Sports Medicine最新文献

{"title":"Acute Effects of Different Training Sessions on the Extended Blood Steroid Profile in Elite Male Football Players.","authors":"Federico Ponzetto, Alberto Franceschi, Laura Leoni, Alessia Melis, Giulia Montesano, Andrea Marchini, Fabio Settanni, Raul Nicoli, Gianluca Aimaretti, Andrea Benso, Tiia Kuuranne, Mirko Parasiliti-Caprino","doi":"10.1007/s40279-026-02467-8","DOIUrl":"10.1007/s40279-026-02467-8","url":null,"abstract":"<p><strong>Background: </strong>Acute exercise is a recognized physiological confounder of circulating steroid hormones, yet evidence on how real-world football training affects the blood steroid profile (BSP) within the Athlete Biological Passport (ABP) remains limited in elite athletes.</p><p><strong>Objective: </strong>To examine acute endocrine response to football training sessions of differing load and to explore their association with perceived exertion.</p><p><strong>Methods: </strong>A total of 27 elite male professional outfield football players from an Italian Serie A club were assessed during the in-season period (2022-2023 competitive season). Each player completed one predefined low-load (LL), moderate-load (ML), or high-load (HL) training session. Venous blood samples were collected immediately before and after training. Collectively, 26 circulating steroids were quantified by liquid chromatography-tandem mass spectrometry. These included both unconjugated hormones and phase II metabolites relevant to the BSP. External training load was assessed using global navigation satellite systems, while internal load was quantified via heart-rate telemetry and rating of perceived exertion (RPE). Data were analyzed using nonparametric statistics, linear mixed-effects models, and multivariable logistic regression.</p><p><strong>Results: </strong>Training elicited significant, load-associated alterations in circulating BSP steroids. HL sessions induced marked post-training increases in free glucocorticoids including cortisone (median Δ + 7.4 ng/mL), and unconjugated androgens such as androstenedione (median Δ + 131.3 pg/mL), whereas LL sessions induced minimal changes. The testosterone-to-androstenedione ratio decreased following ML and HL training (median 8.2-6.6, p < 0.001). Athletes reporting higher perceived exertion (RPE ≥ 4) exhibited greater endocrine perturbations, with significantly larger increases in cortisol-related steroids (e.g., 11-deoxycortisol, p < 0.001).</p><p><strong>Conclusions: </strong>Acute football training is associated with rapid modulation of circulating steroid hormones, particularly following higher training loads and perceived exertion. These findings highlight the potential relevance of recent training exposure when interpreting BSP variations and suggest that integrating steroidomic profiles with training-load information may improve the physiological contextualization of antidoping biomarkers.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":"2569-2582"},"PeriodicalIF":11.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Considerations for Studies in Sport and Exercise Science with Women as Participants Part II: Guidance for Applied Studies in Elite Female Athletes.","authors":"Kirsty J Elliott-Sale, Richard J Burden, Kathryn E Ackerman, Louise M Burke, Naama Constantini, Anthony C Hackney, Rachel Harris, Franco M Impellizzeri, Xanne A K Janse de Jonge, Constance M Lebrun, Clare Minahan, Sophia Nimphius, Stuart M Phillips, Sarianna Sipilä, Juliette A Strauss, Paul Swinton, Craig Sale","doi":"10.1007/s40279-026-02442-3","DOIUrl":"10.1007/s40279-026-02442-3","url":null,"abstract":"<p><p>The purpose of this statement is to guide the design and conduct of high-quality sport and exercise science studies investigating the effects of varied ovarian hormone profiles on the health and athletic performance of elite female athletes. Beyond the menstrual cycle, these athletes present with a wide range of ovarian hormone profiles, including those