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The present study evaluated the effects of a newly developed injury prevention programme for children’s football (“FIFA 11+ Kids”) on motor performance in 7–12-year-old children. We stratified 12 football teams (under-9/-11/-13 age categories) into intervention (INT,N = 56 players) and control groups (CON,N = 67). INT conducted the 15-min warm-up programme “FIFA 11+ Kids” twice a week for 10 weeks. CON followed a standard warm-up (sham treatment). Pre- and post-tests were conducted using: single leg stance; Y-balance test; drop and countermovement jump; standing long jump; 20-m sprint; agility run; slalom dribble; and wall volley test. We used magnitude-based inferences and linear mixed-effects models to analyse performance test results. We observed likely beneficial effects favouring INT in Y-balance (right leg; +3.2%; standardised mean difference (SMD) = 0.34;P = 0.58) and agility run (+3.6%; SMD = 0.45;P = 0.008). Possibly beneficial effects were found in Y-balance, drop jump reactive strength index, drop jump height, countermovement jump, standing long jump, slalom dribble and wall volley test. At least possibly beneficial improvements in favour of “FIFA 11+ Kids” were observed in nearly all parameters. Most effects were small, but slight improvements in motor performance may potentially contribute to a reduction of injury risk. [ABSTRACT FROM AUTHOR]

The definition and scope of sustainability have evolved over the years, stimulated by debates which have won the attention of investors, thereby creating concepts such as responsible investment, socially responsible investment, responsible finance, etc. The purpose of the paper is to demonstrate whether screening has an effect on the financial performance of mutual funds and whether these effects are positive or negative. The study mainly focuses on the U.S. market as it is well developed and therefore provides greater insight and value. The research method uses the Markowitz and Sharpe market models to determine the market value of SRI and non SRI mutual funds. The study also depicts the investors’ attitude towards embedding sustainability driven variables in the decision making process as well as the market response to socially responsible investments.

The study investigated the effects of slackline training (rope balancing) on balance, jump performance and muscle activity in children. Two primary-school classes (intervention, n = 21, INT: age: 10.1 (SD 0.4) y, weight: 33.1 (4.5) kg; control, n = 13, CON: age: 10.0 (SD 0.4) y, weight: 34.7 (7.4) kg) participated. Training was performed within 6 weeks, 5 times per week for 10 min each day. Balance (static and dynamic stance), countermovement jumps, reverse balancing on beams (3, 4.5 and 6 cm width), slackline standing (single- and double-limb) and electromyographic activity (soleus, gastrocnemius, tibialis anterior) were examined. INT significantly improved single- and double-limb slackline standing (double limb: 5.1 (3.4) s–17.2 (14.4) s; right leg: 8.2 (5.8) s–38.3 (36.0) s; left leg: 10.6 (5.8) s–49.0 (56.3) s; p < 0.001; 0.17 < η p ² < 0.22). Reduced left-leg dynamic sway ( − 20.8 %, p = 0.06, η p ² = 0.10), improved 4.5 cm balancing ( + 18.5 %, p = 0.08, η p ² = 0.10) and decreased muscle activity during slackline standing for the mm. soleus ( − 23 %, p = 0.10, η p ² = 0.18) and tibialis anterior ( − 26 %, p = 0.15, η p ² = 0.14) was observed for INT. Jump performance remained unchanged (p = 0.28, η p ² = 0.04). In conclusion, daily slackline training results in large slackline-specific balance improvements. Transfer effects to static and dynamic stance, reverse balancing or jumping performance seemed to be restricted. [ABSTRACT FROM AUTHOR]

Maintaining a certainty degree for the agricultural producers in order to obtain stable and efficient results makes it both necessary and welcomes the protection through insurance and reinsurance in this field. In this paper we carry out an analysis regar

The pension system reform in Romania initiated in 2000 is based on three pillars: 1) the public redistributive mandatory pillar; 2) the private mandatory pillar; 3) the private optional pillar. The paper tries to answer a few questions concerning the juridical and technical problems raised by the implementation of the last two pillars. The method used is that ‘of scenarios’, and the simulations are made separately for men and women, given that the duration of contribution payment and also the life expectancy at retirement are, at least in the present, different for the two categories of beneficiaries.

