Sport and Health Sciences Reviews

Abstract Background: Recent research indicates that rehabilitation exercises and the use of orthoses significantly improve lower limb-related conditions. Therefore, the present study aimed to review the effects of various non-invasive interventions on improving knee hyperextension. Methods: This study was a narrative review. Articles in Persian and English were searched from the beginning of December 1992 to the beginning of January 2025 in specialized databases, including PubMed, WoS, Scopus, SID, Magiran, Science Direct, JCR, and Google Scholar. Ultimately, 9 articles related to various non-invasive interventions for individuals with knee hyperextension were reviewed. Results: The articles in the field of non-invasive interventions for improving posture in individuals with knee hyperextension demonstrated that exercises and the use of orthoses help achieve proper posture. Another group of studies examined the effects of non-invasive interventions on improving knee hyperextension during walking in affected individuals, showing that these interventions significantly enhance gait in people with knee hyperextension. Conclusion: The present review study revealed that non-invasive interventions can effectively improve knee hyperextension.

Abstract This article systematically examines the impact of exercise on increasing levels of brain-derived neurotrophic factor (BDNF) and its role in preventing dementia. BDNF is a vital protein for the survival, function, and synaptic plasticity of neurons. Studies have shown that exercise can serve as a non-pharmacological strategy to reduce the risk of cognitive decline and dementia. In this review, the relationship between exercise, BDNF, and dementia is analyzed based on existing evidence from human and animal studies, and potential mediating mechanisms, including the role of myokines and other circulating factors, are discussed. Research indicates that exercise, particularly aerobic training, can increase BDNF levels and thereby have a positive effect on brain health. At the same time, factors such as the intensity, duration, and type of exercise, as well as individual characteristics including genetics, influence the magnitude of the BDNF response. On the other hand, some findings regarding the direct relationship between exercise-induced increases in BDNF and improvements in cognitive performance have been contradictory, highlighting the need for more precise research to determine the definitive mechanisms of this effect. Despite methodological challenges, there is strong evidence supporting the protective effect of exercise against dementia. However, further research is necessary to optimize exercise interventions for dementia prevention. This article emphasizes the importance of developing standardized exercise programs and conducting longitudinal studies to clarify the molecular pathways and factors influencing this relationship.

Abstract Smart wearable technologies hold immense potential for continuous collection of physiological data and the enhancement of personal health. However, challenges related to data privacy, security, and the integration of data from fragmented sources (data silos) hinder the full realization of this potential. Federated Learning (FL), as an emerging machine learning paradigm, offers a promising solution by enabling decentralized data analysis without the need to transfer raw data to a central server.

This systematic review aims to examine the applications, opportunities, and challenges of using federated learning for analyzing physiological data collected by smart wearables. Through a comprehensive search of reputable scientific databases, relevant studies are identified and analyzed.

Key opportunities include preserving user privacy, enhancing data security, overcoming data fragmentation, and achieving scalability across a large number of devices. On the other hand, the main challenges involve data heterogeneity across different devices, communication overhead, model aggregation complexities, and vulnerability to specific attacks unique to federated learning.

The findings of this review suggest that federated learning represents a promising pathway for advancing artificial intelligence in the domain of wearable health technologies. However, further research and innovation are required to address practical limitations and to ensure the efficiency and security of such systems at scale.

Abstract Oxidative stress plays a significant role in the development and exacerbation of exercise-induced muscle damage (EIMD). This condition arises from an imbalance between the production of reactive oxygen species (ROS) and the body's ability to neutralize them with antioxidants. Intense exercise leads to increased ROS production, which can cause tissue damage and impair muscle contractile function. EIMD often occurs after strenuous exercise, particularly eccentric movements, and is associated with muscle soreness, reduced strength, and limited range of motion. ROS are produced during both aerobic and anaerobic exercise and, when excessively elevated, can lead to lipid peroxidation, protein modifications, and increased inflammation. To counteract this, the body utilizes enzymatic antioxidants such as superoxide dismutase (SOD) and non-enzymatic antioxidants like vitamins C and E. However, factors such as high training volume, poor nutrition, and environmental stress can exacerbate oxidative stress in athletes. Nutritional strategies, including the use of antioxidant supplements such as vitamin C, vitamin E, polyphenols, and curcumin, as well as a diet rich in fruits, vegetables, whole grains, lean proteins, and omega-3 fatty acids, can help reduce oxidative stress and enhance recovery. Additionally, proper training planning through periodization, management of eccentric exercises, cross-training, and active recovery can effectively mitigate muscle damage. Recent research also highlights the role of gut microbiota in regulating inflammation and oxidative stress induced by exercise, suggesting that nutritional interventions can improve microbial balance. Ultimately, a deeper understanding of the mechanisms of oxidative stress and the application of appropriate nutritional and training strategies can enhance athletic performance and overall health.

