Search Results (1,095)

Background and Objectives: Outcomes after cochlear implantation are usually judged using audiological measures, although recipients’ everyday benefit also depends on psychological and social functioning. This study characterized post-implant quality of life (QoL) across six patient-reported domains in cochlear implant recipients followed at a tertiary center in Romania and explored factors associated with social integration. Methods: In this cross-sectional study, 50 consecutive cochlear implant recipients (24 children and adolescents, 26 adults) completed a validated 35-item Romanian-language questionnaire covering speech perception, psychological self-esteem, media and music, environmental sound, listening effort, and social integration, with parent-proxy completion for the youngest children. Domain scores were transformed to a 0–100 scale. Subgroup comparisons used rank-based tests, and associations with social integration were examined with Spearman correlations and an exploratory multivariable regression. Results: The median overall QoL score was 67.1 (interquartile range, 53.6–77.9). Media and music scored highest (median 85.7) and listening effort lowest (median 56.2); psychological self-esteem had a median of 66.7 (interquartile range, 50.0–79.2). QoL scores did not differ significantly by sex, age group, time since implantation, surgical approach, or SMART NAV use, although several subgroup analyses were underpowered. Psychological self-esteem showed the strongest correlation with social integration (rho = 0.56, p < 0.001) and was the only predictor with p < 0.05 in the exploratory multivariable model (B = 0.456, 95% CI, 0.117–0.795; p = 0.010; R² = 0.428). Conclusions: In this cohort, post-implant QoL varied across functional domains, with listening effort remaining a relative challenge. Social integration was more closely associated with psychological self-esteem than with individual auditory domains. These findings are exploratory and require confirmation in larger longitudinal studies with pre-implant measurements. Full article

Background: Lumbosacral discogenic syndrome (LSDS) is a common cause of low back pain (LBP) and lower limb pain (LLP) in athletes, often resulting in impaired sporting performance and delayed return to sport (RTS). Evidence regarding minimally invasive interventions, such as epidural perineural release (PNR), remains limited in athletic populations. Aim: This study aimed to compare outcomes following PNR with versus without balloon decompression neuroplasty in athletes with LSDS. Methods: We conducted a retrospective review of PNR performed between 2019 and 2024 for the treatment of LSDS among professional athletes. Demographic, clinical, and outcome data were collected from medical records and follow-up assessments. Pain intensity was assessed using the Numerical Rating Scale (NRS), while patient-reported outcomes were evaluated using the EuroQoL-5D (EQ-5D). Additional outcomes included pain-free walking, standing, and sitting durations, and self-reported health scores. Results: A total of 33 patients who had one intervention were included. Significant improvements were observed in all pain, functional, and quality-of-life outcomes following treatment (all p < 0.001). Maximum, minimum, and average pain intensity decreased from 7.5 ± 1.7 to 2.8 ± 2.2, 3.8 ± 2.3 to 0.3 ± 0.7, and 5.6 ± 1.7 to 1.5 ± 1.2, respectively. All EQ-5D domains and quality of sleep also improved significantly (all p < 0.001). Pain-free walking, standing, and sitting durations increased significantly, from 24.8 ± 23.2 to 49.7 ± 26.7 min, 18.4 ± 20.0 to 44.1 ± 23.1 min, and 25.5 ± 23.7 to 44.6 ± 24.9 min, respectively (all p < 0.001). Self-reported health scores improved from 51.9 ± 22.6 to 83.0 ± 14.3 (p < 0.001). Conclusions: Epidural perineural release, with or without balloon decompression neuroplasty, was associated by significant improvements in pain, functional capacity, and quality of life among athletes with LSDS refractory to conservative management. These findings suggest that PNR may be a promising minimally invasive treatment option; however, controlled prospective studies are required to establish its effectiveness and determine the additional benefit of balloon decompression. Full article

