(1) Background: Conventional strength training and core exercises are commonly prescribed to improve cycling performance. Although previous studies have explored the utility of strength training in various cycling populations, this intervention has never been compared to core exercises; (2) Methods: 36 trained road cyclists were divided in 3 groups of 12 participants that performed either no strength training, conventional strength training or core exercises, in all cases together with their regular cycling training during a 12-week period. Peak power outputs across different durations (5 seconds, 60 seconds, 5 minutes, and 20 minutes) were recorded before and after the intervention; (3) Results: Conventional strength training is superior to core training and no strength training for all measured durations. At the same time, core training results in improved 5 second power output when compared to no strength training, while all the other measures are comparable among groups; (4) Conclusions: Conventional strength training is superior to core exercises and no strength training in trained road cyclists, and accordingly, it is recommended that this population incorporates strength training during their regular weekly workouts.

Exercise can ameliorate cardiovascular dysfunctions in diabetes condition, but its precise molecular mechanisms have not been entirely understood. The aim of the present study was to determine the impact of endurance training on expression of angiogenesis-related genes in cardiac tissue of diabetic rats. Thirty adults male Wistar rats were randomly divided into three groups (N=10) including diabetic training (DT), sedentary diabetes (SD), and sedentary healthy (SH) in which diabetes was induced by a single dose of streptozotocin (30 mg/kg). Endurance training (ET) with moderate-intensity was performed on a motorized treadmill for six weeks. Training duration and treadmill speed were increased during five weeks, but they were kept constant at the final week and slope was zero at all stages. Real-time polymerase chain reaction (RT- PCR) analysis was used to measure the expression of myocyte enhancer factor-2C (MEF2C), histone deacetylase-4 (HDAC4) and Calmodulin-dependent protein kinase II (CaMKII) in cardiac tissues of the rats. Our results demonstrated that six weeks of ET increased gene expression of MEF2C significantly (P<0.05), and caused a significant reduction in HDAC4 and CaMKII gene expression in the DT rats compared to the SD rats (P<0.05). We concluded that moderate-intensity ET could play a critical role in ameliorating cardiovascular dysfunction in a diabetes condition by regulating the expression of some angiogenesis-related genes in cardiac tissues.

Background: Knee joint is a common site for injury among younger people, the purpose of this study is to measure the skeletal muscle endurance and strength on people with prior knee reconstruction surgery. Methods: Young healthy female subjects were tested who reported having knee reconstruction surgery of over one year prior to testing. The skeletal muscle endurance index of the hamstring and quadriceps muscles was determined as the decline in the specific muscle acceleration in response to 2, 4, and 6 Hz electrical stimulation. Maximal isometric muscle strength (MVC) was measured in the hamstring and quadriceps muscles. Results: The hamstring muscles in the affected leg had less endurance than the non-affected leg at 6 Hz stimulation (55.5 ± 13.2% versus 78.0 ± 13.3%, P = 0.01). Muscle endurance was not reduced in the quadriceps muscles in the affected leg compared to the non-affected leg at 6 Hz stimulation (78.0 ± 13.3% versus 80.3 ± 10.0%, P = 0.69). There were no differences in MVC between the affected and non-affected legs for either the hamstring (P= 0.20) or quadriceps muscles (p = 0.67). Conclusions: Muscle endurance is reduced in the hamstring muscles at least one-year post injury, while hamstring strength is not. Reduced hamstring muscle endurance could be a result of a lack of focus on muscle endurance during rehabilitation after injury and may contribute to re-injury in the particular muscle even in people who have recovered muscle strength.

This study investigated the impact of six high-intensity interval training (HIIT) running sessions at 1% or 10% slope on various physiological and performance parameters in 25 men. The partic-ipants underwent assessments of VO2max, time to exhaustion at 1% slope (TLim1%), and time to exhaustion at 10% slope (TLim10%) in the initial three visits. They were then randomly assigned to control (CON), HIIT at 1% slope (GT1%), or HIIT at 10% slope (GT10%) groups. Over three weeks, participants performed six HIIT sessions with equalized workload based on their indi-vidual maximal oxygen uptake (vVO2max). The sessions comprised 50% of TLim, with a 1:1 ratio of exercise to recovery at 50% vVO2max. Results indicated significant improvements in VO2max and peak velocity (VPeak) after HIIT at both slopes. Heart rate (HR) behavior differed between sessions for GT1%, while no significant differences were observed for GT10%. Rating of perceived exertion (RPE) significantly reduced for GT1% after the third session, with a similar trend for GT10%. In summary, six sessions of 1% or 10% slope HIIT effectively enhanced VO2max and VPeak, but there was no improvement in TLim performance, suggesting no adaptive transfer between training groups.