In modern economies, the public authority entrusted to manage the public affairs of the community is the state. In fulfilling their objectives the public decision makers assume a number of tasks according to the doctrines embraced by the government. The government results as an outcome of the election process and thus, faithful to its own doctrine is more or less invasive in the economy provides more or less protection and public goods therefore increasing or decreasing its spending according to its needs. The final outcome pursued by the state is the welfare of its citizens. Eventually, the way this goal is achieved as well as the perception the society has regarding the way the state performs is a matter of choice the state makes in order to fulfill its tasks. Traditionally, the main roles assumed by the state are: the distributive role, the regulation role, the stabilising and the assurance role.

Objectives: As a high-intensity intermittent sport with short and repeated rapid accelerations, decelerations and changes of direction, badminton involves high joint and muscle loads. This review aims to identify relevant injury risk characteristics and factors that facilitate developing and implementing badminton-specific injury prevention programmes., Design: This systematic review of badminton injuries assessed the risk of bias, injury incidence, mechanism, location, type, severity, and risk factors., Data Sources: PubMed, WoS, SURF, EBSCO, Ovid and SPORTDiscus., Eligibility Criteria: Only English or German peer-reviewed articles presenting epidemiological data. All age groups, genders and levels of play were represented., Results: Examination of 19 studies with male (60%) and female players (41%) at different player levels (age: 10-50 years). The mean injury incidence was between 1 and 4 injuries/1000 hours, whereby the incidence in the studies that were only carried out with elite players tended to be at the upper end. Lower body injuries occurred most frequently (41%-92%), including strains (11%-64%), sprains (10%-61%), tendinopathy (6%-14%) and stress fractures (5%-11%). There was a high proportion of overuse injuries (25%-74%) and a predominance of mild and moderate injuries (73%-100%). The following risk factors can only be cautiously emphasised due to the heterogeneous results: The risk of injury increases with increasing level of play and a history of injury., Conclusion: Young players with a history of injury quickly moving to higher competition classes must be targeted with the highest injury prevention priority. Future studies should focus on improving the quality of studies by using comparable data collection methods., Competing Interests: None declared., (Copyright © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

The aim of this study was to investigate the change of direction (COD) frequencies and intensities of high-performance soccer players of the German Bundesliga independent of tactical and match context. COD data were collected from 18 German Bundesliga soccer teams (season 2016-2017; 308 fixtures) by an optical tracking system (OTS) (TRACAB). CODs were tracked using a modified algorithm and were sub-categorized by entry velocity (<3.0 m⋅s -1 , 3.0-5.5 m⋅s -1 , 5.5-7.0 m⋅s -1 and >7.0 m⋅s -1 ) and COD angle (20-59°, 60-119° and 120-180°). COD metric frequencies were compared between playing positions (goalkeepers, centre backs, full-backs, central midfielders, wide midfielders, and strikers). In general, regardless of entry velocity or COD angle, central midfielders consistently executed the highest number of COD actions during matches compared to the other playing positions. About ≈ 55% and ≈ 38% of CODs were <3.0 m⋅s -1 and <5.5 m⋅s -1 , whereas ≈ 7% were >5.5 m⋅s -1 . The distribution of COD angle types was ≈ 5% for 20-59°, ≈25% 60-119° and ≈ 70% for 120-180° COD angles. Our data provide insights into the COD demands of high-performance soccer in the German Bundesliga in terms of entry velocity and COD angles and their combination based on a large dataset of OTS data, which provides insights to facilitate the development of physical conditioning strategies, position-specific external load management, and multidirectional speed training with adequate test battery selection and return-to-play protocols for soccer players.

