Medicine and Science in Sports and Exercise最新文献

{"title":"Influence of Running Speed and Time Post-Operatively on Lower Extremity Work in Collegiate Athletes after Anterior Cruciate Ligament Reconstruction.","authors":"Keith A Knurr, Daniel G Cobian, Stephanie A Kliethermes, Mikel R Joachim, Bryan C Heiderscheit","doi":"10.1249/MSS.0000000000003695","DOIUrl":"https://doi.org/10.1249/MSS.0000000000003695","url":null,"abstract":"<p><strong>Purpose: </strong>Following anterior cruciate ligament reconstruction (ACLR), individuals present with significant and persistent deficits in surgical knee biomechanics during running. Little is known regarding the role of the hip and ankle in compensating for these knee-specific deficits. The purpose of this study was to characterize how limb (surgical and non-surgical), time post-operatively (3.5-7 months [EARLY], 8-13 months [LATE]), and running speed influence lower extremity joint-specific and total work during running post-ACLR.</p><p><strong>Methods: </strong>Fifty-six Division I collegiate athletes post-ACLR (EARLY: n = 41, LATE: n = 42, Both: n = 27) completed running analyses at 2.68, 2.95, 3.35, 3.80 and 4.47 m/s or up to their maximum comfortable speed. Linear mixed effects models assessed the influence of limb, speed, time post-ACLR, and their interactions on hip, knee, ankle, and total negative and positive work.</p><p><strong>Results: </strong>Surgical limb hip positive work was greater (0.044 J/kg [0.015, 0.074], p < 0.001) than the non-surgical limb EARLY. Surgical limb ankle negative (-0.054 J/kg [-0.093, -0.015], p = 0.003) and positive work (-0.115 J/kg [-0.168, -0.063], p < 0.001) were less than the non-surgical limb EARLY. Surgical limb knee negative (EARLY: -0.339 J/kg [-0.382, -0.296], p < 0.001; LATE: -0.222 J/kg [-0.265, -0.180], p < 0.001) and positive work (EARLY: -0.214 J/kg [-0.246, -0.182], p < 0.001; LATE: -0.142 J/kg [-0.174, -0.110], p < 0.001) were less than the non-surgical limb. Total negative and positive work followed the same pattern as the knee. Conclusions: Athletes post-ACLR exhibited greater hip positive work and lesser ankle positive and negative work during running of the surgical limb EARLY, that resolved LATE. Both knee and total negative and positive work of the surgical limb were substantially less than the non-surgical limb, which improved from EARLY to LATE, but between-limb asymmetries remained.</p>","PeriodicalId":18426,"journal":{"name":"Medicine and Science in Sports and Exercise","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567512","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":"Exercise Rescues Blood-Brain Barrier Structural Impairment and Enhances Mitochondrial Biogenesis in a Hypertensive Mouse Model.","authors":"Ying-Shuang Chang, Chu-Wan Lee, Han-Chen Lin, Wan-Erh Hu, Chih-Lung Lin, Yi-Ting Wu, Yao-Hsiang Shih","doi":"10.1249/MSS.0000000000003696","DOIUrl":"10.1249/MSS.0000000000003696","url":null,"abstract":"<p><strong>Abstract: </strong>Purpose. Blood-brain barrier (BBB) dysfunction is implicated in various neurodegenerative diseases, including Alzheimer's disease and frontotemporal dementia. Over the past decades, numerous studies have suggested that exercise can mitigate neurodegenerative processes by improving mitochondrial function. Recently, we demonstrated that exercise could reverse hippocampus-associated memory deficits and reduce BBB leakage in a modified two-kidney, one-clip (2K1C) hypertensive animal model. Based on these findings, we hypothesize that exercise restores BBB integrity in hypertensive animal models. Methods. Hypertension was induced in C57BL/6 mice via 2K1C surgery. Following three weeks of hypertension induction, mice underwent moderate-intensity treadmill exercise for five weeks. Subsequently, brain tissues were collected for immunofluorescence staining and immunoblotting analyses to assess changes in BBB structure and mitochondria-related protein expression. Results. Exercise restored hypertension-induced reductions in blood vessel density within the hippocampus. Additionally, it repaired BBB structural impairments, as evidenced by increased levels of Claudin-5 co-localization with blood vessels, enhanced perivascular astrocyte levels, and improved perivascular AQP-4 protein expression. An immunoblotting analysis revealed that exercise upregulated the PGC-1α/Nrf1/UCP-2 pathway in the 2K1C hypertensive model. However, exercise did not significantly affect Drp-1 expression. Conclusions. Exercise alleviates BBB leakage by restoring structural integrity to the BBB. These improvements may be mediated through the enhancement of mitochondrial biogenesis.