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Search Results (2,433)

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Keywords = exercise and rehabilitation

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17 pages, 1073 KB  
Article
From Exhaustion to Empowerment: A Pilot Study on Motor Control-Based Exercise for Fatigue and Quality of Life in Long COVID-19 Patients
by Carmen Jiménez-Antona, Ricardo Moreta-Fuentes, David Varillas-Delgado, César Moreta-Fuentes and Sofía Laguarta-Val
Medicina 2026, 62(1), 210; https://doi.org/10.3390/medicina62010210 - 20 Jan 2026
Abstract
Background and Objectives: Long COVID-19 (LC) is a multifaceted condition characterized by persistent fatigue and impaired health-related quality of life (HRQoL). Exercise intolerance and post-exertional symptom exacerbation (PESE) pose challenges for rehabilitation. This study aimed to evaluate the effects of a 12-week [...] Read more.
Background and Objectives: Long COVID-19 (LC) is a multifaceted condition characterized by persistent fatigue and impaired health-related quality of life (HRQoL). Exercise intolerance and post-exertional symptom exacerbation (PESE) pose challenges for rehabilitation. This study aimed to evaluate the effects of a 12-week core-focused plank exercise program on fatigue and HRQoL in women with LC, using validated patient-reported measures. Materials and Methods: A pilot quasi-experimental design was implemented, with non-randomized group allocation. Thirty-nine women with LC were recruited from the Madrid Long COVID Association. Participants were assigned to either an intervention group (n = 20), which completed a supervised plank-based motor control program, or a control group (n = 19), which maintained usual activity. Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS), and HRQoL was measured using the EQ-5D-5L and EQ Visual Analog Scale (EQ-VAS). Body composition was evaluated via bioelectrical impedance analysis. Results: The intervention group showed significant reductions after intervention in the MFIS total scores compared to the control group, particularly in the physical (21.26 ± 6.76 vs. 25.21 ± 6.06; p < 0.001) and psychosocial domains (4.51 ± 0.41 vs. 5.21 ± 0.38; p < 0.001), without triggering PESE. EQ-VAS scores improved significantly (63.94 ± 15.33 vs. 46.31 ± 14.74; p = 0.034). No significant changes were found in body composition parameters, suggesting that benefits were driven by neuromuscular adaptations rather than morphological changes. Conclusions: A core-focused, non-aerobic exercise program effectively reduced fatigue and improved perceived health status in women with LC. These findings support the use of motor control-based interventions as a safe and feasible strategy for LC rehabilitation, particularly in populations vulnerable to PESE, suggesting clinical applicability for the rehabilitation of women with LC. Further randomized trials are warranted to confirm these results and explore long-term outcomes. Full article
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15 pages, 1289 KB  
Article
Does a Novel Gamification Approach Improve Hand Function in Patients Undergoing Rehabilitation? A Mono-Centric Randomized Controlled Trial
by Heithem Ben Abdallah, Janina Tennler, Christine Seelmann, Viola Haverkamp, Christian Schmitz, Heinz-Herbert Homann and Tobias Ohmann
Appl. Sci. 2026, 16(2), 987; https://doi.org/10.3390/app16020987 - 19 Jan 2026
Viewed by 79
Abstract
Background: Gamification is a promising approach to support rehabilitation, but implementing new devices after hand surgery (HS) faces challenges, especially in patient motivation and compliance. Technology-based, personalized solutions may encourage patients to perform gamified exercises consistently. This study investigated the impact of [...] Read more.
Background: Gamification is a promising approach to support rehabilitation, but implementing new devices after hand surgery (HS) faces challenges, especially in patient motivation and compliance. Technology-based, personalized solutions may encourage patients to perform gamified exercises consistently. This study investigated the impact of a tablet-based gamified hand-mobilization system on functional outcomes after HS compared to standard finger-expander training. Methods: Forty inpatients at BG Klinikum Duisburg were randomly assigned to a gamified or control group. Both groups underwent four weeks of stationary rehabilitation. Outcomes were assessed using the Disabilities of Arm, Shoulder, and Hand questionnaire (DASH), SF-36 health-related quality of life, and a visual analog scale (VAS) at pre- (T0) and post-training (T1). Tablet use frequency and duration were recorded. Results: DASH scores improved significantly over time (F(1.55, 58.85) = 16.36, p < 0.001, partial η2 = 0.137) with no Group or Time × Group effects (p > 0.40), exceeding the MCID in both groups. SF-36 MCS, PCS, and VAS pain also improved over time (all p < 0.05) with no between-group differences (p > 0.40). Exercise duration differed (p = 0.007), but training frequency did not. Conclusions: Both gamified and conventional rehabilitation programs led to clinically meaningful improvements in hand function after hand surgery. No significant differences were observed between groups, indicating that the tablet-based system was feasible and well-accepted but not superior to standard training. Full article
(This article belongs to the Special Issue Novel Approaches of Physical Therapy-Based Rehabilitation)
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15 pages, 2080 KB  
Systematic Review
Cardiac Rehabilitation in Patients with Implantable Cardioverter-Defibrillators: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and TSA
by Liviu Ștefan Călin, Darie Ioan Andreescu, Mircea Ioan Alexandru Bistriceanu, Cosmin Gabriel Ursu, Andrei Constantin Anghel, Remus Valentin Anton, Vasile Bogdan Fodor, Maria Daria Răileanu, Cristian Valentin Toma, Gabriel Olteanu, Dragoș Alin Trache, Liviu Ionuț Șerbănoiu, Anamaria Georgiana Avram, Francesco Perone and Ștefan Sebastian Busnatu
Biomedicines 2026, 14(1), 207; https://doi.org/10.3390/biomedicines14010207 - 18 Jan 2026
Viewed by 218
Abstract
Background/Objectives: Cardiac rehabilitation (CR) is known to improve clinical outcomes in cardiovascular disease, yet its benefits in patients with implantable cardioverter-defibrillators (ICD) are not well established. This meta-analysis evaluated the impact of CR on functional capacity and safety in ICD recipients. Methods [...] Read more.