Background: Older adults experience chronic inflammation, which is associated with health conditions such as sarcopenia, and resulting in reduced functional capacity. Resistance training (RT) is a beneficial intervention for improving health in the elderly., Objective: This study aimed to investigate the effect of RT on inflammatory biomarkers, body composition, and functional capacity in healthy adults aged 60 years and over. Additionally, this study conducted a meta-regression to investigate the moderating effect of exercise variables on inflammatory markers., Method: Medline, PubMed, Web of Science, Cochrane Library, Embase, and Google Scholar were searched systematically until December 2023. Randomized controlled trials (RCTs) assessing the impact of RT on C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), body weight, BMI, fat percentage, fat mass, lean mass, leg extension strength and six-minute walk test (6-MWT) were included. Effect size was estimated by using the mean difference (MD) with 95 % confidence interval (CI)., Results: Nineteen RTCs involving 728 participants were included. The results revealed that CRP levels significantly decreased following RT programs (MD:0.74, p= 0.008), while TNF-α (MD: 0.1, p= 0.95) and IL-6 (MD:0.27, p= 0.12) did not show significant changes. Additionally, RT enhanced leg extension strength and 6-MWT performance., Conclusion: RT effectively reduces CRP concentrations and enhances functional capacity in healthy older adults. However, it does not have a significant impact on TNF-α and IL-6 levels. Future researches are needed to make a clear conclusion and understand the mechanisms underlying the effects of RT in healthy older adults., Registration: The original protocol was registered (CRD42023487573) in PROSPERO database., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Existing data suggest placebo responses to treatments are small, but some people may be more likely to respond. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) on interindividual variability in response to placebo interventions MEDLINE, EMBASE, CINAHL, Web of Science Core Collection, CENTRAL, and SPORTDiscus were searched from inception to September 2023. Trial registry searches, citation tracking, and searches for prior systematic reviews were completed. The PEDro scale assessed study quality. Random effects robust variance estimation estimated the log variability ratio (VR), identifying subgroups with varying responses. Twenty-six studies were included, comprising various musculoskeletal pain conditions. Analysis of pain intensity (VR: 1.06, 95%-confidence interval (CI):[0.97; 1.16], 95%-prediction interval (PI):[0.75; 1.51], p = 0.17, k = 26 studies, N = 52 outcomes, GRADE: low), physical function (VR: 1.14, 95%-CI:[0.97; 1.34], 95%-PI:[0.62; 2.11], p = 0.11, k = 19, N = 40, GRADE: low), and health-related quality of life (VR: 1.14, 95%-CI:[0.91; 1.41], 95%-PI:[0.72; 1.80], p = 0.19, k = 7, N = 13, GRADE: low) outcomes revealed minimal, non-statistically significant variability in placebo response compared to control. However, wide prediction intervals suggest uncertainty regarding individual response patterns. There are likely no distinct subgroups of people who are more likely to respond to placebo interventions in musculoskeletal pain; although the available data limits the certainty of this assessment. Future work should consider individual participant data meta-analyses to better elucidate potential responder subgroups and optimize treatment strategies for musculoskeletal pain. PERSPECTIVE: This study systematically reviewed and analyzed RCTs to assess interindividual variability in placebo responses for musculoskeletal pain. Findings suggest minimal variability in placebo response, with no distinct subgroups more likely to respond. Wide prediction intervals indicate uncertainty, highlighting the need for future individual participant data meta-analyses to better elucidate potential responder subgroups., Competing Interests: Declaration of Competing Interests The authors declare no conflicts of interest., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: High-intensity functional interval training (HIFT) is predominantly composed of high exercise training intensities (HiT) and loads. Both have been linked to a higher risk of overtraining and injuries in inexperienced populations. A polarized training approach is characterized by high amounts of low-intensity training (LiT) and only approximately 5%-20% HiT. Compared to HIT-based training, this approach can result in temporary training load and intensity reductions without diminishing training gains. Thus, we aimed to examine the effects of traditional (TRAD) HIFT vs. polarized (POL) HIFT on relevant performance parameters., Methods: Thirty athletes (15 females, age: 26.6 ± 5.0 years, height: 1.76 ± 0.13 m, body mass: 79.6 ± 12.4 kg, prior experience: 2.3 ± 2.0 years, training volume: 6.1 ± 2.4 h/wk) were randomly assigned to 6 weeks of either POL (78% LiT, 22% threshold intensity training (ThT) to HiT) or TRAD (26% LiT, 74% ThT to HiT). HIFT performance testing focused on maximal strength (squat: SQ1RM, deadlift: DL1RM, overhead press: OHP1RM, high pull: HP1RM), endurance (peak oxygen uptake: V̇O 2 peak, lactate threshold: LT, peak power output (PPO), and benchmark HIFT workout (Jackie: 1000 m rowing, 50 thrusters, and 30 pull-ups for time)., Results: POL (785 ± 71 au) completed significantly ( p ≤ 0.001; SMD = 4.55) lower training load (eTRIMP) than TRAD (1,273 ± 126 au). rANCOVA revealed no statistical relevant group×time interaction effects (0.094 ≤ p ≤ 0.986; 0.00 ≤ η p 2 ≤ 0.09) for SQ1RM, DL1RM, OHP1RM, high pull, V̇O2peak, LT, PPO, and Jackie performance. Both groups revealed trivial to moderate but significant (rANCOVA time effects: p ≤ 0.02; 0.01 ≤ η p 2 ≤ 0.11; 0.00 ≤ SMD ≤ 0.65) performance gains regarding DL1RM, OHP1RM, HP1RM, and Jackie., Conclusion: Despite a notably lower total training load, conditioning gains were not affected by a polarized functional interval training regimen., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Held, Isenmann, Rappelt, Wiedenmann, Kutschki, Harbrecht, Kirchner, Geisler and Donath.)