</p>","PeriodicalId":18426,"journal":{"name":"Medicine and Science in Sports and Exercise","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557239","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":"Training Parameters and Adaptations that Mediate Walking Capacity Gains from High-Intensity Gait Training Post-Stroke.","authors":"Pierce Boyne, Allison Miller, Sarah M Schwab-Farrell, Heidi Sucharew, Daniel Carl, Sandra A Billinger, Darcy S Reisman","doi":"10.1249/MSS.0000000000003691","DOIUrl":"10.1249/MSS.0000000000003691","url":null,"abstract":"<p><strong>Purpose: </strong>Locomotor high-intensity interval training (HIIT) has been shown to improve walking capacity (speed and endurance) more than moderate-intensity aerobic training (MAT) after stroke, but it is unclear which training parameter(s) should be prioritized (e.g. speed, heart rate, blood lactate, step count) and to what extent walking capacity gains are the result of gait changes versus cardiorespiratory adaptations. This study aimed to assess which training parameters and longitudinal adaptations most strongly mediate 6-minute walk distance (6MWD) gains from post-stroke HIIT.</p><p><strong>Methods: </strong>The HIT-Stroke Trial randomized 55 persons with chronic stroke and walking limitations to HIIT or MAT; each involving overground and treadmill walking, 45 minutes, 3 times/week for 12 weeks. HIIT used short maximum speed intervals, targeting >60% heart rate reserve (HRR). MAT targeted 40-60% HRR. Blinded outcomes included 6MWD, short-distance gait function (e.g. fastest 10-meter gait speed) and aerobic capacity (e.g. ventilatory threshold). This ancillary analysis used structural equation models to compare mediating effects of different training parameters and longitudinal adaptations on 6MWD changes.</p><p><strong>Results: </strong>Net gains in 6MWD from HIIT versus MAT were primarily mediated by faster training speeds (+57 meters, p < .0001) and longitudinal gait adaptations (+37 meters, p = .0005). Training step count was also positively associated with 6MWD gains, but was lower with HIIT versus MAT, which decreased the net 6MWD gain from HIIT (-14 meters, p = .02). HIIT generated higher training heart rate and lactate than MAT, but aerobic capacity gains were similar between groups, and 6MWD changes were not associated with training heart rate, training lactate, or aerobic adaptations.</p><p><strong>Conclusions: </strong>To increase walking capacity with post-stroke HIIT, training speed and step count appear to be the most important parameters to prioritize.</p>","PeriodicalId":18426,"journal":{"name":"Medicine and Science in Sports and Exercise","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537242","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":"Effect of a Pragmatic Exercise Intervention Pilot Study on Preventing Functional and Physical Decline in Hospitalized Older Adults.","authors":"Eva Peyrusqué, Marie-Jeanne Kergoat, Ali Filali-Mouhim, Nathalie Veillette, Raquel Fonseca, Marie-Josée Sirois, Mylène Aubertin-Leheudre","doi":"10.1249/MSS.0000000000003687","DOIUrl":"https://doi.org/10.1249/MSS.0000000000003687","url":null,"abstract":"<p><strong>Purpose: </strong>Although physical activity (PA) has the potential to prevent iatrogenic disability, it is rarely integrated into usual care. We evaluated whether MATCH, a pragmatic unsupervised exercise intervention, could help prevent physical and functional decline in hospitalized older adults.