Venere Quintiero

Arachidonic acid (AA), an omega-6 polyunsaturated fatty acid, serves as a metabolic precursor for prostaglandins (PGs) such as PGE₂ and PGF_2α, which have been implicated in the regulation of skeletal muscle adaptations to resistance exercise. On this basis, AA supplementation has been proposed as a potential ergogenic aid in resistance training, under the hypothesis that increasing endogenous AA availability through supplementation may enhance PGs synthesis, thereby potentially influencing muscle remodeling and recovery process. However, AA remains a relatively underexplored candidate. This review aimed to summarize and critically evaluate the current evidence regarding the effects of AA supplementation in the context of resistance exercise. The limited available studies provide preliminary mechanistic observations suggesting that AA supplementation may be associated with changes in muscle strength and anaerobic performance and with modulation of the acute inflammatory response to exercise, without affecting chronic inflammation. Conversely, findings related to body composition and muscle hypertrophy remain inconsistent and a significant effect has not been consistently observed. Despite these preliminary insights, the current body of evidence is insufficient and heterogeneous, precluding the recommendation of routine clinical or practice-based use. Future well-designed, long-term investigations are warranted to clarify the efficacy, optimal dosage, and timing of AA supplementation, as well as its safety profile and potential applications across populations differing in age, sex, nutritional status, and training background.

Background. This study aimed to quantify differences in the internal training load (ITL) of an elite rink hockey (RH) team across days within and between three types of microcycles: pre-season, in-season regular, and in-season congested, to provide insights to optimise microcycle scheduling. Methods. One international-level male RH team comprising seven outfielders (29.6 ± 4.7 years; height, 178.9 ± 2.3 cm; body mass, 77.8 ± 5.7 kg) and one goalkeeper (32 years; height, 180.4 cm; body mass, 83.6 kg) was monitored for 21 microcycles. The ITL was assessed using the session rate of perceived exertion (sRPE) and quantified as time based on a triphasic classification commonly utilised in team sports: low-intensity training (LIT, 90% HRmax). Generalized estimating equations were used to examine differences across within-microcycle training days and between seasonal phases, with linear mixed models applied as sensitivity analyses. Results. Across all phases, significant day-to-day variations in ITL were observed within microcycles (all p < 0.001), with both subjective (sRPE) and objective (LIT–HIT) ITLs progressively decreasing as match days (MDs) approached, showing moderate-to-large population-averaged effects with 95% confidence intervals consistently not crossing zero. The pre-season exhibited the highest overall ITL (p < 0.001), characterised by a substantially greater sRPE and increased time spent across all intensity zones, with the largest magnitudes observed for LIT and MIT compared with the in-season phases. Conclusions. Findings suggest that an international-level RH team progressively reduced the ITL as MDs approached with the highest loads scheduled earlier within microcycles. Moreover, the pre-season had the highest ITLs. This ITL distribution may provide useful guidance for RH coaches and support staff in optimising microcycle planning.

In cervical dystonia (CD), balance and gait impairments can compromise daily activities and negatively affect quality of life. However, interventions addressing these deficits remain poorly investigated. A 54-year-old woman with CD, presenting balance and gait difficulties that interfered with work-related motor tasks, underwent a four-month training program. Sessions (40 min, three times per week) combined lower-limb strengthening, proprioceptive and balance exercises, and integrated motor–cognitive tasks. Pre- and post-intervention assessments included gait speed (GS), stride length (SL), and stance time (ST) under usual (UW), fast (FW), and dual-task (DT) walking conditions, measured with an inertial sensor (BTS G-Walk). DT cost was calculated for GS and SL. Balance was evaluated with the Mini-BEST and Four-Square Step Test (FSST), while fear of falling was measured with the Falls Efficacy Scale-International (FES-I). Of note, both assessment sessions were conducted in the absence of botulinum toxin effects, whereas the training was performed, at least in part, under its influence. After training, increase were observed in GS and SL, with reductions in ST across all gait conditions. DT cost decreased for both GS and SL. Balance performance increased, and fear of falling was reduced. Importantly, the patient reported a marked improvement in work-related performance. This case suggests that a specific training program may effectively ameliorate balance and gait in CD, with positive effects on functional mobility. Further studies on larger samples are warranted to confirm efficacy.

