medRxiv - Sports Medicine最新文献

{"title":"The Investigation of Nonlinear Variability Underlying Postural Control in The Injure-Limb in Individuals with and without Chronic Ankle Instability","authors":"Yuki A Sugimoto, Patrick O McKeon, Christopher K Rhea, Randy J Schmitz, Carl G Mattacola, Scott E Ross","doi":"10.1101/2024.03.11.24304094","DOIUrl":"https://doi.org/10.1101/2024.03.11.24304094","url":null,"abstract":"Background: Less flexible and adaptable sensorimotor systems reflect in movement variability in individuals with Chronic Ankle Instability (CAI), which may limit their ability to detect relevant information using a variety of primary sensory feedback. Thus, the aim of the study was to investigate underlying biological noise pertaining to postural control in single-limb stance during increased environmental constraints with sensory feedback manipulations in individuals with and without CAI. Methods: Forty-two individuals with and without CAI participated in the study. A one-way ANOVA was utilized to examine group differences in biological noise underlying postural control during the SOT conditions in single-limb stance. Results: Individuals with CAI demonstrated significantly lower SampEN while maintaining posture during Condition 5 (P=.037) and Condition 6 (P=.030), where they were forced to exclusively rely on vestibular feedback, in single-limb stance compared to healthy controls. Discussion: Individuals with CAI did not demonstrate decreased movement variability pertaining to postural control during all six SOT conditions. Those participants with CAI only displayed decreased movement variability when they were forced to executively rely on vestibular feedback while maintaining posture in the injured-limb compared to healthy controls.","PeriodicalId":501122,"journal":{"name":"medRxiv - Sports Medicine","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140149007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zapping the brain to enhance sport performance? Evidence from an umbrella review of the effect of transcranial direct current stimulation on physical performance","authors":"Darias Holgado, Daniel Sanabria, Miguel A. Vadillo, Rafael Roman Caballero","doi":"10.1101/2024.03.07.24303915","DOIUrl":"https://doi.org/10.1101/2024.03.07.24303915","url":null,"abstract":"Concepts such as \"neuro-doping\" or brain doping have contributed to an expansion in the area of transcranial direct current stimulation (tDCS) and its impact over exercise and physical performance in recent years. Here we assess the evidence supporting the healthy population using an umbrella review of meta-analyses investigating the role of tDCS to enhance exercise performance. We identified 9 meta-analyses encompassing 50 crossover studies and 683 participants that met our inclusion criteria. Despite the fact that most meta-analyses reported a positive effect of tDCS, our analyses revealed overly low statistical power in the primary studies, publication bias, and large variability in pre-processing and analytic decisions. Indeed, a specification-curve analysis showed that the final effect could range from g = −0.23 to g = 0.33, depending on decisions such as the formula used for estimating the effect size and multiple additional analytic steps. Moreover, a meta-analysis of all the primary studies included in the umbrella review showed a small effect of tDCS (gz = 0.28, 95%CI [0.18, 0.39]) that became substantially smaller and inconclusive after accounting for publication bias, grm = 0.10, 95%CrI [−0.04, 0.20], BF10 = 0.99. In summary, our findings highlight that current evidence, from both individual studies and meta-analyses, does not conclusively support the idea that tDCS enhances performance outcomes.","PeriodicalId":501122,"journal":{"name":"medRxiv - Sports Medicine","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140074855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MUSCLE ENDURANCE, NEUROMUSCULAR FATIGABILITY AND COGNITIVE CONTROL DURING PROLONGED DUAL-TASK IN PEOPLE WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A CASE-CONTROL STUDY","authors":"Cyril Chatain, Jean-Marc Vallier, Nicolas Paleiron, Fanny Cucchietti Waltz, Sofiane Ramdani, Mathieu Gruet","doi":"10.1101/2024.03.05.24303798","DOIUrl":"https://doi.org/10.1101/2024.03.05.24303798","url":null,"abstract":"Recent studies suggest that, compared to healthy individuals, people with chronic obstructive pulmonary disease (pwCOPD) present a reduced capacity to perform cognitive-motor dual-task (CMDT). However, these studies were focused on short-duration CMDT offering limited insight to prolonged CMDT inducing fatigue, which can be encountered in daily life. The present study aimed to explore the effect of adding a cognitive task during