Visual Article Details Quality in Sport eISSN 2450-3118 is a Humanistic Journal with an international reach, published in line with top standards applicable in scientific journals. Each issue contains original and review papers, and case reports of different specialties associated with Multidisciplinary Education Sections: Physical Culture Sciences; Health Sciences; Medical Sciences; Pedagogy; Socio-Economic Geography and Spatial Management; Earth and Environmental Sciences; Cultural and Religious Sciences; Proceeding; Book of Abstracts, is a double anonymized scientific published by the University Center for Sports Research, Nicolaus Copernicus University in Toruń, Poland. Manuscripts Preparation. Journal of Education, Health and Sport. 2025; eISSN2391-8306. In order to facilitate publication, the authors are kindly requested to submit texts written according to the rules presented below. Template How to prepare an Article for the Quality in Sport.docx How to prepare an Article for the Quality in Sport.pdf Creating an Account. Submitting an Article. Quality in Sport is: a Humanistic Journal with a Global International Reach. Our mission is to offer the worldwide scientific community a broad, fast and direct access to publish the latest results of the research areas that are developing rapidly and where there are changes with a high potential impact. All Articles submitted for publication will be peer-reviewed within 2-30 weeks. All accepted articles will be published online before appearing in the print journal within 2-30 weeks from acceptance. The journal has had 20 points in Ministry of Higher Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Higher Education and Science of 05.01.2024. No. 32553. Has a Journal's Unique Identifier: 201398. Scientific disciplines assigned: Economics and finance (Field of social sciences); Management and Quality Sciences (Field of social sciences). Punkty Ministerialne z 2019 - aktualny rok 20 punktów. Załącznik do komunikatu Ministra Szkolnictwa Wyższego i Nauki z dnia 05.01.2024 r. Lp. 32553. Posiada Unikatowy Identyfikator Czasopisma: 201398. Przypisane dyscypliny naukowe: Ekonomia i finanse (Dziedzina nauk społecznych); Nauki o zarządzaniu i jakości (Dziedzina nauk społecznych). The aim of the journal is to establish the platform for scientific discussion and to disseminate the research findings on sport, tourism management and event management, sport in various aspects, including social, humanistic, health and medical aspects. The scope of the papers published in the Quality in Sport covers the issues of: sport in various aspects, including social, humanistic, health and medical aspects; implementation of scientific research results into the practice of sports life, recreational, social, medical, health, managerial, media and economic; cooperation with the sports, recreational, cultural and social environment, media, managerial, medical, health and economic; supporting in organizing conferences, congresses and scientific symposia; management in sports and tourism organization; quality of sports event; satisfaction of participants of sports events and fans; management of sports facilities. 759 Citations from Scopus for Quality in Sport. 136 Secondary documents Citations from Scopus for Quality in Sport. + 70 Citations from Scopus for Qual Sport. 42 Secondary documents Citations from Scopus for Qual Sport. 136+42=178 Secondary documents Citations from Scopus for Quality in Sport. Frequency: First Semi-annually, Quarterly, Current is Monthly. Open access model. Quality in Sport only prints the papers which have not been published earlier. The journal is published in an on-line version. The on-line version is a reference one. Acceptance Rate 35% Rejection Rate 65% Quality in Sport EISSN 2450-3118 The manuscripts must be submitted via the online article system, represented on the journal website. The journal offers access to the contents in the open access system on the principles of non-exclusive license Creative Commons (CC BY-ND 3.0).
University Center for Sports Research, Nicolaus Copernicus University, Torun, Poland
Current trends in treatment of uterine fibroids. A Perspective Review of Recent Literature
Uterine fibroids, or leiomyomas, are the most prevalent benign tumors in the female reproductive tract, affecting up to 70–80% of women by age 50. These tumors, which are composed of smooth muscle and connective tissue, often arise during the reproductive years and are influenced by a combination of genetic and hormonal factors. While many fibroids are asymptomatic, a significant number of women experience debilitating symptoms such as heavy menstrual bleeding, pelvic pressure, pain, and infertility, necessitating the need for effective treatment options. Historically, hysterectomy was the primary treatment; however, the desire for fertility preservation and advancements in medical technology have led to the emergence of minimally invasive and non-surgical treatment alternatives, including myomectomy, uterine artery embolization (UAE), and pharmacological therapies. Each treatment modality presents unique benefits and risks and should be tailored to individual patient factors, such as fibroid characteristics and reproductive goals. Despite the evolution of treatment options, awareness remains limited among patients, underscoring the need for enhanced patient education and shared decision-making in fibroid management. This review synthesizes current literature on the efficacy of various treatment strategies for uterine fibroids, highlighting the importance of personalized, evidence-based approaches to improve clinical outcomes and quality of life for women affected by this condition. This perspective review summarizes recent literature on current treatment options and trends, focusing on myomectomy, hysterectomy, embolization, and non-invasive techniques of uterine fibroids.
Copyright (c) 2026 Kinga Bylica, Łukasz Dylewicz, Joanna Brzoza , Jakub Rudzki, Wojciech Warmuz, Ewa Wystalska, Kacper Solarz, Natalia Czołpińska, Zuzanna Kata, Jakub Andrzejewicz https://creativecommons.org/licenses/by-nc-sa/4.0
Creatine Supplementation as an Adjunct to Exercise in Type 2 Diabetes: Effects on Muscle Metabolism and Glycemic Control – A Literature-Based Review
Introduction and aim of the study. This study aimed to evaluate the role of creatine supplementation, particularly in combination with physical activity, in the management of type 2 diabetes mellitus, with emphasis on muscle metabolism and glycemic control. Research materials and methods: A literature-based review was conducted using major scientific databases, including PubMed, Scopus, and Web of Science. The analysis included randomized controlled trials, systematic reviews, and mechanistic studies investigating creatine supplementation and its metabolic effects in diabetic and non-diabetic populations. Basic results: Creatine plays a central role in cellular energy metabolism through the phosphocreatine system. Evidence suggests that supplementation may enhance glucose uptake via increased GLUT-4 translocation, improve insulin sensitivity, and support skeletal muscle function. When combined with exercise, creatine may exert synergistic effects on glycemic control. However, available clinical evidence remains limited and heterogeneous. Conclusions: Creatine supplementation may be a promising adjunct strategy in the management of type 2 diabetes, particularly when combined with regular physical activity. Further high-quality clinical trials are required to establish clear clinical recommendations.