Balance impairments can affect walking ability and, consequently, limit physical activity level (PAL). This investigation in facioscapulohumeral muscular dystrophy (FSHD) may help unravel factors limiting PAL and identify new rehabilitation strategies to improve mobility in these patients. Eighteen FSHD patients (10 males; mean age: 36.33 years) and twenty-three age-and sex-matched healthy controls (HC) were recruited. Balance was assessed using the Mini-BEST and Four Step Square test (FSST), while PAL was measured with the International Physical Activity Questionnaire. Gait performance during usual walking (UW), fast walking (FW), and dual-task walking (DT) was evaluated using an inertial sensor (BTS G-Walk). Gait speed (GS), stance time (ST), gait cycle (GC), stride length (SL), pitch and roll angles were considered. Correlations between gait parameters and Mini-BEST were performed in patients, while between PAL, GS, and SL were assessed in both groups. Compared to HC, patients showed lower PAL, Mini-BEST scores and longer FSST times. As group effect, patients exhibited major ST, GC, and roll angle. In the interaction between group and walking condition, during FW patients showed reduced GS and prolonged GC, while no differences were observed in UW and DT. Altered gait parameters, except roll angle, were associated with Mini-BEST, while PAL correlated with gait parameters only in HC. Balance resulted associated with impaired gait parameters in FSHD. The association between balance and gait deficits emerging during FW indicate balance impairment as an element discouraging patients from engaging in physically demanding tasks, plausibly decreasing PAL.

Metabolic myopathies are a diverse group of inherited genetic disorders that disrupt carbohydrate and fatty acid metabolism, leading to impaired production of adenosine triphosphate and consequently, compromised muscle function. In many of these conditions, regardless of the specific metabolic defect, physical exercise (PE) can induce rhabdomyolysis (RML), posing a significant health risk to patients. Except for Glycogen Storage Disease (GSD) Type V, for which specific PE guidelines are available, clinical management of these conditions typically advocates for substantial physical inactivity to prevent complications. However, while this strategy helps avoid RML and its dangerous consequences, such as acute kidney failure, it also exposes patients to several long-term risks, including a decline in physical efficiency, reduced autonomy, and the emergence of comorbidities. Therefore, it is crucial to identify disease-specific PE modalities that can be safely performed to improve clinical management and enhance patients’ quality of life. The existing literature on this topic is generally limited, likely due to the rarity of these conditions. Nevertheless, a comprehensive analysis of the available evidence could provide a foundation for identifying feasible PE modalities and developing innovative strategies for adapting PE to different diseases. This review critically examines the current evidence on the effects and feasibility of PE in GSDs and fatty acid oxidation disorders, focusing on the distinction between aerobic and anaerobic exercise. Additionally, it explores the usefulness of supporting nutritional strategies while identifying literature gaps. Finally, based on the available data, novel theories for exercise adaptation are discussed, aiming for prospective validation in future studies.