The paper introduces a valuable new description of fatigue strength in relation to material properties and thus a new perspective on the overall understanding of the fatigue process. Namely, a relation between the endurance limits and the accompanying values of the critical resolved shear stress (CRSS) for various metallic materials has been discovered by means of a multiscale approach for fatigue simulation. Based on the uniqueness of the relation, there is a strong indication that it is feasible to relate the endurance limit to the CRSS, and not to the ultimate strength as often done in the past.

The effectiveness of combining strength-specific training with endurance training to enhance the performance of endurance runners remains uncertain. This study aimed to analyze effect of practising maximum-strength (MAX), explosive strength (EXP) or both combined (COMB) on seven runners’ performance-indicators: vertical jump (VJ), one-repetition-maximum-squat (1RM), peak-velocity/peak-running-speed (PV), lactate-threshold (over incremental-test-protocols, LT), middle-distance-time-trial (TT), maximum-oxygen-consumption (VO2max), running-economy (RE). Systematic-review (Scopus, Wed of Science, Sports Discuss, PubMed) with meta-analysis was conducted following PRISMA standards. Inclusion-criteria (PICOS) were: recreational or well-trained athletes aged 18-45 performing concurrent-training ≥five-week. Used search-terms were related to different types of strength/endurance, participants’ age, sport-modality. 20 manuscripts were selected, quality-assessed with PEDro. MAX training is more effective than EXP, COMB in improving VJ, 1RM, PV, while COMB is more effective than MAX, EXP to enhance TT. MAX is more effective than EXP in improving LT. Concurrent-workouts do not provide additional benefits to VO2max. It is unknown which strength-modality (MAX, EXP or COMB) is more effective in improving RE. Concurrent-training is more effective than single-mode-endurance-training for enhancing specific performance-variables in adult-endurance-runners. Middle-, long-distance-runners may consider incorporating MAX-training to target specific goals, e.g., improving VJ, 1RM, LT, PV while utilizing COMB-training to enhance TT. Certain variables may benefit from EXP. New randomized-controlled-trials are required to confirm these findings.

(1) Background: Ultra-endurance exercise involves a high physical impact, resulting in muscle damage, inflammatory response and production of free radicals that alter the body's oxidative state. Supplementation with antioxidants, such as beetroot, may improve recovery in ultra-endurance runners. The aim of this study was to determine whether there is a correlation between the beetroot intake and the recovery of serum oxidative status, inflammatory response and muscle damage parameters after an ultra-endurance race. (2) Methods: An observational and longitudinal study was conducted by means of surveys and blood samples collected from 32 runners during the IX Penyagolosa Trails CSP® race and the two following days. The variables C-reactive protein (CRP), lactate dehydrogenase (LDH), creatine kinase (CK), the activity of the antioxidant enzymes glutathione peroxidase (GPx) and glutathione reductase (GR), as well as the oxidative damage markers malondialdehyde (MDA), carbonyl groups (CG) and loss of muscle strength using the Squat Jump test (SJ) were analyzed to discriminate whether beetroot consumption can modulate the recovery of ultra-trail runners. (3) Results: Significant differences were observed between runners who ingested beetroot and those who did not, in terms of oxidative status, specifically in serum GPx activity at 24 and 48 hours, muscle damage variables CK and LDH and in SJ test at the finish line. Therefore, the intake of supplements containing beetroot positively influences the recovery of serum oxidative status and muscle damage after ultra-endurance running.