repeated muscle contractions on muscle endurance, neuromuscular fatigability and cognitive control in pwCOPD compared to healthy participants Thirteen pwCOPD and thirteen age- and sex-matched healthy participants performed submaximal isometric contractions of the knee extensors until exhaustion in two experimental sessions: (1) without cognitive task and (2) with a concurrent working memory task (i.e., 1-back task). Neuromuscular fatigability (as well as central and peripheral components measured by peripheral magnetic stimulation), cognitive performance and perceived muscle fatigue were assessed throughout the fatiguing tasks. Independently to the experimental condition, pwCOPD exhibited lower muscle endurance compared to healthy participants (p=0.039), mainly explained by earlier peripheral fatigue and faster attainment of higher perceived muscle fatigue (p<0.05). However, neither effect of cognitive task (p=0.223) nor interaction effect (group × condition ; p=0.136) was revealed for muscle endurance. Interestingly, cognitive control was significantly reduced only in pwCOPD at the end of CMDT (p<0.015), suggesting greater difficulty for patients with dual-tasking under fatigue. These findings provide novel insights into how and why fatigue develops in COPD in dual-task context, offering a rationale for including such tasks in rehabilitation programs.","PeriodicalId":501122,"journal":{"name":"medRxiv - Sports Medicine","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140044467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of maternal exercise on infant mesenchymal stem cell mitochondrial function, insulin action, and body composition in early infancy","authors":"Filip Jevtovic, Donghai Zheng, Alex Claiborne, Ericka M. Biagioni, Breanna L. Wisseman, Polina M. Krassovskaia, David N. Collier, Christy Isler, James E. DeVente, P. Darrell Neufer, Linda E. May","doi":"10.1101/2024.03.04.24303710","DOIUrl":"https://doi.org/10.1101/2024.03.04.24303710","url":null,"abstract":"Objective: Rates of pediatric obesity are continuously rising and are likely to translate into a high incidence of metabolic disease later in life. Maternal exercise (ME) has been established as a useful non-pharmacological intervention to improve infant metabolic health; however, mechanistic insight behind these adaptations remains mostly confined to animal models. Infant mesenchymal stem cells (MSCs) give rise to infant tissues (e.g., skeletal muscle), and remain involved in mature tissue maintenance. Importantly, these cells maintain metabolic characteristics of an offspring donor and provide a model for the investigation of mechanisms behind infant metabolic health improvements. Methods: We used undifferentiated MSC to investigate if ME affects infant MSC mitochondrial function and insulin action, and if these adaptations are associated with lower infant adiposity. Results: We found that infants from exercising mothers have improvements in MSC insulin signaling are related to higher MSC respiration and fat oxidation, and expression and activation of energy-sensing and redox-sensitive proteins. Further, we found that infants exposed to exercise in utero were seemingly leaner at 1-month of age, with a significant inverse correlation between infant MSC respiration and infant adiposity at 6-months of age. Conclusion: These data suggest that infants from exercising mothers are relatively leaner and this is associated with higher infant MSC mitochondrial respiration, fat use, and insulin action.","PeriodicalId":501122,"journal":{"name":"medRxiv - Sports Medicine","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140036507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The downhill race for a Rainbow jersey. The Epidemiology of Injuries in Downhill Mountain Biking at the 2023 UCI Cycling World Championships using the International Olympic Committee Consensus: A Prospective Cohort Study","authors":"Thomas Fallon, Debbie Palmer, Xavier Bigard, Niall Elliott, Emma Lunan, Neil Heron","doi":"10.1101/2024.02.29.24303534","DOIUrl":"https://doi.org/10.1101/2024.02.29.24303534","url":null,"abstract":"Introduction Downhill Mountain Biking (DHMTB) is one of the more spectacular sub-disciplines of mountain bike (MTB) cycling. The primary aim of our study was to prospectively document the injury rate, severity, aetiology, location and type during official training and racing by elite DHMTB riders during the 2023 UCI Cycling World Championships. Methods The participants of this prospective, observational study were elite male and female cyclists competing at the UCI DHMTB World Championships located in the Nevis range in Fort William, Scotland, in 2023. This study followed the injury reporting guidelines established by the