Plicní arteriální hypertenze (PAH) je vzácné a potenciálně fatální onemocnění malých plicních cév, jejichž vazokonstrikce a remodelace vede k nárůstu plicní cévní rezistence a k tlakovému zatížení pravé komory srdeční. I přes významný pokrok ve specifické léčbě PAH, která má přede- vším vazodilatační a částečně antiremodelační potenciál, zůstává mortalita PAH relativně vysoká. Sotatercept je rekombinantní fúzní protein, který ovlivněním signální cesty aktivinu rebalancuje proproliferativní působení této signální cesty a antiproliferativní působení signální cesty kostního morfogenetického proteinu. V rozsáhlém klinickém programu se sotaterceptem u nemocných s PAH, kteří již byli léčeni specifickou léčbou, vedlo podání přípravku formou podkožní injekce v intervalu 3 týdny k významnému zlepšení hemodynamiky, zátěžové kapacity, funkce pravé komory srdeční, kvality života a k oddálení doby do klinického zhoršení. Ke klinicky významným nežádoucím účinkům patří vzestup koncentrace hemoglobinu se zvýšením rizika tromboembolických komplikací, pokles počtu trombocytů, rozvoj teleangiektazií a riziko krvácení. Na základě rozsáhlé evidence o významné účinnosti a dobré bezpečnosti sotaterceptu se tento lék stává součástí kombinačních terapeutických schémat u PAH. Součástí léčby musí být pečlivá monitorace možných nežádoucích účinků, především pravidelné sledování koncentrace hemoglobinu a počtu trombocytů

Pulmonary arterial hypertension (PAH) is a rare and potentially fatal disease of the small pulmonary vessels, whose vasoconstriction and remodeling leads to an increase in pulmonary vascular resistance and pressure load on the right ventricle. Despite significant advances in specific treatments for PAH, which have primarily vasodilatory and partially antiremodeling potential, mortality in PAH remains relatively high. Sotatercept is a recombinant fusion protein that, by affecting the activin signaling pathway, rebalances the proproliferative action of this signaling pathway and the antiproliferative action of the bone morphogenetic protein signaling pathway. In a large clinical program with sotatercept in patients with PAH who were already treated with specific therapy, administration of the drug by subcutaneous injection at 3-week intervals resulted in significant improvements in hemodynamics, exercise capacity, right ventricular function, quality of life, and delayed time to clinical deterioration. Clinically significant adverse effects include a rise in haemoglobin concentration with an increased risk of thromboembolic complications, a decrease in platelet count, the development of telangiectasia and the risk of bleeding. On the basis of the extensive evidence of significant efficacy and good safety of sotatercept, it is becoming part of combination therapy regimens for PAH. Careful monitoring of possible adverse effects, especially regular monitoring of haemoglobin concentration and platelet count, must be part of the treatment.

Obezita a diabetes mellitus 2. typu (DM2T) sú významnými rizikovými faktormi rozvoja kognitívnej dysfunkcie a neurodegeneratívnych ochorení. Ich spoločný patofyziologický základ zahŕňa inzulínovú rezistenciu, chronický subklinický systémový zápal a neurozápal, poruchy mikrobiómu, hormonálnu dysreguláciu a štrukturálne zmeny mozgu. Tieto faktory vedú k zhoršeniu pamäte, exekutívnych funkcií a k akcelerácii neurodegenerácie. Pozitívne účinky úpravy životného štýlu – vrátane zníženia telesnej hmotnosti, zvýšenia fyzickej aktivity a úpravy výživy a stravovacích návykov – sa prejavujú zlepšením inzulínovej senzitivity v mozgu, zvýšením neurotrofických faktorov, redukciou systémového zápalu a neurozápalu a zlepšením metabolizmu. Kombinácia behaviorálnych a farmakologických intervencií môže spomaliť kognitívny pokles a znížiť riziko demencie u populácie s obezitou a poruchou metabolizmu glukózy.

