International Society of Sports Nutrition Position Stand: Long-Chain Omega-3 Polyunsaturated Fatty Acids

Position Statement: The International Society of Sports Nutrition (ISSN) presents this position based on a critical examination of the literature surrounding the effects of long-chain omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplementation on exercise performance, recovery, and brain health. This position stand is intended to provide a scientific foundation for athletes, dietitians, trainers, and other practitioners regarding the effects of supplemental ω-3 PUFA in healthy and athletic populations. The following conclusions represent the official position of the ISSN: Athletes may be at a higher risk for ω-3 PUFA insufficiency.Diets rich in ω-3 PUFA, including supplements, are effective strategies for increasing ω-3 PUFA levels.ω-3 PUFA supplementation, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), has been shown to enhance endurance capacity and cardiovascular function during aerobic-type exercise.ω-3 PUFA supplementation may not confer a muscle hypertrophic benefit in young adults.ω-3 PUFA supplementation in combination with resistance training may improve strength in a dose- and duration-dependent manner.ω-3 PUFA supplementation may decrease subjective measures of muscle soreness following intense exercise.ω-3 PUFA supplementation can positively affect various immune cell responses in athletic populations.Prophylactic ω-3 PUFA supplementation may offer neuroprotective benefits in athletes exposed to repeated head impacts.ω-3 PUFA supplementation is associated with improved sleep quality.ω-3 PUFA are classified as prebiotics; however, studies on the gut microbiome and gut health in athletes are currently lacking.

Effects of protein supplementation during pilates training on body composition, core muscle endurance, and joint flexibility in trained women: a randomized controlled trial

BACKGROUND

Pilates is a popular type of exercise, aimed at improving core muscle strength and endurance, core stability, and joint flexibility through a variety of whole-body exercises. Research has shown that Pilates improves body composition, muscle endurance, and joint flexibility. Adequate protein intake is a key factor in supporting the adaptive response of skeletal muscle to exercise training. However, whether protein supplementation augments the adaptations to Pilates training remains unknown. Thus, the aim of the present study was to investigate the effects of protein supplementation during Pilates training on body composition, core muscle endurance, and joint flexibility in trained women.

METHODS

Nineteen Pilates-trained women (31 ± 9 y) performed 10 weeks of Pilates training using the Reformer and Cadillac apparatuses, at least 2 times per week. Participants were randomly allocated to either a placebo (n = 10) or protein supplementation group (n = 9) in a quadruple-blind (participants, intervention providers, investigators, and outcome assessors) design. Participants received 0.6 g of maltodextrin or whey protein per kg body weight daily, respectively. Habitual dietary intake was monitored throughout the study. Before and after the intervention, anthropometric measures (body weight, body mass index, waist and hip circumferences), body composition [through full-scan dual-energy X-ray absorptiometry (DXA) and multifrequency bioelectrical impedance analysis (BIA)], core muscle endurance (through the McGill's torso muscular endurance test battery), and joint flexibility (through the sit-and-reach test) were assessed. Data were analyzed by 2-way ANOVA (supplement × time) with repeated measures on time. Common DXA and BIA variables (whole-body fat and lean mass) were compared through paired Student's t tests and subjected to Pearson's correlation analysis. The level of statistical significance was set at α = 0.05.

RESULTS

Participants received, on average, 1.3 g protein/kg body weight/day from their habitual diet. After 10 weeks of Pilates training and regardless of supplementation, body fat (assessed by BIA) and hip circumference decreased; lean mass, total water, and extracellular water (by BIA) increased; and arm lean mass, trunk bone mineral content, and trunk bone area (by DXA) increased (all p < 0.05). The common BIA and DXA variables were highly correlated (r > 0.78, p < 0.001) and did not differ pre-intervention (p > 0.1), although they differed post-intervention (p < 0.001), with BIA overestimating lean mass compared with DXA. Core muscle endurance and joint flexibility increased with training (p < 0.05), with no effect of supplementation.

CONCLUSION

Ten weeks of Pilates training improved core muscle endurance, joint flexibility, and aspects of body composition in healthy trained women, but these adaptations were not enhanced by daily supplementation with 0.6 g of protein per kilogram body weight.

High-heeled shoes increase motion of the talocrural joint while limiting the subtalar joint

BACKGROUND

Foot issues caused by High-heeled shoes (HHS) may be related to changed kinematics. This study aimed to use novel dynamic biplane radiography (DBR) to investigate the effect of HHS on the in vivo six degrees of freedom (6DOF) kinematics of the talocrural and subtalar joints.

METHODS

Fourteen healthy female participants were recruited. Magnetic Resonance Imaging (MRI) scan images of each participant's ankle were used to create three-dimensional (3D) bone models. Two-dimensional (2D) motion perspective views of the foot were captured by DBR while walking with and without HHS. The 2D perspective views and 3D bone models are imported into a customized program for alignment. 6DOF kinematic data were extracted for the talocrural and subtalar joints during the stance phase of gait.

RESULTS

Compared to barefoot, the maximum plantarflexion angle of the talocrural joint increased (6.5 ± 2.4° vs. 28.8 ± 6.0°, P < 0.001) when walking with HHS; minimum inversion angle increased (-1.8 ± 1.7° vs. -4.9 ± 2.3°, P < 0.001). The range of motion (ROM) of the talocrural joint was increased in plantarflexion (13.8 ± 3.2° vs. 20.3 ± 7.4°, P = 0.002). The maximum internal rotation angle of the subtalar joint increased during HHS (-0.4 ± 1.8° vs. -3.2 ± 2.7°, P = 0.02). The ROM of external rotation (7.6 ± 2.5° vs. -5.9 ± 2.3°, P = 0.03) and eversion (10.4 ± 3.5° vs. 8.2 ± 2.6°, P = 0.041) decreased.

CONCLUSION

During the stance phase, HHS increased peak plantarflexion, inversion angle, and plantarflexion ROM of the talocrural joint. HHS decreased external rotation and eversion ROM of the subtalar joint. These results may provide a basis for developing prevention and treatment strategies for HHS injuries.

Castro FA, Costa EC, Boullosa D, Astorino TA. Affective valence predictors from real-world based short sprint interval training

Affective valence is typically positive at exercise intensities below the lactate threshold, yet more aversive responses occur at supra-threshold intensities. Nevertheless, the physiological and psychological predictors of affective valence during supramaximal intensities including short sprint interval training (sSIT) have not yet been elucidated. Seventeen (7 women/10 men) moderately active young adults (age ​= ​[28.2 ​± ​5.6] years;V ˙ O2max [maximum oxygen consumption] ​= ​[52.9 ​± ​8.1] mL·kg- 1·min- 1; BMI [body mass index] ​= ​[24 ​± ​2] kg·m- 2) completed four low-volume running sSIT sessions (10 ​× ​4 ​s efforts with 30 ​s of passive recovery). We recorded participants' heart rate (HR), root mean square of successive differences of normal RR intervals (RMSSD), heart rate recovery (HRR), ratings of perceived exertion (RPE), feeling scale (FS), intention and self-efficacy during, and after each session. Overall, no significant correlation (p ​> ​0.05) was found between FS and baseline clinical outcomes. No significant correlation (p ​> ​0.05) was detected between FS and any training parameter. No significant correlations were noted between FS and exercise task self-efficacy and intentions (p ​> ​0.05). The regression model was significant (F 3,61  ​= ​5.57; p ​= ​0.002) and only three variables significantly entered the generated model: ΔHRRend-120s end (p ​= ​0.002; VIF ​= ​2.58; 40.8%), time ≥ 90% HRpeak (p ​= ​0.001; VIF ​= ​1.26; 31.6%), and RMSSDend (p ​= ​0.025; VIF ​= ​2.23; 27.6%). These findings suggest that HR-based measures, particularly those related to in-task stress (time ≥ 90% HRpeak) and acute recovery (ΔHRRend-120s end, and RMSSDend), may predict affective valence during real-world sSIT.

Therapeutic effects of intracerebral transplantation of human modified bone marrow-derived stromal cells (SB623) with voluntary and forced exercise in a rat model of ischemic stroke

Ischemic stroke results in significant long-term disability and mortality worldwide. Although existing therapies, such as recombinant tissue plasminogen activator and mechanical thrombectomy, have shown promise, their application is limited by stringent conditions. Mesenchymal stem cell (MSC) transplantation, especially using SB623 cells (modified human bone marrow-derived MSCs), has emerged as a promising alternative, promoting neurogenesis and recovery. This study evaluated the effects of voluntary and forced exercise, alone and in combination with SB623 cell transplantation, on neurological and psychological outcomes in a rat model of ischemic stroke. Male Wistar rats that had undergone middle cerebral artery occlusion (MCAO) were divided into six groups: control, voluntary exercise (V-Ex), forced exercise (F-Ex), SB623 transplantation, SB623 + V-Ex, and SB623 + F-Ex. Voluntary exercise was facilitated using running wheels, while forced exercise was conducted on treadmills. Neurological recovery was assessed using the modified neurological severity score (mNSS). Psychological symptoms were evaluated through the open field test (OFT) and forced swim test (FST), and neurogenesis was assessed via BrdU labeling. Both exercise groups exhibited significant changes in body weight post-MCAO. Both exercises enhanced the treatment effect of SB623 transplantation. The forced exercise showed a stronger treatment effect on ischemic stroke than voluntary exercise alone, and the sole voluntary exercise improved depression-like behavior. The SB623 + F-Ex group demonstrated the greatest improvements in motor function, infarct area reduction, and neurogenesis. The SB623 + V-Ex group was most effective in alleviating depression-like behavior. Future research should optimize these exercise protocols and elucidate the underlying mechanisms to develop tailored rehabilitation strategies for stroke patients.

