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A Special Issue of Applied Sciences (ISSN 2076-3417) belonging to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (20 May 2026) | Viewed by 17099

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Editors

Dr. Patsaki Irini

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Guest Editor

Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
Interests: physical therapy; respiratory physiotherapy; rehabilitation; muscular weakness; ICU rehabilitation; virtual reality; innovation in rehabilitation; critical illness; prevention
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Dr. George A. Koumantakis

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Guest Editor

Laboratory of Advanced Physiotherapy (LAdPhys), Physiotherapy Department, School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
Interests: evidence-based physiotherapy practice; prevention; neuromusculoskeletal pathologies; occupational health; physical activity; exercise; low back pain
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Advances in the field of technology and physical therapy have facilitated and augmented the recovery process in the spectrum of pathologies treated in physical therapy rehabilitation. Injuries, chronic illnesses, and different kinds of disabilities often affect peoples’ functionality and quality of life. These effects and the long recovery pathway that most would have are being described as a significant burden not only for the patient but also for society and health systems.

New insights into physical therapy rehabilitation include all new techniques and technologies that provide new possibilities and transform the rehabilitation process. New techniques such as blood flow restriction, motor imagery, clinical pilates, and emerging technologies such as virtual reality provide new opportunities to enhance function, mobility, and quality of life. These advances beyond the strict aspect of pathology could also lead the field of prevention and healthy aging, minimizing disability, and preserving healthy and mobile living. New technologies have especially managed to overcome environmental barriers and make physical rehabilitation more accessible.

We welcome the latest research developments and findings in the above areas in this Special Issue. Thus, we invite you to contribute original research articles and reviews of the literature, aiming to include high-quality papers on new techniques and technologies in the field of physical rehabilitation.

You may choose our Joint Special Issue in JCM.

Dr. Patsaki Irini
Dr. George A. Koumantakis
Guest Editors

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Keywords

physical rehabilitation
new technologies
virtual reality
augmented reality
telerehabilitation
clinical pilates
blood flow restriction
manual therapy
motor imagery
electrophysical modalities
therapeutic exercises
neurology
musculoskeletal
geriatric
respiratory
acute illness
cardiovascular

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Related Special Issue

New Insights into Physical Therapy, 2nd Edition in Applied Sciences

Published Papers (10 papers)

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Editorial

Jump to: Research, Review

6 pages, 180 KB

Open AccessEditorial

New Insights into Physical Therapy: Advancing Rehabilitation Through Innovation, Technology, and Evidence-Based Practice

by Irini Patsaki and George A. Koumantakis

Appl. Sci. 2026, 16(16), 8292; https://doi.org/10.3390/app16168292 - 20 Aug 2026

Viewed by 1151

Abstract

The evolution of physical therapy over the years reflects the entire transformation of healthcare itself [...] Full article

(This article belongs to the Special Issue New Insights into Physical Therapy)

Research

Jump to: Editorial, Review

15 pages, 757 KB

Open AccessArticle

Short Versus Standard Corridor Six-Minute Walk Test in Older Adults with Controlled Arterial Hypertension: Clinical Agreement and Determinants of Performance

by Garyfallia Pepera, Miltiadis Papageorgiou, Theodora Xenofontos, Konstantinos Kalatzis and Varsamo Antoniou

Appl. Sci. 2026, 16(13), 6438; https://doi.org/10.3390/app16136438 - 28 Jun 2026

Viewed by 529

Abstract

Arterial hypertension (AH) is strongly associated with reduced functional capacity and elevated cardiovascular risk. The Six-Minute Walk Test (6MWT) assesses submaximal exercise capacity; however, the standard 30 m walkway is often unavailable in clinical settings, necessitating the use of shorter corridors. Evidence regarding the agreement between different walkway lengths in hypertensive populations remains limited. This study investigated the agreement between 15 m and 30 m 6MWT protocols in 23 older adults with medically controlled AH (13 men, 10 women; age 74.04 ± 8.89 years) in randomized order. Anthropometric, cardiovascular, physical activity (IPAQ), and health-related quality of life (SF-36) data were collected. Results showed significantly greater walking distances on the 30 m walkway (p < 0.001). Moderate agreement was observed between protocols (ICC = 0.65), with Bland–Altman analysis demonstrating systematically higher distances on the 30 m walkway. Age was negatively correlated with performance, while height and SF-36 physical functioning showed positive correlations (p < 0.05). Distinct regression models for each protocol suggest walkway-specific performance determinants. Although the 15 m protocol demonstrated acceptable agreement, it should not be used interchangeably with the standard 30 m protocol in older adults with controlled arterial hypertension. Further research is required to better understand the relationship between the two protocols. Full article