Copyright (c) 2026 Patryk Marek Modelewski, Jakub Białożyt, Weronika Wagner, Anna Dębniak, Patryk Twardy, Maciej Gutarowicz, Kaja Nieradka, Krystyna Klahs, Michał Armatys, Maciej Muraszko-Kuźma https://creativecommons.org/licenses/by-nc-sa/4.0
Physical Activity Levels, Sport Participation, and Exercise Outcomes in Individuals with Attention-Deficit/Hyperactivity Disorder: A Literature Review
Background. Attention deficit hyperactivity disorder (ADHD) affects approximately 7.2% of children and adolescents internationally and is associated with functional impairment across educational, social, occupational, and health behavioral domains. Despite evidence that physical activity benefits cognition and psychosocial functioning, participation remains markedly insufficient, with only 6.5% of adolescents with ADHD meeting all recommended movement guidelines. Aim. To synthesize evidence on physical activity levels, sport participation, exercise types, barriers and facilitators, sex differences, and dose effects in individuals with ADHD. Material and methods. PubMed search (January 2015 – May 2026); studies reporting physical activity, sport participation, or exercise outcomes in individuals with ADHD. Findings were synthesized narratively. Results. Several forms of physical activity — aerobic exercise, martial arts, racket sports, swimming, equine-assisted activities, target shooting, exergaming, combined aerobic-cognitive exercise, and multicomponent school-based programs — were associated with improvements in cognitive, behavioral, or psychosocial outcomes. Barriers were primarily related to executive dysfunction, motivational difficulties, and low self-esteem; facilitators were largely tied to direct experience of the benefits of exercise. Conclusions. Individuals with ADHD engage in physical activity at markedly insufficient levels and face distinctive barriers rooted in executive dysfunction and motivational dysregulation. Multiple forms of physical activity produced meaningful benefits, suggesting interventions need not be restricted to aerobic exercise alone. Sex-specific factors and exercise intensity warrant explicit consideration in intervention design.
Copyright (c) 2026 Paweł Arkadiusz Trzepizur, Nikola Agnieszka Samp, Beniamin Andrzej Bekrycht, Jędrzej Marek Foryński, Michelle Martina Stachurska, Kamila Zera, Weronika Piekarska, Konstancja Radiczew, Karolina Rogala, Rafał Wilczyński https://creativecommons.org/licenses/by-nc-sa/4.0
Creatine supplementation and renal safety: The nephron reserve hypothesis
Purpose: This narrative review proposes the nephron reserve hypothesis as a framework for reconciling conflicting evidence on creatine supplementation and kidney health. Materials and methods: Evidence was synthesized from meta-analyses, randomized controlled trials, animal models, and case reports identified through PubMed, Scopus, Web of Science, and Google Scholar through March 2025, with priority given to studies using creatinine-independent renal endpoints. Results: In individuals with preserved renal functional reserve, creatine at standard doses (3–5 g/day) does not impair glomerular filtration rate. Meta-analyses confirm that observed creatinine elevations reflect altered metabolic turnover rather than nephron injury. Evidence in chronic kidney disease remains sparse. Case reports of interstitial nephritis, tubular necrosis, and cast nephropathy, together with animal data from reduced-nephron-mass models, suggest creatine may unmask renal vulnerability in high-risk settings. Conclusions: Creatine safety should be assessed according to baseline renal reserve and clinical phenotype. Recommendations for compromised kidneys remain precautionary and are intended to guide risk assessment and future research.
Copyright (c) 2026 Michał Kasznicki, Mikołaj Kamela, Alicja Rogozińska, Emilia Skrzypek, Małgorzata Czechowska, Jakub Łącki, Karol Jackowiak, Michał Kalisiak, Natalia Micek, Wiktor Beśka https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Physical Activity During Pregnancy on Maternal and Fetal Outcomes: A Literature Review
Background. Physical activity during pregnancy is widely recognized as a key determinant of maternal and fetal health. Levels and patterns of physical activity often change across trimesters due to physiological, metabolic, and psychological adaptations. Given the dynamic nature of pregnancy, a comprehensive synthesis of current evidence on the effects and safety of physical activity across all trimesters is warranted to support trimester-specific recommendations and optimize maternal and neonatal outcomes. Aim. The aim of this review is to synthesize current evidence on physical activity throughout the entire course of pregnancy. Particular attention is given to trimester-specific patterns of physical activity, associated maternal and fetal health outcomes. Material and Methods A systematic literature review was conducted across international databases, encompassing meta-analyses, randomized controlled trials, cohort studies, and official guidelines from scientific societies. Key publications evaluating the physiological, biomechanical, and epigenetic effects of physical exertion were selected. Results. The accumulated evidence unequivocally demonstrates that regular physical exertion lowers the risk of gestational diabetes (by approx. 38%), pregnancy-induced hypertension (by approx. 58%), and fetal macrosomia, without negatively affecting the hemodynamic parameters of the umbilical artery. Studies from 2024-2025 confirm the safety of high-intensity training and submaximal resistance training. Furthermore, maternal exercise has been shown to have a stimulating effect on fetal epigenetic programming and neurogenesis, as well as a fundamental role of early mobilization in reducing symptoms of postpartum depression and pelvic floor dysfunction. Conclusion. Physical activity during pregnancy and the postpartum period is not only safe but constitutes a key prophylactic and therapeutic mechanism.