associated with puberty and menarche, menstrual dysfunction, hormonal contraceptive use, pregnancy and postpartum, perimenopause, menopause and post-menopause. To effectively integrate knowledge of ovarian hormone profiles into high-performance sport and address the diverse needs of female athletes, future research and educational initiatives must encompass this broader spectrum of ovarian hormone profiles. However, to produce this knowledge, improvements in research design and conduct are necessary and can be facilitated by adopting reporting checklists as a structured approach to enhance transparency and reproducibility. We recommend that such quality assurance measures be integrated at the study design phase, along with clear research questions, appropriate study designs, and valid analysis methods. Consequently, the proposed guidelines aim to support researchers working in applied settings with elite female athletes in generating more robust and impactful evidence.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":"2349-2366"},"PeriodicalIF":11.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fuelled or Fooled? Examining the Evidence and Mechanisms Behind Ultra-High Carbohydrate Intake in Endurance Athletes.","authors":"Daniel J Plews, Paul D Booth, Taj Krieger, Ed Maunder","doi":"10.1007/s40279-026-02462-z","DOIUrl":"10.1007/s40279-026-02462-z","url":null,"abstract":"<p><p>Ultra-high carbohydrate (U-HC) ingestion strategies, typically > 90 g·h⁻¹, have gained remarkable traction among elite endurance athletes in recent years. This rise has been fuelled by anecdotal reports linking aggressive carbohydrate fuelling with superior race execution, and record-breaking performances. However, the scientific literature supporting these practices remains limited, and current frameworks used to explain carbohydrate-mediated performance effects, such as muscle glycogen sparing, maintenance of blood glucose or maximisation of exogenous carbohydrate oxidation, do not fully account for the reported U-HC benefits. Indeed, available studies reveal a disconnect between metabolic data and the real-world adoption of intakes far beyond established oxidation ceilings. We examine the existing research on carbohydrate ingestion during endurance exercise, highlighting the metabolic responses and performance outcomes. We identify how traditional mechanisms have been interpreted to justify escalating carbohydrate intake and discuss the constraints of current methodologies in detecting meaningful performance benefits at ultra-high ingestion rates. The article then introduces emerging, yet largely untested, possible mechanistic models that may underpin the perceived utility of U-HC fuelling, including shifts in substrate selection, enhanced lactate shuttling and potential central effects associated with carbohydrate availability. Finally, we explore the relevance of inter-individual variation in carbohydrate oxidation capacity and the implications for developing practical guidelines for athletes. By integrating physiological, metabolic and perceptual perspectives, this current opinion outlines why U-HC strategies have gained prominence and identifies key areas where further research is required to clarify their role within contemporary endurance performance for the masses.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":"2367-2388"},"PeriodicalIF":11.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Acute Effects of Short-Bout High-Intensity Interval Training on Physiological and Perceptual Outcomes: A Systematic Review and Meta-analysis.","authors":"Fraser Thurlow, Nicholas Cowley, Katie Slattery, Jonathon Weakley","doi":"10.1007/s40279-026-02456-x","DOIUrl":"10.1007/s40279-026-02456-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Understanding the acute demands of short-bout high-intensity interval training can enhance training outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to examine the acute physiological and perceptual demands of short-bout high-intensity interval training in athletes and identify how they are moderated by programming variables, fitness level and competitive level.