International Olympic Committee (IOC), which include the STROBE-SIIS and the cycling-specific extension. Results Throughout the championships, 10.4% of riders sustained one injury, with 4.3% of riders injuring more than one location per injury event. The overall injury incidence was 3.3 injuries per 100 rides. The incidence rates were higher in the training group (6.4/100rides) than in the race group (2.3/100rides). There was a greater incidence of injury in females in the training 5.7/100 rides and racing 4.4/100rides compared to male riders. Female athletes experienced more severe injuries, with double the estimated time lost to injury. Additionally, female athletes were found to have a significantly greater risk of head injuries and concussions than males. Conclusion Overall, injuries are more prevalent in training than in competition. Compared with male DHMTB athletes, female DHMTB athletes are more at risk of injury and show a greater incidence of injury within official training and competition as well as more severe injuries.","PeriodicalId":501122,"journal":{"name":"medRxiv - Sports Medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140011397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal changes in anthropometric, physiological, and physical qualities of international women’s rugby league players.","authors":"Sean Scantlebury, Nessan Costello, Cameron Owen, Sarah Chantler, Carlos Ramirez, Santiago Zabaloy, Neil Collins, Hayden Allen, Gemma Phillips, Marina Alexander, Matthew Barlow, Emily Williams, Peter Mackreth, Stuart Barrow, Anthony Clarke, Benjamin Samuels, Stephanie Roe, Cameron Blake, Ben Jones","doi":"10.1101/2024.02.05.24302089","DOIUrl":"https://doi.org/10.1101/2024.02.05.24302089","url":null,"abstract":"This is the first study to assess longitudinal changes in anthropometric, physiological, and physical qualities of international women’s rugby league players. Thirteen forwards and 11 backs were tested three times over a 10-month period. Assessments included: standing height and body mass, body composition measured by dual x-ray absorptiometry (DXA), a blood panel, resting metabolic rate (RMR) assessed by indirect calorimetry, aerobic capacity (i.e., VO2max) evaluated by an incremental treadmill test, and isometric force production measured by a force plate. During the pre-season phase, lean mass increased significantly by ~2% for backs (testing point 1: 47 kg; testing point 2: 48 kg) and forwards (testing point 1: 50 kg; testing point 2: 51 kg) (p = ≤ 0.05). Backs significantly increased their VO2max by 22% from testing point 1 (40 ml·kg-1·min-1) to testing point 3 (49 ml·kg-1·min-1) (p = ≤ 0.04). The VO2max of forwards increased by 10% from testing point 1 (41 ml·kg-1·min-1) to testing point 3 (45 ml·kg-1·min-1), however this change was not significant (p = ≥ 0.05). Body mass (values represent the range of means across the three testing points) (backs: 68 kg; forwards: 77-78 kg), fat mass percentage (backs: 25-26%; forwards: 30-31%), resting metabolic rate (backs: 7 MJ·day-1; forwards: 7 MJ·day-1), isometric mid-thigh pull (backs: 2106-2180 N; forwards: 2155-2241 N), isometric bench press (backs: 799-822 N; forwards: 999-1024 N), isometric prone row (backs: 625-628 N; forwards: 667-678 N) and bloods (backs: ferritin 21-29 ug/L, haemoglobin 137-140 g/L, iron 17-21 umol/L, transferrin 3 g/L, transferring saturation 23-28%; forwards: ferritin 31-33 ug/L, haemoglobin 141-145 g/L, iron 20-23 umol/L, transferrin 3 g/L, transferrin saturation 26-31%) did not change (p = ≥ 0.05). This study provides novel longitudinal data which can be used to better prepare women rugby league players for the unique demands of their sport, underpinning female athlete health.","PeriodicalId":501122,"journal":{"name":"medRxiv - Sports Medicine","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139772509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Internal and External Shoulder Rotation Using a Kirigami-Based Shoulder Patch","authors":"Amani A Alkayyali, Conrad P.F. Cowan, Callum J Owen, Emmanuel Giannas, Susann Wolfram, Ulrich Hansen, Alanson P Sample, Roger J.H. Emery, Max Shtein, David B Lipps","doi":"10.1101/2024.02.02.24302225","DOIUrl":"https://doi.org/10.1101/2024.02.02.24302225","url":null,"abstract":"Internal and external rotation of the shoulder is often challenging to quantify in the clinic. The current study evaluates a novel, engineered, wearable sensor system for improved internal and external shoulder rotation monitoring, and applies it in healthy individuals. Using the design principles of the Japanese art of kirigami (folding and cutting of paper to design 3D shapes), the sensor platform conforms to the shape of the shoulder with on-board strain gauges to measure movement. Our