Maternal exercise may influence long-term cardiovascular health in offspring, yet its effects on intrinsic myocardial performance and mitochondrial metabolism remain incompletely defined. We investigated whether maternal voluntary wheel running before and during pregnancy is associated with cardiac adaptations in adult offspring. Female C57BL/6J mice were assigned to sedentary (Sed) or exercise (Ex) groups, with running initiated 3 weeks before mating and continued through gestation and lactation. Adult offspring (29-32 weeks) underwent high-fidelity pressure-volume (P-V) loop analysis at baseline and, in females, during β-adrenergic stimulation to assess systolic reserve. Cardiac mitochondria were evaluated by high-resolution respirometry together with measurements of reactive oxygen species emission. Maternal exercise did not alter maternal body weight before delivery or adult offspring body weight, whereas cardiac mass index was significantly lower in A-Ex offspring than in A-Sed offspring. Baseline hemodynamics were largely similar between maternal groups. In females, maternal exercise was associated with lower end-systolic elastance (Ees) at rest and a greater dobutamine-induced increase in Ees, consistent with enhanced load-independent systolic reserve. Mitochondrial analyses revealed substrate-dependent adaptations in females: maternal exercise was associated with lower pyruvate/malate-supported LEAK respiration, higher fatty acid-supported LEAK respiration, and reduced fatty acid coupling efficiency compared with sedentary offspring. ROS emission, sarcoplasmic reticulum Ca2+-handling proteins, fetal gene expression, and collagen-related transcript expression were unaffected. These findings suggest persistent functional and mitochondrial respiratory adaptations in adult offspring following maternal exercise, with the clearest adaptations observed in females.
Adult weight management interventions are complex; better understanding of the intervention components that may impact eating disorder (ED) risk is required. Weight management randomized controlled trials (RCTs) for adults with overweight/obesity that measured ED risk were systematically searched in four databases and two trial registries. A project-specific codebook was used to code 84 delivery features and 89 intervention strategies of trials. Individual strategies were grouped into 20 clusters which were further grouped into five broad categories. Trial investigators verified coding and narrative synthesis using descriptive statistics of findings was reported. Of 14,880 identified, 58 eligible trials were coded, of which 26 trials with 64 intervention arms were verified and therefore included. Intervention arms included a mean (SD) of 24 (11) intervention strategies. Commonly used intervention strategy clusters were nutrition education (91%), dietary behavior change strategies (84%), physical activity education (81%), and dietary self-monitoring (80%). Few interventions used strategies in the category of psychological components (13-41%). The median (range) intervention duration was 27 (4-104) weeks, and contacts with participants typically included a staged approach of weekly to monthly contact. Adult weight management interventions are multifactorial with varying delivery features and intervention strategies. Despite this, psychological (e.g. weight stigma) and sleep-health related strategies are either rarely used or are underreported. Breaking down intervention components using our framework can help identify which strategies influence outcomes, including eating disorder risk, and inform the design and reporting of future interventions. Some adults seeking weight management for obesity may have an eating disorder or disordered eating behaviors. Research shows most people who take part in behavioral weight management programs have an improvement in eating disorder symptoms, however a small number may experience worsening symptoms. In this study, we break down behavioral weight management programs that measure eating disorder risk to better understand the features they use. We found that these programs vary widely in the number and type of strategies they use, as well as in how they are delivered, such as the length of the program. Strategies that focus on psychological factors (for example, addressing weight stigma) and sleep health were rarely used or reported. These findings are useful in guiding the design and reporting of future behavioral weight management programs. They can also be used in future research to determine which specific program features improve or worsen outcomes such as eating disorder risk.
