In this systematic review, we collected and analyzed literature works comparing self-reported fatigue and objectively-measured fatigue in individuals with cerebral palsy (CP) and in age-matched typically developing/typically developed (TD) controls (Healthy). The search was conducted on four electronic databases/platforms (PubMed, Web of Science, Cochrane Library, and Scopus) using the key words “cerebral palsy” combined with “fatig^*,” where the asterisk was used as a wildcard. As a critical appraisal tool, the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies (2017) was used. A total of 22 studies passed the critical appraisal rating and were included in both narrative and quantitative analyses. The overall evidence quality of the findings was considered very good. Data of objectively-measured fatigue in performing maximal fatiguing tasks indicated lower fatigue levels in participants with CP, possibly due to their pathological inability to recruit highly fatigable muscle fibers. Highly trained individuals with CP and TD controls performing maximal fatiguing tasks seem to be an exception to this, as they exhibited similar levels of fatigue. In submaximal fatiguing tasks, including daily physical activities, either objectively-measured or self-reported fatigue was higher in participants with CP than in TD controls, indicating a lower ability for development of neurophysiological compensation for fatigue among participants with CP. Further studies on fatigue are needed to gain an insight into the multifold mechanisms of fatigue in individuals with CP. Understanding fatigue mechanisms could help in setting up strategies for effective intervention programs, with benefits in healthcare and improved quality of life of individuals with CP.Systematic Review Registration: [PROSPERO 2019], identifier [CRD42019143524].

In the biomedical field, the differentiation between sex and gender is crucial for enhancing the understanding of human health and personalizing medical treatments, particularly within the domain of orthopedics. This distinction, often overlooked or misunderstood, is vital for dissecting and treating musculoskeletal conditions effectively. This review delves into the sex- and gender-specific physiology of bones, cartilage, ligaments, and tendons, highlighting how hormonal differences impact the musculoskeletal system’s structure and function, and exploring the physiopathology of orthopedic conditions from an epidemiological, molecular, and clinical perspective, shedding light on the discrepancies in disease manifestation across sexes. Examples such as the higher rates of deformities (adolescent idiopathic and adult degenerative scoliosis and hallux valgus) in females and osteoporosis in postmenopausal women illustrate the critical role of sex and gender in orthopedic health. Additionally, the review addresses the morbidity–mortality paradox, where women, despite appearing less healthy on frailty indexes, show lower mortality rates, highlighting the complex interplay between biological and social determinants of health. Injuries and chronic orthopedic conditions such osteoarthritis exhibit gender- and sex-specific prevalence and progression patterns, necessitating a nuanced approach to treatment that considers these differences to optimize outcomes. Moreover, the review underscores the importance of recognizing the unique needs of sexual minority and gender-diverse individuals in orthopedic care, emphasizing the impact of gender-affirming hormone therapy on aspects like bone health and perioperative risks. To foster advancements in sex- and gender-specific orthopedics, we advocate for the strategic disaggregation of data by sex and gender and the inclusion of “Sexual Orientation and Gender Identity” (SOGI) data in research and clinical practice. Such measures can enrich clinical insights, ensure tailored patient care, and promote inclusivity within orthopedic treatments, ultimately enhancing the precision and effectiveness of care for diverse patient populations. Integrating sex and gender considerations into orthopedic research and practice is paramount for addressing the complex and varied needs of patients. By embracing this comprehensive approach, orthopedic medicine can move towards more personalized, effective, and inclusive treatment strategies, thereby improving patient outcomes and advancing the field.

Regular physical activity plays a critical role in health promotion and athletic performance, necessitating personalized exercise and training prescriptions. While traditional methods rely on expert assessments, artificial intelligence (AI), particularly generative AI models such as ChatGPT and Google Gemini, has emerged as a potential tool for enhancing personalization and scalability in training recommendations. However, the applicability, reliability, and adaptability of AI-generated exercise prescriptions remain underexplored. A comprehensive search was performed using the UnoPerTutto metadatabase, identifying 2891 records. After duplicate removal (1619 records) and screening, 61 full-text reports were assessed for eligibility, resulting in the inclusion of 10 studies. The studies varied in methodology, including qualitative assessments, mixed-methods approaches, quasi-experimental designs, and a randomized controlled trial (RCT). AI models such as ChatGPT-4, ChatGPT-3.5, and Google Gemini were evaluated across different contexts, including strength training, rehabilitation, cardiovascular exercise, and general fitness programs. Findings indicate that generative AI-generated training programs generally adhere to established exercise guidelines but often lack specificity, progression, and adaptability to real-time physiological feedback. AI-generated recommendations were found to emphasize safety and broad applicability, making them useful for general fitness guidance but less effective for high-performance training. GPT-4 demonstrated superior performance in generating structured resistance training programs compared to older AI models, yet limitations in individualization and contextual adaptation persisted. A critical appraisal using the METRICS checklist revealed inconsistencies in study quality, particularly regarding prompt specificity, model transparency, and evaluation frameworks. While generative AI holds promise for democratizing access to structured exercise prescriptions, its role remains complementary rather than substitutive to expert guidance. Future research should prioritize real-time adaptability, integration with physiological monitoring, and improved AI-human collaboration to enhance the precision and effectiveness of AI-driven exercise recommendations.

