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Search Results (2,869)

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Keywords = activities of daily living

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18 pages, 599 KB  
Article
Relationships Among Functional Status, Global Self-Reported Categorical Measure of Activity Level, Health-Related Quality of Life and Psychological State in Patients with Parkinson’s Disease in Greece
by Anna Christakou, Nektaria Angeliki Komisopoulou, Amalia Panagiota Louka and Vasiliki Sakellari
Brain Sci. 2026, 16(1), 90; https://doi.org/10.3390/brainsci16010090 - 15 Jan 2026
Viewed by 42
Abstract
Background/Objectives: Parkinson’s disease is the second most common neurodegenerative disorder, affecting patients’ daily lives in multiple domains, including functional status, health-related quality of life, and psychological well-being. This study examined the relationship between self-reported global activity level, functional status, Health Related QoL [...] Read more.
Background/Objectives: Parkinson’s disease is the second most common neurodegenerative disorder, affecting patients’ daily lives in multiple domains, including functional status, health-related quality of life, and psychological well-being. This study examined the relationship between self-reported global activity level, functional status, Health Related QoL (HRQoL), and psychological state among patients with Parkinson’s disease in Greece. Methods: Thirty volunteers (mean age = 69.07, SD = 11.24), members of the Greek Parkinson’s Patients and Caregivers Association, completed (a) the Parkinson’s Disease Questionnaire to evaluate HRQoL and (b) the Hospital Anxiety and Depression Scale (HADS) to assess psychological state. Participants then performed (a) the Five Times Sit to Stand Test (FTSST) and (b) the Berg Balance Scale (BBS) to evaluate functional status. All questionnaires and the test used in the present study have been validated in Greek. Correlation analysis with Spearman r tests with Bonferroni correction was performed between the above variables. Subsequent linear regression models were used to identify independent predictors of HRQoL and balance using SPSS 29.0.2.0. Results: Participants reported elevated anxiety (M = 9.67, SD = 4.44) and depressive symptoms (M = 8.97, SD = 4.08), alongside relatively high HRQoL scores (M = 40.09, SD = 18.40). Impaired functional performance was observed, with 22 participants failing to complete the FTSST within 16 s and 16 scoring below 40 on the BBS. Functional status was strongly correlated with HRQoL (r = −0.696, p < 0.001) and activity level (r = −0.521, p < 0.008). Depression was also significantly associated with poorer HRQoL (r = 0.618, p < 0.008) and lower activity levels (r = −0.545, p < 0.008). Regression analyses revealed that balance (β = −0.526), disease duration (β = 0.437), anxiety (β = 0.411), and lower limb function (β = −0.351) were significant independent predictors of HRQoL (R2 = 0.785; F(9, 20) = 12.69; p < 0.001), while HRQoL (β = −0.738) and lower limb function (β = −0.391) independently predicted balance (R2 = 0.699; F(9, 20) = 4.72; p = 0.002), suggesting a bidirectional relationship between physical function and subjective well-being. Conclusions: Activity level, HRQoL, functional status, and psychological state in patients with Parkinson’s disease are interrelated factors. Increased levels of anxiety and depression, as well as reduced HRQoL, were observed. The findings point to a potentially reinforcing cycle between poor balance and diminished quality of life, with anxiety and age playing key roles. Overall, the results illustrate that functional, psychological, and HRQoL measures interact in complex ways, emphasizing the multidimensional profile of patients with Parkinson’s disease. Further studies with larger samples are required to confirm these findings. Full article
(This article belongs to the Section Neurodegenerative Diseases)
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8 pages, 211 KB  
Article
Sex-Based Differences in Patient-Reported Outcome Measures Are Not Present Three Months After ACL Reconstruction
by Abdulmajeed Alfayyadh, Jack R. Williams, Kelsey Neal, Ashutosh Khandha, Lynn Snyder-Mackler and Thomas S. Buchanan
J. Clin. Med. 2026, 15(2), 680; https://doi.org/10.3390/jcm15020680 - 14 Jan 2026
Viewed by 81
Abstract
Background: Patient-reported outcome measures (PROMs) provide important insights into recovery after anterior cruciate ligament reconstruction (ACLR). Previous research suggests that males and females recover differently after ACLR, with females reporting greater pain, slower functional gains, and lower psychological readiness at later stages of [...] Read more.