</p><p><strong>Methods: </strong>A quasi-randomized trial (ClinicalTrials #NCT04078334) was conducted involving 100 hospitalized patients, who were allocated to either the usual care + MATCH group (MG; n = 62) or the usual care only group (CG; n = 38). MATCH is an unsupervised PA program guided by a decision tree (3 exercises/session; 3x/day). Outcomes were assessed at admission and discharge: 1) primary outcome: functional capacities (Short Physical Performance Battery (SPPB)); 2) secondary outcomes: handgrip strength, walking speed, functional mobility (3-metre Timed-Up-and-Go (TUG)), leg muscle power (30-second chair-test), need for home care support, and functional autonomy in both instrumental and basic activities of daily living (ADL).</p><p><strong>Results: </strong>At admission, groups were similar, except for nutritional status (p = 0.047). There were no significant differences between groups for the primary outcome (SPPB: MG:+1.5 ± 1.9 vs. CG:+1.0 ± 1.4/12pts, p = 0.25). However, the MG showed greater improvements in handgrip strength (MG:+1.7 ± 3.9 vs. CG:-0.15 ± 3.0 kg, p = 0.02) and had a lower need for home care support at discharge (MG:44.3% vs. CG:65.8%, p = 0.041). A higher proportion of MG participants improved to being at no risk of falling (TUG<14 sec), achieved good functional capacity (SPPB ≥10/12: +6.6%), increased leg muscle power (Women:<2.1/Men:<2.6(W/kgBW): -15.1%), and improved walking speed (<0.6 m/s: -30.6%) compared to the CG. Clinically meaningful improvements in ADL (+82.7%) were observed only in the MG.</p><p><strong>Conclusions: </strong>Combining usual care with the MATCH intervention appears more effective that usual care alone in preventing physical and functional decline and reducing the need for home care support at discharge. Larger-scale efficacy studies are needed to confirm these promising results.</p>","PeriodicalId":18426,"journal":{"name":"Medicine and Science in Sports and Exercise","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537233","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":"Development and Validation of a Heat Risk Mitigation Tool for Burn Survivors.","authors":"Zachary J McKenna, Josh Foster, Whitley C Atkins, Elizabeth A Gideon, Ollie Jay, Federico Tartarini, Craig G Crandall","doi":"10.1249/MSS.0000000000003694","DOIUrl":"https://doi.org/10.1249/MSS.0000000000003694","url":null,"abstract":"<p><strong>Purpose: </strong>Burn survivors have an increased risk for heat related illnesses, and a heightened perceptual strain during exercise (thereby impeding physical activity), both due to impaired body temperature regulation. We developed and validated a freely deployed online model that burn survivors can use to estimate their heat risk during physical activity.</p><p><strong>Methods: </strong>Model inputs included environmental conditions, physical activity intensity and duration, body size, clothing, and burn injury size. The developed model predicts heat risk categorized as either low to moderate (change in core temperature < 1.7 °C) or high to extreme (change in core temperature ≥ 1.7 °C). We compared the core temperature responses and predicted heat risk from laboratory trials conducted in adults aged 19 to 61 years with well healed burn injuries (n = 134) or simulated burn injuries (n = 157). Burn injury sizes ranged from 20 to 80% of body surface area. Trials were conducted in our laboratory across a variety of environmental conditions (25 to 39 °C and 20 to 40 % relative humidity) and exercise intensities (46 to 357 W/m2).</p><p><strong>Results: </strong>With heat risk as a binary outcome, the predictive accuracy of the model was 85%. The specificity of the model was 85% and the sensitivity of the model was 79%. The positive predictive value was 27% and the negative predictive value was 98%.</p><p><strong>Conclusions: </strong>The developed model (www.bsrcalculator.org) predicts heat-risk across a variety of environmental conditions and exercise intensities. We anticipate that this tool will inform individuals of their potential risk (or lack thereof) associated with performing physical activity in the heat while also promoting a physically active lifestyle in burn survivors.