{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T05:26:00Z","timestamp":1779254760271,"version":"3.51.4"},"reference-count":64,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Sarcopenia is characterized by progressive muscle weakness, impaired physical function, and reduced quality of life. Multimodal strategies combining rehabilitation and nutritional support that influence gut microbiota may help improve functional outcomes in adults at risk of sarcopenia. Objective: To evaluate whether a polyphenol-rich dietary recommendation associated with a nutritional supplement containing leucine, vitamin D3, and magnesium (SarcoDYN\u00ae), in the context of a standardized rehabilitation program, provides superior improvements in functional and patient-reported outcomes compared with rehabilitation alone. Methods: This quasi-experimental, non-randomized retrospective study included 28 adults at risk of sarcopenia, divided into a study group (rehabilitation + polyphenol-rich diet + SarcoDYN\u00ae) and a control group (rehabilitation only). Assessments were performed at baseline and after 3 months. Outcomes included SARC-F score, handgrip strength (dominant and non-dominant), sit-to-stand performance, perceived mobility, and perceived health status. Within- and between-group comparisons were conducted using appropriate parametric or non-parametric tests, and Spearman correlation analysis explored associations between functional, strength, and perceptual variables. Results: Both groups demonstrated significant within-group improvements in functional and patient-reported outcomes. At follow-up, the study group showed significantly better subjective outcomes, including lower SARC-F scores (U = 30.0, p = 0.002), higher perceived mobility (U = 40.0, p = 0.008), and higher perceived health status (U = 40.0, p = 0.008), compared with the control group. Objective post-intervention measures of handgrip strength and chair-rise performance did not differ significantly between groups. Correlation analysis revealed strong associations between SARC-F score, muscle strength, functional mobility, and perceived health. Conclusions: The combined intervention consisting of a polyphenol-rich diet that influence gut microbiota and SarcoDYN\u00ae supplementation, delivered alongside a structured rehabilitation program, was associated with better patient-reported mobility and health perception in adults at risk of sarcopenia. These findings should be considered exploratory and hypothesis-generating, and require confirmation in larger controlled studies.<\/jats:p>","DOI":"10.3390\/life16040554","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:33:33Z","timestamp":1774622013000},"page":"554","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of Polyphenol-Rich Diet Combined with Leucine, Vitamin D3, and Magnesium Supplementation on Self-Reported Mobility and Health Perception in Adults at Risk of Sarcopenia: A 3-Months Quasi-Experimental Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Diana-Lidia","family":"Tache-Codreanu","sequence":"first","affiliation":[{"name":"Medical Rehabilitation Department, Colentina Clinical Hospital, 020125 Bucharest, Romania"},{"name":"Department of Medical, Surgical and Preventive Disciplines, Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana-Maria","family":"Tache-Codreanu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Farmacy, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7234-1865","authenticated-orcid":false,"given":"Georgeta","family":"Stefan","sequence":"additional","affiliation":[{"name":"Faculty of Veterinary Medicine, University of Agronomic Sciences and Veterinary Medicine,  050097 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena Rodica","family":"Tr\u0103istaru","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, University of Medicine and Pharmacy of Craiova, 200349 Craiova-Dolj, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Rusu","sequence":"additional","affiliation":[{"name":"Department of Preclinical Disciplines, Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrei","family":"Tache-Codreanu","sequence":"additional","affiliation":[{"name":"Faculty of Theatre, National University of Theatre and Film \u201cI.L. Caragiale\u201d, 021452 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3481-9690","authenticated-orcid":false,"given":"Corina","family":"Sporea","sequence":"additional","affiliation":[{"name":"Faculty of Midwifery and Nursing, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"National Teaching Center for Children\u2019s Neurorehabilitation \u201cRobanescu-Padure\u201d, 041408 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Tr\u0103istaru, R.M., Kamal, K.C., Kamal, D., Tache-Codreanu, D.