INTRODUCTION The aim of this review is to provide methodological recommendations for menstrual cycle research in exercise science and sports medicine based on a review of recent literature. Research in this area is growing, but often reports conflicting results and it is proposed that some of this may be explained by methodological issues. METHODS This review examined the menstrual cycle verification methodologies used in recent literature on exercise performance over the menstrual cycle identified through a literature search of PubMed and SportDiscus from 2008 until 2018. RESULTS Potential changes over the menstrual cycle are likely related to hormone fluctuations, however, only 44% of the selected studies measured the actual concentrations of the female steroid hormones estrogen and progesterone. It was shown that the likely inclusion of participants with anovulatory or luteal phase deficient cycles in combination with small participant numbers has impacted results in recent menstrual cycle research and consequently our understanding of this area. CONCLUSION To improve the quality of future menstrual cycle research it is recommended that a combination of three methods is used to verify menstrual cycle phase: the calendar-based counting method combined with urinary luteinizing hormone surge testing and the measurement of serum estrogen and progesterone concentrations at the time of testing. A strict luteal phase verification limit of >16 nmol·L for progesterone should be set. It is also recommended that future research focusses on the inclusion of the late follicular estrogen peak. It is envisaged that these methodological recommendations will assist in clarifying some of the disagreement around the effects of the menstrual cycle on exercise performance and other aspects of exercise science and sports medicine.
Ashkan Sohrabi, Samaneh Ebrahimi, Ehsan Arabzadeh
et al.
Cystic fibrosis (CF) is a multisystem disease that may affect organ systems, including the respiratory system. Exercise training provides multiple benefits for people with CF. The purpose of this study was to determine the effects of three exercise-training programs on respiratory capacity and pulmonary function in patients with CF. Sixty CF patients (age 8–15 years, body mass index or BMI > 16 kg/m2) were randomly allocated to three experimental groups including: Endurance training (ET, n = 15), Resistance training (RT, n = 15), Concurrent Training (CT, n = 14) and control (C, n = 16). Trainings groups completed a 10-week moderate exercise programs (endurance, resistance and concurrent modality). Spirometry was performed both prior to randomization and following the intervention to assess first second of forced expiration (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio. Health-related quality of life (HRQoL) was assessed using the adolescent/adult version of the CF Questionnaire. The results show that 10-weeks of supervised ET, RT and CT improved FEV1, FVC, FEV1/FVC (%), peak expiratory flow (PEF) (l/s), forced mid-expiratory flow (FEF) 25–75 % (l/s), maximal voluntary ventilation (MVV) dimension, and HRQoL (p < 0.05). In addition, in the three exercise groups, a significant improvement in all variables at post-test was observed when compared to pre-test (p < 0.05). In CF patients, performing controlled endurance, resistance and combined exercises improved functional and respiratory parameters. However, it seems that combined exercises had a greater effect on these variables than resistance and endurance exercises alone.
Alessandro Carrozzo, Régis Pailhé, Ophélie Manchec
et al.
Abstract Purpose The aim of this study was to compare implant survival, clinical outcomes and radiographic alignment between navigated and non‐navigated total knee arthroplasty (TKA) performed with a single implant system. Methods A retrospective multicenter analysis of prospectively collected data from 6078 TKAs performed for primary osteoarthritis using a single implant system was performed. Procedures were divided into two groups: navigated (n = 3602) and non‐navigated (n = 2476). The primary outcome was implant survival. Secondary outcomes included re‐intervention rates, patient‐reported outcomes measures (PROMs, International Knee Society scores), and range of motion. Results Five‐year implant survival was similar between the non‐navigated (98.9%; 95% confidence interval [CI], 98.2%–99.3%) and navigated (98.3%; 95% CI, 97.6%–98.8%) groups (p = 0.505). After adjustment for potential confounders, navigated procedures showed a slightly higher risk of surgical reintervention excluding infection (hazard ratio 1.42, 95% CI: 1.02–1.96, p = 0.036). PROM analyses were restricted to patients with both baseline and 5‐year questionnaires (n = 470). The improvement of patient‐reported functional outcomes at 5 years was not significantly different between groups (p = 0.893 after adjustment for potential confounders). Conclusions Navigation was equivalent to conventional instrumentation TKA with respect to implant survival. After adjusting for confounders and excluding septic revisions, navigated procedures showed a slightly higher reoperation risk. No significant advantage in functional outcomes was observed at mid‐term follow‐up. These findings do not support a clear clinical benefit for routine use of navigation in this setting. Level of Evidence Level III, retrospective comparative study.
