Objectives: To compare the acute effects of upper cervical manipulation (CM) and manual massage (MM) to simulated CM (Sham) and Control conditions (Control) on heart rate variability (HRV) and blood pressure (BP) responses in women with non-elevated BP. Methods: A single-blind, four-arm, parallel-group, randomized, crossover, placebo-controlled trial recruited 15 apparently healthy women with non-elevated BP who visited the lab on four occasions with 48 h intervals to ensure adequate washout between interventions. A Latin square randomization approach was employed to assign participants to one of four experimental conditions: (1) Control: Rest without intervention; (2) CM: Bilateral high-velocity, low-amplitude manipulation of the upper cervical spine (C0–C2); (3) MM: A single 120 s session of MM release applied unilaterally to the anterior and posterior thigh, posterior lower leg, and lumbar musculature; or (4) Sham: Mimicking the positioning used in CM without the application of thrust manipulation. In each experiment, HRV, systolic and diastolic BP were measured at rest (Baseline) and every 15 min for 60 min after each intervention. All procedures were performed in the morning to avoid any confounding circadian rhythm effect on HRV and BP. Results: We found significant increases within conditions for RMSSDms (Control: Post-0 (p = 0.032), Post-15 (p = 0.023); Sham: Post-15 (p = 0.014); CM: Post-15 (p = 0.027)); SDNNms (Control: Post-45 (p = 0.037); CM: Post-45 (p = 0.014) and Post-60 (p = 0.019)); PNN50% (CM: Post-0 (p = 0.044), Post-15 (p = 0.044) and Post-45 (p = 0.019)); LF Power (ms2) (CM: Post-60 (p = 0.001)), and LF/HF ratio (MM: Post-60 (p = 0.022). Conclusions: Although no statistically significant between-condition differences were detected, within-condition changes with moderate-to-large effect sizes suggest potential clinical relevance of CM and MM. These preliminary findings emphasize the importance of effect sizes and may indicate greater translational significance in populations with non-elevated cardiovascular risk.

É superficial dizer que a prática de esportes é uma questão física, uma vez que após inúmeros estudos começamos a ter um entendimento mais amplo sobre a importância da mente sobre os aspectos da mente quanto ao desenvolvimento satisfatório nas competições. O aprendizado de habilidades psicológicas, tal como o aprendizado das habilidades técnicas e táticas, deve ser praticado regularmente e refinado a partir de seu emprego sistemático. O objetivo do presente estudo foi realizar uma revisão de escopo na literatura existente sobre os efeitos da meditação mindfulness nas respostas psicológicas e fisiológicas em atletas de alto rendimento e de ambos os sexos. A busca foi realizada em maio de 2024 nas bases de dados da Nursing and Allied Health (CINAHL), Cochrane Library, PubMed® e Scielo, retornando com 32 artigos, aceitos pelos critérios de inclusão, sendo analisados. Foram incluídos no estudo atletas de ambos os sexos que utilizavam como abordagem principal o mindfulness. Neste contexto foi avaliado, como desfechos, o desempenho fisiológico (concentração de cortisol, creatina quinase, lactato desidrogenase, testosterona, resposta imunológica, variabilidade da frequência cardíaca, frequência cardíaca de repouso e volume máximo de oxigênio), respostas psicológicas (níveis de ansiedade e depressão) e índices de desempenho muscular (número de repetições máximas, volume total de treino e carga mobilidade ao longo de testes de repetições máximas). Observou-se que a meditação mindfulness apresentou melhora na qualidade do sono, aumento na tolerância a dor, redução nos níveis séricos de cortisol sanguíneo, aumento da confiança, redução do estresse e ansiedade. A literatura de fato começa a se aprofundar sobre a meditação relacionada ao desempenho físico-esportivo, mas ainda assim novas pesquisas precisam ser aplicadas para que traga mais embasamento científico afim de favorecer esporte de alto rendimento de forma eficiente e segura. Baseado nas respostas encontradas nesta revisão sistemática, a meditação mindfulness parece ser uma interessante estratégia a ser incorporada no âmbito esportivo, principalmente por observar respostas positivas na capacidade psicológica dos atletas. Palavras-chaves: atenção plena, desempenho atlético, meditação, saúde mental.