-L., and Kamal, A.M. (2025). Assessment and Rehabilitation in Cervical Radiculopathy\u2014Efficacy of Structured Program with or Without Neurotrophic Agents. Life, 15.","DOI":"10.3390\/life15111690"},{"key":"ref_2","first-page":"38","article-title":"Current Nutritional Recommendations and Novel Dietary Strategies to Manage Sarcopenia","volume":"2","author":"Calvani","year":"2013","journal-title":"J. Frailty Aging"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"851","DOI":"10.12680\/balneo.2025.851","article-title":"Exploring the Role of Therapeutic Filmmaking as an Expressive Arts Intervention in the Rehabilitation of Adolescents with Anxiety or Depression: A Narrative Review","volume":"16","author":"David","year":"2025","journal-title":"Balneo PRM Res. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.pmedr.2016.06.005","article-title":"The Association between Social Participation and Lower Extremity Muscle Strength, Balance, and Gait Speed in US Adults","volume":"4","author":"Warren","year":"2016","journal-title":"Prev. Med. Rep."},{"key":"ref_5","first-page":"157","article-title":"Impact of Physical Activity Participation on Social Participation and Life Satisfaction in Elderly People with Sarcopenia and Its Psychological Adaptation Mechanism","volume":"34","author":"Zhang","year":"2025","journal-title":"Rev. Psicol. Deport. J. Sport Psychol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Tache-Codreanu, D.-L., and Tache-Codreanu, A. (2024). Acting and Dancing during the COVID-19 Pandemic as Art Therapy for the Rehabilitation of Children with Behavioural Disorders Living in Socially Disadvantaged Environments. Children, 11.","DOI":"10.3390\/children11040461"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Cacciatore, S., Calvani, R., Marzetti, E., Picca, A., Coelho-J\u00fanior, H.J., Martone, A.M., Massaro, C., Tosato, M., and Landi, F. (2023). Low Adherence to Mediterranean Diet Is Associated with Probable Sarcopenia in Community-Dwelling Older Adults: Results from the Longevity Check-Up (Lookup) 7+ Project. Nutrients, 15.","DOI":"10.3390\/nu15041026"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1093\/gerona\/glaa277","article-title":"Adherence to the Mediterranean Diet and Physical Resilience in Older Adults: The Seniors-ENRICA Cohort","volume":"76","year":"2021","journal-title":"J. Gerontol. Ser. A"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Nikawa, T., Ulla, A., and Sakakibara, I. (2021). Polyphenols and Their Effects on Muscle Atrophy and Muscle Health. Molecules, 26.","DOI":"10.3390\/molecules26164887"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Capozzi, A., Saucier, C., Bisbal, C., and Lambert, K. (2022). Grape Polyphenols in the Treatment of Human Skeletal Muscle Damage Due to Inflammation and Oxidative Stress during Obesity and Aging: Early Outcomes and Promises. Molecules, 27.","DOI":"10.3390\/molecules27196594"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Yadav, E., Yadav, P., Khan, M.M.U., Singh, H., and Verma, A. (2022). Resveratrol: A Potential Therapeutic Natural Polyphenol for Neurodegenerative Diseases Associated with Mitochondrial Dysfunction. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.922232"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.nutres.2019.11.004","article-title":"Polyphenols and Their Potential Role in Preventing Skeletal Muscle Atrophy","volume":"74","author":"Salucci","year":"2020","journal-title":"Nutr. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"R708","DOI":"10.1152\/ajpregu.00693.2004","article-title":"Green Tea Extract Improves Endurance Capacity and Increases Muscle Lipid Oxidation in Mice","volume":"288","author":"Murase","year":"2005","journal-title":"Am. J. Physiol. Integr. Comp. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"186","DOI":"10.4162\/nrp.2025.19.2.186","article-title":"Resveratrol Attenuates Aging-Induced Mitochondrial Dysfunction and Mitochondria-Mediated Apoptosis in the Rat Heart","volume":"19","author":"Choi","year":"2025","journal-title":"Nutr. Res. Pract."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1038\/nature05354","article-title":"Resveratrol Improves Health and Survival of Mice on a High-Calorie Diet","volume":"444","author":"Baur","year":"2006","journal-title":"Nature"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"628","DOI":"10.7150\/ijms.22723","article-title":"Resveratrol Attenuates Denervation-Induced Muscle Atrophy Due to the Blockade of Atrogin-1 and P62 Accumulation","volume":"15","author":"Asami","year":"2018","journal-title":"Int. J. Med. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Bennett, B.T., Mohamed, J.S., and Alway, S.E. (2013). Effects of Resveratrol on the Recovery of Muscle Mass Following Disuse in the Plantaris Muscle of Aged Rats. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0083518"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2217","DOI":"10.18632\/aging.101910","article-title":"Resveratrol Prevents Sarcopenic Obesity by Reversing Mitochondrial Dysfunction and Oxidative Stress via the PKA\/LKB1\/AMPK Pathway","volume":"11","author":"Huang","year":"2019","journal-title":"Aging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1021\/tx990003t","article-title":"Antioxidant Chemistry of Green Tea Catechins. Identification of Products of the Reaction of (\u2212)-Epigallocatechin Gallate with Peroxyl Radicals","volume":"12","author":"Valcic","year":"1999","journal-title":"Chem. Res. Toxicol."},{"key":"ref_20","first-page":"209","article-title":"The Green Tea Polyphenol Epigallocatechin-3-Gallate (EGCg) Attenuates Skeletal Muscle Atrophy in a Rat Model of Sarcopenia","volume":"4","author":"Meador","year":"2015","journal-title":"J. Frailty Aging"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"29477","DOI":"10.1039\/D3RA04527G","article-title":"Mitochondria-Targeting EGCG Derivatives Protect H9c2 Cardiomyocytes from H2O2-Induced Apoptosis: Design, Synthesis and Biological Evaluation","volume":"13","author":"Sahadevan","year":"2023","journal-title":"RSC Adv."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"C320","DOI":"10.1152\/ajpcell.1999.277.2.C320","article-title":"Systemic Administration of the NF-\u039aB Inhibitor Curcumin Stimulates Muscle Regeneration after Traumatic Injury","volume":"277","author":"Thaloor","year":"1999","journal-title":"Am. J. Physiol. Physiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"317851","DOI":"10.1155\/MI\/2008\/317851","article-title":"The NF-\u03baB Inhibitor Curcumin Blocks Sepsis-Induced Muscle Proteolysis","volume":"2008","author":"Poylin","year":"2008","journal-title":"Mediat. Inflamm."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1113\/EP085049","article-title":"Curcumin Ameliorates Skeletal Muscle Atrophy in Type 1 Diabetic Mice by Inhibiting Protein Ubiquitination","volume":"100","author":"Ono","year":"2015","journal-title":"Exp. Physiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"6214","DOI":"10.1021\/acs.jafc.1c00699","article-title":"Curcumin Attenuates Sarcopenia in Chronic Forced Exercise Executed Aged Mice by Regulating Muscle Degradation and Protein Synthesis with Antioxidant and Anti-Inflammatory Effects","volume":"69","author":"Lee","year":"2021","journal-title":"J. Agric. Food Chem."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"140","DOI":"10.2174\/1871530316666160613115221","article-title":"Dietary Supplementation of Curcumin Alleviates NF-\u03baB-Dependent Skeletal Muscle Wasting in Rat","volume":"16","author":"He","year":"2016","journal-title":"Endocr. Metab. Immune Disord.-Drug Targets"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wu, C., and Suzuki, K. (2023). The Effects of Flavonoids on Skeletal Muscle Mass, Muscle Function, and Physical Performance in Individuals with Sarcopenia: A Systematic Review of Randomized Controlled Trials. Nutrients, 15.","DOI":"10.3390\/nu15183897"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1093\/gerona\/glt107","article-title":"Markers of Human Skeletal Muscle Mitochondrial Biogenesis and Quality Control: Effects of Age and Aerobic Exercise Training","volume":"69","author":"Konopka","year":"2014","journal-title":"J. Gerontol. Ser. A"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/j.cmet.2012.09.015","article-title":"Resveratrol Supplementation Does Not Improve Metabolic Function in Nonobese Women with Normal Glucose Tolerance","volume":"16","author":"Yoshino","year":"2012","journal-title":"Cell Metab."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1002\/mnfr.200600173","article-title":"Overview of Antibacterial, Antitoxin, Antiviral, and Antifungal Activities of Tea Flavonoids and Teas","volume":"51","author":"Friedman","year":"2007","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/1475-2891-11-79","article-title":"Diverse Effects of a Low Dose Supplement of Lipidated Curcumin in Healthy Middle Aged People","volume":"11","author":"DiSilvestro","year":"2012","journal-title":"Nutr. J."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Tache-Codreanu, D.-L., David, I., Butum-Cristea, M.-A., Tache-Codreanu, A.-M., Burcea, C.