Wearable monitoring of muscle health across fatigue, injury and recovery in sports

Abstract

Muscle fatigue and injury are the core issues that restrict the improvement of athletes’ competitive performance and the maintenance of sports health for the general population. The traditional muscle health management paradigm is limited by lagging assessment and single indicators, failing to meet the demands of precise training and individualized rehabilitation. With the advances in wearable sensing technology, muscle health management has the potential to transform from the empirical modality to a new data-driven paradigm. However, existing publications either focus on materials innovation and structure design in sensor development, or solely highlight the overlapping physiological mechanisms inducing muscle fatigue and injury. Thus, a comprehensive review presenting insights on the physiological relevance between biological signals fluctuations and muscle health status, the detection mechanisms and functional layouts of wearable sensors to capture these signals, as well as their real-world applications in competitive sports and public fitness is timely needed. Herein, this article systematically reviews the physiological mechanisms of muscle fatigue, injury and repair, with a focus on elaborating the characteristic change patterns of related bioelectrical, biochemical and biomechanical markers in the process. Sensing mechanisms and working layouts of wearable technology are comprehensively summarized. Importantly, corresponding applications in real-world settings associated with improving professional athletic performance and public fitness are proposed, including load monitoring, fatigue evaluation, personalized nutrition management, as well as artificial intelligence (AI)-enabled multimodal fusion. Based on this, future perspectives are envisioned to better aid sports activities and engineer the development of sports science and sports medicine.

Keywords

Muscle fatigue / muscle injury and repair / wearable monitoring / sports medicine

References

[1] Smith J. A. B.,Murach K. A.,Dyar K. A.,Zierath J. R.. Exercise metabolism and adaptation in skeletal muscle Nat. Rev. Mol. Cell Biol. 2023 24 607 32 PMC10527431

[2] Egan B.,Sharples A. P.. Molecular responses to acute exercise and their relevance for adaptations in skeletal muscle to exercise training Physiol. Rev. 2023 103 2057 170

[3] Gabbett T. J.. The training-injury prevention paradox: should athletes be training smarter and harder? Br. J. Sports Med. 2016 50 273 80 PMC4789704

[4] Cheung K.,Hume P.,Maxwell L.. Delayed onset muscle soreness: treatment strategies and performance factors Sports Med. 2003 33 145 64

[5] Valle X.,Alentorn-Geli E.,Tol J. L..et al. Muscle injuries in sports: a new evidence-informed and expert consensus-based classification with clinical application Sports Med. 2017 47 1241 53

[6] Edouard P.,Reurink G.,Mackey A. L..et al. Traumatic muscle injury Nat. Rev. Dis. Primers 2023 9 56

[7] Impellizzeri F. M.,Shrier I.,McLaren S. J..et al. Understanding training load as exposure and dose Sports Med. 2023 53 1667 79 PMC10432367

[8] Martinez-Valdes E.,Negro F.,Laine C. M.,Falla D.,Mayer F.,Farina D.. Tracking motor units longitudinally across experimental sessions with high-density surface electromyography J. Physiol. 2017 595 1479 96 PMC5330923

[9] Koh A.,Kang D.,Xue Y..et al. A soft, wearable microfluidic device for the capture, storage, and colorimetric sensing of sweat Sci. Transl. Med. 2016 8 366ra165 PMC5429097

[10] Lee S. P.,Ha G.,Wright D. E..et al. Highly flexible, wearable, and disposable cardiac biosensors for remote and ambulatory monitoring NPJ Digit. Med. 2018 1 2 PMC6550217

[11] Wang R.,Shen Y.,Qian D..et al. Tensile and torsional elastomer fiber artificial muscle by entropic elasticity with thermo-piezoresistive sensing of strain and rotation by a single electric signal Mater. Horiz. 2020 7 3305 15

[12] Li Y, ; Li W, ; Sun A, ; et al. A self-reinforcing and self-healing elastomer with high strength, unprecedented toughness and room-temperature reparability Mater. Horiz. 2021 8 267 75

[13] Li C.,Wang H.,Song Z..et al. Wireless, wearable elastography via mechano-acoustic wave sensing for ambulatory monitoring of tissue stiffness Sci. Adv. 2025 11 eady0534 PMC12407073

[14] Cudejko T.,Button K.,Al-Amri M.. Wireless pressure insoles for measuring ground reaction forces and trajectories of the centre of pressure during functional activities Sci. Rep. 2023 13 14946 PMC10495386

