Journal of science and medicine in sport最新文献

{"title":"Cryotherapy added to PEACE & LOVE rehabilitation for acute lateral ankle sprain in physically active adults: A randomized controlled trial in sports rehabilitation.","authors":"Polok Halder, Md Zahid Hossain, Md Asfan Afroz Akash, Joy Saha, Md Feroz Kabir, K M Amran Hossain, Sharmila Jahan, Kabir Hossain, Tofajjal Hossain, Ehsanur Rahman","doi":"10.1016/j.jsams.2026.09.009","DOIUrl":"https://doi.org/10.1016/j.jsams.2026.09.009","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether adding cryotherapy during the first 72 h to a standardized PEACE & LOVE rehabilitation program improves early recovery after acute lateral ankle sprain compared with a room-temperature gel-pack control.</p><p><strong>Design: </strong>Randomized, parallel-group controlled trial.</p><p><strong>Methods: </strong>Sixty physically active adults with Grade I-II acute lateral ankle sprain within 48 h of injury were randomized 1:1 to PEACE & LOVE rehabilitation plus either active cryotherapy or room-temperature gel-pack control. Cryotherapy was delivered using a 0-4 °C gel pack for 20 min, three times daily for 72 h. Both groups received identical progressive rehabilitation for four weeks. The primary outcome was average ankle pain during the previous 24 h measured using the Numeric Pain Rating Scale at Day 7. Secondary outcomes were swelling, Lower Extremity Functional Scale score, Weight-Bearing Lunge Test, paracetamol use, and re-injury. Outcomes were analyzed using linear mixed-effects models.</p><p><strong>Results: </strong>All randomized participants completed follow-up. Pain decreased in both groups, with a statistically greater Day 7 reduction in cryotherapy than control (adjusted difference -1.10, 95% confidence interval -1.85 to -0.35; p = 0.004). However, this did not reach the pre-specified 2-point minimal clinically important difference. Swelling also decreased more with cryotherapy (-1.78 cm, 95% confidence interval -3.26 to -0.30; p = 0.019). Functional recovery, dorsiflexion, paracetamol use, and re-injury were comparable. Responder analysis produced a number needed to treat estimate with confidence intervals crossing infinity.</p><p><strong>Conclusions: </strong>Cryotherapy provided statistically greater short-term pain and swelling reductions, but its added clinical value beyond progressive rehabilitation remains uncertain within four weeks.</p>","PeriodicalId":16992,"journal":{"name":"Journal of science and medicine in sport","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and determinants of thoracic aortic dilatation detected by focused cardiac ultrasound in recreational and competitive sport participants.","authors":"Clémence Macquaire, Mélanie Philippot, Ophélie Faivre, Pierre Ollitrault, François Tournoux, Fabien Labombarda, Eric Saloux, Emmanuel Reboursiere, Amir Hodzic","doi":"10.1016/j.jsams.2026.09.018","DOIUrl":"https://doi.org/10.1016/j.jsams.2026.09.018","url":null,"abstract":"<p><strong>Objectives: </strong>Ascending aortic dilation is a clinically important cardiovascular condition, yet its prevalence and associated factors in recreational athletes remain poorly described. This study aimed to determine the prevalence and predictors using an aorta-focused echocardiographic protocol (FoCUS) performed by non-expert operators.</p><p><strong>Design: </strong>Retrospective cross-sectional observational study.</p><p><strong>Methods: </strong>400 participants (79% men; median age 45 years; range 11-78; 65% recreationally active individuals) undergoing routine sport cardiology screening were included. Aortic root and tubular diameters were measured using FoCUS by trained sport physicians. Cardiovascular risk factors and sport exposure were recorded. Agreement between FoCUS and transthoracic echocardiography (TTE) performed by cardiologists was assessed in participants undergoing both examinations. Multivariate logistic regression identified independent predictors of aortic dilation.</p><p><strong>Results: </strong>Thoracic aortic dilatation was detected in 45 participants (11.3%), 42 of whom were aged ≥35 years. Among cases, 62.2% had isolated aortic root dilation, 15.6% isolated tubular dilation, and 22.2% combined dilation. Prevalence did not differ by sex (p = 0.32). Hypertension was independently associated with aortic dilation (OR 3.15; 95% CI 1.2-8.3; p < 0.001), together with years of regular sport practice (OR 1.06 per year; 95% CI 1.03-1.10; p = 0.021). FoCUS showed good agreement with TTE (n = 59; CCC 0.948 for the aortic root and 0.93 for the tubular aorta), with minimal bias (-0.01 mm and +0.05 mm, respectively).</p><p><strong>Conclusions: </strong>Ascending aortic dilation was a relatively frequent finding in our cohort, particularly among participants aged ≥35 years. Hypertension and years of regular sport practice were independently associated with aortic dilatation. An aorta-focused echo protocol performed by trained non-experts is accurate and may support routine cardiovascular screening.