Search Results (1,092)

Background/Objectives: Knee injuries and overuse-related disorders are common among athletes participating in jumping sports such as handball and basketball. Musculoskeletal ultrasonography is increasingly used for the assessment of knee pathology; however, evidence regarding the prevalence and clinical relevance of ultrasonographic abnormalities in young athletes remains limited. The aim of this study was to investigate the prevalence of ultrasonographic knee abnormalities in young male handball and basketball athletes and to examine their association with pain intensity. Methods: A cross-sectional observational study was conducted between June 2025 and June 2026 and included 69 competitive male athletes (35 handball players and 34 basketball players). All participants underwent bilateral knee ultrasonographic examination using a standardized assessment protocol and completed a questionnaire regarding demographic and training characteristics. Knee pain intensity was evaluated using the Visual Analogue Scale (VAS). Comparisons between sports were performed using χ² and t-tests, while associations between participant-level ultrasonographic findings and pain were evaluated using independent-samples t-tests (or Mann–Whitney U tests, as appropriate), with Cohen’s d effect sizes and exploratory multivariable linear regression. Sensitivity analyses stratified by sport were additionally performed. Results: Patellar tendinopathy was the most prevalent ultrasonographic abnormality (21.0%), followed by medial meniscal abnormality (15.9%) and infrapatellar bursitis (13.0%). Athletes with patellar tendinopathy, medial meniscal abnormality, or infrapatellar bursitis had significantly higher VAS pain scores than athletes without the corresponding ultrasonographic abnormality. Patellar tendinopathy demonstrated the strongest association with participant-reported pain (VAS: 4.1 ± 1.3; Cohen’s d = 1.24; p < 0.001). Handball athletes exhibited a significantly higher prevalence of patellar tendinopathy than basketball athletes (34.3% vs. 11.8%; OR = 3.90, 95% CI: 1.09–13.95; p = 0.027). In multivariable regression analysis adjusted for age, BMI, sport type, previous knee injury, and weekly training volume, patellar tendinopathy (β = 1.34, p < 0.001), medial meniscal abnormality (β = 0.70, p = 0.017), and infrapatellar bursitis (β = 0.54, p = 0.046) remained independently associated with higher pain scores. The regression model explained 39% of the variance in VAS pain scores (R² = 0.39). Conclusions: Ultrasonographic knee abnormalities are common among young male handball and basketball athletes and are significantly associated with pain intensity. Because ultrasonography has limited ability to characterize intra-articular pathology, particularly the menisci, the ultrasonographic abnormalities identified in this study should not be interpreted as definitive diagnoses, and MRI remains the reference imaging modality when comprehensive evaluation of intra-articular pathology is clinically indicated. Patellar tendinopathy was the most prevalent ultrasonographic abnormality and was most strongly associated with pain intensity. These findings support the use of musculoskeletal ultrasonography as a complementary imaging modality alongside clinical assessment in the evaluation of symptomatic athletes. However, prospective longitudinal studies are required to determine whether these ultrasonographic abnormalities have prognostic value for future pain, functional limitation, or time-loss injury. Full article

Ice hockey represents a sport with predominantly anaerobic efforts best reflected by repeated sprint ability (RSA) testing (5 × 5 s with 10 s recovery). A controversy persists about the usefulness of VO₂max laboratory testing for the assessment of ice hockey players. The purpose of this study was to evaluate the relationship between laboratory-measured VO_2max and RSA simulated on a supine ergometer and tested on ice. Elite male hockey players (n = 64) were tested in the laboratory (VO_2max and RSA). RSA testing was performed by a modified Wingate test (5 × 5 s sprints with 10 s recovery). In 28 athletes RSA was assessed during on-ice testing (five maximal skating sprints between the goal and the blue line). The decrease in performance was assessed by fatigue indices. In the laboratory setting, VO₂max correlated significantly with maximum workloads of the second, third, fourth and fifth bouts with increasing correlation strength (r = 0.26, p = 0.02; r = 0.48, p < 0.001; r = 0.57, p < 0.001; and r = 0.60, p < 0.001) and with fatigue indices—the percentage workload decrement index (r = 0.44, p < 0.001) and percentage maximum average workload decrement (%) (r = 0.38, p = 0.002). In addition, VO₂max correlated with lactate levels after 10 min of recovery (r = 0.31, p = 0.01). There was no correlation between VO₂max and on-ice testing results. Moreover, the results of RSA measured in the laboratory and on ice did not show any correlation. The lack of relationship between laboratory and on-ice testing further challenges the usefulness of bicycle ergometry laboratory testing in ice hockey. Full article

