Search Results (4,969)

Background: Parkinson’s disease (PD) is a neurodegenerative condition that affects quality of life due to motor (gait, balance) and cognitive alterations, raising the risk of falling. Virtual reality (RV) and dancing have shown benefits for speed of walking, balance, and postural stability, as well as decreased risk of falls. Objective: The goal of this study was to analyze the effectiveness of RV and dancing using a Kinect Xbox 360 video game to improve walking speed and motor performance and reduce the risk of falls in patients with PD. Method: This is a pre-experimental study with a simple pre-post design, involving a single group of 14 patients diagnosed with PD in stages 1 to 4 of the Hoehn and Yahr (H and Y) scale, from the National Institute of Neurology (INNN). Before and after the intervention, motor tests, the Unified Parkinson’s Disease Rating Scale (UPDRS-III), the Timed Up and Go (TUG) test, and the Tinetti were applied. The intervention consisted of 16 bi-weekly sessions, which included warm-up, coordination exercises, 10 songs, and cool-down. Results: Effects of the RV intervention were observed on improvements in motor tests (z = −2.640, p = 0.008), gait (z = −3.316, p = 0.001), balance (TUG) (z = −2.966, p = 0.001), and on the UPDRS-III scale (total index) (z = −3.048, p = 0.002). An increase in the difficulty level of dancing was also observed (X² = 144.13, p < 0.01). Conclusions: The virtual reality intervention with dancing improved motor performance, including increased walking speed, enhanced postural stability, reduced stiffness and bradykinesia, and a decreased risk of falls Full article

This paper establishes the Brain Booster Buildings framework, the first model to demonstrate how daily stair use can elevate brain-derived neurotrophic factor (BDNF), a vital molecule for lifelong neurogenesis and brain health in humans. Through a novel framework of the associations between metabolic equivalents (METs) data and BDNF response studies, we establish that stairs are generally higher in METs than any indoor activity. We further explain how architectural parameters (riser height, floor number, pace) predictably modulate exercise intensity during stair use. We identify two implementable patterns: moderate-intensity continuous use (≥20 min, 1–3 floors) and high-intensity interval training (6 min, carrying loads while using stairs in a building with three floors or less, or using stairs in a building with ≥3 floors, load-free). Based on BDNF responses to comparable exercise intensities, 6 min of high-intensity stair climbing is predicted to increase serum BDNF by up to 40%. Since people spend ~90% of their time indoors while neurogenesis declines fourfold throughout the adult lifespan, affecting mood, stress resilience, and memory, vertical architecture emerges as a vital, accessible, and cost-effective infrastructure that boosts BDNF for neurogenesis, plasticity, and brain health. We conducted scenario-based modelling using the Brain Booster Buildings framework to estimate how the use of stairs in residential, office, educational, hospital, and commercial buildings may boost BDNF levels based on established intensity–BDNF relationships. The framework provides architects, policymakers, and clinicians with evidence-based estimated specifications to use buildings as daily brain boosters. Full article

Background/Objectives: High-intensity interval training (HIIT) is considered an effective way in improving aerobic capacity and selected health parameters. Ashwagandha is an herb with possible health-promoting properties that may affect metabolism and performance. The aim of this study was to evaluate the effects of ashwagandha supplementation (600 mg/day) during an 8-week HIIT on body composition, lipid profile and hormone levels related to energy homeostasis in healthy young men. Methods: The study was randomised, double-blind and placebo-controlled (Placebo group, PL, n = 20; ashwagandha, A, n = 18). HIIT was conducted on a rowing ergometer (3 times per week, 5–7 series of 1.5 min at 85–95% of maximum power, with intervals of 1.5 min at 70 W). Body composition (BIA, Tanita TBF 300P), serum lipid profile (tChol, HDL-cholesterol, LDL-cholesterol, TG) and serum levels of adiponectin, asprosin and irisin were analysed before (term 1) and after the8-week study (term 2). Both the lipid and hormonal profiles were measured in three time points: pre- and post-graded exercise test and after 24 h recovery period. Results: Analysis showed no effect of training or supplementation on body composition and lipid profile (p > 0.05). In turn, the 8-week HIIT decreased resting levels of adiponectin and increased irisin levels post-exercise and after 24 h (p < 0.05). Conclusions: In young, healthy men, an 8-week HIIT programme significantly affects selected hormones related to energy metabolism of adipose (adiponectin) and muscle (irisin) tissues, but ashwagandha supplementation did not significantly affect any of the hormonal parameters analysed. Full article

