ABSTRACT Context Stable resistance training (SRT) effectively enhances trunk strength and endurance but may insufficiently develop muscular coordination. Unstable resistance training (URT) potentially offers superior benefits for trunk function development. Although research has explored the benefits of SRT and URT, a direct comparison of their effects on trunk strength and endurance is lacking. Objective The aims of this study were to evaluate the effects of URT versus SRT on trunk strength and endurance in healthy individuals. Design A comprehensive search of SPORTDiscus, Web of Science, Scopus, and Ovid (all resources) and a partial search of Google Scholar were conducted up to December 2024. Study quality was assessed using the Tool for the Assessment of Study Quality and Reporting in Exercise (TESTEX). Eligibility Criteria Eligible studies included healthy individuals, compared resistance training with and without additional unstable surfaces or equipment, and assessed trunk strength and/or endurance. Study Selection Data extraction was independently conducted by two reviewers. Main Outcome Measures Means and standard deviations for trunk strength and endurance were extracted to calculate mean differences. Random-effects meta-analyses calculated Hedges’ g with 95% confidence intervals (CI). Results Seventeen studies with 836 participants were included. URT produced a statistically significant improvement in trunk endurance versus SRT ( g = 0.34; 95% CI, 0.12–0.56; P < 0.01). Subanalysis showed that URT enhanced dynamic trunk endurance ( g = 0.45; 95% CI, 0.19–0.71; P < 0.01) but not isometric trunk endurance. No statistically significant differences between groups were found in trunk flexion and extension strength. The included studies had satisfactory quality (mean TESTEX score: 9.1/15). Conclusion URT is more effective than SRT for enhancing trunk endurance, particularly dynamic trunk endurance, in healthy individuals. However, URT does not provide additional benefits for trunk strength. Practitioners aiming to improve trunk endurance for injury prevention and athletic performance should consider incorporating URT into training programs.

ABSTRACT Introduction Persistent symptoms following severe acute respiratory syndrome coronavirus 2 (the virus that causes coronavirus disease 2019 (COVID-19)) infection frequently include pain that interferes with activities of daily living. The primary aim of this study was to assess current and past pain intensity and body distribution in nonhospitalized COVID-19 (COV) survivors and control (CON) participants matched for sex, age, and body mass index (BMI). A secondary aim was to compare endogenous pain inhibition (i.e., conditioned pain modulation (CPM)) in COV and CON participants, including relationships with pre-COVID-19 physical activity (PA) levels (COV only). Methods Participants (42 COV: 30 women, 37.4 ± 16.8 yr old, BMI 24.3 ± 4.0 kg·m −2 ; 42 CON: 30 women, 37.9 ± 16.5 yr old, BMI 23.7 ± 4.4 kg·m −2 ) completed one session that included the following assessments: pain intensity and distribution during COVID-19 (COV only), at rest, and during tests of pulmonary function, lower extremity strength, and submaximal aerobic cycling; CPM measured by pressure pain thresholds at upper trapezius and quadriceps muscles with and without cool water foot submersion; and pre-COVID-19 PA (COV only). Results Average and worst pain were greater in COV than CON, and COV reported more widespread pain ( n = 10 vs n = 2). At the time of testing (7.9 ± 3.6 months post-infection), pain intensity at rest and during functional tasks and CPM were similar between the groups except during pulmonary function testing; COV reported higher peak pain intensity and chest pain that negatively impacted their ability to forcibly exhale. Higher PA pre-COVID-19 was associated with lower pain intensity at the time of testing. Conclusion From a clinical perspective, COV appeared to recover with minimal pain intensity 8 months post-infection and had similar pain distribution at rest to CON, although COV reported greater pain with deep breathing that may impact their ability to participate in therapeutic exercise.

