Search Results (806)

Objectives: The objective of this study was to separately examine the effects of exercise addiction and the Collagen Type I Alpha 1 Chain (COL1A1) gene rs1800012 G/T polymorphism on injury susceptibility in elite female volleyball players, and to test the hypothesis that the T allele, previously identified as a risk allele, is underrepresented in volleyball players compared to the general population. Methods: The study included 50 professional Turkish female volleyball players with documented injury data, along with 557 Turkish controls, 53 professional Russian volleyball players, and 810 Russian controls. The Turkish participants were enrolled in a case–control study, an injury study, and an exercise addiction study, whereas the Russian participants were enrolled solely in a case–control study. Results: Injured players had significantly higher scores in the Delay of Individual Social Needs and Conflict subscale of the Exercise Addiction Scale compared to their uninjured counterparts (p = 0.036). The random-effects meta-analysis revealed a significantly lower frequency of the COL1A1 T allele in volleyball players compared to controls (pooled OR = 0.63, 95% CI: 0.41–0.96, p = 0.031). Athletes who had not undergone surgery had a significantly higher frequency of the G allele compared to controls (89.2% vs. 78.7%, p = 0.037; OR = 2.23, 95% CI: 1.1–4.7). Among injured athletes, those carrying the GT genotype were significantly more likely to experience prolonged recovery (≥3 months) (57.1%) compared to those with the GG genotype (28.0%, p = 0.017). Conclusions: Exercise addiction and the COL1A1 rs1800012 T allele were associated with a higher incidence of injury in female volleyball players. The T allele was also associated with a longer recovery time following injury. Full article

Background: Oral frailty is a new concept, introduced in Japan in 2013. In our preliminary study, oral hypofunction was observed in more than half of patients undergoing maintenance hemodialysis (MHD). This allowed us to determine the exact prevalence of oral frailty in MHD patients and investigate the association between oral cavity function, findings obtained via comprehensive geriatric assessment, and motor features. Methods: We initiated a two-week hospitalization program for MHD patients to evaluate frailty including oral cavity functions. Along with a comprehensive geriatric assessment and evaluation of motor functions, seven items pertaining to oral cavity functions were assessed by a professional dentist to determine oral frailty. After the incidence of each item had been determined, the association between these factors was retrospectively analyzed to explore the factors that affect oral frailty. Results: Oral frailty was observed in 33 out of 50 patients (66%). In particular, tongue lip motor functions were frequently impaired in this population. Oral cavity function scores, which increased as oral function deteriorated, negatively correlated with cognitive function (r = −0.349; p = 0.0129; 1−β = 0.71) and grip strength (r = −0.364; p = 0.00933; 1−β = 0.75). Conclusions: Oral frailty was commonly observed in MHD patients. We are currently considering implementing exercise programs to improve tongue lip motor function, enhance cognitive function through interprofessional cooperation, and strengthen grip. Full article

Background/Objectives: Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine that can negatively impact on quality of life, pulmonary function, and body image. Its conservative management includes various interventions, among which the Schroth method stands out. This approach is based on three-dimensional corrective exercises and rotational breathing. This review aimed to analyze the effectiveness of the Schroth method, applied either alone or in combination with other conservative therapies, on variables such as Cobb angle, angle of trunk rotation (ATR), pulmonary function, and health-related quality of life in patients with AIS. Methods: A scientific literature search was conducted using the PubMed database. We searched for randomized controlling trials (RCTs), systematic reviews, and meta-analyses reported in English from 2020 to 2025. Different combinations of the terms and MeSH terms “adolescent”, “idiopathic”, “scoliosis”, and “Schroth” connected with various Boolean operators. Results: Overall, 82 articles were reviewed from the selected database. After removing duplicated papers and title/abstract screening, 13 studies were included in our review. The results showed that the Schroth method proved effective in reducing the Cobb angle and ATR, particularly in patients with mild curves and in early stages of skeletal growth. Improvements were also observed in health-related quality of life and aesthetic perception, and to a lesser extent, in pulmonary function. Moreover, therapeutic adherence and treatment continuity were important to maintaining long-term benefits. Conclusions: The Schroth method could be an effective treatment associated with orthopedic treatment, yielding satisfactory results. Its implementation requires structured programs, professional supervision, and strategies to enhance therapeutic adherence. Nevertheless, to validate its long-term effectiveness, we need more homogeneous studies with longer follow-up durations. Full article