</p>","PeriodicalId":18426,"journal":{"name":"Medicine and Science in Sports and Exercise","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537231","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":"Hormonal Contraceptive Use and Physical Performance, Body Composition, and Musculoskeletal Injuries during Military Training.","authors":"Thomas J O'Leary, Hope A Evans, Marie-Elise O Close, Rachel M Izard, Neil P Walsh, Charlotte V Coombs, Alexander T Carswell, Samuel J Oliver, Jonathan C Y Tang, William D Fraser, Julie P Greeves","doi":"10.1249/MSS.0000000000003588","DOIUrl":"10.1249/MSS.0000000000003588","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate associations between hormonal contraceptive use and physical performance, body composition, and musculoskeletal injuries in basic military training.</p><p><strong>Methods: </strong>Female British Army recruits ( n = 450) were grouped as nonusers ( n = 182), combined oral contraceptive users (COCP; n = 184), or progestin-only users (POC; n = 144). Physical performance (2.4-km run, lift strength, leg power), body composition, iron and vitamin D status, and bone metabolism were measured at the start (week 1) and end (week 13) of training. Lower body musculoskeletal injuries were recorded from medical records.</p><p><strong>Results: </strong>Training decreased 2.4-km run time (-3.7%) and fat mass (-9.6%), and increased lift strength (4.5%), leg power (1.5%), lean mass (5.4%), and whole-body (0.9%), arms (1.8%), and legs (1.4%) areal bone mineral density ( P ≤ 0.015); the training response was not different between groups ( P ≥ 0.173). Lift strength was lower in COCP users than nonusers ( P = 0.044). Whole-body, trunk, and leg areal bone mineral densities were lower in POC users than nonusers and/or COCP users ( P ≤ 0.041). There were no associations between hormonal contraceptive use and musculoskeletal or bone stress injury ( P ≥ 0.429). Training did not change ferritin ( P = 0.968), but decreased hemoglobin and total 25-hydroxyvitamin-D, and increased parathyroid hormone, c-telopeptide cross-links of type 1 collagen (βCTX), and procollagen type 1 N-terminal propeptide (PINP; P ≤ 0.005); the training response was not different between groups ( P ≥ 0.368). Total 25-hydroxyvitamin-D was higher, and βCTX and PINP were lower, in COCP users than nonusers and POC users; parathyroid hormone was lower in COCP users than nonusers; and βCTX and PINP were higher in POC users than nonusers ( P ≤ 0.017).</p><p><strong>Conclusions: </strong>Hormonal contraceptive use was not associated with performance or injury outcomes in military training.</p>","PeriodicalId":18426,"journal":{"name":"Medicine and Science in Sports and Exercise","volume":" ","pages":"613-624"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583448","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":"The Validity and Usability of Markerless Motion Capture and Inertial Measurement Units for Quantifying Dynamic Movements.","authors":"Nathan A Edwards, Jaclyn B Caccese, Ryan E Tracy, Joshua Hagen, Catherine C Quatman-Yates, James OñATE","doi":"10.1249/MSS.0000000000003579","DOIUrl":"10.1249/MSS.0000000000003579","url":null,"abstract":"<p><strong>Purpose: </strong>Motion capture technology is quickly evolving, providing researchers, clinicians, and coaches with more access to biomechanics data. Markerless motion capture and inertial measurement units (IMUs) are continually developing biomechanics tools that need validation for dynamic movements before widespread use in applied settings. This study evaluated the validity of a markerless motion capture, IMU, and red, green, blue, and depth (RGBD) camera system as compared with marker-based motion capture during countermovement jumps, overhead squats, lunges, and runs with cuts.</p><p><strong>Methods: </strong>Thirty adults were recruited for this study (sex: 18 females, 12 males; age: 25.4 ± 8.6 yrs; height: 1.71 ± 0.08 m; weight: 71.6 ± 11.5 kg). Data were collected simultaneously with four motion capture technologies (i.e., Vicon, marker-based; Theia/Optitrack, markerless; APDM Opals, IMUs; and Vald HumanTrak, RGBD camera). System validity for lower and upper body joint angles was evaluated using bias, root mean squared error (RMSE), precision, maximum absolute error, and intraclass correlation coefficients. System usability was descriptively analyzed.</p><p><strong>Results: </strong>Overall, markerless motion capture had the highest validity (sagittal plane RMSE: 3.20°-15.66°; frontal plane RMSE: 2.12°-9.14°; transverse plane RMSE: 3.160°-56.61°), followed by the IMU system (sagittal plane RMSE: 8.11°-28.37°; frontal plane RMSE: 3.26°-16.98°; transverse plane RMSE: 5.08°-116.75°), and lastly the RGBD system (sagittal plane bias: 0.55°-129.48°; frontal plane bias: 1.35°-52.06°).