External motivational stimuli have been shown to improve athletic performance. However, the neurophysiological mechanisms underlying this improvement remain poorly understood. This randomized crossover study investigated the effects of music and verbal encouragement on measures of muscle excitation and myoelectric manifestations of fatigue in the biceps brachii (BB) and brachioradialis (BR) muscles during an endurance task. Fifteen untrained (mean age 29.57 ± 2.77 years) and 13 trained individuals (mean age 32.92 ± 2.90 years) were included. The endurance task, performed to exhaustion, consisted of keeping the dominant arm flexed to 90 degrees while holding a dumbbell loaded to 80% of 1RM with a supine grip in three randomized conditions: standard, with self-selected music, and with verbal encouragement. The untrained subjects showed an increase in task duration of 15.26% (p < 0.003) with music and 15.85% (p < 0.002) with verbal encouragement compared to the condition without external stimuli. There were no significant differences in the myoelectric manifestations of fatigue between the dif-ferent conditions. Regarding the muscle excitation metrics, although the mean amplitude, peak value and area under the curve remained unchanged across conditions, a significant reduction in the trend coefficient, indicating motor unit recruitment over time, was observed with both music (BB: -10.39%, p < 0.001; BR: -9.40%, p < 0.001) and verbal encouragement (BB: -7.61%, p < 0.001; BR: -6.51%, p < 0.001) compared to the standard condition. For the trained participants, no significant differences were observed between conditions in terms of task duration and outcome measures related to muscle excitation and myoelectric manifestations of fatigue, suggesting the possible presence of a ceiling effect on motivation. These results highlight the significant role of external motivational stimuli, such as music and verbal encouragement, in improving task performance in untrained subjects, probably through more ef-fective and efficient recruitment of motor units.

The research deals with the particularities of the initiation in the sport of kin ball, of 94 students (54 boys and 40 girls), without a history of practicing the sport intensively, and the measure of the influence of some components of the motor capacity. Kin ball is a sport that appeared in Canada, in an academic setting and can become an alternative sport in the common university curricula in Romania. The research was carried out in 4 research groups in 2019 and 2022, two of boys and two of girls, similarly, before and after the declaration of the acute phase of the Covid-19 Pandemic, generating physical activity constraints. The originality of the research refers to the initiation, unprecedented in Romania, in the Kin ball sport, through 20 training sessions, carried out in 10-day stages and the evaluation of some motor skills on the subjects. During the experiment, the following components were tested pre- and post-intervention Kin-Ball: palmar muscle strength using the dynamometer, general resistance by running as long as possible for 2 min and general coordination function - body balance, by the Matorin test. The statistical calculation included the application of the Kolmogorov-Smirnov test, depending on which parametric or non-parametric statistical significance tests were applied and the estimation of the size of the intervention effect. The results highlighted particularities of initiation in Kin ball, but also significant differences (p<0.05) in all measurements performed in 2022. The tests in 2019 recorded both significant and statistically insignificant differences, also highlighted by the calculation of the d indicator of to Cohen. The lower initial level of all motor components measured in 2022 and their significant improvement represent aspects that can be understood as collateral effects of the lack of movement during the pandemic.

The need to carry different items, which become an extra load, is a characteristic of trail running. The aim of this study is to determine physiological-metabolic changes produced by running with extra load. Four male well-trained trail runners completed three treadmill maximal metabolic tests carrying different loads (0% (L0), 5% (L5), and 10% (L10) of their body mass) in a weighted vest. Gasses exchange was monitored to assess ventilatory thresholds 1 (VT1), and 2 (VT2), zone of maximal fat oxidation, and peak oxygen consumption (VO2peak). Heart rate (HR), power and velocity (V) were tracked for comparing their behavior. A repeated measures ANOVA showed significant differences in V (p&lt;.001; ηp2= 0.910) as a limitation for reaching peak velocity (Vpeak) with L10 respect to L0 (p=0.001), and L5 (p=0.011). Power expression showed differences (p=0.068; ηp2= 0.592). It tended to be greater with L10 than L0 (p=0.057), despite achieving lower V. VT2 tended to occur at different %VO2peak (p=0.069; ηp2= 0.591). L5 VT2 was reached at higher %VO2peak than L0 (p=0.062), and L10 (p=0.071). ANOVA also showed a tendency to signification for V at this point (p= 0.098; ηp2= 0.538). In conclusion, L10 seems to limit Vpeak while L5 may delay VT2 expression.