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched the databases PubMed, SPORTDiscus and CINAHL on 2 December, 2025 for original research articles investigating running-based, short-bout high-intensity interval training in healthy athletes, aged 16-40 years, of any sex, who were recreationally active or above. Outcomes were analysed using a multi-level mixed-effects meta-analysis. The analysed outcomes were: average heart rate (HR&lt;sub&gt;avg&lt;/sub&gt;), peak heart rate (HR&lt;sub&gt;peak&lt;/sub&gt;), peak and average oxygen consumption (VO&lt;sub&gt;2&lt;/sub&gt;), time &gt; 90% of maximal oxygen consumption (T &gt; 90% VO&lt;sub&gt;2max&lt;/sub&gt;), time &gt; 95% of VO&lt;sub&gt;2max&lt;/sub&gt; (T &gt; 95% VO&lt;sub&gt;2max&lt;/sub&gt;), T &gt; 90% VO&lt;sub&gt;2max&lt;/sub&gt;/exercise time ratio (T&lt;sub&gt;90&lt;/sub&gt;/ET), T &gt; 95% VO&lt;sub&gt;2max&lt;/sub&gt;/exercise time ratio (T&lt;sub&gt;95&lt;/sub&gt;/ET), blood lactate concentration (B[La]) and session ratings of perceived exertion (sRPE). To examine the influence of programming variables, fitness level, and competitive level, a meta-regression was performed on moderators with ten or more samples. Effects were evaluated based on coverage of their confidence limits against elected thresholds of practical importance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From 139 data samples within 46 studies, the pooled demands (± 90% confidence limit) of short-bout high-intensity interval training were: HR&lt;sub&gt;avg&lt;/sub&gt;, 169 ± 4 b·min&lt;sup&gt;-1&lt;/sup&gt; and 88 ± 2% of maximum heart rate; HR&lt;sub&gt;peak&lt;/sub&gt;, 184 ± 4 b·min&lt;sup&gt;-1&lt;/sup&gt; and 94 ± 2% of maximum heart rate; average VO&lt;sub&gt;2&lt;/sub&gt;, 46 ± 3 mL·kg&lt;sup&gt;-1&lt;/sup&gt;·min&lt;sup&gt;-1&lt;/sup&gt; and 78 ± 4% of velocity at VO&lt;sub&gt;2max&lt;/sub&gt;; peak VO&lt;sub&gt;2&lt;/sub&gt;, 55 ± 5 mL·kg&lt;sup&gt;-1&lt;/sup&gt;·min&lt;sup&gt;-1&lt;/sup&gt; and 93 ± 7% of VO&lt;sub&gt;2max&lt;/sub&gt;; T &gt; 90% velocity at VO&lt;sub&gt;2max&lt;/sub&gt;, 259 ± 57 s; time &gt; 95% VO&lt;sub&gt;2max&lt;/sub&gt;, 125 ± 48 s; T&lt;sub&gt;90&lt;/sub&gt;/ET, 0.34 ± 0.9; T&lt;sub&gt;95&lt;/sub&gt;/ET, 0.15 ± 0.07; B[La], 8.3 ± 0.5 mmol·L&lt;sup&gt;-1&lt;/sup&gt;; and sRPE, 7.1 ± 0.5 au. When compared to an athlete VO&lt;sub&gt;2max&lt;/sub&gt; of 50-55 mL·kg&lt;sup&gt;-1&lt;/sup&gt;·min&lt;sup&gt;-1&lt;/sup&gt;, a VO&lt;sub&gt;2max&lt;/sub&gt; of 55-60 mL·kg&lt;sup&gt;-1&lt;/sup&gt;·min&lt;sup&gt;-1&lt;/sup&gt; and &gt; 60 mL·kg&lt;sup&gt;-1&lt;/sup&gt;·min&lt;sup&gt;-1&lt;/sup&gt; were associated with a substantial decrease in sRPE (- 1.7 ± 1.3 au and -1.6 ± 1.1 au, respectively). Compared to a reference protocol of 1 set of 12 straight-line repetitions, performed at 120% of maximal aerobic speed for a 15-s work duration with 15 s of passive rest: shuttle runs were associated with a substantial increase in B[La] (1.9 ± 1.0 mmol·L&lt;sup&gt;-1&lt;/sup&gt;) and sRPE (1.7 ± 0.4 au); active rest was associated with a substantial increase in T&lt;sub&gt;90&lt;/sub&gt;/ET","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":"2497-2526"},"PeriodicalIF":11.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Comment on: \"35 Years of Joyner's Endurance Performance Model: Assessing the Contribution of Physiological Determinants of Performance Proxies in 888 Individuals from Recreational to World Class\".","authors":"Loïs Mougin, Stephen J Bailey, Andrew M Jones, Michael J Joyner, Stephen A Mears, Rhona Pearce, Michele Zanini","doi":"10.1007/s40279-026-02502-8","DOIUrl":"10.1007/s40279-026-02502-8","url":null,"abstract":"","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":"2629-2631"},"PeriodicalIF":11.