[15] Scheltinga B. L.,Kok J. N.,Buurke J. H.,Reenalda J.. Estimating 3D ground reaction forces in running using three inertial measurement units Front. Sports Act. Living 2023 5 1176466 PMC10225635

[16] Ai Y.,Wang Z.,Liu Y..et al. Robust fiber strain sensor by designing coaxial coiling structure with mutual inductance effect Adv. Fiber Mater. 2024 6 1629 39

[17] Davis N.,Heikenfeld J.,Milla C.,Javey A.. The challenges and promise of sweat sensing Nat. Biotechnol. 2024 42 860 71

[18] Childs A.,Mayol B.,Lasalde-Ramírez J. A.,Song Y.,Sempionatto J. R.,Gao W.. Diving into sweat: advances, challenges, and future directions in wearable sweat sensing ACS Nano 2024 18 24605 16 PMC12129723

[19] Liu K.,Meng Z.,Fang Y.,Jiang H.. Conductive MOFs for electrocatalysis and electrochemical sensor eScience 2023 3 100133

[20] Yang Y.,Gao W.. Wearable and flexible electronics for continuous molecular monitoring Chem. Soc. Rev. 2019 48 1465 91

[21] Sempionatto J. R.,Lasalde-Ramírez J. A.,Mahato K.,Wang J.,Gao W.. Wearable chemical sensors for biomarker discovery in the omics era Nat. Rev. Chem. 2022 6 899 915 PMC9666953

[22] Mohamed Refai M. I.,van Beijnum B. F.,Buurke J. H.,Veltink P. H.. Portable gait lab: estimating over-ground 3d ground reaction forces using only a pelvis IMU Sensors (Basel). 2020 20 6363 PMC7664647

[23] Baker L. B.,Model J. B.,Barnes K. A..et al. Skin-interfaced microfluidic system with personalized sweating rate and sweat chloride analytics for sports science applications Sci. Adv. 2020 6 eabe3929 PMC7732194

[24] Schwiete C.,Roth C.,Mester J.,Broich H.,Behringer M.. Overlaps of skeletal muscle fatigue and skeletal muscle damage: the muscle injury continuum Sports Med. Open 2025 11 73 PMC12151979

[25] Chazaud B.. Inflammation during skeletal muscle regeneration and tissue remodeling: application to exercise-induced muscle damage management Immunol. Cell Biol. 2016 94 140 5

[26] Bestwick-Stevenson T.,Toone R.,Neupert E.,Edwards K.,Kluzek S.. Assessment of fatigue and recovery in sport: narrative review Int. J. Sports Med. 2022 43 1151 62

[27] Jorgenson K. W.,Phillips S. M.,Hornberger T. A.. Identifying the structural adaptations that drive the mechanical load-induced growth of skeletal muscle: a scoping review Cells 2020 9 1658 PMC7408414

[28] Paluch, Ł.; Nawrocka-Laskus, E.; Wieczorek, J.; Mruk, B.; Frel, M.; Walecki, J. Use of ultrasound elastography in the assessment of the musculoskeletal system Pol. J. Radiol. 2016 81 240 6 4880311

[29] Lee S. R.,Directo D.,Kang Y..et al. Effects of acute fish oil supplementation on muscle function and soreness after eccentric contraction-induced muscle damage Nutrients 2025 17 3408 PMC12608564

[30] Presland J. D.,Timmins R. G.,Maniar N..et al. Muscle activity and activation in previously strain-injured lower limbs: a systematic review Sports Med. 2021 51 2311 27 10399111

[31] Schwartz F. P.,Celes R. S.,Bottaro M.,Nascimento F. A.. Isokinetic work-to-surface electromyographic signal energy ratios as a muscular fatigue indicator Annu. Int. Conf. IEEE Eng. Med. Biol. Soc. 2009 2009 1310 3

[32] Sbriccoli P.,Felici F.,Rosponi A..et al. Exercise induced muscle damage and recovery assessed by means of linear and non-linear sEMG analysis and ultrasonography J. Electromyogr. Kinesiol. 2001 11 73 83

[33] Cifrek M.,Medved V.,Tonković S.,Ostojić S.. Surface EMG based muscle fatigue evaluation in biomechanics Clin. Biomech. (Bristol). 2009 24 327 40

[34] Sun J.,Liu G.,Sun Y.,Lin K.,Zhou Z.,Cai J.. Application of surface electromyography in exercise fatigue: a review Front. Syst. Neurosci. 2022 16 893275 PMC9406287