The purpose of this study was to assess validity, stability and sensitivity, of 4 spectral parameters–median frequency (F_med), mean frequency (F_mean), Dimitrov index (DI), and mean instant frequency (F_mi)–in measuring localized muscle fatigue in swimming and to investigate their correlation with the variations of kinematic data and mechanical fatigue. Electrophysiological measures of muscle fatigue were obtained in real-time during a 100 m front crawl test at maximum speed in 15 experienced swimmers, using surface electromyography in six muscles employed in front crawl, while kinematic data of swimming was measured from video analysis. Mechanical fatigue was measured as the difference between muscle strength prior to and immediately after the 100 m front crawl in a dry-land multi-stage isometric contraction test. Statistically significant fatigue (p < 0.0001) was found for all spectral parameters in all muscles. F_med and F_mean varied between 10 and 25%, DI between 50 and 150%, and F_mi between 5 and 10%. Strong correlation (Pearson r ≥ 0.5) with mechanical fatigue was found for all spectral parameters except for F_mi and it was strongest for F_med and F_mean. From our study, it turns out that F_med and F_mean are more valid and stable parameters to measure fatigue in swimming, while DI is more sensitive.

Background and Objectives: Verbal encouragement (VE) can be used to enhance performance in several sports, even though no studies have been conducted among swimmers and only a few effects have been reported in elite athletes. Besides influencing motor performance, VE is also known to enhance the physical load, thus potentially increasing the probability of developing fatigue. With this in mind, this study aimed to explore the effects of VE in swimmers in order to fill in the knowledge gap concerning the aquatic environment. Materials and Methods: Each athlete swam a maximal 200 m freestyle trial under two different conditions: one trial with VE and the other without VE. The two main outcome measures were: (1) performance velocity (m/s); and (2) muscle fatigue, investigated by means of surface electromyography. Sixty swimmers were recruited, aged 18.63 ± 3.46 years (median 18 years), 28 men (47%), and 32 women (53%), with 7.03 ± 3.9 years of experience. Results: With VE, performance significantly improved in the swim trial (p < 0.001, effect size (ES) −0.95, large). When breaking the results down into the first half (first (0–100 m) vs. the second half (100–200 m)), the ES was large in the first part (−1.11), indicating an improvement in performance. This worsened, however, in the second part of the trial (ES 0.63). In the multivariate analysis, years of experience were found to be a significant predictor of the change in overall performance (p = 0.011). There was a significant increase in muscle fatigue induced by VE, overall, and during the second half, but not during the first half of the trial. Conclusions: The present study indicates that VE during a middle-distance event (200 m) increases performance most in swimmers with little experience. However, it has a negative impact on fatigue.

Background and Objectives: Table tennis represents one of the fastest ball games in the world and, as such, is characterized by unique physiological demands. Despite its popularity, there is a dearth of data related to table-tennis-related risk factors and injuries. Therefore, the present review was conducted to fill in this gap of knowledge. Material and Methods: The present review was designed as a scoping review. Eleven online databases were searched with no language/date limitations. Results: Forty-two investigations were retained in the present review. These studies indicated that tenosynovitis, benign muscle injuries, strains, and sprains were the most common injury types. In order, the most commonly affected anatomical regions were the lower limb, shoulder, spine, knee, upper limb, and trunk. When comparing the injury occurrence between training and competition, the results were contradictory. National/international athletes had higher indices of injury than regional players, even though other investigations failed to replicate such findings. According to some scholars, there was a difference between female and male athletes: in females, more injuries involved the upper limbs when compared to men who had more injuries to the lower limbs, while other studies did not find differences in terms of gender. Conclusions: Table tennis is generally considered at lower risk for injuries than other sports. However, the present scoping review showed that injuries can occur and affect a variety of anatomic regions. Sports scientists/physicians could utilize the information contained in the current review for devising ad hoc programs to adopt an effective/appropriate prevention strategy and to monitor table tennis players’ training load and to achieve maximal fitness, as these will reduce the risk of injuries. However, most of the studies included in our scoping review are methodologically weak or of low-to-moderate evidence, being anecdotal or clinical case reports/case series, warranting caution when interpreting our findings and, above all, further high-quality research in the field is urgently needed.