Background/Objectives: Cardiac rehabilitation (CR) is known to improve clinical outcomes in cardiovascular disease, yet its benefits in patients with implantable cardioverter-defibrillators (ICD) are not well established. This meta-analysis evaluated the impact of CR on functional capacity and safety in ICD recipients. Methods: A systematic search of PubMed, Scopus, and Cochrane Library was performed to identify randomized controlled trials (RCT) involving adults who underwent ICD implantation and were assigned to either CR or standard care. The primary outcome was the change in peak oxygen uptake (peak VO2) from the baseline to the final follow-up. Random-effects models were applied, and subgroup analyses were conducted based on follow-up duration, supervision type, baseline peak VO2, and ischemic vs. non-ischemic etiology. Results: Seven RCTs involving 1461 participants (784 CR; 677 control) met the inclusion criteria. CR was associated with a significant improvement peak VO2 compared with usual care, expressed as the mean difference (MD) in change from the baseline to the last follow-up (MD 2 mL·kg−1·min−1; 95% CI 1.02–2.81; I2 = 65.7%), with consistent effects across all subgroups. Quality of life improved in the CR group (MD 6.46; 95% CI 2.25–10.67; I2 = 0%). A non-significant trend toward increased 6MWT distance was observed. CR did not increase adverse events, including ICD shocks, hospitalizations, or cardiac deaths. Conclusions: CR safely enhances exercise capacity and quality of life in ICD recipients without increasing arrhythmic events or mortality. Larger standardized trials are warranted to optimize CR delivery in this population. Full article
(This article belongs to the Section Molecular and Translational Medicine)
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23 pages, 404 KB  
Article
The Health and Physical Education Curriculum: Does It Address Muscular Fitness?
by Andrew Sortwell, Rodrigo Ramirez-Campillo, Urs Granacher, Christopher Joyce, Pedro Forte, Daniel A. Marinho, Ricardo Ferraz and Kevin Trimble
J. Funct. Morphol. Kinesiol. 2026, 11(1), 40; https://doi.org/10.3390/jfmk11010040 - 18 Jan 2026
Viewed by 115
Abstract
Background: The World Health Organization and the Australian physical activity guidelines, in line with contemporary research, recommend regular muscle-strengthening activities for optimal muscular fitness in children and adolescents. However, the extent to which muscle-strengthening or muscular fitness receives curricular emphasis is unknown [...] Read more.