[35] Mu D.,Li F.,Yu L.,Du C.,Ge L.,Sun T.. Study on exercise muscle fatigue based on sEMG and ECG data fusion and temporal convolutional network PLoS ONE 2022 17 e0276921 PMC9714888

[36] Li D.,Chen C.. Research on exercise fatigue estimation method of Pilates rehabilitation based on ECG and sEMG feature fusion BMC Med. Inform. Decis. Mak. 2022 22 67 PMC8932330

[37] Yuan Y.,Cao D.,Li C.,Liu C.. Feature fusion of electrocardiogram and surface electromyography for estimating the fatigue states during lower limb rehabilitation Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2020 37 1056 64 (in Chinese)

[38] Chen S.,Xu K.,Yao X..et al. Information fusion and multi-classifier system for miner fatigue recognition in plateau environments based on electrocardiography and electromyography signals Comput. Meth. Prog. Bio 2021 211 106451

[39] Wang Y.,Chen M.,Gao Y..et al. Effect of one-time high load exercise on skeletal muscle injury in rats of different genders: oxidative stress and mitochondrial responses Acta Cir. Bras. 2022 37 e370805 PMC9746543

[40] Armstrong R. B.. Muscle damage and endurance events Sports Med. 1986 3 370 81

[41] Elustondo P. A.,White A. E.,Hughes M. E.,Brebner K.,Pavlov E.,Kane D. A.. Physical and functional association of lactate dehydrogenase (LDH) with skeletal muscle mitochondria J. Biol. Chem. 2013 288 25309 17 3757195

[42] Papadopoulos D.,Skopas V.,Trakas N..et al. Serum lactate dehydrogenase and its isoenzymes as predictors of clinical outcomes in acute exacerbation of chronic obstructive pulmonary disease: a retrospective analysis of a hospitalized cohort Monaldi Arch. Chest Dis. 2023 94 2543

[43] Cairns S. P.. Lactic acid and exercise performance: culprit or friend? Sports Med. 2006 36 279 91

[44] Haralambie G.,Berg A.. Serum urea and amino nitrogen changes with exercise duration Eur. J. Appl. Physiol. 1976 36 39 48

[45] Prylutskyy Y.,Nozdrenko D.,Omelchuk O..et al. Effect of C₆₀ fullerene on muscle injury-induced rhabdomyolysis and associated acute renal failure Int. J. Nanomedicine 2024 19 8043 58 PMC11316485

[46] Wang Y.,Liu D.,Wang S.,Li Y.,Liu G.. IBS008738, a TAZ activator, facilitates muscle repair and inhibits muscle injury in a mouse model of sport-induced injury Cytotechnology 2025 77 2 PMC11576750

[47] Brancaccio P.,Lippi G.,Maffulli N.. Biochemical markers of muscular damage Clin. Chem. Lab. Med. 2010 48 757 67

[48] Hanu G.,Thota S.,Venkat K..et al. Comparative study of microsurgical lumbar discectomy and percutaneous endoscopic lumbar discectomy based on clinical outcome and muscle injury markers J. Krishna Inst. Med. S. 2023 12 12 9 https://doaj.org/article/2fc9a4b213594359ab7d0654328c2772

[49] Manfredi T. G.,Fielding R. A.,O’Reilly K. P.,Meredith C. N.,Lee H. Y.,Evans W. J.. Plasma creatine kinase activity and exercise-induced muscle damage in older men Med. Sci. Sports Exerc. 1991 23 1028 34

[50] Mougios V.. Reference intervals for serum creatine kinase in athletes Br. J. Sports Med. 2007 41 674 8 PMC2465154

[51] Clarkson P. M.,Kearns A. K.,Rouzier P.,Rubin R.,Thompson P. D.. Serum creatine kinase levels and renal function measures in exertional muscle damage Med. Sci. Sports Exerc. 2006 38 623 7

[52] Abaïdia A. E.,Lamblin J.,Delecroix B..et al. Recovery from exercise-induced muscle damage: cold-water immersion versus whole-body cryotherapy Int. J. Sports Physiol. Perform. 2017 12 402 9

[53] Martínez-Navarro I.,Collado E.,Hernando C.,Hernando B.,Hernando C.. Inflammation, muscle damage and postrace physical activity following a mountain ultramarathon J. Sports Med. Phys. Fitness 2021 61 1668 74

[54] Reid M. B.,Lännergren J.,Westerblad H.. Respiratory and limb muscle weakness induced by tumor necrosis factor-alpha: involvement of muscle myofilaments Am. J. Respir. Crit. Care Med. 2002 166 479 84