Copyright (c) 2026 Natalia Padula, Tomasz Pluszyński, Karol Piotrowski, Małgorzata Jerczak, Iga Piórkowska, Mikołaj Polewka, Aleksandra Polańska, Kacper Paczosa, Filip Przybył https://creativecommons.org/licenses/by-nc-sa/4.0
Clinical and psychosocial benefits of 3D printing and virtual planning in complex facial reconstruction after oncological resection: a systematic review
Background. Head and neck cancers and their surgical treatment frequently lead to functional and aesthetic impairments that negatively affect patients’ quality of life and psychosocial functioning. The development of virtual surgical planning (VSP) and 3D printing has increased the precision of reconstructive procedures. Aim. To evaluate the clinical and psychosocial benefits of 3D printing and virtual surgical planning in facial reconstruction after oncological treatment. Materials and methods. A systematic review of the literature regarding computer-assisted surgery, CAD/CAM technologies, augmented reality, and 3D printing in craniofacial reconstruction following head and neck cancer resection was conducted. Results. The use of VSP and 3D printing improves the accuracy of resection and reconstruction, shortens operative time, and increases treatment predictability. Patient-specific implants and surgical guides enable better functional and aesthetic outcomes, improving mastication, swallowing, speech, and rehabilitation. These technologies also enhance physician–patient communication, increase treatment satisfaction, and support social reintegration. Conclusions. Virtual surgical planning and 3D printing significantly improve reconstructive treatment outcomes and quality of life in patients undergoing oncological surgery within the head and neck region.
Copyright (c) 2026 Karolina Gwóźdź, Magdalena Zawadzka, Aleksandra Natalia Bystros, Marta Drozdowska, Dominika Marszałek, Klaudia Kurzątkowska, Emilia Borychowska, Michalina Czudowska, Aleksandra Ocimek, Zofia Aneta Mierzejewska https://creativecommons.org/licenses/by-nc-sa/4.0
Coronary Artery Bypass Grafting (CABG) After Failed Percutaneous Coronary Intervention (PCI): Integrative Review
Background. The dynamic development of interventional cardiology and the widespread use of drug-eluting stents (DES) have made percutaneous coronary intervention (PCI) the first-line treatment for many forms of coronary artery disease. However, phenomena such as in-stent restenosis (ISR), late stent thrombosis and the natural progression of multivessel atherosclerosis contribute to a growing population of patients requiring a shift toward surgical treatment (prior-PCI patients). Coronary artery bypass grafting (CABG) remains the gold standard for managing advanced coronary artery disease, including cases of failed prior percutaneous interventions. Aim. The aim of this study is to review the literature regarding the outcomes of CABG following failed PCI and to assess the impact of this surgical procedure on patient health and survival. Material and methods. A literature review (2016–2026) was conducted using the PubMed database, focusing on CABG procedures performed after prior PCI. An integrative approach was used to evaluate clinical outcomes, baseline risk factors, complication rates and duration of hospitalization. Results. Research findings suggest that patients undergoing CABG after prior PCI present with a significantly higher baseline operative risk, more complex coronary anatomy and a higher burden of comorbidities, particularly diabetes, compared to primary CABG patients. Although a history of multiple PCIs is associated with technically more demanding surgeries and a slightly increased risk of postoperative complications, CABG consistently provides superior long-term survival and lower rates of repeat revascularization. Conclusions. The analysis highlights that despite the increased baseline clinical risk, CABG remains a highly effective, safe and definitive salvage strategy for patients with exhausted percutaneous options. Careful qualification by a multidisciplinary Heart Team is essential in this high-risk group.
Copyright (c) 2026 Piotr Krzyszczak, Aleksandra Wnuk, Michał Krzak, Monika Kurpiel, Piotr Kulig, Krzysztof Ożóg https://creativecommons.org/licenses/by-nc-sa/4.0
Physical activity as a factor influencing mental health: integrating neurobiological mechanisms, regulatory processes, and the sports context
Physical activity (PA) is a recognized protective factor for mental health; however, its mechanisms of action and the variability of its therapeutic effects remain the subject of active research. This paper is a narrative review of the literature aimed at synthesizing available data on the neurobiological and behavioral mechanisms of PA, along with an analysis of environmental factors that modulate its effectiveness, with a particular focus on the context of competitive sports. Physical activity influences mental health through three main mechanisms: neuroplasticity based on the stimulation of neurotrophic factors, the regulation of metabolic and inflammatory processes, and the improvement of executive function and cognitive control. These effects are simultaneously significantly modulated by systemic factors, such as sleep quality, the severity of psychosocial stress, and the interpersonal environment. Based on our analysis, we identify three trajectories of response to physical activity and propose a three-level integrative model encompassing biological, psychological, and environmental dimensions. An analysis of competitive sports as a boundary model reveals the limitations of a simplified understanding of the relationship between the amount of physical activity and mental well-being and highlights the need to consider contextual factors when designing therapeutic interventions.