Background: L-arginine is a conditionally essential amino acid that serves as a substrate for nitric oxide synthase and regulates energy metabolism. While its ergogenic effects have been proposed, the mechanisms underlying its anti-fatigue properties are not fully understood. Methods: Male ICR mice were orally administered L-arginine (300, 600, or 1200 mg/kg bw/day) for 28 days. Fatigue was chronically induced using twice-weekly forced swimming or treadmill running, and fatigue resistance was then assessed under these paradigms. Blood, skeletal muscle, and liver were analyzed for biomarkers including glucose, lactate, LDH, CPK, NEFA, ammonia, glycogen, nitric oxide, cortisol, and antioxidant enzymes. In parallel, C2C12 myoblasts were treated with L-arginine under proliferative and differentiated conditions to assess hexokinase (HK) activity, myogenin expression, and ROS generation. Results: In vivo, L-arginine decreased serum LDH, CPK, NEFA, ammonia, nitric oxide, and cortisol, while enhancing blood glucose and glycogen storage in both muscle and liver. Forced swimming reduced serum lactate, whereas treadmill exercise elevated intramuscular lactate, suggesting context-dependent lactate regulation. Importantly, L-arginine did not significantly improve forced-swimming immobility time, whereas treadmill time-to-exhaustion increased at the highest dose. Antioxidant responses were improved, as reflected by normalized hepatic catalase activity. In vitro, L-arginine increased HK activity, promoted myogenin expression, and reduced ROS levels, supporting improved glucose utilization, muscle differentiation, and oxidative stress resistance. Conclusions: These findings demonstrate that L-arginine supplementation under chronic fatigue-inducing paradigms improves endurance and alleviates fatigue by enhancing energy metabolism, preserving glycogen, reducing muscle injury, and attenuating oxidative stress. L-arginine shows potential as a functional ingredient for promoting exercise performance and recovery. Full article

Aging contributes to neurodegeneration, predominantly characterized by increased oxidative stress, which leads to neurodegenerative changes and cognitive decline. This cognitive impairment is often associated with neuroinflammation, oxidative stress, and neuronal damage. Exercise is widely recognized for its capacity to elevate levels of irisin, a hormone derived from the cleavage of fibronectin type III domain-containing protein 5 (FNDC5). FNDC5/irisin acts as a myokine that mediates numerous beneficial effects of physical activity on metabolic health. It has also been recognized for its neuroprotective roles, suggesting its potential to mitigate neurodegenerative processes by promoting neuronal survival, reducing oxidative stress, and enhancing synaptic plasticity. However, the specific impact of exercise on the FNDC5/irisin pathway and antioxidant mechanisms in the aged brain remains insufficiently explored. In this study, we aimed to validate the neuroprotective role of exercise-induced FNDC5/irisin against aging-related oxidative stress, glial activation, neuronal damage, and cognitive impairment in 20-month-old mice. The exercise group underwent treadmill running for 60 min daily over an 8-week period. Our findings indicated that aging mice exhibited cognitive impairment, as evidenced by the Y-maze test; however, treadmill exercise effectively alleviated this impairment. Aged mice showed the activation of microglia and astrocytes in the hippocampus, which was notably reduced by exercise. Moreover, exercise improved the levels of calbindin and irisin, which were diminished due to aging. Our study demonstrated that aging led to a decrease in the antioxidant response element system and FNDC5/irisin pathway. However, exercise effectively activated Nrf2 and FNDC5/irisin expression, subsequently enhancing levels of SOD1, GSTO1/2, Sirt1, PGC-1α, BDNF, IGF-1, and IGF-2 in the hippocampus. The exercise-induced activation of Nrf2 signaling and FNDC5/irisin has emerged as a potent mechanism for alleviating oxidative stress and neuroinflammation associated with aging. In conclusion, our findings suggest that regular exercise has the potential to alleviate cognitive impairment through the activation of PGC-1α-FNDC5/irisin signaling, the Nrf2 ARE system, and neurotrophic factors in aged mice. Full article

