Simone Ciaccioni1,2*
Youngjun Lee3
Flavia Guidotti4
Nemanja Stankovic5
Elena Pocecco6
Pascal Izzicupo7
Laura Capranica2- 1Department of Education and Sport Sciences, Pegaso Telematic University, Naples, Italy
- 2Department of Movement, Human and Health Sciences, University of Rome “Foro Italico,” Rome, Italy
- 3Department of Kinesiology, Michigan State University, East Lansing, MI, United States
- 4Department of Human Sciences and Promotion of Quality of Life, University of Rome “San Raffaele,” Roma, Italy
- 5Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
- 6Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- 7Department of Medicine and Aging Sciences, University of Chieti-Pescara “Gabriele D'Annunzio”, Pescara, Italy
1 Introduction
Historically, combat sports have been predominantly conceptualized within the framework of elite competition, emphasizing physical aptitude, technical proficiency, and strategic execution (James et al., 2016; Slimani et al., 2017; Chaabene et al., 2018). Despite their traditional and peculiar constitutions and developments, disciplines such as judo, karate, taekwondo, wrestling, fencing, boxing, and mixed martial arts have commonly been associated with high-performance athletes striving for competitive excellence on national and international stages (James et al., 2016; Franchini et al., 2011; Lystad et al., 2020; Jäggi et al., 2015). However, contemporary discourse increasingly recognizes their expansive role in contributing to physical and psychological wellbeing, and social inclusion of the practitioners (Valdes-Badilla et al., 2021; Zou et al., 2018). This paradigmatic shift underscores the capacity of combat sports to function as inclusive and accessible modalities for fostering multidimensional health benefits across diverse populations, including individuals with disabilities and other marginalized groups (Gutierrez-Santiago et al., 2023; Palumbo et al., 2023; Rajan, 2015; Morales et al., 2022; Pierantozzi et al., 2022).
The interdisciplinary exploration of physical activity and health highlights the intricate interrelationship between structured sports engagement and holistic wellbeing (Rato Barrio et al., 2021). Whilst conventional team and individual sports have long been acknowledged for their physiological and psychosocial benefits, combat sports exhibit distinct characteristics that might amplify these advantages (Malm et al., 2019; Garcia-Falgueras, 2015). Within combat sports, the synergistic interplay of rigorous physical conditioning, the cognitive engagement, adherence to rules, competition dynamics, respect, externalizing emotions regulation, are intertwined with pedagogical and philosophical values, thus presenting a unique framework for enhancing psychological resilience, cognitive adaptability, and emotional control. Consequently, the systematic practice of combat sports has been increasingly examined as a way of promoting mental health, stress modulation, and social cohesion (Ciaccioni et al., 2024a; Kujach et al., 2022).
The inclusive nature of many combat sports programmes further accentuates their relevance in dismantling stereotypes, facilitating integration, and fostering equity and social integration (Ciaccioni et al., 2024e; Jeong et al., 2021; Descamps et al., 2024). In fact, they demonstrated significant adaptability to accommodate individuals with disabilities (e.g., physical impairments, developmental, emotional, intellectual disorders), thereby ensuring equitable access and fostering empowerment (Gutierrez-Santiago et al., 2023; Salgado and Jauregui, 2022). Adapted judo, para-taekwondo, and other modified combat disciplines provide individuals with disabilities a structured platform to engage in physical activity, cultivate self-efficacy, and develop meaningful social connections within a supportive and adaptive environment (Lee et al., 2025). From a public health perspective, the integration of combat sports within community-based health initiatives offers a compelling opportunity to engage populations that may not traditionally participate in structured physical activity programmes (Valdes-Badilla et al., 2021; Zou et al., 2018; Ciaccioni et al., 2024e). The distinctive accessibility of combat sports, which cater to practitioners of all skill levels (e.g., from novices to elite athletes) sets them apart from many other sports. While their structured progression, adaptability, and emphasis on holistic development make them a viable option for lifelong and intergenerational participation (Ciaccioni et al., 2024e, 2019b, 2024b), the mentorship and pedagogical frameworks cultivate positive role modeling, discipline, and intrinsic motivation, which are integral for sustaining long-term adherence to health-promoting behaviors (Zou et al., 2018).
Furthermore, the intersection between combat sports and mental health has increasingly emerged as a focal point within academic and clinical research (Ciaccioni et al., 2024a) with empirical evidence suggesting an association between participation and enhanced self-regulation and self-efficacy, and reduction in anxiety and depressive symptomatology (Zou et al., 2018; Piskorska et al., 2016; Mojtahedi et al., 2023). In necessitating sustained focus, adaptability, and emotional equilibrium, combat sports inherently require cognitive and affective demands, which align closely with established psychological frameworks that underpin mental wellbeing (Healey et al., 2025; Sullivan et al., 2024). Moreover, the integration of mindfulness techniques, stress management strategies, and resilience-building paradigms within combat sports training substantiates their potential as a non-pharmacological intervention for addressing various mental health challenges (e.g., autism spectrum and oppositional defiant disorders; Pedrini and Jennings, 2021; Andreato et al., 2022).