Copyright (c) 2026 Maria Michalina Kurek, Oliwia Kinga Polit-Różycka, Konstancja Anna Baltyzar, Krzysztof Gadzalski, Filip Robert Rogowski, Joanna Chrabąszcz, Wojciech Grzywna, Julia Lorek, Karol Perski, Marta Zarzycka https://creativecommons.org/licenses/by-nc-sa/4.0
The role of vitamin D and E in dysmenorrhea: a narrative review
Background. Dysmenorrhea, one of the most common gynecological problems, significantly reduces patients’ quality of life. Standard therapy is based on the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives, however it is associated with adverse effects. Alternative treatment methods are being sought, including vitamin supplementation, particularly vitamin D and E. Aim. The aim of this study was to evaluate the role of vitamin D and E supplementation in dysmenorrhea. Material and methods. In March 2026, the PubMed database was searched. The following strategies were applied: (Dysmenorrhea OR "menstrual pain") AND ("Vitamin D" OR cholecalciferol OR "vitamin D3" OR "25-hydroxyvitamin D" OR 25(OH)D) and (Dysmenorrhea OR "menstrual pain") AND ("Vitamin E" OR tocopherol OR alpha-tocopherol). Studies published in English within the last 10 years were included. After screening titles and abstracts, full-text analysis was performed. Ultimately, 12 publications were included. Results. An association between vitamin D levels and the severity of menstrual pain was demonstrated, and supplementation led to symptom reduction. Beneficial effects were also observed with the combined use of vitamins D and E, suggesting a possible synergistic effect. The results regarding vitamin E are inconsistent - some studies indicate its effectiveness, particularly in combination with other compounds (e.g., omega-3 fatty acids or vitamin C), which may be related to its antioxidant properties. However, not all studies confirm this relationship. Conclusions. Vitamin D and E supplementation may be an effective adjunct in the treatment of dysmenorrhea. However, further studies on larger populations are required.
Copyright (c) 2026 Katarzyna Cencelewicz, Patrycja Bździuch, Barbara Pieniążek, Aleksandra Domańska, Natalia Pijas, Daria Piekarz https://creativecommons.org/licenses/by-nc-sa/4.0
Overtraining Syndrome: Pathophysiology, Diagnostic Challenges and Prevention Strategies – A Narrative Review
Background. Overtraining Syndrome (OTS) represents a complex, maladaptative state characterized by a persistent decline in athletic performance and systemic physiological dysfunction. Despite its prevalence in elite and amateur sports, it remains one of the most challenging conditions to diagnose and treat. Aim. The study aims to provide a comprehensive review of the current physiological frameworks, diagnostic challenges, and modern management strategies for OTS, while integrating classical theories with emerging research on the gut-brain axis and metabolomics. Material and methods. A narrative review of academic literature from 1980 to 2024 was conducted using databases such as PubMed and Google Scholar. The selection focused on joint consensus statements, clinical trials, and systematic reviews. Analysis was assisted by AI tools for structural organization and linguistic refinement, ensuring adherence to modern scientific writing standards. Results. The findings indicate that the pathophysiology of OTS is multifaceted, involving systemic inflammation (the cytokine hypothesis), metabolic depletion (the glycogen hypothesis), and structural changes in intestinal permeability (the gut-brain axis). The review distinguishes between sympathetic and parasympathetic OTS phenotypes, each requiring different monitoring approaches. Modern research highlights a significant clinical overlap between OTS and Relative Energy Deficiency in Sport (RED-S), suggesting that low energy availability is a primary driver of the syndrome. Diagnostic methodologies continue to rely on the exclusion of organic diseases, supplemented by longitudinal monitoring of heart rate variability (HRV) and psychological profiling (POMS).
Copyright (c) 2026 Barbara Głowacka, Hanna Mruzek, Aleksandra Wesołowska, Paulina jasak, Zofia Kania-Bonicka, Sandra Owczarek, Marta Żółtowska, Aleksandra Sobótka, Oliwia Kałwak, Oriana Dziechciarz, Dominika Zgodzińska https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Physical Activity on Lipid Profile and Dyslipidemia: What Type of Exercise Is Most Effective in Preventing Cardiovascular Diseases?
Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide. Dyslipidemia significantly contributes to atherosclerosis, endothelial dysfunction, and chronic vascular inflammation, increasing the risk of ischemic cerebral and cardiac events. Regular physical activity is a key component of cardiovascular prevention due to its beneficial effects on lipid metabolism and systemic inflammation. The study aimed to evaluate the impact of physical activity on lipid profile parameters and cardiovascular risk, with particular emphasis on the effects of aerobic, resistance, high-intensity interval training (HIIT), and combined exercise models on LDL-C, HDL-C, and triglyceride levels. A narrative literature review was performed using PubMed and Google Scholar databases. The search included keywords such as “dyslipidemia,” “lipid profile,” “physical activity,” and “cardiovascular risk.” Original studies, randomized controlled trials, systematic reviews, meta-analyses, and current clinical guidelines on cardiovascular prevention were analyzed. Regular physical activity improves lipid profile by lowering LDL-C and triglyceride levels while increasing HDL-C concentration. Aerobic exercise is the most extensively studied modality in cardiovascular prevention and demonstrates significant cardioprotective effects. Resistance training improves insulin sensitivity and body composition, indirectly supporting lipid metabolism. HIIT induces rapid metabolic adaptations and may be an effective alternative for selected patients. Combined training integrates the benefits of aerobic and resistance exercise, providing comprehensive cardiovascular and metabolic effects. Regular physical activity, regardless of exercise type, plays a fundamental role in improving lipid profile and reducing cardiovascular risk. The greatest benefits are associated with combined training programs and regular moderate-intensity aerobic exercise.
