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Krokidas A, Gakis AG, Aktypi O, Antonopoulou S, Nomikos T. Effect of Spirulina Nigrita® Supplementation on Indices of Exercise-Induced Muscle Damage after Eccentric Protocol of Upper Limbs in Apparently Healthy Volunteers. Nutrients 2024; 16:1651. [PMID: 38892584 PMCID: PMC11174877 DOI: 10.3390/nu16111651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/23/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Spirulina is a supplement with antioxidant and anti-inflammatory properties that may enhance performance and recovery after intense exercise. The present study aimed to investigate the effects of Spirulina Nigrita® on physical performance, and recovery markers after intense eccentric exercise in healthy moderately physically active volunteers. In a double-blind crossover design, participants were supplemented either with spirulina (42 mg Kg-1 BW per day) or a placebo for 15 days before conducting an eccentric exercise protocol using the non-dominant arm. A six-week washout period was required between conditions. Performance and mobility markers such as isometric peak torque (PTQ), ligament range of motion (ROM), and perceived muscle discomfort (VAS) were assessed and blood samples (CK, LDH) were obtained at 1, 24, 48, and 72 h post-exercise. No significant differences were noticed between the two conditions on any of the investigated markers, indicating that spirulina supplementation has no positive effect on isometric muscle performance or alleviation of exercise-induced muscle damage (EIMD) symptoms in the specific population.
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Affiliation(s)
| | | | | | | | - Tzortzis Nomikos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, 176 76 Athens, Greece; (A.K.); (A.G.G.); (O.A.); (S.A.)
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Delfan M, Saeidi A, Supriya R, Escobar KA, Laher I, Heinrich KM, Weiss K, Knechtle B, Zouhal H. Enhancing cardiometabolic health: unveiling the synergistic effects of high-intensity interval training with spirulina supplementation on selected adipokines, insulin resistance, and anthropometric indices in obese males. Nutr Metab (Lond) 2024; 21:11. [PMID: 38454429 PMCID: PMC10921712 DOI: 10.1186/s12986-024-00785-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/16/2024] [Indexed: 03/09/2024] Open
Abstract
This study investigated the combined effects of 12 weeks of high-intensity interval training (HIIT) and spirulina supplementation on adipokine levels, insulin resistance, anthropometric indices, and cardiorespiratory fitness in 44 obese males (aged 25-40 years). The participants were randomly assigned to one of four groups: control (CG), supplement (SG), training (TG), or training plus supplement (TSG). The intervention involved daily administration of either spirulina or a placebo and HIIT three times a week for the training groups. Anthropometric indices, HOMA-IR, VO2peak, and circulating adipokines (asprosin and lipocalin2, omentin-1, irisin, and spexin) were measured before and after the 12-week intervention. Post-intervention analysis indicated differences between the CG and the three interventional groups for body weight, fat-free mass (FFM), percent body fat (%BF), HOMA-IR, and adipokine levels (p < 0.05). TG and SG participants had increased VO2peak (p < 0.05). Spirulina supplementation with HIIT increased VO2peak, omentin-1, irisin, and spexin, while causing decreases in lipocalin-2 and asprosin levels and improvements in body composition (weight, %fat), BMI, and HOMA-IR. Notably, the combination of spirulina and HIIT produced more significant changes in circulating adipokines and cardiometabolic health in obese males compared to either supplementation or HIIT alone (p < 0.05). These findings highlight the synergistic benefits of combining spirulina supplementation with HIIT, showcasing their potential in improving various health parameters and addressing obesity-related concerns in a comprehensive manner.
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Affiliation(s)
- Maryam Delfan
- Department of Exercise Physiology, Faculty of Sport Sciences, Alzahra University, Tehran, Iran.
| | - Ayoub Saeidi
- Department of Physical Education and Sport Sciences, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Kurdistan, Iran
| | - Rashmi Supriya
- Centre for Health and Exercise Science Research, SPEH, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Kurt A Escobar
- Department of Kinesiology, California State University, Long Beach, CA, 90840, USA
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Katie M Heinrich
- Department of Kinesiology, Kansas State University, Manhattan, KS, 66502, USA
| | - Katja Weiss
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland.
