ObjectiveThis study aims to assess the acute and chronic effects of three aerobic exercise protocols, namely, Moderate-Intensity Interval Training (MIIT), Low-to-Moderate Intensity Continuous Training (LMICT), and Reduced-Exertion High-Intensity Training (REHIT), on glycemic control in patients with Type 2 Diabetes Mellitus (T2DM) and stroke.MethodsForty-nine patients diagnosed with both T2DM and stroke were randomly assigned to LMICT, MIIT, REHIT, or the control group. The intervention comprised two phases: from day 3 to day 14 and from day 15 to day 28, with days 1 and 2 designated as a baseline control period. Throughout the intervention, blood glucose levels were continuously monitored and recorded using a Continuous Glucose Monitoring (CGM) system.ResultsAll exercise intervention groups exhibited significant immediate reductions in blood glucose levels following exercise (t = 30.68, p < 0.001). Repeated measures analysis of variance (ANOVA) demonstrated significant main effects of group and time, as well as a significant interaction, on mean glucose (MG) and time above range (TAR) (p < 0.05). CGM indicated progressive improvements in MG, time in range (TIR), TAR, peak blood glucose, glucose standard deviation (SD-glucose), and mean amplitude of glycemic excursion (MAGE) in the MIIT group. The REHIT group exhibited significant improvements in peak blood glucose, TIR, TAR, MAGE, SD-glucose, and coefficient of variation (CV) (all p < 0.01). These trends were not evident in the LMICT group. Notably, the MIIT and REHIT groups exhibited early, significant improvements in MG, peak blood glucose, TIR, and TAR, which preceded subsequent changes in SD-glucose and MAGE relative to controls.ConclusionsWhile all exercise regimens resulted in acute reductions in blood glucose, sustained improvements in overall glycemic control and variability were observed exclusively following the four-week MIIT and REHIT interventions. Specifically, REHIT significantly reduced glucose variability, as reflected by decreases in the CV, whereas MIIT was more effective in lowering MG levels. Conversely, the lower-intensity LMICT regimen (51.23% ± 6.94% heart rate reserve) exerted minimal long-term effects. These findings underscore the potential of moderate- to high-intensity intermittent aerobic training in managing glycemic fluctuations in individuals with T2DM and stroke, thereby emphasizing their clinical relevance.Trial registrationThe study was registered with the Chinese Clinical Trial Registry (ChiCTR2200065677, http://www.chictr.org.cn/) on 11/11/2022.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13102-025-01402-0.

ObjectiveInflammation is a condition that trigger an immune response and oxidative stress refers to an imbalance between production and elimination of reactive oxygen species (ROS). However, several non-pharmacological approaches have been proposed to improve health outcomes, among which exercise programs have shown promising effects on inflammatory and oxidative biomarkers across various health conditions.AimIn this regard, the present umbrella meta-analysis aimed to evaluate the potential of exercise interventions to modulate inflammatory and oxidative stress biomarkers across different population.MethodsA comprehensive systematic search was carried out in on Scopus, PubMed, Embase, Web of Science, and Google Scholar up to March 2025. The overall effect size (ESs) was calculated using random effect model. Also, subgroup analyses were performed regarding ESs, health status, ad type of exercise program.ResultsOur comprehensive systematic search initially identified 1246 studies, of which twenty-nine meta-analyses, were included in the present umbrella meta-analysis. Finding revealed that training program could significantly reduce C-reactive protein (CRP) (ES: -0.50; 95% CI: -0.65, -0.36, P < 0.001), interleukin-6 (IL-6) (E: -0.29; 95% CI: -0.41, -0.18; P < 0.001), IL-8 (ES: -1.20; 95% CI: -2.19, -0.21, P = 0.018), tumor necrosis factor-α (TNF-α) (ES: -0.47, 95% CI: -0.60, -0.34; P < 0.001). In addition, it was accompanied with an improvement in malondialdehyde (MDA) (ES: -1.26; 95% CI: -1.60, -0.93, P < 0.001) and glutathione peroxidase (GPx) (ES: 0.88, 95% CI: 0.25, 1.51; P = 0.006) level too. Subgroup analyses indicated that all aerobic, resistance and combined exercise could improve inflammatory state significantly. Also, exercise favorable properties were evident in most health state to affect CRP, IL-6, and TNF-α level.ConclusionExercise program could attenuate the CRP, IL-6, IL-8 and TNF-α level. Additionally, exercise demonstrated a beneficial impact on oxidative status, as evidenced by decreased MDA levels and increased GPx activity.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13102-025-01327-8.