Background: Patient-reported outcome measures (PROMs) provide important insights into recovery after anterior cruciate ligament reconstruction (ACLR). Previous research suggests that males and females recover differently after ACLR, with females reporting greater pain, slower functional gains, and lower psychological readiness at later stages of rehabilitation. However, it is unknown if patient-reported outcomes differ by sex early after ACLR. To address this gap, we conducted a cross-sectional analysis comparing patient-reported outcome measures between sexes three months after ACLR. We hypothesized that females would report worse PROMs compared to males. Methods: This cross-sectional analysis used data from a prospectively maintained ACL reconstruction cohort. Fifty-six individuals (female: 23 and male: 33) with primary, unilateral ACLR completed PROMs three months after surgery. These PROMs included the Knee Injury and Osteoarthritis Outcome Score (KOOS; Symptoms, Pain, Activities of Daily Living, Sport and Recreation, Quality of Life), International Knee Documentation Committee (IKDC) subjective score, Knee Outcome Survey–Activities of Daily Living Scale (KOS-ADLS), Anterior Cruciate Ligament–Return to Sport After Injury (ACL-RSI), and the Tampa Scale of Kinesiophobia (TSK). All outcomes were expressed on a 0 to 100 percent scale, with higher scores indicating better outcomes, except for TSK, where lower scores indicated better outcomes. Normality was assessed within sex, using the Shapiro–Wilk test. Two-tailed independent-samples t-tests with Welch correction were used for approximately normal variables; otherwise, Mann–Whitney U tests were utilized (α = 0.05). Several outcomes had limited statistical power to detect MCID-sized differences, and findings for these measures should be interpreted cautiously. Results: No significant differences between sexes were found for any of the PROMs. Males trended towards having better KOOS Sport and Recreation and IKDC, but these were not statistically significant, and the effect sizes were small-to-moderate. Conclusions: No statistically significant sex-based differences were detected in PROMs at approximately 3 months after ACLR, indicating that any sex-related divergences between these measures may not occur until later in recovery. Full article
13 pages, 639 KB  
Article
Fracture Occurrence Within FRAX-Defined High-Risk Myasthenia Gravis: An Exploratory Stratification by Age and Activities of Daily Living
by Takafumi Uchi and Shingo Konno
J. Clin. Med. 2026, 15(2), 672; https://doi.org/10.3390/jcm15020672 - 14 Jan 2026
Viewed by 83
Abstract
Background/Objectives: Patients with myasthenia gravis (MG) are at increased risk of osteoporotic fractures due to long-term oral corticosteroid use and disease-related muscle weakness. FRAX® estimates 10-year fracture probability but does not incorporate falls or MG-specific functional impairment. To explore heterogeneity of [...] Read more.
Background/Objectives: Patients with myasthenia gravis (MG) are at increased risk of osteoporotic fractures due to long-term oral corticosteroid use and disease-related muscle weakness. FRAX® estimates 10-year fracture probability but does not incorporate falls or MG-specific functional impairment. To explore heterogeneity of fracture occurrence within MG patients classified as high risk by FRAX major osteoporotic fracture (MOF) probability. Methods: In a single-center retrospective cohort of 68 MG patients assessed in 2012, FRAX MOF with femoral neck BMD was calculable in 54 patients; the 29 patients with FRAX MOF ≥ 9.0% (the median of these 54 patients) comprised the high-FRAX cohort. Patients were stratified by the cohort medians of age (67 years) and MG-ADL (2 points) into four strata (HH, HL, LH, LL). This median-based stratification was exploratory and not intended as a clinically meaningful threshold. The primary outcome was time to first MOF (up to 10 years). We compared fracture occurrence using both proportions and Kaplan–Meier analyses (log-rank test) and performed exploratory univariable Cox models for selected predictors. No multivariable confounder adjustment was performed. Results: Eight of twenty-nine patients (27.6%) experienced an MOF. The proportions with MOF were HH 25.0%, HL 40.0%, LH 57.1%, and LL 0.0% (global p = 0.068). Kaplan–Meier curves differed across strata (log-rank p = 0.03), with separation most evident between LH and LL. For univariable Cox analyses, age was associated with shorter time to MOF (hazard ratio [HR] 1.13 per year, p = 0.041), and baseline difficulty rising from a chair (MG-ADL item) was associated with higher hazard rates (HR 3.45, p = 0.048). Conclusions: In this small, selected high-FRAX MG cohort, fracture events appeared to cluster in patients with impaired ADL and fall-related MG-ADL abnormalities, whereas FRAX values remained strongly age-driven. These findings are exploratory and hypothesis-generating and should not be interpreted as evidence of FRAX miscalibration; confirmation in larger, prospectively followed cohorts is needed. Full article
(This article belongs to the Section Clinical Neurology)
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22 pages, 1317 KB  
Systematic Review
High-Intensity Laser Therapy Versus Extracorporeal Shockwave Therapy for Plantar Fasciitis: A Systematic Review and Meta-Analysis
by Pei-Ching Wu, Dung-Huan Liu, Yang-Shao Cheng, Chih-Sheng Lin and Fu-An Yang
Bioengineering 2026, 13(1), 90; https://doi.org/10.3390/bioengineering13010090 - 13 Jan 2026
Viewed by 120
Abstract
Background: Plantar fasciitis is a prevalent musculoskeletal disease characterized by heel pain and functional impairment. Both high-intensity laser therapy (HILT) and extracorporeal shockwave therapy (ESWT) have demonstrated efficacy in managing plantar fasciitis; however, their relative effectiveness remains unclear. Purpose: This systematic review and [...] Read more.