Background: Physical activity provides substantial survival and quality-of-life benefits for cancer survivors, yet participation remains suboptimal globally, particularly in the Middle East and North Africa (MENA) regions. This study represents the first comprehensive examination of physical activity barriers and facilitators among Tunisian cancer survivors. Methods: This cross-sectional study recruited 120 cancer survivors ≥3 months post-chemotherapy completion from University Hospital Farhat Hached, Sousse, Tunisia (October–December 2024). Participants completed validated questionnaires via structured telephone interviews: the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Physical Activity Barriers After Cancer scale (PABAC), the Fatigue Assessment Scale (FAS), and the Patient Activation Measure (PAM-13). Statistical analyses included descriptive statistics, receiver operating characteristic (ROC) analysis, correlation analyses, and multivariable regression modeling with Bonferroni correction for multiple comparisons. Results: Participants (mean age 51.89 ± 10.2 years, 73.9% female) demonstrated significant physical activity declines post-chemotherapy: moderate activity decreased from 31.1% to 1.7% (p < 0.001), median intensity declined from 297 to 44 MET-min/week (p < 0.001). Mean PABAC score was 29.72 ± 5.13, with cognitive barriers predominating (2.85 ± 0.58). Fatigue was universal (100%), with 21% reporting severe fatigue (FAS ≥ 35). Only 26.1% received exercise guidance from healthcare professionals. PABAC demonstrated excellent predictive performance for physical inactivity (AUC = 0.805, 95%CI: 0.724–0.887). Independent predictors of higher barriers included fatigue severity (β = 0.466, p < 0.001), low patient activation (β = −0.091, p = 0.010), and advanced cancer stage (β = 1.932, p = 0.008). Conclusions: Tunisian cancer survivors experience substantial, multidimensional barriers to physical activity, with inadequate healthcare guidance representing a critical system-level gap. Findings support the development of culturally adapted, multidisciplinary interventions that target modifiable cognitive and symptom-related barriers, while enhancing patient activation and healthcare provider engagement. Full article

The global rise in the elderly population inherently escalates the demand for health and social care. Ensuring cognitive performance for healthy brain aging presents significant challenges for researchers and health professionals promoting self-care behaviors. This article aims to provide a comprehensive and critical analysis of the latest research on healthy brain aging by employing a biopsychosocial framework. It integrates biological, psychological, and social dimensions to elucidate their collective influence on cognitive health in older adults. Methodologically, this article provides a narrative review of the existing literature. A diverse array of bibliographic resources was obtained from prominent electronic databases, including MEDLINE, PubMed, Scopus and Web of Science, to ensure broad coverage of the topic. The search was designed to capture relevant studies published between 2010 and 2025, using key terms such as ‘aging’, ‘biomarker’, ‘neurodegeneration’, and ‘cognitive performance’. Following a rigorous selection process, two field specialists evaluated a total of 106 full-text articles to identify those that met the eligibility criteria, ultimately yielding 70 relevant studies. The findings reveal important connections between psychosocial and biological biomarkers and brain morphology, highlighting lifestyle factors—such as diet, exercise, and social engagement—as crucial for cognitive health. The article also underscores specific biomarkers relevant for assessing brain age and their relationship to neurodegenerative disorders. Notably, while biological markers like Aβ, tau, and α-synuclein (proteins that define the core molecular pathology of common neurodegenerative diseases) are present, they do not guarantee the onset of neurodegenerative diseases; psychosocial factors play an essential role in determining disease manifestation. In conclusion, these results support a holistic approach to healthy aging, which integrates psychosocial environments and lifestyle choices that enhance cognitive resilience. We propose further cross-sectional descriptive studies to better identify the biopsychosocial variables influencing cognitive performance and healthy brain aging, aiming to improve clinical practices and inform public health strategies. Full article