Background: Continuous-flow left ventricular assist devices (LVADs) and heart transplantation (HTX) improve survival and quality of life in advanced heart failure. However, restoration of central hemodynamics does not consistently normalize exercise capacity, physical performance, or body composition. Persistent skeletal muscle dysfunction, endothelial abnormalities, metabolic disturbances, and adverse body composition changes frequently limit functional recovery. Methods: This narrative review examines determinants of rehabilitation outcomes across the transition from advanced heart failure to LVAD support and subsequent HTX. Particular emphasis is placed on restoration of pulsatile circulation, vascular and microcirculatory adaptation, immunosuppressive therapy, body composition remodeling, and emerging immunometabolic mechanisms. Results: Rehabilitation outcomes appear to be increasingly determined by peripheral rather than central cardiovascular factors. Continuous-flow LVAD support induces vascular, endothelial, autonomic, and microcirculatory adaptations that may persist after transplantation. Although HTX restores physiological pulsatile circulation and cardiac output, recovery is often limited by skeletal muscle dysfunction, impaired mitochondrial capacity, chronotropic abnormalities, and adverse body composition changes. Immunosuppressive therapies further influence muscle plasticity, adipose tissue distribution, insulin sensitivity, endothelial function, and exercise adaptation, contributing to phenotypes such as sarcopenia, myosteatosis, and sarcopenic obesity. Conclusions: Functional recovery after LVAD support and HTX is a multidimensional process extending beyond restoration of cardiac function. We propose a hemodynamic–immunometabolic framework in which vascular adaptation, skeletal muscle biology, body composition remodeling, and immunosuppressive therapy interact to determine rehabilitation success and may inform personalized rehabilitation strategies. Full article

Background: Normalized strength outcomes and limb symmetry indices (LSIs) are widely used but poorly characterized across testing conditions, and it is unclear if these vary by sex. This study aimed, first, to investigate sex-related differences in normalized knee flexor strength and LSI values across multiple strength-testing conditions in healthy recreational athletes, and, second, to descriptively examine associations among strength outcomes obtained under different testing conditions within female and male participants. Methods: In this cross-sectional study, 52 healthy, recreationally active adults (26 females and 26 males) underwent bilateral knee flexor strength testing using three force plate-based isometric assessments, one static dynamometer-based isometric assessment, and three isokinetic dynamometer-based assessments. Differences were analyzed with a mixed analysis of variance (ANOVA), and associations were assessed using Pearson correlations. Results: Males showed higher normalized knee flexor strength than females across all testing conditions (main effect of sex: p < 0.001; partial η² = 0.334–0.371), with the magnitude of these sex-related differences varying across testing conditions (sex-by-testing condition interaction: p < 0.001; partial η² = 0.215–0.230). LSI values did not differ by sex (p = 0.896) and remained consistent across testing conditions (p = 0.385). Correlations were generally stronger within force plate-based and isokinetic dynamometer-based assessments (r = 0.528–0.922) than between different testing conditions. Conclusions: Sex-related differences were observed for normalized knee flexor strength but not for LSI values. Strength outcomes obtained under different testing conditions should not be considered directly interchangeable. Full article

Obesity and metabolic dysregulation are closely associated with chronic low-grade inflammation, in which interleukin-6 (IL-6) plays a key regulatory role. Genetic variation in the IL-6 gene may influence inflammatory responses and metabolic homeostasis. To identify single-nucleotide variants (SNVs) in the IL-6 gene in a cohort of Colombian high-performance athletes and to evaluate their potential functional and structural consequences using bioinformatic prediction and protein-modeling approaches. A descriptive observational study was conducted in a cohort of 23 high-performance Colombian athletes from Valle del Cauca representing cycling, karate, and weightlifting disciplines. Genomic Deoxyribonucleic Acid (DNA) extracted from peripheral blood samples was analyzed using Next-Generation Sequencing (NGS). Identified variants were evaluated using several in silico prediction tools, including Basic Local Alignment Search Tool (BLAST version 2.16.0), Expert Protein Analysis System (ExPASy version 4.0), Open Reading Frame Finder (ORFfinder version 0.4.3), and population databases such as Genome Aggregation Database (gnomAD version 4.0). Structural modeling was used to explore the potential impact of amino-acid substitutions on IL-6 protein stability. Eight single-nucleotide variants were identified in the IL-6 gene. Among them, the rs1524107 variant generated a missense substitution predicted to modify the amino-acid sequence of the IL-6 protein. Structural modeling suggested a potential alteration in protein stability associated with this variant. The rs1524107 variant may influence IL-6 protein structure according to computational predictions. These findings provide preliminary hypothesis-generating evidence regarding the potential role of IL-6 genetic variation in inflammatory regulation; however, functional validation and larger cohort studies are required to determine their biological significance. Full article

