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Search Results (2,282)

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19 pages, 346 KB  
Review
Prospects for Physical Therapy in Rheumatoid Arthritis: Literature Review
by Dana Taizhanova, Olga Pokrashenko and Anna Shalygina
Healthcare 2026, 14(17), 2751; https://doi.org/10.3390/healthcare14172751 - 28 Aug 2026
Abstract
Background: The incidence of rheumatoid arthritis is steadily increasing worldwide, resulting in a growing number of individuals who may lose the ability to perform self-care activities and professional duties, thereby reducing their quality of life. Rheumatoid arthritis represents a significant social problem, [...] Read more.
Background: The incidence of rheumatoid arthritis is steadily increasing worldwide, resulting in a growing number of individuals who may lose the ability to perform self-care activities and professional duties, thereby reducing their quality of life. Rheumatoid arthritis represents a significant social problem, limiting the ability of the working population to lead a full life. A comprehensive approach to the treatment of patients with rheumatoid arthritis, including both pharmacological therapy and an individualized rehabilitation program, is of strategic importance for maintaining their functional status. Materials and Methods: A review of modern physiotherapy methods (physical factors) in patients with rheumatoid arthritis was conducted in the international scientific databases Web of Science, PubMed, Google Scholar, and Elibrary over a seven-year period to identify an alternative approach to the treatment of this disease. Results: The search identified 12 articles presenting the results of clinical studies (3), cross-sectional study (1) and randomized clinical trials (8). These studies investigated physiotherapy interventions in patients with RA and highlighted the potential value of exploring alternative treatment approaches for this patient population. Despite substantial heterogeneity in the interventions, treatment protocols, and combinations of physical factors used, all of the reviewed methods demonstrated positive effects. Conclusions: Physiotherapy interventions may have a positive impact on the clinical course of rheumatoid arthritis; however, the available evidence is insufficient to draw definitive conclusions regarding their effectiveness, primarily due to the lack of long-term follow-up data and substantial heterogeneity in the number and design of treatment sessions, as well as in the physical factors applied. The long-term effects of physiotherapy interventions remain insufficiently studied and warrant further research aimed at developing standardized and evidence-based treatment protocols. Full article
28 pages, 1073 KB  
Review
Mechanisms of Action of Herbal Preparations for the Rehabilitation of Dust-Related Diseases of the Bronchopulmonary System
by Georgiy A. Demchenko, Alexandr E. Gulyayev, Sayagul A. Kairgeldina, Madina B. Baurzhan, Marat R. Khanturin, Kanat K. Tekebayev, Nazym S. Sagandykova, Laura U. Koibasova and Makpal A. Yessenova
Biomedicines 2026, 14(9), 1936; https://doi.org/10.3390/biomedicines14091936 - 28 Aug 2026
Abstract
The aim of this study was to summarize current evidence on dust-related diseases of the bronchopulmonary system, medicinal plants, herbal formulations, and their underlying mechanisms of action. A literature review was conducted based on publications indexed in ScienceDirect, Google Scholar, SciFinder, Scopus, and [...] Read more.
The aim of this study was to summarize current evidence on dust-related diseases of the bronchopulmonary system, medicinal plants, herbal formulations, and their underlying mechanisms of action. A literature review was conducted based on publications indexed in ScienceDirect, Google Scholar, SciFinder, Scopus, and Medline (PubMed), focusing on the mechanisms underlying dust-related diseases of the bronchopulmonary system, pneumoconiosis, and the potential of phytotherapeutic approaches to modulate these processes. The following keywords were used: bronchopulmonary system, pneumoconiosis, dust-related lung diseases, medicinal plants, herbal preparations, pulmonary rehabilitation, and lymphatic sanitation. The pathogenesis of pneumoconiosis involves the deposition of inhaled dust particles in the lung tissue, followed by chronic inflammation, oxidative stress, and progressive fibrosis. In experimental models, flavonoids, alkaloids, terpenoids, glycosides, tannins, and other phytochemical groups have demonstrated therapeutic potential in bronchopulmonary diseases. Among the compounds investigated, emodin, celastrol, kaempferol, sodium tanshinone IIA sulfonate, astragaloside IV, and dioscin have shown promising effects by modulating key signaling pathways and reducing inflammatory responses. Experimental evidence indicates that these phytochemicals can target major pathways involved in inflammation and fibrogenesis, thereby exerting antioxidant, anti-inflammatory, and antifibrotic effects. The lymphatic system also contributes to the pathogenesis of pneumoconiosis by transporting inhaled dust particles to regional lymph nodes, where their accumulation may promote lymph node sclerosis. Therefore, lymphatic sanitation may represent an important therapeutic mechanism of action of herbal formulations in pneumoconiosis. Our proposed lymphotropic herbal formulation enhances physiological lymphatic drainage and may positively influence the motility and functional activity of the tracheobronchial lymph nodes. The therapeutic potential of medicinal plants and herbal formulations in pneumoconiosis is supported by experimental findings for Tripterygium wilfordii (celastrol, through suppression of the EDNRB/Kng1 – (endothelin receptor type B/kininogen1), Delphinium, Camellia, and Berberis species (kaempferol, through inhibition of TLR4 (Toll-like receptor 4 signaling), Astragalus membranaceus (astragaloside IV, through antifibrotic activity mediated by inhibition of the TGF-β1/Smad3 (transforming growth factor beta1)pathway), and Reynoutria japonica Houtt., Rheum, and Aloe species (emodin, through inhibition of Smad3 (Smad family member 3) and NF-κB (nuclear factor kappa B)phosphorylation and reduction of TGF-β1, α-SMA (alpha-smooth muscle actin), collagen I, TNF-α (tumor necrosis factor alpha), and IL-1β (interleukin-1 beta) levels in lung tissue). For these and several other medicinal plants and their flavonoids, antifibrotic activity has been demonstrated through inhibition of the Akt/NF-κB (protein kinase B/nuclear factor kappa B) signaling pathway. A promising direction for future research is to evaluate the combined use of herbal formulations with established antifibrotic agents to determine whether synergistic therapeutic effects can be achieved. Full article