Background: Plantar fasciitis is a prevalent musculoskeletal disease characterized by heel pain and functional impairment. Both high-intensity laser therapy (HILT) and extracorporeal shockwave therapy (ESWT) have demonstrated efficacy in managing plantar fasciitis; however, their relative effectiveness remains unclear. Purpose: This systematic review and meta-analysis aimed to compare the effects of HILT and ESWT for treating plantar fasciitis. Methods: A comprehensive literature search of PubMed, the Cochrane Library, EMBASE, and Scopus was conducted from inception to 13 July 2025 to identify randomized controlled trials (RCTs) investigating both interventions. Two reviewers independently extracted data and assessed the methodological quality of the trials using the Physiotherapy Evidence Database (PEDro) scale. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The primary outcomes of this study were pain intensity and foot function. The visual analog scale (VAS) was used for pain assessment. Foot function was evaluated by the total scores of the Foot Function Index (FFI) and American Orthopedic Foot & Ankle Society Scale (AOFAS) and the activities of daily living (ADL) subscale scores of the Foot and Ankle Ability Measure (FAAM). Outcomes were assessed at the end of treatment and during short-, medium-, and long-term follow-ups. The meta-analysis utilized standardized mean differences (SMDs), assessed heterogeneity using the I2 test, applied the inverse variance method for pooling continuous variables, and employed a random-effects model because of the variable study methods used across the included articles. Results with p < 0.05 were considered statistically significant. The I2 test was used to objectively measure statistical heterogeneity, with I2 ≥ 50% indicating significant heterogeneity. Results: Five RCTs met the inclusion criteria, with methodological quality scores ranging from 6 to 7 on the 10-point PEDro scale. In total, 120 participants received HILT and 116 received ESWT. Regarding pain intensity (VAS), no statistically significant differences were detected between HILT and ESWT at any time point, including short-term morning pain (SMD = −0.11, 95% CI −0.42 to 0.19, p = 0.40), resting pain (SMD = 0.01, 95% CI −0.48 to 0.49, p = 0.05), and activity pain (SMD = −0.08, 95% CI −0.41 to 0.26, p = 0.89), as well as medium-term morning, resting, and activity pain (all p > 0.05). For foot function (FFI), the pooled analysis of all studies showed no significant short-term difference (SMD = 0.37, 95% CI −0.22 to 0.95, p = 0.01; I2 = 73%); however, a subsequent sensitivity analysis, which excluded one studyreduced heterogeneity to 0% and revealed a significant short-term advantage of ESWT (SMD = 0.64, 95% CI 0.32 to 0.95, p < 0.01). Medium-term FFI also favored ESWT (SMD = 0.53, 95% CI 0.14 to 0.92, p < 0.01). Overall, the certainty of evidence ranged from moderate to low, mainly due to risk of bias and heterogeneity, as assessed by the GRADE approach. Conclusions: While the pooled results suggested a trend toward greater functional improvement with ESWT than with HILT in the short- and medium-term, the effect sizes were small. No significant between-group differences were observed in pain-related outcomes. Given the limited number of available trials and variability in treatment protocols, current evidence remains insufficient to draw definitive conclusions about the comparative efficacy of ESWT and HILT. Further high-quality, large-scale randomized controlled trials with standardized methodologies are needed to better inform clinical decision-making. Full article
(This article belongs to the Section Biomechanics and Sports Medicine)
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14 pages, 1945 KB  
Article
Multiuser Exercise-Based Telerehabilitation Intervention for Older Adults with Frailty: A Pilot Study
by Naoki Yamada, Itsuki Sato, Shoji Kinoshita, Atsushi Muraji, Seiki Tokunaga, Taro Naka and Ryo Okubo
NeuroSci 2026, 7(1), 11; https://doi.org/10.3390/neurosci7010011 - 13 Jan 2026
Viewed by 102
Abstract
Objectives: This pilot study examined telerehabilitation, which has emerged as a crucial modality in light of recent global challenges such as the COVID-19 pandemic. We examined the effectiveness of a mobile health telerehabilitation intervention developed for older adults with frailty. Methods: Six participants [...] Read more.