</p>","PeriodicalId":16992,"journal":{"name":"Journal of science and medicine in sport","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an 8-week elastic band resistance training program on hepatic steatosis, insulin resistance, and circulating irisin in postmenopausal women with MASLD: A randomized controlled trial.","authors":"Akram Jafari, Ali Haghighati Borujeni, Mahsa Heydari Soreshjani","doi":"10.1016/j.jsams.2026.09.019","DOIUrl":"https://doi.org/10.1016/j.jsams.2026.09.019","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effects of an 8-week elastic band resistance training program (EBRT) on hepatic steatosis, liver stiffness, liver enzymes, metabolic outcomes, body mass index, and circulating irisin in postmenopausal women with metabolic dysfunction-associated steatotic liver disease (MASLD).</p><p><strong>Design: </strong>A randomized controlled trial.</p><p><strong>Methods: </strong>Fifty-two postmenopausal women with MASLD were EBRT (n = 26) or a control group (n = 26) for eight weeks. Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were assessed using transient elastography. Liver enzymes, glycemic indices, BMI, and circulating irisin were measured at baseline and post-intervention. Dietary intake and daily step counts were monitored throughout the study. Group × time effects were analyzed using linear mixed-effects models.</p><p><strong>Results: </strong>All participants completed follow-up. A significant group × time interaction was observed for CAP (β = -36.77 dB/m, 95% CI -50.90 to -22.64; p < 0.001). Significant interactions also favored EBRT for LSM (β = -1.51 kPa), ALT (β = -11.49 U/L), GGT (β = -11.18 U/L), fasting insulin (β = -3.32 μU/mL), BMI (β = -0.73 kg/m²), and circulating irisin (β = 3.73 ng/mL; all p ≤ 0.006). Interactions for AST, fasting glucose, and HOMA-IR were not significant.</p><p><strong>Conclusions: </strong>Eight weeks of supervised EBRT reduced hepatic steatosis and was associated with favorable changes in selected hepatic, metabolic, anthropometric, and myokine outcomes. EBRT may be a feasible low-impact exercise strategy for postmenopausal women with MASLD; however, secondary outcomes should be interpreted cautiously because no multiplicity adjustment was applied.</p>","PeriodicalId":16992,"journal":{"name":"Journal of science and medicine in sport","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhaling cooler air reduces thermal, cardiorespiratory, and perceptual strain during prolonged exercise in the heat and extends exercise duration in young men.","authors":"Akira Katagiri, Bun Tsuji, Takeshi Nishiyasu, Naoto Fujii","doi":"10.1016/j.jsams.2026.09.016","DOIUrl":"https://doi.org/10.1016/j.jsams.2026.09.016","url":null,"abstract":"<p><strong>Objectives: </strong>In hot environments, hyperthermia and the associated physiological and perceptual strain potentially limit prolonged exercise capacity. We tested the hypothesis that during prolonged exercise in the heat, lowering the temperature of inspired air would attenuate elevations in core temperature, cardiorespiratory strain, cerebral hypoperfusion, and perceptual stress, thereby enhancing exercise capacity.</p><p><strong>Design: </strong>Randomized crossover design.</p><p><strong>Methods: </strong>Twelve healthy males cycled at 50% of peak oxygen uptake in the heat (38 °C, 50% relative humidity) until esophageal temperature (an index of core temperature) reached 39.0 °C or volitional exhaustion. On two occasions, participants inhaled room air at 38 °C (control trial) or air gradually cooled from ~35 °C to ~28 °C (cooler-air trial) throughout exercise.</p><p><strong>Results: </strong>Exercise duration was 11.3 min longer in the cooler-air than the control trial (p = 0.004). Esophageal temperature and heart rate were 0.13-0.23 °C and 3.3-7.5 beats/min lower, respectively, in the cooler-air trial at 30-45 and 10-45 min of exercise (all p ≤ 0.011). Minute ventilation and thermal sensation were 1.3-5.8 L/min and 0.3-0.8 units lower, respectively, whereas end-tidal CO₂ partial pressure was 1.2-2.3 mmHg higher in the cooler-air trial at 5-45 min of exercise (all p ≤ 0.012 for trial effects). Middle cerebral artery mean blood velocity did not differ between trials throughout exercise.</p><p><strong>Conclusions: </strong>During prolonged exercise in the heat (38 °C), inhaling gradually cooled air from ~35 °C to ~28 °C reduces esophageal temperature, cardiorespiratory strain, and perceived thermal stress at corresponding time points in the ambient air inhalation and enhances exercise capacity.