Search Results (1,326)

Background: Therapeutic exercises have gained great prominence due to the benefits shown in the treatment of knee osteoarthritis (OA). However, to date, there is no evidence on the effects of an exercise program combined with balance and gait training with visual feedback. Objective: To evaluate the therapeutic effect of an intervention program combining lower-limb muscle strengthening, balance training, and gait exercises with visual feedback on the chronic pain, functional, and biomechanical aspects of older women with and without OA knee. Methods: Clinical trials study with stratified allocation based on disease status (two-arm, triple-blind—assessor, interventionist, and data manager, parallel-group). In total, 40 older women were recruited: 20 in the OA knee group (OAG, n = 20) and 20 in the control group (CG, n = 20). The intervention included a muscular resistance training program in the lower limbs, and reactive and proactive balance and gait training associated with visual feedback. Both groups received the same intervention. The primary outcomes were pain measured by the Visual Analogue Scale and the questionnaires Western Ontario and McMaster Universities Osteoarthritis Index and Lequesne Algofunctional Index. The secondary outcomes were the six-minute walk test, the Falls Risk Awareness Questionnaire, the Timed Up and Go Test, plantar load distribution during gait, and patients’ acceptability. Results: The intervention was effective in improving pain and increasing functionality in older women with OA knee, as measured pre- and post-intervention, compared to the control, with a moderate to high effect size. Body balance increased in older women with OA, as indicated by perceptions of fall risk and walk-test pre- and post-intervention. During gait, a reduction in plantar load (midfoot and rearfoot areas) was observed pre- and post-intervention in OAG compared to the CG. Both groups showed excellent acceptability, suitability, and feasibility of the intervention program. Conclusions: The intervention protocol was effective over 2 consecutive months in reducing pain and increasing knee functionality, balance, walking distance, and perception of falls in older women with OA of the knee compared with women without the condition. During gait, when visual feedback was combined with the intervention protocol, it promoted a better distribution of plantar load over the midfoot and the medial and lateral rearfoot regions in older women with knee OA. Clinical Trial: ReBEC (RBR-5w67pz4). Ethics Committee approval (number: 4.091.004). Full article

Background/Objectives: The growing population of stroke survivors living in rural communities, who require ongoing rehabilitation, highlights the need for effective, home-based rehabilitation methods. The aim of this study was to evaluate the potential benefits of Proprioceptive Neuromuscular Facilitation (PNF) on segmental and global motor function, gait performance, Activities of Daily Living (ADLs), and quality of life in a patient with chronic hemiplegia living at home. Methods: A 71-year-old woman, five years after an ischemic stroke of the left cerebral hemisphere, presented with severe right-sided hemiplegia and participated in a two-month home-based PNF rehabilitation programme consisting of 20 one-hour sessions delivered 2–3 times per week. To evaluate the effectiveness of the intervention, the following standardised outcome measures were used in given order: Fugl-Meyer Assessment of Lower Extremity (FMA-LE), Trunk Impairment Scale (TIS), Timed Up and Go Test (TUG), Rivermead Motor Assessment Scale (RMA), Barthel Scale (BS), and the Short Form Health Survey (SF-36). Results: Improvements were observed in lower limb motor function (FMA-LE), gait performance (TUG), and overall quality of life (SF-36). Conclusions: PNF-based physiotherapy delivered at home environment may provide meaningful benefits for patients living in rural areas, even years after stroke. Full article

Historic department stores are an underexamined lever for circular, low-carbon urban transition. This study tests whether Langston’s Adaptive Reuse Potential (ARP) can be applied retrospectively and how contextual readiness shapes the timing of interventions. Using the Renoma Department Store in Wroclaw, Poland (1930–2025), we reconstruct five adaptive phases and combine expert scoring of seven obsolescence dimensions (O1–O7) with a Readiness index covering finance, governance/approvals, use commitment, delivery/supply chain, and policy priority. Decision windows are interpreted via a WAIT–PREPARE–GO lens. Results show that peaks in ARP and Readiness aligned with major reinvestments—post-war reconstruction, socialist modernisation, and post-EU-accession renewal—while the original steel frame retained high structural reserves, indicating that timing was driven more by institutional and economic conditions than by technical decay. We propose ARP as an interpretive lens for circular regeneration and show that the Readiness index clarifies feasibility and risk. The combined ARP × Readiness approach yields a replicable, phase-sensitive diagnosis of adaptive capacity and intervention timing, contributing evidence to circular city practice and aligning with New European Bauhaus principles of sustainability, inclusion, and quality of place. Full article