</p><p><strong>Conclusions: </strong>Markerless motion capture and IMUs have moderate validity for joint kinematics, whereas the RGBD system did not have adequate validity. Markerless systems have lower data processing time, require moderate technical expertise, but have high data storage size. IMUs are easier to use, can collect data in any location, but require participant set-up. Overall, individuals using motion capture should consider the specific movements, testing locations, and technical expertise available before selecting a system.</p>","PeriodicalId":18426,"journal":{"name":"Medicine and Science in Sports and Exercise","volume":" ","pages":"641-655"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896008","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":"Prenatal Exercise Decreases Urinary Incontinence in Late Pregnancy and 3 Months Postpartum: A Randomized Controlled Trial.","authors":"Dingfeng Zhang, Miguel Sánchez-Polán, Cristina Silva-Jose, Ángeles Díaz-Blanco, Maia Brik, Aranzazu Martín Arias, Paloma Hernando, Rubén Barakat","doi":"10.1249/MSS.0000000000003597","DOIUrl":"10.1249/MSS.0000000000003597","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the impact of a supervised exercise program, including pelvic floor muscle training, throughout pregnancy on Urinary Incontinence (UI).</p><p><strong>Methods: </strong>A randomized clinical trial (NCT04563065) was conducted. Initially, 600 pregnant women were screened for eligibility, with data from 356 participants eventually analyzed. Of these, 172 were allocated to the exercise group (EG) and 184 to the control group (CG). Participants in the EG engaged in a supervised moderate exercise program 3 d·wk -1 , each session lasting 60 min, from 8-10 to 38-40 wk of gestation, achieving an adherence rate of 73.5%.</p><p><strong>Results: </strong>A lower prevalence of UI in the EG compared with the CG was observed during late pregnancy ( χ2 = 20.04; P = 0.001) and at 3 months postpartum ( χ2 = 12.52; P = 0.03), as well as in birth weight ( F = 4.16; P = 0.04). No significant differences were found between the groups in other maternal and newborn outcomes.</p><p><strong>Conclusions: </strong>Supervised exercise during pregnancy, which included pelvic floor muscle training, effectively reduced the incidence of UI in late pregnancy and at 3 months postpartum.</p>","PeriodicalId":18426,"journal":{"name":"Medicine and Science in Sports and Exercise","volume":" ","pages":"555-562"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984042","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":"Bolstering the Prognostic Utility of Coronary Risk Assessments with PAI: A Physical Activity Metric.","authors":"Javaid Nauman, Tania Mirzaamin, Barry A Franklin, Bjarne M Nes, Carl J Lavie, Patrick Dunn, Ross Arena, Chi Pang Wen, Atefe R Tari, Ulrik Wisløff","doi":"10.1249/MSS.0000000000003584","DOIUrl":"10.1249/MSS.0000000000003584","url":null,"abstract":"<p><strong>Purpose: </strong>Personal activity intelligence (PAI) translates heart rate during physical activity (PA) into a weekly score, which credits vigorous over low- and moderate-intensity PA. We prospectively investigated the association between PAI and fatal and nonfatal coronary heart disease (CHD) in self-reported healthy participants from Norway, with specific reference to improving the accuracy of conventional coronary risk assessment.</p><p><strong>Methods: </strong>We studied 40,961 healthy adults (56% women) from the population-based Trøndelag Health Study (the HUNT study). Individual data were linked to hospital and cause of death registries. The weekly PAI score of each participant was divided into four groups (PAI scores of 0, ≤50, 51-99, or ≥100). Adjusted hazard ratios and 95% confidence intervals for fatal and nonfatal CHD related to PAI were estimated using Cox proportional hazard regression analyses.