The Indiana Complex Care Coordination Collaborative (IC4) is a statewide model of care coordination design to enhance the quality of medical care for children with medical complexity (CMC) by training and embedding nurse care coordinators in primary care practices. This study examines the impact of IC4 care coordinators on caregivers' and patients' quality of medical care, access to medical and community resources, care workload, and the quality of life of caregivers and CMC. Caregivers of CMC (n = 13) completed one-hour semi-structured interviews focused on met/unmet needs, quality of medical care, co-developed shared plan of care, caregiver/patient quality of life, caregiver workload, and medical home experience. Using NVIVO, researchers used a codebook to conduct an inductive thematic analysis of the interview transcripts. The thematic analysis was revealed five overarching themes: (1) central role of the care coordinator, (2) proactive and personalized support, (3) care across the lifespan, (4) emotional support, and (5) navigating healthcare systems. Caregivers reported that they considered their care coordinator a trusted health professional who can advocate for them with other health professionals. Families appreciated that the shared plan of care created with the care coordinator can be easily disseminated to other healthcare and service professionals, as well as other family members, and helps the patients and families be seen as individuals, not just as a medical record. Care coordination can address unmet needs and greatly improve the quality of and access to care received by CMCs and their families. Unanimously, caregivers report the substantial instrumental, informational, and emotional support care coordinators (CCs) provide to access medical systems, resources, planning, and reduce patient care workload. Additionally, several caregivers reported substantial social support from the CC. However, several caregivers still reported feelings of loneliness and difficulties engaging with families without CMC.
To evaluate the feasibility and safety of implementing a patient-oriented pole walking (PW) intervention in retirement home settings and preliminary changes in outcome measures related to physical function and other fall- and fracture-related risk factors to inform a future randomized controlled trial (RCT). This single-arm, non-randomized feasibility trial implemented a patient-oriented PW intervention across four retirement homes in Saskatoon, Saskatchewan, Canada. During Summer 2022, we assessed 24 residents for eligibility, of which 19 consented and 17 received the intervention. The intervention was offered as supervised group sessions (20-60 minutes) three times per week for 12 weeks. Each session consisted of posture and balance warm-up, PW, muscle strengthening, and stretching. The primary outcome measure was feasibility as assessed by consent, recruitment, retention, and adherence rates as well as by intervention acceptability, appropriateness, and feasibility scores. The secondary outcome measures included safety (evaluated by recorded adverse events) and preliminary 12-week changes in physical function and other fall- and fracture-related risk factors (examined with paired-samples t-tests or repeated measures analysis of covariance models). Fifteen participants (mean age 85.2 years; 93% female) completed the study. The consent, recruitment, retention, and mean adherence rates were 79%, 2.7 participants/site/month, 88%, and 90%, respectively. The mean participant- and instructor-reported scores for intervention acceptability, appropriateness, and feasibility were all > 4.0 (out of 5). There were no recorded intervention-related serious adverse events. Participants improved their functional balance/mobility (timed "up & go" test: -1.6 seconds; 95% CI: -2.7 to -0.4), lower-body strength (30-second chair stand test: 2.4 repetitions; 1.2 to 3.5), 36-item short-form survey physical functioning score (12.9; 3.7 to 22.2), and forearm muscle area (67.7 mm2; 12.9 to 122.6) over 12 weeks. It was feasible and safe to implement our patient-oriented PW intervention in retirement homes. Findings will inform our future RCT in these settings. ClinicalTrials.gov NCT05388227.
Rotator cuff tears (RCT) cause pain and disability in adults. Histological studies indicate that the degenerative process following a rotator cuff tear may disrupt the vascularity and energetics of the shoulder muscles. Magnetic resonance imaging (MRI) post-contractile blood oxygen level-dependent (BOLD) response and 31phosphorus magnetic resonance spectroscopy (31P‑MRS) offer methods to non-invasively assess muscle microvascular function and energetic status in vivo. This study aimed to evaluate the post-contractile BOLD response and 31P-MRS as potential markers of microvascular function and energetic status of the supraspinatus muscle in individuals with chronic full‑thickness supraspinatus tendon tears and healthy individuals without a tear. Using a 3‑T MR Phillips system, all participants performed five 2‑s maximal isometric shoulder abductions to obtain a post-contractile BOLD response using a custom MR‑compatible dynamometer. Dixon fat/water imaging was used to quantify muscle fat fraction (FF). A surface 31P‑MRS coil acquired spectra concentrations of high energy phosphates and intracellular pH from the supraspinatus and surrounding muscles. Results revealed a lower peak BOLD response (P < 0.01) and longer time-to-peak (P = 0.02) in RCT, indicating impaired microvascular function. Analysis of 31P-MRS spectra showed elevated unlocalized Pi/PCr (P = 0.04) and PDE (P < 0.01) concentrations in RCT, consistent with muscle damage. No differences in muscle PCr (P = 0.30) or pH (P = 0.50) were observed. Overall, these findings support that the post-contractile BOLD response and 31P-MRS may be valuable markers to assess shoulder muscle health status and evaluate therapeutic interventions aimed at improving clinical outcomes following a rotator cuff tear.
