Search Results (486)

Background: This systematic review evaluates the efficacy of rehabilitation-focused exercise interventions for lumbar degenerative disc disease (DDD), a leading cause of chronic low back pain. Methods: Following PRISMA guidelines, a comprehensive search was conducted across international and regional databases (PubMed, Scopus, Web of Science, Magiran, SID, and Noormags) covering the period from January 2010 to January 2025. The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD420251088811. Using keywords such as “lumbar DDD,” “exercise therapy,” and “rehabilitation,” a total of 2495 records were identified. After screening, 20 studies—including clinical trials, quasi-experimental, and experimental designs—met the inclusion criteria and were assessed using the McMaster Critical Review Form for Quantitative Studies. Results: Interventions such as hydrotherapy, core stability training, Pilates, and suspension exercises were found to significantly reduce pain and improve functional outcomes. While multimodal approaches (e.g., aquatic exercise combined with acupuncture) showed positive effects, the comparative studies revealed no significant differences between modalities. Suspension training demonstrated superior efficacy in pain reduction compared to isolated core stability exercises. The methodological quality of included studies ranged from good to excellent, with the majority rated as very good or excellent (McMaster scores: 8 “excellent,” 7 “very good,” and 5 “good”). Common limitations among the studies included methodological heterogeneity, small sample sizes (n = 14–30), and insufficient long-term follow-up. Conclusions: Exercise-based rehabilitation is an effective strategy for managing lumbar DDD. Evidence particularly supports the use of suspension training and aquatic therapy for superior improvements in pain and functional outcomes. Future research should aim to adopt standardized protocols, recruit larger sample sizes, and include extended follow-up periods to produce more robust and generalizable findings. Full article

Degenerative disc disease (DDD) is a major cause of chronic low back pain (LBP), yet the molecular mechanisms driving disc degeneration and pain remain poorly understood. This study analyzed intervertebral disc (IVD) tissue from 36 young patients (median age = 36.00 [31.00, 42.50] years) with herniated discs and LBP, alongside healthy controls, to investigate changes in the extracellular matrix (ECM) and neurochemical alterations. Disc degeneration was assessed using MRI (Pfirrmann grading) and histology (Sive’s criteria). Histochemical and immunohistochemical methods were used to evaluate aggrecan content, calcification, and the expression of nerve growth factor (NGF), substance P (SP), and S-100 protein. MRI findings included Pfirrmann grades V (30.55%), IV (61.11%), III (5.56%), and II (2.78%). Severe histological degeneration (10–12 points) was observed in three patients. Aggrecan depletion correlated with longer pain duration (r = 0.449, p = 0.031). NGF expression was significantly elevated in degenerated discs (p = 0.0287) and strongly correlated with SP (r = 0.785, p = 5.268 × 10⁻⁹). Free nerve endings were identified in 5 cases. ECM calcification, present in 36.1% of patients, was significantly associated with radiculopathy (r = 0.664, p = 0.005). The observed co-localization of NGF and SP suggests a synergistic role in pain development. These results indicate that in young individuals, aggrecan loss, neurochemical imbalance, and ECM calcification are key contributors to DDD and chronic LBP. Full article

Aging is a complex physiological process that profoundly affects the functionality of the musculoskeletal system, contributing to an increase in the incidence of diseases such as osteoporosis, osteoarthritis, and sarcopenia. Cellular senescence plays a crucial role in these degenerative processes, promoting chronic inflammation and tissue dysfunction through the senescence-associated secretory phenotype (SASP). Recently, senotherapeutics have shown promising results in improving musculoskeletal health. Natural compounds such as resveratrol, rapamycin, quercetin, curcumin, vitamin E, genistein, fisetin, and epicatechin act on key signaling pathways, offering protective effects against musculoskeletal decline. On the other hand, molecules such as dasatinib, navitoclax, UBX0101, panobinostat, and metformin have been shown to be effective in eliminating or modulating senescent cells. However, understanding the mechanisms of action, long-term safety, and bioavailability remain areas for further investigation. In this context, physical exercise emerges as an effective non-pharmacological countermeasure, capable of directly modulating cellular senescence and promoting tissue regeneration, representing an integrated strategy to combat age-related diseases. Therefore, we have provided an overview of the main anti-aging compounds and examined the potential of physical exercise as a strategy in the management of age-related musculoskeletal disorders. Further studies should focus on identifying synergistic combinations of pharmacological and non-pharmacological interventions to optimize the effectiveness of anti-aging strategies and promoting healthier musculoskeletal aging. Full article