Six Weeks to Wellness: The Role of Breathing Exercises Based on Motor Development Pattern in Improving Fitness and Quality of Life in Overweight Elderly Women

Background: Being overweight is a major global health epidemic of the 20th and 21st centuries, which can affect the movement system function of older adult women. This study evaluated the effects of a breathing exercise based on motor development patterns on functional fitness and quality of life in overweight older adult women. Methods: A randomized controlled trial was conducted with 40 community-dwelling women aged 65-75. Participants were randomly assigned to an intervention group, which completed a 6-week breathing exercise program (three supervised and three home-based sessions per week), or a control group, which maintained usual routines. Outcome measures included cardiovascular fitness, upper and lower body flexibility, muscle strength, dynamic balance, and quality of life, assessed at baseline and post-intervention. Results: The intervention group showed significant improvements in cardiovascular fitness (p < .001, ES = 0.652), upper body flexibility (p < .001, ES = 0.652), lower body flexibility (p < .001, ES = 0.538), upper body strength (p < .001, ES = 0.538), lower body strength (p < .001, ES = 0.538), and dynamic balance (p < .001, ES = 0.475) compared to the control group. Quality of life also significantly improved in the intervention group (p < .001, ES = 0.475). Conclusion: Breathing exercises based on motor development patterns significantly enhance functional fitness and quality of life in overweight older adult women. Incorporating these exercises into regular physical activity routines may promote health and independence in older adults. Further research should explore long-term benefits and optimal exercise parameters for older adults.

Vibrational exercise for Crohn's to observe response (VECTOR): Protocol for a randomized controlled trial

Crohn's disease (CD) is a long-term inflammatory gastrointestinal disorder, often adversely affecting physical, emotional, and psychological well-being. Pharmaceutical management is habitually adopted; although medicinal therapies require continuous administration, and are often associated with significant side effects and low adherence rates. Whole body vibration (WBV) represents a non-invasive technique, that provides vibration stimulation to the entire body. As WBV appears to target the physiological pathways and symptoms pertinent to CD epidemiology, it may have significant potential as a novel non-pharmaceutical intervention therapy in CD. This paper presents the study protocol for a randomised controlled trial investigating the impact of WBV on health outcomes in individuals with CD. This 6-week, parallel randomised controlled trial will recruit 168 individuals, assigned to receive WBV and lifestyle education 3 times per week compared to control, receiving lifestyle education only. The primary outcome of the trial will be the difference from baseline to post-intervention in health-related quality of life between the groups, assessed with the Inflammatory Bowel Disease Quality of Life Questionnaire. Secondary outcomes will include between-group differences in other questionnaires assessing fatigue, anxiety and pain, measures of physical fitness, and biological markers for disease activity and inflammation. Statistical analyses will follow an intention-to-treat approach, using linear mixed-effects models to compare changes between time points and both trial groups. Ethical approval was granted by the Nottingham Research Ethics Committee (REC: 24/EM/0106) and the study has been registered prospectively as a clinical trial (NTC06211400).

The Consistency of Primary, Secondary and Tertiary Prevention Definitions in the Context of Musculoskeletal Sports Injuries: A Rapid Review and Critical Exploration of Common Terms of Usage

BACKGROUND

Formal statements articulating the meaning of primary, secondary and tertiary prevention concepts are commonly used in the musculoskeletal sports injuries literature, but appear to be employed inconsistently and incorrectly. Standard definitions, appropriate to athletic health and performance practice, are required to systematically develop the state-of-the-art. To accomplish this, we summarized prevention definitions with the aim of improving conceptual clarity across the musculoskeletal sports injuries literature.

MAIN BODY

We used a rapid literature review method, searching Scopus, PubMed/Medline, Cochrane Library reviews/trials, Web of Science, Sports Medicine and Education Index, SPORTDiscus and CINAHL databases for titles/abstracts for available literature, published in English from database-inception to November 2023. Our search terms were: sport/athlete, injury, primary prevention, secondary prevention, and/or tertiary prevention. Definitions were extracted to create categories illustrating overlap and variation. We extracted definitions from 144 included studies (n). Primary prevention appears focused on mitigating injury risk (n = 52) and preventing initial injuries (n = 42). Secondary prevention appears to address five distinct concepts: preventing recurrences (n = 42), preventing sequelae (n = 41), preventing index injury worsening (n = 27), mitigating injury risk (n = 15), and restoring function (n = 12). Tertiary prevention appears focused on preventing sequelae (n = 17) and restoring function (n = 9).

CONCLUSIONS

From a definition viewpoint, the aim of primary prevention is narrowly conceptualized and consistent in the musculoskeletal sports injury research literature. However, secondary prevention definitions vary substantially, with at least three distinct conceptual aims observable. Tertiary prevention definitions appear infrequently in the literature and when observed tend to overlap with secondary prevention. Currently, researchers are likely to struggle with the formulation of clearly-defined and transferrable research questions relating to the aims of secondary prevention.

Who Is Keeping Score: The Effect of a Mercy Rule on Head Impact Rates in Canadian High School Tackle Football Games

OBJECTIVE

To examine the association between the Mercy Rule (MR) and head impact incidence rates (IRs) in Canadian high school football games.

DESIGN

Cross-sectional.

SETTING

Calgary, Canada.

PARTICIPANTS

Two high school football teams (ages 15-16 years) had a total of 16 team-games videorecorded and analyzed.

INTERVENTIONS

The MR mandates continuous running time in the second half of games when the score differential is 35 points or greater.

MAIN OUTCOME MEASURES

Head impact IRs and incidence rate ratios (IRRs) were used to compare head impact rates in MR and non-MR games.

RESULTS

Mercy Rule games had 28% fewer plays, and the head impact IR per team-game was 27% lower [IRR, 0.73; 95% confidence interval (CI), 0.61-0.89] in MR games (IR, 241.67; 95% CI, 199.24, 293.13) than in non-MR games (IR, 328.91; 95% CI, 313.04, 345.57). Across all games (MR and non-MR), running plays accounted for more than half of all head impacts, and the head impact rates for running plays exceeded all other play types except for a sack of the quarterback. Players engaged in blocks (blocking or being blocked) accounted for 68.90% of all recorded head impacts. The highest proportion of impacts involved the front of the helmet (54.85%). There was no difference in head impact rates by player-play comparing MR and non-MR games (IRR, 1.01; 95% CI, 0.85, 1.19).

CONCLUSIONS

Given the concerns for potential long-term consequences of repetitive head impacts, the MR is a prevention strategy by which head impact rates can be significantly lowered when a significant score differential exists.

Physical Fitness, Interlimb Asymmetry, and Injury Reports in Judo Athletes With Vision Impairments: A Cross-Sectional Study

CONTEXT

Investigating parameters related to physical capacities, muscular imbalance between the limbs, and injury reports in judo athletes with vision impairments (VI) is something extremely relevant for competitive performance, especially considering the absence of vision, which can be a determining factor in these aspects. For this, this study aimed to explore the interlimb asymmetry and bilateral strength index in upper and lower limbs in judo athletes with VI and describe the injury reports and the association with the muscular imbalance.

DESIGN

A cross-sectional study.

METHODS

Eighteen judo athletes with VI participated in this cross-sectional study. Athletes performed the following physical tests: handgrip strength, countermovement jump, and medicine ball throw. All tests were performed unilaterally and bilaterally to calculate the interlimb asymmetry and the bilateral strength index. After this, an injury questionnaire was applied, considering injuries that occurred in the previous 6 months. Student t tests and chi-square tests were used to compare groups and test the associations between injury reports, adopting the level of 5%.

RESULTS

The results demonstrated that performance was higher for male compared with female athletes (P < .05) and asymmetry was influenced by sex (higher for male; P < .05) and the origin of the impairment (higher for acquired; P < .05). Furthermore, the bilateral strength deficit was more present in injured groups (mainly in medicine ball throw and countermovement jump). Finally, the most common mechanism of injury was direct contact with another athlete.

CONCLUSION

Muscle imbalances were identified in male and female VI judo athletes and seem to be related to injury reports.

Evaluation of the winning technical and tactical actions of the best female table tennis players in the years 1970-2021

The aim of the research was to determine the quantitative structure of winning systems of the world's leading women players in table tennis in the years 1970-2021. The study used the Wu Huanqin game analysis method. It consists of observing the game, counting the scoring actions within the three stages or situations of a rally: serve/attack', 'return/attack', and 'stalemate phase'. In total 165 women's matches were analysed. The type and size of the ball (celluloid vs. plastic and 38 mm vs. 40 mm diameter) were factors according to which three research periods had been distinguished. With the changes of the ball used an increase in the use of subsequent actions in the so-called stalemate phase can be seen. This is probably related to slowing down the game and reducing the use of spin rotation when playing a large, plastic ball. The number of points scored directly with the serve decreases in particular periods. However, the use of side-forehand-serves and forehand-hook-serves increases over time. Service returns are dominated by backhand returns. This may be related to the greater possibilities of using disguised and diverse techniques to receive the serve (e.g. push, so called "banana" flick or "strawberry" flick, topspin). An interesting observation also was the large number of scorings with repetitive techniques in stalemate phase (e.g. repetition of topspin forehand or block backhand).

Can mat Pilates improve quality of life components in breast cancer survivors receiving hormone therapy? A randomized controlled trial

BACKGROUND

Short and long-term breast cancer treatment side-effects allied with the increase of sedentary behavior, affect quality of life (QoL). Nonetheless, regular physical exercise appears to ameliorate breast cancer survivor (BCS) QoL components.