Determining whether knee joint kinematics amenable to wearable sensing associate with patient-reported outcomes in individuals with knee osteoarthritis (KOA) may inform modifiable targets for intervention and remote monitoring. This study examined whether high-fidelity knee joint angular kinematics (angle and angular velocity, acceleration, and jerk) as well as their step-to-step variabilities during walking associate with patient-reported outcomes in individuals with mild-to-moderate KOA. Sixteen individuals with KOA (age: 67.7 ± 7.9 yrs, preferred speed: 1.19 ± 0.18 m/s) completed standardized surveys and walked at three treadmill speeds: Slow (80% of preferred), Preferred (100%), and Fast (120%). Overground speeds established a standardized baseline to maintain relative intensity. Knee joint angles were computed via 3D motion capture and inverse kinematics and time derivatives yielded angular velocities, accelerations, and jerks. Collectively, "less dynamic" walking knee joint kinematics at slower speeds (i.e., 80% of preferred) - defined using stride-average magnitudes and reduced step-to-step variability magnitudes, especially step-to-step variabilities in late stance - demonstrated exploratory associations with worse self-reported symptoms. Conversely, higher step-to-step knee joint kinematic variabilities associated with markers of kinesiophobia at preferred and faster walking speeds. These findings likely represent a conservative estimate of the associations between variability and function given the constrained nature of treadmill gait. Given the kinematic nature of our outcome measures, our findings support the potential for wearable sensing to capture metrics of knee joint health, paving the way for scalable remote monitoring and better precision management of this degenerative disease.
Psychosocial well-being relates to lower cardiovascular risk, and a healthy lifestyle may contribute to this association. Prior research has focused on aging adults, although health behaviors are usually consolidated in early adulthood. This longitudinal study assessed the association between two psychosocial well-being indicators and subsequent healthy lifestyles in young adults. Participants (n = 799; agemean = 30.6 years) in the Nicotine Dependence in Teens Study completed items to derive the emotional vitality score, a flourishing scale, and covariates in 2017-2020. Data on selected outcomes (i.e., smoking, sleep, physical activity, alcohol intake, diet quality), collected in 2017-2020 and 2020-2021, were combined into a lifestyle score used categorically (≥ 4 healthy behaviors) and continuously (0-5 scores). Associations between psychosocial well-being indicators and lifestyle up to 4 years later were modeled using logistic and linear regressions. In model 3 adjusting for sociodemographic, health-related, and depression covariates, higher likelihood of a healthy lifestyle (≥ 4 healthy behaviors) was observed with flourishing (OR = 1.56, 95%CI = 1.02-2.40), but the CI for emotional vitality included the null (OR = 1.62, 95%CI = 0.93-2.81). Both well-being indicators were similarly associated with continuous lifestyle scores (e.g., model 3, per 1-SD unit: βflourishing = 0.13, 95%CI = 0.06-0.21; βemotional vitality = 0.10, 95%CI = 0.02-0.17). Further controlling for baseline lifestyle attenuated associations (model 4; βflourishing = 0.10, 95%CI = 0.03-0.18; βemotional vitality = 0.06, 95%CI = -0.02 to 0.14). When assessing behaviors separately, both well-being indicators were associated with healthy diets and sleep only. Flourishing and emotional vitality may promote healthy behaviors among young adults and be considered in prevention strategies aiming to foster healthy lifestyles in this age group.