Purpose: Within human skeletal muscle, statin treatment leads to elevated levels of the glucocorticoid-induced leucine zipper (GILZ). Further, GILZ mediates the muscle-related side effects of statins. Physical exercise leads to GILZ suppression, in a mechanosensitive manner. Given that statin treatment is rarely tolerated by habitually exercising individuals due to statin-associated muscle symptoms (SAMS), it appears that the opposing regulation of GILZ facilitates this detrimental interaction of two key measures of cardiovascular prevention, specifically for exercise modalities with high muscle strain. Similarly, opposing regulation of atrophy associated genes (atrogenes) may be a further mechanism. If confirmed, these results might have implications for the exercise prescription of statin-users., Methods: A systematic search of the Gene Expression Omnibus (GEO) repository for studies reporting the acute effects of either endurance (END), conventional resistance (RT), or eccentric resistance training (ECC) was conducted. GILZ, as well as the expression of pivotal atrogenes (e.g., muscle atrophy F-box, cathepsin L, etc.) were quantified., Results: 15 studies with 204 participants (22 females; 182 males) were included. RT resulted in the highest GILZ suppression, significantly differing from the expressional change after END ( - 0.46 ± 1.11 vs.  - 0.07 ± 1.08), but not from ECC ( - 0.46 ± 1.11 vs. - 0.46 ± 0.95). Similar results were seen for various atrogenes., Conclusion: Our results strengthen the assumption that mechanical loading can be considered a key mediator of exercise-induced changes in GILZ and atrogene expression., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Major depressive disorders (MDD) are a leading health concern worldwide. While first line medication treatments may fall short of desired therapeutic outcomes, physical activity (PA) interventions appear to be a promising and cost-effective add-on to improve symptoms of depression. This study aimed to address challenges in the assessment of PA in inpatients treated for MDD by examining the correspondence of self-reported and accelerometer-based PA., Methods: In 178 inpatients treated for MDD (mean age: M  = 41.11 years, SD = 12.84; 45.5% female) and 97 non-depressed controls (mean age: M  = 35.24 years, SD = 13.40; 36.1% female), we assessed self-reported PA via the Simple Physical Activity Questionnaire (SIMPAQ) for one week, followed by a week where PA was monitored using an accelerometer device (Actigraph wGT3x-BT). Additionally, we examined correlations between PA levels assessed with the SIMPAQ and exercise determinants in both groups., Results: Descriptively, inpatients treated for MDD showed lower levels of light PA on accelerometer-based measures, whereas they self-reported increased levels of certain types of PA on the SIMPAQ. More importantly, there was only a small degree of correspondence between self-reported and actigraphy-based PA levels in both in patients ( r  = 0.15, p  < 0.05) and controls ( r  = 0.03, ns). Only few significant correlations were found for self-reported PA (SIMPAQ subscores) and perceived fitness, whereas self-reported PA and estimated VO 2 max were unrelated. Furthermore, only weak (and mostly statistically non-significant) correlations were found between exercise determinants and SIMPAQ-based exercise behavior in both populations., Discussion: Our findings emphasize the intricate challenges in the assessment of PA, not only in inpatients treated for MDD, but also in non-depressed controls. Our findings also underline the necessity for a diversified data assessment. Further efforts are needed to refine and improve PA questionnaires for a more accurate data assessment in psychiatric patients and healthy controls., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Schilling, Cody, Kreppke, Faude, Beck, Brand, Donath, Hatzinger, Imboden, Lang, Mans, Mikoteit, Oswald, Schweinfurth-Keck and Gerber.)

