Perceived Exertion Research Articles (Page 1)

The thermos-physiological characteristics of medical personnel wearing protective clothing during prolonged activities under low oxygen pressure (LOP) and normal oxygen pressure (NOP) are crucial. The average age of the 24 participants was 22.13 ± 1.849years, with an average height of 168.58 ± 6.268cm, an average weight of 61.62 ± 8.128kg, and an average BMI of 21.59 ± 1.761kg/m2. Participants were first exposed to an LOP environment. The 6-h experiment involved a three-phase cycle (sitting, walking, and cardiopulmonary resuscitation (CPR)) repeated every hour. After a 2-week washout period, 24 participants were exposed to a NOP environment and repeated the aforementioned experimental procedure. Logistic regression and Cox analysis were used to assess the relationship between different oxygen pressures and human indicators. Restricted cubic spline (RCS) analysis was employed to examine the temporal changes in physiological indicators, and the Kaplan-Meier (K-M) method was used to plot survival curves. Each observation time point identified 120min as the optimal protection time, with the greatest intergroup differences observed for both continuous (5/8 variables) and categorical (8/12 variables) parameters at this time point. Stepwise Regression analyses combining logistic and Cox regression identified six significant variables (P < 0.05): temperature, SpO₂, pulse pressure, thermal sensation vote (TSV), sultriness, and rating of perceived exertion (RPE). K-M analysis revealed significantly higher probabilities of adverse outcomes in the LOP group compared to the NOP group: SpO₂ abnormalities (HR = 1.439, 95% CI: 1.026-2.017; log-rank P = 0.022), High TSV scores (HR = 2.463 [1.537-3.946]; P < 0.001), High sultriness scores (HR = 1.603 [1.260-2.040]; P < 0.001). RCS analysis of LOP group data showed significant temporal effects: RPE exhibited a nonlinear upward trend (overall P < 0.001; nonlinear P = 0.002), reaching an inflection point at 200min. SpO₂ demonstrated linear decline (P = 0.002/0.143; inflection point = 200min). Pulse pressure showed covariate-dependent effects: nonsignificant before adjustment (P = 0.430) but significant after adjustment (P = 0.008/0.891; inflection point = 200min). Our research shows that 120 ~ 200min is an optimal working time that does not affect the work efficiency of medical personnel.

Research on tennis coaching primarily targets beginner children, with limited focus on adults. This study compared traditional (TRT) and game-based (GBT) methods for their effects on technical skills and perceptual responses in beginner young players. Thirty-two males (age 21.5 ± 2.4 years) with no tennis experience were randomized into TRT (n = 16) and GBT (n = 16) groups, training twice weekly for six weeks with adapted equipment. Pre- and post-tests included the International Tennis Number (ITN) and Tennis-Specific Skills Test (TSST), ratings of perceived exertion (RPE), rating scale of mental effort (RSME), and physical enjoyment scale (PES). TRT showed greater technical improvements (ITN: p &lt; 0.05, η 2 p = 0.470; TSST: p &lt; 0.05, η 2 p = 0.332–0.622). GBT achieved smaller but significant gains (ITN: p &lt; 0.05, η 2 p = 0.294–0.339; TSST: p &lt; 0.05, η 2 p = 0.16–0.19) with higher enjoyment (PES: GBT 46.0 ± 3.9 vs. TRT 35.4 ± 2.9, p &lt; 0.05) and lower exertion (RPE: GBT 12.3 ± 0.7 vs. TRT 15.7 ± 1.0, p &lt; 0.05). TRT methods seem to be more effective for rapid technical skill acquisition, while GBT approaches may offer a more engaging and less stressful learning experience. Coaches should balance skill acquisition and engagement for optimal learning.