</p><p><strong>Results: </strong>During a median follow-up period of 13.1 yr (interquartile range, 12.7-13.6), 3303 (3109 nonfatal, 194 fatal) CHD events occurred. Compared with the inactive group (0 PAI), weekly PAI scores at baseline of 51-99 and ≥100 were associated with a lower risk of CHD [0.80 (0.71-0.91) and 0.86 (0.78-0.95), respectively]. By adding PAI to traditional risk factors, the net reclassification improvement of CHD was 0.472 ( P < 0.001).</p><p><strong>Conclusions: </strong>PAI was inversely associated with CHD risk among healthy participants at baseline, and its cardioprotective effect persisted across diverse risk factor profiles. A PAI score >50 was substantially associated with a reduced risk of CHD. These findings have implications for improving the accuracy of conventional coronary risk assessments with PAI.</p>","PeriodicalId":18426,"journal":{"name":"Medicine and Science in Sports and Exercise","volume":" ","pages":"481-489"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise in Pediatric COVID-19: A Randomized Controlled Trial.","authors":"Camilla Astley, Jonathan A Drezner, Sofia Mendes Sieczkowska, Amanda Ihara, Tathiane Franco, Saulo Gil, Danilo Marcelo Leite DO Prado, Igor Longobardi, Priscila Suguita, Thais Fink, Livia Lindoso, Olivia Matsuo, Fernanda Martins, Vera Bain, Gabriela Nunes Leal, Maria Fernanda Badue, Heloisa Helena Marques, Clovis Artur Silva, Hamilton Roschel, Bruno Gualano","doi":"10.1249/MSS.0000000000003589","DOIUrl":"10.1249/MSS.0000000000003589","url":null,"abstract":"<p><strong>Purpose: </strong>This study assessed the impact of a 12-wk, home-based exercise training (HBET) program on health-related quality of life (HRQOL; primary outcome), and cardiovascular and metabolic parameters in pediatric COVID-19 patients.</p><p><strong>Methods: </strong>This was a single-center, randomized controlled trial conducted in a tertiary hospital in Sao Paulo, from October 2020 to January 2022. Thirty-two patients (mean age, 12 ± 3.3 yr) were randomly assigned to either HBET or standard of care (CONTROL) in a 2:1 ratio 4 months (range: 0.7-6.6 months) after COVID-19 discharge ( n = 25 mild, n = 4 moderate, n = 3 severe illness). The HBET group underwent supervised and unsupervised sessions three times a week for 12 wk emphasizing aerobic and body weight exercises, while the CONTROL group received standard care, which included general advice for a healthy lifestyle with no prescribed exercise intervention. HRQOL (evaluated by the Pediatric Quality of Life Inventory), cardiopulmonary exercise test, brachial endothelial function and echocardiography assessments were conducted in both groups. Statistical analysis was performed using an intention-to-treat approach for the primary analysis and complete case (per-protocol) as sensitivity analysis.The significance was set at P ≤ 0.05 and P ≤ 0.10 was considered as trend.</p><p><strong>Results: </strong>There was no difference in HRQOL between groups. Intention-to-treat analysis indicated a trend toward increased oxygen uptake (V̇O 2 ) at anaerobic threshold following the intervention in the HBET group. In addition, a sensitivity analysis showed significant changes in peak heart rate and 1-min recovery, respiratory exchange ratio, and chronotropic response. A trend toward significance was observed in ventilation-to-maximum voluntary ventilation ratio and chronotropic response in the HBET group. No other between-group differences were detected for the cardiopulmonary exercise test, brachial flow-mediated dilation, and echocardiography variables (all P > 0.05).</p><p><strong>Conclusions: </strong>In this randomized controlled trial, a 12-wk HBET intervention did not impact HRQOL in pediatric COVID-19 patients. However, exercise was able to improve the V̇O 2 at the ventilatory anaerobic threshold, heart rate peak and 1-min recovery, ventilation-to-maximum voluntary ventilation ratio, and chronotropic response, with no changes observed in other cardiovascular parameters. Further studies are needed to investigate the long-term effects of exercise interventions on the recovery of pediatric COVID-19 patients with and without preexisting chronic conditions.</p>","PeriodicalId":18426,"journal":{"name":"Medicine and Science in Sports and Exercise","volume":" ","pages":"514-523"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583428","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}