Abstract Introduction: Functional stability is considered one of the most important components of motor control and optimal function of the musculoskeletal system, playing a key role in the execution of daily and sports activities. In recent years, researchers' attention has increasingly focused on the role of hip muscles in controlling lower extremity movements and maintaining functional stability. Hip muscles, particularly the abductors, extensors, and external rotators, play an essential role in maintaining lower limb alignment by controlling pelvic and femoral positioning. Weakness or strength imbalance in these muscles can lead to impaired neuromuscular control, increased dynamic knee valgus, and reduced quality of performance in functional movements.
Methodology: A comprehensive search was conducted in electronic databases including PubMed, Web of Science, Scopus, and Google Scholar from January 2000 to May 2026. This search was performed using a combination of specialized keywords related to isometric hip muscle strength and indices of functional stability across various motor tasks. Studies that assessed the relationship between isometric hip strength and functional stability in healthy individuals were included in this review.
Results: Numerous studies have investigated the relationship between various types of hip muscle strength, including isometric, concentric, and eccentric strength, with indices of static and dynamic balance. Furthermore, in recent years, the role of hip strength ratios, eccentric control, and proximal muscle coordination in high-demand functional tasks such as landing, single-leg squat, direction change, and plyometric movements has received increasing attention. Nevertheless, findings regarding the intensity and nature of this relationship have not always been consistent across studies.
Conclusion: The present narrative review demonstrates that hip muscle strength can be one of the factors influencing postural control, movement quality, and balance performance; however, this relationship depends on the type of motor task, muscle contraction type, level of motor skill, and assessment conditions. Moreover, it appears that eccentric control and strength balance among hip muscle groups play a more prominent role in high-demand functional activities than isolated isometric strength.

Abstract Background: Physical activity and exercise are recognized as effective strategies for improving neurological and psychological health. This review study aimed to analyze the impact of exercise on key biomarkers of the nervous system, including amyloid beta protein, tau protein, BDNF, inflammatory cytokines, and lactate, and to investigate the underlying mechanisms.
Materials and Methods: This is a narrative review study conducted using library research. Searches were performed in PubMed, Google Scholar, and Scopus databases using specialized keywords in May 2024. From a total of 40 identified articles, following the application of inclusion and exclusion criteria and quality assessment using the CASP checklist, 9 valid articles including laboratory, clinical, and review studies were selected for final analysis.
Results: The results indicated that aerobic and resistance exercises positively impact the nervous system by stimulating neurotrophic pathways, enhancing neuroplasticity, reducing inflammation, and improving neurochemical balance. In aerobic exercise, metabolic-molecular mechanisms including lactate, cathepsin B, irisin, and kynurenine pathways play a dominant role, while in resistance exercise, neuromuscular and hormonal mechanisms including irisin secretion and acute IGF-1 increase are more prominent. These effects lead to a reduction in symptoms of neurodegenerative diseases, enhancement of memory and learning, and improvement of mood, emphasizing the importance of personalizing the intensity and type of exercises.
Conclusion: Exercise is recognized as an effective method for improving nervous system health and managing neurological and psychological disorders. Aerobic exercise exerts its effects through metabolic-molecular mechanisms, while resistance exercise acts through neuromuscular and hormonal mechanisms; combining both types yields the strongest effects on neural biomarkers. However, heterogeneity in training protocols and the limited number of human studies highlight the need for further research.

Abstract Background and Objective: Adolescence is a critical period in human development during which rapid physiological changes create special nutritional needs, particularly in adolescent athletes. This study aimed to systematically review the evidence published between 2010 and 2025 on the effects of nutritional interventions on sports performance in adolescent and elite athletes.
Methods: This review was conducted in accordance with the PRISMA 2020 guidelines and the PICO framework. A structured search was performed in PubMed, Scopus, and ScienceDirect using relevant keywords. Studies were included if they involved adolescents aged 10–19 years, implemented at least one nutritional intervention, and reported sports performance outcomes. After screening titles, abstracts, and full texts, 82 studies met the inclusion criteria.
Results: The interventions examined included dietary supplements (protein, creatine, sports drinks), targeted dietary regimens, and nutrition education programs. The findings indicated that these interventions produced significant improvements in indicators such as VO₂max, muscle strength, endurance, speed, and body composition. However, heterogeneity in sport type, duration and intensity of the interventions, and performance assessment methods limited the possibility of conducting a unified pooled quantitative analysis. Evidence also showed that many adolescents have insufficient nutrition knowledge, which may lead to relative energy deficiency, poor food choices, and an increased risk of eating disorders. The use of supplements is also on the rise, yet conclusive evidence regarding the efficacy and safety of some of these products in this age group is lacking.
Conclusion: This review highlights the need to design nutritional interventions tailored to the specific requirements of adolescent athletes and to strengthen nutrition education within families, sports clubs, and schools. Furthermore, well-designed prospective studies with larger sample sizes are required to provide more applicable recommendations.

