Background: Isometric exercise effectively reduces blood pressure (BP) but its effects on myocardial work have been poorly studied. For the present study, we compared acute changes in myocardial work during two different isometric exercises, namely, bilateral knee extension and handgrip, in patients with hypertension and underlying ischemic heart disease (IHD). Methods: This was a randomized pilot study in which 48 stable, trained patients with hypertension and IHD were enrolled. Patients were randomly assigned to perform a single session of bilateral knee extension (IKE) or handgrip (IHG) exercises or no exercise (control), with a 1:1:1 ratio. Both exercises were performed at 30% of maximal voluntary contraction and lasted three minutes. Echocardiography and BP measurements were performed at rest, during the exercise, and after ten minutes of recovery. Results: Both exercises were tolerated well, and no side effects occurred. During the exercise, the systolic BP increased significantly in the IKE group compared with the IHG and control groups (ANOVA p < 0.001). Left ventricular global longitudinal strain decreased significantly in the IKE group (−21%) compared with the IHG and control groups (ANOVA p 0.002). The global work index increased significantly in the IKE group (+28%) compared with the IHG and control groups (ANOVA p 0.034). Global constructive work and wasted work increased significantly in the IKE group compared with the IHG and control groups (ANOVA p 0.009 and <0.001, respectively). Global work efficiency decreased significantly in the IKE group (−8%) while remaining unchanged in the IHG and control groups (ANOVA p 0.002). Conclusions: Myocardial work efficiency was impaired during isometric bilateral knee extension but not during handgrip, which evoked a limited hemodynamic response.

Background: Short sessions of isometric exercise have been shown to reduce blood pressure (BP) in normotensive and hypertensive subjects. However, there are few data in hypertensive patients with underlying ischemic heart disease (IHD). In the present study, we compared post-exercise hypotension (PEH) induced by isometric versus combined, aerobic plus dynamic resistance exercise in IHD patients. Methods: Twenty-five stable patients with established IHD and with treated hypertension were enrolled. The study had a cross-over design. All patients performed in a random order and on different days: (1) isometric exercise session (IES) consisting of bilateral knee extension, performed at 20% of maximal voluntary contraction and lasting 20 min; (2) combined exercise session (CES) including moderate-intensity continuous exercise at and dynamic resistance exercise performed at 60% of one repetition maximum, and lasting 60 min and (3) control session (no exercise). BP was measured at rest, immediately after the training and then every 15 min up to 90 min. Results: The repeated measures ANOVA analysis showed that systolic BP significantly decreased after the CES session compared to the control (F = 6.2; p 0.001) and IES (F = 4.4; p 0.004). Systolic BP significantly decreased after IES compared to the control (F = 3.6; p 0.036). Diastolic BP did not show significant changes after CES and IES compared to the control (CES vs. control: F = 2.2; p 0.142; IES vs. control (F = 2.5; p 0.062). There were no significant differences in diastolic BP changes between CES and IES (CES vs. IES: F = 1.8; p 0.156). Conclusions: We observed that CES was more effective than IES in reducing systolic BP; IES was as effective as CES in inducing diastolic PEH in hypertensive patients with underlying IHD.

Background: Isometric handgrip (IHG) exercise reduces blood pressure (BP) in both normotensive and hypertensive individuals. However, there are few studies specifically addressing its effects in hypertensive patients with ischemic heart disease (IHD). This research aimed to compare acute hemodynamic responses and post-exercise hypotension to single bouts of IHG handgrip performed at two different intensities in patients with IHD. Methods: Fifty-four sedentary patients were enrolled and randomly assigned to one of three groups: (1) high-intensity isometric handgrip performed at 70% of maximal voluntary contraction (MVC) (IHG-70%); (2) low-intensity isometric handgrip performed at 30% of MVC (IHG-30%); (3) control group (no exercise). Heart rate and BP were measured, and transthoracic echocardiography was performed at baseline, during exercise (lasting 3 min), and after 15 min post-exercise. BP was also measured at 30, 45, and 60 min of recovery. Results: No significant changes in systolic BP occurred during the exercise phase between the three study groups. Systolic BP decreased significantly in IHG-70% compared to the control at 30 (−7.7 ± 1.9; p = 0.035) and 45 min (−8.1 ± 2.3; p = 0.021) post-exercise, while there were no significant differences between IHG-70% and IHG-30% at different time-points. There were no significant changes in diastolic BP between the two active groups and between IHG-70 and IHG-30 versus control at different time-points (repeated-measures ANOVA p = 0.257). Global work efficiency was unchanged in IHG-70% (−4%) and IHG-30% (+1%) compared to control (ANOVA p = 0.154). Conclusions: High-intensity and low-intensity isometric handgrip exercises did not cause hemodynamic impairment in IHD. High-intensity exercise was more effective than low-intensity in reducing post-exercise systolic BP.