PURPOSE

to analyze the effect of 24 weeks of mat Pilates (3 times/week, 60 min session) in BCS receiving hormone therapy on QoL components.

MATERIALS AND METHODS

43 participants were randomized according to hormone therapy (Tamoxifen (TMX) or Aromatase Inhibitors (AIs)) in the Pilates group (PG) and control group (CG). The QoL data was collected through SF-36, EORT-30, and 23 questionnaires. The evaluations occurred at baseline (T1), at week 12 (T2), and week 24 (T3) of the intervention. The generalized estimating equations model was used with the Bonferroni post hoc test (p < 0.05).

RESULTS

The SF-36 showed that CG improved physical limitations at T2 compared to T1 (p = 0.032). The Pilates group enhanced emotional aspects compared to CG at T3 (0.009), social aspects at T3 compared to its baseline (p = 0.023), and mental health at T3 compared to CG (p = 0.026). The specific breast cancer questionnaires (EORT-30 and 23) did not show differences throughout the intervention.

CONCLUSIONS

Only the SF-36 showed enhancement for PG QoL components. The EORT-30 and 23 domains are directly related to the side effect treatments, which could influence the outcomes.

Genetic Associations with the Susceptibility to High-Altitude Pulmonary Edema in the Japanese Population

Yunden Droma, Masao Ota, Nobumitsu Kobayashi, Michiko Ito, Toshio Kobayashi, and Masayuki Hanaoka. Genetic Associations with the Susceptibility to High-Altitude Pulmonary Edema in the Japanese Population. High Alt Med Biol. 00:00-00, 2025.-High-altitude pulmonary edema (HAPE) is a life-threatening, noncardiogenic pulmonary condition that may occur in individuals rapidly ascending to altitudes higher than 2,500 m above sea level. Exaggerated hypoxia-induced pulmonary hypertension plays a critical role in its pathophysiological mechanism. In addition to environmental factors such as hypoxia and hypobaria at high altitudes, individual genetic predisposition significantly influences HAPE occurrence. Several candidate genes have been proposed based on the pathophysiology of HAPE, particularly involving the hypoxia-induced factor pathway and vasodilators/vasoconstrictors. Over the past two decades, we have investigated the associations between susceptibility to HAPE and these candidate genes, including genes EPAS1 (endothelial Per-ARNT-Sim [PAS] domain protein 1), EGLN1 (egl-9 family hypoxia inducible factor 1), eNOS (endothelial nitric oxide synthase), ACE (angiotensin-converting enzyme), and TIMP3 (tissue inhibitor of metalloproteinase 3) in the Japanese population. This review summarizes the major findings of these studies, shedding light on genetic associations with HAPE in the Japanese population.

Blood pressure changes during different methods of resistance training in normotensive and stage 1 hypertensive individuals: a repeated measures cross-sectional study

BACKGROUND

Stage 1 hypertension influences acute cardiovascular responses to resistance exercises and post-exercise recovery. We examined whether the order of exercises, particularly in agonist-antagonist pairings, can alter these cardiovascular responses. This study compares systolic and diastolic blood pressure responses during agonist and agonist-antagonist paired sets of upper and lower-body resistance exercises with a load of 75% repetition maximum in individuals with normotension and stage 1 hypertension.

METHODS

A cross-sectional study enrolled 47 participants with sedentary jobs, comprising 30 normotensive individuals (47.8 ± 5.9 years, height 174.8 ± 10.2 cm, weight 77.7 ± 15.4 kg, BMI 25.3 ± 3.6 kg/m2) and 17 hypertensive individuals (54.3 ± 6.0 years, 177.6 ± 11.3 cm, 89.8 ± 16.4 kg, BMI 28.5 ± 4,5 kg/m2). Acute cardiovascular parameters were measured using an arteriograph, a non-invasive device designed to assess vascular stiffness and cardiovascular health, after each set of resistance training.

RESULTS

No significant differences in systolic blood pressure changes were found between the resistance training methods and aerobic exercise when comparing normotensive and hypertensive individuals. However, significant increases in systolic blood pressure were observed during lower-body exercises (11.3-24.7 mmHg for normotensives and 11.7-24.1 mmHg for hypertensives, p < 0.05). Hypertensive individuals showed slightly higher increases during lower-body supersets (p < 0.05). Regarding diastolic blood pressure, significant decreases were noted during upper-body resistance training for both groups, especially for normotensives (-10.6 to -13.7 mmHg, p < 0.05).

CONCLUSIONS

Agonist and agonist-antagonist paired set resistance training for both lower and upper-body exercises resulted in similar blood pressure changes in individuals with normotension and stage 1 hypertension. These findings suggest that both methods may have comparable cardiovascular effects across blood pressure.

TRIAL REGISTRATION

The study was registered on ClinicalTrials.gov (NCT06047678). Registration date: 31 August 2023.

Gut Microbiome dysbiosis and immune activation correlate with somatic and neuropsychiatric symptoms in COVID-19 patients

BACKGROUND

Infection with SARS-CoV-2, the virus responsible for COVID-19, can lead to a range of physical symptoms and mental health challenges, including stress, anxiety, and depression. These effects are particularly pronounced in hospitalized patients, likely due to the virus's direct and indirect impact on the nervous system. Gut dysbiosis, an imbalance in the gut microbiome, has been implicated in immune dysfunction and chronic inflammation in COVID-19 patients. However, the interactions between gut microbiome composition and the physical and mental symptoms of COVID-19 remain incompletely understood.

METHODS

We investigated the association between physical and mental symptoms, cytokine profiles, and gut microbiota composition in 124 hospitalized COVID-19 patients. We collected data on demographics, COVID-19 severity, and mental health indicators (stress, anxiety, and depression). Gut microbiome profiling was performed using full-length 16 S rRNA gene sequencing to evaluate microbial diversity and composition.

RESULTS

COVID-19 severity was categorized as low (27.4%), moderate (29.8%), or critical (42.8%). Common symptoms included fever (66.1%) and cough (55.6%), while somatic symptoms (27.3%), anxiety (27.3%), depressive symptoms (39%), and stress (80.5%) were frequently self-reported. Elevated interleukin-6 levels in severe cases highlighted systemic inflammation, reduced gut bacterial diversity, particularly among women and obese patients, correlated with higher disease severity. Notably, the genus Mitsuokella was associated with increased physical symptoms and mental distress, while Granulicatella was linked to critical illness.

CONCLUSIONS

Our findings reveal significant associations between mental health status, systemic inflammation, and gut dysbiosis in hospitalized COVID-19 patients. These results indicate the potential for microbiome-targeted therapies to mitigate psychological and physical complications and improve recovery outcomes in this population.

Consistency assessment of tissue-level brain injury criteria in FEHM

Tissue-level brain injury criteria are essential for analyzing brain injuries using finite element head models (FEHMs), but their consistency remains unclear. This study applied the data-driven method previously proposed for maximum principal strain (MPS) injury criterion to determine thresholds for von Mises stress (VMS), pressure, maximum shear stress (MSS), and the rate of MPS. It then assessed the consistency of these criteria in terms of injury status, injury location, and injury overlap rate in 18 impact simulations. The results showed that the MPS, VMS, and MSS criteria had strong consistency, enhancing the utility of FEHMs in clinical brain injury analysis.

Hemodynamic analysis of blood flow restriction training: a systematic review

Blood Flow Restriction Training (BFRT) is a low-load training technique that involves applying pressure to partially restrict arterial blood flow while occluding venous return. Despite its growing popularity, there is still no consensus on how combining BFRT with resistance or aerobic training influences hemodynamic responses, or on the safest and most effective methods for implementing it. This review aims to systematically identify the effects of BFRT on hemodynamic parameters. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines. The Chinese literature search was performed in the China National Knowledge Infrastructure (CNKI) database. English literature search was conducted in the Web of Science, PubMed, and Google Scholar databases. The studies included human subjects, the outcome indicators included hemodynamic evaluation indicators, and only randomized controlled trials and randomized crossover trials were considered. Non-Chinese or English literature, duplicate studies, and those with missing data were excluded. The adapted STROBE checklist was used to assess the risk of bias, 44 articles were included in this review. Results indicated that BFRT has increased heart rate and blood lactate levels, while its effect on blood oxygen saturation varies. Additionally, BFRT significantly enhances cardiac output but may either have no significant effect or cause a decrease in stroke volume. Furthermore, BFRT improves pulse wave velocity from the femur to the posterior tibia, suggesting a positive influence on cardiovascular function. BFRT induces changes in arterial structure and function, with these indicators interacting to produce both positive and negative effects on cardiovascular health. The primary mechanisms by which BFRT influences hemodynamics include the activation of the sympathetic and vagus nerves, as well as the regulation of chemical mediators in body fluids that modulate cardiovascular function. Convenient, economical, non-invasive, and easily measurable hemodynamic indicators are expected to become an efficient tool for evaluating the effects of exercise training. Further research is needed to establish the optimal compression thresholds and durations for different populations and exercise types, as well as to assess the long-term impact of BFRT on hemodynamic parameters.