Despite these advantages, the discourse surrounding combat sports and wellbeing necessitates a critical examination of inherent risks and potential challenges. Issues related to injury risk, hypercompetitive environments, eating disorders, sexual harassment, and the psychological stressors associated with high-intensity training warrant careful scrutiny (Hammami et al., 2018; Bromley et al., 2018; Gauthier, 2009; Barcelos et al., 2024; Mathisen et al., 2022). The implementation of evidence-based injury prevention protocols, the establishment of ethically responsible coaching methodologies, and the promotion of safe training environments are imperative to ensure that the benefits of combat sports are maximized while minimizing adverse outcomes.
Against this backdrop, this opinion paper seeks to examine the role of combat sports in advancing health and social inclusion among athletes and practitioners. Through a synthesis of contemporary empirical findings, theoretical paradigms, and applied insights, this paper aims to contribute to the evolving discourse on the potential of combat sports as a catalyst for holistic wellbeing. By delineating the multidimensional impact of combat sports on physical, psychological, and social health, this paper endeavors to underscore their transformative potential as an instrument for fostering individual and community wellbeing within different populations.
2 Discussion
Whilst an expanding body of research and an evolution in scholarly discourse is recognizing the combat sports' broader implications for holistic wellbeing (Pedrini and Jennings, 2021; Klimczak et al., 2015), a rigorous evaluation of the investigation methodologies, the validity of hypotheses, and the translational potential of recent findings is necessary to contextualize their significance within the sports and public health sciences, considering their strengths, weaknesses, opportunities, and threats (Figure 1).
Figure 1. Strengths, weaknesses, opportunities, and threats (SWOT) analysis for combat sports.
Empirical evidence robustly shows the positive impact of combat sports on physical fitness, motor coordination, and cardiovascular health (Chaabene et al., 2018; Origua Rios et al., 2018). These benefits are attributed to the high-intensity, intermittent nature of combat sports training, which enhances aerobic and anaerobic endurance, muscular strength, and neuromuscular control (Eckstein et al., 2022). However, concerns regarding injury risk, particularly in striking and contact-intensive disciplines such as boxing, taekwondo, and mixed martial arts, necessitate continued research into injury mitigation strategies, particularly those targeting concussion and repetitive head trauma (Jäggi et al., 2015; Barcelos et al., 2024; Lota et al., 2022; Pocecco et al., 2013). Moreover, many combat sports have developed styles with reduced or simulated contact to minimize injury risk. For example, the French “boxe éducative” emphasizing technique and control, penalizing any violent behaviors (Cougoulic et al., 2003) and the value and application of kata (i.e., forms; prearranged, pattern practices) to learning and adopting judo technique in a safe way educating the athlete culturally, to enrich her/him as a person (Calmet et al., 2024).
Beyond physical health, recent studies highlight the psychological benefits of combat sports, including reductions in anxiety and depression and improvements in self-efficacy, emotional regulation, resilience, and stress management (Mojtahedi et al., 2023; Matsumoto et al., 2009; Stankovic et al., 2021; Slimani et al., 2018; Ciaccioni et al., 2024d). Therefore, combat sports-based interventions for individuals with mental health conditions have yielded promising outcomes (Lee et al., 2025). Despite these encouraging findings, variability in study designs, participant demographics, and intervention protocols limits their external validity, underscoring the need for further rigorously controlled investigations. Furthermore, some authors claimed that combat sport athletes might present symptoms of low energy availability and high anxiety levels associated with competition- and injury-related psychological stressors, deficits in executive functions and neuropsychological impairments associated with occurrence of concussions, disordered eating and eating disorders associated with weight-loss, and might suffer offensive, frightening, hostile, degrading, humiliating experiences, or sexual harassment, which urge safeguarding actions (Hammami et al., 2018; Bromley et al., 2018; Gauthier, 2009; Barcelos et al., 2024; Mathisen et al., 2022).
The role of combat sports in fostering social inclusion has gained empirical support, particularly in programmes aimed at individuals with disabilities and marginalized communities (Ciaccioni et al., 2024b; Boguszewski and Torzewska, 2011). For instance, a recent systematic review shows that judo interventions adapted for intellectual disabilities help improve social integration and self-perception and enhance participants' quality of life (Pečnikar Oblak et al., 2020). The development of para-combat sports demonstrates enhanced physical and motor abilities while providing psychosocial benefits to various populations with different disabilities, promoting social integration, self-perception, and community belonging (Connor et al., 2018; Kasum et al., 2011). However, longitudinal research is needed to assess the long-term retention rates and sustainability of these benefits. Furthermore, there is a need of studies focused on the most appropriate adapted rules to achieve a fairer competition for ensuring a sense of success in individuals with physical, emotional, mental, hearing or visual impairments participating in adapted sports competitions at local, national, and international levels.