Background: Isometric exercise effectively reduces blood pressure (BP) but its effects on myocardial work have been poorly studied. In the present study we compared acute changes in myocardial work during two different isometric exercise, bilateral knee extension and handgrip in patients with hypertension and underlying ischemic heart disease (IHD). Methods: 48 stable, trained patients with hypertension and IHD were enrolled. They were randomly assigned to perform a single session of bilateral knee extension (IKE) or handgrip (IHG) or no exercise (control) with a 1:1:1 ratio. Both exercises were performed at 30% of maximal voluntary contraction and lasted three minutes. Echocardiography and BP measurements were performed at rest, during the exercise and after ten minutes of recovery. Results: both exercises were well tolerated, and no side effects occurred. During the exercise: systolic BP increased significantly in the IKE group compared to IHG and control (ANOVA p <0.001). LVGLS decreased significantly in IKE (-21%) compared IHG and control (ANOVA p 0.002). The global work index increased significantly in KE (+28%) compared to HG and control (ANOVA p 0.034). Global constructive work and wasted work increased significantly in the IKE compared to HG and control (ANOVA p 0.009 and <0.001 respectively). Global work efficiency decreased significantly in the IKE group (-8%) while remained unchanged in the IHG and controls (ANOVA p 0.002). Systolic BP increased significantly in the KE group and was unchanged in HG and control. Conclusion: myocardial work efficiency was impaired during isometric bilateral knee extension but not during handgrip. Handgrip evoked a limited hemodynamic response.

Italian swimming emphasizes the early specialization of selected children from approximately 6 to 7 years old. Such an approach often leads to selection biases (i.e., birth advantages), which may undermine swimmers’ development and progression through the talent pathway. Accordingly, this study aimed to: (a) explore the presence of birth advantages at the annual Italian national age-group competition by observing the birth quarter (BQ) and place of early development (PED) distribution of 514 U15 swimmers; and (b) investigate how birth advantages affect swimmers’ ability to maintain their national status by comparing the BQ and PED distributions of 555 U17 national-level swimmers to the expected values (i.e., U15 distribution). Chi-square statistics for the U15 revealed an overrepresentation of BQ1s and swimmers developing in north and central Italy (p-values < 0.0001). In contrast, the U17’s BQ (p < 0.001) and PED (p = 0.01) distributions appeared skewed compared to the U15, favoring swimmers born in BQ3 and BQ4, and swimmers developing in north Italy (odds ratios: 1.69, 1.76, 1.39 respectively). The findings highlighted that cultural–contextual features of the environment shape Italian youth swimmers’ development and their progression through the current talent pathway.

Background: Quantitative gait analysis is essential in both clinical and research contexts; however, traditional marker-based motion capture systems are costly and burdensome. Advances in three-dimensional markerless motion capture (3D-MMC) offer more accessible alternatives; however, they lack standardized protocols. Objectives: The present study aimed to establish a standardized protocol and procedures for 3D MMC-based gait analysis using OpenCap and to quantify the reliability and within-session precision of key spatiotemporal gait parameters. Methods: Fifty healthy university students (mean age = 22.15 ± 2.12 years) completed walking trials along a 10 m walkway under single-task (ST) and five dual-task (DT) conditions of varying cognitive complexity. Gait data were collected using a two-camera OpenCap 3D-MMC system, with standardized calibration, lighting, clothing, and trial segmentation. Spatiotemporal parameters were extracted, and within-session relative reliability was quantified using two-way mixed-effects intraclass correlation coefficients, and absolute reliability was quantified using general linear model–derived within-subject error (standard error of measurement, SEM) and minimal detectable change (MDC). Repeated-measures ANOVA with Bonferroni corrections were used to examine condition-related differences. Results: Of 500 trials, 491 (98.2%) were successfully processed. Within-subject test–retest reliability ranged from moderate to excellent for all variables, with gait speed, stride length, and cadence showing the highest ICCs and smallest SEM and MDC values, and step width and double support exhibiting larger measurement error. Conclusions: This study establishes a standardized 3D-MMC protocol for gait analysis using OpenCap and demonstrates good to excellent within-session relative and absolute reliability for most spatiotemporal gait parameters in healthy young adults. Dual-task walking is used here to illustrate how trial-averaged OpenCap measurements and their SEM/MDC can be used to determine which condition-related changes in gait exceed measurement error.