Background Resting metabolic rate (RMR) and phase angle (PhA) are muscle-related measures whose relationship has been analyzed in several cohorts. However, such parameters and their association are underexplored in facioscapulohumeral dystrophy (FSHD). Methods Thirty-nine genetically confirmed and clinically categorized FSHD patients (13 females, 26 males; mean age 37.9 years) and 26 matched healthy controls (HC) were recruited. RMR and PhA were assessed using indirect calorimetry and bioimpedance analysis, respectively. Physical activity level (PAL), as potential confounder, was assessed using the International Physical Activity Questionnaire in HC and a subgroup of 18 patients. Comparative and associative analyses were conducted. For associative analyses, PAL and age were included as covariates, while clinical category [grouping patients into Group 1 (category A, classical phenotype, n = 28) and Group 2 (categories B–D, non-classical phenotypes, n = 11)] and sex were used as stratification factors. Results Patients showed significantly lower PhA and PAL than HC, but similar RMR. The association was strong in HC, weaker but still significant in the overall FSHD group, and non-significant in the PAL subgroup. As a covariate, PAL weakened the association only in HC, while age weakened the association only in patients. Stratification by sex resulted in loss of significance in both groups, while category stratification showed significant association only in Group 2. Conclusions While the reduced PhA in FSHD aligns with literature, an RMR comparable to HC contradicts previous findings, suggesting the need for further investigation. Overall, PhA does not emerge as a parameter strongly associated with RMR in patients with FSHD.

Background: To achieve victory, kayaking and rowing athletes must develop optimal aerobic conditioning and the capacity to sustain anaerobic work production. To assess these characteristics, power output (PO), lactatemia response, and maximum oxygen uptake (VO₂max) are usually measured. The goal of this research is to report the values of PO, lactatemia, and VO₂max—expressed in relative, absolute, and body size-scaled values—in successful international-level athletes to provide reference values for those striving to compete at the highest level. Methods: A total of 15 international-level medallist boat sports athletes were recruited: 8 male kayakers (age 21 ± 3 years, height 181.7 ± 5.3 cm, body mass 78.7 ± 5.6 kg), 2 female kayakers (age 22 ± 2 years, height 168.0 ± 2.8 cm, body mass 64.9 ± 2.7 kg), and 5 male rowers (age 20 ± 1 years, height 181.9 ± 4.7 cm, body mass 83.9 ± 7.3 kg). The athletes’ PO, lactatemia, and VO₂max were assessed using an off-water, sport-specific cardiopulmonary test on a paddle and rowing ergometer. Results: Respectively, in male and female kayakers and male rowers, maximum lactatemia was 11.9 ± 2.2 mmol/L, 9.3 ± 3.6 mmol/L, and 13.2 ± 3.7 mmol/L; maximum PO was 225.0 ± 13.4 W, 162.5 ± 31.8 W and 432.0 ± 33.5 W; and VO₂max was 57.6 ± 5.4 mL/min/kg, 52.2 ± 1.0 mL/min/kg, and 63.7 ± 11.7 mL/min/kg. VO₂max scaled by body size was, respectively, 311 ± 39 mL/kg^0.67/min, 319 ± 15 mL/kg^0.67/min, and 330 ± 72 mL/kg^0.67/min. Conclusions: This study is the first to report the values of PO, lactatemia, and VO₂max—expressed in relative, absolute, and body size-scaled values—assessed during a sport-specific cardiopulmonary test in international-level boat sports athletes. These values could be a preliminary reference guideline for optimal cardiorespiratory conditioning in athletes aiming at international-level competitions.

Facioscapulohumeral dystrophy (FSHD), the second most common inherited muscular dystrophy in adulthood, is characterized by progressive muscle loss, accompanied by an increase in fat mass. Beyond these alterations in body composition, which contribute to the risk of sarcopenic obesity, FSHD is associated with systemic inflammation and oxidative stress. These interconnected mechanisms may worsen muscle atrophy, leading to a decline in physical efficiency and quality of life. While the therapeutic benefits of physical therapy and exercise have been investigated, the impact of dietary interventions remains underexplored. Given the established role of nutrition in managing various chronic diseases, there is growing interest in understanding how it might influence the clinical management of FSHD. By addressing current gaps in the literature, this review aims to investigate the potential role of dietary patterns and specific nutrients in modulating muscle metabolism within the context of FSHD. Some studies have indicated various compounds (flavonoids, curcumin, L-carnitine, coenzyme Q10, and omega-3), vitamins (C and E), and minerals (zinc and selenium) with antioxidant and anti-inflammatory properties as promising treatment strategies for FSHD. Instead, few data regarding the effects of proteins and creatine supplementation are available. Furthermore, the potential benefits of essentials amino acids, β-hydroxy-β-methylbutyrate, and vitamin D in contrasting muscle atrophy and enhancing muscle function remain unexplored. Despite these preliminary findings, the existing body of evidence is limited. Identifying novel therapeutic strategies to complement existing treatments could provide a more comprehensive management framework, aimed at improving the long-term health outcomes and quality of life of FSHD patients.