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Return to Performance Continuum for Football (Soccer) Players After ACL Reconstruction: Bridging Rehabilitation, Return to Play and Sustained Performance","authors":"Matthew Buckthorpe,Paul Read,Eric Hamrin Senorski,Alessandro Compagnin,Stefano Di Paolo,Francesco Della Villa","doi":"10.1007/s40279-026-02543-z","DOIUrl":"https://doi.org/10.1007/s40279-026-02543-z","url":null,"abstract":"Abstract Anterior cruciate ligament reconstruction (ACLR) in football (soccer) players is associated with high return-to-competition rates but persistent deficits in performance and elevated risk of secondary injury. Whilst rehabilitation frameworks have evolved to optimise early, mid-, and late-stage recovery, limited guidance exists regarding the structured transition from typical return-to-sport clearance to sustained return-to-performance (RTP erf ). Failure to adequately bridge this gap may contribute to early re-injury, suppressed match performance and compromised career longevity. This paper outlines a staged RTP erf continuum comprising: (1) structured on-field rehabilitation, (2) return to team training, (3) return to competitive match play and (4) early and sustained RTP erf. Four interdependent pillars underpin this process: (i) the restoration of movement quality under realistic football specific situations; (ii) progressive football-specific technical and tactical re-training; (iii) football-specific physical reconditioning including speed, acceleration, deceleration and change of direction ability, endurance and chronic workload development and (iv) maximal strength and explosive neuromuscular performance restoration.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: “Sport-Specific Impact Loading is Associated with Bone Mineral Density in Athletes: Implications for Relative Energy Deficiency in Sport (REDs) Assessment”","authors":"Nizhou Jiang,Yanchao Zhang,Lei Li","doi":"10.1007/s40279-026-02537-x","DOIUrl":"https://doi.org/10.1007/s40279-026-02537-x","url":null,"abstract":"","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"46 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149022459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Comment on: “Sport-Specific Impact Loading is Associated with Bone Mineral Density in Athletes: Implications for Relative Energy Deficiency in Sport (REDs) Assessment”","authors":"Trent Stellingwerff,Ming-Chang Tsai,Walter T. P. McCluskey,Louise M. Burke,Matthew D. Fliss,Kathryn E. Ackerman,Ida A. Heikura","doi":"10.1007/s40279-026-02536-y","DOIUrl":"https://doi.org/10.1007/s40279-026-02536-y","url":null,"abstract":"","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"6 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Prevention for Health: The Global Alliance Framework for the Promotion of Physical Activity.","authors":"Jürgen M Steinacker, Willem van Mechelen, Lars Engebretsen, Evert Verhagen, Mats Börjesson, Marcela González-Gross, Mark R Hutchinson, Petra Zupet, Herbert Löllgen, Dina C Janse van Rensburg, Norbert Bachl, Sergio Migliorini, Pieter D'Hooghe, Christian Schneider, Jiao Jiao, Ka Ki Wong, Jeroen Swart, Leigh Gordon, Victoria Badtieva, Borja Muniz-Pardos, Tony Lei Shi, Li Xiangchen, Feng Qiang, Guoping Li, Minhao Xie, Xia Zhang, Uğur Erdener, Federica Fagnani, Fabio Pigozzi, Chiara Fossati, Luigi Di Luigi, Francisco Arroyo, Jean-François Kaux, Camille Tooth, Shulin Cheng, Xiuqiang Wang, Emin Ergen, Bülent Ülkar, Frederic Dutheil, Ruediger Reer, Theodora Papadopoulou, Clea Papaellina, Demitri Constantinou, Jason Constantinou, Merling Phaswana, Mamosilo Lichaba, Philippe Gradidge, Mandisa Simamane, Georgia Torres, Natalia Neophytou, Elelwani D Nevhufumba, Bernhard Schwaab, José Antonio Casajús Mallen, Martin Halle, Martine Duclos, Daniel Neunhaeuserer, Andrea Ermolao, Francesca Battista, Federica Duregon, Julio Motta-Pensabene, Yiannis Koutedakis, Lena Tepohl, Wilhelm Bloch, Nicolaas P Pronk, Anastasia Fischer, Lisset Pantoja-Arévalo, Ana V Cintrón, Adewale S Adebero, Jill Borresen, Johannes