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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Total Body Water and Fluid Distribution in Relation to Musculoskeletal Injury History: A Bayesian Analysis in Physically Active Young Adults

  1. 1Department of Biological Principles of Physical Activity, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland

Abstract

Background/Objectives: Body water status is relevant to physiological function during physical activity, yet its relationship with musculoskeletal injury occurrence remains insufficiently understood. This study examined whether total body water (TBW) and relative extracellular water distribution (ECW/TBW) were associated with injury occurrence in physically active young adults using Bayesian inference. Methods: Analysis included 418 physically active university students (199 men, 219 women). Body-water characteristics were measured at a single time point, whereas musculoskeletal injuries were retrospectively reported for the preceding 12 months. Bayesian logistic regression models examined associations of TBW and ECW/TBW with injury history, adjusting for sex, total physical activity, weekly training volume, and training age. Posterior probabilities were evaluated for meaningfully negative, practically negligible, and meaningfully positive associations using a predefined region of practical equivalence (ROPE; β = −0.10 to +0.10). Results: Overall, 51.4% of participants reported at least one injury. Higher TBW was associated with higher odds of reporting an injury in the adjusted model (OR = 1.38, 95% credible interval [CrI]: 1.11–1.73), with a 97.8% posterior probability of a meaningfully positive association. In contrast, higher ECW/TBW was associated with lower odds of injury occurrence (OR = 0.77, 95% CrI: 0.62–0.95), with a 93.6% posterior probability of a meaningfully negative association. The direction of both associations remained stable across unadjusted models and alternative ROPE definitions. Conclusions: TBW and relative extracellular water distribution showed distinct and opposing associations with retrospectively reported musculoskeletal injury history. These findings provide information about cross-sectional relationships but do not establish temporal direction or prospective injury risk. Longitudinal studies are needed to clarify their physiological and potential predictive relevance.

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BibTeX
@article{domaradzki2026total,
  title = {{Total Body Water and Fluid Distribution in Relation to Musculoskeletal Injury History: A Bayesian Analysis in Physically Active Young Adults}},
  author = {Jarosław Domaradzki},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218392},
  url = {https://www.mdpi.com/2077-0383/15/21/8392},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Total Body Water and Fluid Distribution in Relation to Musculoskeletal Injury History: A Bayesian Analysis in Physically Active Young Adults
AU  - Jarosław Domaradzki
PY  - 2026
DA  - 2026/10/28
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218392
UR  - https://www.mdpi.com/2077-0383/15/21/8392
AB  - Background/Objectives: Body water status is relevant to physiological function during physical activity, yet its relationship with musculoskeletal injury occurrence remains insufficiently understood. This study examined whether total body water (TBW) and relative extracellular water distribution (ECW/TBW) were associated with injury occurrence in physically active young adults using Bayesian inference. Methods: Analysis included 418 physically active university students (199 men, 219 women). Body-water characteristics were measured at a single time point, whereas musculoskeletal injuries were retrospectively reported for the preceding 12 months. Bayesian logistic regression models examined associations of TBW and ECW/TBW with injury history, adjusting for sex, total physical activity, weekly training volume, and training age. Posterior probabilities were evaluated for meaningfully negative, practically negligible, and meaningfully positive associations using a predefined region of practical equivalence (ROPE; β = −0.10 to +0.10). Results: Overall, 51.4% of participants reported at least one injury. Higher TBW was associated with higher odds of reporting an injury in the adjusted model (OR = 1.38, 95% credible interval [CrI]: 1.11–1.73), with a 97.8% posterior probability of a meaningfully positive association. In contrast, higher ECW/TBW was associated with lower odds of injury occurrence (OR = 0.77, 95% CrI: 0.62–0.95), with a 93.6% posterior probability of a meaningfully negative association. The direction of both associations remained stable across unadjusted models and alternative ROPE definitions. Conclusions: TBW and relative extracellular water distribution showed distinct and opposing associations with retrospectively reported musculoskeletal injury history. These findings provide information about cross-sectional relationships but do not establish temporal direction or prospective injury risk. Longitudinal studies are needed to clarify their physiological and potential predictive relevance.
SN  - 2077-0383
ER  -