- Medbase St. Gallen Am Vadianplatz, Vadianstrasse 26, St. Gallen, 9001, Switzerland.
| | - Hassane Zouhal
- Univ Rennes, M2S (Laboratoire Mouvement, Sport, Rennes, Santé, EA 1274, F-35000, France.
- Institut International des Sciences du Sport (2I2S), Irodouer, 35850, France.
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Supriya R, Delfan M, Saeidi A, Samaie SS, Al Kiyumi MH, Escobar KA, Laher I, Heinrich KM, Weiss K, Knechtle B, Zouhal H. Spirulina Supplementation with High-Intensity Interval Training Decreases Adipokines Levels and Cardiovascular Risk Factors in Men with Obesity. Nutrients 2023; 15:4891. [PMID: 38068748 PMCID: PMC10707917 DOI: 10.3390/nu15234891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Adiposity, a state characterized by excessive accumulation of body fat, is closely linked to metabolic complications and the secretion of specific adipokines. This study explores the potential of exercise and Spirulina supplementation to mitigate these complications and modulate adipokine release associated with obesity. The primary objective of this investigation was to examine the impact of a 12-week regimen of high-intensity training combined with Spirulina supplementation on adipokine concentrations and lipid profiles in male individuals with obesity (N = 44). The participants were randomly distributed into four groups, each consisting of 11 participants: a control group (CG), a supplement group (SG), a training group (TG), and a training plus supplement group (TSG). The intervention comprised a 12-week treatment involving Spirulina supplementation (6 g capsule daily), a 12-week high-intensity interval training (HIIT) protocol with three sessions per week, or a combined approach. Following the interventions, metabolic parameters, anthropometric measurements, cardiorespiratory indices, and circulating adipokines [CRP, Sema3C, TNF-α, IL-6, MCP1, IL-8] were assessed within 48 h of the before and final training session. Statistical analyses revealed significant differences across all measures among the groups (p < 0.05). Notably, post hoc analyses indicated substantial disparities between the CG and the three interventional groups regarding body weight (p < 0.05). The combined training and supplementation approach led to noteworthy reductions in low-density lipoprotein (LDL), total cholesterol (TC), and triglyceride (TGL) levels (all p < 0.0001), coupled with an elevation in high-density lipoprotein-cholesterol (HDL-C) levels (p = 0.0001). Furthermore, adipokine levels significantly declined in the three intervention groups relative to the CG (p < 0.05). The findings from this 12-week study demonstrate that Spirulina supplementation in conjunction with high-intensity interval training reduced adipokine levels, improved body weight and BMI, and enhanced lipid profiles. This investigation underscores the potential of Spirulina supplementation and high-intensity interval training as a synergistic strategy to ameliorate obesity-related complications and enhance overall cardiometabolic well-being in obese males.
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Affiliation(s)
- Rashmi Supriya
- Center For Health & Exercise Science Research, Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR 999077, China;
| | - Maryam Delfan
- Department of Exercise Physiology, Faculty of Sport Sciences, Alzahra University, Tehran 15847-15414, Iran
| | - Ayoub Saeidi
- Department of Physical Education and Sport Sciences, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Kurdistan 66177-15175, Iran;
| | - Seyedeh Somayeh Samaie
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Alborz Campus, University of Tehran, Tehran 15719-14911, Iran;
| | - Maisa Hamed Al Kiyumi
- Department of Family Medicine and Public Health, Sultan Qaboos University, Muscat P.O. Box 35, Oman;
- Department of Family Medicine and Public Health, Sultan Qaboos University Hospital, Muscat P.O. Box 35, Oman
| | - Kurt A. Escobar
- Department of Kinesiology, California State University, Long Beach, CA 90840, USA;
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
| | - Katie M. Heinrich
- Department of Kinesiology, Kansas State University, Manhattan, KS 66502, USA;
- Research Department, the Phoenix, Manhattan, KS 66502, USA
| | - Katja Weiss
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland; (K.W.); (B.K.)