Napping is recognized as a strategy to enhance athletic performance. However, the optimal timing and duration for maximizing its benefits remain unclear. This study investigated the effects of a 90 min nap at different times on physical performance, psycho-cognitive responses, and perceived recovery in trained youth male athletes. Fourteen athletes (18 ± 1 years) completed four conditions in a randomized crossover design: (1) No-nap-13h, (2) No-nap-15h, (3) Nap-13h, and (4) Nap-15h. After each condition, athletes performed a 5 m shuttle run test (5mSRT) and were assessed on best distance (BD), total distance (TD), and fatigue index (FI). Ratings of perceived exertion (RPE) were recorded after each 5mSRT repetition, whereas muscle soreness (DOMS) and recovery (PRS) were assessed post-test and 24 h later. The digit cancelation test (DCT), feeling scale (FS), Stanford Sleepiness Scale (SSS), and Hooper Questionnaire evaluated sleep quality and psycho-cognitive state. Results showed that the athletes felt greater sleepiness before Nap-15h and after Nap-13h versus the no-nap conditions. TD was higher in Nap-13h than Nap-15h (p = 0.001) and No-nap-15h (p = 0.0009). BD was higher in Nap-13h versus No-nap-15h and No-nap-13h, while RPE was higher in Nap-13h versus No-nap-13 h, Nap-15h, and No-nap-15h (all, p &lt; 0.05). DCT scores were also higher in Nap-13h. No significant effects were found for FI, FS, or Hooper. In conclusion, a 90 min nap at 13:00 was more effective than a later nap or no nap in improving performance and recovery, suggesting benefits for afternoon training or competitions.

Blood flow restriction (BFR) and body cooling (BC) have been investigated separately during exercise, but little is known about their concurrent use. This study examined acute metabolic responses, respiratory physiology, and rate of perceived exertion (RPE) during interval training (IT) performed with combined BFR and BC (VASPER ON) compared with IT without BFR and BC (VASPER OFF). It was hypothesized that VASPER ON would elicit greater physiological demands. A total of 7 female and 19 male participants (20.2 ± 2.4 years) completed a 21-min IT exercise. In VASPER ON, the participants wore cuffs that simultaneously applied BFR and BC. Total oxygen consumption (TVO2), total carbon dioxide production (TVCO2), total breaths (BRTH), and total ventilation (TVE) were measured during exercise (EX) and for 10 min post-exercise (Post-EX). RPE was recorded during EX. During EX, TVE and ventilatory equivalents for both oxygen and carbon were significantly higher in VASPER ON. Post-EX, all variables remained significantly elevated in VASPER ON except for the ventilatory equivalent for carbon dioxide. Sprint interval RPE was significantly lower in VASPER OFF. These findings suggest that concurrent BFR and BC increase post-exercise metabolic and ventilatory demands without attenuating each other’s effect.

Background A plateau hypoxic environment can increase the physiological burden on athletes. Although nutritional interventions have been recognized as a potential strategy to improve plateau acclimatization, evidence in support of specific dietary patterns is still lacking. This study compared the effects of different dietary interventions on cardiopulmonary fitness during plateau exercise through systematic evaluation and network meta-analysis methods. Methods This study systematically reviewed relevant literature up to June 2025 and included 20 randomized controlled trials (RCTs) conducted at altitudes above 1,500 meters involving healthy participants aged 16 years and above who engaged in physical activities. The primary outcomes included cardiopulmonary indicators [maximal oxygen uptake (VO 2max ), heart rate (HR)], blood biomarkers [peripheral oxygen saturation (SpO 2 ), hematocrit (HCT)], and subjective perception indicators [rating of perceived exertion (RPE)]. For each outcome, the pooled effects of each intervention compared to others were estimated. Mean difference (MD) or standardized mean difference (SMD) with 95% Credible Intervals (95% CrI) were calculated. The Surface Under the Cumulative Ranking Curve (SUCRA) was used to rank the dietary interventions and quantify their relative effectiveness. In addition, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was applied to assess the quality of evidence. Results A total of 20 randomized controlled trials involving 329 participants were included, evaluating eight dietary interventions. Moderate-quality evidence indicated that carbohydrate supplementation significantly improved the percentage of maximal oxygen uptake (VO 2max ) compared to placebo (SMD = 1.13, 95% CrI: 0.25 to 2.05) and reduced RPE scores (MD = −0.77, 95% CrI: −1.83 to −0.09). Moderate-quality evidence indicated that carbohydrate supplementation combined with glutamine ranked highest in improving SpO 2 (SUCRA 84.54%) and RPE (SUCRA 69.37%), while iron supplementation showed the highest SUCRA rankings for HR (56.54%) and HCT (66.67%). However, these interventions did not demonstrate statistically significant advantages. Notably, the observed increase in VO 2max exceeded the minimally clinically important difference (MCID) of 1.0 ml/kg/min reported in previous studies, suggesting that the effect of carbohydrate supplementation on VO 2max may have clinical relevance. Conclusions Differences exist in the effects of different dietary interventions on cardiopulmonary fitness during altitude exercise. The current network meta-analysis indicates that carbohydrate-based strategies show beneficial effects, with carbohydrate plus glutamine supplementation demonstrating greater advantages in SpO 2 and RPE, while carbohydrate alone is more supported in improving VO 2max. Therefore, carbohydrate-based strategies may serve as effective options to promote altitude acclimatization, whereas iron supplementation may have potential benefits in improving HCT and HR. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251069629 , identifier: CRD420251069629.