Background: CrossFit could be an innovative alternative for older adults. Traditional strength training is well-established for safety and progressive overload, while concerns exist about overexertion or poor technique in modified CrossFit, especially for those with musculoskeletal or cardiovascular conditions. However, scaled and supervised CrossFit sessions have shown low injury rates and high satisfaction among older adults. Objective: to evaluate the effects of a CrossFit-adapted program on balance and muscular power. Methods: 60 older adults participated in the study. Participants were randomized into two groups: CrossFit-adapted and control. Functional capacity, balance and strength variables were analyzed. The sample size was calculated a priori using G*Power 3.1 software, considering an effect size of 0.25 [medium], α = 0.05, and a power [1–β] of 0.80 for a repeated-measures ANOVA with two groups and three measurement points. Data were analyzed using SPSS Statistics version 25. Results: Significant improvements in balance scores were observed in the CrossFit group compared to the control group. In the Timed Up and Go test, the CrossFit group improved from 9.83 ± 1.3 s to 8.74 ± 1.1 s, [p = 0.002]. Lower limb muscle power increased significantly in CrossFit group across all tests: chair stand test, the stair ascent and stair descent [p < 0.001]. Conclusions: A CrossFit-adapted program can significantly improve functional capacity, balance, and strength in older adults. Full article

Increasing evidence demonstrates that long noncoding RNAs (lncRNAs) are crucial for brain evolution and proper development and function of the central nervous system (CNS), exhibiting specific time-, spatial-, and sex-biassed expression patterns. This study investigated whether region-specific spatial expression patterns of brain-relevant lncRNAs are conserved between the mouse and human CNS. Demonstrating such cross-species conservation informs the translational value of mouse models for lncRNA biology. To test this, the expression of 14 lncRNAs was studied in the adult CNS of mice and humans across three different regions (spinal cord, brainstem, and frontal cortex), and age effects were assessed in mice. The results demonstrated conserved expression patterns between the two species, with region-specific changes. The frontal cortex exhibited high expression of Meg3, Miat, and Pvt1 lncRNAs, while the spinal cord showed high levels of Hotair and Gas5. Additionally, Malat1 displayed lower levels in females compared to males in the spinal cord compared to other regions. Finally, through GO functional enrichment analysis and literature review, this study emphasizes the role of lncRNAs in CNS physiology and disease, suggesting their involvement in neurological processes and conditions such as cortical development, neuronal synapsis, schizophrenia, Alzheimer’s, Parkinson’s, and amyotrophic lateral sclerosis. Overall, this research highlights the importance of further investigating the role of lncRNAs in brain function and their potential as key players in neurological disorders, opening the door to explaining the high region- and sex-specific effects of these disorders. Full article