Background: The World Health Organization and the Australian physical activity guidelines, in line with contemporary research, recommend regular muscle-strengthening activities for optimal muscular fitness in children and adolescents. However, the extent to which muscle-strengthening or muscular fitness receives curricular emphasis is unknown in Australia. Objectives: To examine to what extent the Australian Health and Physical Education Curriculum, Foundation to Year 10 (AHPEC; F–10) addresses and/or promotes muscular fitness. Methods: This study involved a mixed-methods content analysis of the AHPEC F–10 using: (i) conceptual analysis to identify muscular fitness-related terms; and (ii) relational analysis to examine alignment between muscular fitness content and curriculum rationale/aims. A search of national and international physical activity guidelines and school-based muscular fitness intervention literature generated a keyword set to guide abstraction from the AHPEC. Curriculum aim, rationale, level descriptions, achievement standards and content were coded to determine the extent to which muscular fitness was embedded. Intercoder reliability was established via consensus meetings. Muscular fitness content coverage was quantified as the proportion of directly aligned muscular fitness relevant content points per stage and aggregated primary (F–6), secondary (7–10), and F–10 scores. Results: A review of 32 national and one international physical activity guidelines identified 88 muscular fitness activities in total, with some activities appearing in multiple guidelines; 53.1% of national guidelines did not provide explicit muscular fitness examples, and where examples existed, they emphasised accessible modes (e.g., climbing, bodyweight tasks, jumping, and lifting). Additionally, analysis of school-based muscular fitness intervention literature identified 22 distinct muscular fitness activities to guide abstraction. Muscular fitness was absent in the AHPEC rationale and aims, was largely inferred in primary years level description and achievement standards and became more explicit in secondary achievement standards. Direct alignment of content with muscular fitness was non-existent or low across stages of learning (Foundation = 0%, Stage 1 = 0%, Stage 2 = 6.1%, Stage 3 = 9.1%, Stage 4 = 8.6%, Stage 5 = 8.8%). Overall, muscular fitness content coverage averaged 3.8% in primary, 8.7% in secondary, and 5.4% across F–10. Conclusions: The AHPEC treats muscular fitness as a low priority in primary schooling and a minor content area in secondary, yielding developmental messaging that is less aligned with contemporary evidence and physical activity guidelines. Full article
36 pages, 1805 KB  
Systematic Review
Technology-Enabled (P)rehabilitation for Patients Undergoing Cancer Surgery: A Systematic Review and Meta-Analysis
by Tiffany R. Tsoukalas, Zirong Bai, Claire Jeon, Roy Huynh, Eva Gu, Kate Alexander, Paula R. Beckenkamp, Adrian Boscolo, Kilian Brown, Phyllis Butow, Sharon Carey, Fang Chen, Meredith Cummins, Haryana M. Dhillon, Vesna Dragoje, Kailey Gorman, Matthew Halpin, Abby Haynes, Ilona Juraskova, Sascha Karunaratne, Jamie Keck, Bora Kim, Cherry Koh, Qiang Li, Lara Lipton, Xiaoqiu Liu, Jaime Macedo, Rebecca Mercieca-Bebber, Renee Moreton, Rachael L. Morton, Julie Redfern, Bernhard Riedel, Angus Ritchie, Charbel Sandroussi, Cathy Slattery, Allan Ben Smith, Michael Solomon, Flora Tao, Kate White, Kate Wilson, Kahlia Wolsley, Kun Yu and Daniel Steffensadd Show full author list remove Hide full author list
Cancers 2026, 18(2), 296; https://doi.org/10.3390/cancers18020296 - 18 Jan 2026
Viewed by 109
Abstract
Background/Objectives: (P)rehabilitation, comprising structured exercise, nutritional optimisation, and/or psychological support delivered pre- or postoperatively, has demonstrated efficacy in improving outcomes across the cancer care continuum. However, access remains limited. Technology-enabled (p)rehabilitation offers a novel solution with the potential to enhance equity and continuity [...] Read more.
Background/Objectives: (P)rehabilitation, comprising structured exercise, nutritional optimisation, and/or psychological support delivered pre- or postoperatively, has demonstrated efficacy in improving outcomes across the cancer care continuum. However, access remains limited. Technology-enabled (p)rehabilitation offers a novel solution with the potential to enhance equity and continuity of care. This systematic review aimed to evaluate the efficacy of technology-enabled (p)rehabilitation on perioperative and patient-reported outcomes among individuals undergoing thoracic and/or abdominopelvic cancer surgery. Methods: Six databases were search from inception to October 2024. Eligible studies were randomised controlled trials (RCTs) comparing technology-enabled (p)rehabilitation with usual care, placebo, or non-technology-based interventions in adults undergoing thoracic and/or abdominopelvic cancer surgery. Outcomes included postoperative complications, hospital readmissions, hospital length of stay (LOS), quality of life (QoL), pain, anxiety, depression, fatigue, distress, and satisfaction. Higher scores indicated improved QoL or worse symptom severity. Risk of bias was assessed using the revised Cochrane tool, and evidence strength was determined using GRADE methodology. Relative risks (RR) and mean differences (MD) were calculated using random-effects meta-analysis. Results: Seventeen RCTs (18 publications, n = 1690) were included. Trials most commonly evaluated application-based platforms (n = 8) and the majority exhibited some risk of bias. Technology-enabled (p)rehabilitation was associated with a significant reduction in LOS (MD = 1.33 days; 95% CI: 0.59–2.07; seven trials), and improvements in pain (MD = 6.12; 95% CI: 3.40–8.84; four trials), depression (MD = 2.82; 95% CI: 0.65–4.99; five trials), fatigue (MD = 10.10; 95% CI: 6.97–13.23; three trials) and distress (MD = 1.23; 95% CI: 0.30–2.16; single trial) compared with controls. Conclusions: Technology-enabled (p)rehabilitation shows promise in reducing LOS and improving selected patient-reported outcomes following thoracic and abdominopelvic cancer surgery. Although evidence is limited due to the small number of studies, modest sample sizes, methodological heterogeneity, and intervention variability, the overall findings justify further investigation. Large-scale, adequately powered clinical trials are required to confirm efficacy and guide clinical effectiveness and implementation studies. Full article
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19 pages, 1668 KB  
Article
Early Post-STEMI Cardiac Rehabilitation in the CSC-Infarct Program: Real-World Safety and Effectiveness of Individualized Training Protocols
by Agnieszka Grochulska, Sebastian Glowinski and Aleksandra Bryndal
J. Clin. Med. 2026, 15(2), 746; https://doi.org/10.3390/jcm15020746 - 16 Jan 2026
Viewed by 192
Abstract
Background/Objectives: Cardiac remodeling post-myocardial infarction is a critical process determining patient prognosis. Poland’s Coordinated Specialist Care program enables early cardiac rehabilitation (CSC-Infarct) during peak remodeling period. This study evaluated the safety and effectiveness of very early cardiac rehabilitation initiated during peak remodeling [...] Read more.