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland; (K.W.); (B.K.)
- Medbase St. Gallen Am Vadianplatz, 9000 St. Gallen, Switzerland
| | - Hassane Zouhal
- M2S (Laboratoire Mouvement, Sport, Santé)—EA 1274, Université de Rennes, 35000 Rennes, France
- Institut International des Sciences du Sport (2I2S), 35850 Irodouer, France
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Ali Y, Aubeeluck R, Gurney T. Fourteen-Days Spirulina Supplementation Increases Hemoglobin, but Does Not Provide Ergogenic Benefit in Recreationally Active Cyclists: A Double-Blinded Randomized Crossover Trial. J Diet Suppl 2023; 21:261-280. [PMID: 37807529 DOI: 10.1080/19390211.2023.2263564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Spirulina supplementation has been reported to increase hemoglobin concentration as well as a variety of cardiorespiratory and lactate-based performance parameters during maximal and submaximal states of exercise. This study investigates the efficacy of supplementing a 6 g/day dosage of spirulina for 14-days in recreationally active individuals, analyzing cardiorespiratory parameters during maximal and submaximal cycling as well as the potential mechanistic role of hemoglobin augmentation. 17 recreationally active individuals (Male = 14, Female = 3, Age 23 ± 5 years, V̇O2max 43.3 ± 8.6 ml/min·kg) ingested 6 g/day of spirulina or placebo for 14-days in a double-blinded randomized crossover study, with a 14-day washout period between trials. Participants completed a 20-min submaximal cycle at 40% maximal power output (WRmax), followed by a V̇O2max test. Hemoglobin (g/L), WRmax (watts), time to fatigue (seconds), heart rate (bpm), oxygen uptake (ml/min·kg), RER and blood lactate response (mmol/L) were measured and compared between conditions. Cardiorespiratory variables were recorded at 5-min intervals and lactate was measured at 10-min intervals during the submaximal exercise. There was a significant 3.4% increase in hemoglobin concentration after spirulina supplementation in comparison to placebo (150.4 ± 9.5 g/L Vs 145.6 ± 9.4 g/L, p = 0.047). No significant differences existed between either condition in both testing protocols for V̇O2max, WRmax, time to fatigue, heart rate, oxygen uptake, RER and blood lactate response (p > 0.05). 14-days of spirulina supplementation significantly improved hemoglobin concentration but did not lead to any considerable ergogenic improvements during maximal or submaximal exercise at a 6 g/day dosage in recreationally active individuals whilst cycling.
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Affiliation(s)
- Yunus Ali
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
| | - Rama Aubeeluck
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
| | - Tom Gurney
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
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Lorenzo K, Santocildes G, Torrella JR, Magalhães J, Pagès T, Viscor G, Torres JL, Ramos-Romero S. Bioactivity of Macronutrients from Chlorella in Physical Exercise. Nutrients 2023; 15:2168. [PMID: 37432326 DOI: 10.3390/nu15092168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 07/12/2023] Open
Abstract
Chlorella is a marine microalga rich in proteins and containing all the essential amino acids. Chlorella also contains fiber and other polysaccharides, as well as polyunsaturated fatty acids such as linoleic acid and alpha-linolenic acid. The proportion of the different macronutrients in Chlorella can be modulated by altering the conditions in which it is cultured. The bioactivities of these macronutrients make Chlorella a good candidate food to include in regular diets or as the basis of dietary supplements in exercise-related nutrition both for recreational exercisers and professional athletes. This paper reviews current knowledge of the effects of the macronutrients in Chlorella on physical exercise, specifically their impact on performance and recovery. In general, consuming Chlorella improves both anaerobic and aerobic exercise performance as well as physical stamina and reduces fatigue. These effects seem to be related to the antioxidant, anti-inflammatory, and metabolic activity of all its macronutrients, while each component of Chlorella contributes its bioactivity via a specific action. Chlorella is an excellent dietary source of high-quality protein in the context of physical exercise, as dietary proteins increase satiety, activation of the anabolic mTOR (mammalian Target of Rapamycin) pathway in skeletal muscle, and the thermic effects of meals. Chlorella proteins also increase intramuscular free amino acid levels and enhance the ability of the muscles to utilize them during exercise. Fiber from Chlorella increases the diversity of the gut microbiota, which helps control body weight and maintain intestinal barrier integrity, and the production of short-chain fatty acids (SCFAs), which improve physical performance. Polyunsaturated fatty acids (PUFAs) from Chlorella contribute to endothelial protection and modulate the fluidity and rigidity of cell membranes, which may improve performance. Ultimately, in contrast to several other nutritional sources, the use of Chlorella to provide high-quality protein, dietary fiber, and bioactive fatty acids may also significantly contribute to a sustainable world through the fixation of carbon dioxide and a reduction of the amount of land used to produce animal feed.