Background/Objectives: Spinal cord injuries (SCIs) are among the most debilitating conditions and are a leading cause of disability in young people. This study aimed to analyze the causes of SCIs, assess injury severity using the AIS scale, and evaluate complications during rehabilitation in a hospital setting. Methods: The study involved 176 individuals with SCI, including 142 with a traumatic SCI (TSCI) and 34 with a non-traumatic SCI (NTSCI), rehabilitated at various times post-injury. The data on injury causes, paresis type, complications, wheelchair use, gender, age, and treatment methods were collected. The injury severity was assessed using the AIS. Results: A significant gender difference was found between the TSCI and NTSCI groups (85.2% male vs. 61.8% male). TSCI individuals were also younger. The causes of TSCI were traffic accidents, falls from height, and diving, while the causes for NTSCI included spinal ischemia, tumors, degenerative disc disease, and inflammation. TSCI individuals had more AIS A lesions (52.8% vs. 26.5%) and more cervical injuries (53.5% vs. 14.7%), whereas NTSCI individuals had more AIS C lesions (38.2% vs. 18.3%) and thoracic damage (58.8% vs. 35.2%). TSCI patients were more often treated surgically (95.7% vs. 61.8%) and used wheelchairs (88% vs. 55.9%). No significant differences were found in terms of complications between the groups, though TSCI individuals underwent more chronic rehabilitation. Conclusions: Our research shows that there are significant differences between TSCI and NTSCI both in terms of the level of damage and the severity of damage to neural structures (AIS scales), and thus significant differences in the patients’ functioning in later life for both groups of individuals. Full article

In the wide range of human diseases, Parkinson’s disease (PD) has a high incidence, according to a recent survey by the World Health Organization (WHO). According to WHO records, this chronic disease has affected approximately 10 million people worldwide. Patients who do not receive an early diagnosis may develop an incurable neurological disorder. PD is a degenerative disorder of the brain, characterized by the impairment of the nigrostriatal system. A wide range of symptoms of motor and non-motor impairment accompanies this disorder. By using new technology, the PD is detected through speech signals of the PD victims by using the reduced instruction set computing 5th version (RISC-V) processor. The RISC-V microcontroller unit (MCU) was designed for the voice-controlled human-machine interface (HMI). With the help of signal processing and feature extraction methods, the digital signal is impaired by the impairment of the nigrostriatal system. These speech signals can be classified through classifier modules. A wide range of classifier modules are used to classify the speech signals as normal or abnormal to identify PD. We use Matrix Laboratory (MATLAB R2021a_v9.10.0.1602886) to analyze the data, develop algorithms, create modules, and develop the RISC-V processor for embedded implementation. Machine learning (ML) techniques are also used to extract features such as pitch, tremor, and Mel-frequency cepstral coefficients (MFCCs). Full article

Background: Chronic low back pain (CLBP) is the leading cause of disability both within the United States and globally. However, reliable diagnosis and treatment remains limited due to a lack of objective and image-based biomarkers. Modic changes (MCs) are visible vertebral endplate and bone marrow changes in signal intensity seen on MRI. MCs have emerged as promising correlates with degenerative disc disease and CLBP. Methods: This is a non-systematic literature review. Results: This review synthesizes current evidence on the classification, pathophysiology, and imaging of MCs, with a particular focus on their associations with patient-reported outcomes, including pain (Visual Analog Scale), functional status (Oswestry disability index and Roland-Morris Disability Questionnaire), and health-related quality of life (Short Form-36 and EuroQol 5-Dimension 5 Level). MC type 1 and 2 show significant correlations with symptom severity and predict positive response to basi-vertebral nerve (BVN) ablation, a minimally invasive intervention inhibiting the nerves’ ability to transmit pain signals. Conclusions: Across multiple trials, BVN ablation has shown significant sustained improvements in patient-reported outcomes among patients with MC, reinforcing their role as both a diagnostic and therapeutic biomarker. Full article

