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Aims: Although left ventricular assist device (LVAD) implantation improves prognosis of advanced heart failure patients still suffer from impaired exercise capacity and quality of life (QoL). Exercise training may improve both; however, the available evidence about exercise training effects in LVAD patients remains inconclusive due to small and monocentric randomized controlled trials. This study aims to aggregate the individual participant data (IPD) to perform meta-analysis on the safety and efficacy of exercise training on exercise capacity and QoL over standard care in LVAD patients., Methods: Randomized controlled trials comparing exercise training and standard care (no supervised training) will be identified through database searching. Corresponding authors of eligible randomized controlled trials will be invited to share IPD. All IPD will be checked, recalculated to validate findings in initial reports, merged in a single dataset and stored in a secured encrypted database server. The merged IPD will be screened for quality, risk of bias, and heterogeneity of the included trials. Random effects meta-analyses will be conducted using one-stage and two-stage approaches, in particular with a view to subgroup analyses., Results: Based on findings of the individual randomized trials, we expected to obtain superior effects of exercise training on submaximal exercise capacity and QoL and similar effects on maximal aerobic capacity when compared with standard care., Conclusions: Our study will be the first to harmonize IPD in meta-analysis to demonstrate the effects of exercise training on exercise performance and QoL over standard care in LVAD patients., Prospero Registration Number: CRD42023480119., (© 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Competing Interests: Conflict of interest: None declared.

Competing Interests: The authors declare no conflicts of interest.

Competing Interests: Competing interests: None declared.

Biomechanical adjustments of the jump shot in presence of an opponent and their associations with shooting efficiency remain to be determined in elite basketball. The aim of this research was to examine the selected biomechanical determinants of the jump shot when shooting over opponents of different height. Nineteen elite basketball players, age 22 ± 3 years, performed three trials of 20 basketball shots in a crossover, randomised manner: over an obstacle of the height of standing reach (RH), over reach height with additional 20 cm (RH+20 cm), over reach height with additional 40 cm (RH+40 cm), and the maximum height jump shot without an obstacle (JS max ). Jump height, the ball entry angle, and shooting efficiency were measured on each trial. Jump height when shooting over RH+40 cm was significantly higher than RH+20 cm (+0.022 m, p = 0.030) and RH (+0.023 m, p = 0.029). Similarly, the ball entry angle was greater at RH+40 cm compared to RH (+7.19 °, p < 0.001) and RH+20 cm (+2.90°, p < 0.001). In contrast, shooting efficiency decreased significantly when shooting over RH+40 cm compared to RH (-10.79%, p = 0.048) and RH+20 cm (-8.95%, p = 0.015). We recorded the highest jump height (0.35 ± 0.08m, p < 0.001) and the lowest angle of entry (39.16 ± 1.19°, p < 0.001) when participants performed JS max . Shooting over higher opponents should be prioritised in training to significantly improve shooting efficiency. Future research is needed to determine additional potential biomechanical determinants of a successful jump shot in elite basketball., (© 2022 Tim Kambič, Filip Stepišnik Krašovec, Frane Erčulj, Igor Štirn, published by Sciendo.)

Purpose: This study compared the effects of heavy resisted sprint training (RST) versus unresisted sprint training (UST) on sprint performance among adolescent soccer players., Methods: Twenty-four male soccer players (age: 15.7 [0.5] y; body height: 175.7 [9.4] cm; body mass: 62.5 [9.2] kg) were randomly assigned to the RST group (n = 8), the UST group (n = 10), or the control group (n = 6). The UST group performed 8 × 20 m unresisted sprints twice weekly for 4 weeks, whereas the RST group performed 5 × 20-m heavy resisted sprints with a resistance set to maximize the horizontal power output. The control group performed only ordinary soccer training and match play. Magnitude-based decision and linear regression were used to analyze the data., Results: The RST group improved sprint performances with moderate to large effect sizes (0.76-1.41) across all distances, both within and between groups (>92% beneficial effect likelihood). Conversely, there were no clear improvements in the UST and control groups. The RST evoked the largest improvements over short distances (6%-8%) and was strongly associated with increased maximum horizontal force capacities (r = .9). Players with a preintervention deficit in force capacity appeared to benefit the most from RST., Conclusions: Four weeks of heavy RST led to superior improvements in short-sprint performance compared with UST among adolescent soccer players. Heavy RST, using a load individually selected to maximize horizontal power, is therefore highly recommended as a method to improve sprint acceleration in youth athletes.