Objectives: This pilot study examined telerehabilitation, which has emerged as a crucial modality in light of recent global challenges such as the COVID-19 pandemic. We examined the effectiveness of a mobile health telerehabilitation intervention developed for older adults with frailty. Methods: Six participants received a telerehabilitation intervention (Rehab Studio) that included exercise training videos. The participants were aged ≥65 years, had no history of dementia or psychiatric disorders, and had mild-to-moderate care needs. For 1 month, the participants received 1 h live online rehabilitation sessions with real-time communication with rehabilitation specialists (physical therapists and occupational therapists: PTs/OTs). The quality of life (QoL) (EuroQol 5 dimensions 5-level [EQ-5D-5L] questionnaire) and self-rated health scores were recorded before and after the intervention, and the data were analyzed using paired t-tests to determine whether the service was effective. Results: Significant differences were found in the total EQ-5D-5L and self-rated health scores (p < 0.05). The mean EQ-5D-5L score increased from 0.63 ± 0.13 before the intervention to 0.77 ± 0.14 after the intervention (p = 0.010), while the mean self-rated health score increased from 66.0 ± 18.0 to 83.3 ± 10.3, respectively (p = 0.019). Conclusions: This study revealed that the mobile health telerehabilitation intervention is safe and can improve QoL for older adults with frailty. However, the effectiveness of the intervention needs to be further investigated in patients with poor performance in daily living activities. Telerehabilitation could help to reduce the burden of nursing care in aging societies with declining birthrates. However, given the extremely small sample size (N = 6), these p-values should be interpreted with considerable caution. Statistical significance in such a small sample does not provide strong evidence for population-level effects, and our findings should be regarded as hypothesis-generating rather than confirmatory. Full article
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22 pages, 9389 KB  
Article
Validation of a Multimodal Wearable Device Integrating EMG and IMU Sensors for Monitoring Upper Limb Function During Tooth Brushing Activities of Daily Living
by Patrícia Santos, Filipa Marquês, Carla Quintão and Cláudia Quaresma
Sensors 2026, 26(2), 510; https://doi.org/10.3390/s26020510 - 12 Jan 2026
Viewed by 174
Abstract
Analyzing the dynamics of muscle activation patterns and joint range of motion is essential to understanding human movement during complex tasks such as tooth brushing Activities of Daily Living (ADLs). In individuals with neuromotor impairments, accurate assessment of upper limb motor patterns plays [...] Read more.
Analyzing the dynamics of muscle activation patterns and joint range of motion is essential to understanding human movement during complex tasks such as tooth brushing Activities of Daily Living (ADLs). In individuals with neuromotor impairments, accurate assessment of upper limb motor patterns plays a critical role in rehabilitation, supporting the identification of compensatory strategies and informing clinical interventions. This study presents the validation of a previously developed novel, low-cost, wearable, and portable multimodal prototype that integrates inertial measurement units (IMU) and surface electromyography (sEMG) sensors into a single device. The system enables bilateral monitoring of arm segment kinematics and muscle activation amplitudes from six major agonist muscles during ADLs. Eleven healthy participants performed a functional task, tooth brushing, while wearing the prototype. The recorded data were compared with two established gold-standard systems, Qualisys® motion capture system and Biosignalsplux®, for validation of kinematic and electrophysiological measurements, respectively. This study provides technical insights into the device’s architecture. The developed system demonstrates potential for clinical and research applications, particularly for monitoring upper limb function and evaluating rehabilitation outcomes in populations with neurological disorders. Full article
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16 pages, 320 KB  
Systematic Review
Mapping the Outcomes of Low-Vision Rehabilitation: A Scoping Review of Interventions, Challenges, and Research Gaps
by Kingsley Ekemiri, Onohomo Adebo, Chioma Ekemiri, Samuel Osuji, Maureen Amobi, Linda Ekwe, Kathy-Ann Lootawan, Carlene Oneka Williams and Esther Daniel
Vision 2026, 10(1), 3; https://doi.org/10.3390/vision10010003 - 12 Jan 2026
Viewed by 90
Abstract
Introduction: Low vision affects more than visual acuity; it substantially disrupts daily functioning and may contribute to long-term cognitive, emotional, and social consequences. When medical or surgical treatment options are no longer effective, structured low-vision rehabilitation becomes essential, providing strategies and tools that [...] Read more.