(This article belongs to the Section Drug Discovery, Development and Delivery)
18 pages, 898 KB  
Review
Wearable Technologies for Gait Instability Rehabilitation: Mechanisms, Clinical Evidence, and Future Directions
by Lijin Liu, Changfa Huang, Zhongyin Ji, Yujie Zhou, Zihua Li, Xueyi Zhang and Zhihong Wu
Bioengineering 2026, 13(9), 1002; https://doi.org/10.3390/bioengineering13091002 - 28 Aug 2026
Abstract
Wearable technologies are reshaping gait rehabilitation by shifting assessment and therapy from intermittent, clinic-based observation to continuous, data-driven, and adaptive care. This narrative review synthesizes the biomechanical basis of gait instability, the architecture and classification of wearable rehabilitation systems, and the clinical evidence [...] Read more.
Wearable technologies are reshaping gait rehabilitation by shifting assessment and therapy from intermittent, clinic-based observation to continuous, data-driven, and adaptive care. This narrative review synthesizes the biomechanical basis of gait instability, the architecture and classification of wearable rehabilitation systems, and the clinical evidence for motion sensors, smart insoles, biofeedback devices, robotic and orthotic wearables, neuromodulatory systems, immersive platforms, and artificial intelligence (AI)-enabled closed-loop interventions. Its main contribution is an integrated framework that links AI, digital biomarkers, device components, adaptive control, and translational implementation, rather than treating wearable rehabilitation as a device-only or disease-specific topic. Current evidence indicates that these technologies can improve gait speed, symmetry, balance, endurance, fall-risk monitoring, and dual-task performance in neurological, musculoskeletal, frailty-related, and aging populations. However, the field is still limited by heterogeneous protocols, small samples, limited longitudinal validation, insufficient device standardization, usability barriers, cybersecurity concerns, uncertain reimbursement, and restricted interoperability with healthcare systems. Future progress will depend on multimodal sensor fusion, explainable and federated AI, digital twins, adaptive wearable robotics, tele-rehabilitation pathways, and large-scale pragmatic trials that validate effectiveness in real-world rehabilitation settings. Full article
(This article belongs to the Special Issue Biomechanics of Human Motion)
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20 pages, 5106 KB  
Review
Balance and Mobility Impairment in Older Adults with Cardiovascular Disease Before and After Rehabilitation: A Narrative Review
by Zhengyang Song, Sasha Douglas, Imran Khan Niazi, Yanxin Zhang, Jocelyne Benatar and Paul W. Marshall
J. Clin. Med. 2026, 15(17), 6657; https://doi.org/10.3390/jcm15176657 (registering DOI) - 28 Aug 2026
Abstract
Balance impairment threatens mobility and independence in older adults with cardiovascular disease, yet cardiac rehabilitation (CR) has traditionally prioritised aerobic capacity and cardiovascular outcomes. This narrative review examines the mechanisms and assessment of balance impairment, balance recovery within CR, and implications for clinical [...] Read more.
Balance impairment threatens mobility and independence in older adults with cardiovascular disease, yet cardiac rehabilitation (CR) has traditionally prioritised aerobic capacity and cardiovascular outcomes. This narrative review examines the mechanisms and assessment of balance impairment, balance recovery within CR, and implications for clinical practice. Balance impairment reflects interactions among musculoskeletal, sensory, cognitive–motor, and cardiovascular constraints that affect different domains of postural control to varying extents. Standardised clinical measures do not capture these domains equally, and single scores or completion times can obscure the deficits underlying poor performance. Instrumented and wearable technologies extend clinical assessment by quantifying postural sway and gait, helping to distinguish broader mobility gains from recovery within specific balance domains. To translate this distinction into practice, this review recommends individualised, balance-focused CR, with assessment guiding task-specific training and virtual reality or exergaming providing graded practice and performance feedback to promote mobility and independence. Full article
(This article belongs to the Section Clinical Rehabilitation)
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19 pages, 2879 KB  
Review
Closing Europe’s Cardiovascular Implementation Gap: A Critical Review of the Safe Hearts Plan and the Cyprus Test Case
by Georgios P. Georghiou, Sotiris Kyriakou, Panos Georghiou, Amalia Georgiou, Nikolas Iosif, Konstantinos Toutouzas, Andrew Xanthopoulos, Konstantinos Lampropoulos, Argyris Kyriakou and Filippos Triposkiadis
J. Clin. Med. 2026, 15(17), 6614; https://doi.org/10.3390/jcm15176614 - 27 Aug 2026
Abstract
Cardiovascular disease remains Europe’s leading cause of death and disability despite mature evidence for prevention, acute and chronic treatment, rehabilitation, and secondary prevention. This structured critical narrative review evaluates whether the European Safe Hearts Plan can convert this evidence into coordinated, measurable, and [...] Read more.