Primary ciliary dyskinesia (PCD) is a rare disorder characterized by defective motile cilia, impairing airway mucociliary clearance. Children with PCD (cwPCD) may exhibit distinctions in exercise responses compared to healthy peers (HP). We aimed to compare physiological responses to cardiopulmonary exercise testing (CPET), incremental shuttle walk test (ISWT), and 6-min walk test (6MWT) in cwPCD and HP and investigate the associations between clinical parameters. Twenty-three cwPCD and 23 HP were included. Pulmonary function and respiratory muscle strength were assessed. All participants performed CPET, ISWT, and 6MWT. Heart rate (HR), blood pressure (BP), oxygen saturation (SpO2), anddyspnea and fatigue (modified Borg Scale) were assessed before and after tests. In cwPCD, CPET and ISWT revealed similar HR, SpO2, systolic BP, dyspnea, and fatigue responses (p > 0.05), while 6MWT elicited lower responses in these parameters (p < 0.05). cwPCD had lower ∆HR (p = 0.003), peak oxygen uptake (peak ) (p = 0.048), relative peak (p = 0.041), and higher minute ventilation/carbon dioxide production (V̇E/ ) at anaerobic threshold (p = 0.047) compared to HP. Peak correlated with ISWT distance (ISWD) (r = 0.592) and 6MWT distance(6MWD)(r = 0.601) in cwPCD and HP(r = 0.648, r = 0.507, respectively)(p < 0.05). Regression equations were developed: relative peakV̇O₂(mL/min/kg) = - 25.630 + 0.083 × 6MWD(m)[F(1-21) = 7.719, p = 0.011, R2 = 0.269] and relative peak (mL/min/kg) = 1.922 + 0.032 × ISWD(m)[F(1-21) = 11.790, p = 0.002, R2 = 0.329). CPET and ISWT evoke comparable responses, while 6MWT results in lower physiological responses. However, 6MWT remains useful, given its association with peak . ThecwPCD have an altered control and early CO2 increase with exercise, greater ventilatory inefficiency, and chronotropic impairment. Compared to field tests, CPET can be more helpful for determining ventilatory inefficiency and chronotropic impairment in PCD. NCT05712798 (Registration Date: 26.01.2023).

Heart rate (HR) monitoring is a practical method for assessing internal load (IL). However, it remains unclear for which age group HR would be an appropriate predictor of IL considering the relationship with external load (EL). Thus, this study aims to evaluate the relevance and applicability of HR monitoring by exploring the relationship between EL and IL among U16 soccer players. EL was measured using global positioning system (GPS) data, while IL was assessed through training impulse (TRIMP), Edward’s TRIMP, HR exertion, rate of perceived exertion (RPE), and session-RPE (s-RPE). Nineteen (N = 19) male footballers from an elite football academy participated, with data collected from 50 training sessions and 11 matches. In the analysis of the training sessions, TRIMP demonstrated a near-perfect correlation with total distance (TD) (p &lt; 0.001), and eTRIMP correlated strongly with TD (r = 0.82) and player load (r = 0.79). HR exertion also correlated significantly with TD, medium-speed running, decelerations, inertial movement analysis (IMA) events, and player load (p &lt; 0.001). In matches, a large correlation was observed between TRIMP and TD (r = 0.73), while the strongest correlation was between RPE and s-RPE with TD and PL (p &lt; 0.001). Furthermore, TD emerged as the best GPS-derived predictor of both TRIMP and HR exertion in training contexts. These findings provide evidence for the validity and usability of heart rate-based and RPE-based measures to indicate IL in U16 soccer players. Future research should focus on contextual factors in exploring the relationship between EL and IL.