The decision of the Union Internationale de Pentathlon Moderne to replace horse riding with Obstacle after the 2024 Olympic Games challenges training, testing, and recovery management in Modern Pentathlon. This commentary discusses physiological, technical, and tactical effects of rule changes in the 5 disciplines with a specific focus on the new discipline Obstacle. Modern Pentathlon requires athletes to develop specific endurance capacities relying on both the aerobic and anaerobic systems while simultaneously increasing lower- and upper-body strength capabilities. In addition, movements must be repeatedly executed in an explosive and precise manner. Running and swimming must be fast but economical. Swapping from horse riding to Obstacle will prioritize the explosive strength of the upper extremities and core while keeping high levels of endurance and precision in swimming, fencing, and shooting. Moreover, condensing the Modern Pentathlon competition to a 90-minute television-friendly format enables more competitions in the future. Athletes and coaches will thus also need to develop and maintain effective individual peri-exercise routines (before, during, and after the competition) to successfully meet the resulting tactical and physical challenges of the new format. This commentary aims to stimulate the discussion on the effect of the Union Internationale de Pentathlon Moderne's decisions to replace riding with the new Obstacle discipline and implement a more television-friendly format with a focus on physiological, technical, and tactical aspects.

Chronic low back disorders are the leading cause of direct and indirect healthcare burden globally. Exercise training improves pain intensity, mental health and physical function. However, the optimal prescription variables are unknown. We aim to compare the efficacy of various exercise dosages for chronic low back disorders to identify the optimal prescription variables. Six databases (Medline, SPORTDiscus, CINAHL, PsycINFO, EMBASE and CENTRAL), trial registries (ClinicalTrials.gov and WHO International Clinical Trials Registry Platform) and reference lists of prior systematic reviews will be searched, and we will conduct forward and backward citation tracking. We will include peer-reviewed randomised controlled trials (individual, cluster or cross-over trials) published in English or German language comparing exercise training to other exercise training or non-exercise training interventions (conservative, non-surgical, non-pharmacological, non-invasive treatments, placebo, sham, usual/standard care, no-treatment control, waitlist control) in adults with chronic low back disorders. Outcomes will include pain intensity, disability, mental health, adverse events, adherence rate, dropout rate and work capacity. Version 2 of the Cochrane risk-of-bias tool will be employed. The dose will be categorised as cumulative dose (total and weekly minutes of exercise training) and individual dose prescription variables (intervention duration, session duration, frequency and intensity). Dose-response model-based network meta-analysis will be used to assess the comparative efficacy of different exercise doses to determine a dose-response relationship. The certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation. Information about optimal exercise training dosage will help in enhancing treatment outcomes., Competing Interests: None declared., (Copyright © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Post-activation performance enhancement (PAPE) cannot be clearly distinguished from and may be explained in large by warm-up effects. To disentangle PAPE from a systemic warm-up effect, we conducted three randomized crossover trials (RCT). Methods: Each RCT consisted of a familiarization/one-repetition-maximum (1RM) assessment session followed by two interventional sessions (random order). In Study I, 18 participants (age: 26 ± 4 years; height: 1.84 ± 0.06 m; mass: 83.7 ± 8.7 kg; Squat-1RM: 146 ± 19 kg) performed either a 3-s isometric squat at 130%1RM or a 6-s isometric squat at 65%1RM. In Study II, 28 participants (11 female; age: 23 ± 3 years; height: 1.77 ± 0.08 m; mass: 76.5 ± 10.4 kg; Squat-1RM: 109 ± 38 kg) completed either Squat (3 × 3 repetitions, 85%1RM) or local electromyostimulation of the quadriceps muscle (85% of individual pain threshold). In Study III, 20 participants (6 female, age: 25.0 ± 3.5 years, mass: 78.5 ± 15.8 kg, height: 1.75 ± 0.08 m; SQ-1RM: 114 ± 33 kg, chest-press-1RM: 74 ± 29 kg) performed either squats or chest press (4 repetitions, 80%1RM). Counter-Movement-Jump height (CMJ) was assessed after a general (PRE) and/or muscle-specific warm-up (POST&#95;WU) and for up to 11 min after the PAPE protocols. To identify possible differences in CMJ between the experimental conditions, mixed-design ANOVA models were used for each study individually, with condition and time modelled as fixed effects, while participants were included as a random effect blocking factor. The level of statistical significance was set at α = 5%. Results: In studies I and II, significant effects for time ( p < 0.05, ω p 2 = 0.06 and p < 0.001, ω p 2 = 0.43) were found with the highest CMJ compared to all other time points at PRE (≤8.2 ± 4.6%, standardized mean difference: ≤0.39), regardless of condition. In study III, no significant effects were observed. Discussion: Thus, PAPE protocols do not further improve jumping performance compared to a general and muscle-specific traditional warm-up. Prior to tasks requiring explosive strength, general and sport-specific warm-up strategies should be used., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Rappelt, Held, Wiedenmann, Micke and Donath.)