(This article belongs to the Special Issue New Insights into Physical Therapy)

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13 pages, 729 KB

Open AccessArticle

Assessment of Mood, Acceptance of Illness, and Quality of Life in Dialysis Patients Undergoing Relaxation Therapy Using Virtual Reality

by Łukasz Rogowski, Joanna Kowalska, Mariusz Kusztal, Małgorzata Stefańska, Agnieszka Zembroń-Łacny, Tomasz Gołębiowski and Wioletta Dziubek

Appl. Sci. 2026, 16(12), 5897; https://doi.org/10.3390/app16125897 - 11 Jun 2026

Viewed by 334

Abstract

Background/Objectives: Regular dialysis sessions impose a fixed schedule on the patient’s days and weeks; this can lead to negative emotions, low mood, helplessness, and a lack of control over their treatment, which significantly reduces the quality of life for these patients. The aim of this study was to assess the mood, level of illness acceptance, and quality of life among dialysis patients undergoing relaxation therapy using virtual reality (VR). Methods: Sixty hemodialysis (HD) patients were recruited for a single-arm study. A personal questionnaire as well as the AIS, PHQ-9, and KDQOL-36™ were used. After one month of the control period, 22 patients were analyzed and then continued with one month of VR relaxation therapy consisting of 360° scenarios or 2D landscape movies. Finally, 16 patients were analyzed for the outcomes during dialysis, three times a week. Results: The data analysis showed a small significant increase in AIS scores after the VR therapy. In the PHQ-9, slight significant reductions in scores were observed at the end of VR therapy. Analysis of the Physical Component Summary (PCS), but not for Mental Component Summary (MCS), results showed statistically significant increases after VR therapy. Conclusions: The study group of dialysis patients showed small but significant improvements in mood, disease acceptance, and quality of life. The VR therapy intervention may be a useful complementary tool to comprehensive treatment and rehabilitation for hemodialysis patients, but multi-center studies are needed for a larger group of patients. Full article

(This article belongs to the Special Issue New Insights into Physical Therapy)

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21 pages, 2402 KB

Open AccessArticle

The Effect of Lumbar Spine Stabilization Exercises on the Quality of Life, Functional Movement, and Dynamic Balance in a Population with a Sedentary Lifestyle: A Pilot Randomized Controlled Trial

by Dimitra Korda, Maria Papandreou, Nikolaos Chrysagis and George A. Koumantakis

Appl. Sci. 2026, 16(11), 5432; https://doi.org/10.3390/app16115432 - 29 May 2026

Viewed by 515

Abstract

This pilot randomized controlled trial (RCT) aimed to evaluate the effect of a lumbar spine stabilization exercise program (LSSEP) in healthy adults with a sedentary lifestyle. Thirty-eight healthy Greek adults (mean age 40.53 ± 11.91 years) who had been sedentary for at least six months participated in the study. They were randomly assigned to an intervention group (n = 18) and a control group (n = 20). The intervention group followed a supervised progressive four-week LSSEP, while the control group received a booklet with ergonomic and stretching instructions (passive control). The primary outcome was the 12-Item Short Form Health Survey version 2 (SF-12v2), which measures quality of life, and secondary outcomes were the Functional Movement Screen (FMS) and the Y-Balance test (YBT), assessed before and immediately after the intervention period. A repeated-measures 2 × 2 mixed ANOVA revealed significant time × group interactions in favor of the intervention group for the mental component of quality of life and for functional movement and dynamic balance performance (p < 0.05), with moderate to large effect sizes. The LSSEP appears to improve specific aspects of quality of life and movement performance in healthy sedentary adults, with potentially clinically meaningful benefits observed even within a short four-week period. Confirmation through larger, longer-term trials is warranted. Full article

(This article belongs to the Special Issue New Insights into Physical Therapy)