Background: There is a critical need for feasible, non-equipment based, safe, and cost-effective exercise interventions to promote muscle strength, dynamic postural balance, and independent mobility in adolescents with cerebral palsy (CP) or spina bifida (SB). Objectives: This study aimed to examine the feasibility and preliminary response of a novel exercise program: Functionally Loaded High-Intensity Circuit Training (FUNHIT) and conventional High-Intensity Circuit Training (HIT) in adolescents with CP/SB. Methods: Enrolled participants were allocated to FUNHIT or HIT or Controls in our randomized control trial. The interventions were delivered 2×/week × 4 weeks. Feasibility was assessed through process, operational, and scientific metrics. Outcome measures included maximum walking speed, Four Square Step Test (FSST), Timed Up and Go (TUG) and its dual-task variants, Lateral Step-Up Test (LSUT), Fear of Falling (FoF) and physical activity (PA) questionnaires. Results: We tested 5 participants (1 CP, 4 SB) in our study. Recruitment and retention rates were acceptable (63% enrollment, 100% retention and adherence). FUNHIT (n = 2) participants showed improvements in maximum walking speed (8–12%), FSST (15–29%), LSUT (22–33%), and TUG (4%). The HIT participant (n = 1) demonstrated improved TUG dual-task performance (40%) and FSST (30%) only. Control participants (n = 2) had varied changes (from 0–24%) in mobility, strength, balance. No adverse events were reported. Participants successfully followed (100%) the prescribed exercise dosage over the four-week period. Conclusions: FUNHIT and HIT are feasible and safe interventions for adolescents with ambulatory CP and SB who retain motor function, showing promising preliminary improvements in muscle strength, dynamic balance, and independent mobility. Our findings need to be validated in larger samples. Full article

Background/Objectives: Task-oriented training (TOT) is a functional, goal-directed rehabilitation approach that promotes motor recovery after stroke through repetitive, task-specific practice; however, its overall effects on gait and balance in stroke survivors remain unclear. This systematic review- and meta-analysis-based study aims to evaluate the effects of TOT on gait and balance in patients with stroke. Methods: Comprehensive searches of PubMed, Embase, Web of Science, the Cochrane Library, and Scopus were performed. Eligible studies involving TOT interventions in patients with stroke were included, and methodological quality was assessed using the PEDro scale. A random-effects meta-analysis was then performed to estimate pooled effect sizes. Results: In total, 17 randomized controlled trials involving 888 participants were included. Compared with control interventions, TOT significantly improved gait speed (standardized mean difference [SMD] = 0.48, 95% confidence interval [CI]: 0.27–0.69, p < 0.0001), gait endurance (SMD = 0.49, 95% CI: 0.27–0.71, p < 0.0001), Berg Balance Scale (BBS) (SMD = 0.45, 95% CI: 0.08–0.82, p = 0.02), and timed up and go test performance (SMD = −0.28, 95% CI: −0.47 to −0.09, p = 0.003). Subgroup analysis of the BBS revealed differences based on stroke phase. Conclusions: Task-oriented training effectively improves gait and balance in stroke survivors and should be considered a key component of post-stroke rehabilitation. Future studies should explore its long-term effects and determine optimal training parameters according to stroke phase and patient characteristics. Full article

Hemophilia B is a hereditary bleeding disorder caused by mutations localized throughout the F9 gene. Existing gene therapy products containing AAV vectors have significant limitations. Replacement therapy with coagulation factor FIX infusions is not an optimal way of treatment, as patients still have periodic bleeding and require frequent transfusions. Moreover, approximately 5% of adult patients with hemophilia B develop inhibitory antibodies to recombinant forms of FIX. Therefore, it is important to develop universal CRISPR/Cas gene therapy approaches for F9 editing using non-viral delivery systems to enable gene reversion to a functional sequence at an early stage of disease development and establishment of the patients’ immune system. In this study, a unique approach of F9 prime-editing was tested for the first time. This method is estimated to edit 7.3% of pathogenic F9 mutation types. Specifically, it targets the gene region encoding amino acids 374 V to 408 Q, which accounts for approximately 9.35% of patients with hemophilia B. An advantage of this gene therapy approach is the absence of the need to change Primer Binding Site (PBS) or Reverse Transcriptase Template (RTT) sequences until going from preclinical to clinical trials, as well as the introduction of gain of function mutations in order to compensate for the low prime-editing frequencies and enhance the effect of treatment in vivo. Full article