Background: Blood flow-restricted resistance training (BFR-RT) has been proven to be safe and efficacious in healthy older adults, but not in cardiovascular disease., Objective: The aim of this study was to investigate the acute and training induced effects of BFR-RT on hemostatic and hemodynamic responses in patients with coronary artery disease (CAD)., Methods: Stable patients with CAD were randomized to 8 weeks of BFR-RT (30%-40% 1-repetition maximum unilateral knee extension) combined with aerobic training or aerobic training alone (control group). At baseline and after 4 and 8 weeks, blood samples were taken before and after BFR exercise, whereas hemodynamic parameters were monitored throughout the exercise., Results: Twenty-four patients (12 per group; mean age, 60 ± 2 years; mostly male [75%]) completed the study. The BFR-RT significantly improved systolic blood pressure (-10 mm Hg; P = .020) and tended to lower diastolic blood pressure (-2 mm Hg; P = .066). In contrast, no posttraining alterations were observed in N-terminal prohormone B-type natriuretic hormone, fibrinogen, and D-dimer values. During BFR exercise, all hemodynamic variables significantly increased after the first and second set, whereas blood pressure immediately lowered after the cuff was released in the third set. Last, significant interaction was only observed for repetitions × intensity (P < .001; partial η2 = 0.908) of diastolic blood pressure at higher exercise intensity (40% 1-repetition maximum)., Conclusions: The BFR-RT was proven to be safe, with favorable hemodynamic and hemostatic responses in patients with CAD, and can be recommended as an additional exercise modality in cardiac rehabilitation.Trial Registration:ClinicalTrial.gov Identifier: NCT03087292., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Isokinetic dynamometry is the gold standard for testing maximal strength in elite sport and rehabilitation settings. To be clinically useful, such tests should be valid and reliable. Despite some evidence regarding the relative test vs retest reliability of knee dynamometry, there is still a paucity of research regarding the absolute reliability parameters. The purpose of this study was to assess the absolute and relative intra-device reproducibility of isokinetic knee flexion and extension using the novel SMM iMoment dynamometer. A total of 19 participants (13 males and 6 females, aged 24 (2) years, height 178 (9) cm and weight 76 (11) kg) performed two identical knee isokinetic tests with at least a week of rest between measurements. Peak torque of knee extension and flexion were determined at 60°/s. Moderate (0.892) to excellent (0.988) relative reliability using the intraclass correlation coefficient (ICC) was obtained for peak knee torque. Absolute reliability assessed with a standard error of measurement (SEM %) was low, ranging from 2.54% to 6.93%, whereas the smallest real difference (SRD %) was moderate, ranging from 7.04% to 19.22%. Furthermore, there were no significant correlations between means and differences of two measurements, and Bland-Altman plots also showed no signs of heteroscedasticity. Our measurement protocol established the moderate to excellent reliability of the novel SMM iMoment isokinetic dynamometer. Therefore, this dynamometer can be applied in sport rehabilitation settings to measure maximal knee strength., Competing Interests: The authors have declared that no competing interests exist.

Background: The aim of presented cross-sectional study was to determine the association of different types of physical activity (PA) with metabolic control in people with type 1 diabetes., Materials and Methods: A total of 109 adult subjects with type 1 diabetes were asked to complete the non-exercise activity thermogenesis (NEAT) questionnaire, the hypoglycemia questionnaire, and the World Health Organization Global PA Questionnaire (GPAQ) which was used to assess moderate PA (MPA) and vigorous PA (VPA)., Results: NEAT score ( p < 0.001) and total duration of work as assessed with GPAQ ( p = 0.007) were positively associated with chronic glycemic control when controlled for sex, BMI, and continuous glucose monitoring system (CGMS) use. We could not confirm such association with total leisure time PA (LTPA) assessed with GPAQ ( p = 0.443), though. Multivariate regression model controlled for sex showed positive effects of HbA 1 c ( p = 0.011) and age ( p = 0.035), and negative effect of NEAT score ( p = 0.001) on BMI. Systolic blood pressure was positively associated with duration of MPA ( p = 0.009) and VPA ( p = 0.012), but not with NEAT score ( p = 0.830) when controlled for sex and BMI. NEAT score and VPA were positively associated with HDL levels when controlled for sex and BMI. Controlled for sex and BMI, higher values of VPA were significantly associated with lower levels of total cholesterol ( p = 0.009) and LDL ( p = 0.005)., Conclusion: Higher levels of NEAT are associated with some favorable metabolic effects in adult people with type 1 diabetes, but may also present an additional burden for them with more challenging environment regarding glycemic control., (Copyright © 2019 Štotl, Kambič, Hadžić and Zdolšek.)

Resistance training may be associated with unfavorable cardiovascular responses (such as hemodynamic alterations, anginal symptoms or ventricular arrhythmias). In healthy adults, blood flow-restricted (BFR) resistance training improves muscle strength and hypertrophy improvements at lower loads with minimal systemic cardiovascular adverse responses. The aim of this study was to assess the safety and efficacy of BFR resistance training in patients with coronary artery disease (CAD) compared to usual care. Patients with stable CAD were randomized to either 8 weeks of supervised biweekly BFR resistance training (30-40% 1RM unilateral knee extension) or usual exercise routine. At baseline and after 8 weeks, patients underwent 1-RM knee extension tests, ultrasonographic appraisal of vastus lateralis (VL) muscle diameter and of systemic (brachial artery) flow-mediated dilation, and determination of markers of inflammation (CD40 ligand and tumor necrosis factor alfa), and fasting glucose and insulin levels for homeostatic model assessment (HOMA). A total of 24 patients [12 per group, mean age 60 ± 2 years, 6 (25%) women] were included. No training-related adverse events were recorded. At baseline groups significantly differ in age (mean difference: 8.7 years, p < 0.001), systolic blood pressure (mean difference: 12.17 mmHg, p = 0.024) and in metabolic control [insulin ( p = 0.014) and HOMA IR ( p = 0.014)]. BFR-resistance training significantly increased muscle strength (1-RM, +8.96 kg, p < 0.001), and decreased systolic blood pressure (-6.77 mmHg; p = 0.030), whereas VL diameter (+0.09 cm, p = 0.096), brachial artery flow-mediated vasodilation (+1.55%; p = 0.079) and insulin sensitivity (HOMA IR change of 1.15, p = 0.079) did not improve significantly. Blood flow restricted resistance training is safe and associated with significant improvements in muscle strength, and may be therefore provided as an additional exercise option to aerobic exercise to improve skeletal muscle functioning in patients with CAD. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03087292.