Introduction: Low vision affects more than visual acuity; it substantially disrupts daily functioning and may contribute to long-term cognitive, emotional, and social consequences. When medical or surgical treatment options are no longer effective, structured low-vision rehabilitation becomes essential, providing strategies and tools that support functional adaptation and promote independence. This review aims to map the current outcomes of rehabilitation services, identify gaps in existing research, and highlight opportunities for further study. Methods: An article search was conducted via PubMed, Scopus, PsycInfo, and Google Scholar. Then, title, abstract, and full-text screenings for inclusion were performed by all the authors independently, and disagreements were resolved through discussion. The relevant outcomes from the eligible publications were extracted by four authors and then cross-checked by the other authors. The results are presented via the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews checklist. Results: A total of 13 studies met the inclusion criteria. Most were randomized controlled trials (n = 10,77%), with the majority conducted in the United States and the United Kingdom. Study populations consisted of adults aged 18 years and older. Across the included studies, low-vision rehabilitation interventions particularly visual training, magnification-based programs, and multidisciplinary approaches, were associated with significant improvements in visual function, activities of daily living, and vision-related quality of life. Conclusions: Low vision rehabilitation interventions demonstrate clear benefits for visual acuity, contrast sensitivity, reading speed, and functional independence. However, substantial gaps remain, including limited evidence on long-term outcomes, inconsistent assessment of psychosocial influences, and underrepresentation of diverse populations. Standardized outcome measures and long-term, inclusive research designs are needed to better understand the sustained and equitable impact of low-vision rehabilitation. Full article
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14 pages, 884 KB  
Article
Multidomain Predictors of Four-Year Risk for Dementia and Mild Cognitive Impairment Among Community-Dwelling Korean Older Adults
by Jinhee Shin, Hyebeen Sim, Kennedy Diema Konlan and Chang Gi Park
Healthcare 2026, 14(2), 184; https://doi.org/10.3390/healthcare14020184 - 12 Jan 2026
Viewed by 103
Abstract
Background: Dementia and mild cognitive impairment (MCI) are major public health concerns in rapidly aging societies. However, evidence from non-Western populations with self- or proxy-reported physician-diagnosed cognitive outcomes remains limited. Methods: This study investigated the four-year (2018–2022) incidence of self- or proxy-reported dementia [...] Read more.
Background: Dementia and mild cognitive impairment (MCI) are major public health concerns in rapidly aging societies. However, evidence from non-Western populations with self- or proxy-reported physician-diagnosed cognitive outcomes remains limited. Methods: This study investigated the four-year (2018–2022) incidence of self- or proxy-reported dementia and MCI, and their multidomain risk markers in a nationally representative sample of 3432 Korean adults aged ≥ 65 years from the Korean Longitudinal Study of Aging. Weighted descriptive analyses and multinomial logistic regression accounting for the complex survey design (sampling weights, strata, and clusters) were used to identify demographic, functional, mental health, and social factors associated with the incidence of cognitive impairment. Adjusted predicted probabilities were estimated for age, depressive symptoms, and instrumental activities of daily living (IADL). Results: Over the four-year follow-up period, among 3432 initially cognitively normal community-dwelling older adults, 34 participants developed MCI and 70 developed dementia. Older age, increased IADL impairment, depressive symptoms, and multimorbidity were significantly associated with a higher likelihood of incident cognitive impairment, while living with family was associated with a lower likelihood. Frequent social interaction showed a protective association against dementia. Predicted probabilities demonstrated overall increasing trends across age, depressive symptoms, and IADL, reflecting general risk patterns. Conclusions: These findings emphasize the importance of multidomain assessments for early detection and community-based prevention strategies. By identifying key clinical and social markers, this study provides culturally relevant evidence to support dementia risk management in rapidly aging populations, highlighting the protective roles of family co-residence and frequent social interaction among Korean older adults. Full article
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12 pages, 822 KB  
Article
Association Between Floor of Residence and Frailty in Walk-Up Buildings Among Functionally Independent Older Adults: A Cross-Sectional Study
by Masataka Ando, Naoto Kamide and Akie Kawamura
Healthcare 2026, 14(2), 162; https://doi.org/10.3390/healthcare14020162 - 8 Jan 2026
Viewed by 234
Abstract
Background/Objectives: Frailty has been associated with various physical, psychological, and social factors; however, the influence of the residential environment—particularly walk-up buildings without elevators—remains unclear. This study aimed to examine the association between the floor of residence and frailty among functionally independent older [...] Read more.
Background/Objectives: Frailty has been associated with various physical, psychological, and social factors; however, the influence of the residential environment—particularly walk-up buildings without elevators—remains unclear. This study aimed to examine the association between the floor of residence and frailty among functionally independent older adults. Methods: A total of 793 older adults (mean age: 76.46 ± 6.29 years; 58.83% women) living in walk-up buildings without elevators and not certified as requiring long-term care participated in a questionnaire survey. Frailty was assessed using the Kihon Checklist (KCL) and the FRAIL Scale (FS). Logistic regression analyses were conducted to examine the association between floor of residence and frailty status (non-frail vs. frail), adjusting for potential confounders. Sensitivity analyses were performed using stratified models based on age group, functional status, and living conditions. Results: Frailty prevalence was 23.28% (KCL) and 16.88% (FS). Higher floor of residence was significantly associated with lower odds of frailty (KCL: odds ratio [OR] = 0.82, 95% confidence interval [CI]: 0.69–0.97; FS: OR = 0.80, 95% CI: 0.65–0.97). Stratified analyses showed consistent associations in subgroups including those aged ≥ 75 years, with full Instrumental Activities of Daily Living scores, non-homebound status, poor subjective economic status, and living alone (all p < 0.05). Conclusions: Living on higher floors in walk-up buildings without elevators may be protective against frailty among functionally independent older adults. While barrier-free environments are essential for those with functional decline or disabilities, moderate physical challenges such as stairs may contribute to frailty prevention in populations who maintain independence. Full article
(This article belongs to the Section Public Health and Preventive Medicine)
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26 pages, 3099 KB  
Article
Bread and Bakery Products: Cultural Importance, Consumption, Purchase Patterns, and Household Waste During Ramadan in Constantine, Algeria
by Fatima Zohra Becila, Linda Dridi, Abdallah Bouasla, Rania Boussekine and Meriem Bencharif
Sustainability 2026, 18(1), 543; https://doi.org/10.3390/su18010543 - 5 Jan 2026
Viewed by 279
Abstract
Household bread and bakery product waste constitutes a growing issue in Algeria, with significant economic, environmental, and socio-cultural implications. This research is situated within the framework of sustainable food systems and responds to recent transformations in domestic food practices, driven by increased female [...] Read more.
