The purpose of this article is to provide a follow-up review of the impact of the SARS-CoV-2 Disease or Coronavirus Disease 2019 (COVID-19) pandemic on human health and the role of physical activity (PA) during the 5-year pandemic. We aim to cover the immune system, the cardiopulmonary system, the musculoskeletal system, and the central nervous system (brain function), particularly among older adults, college students, and individuals with post-acute sequelae of COVID-19 (Long-COVID). The COVID-19 pandemic has given us many lessons, learned from the death of six million lives and tremendous disturbance to human life. First, we need to continue to investigate cellular and molecular mechanisms that mediate various organistic failures resulting from the viral infection. Such investigations are the only way to completely understand the etiology of the diseases and to develop new drugs and vaccines. The molecular pathways that transmit the signals of viral infection to each organ system are different requiring both basic and clinical research. Available evidence suggests that mitochondrial dysfunction, reduced microcirculation and latent immune activation play a major role, eventually impairing cardiovascular tolerance and peripheral bioenergetics. Second, the COVID-19 pandemic has manifested major disturbances to human lifestyles with reduced PA and exercise standing out as a major factor. Conversely, physical inactivity due to social confinement and mental/psychological stresses has been clearly linked to intensified pathogenic symptoms and amplification of adverse effects on multiple physiological systems. If not intervened, this interaction can lead to Long-COVID, a dangerous futile circle to cause systemic failure. Finally, the COVID-19 pandemic has exerted differential impacts on different populations. Thus, the strategy to develop and conduct to cope with the negativity of pandemic needs to be specific, flexible and tailored to fit different patient populations.

Purpose: To consolidate and evaluate meta-analyses reporting the effects of blood flow restricted exercise (BFRE) on measures of health and physical fitness across all populations.

Methods: This preregistered umbrella review followed PRISMA guidelines. A comprehensive search of five databases identified meta-analyses evaluating the effects of BFRE interventions (aerobic, resistance, combined) compared to exercising and non-exercising control conditions on measures of health and performance. A multilevel meta-analysis of standardised mean differences (SMDs) was conducted to examine the effects of BFRE. Subgroup analyses were conducted for the participant and intervention characteristics. Risk of bias was assessed using the AMSTAR-2.

Results: 47 meta-analyses comprised of 265 unique studies were included. All reviews were rated as low-moderate quality. BFRE had a small effect on hypertrophy (SMD ​= ​0.39, p ​< ​0.001) and a moderate effect on strength (SMD ​= ​0.61, p ​< ​0.001) when compared to low load, but not high load resistance training (hypertrophy, SMD = −0.13, p ​= ​0.142; strength, SMD = -0.28, p ​< ​0.001). BFRE had small-to-moderate effects on aerobic fitness (SMD = 0.50, p ​< ​0.001), vascular health (SMD = 0.45, p ​< ​0.001), blood pressure (SMD = 0.46, p ​< ​0.001), and muscular power (SMD = 0.56, p ​< ​0.001). BFRE had no effect on physical function (SMD = 0.16, p ​= ​0.096), pain (SMD = 0.00, p ​= ​0.996), and speed (SMD = 0.22, p ​= ​0.213).

Conclusions: BFRE is a viable option to improve hypertrophy, strength, aerobic fitness, and vascular health across various populations, though its effects on hypertrophy and strength are smaller when compared to traditional high load resistance training. It doesn't appear to offer any additional benefits than other training methods for physical function, pain, or speed, although sub-analyses suggest further research is warranted in select areas of application.

