Sports Medicine - Open最新文献

{"title":"Inciting Events of Lower-Limb Muscle Injury: A Systematic Review and Meta-analysis of Video-Based Studies.","authors":"Aaron Miralles-Iborra, Heidy Rondón-Espinosa, Francisco J Vera-Garcia, Javier Courel-Ibáñez, Manuel Manchón-Davó, Juan Del Coso, Víctor Moreno-Pérez","doi":"10.1186/s40798-026-01090-1","DOIUrl":"https://doi.org/10.1186/s40798-026-01090-1","url":null,"abstract":"<p><strong>Background: </strong>Understanding the situational contexts of lower-limb muscle injuries in football is critical for informing the design of effective prevention strategies. While their frequency and burden are well documented, the frequently observed inciting events and situational patterns underlying these injuries remain insufficiently synthesised.</p><p><strong>Objective: </strong>To systematically review and meta-analyse video-based analysis studies examining the inciting events, timing, field location, and situational patterns associated with lower-limb muscle injuries in professional football players.</p><p><strong>Methods: </strong>A PRISMA-guided systematic review was conducted across five databases (PubMed, Web of Science, Embase, Scopus, SPORTDiscus) from inception to October 1, 2025. Eligible studies used video analysis to examine inciting events (type, kinetic chain, vertical and horizontal velocities), timing (match half, minute), field location (short and long axis), and situational/tactical patterns (specific action, defensive/offensive context, ball possession status) of lower-limb muscle injuries in professional football. Dichotomous outcomes were pooled using random-effects odds ratios (OR), and multi-category outcomes were synthesised via a Bayesian hierarchical multinomial-logit model with study-level pooled random-effects marginal proportions (RE) and 95% credible intervals (CrI). Risk of bias and methodological quality of included studies were appraised using the AXIS, QA-SIVAS and STROBE-SIIS tools.</p><p><strong>Results: </strong>Twelve studies (513 players [434 male and 79 female]; 538 injuries [452 in males, 86 in females]) were included. Hamstring injuries predominated (74.7%), followed by adductor (14.3%), quadriceps (7.1%), and calf (3.9%) injuries. Sufficient data for meta-analysis were available only for male players. Non-contact injuries (n = 322) were significantly more frequent than indirect contact (n = 108) injuries (OR = 8.01, 95% CI 3.85-16.64; p < 0.001). These injuries occurred predominantly during moderate-to-high horizontal velocity actions, compared with zero-to-low velocity actions (OR = 19.56, 95% CI 2.55-150.12; p = 0.004). Pooled proportions were highest during running (RE = 0.29, 95% CrI: 0.17-0.44), stretching/reaching (RE = 0.24, 95% CrI: 0.12-0.40), or kicking actions (RE = 0.22, 95% CrI: 0.09-0.38), although no credible differences were observed between categories. No consistent effects were found for the kinetic chain, match time, field location, or tactical phase.</p><p><strong>Conclusions: </strong>In professional football, lower-limb muscle injuries were predominantly observed during non-contact inciting events occurring at moderate-to-high horizontal speed, frequently involving the hamstrings during running, stretching/reaching, or kicking actions. No consistent effects were found for match time, field location, or tactical phase. Methodological heterogeneity and the absence of","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13486463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797882","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":"Movement Configuration Elements in Football Players: Beyond Dynamic Correspondence Principles.","authors":"Oliver Gonzalo-Skok, Julio Tous-Fajardo","doi":"10.1186/s40798-026-01093-y","DOIUrl":"https://doi.org/10.1186/s40798-026-01093-y","url":null,"abstract":"<p><p>In real-world football training, limited time is available for strength and conditioning sessions during the in-season period. The search for time-efficient strategies that concurrently enhance several locomotive-specific actions while preventing injuries seems crucial. Individual sports coaching literature has provided valuable concepts such as \"transfer of training\" and \"dynamic correspondence\" to describe the extent to which a given exercise may enhance sports performance, based on how