</p>","PeriodicalId":16992,"journal":{"name":"Journal of science and medicine in sport","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the algorithm: A qualitative study of expert perceptions on the impact of injury prediction models in men's professional football.","authors":"Francisco Martins, Élvio Rúbio Gouveia, Krzysztof Przednowek, Honorato Sousa, Hugo Sarmento","doi":"10.1016/j.jsams.2026.09.010","DOIUrl":"https://doi.org/10.1016/j.jsams.2026.09.010","url":null,"abstract":"<p><p>The potential of machine learning to predict injury risk in men's professional football has been explored in quantitative studies, yet the perceptions and experiences of performance staff who integrate these technologies into daily practice remain underexplored.</p><p><strong>Objectives: </strong>This qualitative investigation aimed to explore performance professionals' perceptions of the practical utility, implementation barriers, and role in decision-making of muscle injury prediction models in men's professional football.</p><p><strong>Design: </strong>Semi-structured interviews were conducted with 10 male performance staff members (4 physical trainers, 3 physiologists, 3 heads of performance; mean experience: 11.0 ± 5.0 years) working in men's professional football.</p><p><strong>Methods: </strong>Data were analyzed using a deductive-inductive thematic approach.</p><p><strong>Results: </strong>The analysis identified three main themes: (i) determinants of prevention and injury risk profile, (ii) strategies for assessing and monitoring injury risk, and (iii) applicability and impact of injury prediction models. Participants described prediction models as decision-support tools whose usefulness depended on integration with clinical judgment, longitudinal monitoring, and organizational context. Implementation was constrained by financial and structural limitations and required translating complex data into actionable information for coaches. High-risk situations required shared negotiation among staff and players rather than unilateral decisions based on algorithmic outputs.</p><p><strong>Conclusions: </strong>In men's professional football, injury prediction models were perceived less as a replacement for human judgment and more as a complement to multidisciplinary decision-making. As the sample comprised exclusively male professionals in men's football, transferability to women's football and female professionals should be examined in future research.</p>","PeriodicalId":16992,"journal":{"name":"Journal of science and medicine in sport","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amount and patterns of physical activity accumulation during the transition from midlife to older adulthood: Introducing the Physical Activity Bank.","authors":"Ruyi Yu, Stephanie L Duncombe, Wendy J Brown, Nicola W Burton, Hsin-Fang Chung, Gregore I Mielke","doi":"10.1016/j.jsams.2026.09.013","DOIUrl":"https://doi.org/10.1016/j.jsams.2026.09.013","url":null,"abstract":"<p><strong>Objectives: </strong>Previous studies have examined 'trajectories' of physical activity, but few have investigated physical activity 'accumulation'. In this study, we explored the 'Physical Activity Bank' concept, incorporating both 'accumulation amount' and 'accumulation pattern'. The aims were to jointly describe the amount and patterns of physical activity accumulation in mid-to-older-adulthood and show how these vary by demographic characteristics.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>Data were collected from five mail surveys (2007-2016) of an Australian cohort transitioning from midlife to older adulthood. An individual Physical Activity Bank score was calculated as the total amount of physical activity across the five surveys. Patterns of accumulation were determined using group-based trajectory modelling. The resulting scores and patterns were compared against guideline-based cumulative thresholds (e.g., 2500 MET.mins across five surveys, 500 MET.mins/week on average) and stratified by gender, age, education, and body mass index.</p><p><strong>Results: </strong>Large variations were observed in Physical Activity Bank amounts over five surveys in nine years, from 0 to 21,479 MET.mins. Accumulation patterns were identified as low-stable (45.9%), moderate-stable (29.4%), moderate-increasing (11.7%), high-declining (7.5%), and high-stable (5.6%). Two contrasting patterns (moderate-increasing and high-declining) achieved a similar Bank amount; however, the former reflected more consistent accumulation, whilst the latter accumulated a large amount of activity only at baseline. Women, participants with lower education, or overweight/obese tended to have less active Bank amount and patterns.</p><p><strong>Conclusions: </strong>This study demonstrates large variations in both the amount and accumulation patterns of the 'Physical Activity Bank'. Future research may consider both dimensions, rather than a single metric, to assess long-term physical activity.