The use of isolated supplements to enhance performance is widespread among athletes. The aim of this study was to increase knowledge about the combined effects of caffeine and New Zealand blackcurrant (NZBC) dietary supplements. In this study, two subjects each underwent four phases of four sessions in a double-blind and randomized alternating treatment single-case design. After a 3-week pre-test phase, the supplement combinations of placebo/placebo, caffeine/placebo (5 mg/kg), NZBC/placebo (600 mg), and caffeine/NZBC (5 mg/kg + 600 mg) were taken and weekly performance tests were conducted to examine their effects on relative power (W/kg) during a 20-minute time trial on a bicycle. Data were analyzed descriptively and using the Tau-U calculator from Single Case Research. The ergogenic effect of caffeine was confirmed in both subjects, with increases of 3.3% and 6.5%, while the positive effect of NZBC on performance was only seen in one subject (13.4%). The combination of caffeine and NZBC again increased performance in both subjects (2.2% and 19.2%), but the data only showed an additive effect of the supplements in one subject. Further studies are required to confirm or refute this evidence of the synergistic effects of these supplements.

Branched-chain amino acid (BCAA) levels are associated with skeletal muscle cross-sectional area (CSA). Serum BCAA levels are enhanced by whey protein supplementation (WPS), and evidence in clinical populations suggests an association of single nucleotide polymorphisms (SNPs) with BCAA metabolite levels. It is not known whether the same SNPs are associated with the ability to catabolise BCAAs from exogenous sources, such as WPS. The present study investigated whether possessing a higher number of alleles associated with increased BCAA metabolites correlates with muscle fiber CSA of m. vastus lateralis in physically active participants, and whether any relationship is enhanced by WPS. Endurance-trained participants (n=75) were grouped by self-reported habitual WPS consumption and genotyped for 5 SNPs (PPM1K rss1440580, APOA5 rs2072560, CBLN1 rs1420601, DDX19B rs12325419, TRMT61A rs58101275). Body mass, BMI and fat percentage were significantly lower and muscle mass higher in the WPS group (n=22) compared to Non-WPS (n=53). The number of BCAA-increasing alleles was correlated with fiber CSA in the WPS group (r=0.75, p&lt;0.0001) and was stronger for fast-twitch fibers (p=0.001) than slow-twitch fibers (p=0.048). Similar results remained when corrected for multiple covariates (age, physical activity, meat and dairy intake). No correlation was found in the Non-WPS group. This study presents novel evidence of a positive relationship between BCAA-increasing alleles and muscle fiber CSA in athletes habitually consuming WPS. We suggest that a high number of BCAA-increasing alleles improves the efficiency of WPS by stimulation of muscle protein synthesis, and contributes to greater fiber CSA.

Introduction: The Elevation Training Mask 2.0 (ETM) has been introduced as a novel tool to allow for respiratory muscle training and altitude exposure during exercise that can improve performance and hematological markers in elite and well-trained athletes. Thus, the aim of the present study was to assess the effect of wearing ETM while training on erythropoietin (EPO), vascular endothelial growth factor (VEGF), peak oxygen consumption (VO2max), lactate, and 1000-m kayaking performance in elite Kayaking girls. Methods: Thirty elite Kayaking girls (14 to 18-year-old) were equally and randomly assigned into mask, no mask, and control groups. The mask and no-mask groups completed 8 weeks of repeated sprint training, while the control group performed their routine kayaking training programs. Pre- and post-training tests included EPO, VEGF, VO2max, lactate, and 1000-m kayaking performance. Results: 1000-m time trial significantly decreased for mask (p < 0.001) and control (p = 0.035) groups, and was significantly lower in mask group than control (p = 0.014) and no mask (p = 0.009) groups. EPO did not show any significant changes for all groups. VEGF was increased significantly for mask (p = 0.04) and no mask (p = 0.014) groups. Lactate was decreased significantly for mask group (p = 0.025). VO2max increased significantly for no mask group (p = 0.021). Conclusion: Wearing the ETM while participating in 8 weeks of repeated sprint training might improve specific blood markers and endurance performance, especially anaerobic pathways. Performing repeated sprint training while wearing ETM has the potential to enhance performance in Kayak racing.