A one-size-fits-all approach to fall risk assessment in older adults has critical limitations. This study aimed to overcome this by identifying distinct gait phenotypes and their specific fall mechanisms using foot-mounted IMU waveform data from 146 older adults (mean age 82.6 ± 6.2 years). A data-driven clustering algorithm identified four phenotypes (Robust, High-cadence, Intermediate, and Cautious), each with different fall prevalence rates (27–68%). Interpretable machine learning (SHAP) revealed that fall trajectories were phenotype-dependent. While physiological declines such as gait speed were the primary cause of falls in the Cautious group, fear of falling (FES-I) was the primary cause in the physically healthy Robust group, suggesting a psychological pathway. Consequently, the optimal Timed Up and Go (TUG) test screening cutoff varied across phenotypes, ranging from 11.95 s to 14.00 s, demonstrating the limitations of a one-size-fits-all approach. These findings demonstrate that fall mechanisms are phenotype-dependent, underscoring the necessity of a personalized assessment strategy to improve fall prevention. Full article

Objective: This study aimed to investigate the effects of dual-task stroboscopic visual training (DTSVT) on balance, functional mobility, and gait in children who are hard-of-hearing. Methods: This randomized controlled study included 31 children (17 girls, 14 boys) with congenital sensorineural hearing loss. Participants were assigned to one of three groups: control group, conventional balance training (CBT) group, and DTSVT group. The CBT and DTSVT groups participated in an exercise program for 16 weeks, twice weekly, for 40 min (a total of 24 sessions). Static balance was assessed using the Tandem Romberg test and Single-Leg Stance (SLS) test, while dynamic balance was evaluated using the Functional Reach Test (FRT), balance disc test, and the Four Square Step Test (FSST). The Pediatric Balance Scale (PBS) was used as a subjective balance assessment. Functional mobility was assessed using the Timed Up and Go (TUG) Test, Step Test, 10 m Walk Test (10 MWT), and Functional Gait Assessment (FGA). Postural sway parameters were recorded using the GyKo device, including Sway Area (EA, cm²), Distance Length (DL, cm), Length (anterior–posterior (AP)) (cm), Length (medial–lateral (ML)) (cm), Mean Distance (D) (cm), Mean Distance (AP) (cm), and Mean Distance (ML) (cm). Results: Significant between-group differences were primarily observed in favor of the DTSVT group post-treatment, particularly in PBS scores, GyKoDL values during the eyes-open SLS test, and TUG test completion times (p < 0.05). Some baseline differences were noted among groups in functional reach distance, FSST completion time, and eyes-closed duration on the Balance Disc test (p < 0.05). Within-group comparisons revealed significant improvements in FSST times in both intervention groups, reduced postural sway parameters during the FRT in the DTSVT and control groups, and increased eyes-closed Tandem Romberg duration in the CBT group (p < 0.05). Most other outcome measures did not demonstrate statistically significant changes either within or between groups (p > 0.05). Conclusions: Dual-task stroboscopic visual training was more effective than conventional balance training in improving specific aspects of balance and functional mobility in children who are hard-of-hearing. These findings highlight the potential of adding cognitively demanding and visually engaging balance tasks to rehabilitation programs for this population. Larger and more diverse samples in future studies are needed to enhance the generalizability of these results. Studies that assess balance and gait using standardized clinical or laboratory tests may be particularly valuable. Given the small sample size and multiple comparisons, the results should be considered preliminary and exploratory. Full article