Obesity and type 2 diabetes (T2D) are important risk factors for the development of cognitive dysfunction and neurodegenerative diseases. Their common pathophysiological substrate includes insulin resistance, chronic subclinical systemic inflammation, neuroinflammation, shifts in the intestinal microbiome composition, hormonal dysregulation, and structural changes of the brain. These factors lead to impaired memory, executive functions, and accelerated neurodegeneration. The positive effects of lifestyle modifications — including weight loss, increased physical activity, and improved dietary composition — are manifested by improved insulin sensitivity in the brain, increased neurotrophic factors, reduced systemic inflammation and neuroinflammation, and improved metabolism. A combination of behavioral and pharmacological interventions may slow cognitive decline and reduce the risk of dementia in patients with obesity, prediabetes and T2D.

• MeSH
• Exercise MeSH
• Diabetes Mellitus, Type 2 complications   MeSH
• Weight Loss MeSH
• Cognition Disorders * etiology   MeSH
• Humans MeSH
• Neurodegenerative Diseases etiology   MeSH
• Obesity * complications   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

BACKGROUND: Type 2 diabetes and prediabetes represent significant global health challenges, with physical activity (PA) being essential for disease management and prevention. Despite the well-documented benefits, many individuals with (pre)diabetes remain insufficiently active. General practitioners (GP) provide an accessible platform for delivering interventions; however, integrating PA interventions into routine care is hindered by resource constraints. OBJECTIVES: The ENERGISED trial aims to address these barriers through an innovative GP-initiated mHealth intervention combining wearable technology and just-in-time adaptive interventions. METHODS: The ENERGISED trial is a pragmatic, 12-month, multicentre, randomised controlled trial, assessing a GP-initiated mHealth intervention to increase PA and reduce sedentary behaviour in patients with type 2 diabetes and prediabetes. The primary outcome is daily step count, assessed via wrist-worn accelerometry. The primary analysis follows the intention-to-treat principle, using mixed models for repeated measures. Missing data will be handled under the missing-at-random assumption, with sensitivity analyses exploring robustness through reference-based multiple imputation. The trial incorporates the estimand framework to provide transparent and structured treatment effect estimation. DISCUSSION: This statistical analysis plan outlines a robust approach to addressing participant non-adherence, protocol violations, and missing data. By adopting the estimand framework and pre-specified sensitivity analyses, the plan ensures methodological rigour while enhancing the interpretability and applicability of results. CONCLUSIONS: The ENERGISED trial leverages innovative mHealth strategies within primary care to promote PA in individuals with (pre)diabetes. The pre-specified statistical framework provides a comprehensive guide for analysing trial data and contributes to advancing best practices in behavioural intervention trials for public health. TRIAL REGISTRATION: ClinicalTrials.gov NCT05351359 . Registered on April 28, 2022.

• MeSH
• Accelerometry MeSH
• Exercise * MeSH
• Diabetes Mellitus, Type 2 * therapy   psychology   diagnosis   MeSH
• Fitness Trackers MeSH
• Humans MeSH
• Multicenter Studies as Topic MeSH
• Wearable Electronic Devices MeSH
• Pragmatic Clinical Trials as Topic MeSH
• General Practice * methods   MeSH
• Prediabetic State * therapy   psychology   diagnosis   MeSH
• Sedentary Behavior * MeSH
• Telemedicine * statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Clinical Trial Protocol MeSH