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13 pages, 739 KB

Open AccessArticle

Assessment of Immediate Traction Manipulation of the Ankle Joint on the Peroneus Longus, Gluteus Medius and Tensor Fascia Lata Muscles in Healthy People: A Randomized Double-Blind Study

by Rafal Studnicki, Piotr Wojslaw, Piotr Aschenbrenner, Radosław Laskowski and Piotr Łuczkiewicz

Appl. Sci. 2025, 15(21), 11524; https://doi.org/10.3390/app152111524 - 28 Oct 2025

Cited by 1 | Viewed by 1259

Abstract

Objectives: This study aimed to evaluate the effect of a superior ankle traction manipulation on the strength and electrical activity (surface EMG) of the peroneus longus, gluteus medius, and tensor fasciae latae muscles in healthy young adults. Methods: In total, 30 healthy participants (26 men and 4 women) were enrolled in a prospective, randomized, double-blind, controlled study. Participants were randomly assigned to a Manipulation or Sham group. Muscle activity was recorded using surface EMG, and isometric strength was assessed with a Biodex dynamometer. EMG signals were normalized to session-specific maximal voluntary isometric contractions (MVIC) and expressed as %MVIC for amplitude and median frequency. Baseline differences were examined with Welch’s t-tests. The primary analysis used analysis of covariance (ANCOVA) on POST values adjusted for PRE, with partial eta squared (η²_p) as an effect size. Change-score comparisons (Δ = POST − PRE) and Hedges-corrected Cohen’s d were reported as sensitivity analyses. False discovery rate (FDR) correction was applied across outcomes. Results: No significant between-group differences were observed after adjustment for baseline in any %MVIC amplitude or median frequency outcome (p > 0.05, all FDR-adjusted q > 0.05). Within-group analyses showed small, nonsignificant changes in both groups, with the Manipulation group tending toward slightly greater increases in peroneus longus %MVIC amplitude (Δ = +3.1%, p = 0.033, d = 0.79, not significant after FDR correction). Descriptive data indicated similar PRE and POST values across groups for all muscles. Conclusions: When EMG activity is expressed relative to MVIC and baseline differences are controlled, a single superior ankle traction manipulation does not produce statistically significant acute changes in peroneus longus, gluteus medius, or tensor fasciae latae activity compared with a sham procedure. These findings suggest that previously reported differences may have reflected unadjusted baseline variability rather than true intervention effects. Full article

(This article belongs to the Special Issue New Insights into Physical Therapy)

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15 pages, 241 KB

Open AccessArticle

Development of a Website for E-Health Use for Children with Chronic Suppurative Lung Diseases: A Delphi Expert Consensus Study

by Vaia Sapouna, Aspasia Mavronasou, Konstantinos Douros, Eleni Kapreli and Eleni A. Kortianou

Appl. Sci. 2025, 15(17), 9291; https://doi.org/10.3390/app15179291 - 24 Aug 2025

Cited by 1 | Viewed by 2791

Abstract

This study aimed to develop a website providing physiotherapy, exercise, and disease knowledge information as a digital tool for use with children with chronic suppurative lung diseases (CSLDs). Data were analyzed using a mixed qualitative and quantitative approach. Initially, a comprehensive list of the website’s content and functions was developed through a Focus Group study with healthcare professionals (HCPs) and parents. Afterward, two rounds of an online Delphi survey were conducted with a group of expert HCPs (pediatricians and physiotherapists) who were recruited based on their expertise in the field of pediatric physiotherapy. The Focus Groups established 10 main themes. Two rounds of Delphi questionnaires established the important items of a website, based on expert consensus from HCPs. A Delphi survey containing 36 outcomes was completed by participants from Greece. The findings support the integration of multidisciplinary and user-centered approaches in the design of a pediatric website. This website is expected to enhance disease self-management, improve treatment adherence, and support families in daily care. Full article

(This article belongs to the Special Issue New Insights into Physical Therapy)

14 pages, 1956 KB

Open AccessArticle

Relationship Between Physical Fitness Attributes and Dynamic Knee Valgus in Adolescent Basketball Athletes

by Aleksandar Stojiljkovic, Eleni Karagianni, Varsamo Antoniou and Garyfallia Pepera