Background: Patients with end-stage kidney disease (ESKD) often experience significant symptom burden and reduced quality of life (QoL). This study compared these outcomes between hemodialysis (HD) and non-dialysis (ND) ESKD patients in India. Methods: A six-month cross-sectional study was conducted among 247 patients with ESKD aged ≥ 18 years, following Institutional Ethics Committee approval (IEC-214/2021). Symptom burden and QoL were assessed using the Edmonton Symptom Assessment System–Revised: Renal and EuroQol 5-Dimension 5-Level instruments. Results: HD patients reported a higher symptom burden than ND patients (81.3% vs. 65.8%), with fatigue being the most common symptom. They also had greater mobility impairment (63% vs. 45%) and lower EQ-5D-5L utility scores (0.69 ± 0.32 vs. 0.79 ± 0.27), indicating poorer QoL. Older age and lower education were associated with higher symptom burden, while poorer QoL was associated with older age, widowhood, lower education, and longer dialysis vintage (p < 0.05). Symptom burden was moderately correlated with poorer QoL (r = 0.60, p < 0.01). Conclusions: HD patients experience a greater symptom burden and poorer QoL than ND-ESKD patients. Routine symptom assessment and targeted symptom management may improve patient-centered outcomes. Full article

Background/Objectives: Chronic kidney disease (CKD) is a major cause of morbidity and mortality. Evidence on routine management and patient-reported outcomes in Greece is limited. The SPIRIT study assessed real-world treatment patterns, disease management, and quality of life (QoL) among CKD patients in Greece. Methods: This was a prospective, multicenter, observational study in Outpatient Nephrology Clinics of fifteen National Health System (NHS) Hospitals in Greece enrolling adults with estimated glomerular filtration rate (eGFR) calculated using the chronic kidney disease epidemiology collaboration (CKD-EPI) equation (CKD-EPI eGFR) between 15 and <60 mL/min/1.73 m², with a 12-month follow-up. Results: A total of 305 CKD patients participated in the study (40.0% classified as stage G3a, 39.0% G3b, and 21.0% G4), with a mean age of 69.3 years. Antihypertensives were administered to 84.3%, 84.1%, and 85.1% of patients at baseline, 6, and 12 months, respectively, mostly calcium channel blockers, while lipid-lowering agents were administered to 63.3%, 64%, and 63.2% at baseline, 6, and 12 months, respectively, predominantly statins (95.3%, 95.9%, and 96.5% of lipid-lowering users). Interestingly, renin-angiotensin-aldosterone system (RAAS) inhibitors were administered to a total of 160 patients, 91.9% of whom had hypertension, while sodium-glucose cotransporter 2 (SGLT2) inhibitors were administered to 45 patients, with 66.7% of them suffering from CKD and type 2 diabetes. SGLT2i use increased from 15.3% at baseline to 35.4% at 12 months. Mean CKD-EPI eGFR remained stable (mean 40.1, 41.3, and 40.7 mL/min/1.73 m²), while median urine albumin-to-creatinine ratio (UACR) increased from 145.2 mg/g at baseline to 253.4 mg/g at 6 months and 246.6 mg/g at 12 months. Statistically significant improvements (p < 0.05) were observed between 6 and 12 months in specific domains of the Kidney Disease QoL-Short Form (KDQOL-SF) v1.3. Conclusions: The study provides real-world evidence on stage-related treatment patterns, routine management, and QoL in CKD outpatients in Greece. Full article