Abstract Background and Aim: Anabolic-androgenic steroids (AAS) are a family of drugs that include the naturally occurring male hormone testosterone, which exhibit varying degrees of anabolic (muscle-building) and androgenic (masculinizing) effects. When taken in supraphysiological doses, AAS allow individuals to gain large amounts of muscle mass and lose body fat, often beyond the limits that can be achieved naturally. Because of these properties, AAS use has become a major substance use disorder worldwide. AAS use has become a relatively common substance use disorder in many countries, particularly Scandinavia, the United Kingdom, and Brazil. Other countries in continental Europe are also now showing increasing rates of AAS use, while AAS use is very rare in East Asian countries, such as China, Korea, and Japan. The uneven distribution of AAS use worldwide appears to be related to cultural factors. Since AAS use is arguably the newest substance use disorder in the world, many aspects of AAS are still poorly understood by both clinicians and researchers. Recent research findings indicate a high rate of steroid use among Iranian athletes, as well as a low level of awareness among users about these drugs. Low awareness, coupled with misconceptions, accessibility, and ease of obtaining these drugs, can lead to increased use of these drugs in athletes and various populations, which highlights the need for greater attention from authorities and the design of prevention programs. The aim of this study is to review the most fundamental issues related to the diagnosis and treatment of AAS abuse.
Research Method: This study used a narrative review method. Literature review articles or narrative review articles provide abstracts and narrative evaluations of findings or theories in a literature database. Literature databases may include qualitative, quantitative, or mixed methods studies. To collect data, relevant articles between 1990 and 2025 were searched in Google Scholar, PubMed, NOORMAGS, SID, and irandoc databases using the keywords anabolic-androgenic steroids, toxicity, dependence, withdrawal syndrome, and treatment. Articles that were not written in English or Persian or were book chapters, conference papers, extended abstracts, or preprints were excluded. A list of articles was obtained and the abstracts were read to assess relevance. Using this method, 105 articles were identified and accessed. Then, each article was read and analyzed, and finally, 26 articles were selected for data extraction.
Findings: It is difficult to accurately estimate the number of people who use AAS in different countries. Surveys have led to several widespread misconceptions about the prevalence of AAS use, including that AAS use is not uncommon in adolescent girls, that AAS use is a common phenomenon in adolescents, and that AAS use occurs mainly among athletes. In fact, the majority of AAS users are men over 18 years of age who do not participate in any competitive sports. The number of AAS users in different countries has been estimated to be 0.5–2% among men and approximately 30% of Iranian professional athletes and bodybuilders. The most concerning consequence of long-term exposure to AAS is its effect on the cardiovascular system, especially premature death from myocardial infarction in young men. Exogenous AAS suppress the function of the hypothalamic-pituitary-testicular axis in men, leading to decreased gonadotropin production from the hypothalamus, decreased luteinizing hormone and follicle-stimulating hormone from the pituitary, and consequently reduced testicular production of testosterone and sperm, and discontinuation of AAS, especially after a long period of use, is likely to result in AAS-induced hypogonadism, which is defined as decreased functional activity of the gonads. AAS use and withdrawal may precipitate major mood disorders, including hypomania and depression, in some susceptible individuals. These mood effects appear to be highly individual-specific, and the mechanisms underlying these specific responses are not well understood. AAS have also been associated with a variety of other less serious or less common adverse effects on other organs, including severe body acne, gynecomastia, hepatotoxicity, cases of renal failure, apoptosis, delayed sleep onset, impaired daytime functioning, and use of hypnotic drugs in AAS-using athletes. AAS can cause a dependence syndrome characterized by chronic AAS use that may be continued despite adverse effects. AAS users rarely seek treatment, and the available research literature on treatment is therefore sparse.
Discussion and Conclusion: Since widespread AAS use is very new, psychiatric research findings on the epidemiology, characteristics, and treatment of this disorder are limited compared to the volume of research on other forms of substance use, and many findings in this area remain tentative, and misconceptions about AAS use are still prevalent among both the general public and mental health professionals. This situation is likely to change over the next decade or two, as more older AAS users experience side effects that require clinical attention and treatment. AAS use in Iranian athletes appears to be a challenge facing the health system. The lack of sufficient knowledge among Iranian coaches and athletes about the side effects and consequences of steroid use has dramatically facilitated the use of these substances, and therefore the development of comprehensive educational programs to raise the awareness of athletes and coaches seems essential. Studies show an increase in awareness, perceived severity, and behavioral intention to abstain from using anabolic steroids after completing a training program among Iranian athletes, and demonstrate the usefulness of organizing educational classes for them. The epidemiology of AAS users in different Iranian communities, especially competitive athletes, and the subsequent investigation of the consequences of chronic use of these substances is an important step in shaping indigenous knowledge in this area.