BackgroundPrior research has suggested links between youth sport special-ization, inter-limb asymmetries, and injury risk, but findings remain inconsistent regarding whether single-sport athletes show greater asymmetries than their multi-sport peers. This study examined differences in inter-limb asymme-try (global, balance, strength) between single- and multi-sport athletes, and explored the prevalence of exceeding clinical thresholds, sex- and sport-specific interactions, and associations with training volume and injury history.MethodsA cross-sectional study was conducted on 76 youth athletes (24 single-sport, 52 multi-sport; mean age 12.6 ± 1.7 years) using standardized assessments of dynamic balance (Y-Balance Test) and isometric strength (hand-held dynamometry). Inter-limb asymmetry was calculated using Index-9 in three domains: global asymmetry, balance asymmetry, and strength asymmetry. Differ-ences between single-sport specialists and multi-sport athletes were tested using linear mixed effect models, adjusted for sex, maturity status, BMI, training vol-ume, and sport type. Sensitivity and interaction analyzes (e.g., sport symmetry, sex, injury history) were also performed.ResultsInter-limb strength asymmetries greater than 10% were observed in more than half of the participants, especially for ankle plantarflexion and hip abduction. Balance asymmetries were smaller, with fewer than 15% of athletes exceeding the 10% threshold. Training volume was higher in the single-sport group, but was not associated with greater asymmetry. No significant differences were found between single and multisport athletes for global (β = 0.039, p = .597), balance (β = 0.037, p = .745) or strength asymmetry (β = 0.013, p = .879). These null results persisted across the sensitivity analyses and interaction models.ConclusionsDespite higher training volumes, single-sport youth athletes did not exhibit greater balance or strength asymmetries than their multi-sport peers. Inter-limb asymmetries were common across the cohort but were not associated with sport specialization. These findings highlight the need for cautious, individ-ualized interpretation of asymmetry measures in youth athletes, and underscore the importance of further research to clarify their developmental and clinical significance.Trial registrationsClinicalTrials.gov (NCT06325228); registered on 10/03/2024.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13102-025-01420-y.

BackgroundPrevious studies investigating the effects of muscle fatigue on lower limb kinematics in adolescent volleyball players have reported contradictory findings. Thus, the present study aimed to assess the effect of lower-limb fatigue on the kinematic variables during an unanticipated block among adolescent female volleyball players.MethodsGiven the inclusion criteria, 20 adolescent female volleyball players were selected through a convenience sampling method. In the pre-test stage, each subject performed an unanticipated single-leg jump-landing maneuver, the data of which were recorded by using a motion analyzer. Then, the intervention of a volleyball-specific lower-limb fatigue protocol was applied and the players were re-evaluated.ResultsThe results represented a significant decrease in knee and hip joint flexion, as well as a significant increase in ankle inversion at the initial contact after applying the fatigue protocol(P ≤ 0.05). However, no significant difference was observed in terms of the other kinematic variables of the knee, ankle, and hip joints at the initial contact and landing peak(P ≥ 0.05).ConclusionsReduced hip and knee flexion, along with increased ankle inversion, were identified as high risk movement strategies observed at initial contact. These findings suggest that fatigue may influence the proper kinematic pattern of lower-limb, leading to changes in movement control during landing and consequently increasing the risk of knee injuries in athletes.Trial registration numberConsidering that our research is semi-experimental, it does not need a clinical trial number.