(1) Background: Working from home is becoming increasingly common and has many advantages, but also negative consequences such as reduced physical activity, poor ergonomics and stress. Many people find it difficult to attend in-person rehabilitation sessions due to transportation barriers and limited access to rehabilitation facilities. Therefore, the aim of our study was to investigate whether our online preventive exercise programme effectively improves the musculoskeletal and mental health of sedentary workers. (2) Methods: The study participants worked from home on a long-term basis. Our research group consisted of 30 people, 16 in the intervention group and 14 in the control group. The intervention group members participated in a complex preventive exercise programme three times a week for 10 weeks. The training took place online. Before and after the exercise programme, various tests were used to assess the functional status of the participants’ spine, the strength and flexibility of their core muscles (Core, Kempf and Kraus–Weber tests) and their mental state (Beck Depression Inventory). (3) Results: Significant improvement was observed in the intervention group in the Core, Kempf, Kraus–Weber and Beck tests. (4) Conclusions: Our online complex training programme proved to be effective during the evaluation. It is crucial to tailor remote rehabilitation services to the individual needs and preferences of patients and healthcare professionals. Full article

Background/Objectives: The internet has unquestionably altered how people acquire health information. Instead of consulting with a medical professional, billions of pages of information can be accessed by anyone with a smartphone. Women’s health issues have been historically and culturally taboo in many cultures globally; therefore, internet searches may be particularly useful when researching these topics. Methods: As an exercise in scientific information evaluation, we chose 12 non-cancer topics specific to women’s health and developed a scoring metric based on quantifiable webpage attributes to answer: What topics generate the highest and lowest scores? Does the quality of information (mean score) vary across topics? Does the variation (score deviation) differ among topics? Data were collected following systematic searches after filtering with advanced features of Google and analyzed in a Bayesian framework. Results: The mean score per topic was significantly correlated with the number of sources cited within an article. There were significant differences in the quality scores across topics; “pregnancy” and “sleep” scored the highest and had more sources cited per page than all other topics. The greatest variation in scores were for “cortisol” and “weight”. Conclusions: A purposeful, systematic internet search of 12 critical women’s health topics suggests that scrutiny is necessary when this information is obtained by a typical internet user. Future work should include review by medical professionals based on their interaction with patients who self-report what they know or think about a condition they present and respect, while educating, patients’ own internet searching. Full article

Background: Mild cognitive impairment (MCI) affects up to 40% of patients with Parkinson’s disease (PD), yet conventional rehabilitation often lacks engagement. The OPERA project developed a novel Bio-cooperative Robotic Platform (PRoBio), integrating a service robot and a virtual reality-based rehabilitation for personalized cognitive training. This work presents two preliminary user-centred studies aimed to assess PRoBio usability and acceptability. Methods: to gather qualitative feedback on robotic and virtual reality technologies, through ad hoc questionnaires, developed according to participatory design principles and user-centered evaluation literature, Study 1 (Focus group) involved 23 participants: 10 PD patients (F = 6; mean age = 68.9 ± 8.2 years), 5 caregivers (F = 3; mean age = 49.0 ± 15.5), 8 healthcare professionals (F = 6; mean age = 40.0 ± 12.0). Study 2 (Living Lab) tested the final version of PRoBio platform with 6 healthy volunteers (F = 3; mean age = 50.3 ± 11.0) and 8 rehabilitation professionals (F = 3; mean age = 32.8 ± 9.9), assessing usability and acceptability through validated questionnaires. Results: The focus group revealed common priorities across the three groups, including ease of use, emotional engagement, and personalization of exercises. Living Lab unveiled PRoBio as user-friendly, with high usability, hedonic quality, technology acceptance and low workload. No significant differences were found between groups, except for minor concerns on system responsiveness. Discussion: These preliminary findings support the feasibility, usability, and emotional appeal of PRoBio as a cognitive rehabilitation tool. The positive convergence among the groups suggests its potential for clinical integration. Conclusions: These preliminary results support the feasibility and user-centred design of the PRoBio platform for cognitive rehabilitation in PD. The upcoming usability evaluation in a pilot study with patients will provide critical insights into its suitability for clinical implementation and guide further development. Full article

Metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), have become the leading causes of chronic liver disease worldwide, with increasing rates of cirrhosis, hepatocellular carcinoma, and cardiovascular complications. Pathogenesis involves a complex interplay of dietary excess, sedentary lifestyle, insulin resistance, adipose tissue dysfunction, and alterations in the gut microbiome, which collectively lead to hepatocellular stress, inflammation, and fibrogenesis. Despite ongoing advances in pharmacotherapy, lifestyle intervention remains the cornerstone of management. Evidence shows that sustained weight loss of ≥5% reduces hepatic steatosis, ≥7% improves necroinflammation, and ≥10% stabilizes or reverses fibrosis. Dietary strategies, including Mediterranean-style patterns, high-protein approaches, and intermittent fasting, have been shown to be effective in improving insulin sensitivity and reducing intrahepatic triglycerides. Exercise interventions, focusing on both aerobic fitness and resistance training, enhance metabolic flexibility and combat sarcopenia, thereby improving hepatic and systemic outcomes. Equally important are behavioral support, digital health tools, and multidisciplinary approaches that enhance adherence and address barriers such as socioeconomic disparities, limited access, and patient engagement issues. Personalized nutrition plans, integrating physical activity, and ongoing support for behavioral change are essential for long-term disease management. This review synthesizes current evidence on the roles of macronutrients, micronutrients, dietary quality, physical activity, and adjunctive behavioral strategies in managing MASLD. By translating mechanistic insights into practical, evidence-based recommendations, we aim to provide clinicians, dietitians, and exercise professionals with effective frameworks to slow disease progression and improve outcomes across diverse patient populations. Full article

Background/Objectives: Whole-body vibration (WBV) has been widely studied for its effects on neuromuscular activation, circulation, and balance. This study investigates the effect of wearing frequency of vibrating sneakers (18 Hz) on lower limb muscle activation during walking and squatting in middle-aged Koreans (40–60 years old). The objective is to assess whether WBV footwear enhances muscle engagement in both active and sedentary individuals. Methods: A 16-week randomized controlled trial was conducted with 64 participants divided into exercise (walking 30 min, three times a week) and non-exercise groups. Each group was further divided into wearing and non-wearing vibrating sneaker subgroups. Muscle activation of the quadriceps and gastrocnemius was measured using surface electromyography before and after the intervention. Results: Participants wearing vibrating sneakers showed significantly increased quadriceps and gastrocnemius activation during squatting and walking compared to non-wearers (p < 0.05). The exercise group wearing WBV sneakers exhibited greater improvements in muscle activation than the non-exercise group, indicating that WBV enhances the benefits of regular walking. However, no significant differences were observed in some lower leg muscles, suggesting that WBV effects may vary based on movement type and muscle group. Conclusions: Findings suggest that WBV sneakers (18 Hz) can enhance muscle activation during dynamic movements, potentially offering a low-impact training alternative for improving lower limb strength. These results provide valuable insights for exercise professionals, rehabilitation specialists, and wearable sensor developers, highlighting the potential of WBV footwear in neuromuscular conditioning and injury prevention. Full article