ABSTRACT Introduction Physical exercise is a key pillar of healthy aging, influencing both cognitive and functional capacities. Remote health interventions provide a viable means to maintain and enhance exercise engagement among older adults. This study aimed to evaluate the effectiveness of remote physical exercise on the physical and cognitive abilities of trained older adults. Methods Eleven participants (mean age, 67.46 ± 7.34 yr) completed a 24-session online exercise program over 12 wk. Results Participants had significant increases in aerobic capacity ( P < 0.05), but no significant improvements in global cognition, strength, or dynamic balance. Conclusion Although the literature highlights the beneficial effects of web-based interventions for enhancing cognitive and physical function, remote exercise training programs likely improve aerobic capacity while maintaining global cognition and other physical capabilities in physically active older adults.

ABSTRACT Introduction Despite various studies on the benefits of physical training for the health of older adults, there is a scarcity of research on the effects of exercise training with elastic bands on arterial stiffness and hemodynamic markers specifically for older women. Because the aging process is associated with cardiovascular and functional impairments, which increase the risk of mortality, more studies are needed on low-cost, easily accessible, and applicable non-pharmacological interventions for older women. Thus, this study aimed to investigate the effects of different concurrent training protocols with elastic bands on arterial stiffness, hemodynamic markers, functional parameters, and body composition in older women. Methods Thirty older women were randomly assigned to a dynamic power training plus endurance training (ET) group (DPTG) ( n = 15) or a dynamic traditional resistance training plus ET group (DRTG) ( n = 15). Training sessions were performed twice per week over 12 weeks, including seven moderate-intensity exercises performed continuously in a circuit-like format. DRTG performed the concentric and eccentric phases of each exercise for 2 s per phase, and DPTG performed the concentric phase as quickly as possible. Both intervention groups performed the same volume of moderate-intensity ET. Arterial stiffness, hemodynamic markers, functional parameters, and body composition were assessed before and after 12 weeks. Results Systolic blood pressure (SBP), diastolic blood pressure (DBP), central DBP, and functional parameters significantly improved in both groups after 12 weeks ( P < 0.05). Additionally, neither group was superior to the other in terms of functional parameters. Furthermore, a sub-analysis of participants with hypertension found improved SBP, DBP, central SBP, and central DBP with both protocols ( P < 0.05). Both groups also had improvements in lower limb functional capacity and dynamic balance after the intervention ( P < 0.05). Conclusion These findings indicate that the protocols outlined in this study have applicability and efficacy for improving hemodynamic markers and functional parameters in older women.

ABSTRACT Context Classroom-based physical activity (CBPA) provides an important opportunity to improve student health but is underutilized. Advocating for CBPA requires informing stakeholders about the benefits, including energy expenditure, in comprehensible terms. Objective To compare energy expenditure in kcal for elementary school CBPA with energy expenditure values for physical education and recess. Design Using break/lesson duration and physical activity outcome data reported in eligible observational and interventional CBPA studies, we calculated potential energy expenditure using the following formula: energy cost (kcal) = MET y × BMR (kcal·min−1) × duration, where MET y is intensity in metabolic equivalents of task and BMR is basal metabolic rate. Eligibility Criteria Studies included in the energy expenditure calculations had to 1) be conducted among elementary school students in a classroom-based setting: 2) report objective measures of physical activity intensity: and 3) report minutes in moderate-to-vigorous physical activity (MVPA), percentage of time in MVPA, MET-minutes, units that could be converted to MVPA or energy expenditure, or energy expenditure (kcal) directly. Study Selection We reviewed the 111 nonduplicated primary research studies included in the analyses of the eight most recently published (through 2022) reviews of CBPA. Of those, 41 met the eligibility criteria and were used to calculate energy expenditure. Main Outcome Measure Potential energy expenditure in kcal during a standardized 20-min CBPA break/lesson. Results Average break/lesson duration was 11.0 ± 16.2 min, and 10-min breaks/lessons (n = 16, 39%) were most common. The mean energy expenditure calculated across the 41 studies was 67.47 ± 19.06 kcal per 20-min session. Conclusion Potential energy expenditure from elementary CBPA is commensurate with values calculated for both physical education and recess, further highlighting the value of CBPA as an opportunity for increasing student energy expenditure. These findings should be incorporated into advocacy strategies to effect policy change and implementation at distal (i.e., state policy) and proximal (i.e., school policy) levels.