The rapid drop in mortality risk as people become more active has been known for some time. While the public health message is clear (i.e., that any physical activity [PA] is better than no PA), no acceptable explanation as to why this rapid drop in mortality occurs is available. Without an explanation, providing specific answers as to what sedentary people should do to optimize health remains difficult. Research findings from studies on exercise physiology and inactivity physiology show why a lack of understanding of the importance of regular exercise or for becoming physically active exists. These findings also show how new knowledge can modify present PA guidelines. With sedentary people, being less inactive is more critical than becoming more active. Active people can also reduce their inactivity and achieve greater health benefits. Adults doing more vigorous aerobic and strength training achieve greater health benefits. No more than two days should elapse between exercise sessions 1) to improve insulin sensitivity and improve glucose tolerance, and 2) to activate muscle enzymes such as lipoprotein lipase to reduce postprandial lipemia. Older adults should do more strength exercises to minimize the effects of aging on sarcopenia. Subjective perception of effort is an easy, useful way to prescribe exercise. Being less inactive and more active are both important lifestyle considerations, and both must be promoted to all age groups.

Aims: Compare quadriceps voluntary activation, corticospinal and intracortical excitability between people with and without hip osteoarthritis (OA). Exploratory objectives include quantifying the association of corticospinal/intracortical excitability with voluntary activation, corticospinal/intracortical excitability with hip related pain, and motor threshold with motor cortex inhibition and facilitation.

Methods: Case-control study including participants with clinically and radiologically confirmed hip OA and non-OA controls. Quadriceps voluntary activation was assessed using twitch interpolation via femoral nerve stimulation. Single- and paired-pulse transcranial magnetic stimulation over the motor cortex assessed resting motor threshold (RMT), active motor threshold (AMT), short-interval intracortical inhibition (SICI), intracortical facilitation (ICF) and silent period. Generalized linear models assessed outcomes (p < 0.05).

Results: We included 17 hip OA (76% female) and 24 controls (92% female) with a mean (standard deviation) age of 58.7 (7.9) years. Compared to controls, people with hip OA had reduced quadriceps voluntary activation (β= -5.29, 95% confidence intervals [CI], -0.79——-9.79) and increased ICF (β= 0.22, 95%CI, 0.01-0.43). People with hip OA did not differ from controls in RMT (β= 4.76, 95%CI, 14.08-4.56), AMT (β= 2.13, 95%CI, 7.12-2.86), SICI (β= 0.02, 95%CI, 0.15-0.006) or silent period (β= 8.72, 95%CI, 24.75-42.20). More facilitation was associated with increased hip pain (β= 24.55, 95%CI, 6.93-42.18), and more inhibition was associated with less voluntary activation (β= 10.50, 95%CI, 2.00-18.99).

Conclusion: People with hip OA demonstrate reduced quadriceps voluntary activation and complex changes in motor cortex excitability compared to controls. These findings suggest that hip OA can alter quadriceps neuromuscular function (facilitation associated with pain, inhibition associated with activation), thus having implications for rehabilitation.

Chronic diseases are major causes of global death and disability, significantly impacting individual health and imposing economic burdens. This study aims to investigate the causal relationship between physical activity (PA) and the development of chronic diseases. Using a Mendelian randomization (MR) approach, we incorporated average PA and its subtypes (more than 450 ​000 participants) as exposure measures and eight chronic diseases as outcome measures. Data were obtained from the European Genome-Wide Association Study (GWAS). The primary causal analysis technique employed was the inverse variance weighting (IVW) method, with MR-Egger, weighted median, weighted mode, and simple mode used to validate the results. Sensitivity analyses were performed to assess heterogeneity and pleiotropy. The IVW approach results show that vigorous physical activity (VPA) is associated with a modest reduction in the risk of major coronary heart disease (OR ​= ​0.95, 95% CI: 0.91-0.99, p ​= ​0.01). The causal directions of the other four MR methods are consistent with this result and validated by sensitivity analysis. No substantial associations were found between other levels of PA and chronic disease. Our findings underscore the importance of VPA in preventive cardiology and suggest its potential role in public health initiatives. Further research should explore the impact of PA on different demographic groups and the dose-response relationship of VPA on heart health.