Introduction: Ventral incisional hernia repair remains a significant surgical challenge, with ongoing debate regarding the optimal approach. While laparoscopic intraperitoneal onlay mesh (IPOM+) and open Rives–Stoppa techniques are widely utilized, a comprehensive understanding integrating perioperative clinical outcomes, patient-reported quality of life, and the systemic stress response is lacking. This study aimed to compare these two surgical techniques across these multifaceted domains. Methods: This prospective non-randomized comparative study enrolled 96 adult patients (n = 48 per group) undergoing elective ventral incisional hernia repair via either laparoscopic IPOM+ or open Rives–Stoppa techniques. Perioperative clinical outcomes (operative time, hospital stay, bowel function, pain, analgesic use, complications, self-reported return to daily activities) and EuraHS-QoL scores were assessed. A comprehensive panel of endocrine (cortisol, ACTH, prolactin), inflammatory (IL-6, CRP, presepsin, procalcitonin), and coagulation (D-dimer) biomarkers were measured preoperatively and on the first postoperative day. Results: Laparoscopic IPOM+ repair was associated with more favorable postoperative recovery compared to open repair, characterized by reduced pain, shorter hospital stay, faster return to daily activities and better patient-reported quality of life (all p < 0.001). No significant time-by-group interactions were observed for endocrine or coagulation markers, indicating comparable perioperative trajectories (p > 0.05), while the inflammatory response (IL-6, C-reactive protein, presepsin, and procalcitonin) differed between the two approaches. Significant time-by-group interactions were found for IL-6 (p = 0.005), C-reactive protein (p = 0.015), presepsin (p = 0.040) and procalcitonin (p = 0.006). These associations remained after adjustment for baseline age, BMI, employment status and ASA classification. However, following Bonferroni’s adjustment for multiple comparisons, the observed associations between the biomarkers and the outcome did not remain statistically significant. Conclusions: Laparoscopic IPOM+ was associated with more favorable postoperative recovery and lower one-month EuraHS-QoL scores compared to the open Rives–Stoppa repair. Although some biomarkers suggested a possible difference in the postoperative inflammatory response between the two groups, further studies are needed to determine whether these findings reflect true biological differences between the surgical techniques. Full article

Background/Objectives: We aimed to prospectively evaluate the safety, patient-reported quality of life (QoL), and early oncological outcomes of a three-fraction SBRT regimen with real-time transperineal ultrasound guidance in localized prostate cancer. Methods: This prospective single-centre study enrolled patients with localized prostate cancer of all risk groups treated with SBRT (30 Gy in three fractions) between November 2023 and October 2025. Treatment was delivered using VMAT with CBCT-based setup verification and continuous real-time transperineal ultrasound for intrafraction motion monitoring. The primary endpoint was the incidence of acute and late grade ≥ 2 genitourinary (GU) and gastrointestinal (GI) adverse events (AEs) according to CTCAE v5.0. Secondary endpoints included patient-reported QoL (IPSS, EPIC-CP, IIEF-5), biochemical recurrence-free survival (BRFS), PSA kinetics, and factors associated with treatment-related AEs. Results: Seventy-two patients (median age, 78 years; range, 56–87) were enrolled, with a median follow-up of 16 months (range, 6–27). Acute grade ≥ 2 GU and GI AEs occurred in 34.7% and 8.3% of patients, respectively; late grade ≥ 2 GU and GI AEs occurred in 13.9% and 4.2%. One acute and one late grade 3 GU event were observed, with no grade 4–5 AEs. Although several QoL scores changed significantly over time, none exceeded the threshold for clinically meaningful deterioration. Higher baseline IPSS was associated with acute grade ≥ 2 GU AEs (aOR = 1.12, 95% CI: 1.00–1.26; p = 0.045). Median PSA declined from 7.90 to 0.44 ng/mL, and estimated BRFS was 98.2% at 12 months and 96.1% at 24 months. Conclusions: Three-fraction SBRT with real-time transperineal ultrasound guidance was feasible, with severe urinary and bowel AEs remaining uncommon, and associated with preserved clinically meaningful QoL, and encouraging preliminary biochemical control in patients with localized prostate cancer across all risk groups. This regimen may represent a practical intermediate strategy between conventional five-fraction SBRT and ultra-short fractionation, warranting longer follow-up and comparative prospective evaluation. Full article

