Sport-related concussion (SRC) and its potential neurological sequela represent an emerging global health concern, requiring improved recovery management and strategies for return-to-play (RTP) to enhance brain health in athletes. Given the dynamic and multifaceted nature of SRC recovery, the purpose of this review is to synthesize existing literature on post-SRC outcomes in adult athletes, and to outline the temporal trajectories of key recovery indicators (symptoms, cognitive function, blood biomarkers) across distinct recovery phases until resolution. In the acute phase of SRC (first 48 h), symptom scores and brain damage markers peaked immediately, while cognitive impairments and neuroinflammation emerged with a slight delay. Following the initial rise, brain damage marker concentrations rapidly dropped below baseline levels at approximately 48 h following SRC injury. During the early recovery phase, neuroinflammation and most cognitive alterations resolved after 3-5 days, though symptom burden and attention deficits persisted for up to 7 days. Despite prolonged alterations reported in some individuals, recovery markers typically returned to pre-injury levels in the transition phase (>2 weeks), though mild attention deficits were detected up to 3 weeks, and TNF-α concentrations remained elevated throughout late recovery (> 2 weeks). These results reveal distinct temporal discrepancies across recovery markers and emphasize that physiological disturbances can outlast symptom resolution, underscoring the need for both multimodal assessments and appropriately timed evaluations to accurately track recovery progression. Incorporating structured follow-ups at key time points, particularly beyond symptom resolution, may improve RTP decision-making and reduce the risk of premature return and long-term neurological consequences.

Long COVID is characterized by a group of persistent symptoms following the acute SARS-COV2 infection, which presented a multifaceted challenge to the healthcare systems all over the globe. The long COVID symptoms span various organ systems including the respiratory, cardiovascular, gastrointestinal, and neurological manifestations. Mitochondrial dysfunction and immune dysregulation play crucial roles in the long COVID pathophysiology. Recently nutritional intervention gained much attention in managing post-viral syndromes. Effective interventions like supplementation of omega-3 fatty acid, macro and micro nutrients, and vitamins help to reduce systemic inflammation and counteract muscle wasting. Other approaches like nutritional recovery, dietetic interventions, continuous nutritional care post-hospital discharge, nutritional rehabilitation programs, whole-diet approaches like Mediterranean diet, plant-based diet, and caloric optimization, improve overall functional recovery. Physical activity and exercise regimes have been shown to improve fatigue, dyspnea, and cognitive function. Tailored exercise regimes may promote safe rehabilitation. Certain ineffective interventions, such as non-personalized approaches, high dose of antioxidants, use of herbal products that are not clinically validated need to be addressed. Dietary interventions such as personalized nutritional counseling have been demonstrated to improve physical performance in long COVID patients. Further research is needed to refine protocols and identify optimal combinations of dietary and movement-based therapies to support the recovery of long-COVID patients. This narrative review focuses on the ongoing researches that reveals the intricate relationship between nutrition and long COVID recovery and also establishes effective protocols for nutritional care.

Objective: This review aims to explore the efficacy of exercise in the treatment of anxiety disorders and its underlying mechanisms, summarizing recent research advances and focusing on the potential biological and psychological pathways through which exercise exerts its anxiolytic effects.

Methods: To ensure comprehensive coverage of relevant studies, we conducted a systematic search in databases such as PubMed, Web of Science, and Embase, combining MeSH terms with free-text terms. Keywords included “exercise,” “physical activity,” and “anxiety disorder.”

Results and conclusions: Current research widely supports exercise as a safe and effective intervention for anxiety. Both aerobic exercise and resistance training have shown significant anxiety-reducing effects across various populations. The mechanisms of action can be categorized into three main types: cellular and molecular mechanisms, systemic immune effects, and behavioral and cognitive pathways. Different forms of exercise have distinct advantages: aerobic exercise is suitable for the general population, resistance training is beneficial for individuals with coexisting physical conditions, and low-intensity exercises such as yoga and Tai Chi are suitable for pregnant women, the elderly, or postoperative recovery patients. Given its good safety profile and broad applicability, moderate exercise should be considered a first-line treatment for mild anxiety and an adjunctive intervention for moderate to severe anxiety. Future research should further clarify the mechanistic differences between various exercise modalities and promote the development of individualized exercise prescriptions.