Majkić, B, Stojanović, N, Lilić, A, and Milanović, Z. The effects of a 6-week resisted small-sided games training program on the power performance of young soccer players. J Strength Cond Res 39(7): e870-e877, 2025-Small-sided games (SSG) with additional load can improve power performance in soccer players. The purpose of this study was to determine the effects of a 6-week resisted SSG training program on power performance in young soccer players. Twenty-two under-17 top-national youth-level soccer players (age: 16.11 ± 0.41 years; height: 176.31 ± 5.71 cm; body mass: 65.16 ± 8.1 kg) were randomly allocated to a weighted vests group (WV; n = 11), which wore weighted vests of 10% of their body mass or control group (CG; n = 11) with no additional load during sessions. Subjects performed vertical jump test, sprint running test (5, 10, and 30 m), and change of direction tests (COD) (Slalom, t test, and 4 × 5 m). The 6-week experimental program, implemented into regular sessions, included 2 additional SSGs per week and consisted of 3 sets lasting 3 minutes with 3-minute rest intervals. The players were divided into 2 teams of 5 and 2 of 6 players, each consisting of a mix of players from WV and CG, and performed SSG on the field area corresponding to 75 m 2 per player. Results revealed an improvement for WV in jump height by 7.34% (ES = 1.79) and in Peak Power (PP) by 4.40%. Significant interaction effects were observed in the Slalom and 4 × 5 m tests, and there was a distinction for 5 and 30 m sprints but with no statistically significant interaction effects. It is concluded that implementing resisted SSGs during the preparatory period can enhance jump height, PP, COD, and 5 m sprint time in young soccer players.

• MeSH
• Running physiology   MeSH
• Soccer * physiology   MeSH
• Humans MeSH
• Adolescent MeSH
• Resistance Training * methods   MeSH
• Athletic Performance * physiology   MeSH
• Muscle Strength * physiology   MeSH
• Exercise Test MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Randomized Controlled Trial MeSH

The aim of this study was to compare the effects of 3 sets of isometric conditioning activity (ICA), each with an equal total duration (9 s per set) but with different distributions contractions, on force production during ICA and subsequent countermovement jump (CMJ) performance. Fifteen resistance-trained males participated in this study (age: 22.1 ± 2.4 years; body mass: 85.1 ± 9.7 kg; height: 181.3 ± 6.5 cm; relative one-repetition maximum (1RM) in back squat: 1.59 ± 0.32 kg/kg of body mass). Participants completed 3 conditions, each consisting of ICA in the half-back squat with a pushing isometric muscle action (PIMA) position at a 120-degree knee angle against an immovable barbell, differing in repetition distribution: 3 sets of 9 repetitions lasting 1 s each (SUST-1), 3 sets of 3 repetitions lasting 3 s each (SUST-3), 3 sets of single repetitions lasting 9 s (SUST-9), and a control condition (CTRL) without ICA. A 1-minute rest was allowed between sets. Approximately 3 min pre-ICA and at 15 s, 3-, 6-, 9-, and 12-minutes post-ICA, the CMJ performance was assessed. Moreover, peak force (PF) production, and force generated at 100 (Force100) and 200 ms (Force200) during each ICA were evaluated. A two-way repeated measures ANOVA indicated a main effect of time on CMJ height (F = 2.674; p = 0.029; ηp2=0.171) but did not show significant differences between conditions (F = 0.934; p = 0.434; ηp2=0.067) or interactions (F = 0.826; p = 0.648; ηp2=0.060). Post-hoc comparisons indicated a significant decrease in CMJ height at the 9th minute compared to the 3rd minute (35.7 ± 5.6 cm vs. 36.8 ± 5.5 cm post-CA; d = 0.161; p = 0.048). In addition, no significant interactions or main effects were found for CMJ contraction time, PF and Force100 during ICA. However, a main effect of condition was demonstrated on Force200 (F = 19.181; p < 0.001; ηp2= 0.013). Post-hoc comparisons revealed higher Force200 values in SUST-1 (mean difference [MD] = 549 ± 137 N; d = 1.049; p < 0.001) and SUST-3 (MD = 348 ± 112 N; d = 0.665; p = 0.002) compared to the SUST-9 condition. None of the ICAs used in the present study had any effect on the CMJ performance. However, the significantly higher Force200 values noted in the SUST-1, and SUST-3 conditions compared to the SUST-9 condition suggest that the specific distributions of isometric contraction influence the force generated during their execution.

