Peer-reviewed research.

Background: Relative Energy Deficiency in Sport (REDs) is traditionally conceptualised as a physiological consequence of low energy availability, yet emerging evidence implicates psychological and behavioural mechanisms in its development. This study examined the associations among body image, disordered eating, social physique anxiety, and female health knowledge to clarify psychosocial antecedents of REDs risk in female athletes. Methods: 105 female athletes (mean age = 21.7 ± 3.4 years) completed validated measures assessing body image, social physique anxiety, disordered eating, REDs risk, and female health knowledge. Pearson correlations, multiple regression, and mediation analyses were performed to examine psychological predictors and mediating pathways of REDs risk. Results: Negative body image was strongly associated with REDs risk (r = .61, p < .001) and remained the dominant independent predictor (β = .58, p < .001). Disordered eating partially mediated this relationship (indirect = 1.10, 95% CI [0.88, 1.36]), while the direct effect persisted(c′ = 1.10, 95% CI [0.85, 1.34], p < .001). Positive body image exerted a protective influence (B = −1.47, p < .001), and social physique anxiety contributed modestly (β = .18, p = .013). Female health knowledge was inversely related to REDs risk (r = −.28, p = .002). The model explained 44 % of variance (R² = .44, p < .001). Conclusions: Findings support a psychological–behavioural framework in which body-image disturbance amplifies REDs vulnerability through both direct and disordered-eating-mediated pathways. Conversely, positive body image and female health literacy may serve protective roles. Integrating psychological screening and assets-based education into REDs prevention could shift practice from reactive physiological detection toward proactive, holistic athlete health care.

This study examined acute vascular responses to three resistance training (RT) protocols differing in load and volume but matched for proximity to failure. Eleven adults (6 males and 5 females) performed three RT protocols consisting of the hexagonal deadlift and bench pull exercises with the following: (i). Low-volume, moderate-load, and high-repetition (Condition A: 2 × 10 repetitions), (ii). Low-volume, high-load, and low-repetition (Condition B: 2 × 4 repetitions), and (iii). Moderate-volume, high-load, and low-repetition (Condition C: 5 × 4 repetitions). Proximity to failure was set at 2 repetitions in reserve. Measurements of carotid-femoral pulse wave velocity (cfPWV) and pulse wave analysis (e.g., augmentation index) were collected at baseline, immediately post, and 15 min posttraining, whereas muscle oxygenation was monitored during performance the hexagonal deadlift. Condition A induced significantly greater increases in cfPWV (6.2 ± 0.6 to 6.9 ± 0.8 m/s) when compared to both Condition B (6.5 ± 0.8 to 6.4 ± 0.7 m/s) and Condition C (6.3 ± 0.8 to 6.4 ± 0.6 m/s), (all p < 0.05). No significant changes were observed in muscle oxygenation variables across conditions. These findings suggest that the number of repetitions per set and total time under tension (Condition A), rather than absolute load or set volume, play a more important role in mediating acute hemodynamic responses following RT.

Objective To summarise the evidence for changes in physical activity outcomes during robot-assisted gait training in patients with spinal cord injury. Data sources The Web of Science, Physiotherapy Evidence Database, Central, Medline, Scopus and SportDiscus databases were searched in August 2025 for studies that recorded ≥1 physical activity outcome during robot-assisted gait training. Review methods Data were synthesised according to the Synthesis Without Meta-analysis guidelines. Risk of bias was assessed using the Physiotherapy Evidence Database scale or the Revised Risk of Bias Assessment Tool for Non-Randomised Studies. Certainty of evidence was established following the Grading of Recommendations, Assessment, Development and Evaluations framework. The report followed the Preferring Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results Thirty studies (638 participants) were eligible for inclusion. Quality of the randomised studies ranged from ‘Fair’ to ‘Good’, while there was high risk of bias for all non-randomised studies in ≥1 domain. Robot-assisted gait training significantly improved physical activity outcomes (up time, walk time, walk distance, walk speed and number of steps) over time, though these findings were constrained by very low certainty of evidence. Conclusion Up time, walk time, walk distance, walk speed, and number of steps were significantly improved across the robot-assisted gait training period for patients with spinal cord injury. Robot-assisted gait training during rehabilitation for people following spinal cord injury is a useful adjunct to support independence and improved walking ability.

Acute prolonged sitting increases blood pressure (BP) and arterial stiffness (AS). Both of these may be mitigated via light physical activity (LPA). Whether long COVID (LC), which partly manifests as vascular sequelae, predisposes a heightened sensitivity to sitting or diminished benefits from its interruption is unknown. The aims of this study were to identify whether individuals with LC: (i) exhibit a worse BP/AS response to uninterrupted sitting and (ii) a diminished mitigation of BP/AS response to sitting interrupted with LPA, compared to healthy controls. Thirty participants with LC and 15 controls completed 2 h of uninterrupted sitting and sitting interrupted with LPA. Central and peripheral systolic and diastolic BP and carotid‐femoral pulse wave velocity (cfPWV) were determined pre and post sitting. Linear mixed‐effects models demonstrated no three‐way or two‐way interactions for any variable. There was a significant main effect of time, with increases in central systolic (MD = 3.37 mmHg, SE = 0.93 mmHg, p < 0.001) and central diastolic (MD = 3.00 mmHg, SE = 0.58 mmHg, p < 0.001) BP. cfPWV was not altered in sitting in either group (MD = 0.13 m/s, SE = 0.09 m/s, p = 0.170). Uninterrupted sitting increases BP similarly, but AS is unchanged. Interrupting sitting with LPA did not mitigate sitting‐induced increase in BP regardless of LC diagnosis.