BackgroundKinesio taping (KT) is commonly used to support muscle function, enhance performance, and reduce fatigue in both athletic and clinical settings. Understanding its effects on agonist and antagonist muscle groups during resistance exercises is essential for optimizing training and rehabilitation strategies. This study aimed to investigate the effects of kinesiotaping (KT) applied to the biceps brachii on the activation and fatigue of the biceps brachii (BB) and triceps brachii (TB) muscles during bicipital curl exercise.MethodsA total of 40 participants (10 female athletes, 10 male athletes, 10 sedentary females, and 10 sedentary males), aged 18–24 years, were included in the study. The participants performed isotonic muscle activation and isometric fatigue protocols targeting the BB (agonist) and TB (antagonist) muscles during the bicipital curl movement following KT application. Surface EMG signals were collected via wireless Ag/AgCl electrodes and a Noraxon system.ResultsA statistically significant difference was observed in the pre- and posttest values of the BB muscle during the bicep curl exercise (p < 0.05). Additionally, analysis of median frequency (MF) values revealed no overall pre–post differences. However, a significant posttest between-group difference was observed in the BB muscle, with athletes showing lower MF values than sedentary participants, indicating relatively greater fatigue in athletes.ConclusionsThe 48-hour application of Kinesio tape led to increased electrical activation of the agonist muscle (BB), and sedentary individuals demonstrated higher MF values compared to athletes, indicating relatively lower fatigue levels after taping. These findings suggest that short-term KT may alter neuromuscular function by modulating muscle activation and fatigue patterns. Furthermore, the results highlight the differential impact of KT depending on training status, suggesting that while KT may facilitate performance in trained individuals, it could accelerate fatigue in untrained individuals. Future research should explore optimal taping duration, tension, and placement strategies to tailor KT interventions for specific functional goals.

The aim of this study is to comparatively investigate the acute effects of traditional and reaction-based HIIT (High Intensity Interval Training) methods on brain connectivity and cognitive responses. A total of 33 athletes (17 female, 16 male), 3 from each of the elite shooting, badminton, basketball, gymnastics, football, softball, karate, taekwondo, tennis, swimming and volleyball branches, were included in the study. The average age of the athletes included in the study was 21.4 ± 1.8 years and the average sports history was 9.4 ± 2.9 years. The athletes were equally and randomly distributed to traditional HIIT (11), reaction-based HIIT (11) and control groups (11). First, 2-min eyes-open resting EEG recordings were taken from the athletes. After the resting records, the Stroop Test consisting of 100 images (50% compatible) was applied in a computer environment and EEG records were taken simultaneously. The athletes applied a 5-min run and warm-up exercises. At the end of the warm-up period, the athletes applied 10 min of HIIT according to their groups. After the completion of HIIT, rating of perceived exertion was applied to determine the perceived exertion. Finally, the Stroop post-tests simultaneously with the EEG of all groups were taken and the measurement process was completed. All measurements related to the research were carried out at 23.1 °C (± 0.17) ambient temperature in Gazi University, Faculty of Sports Sciences Wrestling Hall. Three-way repeated measures ANOVA and independent groups T-Test were applied to the data obtained from the athletes in R and SPSS statistical programs. According to the obtained findings, significant differences were detected between the fronto-temporal, fronto-occipital, occipito-temporal regions in terms of connectivity and between the groups in terms of perceived difficulty level (p < 0.05). As a result of the research, in terms of brain connectivity; While the reaction-based HIIT method was observed to have positive effects on cognitive processes such as focused attention and decision-making skills by increasing synchronization especially in the fronto-temporal regions; it was observed that the traditional HIIT method decreased the perception of effort of the activity by decreasing the synchronization in the fronto-occipital region and contributed positively to the visual information processing processes by increasing the synchronization in the occipito-temporal region. In addition, although the heart rates of both groups were similar during HIIT, the reaction-based HIIT group perceived a higher level of difficulty than the traditional HIIT group. In the light of these results, it can be said that the use of applications that include unpredictability and variable environmental conditions, such as reaction-based HIIT, more in the development of athletic performance can make the applied training method more functional in cognitive terms.