Gait variability predicts post-fatigue obstacle course performance among military cadets: An exploratory study

We explored the extent to which pre-fatigue gait variability during load carriage is associated with the ability of an individual to perform an obstacle course post-fatigue. Twenty-four military cadets were monitored during treadmill gait and completed an obstacle course before and after a full-body fatigue protocol. Gait variability measures were determined from spatiotemporal stride characteristics, joint angle trajectories, and inter-joint coordination. These measures were then used in multiple linear regression models to predict three measures of post-fatigue performance (i.e., hurdle completion time, maximum jump height, and maximum jump distance). Measures of joint kinematic variability predicted 73-89% of the variance in post-fatigue performance. Specifically, the significant predictors were sagittal plane variability of 1) hip angle and hip-knee coordination during swing phase; and 2) knee-ankle coordination during both stance and swing phase. Measures of joint kinematic variability obtained from gait thus appear relevant for predicting individual differences in adapting to fatigue, and such measures could aid in predicting post-fatigue performance in diverse dynamic tasks.

Validity of recurrent neural networks to predict pedal forces and lower limb kinetics in cycling

Dynamic variables contribute to understand the mechanics of pedalling and can assist with injury prevention. Measuring pedal forces and joint moments and powers has a high cost, which can be mitigated by using trained artificial neural networks (ANN) to predict forces from kinematics. Thus, this study aimed at training and validating recurrent ANN to predict 3D pedal forces, lower limb joint moments and powers from lower limb kinematics. Ergometer pedalling data from seventeen cyclists recorded in a single laboratory session were used to train the ANN, where various ergometer power outputs and cadences were combined. A different dataset with ten cyclists was utilized to test the ANŃs performance. Statistical Parametric Mapping (SPM) was performed to explore significant correlations between measured and predicted kinetic variables throughout the pedal cycle. Mean correlation values ranged from 0.79 to 0.96 and all variables exhibited significant positive correlations at their peak absolute values (p < 0.05), except for the anteroposterior (p = 0.28) and mediolateral (p = 0.51) pedal forces and the knee flexion power (p = 0.33). The maximum prediction errors of the ANN in the sagittal plane were 12.1 % for the pedal forces, 17.2 % for the net joint moments and 9.4 % for the joint powers, while for non-sagittal plane were 13.0 %, 28.9 % and 24.0 %, respectively. Thus, the ANN produces kinetic data in cycling within the errors expected from the variability between assessment days.

The glamor of and insights regarding hydrotherapy, from simple immersion to advanced computer-assisted exercises: A narrative review

Water-based therapy has been gaining attention in recent years and is being widely used in clinical settings. Hydrotherapy is the most important area of water-based therapy, and it has distinct advantages and characteristics compared to conventional land-based exercises. Several new techniques and pieces of equipment are currently emerging with advances in computer technologies. However, comprehensive reviews of hydrotherapy are insufficient. Hence, this study reviewed the status quo, mechanisms, adverse events and contraindications, and future prospects of the use of hydrotherapy. This study aims to comprehensively review the latest information regarding the application of hydrotherapy to musculoskeletal diseases, neurological diseases, and COVID-19. We have attempted to provide a "take-home message" regarding the clinical applications and mechanisms of hydrotherapy based on the latest evidence available.

Influence of repeated sprint exercise on leukocyte morphology in adolescent athletes at different biological maturation rates

Background

After performing strenuous physical exercises such as repeated sprint exercise (RSE), the leukocyte morphology undergoes changes suggesting immunodepression. Furthermore, it has been previously suggested that, in pediatrics, leukocyte changes may be influenced by the rates of the biological maturation (BM) process, which varies among individuals of similar chronological age.

Objective

To investigate the influence of RSE on leukocyte morphology in adolescent athletes at different rates of BM.

Methods

We conducted an experimental trial with a final sample consisting 21 adolescent athletes (male sex, age = 12.7 ± 1.2) underwent an RSE protocol, and blood samples were collected at "before, after, and 2 h post" moments. Based on the BM rates assessed by a predictive equation of skeletal age, participants were divided into two groups (Accelerated [n = 10] and Synchronized [n = 11]). Leukocyte morphology was analyzed microscopically and by leukogram.

Results

Regardless of the BM rates, a time effect was observed on the absolute levels of total leukocytes (g/L: η2p = 0.36), lymphocytes (g/L: η2p = 0.50, %: η2p = 0.29), segmented neutrophils (g/L: η2p = 0.16, %: η2p = 0.43), and neutrophil-to-lymphocyte ratio [NLR] (g/L: η2p = 0.30). The synchronized BM group showed higher values than the accelerated group for total leukocyte levels (moments after and 2 h post [η2p = 0.10; p < 0.001]) and segmented neutrophils (moments after and 2 h post [η2p = 0.10; p < 0.001]).

Conclusion

In adolescent athletes, changes caused by RSE in leukocyte morphology appear to be dependent on the BM rates.

Effects of repeated use of post-exercise infrared sauna on neuromuscular performance and muscle hypertrophy

Purpose

The aim of this study was to investigate whether regular use of infrared sauna (IRS) after training can promote neuromuscular performance and positive changes in body composition during a 6-week training period.

Methods

Forty female team sport athletes were pair-matched into two groups: IRS (n = 20) and control (CON; n = 20). Physical performance tests, body composition and hypertrophy measurements (dual-energy x-ray absorptiometry and ultrasound of m. vastus lateralis) were performed PRE and POST a 6-week strength and power training period, involving 2-3 sessions per week. Performance tests included a 20 m sprint, squat jump (SJ), countermovement jumps with body weight (CMJ) as well as with 15, 25, and 50% additional load (CMJ15%, CMJ25%, and CMJ50%), and a maximal isometric leg press (MVC). Participants in the IRS-group used IRS (10 min, 50℃) after training three times per week.

Results

Training improved neuromuscular performance and muscle hypertrophy in both groups (p < 0.05). Following the discovery of an interaction effect for CMJ15% height (p = 0.002) and peak power (p = 0.010), post hoc tests revealed higher jump height POST-IRS (p = 0.006) and PRE-CON (p = 0.023) compared to PRE-IRS, and higher peak power POST-IRS (p = 0.002) compared to PRE-IRS. Furthermore, an interaction effect was observed for 5 m split time of the 20 m sprint (p = 0.020), but no differences were found between groups and timepoints. There were no interactions for the hypertrophy measures.

Conclusion

Incorporating post-exercise IRS bathing does not significantly impact hypertrophy gains, but might boost long-term power production capabilities.

Multi-omics analysis reveals the anti-fatigue mechanism of BCAA-enriched egg white peptides: the role of the gut-muscle axis

Bioactive peptides rich in branched-chain amino acids (BCAAs) are an effective way to alleviate fatigue conditions, but the deep mechanism remains unclear. This study investigated the anti-fatigue effect of branched-chain amino acid-enriched egg white peptides (BEWPs) through the gut-muscle axis by gut bacteria and untargeted metabolomic analyses. The results demonstrated that BEWPs enhanced exercise endurance and strength by also promoting gastrocnemius development in mice. Furthermore, there was a reduction in oxidative stress, inflammatory response, and the accumulation of unexpected metabolites generated under fatigue conditions. The intake of BEWPs increased the abundances of Lactobacillus, Akkermansia, and unclassified_f_Lachnospiraceae, while decreasing the abundance of Bacteroides. BEWPs also regulated the levels of key metabolites in mouse muscles, including L-glutamic acid by arginine biosynthesis and bile secretion pathways. Notably, Spearman's correlation analysis indicated that there was a significant correlation between these altered metabolites, microbial populations, and indicators of fatigue. In summary, our research demonstrated that BEWPs alleviated fatigue through the gut-muscle axis, which provided new insights into fatigue management and prevention.

Evaluation of sevoflurane volatilization from gel and microsphere formulations and prediction of workplace exposure

The general inhalation anesthetic sevoflurane can be used as a topical analgesic in patients with painful wounds. For this new indication, it is irrigated in its liquid formulation into the wound bed, which inevitably causes room pollution. This investigation aimed to analyze the environmental contamination caused by new sevoflurane gel and microsphere formulations at different concentrations (50 %, 30 %, and 10 %) to find which would produce air levels below 2 ppm. The weight loss over time of each formulation was recorded to calculate the amount of sevoflurane volatilized, and the associated room pollution was further calculated under demanding conditions (a small 12 m3 room with three air exchanges per hour, a patient treated every 30 min). Air levels below 2 ppm were found for the gel at 10 % and the microspheres at 30 %. Both new formulations would reduce the environmental pollution caused by unformulated sevoflurane, further improving occupational safety when treating painful wounds.

Foot sole two-point discrimination is not associated with dynamic standing balance in healthy adults

[Purpose] To evaluate the association between foot sole two-point discrimination and dynamic standing balance. [Participants and Methods] This cross-sectional, observational study included 50 healthy adults. Participants were made to stand on a firm or foam surface with eyes open or closed, and the center of pressure length was measured for static standing balance and limits of stability for dynamic standing balance. Two-point discrimination and muscle strength were assessed using the two-point discrimination test and toe grip strength, respectively. We then analyzed the association with sensory-motor assessment and standing balance. [Results] Significant differences were observed for almost all factors between static and dynamic standing balance. Two-point discrimination was associated with static standing balance, and muscle strength was associated with dynamic standing balance on a firm floor. There was no significant association between two-point discrimination and dynamic standing balance. [Conclusion] These results indicate that foot sole two-point discrimination is not directly associated with dynamic standing balance in healthy adults. Therefore, postural stability must be evaluated considering the specific floor surfaces and sensory conditions in clinical situations, and assessment of dynamic standing balance based only on two-point discrimination should be avoided.

Spirulina supplementation and circuit resistance training (CRT) reduce serum asprosin and appetite and improve energy balance in men with obesity and overweight

PURPOSE

The present study aimed to investigate the effects of 8 weeks spirulina supplementation and circuit resistance training (CRT) on asprosin, appetite, and energy balance in men with obesity and overweight.