This study compared the acute effects of resistance training (RT) between a moderate (ML) and a high loading (HL) intensity (12RM vs. 4RM, respectively), with the same intensity of effort on arterial stiffness and wave reflection in young healthy adults. Eleven healthy adults (age 36.4 ± 6.8 years) performed two RT protocols, ML and HL, in a randomized order. Both RT sessions consisted of three sets of deadlifts and three sets of bench presses, with 2 min rest between sets and exercises. Loading intensity was 12RM and 4RM for the ML and HL conditions, respectively. Measurements of pulse wave velocity (PWV) and pulse wave analysis (PWA; e.g., augmentation index) were collected at baseline, immediately post, and 15 min post‐training. ML elicited significantly greater increases in carotid‐femoral PWV (from 6.4 ± 0.3 to 7.3 ± 0.5), and augmentation index normalized to 75 bpm (from −5.1 ± 1.1) than HL (all p < 0.05). These findings demonstrate that an acute bout of RT performed to volitional failure using lower loads and higher repetitions impose a greater workload on the arterial and cardiovascular system in comparison to a RT scheme with heavier loads and lower repetitions.

This study compared acute changes in measures of arterial stiffness (AS) between two resistance training (RT) protocols that were load, volume and rest matched, but differed in intensity of effort. Eleven healthy adults (36.4 ± 6.8 years) performed a RT protocol with high intensity of effort (HE) and a RT protocol with low intensity of effort (LE). The HE protocol consisted of 3 sets of 12 repetitions, while the LE comprised of 6 sets of 6 repetitions. Loading intensity, volume load, and total rest duration were equivalent between the RT sessions. Pulse wave velocity, augmentation index values collected at baseline, immediately post and 15 min post‐exercise. HE elicited significantly greater increases in carotid‐femoral pulse wave velocity (6.4 ± 0.3 to 7.3 ± 0.5 m/s) when compared to LE (6.6 ± 0.3 to 6.7 ± 0.3 m/s) (p < 0.05). Both HE and LE induced significant increases in augmentation index (13 ± 5.6 to 28.1 ± 9.3%) post exercise (all p < 0.05). These findings demonstrate that RT with a lower intensity of effort attenuate increases in measures of arterial stiffness compared to a RT scheme at higher intensity of effort when volume load and total rest are equalized.

Background: Intermittent pneumatic compression (IPC) therapy may benefit stroke patients by eliciting more intensive training sessions that may result in better health, mobility and ultimately quality of life. The purpose of this randomized controlled trial was to assess the effect of using a home-based IPC device on functional outcomes and vascular health in individuals with chronic stroke. Methods: Thirty-one stroke survivors (64.3 ± 14.3y; 4.3 ± 2.7y since stroke) completed pre- and post-intervention assessments of functional capacity (six-minute walk test [6MWT], timed-up-and-go, 10m walk test), vascular health (pulse wave analysis, carotid-femoral pulse wave velocity), and physical activity. Following the pre-assessment, individuals were randomly assigned to either a daily, 12-week, home-based IPC group, or to a usual care control (CON) group. Outcomes were assessed using analysis of covariance (ANCOVA), controlling for age and any baseline differences. Results: Following ANCOVA, a significant increase in 6MWT walking distance was observed post-assessment for the IPC (Mean ± SD [95%CI]; 188 ± 19 m [177–199m]) but not the CON group (167 ± 19 m [157–178m]) (p < 0.05). A significant reduction in peripheral systolic blood pressure was reported at the post-assessment for the IPC group (136.2 ± 8.0 mmHg [131.9–140.4 mmHg]) but not for CON (142.2 ± 8.0 mmHg [138.1–144.6 mmHg]) (p < 0.05). Similar findings were observed for central systolic blood pressure. Physical activity levels significantly increased at the post-assessment for IPC (1857 ± 879 MET·min−1·week−1 [1390–2325 MET·min−1·week−1]) but not for the CON group (1161 ± 879 MET·min−1·week−1 [677–1645 MET·min−1·week−1]), while for time spent sitting, a significantly greater reduction was observed at the post-assessment for the IPC group (396 ± 86 mins [350–442 mins]) compared to CON (486 ± 86 mins [439–534 mins]) (both p < 0.05). Conclusions: The observed improvements in functional mobility, cardiovascular health, increased physical activity and reduced sedentary time demonstrates important clinical implications of ‘home-based’ IPC therapy as a clinical training aid for stroke rehabilitation. Home-based IPC therapy could serve as an adjunct to conventional rehabilitation, however, further research is needed to determine whether IPC therapy can sustain or improve function over time for individuals in the chronic stage of recovery.

To maintain normal cellular and physiological function, sufficient oxygen is required. Recently, evidence has suggested that hypoxia, either pathological or environmental, may influence bone health. It appears that bone cells are distinctly responsive to hypoxic stimuli; for better or worse, this is still yet to be elucidated. Hypoxia has been shown to offer potentially therapeutic effects for bone by inducing an osteogenic–angiogenic response, although, others have noted excessive osteoclastic bone resorption instead. Much evidence suggests that the hypoxic-inducible pathway is integral in mediating the changes in bone metabolism. Furthermore, many factors associated with hypoxia including changes in energy metabolism, acid–base balance and the increased generation of reactive oxygen species, are known to influence bone metabolism. This review aims to examine some of the putative mechanisms responsible for hypoxic-induced alterations of bone metabolism, with regard to osteoclasts and osteoblasts, both positive and negative.