Background: Vulvar lichen sclerosus (VLS) represents a chronic inflammatory dermatosis associated with significant symptoms, architectural changes of the vulva, and impaired quality of life (QoL). Photodynamic therapy (PDT) with 5-aminolevulinic acid (5-ALA) has emerged as a potential therapeutic option for patients with disease refractory to standard topical treatments. The aim was to investigate whether PDT is associated with QoL and sexual functioning outcomes. Methods: Patients with refractory VLS were treated with PDT using a 10% 5-ALA nanoemulsion applied to affected areas and covered with an aluminum foil occlusive dressing. Participants underwent between one and six PDT sessions, each consisting of 10 min of LED illumination (37 J/cm², approximately 77 mW/cm²), delivered at 4–6-week intervals. Outcomes were assessed using the Dermatology Life Quality Index (DLQI; n = 37) and the Female Sexual Function Index (FSFI; n = 20). Results: A greater number of PDT sessions was associated with better quality of life (lower DLQI score; tau = −0.5831, adjusted p = 0.0002) and improved overall sexual function (higher FSFI score; tau = 0.5562, adjusted p = 0.0143). Analysis of individual FSFI domains showed significant positive correlations for desire (tau = 0.5125, adjusted p = 0.0166), arousal (tau = 0.4734, adjusted p = 0.0201), orgasm (tau = 0.4878, adjusted p = 0.0201), and satisfaction (tau = 0.5075, adjusted p = 0.0166), while lubrication (tau = 0.2019, adjusted p = 0.3960) and pain (tau = 0.0407, adjusted p = 0.8707) were not significantly associated with the number of PDT sessions. Conclusions: This study demonstrates an association between a higher number of PDT sessions and better quality-of-life and sexual-function outcomes in patients with refractory VLS. The findings support an individualized treatment approach guided by clinical response rather than fixed session limits. Future studies should focus on optimizing treatment protocols and identifying predictors of response. Full article

Background/Objectives: Grandparent caregiving is a common and demanding role, and perceived economic strain is among the more consistent correlates of caregiver well-being. Guided by Hill’s ABC-X family stress model, this study examined whether perceived economic strain was associated with quality of life (QoL) among U.S. caregiving grandparents through two caregiving appraisals, caregiver burden and caregiver ambivalence, and whether perceived residential area type (a single self-classification item, with higher scores indicating a more urban perception) moderated the ambivalence–QoL relation. Methods: Participants included 424 caregiving grandparents recruited through an opt-in online panel. QoL was measured with the two-item WHOQOL-BREF general facet. Storage codes for the health-satisfaction item were verified against the survey instrument; a scoring error affecting them was corrected, and all results reflect the corrected scoring. A serial mediation model (PROCESS Model 6) and a moderated serial mediation model (PROCESS Model 87) were tested, controlling for age, sex, and marital status entered as categorical indicators, with percentile bootstrap confidence intervals (5000 samples). Results: Perceived economic strain was strongly and negatively associated with QoL (total effect B = −4.64, p < 0.001; the full QoL regression model explained 38% of the variance, R² = 0.38). Greater strain was associated with greater burden, and burden with greater ambivalence, but the hypothesized negative serial pathway was not supported, and the serial indirect relation was positive and small (effect = 0.20, 95% CI [0.04, 0.41]). Perceived area type moderated the ambivalence–QoL relation (interaction B = 0.63, p = 0.002). Ambivalence was associated with lower QoL among grandparents who perceived their communities as small towns (B = −3.97) and with higher QoL among those with urban (B = 0.93) or major metropolitan (B = 1.09) perceptions. The moderation held across robustness checks, including an ordinal specification of the outcome, but did not replicate with an objective metropolitan versus nonmetropolitan indicator. Conclusions: The findings are cross-sectional, come from a relatively advantaged and nonrepresentative sample, and rest on brief measures, so causal conclusions are not warranted, and practice implications remain preliminary. Even so, the results support the idea that the meaning of caregiving ambivalence for well-being may depend on the kind of community caregivers believe they live in, and the strong relation between perceived economic strain and QoL supports continued attention to financial hardship in policies and programs serving caregiving grandparents. Full article

Background/Objectives: Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. Dietary interventions can potentially control ADHD symptoms, providing a non-pharmacological approach that may improve the quality of life (QoL). This cross-sectional study aimed to assess the association between ultra-processed food intake (UPF) and QoL in children and adolescents with ADHD in Saudi Arabia. Methods: A total of 128 participants (66% males and 33% females) diagnosed with ADHD, aged 8–18 years, were assessed. A validated Saudi food frequency questionnaire was used to assess dietary intake; the degree of food processing was assessed using a novel classification system. The health-related QoL was measured using the Pediatric Quality of Life Inventory. Results: Both the child (57.83 ± 18.12) and parent perspectives (57.97 ± 16.09) of QOL scores were lower than those of healthy norms across all domains. (p-value < 0.0001). The UPF represented the largest proportion of total energy intake (48.76 ± 13.40%), followed by unprocessed or minimally processed foods (39.80 ± 13.35%). Parent- and child-reported QoL scores were strongly correlated (p < 0.0001); both were significantly lower than the healthy normative values across all domains (p < 0.0001). Higher parental educational attainment was associated with better QoL scores from both the child’s and parents’ perspectives (p = 0.049 and p = 0.023, respectively). Conclusions: Children and adolescents with ADHD demonstrated high consumption of UPF and significantly lower QoL scores than healthy norms. No significant association was observed between UPF intake and QoL scores. Further studies are needed to better understand the factors influencing dietary quality and QoL among children and adolescents with ADHD. Full article