Abstract Background and Aim:
Some sports tourism activities are closely linked to specific sports and regions characterized by unique geographical features and stable local conditions. The distribution of sports tourism resources is uneven and varies across regions, each with its own distinctive local attributes. For example, winter sports are prevalent in northern areas, water sports dominate coastal regions, mountain climbing takes place in mountainous zones, and exploratory tours occur in desert areas. Desert tourism has developed globally by leveraging symbolic values such as natural beauty, tranquility, and freshness to meet the growing demands of travelers. According to Atkinson, desert tourism involves individuals visiting rare and unique locations that offer special attractions or activities. Likewise, Ling and colleagues define desert tourism as traveling to places that are geographically and socio-culturally marginal or beyond common human experiences. Natural features such as scenic landscapes, pleasant climates, lakes, mountains, deserts, forests, coasts, and rural areas serve as spiritual resources for valuable tourism destinations and products. Deserts, a type of arid land, include sand dunes, rocky plateaus, salt flats, dry valleys, mountain ranges, volcanoes, rivers, springs, oases, pastures, shrubs, and sometimes even towns. One of Iran’s desert strengths is its unique tourist attractions, with sports tourism being a notable type. This form of tourism not only stimulates domestic tourism but also has the potential to attract many international tourists. The aim of the present study was to conduct a systematic review of research on sports tourism in desert areas. The research method was qualitative, applied in purpose, and systematic in approach.
Research Method:
This study aimed to systematically review published research on sports tourism in desert regions. The population consisted of valid articles related to this topic sourced from databases including the Scientific Information Database of Jahad Daneshgahi, Noormagz specialized journals, and the Persian-language search engine Elmnet. Keywords used in the search included desert sports, sports tourism in deserts, desert tourism, sports tourism in arid lands, and desert sports, covering articles published from the beginning of 2014 (1393) to the end of 2023 (1402). Inclusion criteria were studies with scientific and research purposes that were review or comparative in nature, written in Persian with full-text access and a clear methodology, and published in reputable journals indexed in databases such as ISC. The PRISMA framework was applied for selecting key terms. Exclusion criteria consisted of papers with evident contradictions between research objectives and findings, clear methodological errors in sampling or statistical analysis, or unsuitable study populations. For thorough evaluation, data were extracted based on four dimensions—cognitive, structural, functional, and citation-related—guided by research questions and the systematic review model. The study’s validity was confirmed through expert opinions, and reliability was ensured with a corrected reliability coefficient of 95%.
Findings:
The cognitive status of published articles on sports tourism in deserts from 2014 to 2023 showed that 36 papers appeared in national scholarly journals. The fewest articles were published in 2015 (one article) and the most in 2023 (six articles), indicating an upward trend in publication frequency. Twenty-two journals featured relevant articles, with the "Geographical Studies of Arid Regions" journal publishing the highest number. Following it, journals like "Desert Geographical Explorations" and "Regional Planning" ranked next. Structurally, 50% of the articles lacked a conclusion in their abstracts, 30% missed an English abstract, and 66% did not include a theoretical framework. Regarding author demographics, 72.8% were male and 27.2% female. Most researchers (59.2%) specialized in geography, while only 7.7% had a background in sports management. The University of Tehran contributed the most authors (14.5%). Citation analysis revealed 1281 sources cited across articles, with 47.6% in Persian and 52.4% in English. The number of Persian sources ranged from zero to 44 and English sources from one to 70 per article. On average, each article cited 35 sources, a satisfactory figure, with 87% of these from scholarly research articles. Functionally, the most influential factors in desert sports tourism were identified as infrastructural and managerial elements, followed by economic, security, and cultural factors.
Discussion and Conclusion:
Sports tourism in Iran’s deserts, given its exceptional natural attractions and potential capacities, can play a vital role in economic, cultural, and employment development in arid regions. The systematic review demonstrated that infrastructural and managerial factors are among the most critical components influencing the growth of this tourism type. Moreover, structural and content-related deficiencies in reviewed articles highlight the need for improved theoretical foundations, precise abstract writing, inclusion of English abstracts, and greater diversity in research methodologies, especially qualitative approaches. Additionally, coordination between government agencies and the private sector along with the provision of suitable infrastructure—such as facilities for hosting sports events and enhancing access to desert areas—can accelerate the sector’s development. Advancing sports tourism in deserts requires leveraging the scientific capacity of the research community while prioritizing environmental conservation and utilizing local resources. This emerging field should be supported by policymakers, academics, and investors to foster scientific and practical progress, thereby creating suitable opportunities for introducing the culture and attractions of desert regions to both domestic and international tourists.

Abstract Background and Aim:
Consolidation is a set of neural processes by which a memory both becomes more stable and improves over time. At least two events occur as a result of consolidation: consolidation and enhancement. During consolidation, a new and fragile memory can become strong and stable; this event is called consolidation. During consolidation, a memory may not only be consolidated but also enhanced. Enhancement can also occur offline between training sessions. Such offline learning can often be supported by the passage of time or by a night of sleep. In the neuroscience and behavioral sciences literature, consolidation has two subprocesses; the first process, which occurs in the first minutes and hours, involves changes and exchanges of materials within and between two neurons. These initial changes are referred to as “synaptic consolidation” or rapid and early consolidation. Another type of consolidation takes many hours, days, weeks, or perhaps months. It is believed that this type of consolidation involves the reorganization of brain and systemic circuits over time, such this engram can be transferred to new locations in the brain and lose its dependence on the circuits and initial consolidation points. This type of process is called “system consolidation” or delayed consolidation. This review article is based on two research questions. In the first research question, we sought to understand where motor memory consolidation occurs and which brain regions it involves. We then sought to understand how long the process of motor memory consolidation takes. Therefore, in this review article, we seek to examine the neural processes of consolidation in general, and the spatial neural substrates and temporal trends of each of the subprocesses.
Research Method:
This research is a narrative review study. Based on the keyword consolidation, the search for the following terms was started: consolidation, memory consolidation, motor memory, motor memory consolidation. Regarding the types of motor memory consolidation and stages of motor memory consolidation, the terms cognitive consolidation (news), procedural consolidation, motor memory consolidation, offline promotion, synaptic consolidation, and systemic consolidation were searched. In this review study, four databases of English articles were consulted: Sciencedirect, PubMed, Sage, and Google Scholar, and the time period was considered from 1996 to 2024. Persian research was also searched in Irandoc and Jihad Daneshgahi (SID) databases, and the time period was considered from 1375 to 1403. A total of 147 articles related to the above keywords were found. First, the authors eliminated duplicate studies between databases (23 cases). Second, the titles of all 124 remaining articles were read and those that were clearly irrelevant (some of these studies were on computers, artificial intelligence, and robots) were excluded (26 cases). Then, by reading the abstracts of the remaining articles, the authors determined that 53 articles were suitable for full-text review. Finally, by reading the full-text articles, with particular focus on the methodology and results obtained, and based on agreement between the authors of this text, 37 core articles were selected for this review study.
 