Methodological approaches in combat sports research encompass experimental, longitudinal, qualitative, and systematic review designs. While randomized controlled trials remain the gold standard for establishing causality, their application in combat sports research is constrained by ethical concerns, logistical challenges, and the inherently dynamic nature of training environments (Kordi, 2009; Drid, 2017). Consequently, many studies rely on observational designs, which, despite their value in identifying associations, are susceptible to confounding variables and biases (Ciaccioni et al., 2019b; Grimes and Schulz, 2002).
Qualitative methodologies have provided critical insights into the lived experiences of combat sports practitioners, offering perspectives on psychological and social dimensions that are often overlooked in quantitative studies (Healey et al., 2025). Ethnographic research has been particularly instrumental in elucidating the role of combat sports in shaping identity, discipline, and personal development (García and Spencer, 2013). However, limitations in reproducibility and generalizability highlight the need for mixed-methods approaches to generate a more comprehensive understanding of combat sports' impact (Ciaccioni et al., 2024b; Smith and McGannon, 2017).
Additionally, the incorporation of biometric and neurocognitive assessments, such as heart rate variability analysis, functional MRI, and salivary cortisol measurements, has advanced our understanding of the physiological and psychological mechanisms underlying combat sports participation (Ciaccioni et al., 2024d; Morales et al., 2013; Sethi and Neidecker, 2023). Despite their objective precision, these techniques often face challenges related to cost, accessibility, and limited sample sizes, necessitating the development of scalable and cost-effective methodologies for broader research application.
Finally, recent studies show that virtual reality (VR) technology and digital platforms are increasingly becoming part of combat sports training methods. Due to COVID-19 restrictions, martial arts schools and organizations implemented hybrid or online training models, which allowed athletes to stay engaged. VR boxing programmes provide users with virtual sparring simulations to enhance their motor skills without needing physical interaction. Initial results indicate that VR training enhances response behavior in karate athletes (Witte et al., 2022). Digital adaptations offer great potential, especially for people with limited mobility or remote locations. However, further studies are necessary to prove their enduring effects on physical health and psychological and social aspects (Witte et al., 2022; Xu et al., 2021; Li et al., 2025).
3 Strengths and weaknesses of scientific hypotheses
The hypothesis that combat sports confer multidimensional health benefits is strongly supported by empirical evidence spanning physiological, psychological, and social domains (Zou et al., 2018; Channon and Jennings, 2014; Ciaccioni et al., 2019a; Torres-Luque et al., 2016). The integration of physical exertion, cognitive engagement, and structured discipline inherent in combat sports aligns with established theories of exercise psychology, neuroplasticity, and social identity formation (Krabben et al., 2019; Anastasiou et al., 2024). This multidimensional perspective provides a robust theoretical foundation for advocating combat sports as a health-promoting activity.
Nevertheless, several limitations warrant consideration. The heterogeneity of disciplines, which vary highly in intensity, contact level, and training methodologies, is often inadequately addressed in research, leading to overgeneralized conclusions (Ciaccioni et al., 2024a; Eckstein et al., 2022). Often underexamined, individual differences in personality, motivation, and previous trauma history may strongly moderate the psychological outcomes of combat sports participation (Barcelos et al., 2024; Bojanic et al., 2019; Ziv and Lidor, 2013).
Additionally, a research focus is needed on concerns regarding the potential for adverse psychological effects (e.g., anxiety, depression, disordered eating behaviors, burnout, and decreased self-esteem), particularly in competitive environments where performance pressure, extreme weight-cutting practices, and aggressive coaching styles are prevalent (Barley et al., 2019; Lafuente et al., 2021). Indeed, a balanced perspective that considers both benefits and risks is essential for the development of evidence-based recommendations (Palumbo et al., 2023; Qi et al., 2024).
4 Future directions
To enhance the field, future research should prioritize well-structured longitudinal studies that assess the long-term impact of combat sports participation on physical, psychological, and social health. Standardization of outcome measures, intervention protocols, and participant demographics would facilitate cross-study comparisons and strengthen the reliability of findings (Piggott et al., 2019; Halperin et al., 2018). Moreover, interdisciplinary collaborations incorporating sports science, psychology, and sociology could provide a more holistic perspective on combat sports' broader implications on practitioners (Elferink-Gemser et al., 2018).
From a policy perspective, to yield valuable insights into combat sports' practical applications research should investigate their efficacy within public health, educational, and rehabilitation initiatives, particularly for underserved and vulnerable populations (Lee et al., 2025; Dortants et al., 2016; Ciaccioni et al., 2024c).