Abstract Maladaptive stress responses are associated with a variety of psychological and physical disorders, often characterized by molecular indicators of dysregulated stress pathways. Small extracellular vesicles (sEVs), which play a key role in intercellular communication, may be critically involved in these processes. In this study, we quantified sEV concentrations (specifically CD9+, CD63+, and CD81+ markers) in the plasma of twenty young, healthy men before and after exposure to both acute psychosocial and physical stress, using imaging flow cytometry (IFCM). Both stressors induced significant increases in cortisol, catecholamines, and cell-free DNA (cfDNA) in all participants. sEVs, however, were elevated only after physical stress, showing a rapid rise particularly in CD9- and CD63-positive vesicles, followed by a return to baseline within 40 min. In contrast, psychosocial stress elicited highly heterogeneous, non-directional sEV responses. Recursive partitioning further revealed clearly distinct sEV patterns for psychosocial and physical stress, with the highest discriminatory power observed for CD44⁺ sEVs. These findings support the existence of stressor-specific sEV signatures that could serve as future biomarkers of individual stress experience and act as effectors of distinct signal transduction pathways in both psychosocial and physical stress.
Anna Krysińska, Antonina Drzewiecka, Artur Drzewiecki
et al.
Introduction: Pregnancy is a transformative stage in a woman’s life, often accompanied by questions and concerns about the safety of both the mother and the developing child. Key aspects of daily life, including physical activity, diet, and work, are frequently scrutinized, with many misconceptions persisting about what constitutes a healthy pregnancy. However, scientific evidence consistently demonstrates that an active and healthy pregnancy benefits both maternal and neonatal outcomes.
Aim of the study: This study aims to synthesize current knowledge on the role of physical activity during pregnancy and its impact on labor outcomes. By reviewing recent research, we seek to provide a comprehensive overview of the benefits of physical activity, address barriers to exercise during pregnancy, and highlight evidence-based recommendations. The goal is to raise awareness among healthcare providers and pregnant women about the importance of incorporating physical activity into prenatal care.
Materials and methods: This study incorporated evidence from peer-reviewed articles, meta-analyses, and randomized controlled trials. Over 55 studies, available on PubMed and Google Scholar were analysed and critically reviewed to create a comprehensive overview of the topic.
Conclusion:
Physical activity during pregnancy is a vital component of prenatal care that promotes maternal and neonatal well-being. Regular exercise reduces the likelihood of pregnancy complications and improves delivery outcomes. Additionally, it offers long-term benefits for neonatal development. While current guidelines provide a general framework for exercise during pregnancy, personalized recommendations tailored to individual needs are essential to maximize safety and efficacy. This research emphasizes the importance of raising awareness among healthcare providers and pregnant women about the critical role of physical activity in improving health outcomes during pregnancy and beyond.
Aglaja Busch, Lorena R. R. Gianotti, Frank Mayer
et al.
# Background
Changes in cortical activation patterns after rupture of the anterior cruciate ligament (ACL) have been described. However, evidence of these consequences in the early stages following the incident and through longitudinal monitoring is scarce. Further insights could prove valuable in informing evidence-based rehabilitation practices.
# Purpose
To analyze the angular accuracy, neuromuscular, and cortical activity during a knee joint position sense (JPS) test over the initial six months following ACL reconstruction.
