was collected across multiple contexts: brief in-person individual or small-group interviews during a competitive event; five in-person focus groups; and individual interviews. Data was analyzed using reflexive thematic analysis. Findings revealed a central theme, autonomy to engage in sport, supported by three subthemes: competence and confidence, health, and setting priorities. Participants described sport as a meaningful component of their identity, with sustained engagement driven by intrinsic motivation and harmonious passion. They reported increased self-awareness, intentional health management, and the ability to balance sport participation with other life domains, highlighting positive implications for mental health. Coaches who actively supported athletes’ psychological needs played a key role in fostering autonomy and personal development. Participants also emphasized the importance of inclusive relationships and pedagogical strategies tailored to older athletes’ goals and lived experiences. The findings suggest that sport in older adulthood can be a context for personal growth and mental health development. Full article

Background: Calcaneus secundarius (CS) is an accessory ossicle located at the anterior aspect of the calcaneus and is typically an incidental and asymptomatic radiographic finding. However, it may become symptomatic following trauma or repetitive mechanical stress and can mimic anterior calcaneal process fracture or tarsal coalition, leading to diagnostic confusion. The presence of multiple independent CS ossicles represents a rare morphological variant and a potential source of diagnostic ambiguity. Methods: We report the case of a 19-year-old male soldier who presented with progressive anterior foot pain following soccer activity without a clearly identifiable traumatic event. Radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) were performed to evaluate the underlying pathology. Results: CT demonstrated two separate, well-corticated accessory ossicles adjacent to the anterior calcaneal process without bony continuity. MRI revealed focal bone marrow edema (BME) at the calcaneus–ossicle interface, suggesting mechanical irritation at the fibrous connection. Due to persistent symptoms and concordant imaging findings, surgical excision was performed, resulting in immediate pain relief and return to full daily and sports activities without recurrence at the 1-year follow-up. Conclusions: Multiple CS ossicles may produce fragment-like imaging appearances and increase the risk of misdiagnosis. Recognition of characteristic imaging features, particularly well-corticated ossicles and focal BME at the ossicle–calcaneus interface, together with clinical correlation, is essential for accurate diagnosis and appropriate management in patients with persistent anterior foot pain. Full article

The aim of this study was to characterise the pedigree and genetic structure of Polish Sport Horses competing in Grand Prix show jumping events and to assess the implications for international sport horse breeding. Pedigrees of 513 horses were analysed, encompassing a total of 18,836 individuals over a maximum of 16 generations. The completeness and depth of the pedigrees allowed for a reliable estimation of inbreeding coefficients and genetic diversity. The mean inbreeding coefficient was low (0.645%), yet 82% of the horses exhibited some degree of inbreeding. The greatest loss of genetic variability was observed in non-founder generations, most likely due to the intensive use of a limited number of high-value stallions with domestic mares—a bottleneck effect. The most significant founders contributing to the population were the Thoroughbred stallions Ladykiller and Rantzau, as well as the Anglo-Arab stallion Ramzes, highlighting the international influence on the contemporary population. These findings emphasise the need for systematic monitoring of genetic diversity and the strategic use of pedigree data to minimise inbreeding and preserve the genetic potential of Polish Sport Horses for international breeding programmes. Full article

Major social, cultural, and sociopolitical events routinely disrupt daily life, yet their effects on sleep are rarely conceptualized at the population level beyond anecdotal sharing. The purpose of this Opinion piece is to initiate a preliminary discussion of “public sleep” as a novel construct describing systematic, event-related changes in sleep timing, duration, and quality that emerge coherently within communities in response to shared social experiences. Drawing on similarities with the well-established concept of public mood, we posit that sleep can be shaped by social environments in which shared attention, emotional climate, and coordinated schedules exert systematic influence. In support of this claim, we describe preliminary evidence from diverse domains demonstrating population-level sleep disruption following major events, including the transition to Daylight Saving Time, national elections, prolonged crises such as the COVID-19 pandemic and armed conflicts, and highly salient cultural activities such as major sporting events. These reports from disparate fields provide an initial indication that public sleep disruptions can be acute or prolonged, geographically localized or global, and may be shaped by the duration, emotional intensity, and perceived importance of the associated event. We further highlight the potential public health, safety, social, and economic consequences of collective sleep loss, underscoring its relevance beyond individual well-being. Finally, we outline key directions for future research, emphasizing the need for systematic reviews, mechanistic studies, longitudinal designs, and policy-relevant recommendations. Recognizing public sleep as a measurable population phenomenon would provide a foundation for anticipating, monitoring, and mitigating sleep disruption during periods of collective strain, with implications for both individual health and societal resilience. Full article