Background: This study compared energy expenditure (EE), substrate metabolism, and excess post-exercise oxygen consumption (EPOC) during moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), and high-intensity circuit training (HICT) isocaloric sessions. Methods: Twelve trained male participants completed isocaloric exercise sessions equalized for EE and average power (AP) across the three modalities. Postexercise EE, carbohydrate and lipid oxidation rates, and EPOC were measured 30 and 60 min after training. Results: Total EE and AP during exercise were similar between the protocols. However, EPOC was significantly higher for HIIT (319.0 ± 88.03 mL) and HICT (329.1 ± 27.79 mL) than for MICT (168.5 ± 21.84 mL), demonstrating greater post-exercise metabolic demand in high-intensity protocols. At 30 min post-exercise, carbohydrate oxidation remained elevated in the HIIT (3.70 ± 1.04 mg/kg/min) and HICT (4.06 ± 1.03 mg/kg/min) groups compared to that in the MICT group (1.42 ± 0.58 mg/kg/min), while lipid oxidation rates were also higher (HIIT: 1.08 ± 0.41; HICT: 1.20 ± 0.24 mg/kg/min; MICT: 0.61 ± 0.20 mg/kg/min). These effects persisted for 60 min, with HIIT and HICT maintaining significantly greater carbohydrate and lipid oxidation than MICT. Correlation analysis indicated a strong relationship between carbohydrate oxidation during exercise and lipid oxidation after 60 min of exercise. Conclusions: High-intensity protocols (HIIT and HICT) promote prolonged postexercise EE, enhance carbohydrate and lipid oxidation, and optimize metabolic recovery, making them effective strategies for maximizing energy utilization beyond the training session.

Introduction: Population aging is a growing and challenging phenomenon, primarily due to its association with functional decline and sarcopenia, which increase the risk of falls. These events have significant impacts on public health and the quality of life of older adults. Regular physical activity has shown benefits in reducing falls and their consequences, with systemic vibratory therapy (SVT) emerging as a promising strategy to mitigate these adverse outcomes. However, evidence on the actual effectiveness of this therapeutic approach remains limited, as does clarity regarding optimal body position, protocol parameters, and equipment when combined with physical activity programs. Objectives: To compare the effect of systemic vibratory therapy (SVT) associated with a physical activity program on the perception of fear of falling in older adults (M01.060.116.100). As secondary outcomes, the study will assess functional physical conditioning, electromyographic activity, muscular synergy, and center of pressure oscillation in this population. Methods: A randomized controlled clinical trial with blinded outcome assessors and blinded statistical analysis will be conducted with 192 older adults participating in the UNATI/UNISUAM program. Participants will be allocated into three groups: (A) usual physical activity; (B) usual physical activity + SVT in a semi-squat position; and (C) usual physical activity + SVT in a seated position. Assessments will include sociodemographic data, concern about falling assessed using the Falls Efficacy Scale-International (FES-I), physical performance (2 min stationary march test), surface electromyography of the tibialis anterior and medial gastrocnemius muscles, along with posturography using a force platform. Results: This study will provide information on outcomes related to fall risk, balance, physical fitness, and neuromuscular variables in older adults undergoing two distinct SVT protocols. Clinical Trials Registration: Brazilian Registry of Clinical Trials RBR-68pry5j. Registered on 8 December 2025.