Background/Objectives: Cardiac remodeling post-myocardial infarction is a critical process determining patient prognosis. Poland’s Coordinated Specialist Care program enables early cardiac rehabilitation (CSC-Infarct) during peak remodeling period. This study evaluated the safety and effectiveness of very early cardiac rehabilitation initiated during peak remodeling (mean 16.8 ± 3.4 days post- ST-elevation myocardial infarction [STEMI]) within the CSC-Infarct program. We examined outcomes following two training modalities—interval and continuous—applied according to clinical guidelines based on baseline exercise capacity. Methods: We enrolled 288 patients (135 women, 153 men, age 59.7 ± 9.8 years) after first STEMI into a 24-day rehabilitation program (5 sessions/week) within CSC-Infarct. Patients received either interval training (n = 127) or continuous training (n = 161) according to National Health Fund protocols. Hemodynamic, metabolic (metabolic equivalents [MET], maximal oxygen uptake [VO2max]), and functional parameters (6-minute walk test [6MWT]) were assessed pre- and post-rehabilitation. Results: Both groups showed significant improvement in most parameters. The continuous training group achieved higher final MET values (8.9 ± 2.5 vs. 6.5 ± 1.9; p < 0.001), VO2max (31.0 ± 8.8 vs. 22.9 ± 6.5 mL/kg/min; p < 0.001), and 6MWT distance (530.9 ± 108.9 vs. 455.6 ± 104.3 m; p < 0.001). Significant improvement in heart rate recovery (HRR), indicating autonomic balance, was observed only in the continuous training group (p = 0.026), not in the interval group (p = 0.290). Conclusions: Early rehabilitation within CSC-Infarct (mean 16.8 days post-infarction) during intensive remodeling is safe and effective. Both training modalities produced clinically significant improvements when appropriately matched to patient baseline capacity. Continuous training showed additional benefit in autonomic balance (HRR improvement), while interval training achieved substantial relative gains (+11.8% in 6MWT) in lower-capacity patients. The CSC-Infarct program provides optimal timing for rehabilitation implementation during the critical cardiac remodeling period. Full article
(This article belongs to the Section Cardiology)
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14 pages, 808 KB  
Article
The Effects of 24 Weeks Sensorimotor Training on Balance, Physical Function, and Pain in Women with Knee Osteoarthritis
by Caterina Mauri, Charles James Steward, Attilio Parisi, Mathew Hill, Sara Severoni, Claudia Cerulli and Elisa Grazioli
Sports 2026, 14(1), 43; https://doi.org/10.3390/sports14010043 - 16 Jan 2026
Viewed by 245
Abstract
Background: Osteoarthritis (OA) is a common degenerative joint disease that often leads to impaired postural control, pain, and reduced physical function. Exercise is considered a first-line treatment, with sensorimotor training being an effective approach for managing OA. However, the optimal method of sensorimotor [...] Read more.