Individuals with severe neurological injuries often rely on assistive technologies, but current methods have limitations in accurately decoding multi-degree-of-freedom (DoF) movements. Intracortical brain-machine interfaces (iBMIs) use neural signals to provide a more natural control method but currently struggle with higher-DoF movements: something the brain handles effortlessly. It has been theorized that the brain simplifies high-DoF movement through muscle synergies, which link multiple muscles to function as a single unit. These synergies have been studied using dimensionality reduction techniques like principal component analysis (PCA), non-negative matrix factorization (NMF), and demixed PCA (dPCA) and successfully used to reduce noise and improve offline decoder stability in non-invasive applications. However, their effectiveness in improving decoding and generalizability for implanted recordings across varied tasks is unclear. Here, we evaluated whether brain and muscle synergies can enhance iBMI performance in non-human primates performing a two-DoF finger task. Specifically, we tested if PCA, dPCA, and NMF could compress and denoise brain and muscle data and improve decoder generalization across tasks. Our results showed that while all methods effectively compressed data with minimal loss in decoding accuracy, none improved performance through denoising in our datasets. Additionally, none of the methods enhanced generalization across tasks. These findings suggest that while dimensionality reduction can aid data compression, extracting synergies alone did not provide an advantageous or cleaner control space for linear decoding in our study. Further research with larger sample sizes and more channels in muscle recordings is required to determine whether synergies can be leveraged as an optimal control framework or if alternative approaches are required to enhance decoder robustness in iBMI applications.
GLP1 receptor agonists, such as semaglutide, are used in the management of obesity. While causing weight loss, these drugs reduce both fat and lean mass. The impact of GLP1 receptor agonists on bone health has not been explored. Femur mass, stiffness, and strength are lower in obese male C57BL/6J mice treated with semaglutide, and these effects are more pronounced than in mice that are calorically restricted to the same extent. Decrements in bone are paralleled by lower circulating levels of markers of osteoblast activity. In an additional cohort, femur weight, strength, and stiffness are the same 6 weeks following the discontinuation of semaglutide compared to vehicle. Our findings provide evidence that bone mass and strength decrease with semaglutide and that this effect is dependent upon continued exposure to the drug. Clinical investigations are needed to determine if GLP1 receptor agonists have similar impacts on bone in patient populations.
Previously, we observed divergent vascular responses to the cold pressor test (CPT) among young healthy female participants. This short report examined circulating hormones as contributors to this variability in a larger cohort of female participants. We tested the hypothesis that gonadal hormones would be associated with vascular and muscle sympathetic nerve activity (MSNA) responses to the CPT. CPT responses from 20 young females tested in the early follicular phase of the menstrual cycle or placebo phase of oral contraceptive use were pooled for analyses. Venous blood samples were analyzed (radioimmunoassay; n=18) for circulating total testosterone, 17β-estradiol, progesterone, sex hormone binding globulin (SHBG), and free androgen index (FAI; [total testosterone]/[SHBG]). Mean arterial pressure (MAP; finger photoplethysmography), femoral blood flow (FBF; vascular ultrasound), femoral vascular conductance (FVC; FBF/MAP), and MSNA burst incidence (bursts/100hb; peroneal microneurography), were assessed at baseline and during a hand CPT (3-min). The CPT induced increases in MSNA (baseline: 10±5 vs CPT: 28±12bursts/100hb; P<0.01) and MAP (86±9 vs 96±7mmHg; P<0.01), whereas changes in FVC were not significant (2.6±0.9 vs 3.4±0.6mL/min/mmHg; P=0.89). Neither [17-β-estradiol] (R=0.07; P=0.27) nor [progesterone] (R<0.01, P=0.73) were associated with CPT-induced increases in MSNA, whereas FAI was positively associated with increases in MSNA (R=0.47; P<0.01). Likewise, neither [17β-estradiol] (R=0.11, P=0.65) nor [progesterone] (R=0.01, P=0.98) were associated with percent change in FVC (%FVC). However, there was a negative association between FAI and %FVC (R=0.49, P<0.01). These data suggest that bioavailable testosterone may be associated with CPT-induced increases in MSNA and peripheral vasoconstriction in young healthy females.