• MeSH
• Adult MeSH
• Isometric Contraction * physiology   MeSH
• Muscle, Skeletal * physiology   MeSH
• Humans MeSH
• Young Adult MeSH
• Resistance Training * methods   MeSH
• Athletic Performance * physiology   MeSH
• Muscle Strength physiology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: Effective diabetes management requires a multimodal approach involving lifestyle changes, pharmacological treatment, and continuous patient education. Self-management demands can be overwhelming for patients, leading to lowered motivation, poor adherence, and compromised therapeutic outcomes. In this context, digital health apps are emerging as vital tools to provide personalized support and enhance diabetes management and clinical outcomes. OBJECTIVE: This study evaluated the impact of the digital health application Vitadio on glycemic control in patients with type 2 diabetes mellitus (T2DM). Secondary objectives included evaluating its effects on cardiometabolic parameters (weight, BMI, waist circumference, blood pressure, and heart rate) and self-reported measures of diabetes distress and self-management. METHODS: In this 6-month, 2-arm, multicenter, unblinded randomized controlled trial, patients aged 18 years or older diagnosed with T2DM were randomly assigned (1:1) to an intervention group (IG) receiving standard diabetes care reinforced by the digital health app Vitadio or to a control group (CG) provided solely with standard diabetes care. Vitadio provided a mobile-based self-management support tool featuring educational modules, motivational messages, peer support, personalized goal setting, and health monitoring. The personal consultant was available in the app to provide technical support for app-related issues. The primary outcome, assessed in the intention-to-treat population, was a change in glycated hemoglobin (HbA1c) levels at 6 months. Secondary outcomes included changes in cardiometabolic measures and self-reported outcomes. Data were collected in 2 study centers: diabetologist practice in Dessau-Roßlau and the University of Dresden. RESULTS: Between November 2022 and June 2023, a total of 276 patients were screened for eligibility, with 149 randomized to in intervention group (IG; n=73) and a control group (CG; n=76). The majority of participants were male (91/149, 61%). The dropout rate at month 6 was 19% (121/149). While both groups achieved significant HbA1c reduction at 6 months (IG: mean -0.8, SD 0.9%, P<.001; CG: mean -0.3, SD 0.7%, P=.001), the primary confirmatory analysis revealed statistically significant advantage of the IG (adjusted mean difference: -0.53%, SD 0.15, 95% CI -0.24 to -0.82; P<.001; effect size [Cohen d]=0.67, 95% CI 0.33-1). Significant between-group differences in favor of the IG were also observed for weight loss (P=.002), BMI (P=.001) and systolic blood pressure (P<.03). In addition, Vitadio users experienced greater reduction in diabetes-related distress (P<.03) and obtained more pronounced improvements in self-care practices in the areas of general diet (P<.001), specific diet (P<.03), and exercise (P<.03). CONCLUSIONS: This trial provides evidence for the superior efficacy of Vitadio in lowering the HbA1c levels in T2DM patients compared to standard care. In addition, Vitadio contributed to improvements in cardiometabolic health, reduced diabetes-related distress, and enhanced self-management, highlighting its potential as an accessible digital tool for comprehensive diabetes management. TRIAL REGISTRATION: German Clinical Trials Registry DRKS00027405; https://drks.de/search/de/trial/DRKS00027405.

• MeSH
• Diabetes Mellitus, Type 2 * blood   therapy   MeSH
• Adult MeSH
• Glycated Hemoglobin analysis   MeSH
• Middle Aged MeSH
• Humans MeSH
• Mobile Applications * MeSH
• Self Care MeSH
• Self-Management MeSH
• Aged MeSH
• Telemedicine MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Randomized Controlled Trial MeSH