ABSTRACT Introduction Swearing is often generated by oneself or received from others during physical exertion. Its effects on exercise performance and pain tolerance in relation to different cultures remain largely unexplored. The purpose of this study was to examine the impacts of self-generated and observer-generated swearing and yelling on exercise performance and pain tolerance in individuals living in the United States, where swearing is common, and Thailand, where it is rare. Methods Forty participants (22 ± 3 yr; 20 US-based, 20 Thailand-based) completed a maximum handgrip strength test, plank exercise to failure, and cold pressor test under five randomized conditions: 1) control, 2) self-yelling, 3) observer-yelling, 4) self-swearing, and 5) observer-swearing. Results Among US-based participants, both self- and observer-generated swearing improved plank performance, and observer-swearing increased maximal handgrip strength. Yelling had no effect on any of the tasks. Among Thailand-based participants, neither swearing nor yelling influenced plank performance. Self-yelling enhanced handgrip strength and observer-yelling increased cold pressor test latency. Conclusion These findings suggest that self-directed swearing and swearing from others enhance exercise performance in cultures where swearing is common but have limited effects where it is rare. Swearing could be utilized as a performance-enhancing intervention in exercise, with practical applications for culturally tailored training strategies.

ABSTRACT Context Individuals treated for sarcomas experience impairments to the musculoskeletal system, contributing to altered body composition, decreased mobility, and reduced strength. The impairments in muscle mass and function offer a strong theoretical rationale for the investigation of resistance exercise in the management of sarcoma, although studies in this area are limited. Objective The purpose of this review was to synthesize current evidence on the effects of resistance exercise in individuals treated for sarcoma. Design Electronic databases were searched between September 2024 and December 2024. Eligibility Criteria Studies of resistance exercise in individuals treated for sarcomas (regardless of age) were eligible for inclusion. Study Selection Studies were screened by two independent reviewers, with conflicts resolved by a third independent reviewer. Main Outcome Measures Data relevant to study design, sample, exercise intervention, and outcomes were extracted. Four studies (three randomized controlled trials and one case series) involving a total of 644 participants were included in this review. Studies assessed quality of life and a variety of physical outcomes. Intervention length ranged from 8 to 24 wk (frequency ranged from 1 to 5 d·wk−1), and the ages of participants ranged from 8 to 41 yr. Adherence was ≥85% in each of the included studies, with no adverse events reported. Results The results of the included studies were mixed, with some demonstrating significant effects of resistance exercise on physical function and quality of life and others demonstrating no effects. Importantly, descriptions of the intervention characteristics and assessments of outcomes varied substantially across studies. Conclusions There is strong potential for resistance exercise to counteract musculoskeletal impairments in individuals treated for sarcoma. Despite this, the available evidence is considerably varied on participant demographics, intervention components, and outcome selection, limiting the ability to provide definitive information on the role of resistance exercise in the management of sarcoma.

ABSTRACT Introduction Preoperative risk assessment is essential for identifying high-risk patients who may benefit from prehabilitation programs. This preliminary study aimed to examine the impact of preoperative probable sarcopenia (PS) on postoperative outcomes in patients undergoing gastric cancer surgery. Methods A cross-sectional study was conducted in patients with gastric cancer eligible for major elective surgery at the Instituto Português de Oncologia, Porto, between December 2018 and July 2019. PS was defined as low muscle strength (< 27 kg for males and < 16 kg for females), assessed using a handgrip strength test. Postoperative outcomes included postoperative complications (POCs), length of hospital stay (LOS), need for admission to the intermediate care unit (ICU), 30-d readmission, 30-d reintervention, and 1-yr mortality. Fisher’s exact test or the Fisher–Freeman–Halton exact test were used to analyze associations between PS and outcomes. A P value < 0.05 was considered statistically significant. Results Forty-three patients were included (60.5% male; mean age, 64 ± 13 yr). Of those, seven (19.44%) were classified as having PS. The frequency of POCs was significantly higher in the with-PS group compared to the without-PS group (85.7% vs 33.3%; P = 0.01), including both major (28.6% vs 16.7%; P = 0.01) and minor (57.1% vs 16.7%; P = 0.01) complications. Patients with PS also had higher rates of ICU admission (85.7% vs 13.9%; P < 0.001), prolonged LOS (85.7% vs 38.9%; P = 0.04), 30-d readmission (57.1% vs 5.6%; P = 0.004), and 30-d reintervention after discharge (42.9% vs 2.8%; P = 0.01). No significant difference was observed in 1-yr mortality (P = 0.30). Conclusion These preliminary findings suggest that preoperative PS is associated with poorer postoperative outcomes in gastric cancer patients. Early identification of patients with PS may support timely optimization strategies such as prehabilitation.