Inappropriate antibiotic prescribing for acute pharyngitis remains a key driver of antibiotic resistance and a persistent public health challenge. This study examined antibiotic prescribing patterns and their association with demographic characteristics and health insurance factors among acute pharyngitis visits in Saudi Arabian governmental primary healthcare centers. A cross-sectional analysis was conducted using anonymized electronic health records for 14,550 acute pharyngitis visits by Saudi nationals in 2023 within governmental primary healthcare centers. Descriptive statistics, chi-square tests, and multivariate logistic regression were used to assess predictors of antibiotic prescription, including age, gender, insurance scheme, and private insurance company. Antibiotics were prescribed in 84.7% of visits, with amoxicillin (62%) and azithromycin (37%) accounting for the majority of prescriptions. Younger age, particularly children aged 0-7 years, was significantly associated with higher odds of receiving antibiotics, while gender was not a significant predictor. Similarly, to age, the patient's insurance scheme was a predictor of antibiotic prescription, with patients covered by governmental insurance being 28.6% more likely to receive antibiotics than those under private insurance. These findings indicate a high prevalence of antibiotic use for acute pharyngitis in primary care and suggest that prescribing practices are primarily influenced by patient age and insurance scheme, underscoring the need for strengthened antibiotic stewardship and improved adherence to clinical guidelines.
Biomechanical biofeedback has the potential to enhance rehabilitation by providing clinicians with objective evaluation of patient performances. As feedback systems often depend on expensive and sophisticated motion capture technologies, researchers explore computer vision-based alternatives. Existing methods suffer from substantial joint angle errors, particularly in the upper limb, and neglect the scapular movements. In this paper, we present a method based on a single front-facing RGB-D camera that automatically detects 3D anatomical landmark locations using depth information. We also use a 3D-printed acromial cluster to provide scapular motion. Together, these landmarks and the acromial cluster are used to provide comprehensive estimation of shoulder joint kinematics through inverse kinematics. Annotated images from eight participants were used to fine-tune a convolutional neural network, which was subsequently evaluated on a hand-cycling motion. Our method showed a strong agreement with a reference marker-based system, with 3D anatomical landmark detection errors averaging 5 mm. The resulting kinematics closely aligned with the reference system, maintaining acceptable joint angle errors (∼6.3°). Furthermore, the algorithm could provide real-time anatomical landmark positions and joint kinematics at a rate of 50Hz. This study highlights the potential of using a single consumer-grade depth-sensing camera combined with a 3D-printed acromial cluster to accurately estimate upper-limb kinematics through anatomical landmark detection, paving the way for more accessible clinical assessments.
Background. Core temperature monitoring may provide information to mitigate heat-related illnesses among construction workers. This study evaluated the validity of the ECTemp™ algorithm and compared the use of a photoplethysmography-based smartwatch to a chest strap as the heart rate input for the algorithm. Methods. In 102 construction workers during the summer, gastrointestinal temperature was measured via ingestible telemetric pill (T PILL), and heart rate was measured with a Polar H10 chest strap (n = 102) and a Garmin Instinct 2 smartwatch (n = 60) during a single work shift. Peak, mean and continuous time-series data from each device were used to compute core temperature estimates using ECTemp™ (ECTempGARMIN and ECTempPOLAR). Agreement was evaluated with Bland-Altman analyses, Pearson correlations, and Kendall's Tau correlations. Results. Compared to TPILL, ECTempPOLAR showed a bias of -0.16 ± 0.30 °C for continuous data, with a median Kendall's τ of 0.39. ECTempGARMIN showed a bias of -0.09 °± 0.28 °C (median τ = 0.36). The two devices produced similar heart rate measures (bias: 1.6 ± 4.9 beats min-1; median τ = 0.75) and ECTemp outputs (bias: 0.03 °± 0.06 °C; median τ = 0.83). Conclusion. ECTempPOLAR and ECTempGARMIN are both adequate estimates of core temperature for construction work monitoring at a group level. The more practical ECTempGARMIN appeared to have less bias than ECTempPOLAR, perhaps warranting future consideration for field use.