Furthermore, while safety remains a primary concern, advancements in protective equipment, training methodologies, education for athletes, coaches, referees and tournament directors, and regulatory frameworks should be continually evaluated to optimize benefits while mitigating risks (Lota et al., 2022; Pocecco et al., 2013; Sethi and Neidecker, 2023; Bakirtzis et al., 2024; Pocecco et al., 2024). Ethical considerations, particularly concerning athlete wellbeing and inclusive participation, should remain a central focus in both research and practical implementation (Ciaccioni et al., 2024a; Gauthier, 2009; Mathisen et al., 2022).
Therefore, key research challenges to be addressed are:
• Injury risk and safety: a need for injury prevention strategies, especially for concussions and head trauma in striking sports.
• Psychological wellbeing: risks of stress, anxiety, burnout, and negative self-perception in competitive environments.
• Inclusion and accessibility: a need for more research on long-term social and psychological benefits for marginalized groups and individuals with disabilities.
• Methodological limitations: lack of standardized protocols, variability in study designs, and limited reproducibility of findings.
• Ethical and regulatory issues: concerns over coaching practices, extreme weight-cutting, and athlete wellbeing in high-pressure environments.
• Technological innovations: more research required on the effectiveness of VR and digital training tools in combat sports.
• Public health and policy: exploration of combat sports' role in health initiatives, rehabilitation, and educational programs.
5 Conclusion
The evolving discourse on combat sports highlights their potential as a multidimensional tool for wellbeing promotion. While a substantial body of evidence supports their benefits, a critical examination of methodological limitations, scientific hypotheses, and practical applications is essential for further refine our understanding and enhance their effectiveness. Finally, this article makes a significant contribution not only to the field of martial arts but also to public health and sports psychology. Its interdisciplinary approach calls for scientific collaboration and methodological rigor, reinforces the need for evidence-based policies and can serve as a valuable guide for researchers and policymakers looking to integrate combat sports into strategies for promoting health and social inclusion.
Author contributions
SC: Conceptualization, Methodology, Supervision, Visualization, Writing – original draft, Writing – review & editing. YL: Methodology, Writing – original draft, Writing – review & editing, Visualization. FG: Methodology, Writing – original draft, Writing – review & editing. NS: Methodology, Writing – original draft, Writing – review & editing. EP: Methodology, Writing – original draft, Writing – review & editing. PI: Methodology, Writing – original draft, Writing – review & editing. LC: Methodology, Supervision, Writing – original draft, Writing – review & editing.
Funding
The author(s) declare that no financial support was received for the research and/or publication of this article.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Generative AI statement
The author(s) declare that no Gen AI was used in the creation of this manuscript.
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
References
Anastasiou, K., Morris, M., Akam, L., and Mastana, S. (2024). The genetic profile of combat sport athletes: a systematic review of physiological, psychological and injury risk determinants. Int. J. Environ. Res. Public Health 21:1019. doi: 10.3390/ijerph21081019
Andreato, L. V., dos Santos, M. G., and Andrade, A. (2022). What do we know about the effects of mental training applied to combat sports? A systematic review. Psychol. Sport Exerc. 63:102267. doi: 10.1016/j.psychsport.2022.102267
Bakirtzis, D., Gkiafi, Z., Sioutis, S., Tolis, I. P., Zikopoulos, A., Lykoudis, P. M., et al. (2024). A narrative review of combat sports injuries with a particular focus on cervical spine injuries. Cureus 16:e74980. doi: 10.7759/cureus.74980