Copyright (c) 2026 Olga Kowalczyk, Sebastian Kozłowski, Anna Bulicz, Marta Zdunek, Maciej Stodulski, Izabela Kasprzycka, Justyna Fiks, Monika Kukla, Joanna Dziarnowska, Izabela Kmiecik https://creativecommons.org/licenses/by-nc-sa/4.0
Introduction: Sleep is crucial for preserving general health, and the emergence of numerous chronic illnesses is associated with sleep deprivation. Recent studies suggest that short sleep duration may also have negative effects on the reproductive system. Sleep disturbances are increasingly associated with erectile dysfunction through their impact on hormonal balance and physiological regulation. Aim of the study: This article summarizes the interplay between physiological processes such as sleep and erection, based on an analysis of information regarding the functioning of the autonomic nervous system, hormones, neurotransmitters, and pro-inflammatory cytokines, as well as the NOS-NO-cGMP signaling pathway and REM-related erections. Material and Methods: A literature review was conducted using PubMed and Google Scholar to identify studies on the physiology of erections and the impact of sleep disorders on the erectile mechanism. Peer-reviewed clinical trials, systematic reviews, and other studies were analyzed to provide a comprehensive overview of the current state of knowledge. Conclusion: Erectile dysfunction is becoming increasingly common, affecting not only older men but also younger men as well. One important contributing factor is poor sleep, which can lead to serious hormonal and neurological disturbances. This disrupts both the molecular mechanism and the functioning of the central nervous system in relation to the development of an erection.
Copyright (c) 2026 Krzysztof Gadzalski, Julia Lorek, Karol Perski, Wojciech Grzywna, Joanna Chrabąszcz, Konstancja Anna Baltyzar, Maria Michalina Kurek, Oliwia Kinga Polit-Różycka, Marta Zarzycka https://creativecommons.org/licenses/by-nc-sa/4.0
Digital Rehabilitation Interventions for Musculoskeletal Disorders: Clinical Effectiveness and Implementation Challenges
Background: Telerehabilitation has emerged as a promising model of care in the physiotherapy of musculoskeletal disorders due to its accessibility, convenience, and potential to reduce the burden associated with travel. However, it remains unclear to what extent telerehabilitation can replace face-to-face treatment and which patient groups may derive the greatest clinical benefit from this approach. Aim: The aim of this review was to assess the effectiveness, safety, and clinical usefulness of telerehabilitation in selected musculoskeletal disorders. Methods: A comprehensive literature search for this review was conducted at PubMed and Google Scholar to identify studies evaluating the use of telerehabilitation in selected musculoskeletal disorders. A total of 18 studies were thoroughly screened and applied in this literature review due to its accuracy. Results: The reviewed evidence indicates that telerehabilitation is in most cases comparable or non-inferior to in-person physiotherapy in selected musculoskeletal disorders.. The most favorable outcomes were observed in interventions that preserved the key components of rehabilitation, including a structured exercise program, therapist supervision, treatment progression, and regular follow-up. Across the included studies, improvement was reported primarily in pain, functional performance, and selected patient-reported outcomes. A proper safety and acceptability of this form of therapy was confirmed, while serious adverse events were reported rarely or not at all. Conclusions: Telerehabilitation appears to be a valid and clinically useful rehabilitation option in selected musculoskeletal disorders. Its effectiveness seems to depend more on therapeutic structure and professional supervision than on remote delivery alone. Further multicenter studies are needed to define diagnosis-specific indications and identify patients most likely to benefit from this model of care.
Copyright (c) 2026 Wiktoria Bajek, Joanna Falana, Maciej Łydka, Iga Machała, Julia Łaciak, Natalia Libudzic, Kinga Lichtarska, Piotr Granatowski, Justyna Lewandowska, Anna Gwóźdź https://creativecommons.org/licenses/by-nc-sa/4.0
Vitamin D and the Serotonergic Pathway in Depression: Genomic Mechanisms, Clinical Evidence, and Implications for Sport and Physical Activity — A Narrative Review
Background and Purpose: Vitamin D, acting through the vitamin D receptor (VDR), may directly regulate brain serotonin synthesis, linking vitamin D deficiency to depression. This review examines the serotonergic hypothesis of vitamin D action, evaluates supporting evidence, and considers implications for athletes. Materials and Methods: PubMed, Scopus, Google Scholar, and the Cochrane Library were searched for articles published between 2010 and 2026 using terms related to vitamin D, serotonin, TPH2, VDR, depression, and physical activity. Results: Calcitriol upregulates tryptophan hydroxylase 2 (TPH2), represses the serotonin transporter (SLC6A4) and monoamine oxidase A, together constituting a three-node serotonergic regulatory circuit. Meta-analyses of RCTs confirm vitamin D reduces depressive symptoms (SMD = −0.36 to −0.57), with dose-dependent effects peaking near 8,000 IU/day. Effects are strongest in deficient individuals with existing depression. VDR polymorphisms, particularly FokI, modulate the neuropsychiatric impact of deficiency. Athletes exhibit high rates of insufficiency and may benefit given overlapping exercise-vitamin D effects on serotonin. Conclusions: The serotonergic hypothesis offers a defined molecular account connecting vitamin D and depression. Future research should prioritize CSF serotonin metabolite measurements, genotype-stratified trials, and sport-specific cohort studies.
Copyright (c) 2026 Małgorzata Czechowska, Michał Kasznicki, Emilia Skrzypek, Jakub Łącki, Alicja Rogozińska, Wiktor Beśka, Karol Jackowiak, Michał Kalisiak, Natalia Micek, Mikołaj Kamela https://creativecommons.org/licenses/by-nc-sa/4.0
The Correlation between depression and obesity in children and adolescents
BACKGROUND. Obesity and depression are both major problems of health in almost whole world. Moreover, it is predicted that population of patients of mentioned diseases are going to growth. While these conditions are becoming bigger problem, it is important to mark their impact on childen. Results of illnesses in childhood are associated with many longlasting complications. AIM. The aim of this review was to evaluate the bidirectional relationship of depression and obesity in children and adolescents and to underline their influence on health and proper development. Moreover authors were aiming to highlight the importance of physical activity and appropriate diet in the prevention and treatment of mentioned diseases. MATERIAL AND METHODS. A narrative review of the available literature was conducted. PubMed and Google Scholar databases were used for the research. The following keywords were searched: „depression“, „children“, „obesity“, „anxiety“, „adolescent“, „biological mechanisms“, „depressive episode“, „lifestyle“. RESULTS. There are many common factors occuring in pathophysiology of obesity and depression. It is important to underscore that patients require treatment involving both illnesses and they should not be treated separately. Parents play a crucial role during treatment and they have to teach their children healthy habits. Healthy lifestyle is essential in treating these conditions. CONCLUSIONS. Prevention should be the main focus for medical professionals treating obesity and depression. It is important to observe and react in early stages of mentioned conditions. Studies also show the important role of parents and lifestyle education and their impact on development of illnesses.