Findings:
There are three physiological explanations for synaptic consolidation in the early minutes (short-term memory). First, many physiologists believe that this consolidation is due to the continuous activity of neural signals that are created around a temporary memory trace and form a circuit of reflex neurons. The second explanation is that synaptic consolidation can be the result of presynaptic facilitation or inhibition. This action occurs in the presynaptic neuron, not the postsynaptic neuron. Neurotransmitters released at such terminals repeatedly and repeatedly cause facilitation or inhibition for several seconds or several minutes. The final explanation is synaptic potentiation, which can strengthen synaptic conduction. After training or acquisition, as more time passes without training, the new memory becomes resistant to all kinds of interference. According to the results of the reported research, the process of synaptic consolidation seems to take its longest time during the first four to six hours after training. It is believed that long-term memory (system consolidation process) results from actual structural changes, rather than mere chemical changes in synapses, and these changes cause the enhancement or suppression of signal conduction. The most important structural changes produced in long-term memory are: 1. An increase in the number of vesicle release sites for transmitter secretion; 2. An increase in the number of released vesicles; 3. An increase in the number of presynaptic terminals; 4. A change in the structure of dendritic spines. Several areas of the brain are responsible for the long-term consolidation of non-novel skills, including the primary motor cortex (M1), parts of the neocortex, the cerebellum and deep nuclei, and the striatum. Offline consolidation of newly learned motor skills is a multi-stage and dynamic process. Many studies on systemic consolidation have reported that improvements are often associated with sleep deprivation, with improvements occurring more significantly if the period of non-practice is accompanied by sleep (especially at intervals of 12 to 24 hours). In general, depending on the type of skill and task, systemic consolidation of a skill requires 24 to 72 hours after acquisition to occur, such as consolidation (12 hours), promotion (24 hours, accompanied by sleep), and spatial transfer (48 to 72 hours).
Discussion and Conclusion:
According to the results of the reported studies and their comparison with each other, it was shown that the temporal and spatial contexts of motor memory consolidation can vary depending on the type of task or training provided. Therefore, the results of this study can be a refutation of the idea that motor memory consolidation, like cognitive memory consolidation, has a single cortical area and a specific duration. According to Newell's constraint-based perspective, the development, control, and learning of a movement should be considered with respect to the three constraints of the individual, the environment, and the task. Therefore, the variability of the spatial and temporal infrastructures of movement consolidation with respect to the type of task can indicate the different post-training needs of different motor skills. Finally, it is suggested that more detailed studies and research be conducted in the future on the spatial and temporal contexts of motor memory consolidation with respect to the constraints of the individual and the environment.

Abstract  
Vitamin B12 is known as one of the essential vitamins for maintaining general health and optimal body function. This vitamin plays a vital role in energy metabolism, red blood cell production, and nervous system function. Given the high importance of aerobic performance in athletes, investigating the effect of B12 supplementation on this performance is an important and significant issue. This study aims to investigate the effects of vitamin B12 supplementation on improving aerobic performance in athletes and identify its possible mechanisms.
Research has shown that vitamin B12 deficiency can lead to reduced aerobic capacity and increased fatigue in athletes. Therefore, investigating the positive or negative effects of B12 supplementation can help improve athletic performance and quality of life in athletes. This study seeks to identify the relationship between B12 supplementation and improved aerobic performance, including oxygen consumption capacity (VO2 max), endurance ability, and recovery time.
The results of this study can help coaches and athletes in nutritional planning and selecting appropriate supplements, and also pave the way for further research in this area. Given the increasing use of supplements in the world of sports, this research can be used as a reliable source for scientific and practical decisions in the field of sports nutrition.
Research Method
A systematic and comprehensive approach is taken to write the article. This method involves several steps that collect, analyze, and interpret existing data on the effect of vitamin B12 on sports performance. First, a thorough review of the existing literature is conducted to identify relevant articles. This step involves searching reputable databases such as PubMed, Scopus, and Google Scholar. Relevant keywords include “vitamin B12,” “aerobic performance,” “nutritional supplements,” and “athletes.”
After identifying the initial articles, the inclusion and exclusion criteria are determined for selecting studies. Studies that have investigated the effect of vitamin B12 on aerobic performance in athletes and have been published within the last ten years are considered. Articles that include clinical, experimental, or meta-analyses will also be selected as reliable sources. In addition, articles that examined the possible side effects or risks of vitamin B12 supplementation are included to provide a comprehensive view. Next, the information extracted from the selected articles is carefully analyzed. This information includes the type of study (experimental, observational, systematic review), number of participants, dose and duration of vitamin B12 supplementation, and the main results on aerobic performance.
 
table 1: entry and exit criteria




 


Entry criteria


exit criteria




Study Type


Research articles (clinical studies, observational studies, and systematic reviews) that examined the effect of B12 supplementation on aerobic performance.