Background: Occupational accidents, injuries, and illnesses are serious problems for organizations. Workplace sleepiness is a major issue that affects occupational safety and productivity. Workplace sleepiness is influenced by sleep, diet, and blood glucose levels, but the causal relationship is unclear. This scoping review aimed to investigate the factors affecting work productivity, with a particular focus on the impact of sleepiness caused by food intake and blood glucose level on productivity. Methods: PubMed, and Web of Science were used to search terms, such as “workplace,” “sleepiness or postprandial hypoglycemia,” “productivity,” and “measurement.” The following studies were included: (1) those with working hours evaluations; (2) that excluded patients with diabetes, heart diseases, or other diseases; (3) that excluded patients with mental illness; (4) that did not limit the evaluation of sleepiness at work to sleep only; (5) with publications after 2014; and (6) that were research articles. Results: The search yielded 521 articles. Nine papers met the inclusion criteria. Six studies assessed blood glucose levels, six assessed sleepiness, and one simultaneously assessed blood glucose and sleepiness. The Karolinska Sleepiness Scale (KSS) is the most frequently used sleep measure. Most studies have assessed the effects of controlled diets. Although some studies have used continuous glucometers, their evaluation of blood glucose levels has been limited. The extracted literature also included mild exercise and control of environmental illumination as a countermeasure against sleepiness. Conclusions: Although few studies have analyzed the causes and countermeasures of sleepiness in the workplace, sleepiness affects work productivity, diet affects sleepiness, and several methods for suppressing sleepiness have been researched. However, a few studies have directly evaluated the effects of blood glucose fluctuations and sleepiness on work productivity. These results suggest that further research into the relationship between sleepiness at work and related biological signals and blood glucose fluctuations will be important in understanding the causes, as it will form the basis for measures to improve work productivity. Full article

The main objective of this study is to determine the knowledge and awareness levels of climate change among preparatory class students at Zonguldak Bülent Ecevit University in the Western Black Sea Region of Türkiye using an unsupervised clustering approach. Within this scope, a survey was administered to university students (n = 280). Participant scores for the survey sections containing five-point Likert-type questions on climate change awareness were calculated using min–max normalization. The normalized data was then processed using the k-means algorithm, a well-known technique in unsupervised machine learning. This resulted in a classification (clustering) related to climate change awareness. The number of clusters was determined using the Silhouette index. Three clusters identified using k-means and Silhouette index ($S\approx 0.55)$ revealed the knowledge and application levels of student groups regarding climate change awareness. As a result of clustering, it was determined that Cluster-3 students (n = 134, 47.9%), defined as having a high level of knowledge and application, had a higher impact value in their overall assessments of green space-focused issues related to climate change awareness compared to the overall assessments of students in other clusters. Some notable findings concerning the attitudes of Cluster-3 students highlight climate change awareness-related practices. These include minimizing water consumption to levels necessary for ecosystem water management (mean = 95.7, std. deviation = 10.9) and exercising controlled, sustainable daily energy use to alleviate pressure on green spaces (mean = 94.4, std. deviation = 12.5). This study offers practical insights for policymakers, educators, and institutions, emphasizing the need to enhance climate education and to promote the active involvement of younger generations in shaping sustainable environments. Full article