The kynurenine pathway (KP) of tryptophan degradation generates several metabolites such as kynurenine (KYN) or kynurenic acid (KA) that serve as endogenous ligands of the aryl hydrocarbon receptor (AHR). Due to its distinct biological roles particularly modulating the immune system, the AHR is a current therapeutic target across different inflammation-related diseases. Here, we show an acute exercise-induced increase in AHR ligand availability on a systemic level and a kynurenine pathway activation in peripheral blood mononuclear cells (PBMCs). Concurrently, the AHR is activated in PBMCs following acute exercise. Exercise effects on both, kynurenic acid and AHR activation in PBMCs were greater in response to high-intensity interval exercise (HIIE) (50 min, six 3-min intervals at 90% V̇o 2peak , and 3-min intervals at 50% V̇o 2peak in between) compared with workload-matched moderate-intensity continuous exercise (MICE) (50 min). In conclusion, these data indicate a novel mechanistic link in how exercise modulates the immune system through the kynurenine pathway-AHR axis, potentially underlying exercise-induced benefits in various chronic diseases. NEW & NOTEWORTHY The findings of this study show that acute endurance exercise activates a receptor that has been described to integrate metabolic signals into the immune system. We uncover a potential mechanistic link on how exercise modulates the immune system through the kynurenine pathway-AHR axis, potentially underlying exercise-induced benefits in various chronic diseases and of relevance for other cell types.

Over 300 million individuals worldwide suffer from major depressive disorder (MDD). Individuals with MDD are less physically active than healthy people which results in lower cardiorespiratory fitness (CRF) and less favorable perceived fitness compared with healthy controls. Additionally, individuals with MDD may show autonomic system dysfunction. The purpose of the present study was to evaluate the CRF, perceived fitness and autonomic function in in-patients with MDD of different severity compared with healthy controls. We used data from 212 in-patients (age: 40.7 ± 12.6 y, 53% female) with MDD and from 141 healthy controls (age: 36.7 ± 12.7 y, 58% female). We assessed CRF with the Åstrand-Rhyming test, self-reported perceived fitness and autonomic function by heart rate variability (HRV). In specific, we used resting heart rate, time- and frequency-based parameters for HRV. In-patients completed the Beck Depression Inventory-II (BDI-II) to self-assess the subjectively rated severity of depression. Based on these scores, participants were grouped into mild, moderate and severe MDD. The main finding was an inverse association between depression severity and CRF as well as perceived fitness compared with healthy controls. Resting heart rate was elevated with increasing depression severity. The time-based but not the frequency-based autonomic function parameters showed an inverse association with depression severity. The pattern of results suggests that among in-patients with major depressive disorder, those with particularly high self-assessed severity scores show a lower CRF, less favorable perceived fitness and partial autonomic dysfunction compared to healthy controls. To counteract these conditions, physical activity interventions may be effective., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests. The PACINPAT trial is funded by the Swiss National Science Foundation (grant number: 321003B-179353). The authors JB, MH, CI, UEL, SM, TM, AO, AR and NS supported the patient screening and recruitment processes on the four study sites. JNK and RC recruited the participants and collected the data. EHT, LD, AE, SB, LZ and MG offered thematic support. JNK and OF were responsible for conceptualizing the manuscript. JNK conducted the statistical analyses. JNK wrote the first draft of the manuscript with assistance of OF. All listed co-authors read, contributed to and approved the final manuscript., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)