Thermal protective clothing (TPC) protects firefighters from physical threats associated with structural firefighting. However, it also limits the release of body heat generated, which can result in hyperthermia and dehydration. Despite the prevalence of winter structure fires in the United States, there is a paucity of cold-weather firefighting research. This study documented physiological responses to moderate-intensity exercise in a cold environment while wearing TPC with the hypothesis that while exercising in firefighting TPC, a cold environment would maintain normal core body temperature and decrease extremity temperature compared to a thermal neutral environment. Fourteen firefighters (two females; 30.9 [SD = 8.1] years) participated in both a thermal neutral (20°C) and cold (-8°C) condition simulation. Each subject was outfitted with a heart rate (HR) monitor, eight surface temperature sensors, and a core temperature (Tc) capsule prior to donning TPC. For each condition, subjects walked on a treadmill in an environmental chamber to simulate the common firefighting work intervals of two 20-minute sessions, with a short rest in between, followed by a 20-minute rehabilitation period. Body temperatures, HR, respiratory rate (RR), rate of perceived exertion (RPE), and thermal sensation, comfort, and preference were recorded during exercise and recovery. Core temperature, HR, RR, and RPE increased during exercise in both conditions. Mean skin temperature (MST) rose during the thermal neutral condition but not during the cold condition. Overall, Tc (0.3 [SD = 0.4]°C; P = .0142), HR (26.3 [SD = 8.36] BPM), RR (3.56 [SD = 5.6] BPM), RPE (2.0 [SD = 1.9]), and MST (3.4 [SD = 1.2]°C) were all higher at the end of the neutral condition compared to the cold condition. During recovery, most measures returned to baseline after approximately five-to-20 minutes in both conditions, but they recovered more slowly in the thermal neutral condition. Moderate-intensity exercise in TPC increased physiological and perceptual measures more in a thermal neutral environment than a cold environment. Recovery was faster following the cold condition. This may allow firefighters to work for longer durations or recover faster, possibly allowing for fewer crews on scene. However, this study did not account for the risk of other cold induced conditions due to prolonged exposure, such as frostbite. Further investigations should be conducted on cold weather firefighting and its impact on firefighters to establish guidelines and standard operating procedures.

The continuous growth of the older adult population demands an urgent need to provide innovative ways to stimulate physical activity and promote functional health. This study presents FitFest, a custom-made virtual reality (VR) designed to deliver a complete physical activity (PA) session for older adults. A pilot study involving seven older adults (67.0 ± 3.8 years) was conducted, comprising 18 user testing sessions of two VR exergames: Wine Fest and Flower Fest. PA intensity and heart rate (HR) were measured. The rate of perceived exertion (RPE) and the participants’ rating of the system’s usability were also registered. Overall, sessions involved mostly sedentary behavior (56.5 ± 20.4%) and light PA (42.1 ± 19.3%), with an average of 436.7 steps and 92.1 bpm. Wine Fest elicited less sedentary behavior (53.6 ± 22.1% vs. 62.8 ± 16.2%), higher light PA intensity (44.7 ± 20.4% vs. 36.4 ± 17.0%), and a higher step count (503.0 ± 345.4 vs. 291.0 ± 143.1) than the Flower Fest, although not significantly. Tasks requiring cardiovascular effort and strength were rated as more physically demanding. Most participants found the system user-friendly and showed interest in continued use, though technical support was essential due to limited familiarity with VR. The findings suggest FitFest has potential to promote light PA in older adults, highlighting the importance of usability and support in tech-based interventions.

Background: Schizophrenia is a complex psychiatric disorder that requires both pharmacological and behavioral treatment and is often accompanied by multimorbidity. Physical activity supports overall health and plays an important role in preventing and managing both somatic and mental disorders. This study aimed to evaluate the impact of an Adapted Physical Activity program using Nordic Walking (AAF-NW) on the quality of life of patients with schizophrenia, depending on the number of steps taken during an eight-week intervention, and to assess its influence on body composition and posture. Methods: A prospective, single-center pilot study was conducted using a pre–post experimental design and direct participatory observation. Eighteen patients from a psychiatric hospital (16 men, 2 women; mean age 43.9 years) completed the intervention. Quality of life (WHOQOL-BREF), musculoskeletal pain (Nordic Musculoskeletal Questionnaire), and subjective exercise intensity (Borg scale, 6–20) were assessed. Measurements were taken before and after the program. All continuous variables (step counts, anthropometric measures, and WHOQOL scores) were tested for normality using the Shapiro–Wilk test and visual inspection of histograms and Q–Q plots. Depending on distribution, parametric or non-parametric tests were applied, with results quantified using appropriate test statistics, effect sizes, and p-values to ensure methodological rigor and transparency. Results: No systematic increase in the number of steps was observed during the training period. A non-significant improvement in quality of life was noted, along with significant reductions in body weight and waist circumference. Conclusions: Regular, structured AAF-NW group activities may potentially support the rehabilitation and treatment process in psychiatric hospitals when implemented on a continuous basis. Although improvements were observed, the findings are exploratory and should be interpreted with caution. Further studies on larger, more homogeneous samples are needed to confirm these preliminary results.