[55] Hardin B. J.,Campbell K. S.,Smith J. D..et al. TNF-alpha acts via TNFR1 and muscle-derived oxidants to depress myofibrillar force in murine skeletal muscle J. Appl. Physiol. (1985). 2008 104 694 9

[56] Ament W.,Verkerke G. J.. Exercise and fatigue Sports Med. 2009 39 389 422

[57] Karlsen A.,Mackey A. L.,Suetta C.,Kjaer M.. What is the impact of acute inflammation on muscle performance in geriatric patients? Exp. Gerontol. 2020 138 111008

[58] Huang C.,Ogawa R.. Mechanotransduction in bone repair and regeneration FASEB J. 2010 24 3625 32

[59] Khoury V.,Guillin R.,Dhanju J.,Cardinal E.. Ultrasound of ankle and foot: overuse and sports injuries Semin. Musculoskelet. Radiol. 2007 11 149 61

[60] Guilhem G.,Doguet V.,Hauraix H..et al. Muscle force loss and soreness subsequent to maximal eccentric contractions depend on the amount of fascicle strain in vivo Acta Physiol. (Oxf). 2016 217 152 63

[61] Elmer S.,McDaniel J.,Mattson J.,Martin J.. Effect of a contusion injury on muscular force, power, work, and fatigue Scand. J. Med. Sci. Sports 2012 22 488 94

[62] Silver J. S.,Günay K. A.,Cutler A. A..et al. Injury-mediated stiffening persistently activates muscle stem cells through YAP and TAZ mechanotransduction Sci. Adv. 2021 7 eabe4501 PMC7954458

[63] Lieber R. L.,Fridén J.. Muscle damage is not a function of muscle force but active muscle strain J. Appl. Physiol. (1985). 1993 74 520 6

[64] Yanagisawa O.,Sakuma J.,Kawakami Y.,Suzuki K.,Fukubayashi T.. Effect of exercise-induced muscle damage on muscle hardness evaluated by ultrasound real-time tissue elastography Springerplus 2015 4 308 PMC4488235

[65] Kharraz Y.,Guerra J.,Mann C. J.,Serrano A. L.,Muñoz-Cánoves P.. Macrophage plasticity and the role of inflammation in skeletal muscle repair Mediators Inflamm. 2013 2013 491497 PMC3572642

[66] Alba-Jiménez C.,Moreno-Doutres D.,Peña J.. Trends assessing neuromuscular fatigue in team sports: a narrative review Sports (Basel). 2022 10 33 PMC8950744

[67] Pitzalis R.. F., Lagomarsino, B., Ceroni, I., et al. Evaluating muscle fatigue with non-invasive approaches: a review of methods, metrics, and implications IEEE Trans. Neural Networks Learn. Syst. 2025 33 2707 23

[68] Smith C.,Kruger M. J.,Smith R. M.,Myburgh K. H.. The inflammatory response to skeletal muscle injury: illuminating complexities Sports Med. 2008 38 947 69

[69] Jaén-Carrillo D.,Pérez-Castilla A.,García-Pinillos F.. Wearable and portable devices in sport biomechanics and training science Sensors (Basel). 2024 24 4616 PMC11280876

[70] Isern-Kebschull J.,Mechó S.,Pedret C..et al. Muscle healing in sports injuries: MRI findings and proposed classification based on a single institutional experience and clinical observation Radiographics 2024 44 e230147

[71] Michaud F.,Pérez Soto M.,Lugrís U.,Cuadrado J.. Lower back injury prevention and sensitization of hip hinge with neutral spine using wearable sensors during lifting exercises Sensors (Basel). 2021 21 5487 PMC8402067

[72] Assalve G.,Lunetti P.,Di Cagno A..et al. Advanced wearable devices for monitoring sweat biochemical markers in athletic performance: a comprehensive review Biosensors 2024 14 574 PMC11674680

[73] Alvarez J. T.,Gerez L. F.,Araromi O. A..et al. Toward soft wearable strain sensors for muscle activity monitoring IEEE Trans. Neural Syst. Rehabil. Eng. 2022 30 2198 206 PMC9421605

[74] Zhang W.,Bai Z.,Yan P.,Liu H.,Shao L.. Recognition of human lower limb motion and muscle fatigue status using a wearable FES-sEMG system Sensors (Basel). 2024 24 2377 PMC11014134

[75] Jia W.,Bandodkar A. J.,Valdés-Ramírez G..et al. Electrochemical tattoo biosensors for real-time noninvasive lactate monitoring in human perspiration Anal. Chem. 2013 85 6553 60