Longitudinal studies are essential for understanding health trajectories, but necessary upgrades to measurement instruments over time may compromise data comparability. The Canadian Longitudinal Study on Aging conducted a measurement comparability study to quantify systematic differences between instruments and derive conversion equations to correct for any differences. Overall, 50 participants aged ≥ 45 years (52% females) underwent repeated assessments with old and new instruments including the blood pressure monitor, electrocardiogram (ECG), carotid ultrasound, spirometer, audiometer, tonometer, and dynamometer. Linear mixed-effects models were used to identify systematic differences. Cohen's d was used to assess standardized mean difference, Bland-Altman plots evaluated agreement between instruments, and repeatability was assessed within instruments. Mixed-effects models showed no clinically meaningful difference across instruments, except for systolic blood pressure (SBP), which was on average 5.19 mmHg (95% CI, 2.64, 7.74) higher using the new instrument. Cohen's d demonstrated moderate systematic differences for several measures. Repeatability estimates showed good-to-excellent reliability for most measures; however, certain ECG and tonometer parameters showed moderate or poor precision. The results support the utility of conversion equations to account for systematic differences between instruments. The difference in SBP warrants the implementation of a conversion equation, whereas it is unclear for measures with moderate differences.
Non-specific chronic low back pain (NSCLBP) is a complex condition influenced by physical, psychological, and social factors. Conservative treatments, including manual therapy, exercise and other non-invasive approaches (e.g., patient education, lifestyle modifications), are recommended, however, their impact on objective neuromuscular biomarkers remains unclear. The flexion relaxation phenomenon (FRP), commonly assessed using the flexion relaxation ratio (FRR), has been proposed as a potential biomarker for NSCLBP. This systematic review evaluates the effects of conservative treatments on FRP in individuals with NSCLBP. A comprehensive systematic search was conducted across four databases (PubMed, EMBASE, Cochrane, and PEDro) up to March 31, 2025, following PRISMA guidelines. Randomized controlled trials (RCTs) examining the effects of conservative treatments on FRP in NSCLBP were included. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. The review protocol was registered in PROSPERO (CRD42020162576). Twelve RCTs, including 480 participants, met the inclusion criteria. Most studies were assessed as having a high risk of bias. Several studies reported within-group improvements in FRR following manual therapies; however, the short- and mid-term effects of exercise-based interventions were inconsistent. Only a minority of studies adhered to standardized electromyography (sEMG) electrode placement guidelines, contributing to substantial heterogeneity in FRP assessment. Manual therapies may be associated with immediate changes in FRP; however, these findings should be interpreted with caution due to methodological limitations, including the lack of consistent between-group comparisons. The effects of exercise-based interventions remain unclear. Heterogeneity in FRP recording and analyzis methods further limits the interpretation of results. Further high-quality studies using standardized methodologies are needed to validate FRP as a biomarker for NSCLBP and to clarify its relationship with clinically meaningful outcomes.
This study implemented established signal processing techniques to introduce novel ice skating performance metrics using Inertial Measurement Units (IMUs) in forward ice sprint tests. We hypothesized that the proposed metrics would differentiate skaters of different caliber and skating type and provide additional biomechanical information beyond traditional metrics. Nineteen ice skaters, including high- and low-caliber hockey and figure skaters, performed maximal speed sprints, while six IMUs recorded their ice skating. Primary performance metrics included stride length, velocity, and time. Secondary metrics were calculated to assess skating complexity (multiscale entropy), inter-limb coordination (continuous relative phase), and segment kinematics (joint orientations). Additionally, relationships between the proposed on-ice metrics and off-ice countermovement jump (CMJ) height were studied. Significant differences were observed between high- and low-caliber skaters in stride velocity and length (P = 0.02), and between figure and hockey skaters in stride velocity (P = 0.01). Figure skaters exhibited less complex hip angles (0.01 ≤ P ≤ 0.05) and greater coordination (0.01 ≤ P ≤ 0.05) compared to hockey skaters. Correlation analyses showed that only a few IMU-derived metrics were moderately related to CMJ height, while most exhibited weak or negligible associations. The IMU-derived metrics could differentiate between skaters of varying calibers and types, offering a quantitative characterization and extended view of skating biomechanics. The proposed metrics have the potential to extend conventional performance assessment and provide a framework for developing off-ice tests that more accurately inform the development of off-ice tests related to on-ice performance.