closely it reproduces the exercise's mechanical, neural, and metabolic demands. However, given the highly dynamic and stochastic nature of football movements, there is a need to introduce a more comprehensive and advanced training paradigm that includes the so-called movement/action configuration elements. These variables aim to shape how game-based football actions evolve during a real match situation and include the need to efficiently anticipate/compensate for perturbations and unknown or unexpected events by alternating eccentric overload unilateral, variable, and multidirectional movements. A review of how these elements may shape football movements is conducted to ultimately provide practical recommendations and tools for daily practice.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13486447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797908","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":"Differences in the Thoracolumbar Fascia Between Low Back Pain Patients and Healthy Individuals: A Systematic Review with Meta-Analysis.","authors":"Jan Wilke, Julius Debertshaeuser, Fabio Konrad","doi":"10.1186/s40798-026-01064-3","DOIUrl":"https://doi.org/10.1186/s40798-026-01064-3","url":null,"abstract":"<p><strong>Background: </strong>In view of new evidence revealing a mechanical and nociceptive role of the thoracolumbar fascia (TLF), it has been suggested to be involved in low back pain.</p><p><strong>Objective: </strong>To compare characteristics of the TLF in low back pain (LBP) patients and asymptomatic controls.</p><p><strong>Methods: </strong>Two independent investigators performed a systematic literature search using PubMed, Web of Science, Science Direct, Cochrane Library, and Google Scholar. Imaging studies (ultrasound/MRI) investigating the morphology and mechanics of the TLF in LBP patients and controls were included. We used robust variance estimation to pool (a) the standardized mean differences (SMD) between both groups and (b) the correlation between TLF characteristics and subjective pain ratings in LBP patients.</p><p><strong>Results: </strong>A total of 14 trials with moderate-to-high methodological quality (5.1 ± 1.2 points on the JBI critical appraisal checklist) were identified. Relative to asymptomatic controls, the LBP patients displayed a higher thickness (SMD: 0.64, 95% CI 0.41 to 0.88, p = < .001, 12 studies), stiffness (SMD: 0.82, 95% CI 0.34 to 1.31, p = .018, 3 studies), and echogenicity (SMD 0.43, 95% CI 0.16 to 0.70, p = .02, 3 studies) of the TLF. No effect was found for fascial layers sliding (SMD: - 0.05, 95% CI - 5.82 to 5.71, p = .92, 2 studies), although both studies of this comparison found significant (opposite) difference to controls. TLF thickening correlated with higher pain ratings.</p><p><strong>Conclusion: </strong>The TLF of patients with LBP is thickened, stiffened and more echogenic when compared to controls, while the role of shear mobility is unclear. As we additionally found associations of TLF characteristics with pain ratings, future research addressing the predictive value of these markers is warranted.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797871","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":"Predictive Processing in Sport and Exercise Science: A Scoping Review and Theoretical Overview.","authors":"David J Harris, Callum A O'Malley, Damian Beck, Stephan Zahno, Thomas Arthur","doi":"10.1186/s40798-026-01092-z","DOIUrl":"https://doi.org/10.1186/s40798-026-01092-z","url":null,"abstract":"<p><strong>Background: </strong>This scoping review explored the application of predictive processing in sport and exercise science, examining how cognitive and computational models have been used to understand perceptual-motor skills, decision-making, and physical performance. The review provides a tutorial introduction to key concepts in the predictive processing literature and maps the extent of research in this area, identifying key domains of application and the level of empirical support.</p><p><strong>Methods: </strong>A systematic search of EMBASE, Medline, PsycINFO, and SPORTDiscus databases was performed, adhering to JBI methodology and the PRISMA Extension for Scoping Reviews.