Study design: Cohort Study
# Methods
Twenty participants with ACL reconstruction performed a JPS test with both limbs. The measurement time points were approximately 1.5, 3-4 and 6 months after surgery, while 20 healthy controls were examined on a single occasion. The active JPS test was performed seated with a target angle of 50° for two blocks of continuous angular reproduction (three minutes per block). The reproduced angles were recorded simultaneously by an electrogoniometer. Neuromuscular activity of the quadriceps muscles during extension to the target angle was measured with surface electromyography. Spectral power for theta, alpha-2, beta-1 and beta-2 frequency bands were determined from electroencephalographic recordings. Linear mixed models were performed with group (ACL or controls), the measurement time point, and respective limb as fixed effect and each grouping per subject combination as random effect with random intercept.
# Results
Significantly higher beta-2 power over the frontal region of interest was observed at the first measurement time point in the non-involved limb of the ACL group in comparison to the control group (p = 0.03). Despite individual variation, no other statistically significant differences were identified for JPS error, neuromuscular, or other cortical activity.
# Conclusion
Variation in cortical activity between the ACL and control group were present, which is consistent with published results in later stages of rehabilitation. Both indicate the importance of a neuromuscular and neurocognitive focus in the rehabilitation.
# Level of Evidence
3
Ismail Dergaa, Amine Ghram, Mohamed Romdhani
et al.
Wet-cupping therapy (WCT) is one of the oldest known medical techniques, used as a traditional and complementary therapy with a wide application all around the world for general health. Research on the effects of WCT on sports performance are sparse and inconsistent. Thus, we aimed to explore the effects of WCT on repeated sprint ability, wellness, and exertion in young active males. Forty-nine active adult males (age: [28 ± 5] years; body height [177 ± 8] cm; body mass: [79 ± 7] kg; body mass index: [25.4 ± 1.8] kg/m2) were selected for the study. The participants performed a running-based sprint test on two separate occasions (Control and Post-WCT). WCT was performed 24 h before the testing session. They completed the Hooper questionnaire to assess their well-being (i.e., sleep, stress, fatigue, and soreness) before each session. The rating of perceived exertion (RPE) was collected after each testing session. A higher maximum power (p < 0.05, effect size [ES] = 0.6), mean power (p < 0.01, ES = 0.5) and minimum power (p < 0.01, ES = 0.6) were recorded post-WCT as compared to Control session along with a better perceived sleep (p < 0.01, ES = 0.85). Perceived stress (p < 0.01, ES = 0.6) and RPE (p < 0.001; ES = 1.1) were lower during the post-WCT compared to the Control session. The present findings demonstrated that WCT moderately enhanced repeated sprint ability and had positive effects on perceived sleep, stress, and exertion. WCT may be an effective ergogenic aid to improve repeated sprint ability and general well-being in young adult males. Future large-scale multicentric clinical studies are paramount to confirm the results of our study.
Yahya Süleyman Mollaibrahimoğlu, Nurefşan Kaygas, Özlem Feyzioğlu
et al.
The study aims to compare static and dynamic postural stability, navicular drop, dorsiflexion range of motion, and jumping performance of individuals with neutral, prone, and hyperprone foot postures. Forty-eight participants between the ages of 18 and 40, were categorized into neutral (n=16), prone (n=16), and hyperprone (n=16) according to foot posture index (FPI). Static and dynamic postural control evaluations (with the Biodex Balance System SD), navicular drop test (NDT) weight-bearing lunge test, countermovement jump test without arm swing, and drop vertical jump tests have been completed. In the results, the average age of participants in the NG, PG, and HPG are 22.31 ± 2.75, 23.87± 3.72, and 22.37 ± 1.28 years and BMI are 22.6 ± 3, 23.4 ± 3.8, and 21.4 ± 2.24 (kg/m²), respectively. The demographic data of the participants showed a homogeneous distribution. There were no significant differences in none of the outcomes except the NDT. Navicular drop amount is positively correlated by the subtalar joint pronation. An increase in subtalar joint pronation does not have a significant effect on static and dynamic stability, jump performance, or dorsiflexion range of motion in healthy individuals.
Tetsuya Tachibana, Hiroki Katagiri, Hideyuki Koga
et al.