Soluble receptor for advanced glycation end-products (sRAGE) and soluble Toll-like receptor 4 (sTLR4) are circulating pattern recognition receptor isoforms implicated in inflammatory regulation in type 2 diabetes mellitus (T2DM). This study examined the effects of supervised aerobic exercise training (AET) on circulating sRAGE, sTLR4, and related skeletal muscle inflammatory signalling outcomes in adults with T2DM. Thirty-three sedentary adults with T2DM were randomized to AET (n = 20; age: 54.5 ± 9.3 years; BMI: 34.6 ± 1.3 kg/m2; HbA1c: 7.5% ± 1.1%) or standard of care control (CON; n = 13; age: 59.6 ± 9.3 years; BMI: 32.6 ± 1.6 kg/m2; HbA1c: 6.9% ± 0.9%). Participants in AET completed 12 weeks of supervised aerobic exercise (60 min/day, 5 days/week) at ~70% VO2peak. Pre-and post-intervention assessments included oral glucose tolerance testing, DXA-derived body composition, VO2peak testing, and an acute aerobic exercise trial with blood and skeletal muscle sampling. Circulating sRAGE, sTLR4, hsCRP, and skeletal muscle protein expression of RAGE, TLR2/4, ADAM10, MMP2/9, and TIMP1/3 were quantified. AET increased circulating sRAGE concentrations across the intervention period, whereas sTLR4 was unchanged. AET improved cardiorespiratory fitness, reduced body fat percentage and fat mass, lowered fructosamine concentrations, and increased the Matsuda Index. In skeletal muscle, significant alterations were observed in selected TIMP:MMP and TIMP:ADAM10 ratios, although no changes were detected in ADAM10 activity or skeletal muscle RAGE protein expression. Exploratory analyses demonstrated associations between changes in circulating sRAGE and aerobic fitness. AET increased circulating sRAGE and improved select metabolic health outcomes in adults with T2DM. These findings are consistent with the concept that chronic exercise training may favourably influence inflammatory regulation in metabolic disease. However, the tissue-specific mechanisms contributing to exercise-induced changes in circulating sRAGE remain incompletely understood and warrant further investigation.
García-Santamaría, A, Padrón-Cabo, A, Fernández-Penedo, D, Costa, PB, and Rey, E. Scheduling repeated-sprint training on different microcycle days in professional soccer players: A randomized crossover study. J Strength Cond Res XX(X): 000-000, 2026-This study compared the acute neuromuscular, mechanical, and perceptual responses to repeated-sprint training (RST) performed on match day minus 4 (MD-4) vs. match day minus 3 (MD-3) in professional soccer players. Seventeen male outfield players completed 2 experimental microcycles using a randomized, counterbalanced crossover design. Each player performed a high-volume RST protocol (3 × 10 × 30 m) on either MD-4 or MD-3, with a 1-week washout in between. External (GPS) and internal (rating of perceived exertion) loads were recorded during RST. Countermovement jump, muscle mechanical properties (MyotonPRO), and perceptual markers (total quality recovery, Hooper Index) were assessed pre- and postintervention (MD-2). No significant differences were found in training load between conditions (p > 0.05). Countermovement jump performance decreased significantly after RST (p = 0.031), with no interaction effect. Delayed onset muscle soreness (DOMS) and fatigue increased in both conditions, but DOMS was significantly higher after MD-3 RST (p = 0.030). Total quality recovery scores also decreased (p = 0.003), with no change in muscle tone, stiffness, or elasticity. These results suggest that although RST elicits similar load regardless of day, performing it closer to match day may increase residual soreness. Coaches are advised to schedule high-intensity RST earlier in the microcycle to optimize recovery and match-day readiness.