Theoretical articles, non-systematic reviews, or articles that address the effects of other supplements on aerobic performance.




Study Population


• Professional or amateur athletes (of either sex)
• Adults (18 years and older)


People with chronic diseases (such as diabetes, heart disease, or endocrine disorders).
People taking other supplements simultaneously with B12.




Intervention


Use of vitamin B12 supplementation in any form
(tablets, capsules, injections)


Studies that do not mention a specific dose of B12 supplementation.
Studies with an intervention duration of less than 4 weeks.




Outcomes


Measurement of aerobic performance (such as VO2 max, running time, exercise tolerance, or other relevant parameters).


No measurement of aerobic performance parameters.




Language


Articles published in Persian or English


Articles published in languages other than Persian or English.




Time Period


Articles published in the last 10 years
(e.g., from 2013 onwards).


Articles published before 2013.




Findings
The functions of vitamin B12 are very diverse. One of its main functions is to help metabolize fatty acids and produce energy. This vitamin is also effective in converting nutrients into energy and acts as a cofactor in various biochemical reactions. In addition, B12 is involved in processes related to the production and maintenance of myelin, which is the protective covering of nerves, and for this reason, its deficiency can lead to serious neurological problems. Deficiency of this vitamin can have serious health consequences, including fatigue, weakness, memory problems, mood disorders, and even megaloblastic anemia. Therefore, it is very important to be aware of food sources containing B12 and the daily requirement of this vitamin to maintain general health [2].
B12 also plays an important role in protein metabolism. For athletes, proteins are the main source of muscle building and tissue repair after hard training. Since B12 is effective in converting proteins into energy, supplementation with this vitamin can help with muscle growth and strength. Vitamin B12 has a significant impact on aerobic performance, primarily through increased hemoglobin levels and improved oxygen delivery to tissues. As hemoglobin levels increase, the body’s ability to use oxygen during exercise increases [4].
On the other hand, some studies have shown that excessive vitamin B12 intake may have side effects. In one study, high doses of this supplement resulted in unpleasant symptoms such as headaches and anxiety in some athletes [14]. Therefore, it is important to follow the appropriate dosage and consult a nutritionist before starting supplementation.
Some researchers have also noted the positive effects of vitamin B12 on the immune system of athletes. This vitamin can help strengthen the immune system and reduce the risk of infections in athletes [15,16].
Discussion and Conclusion
Vitamin B12 supplementation is known to be an important factor in improving aerobic performance in athletes. Research results show that this vitamin acts as a vital factor in energy metabolism and can help produce red blood cells. This feature is especially important for endurance athletes who require more oxygen.
In addition to the positive effects on aerobic performance, taking this supplement can help reduce fatigue during long-term exercise, so a vitamin B12 deficiency can lead to serious problems in athletic performance. Athletes who are deficient in this vitamin may experience complications such as anemia, chronic fatigue, and decreased physical ability, and low levels of vitamin B12 are associated with an increased risk of depression and anxiety.