</p><p><strong>Results: </strong>Twenty relevant empirical studies were discovered across all domains of sport and exercise science. Despite promising evidence, the review also uncovers significant gaps, particularly in comparing predictive-processing-specific mechanisms to alternative theories and exploring the broader implications of predictive processing for skill acquisition and training interventions.</p><p><strong>Conclusions: </strong>Based on these findings, the review outlines recommendations for future research, calling for more targeted investigations that empirically test predictive processing predictions and an expansion of this approach to new areas of sport science.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797876","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":"Exploring Factors to Explain Interindividual Responses to Running Economy in Advanced Footwear Technology Shoes: A Randomised Crossover Laboratory Trial with an Explanatory Predictor Analysis.","authors":"Kim Hebert-Losier, Christiaan Cumming, Benjamin Bidois, Anh Phong Nguyen, Marlene Giandolini","doi":"10.1186/s40798-026-01091-0","DOIUrl":"https://doi.org/10.1186/s40798-026-01091-0","url":null,"abstract":"<p><strong>Background: </strong>Advanced footwear technology (AFT) generally improves running economy (RE) measures on average by 4%, although considerable interindividual variability exists. We aimed to explore this interindividual variability in RE response to AFT compared to a CONTROL shoe and identify potential predictors of this variability. Specifically, differences in participant characteristics (e.g., age, sex, anthropometrics, running experience and speed, prior AFT use, V̇O₂ peak, lower-limb neuromuscular performance, passive stiffness, running biomechanics, and perceptual measures) between above-threshold and below-threshold responders (∆RE threshold: 2.5%) and how these measures related to RE responses were explored.</p><p><strong>Methods: </strong>Sixty-four participants (50% female) attended two laboratory sessions at the University of Waikato Sports Science Laboratory in Cambridge, New Zealand, between 10 October 2024 and 7 February 2025. The first session collected baseline information and participant characteristics related to anthropometric, stiffness, strength, and V̇O₂ peak. The second session assessed RE variables at 70% of a maximal aerobic test (i.e., V̇O₂ peak) speed in two randomised shoe conditions: Salomon S/Lab Phantasm 2 (AFT) and Salomon Aero Glide 2 (CONTROL).</p><p><strong>Results: </strong>AFT significantly improved RE (4.13 ± 1.6%, range: - 2.62% [detrimental] to 11.01% [beneficial]) based on change in oxygen consumption. Significant differences between above-threshold (n = 53) and below-threshold (n = 11) responders were limited to the former exhibiting greater gastrocnemius medialis (GM) stiffness normalised to leg length (mean difference = 33.4 N·m^-2, Hedges' g = 0.86 [0.20, 1.51], p = 0.046). GM stiffness normalised to leg length (B = 0.014 N·m^-2, p = 0.015) and navicular drop (B = 1.849 cm, p = 0.028) significantly predicted RE responses in our regression model (R² = 0.273), with greater stiffness (r = 0.35 [0.11, 0.55], p = 0.005) and navicular drop (r = 0.31 [0.07, 0.52], p = 0.012) associated with more beneficial AFT responses.</p><p><strong>Conclusion: </strong>AFT enhanced RE in most runners, with few factors explaining the interindividual variance observed.</p><p><strong>Trial registration: </strong>Australian New Zealand Trials Registry, ACTRN12624000753550, 18th June 2024, prospectively.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797884","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":"Evaluation of GFAP, UCH-L1 and S100B Blood Biomarkers for the Management of Sports-Related Concussion in Professional Rugby Players: A Prospective Observational Study.","authors":"Charlotte Oris, Rémi Gaulmin, Julie Durif, Vincent Goddelière, Bruno Pereira, Damien Bouvier, Vincent Sapin","doi":"10.1186/s40798-026-01094-x","DOIUrl":"https://doi.org/10.1186/s40798-026-01094-x","url":null,"abstract":"<p><strong>Background: </strong>The incidence of sports-related concussion (SRC) in rugby has been rising in recent years. The Head Injury Assessment (HIA) protocol, used to manage SRC, is limited by its reliance on subjective symptom reporting. Blood biomarkers such as glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase L1 (UCH-L1) and S100B could serve as complementary objective tools for SRC management.