[76] Anastasova S.,Crewther B.,Bembnowicz P..et al. A wearable multisensing patch for continuous sweat monitoring Biosens. Bioelectron. 2017 93 139 45

[77] Meng L.,Liu S.,Borsa B. A.,Eriksson M.,Mak W. C.. A conducting polymer-based array with multiplex sensing and drug delivery capabilities for smart bandages Commun. Mater. 2024 5 28

[78] Vaquer, A., Baron, E., de la Rica, R. Dissolvable polymer valves for sweat chrono-sampling in wearable paper-based analytical devices ACS Sensors 2022 7 488 94

[79] Tardy A. L.,Pouteau E.,Marquez D.,Yilmaz C.,Scholey A.. Vitamins and minerals for energy, fatigue and cognition: a narrative review of the biochemical and clinical evidence Nutrients 2020 12 228 PMC7019700

[80] Zhu Y.,Sun S.,Yin X.,Liu Y.,Yang W.,Chen Y.. Carbon nanotube-gold nanoparticle-based self-powered electrochemical biosensors for highly sensitive and stable detection of myoglobin ACS Appl. Nano Mater. 2023 6 11085 94

[81] Lee J.,Oh Y.,Kim H.,Lee S.,Park H. G.. Personal glucose meter-based portable method for creatine kinase assay Biosens. Bioelectron. X 2025 22 100575

[82] Elango P. F. M.,Perera G.,Yang M..et al. Multiplexed cutaneous wound monitor for point-of-care applications Adv. NanoBiomed Res. 2025 5 2500142

[83] Giorgi-Coll S.,Marín M. J.,Sule O.,Hutchinson P. J.,Carpenter K. L. H.. Aptamer-modified gold nanoparticles for rapid aggregation-based detection of inflammation: an optical assay for interleukin-6 Mikrochim. Acta 2019 187 13 PMC6892788

[84] Lee S.,Ho D. H.,Jekal J..et al. Fabric-based lamina emergent MXene-based electrode for electrophysiological monitoring Nat. Commun. 2024 15 5974 PMC11446925

[85] Hsu Y.,Lu Y.,Wang T..et al. An ultra-compliant P(VDF-TrFE) fiber-based muscle patch sensor for a new wearable application: monitoring muscle activities and fatigue through the peripheral length of a muscle’s physiological cross-sectional area Sensor. Actuat. A-Phys. 2025 393 116823

[86] Song E.,Xie Z.,Bai W..et al. Miniaturized electromechanical devices for the characterization of the biomechanics of deep tissue Nat. Biomed. Eng. 2021 5 759 71

[87] Yu X.,Wang H.,Ning X..et al. Needle-shaped ultrathin piezoelectric microsystem for guided tissue targeting via mechanical sensing Nat. Biomed. Eng. 2018 2 165 72

[88] Liu H. C.,Zeng Y.,Gong C..et al. Wearable bioadhesive ultrasound shear wave elastography Sci. Adv. 2024 10 eadk8426 PMC10857377

[89] Wang Y.,Henderson J.,Hafiz P..et al. Near-infrared spectroscopy-enabled electromechanical systems for fast mapping of biomechanics and subcutaneous diagnosis Sci. Adv. 2024 10 eadq9358 PMC11559610

[90] Farina D.,Enoka R. M.. Evolution of surface electromyography: from muscle electrophysiology towards neural recording and interfacing J. Electromyogr. Kinesiol. 2023 71 102796

[91] Cheng L.,Li J.,Guo A.,Zhang J.. Recent advances in flexible noninvasive electrodes for surface electromyography acquisition NPJ Flex. Electron. 2023 7 39

[92] Tacca N.,Dunlap C.,Donegan S. P..et al. Wearable high-density EMG sleeve for complex hand gesture classification and continuous joint angle estimation Sci. Rep. 2024 14 18564 PMC11316006

[93] Meyers E. C.,Gabrieli D.,Tacca N..et al. Decoding hand and wrist movement intention from chronic stroke survivors with hemiparesis using a user-friendly, wearable EMG-based neural interface J. Neuroeng. Rehabil. 2024 21 7

[94] Moin A.,Zhou A.,Rahimi A..et al. An EMG gesture recognition system with flexible high-density sensors and brain-inspired high-dimensional classifier. In 2018 IEEE International Symposium on Circuits and Systems (ISCAS), Florence, May 27-30, 2018; IEEE, 2018, pp 1-5