Abstract Aim and Background:
Low back pain is considered a major cause of functional disability, reduced quality of life, fear of pain and movement, reduced motor control, and absenteeism from work in many countries (1,2). Disorders associated with low back pain are not unidimensional and involve multiple biological, social, and psychological aspects of the individual. The cause of low back pain can include changes in lifestyle, work environment, physical inactivity, muscle weakness, and decreased flexibility due to muscle imbalances in the lumbopelvic complex (3). Current management of chronic low back pain involves a wide range of different treatments, including education, manual therapy, medication, mobilization, manipulation, electrotherapy, and exercise therapy (6-4). Despite the existence of various therapeutic interventions, including physical and mental therapies, the effect size of conservative treatment approaches for chronic nonspecific low back pain has been small to moderate. This may be due to the lack of consideration of multidimensional psychosocial and biological factors, as well as the absence of personalized exercise programs for patients (7,8). The pain neuroscience education approach is a new cognitive behavioral therapy intervention that attempts to reduce pain and disability by explaining the physiology of pain to the patient to change maladaptive cognitive patterns during functional activities (9). Despite many studies aiming to add pain neuroscience education to various therapeutic interventions and exercises, the question remains as to which exercise program, combined with this method, produces better results in terms of pain improvement, disability, psychological factors, and functional outcomes. Therefore, a review of the literature in this field seems necessary and can improve low back pain treatment protocols. Therefore, the present study aimed to review the available resources to investigate the effect of combining pain neuroscience education with exercise on pain, functional disability, and psychological factors in patients with chronic low back pain.
Methods:
This study is a narrative review. Articles indexed in the databases Magiran, Irandoc, PubMed, Google Scholar, PEDro, and Scopus were retrieved between 2010 and 2024. The English keywords used included ("non-specific chronic low back pain" OR "chronic low back pain" OR "back pain") AND ("pain neuroscience education" OR "pain education" OR "pain biology education" OR "pain neurophysiology education" OR "pain physiology education" AND ("training" OR "exercise therapy" OR "therapeutic exercise" OR "Physiotherapy" OR "exercise")). The inclusion criteria included valid clinical trial articles indexed in the aforementioned databases, Persian or English-language studies, patients complaining of chronic non-specific low back pain, an age range of 18 to 70 years, and a score equal to or greater than 5 according to the PEDro scale. If participants had low back pain with known causes, combining the pain neuroscience education approach with passive physiotherapy interventions, including manual therapy, mobilization, manipulation, drug therapy, massage therapy, and other interventions separate from exercise therapy, and replication studies were considered as exclusion criteria.
Finding and results:
Eleven articles were found (Figure 1). One study used only pain neuroscience education as a control group (10). Exercise programs included hydrotherapy (11), exercise-based physiotherapy (5,12,13), aerobic and core stability exercises (10), motor control and postural retraining (14), motor control, and core stability (8), group motor control exercises (4), cognitively targeted motor control exercises (15), and corrective exercises (16) and Pilates (17). Seven studies showed a significant reduction in pain in the intervention group compared to the control group (16-4,8,11,13). In three studies, although pain improved, the changes between the two groups were not significant (5,12,17). Finally, in one study, the changes in pain were more significant in the control group compared to the intervention group (10). In three studies, a significant reduction in disability was observed in the intervention group compared to the control group (4,14,16) In eight studies, despite improvement in disability in the intervention group compared to the control group, the between-group changes were not significant (13,15,17-5,8,10). In five studies, fear of movement improved significantly in the intervention group compared to the control group (16-5,12,4). In three studies, despite greater improvement in the intervention group, the between-group changes in fear of movement were not significant (10,11,17). In one study, a significant improvement in pain catastrophizing was observed in the intervention group compared to the control group (16). In contrast, three studies found no significant difference in the pain catastrophizing variable between the two groups (12,13,17). In fear avoidance beliefs, there was a significant improvement in one study (14), and in one study, there was no significant difference between the two groups (4,13). In central pain sensitization, one study showed significant improvement in the intervention group compared to the control group (15), and in one study, the changes between groups were not significant (12). In the self-efficacy variable, in one study, there was significant improvement (14), in another study, there was no significant difference between the two groups (4), and in another study, the control group had a more significant improvement compared to the intervention group (10). Finally, there was no significant difference between the two groups in the depression variable; however, the changes in the intervention group were greater (12).
Discussion and Conclusion:
The results showed that combining the pain neuroscience education approach with exercise programs in the intervention group significantly improved pain (16-4,8,11,13), disability (4,16), fear of movement (5,12,15,16), pain catastrophizing (16), and central pain sensitivity (15). In other studies, despite greater improvement in the intervention group compared to the control group, changes in pain (5,12,17), disability (13,15,17-5,8,10), fear of movement (10,11,17), pain catastrophizing (12,13,17), fear-avoidance beliefs (4,13), depression, central pain sensitivity (12), and self-efficacy (4) were not significant. Rehabilitation and corrective exercise specialists can use this protocol in the treatment of patients with chronic non-specific low back pain. Limitations of the present study include differences in the exercise protocol, time, and dose of pain neuroscience education, and a lack of follow-up. It is suggested that future research should examine the combination of pain neuroscience education with exercise interventions in other common injuries (such as knee pain).

Abstract Abstract
The sagittal plane of the pelvis is a fundamental mechanism for maintaining the body's balance and the spine's alignment, which may undergo changes during the aging process and due to spinal deformities. Pelvic indices, which refer to the definition of the sagittal plane of the pelvis, are evaluated in two classifications: pelvic postural indices and pelvic anatomical indices. Pelvic tilt is one of the two variables (the other variable is sacral slope) that has been more extensively evaluated and analyzed compared to other pelvic postural indices, and it has always posed a challenge for researchers and physiotherapists in terms of how to measure it. Given the presence of contradictory information and the importance of the topic, the aim of this review article is to examine the factors influencing pelvic tilt, such as muscle performance and the positioning of various regions and limbs in the body, and intends to discuss the impact of different exercise regimens on the angle of pelvic tilt.
Methods
Access to articles was conducted using databases and search engines such as Google Scholar, PubMed, Science Direct, and Elsevier with keywords including Pelvic Tilt, Pelvic Review, Pelvic, Pelvic Assessment, Pelvic Evaluation, and their Persian keywords; pelvic tilt and pelvic, on the websites of the country's journal databases (MAGIRAN), the Iranian Academic Research Center (SID), and the Islamic World Science Citation Center (ISC). The time frame for the articles used ranged from 1980 to 2023. The method for selecting articles is illustrated in Figure 2. In this study, 22 English articles and 2 Persian articles were reviewed. Additionally, the studies were qualitatively assessed based on the PEDro scale, which is an 11-point scale. Given that the aim of this review article was to explore the factors influencing pelvic tilt as comprehensively as possible, no specific inclusion or exclusion criteria regarding the age of the subjects were considered, resulting in a wide statistical population that included ordinary and healthy individuals.
Findings
After reviewing and studying various articles, the research findings were categorized into two parts: the relationship between pelvic tilt and the performance of the muscles influencing, and the correlation between different exercise regimens and pelvic position (summarized in Table 1). The results of this study indicated that there is conflicting information regarding the relationship between pelvic tilt and muscle performance, as well as the effects of exercise. It has been stated that abdominal muscles, by affecting the lumbar lordosis area, can influence pelvic tilt and the degree of lumbar curvature. Although conflicting information has been reported in research, it appears that such a relationship exists, and strengthening the abdominal muscles reduces anterior pelvic tilt.
 