This study examined the effects of cluster sets (CS) versus traditional sets (TRAD) on performance and perceptual responses during pneumatic chest press (CP) and leg press (LP). Exercise-specific differences and the influence of sex and strength were also explored. Forty-seven recreationally resistance-trained young adults (23 male and 24 female) performed CP and LP at 70% 1-repetition maximum in either CS (4 × [2 × 5], 30-s intraset rest, 150s between sets) or TRAD (4 × 10, 180-s rest between sets) in randomized order. Mean concentric velocity (MCV), MCV loss, rating of perceived exertion(RPE), and estimated repetitions to failure were recorded. Repeated-measures analyses of variance were used for statistical comparisons, with sex and strength included as exploratory variables. MCV was higher (P < .001, partial η2 = .272), RPE was lower (P < .001, partial η2 = .246), and estimated repetitions to failure was higher (P < .001, partial η2 = .429) in CS than TRAD, with no exercise-specific differences. Although MCV loss was lower in CS (P < .001, partial η2 = .364), post hoc analyses revealed that this benefit was only significant during CP and among males. However, the sex-related effect did not remain significant after adjusting for strength. While sex- and strength-related interactions emerged for MCV, they were limited to higher-order interactions involving repetitions but did not alter the overall CS benefit. CS effectively maintained MCV, reduced RPE, and increased estimated repetitions to failure compared with TRAD across CP and LP using pneumatic-resistance devices. The benefit of CS in attenuating MCV loss differed by exercise and sex, with the sex effect moderated by strength.

The article presents an analysis of the organizational and methodological features of conducting a training and competition complex in beach handball, which consisted of an Identification/Selection Camp and the John Kovacik Memorial Tournament. The aim of the study is to analyze the organizational and methodological features of the Beach Bash 2025 tournament and the associated Identification/Selection Training Camp, to determine their physiological and preparatory impact on athletes, and to assess the compliance of the proposed model with the principles of Long-Term Athlete Development (LTAD). Research methods: analysis and synthesis of scientific and methodological literature and regulatory documents on the training of beach handball athletes; content analysis of official regulations and schedules of the tournament and training camp; pedagogical observation of the training and game process; synthesis of results from the perspective of the LTAD concept. Research results. At the first stage (camp), the priorities were sensorimotor coordination, neuromuscular adaptation, and the formation of specific movement patterns; proprioceptive systems were activated, intermuscular coordination improved, "sand versions" of movements and throws were practiced, and plyometric, stabilization, and eccentric exercises were applied. At the second stage (tournament), the focus shifted to the development of specific endurance and stress adaptation, including the regulation of neuroendocrine responses (cortisol, catecholamines). Training tasks were performed at an rating of perceived exertion (RPE) of 6–8 (75–90% HRmax), simulating competitive intensity and increasing resistance to metabolic stress. Conclusions. It is recommended to develop a "sand" test profile (CMJ, T-test, 5–20 m sprint, throwing tests) and repeat it at key points of the season. Practical value – the integration of the Identification/Selection Camp and the tournament as a chain of control–intervention–verification with subsequent individualization of plans according to the principle of progressive overload; the application of block-modular sessions "decision under pressure" with video analysis; the implementation of a preventive package (neuromuscular warm-up, heat monitoring, court inspection standards). The proposed model meets the modern requirements of LTAD and can be applied within the national system of beach handball player development.