</p><p><strong>Results: </strong>A prospective cohort study was conducted in a French elite professional rugby team (Association Montferrandaise Clermont Auvergne Sports, Association Sportive Montferrandaise Clermont Auvergne). A total of 68 professional rugby players were followed from September 2022 to June 2024. During this study period, 23 SRC episodes with blood samples collected according to the HIA protocol were included. S100B baseline levels remained stable across the season in control players. For GFAP and UCH-L1, all baseline values were consistently below the measurable range limits (GFAP < 30 ng/L and UCH-L1 < 200 ng/L). At 2 h post-match (in the absence of SRC), both S100B and UCH-L1 levels increased significantly and were positively correlated with contact frequency, whereas GFAP levels showed no significant change at this early timepoint. At the 36-h post-match follow-up, concentrations of all three biomarkers had returned to baseline, supporting the use of this timepoint within the validated HIA protocol. At 36 h following SRC, UCH-L1 concentrations remained below the quantifiable range, suggesting that earlier sampling may be required to capture post-injury changes for this biomarker. At this timepoint, an increase in S100B of ≥ 15% from baseline yielded 100% specificity (SP) and 39% sensitivity (SE) for SRC diagnosis. Elevated GFAP concentrations (≥30 ng/L) were observed in some players with SRC, providing 100% SP and 17% SE. Combining S100B and GFAP maintained 100% SP while improving SE to 52%.</p><p><strong>Conclusion: </strong>At 36 h post-match, both GFAP and S100B demonstrated 100% SP for the diagnosis of SRC in professional rugby players. Their integration into routine HIA assessments may offer objective support to clinical decision-making and help enhance player safety.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762274","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":"The Role of Training Age and Sport Specialization in Achieved Selection Tier in Adolescent Handball Talents.","authors":"Lutz Thieschäfer, Jörg Schorer, Urs Granacher, Dirk Büsch","doi":"10.1186/s40798-026-01079-w","DOIUrl":"10.1186/s40798-026-01079-w","url":null,"abstract":"<p><strong>Background: </strong>The debate over whether beginning a sport early and specializing in it promotes athletic success in adulthood has been the subject of academic discussion for decades. Current evidence suggests the opposite. Multisport participation during youth and a later start in the primary sport may positively influence athletic success in adulthood, although the effects on youth athletes remain inconclusive. However, youth sports performance and developmental potential are central to success in talent selection processes, which decisively shape athletes' subsequent talent development. Therefore, this study aimed to determine the handball training age and prevalence rates of sport specialization in talented female U15 and male U16 handball players and to examine their associations with the attained selection tier. In addition, the years of practice in other sports (i.e., depth), the number of other sports (i.e., breadth), and the type of other sports were compared between selection tiers.</p><p><strong>Results: </strong>The vast majority of female (92.8%) and male (97.0%) players were classified as specialized athletes. Almost one third of the female (30.9%) and male players (30.8%) have never been involved in sports other than handball (i.e., single-sport players). Multisport engagement was not significantly associated with the selection tier in both sexes. Furthermore, there were no adverse associations between the breadth, depth, and type of other sports practiced and the selection tier. Female (g = 0.59) and male (g = 0.40) players who achieved higher selection tiers demonstrated a higher training age compared to non-selected players.</p><p><strong>Conclusions: </strong>In light of the players' mid-teen age, the high prevalence rates of sport specialization were as expected. Nevertheless, the relatively high proportion of single-sport players may give cause for concern, particularly given that multisport engagement did not impede players from reaching high selection tiers. In fact, multisport engagement can be considered a viable alternative developmental pathway toward adult high performance. Furthermore, training age was associated with selection tier. Consequently, having a high training age may increase the likelihood of being selected as a \"talent\" which should be considered in talent selection processes.