Background: Osteoarthritis (OA) is a common degenerative joint disease that often leads to impaired postural control, pain, and reduced physical function. Exercise is considered a first-line treatment, with sensorimotor training being an effective approach for managing OA. However, the optimal method of sensorimotor training for individuals with OA has not yet been established. Thus, the aim of this study was to compare the effects of a 24-week Gyrokinesis method (GK) versus Pilates (PL) intervention on balance control, function, pain and kinesiophobia in women with knee OA. Methods: Twenty women (aged 60 ± 7 years) with grade 2 or 3 knee OA were assigned to either GK (n = 12) or PL (n = 8). Both groups trained twice weekly for 24 weeks. Pre- and post-intervention assessments included postural sway parameters (RMS, velocity, frequency), physical function tests (e.g., TUG, Sit-to-Stand), flexibility, pain (Brief Pain Inventory), kinesiophobia (Tampa Scale), and quality of life (SF-36). Results: GK resulted in significantly greater improvements than PL in postural sway mean velocity AP right (GK −53.85% vs. PL −20.17%), AP left (GK −43.48% vs. PL +13.45%), and ML left (GK −40.18% vs. PL +37.95), pain reduction (GK −82.5% vs. PL −33.3%), and physical function (Sit-to-Stand: GK +75.9% vs. PL +3.7%; TUG: GK −16.4% vs. PL −13.8%; Step Test right: GK +34.2% vs. PL +19.9%; Step Test left: GK +41.4% vs. PL +18.1%) (all, p < 0.05). No significant between-group differences were observed for kinesiophobia or SF-36 scores (both, p > 0.05). Conclusions: Gyrokinesis method may be more effective than Pilates in enhancing balance, reducing pain, and improving physical function in women with knee OA. These findings support the use of the Gyrokinesis method in rehabilitation programs for individuals with OA. Full article
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11 pages, 608 KB  
Article
Muscle-Specific Biomechanical Adaptations Following Rehabilitation Treatment in Cervical Spondylosis: A Pilot Study
by Andreea Ancuța Talinga, Roxana Ramona Onofrei, Ada-Maria Codreanu, Veronica Aurelia Romanescu, Marius-Zoltan Rezumeș, Dan-Andrei Korodi, Oana Suciu and Claudia Borza
Life 2026, 16(1), 147; https://doi.org/10.3390/life16010147 - 16 Jan 2026
Viewed by 143
Abstract
Background. Cervical spondylosis is a degenerative disorder of the spine, frequently associated with chronic neck pain, reduced mobility, and functional impairment. Patients develop alterations in muscle tone, stiffness, and elasticity, which further contribute to disability. This study aimed to investigate the effects of [...] Read more.
Background. Cervical spondylosis is a degenerative disorder of the spine, frequently associated with chronic neck pain, reduced mobility, and functional impairment. Patients develop alterations in muscle tone, stiffness, and elasticity, which further contribute to disability. This study aimed to investigate the effects of a 14-day standardized rehabilitation program on the biomechanical and contractile properties of cervical and scapular muscles in patients with cervical spondylosis. Methods. This study used a single-group pre–post observational design on 23 patients (16 women, 7 men; mean age 61.1 ± 14.2 years) diagnosed with cervical spondylosis. All participants completed a standardized rehabilitation treatment that included cervical mobilization, stretching, isometric exercises, scapular stabilization, electrotherapy, ultrasound, thermotherapy, and balneotherapy. Muscle properties were evaluated bilaterally using the MyotonPRO® device, measuring frequency, stiffness, decrement, relaxation time, and creep. Assessments were performed in a sitting position for the deltoid, upper trapezius and pectoralis major, both at baseline (T0) and after treatment (T1). Handgrip strength was assessed bilaterally with a handheld dynamometer. Results. The deltoid muscle showed a significant reduction in frequency (14.86 → 13.50 Hz, p = 0.034) and stiffness (306.4 → 256.1 N/m, p = 0.014) on the right side, suggesting normalization of tone and passive resistance. The upper trapezius had a significant bilateral decrease in decrement (p < 0.05), reflecting improved elasticity. The pectoralis major displayed the most consistent adaptations, with increased frequency (right side, p = 0.008), improved relaxation bilaterally (p < 0.05), and significant reductions in decrement and creep (p < 0.01). Handheld dynamometry confirmed increased handgrip strength, with a 5.4% improvement on the left side and 7.6% on the right side. Conclusions. In our study measurable changes in muscle parameters were observed following a rehabilitation program in patients with cervical spondylosis. The integration of myotonometry and dynamometry allowed objective assessment of muscle adaptations supporting the clinical value of individualized rehabilitation strategies. Full article
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11 pages, 335 KB  
Article
Effectiveness and Safety of Hybrid Comprehensive Telerehabilitation in Women with Heart Failure—A Subanalysis of the TELEREH-HF Randomized Clinical Trial
by Ewa Piotrowicz, Renata Główczyńska, Dominika Szalewska, Ilona Kowalik, Piotr Orzechowski, Sławomir Pluta, Zbigniew Kalarus, Anna Mierzyńska, Izabela Jaworska, Robert Irzmański and Ryszard Piotrowicz
J. Clin. Med. 2026, 15(2), 694; https://doi.org/10.3390/jcm15020694 - 15 Jan 2026
Viewed by 106
Abstract
Background/Objectives: Despite the known benefits of cardiac rehabilitation, it remains underutilized among women. In particular, little is known about the effectiveness of hybrid comprehensive telerehabilitation (HCTR) in women with heart failure (HF). The purpose of this study was to assess effectiveness and [...] Read more.