[95] Resnik L.,Huang H. H.,Winslow A.,Crouch D. L.,Zhang F.,Wolk N.. Evaluation of EMG pattern recognition for upper limb prosthesis control: a case study in comparison with direct myoelectric control J. Neuroeng. Rehabil. 2018 15 23 PMC5856206

[96] Rea M. S.,Nagare R.,Figueiro M. G.. Modeling circadian phototransduction: quantitative predictions of psychophysical data Front. Neurosci. 2021 15 615322 PMC7893103

[97] Enoka R. M.,Duchateau J.. Rate coding and the control of muscle force Cold Spring Harb. Perspect. Med. 2017 7 a029702 PMC5629984

[98] Qiu C.,Wu F.,Han W.,Yuce M. R.. A wearable bioimpedance chest patch for real-time ambulatory respiratory monitoring IEEE Trans. Biomed. Eng. 2022 69 2970 81

[99] Stupin D. D.,Kuzina E. A.,Abelit A. A..et al. Bioimpedance spectroscopy: basics and applications ACS Biomater. Sci. Eng. 2021 7 1962 86

[100] Bayoumy K.,Gaber M.,Elshafeey A..et al. Smart wearable devices in cardiovascular care: where we are and how to move forward Nat. Rev. Cardiol. 2021 18 581 99 PMC7931503

[101] Peabody J. E.,Ryznar R.,Ziesmann M. T.,Gillman L.. A systematic review of heart rate variability as a measure of stress in medical professionals Cureus 2023 15 e34345 PMC9974008

[102] Johnstone J. A.,Ford P. A.,Hughes G.,Watson T.,Garrett A. T.. Bioharness(^TM) multivariable monitoring device: part. I: validity J. Sports Sci. Med. 2012 11 400 8 PMC3737934

[103] Khalili M.,GholamHosseini H.,Lowe A.,Kuo M. M. Y.. Motion artifacts in capacitive ECG monitoring systems: a review of existing models and reduction techniques Med. Biol. Eng. Comput. 2024 62 3599 622 PMC11568998

[104] Van Doornik D. M.,Berejikian B. A.,Claiborne A. M.. Genetic monitoring of a long-term, large-scale experimental steelhead supplementation program PLoS ONE 2025 20 e0339458 PMC12721512

[105] Pickart L.,Margolina A.. Regenerative and protective actions of the GHK-Cu peptide in the light of the new gene data Int. J. Mol. Sci. 2018 19 1987 PMC6073405

[106] Brancaccio A.,Tabarelli D.,Bigica M.,Baldauf D.. Cortical source localization of sleep-stage specific oscillatory activity Sci. Rep. 2020 10 6976 PMC7181624

[107] Zhong S.,Jia N.,Qu Y..et al. Analysis and study on biomarkers of local muscle fatigue caused by repetitive lifting task BMC Musculoskelet. Disord. 2024 25 660 PMC11342632

[108] Deng Y. T.,You J.,He Y..et al. Atlas of the plasma proteome in health and disease in 53,026 adults Cell 2025 188 253 271.e7

[109] Gao F.,Liu C.,Zhang L..et al. Wearable and flexible electrochemical sensors for sweat analysis: a review Microsyst. Nanoeng. 2023 9 1 PMC9805458

[110] Evert B.,Peterson K. L.,Songkakul T.,Bozkurt A.,Daniele M. A.. Multimodal wearable platform with simultaneous electrochemical and biophotonic sensing ACS Sens. 2025 10 5495 507

[111] Zhou S.,Zhong Q.,Wang Y..et al. Chemically engineered mesoporous silica nanoparticles-based intelligent delivery systems for theranostic applications in multiple cancerous/non-cancerous diseases Coord. Chem. Rev. 2022 452 214309

[112] Wu T.,Liu G.. Non-invasive wearables in inflammation monitoring: from biomarkers to biosensors Biosensors 2025 15 351 PMC12190971

[113] Bandodkar A. J.,Jeang W. J.,Ghaffari R.,Rogers J. A.. wearable sensors for biochemical sweat analysis Annu. Rev. Anal. Chem. (Palo Alto. Calif). 2019 12 1 22

[114] Ibáñez-Redín G.,Rosso Cagnani G.,O Gomes N..et al. Wearable potentiometric biosensor for analysis of urea in sweat Biosens. Bioelectron. 2023 223 114994

[115] Chen H.,Zhao L.,Dong W..et al. Spatiotemporal variation of mortality burden attributable to heatwaves in China, 1979-2020 Sci. Bull. (Beijing). 2022 67 1340 4