Sever's disease (calcaneal apophysitis) is a common cause of heel pain in physically active youth. Evidence-based treatment options are limited, with no consensus for the standard of care. This study aimed to assess the feasibility of delivering an intervention comprising exercise therapy and pain-guided activity modification for youth patients with Sever's disease and to describe patient symptoms, functional limitations, psychosocial factors, and ultrasound imaging findings to inform future clinical trials. This single-cohort study enrolled patients between 7 and 17 years old with Sever's disease. Participants received a comprehensive 12-week intervention combining daily Achilles-tendon loading exercises, activity modification using a pain-monitoring model, and patient education. Training diaries were provided to monitor adherence, daily activities, and pain. Feasibility was assessed via recruitment and retention rates, daily activity modification adherence, rehabilitation adherence, and safety. Secondary outcomes (patient-reported outcome measures, functional test battery, and ultrasound imaging) were collected at baseline and at 4-, 8-, and 12 weeks and were reported descriptively to characterize the biopsychosocial burden of the condition and inform selection of outcomes and hypotheses for future clinical trials. Of the 13 participants enrolled (7F/6 M, (mean ± SD) age 11.5 ± 2.5 years, BMI 21.6 ± 4.6 kg/m2), recruitment and retention rate was 65% and 69%, respectively. Activity modification adherence was 91 ± 28% (range 37-100%), and rehabilitation adherence was 91 ± 25% (range 25-100%). Three adverse events occurred and each was unrelated to participation. All participants expressed satisfaction with the intervention (75% [10/10] very satisfied). Our findings support that this exercise therapy and activity modification intervention is feasible, safe, and appropriate for the treatment of Sever's disease. Intervention satisfaction ratings and favorable global rating of change scores reported imply that educating patients to use a pain-monitoring model, allowing for modified physical activity, is not detrimental to patients with Sever's disease. A larger randomized controlled trial is warranted to evaluate the effectiveness of this intervention. ClinicalTrials.gov Identifier: NCT04816188. Registered 18th of March, 2021 retrospectively.
Bed rest accelerates bone loss and may exacerbate skeletal fragility. This study examined the effects of 14 days of head-down tilt bed rest (HDBR) with or without exercise, and subsequent recovery, on bone turnover, density and structure in older adults. Twenty-two healthy older adults (55-65 years) completed the HDBR protocol. Participants were randomized to a control group that received passive physiotherapy (CON, n = 11) or a group that performed daily exercise (EX, n = 11). Serum biomarkers of bone formation (procollagen type 1 N-terminal propeptide (P1NP) and bone-specific alkaline phosphatase (BSAP)), resorption (N-terminal cross-linked telopeptide of type I collagen (NTX) and C-terminal cross-linked telopeptide of type I collagen (CTX)), and osteocalcin were measured at baseline (BDC4), day-9 (HDT9), and immediately (R1), 4 weeks (4W), and 4 months (4M) post-HDBR. Bone mineral density (BMD) was assessed via dual-energy X-ray absorptiometry (DXA) at BDC4, R1, 4W and 4M. Femoral bone structure was measured via peripheral quantitative computed tomography (pQCT) at BDC4 and R1. CTX and NTX increased at R1 vs. BDC4 (time: P < 0.001), while P1NP and BSAP increased at 4W and 4M (time: P < 0.001). No DXA-derived BMD changes occurred. pQCT revealed reduced femoral trabecular volumetric BMD at 4% (EX: 342.3 ± 7.8 to 337.9 ± 8.0 mg/cm3; CON: 329.3 ± 8.1 to 326.4 ± 8.4 mg/cm3; time: P = 0.05) and cortical volumetric BMD at 25% (EX: 1089.5 ± 6.7 to 1087.5 ± 7.1 mg/cm3; CON: 1102.7 ± 6.7 to 1095.7 ± 7.1 mg/cm3; time: P = 0.05). However, changes were within the precision error of pQCT measurements. Fourteen days of HDBR, with or without exercise, increased biomarkers of bone resorption but did not alter BMD or bone structure.