International Journal of Environmental Research and Public Health

In cervical dystonia (CD), balance and gait impairments can compromise daily activities and negatively affect quality of life. However, interventions addressing these deficits remain poorly investigated. A 54-year-old woman with CD, presenting balance and gait difficulties that interfered with work-related motor tasks, underwent a four-month training program. Sessions (40 min, three times per week) combined lower-limb strengthening, proprioceptive and balance exercises, and integrated motor–cognitive tasks. Pre- and post-intervention assessments included gait speed (GS), stride length (SL), and stance time (ST) under usual (UW), fast (FW), and dual-task (DT) walking conditions, measured with an inertial sensor (BTS G-Walk). DT cost was calculated for GS and SL. Balance was evaluated with the Mini-BEST and Four-Square Step Test (FSST), while fear of falling was measured with the Falls Efficacy Scale-International (FES-I). Of note, both assessment sessions were conducted in the absence of botulinum toxin effects, whereas the training was performed, at least in part, under its influence. After training, increase were observed in GS and SL, with reductions in ST across all gait conditions. DT cost decreased for both GS and SL. Balance performance increased, and fear of falling was reduced. Importantly, the patient reported a marked improvement in work-related performance. This case suggests that a specific training program may effectively ameliorate balance and gait in CD, with positive effects on functional mobility. Further studies on larger samples are warranted to confirm efficacy.

Intimate partner violence (IPV) is a public health issue that produces significant psychological and physiological consequences. This exploratory descriptive study examines whether sustaining a serious injury increases the likelihood that IPV survivors experience emotional and physical symptoms. We analyzed nonfatal violence by an intimate partner reported in the U.S. National Crime Victimization Survey (2009–2023) and applied survey-adjusted logistic regression models. We assessed two dichotomous outcomes: (1) whether respondents reported at least one emotional symptom (e.g., vulnerable, violated, distrustful, or unsafe) and (2) whether they reported at least one physical symptom (e.g., headaches, fatigue, or muscle tension). We define serious injury as broken bones, gunshot wounds, internal injuries, or loss of consciousness. We included demographic characteristics (age, race, sex, and educational attainment) as control variables. The results show that IPV survivors who sustained serious injuries had significantly higher odds of reporting both emotional and physical symptoms than those who did not sustain such injuries. These findings underscore how serious injury compounds the burden of IPV and emphasize the need for comprehensive medical, legal, and psychosocial interventions to address its lasting health impacts.

Violence is a major public health concern, but long-term hospital-based analyses in Latin America remain scarce. This study examined trends, structural breaks, and seasonality of violence-related emergency visits at the José Casimiro Ulloa Emergency Hospital in Lima, Peru, between 2015 and 2024. A retrospective analysis of 14,570 visits was performed, classifying cases according to the World Health Organization typology into self-inflicted, interpersonal community, and interpersonal family violence. Descriptive statistics were stratified by sex, life stage, migratory status, and pandemic period: pre-pandemic (2015–2019), pandemic (2020–2021), and post-pandemic (2022–2024). Time-series analyses included segmented regression and seasonal-trend decomposition. Males (78.3%), youth, and adults were the most affected groups. Interpersonal community violence accounted for 94.2% of cases and closely mirrored the overall series, peaking at 327 visits in July 2019 and falling to 28 in April 2020. Segmented regression showed significant immediate decreases at the onset of the pandemic (−71.6 visits, p < 0.001) and partial rebounds after 2022. Family violence remained consistently low and stable, while self-inflicted violence displayed a pre-pandemic upward trend, a sharp decline in 2020, and higher post-pandemic levels. Seasonality was evident before 2020, disappeared during the pandemic, and re-emerged with reduced amplitude thereafter. The COVID-19 pandemic caused abrupt but heterogeneous disruptions in violence-related emergency visits in Lima.