Purpose: Normobaric hypoxia (NH) is a frequent strategy for training under hypoxic conditions that can be administered through different equipment, including face masks or hypoxic chambers/tents. Nonetheless, the versatility of administration methods may influence the outcomes.

Methods: Web of Science, Scopus, SPORTDiscus and PubMed/MEDLINE were searched to identify studies assessing the effect of NH administered by face mask or chamber/tent equipment on maximal oxygen uptake ($\dot{\text V} $O2max) after a training period. An overall meta-analysis and sub-analysis of total program session volume (low, moderate, high), participants’ training level (trained, active, sedentary), and the severity of hypoxia (moderate, severe) were conducted to explore the effects of the NH-administration system.

Results: Eighteen studies were included. Compared with normoxia, NH showed a moderate global improvement in $\dot{\text V} $O2max (standardized mean difference [SMD] ​= ​0.74; p ​= ​0.06), favoring the chamber/tent (SMD ​= ​1.30; p ​< ​0.01) over the face mask. Sub-analysis showed a very large effect in support of the hypoxic chamber/tent among sedentary individuals and training programs with a high volume of sessions. Severe hypoxia did not yield conclusive findings in $\dot{\text V} $O2max improvements, although the chamber/tent proved more effective (SMD ​= ​1.42; p ​< ​0.01) than the face mask under moderate hypoxia.

Conclusions: Chambers/ tents may slightly accentuate the benefit of NH on aerobic performance, particularly in participants with limited training experience following a high volume of sessions under moderate hypoxia. However, the variability of sub-analysis factors (session volume, participants' training level, and methodological approaches) between studies using each type of hypoxia-generating equipment may influence this result.

Purpose: This study examined potential differences in strength, muscle morphology, and motor unit (MU) behavior of the abductor digiti minimi (ADM) between normal-fat (NF) and over-fat (OF) males.

Methods: Dual-energy X-ray absorptiometry assessed percent body fat (%BF). Ultrasonography determined muscle cross-sectional area (CSA), echo intensity (EI), and subcutaneous fat (sFAT). MU behavior was assessed during isometric muscle actions at 50% of maximal voluntary contraction (MVC) by analyzing the y-intercepts and slopes for the MU action potential amplitude (MUAP_AMP) vs. recruitment threshold (RT) relationships, the A and B terms for the mean firing rate (MFR) vs. RT relationships, and normalized electromyographic amplitude (N-EMG_RMS). MU firing times and waveforms were validated with reconstruct-and-test and spike trigger average procedures.

Results: %BF was greater for OF (25.70% ​± ​5.40%) than NF (16.50% ​± ​2.20%; p < 0.001). MVC was greater for NF (27.13 ​± ​7.16) N than OF ([19.89 ​± ​4.96] N; p ​= ​0.014). CSA was greater for NF (2.48 ​± ​0.39) cm² than OF ([1.95 ​± ​0.47] cm²; p ​= ​0.011). The y-intercepts for the MUAP_AMP vs. RT relationships were greater for NF (0.283 ​± ​0.254) mV than OF ([-0.221 ​± ​0.659] mV; p ​= ​0.004). The B terms for the MFR vs. RT relationships were greater for NF (−0.024 ​± ​0.003) pps/%MVC than OF ([-0.031 ​± ​0.009] pps/%MVC; p ​= ​0.038). N-EMG_RMS was similar between groups (p ​= ​0.463).

Conclusion: Maximal strength, muscle size, and MU recruitment and firing rate patterns for a non-weight bearing muscle differed between normal-fat and over-fat males.

Background: Post- workout supplementation has been used in athletes and recreational exercisers; however, responses between normal and overweight individuals on exercise performance and muscle recovery are less known.

Methods: Normal and overweight young adult males (21 subjects/group) participated in resistance and fatiguing exercises before receiving post-workout supplements: placebo, coenzyme Q10 (CoQ10), or sports drink in a crossover design. Resistance exercises included upper body exercise (bench press, upright row, and standing shoulder press) and lower body exercise (dead lift, back squat, and front squat) at 75% of one-repetition maximum (1 RM). Fatiguing exercise was performed on a cycle ergometer with 3 ​min of all-out effort at 3.5% of body mass. Participants consumed post-workout supplements within 10 ​min of exercise completion and repeated-bout exercise was performed 1 ​h later, followed by cardiovascular responses, urinary biomarkers, and delayed onset muscle soreness (DOMS) assessments.