Household bread and bakery product waste constitutes a growing issue in Algeria, with significant economic, environmental, and socio-cultural implications. This research is situated within the framework of sustainable food systems and responds to recent transformations in domestic food practices, driven by increased female labor force participation, time constraints, and the widespread availability of industrial bread, which have reshaped household food management and traditional home bread-making practices. The study aims to (1) review traditional Algerian breads, emphasizing their culinary, nutritional, and cultural significance; (2) examine household behaviors during the month of Ramadan in the city of Constantine, focusing on patterns of consumption, purchasing, waste generation, and strategies for reusing leftovers; and (3) assess the economic implications of these practices using the FUSIONS methodology and explore their contribution to household-level food sustainability. Methodologically, a cross-sectional exploratory survey was conducted among 100 married women, the majority of whom were middle-aged (62%; range: 27–71 years; mean age: 52.0 ± 10.21), well-educated (59% with a university degree), economically active (68%), and living in medium-sized households (63%). The findings reveal pronounced contrasts across bread categories. Industrial breads, particularly baguettes, are characterized by high daily purchase frequencies (4.16 ± 1.31 units/day) and the highest waste rates (12.67%), largely attributable to over-purchasing (92%) and low perceived value associated with subsidized prices, with convenience (100%) remaining the primary factor explaining their dominance. In contrast, traditional breads exhibit minimal waste levels (1.63%) despite frequent purchase (3.85 ± 0.70 loaves/day), reflecting more conscious food management shaped by strong cultural attachment, higher perceived value, and dietary preferences (100%). Modern bakery products, along with confections and pastries, the latter representing of 58% of total household food purchases, comprise a substantial share of food expenditure during Ramadan (2.16 ± 0.46 loaves/day and 12.07 and 7.28 ± 2.50 units/day, respectively), while generating relatively low levels of food waste (5.69%, 4.19%, and 0%, respectively). This suggests that higher prices and symbolic value encourage more careful purchasing behaviors and conscious consumption. Freezing leftovers (63%) emerges as the most commonly adopted waste-reduction strategy. Overall, this work provides original quantitative evidence at the household level on bread and bakery product waste in Algeria. It highlights the key socio-economic, cultural, and behavioral drivers underlying waste generation and proposes actionable recommendations to promote more sustainable food practices, in line with the United Nations Sustainable Development Goal 12 on responsible consumption and production. Full article
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42 pages, 4049 KB  
Systematic Review
Duration as the Sixth Dimension of the Built Environment Travel Behaviour Framework
by Irfan Arif, Fahim Ullah and Siddra Qayyum
Urban Sci. 2026, 10(1), 26; https://doi.org/10.3390/urbansci10010026 - 2 Jan 2026
Viewed by 449
Abstract
The built environment (BE) plays a central role in shaping everyday mobility patterns and determining how physical activity (PA) is integrated into daily life. Foundational BE frameworks such as the 5Ds (density, diversity, design, distance to transit, and destination accessibility) have shaped policy [...] Read more.