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Affiliation(s)
- Karenia Lorenzo
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, University of Barcelona, 08028 Barcelona, Spain
| | - Garoa Santocildes
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, University of Barcelona, 08028 Barcelona, Spain
- Department of Biological Chemistry, Institute of Advanced Chemistry of Catalonia (IQAC-CSIC), 08034 Barcelona, Spain
| | - Joan Ramon Torrella
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, University of Barcelona, 08028 Barcelona, Spain
| | - José Magalhães
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Teresa Pagès
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, University of Barcelona, 08028 Barcelona, Spain
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, University of Barcelona, 08028 Barcelona, Spain
| | - Josep Lluís Torres
- Department of Biological Chemistry, Institute of Advanced Chemistry of Catalonia (IQAC-CSIC), 08034 Barcelona, Spain
| | - Sara Ramos-Romero
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, University of Barcelona, 08028 Barcelona, Spain
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Barone GD, Cernava T, Ullmann J, Liu J, Lio E, Germann AT, Nakielski A, Russo DA, Chavkin T, Knufmann K, Tripodi F, Coccetti P, Secundo F, Fu P, Pfleger B, Axmann IM, Lindblad P. Recent developments in the production and utilization of photosynthetic microorganisms for food applications. Heliyon 2023; 9:e14708. [PMID: 37151658 PMCID: PMC10161259 DOI: 10.1016/j.heliyon.2023.e14708] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/08/2023] [Accepted: 03/15/2023] [Indexed: 05/09/2023] Open
Abstract
The growing use of photosynthetic microorganisms for food and food-related applications is driving related biotechnology research forward. Increasing consumer acceptance, high sustainability, demand of eco-friendly sources for food, and considerable global economic concern are among the main factors to enhance the focus on the novel foods. In the cases of not toxic strains, photosynthetic microorganisms not only provide a source of sustainable nutrients but are also potentially healthy. Several published studies showed that microalgae are sources of accessible protein and fatty acids. More than 400 manuscripts were published per year in the last 4 years. Furthermore, industrial approaches utilizing these microorganisms are resulting in new jobs and services. This is in line with the global strategy for bioeconomy that aims to support sustainable development of bio-based sectors. Despite the recognized potential of the microalgal biomass value chain, significant knowledge gaps still exist especially regarding their optimized production and utilization. This review highlights the potential of microalgae and cyanobacteria for food and food-related applications as well as their market size. The chosen topics also include advanced production as mixed microbial communities, production of high-value biomolecules, photoproduction of terpenoid flavoring compounds, their utilization for sustainable agriculture, application as source of nutrients in space, and a comparison with heterotrophic microorganisms like yeast to better evaluate their advantages over existing nutrient sources. This comprehensive assessment should stimulate further interest in this highly relevant research topic.