Background: Mothers of children with autism spectrum disorder (ASD) play a central role in coordinating multidisciplinary interventions. This study examined quality of life (QoL) among Saudi mothers of children with ASD and its associations with caregiver burden, psychological distress, financial experiences, and perceived clarity of post-diagnosis service pathways. Methods: This cross-sectional quantitative survey included an exploratory free-text component. Of 109 survey submissions, 106 contained completed core survey data. Two brief open-ended questions were presented to 60 participants; 53 provided a post-diagnosis challenge response and 46 provided a general additional comment. These responses were reviewed descriptively as supplementary contextual observations. QoL was assessed using an adapted 22-item Arabic questionnaire derived from the Arabic WHOQOL-BREF source instrument and was analysed as an adapted QoL composite rather than as standard WHOQOL-BREF domain scores. Hierarchical linear regression used a fixed complete-case sample, and regression diagnostics and sensitivity analyses were conducted. Results: Ninety-nine mothers had sufficient valid responses to calculate the adapted QoL composite (mean = 50.65, SD = 17.32, on a 0–100 metric). The hierarchical regression included 82 participants and explained 59.3% of the variance in adapted QoL (R² = 0.593; adjusted R² = 0.536). Higher caregiver burden was associated with lower adapted QoL (B = −12.94, p < 0.001), whereas higher household income (B = 3.19, p = 0.040) and greater pathway clarity (B = 6.92, p = 0.005) were associated with higher adapted QoL. Psychological distress and perceived financial burden were associated with QoL in bivariate analyses but did not show statistically significant unique associations in the multivariable model. The free-text observations referred to caregiving demands, emotional adjustment, service-navigation uncertainty, and therapy affordability; they were not treated as formal qualitative findings. Conclusions: In this cross-sectional Saudi sample, caregiver burden emerged as the factor most strongly associated with lower adapted maternal QoL, whereas higher household income and clearer post-diagnosis service pathways were associated with better QoL. These findings highlight the importance of family-centred approaches that attend to caregiving demands, affordability, and access to clear post-diagnosis guidance. Prospective research using validated or fully documented measures should examine how caregiver and service-related factors can be addressed to strengthen maternal wellbeing over time. Full article

Physical activity (PA) and sedentary behavior (SB) have emerged as modifiable factors in chronic kidney disease (CKD) patients undergoing hemodialysis (HD). The aim was to evaluate the association between PA, SB, quality of life, and mortality in patients with CKD undergoing HD. This prospective study included 167 patients who were assessed in 2023 and followed until September 2024. The long version of the IPAQ was used to assess PA and SB, and the Kidney Disease Quality of Life Short Form (KDQOL-SF 1.3) was used to evaluate health-related QoL. Survival was estimated using Kaplan–Meier curves, and a parsimonious Cox proportional hazards model. During the follow-up period, 15 patients (9.0%) died. Longer daily sitting time was independently associated with a higher mortality hazard (HR: 1.197; 95% CI: 1.026–1.396; p = 0.022), as was older age (HR: 1.055; 95% CI: 1.009–1.103; p = 0.019). MVPA was not significantly associated with mortality (HR: 1.217; 95% CI: 0.997–1.486; p = 0.054). The Active/Low SB profile showed the highest baseline QoL [median: 74.0 (IQR: 64.5–84.0)], whereas the Inactive/High SB profile showed the lowest QoL [median: 66.0 (IQR: 54.0–76.0)] and the highest mortality proportion (14.6%). However, mortality differences across the combined PA and SB profiles were not statistically significant and should be interpreted as exploratory. Baseline QoL differed significantly across profiles (p = 0.021). These findings identify prolonged sitting time as the main modifiable behavioral factor independently associated with all-cause mortality in patients undergoing HD, whereas MVPA was not independently associated with mortality. In contrast, physical activity and combined PA/SB profiles were more clearly related to health-related QoL, with the Active/Low SB profile showing the most favorable KDQOL-SF™ 1.3 scores. Therefore, reducing prolonged sedentary time may be particularly relevant to survival risk, while promoting appropriately tailored physical activity may contribute to better health-related QoL in this population. Full article