This review examined study characteristics and common practices in continuous glucose monitoring (CGM)-based exercise studies. Following PRISMA guidelines, a systematic search in the PubMed database was conducted. Data were extracted from 93 publications. A minority of studies (12.9%) focused on CGM system validation. Acute exercise studies were more common (87.1%) than chronic exercise studies (12.9%). Randomized crossover designs predominated (71.0%). Participant populations varied and included 46.2% non-diabetic individuals (7.5% athletes), 36.6% individuals with type 1 diabetes mellitus, and 17.2% individuals with type 2. The upper arm was the most common sensor placement site (41.9%), although nearly one-third of studies did not report placement details. Devices were primarily from Abbott (40.9%), Medtronic (36.6%), and Dexcom (26.9%). Sample sizes were typically small, with 40.9% of studies including 10–14 participants. Reporting practices frequently deviated from the International Consensus Statement on CGM Metrics for Clinical Trials. Many studies used modified or non-standard metrics, whereas “mean sensor glucose” was reported in compliance with consensus recommendations in 58.1% of studies. Regarding data completeness, “data gaps” was the most frequently reported consensus-compliant metric (43.0%). In validation studies, accuracy metrics predominated, with “absolute relative difference” representing the most common outcome (87.5%). Overall, substantial heterogeneity limits comparability across studies, highlighting the need for standardized CGM reporting. Full article

The “athlete’s heart” represents a physiological condition consequent to long-term adaptation to sport-specific training loads. Cardiac imaging is a pivotal tool in the assessment of athletes. The study of the autonomic nervous system (ANS) using heart rate variability is becoming increasingly popular in sports fields, given its fundamental role in cardiovascular adaptation to exercise. Unfortunately, many barriers limit the clinical use of this methodology. In this observational study of 330 elite athletes, we used a composite index of ANS control (ANSI), designed to overcome pitfalls, following the hypothesis that studying the ANS could help address cardiac adaptation to high-volume training. In athletes subdivided into three groups considering the level (LOW/HIGH) of combined static/dynamic exercise and the presence [+]/absence [−] of left ventricular hypertrophy (LVH), we found that ANSI showed a progressive increase (LOW: 38.2 ± 27.6%; HIGH-LVH [−]: 52.1 ± 27.2%; HIGH-LVH [+]: 64.4 ± 24.9%, J-T test p < 0.001), with significant differences between all groups considered (p < 0.001). After adjustment and within the HIGH group, ANSI showed the strongest association with LVH and the highest explanatory power among autonomic variables. In conclusion, ANSI was able to differentiate elite athletes characterized by different cardiac remodeling and workloads (as suggested by different sport disciplines), corroborating the hypothesis for a wider use of ANS evaluation in the sports field. Full article

Background: Telerehabilitation has grown with the advances of modern communication technologies, but it experienced its greatest surge during the COVID-19 pandemic. Our department also wanted to offer our patients with chronic neurological conditions (specifically, multiple sclerosis (MS)) the opportunity to exercise with a physiotherapist remotely during pandemic restrictions. We continued with telerehabilitation afterwards, but for further development of telerehabilitation programs we sought feedback from participants. Methods: People with multiple sclerosis (MS) who participated in any form of telerehabilitation offered at our MS centre between January 2021 and June 2024 were invited to complete a brief semi-structured interview to assess their feedback. To ensure unbiased responses, the feedback was obtained from a therapist other than the one with whom they had completed the online session. Results: A total of 95 multiple sclerosis (MS) patients (14 of whom were male) participated in telerehabilitation programs during the study period, with a mean age of 46.5 years. Of these, 82 agreed to participate in short interview. Patients particularly valued the ability to avoid commuting and the time flexibility in scheduling sessions. They perceived the limited opportunities for hands-on correction and the lack of personal interaction with the therapist and other patients as the most significant disadvantages. Conclusions: Telerehabilitation appears to be a viable complement to in-person physiotherapy for some patients with chronic conditions. In our experience, it is feasible to deliver telerehabilitation to people with multiple sclerosis who do not have severe disability, without the need for complex equipment. Full article