2S-hesperidin is a flavanone (flavonoid) found in high concentrations in citrus fruits. It has an antioxidant and anti-inflammatory effect, improving performance in animals. This study investigated the effects of chronic intake of an orange extract (2S-hesperidin) or placebo on aerobic-anaerobic and metabolic performance markers in amateur cyclists. A double-blind, randomized, placebo-controlled trial was carried out between late September and December 2018. Forty amateur cyclists were randomized into two groups: one taking 500mg/day 2S-hesperidin and other taking 500 mg/day placebo (microcellulose) for 8 weeks. All participants completed the study. Performance and metabolic aerobic-anaerobic markers were measured using incremental and rectangular tests by indirect calorimetry. The anaerobic power was determined using Wingate tests. After 8 weeks supplementation, there was a significant increase in the incremental test in estimated functional threshold power (FTP) (3.23%; p≤0.05) and maximum power (2.68%; p≤0.05) with 2S-Hesperdin compared to placebo. In the rectangular test, there was a significant decrease in VO₂ (-8.26%; p≤0.01) and VO₂R (-8.88%; p≤0.01) at VT2 in placebo; however, there were no significant differences between groups. In the Wingate test, there was a significant increase (p≤0.05) in peak and relative power in both groups, but without significant differences between groups. Supplementation with an orange extract (2S-hesperdin) 500mg/day improves estimated FTP and maximum power performance in amateur cyclists.

Athlete’s heart is characterised by structural, functional, and electrical remodelling. During an exercise session, the heart increases the use of oxygen, which is associated with decreased vascular resistance in the lungs’ circulation. Left ventricular hypertrophy is an echocardiographic modification especially met in endurance athlete’s heart. Moreover, left atrial dilatation represents another important characteristic of endurance athletes. Electrical modulation in the athletic heart induces neurological modifications leading to sinus arrhythmia, bradycardia, early repolarisation, and first-grade atrioventricular (AV) blocks. Athletes' nutritional status involves the assimilation of macronutrients such as proteins, carbohydrates, and fats. Depending on the duration of physical exercise, ATP can be obtained in aerobic or anaerobic conditions. This systematic review aims to find correlations between different evaluative methods of cardiac adaptation and present the metabolism in performance athletes.

Endurance triathlons impose substantial physiological stress, yet effects of short-course formats remain relatively unexplored. In this preliminary study, we assessed proteinuria and hydration levels in 27 well-trained triathletes (41.9 [7.4] years) who completed a sprint triathlon consisting of a 1500-m swim, 26-km cycle, and 8-km run. Urine samples were collected before and after the race. The results showed an increase in cases of post-race proteinuria from four to nine (p=0.03). Also, one case of urobilinuria and ketoacidosis was observed after the race. Pre-race glucosuria, which was present in nine cases, decreased to three cases post-race. Although hematuria cases decreased from six to two (p=0.13), pre-race leukocyturia (found in two cases) resolved post-race. There was a significant increase in urine specific gravity (from 1.018 to 1.023, p=0.03), indicating dehydration. In conclusion, short-course triathlons were found to induce post-race proteinuria, urobilinuria, and dehydration without exacerbating pre-race glucosuria, hematuria, or leukocyturia. These preliminary findings contribute to our understanding of medical guidelines for sprint triathlons, an area of endurance sports that has received limited research attention. Further investigation, both mechanistic and longitudinal, is warranted in this regard.

Introduction: Post-COVID-19 syndrome (PCS) is a multisystemic disorder marked by impaired physical performance as one lead symptom. Since it has been suggested that endurance training as part of medical rehabilitation may be effective to improve physical performance capacity in PCS, this study aimed to compare different modes of aerobic endurance training. Methods: Hundred-ten PCS patients (49.3±11.8 years, 38% women, time after infection=260.2±127.5 days) underwent detailed clinical screening including symptom-limited cardiopulmonary exercise testing at admission and after 4-6 weeks of inpatient medical rehabilitation. Questionnaires were used to assess disease perception. Patients performed controlled isocaloric cycle ergometer training (3-5 sessions/week, 18 min) as either continuous training (CT) at 50% of maximal workload or as interval training (IT, load=60%, relief=30%). Outcomes of PCS patients were compared to coronary artery disease patients (CAD, n=96) to evaluate overall training effectiveness. Results: Training participation was comparable between both groups with no indication of training-specific exercise-induced fatigue. Overall, PCS patients improved significantly by a mean of 6.8±12.1% for W at VT1, 3.1±10.0% for VO2 at VT1, 5.5±14.7% for O2-pulse at VT1, 7.5±15.0% for W at VO2peak, 2.7±11.0% for VO2peak and 4.6±12.4% for O2-pulse at VO2peak (all p<0.05) with no significant differences between groups (p>0.05). Both groups showed reduced levels of fatigue, anxiety and depression as well as improved quality of life and wellbeing (all p<0.05). Compared to guideline-based cardiac rehabilitation, PCS patients showed a similar improvement in workload and oxygen uptake compared to CAD patients. Conclusion: PCS patients benefit from aerobic endurance training, performed as moderate continuous or interval training as part of a medical rehabilitation program in terms of improved physical exercise capacity and disease perception. Results for PCS patients are comparable to guideline-based rehabilitation of CAD patients. Clinical Trial: NCT06016192