Zwerver, Diana M Ramos-Caballero, Erica M Mancera-Soto, Pedro Manonelles, Benedict Tan, Ingrid Burrowes, Carl Ward, Kim R Quimby, Christina Howitt, Robert Clive Landis, Hans Hauner, Mikio Hiura, Luz Divina De La Cruz Lastre, Gunnar Treff, Fotini Tsofliou, José Kawazoe Lazzoli, Umutcan Kayıkçı, Mourad Ghrairi, Vincent Onywera, Robert Ojiambo, Robert Sallis, Sophia Papamichalopoulos, Maher Zahar, Christine Joisten, Bernd Wolfarth, Sandra Rozenstoka, Hashel Al Tunaiji, Kiera Wason, Felix Drummond, Wolfgang Schobersberger, Vahur Ööpik, Eve Unt, Anna Jegier, Stéphane Doutreleau, Seung Hoon Han, Jörg F Debatin, Nils Schumacher, Luís B Sardinha, Lenka Dienstbach-Wech, Tuba Melekoğlu, Sheng Zeng, Maurizio Casasco, Kristy Howells, Eva-Maria Klinkisch, James Bilzon, Gregory Heath, Thomas Horstmann, Eduardo H De Rose, Nick Webborn, Klaus-Michael Braumann, Li Jing, Xiao Xu, Elizabeth Moxley, Yi Zheng, Alison V September, Malcolm Collins, Olena Andrieieva, Svitlana Drozdovska, Andreas Michael Nieß, Rikke Helene Moe, Carolin Knoke, Silvano Zanuso, Francesco Zanatta, Veronika Všetíčková, Spyridon Zormpas, Christoforos D Giannaki, Brian P Carson, Matthew P Herring, Ciara McCormack, Marco Vecchiato, Thomas Yvert, Makro Korenjak, Benjamin Billet, Andréia Lópes Azevedo, Naama Constantini, Sigmund Loland, Aaron Leigh Baggish, Luis Monteiro, Nuray Yazihan, Yannis P Pitsiladis","doi":"10.1007/s40279-026-02495-4","DOIUrl":"https://doi.org/10.1007/s40279-026-02495-4","url":null,"abstract":"&lt;p&gt;&lt;p&gt;This conceptual, implementation-oriented paper proposes a framework for precision prevention centred on physical activity promotion and early risk mitigation, aiming to support a shift from reactive disease management toward proactive prevention. The proposed framework focuses on the early identification of risk trajectories by integrating biological, environmental, and social determinants of health through systems thinking, multi-omics technologies, digital health, and behavioural science. It aims to inform tailored, context-sensitive interventions that will help to mitigate chronic non-communicable diseases (NCDs), while supporting lifelong resilience. Within this framework, physical activity is positioned as the central, modifiable anchor behaviour through which personalised prevention strategies may be operationalised. Building on the 2025 Hamburg Declaration and the Global Alliance for the Promotion of Physical Activity's (GA@PA) mission, this conceptual paper proposes a multidimensional model, combining personalised strategies for physical activity, nutrition, sleep, and mental health with contextual environmental adaptations. By bringing together stakeholders across multiple sectors, including healthcare, education, urban planning, sport organisations, industry, and community groups, GA@PA aims to strengthen global collaboration and to accelerate the implementation of evidence-based strategies for physical activity promotion. Emerging technologies, including digital twins, wearable biosensors and artificial intelligence (AI)-driven analytics, are discussed as potential enabling tools for real-time monitoring and for providing input for adaptive interventions, while mobile health platforms may extend access to underserved populations. Rather than providing prescriptive solutions, the paper outlines key implementation fundamentals. These include technological infrastructure with interoperable biosensors and AI aligned with prevailing ethical frameworks such as the AI Act and UNESCO recommendations; interdisciplinary research on resilience and outlier populations; policy and education reform, including routine assessment of physical activity as a vital sign within healthcare encounters; and cross-sector collaboration spanning urban design to sport-for-development initiatives such as the International Olympic Committee (IOC)'s Olympism365. Sports organisations may support broader participation through sport-for-all programmes. The framework