Cardiovascular disease remains Europe’s leading cause of death and disability despite mature evidence for prevention, acute and chronic treatment, rehabilitation, and secondary prevention. This structured critical narrative review evaluates whether the European Safe Hearts Plan can convert this evidence into coordinated, measurable, and accountable cardiovascular pathways. We appraise the plan’s ten flagship actions by evidence maturity and implementation readiness; distinguish shared system functions from disease-specific delivery for acute coronary syndromes, heart failure, and atrial fibrillation; compare selected European Society of Cardiology and American Heart Association/American College of Cardiology recommendations; and propose a core indicator set and staged Cyprus pilot. Guideline-supported interventions should be standardised and audited, whereas screening technologies, digital health, artificial intelligence, and novel phenotyping require governed implementation and prospective assessment of patient outcomes, costs, equity, and unintended consequences. Cyprus is presented as a bounded implementation setting rather than a directly generalisable European model. The plan should be judged through a limited set of clinical, implementation, and equity indicators, including premature cardiovascular mortality, risk factor control, guideline-directed therapy, rehabilitation participation, registry completeness, reach, and fidelity. Full article
(This article belongs to the Special Issue Cardiovascular Disease Risk Assessment and Clinical Management)
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18 pages, 1091 KB  
Article
Long-Term Attrition in a 12-Month Adapted Physical Activity Program After Cardiac Rehabilitation: A Real-World Longitudinal Study
by Francesca Coppi, Gianluca Pagnoni, Aurora Vicenzi, Susan Darroudi, Gustavo Savino, Cecilia Zurlo, Laura Bernaroli, Francesco Marangi, Milena Nasi, Marcello Pinti, Alessio Baccarani, Anna Vittoria Mattioli, Francesco Fedele and Gilda Sandri
J. Cardiovasc. Dev. Dis. 2026, 13(9), 418; https://doi.org/10.3390/jcdd13090418 - 27 Aug 2026
Viewed by 6
Abstract
Background: Exercise-based cardiac rehabilitation (CR) is a cornerstone of secondary cardiovascular prevention and improves functional capacity, quality of life, and clinical outcomes. However, maintaining long-term participation remains a major challenge in routine clinical practice. Adapted Physical Activity (APA) programs represent a community-based [...] Read more.
Background: Exercise-based cardiac rehabilitation (CR) is a cornerstone of secondary cardiovascular prevention and improves functional capacity, quality of life, and clinical outcomes. However, maintaining long-term participation remains a major challenge in routine clinical practice. Adapted Physical Activity (APA) programs represent a community-based strategy to promote continued exercise after outpatient cardiac disease, although evidence regarding long-term retention and functional outcomes in real-world settings remains limited. The aim of this study was to evaluate attrition patterns during a 12-month APA follow-up pathway following cardiac rehabilitation and to explore longitudinal changes in functional outcomes among participants who remained under follow-up. Methods: This retrospective longitudinal observational study included 78 consecutive patients referred to an APA program following outpatient cardiac rehabilitation for myocardial infarction or other cardiovascular conditions. Assessments were performed at baseline (T0), 2 months (T1), 6 months (T2), and 12 months (T3). The primary outcome was attrition, operationally defined as failure to attend scheduled follow-up assessments. Secondary outcomes included walking speed during the 1 km Treadmill Walk Test, lower-limb functional performance, handgrip strength, balance, pain, and self-reported physical activity. Longitudinal changes were analyzed using linear mixed-effects models adjusted for age and sex. Results: Seventy-eight patients were enrolled (48 men, 29 women, one participant with missing sex data; mean age 64 ± 11 years). Follow-up attendance progressively declined from 81% at 2 months to 27% at 6 months and 18% at 12 months. Among participants with available follow-up data, significant improvements were observed in walking speed, lower-limb performance, balance, and motor pain during the early supervised phase of the program, with the most robust changes evident at the 2-month assessment (all p < 0.001). Although favorable values were also observed at later assessments, the marked loss to follow-up substantially limited interpretation of the 6- and 12-month estimates. Handgrip strength showed no significant longitudinal changes, while self-reported physical activity increased at 6 months but remained highly variable across participants. Conclusions: In this real-world APA follow-up pathway after cardiac rehabilitation, substantial attrition was observed, with fewer than one-fifth of participants attending follow-up assessments at 12 months. The most robust secondary finding was the short-term improvement in functional outcomes during the initial supervised phase. Long-term functional estimates should be considered exploratory because of the high attrition rate and potential survivor/selection bias. These findings highlight long-term retention as a key outcome for future community-based exercise programs and support the development of strategies aimed at improving sustained participation after cardiac rehabilitation. Full article
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22 pages, 376 KB  
Review
Laryngeal Anatomy and Morphometry: Foundations for Interdisciplinary Collaboration and Personalized Management of Laryngeal Pathology
by Anca Simioniuc-Petrescu, Mihai Dumitru, Adrian Costache, Daniela Vrinceanu, Andreea Marinescu, Nicoleta Sanda, Alina Lavinia Antoaneta Oancea, Adina Zamfir Chiru Anton and Romica Cergan
Diagnostics 2026, 16(17), 2739; https://doi.org/10.3390/diagnostics16172739 - 26 Aug 2026
Viewed by 89
Abstract
Laryngeal pathology requires individualized management because the larynx integrates airway protection, phonation, swallowing, and respiratory function within a compact and highly variable anatomical framework. This narrative review examines how laryngeal anatomy and morphometry support interdisciplinary collaboration and personalized care in oncologic, stenotic, functional, [...] Read more.