objective was to examine how well this kirigami-inspired shoulder patch could identify differences in shoulder kinematics between internal and external rotation as healthy individuals moved their humerus through specified movement patterns. Seventeen participants donned the wearable sensor on their right shoulder. Four strain gauges measured skin deformation patterns while participants moved their arm into internal or external rotation based on Codman's paradox. One-dimensional statistical parametric mapping explored differences in strain voltage change of the strain gauges between internally-directed and externally-directed movements. The kirigami shoulder sensor, with its four on-board strain gauges, detected distinct differences in the movement pattern of participants who performed prescribed movements that resulted in either internal or external shoulder rotation. Three of the four strain gauges detected significant temporal differences between internal and external rotation (all p <0.047), particularly for the strain gauges placed distal or posterior to the acromion. These results are clinically significant, as they suggest a new class of wearable sensors conforming to the shoulder can measure differences in skin surface deformation corresponding to the underlying humerus rotation.","PeriodicalId":501122,"journal":{"name":"medRxiv - Sports Medicine","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139662430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity, Sedentary Behavior and Microbiome: A Systematic Review and Meta-analysis","authors":"Inmaculada Perez-Prieto, Abel Plaza-Florido, Esther Ubago-Guisado, Francisco B. Ortega-Porcel, Signe Altmae","doi":"10.1101/2024.01.29.24301919","DOIUrl":"https://doi.org/10.1101/2024.01.29.24301919","url":null,"abstract":"Background. The effects of physical activity and sedentary behavior on human health are well known, however, the molecular mechanisms are poorly understood. Growing evidence points to physical activity as an important modulator of the microbial composition, while evidence of sedentary behavior is scarce. We aimed to synthesize and meta-analyze the current evidence about the effects of physical activity and sedentary behavior on microbiome across different body sites and in different populations.\u0000Methods. A systematic search in PubMed, Web of Science, Scopus and Cochrane databases was conducted until September 2022. Random-effects meta-analyses including cross-sectional studies (active vs. inactive / athletes vs. non-athletes) or trials reporting the chronic effect of physical activity interventions on gut microbiome alpha-diversity in healthy individuals were performed.\u0000Results. Ninety-one studies were included in this systematic review. Our meta-analyses of 2632 participants indicated no consistent effect of physical activity on microbial alpha-diversity, although there seems to be a trend toward a higher microbial richness in athletes compared to non-athletes. We observed an increase in short-chain fatty acids-producing bacteria such as Akkermansia, Faecalibacterium, Veillonella or Roseburia in active individuals and after physical activity interventions.\u0000Conclusions. Physical activity levels were positively associated with the relative abundance of short-chain fatty acids-producing bacteria. Athletes seem to have a richer microbiome compared to non-athletes. However, high heterogeneity between studies avoids to obtain conclusive information on the role of physical activity in microbial composition. Future multi-omics studies would enhance our understanding of the molecular effects of physical activity and sedentary behavior on the microbiome.","PeriodicalId":501122,"journal":{"name":"medRxiv - Sports Medicine","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139584640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supervised land- and water-based exercis intervention in women with fibromyalgia: CERT- based exercise study protocol of the al-Andalus physical activity randomised controlled trial","authors":"Inmaculada C Alvarez-Gallardo, Blanca Gavilan-Carrera, Ana Carbonell-Baeza, Victor Segura-Jimenez, Daniel Camiletti-Moiron, Milkana Borges-Cosic, Virginia Aparicio, Manuel Delgado-Fernandez","doi":"10.1101/2024.01.24.24301515","DOIUrl":"https://doi.org/10.1101/2024.01.24.24301515","url":null,"abstract":"Background: Exercise is recommended for managing fibromyalgia; however, the scant details provided about exercise programs (EP) in the available literature make standardization, replicability, and interpretation of results difficult. The aim of the present report is to provide a comprehensive CERT (Consensus on Exercise Reporting Template)-based description of the rationale and details of the land- and water-based EP implemented in the al-Andalus Randomized Controlled Trial (RCT). Methods: Women aged 35-65 with fibromyalgia (n=180) were planned to be recruited in Southern Spain (Andalucia). The study design was composed of three groups: the usual care (control) group, the land- and the water-based supervised exercise intervention groups (n=60 for each group). Participants allocated in the exercise intervention groups undertook a 24-week supervised multicomponent (strength, aerobic and flexibility) EP (three non-consecutive sessions per week, 45-60 min/session). The rationale of the exercise program is described in detail following the CERT criteria detailing its 16 key items.