Appl. Sci. 2025, 15(9), 4881; https://doi.org/10.3390/app15094881 - 28 Apr 2025

Cited by 5 | Viewed by 3536

Abstract

(1) Background: Dynamic knee valgus (DKV) is a common biomechanical risk factor for knee injuries, particularly in sports involving high-intensity movements, such as basketball. While neuromuscular control and structural alignment contribute to DKV, recent evidence indicates that lower limb muscle power (LLMP) and cardiorespiratory fitness (CRF) may significantly influence DKV. This study aims to examine the relationship among LLMP, CRF, and DKV in adolescent basketball athletes. (2) Methods: A total of 104 adolescent basketball athletes (63.5% boys), 12 to 17 years old (13.87 ± 1.46 years) participated in this study. Anthropometric and demographic characteristics such as sex, age, height, weight, and body mass index (BMI) were recorded. The Counter Movement Jump (CMJ) was used for the evaluation and prediction of the LLMP, the 20 m shuttle run test (20mSRT) was used for the evaluation and prediction of CRF, and the single-leg drop jump (SLDJ) was used for the evaluation of DKV via a two-dimensional (2D) kinematic analysis. Statistical analysis included Pearson and Spearman correlations, as well as multiple linear regression, to determine the relationship among LLMP, CRF, and DKV. (3) Results: A statistical analysis revealed strong correlations among LLMP, CRF, and DKV. Pearson’s correlation coefficients demonstrated significant associations between the VO₂max and frontal plane projection angle (FPPA) (r = 0.78, p < 0.001), as well as between LLMP and FPPA (r = 0.82, p < 0.001). Multiple linear regression analysis showed that VO₂max and LLMP together accounted for 85% of the variance in FPPA (R² = 0.85, p < 0.001). (4) Conclusions: The findings highlight that both aerobic capacity and lower limb muscle power significantly contribute to knee valgus control among adolescent basketball players. Implementing training programs focused on improving lower limb muscle power and cardiorespiratory fitness may enhance knee stability and reduce the risk of lower limb injuries. Given the strong predictive value of VO₂max and LLMP for knee control, targeted training programs focusing on neuromuscular conditioning and aerobic capacity may be effective for injury prevention. Full article

(This article belongs to the Special Issue New Insights into Physical Therapy)

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Review

Jump to: Editorial, Research

20 pages, 1677 KB

Open AccessReview

Sauna Exposure and Rehabilitation: An Underutilized Adjunct for Physiotherapy Practice

by Morey J. Kolber, Nick Smith, William J. Hanney and Kristina Martin

Appl. Sci. 2026, 16(13), 6466; https://doi.org/10.3390/app16136466 - 29 Jun 2026

Viewed by 1085

Abstract

This narrative review explores sauna exposure as an emerging adjunctive intervention with potential relevance to physiotherapy practice. The physiological effects of sauna exposure are presented as related to neuromusculoskeletal performance, cardiorespiratory function, exercise recovery, and systemic health domains relevant to advanced physiotherapy care. The key benefits, owing to hyperthermia and upregulation of heat shock proteins, include thermoregulatory, cardiovascular, neuroendocrine, and cytoprotective responses that support homeostasis and adaptive stress tolerance. From a clinical perspective, frequent sauna use is linked to improved aerobic capacity and blood pressure regulation, particularly when combined with exercise. Furthermore, sauna exposure may support post-exercise and post-intervention recovery through attenuation of muscle soreness and modulation of inflammatory and hormonal responses, contributing to tissue repair and a timely return of neuromuscular function. Despite these potential benefits, substantial variability in evidence-informed dosing parameters exists, underscoring the need for appropriate patient selection and safety considerations. Despite inconsistent dosing parameters, sauna exposure represents a physiologically plausible and increasingly evidence-informed intervention that may complement established physiotherapy interventions. Further clinical research is needed to define optimal dosing, safety guidelines, and its targeted role within rehabilitation populations. Moreover, studies comparing sauna exposure to other physiotherapy thermal modalities are needed to determine efficacy. This manuscript is classified as level 5 evidence based on the Oxford Centre for Evidence-Based Medicine guidelines. Thus, no indication of the superiority of sauna over other interventions is being established. Full article

(This article belongs to the Special Issue New Insights into Physical Therapy)

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26 pages, 485 KB

Open AccessReview

Predictive Factors of Inpatient Rehabilitation Stay After Elective Hip and Knee Replacement: A Scoping Review

by Federico Pennestrì and Giuseppe Banfi

Appl. Sci. 2025, 15(22), 11957; https://doi.org/10.3390/app152211957 - 11 Nov 2025