Laryngeal pathology requires individualized management because the larynx integrates airway protection, phonation, swallowing, and respiratory function within a compact and highly variable anatomical framework. This narrative review examines how laryngeal anatomy and morphometry support interdisciplinary collaboration and personalized care in oncologic, stenotic, functional, and reconstructive laryngeal disease. Evidence from morphometric studies, CT, MRI, endoscopy, ultrasonography, three-dimensional reconstruction, artificial intelligence, and multidisciplinary clinical workflows was synthesized qualitatively. Key parameters—including vocal fold length, glottic width, thyroid cartilage angle, cricoid diameter, subglottic diameter, anterior commissure thickness, and the status of paraglottic and pre-epiglottic spaces—provide actionable information for diagnosis, T-staging, airway assessment, surgical planning, reconstruction, and functional rehabilitation. Morphometry concretely informs clinical decisions: thyroid cartilage angle guides thyroplasty and phonosurgical planning; subglottic diameter supports stenosis surgery and airway instrumentation; and anterior commissure, conus elasticus, cartilage, and deep-space measurements refine oncologic staging and margin strategy. Technological accelerators, including AI segmentation, radiomics, 3D printing, photogrammetry, and ultrasonography, extend morphometry from static measurement toward predictive modeling and patient-specific simulation. However, implementation remains limited by heterogeneous CT protocols, inconsistent measurement planes, uneven access to advanced technologies, lack of global normative databases, and unresolved ethical issues surrounding AI validation and data governance. This review supports standardizing CT morphometry using parallel vocal fold planes, routinely measuring anterior commissure thickness in T1 glottic cancer, incorporating ultrasonography as a first-line morphometric tool in voice clinics, and validating AI segmentation against population-specific morphometric norms. Laryngeal morphometry should therefore become a routine decision-making framework for precision laryngology. Full article
21 pages, 1345 KB  
Review
Exercise-Based Rehabilitation Following Lower-Limb Revascularisation in Patients with Peripheral Arterial Disease: A Scoping Review
by Shinichi Watanabe, Takayasu Koike, Kenji Tsujimoto, Ryoma Tahara, Tomohiko Kamo, Katsuyoshi Suzuki and Keisuke Suzuki
Diseases 2026, 14(9), 311; https://doi.org/10.3390/diseases14090311 - 26 Aug 2026
Viewed by 58
Abstract
Objective: Exercise therapy is recommended for patients with peripheral arterial disease (PAD) to improve walking capacity and functional outcomes. However, rehabilitation programmes after lower-limb revascularisation remain poorly defined. We aimed to map the existing literature on exercise-based rehabilitation following lower-limb revascularisation in patients [...] Read more.