</p>","PeriodicalId":16992,"journal":{"name":"Journal of science and medicine in sport","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Running together vs. alone: Women's HRV adapts more in groups, men's more when running solo.","authors":"Andreas Fink, Patrick Klepits, Karl Koschutnig, Corinna M Perchtold-Stefan, Andreas R Schwerdtfeger, Christian Rominger","doi":"10.1016/j.jsams.2026.09.011","DOIUrl":"https://doi.org/10.1016/j.jsams.2026.09.011","url":null,"abstract":"<p><strong>Objectives: </strong>Three objectives guided this study: (1) to test whether a brief, two-week running intervention changes heart rate variability (HRV) and mental-health parameters; (2) to examine whether running alone versus in groups differentially affects these outcomes; and (3) to assess whether participants' gender moderates these effects.</p><p><strong>Design: </strong>131 young adults with sedentary lifestyles were randomized to an individual (solo) running condition, a group-running condition, or a waitlist control, and were assessed before and after the two-week intervention.</p><p><strong>Methods: </strong>Primary self-report outcomes were perceived stress, positive affect, negative affect, and depressive symptoms. Autonomic regulation was indexed by different HRV measures quantifying both parasympathetic and sympathetic aspects of autonomic function, derived from ECG recordings obtained pre- and post-intervention.</p><p><strong>Results: </strong>There were no general effects of running on any HRV index, in either the solo or the group-running condition. However, HRV changes were moderated by gender and running context, as evidenced by significant TIME × GROUP × GENDER interactions in vagally mediated (parasympathetic) indices: among women, HRV increased particularly in the group-running condition, whereas among men, HRV increases were observed primarily in the solo condition.</p><p><strong>Conclusions: </strong>This exploratory study indicates that HRV might not generally adapt to physical activity, but rather depends on individual or contextual factors such as gender and running context (in groups versus solo). The findings reinforce the value of HRV metrics as a tool to further support the role of physical activity in enhancing overall health and underscore the importance of tailoring physical activity interventions to individual characteristics.</p>","PeriodicalId":16992,"journal":{"name":"Journal of science and medicine in sport","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A preventive intervention program, ankle sprain incidence and functional abilities in male infantry recruits.","authors":"Michal Shenhar, Gali Dar, Aharon S Finestone, Yaakov Fixler, Gordon Waddington, Avi Shina, Nili Steinberg","doi":"10.1016/j.jsams.2026.09.012","DOIUrl":"https://doi.org/10.1016/j.jsams.2026.09.012","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effectiveness of a daily, 5-minute field-based neuromuscular exercise program on ankle sprain incidence and functional performance in infantry recruits.</p><p><strong>Design: </strong>Prospective quasi-experimental intervention study.</p><p><strong>Methods: </strong>Two induction cohorts were assigned to either an intervention group (n = 421) or a control group (n = 365). The intervention group performed a daily 5-minute program of balance, agility, and strength exercises for 12 weeks, while the control group continued standard training. Outcomes included ankle sprain incidence, functional performance (Hexagon hop, Y-Balance Test), and perceived instability (Cumberland Ankle Instability Tool).</p><p><strong>Results: </strong>Analysis included 431 completers (intervention n = 183; control n = 248). Ankle sprain incidence was significantly lower in the intervention group (13.1%) compared to the control group (31.0%; p < 0.001). Significant time × group × sprain interactions were observed for all functional measures (p < 0.001); while injured control recruits experienced significant functional decline and worsened instability, injured intervention recruits maintained baseline performance levels or improved. Multivariate analysis identified participation in the intervention (odds ratio = 0.208), body mass index (odds ratio = 1.058), Cumberland ankle instability tool score (odds ratio = 0.960), and a group × previous sprain interaction (odds ratio=2.969) as the primary factors significantly associated with ankle sprains. A significant group × previous sprain interaction (odds ratio = 2.969, p = 0.015) indicated the program was particularly effective for recruits with a history of prior injury.</p><p><strong>Conclusions: </strong>Integrating a brief, equipment-free neuromuscular training program into daily military routines significantly reduced ankle sprains and preserved readiness, particularly for high-risk recruits. This feasible intervention is highly recommended across infantry training.