Background/Objectives: Obesity is the primary risk factor for the development of chronic degenerative diseases. Multidisciplinary treatments target multiple pathologies associated with obesity. In this study, a potential adjuvant therapy was evaluated by combining extracts from Hibiscus sabdariffa and Zingiber officinale. These extracts were used in both a simple and liposomal suspension, the latter aimed at enhancing the activity of phenolic compounds and determining various metabolic benefits. Methods: In this research, the use of biotechnological approaches for the development of a liposomal suspension formulation with appropriate characteristics of stability, particle size, polydispersity index, concentration, and zeta potential induced an effective reduction in body weight and epididymal fat in a murine obesity model over 8 and 45 days. Results: Treatment with the liposomal suspension reduced variables in the lipid profile, aspartate aminotransferase activity, and energy expenditure, while also promoting an increase in locomotor activity. Conclusions: Therefore, it is suggested that the liposomal suspension represents an alternative for obesity treatment and the reduction of cardiovascular risks. Full article

Background: Spinal cord stimulators can offer an effective treatment in chronic pain refractory to conventional medical management. However, with a failure rate of up to 44% and an annual explantation rate of 6–9%, there is a need to better identify patients at high risk for therapeutic failure. The objective of this retrospective cohort study was to determine predictors of early SCS explantation following device placement. Methods: The Medical Informatics Operating room Vitals and Events Repository database was queried for patients with a spinal cord stimulator and at least two years of follow-up (n = 56). A multivariate logistic regression was fitted. Recursive factor elimination with cross-validation and L1 penalization were used to reduce the number of predictors and minimize the risk of overfitting. The model was used to predict risk factors for explantation, odds ratio (OR), 95% confidence interval (CI), and false discovery rate-adjusted p-value. Results: The final model displayed adequate performance with an average precision of 0.769. Sleep disorders were identified as a statistically significant predictor of SCS explantation (OR: 3.88, CI: 1.36–11.04, FDR p-value: 0.0497). Conclusions: While further prospective studies are needed, our study indicates that sleep disorders are a risk factor for spinal cord stimulator explantation and should be considered during pre-operative evaluation. Full article

Background/Objectives: Degenerative arthritis is a chronic inflammatory disease marked by tissue degradation and vascular fibrosis. Macrophages play a central role in the inflammatory response by releasing mediators such as nitric oxide (NO), interleukin (IL)-6, tumor necrosis factor alpha (TNF-α), and prostaglandin E2 (PGE2). This study aimed to investigate the anti-inflammatory potential of BTEX-K, a formulation of dried red ginseng combined with alpha-galactosidase, in lipopolysaccharide (LPS)-stimulated cells. Methods: LPS-treated immune cells were used to assess the anti-inflammatory effects of BTEX-K. The levels of NO, IL-6, TNF-α, and PGE2 were measured following BTEX-K treatment. The protein expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) was evaluated. Cytotoxicity assays were conducted to determine whether the observed effects were due to cell viability loss. The involvement of MAPK signaling and NF-κB pathway modulation was examined by analyzing JNK phosphorylation, IκB degradation, and PPAR-γ expression. Results: BTEX-K significantly reduced the production of NO, IL-6, TNF-α, and PGE2 in LPS-treated cells without inducing cytotoxicity. The protein expression levels of iNOS and COX-2 were also suppressed. Furthermore, BTEX-K inhibited the LPS-induced phosphorylation of JNK in the MAPK pathway. It restored IκB levels and suppressed NF-κB activation by preventing the downregulation of PPAR-γ. Conclusions: BTEX-K demonstrates notable anti-inflammatory effects by inhibiting key inflammatory mediators and signaling pathways in immune cells. These findings support its therapeutic potential in mitigating inflammation-related symptoms, including pain, swelling, and redness, commonly seen in degenerative arthritis. Full article