ABSTRACT Introduction The aim of this study was to investigate the association between sedentary behavior (SB) and eating habits of children and adolescents according to their physical activity (PA) levels. Method A total of 1011 adolescents participated in the study, comprising 454 males and 557 females. Data were self-reported via pen-and-paper questionnaires completed in classrooms. The relationship between three SB domains (television (TV), computer, and cellphone) and eating habits according to PA level was analyzed using Pearson’s correlation and linear regression. A cluster analysis was also conducted for high SB in the three domains. Results In inactive adolescents, TV use (β = 0.07, 95% confidence interval (CI) = 0.01–0.13, P = 0.04) and computer use (β = 0.07, 95% CI = 0.01–0.12, P = 0.04) were associated with higher consumption of fried foods, whereas computer use (β = 0.07, 95% CI = 0.01–0.13, P = 0.04) and cellphone use (β = 0.07, 95% CI = 0.01–0.12, P = 0.04) were associated with consumption of sugary foods. Cellphone use was also associated with the consumption of soft drinks in inactive adolescents (β = 0.05, 95% CI = 0.01–0.11, P = 0.00). In active adolescents, only TV use (β = 0.16, 95% CI = 0.04–0.28, P = 0.00) and computer use (β = 0.11, 95% CI = 0.01–0.21, P = 0.03) were associated with consumption of sugary foods. Together, the three domains of SB had an inverse relationship with vegetable consumption (β = −0.08, 95% CI = −0.17 to −0.01, P = 0.00) and were positively related to the consumption of fried foods (β = 0.08, 95% CI = 0.01–0.16, P = 0.02) and sugary foods (β = 0.10, 95% CI = 0.02–0.18, P = 0.01) in inactive adolescents. Active adolescents only presented an increased consumption of sugary foods (β = 0.15, 95% CI = 0.02–0.27, P = 0.02). Conclusion Physically inactive adolescents display stronger associations between higher SB and poor eating habits, including an increased consumption of fried foods and sugary foods and a decreased consumption of vegetables.

ABSTRACT Context High-intensity interval training (HIIT) has demonstrated potential for improving both motor and non-motor symptoms in individuals with Parkinson’s disease (PD). Despite this promise, there is limited evidence regarding the feasibility and acceptability of HIIT protocols that integrate both upper and lower limb activity, particularly in individuals with mild to moderate PD. Objective To evaluate the preliminary efficacy and feasibility of a novel HIIT protocol using a combined arm-and-leg ergometer in individuals with mild to moderate PD. Design A three-arm, parallel-group, randomized pilot trial. Setting University-based clinical exercise physiology laboratory. Participants Individuals with mild to moderate PD will be recruited from the local community and clinical networks. Intervention Participants will be randomly allocated to one of three groups: 1) control (usual care), 2) HIIT using a combined arm-and-leg ergometer added to usual care, or 3) HIIT using a leg-only ergometer added to usual care. HIIT sessions will be conducted three times per week for 8 wk. Main Outcome Measures Preliminary efficacy outcomes include maximal oxygen consumption, functional performance, muscular strength and power, fine motor skills, PD symptom severity, and cognitive function. Feasibility will be assessed via recruitment, retention, and adherence rates. Conclusion This study will provide initial evidence on the preliminary efficacy and feasibility of a novel combined-limb HIIT protocol for individuals with PD. Findings will inform the development of larger-scale studies and contribute to evidence-based exercise prescriptions aimed at improving functional outcomes and quality of life in individuals with PD.