Purpose: The advantage of total hip arthroplasty (THA) in an anterior approach compared with a posterior approach in terms of early postoperative pain and function and lowering dislocation risks is controversial. This study aimed to identify whether THA using the anterior approach lowers costs compared with the posterior approach. Methods: We identified 294 patients who underwent primary THA and compared the cost of total inpatient stay, inpatient length of stay (LOS), cost of operating room, and the rates of discharged patients, complications, and reoperation between the anterior and posterior approaches using propensity score matching analysis. Results: One-to-one matching resulted in 135 pairs of patients who underwent THA using both approaches. The cost of total inpatient stay was significantly lower in the anterior approach (anterior vs. posterior [1,322,800 vs. 1,445,219 yen]; p = 0.04). Furthermore, in the anterior approach, the inpatient LOS was shorter (anterior vs. posterior [19.9 vs. 25.0 days]; p < 0.001). However, there was no significant difference in the cost of the operating room and the rates of patients discharged home, total complications (anterior vs. posterior [5.2 vs. 11.1 %]; p = 0.08), or revisions between the two approaches. Conclusions: Using propensity score matching, the current study demonstrated that THA in the anterior approach shortened inpatient LOS and rendered an 8 % reduction in the total inpatient cost compared with the posterior approach.
Background: Knee injury is common in half-marathon runners, however, the effect of compression running pants on fatigue and knee proprioception remains unclear.Objectives: The study aims to investigate whether wearing compression running pants (CRP) and treadmill running stages affect knee proprioception and fatigue-related physiological responses during half-marathon running.Methods: Eighteen half-marathon runners completed two self-paced 21 km treadmill running trials, once wearing CRP and once wearing loose running shorts (LRS). For each 21 km run, RPE, heart rate, blood lactic acid, and knee flexion proprioception were assessed before starting, and after each 7 km stage.Results: Data analysis revealed no difference between CRP and LRS conditions in heart rate, RPE, or blood lactic acid. Repeated measures ANOVA showed a significant garment condition main effect whereby wearing CRP was associated with higher knee proprioceptive acuity (p = 0.006). Polynomial trend analysis showed a significant linear downwards trend in proprioceptive acuity across the four measurement occasions (p = 0.048). Stage analysis showed that wearing CRP was associated with better knee proprioception at running distances of 14 km (p = 0.007, 95%CI = -0.054, -0.010) and 21 km (p = 0.016, 95%CI = -0.051, -0.006).Conclusion: Compression running pants provide an overall positive effect on knee proprioception, particularly after 14 km and 21km, which may reduce the probability of knee injury. CRP had no significant effect on physiological measures in half-marathon running.
Damoon Ashtary-Larky, Reza Bagheri, Matin Ghanavati
et al.
Purpose Previous studies have suggested that beta-alanine supplementation may benefit exercise performance, but current evidence regarding its effects on body composition remains unclear. This systematic review and meta-analysis aimed to investigate the effects of beta-alanine supplementation on body composition indices. Methods Online databases, including PubMed/Medline, Scopus, Web of Science, and Embase, were searched up to April 2021 to retrieve randomized controlled trials (RCTs), which examined the effect of beta-alanine supplementation on body composition indices. Meta-analyses were carried out using a random-effects model. The I2 index was used to assess the heterogeneity of RCTs. Results Among the initial 1413 studies that were identified from electronic databases search, 20 studies involving 492 participants were eligible. Pooled effect size from 20 studies indicated that beta-alanine supplementation has no effect on body mass (WMD: −0.15 kg; 95% CI: −0.78 to 0.47; p = 0.631, I2 = 0.0%, p = 0.998), fat mass (FM) (WMD: −0.24 kg; 95% CI: −1.16 to 0.68; p = 0.612, I2 = 0.0%, p = 0.969), body fat percentage (BFP) (WMD: −0.06%; 95% CI: −0.53 to 0.40; p = 0.782, I2 = 0.0%, p = 0.936), and fat-free mass (FFM) (WMD: 0.05 kg; 95% CI: −0.71 to 0.82; p = 0.889, I2 = 0.0%, p = 0.912). Subgroup analyses based on exercise type (resistance training [RT], endurance training [ET], and combined training [CT]), study duration (<8 and ≥8 weeks), and beta-alanine dosage (<6 and ≥6 g/d) demonstrated similar results. Certainty of evidence across outcomes ranged from low to moderate. Conclusions This meta-analysis study suggests that beta-alanine supplementation is unlikely to improve body composition indices regardless of supplementation dosage and its combination with exercise training. No studies have examined the effect of beta-alanine combined with both diet and exercise on body composition changes as the primary variable. Therefore, future studies examining the effect of the combination of beta-alanine supplementation with a hypocaloric diet and exercise programs are warranted.