This study aimed to investigate the energy supply of athletes, who had a mild form of coronavirus infection (COVID-19) under cycling ergometric load (CEL) to substantiate the timing of recovery, as well as to determine the volume and intensity of physical activity. Eighty-seven athletes aged from 18 to 28 years old, involved in cyclic sports, were examined. Group I consisted of 52 athletes with COVID-19, and group II consisted of 37 healthy self-isolating athletes. In addition to the comprehensive examination, the tested athletes underwent special examinations: the study of diagnostic material using methods of nucleic acid amplification, spirography and spiroergometry, electrocardiography (ECG), and CEL. The results of athletes from both groups did not differ significantly (p ​> ​0.5) in the 1^st, 2^nd, and 3^rd examinations. The second examination revealed a discrepancy between functional reserves and the load performed, as evidenced by the difference in the recovery rate of most indicators, the results of the third examination in the long-term period (6 months) showed that the athletes of the first group did not have any violations of the parameters of the respiratory function (RF) and cardiovascular system at rest, after performing CEL, as well as in the recovery period. The results suggest that the full resumption of training loads and participation in competitions are possible only with the complete normalization of the functional state of the cardiorespiratory system. The most informative indicators are: minute ventilation (V˙E), heart rate (HR), oxygen pulse (OP), and coefficient of oxygen utilization (COU).

Purpose: The purpose of the current study is to investigate the within-pitcher differences in time series angular velocities of the pelvis, trunk, shoulder, and elbow for high and low velocity fastballs in college baseball pitchers.

Methods: In- game data were retrospectively analyzed from 82 NCAA Division 1 pitchers ([1.89 ​± ​0.06] m, [92.8 ​± ​9.5] kg). Kinematic data were collected using an in-game markerless motion capture system. Time series data of pelvis, trunk, shoulder, and elbow angular velocities for each pitcher's fastest and slowest fastball were extracted for the pitch cycle (foot contact to ball release) and used for analysis. Within-subject time series comparisons were conducted using statistical parametric mapping (SPM) paired samples t-tests (α ​= ​0.012 5).

Results: Each of the tested segments were significantly faster in the fastest fastball trial compared to the slowest fastball trial. The duration of significance in reference to the pitch cycle, test statistic, and p-value, for each segment are as follows: Pelvis: 0%-4%, t ​= ​3.54, p ​= ​0.012; Trunk: 30%-67%, t ​= ​5.62, p ​< ​0.001; Shoulder External Rotation: 3%-50%, t ​= ​−6.03, p ​< ​0.001; Shoulder Internal Rotation: 96%-100%, t ​= ​4.11, p ​= ​0.008; Elbow: 75%-86%, t ​= ​4.13, p ​< ​0.001.

Discussion: Within- subjects differences exist in time series angular velocities when comparing the fastest and slowest fastball. These time series differences provide additional information to distinguish fastball velocity beyond what discrete metrics can provide. Pitchers should look to rotate each segment faster, and optimize the sequencing of these movements, to increase pitch velocity.

Background: Surf skateboards have grown in popularity among young people in recent years. However, no research studies have analyzed the effect of surf skateboarding on physical fitness.

Objective: The purpose of this study was to determine the effects of 8-week surf skateboard training on physical fitness in young adults.

Methods: Twenty-two young people, ages 18-24 years were randomly assigned into two groups: a control (CON; n ​= ​11) and surf skateboarding (SSK; n ​= ​11) group. The surf skateboard training group received an eight-week intervention consisting of three 60-minute (min) sessions per week, while the control group continued with their normal daily lives. Physical fitness was assessed before and after the intervention through a battery of tests that included body composition, cardiorespiratory fitness, muscular strength and endurance, flexibility, and balance.