Results: There were effects of overweight on resistance exercise volume, critical power, fatigue index, and post-exercise diastolic blood pressure (DBP). However, no differences in urinary biomarkers of muscle damage (potassium and creatinine) or DOMS between normal and overweight individuals. After supplementation, CoQ10 and sports drink increased resistance exercise volume regardless of body mass and increased critical power in the normal group. Additionally, CoQ10 supplementation was associated with a reduction in urinary biomarkers and DOMS in both groups.

Conclusion: These findings are beneficial for sport scientists, nutritionists, and exercise physiologists in guiding post-workout supplementation with CoQ10 and sports drink to improve exercise performance and muscle recovery in normal and overweight individuals.

The purpose is to explore the effects of Exercise rehabilitation (ER) on bone mineral density (BMD) of the knee, muscle strength (MS), and physical function (PF) after ACL rupture. Finally, A total of 58 patients were randomized into 2 groups (Control Group [CON]: conventional treatment, male =16, female =13, age =[31.63 ±8.01] years; Exercise rehabilitation group [ER]: 6-week ER on CON basis, male =17, female =12, age =[31.26 ±7.07] years). At baseline and 6 weeks, the knee BMD was measured using DEXA, MS and PF measures were recorded by isokinetic strength test, IKDC, Lysholm, and VAS score. T-tests, analysis of variance (ANOVA), and Mann-Whitney tests were used for comparisons. The BMD outcomes: after a 6-week period, the BMD of the CON ([1.47 ±0.24] g ·cm^-2) was significantly lower than that of the ER ([1.65 ±0.37] g ·cm^-2) at lateral condyle of femur (LCF) (p =0.041). MS outcomes: at 6 weeks, the relative peak torque (RPT) of the quadriceps and hamstrings during concentric contractions in ER group were significantly higher than that in CON group (p <0.001, p =0.017). Similarly, during eccentric contractions in ER group, the RPT of the quadriceps and the H/Q ratio revealed significant variations from the CON group (p =0.033, p =0.043). PF outcomes: the IKDC, Lysholm, and VAS scores of the ER group were significantly improved compared to the CON group (p <0.001, p <0.001, p =0.002). The conclusion is that 6 weeks of ER intervention for patients with ACL rupture can effectively delay the decline of BMD in the LCF of the knee joint, and enhance the restoration of MS and PF. This provides guidance for clinical rehabilitation.

Background: We monitored changes in salivary creatine pre- and post-high-intensity exercise in young adults while also investigating the potential correlation between salivary and serum creatine levels.

Method: Saliva and serum samples were collected before and immediately after an incremental running-to-exhaustion treadmill test in fifteen young adults (mean age [23.9 ±2.9] years, eight females), with samples analyzed for guanidinoacetic acid, creatine, and creatinine using a liquid chromatography -tandem mass spectrometry method.

Results: Following exercise, there was a substantial elevation in salivary creatine levels from (17.5 ±14.2) μmol ·L-1 to (43.6 ±30.4) μmol ·L-1 (p < 0.001), coupled with a significant increase in salivary creatinine from (11.3 ±5.8) μmol ·L-1 to (17.0 ±9.3) μmol ·L-1 (p = 0.04). In contrast, serum creatine levels were unaffected by exercise (p = 0.80), while creatinine levels exhibited a strong tendency to decrease post-exercise (from [81.8 ±17.5] μmol ·L-1 to [73.1 ±11.6] μmol ·L-1; p = 0.06). A comparison of the slopes of the two regression lines (saliva vs. serum) revealed significant differences for both creatine (p = 0.01) and creatinine (p = 0.03).

Conclusions: The above findings suggest a potential difference in the dynamics of creatine metabolites in these two bodily fluids, both pre and post-exercise.

Purpose: This study aimed to explore the effects of a 10-week combined exercise regimen on immobilization-induced muscle atrophy and elucidate the possible function of Protein arginine methyltransferase 1 (Prmt1) in this process.