Barcelos, G., Miranda de Oliveira, J. G., Melo, R., Norte, C. E., and Filgueiras, A. (2024). Concussion and executive functions in combat sports: a systematic review. J. Sports Sci. 42, 1–10. doi: 10.1080/02640414.2024.2433902
Barley, O. R., Chapman, D. W., and Abbiss, C. R. (2019). The current state of weight-cutting in combat sports-weight-cutting in combat sports. Sports 7:123. doi: 10.3390/sports7050123
Boguszewski, D., and Torzewska, P. (2011). Martial arts as methods of physical rehabilitation for disabled people. J. Combat Sports Martial Arts 1, 1–6. doi: 10.5604/20815735.1047111
Bojanic, Z., Nedeljkovic, J., Sakan, D., Mitic, P. M., Milovanovic, I., Drid, P., et al. (2019). Personality traits and self-esteem in combat and team sports. Front. Psychol. 10:2280. doi: 10.3389/fpsyg.2019.02280
Bromley, S. J., Drew, M. K., Talpey, S., McIntosh, A. S., and Finch, C. F. A. (2018). Systematic review of prospective epidemiological research into injury and illness in olympic combat sport. Br. J. Sports Med. 52, 8–16. doi: 10.1136/bjsports-2016-097313
Calmet, M., Pierantozzi, E., De Crée, C., and Crémieux, J. (2024). Judo and kata teaching: can personal expression be addressed before formal expression? Ido movement for culture. J. Martial Arts Anthropol. 24, 39–53. doi: 10.14589/ido.24.1.5
Chaabene, H., Negra, Y., Bouguezzi, R., Capranica, L., Franchini, E., Prieske, O., et al. (2018). Tests for the assessment of sport-specific performance in olympic combat sports: a systematic review with practical recommendations. Front. Physiol. 9:386. doi: 10.3389/fphys.2018.00386
Channon, A., and Jennings, G. (2014). Exploring embodiment through martial arts and combat sports: a review of empirical research. Sport Soc. 17, 773–789. doi: 10.1080/17430437.2014.882906
Ciaccioni, S., Capranica, L., Forte, R., Chaabene, H., Pesce, C., Condello, G., et al. (2019a). Effects of a judo training on functional fitness, anthropometric, and psychological variables in old novice practitioners. J. Aging Phys. Act. 27, 831–842. doi: 10.1123/japa.2018-0341
Ciaccioni, S., Castro, O., Bahrami, F., Tomporowski, P. D., Capranica, L., Biddle, S. J. H., et al. (2024a). Martial arts, combat sports, and mental health in adults: a systematic review. Psychol. Sport Exerc. 70:102556. doi: 10.1016/j.psychsport.2023.102556
Ciaccioni, S., Condello, G., Guidotti, F., and Capranica, L. (2019b). Effects of judo training on bones: a systematic literature review. J. Strength Cond. Res. 33, 2882–2896. doi: 10.1519/JSC.0000000000002340
Ciaccioni, S., Guidotti, F., Palumbo, F., Forte, R., Galea, E., Sacripanti, A., et al. (2024b). Development of a sustainable educational programme for judo coaches of older practitioners: a transnational european partnership endeavor. Sustainability 16:1115. doi: 10.3390/su16031115
Ciaccioni, S., Guidotti, F., Palumbo, F., Forte, R., Galea, E., Sacripanti, A., et al. (2024c). Judo for older adults: the coaches' knowledge and needs of education. Front. Sports Act Living 6:1375814. doi: 10.3389/fspor.2024.1375814
Ciaccioni, S., Martusciello, F., Di Credico, A., Guidotti, F., Conte, D., Palumbo, F., et al. (2024d). Stress-related hormonal and psychological changes to simulated and official judo black belt examination in older tori and adult uke: an exploratory observational study. Sports12:310. doi: 10.3390/sports12110310
Ciaccioni, S., Perazzetti, A., Magnanini, A., Kozsla, T., Capranica, L., Doupona, M., et al. (2024e). Intergenerational judo: synthesising evidence- and eminence-based knowledge on judo across ages. Sports 12:177. doi: 10.3390/sports12070177
Connor, J. L., Liadis, J. G., and De Luigi, A. J. (2018). “Adaptive combative sports (judo, boxing, wrestling, mixed martial arts),” in Adaptive Sports Medicine: A Clinical Guide (Cham: Springer), 333–342. doi: 10.1007/978-3-319-56568-2_27
Cougoulic, P., Raynaud, S., and Cougoulic, B. (2003). La Boxe Éducative: 200 Jeux Et Situations Pédagogiques. Paris: Editions Amphora.