Background/Objectives: Despite the known benefits of cardiac rehabilitation, it remains underutilized among women. In particular, little is known about the effectiveness of hybrid comprehensive telerehabilitation (HCTR) in women with heart failure (HF). The purpose of this study was to assess effectiveness and safety of HCTR in women with HF. Methods: This analysis formed part of the TELEREH-HF multicenter, randomized trial that enrolled 850 HF patients (NYHA I-III, LVEF ≤ 40%). Patients were randomized 1:1 to HCTR plus usual care (UC) or UC alone. Patients underwent either HCTR (1 week in hospital and 8 weeks at home, five times weekly) or UC with observation. The effectiveness of HCTR was assessed by changes in peak oxygen consumption (VO2peak), workload duration (t) in cardiopulmonary exercise test and quality of life (QoL) based on Medical Outcome Survey Short Form 36 Questionnaire (SF-36). Measurements were taken before and after intervention/observation. Results: Women constituted 11.5% of the TELEREH-HF study population. Forty women in the HCTR group and 44 women in the UC group completed program and observation, respectively. HCTR resulted in a significant improvement in VO2peak (13.4 ± 4.3 vs. 14.3 ± 4.6; 95%CI 0.91 [0.05; 1.77], p = 0.038), workload duration (301 ± 162.3 vs. 334 ± 156.6; 95%CI 33 [5; 60], p = 0.022) and SF-36 overall score (85.9 ± 13.6 vs. 89.9 ± 13.5; 95%CI 4.0 [0.6; 7.4], p = 0.024). These favorable results were not observed in the UC group VO2peak (14.2 ± 4.8 vs. 14.2 ± 4.8; 95%CI 0.02 [−1.20; 1.24], p = 0.971) and SF-36 overall score (89.1 ± 17.4 vs. 89.5 ± 15.8; 95%CI 4.0 [−2.1; 2.8], p = 0.796), except for an increase workload duration (268 ± 138.4 vs. 300 ± 130.1; 95%CI 32 [2; 62], p = 0.036). The HCTR group showed a significantly greater improvement in the physical component of QoL than the UC group. In neither group were there deaths nor major adverse events related to exercise training. Conclusions: Among women with heart failure, hybrid comprehensive telerehabilitation appears safe and leads to statistically significant although moderate improvements in physical capacity and quality of life. However, due to the small sample size, further studies in larger female populations are needed to confirm these findings. Full article
(This article belongs to the Special Issue Recent Clinical Advances in Cardiac Rehabilitation)
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13 pages, 239 KB  
Review
Rehabilitative Ultrasound Imaging as Visual Biofeedback in Pelvic Floor Dysfunction: A Narrative Review
by Dana Sandra Daniel, Mila Goldenberg and Leonid Kalichman
Tomography 2026, 12(1), 10; https://doi.org/10.3390/tomography12010010 - 15 Jan 2026
Viewed by 199
Abstract
Background: Pelvic floor dysfunction, more prevalent in women but affecting both genders, impairs sphincter control and sexual health, and causes pelvic pain. Pelvic floor muscle (PFM) training is the first-line treatment for urinary incontinence, supported by robust evidence. Rehabilitative ultrasound imaging (RUSI) [...] Read more.
Background: Pelvic floor dysfunction, more prevalent in women but affecting both genders, impairs sphincter control and sexual health, and causes pelvic pain. Pelvic floor muscle (PFM) training is the first-line treatment for urinary incontinence, supported by robust evidence. Rehabilitative ultrasound imaging (RUSI) serves as a visual biofeedback tool, providing real-time imaging to enhance PFM training, motor learning, and treatment adherence. Aim: This narrative review evaluates the role and efficacy of RUSI in pelvic floor rehabilitation. Method: A comprehensive search of PubMed, Cochrane, and MEDLINE was conducted using keywords related to pelvic floor rehabilitation, ultrasound, and biofeedback, limited to English-language publications up to July 2025. Systematic reviews, meta-analyses, and clinical trials were prioritized. Results: Transperineal and transabdominal ultrasound improve PFM function across diverse populations. In post-prostatectomy men, transperineal ultrasound-guided training enhanced PFM contraction and reduced urinary leakage. In postpartum women with pelvic girdle pain, transabdominal ultrasound-guided biofeedback combined with exercises decreased pain and improved function. Ultrasound-guided pelvic floor muscle contraction demonstrated superior performance compared to verbal instruction. Notably, 57% of participants who were unable to contract the pelvic floor muscles with verbal cues achieved a correct contraction with ultrasound biofeedback, and this approach also resulted in more sustained improvements in PFM strength. Compared to other biofeedback modalities, RUSI demonstrated outcomes that are comparable to or superior to those of alternative methods. However, evidence is limited by a lack of standardized protocols and randomized controlled trials comparing RUSI with other modalities. Conclusions: RUSI is an effective visual biofeedback tool that enhances outcomes of PFM training in pelvic floor rehabilitation. It supports clinical decision-making and patient engagement, particularly in cases where traditional assessments are challenging. Further research, including the development of standardized protocols and comparative trials, is necessary to optimize the clinical integration of this method and confirm its superiority over other biofeedback methods. Full article
24 pages, 617 KB  
Systematic Review
Effects of Pulmonary Rehabilitation on Dyspnea, Quality of Life and Cognitive Function in COPD: A Systematic Review
by Alessandro Vatrella, Angelantonio Maglio, Maria Pia Di Palo, Elisa Anna Contursi, Angelo Francesco Buscetto, Noemi Cafà, Marina Garofano, Rosaria Del Sorbo, Placido Bramanti, Colomba Pessolano, Andrea Marino, Mariaconsiglia Calabrese and Alessia Bramanti
J. Clin. Med. 2026, 15(2), 670; https://doi.org/10.3390/jcm15020670 - 14 Jan 2026
Viewed by 151
Abstract
Background/Objectives: Chronic Obstructive Pulmonary Disease (COPD) is frequently associated with dyspnea, impaired health-related quality of life (HRQoL), and cognitive dysfunction. Although pulmonary rehabilitation (PR) is considered a core therapeutic strategy, its specific effects on cognitive function, dyspnea, and dysphonia remain unclear. This systematic [...] Read more.