Introduction: Multiple sclerosis (MS) is a chronic neurodegenerative disease that entails high costs, progressive disability, and reduced quality of life (QoL). Telerehabilitation (TR), supported by new technologies, is emerging as an alternative or complement to in-person rehabilitation, potentially lowering socioeconomic impact and improving QoL. Aim: The objective of this study was to evaluate the effect of TR on the QoL of people with MS compared with in-person rehabilitation or no intervention. Materials and methods: A systematic review of randomized clinical trials was conducted (March–May 2025) following PRISMA guidelines. Searches were run in the PubMed-Medline, EMBASE, PEDro, Web of Science, and Dialnet databases. Methodological quality was assessed with the CASP scale, risk of bias with the Risk of Bias 2 tool, and evidence level and grade of recommendation with the Oxford Classification. The protocol was registered in PROSPERO (CRD420251110353). Results: Of the 151 articles initially found, 12 RCTs (598 total patients) met the inclusion criteria. Interventions included (a) four studies employing video-controlled exercise (one involving Pilates to improve fitness, another involving exercise to improve fatigue and general health, and two using exercises focused on the pelvic floor muscles); (b) three studies using a monitoring app to improve manual dexterity, symptom control, and increased physical activity; (c) two studies implementing an augmented reality system to treat cognitive deficits and sexual disorders, respectively; (d) one platform with a virtual reality headset for motor and cognitive training; (e) one study focusing on video-controlled motor imagery, along with the use of a pain management app; (f) a final study addressing cognitive training and pain reduction. Studies used eight different scales to assess QoL, finding similar improvements between groups in eight of the trials and statistically significant improvements in favor of TR in four. The included trials were of good methodological quality, with a moderate-to-low risk of bias and good levels of evidence and grades of recommendation. Conclusions: TR was more effective in improving the QoL of people with MS than no intervention, was as effective as in-person treatment in patients with EDSS ≤ 6, and appeared to be more effective than in-person intervention in patients with EDSS between 5.5 and 7.5 in terms of QoL. It may also eliminate some common barriers to accessing such treatments. Full article

Background: Proximal hamstring tendinopathy (PHT) is a challenging overuse injury, particularly in athletes, characterized by deep buttock pain localized to the ischial tuberosity and often exacerbated by sports activities. This condition can impact an athlete’s performance, limiting high-level athletic activity. Return to sport (RTS) thus becomes a medical, physical, athletic, and economic necessity. Previous research has explored several conservative and injection-based therapies, but evidence regarding the efficacy of porcine collagen injections remains limited. Therefore, this study aims to compare the results obtained from ultrasound-guided porcine collagen injections versus a structured rehabilitation program in reducing time to return to sport (RTS) and improving Victorian Institute of Sport Assessment—Hamstring (VISA-H) scores with respect to athletes with clinically diagnosed PHT. Conservative approaches for PHT treatments include various options, such as physiotherapy, corticosteroids, plasma-rich-platelet, shockwave therapy, and collagen injection. Collagen demonstrated to be a validated option for tendinopathies treatment due its regenerative and restorative mechanism of action. Methods: Retrospective data were collected from twenty-eight athletes with a clinical diagnosis of PHT, confirmed based on pain provocation tests (Puranen–Orava, bent-knee, and modified bent-knee tests), who were divided into two groups: COL and REHAB. The VISA-H outcomes were recorded for all subjects. The COL group received three ultrasound-guided collagen injections at weekly intervals, plus standard care instructions. The REHAB group completed a progressive exercise program targeting hamstring and lumbopelvic stabilization. The primary outcomes were RTS time (days) and VISA-H scores at baseline and 8 weeks. Adverse effects were recorded. Results: The two groups of treatment were very homogeneous and showed parametric distribution concerning the biological and pathophysiological conditions. No adverse events were reported. The mean times to RTS were 57 and 72 days for COL and REHAB, respectively (p = 0.0083). The VISA-H results revealed better improvement for the COL group than the REHAB treatment (p < 0.0001), and the log-rank test showed a higher odds ratio (HR) for RTS, 5.35 (p = 0.0008), for the COL athletes. Conclusions: Ultrasound-guided porcine collagen injections, combined with standard care, significantly reduced RTS time and improved VISA-H scores compared with rehabilitation alone in athletes with PHT. However, a larger cohort of athletes might be needed to gather more information about this conservative treatment in PHT pathology. Full article