[116] Mei X.,Yang J.,Liu J.,Li Y.. Wearable, nanofiber-based microfluidic systems with integrated electrochemical and colorimetric sensing arrays for multiplex sweat analysis Chem. Eng. J. 2023 454 140248

[117] Xiao P.,Yun X.,Chen Y..et al. Insights into the solvation chemistry in liquid electrolytes for lithium-based rechargeable batteries Chem. Soc. Rev. 2023 52 5255 316

[118] Kim G.,Ahn H.,Chaj Ulloa J.,Gao W.. Microneedle sensors for dermal interstitial fluid analysis Med. X. 2024 2 15 PMC11445365

[119] Hayes E. J.,Stevenson E.,Sayer A. A.,Granic A.,Hurst C.. Recovery from resistance exercise in older adults: a systematic scoping review Sports Med. Open 2023 9 51 PMC10317890

[120] Fishbein A. B.,Knutson K. L.,Zee P. C.. Circadian disruption and human health J. Clin. Invest. 2021 131 e148286 8483747

[121] Pan X. F.,Wang L.,Pan A.. Epidemiology and determinants of obesity in China Lancet. Diabetes Endocrinol. 2021 9 373 92 12054858

[122] Wu Z.,Qiao Z.,Chen S..et al. Interstitial fluid-based wearable biosensors for minimally invasive healthcare and biomedical applications Commun. Mater. 2024 5 33

[123] Stoffel E. M.,Brand R. E.,Goggins M.. Pancreatic cancer: changing epidemiology and new approaches to risk assessment, early detection, and prevention Gastroenterology 2023 164 752 65 PMC10243302

[124] Brancaccio P.,Maffulli N.,Limongelli F. M.. Creatine kinase monitoring in sport medicine Br. Med. Bull. 2007 81-82 209 30

[125] Haller N.,Behringer M.,Reichel T..et al. Blood-based biomarkers for managing workload in athletes: considerations and recommendations for evidence-based use of established biomarkers Sports Med. 2023 53 1315 33 PMC10197055

[126] Wang Z.,Luan J.,Seth A..et al. Microneedle patch for the ultrasensitive quantification of protein biomarkers in interstitial fluid Nat. Biomed. Eng. 2021 5 64 76 PMC8020465

[127] Gao Y.,Nguyen D. T.,Yeo T..et al. A flexible multiplexed immunosensor for point-of-care in situ wound monitoring Sci. Adv. 2021 7 PMC8139589

[128] Agustí A.,Hogg J. C.. Update on the pathogenesis of chronic obstructive pulmonary disease N. Engl. J. Med. 2019 381 1248 56

[129] Stark T.,Walker B.,Phillips J. K.,Fejer R.,Beck R.. Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: a systematic review PM R. 2011 3 472 9

[130] Huang L.,Liu Y.,Lin T..et al. Reliability and validity of two hand dynamometers when used by community-dwelling adults aged over 50 years BMC Geriatr. 2022 22 580 PMC9284760

[131] Garrett S.,Jenkinson T.,Kennedy L. G.,Whitelock H.,Gaisford P.,Calin A.. A new approach to defining disease status in ankylosing spondylitis: the bath ankylosing spondylitis disease activity index J. Rheumatol. 1994 21 2286 91

[132] Lang S.,Yang J.,Zhang Y..et al. Application of wearable insole sensors in in-place running: estimating lower limb load using machine learning Biosensors 2025 15 83 PMC11853649

[133] Knihs D. A.,Zimmermann H. B.,Pupo J. D.. Acute and delayed effects of fatigue on ground reaction force, lower limb stiffness and coordination asymmetries during a landing task J. Hum. Kinet. 2021 76 191 9 PMC7877279

[134] Sun Q.,Yu D.,Fan J..et al. China Kadoorie Biobank Collaborative Group. Healthy lifestyle and life expectancy at age 30 years in the Chinese population: an observational study Lancet. Public Health 2022 7 e994 e1004 7615002

[135] Tsuchida W.,Yamakoshi Y.,Matsuo S..et al. Application of the novel estimation method by shear wave elastography using vibrator to human skeletal muscle Sci. Rep. 2020 10 22248 PMC7747727

[136] Ohiri K. A.,Pyles C. O.,Hamilton L. H..et al. E-textile based modular sEMG suit for large area level of effort analysis Sci. Rep. 2022 12 9650 PMC9187645

[137] Pinelli S.,Mandorino M.,Lacome M.,Fantozzi S.. Evaluation of WIMU sensor performance in estimating running stride and vertical stiffness in football training sessions: a comparison with smart insoles Sensors (Basel). 2024 24 8087 PMC11679392