Background/Objectives: Chronic Obstructive Pulmonary Disease (COPD) is frequently associated with dyspnea, impaired health-related quality of life (HRQoL), and cognitive dysfunction. Although pulmonary rehabilitation (PR) is considered a core therapeutic strategy, its specific effects on cognitive function, dyspnea, and dysphonia remain unclear. This systematic review aimed to evaluate the impact of PR and respiratory or cognitive-focused rehabilitative interventions on dyspnea, quality of life, cognitive performance, and voice outcomes in adults with COPD. Methods: This review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251131325). A systematic search of PubMed, Scopus and Web of Science identified studies published between 2010 and 21 August 2025. Eligible designs included randomized and non-randomized controlled studies, cohort, and mixed-method studies involving adults with COPD undergoing rehabilitative interventions targeting dyspnea, cognition, dysphonia, or swallowing. Outcomes included cognitive measures, dyspnea scales, voice parameters, and HRQoL indices. Results: Twelve studies (n ≈ 810 participants) met inclusion criteria. Most PR and exercise-based programs showed improvements in global cognition and executive functions, particularly when combined with cognitive training or high-intensity exercise modalities. Dyspnea improved consistently following short- to medium-term PR or respiratory muscle training, whereas low-frequency long-term programs yielded limited benefit. HRQoL improved across structured PR programs, especially in multidimensional interventions. Only one study assessed dysphonia, reporting transient improvements in maximum phonation time following inspiratory muscle training. No included study evaluated dysphagia-related outcomes. Conclusions: PR and respiratory muscle training can enhance cognition, dyspnea, and HRQoL in COPD, although evidence for dysphonia remains scarce and dysphagia is entirely unaddressed. Future high-quality trials should adopt standardized outcome measures, include long-term follow-up, and integrate voice and swallowing assessments within PR pathways. Full article
(This article belongs to the Section Respiratory 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
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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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15 pages, 1147 KB  
Article
The Effects of Gamified Virtual Reality on Muscle Strength and Physical Function in the Oldest Old—A Pilot Study on Sarcopenia-Related Functional Outcomes
by Żaneta Grzywacz, Justyna Jaśniewicz, Anna Koziarska, Joanna Macierzyńska and Edyta Majorczyk
J. Clin. Med. 2026, 15(2), 621; https://doi.org/10.3390/jcm15020621 - 13 Jan 2026
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Abstract
Background/Objectives: Sarcopenia is an age-related decline in muscle mass and strength, reducing mobility and functional independence and increasing the risk of falls. Non-pharmacological interventions remain the most effective strategies to prevent or delay its progression, with exercise recognized as the primary approach. Virtual [...] Read more.
Background/Objectives: Sarcopenia is an age-related decline in muscle mass and strength, reducing mobility and functional independence and increasing the risk of falls. Non-pharmacological interventions remain the most effective strategies to prevent or delay its progression, with exercise recognized as the primary approach. Virtual reality (VR)-based training has recently emerged as a promising tool to promote physical activity; however, its application among the oldest-old individuals remains underexplored. This is a randomized controlled pilot study to evaluate the effects of VR-based intervention using the game “Beat Saber” on muscle strength and selected physical performance indicators related to sarcopenia risk in older adults. Methods: Thirty-eight residents (mean age: 87.2) of a long-term care facility were randomly assigned to either a VR group or a control group. The VR group participated in 12 supervised VR-based training sessions of 20 min per session, three times per week for four weeks. Handgrip strength, the arm curl test, 30-s chair stand, a 2-min step-in-place test, and an 8-foot up-and-go test were assessed before and after the intervention. Results: Linear mixed-model analyses revealed significant group-by-time interactions for upper- and lower-limb strength (handgrip, arm curl, chair stand; p < 0.05), favoring the VR group. Agility and endurance (8-foot up-and-go, 2-min step-in-place) showed no significant interactions. In the VR group, the 30-s chair stand performance correlated positively with the arm curl and the 2-min step-in-place tests results, while handgrip strength correlated with the arm curl performance. In the control group, the 30-s chair stand test results correlated strongly with the 8-foot up-and-go and 2-min step-in-place tests, but no significant correlations were found for handgrip strength. Conclusions: The findings indicate short-term functional benefits of VR exercise among the oldest-old adults. VR-based training appears to be an effective and well-tolerated method to enhance physical performance in individuals aged 80 and older and may represent a valuable strategy for improving functional performance indicators associated with sarcopenia risk in adults aged 80 years and older. Full article
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19 pages, 1826 KB  
Article
Evaluation of the Efficacy of an Artificial Intelligence-Based Assessment and Correction System in the Rehabilitation of Patients Following Anterior Cruciate Ligament Reconstruction Surgery
by Tingting Zhu, Ying Huang, Jingjing Pu, Chaolong Wang, Min Ruan, Ping Lu, Xiaojiang Yang, Nirong Bao, Yueying Chen and Aiqin Zhang
J. Clin. Med. 2026, 15(2), 575; https://doi.org/10.3390/jcm15020575 - 10 Jan 2026
Viewed by 275
Abstract
Background: Arthroscopic anterior cruciate ligament (ACL) reconstruction is widely recognised as the primary treatment for ACL injuries. However, with the increasing incidence of sports-related injuries and growing demand for rehabilitation services, conventional rehabilitation models—largely reliant on therapists’ experience and subjective assessment—are increasingly insufficient [...] Read more.