METHODS

The study comprised a single-blind randomized controlled trial. Sixty men with obesity and overweight (BMI > 25) were selected and randomly divided into four equal groups (n = 15 each) of training plus spirulina, training plus placebo, spirulina, and placebo. The participants of the training groups performed 12 movements with 40-90% maximal repetition (three sessions per week) and the supplemental groups consumed 1000 mg of spirulina per day for 8 weeks. Asprosin, appetite using visual analog scales, calorie intake, energy expenditure, and body composition were measured before and after the intervention. To analyze the data, the paired sample t-test, analysis of covariance, Bonferroni post-hoc, and Pearson correlation tests were employed using SPSS (version 20) at a significance level of p < 0.05.

RESULTS

After the intervention, asprosin level (P = 0.015, P = 0.015, and P = 0.020, respectively), weight (P < 0.001, P < 0.001, and P < 0.001, respectively), calorie intake (P = 0.015, P = 0.011, and P = 0.004, respectively), and hunger (P = 0.011, P = 0.015, and P = 0.015, respectively) declined in the training plus spirulina, training plus placebo, and spirulina groups (p < 0.05). In addition, energy expenditure (P = 0.012 and P = 0.015, respectively) and fullness (P = 0.015 and P = 0.011, respectively) increased in the training plus spirulina and training plus placebo groups. The mean changes of the research indicators in the training plus spirulina group were significantly more than those of the other groups (p < 0.001).

CONCLUSION

It was shown that 8 weeks of CRT and spirulina supplementation decreases the level of asprosin and improves appetite and energy balance in men with obesity and overweight.

The influence of resistance training on inflammatory markers, body composition and functional capacity in healthy older adults: A systematic review and meta-analysis

BACKGROUND

Older adults experience chronic inflammation, which is associated with health conditions such as sarcopenia, and resulting in reduced functional capacity. Resistance training (RT) is a beneficial intervention for improving health in the elderly.

OBJECTIVE

This study aimed to investigate the effect of RT on inflammatory biomarkers, body composition, and functional capacity in healthy adults aged 60 years and over. Additionally, this study conducted a meta-regression to investigate the moderating effect of exercise variables on inflammatory markers.

METHOD

Medline, PubMed, Web of Science, Cochrane Library, Embase, and Google Scholar were searched systematically until December 2023. Randomized controlled trials (RCTs) assessing the impact of RT on C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), body weight, BMI, fat percentage, fat mass, lean mass, leg extension strength and six-minute walk test (6-MWT) were included. Effect size was estimated by using the mean difference (MD) with 95 % confidence interval (CI).

RESULTS

Nineteen RTCs involving 728 participants were included. The results revealed that CRP levels significantly decreased following RT programs (MD:0.74, p= 0.008), while TNF-α (MD: 0.1, p= 0.95) and IL-6 (MD:0.27, p= 0.12) did not show significant changes. Additionally, RT enhanced leg extension strength and 6-MWT performance.

CONCLUSION

RT effectively reduces CRP concentrations and enhances functional capacity in healthy older adults. However, it does not have a significant impact on TNF-α and IL-6 levels. Future researches are needed to make a clear conclusion and understand the mechanisms underlying the effects of RT in healthy older adults.

REGISTRATION

The original protocol was registered (CRD42023487573) in PROSPERO database.

Long-Term Outcomes in Female Patients With Carpometacarpal Arthroplasty and Metacarpophalangeal Fusion Compared With the Unoperated Side or Carpometacarpal Arthroplasty

PURPOSE

Patients with carpometacarpal (CMC) osteoarthritis (OA) often present with metacarpophalangeal (MP) hyperextension and/or thenar atrophy. This study hypothesizes that MP fusion (MPF) performed at the time of CMC arthroplasty (CMCA) for patients who have moderate-to-severe thenar atrophy, MP hyperextension >30°, or MP arthritis will have greater long-term pinch strength and improvements in the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score from preoperative values when compared with the unoperated side or those who had CMCA only.

METHODS

This study involved a retrospective review of long-term results from patients who underwent either CMCA or CMCA/MPF. The QuickDASH score, the pain visual analog scale (VAS), and an average of three pinch readings from each thumb were measured on the Baseline pinch gauge and recorded with a correction for hand dominance in right-handed patients.

RESULTS

Fifty-three female patients with 70 operated thumbs were included in the study. The mean age was 67.2 years. There were 29 CMCAs and 41CMCA/MPFs. The mean follow-up was 6.3 years (range 2-16.9 years). At the latest follow-up, the mean CMCA/MPF pinch strength (11.3 lbs) was significantly stronger than that of CMCA (8.0 lbs) and carpometacarpal osteoarthritis thumbs (8.9 lbs). There was no significant difference in pinch strength between patients who underwent a CMCA and CMCOA thumbs (8.0 lbs vs 8.9 lbs, respectively). Preoperative QuickDASH demonstrated worse function in the CMCA/MPF group (55.8 vs 36.5). At the latest follow-up, QuickDASH and VAS revealed similar values in both the CMCA/MPF (10.5 and 0.66) and CMCA (18.5 and 0.52) groups.

CONCLUSION

Long-term results demonstrate stronger pinch and greater improvement in QuickDASH scores in patients who underwent CMCA/MPF compared with those who underwent a CMCA or untreated carpometacarpal osteoarthritis thumbs.

TYPE OF STUDY/LEVEL OF EVIDENCE

Therapeutic IV.

Adding vibration and non-vibration foam rolling to routine soccer training alters muscle strength, flexibility, and dynamic balance in young male semi-professional soccer players: a randomized, controlled comparative study

This study aimed to examine the effects of 6-week vibration (VFR) and non-vibration foam rolling (FR) on muscle strength, hamstrings-to-quadriceps (H:Q) ratio, flexibility, and dynamic balance in soccer players. Thirty-six players were included in the study. The players were randomly assigned to either VFR (n=12), FR (n=12), or control group (CG) (n=12). The players in VFR and FR groups performed VFR or FR thrice per week for 6 weeks. The CG did not receive any intervention. Pre- and post-test assessment included muscle strength, H:Q ratio, flexibility, and dynamic balance. Dominant extremity knee flexor and non-dominant extremity knee flexor and extensor muscle strength improved in VFR and FR groups (p<0.05). Flexibility and dynamic balance improved in VFR group (p<0.05). Both 6-week VFR and FR increased muscle strength without affecting H:Q ratio. VFR was more effective than FR for improving flexibility and dynamic balance. The results can be stunning for performance enhancement.

A narrative review of thalassotherapy and the health benefits of seawater and coastal climates

Thalassotherapy refers to the therapeutic use of controlled exposure to marine environments and their natural elements for health promotion. This review aims to summarize evidence-based clinical applications of thalassotherapy. A narrative review was conducted, with PubMed searched in September 2024 for clinical studies evaluating the efficacy of thalassotherapy. Relevant evidence was summarized and critically analyzed. A total of 566 articles were identified, of which 16 studies met the inclusion criteria. Thalassotherapy was primarily studied for its effects on skin disorders, including psoriasis, atopic dermatitis, and vitiligo, as well as rheumatic conditions like fibromyalgia and ankylosing spondylitis. The intervention showed significant improvements in disease severity and patient quality of life, with the strongest evidence seen in psoriasis and fibromyalgia treatment. Thalassotherapy appears beneficial for symptom relief in several conditions, particularly skin and rheumatic disorders. However, further research is needed to quantify its effect size, evaluate long-term benefits, assess potential risks, and identify factors that may influence treatment outcomes.

The Acquisition of Cardiovascular Adaptation to Aerobic Exercise: When Does It Begin and How Does It Evolve Depending on Intrinsic and Extrinsic Factors?

The acquisition and evolution of cardiovascular (CV) adaptation to physical activity or exercise training are critical in enhancing cardiorespiratory fitness and reducing CV disease (CVD) risk. CV adaptations to exercise occur through structural, functional, and molecular changes that enhance cardiac efficiency. These adaptations, such as increased stroke volume, improved blood pressure regulation, and enhanced endothelial function, collectively reduce CVD morbidity and mortality. In this review we explore how CV adaptations vary across different demographic characteristics, and highlight the importance of exercise timing, intensity, and recovery periods. We delve into the immediate physiological responses to physical activity, such as increased heart rate and cardiac output, and the longer-term adaptations, including cardiac hypertrophy and improved vascular function. The influence of age, sex, and preexisting health conditions on CV responses to exercise is also discussed, emphasizing the need for tailored exercise interventions. Finally, the review highlights the significance of recovery periods in optimizing CV adaptations and how insufficient recovery might lead to adverse outcomes. Overall, understanding the timing and evolution of CV adaptations can inform exercise prescriptions to improve CV health across populations for the primary and secondary prevention of CVD.