[138] Oubre B.,Lane S.,Holmes S.,Boyer K.,Lee S. I.. Estimating ground reaction force and center of pressure using low-cost wearable devices IEEE Trans. Biomed. Eng. 2022 69 1461 8 8986131

[139] Moraes J. L.,Rocha M. X.,Vasconcelos G. G.,Vasconcelos Filho J. E.,de Albuquerque V. H. C.,Alexandria A. R.. Advances in photopletysmography signal analysis for biomedical applications Sensors (Basel). 2018 18 1894 PMC6022166

[140] Imani S.,Bandodkar A. J.,Mohan A. M..et al. A wearable chemical-electrophysiological hybrid biosensing system for real-time health and fitness monitoring Nat. Commun. 2016 7 11650 PMC4879240

[141] Resnik L.,Huang H.,Winslow A.,Crouch D. L.,Zhang F.,Wolk N.. Evaluation of EMG pattern recognition for upper limb prosthesis control: a case study in comparison with direct myoelectric control J. NeuroEngineering. Rehabil. 2018 15 23 PMC5856206

[142] Wang Z.,Fu Y.,Bu T..et al. A soft on-skin sensor simultaneously capturing bioelectrical and biomechanical signals for muscle spasticity detection and assessment Adv. Funct. Mater. 2025 36 e23580

[143] Gao W.,Emaminejad S.,Nyein H. Y. Y..et al. Fully integrated wearable sensor arrays for multiplexed in situ perspiration analysis Nature 2016 529 509 14 PMC4996079

[144] He X.,Fan C.,Luo Y.,Xu T.,Zhang X.. Flexible microfluidic nanoplasmonic sensors for refreshable and portable recognition of sweat biochemical fingerprint NPJ Flex. Electron. 2022 6 60

[145] Mascharak S.,Griffin M.,Talbott H. E..et al. Inhibiting mechanotransduction prevents scarring and yields regeneration in a large animal model Sci. Transl. Med. 2025 17 eadt6387 PMC12893899

[146] McNamara S. L.,Seo B. R.,Freedman B. R..et al. Anti-inflammatory therapy enables robot-actuated regeneration of aged muscle Sci. Robot. 2023 8 eadd9369 PMC10328427

[147] Alisafaei F.,Shakiba D.,Hong Y..et al. Tension anisotropy drives fibroblast phenotypic transition by self-reinforcing cell-extracellular matrix mechanical feedback Nat. Mater. 2025 24 955 65 PMC12368865

[148] Chen J.,Wang X.,Li Q.,Shen B.,Tao X.. Wearable multimodal sensing platform for contraction and fatigue transition monitoring of biceps in motion using machine learning Sensor. Actuat. A-Phys. 2025 396 117127

[149] Westerblad H.,Bruton J. D.,Katz A.. Skeletal muscle: energy metabolism, fiber types, fatigue and adaptability Exp. Cell Res. 2010 316 3093 9

[150] Hostrup M.,Deshmukh A. S.. Fiber type-specific adaptations to exercise training in human skeletal muscle: lessons from proteome analyses and future directions Scand. J. Med. Sci. Sports 2025 35 e70059 PMC12031692

[151] Sempionatto J. R.,Montiel V. R.,Vargas E.,Teymourian H.,Wang J.. Wearable and Mobile Sensors for Personalized Nutrition ACS Sens. 2021 6 1745 60 8983331

[152] Yu D.,Zhu Z.,Sheng Q..et al. Multimodal wearable sensing for biomechanics and biomolecules enabled by the M-MPM/VCFs@Ag interface with machine learning pipeline ACS Sens. 2025 10 4307 17

[153] S. Bai, J. Z. Kolter, V. J. A. Koltun, An empirical evaluation of generic convolutional and recurrent networks for sequence modeling. arXiv 2018;arXiv:1803.01271. Available online: https://doi.org/10.48550/arXiv.1803.01271. [accessed 13 April 2026]

[154] Foltynie T.. Scaling up GMP-grade dopaminergic cells for Parkinson’s disease Cell Stem Cell 2024 31 5 6

[155] Bradford J. C.,Tweedell A.,Leahy L.. High-density surface and intramuscular EMG data from the tibialis anterior during dynamic contractions Sci. Data 2023 10 434 PMC10326057

[156] Celik Y.,Godfrey A.. Bringing it all together: wearable data fusion NPJ Digit. Med. 2023 6 149 PMC10435508