Sonam Hitendre, Rebecca Jordan, Christos Theodorakopoulos
et al.
Background Adequate nutritional intake plays a pivotal role in optimizing performance, recovery, and body composition goals. This study aimed to investigate the dietary intakes (DIs); nutritional knowledge (NK); and attitudes, perceptions, and challenges (APC) of semiprofessional rugby players in Scotland. Methods Dietary intakes and NK of 24 male semiprofessional rugby players of a Super6 club were evaluated using validated questionnaires. Players were categorized as having good or poor NK according to NK scores. Diet-related APCs were assessed using researcher-developed questionnaires and 1-1 semi-structured interviews. Results Mean ± SD total NK% was poor, 53.7 ± 11.9%. The ‘Good’ NK group scored significantly higher in the Weight Management (p = 0.014), Macronutrients (p < 0.001), Micronutrients (p = 0.001), and Sports Nutrition (p < 0.001) sections. Mean DIs from food sources were 26.3 ± 9.2 kcal/kg/day energy, 1.4 ± 0.4 g/kg/day protein, and 21.7 ± 10.1 g/day fibre. Median (25th,75th) carbohydrate intake was 3.0 (2.0, 3.0) g/kg/day, and 6.3 (2.3, 10.6) units/week alcohol. Mean ± SD fat and saturated fat (SFA) % total energy intake (EI) were 36.2 ± 3.7% and 12.8 ± 1.9%, respectively, and SFA %EI exceeded recommendations (p < 0.001). The ‘Good’ NK group had significantly higher intakes of all macronutrients (p < 0.05). Total NK% positively correlated with intakes of meat (r = 0.556, p = 0.011), cereals (r = 0.458, p = 0.042), dietary fat (r = 0.477, p = 0.034), vegetables (r = 0.487, p = 0.030), and alcoholic beverages (r = 0.541, p = 0.014). Supplement use was 68%. Players felt diet affected performance (94%) but 31% of them were unaware of any specific nutritional strategies. A healthy diet was perceived to be ‘balanced’ with ‘variety from all food groups. Lack of time for preparation was described as the main barrier to healthy eating. Conclusions Overall, players had poor NK, their fibre and carbohydrate intake was suboptimal, whereas saturated fat intake exceeded recommendations. Many lacked awareness of current sports nutrition guidelines. Further nutrition education may be needed to improve diet quality and aid performance goals.
Melese Yeshambaw Teferi, Ziad El-Khatib, Endawoke Amsalu Alemayehu
et al.