Background: Prostate cancer substantially affects patients’ quality of life (QoL). However, whether distinct QoL profiles exist among patients remains unclear. Objective: This study aimed to identify latent QoL profiles among patients with prostate cancer and explore factors associated with profile membership. Methods: A cross-sectional study included 200 patients with prostate cancer recruited from a tertiary hospital in China between May and December 2024. QoL was assessed using the Functional Assessment of Cancer Therapy–Prostate (FACT-P). Latent profile analysis was performed using Mplus 8.3, and the optimal model was selected according to information criteria, entropy, and likelihood ratio tests. Multivariable logistic regression was used to examine factors associated with profile membership. Results: LPA identified two distinct subgroups: low QoL (32.5%) and high QoL (67.5%). Medium and heavy economic burden significantly increased odds of low QoL (OR = 4.13, 95% CI: 1.13–15.02, p = 0.032; OR = 11.12, 95% CI:1.55–79.86, p = 0.017). Urinary continence markedly reduced odds of low QoL (OR = 0.08, 95% CI: 0.02–0.25, p < 0.001). Longer diagnosis-to-treatment intervals were associated with membership in the low-QoL profile (1–3 months: OR = 2.99, 95% CI: 1.26–7.08, p = 0.013; >3 months: OR = 3.36, 95% CI: 1.02–11.07, p = 0.046). Conclusions: This study identified two QoL profiles among patients with prostate cancer. The findings suggest that person-centered QoL assessment may facilitate early identification of patients with greater supportive care needs and contribute to more individualized survivorship care. Full article

Background: Spiritual wellbeing is increasingly recognised as a key area of complex oncology and palliative care, but evidence from Eastern Europe is still limited. Understanding how spiritual well-being and religiosity are related to psychological distress and quality of life can inform holistic support interventions in cancer patients. Objective: To describe spiritual well-being, religiosity, anxiety, depression, and quality of life in a Romanian cancer cohort, and to examine associations between spiritual well-being and psychological distress. Methods: A cross-sectional study was carried out in 124 cancer-stricken adults at a regional cancer centre in Romania. Participants completed FACIT-Sp-12 (spiritual well-being), RCI-10 (religious belief), HADS (depression), and EQT QLQ-C30 (QoL). Multivariable linear regression was used to determine independent predictors of outcomes in patients. Results: Participants had a median age of 65 years (53–71) and 70 (56%) patients had metastatic disease. Religious involvement was high and spirituality related to disease was commonly reinforced, with 66 (53%). There were twice as many cases of clinical depression symptoms (28%) as anxiety symptoms (14%). A median QoL score of 51 (IQR: 37–64 points) was revealed by descriptive analysis of the EORTC QLQ-C30. In adjusted multivariable models, spiritual well-being was significantly and independently associated with lower anxiety (β = −0.25, p = 0.030) and depression (β = −0.29, p = 0.013), with models accounting for 11.5% and 10.8% of variance, respectively. Global quality of life was best explained by the model (R² = 26.4%), with independent contributions from impaired ECOG performance status (β = −0.27, p = 0.006) and depressive symptoms (β = −0.22, p = 0.014), whereas religious commitment showed no independent association with any primary outcome. Conclusions: In this Romanian cohort, spiritual well-being, not religious adherence, remained independently associated with lower anxiety and depression, suggesting that spiritual well-being is associated with better psychological health among cancer patients. Religious affiliation has not been shown to be independent of any outcome, a difference with direct implications for the screening of spiritual care. Global quality of life, on the other hand, was independently associated with both physical functional status (ECOG) and depressive symptom burden, rather than with spiritual or religious factors, underlining that both functional decline and psychological distress remain central to cancer-related quality of life. Full article