Background: Knee osteoarthritis (OA) is a leading cause of disability globally. Conventional physiotherapy, while effective, faces barriers including accessibility and adherence. Telerehabilitation augmented by wearable sensor technology and AI-driven feedback offers a scalable alternative. Objective: This pilot randomized controlled trial compared the feasibility, safety, and preliminary clinical effectiveness of a sensor-based telerehabilitation protocol using the KneE-PAD patient monitoring approach which was also combined with an avatar-guided visual feedback add-on tool. Although this approach is capable of AI-driven postural error detection, this feature was not enabled during the current study, and feedback was provided solely through visual cues. Methods: Twenty adults with radiographically confirmed Kellgren–Lawrence grade 1 to 3 knee OA were randomized into two groups (Control/Intervention groups, n = 10 in each). The control group received in-person physiotherapy, while the intervention group engaged in remote rehabilitation supported by wearable sEMG and IMU sensors. The 8-week program included supervised and home-based sessions. Primary outcomes were WOMAC scores (Functionality/Pain), quadriceps strength, and sEMG-derived neuromuscular activation. Secondary outcomes included Timed Up and Go test (TUG), psychological measures (HADS, TSK), and self-efficacy measure (ASES). Analyses employed both parametric and non-parametric statistics including an effect size estimation. Results: Both groups demonstrated significant improvements in WOMAC total scores (Intervention: −11.8 points; Control: −6.4 points), exceeding the minimal clinically important difference (MCID) for knee OA. Strength and mobility also improved significantly in both groups, with the Intervention group showing superior gains in sEMG measures (RMS: p = 0.0077; Peak-to-Peak: p < 0.005), indicating enhanced neuromuscular adaptation. TUG performance improved more in the intervention group (–3.17 s vs. –2.57 s, p = 0.037). Psychological outcomes favored the control group, particularly in depression scores (HADS-D, t(18) = 2.37, p = 0.03). Adherence was high (94.8%), with zero attrition and no adverse events. Conclusions: The KneE-PAD monitoring approach offers a feasible and clinically effective alternative to conventional physiotherapy, enhancing neuromuscular outcomes through real-time sensor feedback. These findings support the viability of intelligent telerehabilitation for scalable OA care and inform the design of future large-scale trials. Full article

Background: Opioid use disorder (OUD) and associated overdose deaths have reached epidemic proportions worldwide over the past two decades, with death rates for men consistently reported at twice the rate for women. We have recently reported sex-specific differences in electrocortical activity in persons with OUD in a visual object recognition task. The mesolimbic dopamine (DA) system is implicated in OUD but also plays a critical role in some disorders of visual attention and a modulatory role in the processing of visual stimuli in the blue cone pathway of the retina. We hypothesized that electrocortical responses to color stimuli would be affected differentially in men and women with OUD. Methods: Using a controlled, cross-sectional, age-matched (18–56 years) design, we evaluated color processing in male and female subjects recruited from a community-based, high-intensity residential substance abuse and detoxification treatment program. We evaluated electroencephalogram (EEG) event-related potentials (ERPs) and reaction time (RT), in male and female participants with OUD (n = 38) vs. sex- and age-matched non-OUD control participants (n = 37) in a simple color recognition Go/No-Go task, as well as perceptual and behavioral responses in physiological and neuropsychological tests. Results: N200, P300, and late potential (LP) Relevant stimulus-induced ERPs were evoked by the task and were well-differentiated from Irrelevant distractor stimuli. P300 amplitudes were significantly greater and N200 and LP latencies were significantly shorter in male vs. female non-OUD controls in this task. There were significant sex differences in N200, P300, and LP amplitudes and latencies between male vs. female non-OUD subjects and OUD differences with blue color as the Relevant stimulus. In the Binocular Rivalry Test, there were shorter dwell times for perceiving a blue stimulus in male OUD subjects and there were significant sex and OUD differences in neuropsychological tests including Finger Tapping, Trails A/B, and Symbol Digit Modalities Test. Conclusions: These findings suggest that there are significant sex-related physiological, perceptual, and cognitive differences in color processing that may result from deficits in DA production in the retina that mirror deficits in mesolimbic DA transmission correlating with OUD, suggesting that blue color processing has the potential to be an effective biomarker for brain DA and for diagnosis and monitoring of treatment efficacy in substance use disorders. Full article

Background/Objectives: Gait performance in aging relies heavily on cognitive resources, yet the extent to which short-term interventions can mitigate dual-task costs in institutionalized populations remains understudied. This study aimed to compare single and dual-task gait performance between older adults with and without suspected cognitive impairment and to evaluate the effects of an 8-week multicomponent exercise program on functional mobility. Methods: Institutionalized older adults (n = 42) were stratified into two groups: suspected cognitive impairment (n = 26) and no suspected impairment (n = 16), based on MMSE and Clock Drawing Test screening. Participants performed the Timed Up and Go (TUG) and Dual-Task TUG (TUG-DT) at baseline and post-intervention. Results: At baseline, the suspected impairment group exhibited significantly poorer performance on both tests (p < 0.001) compared to the non-impaired group. Following the 8-week intervention, the suspected impairment group demonstrated large, significant improvements in both TUG (r = −0.73) and TUG-DT (r = −0.59), whereas the non-impaired group remained stable. Notably, while the single-task TUG showed the greatest responsiveness to the exercise program, the TUG-DT continued to reveal a significant cognitive-motor load. Conclusions: Multicomponent exercise effectively enhances functional mobility in cognitively vulnerable older adults, reversing declines in both single and dual-task conditions. Significance: These findings support the implementation of dual-task screening to unmask latent functional deficits and validate the use of accessible, short-term multicomponent exercise programs as a vital strategy to preserve autonomy in institutionalized older adults. Full article