Descamps, G., Campos, M. J., Rizzo, T., Pecnikar Oblak, V., and Massart, A. G. (2024). Benefits of judo practice for individuals with neurodevelopmental disorders: a systematic literature review. Sports 12:182. doi: 10.3390/sports12070182
Dortants, M., Knoppers, A., and Van Bottenburg, M. (2016). Challenges in regulating full contact martial arts and combat sports. Int. J. Sport Policy Politics 8, 473–490. doi: 10.1080/19406940.2016.1170717
Eckstein, M. L., Schwarzinger, M., Haupt, S., Wachsmuth, N. B., Zimmer, R. T., Sourij, H., et al. (2022). Physiological responses to combat sports in metabolic diseases: a systematic review. J. Clin. Med. 11:1070. doi: 10.3390/jcm11041070
Elferink-Gemser, M. T., Te Wierike, S., and Visscher, C. (2018). “16 multidisciplinary longitudinal studies: a perspective from the field of sports,” in The Cambridge Handbook of Expertise and Expert Performance (Cambridge: Cambridge University Press), 271. doi: 10.1017/9781316480748.016
Franchini, E., Del Vecchio, F. B., Matsushigue, K. A., and Artioli, G. G. (2011). Physiological profiles of elite judo athletes. Sports Med. 41, 147–166. doi: 10.2165/11538580-000000000-00000
García, R. S., and Spencer, D. C. (2013). Fighting Scholars: Habitus and Ethnographies of Martial Arts and Combat Sports. London: Anthem Press. doi: 10.2307/j.ctt1gxpddq
Garcia-Falgueras, A. (2015). Psychological benefits of sports and physical activities. Br. J. Educ. Soc. Behav. Sci. 11, 1–7. doi: 10.9734/BJESBS/2015/21865
Gauthier, J. (2009). “Ethical and social issues in combat sports: should combat sports be banned?” in Combat Sports Medicine (Springer, London), 73–88. doi: 10.1007/978-1-84800-354-5_5
Grimes, D. A., and Schulz, K. F. (2002). An overview of clinical research: the lay of the land. Lancet 359, 57–61. doi: 10.1016/S0140-6736(02)07283-5
Gutierrez-Santiago, A., Gutierrez-Santiago, J. A., Prieto-Lage, I., Parames-Gonzalez, A., Suarez-Iglesias, D., Ayan, C. A., et al. (2023). Scoping review on para judo. Am. J. Phys. Med. Rehabil. 102, 931–938. doi: 10.1097/PHM.0000000000002136
Halperin, I., Vigotsky, A. D., Foster, C., and Pyne, D. B. (2018). Strengthening the practice of exercise and sport-science research. Int. J. Sports Physiol. Perform. 13, 127–134. doi: 10.1123/ijspp.2017-0322
Hammami, N., Hattabi, S., Salhi, A., Rezgui, T., Oueslati, M., Bouassida, A., et al. (2018). Combat sport injuries profile: a review. Sci. Sports 33, 73–79. doi: 10.1016/j.scispo.2017.04.014
Healey, G., Neumann, D., Cornell, S., and Piatkowski, T. (2025). ‘Martial arts crossed over into the rest of my life': a qualitative exploration of Australian practitioners' experiences of martial arts and combat sports on wellbeing. J. Community Appl. Soc. Psychol. 35:e70035. doi: 10.1002/casp.70035
Jäggi, U., Joray, C., Brülhart, Y., Luijckx, E., and Rogan, S. (2015). Injuries in the martial arts judo, taekwondo and wrestling-a systematic review. Sportverletzung Sportschaden 29, 219–225. doi: 10.1055/s-0041-106939
James, L. P., Haff, G. G., Kelly, V. G., and Beckman, E. M. (2016). Towards a determination of the physiological characteristics distinguishing successful mixed martial arts athletes: a systematic review of combat sport literature. Sports Med. 46, 1525–1551. doi: 10.1007/s40279-016-0493-1
Jeong, H. S., O'Sullivan, D. M., Rus, P. R., and de Oca, A. R. M. (2021). Expert consensus statement to guide research into evidence-based classification of athletes for para-taekwondo–a delphi study. J. Men's Health 17, 114–119. doi: 10.31083/jomh.2021.019
Kasum, G., Gligorov, S., and Nastasić, S. T. (2011). Combat sports for persons with disabilities. Fizička Kultura 65, 60–69. doi: 10.5937/fizkul1101060K
Klimczak, J., Krzemieniecki, L. A., and Mosler, D. (2015). Martial arts bibliotherapy - the possibility of compensating the negative effects of the continuous education for aggression by electronic media and the aggressive interpersonal relationship of children and adults. Arch. Budo. 11, 395–401.
Krabben, K., Orth, D., and van der Kamp, J. (2019). Combat as an interpersonal synergy: an ecological dynamics approach to combat sports. Sports Med. 49, 1825–1836. doi: 10.1007/s40279-019-01173-y
Kujach, S., Chroboczek, M., Jaworska, J., Sawicka, A., Smaruj, M., Winklewski, P., et al. (2022). Judo training program improves brain and muscle function and elevates the peripheral BDNF concentration among the elderly. Sci. Rep. 12:13900. doi: 10.1038/s41598-022-17719-6