Discussion and Conclusion
Since the aim of this review research was to examine factors such as muscular performance and the effects of various exercises on pelvic tilt, it appears that due to the contradictory results in these topics, reaching a definitive conclusion in this regard remains quite challenging and should be the focus of future research and studies with high-quality qualitative value. The results of this study indicated that the positions and methods of measuring pelvic tilt (in standing, lying, or moving positions) can have a very significant impact on the outcomes of studies and the significance or lack of effectiveness of different training programs (stretching, strengthening, or other exercises) on the angle of pelvic tilt at the hip, and researchers should avoid measuring and observing the angle of pelvic tilt in a standing position. Although there seem to be contradictory results regarding the effects of exercises such as yoga, swimming, flexibility, balance, and strength on pelvic tilt, the findings clarified that strengthening the abdominal muscles leads to a reduction in pelvic tilt, and for individuals with natural hamstring muscle strength, there is no necessity for a correlation between changes in this muscle group and pelvic tilt.

Abstract Aim and Background:
According to Report of the World Health Organization, 1.3 billion people worldwide have disabilities, which is equivalent to 16% of the world's population, and one in every 6 people has a disability, and this number is increasing dramatically. Sports, as a basic need, can help people resist physical, mental, emotional, and social pressures and suffer less from cardiovascular problems than others. The importance of sport and physical activity is greater for people with disabilities, because sport is not only a means of recreation for those who spend their free time, but also a factor in the development of physical and mental disabilities in disabled people and plays a significant role in reducing secondary complications caused by disability. The issue of physical inactivity among disabled people requires great attention due to their physical and mental problems, as well as problems in the environment and society. In other words, if doing sports and physical activity is recommended for healthy people, it is obligatory for disabled people. This is because people without disabilities meet their movement needs to some extent through the daily activities they do, but people with disabilities do not. Numerous studies have been conducted on the management of sports for people with disabilities, including those with physical disabilities, blindness, deafness, and mental retardation. The present study aimed to systematically review published articles in the field of sports management for people with disabilities between 2014 and 2024. By providing an overview of these articles, a better understanding of these studies can be created, followed by an explanation of the overall and integrated results and determination of research needs in the field of sports for people with disabilities in Iran.
Methods:
The present study was a secondary study and its implementation method was a systematic review. In this study, quantitative content analysis method based on documentary studies was used to evaluate the articles. The statistical population of this study was all scientific-research articles published in domestic journals focusing on sports for people with disabilities (physically, blind, deaf, and mentally) in Iran. In this research, articles were conducted in the fields of sports management, sports psychology, sports sociology, sports law, and sports media, focusing on sports for people with disabilities. In the initial search, more than 120 articles were found, and after separating duplicate records, unrelated articles, articles in invalid journals, and articles without full text, 85 articles were included in the research process. The time period of the articles was from the beginning of 2014 to the middle of 2024. In order to identify and create a bank of articles in the field of sports for people with disabilities, an electronic search was conducted in Persian-language databases. These databases were: The National Publications Database, the Academic Jihad Scientific Database, the Noor Specialized Journals Database, the Comprehensive Humanities Portal, and Google Scholar. Another criterion for selecting articles for inclusion in the study was the ability to access the full text of the articles.
Findings / Results:
Based on the conducted studies, 85 scientific research articles entered the research process. Table 1 shows the studies conducted based on trends and sub-disciplines for sports for people with disabilities:
Discussion and Conclusion:
The purpose of the present study was to systematically review articles published in domestic scientific and research journals in the field of sports for people with disabilities from 2014 to 2024. The results of this study are presented in Tables 1 and 2. The level of attention paid to people with disabilities in the adoption of laws and regulations and in their implementation is not the same, and as observed in research, in practice, people with physical and motor disabilities are given more attention than other disabilities. For example, in paragraph 8 of section A of article 4 of the law, the objectives, duties and authorities of the Ministry of Sports and Youth, the adaptation of sports places and spaces for the use and presence of women, families and the physically and mentally disabled, the duties of this ministry in the field of sports are stated. This is despite the fact that there are different types of disabilities, each with specific needs and conditions, and adaptations that are made for people with physical and motor disabilities do not mean that they are also suitable for other groups of people with disabilities. In addition, despite numerous laws and regulations in the field of sports for people with disabilities, in practice and in implementation, these laws and regulations have not been implemented very well, and even though more than 16 percent of the world's population consists of people with disabilities, and this figure is higher in underdeveloped and developing countries, the amount of sports facilities and amenities available to these people, which are adapted to their specific conditions, is very limited and not proportionate to their percentage of the population. Therefore, it is necessary to consider the necessary implementation guarantees not only in research, but also in legislation, determining policies and guidelines. Also, in implementing laws and regulations with a distributive and procedural justice approach, equal attention should be paid to people with disabilities, which is in line with the fundamental principles of human rights. In conducting studies in the field of sports management for people with disabilities, all spectrums of disabilities should be considered and studied, and studies should not be limited to just one spectrum of people with disabilities. Among the limitations of the present study are the inability to access the full text of some scientific research articles and the failure to review other studies, including foreign books and articles.