INTRODUCTION: Resistance exercises are effective for maintaining health and activating stabilizing muscles, as they trigger abdominal wall tension responses. This study compared the effects of multi-joint and single-joint, upper-body and lower-body exercises (Lat pulldown, Rows, Peck deck, Chest press, Biceps curls, Triceps extensions, French-Press, Step up, Hip abduction/adduction, Squat, Leg press, Romanian deadlift, Hamstring curls) performed at maximal and submaximal intensities. METHODS: This cross-sectional study included 12 men and 18 women (age:47.8 ± 5.9 years, height:174.8 ± 10.2 cm, weight: 77.7 ± 15.4 kg, BMI:25.3 ± 3.6), who wore a noninvasive sensor Ohmbelt to measure abdominal wall tension performing exercises at 15 repetition maximum (RM), 10RM, 5RM, and 1RM. Differences across exercises and sex were compared by Friedman test with Durbin-Conover post-hoc, and intensities were analyzed by Wilcoxon test. RESULTS: The study found significant differences (p < 0.05) in abdominal wall tension changes based on the type of exercise and training intensity. Multi-joint lower-body exercises, such as the Romanian deadlift, dumbbell front squat, and leg press, led to the greatest increases in abdominal tension in both sexes in comparison to single-joint upper-body exercises. Males had higher abdominal wall tension changes than females (p < 0.05) at 1RM, 5RM, and 10RM. However, no significant difference was found at 15RM, indicating that lower intensities produce similar abdominal wall tension changes in both sexes. CONCLUSIONS: This study showed that multi-joint lower-body exercises were found to produce greatest abdominal wall tension increases, especially compared to single-joint upper-body exercises. The abdominal wall tension was higher in males than females due to higher loads, emphasizing the need for exercise-specific approaches.

• Publication type
• Journal Article MeSH

BACKGROUND: Muscle strength and postural control are essential components for performing daily living activities, particularly in older adults, and can therefore serve as screening tools for assessing fall risk in this population. METHODS: The aim of this quasi-experimental study was to evaluate the impact of a 12-week exercise intervention followed by a 2-week detraining period on lower limb strength and postural stability in older adults. The study involved 38 community-dwelling participants of Central European origin over 60 years of age. Participants underwent the measurements consisting of assessments of knee flexors and extensors strength (isokinetic dynamometer, 90° range of motion, 60°/s angular velocity, Humac Norm CSMI, Stoughton MA, USA), toe grip strength (toe grip dynamometer, Takei Scientific Instruments, Niigata, Japan), and postural stability (narrow stand, 30 s, Kistler, Switzerland). Testing was repeated three times during the study (pre-intervention, post-intervention, and post-detraining). Participants were separated into 3 groups according to the type of training: resistance training group (n = 13), proprioceptive training group (n = 14), and endurance training group (n = 11). The intervention program lasted 12 weeks, two 60-min sessions per week. A linear mixed model (LMM) predicted a change in postural stability after the resistance, proprioceptive, and endurance exercise interventions were applied. RESULTS: Results showed that knee extensor strength normalized to body mass significantly increased in the resistance training group post-intervention (p = 0.01). Toe grip strength was significantly higher after the intervention in the endurance training group (p = 0.02). A statistically significant increase in knee flexor strength was observed in the proprioceptive training group (p = 0.01). The 2-weeks detraining period revealed no statistically significant loss in training gains. The LMM found different predictions of postural stability changes related to knee extensor strength after each type of training intervention. The final LMM model explains well the variability of the dependent variable R2 = 0.866. CONCLUSIONS: These results highlight the unique characteristics of specific exercise interventions in enhancing muscular strength and postural stability, which are critical for fall prevention among older adults.