Background: Work-related musculoskeletal disorders impose substantial global burdens. Although Pilates is a recognized biopsychosocial intervention, a quantitative synthesis evaluating its occupational efficacy remains limited. Objective: To compute the pooled effect sizes of workplace Pilates interventions on musculoskeletal pain intensity, functional disability, muscular endurance, and health-related quality of life (QoL). Methods: Twelve randomized controlled trials (14 reports) involving diverse occupational cohorts were analyzed. Data dependency was resolved via outcome aggregation. Random-effects models calculated pooled effect sizes (Hedges’ g), 95% confidence intervals (CI), and 95% prediction intervals (PI). Risk of bias was assessed using RoB 2. Results: The meta-analysis demonstrated a moderate, statistically significant reduction in functional disability (g = −0.660, 95% CI [−1.091, −0.229], p = 0.011). Conversely, pooled estimates for pain intensity (g = −0.461, p = 0.360), muscular endurance (g = 1.354, p = 0.223), and QoL (g = −0.146, p = 0.815) were non-significant. Substantial heterogeneity was observed (I²: 32.02–98.25%), and all prediction intervals crossed the null, indicating high uncertainty regarding future effects. Conclusions: Workplace Pilates consistently mitigates functional disability, but current evidence does not support significant pooled improvements in absolute pain, endurance, or QoL. This divergence between functional recovery and pain reduction aligns with biopsychosocial frameworks, suggesting improved work capacity despite variable pain relief. Given the high heterogeneity and wide prediction intervals, findings must be interpreted cautiously, highlighting the need for rigorously standardized trials. Full article

Background: Low-intensity ultrasound (LIUS) has been proposed as a non-invasive approach to modulate cerebrospinal fluid movement, glymphatic–lymphatic clearance, and amyloid-beta (Aβ) handling in Alzheimer’s disease (AD). However, clinical comparisons in amyloid biomarker-confirmed patients receiving standard pharmacotherapy remain limited, and the short-term cognitive domains most likely to change after LIUS remain uncertain. Objective: The objective of this study was to compare 4-week changes in cognitive function, executive function, quality of life, and neuropsychiatric symptoms between amyloid PET-positive patients receiving add-on LIUS with donepezil-based standard treatment and those receiving donepezil-based standard treatment alone. Methods: This retrospective exploratory comparative cohort study included amyloid PET-positive patients with mild cognitive impairment or early AD who received donepezil-based standard treatment. The treatment cohort received 4 weeks of add-on LIUS at Dongtan or Bundang centers, whereas the comparator cohort received donepezil-based standard treatment alone at Soonchunhyang. Outcomes were changes from baseline to 4 weeks in Trail Making Test A (TMT-A), Trail Making Test B (TMT-B), Mini-Mental State Examination, Second Edition (MMSE-II), Quality of Life in Alzheimer’s Disease (QoL-AD), and Neuropsychiatric Inventory (NPI). Group differences were examined using unadjusted change-score comparisons and stabilized inverse probability of treatment weighting (IPTW). Results: The full analysis set included 51 amyloid PET-positive participants receiving donepezil-based standard treatment: 20 who additionally received LIUS and 31 who received standard treatment alone. Compared with controls, the add-on LIUS group showed greater improvement in TMT-A completion time in unadjusted analysis (−20.0 ± 31.3 s vs. −0.1 ± 5.6 s; p = 0.011), and this association remained significant after IPTW adjustment. TMT-B showed a favorable but less robust pattern, with borderline findings in the primary Fail-excluded analyses and a significant result in the Fail = 300 sensitivity analysis. MMSE-II change did not differ between groups. NPI improved more in the add-on LIUS group in unadjusted analysis, although this finding was exploratory. Conclusions: In amyloid PET-positive patients receiving donepezil-based standard treatment, 4 weeks of add-on LIUS was associated with short-term improvement in TMT-A performance compared with standard treatment alone, while MMSE-II remained unchanged. The findings suggest a preliminary signal for processing-speed or visual-search improvement and support prospective randomized sham-controlled studies with harmonized cognitive testing and biomarker endpoints. Full article