Maximal heart rate (HRmax) is a widely used measure of cardiorespiratory fitness. Prediction of HRmax is an alternative to cardiopulmonary exercise testing (CPET), but its accuracy among endurance athletes (EA) requires evaluation. This study aimed to externally validate HRmax prediction models in the EA independently for running and cycling CPET. 4043 runners (age=33.58 (8.12) years; 83.53% males; BMI=23.66 (2.54) kg·m−2) and 1026 cyclists (age=36.88 (9.03) years; 89.67% males; BMI=24.04 (2.65) kg·m−2) underwent maximum CPET. Student t-test, mean absolute percentage error (MAPE), mean absolute error (MAE), and root mean square error (RMSE) were applied to externally validate 8 running and 5 cycling HRmax equations. HRmax was 184.60 (9.79) beats·min−1 and 182.66 (10.28) beats·min−1 respectively for running and cycling, p=0.001. Measured and predicted HRmax differed significantly (p=0.001) for 9 of 13 (69.23%) models. HRmax was overestimated by 8 (61.54%) and underestimated by 5 (38.46%) formulae. Overestimated HRmax ranged 0.08-4.94 beats·min−1 and underestimated HRmax ranged 0.03-4.90 beats·min−1. MAE and RMSE were 0.18-4.94 beats·min−1 and 9.13-10.47, respectively. MAPE ranged 3.95-4.69%. Prediction models do not allow for accurate estimation of HRmax. HRmax was more often underestimated than overestimated. Predicted HRmax can be implemented for EA as a supplemental method but CPET is the preferable approach.

Pacing strategy refers to the distribution of effort and speed throughout the race to achieve optimal performance. The study aims to understand whether the choice of pacing strategy in swimming depends on the length of competitions and how sex, age, and performance level influence this strategy. Participants were the finalists of the 800-meter and 1500-meter freestyle events at the elite and junior world championships in 2022-2023. Race outcomes and pacing parameters were compared between the two distances and across different groups of swimmers. Swimmers in both distances did not break world records. Pacing strategy generally followed a U-shape with significant differences in the frequency and duration of speed changes between the two distances. The 800-meter exhibited more frequent changes in acceleration while the 1500-meter events generally followed a more consistent time series pattern. There were differences in pacing strategies between males and females and between junior and elite swimmers. Swimmers closer to world records showed more consistent pacing patterns compared to those farther from records. The study suggests that pacing strategies are influenced by race distance, sex, age, and performance level. The research highlights the complex interplay between physiological and psychological factors that shape a swimmer's decision-making during a race.

A 36-year-old professional marathon runner reported sudden heart palpitations occurring during competitions, with heart rates (HR) of 230 bpm recorded on sports HR monitor (HRM) over 4 years. These episodes subsided upon the cessation of exercise. Electrocardiograms, echocardiography, and cardiac magnetic resonance imaging results were borderline for athlete's heart. Because an electrophysiology study and standard exercise tests provoked no arrhythmia, doctors suspected Munchhausen syndrome. Ultimately, an exercise test that simulated the physical effort during a competition provoked tachyarrhythmia consistent with the HRM readings. This case demonstrates the diagnostic difficulties related to exercise-induced arrhythmia and the diagnostic usefulness of sports HRMs.

This narrative review examines the crucial role of physical activity in managing long COVID, characterized by persistent symptoms such as fatigue, breathlessness, and cognitive impairments following SARS-CoV-2 infection. The methodology involved a comprehensive literature search across PubMed, EBSCO (EDS), and Google Scholar, selecting peer-reviewed articles from December 2019 focusing on long-term COVID physical activity interventions. The review highlights that tailored exercise programs, adjusted to individual health status and abilities, significantly alleviate symptoms and enhance psychological well-being. Key findings emphasize the importance of personalized exercise prescriptions due to the variability in patient responses and the need for a multidisciplinary approach in developing and monitoring interventions. Despite promising outcomes, the review identifies research gaps, including the need for long-term studies, randomized controlled trials, and deeper mechanistic insights. It suggests that standardized reporting, templates like CERT, and integrating digital health tools are essential for optimizing interventions. Overall, the review advocates including personalized physical activity programs in standard care for long COVID to improve patient outcomes and quality of life.