• MeSH
• Time Factors MeSH
• Exercise * physiology   MeSH
• Lower Extremity * physiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Linear Models MeSH
• Resistance Training * methods   MeSH
• Postural Balance * physiology   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Muscle Strength * physiology   MeSH
• Exercise Therapy * methods   MeSH
• Accidental Falls prevention & control   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

We aimed to determine the persisting effects of various exercise modalities and intensities on functional capacity after periods of training cessation in older adults. A comprehensive search was conducted across the Cochrane Library, PubMed/MEDLINE, Scopus, and Web of Science Core Collection up to March 2024 for randomized controlled trials examining residual effects of physical exercise on functional capacity in older adults ≥ 60 years. The analysis encompassed 15 studies and 21 intervention arms, involving 787 participants. The exercise and training cessation periods ranged from 8 to 43 weeks and 4 to 36 weeks, respectively. Meta-analyses were performed using change scores from before the physical exercise to after the training cessation. The effect sizes (ES) were calculated as the standardized mean differences between the intervention and control groups' change scores. Subgroup analyses and meta-regressions explored the influence of participant characteristics, the magnitude of the effect produced by the initial training program, various exercise modalities (resistance and multicomponent training) and intensities (high and low), and subdomains of functional capacity (agility, balance, standing ability, walking ability, and stair walking). The findings revealed that exercise interventions had a significant effect on preserving functional capacity after training cessation (ES = 0.87; p < 0.01). This protective effect was consistent across various exercise modalities and intensities (ES ≥ 0.67; p ≤ 0.04). The benefits obtained during the training program were positively associated with the residual effects observed after training cessation (β = 0.73; p < 0.01), while age negatively influenced the persisting adaptations (β = -0.07; p < 0.01). Current evidence suggests that exercise-based interventions, irrespective of modality and intensity, are highly effective in preventing functional declines after training cessation among older adults.

• MeSH
• Exercise * physiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Resistance Training methods   MeSH
• Postural Balance physiology   MeSH
• Randomized Controlled Trials as Topic MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Aged MeSH
• Publication type
• Journal Article MeSH
• Meta-Analysis MeSH
• Review MeSH
• Systematic Review MeSH

This study aimed to investigate the effects of performing either eccentric-only (ECC) or eccentric-concentric (ECC-CON) back squats (BS) with a supramaximal load on countermovement jump (CMJ) performance. Changes in front thigh skin surface temperature and mechanical properties (oscillation frequency and stiffness) of the vastus lateralis were also examined. Fourteen male powerlifters participated in this study (age: 22.5 ± 2.3 years, body weight: 84.2 ± 11.1 kg, height: 178 ± 7 cm, training experience: 5.4 ± 1.6 years, BS one-repetition maximum [1RM]: 177 ± 22.8 kg). The experimental sessions included 2 sets of 2 BS at 110% 1RM of either ECC-CON (load distributed by half on the barbell [55%] and on weight releasers [55%]) or ECC (only eccentric phase of BS) and CTRL with no CA applied. CMJ performance, mechanical properties, and skin surface temperature were measured before and at the third, sixth, ninth, and 12th min. After each protocol, only the ECC-CON condition led to a significant increase in CMJ height after individual optimal rest time compared to pre-CA (38.1 ± 5.2 vs. 39.8 ± 5.0 cm; p = 0.003; effect size [ES] = 0.32; Δ = 4.9 ± 5.0%) with a significant rise in skin surface temperature (32.98 ± 1.24 vs. 33.69 ± 0.96°C; p = 0.006; ES = 0.62; Δ = 2.2 ± 2.6%) and no significant changes in mechanical properties of the vastus lateralis. The ECC-CON condition led to a significant acute improvement in CMJ height and an increase in front thigh skin surface temperature among powerlifters. The ECC-CON supramaximal lower limb PAPE protocol should be effectively used among males representing high levels of lower limb muscle strength (>2 × body mass).

• MeSH
• Biomechanical Phenomena MeSH
• Quadriceps Muscle physiology   MeSH
• Adult MeSH
• Muscle, Skeletal physiology   MeSH
• Humans MeSH
• Young Adult MeSH
• Resistance Training MeSH
• Athletic Performance * physiology   MeSH
• Thigh physiology   MeSH
• Muscle Strength physiology   MeSH
• Skin Temperature * physiology   MeSH
• Weight Lifting * physiology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Publication type
• Journal Article MeSH