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Affiliation(s)
- Giovanni D. Barone
- Institute of Molecular Biotechnology, Graz University of Technology, Petersgasse 14, 8010, Graz, Austria
- Corresponding author.
| | - Tomislav Cernava
- Institute of Environmental Biotechnology, Graz University of Technology, Petersgasse 12/I, 8010, Graz, Austria
| | - Jörg Ullmann
- Roquette Klötze GmbH & Co. KG, Lockstedter Chaussee 1, D-38486, Klötze, Germany
| | - Jing Liu
- State Key Laboratory of Marine Resource Utilization in South China Sea Hainan University, 58 Renmin Avenue, Meilan District, Haikou, Hainan Province, 570228, PR China
| | - Elia Lio
- Institute of Chemical Sciences and Technologies (SCITEC) “Giulio Natta” Italian National Research Council (CNR), via Mario Bianco 9, 20131, Milan, Italy
| | - Anna T. Germann
- Synthetic Microbiology, Department of Biology, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Andreas Nakielski
- Synthetic Microbiology, Department of Biology, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - David A. Russo
- Friedrich Schiller University Jena, Institute for Inorganic and Analytical Chemistry, Bioorganic Analytics, Lessingstr. 8, D-07743, Jena, Germany
| | - Ted Chavkin
- Department of Chemical and Biological Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Farida Tripodi
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, 20126, Milano, Italy
| | - Paola Coccetti
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, 20126, Milano, Italy
| | - Francesco Secundo
- Institute of Chemical Sciences and Technologies (SCITEC) “Giulio Natta” Italian National Research Council (CNR), via Mario Bianco 9, 20131, Milan, Italy
| | - Pengcheng Fu
- State Key Laboratory of Marine Resource Utilization in South China Sea Hainan University, 58 Renmin Avenue, Meilan District, Haikou, Hainan Province, 570228, PR China
| | - Brian Pfleger
- Knufmann GmbH, Bergstraße 23, D-38486, Klötze, Germany
| | - Ilka M. Axmann
- Synthetic Microbiology, Department of Biology, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany
- Cluster of Excellence on Plant Sciences (CEPLAS), Heinrich Heine University Düsseldorf, D-40001, Düsseldorf, Germany
- Corresponding author. Synthetic Microbiology, Department of Biology, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany.
| | - Peter Lindblad
- Microbial Chemistry, Department of Chemistry–Ångström, Uppsala University, Box 523, SE-75120, Uppsala, Sweden
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Calella P, Cerullo G, Di Dio M, Liguori F, Di Onofrio V, Gallè F, Liguori G. Antioxidant, anti-inflammatory and immunomodulatory effects of spirulina in exercise and sport: A systematic review. Front Nutr 2022; 9:1048258. [PMID: 36590230 PMCID: PMC9795056 DOI: 10.3389/fnut.2022.1048258] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Arthrospira platensis, also known as spirulina, is currently one of the most well-known algae supplements, mainly due to its high content of bioactive compounds that may promote human health. Some authors have hypothesized that spirulina consumption could protect subjects from exercise-induced oxidative stress, accelerate recovery by reducing muscle damage, and stimulate the immune system. Based on this, the main goal of this review was to critically analyze the effects of spirulina on oxidative stress, immune system, inflammation and performance in athletes and people undergoing exercise interventions. Of the 981 articles found, 428 studies were considered eligible and 13 met the established criteria and were included in this systematic review. Most recently spirulina supplementation has demonstrated ergogenic potential during submaximal exercise, increasing oxygen uptake and improving exercise tolerance. Nevertheless, spirulina supplementation does not seem to enhance physical performance in power athletes. Considering that data supporting benefits to the immune system from spirulina supplementation is still lacking, overall evidence regarding the benefit of spirulina supplementation in healthy people engaged in physical exercise is scarce and not consistent. Currently, spirulina supplementation might be considered in athletes who do not meet the recommended dietary intake of antioxidants. Further high-quality research is needed to evaluate the effects of spirulina consumption on performance, the immune system and recovery in athletes and active people. Systematic review registration [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=262896], identifier [CRD42021262896].
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Affiliation(s)
- Patrizia Calella
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, Naples, Italy
| | - Giuseppe Cerullo
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, Naples, Italy,*Correspondence: Giuseppe Cerullo,
| | - Mirella Di Dio
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, Naples, Italy
| | - Fabrizio Liguori
- Department of Economics and Legal Studies, University of Naples Parthenope, Naples, Italy
| | - Valeria Di Onofrio
- Department of Sciences and Technologies, University of Naples Parthenope, Naples, Italy
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, Naples, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, Naples, Italy
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