Microbiome modulation after injury to reduce muscle atrophy and accelerate return to play in adolescent basketball players: a randomized controlled trial

Vollständiger Abstract

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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.