The Technology-Enhanced Learning (TEL) Marketplace was a joint initiative by the vice rectorate for academic affairs and the vice rectorate for digitization and change management at Graz University of Technology to modernize lectures. As part of this initiative, an exercise course on chemical thermodynamics was redesigned as a learner-centered course and enriched with interactive learning materials designed to promote self-directed learning. The core of the method used to implement this redesign is interactive notebooks created in Wolfram Mathematica to enable students to work through the examples independently, in depth, and irrespective of time, with the required theoretical background integrated into the notebooks. In this paper, we ask the following questions: RQ1: How did students use and accept the interactive notebooks? RQ2: What was the impact of the interactive notebooks and the corresponding course design as perceived by the students? To answer these questions, we conducted a questionnaire-based survey with 45 course students and statistically analyzed the results. Key results for RQ1 show that $93.33\%$ of the participating students reported using the interactive notebooks, and technology acceptance (1 = low TA, 5 = high TA) was high in both the dimensions of perceived usefulness ($m=3.88$) and attitude ($m=4.24$). Regarding RQ2, our key results show that students perceived the notebooks to have a positive impact on their learning experience, especially regarding their self-directed learning. The results of this work are in alignment with observations by lecturers, which showed that this more student-centric course design and the integration of the interactive learning materials made it possible to clarify detailed questions during the independent learning phase, allowing the interactive part of the course to focus on the tactical approaches, solutions, and problems that arose during the calculations, which raised the overall level of content teaching. Full article

A student’s active thinking state directly affects their learning experience in the classroom. To help teachers understand students’ active thinking states in real-time, this study aims to construct a model which characterizes their active thinking states. The main research objectives are as follows: (1) to achieve accurate classification of the cognitive levels of in-class exercises; (2) to effectively quantify the active thinking state of students through analyzing the correlation between student cognitive levels and exercise cognitive levels. The research methods used in this study to achieve these objectives are as follows: First, LSTM and Chinese-RoBERTa-wwm models are integrated to extract sequential and semantic information from plain text while TBCC is used to extract the semantic features of code text, allowing for comprehensive determination of the cognitive level of exercises. Second, a cognitive diagnosis model—namely, the QRCDM—is adopted to evaluate students’ real-time cognitive levels with respect to knowledge points. Finally, the cognitive levels of exercises and students are input into a self-attention mechanism network, their correlation is analyzed, and the thinking activity state is generated as a state representation. The proposed text classification model outperforms baseline models regarding ACC, micro-F1, and macro-F1 scores on two sets of exercise datasets in Chinese containing mixed code texts, with the highest ACC, micro-F1, and macro-F1 values reaching 0.7004, 0.6941, and 0.6912, respectively. This proves the proposed model’s effectiveness in classifying the cognitive level of exercises. The accuracy of the thinking activity state characterization model reaches 61.54%. In particular, this is higher than the random baseline, thus verifying the model’s feasibility. Full article

Background/Objective: Osteoarthritis (OA) is a progressive joint disease. Physical therapists are essential in managing OA, improving patient outcomes, and slowing disease progression, making it vital to understand their beliefs about optimal knee OA treatment. The objective is to explore physical therapists’ beliefs and attitudes toward knee OA treatment in Saudi Arabia and their alignment with guidelines. Methods: This cross-sectional study includes physical therapists working in Saudi Arabia who had managed at least two knee OA patients in the past six months. The survey questionnaire included questions about attitude statements, clinical management, a case study of an elderly patient with knee OA, and measurements of the level of illness perceptions and treatment choices. Results: This study includes 373 physical therapists (average age: 31.25 (SD 7.17); male (52.4%)). The most commonly used interventions for knee OA were strengthening exercises (19.0%) and flexibility or range of movement exercises (14.7%). About 30.4% of therapists supervised exercises in the clinic, and 89.9% provided educational advice, often focusing on weight loss, analgesia, knee support, and the use of ice or heat. Most therapists opted for treatment programs involving four to seven sessions (45.7%), with 82.2% offering follow-up care through an open appointment after discharge. Conclusions: The results indicate good alignment between clinical practice guidelines and physical therapists’ attitudes toward knee OA management in Saudi Arabia, though some differences exist. Therapists frequently combined exercise with educational advice on weight loss and analgesia, monitored exercise adherence, and offered follow-up care. Full article