Cited by 2 | Viewed by 1706

Abstract

Patient stratification strategies based on digital databases and advanced information technology can predict inpatient rehabilitation outcomes and support safe hospital discharge for patients who underwent joint replacement for hip and knee osteoarthritis. The degree of continuity between surgery and rehabilitation, the perioperative process integration, and the setting where rehabilitation is provided are crucial factors to improve care effectiveness, access, minimize readmissions, and cost increase. The primary aim of this scoping review of the literature is to identify perioperative variables that are predictive of inpatient rehabilitation stay after hip and knee arthroplasty for osteoarthritis. These factors are divided by time of assessment through the perioperative pathway and surgical procedure site. The secondary aim is to explore how different data sources and facilities are linked into a patient-centered perioperative pathway. An electronic search of the literature was performed on PubMed, Embase, and Scopus. No time restrictions were applied. All primary research studies investigating predictive factors of inpatient rehabilitation stay after hip and knee osteoarthritis were included. In total, 25 studies were included in the review. Age, caregiver presence, presence of comorbidities, sex, Body Mass Index, Risk Assessment and Prediction Tool composite score, pre-operative Clinician-Reported Outcome Measures, pre-operative Patient-Reported Outcome Measures, and post-operative Barthel Index of autonomy in the Activities of Daily Living were predictive of some degree of inpatient rehabilitation stay in more than one study. The studies were fairly distributed between retrospective and prospective, with multicentric databases more spread among the latter. Data collection occurred in acute hospitals more than in specialized rehabilitation facilities. Using comprehensive models supported by electronic health records and powerful information technologies, analyzing specific inpatient rehabilitation LOS as distinguished from surgical ward rehabilitation, using institutional registries, and including specific rehabilitation factors in these registries, and promoting vocabulary and federated data sharing can strongly enhance the predictivity of models investigating rehabilitation outcomes and support appropriate discharge from inpatient rehabilitation units. Full article

(This article belongs to the Special Issue New Insights into Physical Therapy)

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16 pages, 3605 KB

Open AccessReview

Exploring the Clinical Utility of Cardiorespiratory Optimal Point in Heart Failure Patients: Creating a New Research Gap

by Weder A. Silva, Alberto Souza Sá Filho, Plinio S. Ramos, Adriana M. Güntzel Chiappa, Vicente Aprigliano, Iransé Oliveira-Silva, Raphael Martins Cunha, James Oluwagbamigbe Fajemiroye, Rodolfo P. Vieira, Gerson Ferrari and Gaspar R. Chiappa

Appl. Sci. 2025, 15(7), 3495; https://doi.org/10.3390/app15073495 - 22 Mar 2025

Cited by 2 | Viewed by 1598

Abstract

The cardiorespiratory optimal point (COP) is an emerging submaximal parameter from cardiopulmonary exercise testing (CPET) that reflects the optimal balance between cardiac workload and pulmonary ventilation. Recent studies have explored the clinical utility and prognostic value of the COP in various populations, particularly in patients with heart failure (HF). This comprehensive literature review evaluated the current evidence on the COP and its potential as an independent risk factor for cardiovascular disease and mortality. The COP has been identified as a predictor of all-cause and cardiovascular mortality, with elevated values being significantly associated with an increased risk. Studies have demonstrated that higher COP values correlate with greater mortality risk independent of traditional risk factors, with significant sex-based differences. Evidence suggests that COP values greater than 26 significantly influence mortality rates and lead to a worse prognosis in patients with HF. For example, individuals with a COP > 30 had an approximately six-fold higher mortality risk (17.1%) than those with a COP < 22, and the combination of a high COP (>30) + low VO₂max leads to a significant increase in the risks of adverse effects (30.9%). This underscores the importance of the COP in the clinical management and risk stratification of HF patients. While the COP shows promise as a valuable submaximal marker with significant prognostic implications, further research is needed to establish its superiority over other established prognostic markers and elucidate the underlying mechanisms linking the COP to health outcomes. Nonetheless, the ability of the COP to predict mortality and enhance risk stratification in diverse populations makes it a promising tool in clinical practice. Full article

(This article belongs to the Special Issue New Insights into Physical Therapy)

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