This study tested whether a single 100 μg inhalation of salmeterol enhances 12-s sprint performance in both fresh and fatigued states in elite road cyclists. In a randomized crossover design, 16 well-trained, non-asthmatic male cyclists completed 2 trials 1 week apart. Participants inhaled either 100 μg salmeterol or placebo 1h before testing. Each trial involved: an initial 12-s sprint (fresh), a 1h race simulation (40%-95% peak power output) with heart rate, blood lactate concentration, and rating of perceived exertion (RPE) monitored, and a final 12-s sprint (fatigued). Peak and mean power, and vastus lateralis myoelectric activity were recorded during the sprints. Power declined from pre- to post-simulation in both conditions (p < 0.016), but the decrement was attenuated with salmeterol (peak: -7.5% vs. -18.2%; mean: -13.0% vs. -19.8%). Fatigued-sprint peak power was higher with salmeterol (915 ± 135 W) than placebo (831 ± 112 W; p = 0.030), as was mean power (692 ± 76 vs. 643 ± 92 W; p = 0.037). No effect of salmeterol was observed on fresh sprint performance and myoelectric activity. Blood lactate concentration and RPE rose similarly in both conditions (p < 0.001), while heart rate was higher with salmeterol during the first 20 min (p = 0.004). Acute inhalation of salmeterol attenuates muscle fatigue and enhances sprint performance at the end of a simulated race. These findings challenge the presumption of no enhancing effect of inhaled salmeterol at therapeutic doses in competitive road cycling, where final sprints often determine outcomes.

Amdi, CH, Spence, A-J, Helms, ER, and McGuigan, MR. Exploring exercise specificity in powerlifting: A survey of powerlifters' training practices and demographic influences. J Strength Cond Res XX(X): 000-000, 2025-This study aimed to examine powerlifters' training practices related to exercise specificity. A total of 548 powerlifters responded to an anonymous online survey, with 401 completing all questions. On average, lifters trained 4.25 times per week and performed the competition-style squat, bench press, and deadlift 1.64, 2.48, and 1.37 times per week, respectively-typically using 1-7 repetitions at ratings of perceived exertion (RPEs) of 6-10. Almost all lifters (>97.5%) incorporated varied practice, including barbell variations (squat: 1.50×, bench press: 2.14×, deadlift: 1.26×) and accessory exercises (squat: 1.73×, bench press: 2.46×, deadlift: 1.72× per week). These were generally performed with 4-7 repetitions at RPE 6-8.5 for variations, and ≥8 repetitions at RPE 6-10 for accessories. The most common barbell variations involved slower eccentric phases, added or prolonged pauses in the bottom position, among others. Most lifters modified how they programmed (i.e., volume, frequency, relative-load, or RPEs) the competition lifts (88.2%), barbell variations (71.7%), and accessory exercises (62.3%) as competition approached, whereas 35.1-45.7% changed exercise selection depending on competition proximity. However, 49.0-58.7% maintained consistent exercise selection throughout competition periods. These programming decisions were influenced by athlete characteristics such as gender, use of supportive equipment, age, weight class, relative strength, and training status. Collectively, these findings indicate that varied practice is common in powerlifting.

BackgroundEarly mobilization seems to benefit patients with acutely decompensated heart failure (ADHF), but its initiation is challenging due to severe dyspnea, clinical instability, and low adherence to treatment. Understanding whether early mobilization has good acceptance, adherence, and safety is key for rehabilitation in this population. Virtual reality (VR) offers a less stressful environment and may reduce dyspnea, yet its effects on ADHF remain unknown. In addition, the feasibility and safety of combining VR with an early mobilization program in the intensive care unit (ICU) setting are not fully established.ObjectiveThis study aimed to assess the effects, feasibility, and safety of an early mobilization protocol combined with immersive VR for dyspnea in patients with ADHF admitted to an ICU.MethodsThe Early Mobilization Protocol with Immersive Virtual Reality (MOVE) study is a single-center, parallel, superiority randomized clinical trial conducted from January 2023 to January 2024 in a teaching hospital in Brazil. Patients with ADHF admitted to the ICU who met the eligibility criteria were invited to participate. After informed consent, participants were electronically randomized into the intervention group (IG) and control group (CG). Both groups underwent up to 3 sessions of the early mobilization protocol supervised by a physiotherapist, including upper- and lower-limb cycle ergometry, standing, and ambulation. Additionally, the IG used VR headsets, headphones, and smartphones displaying 360° videos. The primary outcome was dyspnea measured using the modified Borg scale before and after each session. Secondary outcomes included vital signs before and after each session and the occurrence of adverse events. Physiotherapists were blinded to the primary outcome, and all analyses followed the intention-to-treat principle with a blinded statistician.ResultsA total of 58 participants were randomized (IG: n=28, 48%; CG: n=30, 52%), with a mean age of 59 (SD 11.6) years; 42 (72%) were men, the mean left ventricular ejection fraction was 26.6% (SD 12.5%), and 28 (48%) were categorized as New York Heart Association class III. Only 43% (25/58) of the participants completed all 3 protocol sessions (IG: 11/28, 39%; CG: 14/30, 47%). Reasons for noncompletion of the protocol included refusal, clinical instability, discharge from the unit, or scheduled procedures. Changes in the mean dyspnea scores were similar between groups (IG: −0.17, SD 1.68; CG: 0.01, SD 1.73; P=.67). The mean vital signs remained within expected clinical ranges, with no differences between groups (all P>.05). No serious adverse events occurred.ConclusionsEarly mobilization with or without VR was feasible and safe in ICU patients with ADHF. VR did not significantly reduce dyspnea, but adherence challenges limited protocol completion. These findings suggest that early mobilization can be safely implemented in this population and that future studies should explore strategies to enhance adherence and evaluate the potential benefits of VR in larger cohorts.