\u0000Discussion: This study details the supervised EP of the al-Andalus RCT project, which may serve: 1) exercise professionals who would like to implement an evidence-based supervised EP for people with fibromyalgia in land- and water-based settings, and 2) as an example of the application of the CERT criteria.","PeriodicalId":501122,"journal":{"name":"medRxiv - Sports Medicine","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139584533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of exercise, metformin, and their combination on glucose metabolism in individuals with impaired glycemic control: A systematic review and network meta-analysis","authors":"Tong Zhao, Qize Yang, Joshua F Feuerbacher, Bizhu Yu, Christian Brinkmann, Sulin Cheng, Wilhelm Bloch, Moritz Schumann","doi":"10.1101/2024.01.22.24301604","DOIUrl":"https://doi.org/10.1101/2024.01.22.24301604","url":null,"abstract":"Objective: To compare the efficacy of exercise, metformin, and their combination on glucose metabolism in individuals with prediabetes and type 2 diabetes mellitus (T2DM), and rank these treatments by exercise modality and metformin dosage. Design: Systematic review and network meta-analysis. Data sources: Embase, Web of Science, PubMed/MEDLINE, and SPORTDiscus were searched until February 2023. Eligibility criteria for selecting studies: Randomized controlled trials (RCTs) of exercise, metformin, or their combined treatments in individuals with prediabetes or T2DM were included. Analyses: We estimated pooled mean difference (MD) with 95% confidence intervals (CI) for five glucose metabolism variables (i.e., hemoglobin A1c [HbA1c], 2-h glucose during oral glucose tolerance test [OGTT], fasting glucose, fasting insulin, and homeostasis model assessment of insulin resistance [HOMA-IR]) via a random effect model. Subgroup analyses were conducted for prediabetes and T2DM populations. Results: We identified 15,872 eligible articles and finally included 375 articles with 378 RCTs, comprising 30,884 participants. When all individuals were pooled, metformin had greater effects than exercise in improving HbA1c (MD −0.65 95% CI [−0.77 to −0.53] vs −0.38 [−0.45 to −0.32] %), 2-h glucose during OGTT (−1.16 [−1.67 to −0.65] vs −0.76 [−1.15 to −0.37]), fasting glucose (−0.99 [−1.14 to −0.83] vs −0.57 [−0.65 to −0.48] mmol/L), and fasting insulin (−2.28 [−3.03 to −1.53] vs −1.47 [−1.85 to −1.09] μU/mL), but not in HOMA-IR (−0.36 [−0.77 to 0.04] vs −0.73 [−0.90 to −0.57]). A similar pattern was observed for the subgroup of T2DM patients; however, in prediabetes, exercise showed better efficacy than metformin in HbA1c (−0.17 [−0.23 to −0.11] vs −0.09 [−0.20 to 0.01] %) and 2-h glucose (−0.68 [−1.01 to −0.35] vs −0.04 [−0.51 to 0.43] mmol/L). Exercise + metformin showed a greater efficacy than exercise alone in improving HbA1c (−0.79 [−1.27 to −0.30] %) and fasting glucose (−0.76 [−1.25 to −0.26] mmol/L) when all individuals were pooled. Considering exercise modalities, aerobic interval exercise was most efficient in improving fasting glucose (−0.82 [−1.06 to −0.59] mmol/L), HbA1c (−0.61 [−0.77 to −0.44] %), fasting insulin (−2.22 [−3.34 to −1.10] μU/mL), and HOMA-IR (−0.95 [−1.39 to −0.51]). The confidence in evidence was mostly low or very low. Conclusion: The use of exercise, metformin, and their combination are all effective in improving glucose metabolism in individuals with impaired glycemic control, such as prediabetes or T2DM, but the efficacy varies in the five outcome parameters (i.e., HbA1c, OGTT 2-h glucose, fasting glucose, fasting insulin, and HOMA-IR). The efficacy was modified by exercise modality, metformin dosage, and severity of impaired glycemic control. Future clinical trials may further investigate the specific components of the interactive effects of exercise and metformin, such as the timing of exercise and metformin administration, the dru","PeriodicalId":501122,"journal":{"name":"medRxiv - Sports Medicine","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139560093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}