Effects of oral γ-aminobutyric acid intake on muscle regeneration in diabetic mice

Though γ-aminobutyric acid (GABA) serves as the primary inhibitory neurotransmitter in the brain, its numerous biological activities in the periphery, including anti-inflammatory and antidiabetic functions, have been documented. In addition, GABA may be a mediator underlying effects of ketone bodies/ketogenic diets on muscle regeneration. Here, we investigated the effects of GABA on muscle regeneration in type 1 diabetes mouse models. Akita and wild-type (WT) mice were treated with GABA in drinking water for 6 wk, followed by cardiotoxin (CTX)-induced muscle injury. At 5 days postinjury, GABA treatment exhibited no effects on regenerating myofiber size in both WT and Akita mice. Unexpectedly, regenerating GABA-treated Akita muscles exhibited significantly increased embryonic myosin heavy chain (eMHC) expression and higher intramuscular macrophage content, suggesting delays in muscle regeneration and in elevated macrophage infiltration in diabetic muscles. Next, we determined if GABA treatment delayed the inflammatory process during muscle regeneration. Providing GABA in the drinking water during the peak inflammatory period (days 0-5 postinjury) resulted in a significantly greater amount of small regenerating myofibers and higher expressions of TNFα and eMHC in regenerating streptozotocin (STZ)-diabetic muscles, indicating delays in inflammation process and muscle regeneration in diabetes. Plasma GABA levels were found higher in GABA-treated STZ mice than in WT mice and negatively correlated with regenerating myofiber size. This delay in muscle regeneration in STZ-diabetic mice was abolished by a lower dose of GABA water that did not raise plasma GABA levels. Together, high doses of GABA intake during the early phases of muscle repair may delay regeneration.NEW & NOTEWORTHY With increasing evidence that ketogenic diets improve aspects of muscle health (e.g., insulin sensitivity and mitochondrial function), we hypothesized that supplementation with GABA-a key metabolite changed with ketogenic diets-would improve muscle recovery from injury. Unexpectedly, GABA supplementation during the early inflammatory phases of muscle regeneration delayed muscle repair in type 1 diabetes mice, possibly due to inflammation suppression. Further work is needed to ascertain the effective use of GABA supplementation, particularly following intense or damaging exercise.

Impaired Endothelial Function in Individuals With Post-Acute Sequelae of COVID-19: Effects of Combined Exercise Training

PURPOSE

We investigated the presence of impaired endothelial function in individuals with post-acute sequelae of coronavirus disease-2019 (PASC) compared to healthy individuals and explored the efficacy of combined exercise training in restoring or improving endothelial function in those with PASC.

METHODS

Study I was a cross-sectional study which compared endothelial function between individuals with PASC (n = 29, mean age 22.9 ± 3.9 year) and healthy individuals (n = 42, mean age 21.7 ± 2.0 year). Study II, an intervention design, explored if combined exercise training (n = 14) could reverse the decline in endothelial function associated with PASC compared to controls (n = 14). The combined exercise program included aerobic, resistance, and inspiratory muscle training administered for 8 weeks. We measured endothelial function using flow-mediated dilation of the brachial artery and assessed peak oxygen uptake (VO2peak), dyspnea, and fatigue before and after the intervention.

RESULTS

Individuals with PASC exhibited significantly lower endothelial function compared to healthy controls (4.95 ± 2.0% vs 8.00 ± 2.4%, P < .001). The exercise group showed a significant increase in endothelial function (4.73 ± 1.5% to 7.98 ± 2.4%) as opposed to the control group (5.31 ± 2.5% to 6.30 ± 2.5%) (interaction effect: P = .008), reaching levels similar to those in healthy individuals. Additionally, the exercise group demonstrated improvement in VO2peak (38.3 ± 6.4 ml/min/kg to 42.8 ± 7.3 ml/min/kg, P < .001) and a reduction in dyspnea and fatigue compared to the control group (P < .001).

CONCLUSIONS

Having PASC is associated with impaired endothelial function, but combined exercise training effectively restores it, making it a promising lifestyle intervention for vascular function in PASC.

Relationship between characteristics of segmental phase angles and walking ability in patients with hemiplegia after stroke and traumatic brain injury in a convalescent rehabilitation ward

This study determined the characteristics of the phase angles (PhAs) of the trunk, affected limb, and unaffected limb at admission and their relationship with walking ability at discharge in patients with stroke and traumatic brain injury in a convalescent rehabilitation ward. Stroke and traumatic brain injury survivors with hemiplegia admitted to a convalescent rehabilitation ward were divided into independent- and dependent-walking groups. The trunk, affected limb, and unaffected limb PhAs were evaluated using bioelectrical impedance analysis and compared between the independent- and dependent-walking groups. Friedman's test was performed to analyze differences in the trunk, affected limb, and unaffected limb PhAs within each group. Multiple regression was performed to examine the association between walking ability and segmental PhAs. We enrolled 47 patients (independent-walking group: n  = 12; dependent-walking group: n  = 35). The dependent-walking group had a significantly lower trunk, affected limb, and unaffected limb PhAs. The segmental PhA was higher in the trunk than in the affected and unaffected limbs in the independent-walking group and lower in the affected limb than in the trunk and unaffected limb in the dependent-walking group. Only the trunk PhA at admission was significantly associated with walking ability at discharge ( β = 0.367; P  = 0.002). The trunk PhA at admission may be related to walking ability at discharge in patients undergoing stroke and traumatic brain injury rehabilitation.

Effects of a 40-min nap on performance following evening exercise before, during, and after Ramadan fasting

This study examined the effect of a 40-min nap (N40) the day after a night session of the Loughborough Intermittent Shuttle Test (LIST), before, during and after Ramadan. In a randomized crossover design, fifteen male soccer players completed the LIST in the evening (2100h), followed by either a N40 or no nap (N0) the next day, at 1400h. Performance on the 5-m shuttle run test (5mSRT), digit cancellation test (DCT), and subjective measures (i.e., sleepiness, rating of perceived exertion, and muscle soreness) were assessed at 1700h. During Ramadan, 5mSRT and DCT performance decreased compared to before Ramadan in the N0 condition (p<0.05). However, N40 improved 5mSRT and DCT performance across all periods compared to N0 (p<0.05). In conclusion, a 40-min of nap opportunity is an effective strategy for improving physical and cognitive performance during and following Ramadan after a bout of exercise the previous night.    .

The shear modulus of the vastus lateralis muscle does not follow the passive residual torque enhancement in the knee extensors

In vitro experiments define passive force enhancement as the increase in steady-state passive force following the deactivation of an actively stretched muscle, in contrast to a purely passive stretch. This phenomenon, linked to residual force enhancement, is also observed in voluntarily contracted muscles as passive residual torque enhancement (RTEpass). While mechanisms remain unclear, titin stiffness likey plays a key role. Supersonic shear wave elastography (SSI) estimates tissue stiffness via the shear modulus (μ). The study aimed to assess whether RTEpass of the knee extensor muscles is accompanied by an increase in vastus lateralis stiffness (RμEpass) as measured by shear wave elastography. Passive torque was measured in 20 healthy young adults at a knee flexion angle of 100° before and after both isometric contractions (control protocol) and isometric contractions preceded by an eccentric contraction at 30°/s (from 70° to 100°). The comparison of protocols revealed a significant mean RTEpass of 1.03 N·m (16.5 %; p < 0.001), confirming the RTEpass in knee extensors. Although the experimental protocol showed a significant change in μ from the Before- to Post-contraction moment (5.89 %; p = 0.041), no differences in μ were observed between protocols at any post-contraction moments (p ≥ 0.191). Spearman correlation analysis indicated a weak, non-significant correlation between RTEpass and RμEpass (rs = 0.219; p = 0.352). These findings suggest that changes in vastus lateralis stiffness, as measured by SSI, are insufficient to explain RTEpass. While the literature identifies titin as a primary mechanism for passive residual torque enhancement, SSI elastography did not detect this phenomenon through solely vastus lateralis stiffness.

Exploring Trends between Dance Experience, Athletic Participation, and Injury History

Background and Purpose

Dancers sustain substantial injury rates ranging from 0.62-5.6 injuries per 1000 dance exposure hours with 72% of these injuries attributed to overuse mechanisms. Highly technical activities like dance often require high training volumes incorporating deliberate practice from a young age which may contribute to these high percentages of overuse injuries. The purpose of this study was to determine trends between dance participation, athletic participation, and injury history.

Study Design

Cross-sectional survey.

Methods

Dancers over 18 years old with at least one year of dance experience were recruited from across the United States to complete a survey via Qualtrics. The survey included five sections addressing basic demographic information, dance experience, athletic activity history, and injury history. Relationships between variables were analyzed using the Mann-Whitney U test or the Wilcoxon Signed Rank test. Factorial ANOVAs were also used to observe relationships between three or more groups.

Results

Of 424 total responses, 339 were deemed complete for analysis. Nearly 75% of respondents reported experiencing at least one injury that inhibited their dance ability. Greater total injuries were reported by participants who had more years of dance experience, those who practiced ballet, and individuals who began dance before age 12. Approximately one-third of participants exclusively participated in dance with no involvement with other athletic activities. Respondents starting dance prior to age 12 reported participation in fewer athletic activities. However, no difference in the number of injuries was observed between individuals involved in athletic activity compared to those practicing dance alone.

Conclusion

Increased dance exposure and associated high training volumes and repetitive movements may represent a greater risk for overuse injuries than sport specialization in dancers.

Level of Evidence

3B.

Selected Immunoendocrine and Physiological Performance Adaptations to Different Volume of Upper-Body Plyometric Training in National-Level Male Volleyball Players

PURPOSE

This study aimed to investigate the impact of a 6-week upper-body plyometric-training (PT) program with varying volumes on the immunoendocrine, physiological parameters, and physical performance adaptations in male volleyball players.

METHODS

Twenty-four trained college players were randomly allocated into 3 groups with 8 participants. Each group performed 5 exercises at maximal effort with differences in volume: low (3 sets of 7 repetitions), moderate (3 sets of 10 repetitions), and high (3 sets of 13 repetitions). The training program lasted 6 weeks with participants undertaking 3 sessions of PT per week.