Copyright (c) 2026 Olga Błażowska, Amir Naziri, Maria Styczyńska, Julianna Chyl, Łukasz Kowalewski, Weronika Nowak, Oliwia Gutowska, Wiktoria Kostuch, Agata Zimon, Alicja Jurewicz https://creativecommons.org/licenses/by-nc-sa/4.0
​​Endometriosis Beyond the Body: A Review of Its Impact on Mental Health, Sexual Function, and Fertility
Introduction: Endometriosis is a chronic, hormone-dependent condition affecting up to 15% of women of reproductive age. It is associated with pain, infertility, and a significant reduction in quality of life. Despite increasing awareness, the average diagnostic delay remains between 7 and 11 years. The disease is characterized by chronic pelvic pain, fatigue, dyspareunia, and emotional distress, which may contribute to depression, anxiety, decreased self-esteem, and social isolation. Sexual dysfunction arises from both physical symptoms and psychological factors. Endometriosis is also recognized as a leading cause of infertility. Objective: The aim of this review is to evaluate the impact of endometriosis on women’s mental health, sexual functioning, and fertility, with particular emphasis on diagnostic delays and social stigma. Methods and materials: A literature review was conducted using publications available in the PubMed and Google Scholar databases from 2017-2025. The most relevant and recent studies were selected using appropriate keywords. Conclusions: Endometriosis requires a holistic and multidisciplinary approach that integrates medical management with psychological and sexual health support. Addressing mental health and social well-being is essential for improving overall quality of life in affected women. Early diagnosis and the reduction of stigma remain key challenges in contemporary clinical practice.
Copyright (c) 2026 Gabriela Babiarz, Damian Osiński, Zuzanna Kawa, Maria Kasprzak, Aleksandra Jędrzejewska, Aleksandra Jureczko, Klaudia Kleczaj, Łukasz Starczewski, Julia Jaworowska, Julia Kanarszczuk https://creativecommons.org/licenses/by-nc-sa/4.0
Vitamin D and Glaucoma Risk: Current Evidence and Therapeutic Implications
Introduction and purpose Glaucoma is a chronic, progressive optic neuropathy and a leading cause of irreversible blindness worldwide. Increasing evidence suggests that, beyond intraocular pressure, systemic and metabolic factors may contribute to its pathogenesis. Vitamin D, known for its immunomodulatory and neuroprotective properties, has emerged as a potential factor influencing glaucoma risk. The aim of this study was to evaluate the relationship between vitamin D supplementation and the risk of developing glaucoma. Material and method A narrative review of current literature, including experimental, observational, and clinical studies, was conducted to assess the association between vitamin D status, supplementation, and glaucoma-related outcomes such as intraocular pressure and optic nerve damage. Particular attention was given to studies analyzing serum 25(OH)D levels, supplementation patterns, and disease progression. Results Experimental studies indicate that calcitriol may reduce intraocular pressure and improve aqueous humor outflow, while observational studies often demonstrate an inverse relationship between serum vitamin D levels and glaucoma risk. However, clinical trials assessing supplementation have yielded inconclusive results, with some showing no significant effect on intraocular pressure. Variability in study design, population characteristics, and lack of detailed supplementation data limit the interpretation of findings. Additionally, vitamin D may exert neuroprotective effects independent of pressure regulation. Conclusions Vitamin D may play a supportive role in glaucoma prevention through systemic and ocular mechanisms however, current evidence is insufficient to confirm a clear protective effect of supplementation. Further large-scale, well-designed prospective studies are required to clarify its clinical significance.
Copyright (c) 2026 Marta Zarzycka, Julia Lorek, Karol Perski, Wojciech Piotr Grzywna , Joanna Małgorzata Chrabąszcz , Konstancja Anna Baltyzar , Maria Michalina Kurek , Oliwia Kinga Polit-Różycka, Krzysztof Gadzalski https://creativecommons.org/licenses/by-nc-sa/4.0
Association Between Psoriasis and Hashimoto’s Thyroiditis - A Systematic Review
Background Psoriasis is a chronic immune-mediated inflammatory disease increasingly associated with other autoimmune disorders, including autoimmune thyroid diseases, particularly Hashimoto’s thyroiditis. In recent years, numerous studies have investigated the relationship between psoriasis and thyroid dysfunction; however, the available evidence remains partly inconsistent. Objective The aim of this study was to evaluate the association between psoriasis and autoimmune thyroid diseases based on available observational studies, systematic reviews, and meta-analyses. Methods A literature review was conducted using publications available in PubMed, PMC, Frontiers, and MDPI databases. Observational studies, systematic reviews, meta-analyses, and Mendelian randomization studies investigating the relationship between psoriasis and thyroid diseases were included. Data regarding the prevalence of AITD, thyroid autoantibodies, and thyroid dysfunction in patients with psoriasis were analyzed. Results Available evidence indicates that patients with psoriasis have an increased risk of autoimmune thyroid diseases. In the meta-analysis by Zhang et al., including 253,313 psoriasis patients and 1,376,533 controls, psoriasis was associated with a significantly increased risk of AITD (OR = 1.76; 95% CI: 1.35–2.28), particularly Hashimoto’s thyroiditis (OR = 1.88; 95% CI: 1.50–2.35). Observational studies also demonstrated higher levels of anti-TPO and anti-TG antibodies, more frequent thyroid dysfunction, and ultrasonographic changes suggestive of thyroid autoimmunity among psoriasis patients. Conclusions Psoriasis is associated with an increased prevalence of autoimmune thyroid diseases, especially Hashimoto’s thyroiditis. The observed relationship may result from shared immunological and genetic mechanisms. Further prospective and causal studies are required to better understand the nature of this association.