</p>","PeriodicalId":16992,"journal":{"name":"Journal of science and medicine in sport","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring a systems-based, multifactorial framework for load tolerance and injury risk in women's soccer: A prospective study.","authors":"Oluwatoyosi B A Owoeye, Mallory Hill, Jack Hageman, Evan T Lennox, Aarushi Parmar, Mitchell M Wayne, Katie Sniffen","doi":"10.1016/j.jsams.2026.09.008","DOIUrl":"https://doi.org/10.1016/j.jsams.2026.09.008","url":null,"abstract":"<p><strong>Objectives: </strong>To compare season-average cumulative multifactorial injury risk index scores between injured and uninjured women soccer players, describe the relationship between the weekly injury risk index and subsequent soreness and assess whether strength deficits and sleep disturbances influence the relationships among high load, soreness, and injury.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>Twenty-five National Collegiate Athletic Association Division I women's soccer players were monitored over a 15-week season. External load was tracked using Global Positioning System accelerometers and weekly injury risk index scores were derived from weekly load, preseason strength testing, weekly sleep quality, sleep duration and mood. Lower extremity time-loss injuries were recorded by athletic trainers; weekly soreness was self-reported on a Likert-type scale. Differences between groups were explored descriptively, including relationships between high load, strength deficits, sleep, and injury/soreness.</p><p><strong>Results: </strong>Fifteen players (60%) sustained at least one injury (23 total; 0.92 injuries/player-season). Injured players had a higher mean risk index (33.8%, confidence interval: 22.1-45.5) than uninjured players (24.1%, confidence interval: 17.3-30.9). Under high load, all players with strength deficits were injured, compared with fewer injuries among those without deficits. Suboptimal sleep quality slightly increased soreness risk, whereas suboptimal sleep duration had no influence. The weekly injury risk index correlated moderately with soreness prevalence (r = 0.51).</p><p><strong>Conclusions: </strong>This exploratory study suggests that a multifactorial injury risk index integrating modifiable factors and load exposure may provide a useful framework for understanding injury vulnerability in athletic populations. This approach demands further validation using larger samples and robust longitudinal methods.</p>","PeriodicalId":16992,"journal":{"name":"Journal of science and medicine in sport","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating exertional heat illness risk and preserving performance in mass-participation endurance events: a real-world analysis of a graded cooling and fluid replacement strategy.","authors":"Hai Li, Xiaodong Cao, Shuolei Feng","doi":"10.1016/j.jsams.2026.09.007","DOIUrl":"https://doi.org/10.1016/j.jsams.2026.09.007","url":null,"abstract":"<p><strong>Objectives: </strong>Endurance athletes competing in hot-humid environments face substantial thermoregulatory strain. This study evaluated whether participation in a structured graded cooling and fluid replacement program was associated with lower post-race core body temperature and improved physiological, medical, and performance outcomes.</p><p><strong>Design: </strong>Retrospective comparative analysis of a prospectively collected, non-randomized event-based cohort.</p><p><strong>Methods: </strong>Records from 312 endurance athletes competing in four hot-humid events in southern China (2023-2025) were analyzed. Propensity score matching within event retained 116 matched pairs. The primary outcome was post-race core body temperature; secondary outcomes included race-time deviation, heat-related medical encounters, cortisol, and interleukin-6.</p><p><strong>Results: </strong>Post-race core body temperature was lower with graded cooling and fluid replacement (39.1 ± 0.4°C vs 39.6 ± 0.5°C; mean difference -0.50°C, 95% confidence interval -0.62 to -0.38; P < 0.001). Race-time deviation from personal best was smaller (+4.8 ± 2.9% vs +8.3 ± 4.1%); adjusted between-group difference was -3.08 percentage points (95% confidence interval -4.21 to -1.95; P < 0.001). Heat-related medical encounters occurred in 10/116 versus 20/116 athletes (conditional OR 0.41, 95% confidence interval 0.17-0.99). Cortisol and interleukin-6 responses were attenuated.</p><p><strong>Conclusions: </strong>Participation in the structured program was associated with lower thermal strain, fewer heat-related medical presentations, and better preservation of race performance. The findings support the feasibility of organizer-delivered multimodal cooling and individualized fluid replacement in hot-humid endurance events.</p>","PeriodicalId":16992,"journal":{"name":"Journal of science and medicine in sport","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}