Background: Ageing leads to physical, cognitive, and social changes that affect people’s functioning and social participation. Health literacy, sociodemographic, and environmental factors influence health outcomes and access to care. This study aimed to characterize the health and functioning of Portuguese adults aged 65 and over, focusing on sociodemographic factors, health status, lifestyle, fall risk, functional capacity, and social participation, and on comparing rural and urban populations. Materials and Methods: An exploratory, cross-sectional study was conducted using data from older adults who completed the FallSensing screening protocol. Participants were classified by residence type (rural vs. urban), and group comparisons were made. Results: The sample (n = 474) was predominantly female (66.5%) with a mean age of 74.62 (±6.49) years. Rural participants were older (76.87 ± 6.89 vs. 73.50 ± 5.87) and had higher body mass index (BMI) (28.32 ± 4.31 vs. 27.51 ± 4.12), lower educational attainment—for example, 22.9% had no formal education compared to 7.0% of urban participants—and a higher prevalence of hypertension (72.6% vs. 55.4%), whereas urban participants experienced higher rates of osteoporosis (24.4% vs. 14.3%), hearing loss (41.9% vs. 26.9%), and alcohol consumption (12.7% vs. 2.3%) (p ≤ 0.05). Rural residents also demonstrated significantly poorer results for grip strength (21.03 ± 7.36 vs. 23.73 ± 8.61), gait speed (1.17 ± 0.44 vs. 1.45 ± 0.39), and the Timed Up and Go (TUG) test (13.4 ± 10.40 vs. 9.62 ± 4.43), as well as lower exercise self-efficacy (12.83 ± 4.97 vs. 14.28 ± 4.40) (p < 0.001), and more pronounced moderate-to-severe restrictions in social participation (28.0% vs. 15.7%) (p = 0.013). They reported greater use of assistive devices and more severe limitations in social participation. Although falls were reported more often in urban areas, rural residents experienced greater fall frequency. Conclusions: These findings suggest that rural living is associated with lower functional capacity and poorer health, underscoring the need for targeted physiotherapy and primary care strategies in rural settings. Full article

The high use and improper disposal of chloroquine (CQ) during the COVID-19 pandemic have significantly increased its presence in water bodies, representing an environmental risk. Adsorption is one of the most-used treatments to remove recalcitrant compounds, although there is still a lack of efficient biosorbents. This work aimed to develop an efficient biosorbent using additive manufacturing (AM) to synthesize bionanocomposite hydrogels based on cellulose fibers, sodium alginate (SA), and graphene oxide (GO) for CQ adsorption. The hydrogels were characterized by mechanical, morphological, and physicochemical techniques. Results show that increasing GO content and reducing water contributed to higher yield stress, which is important for maintaining shape fidelity during the printing. SEM images evidenced thin GO layers interacting with the polymer matrix and cellulose fibers, resulting in 3D disordered porous microstructures. The adsorption capacity of the 3D-printed hydrogel samples for aqueous CQ was analyzed by evaluating the pH effect, contact time, and the adsorption equilibrium isotherms, showing notorious potential for CQ removal, with maximum adsorption capacity of ~25 mg∙g⁻¹ at 25 °C. Results show that the tested formulations were stable for producing hydrogels and efficient on chloroquine adsorption, revealing their potential as novel adsorbents for removing emerging organic pollutants from water. Full article