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707653","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-Induced Metaplasticity: Breaking the Addiction Cycle in Methamphetamine Use Disorder.","authors":"Dongshi Wang, Jianjing Jin, Charles H Hillman, Yu-Kai Chang","doi":"10.1186/s40798-026-01088-9","DOIUrl":"10.1186/s40798-026-01088-9","url":null,"abstract":"<p><p>The high relapse rate in methamphetamine (MA) use disorder (MUD) highlights limitations in current treatment approaches. MA disrupts neural circuits underlying reward processing and executive control, inducing maladaptive neuroplastic changes that reinforce compulsive drug-seeking behaviors. We propose a core pathology of MUD that lies in the dysregulation of metaplasticity, pathological alterations in the rules that govern synaptic plasticity. This dysregulation lowers the threshold for strengthening drug-related cues while simultaneously blunting plastic responses to adaptive, non-drug stimuli. This review posits that exercise may interrupt the MA addiction cycle through three interrelated metaplasticity-regulating mechanisms: a threshold recalibration mechanism whereby exercise synergistically lowers the threshold for adaptive learning across molecular (e.g., brain-derived neurotrophic factor-N-methyl-D-aspartic acid receptor signaling), neural circuit (prefrontal-striatal pathways), and large-scale brain network levels (default mode network-central executive network interactions). A competitive resource reallocation mechanism, in which exercise, acting as a natural reward, competes with drug cues for plasticity-related neural resources (e.g., dopamine D2 receptor availability), thereby weakening the dominance of drug-associated representations. This is a self-reinforcing mechanism, through which exercise enhances neural sensitivity to subsequent therapeutic interventions. The metaplasticity dysregulation framework integrates evidence spanning molecular and cellular processes, neural circuits and brain networks, and peripheral-central regulatory pathways (including the gut-brain axis). The framework suggests that exercise shifts the rules of neural plasticity away from pathological drug cue dominance toward adaptive processing of natural rewards, providing a strong neurobiological rationale for incorporating exercise into comprehensive MUD treatment strategies.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679805","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":"Effect of Combined Aerobic and Resistance Training on Exercise Capacity, Muscle Strength, Quality of Life, and Mortality in Patients with Coronary Heart Disease: A Systematic Review with Meta-analysis.","authors":"Caroline Oliveira Gois, Alana Lalucha de Andrade Guimarães, Lino Sérgio Rocha Conceição, Mansueto Gomes-Neto, Vitor Oliveira Carvalho","doi":"10.1186/s40798-026-01080-3","DOIUrl":"10.1186/s40798-026-01080-3","url":null,"abstract":"<p><strong>Background: </strong>CART (combined aerobic and resistance training) has shown important results in exercise-based cardiovascular rehabilitation. However, there are little data concerning the effects of CART on the exercise capacity, muscle strength, health-related quality of life (HRQoL), and mortality of coronary heart disease (CHD) patients. Therefore, the aim of this study was to analyze the published randomized controlled trials (RCTs) that investigated the effects of CART on exercise capacity [peak oxygen consumption (peak VO₂) and 6-min walking distance (6MWD)], muscle strength [1-repetition maximum (1-RM), peak torque and handgrip strength], HRQoL, and mortality in patients with CHD.</p><p><strong>Methods: </strong>We search for references in MEDLINE/PubMed, Scopus, Cochrane Central Register of Controlled Trials, and EMBASE databases to find RCTs that evaluated the effects of CART for CHD. Mean difference (MD), standardized mean difference (SMD), risk ratio (RR), and 95% confidence intervals (CIs) were calculated.