Background/Objectives: Aging is characterized by dysregulation of the immune system. A balanced diet and probiotic intake can play significant roles in preventing aging-related chronic degenerative diseases and promoting immune function in the elderly. This community-based intervention study investigated the effects of an eight-week intervention involving a balanced diet with or without probiotics on nutritional parameters and gut microbiota composition in Korean elderly individuals. Methods: A total of 48 participants were enrolled and randomly allocated into two groups: 24 received a balanced diet alone, and 24 received a balanced diet combined with probiotics. Results: The balanced diet showed beneficial impacts on nutritional and inflammatory biomarkers, including fasting glucose, hemoglobin A1c (HbA1c), albumin, gamma-glutamyl transferase (γ-GT), total cholesterol, high-density lipoprotein cholesterol (HDL-C), immunoglobulin E (IgE), and gut microbiota, such as the Bacteroidaceae family and the genera Prevotella and Faecalibacterium. Additionally, providing probiotics alongside a balanced diet influenced the taxonomic profile and abundance of intestinal microbiota. Conclusions: Overall, the combination of a balanced diet and probiotics has beneficial effects on nutritional and inflammatory biomarkers as well as gut microbiota composition in elderly individuals. Future meticulously designed randomized controlled trials are required to further understand the health benefits and underlying mechanisms of balanced diets and probiotics in the Korean elderly. Full article

This narrative review provides an overview of the link between the sensorimotor system, cognition, emotion and pain syndromes in persons due to deconditioning or delayed sensorimotor development, then applied to persons with cerebral palsy (CP). The brain damage that occurs before, during or even after birth pathophysiologically alters the structure and subsequent function of the sensorimotor function, which is inseparably linked to cognition, emotion, behavior and pain. This damage results in a functional developmental disorder that also affects the structure and function of the neuromatrix in a graded manner due to chronic deconditioning. It is the basis for both primary and secondary chronic degenerative diseases. This leads to an increasing prevalence of chronic pain syndromes, which may be very high in persons with CP. Thus, CP is both a disposing factor and a causal factor for nociplastic pain, defined as persistent pain arising from altered nociception without evidence of tissue or somatosensory damage. Therapy interventions are crucial to optimize movement, cognition and emotion, as well as pain reduction in persons with CP. Full article

The process of aging exerts profound effects on various physiological systems, leading to the progression of chronic degenerative disorders and pathologies associated with advancing age. Cellular senescence plays a central role in the aging process and the onset of various eye conditions associated with advancing age, including age-related macular degeneration (AMD), diabetic retinopathy (DR), glaucoma, cataracts, and ocular surface disorders. The accumulation of senescent cells (SnCs) and their secretion of pro-inflammatory and tissue-remodeling factors, collectively known as the senescence-associated secretory phenotype (SASP), exacerbate chronic inflammation, oxidative stress, and tissue dysfunction, contributing to disease progression. This study is the first to systematically integrate the multifaceted mechanisms of cellular senescence in ocular diseases, revealing differential regulatory mechanisms of specific signaling pathways across different ocular pathologies, thereby providing novel insights into the pathogenesis of these disorders. SnC-targeted therapies such as senolytics, senomorphics, SASP modulators, mitochondrial-targeted antioxidants, and epigenetic reprogramming are emerging as regenerative therapies, demonstrating potent anti-inflammatory effects, restoration of normal tissue physiology, and successful regeneration of ocular defects in preclinical models and clinical trials, while slowing senescence-associated disease progression. This review not only summarizes the role of cellular senescence in ocular diseases but also delves into potential therapeutic strategies, particularly highlighting novel perspectives for root-cause-targeted therapies from the unique angle of senescence biology, which may pioneer new directions for the treatment of ocular pathologies. Full article