Bone–patellar tendon–bone (BPTB) grafts used in anterior cruciate ligament reconstruction bend at the femoral tunnel aperture, forming a graft bending angle (GBA). However, the mechanical effects of GBA-related angled loading on bone–BPTB graft constructs remain unclear. This study investigated the effects of GBA and cyclic tensile loading on stiffness and elongation using porcine BPTB grafts. Fourteen specimens were assigned to tibial bone plug constructs (Type T, n = 7) or patellar bone plug constructs (Type P, n = 7). Each construct was cyclically loaded between 10 and 50 N for 50 cycles under GBA conditions of 0°, 30°, 60°, and 90°. Regardless of GBA condition, cyclic loading produced substantial increases in stiffness and elongation during the first 10 cycles, followed by smaller changes. Stiffness tended to decrease under greater GBA conditions, particularly in Type T constructs, where 60° and 90° reduced stiffness and increased elongation. Type P stiffness showed little dependence on GBA. At 0° and 30°, Type P showed lower stiffness and greater elongation than Type T. These findings indicate that bone–BPTB graft tensile behavior is governed by GBA-related loading geometry and bone plug–tendon junction morphology. Full article

Background: Reference values may assist practitioners in interpreting anthropometric and physical performance profiles in youth handball players within comparable sporting contexts. This study aimed to establish sex- and competitive-age-specific anthropometric and physical performance reference values for Tunisian youth handball players aged 9–15 years and to examine differences by sex and competitive age category. Methods: A total of 370 competitive youth handball players participated in this cross-sectional study (182 boys and 188 girls; U11, n = 130; U13, n = 158; U15, n = 82). Participants had at least two years of structured handball training. Assessment included body size, body composition, flexibility, squat jump, countermovement jump, 3 kg medicine ball throw, horizontal jumps, and handgrip strength. Sex, competitive age category, and sex × age category effects were examined using two-way ANOVA, with Bonferroni-adjusted post-hoc comparisons applied when appropriate. Effect sizes were reported as partial eta squared. Percentile values were calculated. Significance was set at p < 0.05. Results: Boys demonstrated higher values than girls in squat jump, (η_p² = 0.099), countermovement jump (η_p² = 0.097), medicine ball throw (η_p² = 0.202), and both dominant (η_p² = 0.073) and non-dominant handgrip strength (η_p² = 0.048, p < 0.001). Additionally, older age categories showed higher scores on all these tests (p < 0.001). Sex- and competitive-age-category-specific percentile values were established. Conclusions: The established reference values may support descriptive benchmarking and training/monitoring among comparable Tunisian youth handball players. However, these values should not be interpreted as maturity-adjusted standards or general population norms. Full article

Equine sports medicine is increasingly oriented toward objective, field-based monitoring systems that support both performance optimization and welfare assessment. In this context, smartphone-based technologies have emerged as accessible tools capable of integrating data acquisition, processing, and interpretation within a single platform. This narrative review aims to examine the role of smartphones in equine sports medicine, focusing on their function as standalone sensing devices and as gateways for wearable and external sensor systems. The analysis is based on a structured synthesis of current literature addressing technological foundations, including embedded sensors, connectivity architectures, and artificial intelligence-driven data processing, as well as their clinical applications across locomotor, cardiovascular, respiratory, behavioural, and thermoregulatory domains. Evidence indicates that smartphone-based systems improve the feasibility of longitudinal monitoring and facilitate real-time decision-making in field conditions, while enhancing communication between veterinarians, trainers, and owners. However, their performance remains influenced by acquisition conditions, system variability, and algorithmic constraints, requiring careful validation and contextual interpretation. In addition, challenges related to data governance, privacy, and ethical use remain insufficiently addressed. Overall, smartphone-based technologies represent enabling tools that support a transition toward more integrated, data-driven, and welfare-oriented management of the equine athlete, while highlighting the need for standardisation and regulatory development. Full article

Objectives: Skeletal muscle architecture (SMA) defines the mechanical limits of force production. However, its associations with force–time strategy under externally loaded conditions have received little research attention. This exploratory study examined associations between vastus lateralis (VL) and lateral gastrocnemius (LG) architecture and force–time strategy, jump-height retention, and stretch–shortening cycle (SSC) transfer-efficiency in collegiate basketball players. Methods: Seventeen collegiate male basketball players completed B-mode ultrasonographic assessment of VL and LG architecture, including muscle thickness, pennation angle (PA), and fascicle length. Athletes performed the squat jump (SJ), loaded squat jump (LSJ), countermovement jump (CMJ), and loaded countermovement jump (LCMJ) on force platforms, with a 20 kg external load applied for loaded conditions. Loaded retention, defined as the percentage of jump height preserved under load, was proposed as a unified construct. Pearson’s correlations were calculated, with Benjamini–Hochberg false discovery rate (FDR) corrections applied within predefined functional groups and pooled across morphology-sensitive correlations. Results: LG PA showed a large negative association with LCMJ rate of force development (r = −0.68 [−0.87, −0.30]) and a large positive association with LCMJ time to peak force (r = 0.68 [0.29, 0.87]), both surviving within-group FDR correction. VL PA was associated with eccentric acceleration time and concentric time across jump conditions (r = 0.52 to 0.61), interpreted as exploratory. Transfer-efficiency indices showed no significant associations with SMA, except for the LCMJ/LSJ concentric time ratio, which showed a moderate negative association with LG PA (r = −0.49 [−0.79, −0.01]). Conclusions: Resting muscle architecture was associated with the temporal and rate characteristics of force expression under load, rather than with the gross preservation of jump height. Integrating architectural assessment with loaded force–time profiling warrants further investigation as a means of characterizing individual force-development strategies. Full article