ABSTRACTThe purpose of this study was to compare the effects of a 1‐week block of moderate‐intensity interval training (MIT) and high‐intensity interval training (HIT) in well‐trained cyclists. Cyclists (♀ = 1; ♂ = 21; maximal oxygen uptake (V̇O2max) = 69.5 (6.0) mL·min−1·kg−1) performed both a MIT block involving 6 sessions over 7 days (5–7 × 10–14‐min work intervals, rate of perceived exertion (RPE): 14.5 (0.3)) and a HIT block involving 5 sessions over 6 days (5 × 8.75‐min with multiple short intervals, RPE: 17.1 (0.4)). Post‐testing was performed after 6 days of active recovery, and blocks were separated by 2 months. Testing included 15‐min maximal cycling power (PO15min), 10 s maximal sprint power (PO10sec), and power output at a blood lactate concentration of 4 mmol·L−1 (PO4mmol). Both the MIT and HIT block improved PO15min (4.9 (8.7)% and 2.8 (5.3)%, respectively), with no difference between blocks (p = 0.44). MIT displayed greater improvement than HIT in PO4mmol (4.5 (4.5)% vs. 2.1 (2.7)%, respectively, p = 0.03, moderate effect size (ES)), while HIT had a moderate ES compared to MIT for improvement in PO10sec (1.5 (3.7)% vs. −1.5 (7.3)%, respectively), that was not significant (p = 0.08). No differences were observed between blocks in changes in V̇O2max (p = 0.43) or measures of gross efficiency (p range = 0.43–0.79). However, MIT induced a larger increase in % of V̇O2max at PO4mmol compared to HIT (1.2 (3.4)%‐points vs. −0.9 (2.5)%‐points, respectively, p = 0.02, moderate ES). In conclusion, both a MIT block (lower work interval intensity but longer work duration) and a HIT block (higher work interval intensity but shorter work duration) can improve endurance performance determinants and PO15min with some work intensity‐specific adaptations.

Introduction: Cerebral palsy (CP) is a non-progressive neuromotor disorder that causes increased muscle tone and impaired motor control, thus affecting functional ability and participation in adaptive sports such as Boccia. One of the main challenges in athletes with spastic cerebral palsy is the slow recovery of muscles due to spasms and fatigue. Cryotherapy is used in rehabilitation to lower spasticity, but scientific evidence on Boccia athletes is still limited. Objective: this study was to analyze the effectiveness of cryotherapy on the physical recovery process in Boccia athletes with spastic cerebral palsy. Methods: Pre–post experimental research without a control group in 18 Boccia athletes aged 18–35 years. Local cryotherapy is administered to the extremities for four weeks with a frequency of three times per week. Measurements were made using the Modified Ashworth Scale (MAS), hand-held dynamometer, and Borg Rating of Perceived Exertion (RPE). Results and Discussion: Results showed a 26% decrease in muscle tone, a 14% increase in muscle strength, and a 15% decrease in fatigue perception after cryotherapy. Physiologically, this effect is related to decreased stretch reflex activity and increased neuromuscular efficiency due to local vasoconstriction and slowing down of nerve conduction. Conclusion: Cryotherapy effectively accelerates the physical recovery of Boccia athletes with spastic CP through improvements in muscle tone, strength, and fatigue.