RESULTS

Following the intervention, all groups exhibited significant (P = .001) improvements in physical and physiological parameters, as well as skill-based performances, with effect sizes ranging from small to very large. Comparative analysis of individual changes indicated that the high-volume group resulted in greater adaptive responses in the medicine-ball throw (P = .004), peak (P = .001) and average (P = .022) power output, push-ups (P = .001), and strength (P = .032) compared with the low-volume group. No significant between-groups difference (P > .05) was observed regarding immunoendocrine measures, reaction time, attacking, and serving skills.

CONCLUSIONS

The findings indicate that short-term upper-body PT positively influenced performance adaptations, emphasizing that the adaptive response to PT depends on the varying volumes. The study proposes that integrating higher volumes of PT results in more significant adaptive responses among volleyball players with the same immunoendocrine responses as the other training volumes.

Physiological team dynamics explored: physiological synchrony in medical simulation training

INTRODUCTION

For researchers and medical simulation trainers, measuring team dynamics is vital for providing targeted feedback that can lead to improved patient outcomes. It is also valuable for research, such as investigating which dynamics benefit team performance. Traditional assessment methods, such as questionnaires and observations, are often subjective and static, lacking the ability to capture team dynamics. To address these shortcomings, this study explores the use of physiological synchrony (PS) measured through electrocardiogram (ECG) data to evaluate team dynamics automated and in high-resolution.

METHODS

A multicentre observational field study was conducted involving 214 medical first responders during mixed reality (MR) mass casualty training sessions. Participants were equipped with electrocardiogram (ECG) sensors and MR gear. The study measured dyadic PS using heart rate (HR), root mean square of successive differences (RMSSD), and standard deviation of NN intervals (SDNN). Data were collected at high frequency and analysed using dynamic time warping (dtw) to assess fluctuations in PS.

RESULTS

Findings indicate that PS varies significantly by task nature, with higher synchrony during cooperative tasks compared to baseline. Different ECG metrics offered unique insights into team dynamics. Proximity and scenario conditions influenced PS, with closer teamwork leading to higher PS. Smaller sampling intervals (e.g. 5 s) provided a detailed view of PS fluctuations over time.

DISCUSSION

The results demonstrate the potential of PS as an indicator of team performance and cohesion. High-resolution monitoring provides detailed insights into team dynamics, offering high-resolution feedback that traditional methods cannot provide. The integration of physiological measures into training programmes can enhance team performance by providing objective, high-resolution data.

CONCLUSION

This study shows that PS, measured by ECG data, is sensitive to medical team activities, offering insights into team dynamics. Different ECG metrics highlight various aspects of team performance, and high-resolution monitoring captures detailed dynamics. Further research is needed to validate these findings across diverse scenarios. This approach could improve training methodologies, resulting in better-prepared medical teams and improved patient care outcomes.

Breaking up sitting enhances neurocognitive function which is associated with improved postprandial glucose regulation in healthy adults: A randomized crossover study

BACKGROUND AND AIMS

The glucose-centric hypothesis postulates that glycemic control may influence cognition. While research has examined the effects of breaking up sitting on blood glucose and inhibitory control, few studies have integrated these data and employed event-related potential (ERP) measures to delve into the neuroelectric processes. This study aimed to investigate the effects of breaking up sitting on postprandial blood glucose response, inhibitory control, and P3 component.

METHODS

Eighteen healthy male participants [25 ± 4 years, 23.5 ± 3.2 kg/m² (mean ± SD)] were subjected to 3.5 h uninterrupted sitting (SIT) or with 3 min walking at 6.4 km/h every 30 min (ACTIVE) trials in a randomized crossover design. The Stroop task was administered to assess inhibitory control before and after SIT and ACTIVE trials, and electroencephalography was employed to derive stimulus-elicited P3 component. Finger prick blood glucose levels were collected at baseline, 0.5 h, 1 h, and 3.5 h during the trials.

RESULTS

While no significant differences were found in inhibitory control performances between trials, greater P3 amplitude was found in the ACTIVE trial relative to the SIT trial (p = .041). Lower postprandial blood glucose iAUC was found in ACTIVE trial compared to SIT trial (p = .028), and this was correlated with the elevation of P3 amplitude (r = - 0.521, p = .023).

CONCLUSION

Breaking up sitting acutely facilitates neuroelectric indices of attentional processing, which is associated with the optimal postprandial blood glucose control.

When Leaders Don't Walk the Walk: A National Survey of Academic Nurse Leader Perceptions of Staff Burnout

AIM

This survey explored nurse leaders' impressions of burnout on college/school of nursing (CON/SON) administrative staff and leadership-facilitated strategies used to promote resilience building/mitigate burnout.

BACKGROUND

Administrative staff are foundational to the success of a university's CON/SON, yet few studies have explored the impact of burnout in this group.

METHOD

Cross-sectional survey distributed to associate dean and business officer attendees of the 2022 American Association of Colleges of Nursing, Business Officers of Nursing Schools meeting (summer 2022) ( n = 64).

RESULTS

Most respondents lacked a burnout mitigation plan (46/64, 72%); many also lacked a personal strategy for managing their own burnout (46/64, 72%) and did not personally participate in university activities to maintain their well-being (45/64, 70%).

CONCLUSION

This study highlights the impact of nurse leaders who fail to model self-care, which may limit the benefit of costly burnout mitigation activities and resources in their universities.

Harnessing the benefits of physical exercise-induced melatonin: a potential promising approach to combat Alzheimer's disease by targeting beta-amyloid (Aβ)

Alzheimer's disease (AD) is a chronic neurogenerative disease that impairs cognition, learning, behavior, and memory. The aberrant accumulation of extracellular amyloid-β (Aβ) plaques is a characteristic of AD. It has been demonstrated that melatonin exerts a significant role in AD prevention and treatment via its antioxidant effects, reducing neuroinflammation, and Aβ. Moreover, studies have shown that physical exercise (PE) is not only a promising non-pharmacological strategy for AD prevention and treatment but can also lead to an increase in melatonin levels. Hence, we hypothesized that PE can contribute to AD prevention and treatment by increasing melatonin levels and reducing Aβ accumulation, enhancing Aβ clearance, and modulating inflammation in these patients. However, the mechanisms by which PE increases melatonin synthesis and the cellular and molecular mechanisms of actions of melatonin in AD prevention and treatment have not to date been completely understood. Therefore, in the future, further investigations are required to elucidate the underlying mechanisms, optimize intervention strategies, identify biomarkers, and validate findings through clinical trials. Understanding the potential of exercise-induced melatonin in AD holds promise for innovative therapeutic interventions and future directions in AD research.

Effect of Zataria multiflora supplementation on pro- or anti-inflammatory markers: a systematic review and meta-analysis of randomized placebo-controlled trials

The aim of this study was to investigate the effectiveness of Zataria multiflora and carvacrol supplementation on inflammatory markers (IL-2, IL-4, IL-5, IL-6, TNF-α, IL-8, IL-10, interferon gamma (IFN-γ), C-reactive protein (CRP), monocyte chemotactic protein 1 (MCP-1), epidermal growth factor (EGF), and vascular endothelial growth factor (VEGF)) by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs).The exploration of literature was conducted until August 2024 on databases like PubMed/Medline, Web of Science, Scopus, Cochrane CENTRAL, and Google Scholar. The current study incorporated trial studies examining how oral supplements of Zataria multiflora and carvacrol impact concentrations of inflammatory markers. By utilizing a random effects model, the mean differences (SMD) and 95% confidence intervals (CI) were pooled for analysis of the results. The Cochrane Q and I2 values were used to evaluate heterogeneity. The meta-analysis included ten cases, with 562 participants in the Zataria multiflora group and 700 in the control group. A significant decrease in the levels of various cytokines including IL-2, IL-4, IL-5, IL-6, IL-8, CRP, EGF, VEGF, and MCP-1 was observed with the consumption of Zataria multiflora along with a noteworthy increase in both IFN-γ and IL-10. However, TNF-α levels remained unaffected by the intervention involving Zataria multiflora and carvacrol. It should be noted that limitations of this study include the fact that it draws from research in Iran, encompasses a range of different diseases, and overlooks potential confounders like smoking, physical activity, and diet. In summary, the results suggested that Zataria multiflora and carvacrol can be beneficial for reducing inflammation.

Examining the acute cardiovagal consequences of supine recovery during high-intensity interval exercise

PURPOSE

Exercise training requires the careful application of training dose to maximize adaptation while minimizing the risk of illness and injury. High-intensity interval training (HIIT) is a potent method for improving health and fitness but generates substantial autonomic imbalance. Assuming a supine posture between intervals is a novel strategy that could enhance physiological readiness and training adaptations. This study aimed to establish the safety and feasibility of supine recovery within a HIIT session and explore its acute effects.

METHODS

Fifteen healthy, active males (18-34 years) underwent assessment of cardiopulmonary fitness. Participants completed two identical HIIT treadmill sessions (4 x [3 min at 95% VO2max, 3 min recovery]) employing passive recovery in standing (STANDard) or supine (SUPER) posture between intervals. Heart rate variability (HRV), HRV recovery (HRVrec; lnRMSSD) and heart rate recovery at 1 min (HRrec) were assessed using submaximal constant speed running tests (CST) completed prior to, immediately after and 24 h following HIIT.

RESULTS

No severe adverse events occurred with SUPER, and compliance was similar between conditions (100 ± 0%). The change in HRVrec from the CST pre-to-post-HIIT was not different between conditions (p = 0.38); however, HRrec was faster following SUPER (39 ± 7 bpm) vs. STANDard (36 ± 5 bpm). HRV 24 h post-SUPER was also greater (3.56 ± 0.57 ms) compared to STANDard (3.37 ± 0.42 ms). Despite no differences in perceived exertion (p = 0.23) and blood lactate levels (p = 0.35) between SUPER and STANDard, average running HRs were lower (p = 0.04) with SUPER (174 ± 7 bpm) vs. STANDard (176 ± 7 bpm).