Objective: Exercise therapy is recommended for patients with peripheral arterial disease (PAD) to improve walking capacity and functional outcomes. However, rehabilitation programmes after lower-limb revascularisation remain poorly defined. We aimed to map the existing literature on exercise-based rehabilitation following lower-limb revascularisation in patients with PAD and summarise key intervention features and reported outcomes. Data Sources: PubMed/MEDLINE, Embase, the Physiotherapy Evidence Database (PEDro), and the Cochrane Central Register of Controlled Trials were systematically searched from inception to identify relevant studies. Review Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Studies involving adult patients with PAD or chronic limb-threatening ischaemia who underwent lower-limb revascularisation and participated in postoperative exercise or rehabilitation programmes were included. Two reviewers independently screened studies and extracted data on study characteristics, intervention components, and outcomes. Findings were synthesised descriptively and presented in tables and narrative summaries. Results: Fourteen studies were included. Rehabilitation programmes showed substantial heterogeneity in exercise modality, timing of initiation, intensity, supervision, and duration. Walking-based exercise was the most commonly reported modality. Sessions typically lasted 20–60 min. Exercise frequency ranged from daily inpatient mobilisation or 6 days/week during early rehabilitation to two to five sessions/week in outpatient or home-based programmes, and programme length ranged from inpatient-only rehabilitation to 12 months. The most frequently reported outcomes were measures of walking capacity, including treadmill walking distance and the 6 min walk test. In contrast, limb-related outcomes (e.g., wound healing, limb salvage, and reintervention) and safety outcomes were less frequently reported. Conclusions: Exercise-based rehabilitation after lower-limb revascularisation in patients with PAD demonstrates considerable variability in programme characteristics and outcome measures. Although most studies focus on walking performance, key outcomes—particularly limb-related events and safety—remain underreported. Future research should establish standardised postoperative rehabilitation protocols and evaluate a broader range of clinically relevant outcomes, especially in patients with chronic limb-threatening ischaemia. Full article
(This article belongs to the Section Cardiology)
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13 pages, 256 KB  
Article
Neurocognitive and Motor Performance in Pediatric Kidney Transplant Recipients: A Cross-Sectional Controlled Study
by Seyma Tirpanci, Meltem Kaya, Hikmet Ucgun, Mehmet Tasdemir, Hilal Denizoglu Kulli and Ozan Ozkaya
Children 2026, 13(9), 1145; https://doi.org/10.3390/children13091145 - 26 Aug 2026
Viewed by 133
Abstract
Background/Objectives: Although kidney transplantation improves survival and quality of life in children with end-stage kidney disease, neurocognitive and motor impairments acquired during chronic kidney disease (CKD) may persist after transplantation. Cognitive–motor evaluations in this population remain limited. This study compared cognitive function, [...] Read more.
Background/Objectives: Although kidney transplantation improves survival and quality of life in children with end-stage kidney disease, neurocognitive and motor impairments acquired during chronic kidney disease (CKD) may persist after transplantation. Cognitive–motor evaluations in this population remain limited. This study compared cognitive function, manual dexterity, grip strength, reaction time, and balance between pediatric kidney transplant recipients and healthy peers. Methods: This study included 30 pediatric kidney transplant recipients aged 8–18 years and 30 age- and sex-matched healthy controls. Cognitive function was assessed using the Stroop Color–Word Test. Fine and gross manual dexterity were evaluated using the Nine-Hole Peg Test and Box and Block Test, respectively. Handgrip strength was measured with a JAMAR dynamometer, reaction time with the FitLight Trainer™ system, and balance with the Pediatric Balance Scale. Results: Compared with healthy controls, pediatric kidney transplant recipients showed poorer executive function, demonstrated by longer Stroop completion times and more color–word errors (all p < 0.05). Manual dexterity was reduced, with a significantly lower Box and Block Test score for the dominant hand (p = 0.020) and longer Nine-Hole Peg Test completion times for both hands (both p < 0.001), whereas the between-group difference in the non-dominant Box and Block Test did not reach statistical significance (p = 0.055). Dominant-hand reaction time and reaction time during the cognitive task were significantly prolonged (p = 0.018 and p = 0.046, respectively). Handgrip strength and Pediatric Balance Scale scores did not differ significantly between groups (both p > 0.05). Conclusions: Pediatric kidney transplant recipients exhibit persistent impairments in executive function, manual dexterity, and cognitive–motor performance despite transplantation. Long-term follow-up should incorporate cognitive and motor assessments to support early rehabilitation and optimize functional outcomes. Full article
(This article belongs to the Section Pediatric Nephrology & Urology)
23 pages, 8324 KB  
Article
Aerobic Exercise Alleviates Oligodendrocyte Injury and Ferroptosis-Related Features in MPTP-Induced Parkinsonian Mice with Improved Neuropathological Phenotypes
by Min Yan, Sen Zhang, Zigui Zhou, Changzhi Yang, Xuewen Tian and Peijie Chen
Brain Sci. 2026, 16(9), 904; https://doi.org/10.3390/brainsci16090904 - 24 Aug 2026
Viewed by 115
Abstract
Objectives: The pathological progression of Parkinson’s disease (PD) involves alterations across multiple neural cell types, and glial–neuronal communication substantially influences neuronal function. Oligodendrocytes (OLs) have been implicated in PD pathology, but the underlying regulatory mechanisms remain incompletely understood. Methods: In this study, single-nucleus [...] Read more.
