Microbiome modulation after injury to reduce muscle atrophy and accelerate return to play in adolescent basketball players: a randomized controlled trial
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A multi-strain probiotic and prebiotic supplement reduced immobilization-related muscle mass loss and sped return to play in injured adolescent basketball players versus placebo. It also lowered inflammatory markers and increased gut microbiome diversity in the treated group.
Introduction: Musculoskeletal injuries in adolescent basketball athletes often lead to periods of immobilization, resulting in disuse muscle atrophy and delayed return-to-play (RTP). Emerging evidence suggests that the gut-muscle axis plays a key role in regulating muscle mass, systemic inflammation, and recovery.Objective: This randomized controlled trial (RCT) investigated the efficacy of a targeted post-injury microbiome modulation intervention (probiotic and prebiotic supplementation) on mitigating muscle atrophy and accelerating RTP in adolescent basketball players.Methodology: One hundred adolescent basketball athletes (aged 14–16 years) who sustained acute lower extremity injuries requiring at least two weeks of immobilization were randomized into an experimental group (n=50) receiving a daily multi-strain probiotic (including Lactobacillus plantarum and Akkermansia muciniphila) and prebiotic fiber, and a control group (n=50) receiving a placebo. Both groups underwent standard rehabilitation. Primary outcomes included changes in muscle mass (dual-energy X-ray absorptiometry), muscle strength (isokinetic dynamometry), and time to RTP. Secondary outcomes included systemic inflammatory markers (TNF-α, IL-6) and gut microbiome diversity (16S rRNA sequencing).Results: The experimental group demonstrated significantly less muscle mass loss during the immobilization phase than the control group (2.1% vs. 4.8%, p < 0.001). Furthermore, the experimental group achieved RTP criteria significantly faster (38.5 vs. 46.2 days, p < 0.001). Systemic inflammatory markers were significantly lower in the experimental group, correlating with increased gut microbiome diversity and short-chain fatty acid (SCFA) production.Discussion: The results were contrasted with the literature, confirming that targeted post-injury microbiome modulation is a highly effective adjunctive therapy.
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