CONCLUSIONS

Supine recovery within HIIT attenuates acute cardioautonomic perturbation and accelerates post-exercise vagal reactivation. SUPER enhances recovery of vagal modulation, potentially improving physiological preparedness 24 h post-HIIT. Further research exploring the chronic effects of SUPER are now warranted.

Anthropometric-based predictive equations developed with multi-component models for estimating body composition in athletes

PURPOSE

Body composition can be estimated using anthropometric-based regression models, which are population-specific and should not be used interchangeably. However, the widespread availability of predictive equations in the literature makes selecting the most valid equations challenging. This systematic review compiles anthropometric-based predictive equations for estimating body mass components, focusing on those developed specifically for athletes using multicomponent models (i.e. separation of body mass into ≥ 3 components).

METHODS

Twenty-nine studies published between 2000 and 2024 were identified through a systematic search of international electronic databases (PubMed and Scopus). Studies using substandard procedures or developing predictive equations for non-athletic populations were excluded.

RESULTS

A total of 40 equations were identified from the 29 studies. Of these, 36 were applicable to males and 17 to females. Twenty-six equations were developed to estimate fat mass, 10 for fat-free mass, three for appendicular lean soft tissue, and one for skeletal muscle mass. Thirteen equations were designed for mixed athletes, while others focused on specific contexts: soccer (n = 8); handball and rugby (n = 3 each); jockeys, swimming, and Gaelic football (n = 2 each); and futsal, padel, basketball, volleyball, American football, karate, and wheelchair athletes (n = 1 each).

CONCLUSIONS

This review presented high-standards anthropometric-based predictive equations for assessing body composition in athletes and encourages the development of new equations for underrepresented sports in the current literature.

Overview of mechanisms related to citrulline malate supplementation and different methods of high-intensity interval training on sports performance: A narrative review

Regular exercise is a practical non-pharmacological approach to maintaining physical and mental health through rehabilitation and prevention of chronic diseases due to its cardiovascular, cardiorespiratory, neurological, and neuromuscular benefits. Despite awareness of the benefits of exercise, a "lack of time" has proven to be the most common impediment to regular activity. Thus, a time-efficient and potentially enjoyable training modality with growing popularity is high-intensity interval training (HIIT). HIIT incorporates intermittent bouts of work and recovery intervals performed at an intensity close to maximal oxygen consumption (VO2max). HIIT is considered to have equivalent or superior benefits compared to moderate-intensity continuous training (MICT). This narrative review focuses on the mechanisms of Citrulline Malate (CM) supplementation and various modes of HIIT on exercise performance. CM serves as a nitric-oxide enhancer leading to improved aerobic and anaerobic exercise performance by increasing muscle adenosine triphosphate (ATP) production, vasodilation, and blood flow to the active musculature and boosting work capacity. This article reviews the mechanisms related to CM supplementation and different modes of HIIT on exercise performance. Even though a single, acute 8 g dose of CM has been recommended, its mechanism of action remains to be seen due to the synergistic impact of both components (citrulline and malate). Moreover, the limited evidence for the standard level of supplement use and source of purchase results in athletes' self-prescription of supplements. Therefore, to reduce the risk of accidental doping or toxicity, further studies should continue to investigate the optimal dose, timing, mechanism of action, as well as reliable sources of purchase for CM consumption.

Effects of balance and hamstring training on nonspecific low back pain: A randomized controlled trial

Low back pain is a prevalent musculoskeletal disorder and affects approximately 70% of the adults in the world. To explore how balance and hamstring training improve individuals with nonspecific lower back pain (NSLBP). A total of 26 NSLBP people were randomly allocated into either the experimental group (EG) (n = 13) or the control group (CG) (n = 13). The EG was given balance and hamstring training for 45 min, 3 times per week, for up to 6 weeks, while the CG maintained daily life without any intervention. The primary outcome, the Visual Analog Scale for pain intensity, and the secondary outcomes, including the TOGU balance test for balance ability, hamstring and lumbar muscle strength and endurance, and the sit-and-reach test for hamstring flexibility, were assessed at baseline and after 6 weeks of training. For the primary outcome, the EG significantly improved pain intensity (p < 0.001) compared with CG. For secondary outcomes, the EG showed significant improvements in back strength (p = 0.015), abdominal endurance (p = 0.032), back endurance (p = 0.027), and hamstring strength (p = 0.007 left) (p = 0.005 right) following 6 weeks of training compared with the CG. However, the two groups had no significant difference in balance ability, abdominal strength, and hamstring extensibility (p ≥ 0.05). Six weeks of balance and hamstring training effectively reduces pain intensity and improves back strength, abdominal and back endurance, and hamstring strength.Trial registration International Standard Registered Clinical/Social Study Number (ISRCTN) registry, ISRCTN14488937 (28/05/2024).

Resveratrol and Physical Activity: A Successful Combination for the Maintenance of Health and Wellbeing?

Physical exercise is an essential component of human health. In recent years, scientific research has focused on identifying natural compounds and formulating new supplements aimed at enhancing athletic performance, accelerating muscle recovery, and minimizing the damage caused by physical exertion. The use of antioxidants to counteract the formation of reactive oxygen species (ROS) following physical activity (PA) is already a widely adopted practice. Resveratrol (RES), a polyphenol belonging to the stilbene class, is well known for its potent antioxidant activity and anti-inflammatory effects primarily attributed to the activation of sirtuins. RES possesses multiple nutraceutical properties used for the prevention and treatment of inflammatory, cardiovascular, neoplastic, and infectious diseases, thus attracting attention to study its use in combination with physical exercise to promote well-being. Animal trials combining RES and PA have mainly reported improvements in muscle, energy, and cardiovascular functions. The data presented and discussed in this narrative review are from Pubmed, Scopus, and the Human Gene Database (search limited to 2011 to 2025 with the keywords RES, sirtuins, and physical activity altogether or in combination with each other). This review gathers several studies on RES focusing on its nutraceutical properties, epigenetic activities via sirtuins, and the potential benefits of combining RES with PA in maintaining health and well-being based on trials performed first in animals and later in humans. Human studies have been conducted on various populations, including active adults, sedentary individuals, patients with diseases, and elderly individuals. Some studies have confirmed the benefits of RES observed in animal experiments. However, in some cases, no substantial differences were found between RES supplementation and the control group. In conclusion, the benefits of RES on PA reported in the literature are still not fully evident, given the contrasting studies and the still limited number of trials, but both RES and PA are successful tools for the maintenance of health and wellbeing.

Acute Effects of Static Stretching on Handgrip Strength and Wrist Joint Flexibility in Physically Active Older Women

BACKGROUND/OBJECTIVE

The muscle strength and flexibility responses to stretching in older adults are unclear. We aimed to examine the acute effects of static stretching on handgrip strength and wrist joint flexibility in older women.

METHODS

Twenty physically active older women (68 ± 6 years) performed handgrip contractions and wrist joint flexibility assessments before and after a control condition (quiet resting) and an experimental condition of static stretching for 30 s. Peak force and rate of force development variables were obtained from each contraction. Wrist joint range of motion was determined from the flexibility assessments.

RESULTS

There were no significant changes in handgrip peak force or rate of force development variables after the stretching treatment (p = .11-.88). There was, however, a significant stretch-induced increase in wrist joint range of motion (p < .01).

CONCLUSION

These findings indicate that a 30-s bout of static stretching may be an effective intervention for increasing wrist joint flexibility without decreasing handgrip strength. Significance/Implications: The results of our study may have important implications for creating stretching interventions that can be used as part of a warm-up routine to help attenuate the negative effects of age on range of motion. Such interventions may be beneficial for improving functional performance and reducing the risk of injury in older populations.

Addressing Nutritional Knowledge Gaps in Inflammatory Bowel Disease: A Scoping Review

This scoping review aims to map the existing literature on nutritional knowledge among people with IBD, identify gaps in current understanding, and provide guidance for future educational interventions. Background: Inflammatory bowel diseases (IBDs) are chronic conditions affecting the gastrointestinal tract, where nutrition plays a crucial role in symptom management. Despite its significance, patient knowledge about proper dietary practices remains limited, with widespread misconceptions potentially leading to suboptimal health outcomes. Methods: This review followed the Arksey and O'Malley framework and adhered to PRISMA 2020 guidelines. A systematic search was conducted in three databases (PubMed, Web of Science, and SCOPUS) for studies published between 2003 and 2024. Only studies involving adults (≥18 years) with IBD and focusing on nutritional knowledge were included. Results: From 1440 records initially identified, 23 studies met the inclusion criteria. The findings highlight that IBD patients often base dietary decisions on personal beliefs rather than evidence-based guidelines, leading to widespread food avoidance and increased risk of malnutrition. Misconceptions such as avoiding dairy, gluten, and fiber without professional advice were prevalent. Educational interventions, including personalized counseling and group sessions, showed the potential to improve nutritional knowledge and symptom management, though their application remains inconsistent across settings. Conclusions: IBD patients face significant gaps in nutritional knowledge, emphasizing the need for structured educational initiatives. A personalized, multidisciplinary approach, integrating dietary education into standard care, is essential to improve symptom control and enhance quality of life. Future research should focus on developing evidence-based interventions tailored to the unique needs of this population.