</p><p><strong>Results: </strong>CART improved relative peak VO₂ of 2.20 ml/kg/min (P < 0.0001), peak torque of 16.69 N.m (P < 0.0001), handgrip strength of 4.68 kgf (P < 0.0001), and HRQoL of 1.00 (P < 0.00001) and reduced mortality (RR = 0.40; P = 0.002) compared to non-exercising usual care. CART improved (relative and absolute) peak VO₂ by 0.28 (P < 0.002), 6MWD by 21.98 m (P = 0.004), 1-RM by 0.61 kg (P < 0.0001), peak torque by 4.03 N.m (P = 0.002), and HRQoL by 0.50 (P < 0.0004) compared to aerobic training. CART improved relative peak VO₂ by 1.91 ml/kg/min (P < 0.00001) compared to resistance training.</p><p><strong>Conclusion: </strong>CART was efficient in improving peak VO₂, peak torque, handgrip strength, HRQoL, and lower mortality events compared to non-exercising usual care in patients with CHD. CART appears superior to aerobic training in improving peak VO₂, 6MWD, 1-RM, peak torque, and HRQoL in patients with CHD. Furthermore, CART was more effective than resistance training for peak VO₂ in patients with CHD. CART should be considered as a method in the rehabilitation of patients with CHD.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664343","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":"Diabetes Mellitus and Long-Distance Running: A Systematic Review.","authors":"Lorin Braschler, Mabliny Thuany, Thomas Züger, Pantelis T Nikolaidis, Katja Weiss, Thomas Rosemann, Beat Knechtle","doi":"10.1186/s40798-026-01084-z","DOIUrl":"10.1186/s40798-026-01084-z","url":null,"abstract":"<p><strong>Background: </strong>Athletes with diabetes increasingly participate in endurance running, benefiting from physiological adaptations and technological advances like continuous glucose monitoring (CGM) for glycemic control. So far, no comprehensive review summarizing the current knowledge has been performed.</p><p><strong>Objective: </strong>To identify the prevalence of long-distance runners with diabetes, their performance, methods used for blood glucose monitoring and glycemic control.</p><p><strong>Methods: </strong>PubMed, Medline Ovid, Scopus, SPORTDiscus, Cochrane databases, CINAHL, and Web of Science were systematically searched until April 2024 using key terms related to long-distance running and diabetes. An updated search applying the identical strategy was conducted on May 3rd, 2026, to capture subsequently published literature. This study included original research articles, case reports, and case studies published in English or German in peer-reviewed journals, utilizing both quantitative and qualitative methodologies. Eligibility criteria encompassed runners with a confirmed diagnosis of diabetes mellitus, irrespective of type, who participated in endurance events of at least half-marathon distance, including half-marathons, marathons, ultra-marathons, and other ultra-endurance competitions. Patients with prediabetic state, gestational diabetes, or after pancreatic islet-cell transplantation were excluded. For quality assessment, we used the Joanna Briggs Institute of Analytical Cross-Sectional Studies or the Joanna Briggs Institute of Analytical Case Report critical appraisal tool.</p><p><strong>Results: </strong>A total of 656 studies were identified, with 22 meeting the inclusion criteria, comprising 99 runners with diabetes (99.0% Type 1, 1.0% Type 2 diabetes mellitus). Among them, 50.0% used CGM, 27.2% had an insulin pump, 63.6% administered insulin via multiple daily injections, and the method of insulin application was not specified in 7.0% of runners. The weighted mean HbA_1c was 7.4% (95% CI 6.9-8.1). Time-in-range varied by race distance: 40-100% for half-marathoners, 51.6% for marathoners, and 47-73% for ultra-marathoners. No cases of symptomatic hypoglycemia were observed during the races. However, asymptomatic late-onset hypoglycemia (occurring 6-15 h post-exercise) was reported in 27 runners. The most common insulin adjustment strategy before competitive races was a 50-80% reduction of basal insulin.</p><p><strong>Conclusion: </strong>Despite limited research, evidence suggests that with proper preparation and multidisciplinary support, athletes with diabetes can safely participate in endurance events, including ultra-marathons, while maintaining stable glycemic control.</p><p><strong>Trial registration: </strong>PROSPERO-CRD42024539281.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664364","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}