Objectives: The pathological progression of Parkinson’s disease (PD) involves alterations across multiple neural cell types, and glial–neuronal communication substantially influences neuronal function. Oligodendrocytes (OLs) have been implicated in PD pathology, but the underlying regulatory mechanisms remain incompletely understood. Methods: In this study, single-nucleus RNA sequencing and spatial transcriptomics were used to characterize OL-associated changes and explore potentially relevant mechanisms in the substantia nigra pars compacta (SNpc) of MPTP-induced parkinsonian mice. Molecular validation was subsequently performed in an exercise intervention cohort. Results: These analyses revealed a significant reduction in OL abundance in the SNpc, accompanied by enrichment of ferroptosis-related pathways. Aerobic exercise partially restored the expression of the OL marker gene Plp1 and the antioxidant pathway-related molecules Nrf2 and Gpx4, while reducing ferroptosis-related oxidative stress. These changes were associated with improvements in PD-like pathological phenotypes. Exploratory untargeted metabolomics further identified candidate alterations in metabolites and pathways related to redox homeostasis, energy metabolism, and myelin-associated processes after MPTP treatment and exercise intervention. Conclusions: Collectively, exercise-associated improvements in MPTP-induced PD-like phenotypes coincided with reductions in OL/myelin-related injury and ferroptosis-related stress. These findings suggest that OL-associated ferroptosis-related stress may represent one of several processes contributing to neuronal injury in PD and may be responsive to aerobic exercise. This study provides a theoretical basis for further investigation of exercise-based rehabilitation strategies and potential therapeutic targets for PD. Full article
(This article belongs to the Section Neurodegenerative Diseases)
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22 pages, 2333 KB  
Review
Reframing Rehabilitation Retention in Long-Term Conditions: A Theory-Informed Mini-Review of Psychological Adaptation and Engagement
by Mohammad Khoshraftar, Zahra Karimi, Lyudmila S. Yermukhanova, Nurbakyt Ardak and Alireza Afshar
Healthcare 2026, 14(17), 2697; https://doi.org/10.3390/healthcare14172697 - 24 Aug 2026
Viewed by 187
Abstract
Rehabilitation in long-term conditions requires not only clinical capacity but also sustained patient engagement, yet retention is commonly reduced to crude completion metrics. This theory-informed conceptual mini-review used a purposive, non-systematic synthesis of literature identified from the authors’ existing knowledge base, targeted PubMed/MEDLINE [...] Read more.
Rehabilitation in long-term conditions requires not only clinical capacity but also sustained patient engagement, yet retention is commonly reduced to crude completion metrics. This theory-informed conceptual mini-review used a purposive, non-systematic synthesis of literature identified from the authors’ existing knowledge base, targeted PubMed/MEDLINE searches last updated on 9 August 2026, and backward reference checking; the final article cites 76 sources. Retention is reframed as six related phases comprising referral and eligibility, uptake or initiation, early attendance, ongoing attendance or dose, completion or planned discharge, and post-program maintenance, while time to dropout is treated as a longitudinal metric. Across these phases, disengagement may reflect interactions among clinical severity, symptom interpretation, illness beliefs, distress, motivational climate, therapeutic relationships, social context, and structural access. Four author-generated hypotheses concern psychological flexibility and acceptance, illness coherence and rehabilitation self-efficacy, autonomy-supportive care and therapeutic alliance, and social support and peer belonging. Direct evidence is concentrated in selected rehabilitation settings, whereas several stage-specific and cross-condition pathways remain theoretical extrapolations. Rehabilitation resilience is therefore proposed as a provisional interaction between patient adaptive resources and responsive care systems, not as a validated trait or a synonym for observable retention. Structural barriers may prevent participation directly, and discontinuation may be appropriate when treatment is unsafe, ineffective, burdensome, or inconsistent with informed patient goals. The framework is intended to guide prospective, condition-specific testing rather than imply causal validation or scientific consensus. Full article
(This article belongs to the Special Issue Healthcare Resilience and Patient Adherence in Rehabilitation)
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33 pages, 9825 KB  
Review
Exercise-Induced Skeletal Muscle Secretory Factors and Macrophage Functional Remodeling: Mechanistic Advances
by Ziyan Li, Chenyu Lin, Linjia Tang, Yiyao Xu, Jieming Liang, Dehui Pan, Ziran Huang, Xianyan Xie, Yu Wang, Shuqi Qin, Gaoyuan Yang, Xiaoguang Liu and Huiguo Wang
Int. J. Mol. Sci. 2026, 27(17), 7527; https://doi.org/10.3390/ijms27177527 - 22 Aug 2026
Viewed by 303
Abstract
Regular exercise mediates inter-tissue communication between skeletal muscle and the immune system through skeletal muscle-derived secretory factors, providing an important molecular basis for the beneficial effects of exercise on chronic inflammation, metabolic dysregulation, and impaired tissue repair. As key effector cells of the [...] Read more.