Background and Aims: Body composition parameters associated with aerobic fitness, mirrored by maximal oxygen consumption (V̇O ₂ max), have recently gained interest as indicators of physical efficiency in facioscapulohumeral dystrophy (FSHD). Bioimpedance analysis (BIA) allows a noninvasive and repeatable estimate of body composition but is based on the use of predictive equations which, if used in cohorts with different characteristics from those for which the equation was originally formulated, could give biased results. Instead, the phase angle (PhA), a BIA raw bioelectrical parameter reflecting body fluids distribution, could provide reliable data for such analysis. Methods: 33 clinically and genetically characterized FSHD patients (mean age 35.7; 10 females) and 27 sex and age‐matched healthy controls (HC) were included in the analysis. BIA was used to evaluate body fluids distribution (intracellular water [ICW], extracellular water [ECW], and total body water [TBW]), and PhA, while cardiopulmonary exercise test was used to estimate V̇O ₂ max. Results: The groups were comparable for ECW and TBW. Instead, patients showed lower values of ICW ( p = 0.020), ICW/ECW ratio ( p < 0.001), and PhA ( p < 0.001). Moreover, patients reported lower V̇O ₂ max ( p = 0.001 for absolute values; p = 0.002 for values expressed in relation to body weight) which, unlike HC, was not associated to PhA. Conclusion: Based on our results, PhA of FSHD patients is lower than HC. Since PhA mirrors the ICW/ECW ratio, the lower share of ICW seems to be the basis of such difference. Given the lack of association with V̇O ₂ max, PhA cannot be considered a reliable indicator of aerobic fitness in FSHD.

Background/Objectives: Facioscapulohumeral dystrophy (FSHD) patients experience a progressive loss of fat free mass (FFM) and increase of fat mass (FM). Such an occurrence may lead to an impaired physical efficiency. A personalized diet, combined with a physical exercise program, may improve body composition, and potentially reduce functional limitations. Here, we present the case of a nineteen‐years‐old male clinically and genetically characterized FSHD patient who underwent a one‐year nutritional and training intervention aimed at contrasting the disease‐induced body composition modifications and associated negative sequelae. Methods: Baseline assessments included dietary intake (nutritional anamnesis), body composition (bioimpedance analysis), biochemical parameters (blood tests), resting metabolic rate (RMR; measured by indirect calorimetry), physical efficiency, and quality of life (Checklist Individual Strength Fatigue and Functional Assessment Chronic Illness Therapy Fatigue). Based on the initial findings (insufficient daily caloric intake, inadequate leucine distribution, and nonphysiological glycemia), a personalized nutritional (50% carbohydrates, 30% fats and proteins at 1.5 g/kg of body weight/day, with leucine intake of 1–3 g per meal) and supplementation (11 g/day of essential amino acids) plan was prescribed, alongside a physical training program composed by two resistance and one aerobic exercise sessions per week. Results: After one year, improvements in body composition (FFM +6.9 kg, body cell mass +3.3 kg, FM −2.1 kg), RMR (+309 kcal/day), fasting glycemia (−1.6 mmol/L), perceived physical efficiency (diminished perceived fatigue), and quality of life were reported. Conclusions: Our results suggest that a tailored dietary intervention, when combined with an appropriate training program, could represent a promising long‐term strategy for contrasting disease‐related physical deconditioning in FSHD. These findings encourage further research on this approach in a larger cohort of patients.