-C., Rusu, E., Tache-Codreanu, A., Olteanu, R., Poteca, T.D., and Sporea, C. (2025). The Role of Body Mass Index in Outcomes of Radial Shock Wave Therapy for Adhesive Capsulitis. Biomedicines, 13.","DOI":"10.3390\/biomedicines13092117"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1093\/ptj\/pzx056","article-title":"Impact of Inflammation and Anti-Inflammatory Modalities on Skeletal Muscle Healing: From Fundamental Research to the Clinic","volume":"97","author":"Duchesne","year":"2017","journal-title":"Phys. Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"356","DOI":"10.2519\/jospt.2005.35.6.356","article-title":"Pharmacology in Rehabilitation: Nonsteroidal Anti-Inflammatory Agents","volume":"35","author":"Biederman","year":"2005","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Tache-Codreanu, D.-L., David, I., Tache-Codreanu, A.-M., Sporea, C., Burcea, C.-C., Blendea, D.C., Morcov, M.-V., and Cioca, I.E. (2025). RESWT in Shoulder Periarthritis: Does the Protocol Intensity Matter?\u2014A Quasi-Experimental Non-Randomized Comparative Study. Life, 15.","DOI":"10.3390\/life15060922"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Ticinesi, A., Nouvenne, A., Cerundolo, N., Parise, A., and Meschi, T. (2023). Accounting Gut Microbiota as the Mediator of Beneficial Effects of Dietary (Poly)Phenols on Skeletal Muscle in Aging. Nutrients, 15.","DOI":"10.3390\/nu15102367"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Kasprzak-Drozd, K., Oniszczuk, T., Stasiak, M., and Oniszczuk, A. (2021). Beneficial Effects of Phenolic Compounds on Gut Microbiota and Metabolic Syndrome. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22073715"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"801","DOI":"10.12680\/balneo.2025.801","article-title":"Impact of a Multidisciplinary Functional Recovery Program on Post-Lung Transplant Outcomes: A One-Year Follow-Up","volume":"16","author":"David","year":"2025","journal-title":"Balneo PRM Res. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"227S","DOI":"10.1093\/jn\/136.1.227S","article-title":"Signaling Pathways and Molecular Mechanisms through Which Branched-Chain Amino Acids Mediate Translational Control of Protein Synthesis","volume":"136","author":"Kimball","year":"2006","journal-title":"J. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Zhao, Y., Cholewa, J., Shang, H., Yang, Y., Ding, X., Wang, Q., Su, Q., Zanchi, N.E., and Xia, Z. (2021). Advances in the Role of Leucine-Sensing in the Regulation of Protein Synthesis in Aging Skeletal Muscle. Front. Cell Dev. Biol., 9.","DOI":"10.3389\/fcell.2021.646482"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1093\/ajcn\/82.5.1065","article-title":"Aging Is Associated with Diminished Accretion of Muscle Proteins after the Ingestion of a Small Bolus of Essential Amino Acids","volume":"82","author":"Katsanos","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1093\/gerona\/glu103","article-title":"Protein Ingestion to Stimulate Myofibrillar Protein Synthesis Requires Greater Relative Protein Intakes in Healthy Older Versus Younger Men","volume":"70","author":"Moore","year":"2015","journal-title":"J. Gerontol. Ser. A"},{"key":"ref_43","first-page":"859","article-title":"Effect of Vitamin D Supplementation on Muscle Strength: A Systematic Review and Meta-Analysis","volume":"22","author":"Stockton","year":"2021","journal-title":"Osteoporos. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"868","DOI":"10.12680\/balneo.2025.868","article-title":"The Influence of a Physical Rehabilitation Program on Anxiety and Depressive Symptoms in Post-COVID Patients","volume":"16","author":"Morcov","year":"2025","journal-title":"Balneo PRM Res. J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"974","DOI":"10.3945\/ajcn.113.080168","article-title":"Effect of Oral Magnesium Supplementation on Physical Performance in Healthy Elderly Women Involved in a Weekly Exercise Program: A Randomized Controlled Trial","volume":"100","author":"Veronese","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Souza, A., Vasconcelos, A., Dias, D., Komoni, G., and Name, J. (2023). The Integral Role of Magnesium in Muscle Integrity and Aging: A Comprehensive Review. Nutrients, 15.","DOI":"10.3390\/nu15245127"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1111\/ggi.14936","article-title":"Mineral Supplementation in Patients with Frailty and Sarcopenia\u2014A Systematic Review","volume":"24","author":"Ogawa","year":"2024","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Tache-Codreanu, D.-L., and Tr\u0103istaru, M.R. (2024). The Effectiveness of High Intensity Laser in Improving Motor Deficits in Patients with Lumbar Disc Herniation. Life, 14.","DOI":"10.3390\/life14101302"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Widodo, A.F., Tien, C.