This bibliometric study examines the intellectual structure, evolution, and collaboration patterns of phytotherapy research within sports science to identify key themes and research gaps. Publications indexed in the Web of Science Core Collection from 1991 to 2024 were analyzed using a search strategy combining phytotherapy and sports medicine terms, yielding 3404 records, of which 368 met the inclusion criteria after systematic screening. Performance analysis assessed publication trends, citation impact, and author productivity, while science mapping techniques—including keyword co-occurrence, bibliographic coupling, and co-authorship network analysis—were conducted using Bibliometrix and VOSviewer. Thematic positioning was evaluated through Callon’s centrality-density framework. Results indicate steady growth in the field, with a CAGR of 11.83% and peak output in 2021, involving 2103 authors across 199 sources. International collaboration reached 22.55%, led by the United States, United Kingdom, and China. Dominant research themes include exercise, inflammation, oxidative stress, and phytochemicals such as curcumin and resveratrol. Thematic mapping highlights exercise performance and supplementation as central topics. Overall, the field demonstrates significant expansion, though increased international collaboration and clinical translation are needed. Full article

Thymosin beta-4 (TB4) and the related compound commonly referred to as TB-500 are widely discussed in tissue healing and musculoskeletal medicine, but the scope and nature of the supporting literature remain unclear. We conducted a scoping review to map the evidence on TB4 and TB-500 in tissue healing, regeneration, and musculoskeletal repair. PubMed, Europe PMC, and ClinicalTrials.gov were searched through March 2026. English-language in vitro, animal, human, and registered clinical trial sources directly evaluating TB4, TB-500, or included derivatives in repair-related contexts were eligible. Of 1772 records identified, 80 studies were included. The evidence base was weighted toward mixed and in vitro designs, and most studies evaluated TB4 rather than TB-500. The most common tissue categories were wound/skin/soft tissue, vascular/endothelial, ocular/cornea, and bone. Direct musculoskeletal tissue categories such as tendon, ligament, muscle, cartilage, and spine/intervertebral disc were comparatively sparse. Human evidence was concentrated in ocular/cornea and wound/skin/soft tissue settings, whereas direct TB-500 evidence was limited to a single included study. Overall, the mapped literature supports the popular interest in several repair-related pathways but remains unevenly distributed and largely preclinical, with limited human evidence directly relevant to musculoskeletal applications. Full article

Background: Sports injuries impose a substantial burden on athletes. Machine learning (ML) and deep learning (DL) methods, collectively referred to as artificial intelligence (AI), are increasingly applied to develop predictive models and targeted prevention strategies. Objective: This scoping review aimed to map contemporary trends in AI applications for sports injury prediction and personalised prevention strategies, critically appraising the existing methodological approaches and identifying future research directions. Methods: Following PRISMA-ScR guidelines, we systematically searched five electronic databases, i.e., PubMed, Web of Science, Institute of Electrical and Electronics Engineers Xplore, Scopus, and Google Scholar, for peer-reviewed studies published up to February 2026 that applied AI methods for injury prediction and/or prevention in athletic populations. Results: Thirty-nine studies were included. Tree-based ML algorithms were the most common (59% of studies) methods used, with reported area under the curve values ranging from 0.82 to 0.95. DL was used in 18% of studies, with one hybrid model reporting 92% accuracy. Integrating multi-modal data was associated with improved model performance in 37% of studies. Among included studies, AI-informed prevention strategies were associated with injury reductions ranging from 23% to 42%, derived from synthesis-level and single-centre intervention evidence, respectively. The key challenges identified were heterogeneous injury definitions, small sample sizes, and data privacy concerns. Conclusions: AI models can inform personalised injury prevention, but their clinical use is limited by methodological issues. Key limitations include heterogeneous injury definitions, small sample sizes, and a lack of external validation. Standardised protocols are needed to improve the reliability and application of these models in practice. Full article