COVID-19 has harmful impact on health. It is especially important for endurance athletes (EAs). Sleep and psychology influence sport performance. Aims of this study were: (1) investigation of the consequences of mild COVID-19 on sleep and psychology and (2) assessment of the conse-quences of the infection on cardiopulmonary exercise test (CPET) results. 49 EAs (males= 43; 87.76%, females= 6; 12.24%, age= 39.9±7.8 years, height= 178.4±6.8 cm, weight= 76.3±10.4 kg; BMI= 24.0±2.6 kg·m−2) underwent maximal cycling or running CPET pre- and post- COVID-19 and completed a survey. Exercise performance was deteriorated after COVID-19 (maximal oxy-gen uptake; VO2max= 47.81±7.81 vs 44.97±7.00 ml·kg·min−1 respectively pre- and post- infection; p<0.001). Waking up at night affected heart rate (HR) at the respiratory compensation point (RCP) (p=0.028). Sleep time influenced pulmonary ventilation (p=0.013), breathing frequency (p=0.010), and blood lactate concentration (Lac) (p=0.013) at RCP. Maximal power/speed (p=0.046) and HR (p=0.070) linked with the quality of sleep. Stress management and relaxation techniques linked with VO2max (p=0.046), maximal power/speed (p=0.033), and maximal Lac (p=0.045). Cardiorespiratory fitness was deteriorated after mild COVID-19 and was correlated with sleep and mental health. Medical Professionals should encourage EAs to maintain proper mental health and sleep after COVID-19 infection to facilitate recovery.

Surveys on the optimum seismic design of structures reveal that many investigations focus on how to minimize its initial cost while satisfying the performance constraints. Although reducing the initial cost while complying with the requirements of earthquake design codes of practice will significantly guarantee the life safety of occupants against earthquakes, it may still cause considerable economic losses to residents and fatalities. Accordingly, calculating the possible earthquake damages caused during the structure's lifetime may become essential from the optimal Life Cycle Cost (LCC) design point of view. LCC analysis is used to evaluate economic feasibility including construction, operation, occupancy, maintenance and end-of-life costs. For optimization, the population-based, meta-heuristic algorithm based on the Ideal Gas Molecular Movement (IGMM), has established its capability in solving highly nonlinear mono and multi-objective engineering problems. Therefore, this paper investigates the LCC -based mono and multi-objective optimum design of a 3-D four-story concrete building structure combined with the Endurance Time (ET) competence. The results show that, apart from substantially reducing the total number of analyses required, the proposed technique significantly affected dipping minor injury cost, rental, and income costs by 22%, 16%, and 16%, respectively. In total, a 10% reduction in all structural life-cycle costs was achieved, which could well be considered significant.

Exercise-based cardiac rehabilitation requires patients to perform a set of certain prescribed exercises a specific number of times. Local muscular endurance (LME) exercises are an important part of the rehabilitation program. Automatic exercise recognition and repetition counting, from wearable sensor data is an important technology to enable patients to perform exercises independently in remote settings, e.g. their own home. In this paper we first report on a comparison of traditional approaches to exercise recognition and repetition counting, corresponding to supervised machine learning and peak detection from inertial sensing signals respectively, with more recent machine learning approaches, specifically Convolutional Neural Networks (CNNs). We investigated two different types of CNN: one using the AlexNet architecture, the other using time-series array. We found that the performance of CNN based approaches were better than the traditional approaches. For exercise recognition task, we found that the AlexNet based single CNN model outperformed other methods with an overall 97.18% F1-score measure. For exercise repetition counting , again the AlexNet architecture based single CNN model outperformed other methods by correctly counting repetitions in 90% of the performed exercise sets within an error of ±1. To the best of our knowledge, our approach of using a single CNN method for both recognition and repetition counting is novel. In addition to reporting our findings, we also make the dataset we created, the INSIGHT-LME dataset, publicly available to encourage further research.