The built environment (BE) plays a central role in shaping everyday mobility patterns and determining how physical activity (PA) is integrated into daily life. Foundational BE frameworks such as the 5Ds (density, diversity, design, distance to transit, and destination accessibility) have shaped policy and planning worldwide. However, these frameworks remain predominantly spatial and overlook temporal dynamics. This review addresses this omission by introducing Duration as the sixth dimension (6th D) of the BE framework, reframing accessibility in terms of the lived temporal experience of movement rather than static spatial distance. Travel conditions vary across the day. Routes that are safe and efficient at one time often become congested, stressful, and prohibitive at another. Such variability undermines PA and active transport (AT) and diminishes the health benefits of supportive BE. Methodologically, the review synthesises evidence from 1991 to 2025 across public health, transport planning, BE, and environmental psychology. Pertinent literature (102 shortlisted articles) published in English was retrieved from Scopus, Web of Science (WoS), and PubMed, which collectively provide comprehensive coverage of multidisciplinary research spanning transport planning, public health, and behavioural sciences. The PRISMA 2020 approach and VOSviewer (version 1.6.20), were used, together with a structured, Excel-based integrative synthesis, to analyse publication trends, conceptual evolution, and integrative patterns in the retrieved literature. The synthesis shows that accessibility, mobility stress, and travel behaviour are strongly time-dependent. This time dependence is systematic rather than incidental across contexts. Globally, commute durations beyond 45 min are associated with lower life satisfaction and poorer health outcomes. Embedding Duration within BE frameworks establishes a time-responsive and equity-sensitive paradigm for healthier and more resilient urban systems. Full article
(This article belongs to the Special Issue Sustainable Transportation and Urban Environments-Public Health)
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21 pages, 1566 KB  
Article
Robot-Assisted Mirror Therapy for Upper Limb and Hand Recovery After Stroke: Clinical Efficacy and Insights into Neural Mechanisms
by Shixin Li, Jiayi Zhang, Yang Xu and Yonghong Yang
J. Clin. Med. 2026, 15(1), 350; https://doi.org/10.3390/jcm15010350 - 2 Jan 2026
Viewed by 361
Abstract
Objective: This study investigated the efficacy and neural mechanisms of robot-assisted mirror therapy (RMT) for post-stroke upper limb rehabilitation. RMT integrates the multimodal feedback of mirror therapy with robotic precision and repetition to enhance cortical activation and neuroplasticity. Methods: Seventy-eight stroke patients were [...] Read more.
Objective: This study investigated the efficacy and neural mechanisms of robot-assisted mirror therapy (RMT) for post-stroke upper limb rehabilitation. RMT integrates the multimodal feedback of mirror therapy with robotic precision and repetition to enhance cortical activation and neuroplasticity. Methods: Seventy-eight stroke patients were randomly assigned to control, mirror therapy (MT), or RMT groups. All received conventional rehabilitation; the MT group additionally underwent mirror therapy, and the RMT group received robot-assisted mirror therapy combined with functional electrical stimulation. The primary outcome was the Fugl–Meyer Assessment for Upper Extremity (FMA-UE), with secondary measures including spasticity, dexterity, daily living, and quality of life. Functional near-infrared spectroscopy (fNIRS) was applied to assess cortical activation and connectivity at baseline, post-intervention, and one-month follow-up. Results: All groups showed significant time effects, though between-group differences were limited. Subgroup analysis revealed that patients at Brunnstrom stages I–II in the MT group achieved greater improvements in upper limb function, dexterity, and daily living ability. fNIRS findings showed enhanced activation in the right sensory association cortex and increased prefrontal–sensory connectivity. Conclusions: While all interventions improved motor outcomes, MT yielded slightly superior recovery associated with neuroplastic changes. RMT demonstrated high safety, compliance, and potential benefit for patients with severe motor deficits. Full article
(This article belongs to the Section Brain Injury)
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20 pages, 1133 KB  
Article
Physical Activity Patterns and Behavioral Resilience Among Foggia University Students During the COVID-19 Pandemic: A Public Health Perspective
by Tarek Benameur, Neji Saidi, Maria Antonietta Panaro and Chiara Porro
Healthcare 2026, 14(1), 87; https://doi.org/10.3390/healthcare14010087 - 30 Dec 2025
Viewed by 303
Abstract
Background: The (COVID-19) pandemic profoundly disrupted daily routines and physical activity (PA), especially among university students, due to restrictions and limited access to sports facilities. As this group is particularly vulnerable to sedentary lifestyles and mental health issues, understanding their PA patterns [...] Read more.
Background: The (COVID-19) pandemic profoundly disrupted daily routines and physical activity (PA), especially among university students, due to restrictions and limited access to sports facilities. As this group is particularly vulnerable to sedentary lifestyles and mental health issues, understanding their PA patterns is crucial. This study explores overall and domain-specific PA levels and the influence of sociodemographic factors, offering insights for promoting sustainable PA strategies in higher education during and beyond health crises. Methods: A cross-sectional online survey was conducted among University of Foggia students during the pandemic. The participants completed the validated Italian IPAQ-Long to assess PA across various domains. Associations with demographics and perceived barriers were analyzed via t tests, ANOVA, and nonparametric tests. Results: A total of 301 students completed the survey. Despite barriers such as limited living space, low income, and sports facility closures, 66% of the participants reported high PA levels, mainly through work-related and leisure activities. This remains insufficient. PA varied significantly by gender, income, residence, and employment status: males reported higher leisure PA, whereas females engaged more in active transport and domestic activities. Rural residents and those with moderate incomes demonstrated higher overall PA, whereas employed students presented lower activity levels. These findings underscore the complex socioeconomic and environmental factors shaping PA behavior during an unprecedented global health crisis. Conclusions: The findings reveal that students’ resilience in maintaining PA is a coping mechanism despite socioeconomic and environmental barriers. Tailored, accessible PA initiatives integrated into university curricula can enhance student well-being, academic performance, and long-term health during and after public health emergencies. Universities should adopt accessible, equity-oriented PA initiatives to promote physical and mental health and enhance public-health preparedness during future emergencies. Full article
(This article belongs to the Collection COVID-19: Impact on Public Health and Healthcare)
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13 pages, 1196 KB  
Article
Socially Assistive Robot Hyodol for Depressive Symptoms of Community-Dwelling Older Adults in Medically Underserved Areas: A Preliminary Study
by Han Wool Jung, Yujin Kim, Hyojung Kim, Min-kyeong Kim, Hyejung Lee, Jin Young Park, Woo Jung Kim and Jaesub Park
J. Clin. Med. 2026, 15(1), 217; https://doi.org/10.3390/jcm15010217 - 27 Dec 2025
Viewed by 285
Abstract
Background/Objectives: Socially assistive robots effectively support elderly care when they incorporate personalization, person-centered principles, rich interactions, and careful role setting with psychosocial alignment. Hyodol, a socially assistive robot designed for elderly people, embodies a grandchild’s persona, emulating the grandparent–grandchild relationship. Based [...] Read more.