Background: Functional hypothalamic amenorrhea (FHA) is a form of chronic anovulation associated with hypoestrogenism. Weight loss, excessive exercise, stress and long-lasting hypoestrogenism lead to infertility and bone loss. FHA also leads to metabolic changes that increase cardiovascular risk in women who otherwise appear metabolically healthy. Methods: This was a case–control study assessing metabolic and endocrine alterations in patients with FHA, stratified by BMI into underweight (BMI < 18.5) and normal-weight (BMI 18.5–24.99) categories. Results: Women diagnosed with FHA had significantly higher levels of total (193 ± 41.96 vs. 181 ± 28.23 mg/dL; p = 0.037) and LDL cholesterol (67 ± 34.89 vs. 63 ± 24.78 mg/dL; p = 0.018) compared with healthy controls. HDL cholesterol levels did not differ between groups; however, normal-weight participants in the study group had higher HDL cholesterol than underweight participants (p = 0.007). FHA patients had significantly lower HOMA-IR (p = 0.001), lower prolactin (p < 0.001), and higher cortisol levels (p = 0.036). Conclusions: Metabolic and endocrine alterations in FHA patients are modulated both by the condition per se and by BMI. FHA influences total and LDL cholesterol, prolactin, and cortisol levels, while BMI primarily affects HDL cholesterol. Both FHA and BMI have a statistically significant impact on HOMA-IR, but neither influences triglycerides or TSH levels. Our findings indicate that the recovery and prevention of metabolic complications require psychological support and consistent weight management. Full article

Background: Muscle strength asymmetries between limbs are common in physically active populations and may influence performance and injury risk. This study aimed to: (i) analyze the reliability of the seated unilateral cable row exercise using a functional electromechanical dynamometer (FEMD) and to examine differences in reliability between sides and contraction types; (ii) investigate the relationship between the dominant and non-dominant sides, as well as between the dynamic and static force production of the back muscles; and (iii) quantify force output and assess interlimb asymmetries. Methods: Twenty-nine young physically active athletes completed two sets of four repetitions of a seated unilateral cable row at 0.30 m·s⁻¹ using the FEMD, followed by a 6-s isometric contraction. Two testing sessions were conducted seven days apart. Reliability was assessed using paired t-tests, the effect size, the coefficient of variation (CV), the standard error of measurement, and the intraclass correlation coefficient (ICC), with 95% confidence intervals. Results: Peak and average force values showed very high to extremely high relative reliability (ICC = 0.86–0.96) and acceptable absolute reliability (CV ≈ 10%). Differences between dominant and non-dominant sides varied depending on contraction type. While group-level asymmetries did not exceed 10%, individual analysis revealed that 14%, 32%, and 7% of participants had asymmetries greater than 15% in isometric, concentric, and eccentric force, respectively. Conclusions: This test demonstrates strong reliability and provides a practical method for assessing upper limb asymmetries in physically active individuals, with potential applications in performance monitoring and injury prevention. Full article

Background: Physical activity, sedentary behaviour, and sleep are interdependent components of the 24 h movement profile that may influence appetite control. While acute exercise can alter appetite perceptions and food reward, less is known about how reallocating time between daily behaviours affects appetite outcomes under free-living conditions. Methods: We applied isotemporal-substitution modelling in a cross-sectional study of 130 young, healthy, active adults. Accelerometer-derived estimates of sedentary time, light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and sleep were analysed in relation to energy intake (food diaries, laboratory meals), subjective appetite perceptions, appetite-related hormones (acylated ghrelin, PYY, leptin), and psychological traits, including food reward (Leeds Food Preference Questionnaire, LFPQ), food cravings (Control of Eating Questionnaire, CoEQ), and eating behaviour traits (Three-Factor Eating Questionnaire, TFEQ). Results: Reallocating 30 min/day of sedentary time to MVPA was associated with higher energy intake in free-living (+113 kcal/day, 95% CI: 34–192) and laboratory settings (+120 kcal/day, 95% CI: 55–185), along with greater postprandial hunger and prospective food consumption, reduced fullness, elevated fasting acylated ghrelin, and lower postprandial PYY. No associations were observed for reallocations to LPA or sleep. Furthermore, sedentary time reallocations were unrelated to leptin or psychological eating traits assessed by the LFPQ, CoEQ, or TFEQ. Conclusions: In this population, reallocating sedentary time to MVPA was linked to physiological and behavioural compensation consistent with elevated energy demands, whereas reallocating to LPA or sleep showed no associations. Trait-level eating behaviours were unaffected, suggesting MVPA influences appetite primarily through acute physiological rather than enduring cognitive or hedonic pathways. Full article