Results: The results showed that the SSK group demonstrated significant (p ​< ​0.05) improvements in maximum voluntary ventilation, back and leg strength, lower body muscular endurance by the sit-to-stand tests, and balance in all direction compared with the pre-test and the CON group. In addition, the SSK group showed significantly (p ​< ​0.05) decreased body weight, body mass index, percent body fat, and resting heart rate, while increased maximum oxygen consumption, pulmonary function, respiratory muscle strength, upper body muscular endurance by the sit-up test and flexibility compared with the pre-test.

Conclusion: The findings suggest that surf skateboard training have an effective physical activity intervention to improve body composition, ca rdiorespiratory fitness, muscular strength and endurance, flexibility, and balance in young people.

The study aimed to evaluate body mass changes and urine biomarker responses during a Combat Search and Rescue (CSAR) military exercise performed in a tropical region. Ten urinary biomarkers were analyzed via dipstick urinalysis to assess the physiological strain and the potential health risks associated with this exercise. Body mass and urine samples were obtained from 151 male cadets ([21.3 ​± ​1.6] year-old; height [177.2 ​± ​4.1] ​cm) before and after completing the efforts of a CSAR exercise that lasted approximately 10 ​hour (h). Body mass significantly decreased (p ​< ​0.05) by more than 3% immediately post-exercise (from [75.0 ​± ​9.85] kg to [72.6 ​± ​9.6] ​kg), returning to pre-exercise levels within 14 and 38 ​h after the complen. Interestingly, urine specific gravity (USG) paralleled the changes in body mass and exhibited a significant increase immediately after the exercise. Similar patterns of significant alterations were observed in urine acidity, ketonuria, bilirubinuria, and hematuria, mirroring the time course of changes in USG. The other evaluated urine variables did not show significant changes. The reduction in body mass was significantly correlated with changes in USG, ketonuria, bilirubinuria and proteinuria after the military exercise. In summary, cadets engaged in the CSAR military exercise experienced physiologically meaningful dehydration and exhibited indirect markers of cell damage immediately after the exercise. However, these changes were spontaneously resolved within 14 ​h post-task. Monitoring selected non-invasive biomarkers could aid in managing performance and health risks during arduous military training.

Background: Habitual physical activity is known to support cardiovascular health. However, when intensive exercise is performed for long durations, it can negatively affect the cardiovascular system. We evaluated the exercise-induced physiological responses of cardiac markers in male marathon runners based on basal plasma trimethylamine-N-oxide (TMAO) levels, a metabolite related to major adverse cardiovascular events.

Methods: Blood samples from 28 marathon runners were collected two weeks before the marathon run (baseline), after finishing the race (post-marathon), and two weeks after the race (2 weeks post-marathon). Serum cardiac troponin I (cTnI), endothelin-1 (ET-1), galectin-3, pentraxin-3, human growth differentiation factor 15, and neopterin were determined by the enzyme immunoassay method. Plasma trimethylamine (TMA) and TMAO were measured by the ultra-high-performance liquid chromatography-mass spectrometry method.

Results: Running a marathon increased levels of circulating biomarkers. A greater post-marathon elevation of cTnI and ET-1 was associated with baseline plasma TMAO levels (R= 0.400, p = 0.035 and R = 0.476, p = 0.012, respectively). Moreover, we observed an increase in post-marathon TMA levels.

Conclusion: Greater post-marathon elevation of cTnI and ET-1 was associated with higher baseline plasma TMAO levels. Therefore, TMAO could potentially serve as a new marker in assessing the response of cardiovascular stress biomarkers to marathon running.

While traumatic rupture of the pectoralis major is increasingly recognized, simultaneous bilateral pectoralis major tears remain exceedingly rare, with only five previously reported cases. Of these cases, only two were treated in a simultaneous fashion, both relatively acutely after injury. We present, to our knowledge, the first case of chronic bilateral pectoralis major myotendinous junctional tears treated with simultaneous repair. Additionally, given the occupational functional demands of our patient, we provide additional insight into the expected recovery of similar cases, with unrestricted activity at six months post-operatively and fully recovered strength at ten months postoperatively maintained at a three-year follow-up.