Regular exercise mediates inter-tissue communication between skeletal muscle and the immune system through skeletal muscle-derived secretory factors, providing an important molecular basis for the beneficial effects of exercise on chronic inflammation, metabolic dysregulation, and impaired tissue repair. As key effector cells of the innate immune system, macrophages do not simply conform to a dichotomous classification of classically activated M1 macrophages and alternatively activated M2 macrophages; rather, their functional states constitute a dynamic spectrum shaped by exercise load, recovery time window, tissue microenvironment, and disease context. This review focuses on recent advances in exercise-induced skeletal muscle secretory factors involved in macrophage functional remodeling. Representative signals, including interleukin-6 (IL-6), irisin, meteorin-like protein (METRNL), fibroblast growth factor 21 (FGF21), oncostatin M (OSM), decorin, myostatin, chemokines, and extracellular vesicles, are systematically summarized in terms of their exercise responsiveness, evidence for skeletal muscle origin, and evidence supporting macrophage regulation. Based on these dimensions, an evidence-strength grading framework is further proposed. Moreover, this review integrates key signaling axes, including glycoprotein 130 (gp130)/Janus kinase (JAK)/signal transducer and activator of transcription (STAT), signal transducer and activator of transcription 6 (STAT6)/peroxisome proliferator-activated receptor gamma (PPARγ), AMP-activated protein kinase (AMPK)/nuclear factor erythroid 2-related factor 2 (Nrf2)/nuclear factor kappa B (NF-κB), transforming growth factor beta (TGF-β)/Smad, and chemokine receptor pathways, to explain how exercise-induced secretory networks participate in the dynamic regulation of the macrophage functional spectrum through immune cell recruitment, inflammatory clearance, immunometabolic reprogramming, matrix remodeling, and repair-niche formation. Current evidence indicates the translational potential of exercise-induced skeletal muscle secretory factors in skeletal muscle repair, metabolic inflammation, aging-related functional decline, and cancer rehabilitation. However, this field still faces several major challenges, including insufficient tracing of skeletal muscle-derived signals, limited direct causal validation, a lack of human tissue-level evidence, and unclear exercise dose–response relationships. Future studies should combine tissue-specific genetic interventions, receptor blockade, single-cell and spatial omics, metabolic flux analysis, and standardized human exercise interventions to further clarify the mechanistic basis and application boundaries of exercise-induced skeletal muscle–macrophage communication, thereby providing a theoretical foundation for precision exercise prescription and chronic inflammation intervention. Full article
(This article belongs to the Section Molecular Endocrinology and Metabolism)
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14 pages, 8134 KB  
Article
Decompressive Laminectomy for Neurological Complications of Spondylodiscitis: A Case Series of 15 Patients
by Andrea Bruno, Antonio Meola, Stefano Di Bella and Leonello Tacconi
J. Pers. Med. 2026, 16(9), 440; https://doi.org/10.3390/jpm16090440 - 22 Aug 2026
Viewed by 197
Abstract
Background/Objectives: Surgical indications for spondylodiscitis are controversial, particularly when epidural extension and evolving neurological compromise are present. This study aimed to describe the clinical, neurological, pain-related, and inflammatory outcomes of patients with spondylodiscitis treated with decompressive laminectomy without spinal stabilization, at a [...] Read more.
Background/Objectives: Surgical indications for spondylodiscitis are controversial, particularly when epidural extension and evolving neurological compromise are present. This study aimed to describe the clinical, neurological, pain-related, and inflammatory outcomes of patients with spondylodiscitis treated with decompressive laminectomy without spinal stabilization, at a single tertiary center. Methods: We retrospectively reviewed 15 consecutive patients with spondylodiscitis who underwent decompressive laminectomy at the University Hospital of Trieste between January 2017 and December 2023. Inclusion required at least 6 months of clinical and laboratory follow-up. Patients treated with acute vertebral stabilization were excluded. Collected data included spinal level, timing from diagnosis to surgery, visual analog scale (VAS) pain score, Cooper Scale grade, modified Japanese Orthopedic Association score (mJOA), white blood cell count, and C-reactive protein (CRP). Assessments were performed preoperatively (T0), 1 week after surgery (T1), and at 6 months (T2). Imaging findings from representative cases were reviewed to illustrate the radiographic evolution after decompression combined with antibiotic therapy and orthotic support. Results: The cohort included 8 women and 7 men with a mean age of 57.33 years. Twelve patients (80%) underwent surgery within 48 h because of neurological deterioration or urgent compressive findings. Thoracic involvement was predominant (11 cases, 73%), whereas cervical and lumbar disease accounted for 1 and 3 cases, respectively. Intraoperative cultures were positive in 9 patients (60%), and Staphylococcus aureus was isolated in 7 of these 9 cases (77.8%). Mean VAS pain score improved from 6.3 at T0 to 4.3 at T1 and 1.4 at T2. Mean lower-extremity Cooper Scale grade improved from 2.7 to 2.1 to 0.6; mean upper-extremity Cooper Scale grade improved from 1.3 to 1.0 to 0. Mean mJOA improved from 10.3 to 11.4 to 16.0. Mean white blood cell count declined from 11.58 to 8.35 to 6.14 × 103/µL, and mean CRP declined from 123.9 to 72.81 to 19.44 mg/L. No patient worsened neurologically after surgery. No patient required acute stabilization or delayed arthrodesis during follow-up. Conclusions: In our case series of patients with compressive or progressive neurological spondylodiscitis, decompressive laminectomy combined with antibiotic treatment, bracing, and rehabilitation was associated with early neurological stabilization, substantial pain relief, and marked reduction in inflammatory markers, without subsequent need for instrumented stabilization. These data support the role of spinal decompression as part of a personalized, effective treatment strategy in patients with neurological decline. Full article
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24 pages, 1050 KB  
Article
Usability and Technology Acceptance of a Wearable Monitoring System Among Patients with Cardiovascular Diseases: A Cross-Sectional Study
by Marian Morenci, Diana Carina Iovanovici, Carmen Delia Cseppento Nistor, Sebastian Tirla, Anett Jolán Karetka, Rareș Gheorghe Mihuț, Akos Tiboldi, Lisa Lichtenegger, Laura Ioana Bondar and Tünde Jurca
Medicina 2026, 62(8), 1607; https://doi.org/10.3390/medicina62081607 - 21 Aug 2026
Viewed by 283
Abstract
Background and Objectives: Wearable health technologies have become increasingly important in the remote management of cardiovascular diseases (CVDs); however, their successful implementation depends not only on technical performance but also on patient usability and technology acceptance. This study aimed to evaluate the perceived [...] Read more.