Lafuente, J. C., Zubiaur, M., and Gutiérrez-García, C. (2021). Effects of martial arts and combat sports training on anger and aggression: a systematic review. Aggr. Viol. Behav. 58:101611. doi: 10.1016/j.avb.2021.101611
Lee, Y., Capranica, L., Pesce, C., Guidotti, F., Benzing, V., Hauck, J., et al. (2025). Olympic combat sports and mental health in children and adolescents with disability: a protocol paper for systematic review. PLoS ONE 20:e0301949. doi: 10.1371/journal.pone.0301949
Li, Y., Li, H., Jiang, C., Su, Y., Jiang, S., Zhang, G., et al. (2025). Advancements in virtual reality for performance enhancement in combat sports: a mini-review and perspective. Front. Psychol. 16:1563212. doi: 10.3389/fpsyg.2025.1563212
Lota, K. S., Malliaropoulos, N., Blach, W., Kamitani, T., Ikumi, A., Korakakis, V., et al. (2022). Rotational head acceleration and traumatic brain injury in combat sports: a systematic review. Br. Med. Bull. 141, 33–46. doi: 10.1093/bmb/ldac002
Lystad, R. P., Augustovicova, D., Harris, G., Beskin, K., and Arriaza, R. (2020). Epidemiology of injuries in olympic-style karate competitions: systematic review and meta-analysis. Br. J. Sports Med. 54, 976–983. doi: 10.1136/bjsports-2020-101990
Malm, C., Jakobsson, J., and Isaksson, A. (2019). Physical activity and sports—real health benefits: a review with insight into the public health of Sweden. Sports 7:127. doi: 10.3390/sports7050127
Mathisen, T. F., Kumar, R. S., Svantorp-Tveiten, K. M. E., and Sundgot-Borgen, J. (2022). Empowered, yet vulnerable: motives for sport participation, health correlates, and experience of sexual harassment in female combat-sport athletes. Sports 10:68. doi: 10.3390/sports10050068
Matsumoto, D., Konno, J., and Ha, H. Z. (2009). “Sport psychology in combat sports,” in Combat Sports Medicine (Springer, London), 41–53. doi: 10.1007/978-1-84800-354-5_3
Mojtahedi, D., Dagnall, N., Denovan, A., Clough, P., Dewhurst, S., Hillier, M., et al. (2023). Competition anxiety in combat sports and the importance of mental toughness. Behav. Sci. 13:713. doi: 10.3390/bs13090713
Morales, J., Garcia, V., Garcia-Masso, X., Salva, P., Escobar, R., Busca, B., et al. (2013). The use of heart rate variability in assessing precompetitive stress in high-standard judo athletes. Int. J. Sports Med. 34, 144–151. doi: 10.1055/s-0032-1323719
Morales, J., Pierantozzi, E., Fukuda, D. H., Garcia, V., Guerra-Balic, M., Sevilla-Sánchez, M., et al. (2022). Improving motor skills and psychosocial behaviors in children with autism spectrum disorder through an adapted judo program. Front. Psychol. 13:1067310. doi: 10.3389/fpsyg.2022.1067310
Origua Rios, S., Marks, J., Estevan, I., and Barnett, L. M. (2018). Health benefits of hard martial arts in adults: a systematic review. J. Sports Sci. 36, 1614–1622. doi: 10.1080/02640414.2017.1406297
Palumbo, F., Ciaccioni, S., Guidotti, F., Forte, R., Sacripanti, A., Capranica, L., et al. (2023). Risks and benefits of judo training for middle-aged and older people: a systematic review. Sports 11:68. doi: 10.3390/sports11030068
Pečnikar Oblak, V., Karpljuk, D., Vodičar, J., and Simenko, J. (2020). Inclusion of people with intellectual disabilities in judo: a systematic review of literature. Arch. Budo. 16, 245–260.
Pedrini, L., and Jennings, G. (2021). Cultivating health in martial arts and combat sports pedagogies: a theoretical framework on the care of the self. Front. Sociol. 6:601058. doi: 10.3389/fsoc.2021.601058
Pierantozzi, E., Morales, J., Fukuda, D. H., Garcia, V., Gomez, A. M., Guerra-Balic, M., et al. (2022). Effects of a long-term adapted judo program on the health-related physical fitness of children with ASD. Int. J. Environ. Res. Public Health 19:16731. doi: 10.3390/ijerph192416731
Piggott, B., Müller, S., Chivers, P., Papaluca, C., and Hoyne, G. (2019). Is sports science answering the call for interdisciplinary research? A systematic review. Eur. J. Sport Sci. 19, 267–286. doi: 10.1080/17461391.2018.1508506
Piskorska, E., Mieszkowski, J., Kochanowicz, A., Wedrowska, E., Niespodziński, B., Borkowska, A., et al. (2016). Mental skills in combat sports–review of methods anxiety evaluation. Arch. Budo. 12, 301–313.