Copyright (c) 2026 Kinga Anna Krzysztofik, Antoni Klamka, Paulina Kawalec, Kamil Bronikowski, Maksymilian Ryszkowski, Krystian Fornal, Natalia Będkowska-Kuśmierek , Sabina Zaborowska, Paulina Pawlak, Olaf Wojcieszuk https://creativecommons.org/licenses/by-nc-sa/4.0
Transcranial Direct Current Stimulation in Sport: Neurodoping or Performance Support? Systematic Review
Background. Professional athletes increasingly rely on neurophysiology to enhance athletic potential. Transcranial Direct Current Stimulation (tDCS) has become one of techniques to modulate cortical excitability. It can act as ergogenic aid by modifying motor control and fatigue perception. Aim.This systematic review analyzes the impact of tDCS on motor skills, physical endurance, and cognitive performance. It also addresses the ethical debate surrounding “neurodoping”. Materials and Methods. This systematic review was conducted following PRISMA guidelines. The search was conducted in PubMed and Web of Science, and Scopus. 62 publications were analyzed, published up to January of 2026. The review focused on anodal stimulation of M1 and DLPFC regions. Results. Findings indicate small to moderate effects on performance. The most consistent results involve reduced perceived exertion and improved Time-to-Exhaustion (TTE), especially in M1 stimulation. DLPFC stimulation showed benefits in cognitive tasks, decision-making, and emotional regulation. However, significant heterogeneity existed due to variations in study methodology. Conclusions. tDCS can enhance performance by modulating the perception of effort rather than increasing physical capacity. While not currently prohibited by WADA, the high variability in results shows need for standardized protocols and further research into longterm effects and ethical regulations.
Copyright (c) 2026 Kinga Kałuża, Michał Pater, Natalia Kałwa, Mateusz Smerdzyński, Agnieszka Chmurska, Aleksandra Majchrzyk, Aleksandra Strzępek, Julia Łyżwa, Karolina Frączek, Agnieszka Janaszek https://creativecommons.org/licenses/by-nc-sa/4.0
From Leaky Gut to Central Nervous System Autoimmunity: Cross-Reactivity and Molecular Mimicry in Schizophrenia
Background and Aim: Traditional schizophrenia models relying on neurotransmitter dysfunctions are giving way to new perspectives. Stepping beyond the conventional gut-brain axis paradigm, this review emphasizes a fresh autoimmune hypothesis: molecular mimicry and cascading tissue barrier breakdowns as direct triggers of central nervous system (CNS) pathology. Materials and Methods: We analyze recent clinical studies concerning intestinal and blood-brain barrier (BBB) integrity, focusing on specific mechanisms: the kynurenine pathway, cross-reactivity to food antigens (wheat gluten, bovine casein), and NMDA receptor autoantibodies in schizophrenia. Results: Schizophrenia-associated dysbiosis, marked by a depletion of butyrate-producing bacteria, compromises the intestinal barrier, leading to metabolic endotoxemia. Crucially, the pathology is driven by immune deception. Given the structural homologies between foreign or dietary antigens and host tissues (molecular mimicry), cross-reactive lymphocytes and autoantibodies are generated. These penetrate the compromised BBB - sometimes via a macrophage-mediated "Trojan Horse" mechanism - and directly attack host brain structures, including myelin and NMDA receptors. Concurrently, systemic inflammation pathologically redirects tryptophan metabolism, producing neurotoxic kynurenic acid. Conclusions: Schizophrenia's pathophysiology is inextricably linked to immune autoaggression initiated by molecular mimicry. Shifting focus from general microbiome presence to the mechanisms of cross-reactivity and cascading barrier hyperpermeability reveals novel avenues for antigen-specific therapies. Addressing these root causes offers substantial hope for profound clinical improvement or even full remission.
Copyright (c) 2026 Nina Nowicka, Emil Mian, Zuzanna Zapart, Alicja Sikorska, Martyna Szepietowska, Oliwia Zuzanna Gańska, Jakub Bundyra, Dominika Janik, Agata Sochocka, Julia Parda https://creativecommons.org/licenses/by-nc-sa/4.0
Anterior cruciate ligament rupture - exploring mechanism of healing and its impact in different treatment methods
Anterior cruciate ligament (ACL) is one of the primary stabilizers of the knee joint, preventing anterior tibial translation and contributing to rotational stability. ACL rupture is among the most common injuries in young athletes, although it may occur in individuals of any age. In recent years, the incidence of ACL injuries has increased due to greater participation in sports and physically active lifestyles, leading to growing demand for effective treatment methods. Currently, anterior cruciate ligament reconstruction (ACLR) is considered the standard treatment approach. The procedure typically uses autografts harvested from the patient’s own tendons, although allografts and synthetic ligaments may also be utilized. Advances in the understanding of ligament biology and healing mechanisms have contributed to the development of newer primary repair techniques aimed at preserving native ACL tissue and proprioceptive function while reducing donor-site morbidity and enabling earlier rehabilitation. Although ACLR has been extensively studied and refined over decades, newer repair methods still require further long-term clinical evaluation. Each treatment strategy presents specific advantages and limitations, and none completely eliminates the risk of graft failure or post-traumatic osteoarthritis. This review summarizes the biological phases of ACL healing and discusses current treatment options in relation to these processes.