-W., Chen, C.-W., and Lai, S.-C. (2022). Isotonic and Isometric Exercise Interventions Improve the Hamstring Muscles\u2019 Strength and Flexibility: A Narrative Review. Healthcare, 10.","DOI":"10.3390\/healthcare10050811"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.jbmt.2017.08.001","article-title":"Do Isometric, Isotonic and\/or Isokinetic Strength Trainings Produce Different Strength Outcomes?","volume":"22","author":"Lee","year":"2018","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Schroeder, E.C., Franke, W.D., Sharp, R.L., and Lee, D. (2019). Comparative Effectiveness of Aerobic, Resistance, and Combined Training on Cardiovascular Disease Risk Factors: A Randomized Controlled Trial. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0210292"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1016\/j.apmr.2011.02.022","article-title":"Combined Aerobic and Resistance Exercise Program Improves Task Performance in Patients with Heart Failure","volume":"92","author":"Gary","year":"2011","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1177\/1753944708089701","article-title":"Review: Endurance Exercise and Resistance Training in Cardiovascular Disease","volume":"2","author":"Meka","year":"2008","journal-title":"Ther. Adv. Cardiovasc. Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"3258","DOI":"10.1080\/00949655.2019.1658763","article-title":"Shapiro\u2013Wilk Test for Skew Normal Distributions Based on Data Transformations","volume":"89","author":"Cosmes","year":"2019","journal-title":"J. Stat. Comput. Simul."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1177\/0145482X221150592","article-title":"Mann-Whitney U Test and t-Test","volume":"117","year":"2023","journal-title":"J. Vis. Impair. Blind."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Shan, G., and Gerstenberger, S. (2017). Fisher\u2019s Exact Approach for Post Hoc Analysis of a Chi-Squared Test. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0188709"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1007\/s00362-012-0443-4","article-title":"A Generalization of the Wilcoxon Signed-Rank Test and Its Applications","volume":"54","author":"Taheri","year":"2013","journal-title":"Stat. Pap."},{"key":"ref_58","first-page":"231","article-title":"Parametric Measures of Effect Size","volume":"621","author":"Rosenthal","year":"1994","journal-title":"Handb. Res. Synth."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.clnesp.2023.02.019","article-title":"Effects of Adherence to the Mediterranean Diet on Fatigue and Activities of Daily Living in Geriatric Individuals with COPD","volume":"54","author":"Arslan","year":"2023","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/s42269-025-01374-8","article-title":"The Weight-Loss Paradox in Older Adults: Balancing Fat Loss with Muscle Preservation","volume":"49","author":"Arslan","year":"2025","journal-title":"Bull. Natl. Res. Cent."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"175","DOI":"10.62210\/ClinSciNutr.2024.93","article-title":"Innovative Approaches to Integrating Plant-Based Nutrition in Clinical Care: A Path to Better Patient Outcomes","volume":"6","author":"Arslan","year":"2024","journal-title":"Clin. Sci. Nutr."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"331","DOI":"10.47162\/RJME.65.2.21","article-title":"Successfully Physical Therapy Program for Functional Respiratory Rehabilitation after Lung Transplant Surgery\u2014Case Report","volume":"65","author":"David","year":"2024","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.apmr.2017.12.007","article-title":"Do Performance Measures of Strength, Balance, and Mobility Predict Quality of Life and Community Reintegration After Stroke?","volume":"99","author":"Cohen","year":"2018","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"3476","DOI":"10.1080\/09638288.2020.1806365","article-title":"Rehabilitation: Mobility, Exercise & Sports; a Critical Position Stand on Current and Future Research Perspectives","volume":"43","author":"Houdijk","year":"2021","journal-title":"Disabil. Rehabil."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/4\/554\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T08:51:43Z","timestamp":1774947103000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/4\/554"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":64,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["life16040554"],"URL":"https:\/\/doi.org\/10.3390\/life16040554","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]}}}