emphasises equity, cultural adaptation, and community co-design as critical features for scalability across diverse global contexts, highlighting the role of sport, fitness, and public health partnerships in creating a context where healthy choices become accessible and sustainable. Overall, this conceptual paper outlines a practice-informed framework proposing precision prevention as an evolving and testable implementation framework for supporting sustainable and equitable prevention systems. By inte","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Resistance Training on Muscle Hypertrophy in Children and Adolescents: A Systematic Review and Meta-Analysis.","authors":"Yannik Komm, Linda Zeiler, Steffen Held, Paul Comfort, Avery Faigenbaum, Stephan Geisler, Claudia Augste","doi":"10.1007/s40279-026-02499-0","DOIUrl":"https://doi.org/10.1007/s40279-026-02499-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Resistance training is considered safe and beneficial for young individuals, yet the extent to which it results in morphological adaptations before, during and after puberty remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this review was to quantify the effects of resistance training on muscle hypertrophy in children and adolescents and to examine whether the effects differ by maturational stage, sex, and hypertrophy-oriented design of the resistance training program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;PubMed, Scopus, Web of Science and Google Scholar were searched in April 2025. Randomized and non-randomized controlled studies in participants younger than 18 years of age were eligible when hypertrophy was assessed with direct imaging or indirect instrumented methods. Subgroup analyses were conducted by maturational status, sex and the hypertrophy-oriented design of the resistance training program. Effect sizes (Cohen's d) with 95% confidence intervals were pooled using a random-effects model with heterogeneity quantified via the I&lt;sup&gt;2&lt;/sup&gt; statistic. Risk of bias was assessed with RoB 2 and ROBINS-I and methodological quality with the PEDro scale. The review was preregistered on PROSPERO (CRD420251025605). The hypertrophy suitability of the resistance training protocols was evaluated using established hypertrophy guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-three studies with a total of 1443 participants were included. Overall, compared with passive controls, resistance training induced a small increase in muscle mass (Cohen's d = 0.22 95% CI 0.06-0.37), while compared with active controls, the effects were notably greater (Cohen's d =  0.61, 95% CI 0.03-1.20). Subgroup analyses revealed trivial-to-small hypertrophy across maturational stages when compared with passive controls (prepubertal Cohen's d = 0.16, 95% CI - 0.04 to 0.36; peripubertal Cohen's d =  0.30, 95% CI 0.01-0.58 postpubertal Cohen's d = 0.01, 95% CI - 0.31 to 0.33). Compared with active controls, subgroup differences by maturational stage were statistically significant (p =  0.0227), with postpubertal participants showing a large and significant effect (Cohen's d = 1.50, 95% CI 0.46-2.54) compared with smaller, non-significant effects in peripubertal and prepubertal participants. Compared with active controls, hypertrophy was large in males (Cohen's d =  1.26, 95% CI 0.29-2.22), trivial in females (Cohen's d =  - 0.12, 95% CI - 1.05-0.81) and trivial in mixed samples (Cohen's d = 0.04, 95% CI - 0.08 to 0.17). Compared with passive controls, changes were trivial in males (Cohen's d =  0.11, 95% CI - 0.12-0.34), small in females (Cohen's d = 0.20, 95% CI - 0.07 to 0.46) and small in mixed samples (Cohen's d =  0.39, 95% CI -  0.01 to 0.78).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Resistance training induces small hypertrophy compared with passive controls and larger effects compared with active controls. The hypertrophic adaptations o","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}