Typhoid fever continues to be a health challenge in low-and middle-income countries where access to clean water and sanitation infrastructure is scarce. The non-confirmatory diagnostic method continues to hinder effective diagnosis and treatment, ensuring in a high antimicrobial resistance. This systematic review and meta-analysis aimed to estimate the pooled prevalence and antimicrobial susceptibility level of typhoid fever in Ethiopia.The review was designed based on the condition-context-population review approach. Fifteen eligible articles were identified from PubMed, Google Scholar, and Science Direct databases. Risk of bias and quality of studies were assessed using the Joanna Briggs Institute’s appraisal criteria. Heterogeneity was assessed using Cochran’s Q test and I2 statistics. The review protocol was registered in PROSPERO (registration number CRD42021224478).The estimated pooled prevalence of typhoid fever from blood and stool culture diagnosis was 3% (95% CI: 2%–4%, p < 0.01) (I2 = 82.25) and Widal test examination 33% (95% CI: 22%–44%) (I2 = 99.14). The sub-group analyses identified a lower detection of typhoid fever of 2% (95% CI: 1%–3%) among febrile patients compared to typhoid suspected cases of 6% (95% CI: 2%–9%). The stool culture test identified was twofold higher, value of 4% (95% CI: 2%-7%) salmonella S. Typhi infection than blood culture test of 2% (95% CI: 1%–4%). The antimicrobial susceptibility of salmonella S. Typhi for antibiotics was 94%, 80% and 65% for ceftriaxone, ciprofloxacin, and gentamycin respectively. Low susceptibility of salmonella S. Typhi isolates against nalidixic acid 22% (95% CI: 2%–46%) and chloramphenicol 11% (95% CI: 2%–20%) were observed. The diagnosis of typhoid fever was under or overestimated depending on the diagnostic modality. The Widal test which identified as nonreliable has long been used in Ethiopia for the diagnosis of salmonella S. Typhi causing high diagnosis uncertainties. Antimicrobial susceptibility of salmonella S. Typhi was low for most nationally recommended antibiotics. Ethiopian Food and Drug Authority must strengthen its continued monitoring and enhanced national antimicrobial surveillance system using the best available state-of-the-art technology and or tools to inform the rising resistance of salmonella S. Typhi towards the prescription of standard antibiotics. Finally, it is crucial to develop an evidence-based clinical decision-making support system for the diagnosis, empiric treatment and prevention of antimicrobial resistance.
Purpose: One of the changes that occurs in the vascular structure of skeletal muscle during exercise to resolving stress is the process of angiogenesis that has been considered by researchers. Thus, the aim of this study was to investigate the effect of 6-week resistance training with different Time under Tension (TUT) on some serum vascular growth factors in inactive girls.Methods: 20 female volunteer students (mean age 22.3 yrs) were randomly and equally divided into two groups with different TUT of (1s – 1s) and (2s – 4s). Resistance training was performed for 6-week, three times per week, in eight stations,three sets, the intensity of 75% 1RM (10 repetitions) and 50% 1RM (5 repetitions) to equalize the training load in two groups. Blood samples were taken from the subjects before the training period and 48 hours after the last training session to evaluate the variables of VEGF, GH and endostatin. Data were analyzed by analysis of covariance.Results: There were no significant differences in serum levels of VEGF (P = 0.59) and GH (P = 0.89) between groups following six weeks of resistance training. But there were significant differences in serum endostatin level (P = 0.04) and leg strength (P = 0.01) between the two groups. Conclusion: Although there was no significant difference in angiogenesis related-factors between the two groups during six weeks and it is likely to need more time, but in the case of angiogenesis inhibitor, this difference was significant. Also, the more eccentric component was more associated with more strength in the 2s – 4s training.
This study aims to clarify oxygen uptake (VO2) and heart rate (HR) kinetics of body mass-based squat exercise (SQBM) with relation to age. Fourteen healthy adults and 19 healthy children performed SQBM 200 times as well as an incremental loaded bicycle test to determine maximal VO2 and HR. The VO2 and HR during SQBM were normalized to maximal VO2 (%VO2peak) and HR (%HRmax), respectively. Electromyograms (EMGs) were recorded from the vastus lateralis, rectus femoris, vastus medialis and biceps femoris muscles from the right leg. In the VO2 and HR during SQBM, the time constant in children was faster than adults, whereas the physiological load (%VO2peak and %HRmax) was almost the same between children and adults. In both groups, %VO2peak was significantly related to %HRmax during SQBM. The slope of the %VO2peak-%HRmax relationship was 0.92 for children, and 0.73 for adults. The current results demonstrate that, compared to adults, the rise in VO2 and HR after initiation of SQBM is faster in children, and the physiological load during SQBM partially depends on individual maximal aerobic capacity.