Pocecco, E., Ruedl, G., Stankovic, N., Sterkowicz, S., Del Vecchio, F. B., Gutierrez-Garcia, C., et al. (2013). Injuries in judo: a systematic literature review including suggestions for prevention. Br. J. Sports Med. 47, 1139–1143. doi: 10.1136/bjsports-2013-092886
Pocecco, E., Schneider, F., Stavrinou, P. S., De Crée, C., and Burtscher, J. (2024). Fasting in judo-between healthy weight control and health hazard: a narrative review. Obesities 4, 453–467. doi: 10.3390/obesities4040036
Qi, Y., Sajadi, S. M., Baghaei, S., Rezaei, R., and Li, W. (2024). Digital technologies in sports: opportunities, challenges, and strategies for safeguarding athlete wellbeing and competitive integrity in the digital era. Technol. Soc. 77:102496. doi: 10.1016/j.techsoc.2024.102496
Rajan, P. (2015). Martial arts practice in community-based rehabilitation: a review. Int. J. Ther. Rehabil. 22, 31–34. doi: 10.12968/ijtr.2015.22.1.31
Rato Barrio, M., Ley, C., Schomöller, A., and Dumon, D. (2021). Mental well-being or ill-being through coaching in adult grassroots sport: a systematic mapping review. Int. J. Environ. Res. Public Health 18:6543. doi: 10.3390/ijerph18126543
Salgado, V. C., and Jauregui, Z. G. (2022). People with disabilities and martial arts: a systematic review of the literature between 1990 and 2020. Agora Para La Educacion Fisica Y El Deporte 24, 278–303. doi: 10.24197/aefd.24.2022.278-303
Sethi, N. K., and Neidecker, J. (2023). Neuroimaging in professional combat sports: consensus statement from the association of ringside physicians. Phys. Sports Med. 51, 343–350. doi: 10.1080/00913847.2022.2083922
Slimani, M., Davis, P., Franchini, E., and Moalla, W. (2017). Rating of perceived exertion for quantification of training and combat loads during combat sport-specific activities: a short review. J. Strength Cond. Res. 31, 2889–2902. doi: 10.1519/JSC.0000000000002047
Slimani, M., Paravlic, A. H., Chaabene, H., Davis, P., Chamari, K., Cheour, F., et al. (2018). Hormonal responses to striking combat sports competition: a systematic review and meta-analysis. Biol. Sport 35, 121–136. doi: 10.5114/biolsport.2018.71601
Smith, B., and McGannon, K. R. (2017). Developing rigor in qualitative research: problems and opportunities within sport and exercise psychology. Int. Rev. Sport Exerc. Psychol. 11, 101–121. doi: 10.1080/1750984X.2017.1317357
Stankovic, N., Todorovic, D., Milosevic, N., Mitrovic, M., and Stojiljkovic, N. (2021). Aggressiveness in judokas and team athletes: predictive value of personality traits, emotional intelligence and self-efficacy. Front. Psychol. 12:824123. doi: 10.3389/fpsyg.2021.824123
Sullivan, D., Climstein, M., Moore, B., and Del Vecchio, L. (2024). Older persons participation in hard martial arts: opportunities to improve psychological well-being? A scoping review. Int. J. Exerc. Sci. 17, 183–198. doi: 10.70252/CVDF5194
Torres-Luque, G., Hernandez-Garcia, R., Escobar-Molina, R., Garatachea, N., and Nikolaidis, P. T. (2016). Physical and physiological characteristics of judo athletes: an update. Sports 4:20. doi: 10.3390/sports4010020
Valdes-Badilla, P., Herrera-Valenzuela, T., Ramirez-Campillo, R., Aedo-Munoz, E., Baez-San Martin, E., Ojeda-Aravena, A., et al. (2021). Effects of olympic combat sports on older adults' health status: a systematic review. Int. J. Environ. Res. Public Health 18:7381. doi: 10.3390/ijerph18147381
Witte, K., Droste, M., Ritter, Y., Emmermacher, P., Masik, S., Bürger, D., et al. (2022). Sports training in virtual reality to improve response behavior in karate kumite with transfer to real world. Front. Virtual Real. 3:903021. doi: 10.3389/frvir.2022.903021
Xu, W., Liang, H. N., Baghaei, N., Ma, X., Yu, K., Meng, X., et al. (2021). Effects of an immersive virtual reality exergame on university students' anxiety, depression, and perceived stress: pilot feasibility and usability study. JMIR Serious Games 9:e29330. doi: 10.2196/29330
Ziv, G., and Lidor, R. (2013). Psychological preparation of competitive judokas - a review. J. Sports Sci. Med. 12, 371–380.
Keywords: martial arts, benefits, research, psycho-social impact, risks, skills, quality of life, community
Citation: Ciaccioni S, Lee Y, Guidotti F, Stankovic N, Pocecco E, Izzicupo P and Capranica L (2025) Combat sports and wellbeing: advancing health and inclusion in athletes and practitioners. An opinion paper. Front. Psychol. 16:1587672. doi: 10.3389/fpsyg.2025.1587672
Received: 04 March 2025; Accepted: 04 April 2025;
Published: 22 April 2025.
Edited by:
Cristina Cortis, University of Cassino, ItalyReviewed by:
Caio Amaral Gabriel, Independent Researcher, São Paulo, BrazilCopyright © 2025 Ciaccioni, Lee, Guidotti, Stankovic, Pocecco, Izzicupo and Capranica. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Simone Ciaccioni, c2ltb25lY2lhY2Npb25pQHlhaG9vLml0