Copyright (c) 2026 Ewa Tomicka, Olgierd Czapiński, Natalia Zięba, Maciej Ciesielski, Justyna Kuś, Mateusz Pysiewicz, Patrycja Białowąs, Anna Knapik, Anna Brodowska https://creativecommons.org/licenses/by-nc-sa/4.0
Sport-Specific Loading in Femoroacetabular Impingement (FAI): Development, Treatment, and Return to Sport
Femoroacetabular impingement (FAI), particularly cam-type morphology, is increasingly recognized as a major cause of hip pain and functional limitation in young athletes. Growing evidence suggests that repetitive sport-specific mechanical loading during skeletal maturation contributes to the development of cam deformity and may influence postoperative outcomes after hip arthroscopy. High-impact sports involving repetitive hip flexion, internal rotation, axial loading, and rapid directional changes-especially ice hockey, soccer, and basketball-demonstrate a significantly increased prevalence of cam morphology compared with non-athletic populations. Current findings support a mechanobiological model in which repetitive loading during adolescence induces adaptive remodeling of the proximal femur, potentially progressing from physiological adaptation to pathological impingement. Although both physiotherapy and arthroscopic treatment improve symptoms and hip function, hip arthroscopy generally provides superior short-term improvements in patient-reported outcomes. Return-to-sport rates following arthroscopy are consistently high, commonly ranging from 80% to 90%; however, successful return to competition does not necessarily correspond to restoration of pre-injury performance levels. Postoperative recovery appears to vary according to biomechanical demands, age, revision surgery, duration of symptoms, and the severity of intra-articular damage. Arthroscopic treatment provides superior short-term improvements in patient-reported outcomes compared with conservative management. Nevertheless, physiotherapy remains a reasonable first-line approach, particularly in less severe cases, and does not appear to adversely influence the outcomes of subsequent surgical intervention.
Copyright (c) 2026 Maciej Ciesielski, Justyna Kuś, Olga Stadnicka, Mateusz Pysiewicz, Patrycja Białowąs, Olgierd Czapiński, Natalia Zięba, Anna Knapik, Anna Brodowska, Ewa Tomicka https://creativecommons.org/licenses/by-nc-sa/4.0
Physical Activity as a Modulator of Gut Microbiota Diversity: Evidence from Human Studies
Introduction and purpose: The human gut microbiota plays a crucial role in maintaining overall health, influencing metabolic, immune, and neurological processes. Physical activity has emerged as a potentially modifiable factor affecting gut microbiota composition and diversity. The aim of this narrative review was to evaluate current evidence on the impact of physical activity on gut microbiota diversity in humans. Brief description of the state of knowledge: This review was based on a comprehensive search of PubMed and Google Scholar and included studies published between 2010 and 2026. Only studies involving human participants and examining the relationship between physical activity and gut microbiota were considered. Available evidence indicates that physical activity is associated with changes in gut microbiota composition and, in some cases, with increased diversity and a greater abundance of beneficial bacterial taxa. Both observational and interventional studies suggest that exercise may positively influence microbial composition; however, the magnitude of these effects depends on exercise type, intensity, duration, and individual characteristics. Diet was consistently identified as a major confounding factor influencing gut microbiota outcomes. Summary: Physical activity appears to be an important modulator of gut microbiota in humans, with more consistent effects on microbial composition and function than on overall diversity. However, these effects are complex and influenced by multiple interacting factors, particularly dietary habits. Further well-designed human studies are needed to clarify the mechanisms underlying these interactions.
Copyright (c) 2026 Julia Kossakowska, Marcin Ruszkowski, Mikołaj Celmer, Mateusz Majchrzak, Urszula Kacprzak, Zofia Biernacka, Norbert Piątkowski, Andrzej de Laval https://creativecommons.org/licenses/by-nc-sa/4.0
Modulation of Skin Extracellular Matrix and Collagen Homeostasis: Differential Effects of Aerobic and Resistance Training on Skin Aging
Background. The structural integrity of the skin relies on the extracellular matrix (ECM) and collagen homeostasis, which degrade during aging. While physical activity is a systemic regulator of cutaneous homeostasis, the molecular divergence between distinct training modalities remains poorly characterized. Specifically, the pathways through which aerobic training (AT) versus resistance training (RT) influence skin health require elucidation. Aim. To analyze the molecular mechanisms through which physical activity influences skin aging, focusing on ECM remodeling, skin density, and counteracting aging processes. Material and methods. A narrative review of literature from the last decade was conducted, focusing on mechanotransduction, myokine signaling, and fibroblast gene expression under the influence of AT and RT. Results. RT induces skin thickening by activating mechanotransduction pathways and stimulating structural genes like biglycan (BGN), HAS2, and CHSY1. This process is supported by the suppression of circulating plasma inhibitors such as CXCL4. Simultaneously, AT serves as a systemic antioxidant filter. By reducing senescence - associated secretory phenotype (SASP) markers and inhibiting matrix metalloproteinase (MMPs) activity, AT creates a protective environment that prevents the degradation of newly synthesized collagen fibers. Conclusions. A hybrid training model (combining AT and RT) represents the most effective non - pharmacological strategy for skin rejuvenation. Such a dual - pathway approach stimulates the production of structural components and stabilizes the dermal environment against metabolic and oxidative stress. The integration of physical activity into anti - aging protocols offers a biological "reprogramming" of the skin, leading to improved structural integrity and resilience.
Copyright (c) 2026 Anna Brodowska, Justyna Kuś, Patrycja Białowąs, Natalia Zięba, Olgierd Czapiński, Ewa Tomicka, Anna Knapik, Olga Stadnicka, Maciej Ciesielski, Mateusz Pysiewicz https://creativecommons.org/licenses/by-nc-sa/4.0