Background: Arthroscopic anterior cruciate ligament (ACL) reconstruction is widely recognised as the primary treatment for ACL injuries. However, with the increasing incidence of sports-related injuries and growing demand for rehabilitation services, conventional rehabilitation models—largely reliant on therapists’ experience and subjective assessment—are increasingly insufficient to meet the clinical need for precise and individualised rehabilitation programmes. This study aimed to evaluate the effectiveness of a rehabilitation protocol incorporating an artificial intelligence (AI)-based assessment and correction system on functional recovery following ACL reconstruction. Methods: Using convenience sampling, 80 patients undergoing ACL reconstruction between June to December 2024 were recruited for this randomised controlled trial. Participants were randomly assigned to either a control group (n = 40), which received conventional functional exercise training, or a trial group (n = 40), which received rehabilitation intervention guided by an AI-based assessment and correction system. Knee function scores (Lysholm score, IKDC score), Berg Balance Scale (BBS) scores, joint range of motion (ROM), and rehabilitation exercise compliance scores were collected and analysed 1, 2, 3, and 4 months postoperatively. Results: Compared with the control group, the trial group demonstrated significantly greater improvements in Lysholm score, IKDC score, BBS score, and active knee joint ROM (p < 0.05) at postoperative assessment points. Additionally, rehabilitation exercise adherence was significantly higher in the trial group compared to the control group (p < 0.05). Conclusions: Rehabilitation protocols integrating AI-based assessment and correction systems effectively enhance knee function recovery, joint mobility and balance ability following ACL reconstruction. Moreover, these protocols significantly improve rehabilitation exercise adherence, demonstrating superior efficacy compared to conventional rehabilitation approaches. This digital rehabilitation model represents an efficient and promising intervention for postoperative ACL rehabilitation. Full article
(This article belongs to the Section Clinical Rehabilitation)
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25 pages, 5130 KB  
Article
Interpretable Biomechanical Feature Selection for VR Exercise Assessment Using SHAP and LDA
by Urszula Czajkowska, Magdalena Żuk, Michał Popek and Celina Pezowicz
Sensors 2026, 26(2), 464; https://doi.org/10.3390/s26020464 - 10 Jan 2026
Viewed by 231
Abstract
Virtual reality (VR) technologies are increasingly applied in rehabilitation, offering interactive physical and spatial exercises. A major challenge remains the objective assessment of human movement quality (HMQA). This study aimed to identify biomechanical features differentiating correct and incorrect execution of a lateral lunge [...] Read more.
Virtual reality (VR) technologies are increasingly applied in rehabilitation, offering interactive physical and spatial exercises. A major challenge remains the objective assessment of human movement quality (HMQA). This study aimed to identify biomechanical features differentiating correct and incorrect execution of a lateral lunge and to determine the minimal number of sensors required for reliable VR-based motion analysis, prioritising interpretability. Thirty-two healthy adults (mean age: 26.4 ± 8.5 years) performed 211 repetitions recorded with the HTC Vive Tracker system (7 sensors + headset). Repetitions were classified by a physiotherapist using video observation and predefined criteria. The analysis included joint angles, angular velocities and accelerations, and Euclidean distances between 28 sensor pairs, evaluated with Linear Discriminant Analysis (LDA) and SHapley Additive exPlanations (SHAP). Angular features achieved higher LDA performance (F1 = 0.89) than distance-based features (F1 = 0.78), which proved more stable and less sensitive to calibration errors. Comparison of SHAP and LDA showed high agreement in identifying key features, including hip flexion, knee rotation acceleration, and spatial relations between headset and foot or shank sensors. The findings indicate that simplified sensor configurations may provide reliable diagnostic information, highlighting opportunities for interpretable VR-based rehabilitation systems in home and clinical settings. Full article
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