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( Qualitative data assessment The qualitative data based on the Cochrane risk of bias assessment tool were presented in Table 2

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In practical terms, low energy availability may contribute to: Slower muscle and tendon remodeling Reduced tolerance to training volume Delayed strength progression during rehabilitation Higher perceived fatigue Increased risk of overuse symptoms Longer timelines to return to sport at full performance capacity For physical therapists and sports medicine clinicians, this matters more than ever

these cells are the dominant sources of TNF promoting insulin resistance (9)