Background/Objectives: Socially assistive robots effectively support elderly care when they incorporate personalization, person-centered principles, rich interactions, and careful role setting with psychosocial alignment. Hyodol, a socially assistive robot designed for elderly people, embodies a grandchild’s persona, emulating the grandparent–grandchild relationship. Based on the behavioral activation principles and a human-centered approach, this robot continuously supports users’ emotional well-being, health management, and daily routines. Methods: The current study evaluated Hyodol’s impact on depressive symptoms and other quality of life factors among older adults living in medically underserved areas. A total of 278 participants were assessed for depressive symptoms, loneliness, medication adherence, and user acceptance. Results: After six months of use, participants showed significant reductions in overall depressive symptoms, with a 45% decrease in the proportion of individuals at high risk of depression. Significant improvements were also observed in loneliness and medication adherence. Participants reported high levels of user acceptance and satisfaction, exceeding 70% of the total score. Participants who engaged more frequently in free chat with Hyodol showed greater improvements in depressive symptoms. Conclusions: These results highlight Hyodol’s potential as a promising tool for enhancing mental healthcare and overall well-being in this population. This at-home mental-healthcare framework can complement primary care and, if its effects are confirmed in controlled trials, could contribute to reducing healthcare burden and preventing the onset and escalation of depressive symptoms. Full article
(This article belongs to the Special Issue Innovations in the Treatment for Depression and Anxiety)
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15 pages, 1850 KB  
Article
Towards Biomimetic Robotic Rehabilitation: Pilot Study of an Upper-Limb Cable-Driven Exoskeleton in Post-Stroke Patients
by Develyn I. S. Bastos, Sergio C. M. Gomes, Eduardo A. F. Dias, Pedro H. F. Ulhoa, Raphaele C. J. S. Gomes, Fabiana D. Marinho and Rafhael M. Andrade
Biomimetics 2026, 11(1), 11; https://doi.org/10.3390/biomimetics11010011 - 26 Dec 2025
Viewed by 322
Abstract
Stroke is a leading cause of disability, often resulting in motor, cognitive, and language deficits, with significant impact on upper-limb function. Robotic therapy (RT) has emerged as an effective strategy, providing intensive, repetitive, and adaptable practice to optimize functional recovery. This pilot study [...] Read more.
Stroke is a leading cause of disability, often resulting in motor, cognitive, and language deficits, with significant impact on upper-limb function. Robotic therapy (RT) has emerged as an effective strategy, providing intensive, repetitive, and adaptable practice to optimize functional recovery. This pilot study aimed to describe and evaluate the effects of robotic rehabilitation as a complement to conventional therapy, using a biomimetic activities-of-daily-living (ADL)-based protocol, on upper-limb function in post-stroke patients. Three participants (aged 30–80 years) undergoing occupational and/or physiotherapy received individualized robotic training with a lightweight cable-driven upper-limb exoskeleton, m-FLEX™, twice a week for ten weeks (30 min per session). Movements were designed to mimic natural upper-limb actions, including elbow flexion-extension, forearm pronation-supination, tripod pinch, and functional tasks such as grasping a cup. Assessments included the Fugl-Meyer (FM) scale, the Functional Independence Measure (FIM), and device satisfaction, performed at baseline, mid-intervention, and post-intervention. Descriptive analysis of the tabulated data revealed improvements in range of motion and functional outcomes. These findings suggest that biomimetic protocol of robotic rehabilitation, when combined with conventional therapy, can enhance motor and functional recovery in post-stroke patients. Full article
(This article belongs to the Special Issue Bionic Technology—Robotic Exoskeletons and Prostheses: 3rd Edition)
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