Methods: 8-week-old male C57BL/6J mice were carried out combined exercise for 10 weeks. One week before the end of the intervention, mice underwent cast immobilization. Additionally, to investigate the potential mechanism in exercise-induced protection of skeletal muscle, mice in the exercise preconditioning group were administered TC-E-5003(an inhibitor of Prmt1 enzymatic activity). Exercise performance, muscle mass, and the cross-sectional area (CSA) of muscle fibers were analyzed. Besides, Prmt1 and Sestrin1 (Sesn1) were either overexpressed or inhibited in C2C12 myotubes to elucidate the underlying mechanism.

Results: Exercise preconditioning not only significantly improved muscle mass and motor ability in immobilized mice but also inhibited excessive activation of degradation pathways and enhanced protein synthesis. Importantly, Prmt1 mediated the protective effects of exercise preconditioning on muscle atrophy. Mechanistically, Prmt1 regulated the p38 mitogen-activated protein kinase (p38)/activating transcription factor 2 (ATF2) pathway, which modulates Sesn1 expression. Sesn1 acts as a downstream of Prmt1 and ATF2, contributing to the myoblast differentiation and skeletal muscle regeneration through AMP-Activated protein kinase α2 (AMPKα2)/transcriptional co-activator PPAR-γ co-activator-1 α (PGC-1α) signaling pathway.

Conclusions: Taken together, our results highlighted the effectiveness of exercise preconditioning in preventing muscle atrophy via the Prmt1-Sesn1 pathway.

This study compared the acute effects of electrical energy transfer (TECAR) and transcutaneous electrical stimulation (TENS) on pain and flexibility after a hamstring injury. Young athletes received either a 20 min TECAR (n = 24) or TENS (n = 26) session within 5 days following a hamstring injury, while the control (CON, n = 25) group was instructed to rest. Visual analogue scale (VAS), functional Assessment Scale for Acute Hamstring Injuries (FASH), straight leg raise test (SLR), and sit-and-reach scores (STR) were obtained prior to, immediately, 24, and 48 h after therapy. Group differences were detected after therapy in VAS and FASH scores (p < 0.05). Compared to pre-therapy measurements, VAS scores showed a greater decrease in the TECAR group (-38.75% to -63.33%) than in the TENS group (-16.67% to -25.00%) and both were greater than in the CON group (-2.81% to -9.81%) (p < 0.05). The TECAR group improved FASH scores (28.57%-48.21%) more than the TENS group (15.89%-27.79%) and both groups more than the CON group (0%-8.33%) (p < 0.05). The increase in SLR and STR was greater in the TECAR group (6.26%-13.96%) than in the TENS (1.72%-9.53%) and CON groups (0%-3.03%). These results suggest that in the acute phase of hamstring injury, the use of TECAR and, to a lesser extent, TENS may relieve pain symptoms and bring some improvements in flexibility more than instructing patients to rest.

Background and purpose: Lifelong endurance exercise is generally associated with cardiovascular health benefits. However, recent studies suggest that prolonged high-volume training may contribute to coronary atherosclerosis, even in athletes with low traditional cardiovascular risk. This case report aims to explore the cardiovascular status of a master endurance athlete with an exceptionally high lifetime training volume, in light of recent concerns raised in the literature.

Methods: We present the case of a 60-year-old recreational male marathon runner with no history of cardiovascular disease, who completed over 500 marathons between the ages of 30 and 60 years, covering ~127 000-km running. In 2024 alone, he completed 60 marathons. Cardiovascular evaluation included clinical risk assessment and coronary computed tomography angiography (CTCA).

Results: The runner was asymptomatic, had a low ESC-SCORE2 (3.3%), a favorable lipid profile, and normal levels of high-sensitivity C-reactive protein and lipoprotein (a). CTCA revealed no evidence of calcified, mixed, or non-calcified coronary plaques.

Conclusions: This case highlights that some master athletes may demonstrate resilience to coronary atherosclerosis despite decades of high training volume. In low-risk individuals, prolonged endurance training alone may not necessarily lead to coronary artery disease, emphasizing the need for individualized cardiovascular screening strategies.