Background and Objectives: Wearable health technologies have become increasingly important in the remote management of cardiovascular diseases (CVDs); however, their successful implementation depends not only on technical performance but also on patient usability and technology acceptance. This study aimed to evaluate the perceived usability and technology acceptance of a wearable monitoring system among patients with CVDs and to investigate whether demographic and clinical characteristics influenced these outcomes. Materials and Methods: A cross-sectional observational study was conducted among 60 patients with CVDs enrolled in a six-month wearable monitoring program at the Medical Rehabilitation Outpatient Clinic of the Avram Iancu Clinical Hospital, Oradea, Romania. Participants used a Garmin vívosmart® 5 fitness tracker to continuously monitor physiological and behavioral parameters. At the end of the monitoring period, perceived ease of use (PEU) was assessed using the System Usability Scale (SUS), while technology acceptance was evaluated using a Technology Acceptance Model (TAM)-based questionnaire. Descriptive statistics, reliability analysis, Spearman’s rank correlation, and multiple linear regression analyses were performed. Results: The wearable monitoring system demonstrated high PEU, with a median SUS score of 82.5 (IQR = 23.1) and a mean score of 75.5 ± 17.6. Overall, 75.0% of participants rated the system as having good or excellent usability. The SUS questionnaire demonstrated acceptable internal consistency (Cronbach’s α = 0.730; McDonald’s ω = 0.741). Technology acceptance was generally favorable, with an overall median TAM-based score of 1.33 (IQR = 0.78). Age and comorbidity burden were not associated with PEU, and no participant characteristics independently predicted SUS scores. Although the overall regression model was not statistically significant, age showed a statistically significant association with the overall TAM-based score (β = 0.328, p = 0.037). Significant positive correlations were observed between PU, self-efficacy (SE), and reverse-scored technology anxiety (TA) measure (p < 0.001). Conclusions: Patients with CVDs reported high PEU and favorable acceptance of wearable monitoring technology. While usability appeared independent of demographic and clinical characteristics, technology acceptance showed an exploratory association with age, although the overall regression model was not statistically significant. These findings support the integration of wearable monitoring systems into routine cardiovascular care and highlight the importance of patient-centered implementation strategies to promote long-term engagement. Full article
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16 pages, 2699 KB  
Article
Activation of the Nrf2-ARE Signaling Pathway Mediates the Neuroprotective Effects of Exercise in a Mouse Model of Chronic Parkinson’s Disease
by Shuwei Zhang, Dong Yang, Changfa Tang and Yu Zhang
Int. J. Mol. Sci. 2026, 27(16), 7439; https://doi.org/10.3390/ijms27167439 - 20 Aug 2026
Viewed by 179
Abstract
Currently, effective disease-modifying treatments for Parkinson’s disease (PD) remain lacking. Although exercise has been confirmed to exert neuroprotective effects against PD, its specific molecular mechanisms remain unclear. In particular, the causal role of the Nuclear Factor E2-related Factor 2 (Nrf2)–antioxidant response element (ARE) [...] Read more.
Currently, effective disease-modifying treatments for Parkinson’s disease (PD) remain lacking. Although exercise has been confirmed to exert neuroprotective effects against PD, its specific molecular mechanisms remain unclear. In particular, the causal role of the Nuclear Factor E2-related Factor 2 (Nrf2)–antioxidant response element (ARE) signaling axis in this process has not been clearly elucidated. This study aimed to provide direct causal evidence that regular treadmill exercise protects the substantia nigra pars compacta (SNc)–striatal dopaminergic system by activating the Nrf2-ARE pathway. The results showed that exercise significantly improved motor function deficits in PD mice, preserved the number of TH-positive neurons, and restored striatal dopamine homeostasis. Mechanistically, exercise activated the Nrf2-ARE pathway, thereby inhibiting the accumulation of mitochondrial ROS (mtROS) and the activation of pro-inflammatory amoeboid microglia in the substantia nigra. Crucially, the improvements in behavioral, neuropathological, and neurochemical indicators induced by exercise were completely reversed, returning to levels comparable to those in the sedentary model group. In conclusion, this study provides clear pharmacological evidence that the neuroprotective effect of regular treadmill exercise against chronic PD strictly depends on the Nrf2-ARE pathway. These findings indicate that Nrf2 is a key mechanistic node linking exercise and neuroprotection, providing reliable preclinical evidence for Nrf2-targeted disease-modifying strategies in PD rehabilitation. Full article
(This article belongs to the Section Molecular Neurobiology)
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