ABSTRACT This study assessed the effects of hydration and hydration/cooling on various psycho-physiological and cognitive responses in staff during a simulated burns surgery. Twelve participants completed three 2.5-h trials in the heat (33.6°C, 36.4% RH) whilst walking on a treadmill at a rating of perceived exertion of 12 on the Borg scale. Trials consisted of: i) ingestion of 37°C water (HYD); ii) ingestion of 5°C water (COLD); and iii) a no cooling/hydration control (CON). Water ingestion (0.9% of body-mass) was based on fluid loss calculated during a previous 2.5-h burn surgery. Results demonstrated that while treadmill distance was similar between trials (p > 0.05), cold water ingestion resulted in improved manual dexterity (p = 0.03), better thermal comfort (p < 0.01) and lower core and skin temperatures (p < 0.01), compared to CON. Skin temperature was also lower in COLD vs HYD (p < 0.01). Moderate to large effect sizes (ES, g = 0.38–0.77) were observed in favor of COLD versus CON and/or HYD for manual dexterity, counting span, grammatical reasoning and several perceived workload subsets at various time points, however associated 95% confidence intervals were wide and crossed zero, suggesting statistical uncertainty. Similarly, moderate to large ES (g = 0.45–0.77) favored HYD over CON for counting span (120 min) and various perceived workload outcomes, though again confidence intervals suggest that these effects were not statistically conclusive. No differences were observed between trials for sweat loss, thermal sensation, or heart-rate (p > 0.05). Overall, cold water ingestion resulted in benefit to numerous variables assessed here. Small boluses of cold water ingestion are recommended during hot burn surgeries.

Background Interstitial lung disease (ILD) is defined by progressive pulmonary fibrosis, restrictive ventilatory dysfunction, and hypoxemia, with significant differences in disease presentation, clinical course, and prognosis. This study aims to evaluate the clinical benefits of pulmonary rehabilitation with different characteristics in ILD patients. Methods This study searched electronic databases (PubMed, Embase, Web of Science, Cochrane Library, Clinical trials) and included 33 articles in a meta-analysis (1671 ILD patients). Two investigators independently appraised relevance, trial quality, and data extraction. Results The meta-analysis demonstrated that pulmonary rehabilitation is effective in enhancing exercise endurance, alleviating exertional hypoxemia, and improving quality of life among ILD patients. Key outcomes (all p < 0.05): 6-min walk distance (6MWD) [MD = −46.04; 95% CI (−52.63, −39.45)], lowest oxygen saturation during the 6-min walk test (6MWT) [MD = −1.97; 95% CI (−2.11, −1.84)], Borg scale score [MD = 1.20; 95% CI (0.79, 1.60)], and the MOS 36-item Short Form Health Survey (SF-36) [MD = −4.57; 95% CI (−7.19, −1.94)]. Subgroup analyses were performed based on duration, content, and implementation methods. Patients with 4–8 weeks duration showed optimal benefits. Content including breathing training improved exercise endurance more effectively. Medical guidance, home-based, and tele-rehabilitation all enhanced endurance, with no significant differences. Conclusion Pulmonary rehabilitation has a positive therapeutic effect on ILD patients, significantly enhancing exercise endurance and tolerance, and improving quality of life. However, it is essential to assess the patient’s condition and tailor the pulmonary rehabilitation plan to the individual to achieve the best therapeutic outcomes.

Monitoring muscle fatigue is essential for ensuring safety and maximizing the effectiveness of resistance training. Conventional methods such as electromyography (EMG), inertial measurement units (IMU), and ratings of perceived exertion (RPE) involve complex procedures and have limited applicability, particularly in unsupervised or robotic exercise environments. This study proposes a machine learning-based approach to directly predict RPE from force–time data collected during repeated isokinetic bench press sets. Thirty-two male participants (64 limb datasets) performed seven sets at a standardized 7RM load, with load cell data and RPE scores recorded. Biomechanical features representing magnitude, variability, energy, and temporal dynamics were extracted, along with engineered features reflecting relative changes and inter-set variations. The findings indicate that RPE is more closely related to relative fatigue progression than to absolute biomechanical output. Incorporating engineered features substantially improved predictive performance, with the Random Forest model achieving the highest accuracy and more than 93% of predictions falling within ±1 RPE unit of the reported values. The proposed approach can be seamlessly integrated into intelligent resistance machines, enabling automated load adjustment and providing substantial potential for applications in both athletic training and rehabilitation contexts.