BackgroundBlood flow restriction combined with low-load resistance training (BFR-RT) may effectively induce post-activation performance enhancement (PAPE) in team sport athletes. However, the effectiveness of its application in male volleyball players is unclear.ObjectiveThis study aimed to investigate the effect of BFR-RT on PAPE in male volleyball players between 15 s and 20 min after barbell squats.MethodsSixteen male collegiate volleyball players were randomly assigned to two groups, the BFR-RT group and the control group. The BFR-RT group performed two sets of 30 repetitions of barbell squats at 30% of their one-repetition maximum (1RM) with an average pressure of approximately 200 mmHg. The control group did squats at 90% 1RM. PAPE was assessed by measuring countermovement jump (CMJ) height, peak power output (PPO), vertical ground reaction force (vGRF), rate of force development (RFD), and EMG root-mean-square (RMS) of the biceps femoris (BF), vastus lateralis (VL), rectus femoris (RF), vastus medialis (VM), gastrocnemius (GA), and tibialis anterior (TA) at baseline and 15 s, 4, 8, 12, 16, and 20 min after the squats. A two-factor repeated-measures ANOVA was used for statistical analysis of the metrics.ResultsThe BFR-RT elicited PAPE in male volleyball players, with significant improvements observed in CMJ height. CMJ height significantly increased from 4 to 20 min after the conditioning activity (p < 0.01), with a between-group difference favoring BFR-RT at 16 min. For PPO, vGRF, and RFD, no significant time × group interactions were detected; however, time main effects indicated significant increases across both BFR-RT and RT groups (p < 0.05). Moreover, RMS amplitudes significantly increased over time for six muscles (BF, VL, RF, VM, GA, and TA; all p < 0.01), with no significant between-group differences.ConclusionsBFR-RT may induce acute PAPE in male volleyball players: CMJ exceeded RT at 16 min, PPO favored BFR-RT at 8–20 min, while vGRF, RFD, and EMG rose over time without consistent between-group effects. Given the small sample size, these preliminary findings require larger studies to confirm the potential of BFR-RT compared to traditional resistance training.

BackgroundLumbar spondylolysis (LS) is a common cause of low back injury in adolescent athletes; however, little is known about the relationship between trunk muscle morphology, lumbopelvic control, and LS. This study aimed to clarify trunk muscle morphology and clinical test characteristics in adolescent male soccer players with unilateral lumbar spondylolysis (uni-LS).MethodsIn total, 19 of the 107 adolescent male soccer players were enrolled and categorized into a uni-LS group, based on magnetic resonance imaging (MRI), and an age-, height-, and weight-matched control group. MRI-derived cross-sectional areas (CSAs) of the L4/5 vertebrae were extracted, and the psoas major (PM), multifidus (MF), and erector spinae (ES) muscles were analyzed. Active straight leg raise (ASLR) and hip extension (HE) tests were performed, and lumbopelvic depression was evaluated. Two-way analysis of variance was applied to determine trunk muscle CSA differences between groups, and the two-sided Fisher’s exact test was employed to evaluate the association between uni-LS and clinical findings.ResultsA significant main effect [F (1,35) = 15.1, p < 0.001] and interaction effect [F (1,35) = 4.1, p = 0.047] were found in the PM, indicating a smaller PM on the LS side in the uni-LS group. A significant association was also observed between uni-LS and ASLR on the LS side, with 13 of 16 players (81.2%) showing positive ASLR corresponding to the uni-LS group (p = 0.003).ConclusionA smaller PM and lumbopelvic depression during ASLR on the LS side characterize adolescent soccer players with uni-LS. These findings may provide useful information to help clinicians understand potential characteristics of uni-LS.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13102-025-01387-w.

PurposeInjury prevention programs for adolescent athletes include pre-game exercise programs designed to improve individuals physical function. This study aimed to determine the impact of Golfers’ Low back pain Exercise prevention Program (GLEP) on physical function and golf performance.MethodsA total of 45 adolescent golfers participated in this double-blind, randomized, sham-controlled trial. Participants were randomly assigned to the GLEP or sham exercise program. Physical function and golf performance was measured at baseline, 4-week, 8-week, and 12-week. Measurements included hip rotation, trunk lateral flexion and rotation range of motion (ROM), hip external rotation (ER) muscles strength, trunk endurance, and golf performance. Data were compared before the intervention and at each measurement point. Statistical analysis consisted of a mixed-model analysis of variance.ResultsBoth hip rotation ROM and trunk endurance improved significantly over time in both groups (p < .001). No significant effects were observed for trunk lateral flexion and rotation ROM (p > .05). Lead hip ER muscle strength showed a significant interaction, with greater values in the GLEP group (p = .017). There was no significant difference in golf performance measures between groups (p > .05).ConclusionsThe addition of a pre-game exercise program for adolescent golfers may have the potential to affect hip ROM and trunk endurance without negatively impacting performance. The GLEP significantly improved lead hip ER muscle strength when compared to a sham. The GLEP is an effective pre-game exercise program for golfers seeking to enhance hip ER strength.Trial registrationThis study was registered in the UMIN Clinical Trials Registry as a clinical trial (ID: UMIN000051318; registration date: 01/08/2023).Supplementary InformationThe online version contains supplementary material available at 10.1186/s13102-025-01287-z.