This review evaluated the effects of intrinsic foot muscle (IFM)-targeted exercise programs on predefined ankle- and knee-related clinical endpoints and on functional, neuromuscular, and biomechanical surrogate outcomes potentially relevant to lower-limb injury. This systematic review, incorporating a limited meta-analysis where quantitative pooling was feasible, followed PRISMA guidelines. Six electronic databases were searched for randomized controlled trials investigating IFM-targeted exercise programs in adults aged 18–59 years compared with no intervention, sham, or usual care, including parallel-group, cluster-randomized, and randomized crossover or counterbalanced designs when an adequate washout period was reported. Meta-analysis used Hedges’ g under a random-effects model with restricted maximum likelihood (REML) estimation of between-study variance and Hartung–Knapp adjustment for the pooled confidence interval; outcomes with fewer than three poolable studies were synthesized narratively per SWiM guidance. Thirteen randomized controlled trial reports (462 participants in the analyzed samples; 2012–2026) were included. The included samples were predominantly young and physically active, limiting generalizability across the broader adult age range. None of the included trials reported the predefined primary clinical endpoint categories: incident ankle injuries, prospectively recorded ankle-instability events, incident acute knee injuries, or incident knee-related symptoms/clinical syndromes. Consequently, none of these primary endpoint categories could be evaluated quantitatively or through comparative narrative synthesis, resulting in an empty synthesis for the primary clinical outcomes. Therefore, no direct estimate of the effect of IFM-targeted exercise programs on incident ankle injury, ankle-instability events, acute knee injury, or the onset of knee-related symptoms/clinical syndromes could be generated. The available evidence was therefore limited to secondary surrogate outcomes. Ten secondary outcome clusters were identified; however, quantitative pooling was feasible for only one dynamic postural control (k = 3; n = 70), while the remaining outcomes were synthesized narratively. For dynamic postural control, the pooled point estimate favored IFM training in direction (Hedges’ g = 0.39), but the effect was highly uncertain under the REML/Hartung–Knapp model (95% CI −0.62 to 1.41; p = 0.238), and the certainty of evidence was rated Very Low. Individual trials reported improvements in foot muscle strength, morphology, foot posture, ankle instability, and inter-articular coordination, but these findings were generally derived from single studies and cannot establish injury-preventive efficacy. The evidence base is currently empty for the predefined primary outcomes, and the current evidence does not support clinical recommendations for isolated IFM training as an injury-prevention strategy or as an intervention with established broader rehabilitation effectiveness. PROSPERO registration: CRD420261405154.

Objectives: To compare the acute effects of upper cervical manipulation (CM) or manual massage (MM) to simulated CM (Sham) and Control conditions (Control) on heart rate variability (HRV) and blood pressure (BP) responses in asymptomatic individuals. Methods: A double-blind, four-arm, parallel-group, randomized, crossover, place-bo-controlled trial recruited 15 healthy women with normal BP who visited the lab on four occasions with 48-hour intervals to ensure adequate washout between interventions. A Latin square randomization approach was employed to assign participants to one of four experimental conditions: (1) Control: rest without intervention; (2) CM: bilateral high-velocity, low-amplitude manipulation of the upper cervical spine (C0–C2); (3) MM: a single 120-second session of MM release applied unilaterally to the anterior and posterior thigh, posterior lower leg, and lumbar musculature; or (4) Sham: mimicking the posi-tioning used in CM without the application of thrust manipulation. In each experiment, HRV, systolic and diastolic BP were measured at rest (Baseline) and every 15 minutes for 60 minutes after each intervention. All procedures were performed in the morning to avoid any confounding circadian rhythm effect on HRV and BP. Results: We found significant increases within conditions, with a large effect size magnitude, for the HRV indices: RMSSDms (Control: Post-0 (Δ=23.34; p=0.032), Post-15 (Δ=21.47; p=0.023); Sham: Post-15 (Δ=29.22; p=0.014); CM: Post-15 (Δ=24.05; p=0.027)); SDNNms (Control: Post-45 (Δ=26.01; p=0.037); CM: Post-45 (Δ=46.02; p=0.014) and Post-60 (Δ=31.82; p=0.019)); PNN50% (CM: Post-0 (Δ=32; p=0.044), Post-15 (Δ=23; p=0.044) and Post-45 (Δ=26; p=0.019)); LF Power (ms2) (CM: Post-60 (Δ=1482.92; p=0.001)), and LF/HF ratio (MM: Post-60 (Δ=0.11; p=0.022). Conclusion: The effect size findings suggest that both SM and MM may promote autonomic modulation in normotensive women by maintaining a balanced sympa-thovagal response. However, these outcomes were not consistently accompanied by statistically significant differences. Therefore, caution will be warranted when inter-preting and applying these results, as they reveal an emerging gap in the literature that warrants further investigation.