Background/Objectives: Organ transplantation is a vital treatment for individuals with advanced chronic-degenerative diseases. However, the global shortage of donated organs remains a significant challenge. Improving knowledge and attitudes could positively impact this issue. This study assessed the knowledge and attitudes of nursing students regarding organ donation and transplantation. Methods: A cross-sectional study was conducted using a previously validated questionnaire administered to 235 second- and third-year undergraduate nursing students from two Italian universities. Results: The response rate was 67.3%. Only 40.4% of students felt adequately informed about transplants and brain death, while 12.8% would not authorise organ transplantation for a family member. Willingness to authorise organ procurement from family members in a brain-dead state was positively associated with being atheist or agnostic (χ² = 7.235; p = 0.022), being in the third year of study (χ² = 4.282; p = 0.039) and having positive self-assessed knowledge (χ² = 8.061; p = 0.005). Conclusions: Nursing students exhibited suboptimal knowledge and positive attitudes toward organ and tissue donation. However, there is a need for health policymakers to implement strategies to raise awareness of the importance of organ donation through school and community programmes and public education campaigns. Full article

For the past two decades, the consideration of spinopelvic parameters, sagittal balance, and spine shape has gained importance in the diagnosis and optimal surgical management of painful adult spinal deformity. These principles are used with increasing frequency in the surgical planning and treatment of degenerative mechanical lower back pain. Several parameters exist to analyze both global and regional spinal balance. Chronic lower back pain due to degenerative disc disease, degenerative spondylolisthesis, or adult spinal deformity can be surgically managed in a multitude of ways ranging from simple decompression to multilevel arthrodesis with or without corrective osteotomies, depending on the presumed etiology of the pain, surgical planning, and the surgical goal. In surgical candidates, preoperative evaluation of spinopelvic parameters is paramount, as increasing evidence shows that restoration of the shape of the spine while respecting these parameters improves patient-reported outcome measures (PROMs), decreases re-operation rates, and reduces mechanical complications such as proximal junctional kyphosis/failure (PJK/PJF), distal junctional kyphosis/failure (DJK/DJF), adjacent segment disease (ASD), and rod fracture. This review provides a conceptual analysis of spinopelvic alignment, global and regional sagittal balance, and the restoration of the spine’s shape in relation to patient outcomes during surgical treatment of degenerative spine disorders. Full article

Objectives: Osteoarthritis (OA) is a prevalent chronic degenerative joint disorder marked by cartilage degradation, subchondral bone remodeling, and synovial inflammation. Despite its widespread occurrence, effective pharmacological interventions to halt or reverse OA progression remain elusive. Thus, an in-depth understanding of its pathogenesis is imperative for developing novel therapeutic strategies. Methods: Sixty-four male Sprague-Dawley rats (8 weeks old, weighing 180–220 g) were randomly assigned to two groups: the anterior cruciate ligament transection (ACLT) group and the sham-operated group. Primary osteoblasts were isolated from the subchondral bone at 0, 4, 8, and 12 weeks after ACLT. Nuclear magnetic resonance (NMR)-based metabolomics was used to elucidate metabolic changes and the underlying mechanisms in osteoblasts. Results: A total of 26 metabolites were identified from the NMR spectra of osteoblasts. Distinct metabolic profiles were observed in the ACLT group at 0, 4, 8, and 12 weeks after surgery. In particular, several differential metabolites were identified, including glucose, lactate, NADP⁺, phosphocreatine, and alanine, as well as eight perturbed pathways, such as alanine, aspartate, and glutamate metabolism, phenylalanine metabolism, and taurine metabolism. Conclusions: Key energy-related metabolites, including glucose, lactate, creatine phosphate, and creatine, were identified as key markers of osteoblast dysfunction in OA, underscoring the profound metabolic perturbations induced by ACL injury. These disturbances in energy homeostasis are strongly implicated in the progression of OA. In addition, branched-chain amino acids emerged as potential biomarkers, further highlighting the metabolic dysregulation associated with the disease. Taken together, the metabolic changes observed in rat osteoblasts following ACL injury reveal a complex interplay between energy and amino acid metabolism, providing critical insights into the pathogenesis of post-traumatic OA and highlighting potential therapeutic targets. Full article