Background: Chronic autoimmune thyroiditis, also known as Hashimoto’s thyroiditis (HT) or chronic lymphocytic thyroiditis whose pathophysiology includes both cellular (T-cell mediated) and humoral (B-cell mediated) immune responses, leads to the destruction of thyroid follicular cells and progressive fibrosis of the thyroid gland. While hypothyroidism is a common autoimmune disease, athletes may experience unique challenges related to its diagnosis and management within the context of training programme, competition and anti-doping regulations. In turn, it is known that moderate physical exercise can have a positive effect on the immune system, while excessive exercise can cause unfavourable changes in this system. Therefore, we aimed (1) to identify the interplay between physical activity and autoimmune thyroid disease, (2) to quantify changes in thyroid function associated with physical activity, and (3) to explain the underlying mechanisms of autoimmune thyroiditis in athletes. Methods: The medical database PubMed/MEDLINE was searched in the time period 2004–2025, where 12 publications met the inclusion criteria and were ultimately included for further evaluation according to the RAMESES (Realist and Meta-narrative Evidence Syntheses: Evolving Standards). Results: The reviewed studies have clearly indicated that physical exercise has a beneficial effect on thyroid function, and two studies reported that non-excessive physical exercise leads to a decrease in TPO-Ab concentrations. Conclusions: The beneficial effect of physical exercise on thyroid function and immune response underlines the need for further well-designed studies to formulate specific guidelines for patients with HT, as well as for athletes with autoimmune thyroid disease. Similarly, there is a need to evaluate the prevalence of thyroid hormone use among amateur and professional athletes in order to establish prevention strategies. Full article

Background/Objectives: As global aging accelerates, there is a pressing and empirically substantiated demand for integrated and sustainable strategies, as evidenced by the rising prevalence rates of chronic conditions, social isolation, and digital exclusion among older adults worldwide. These factors underscore the urgent need for multidimensional interventions that simultaneously target physical, psychological, and social well-being. The HOPE-FIT (Hybrid Outreach Program for Exercise and Follow-up Integrated Training) model and the SAGE (Senior Active Guided Exercise) program were designed to address this need through a hybrid framework. These programs foster inclusive aging by explicitly bridging digitally underserved groups and mobility-restricted populations into mainstream health promotion systems through tailored exercise, psychosocial support, and smart-home technologies, thereby functioning as a scalable meta-model across healthcare, community, and policy domains. Methods: HOPE-FIT was developed through a formative, multi-phase process grounded in the RE-AIM framework and a Hybrid Type II effectiveness–implementation design. The program combines professional health coaching, home-based and digital exercise routines, Acceptance and Commitment Performance Training (ACPT)-based psychological strategies, and smart-home monitoring technologies. Empirical data from pilot studies, large-scale surveys (N = 1000), and in-depth user evaluations were incorporated to strengthen validity and contextual adaptation. Culturally tailored content and participatory feedback from older adults further informed ecological validity and program refinement. Implementation Strategy/Framework: The theoretical foundation integrates implementation science with behavioral and digital health. The RE-AIM framework guided reach, fidelity, and maintenance planning, while the Hybrid E–I design enabled the concurrent evaluation of effectiveness outcomes and contextual implementation strategies. Institutional partnerships with community centers, public health organizations, and welfare agencies further facilitated the translation of the model into real-world aging contexts. Dissemination Plan: The multi-pronged dissemination strategy includes international symposia, interdisciplinary academic networks, policy briefs, localized community deployment, and secure, authenticated data sharing for reproducibility. This design facilitates evidence-informed policy, empowers practitioners, and advances digital health equity. Ultimately, HOPE-FIT constitutes a scalable and inclusive model that concretely addresses health disparities and promotes active, dignified aging across systems and disciplines. Full article

Background/Objectives. Despite growing interest in capacitive-resistive electric transfer TECAR) and Vibration therapy (VT), their comparative effectiveness in sports recovery remains unclear. This study aimed to evaluate and contrast the short-term effects of TECAR and VT on neuromuscular recovery following eccentric muscle fatigue, relative to passive rest, in active young adults. We hypothesized that both interventions would accelerate recovery and potentially reduce injury risk. Methods. Forty-one participants were randomized into two groups: TECAR therapy (Group 1) and VT (Group 2). Neuromuscular function was assessed at baseline, post-exercise, and post-intervention using tensiomyography (TMG) and electromyography (EMG). Results. Both groups showed a significant increase in EMG MDF intercept after exercise. Post-intervention, VT induced a further rise in this parameter, whereas TECAR stabilized values without significant change. In the contralateral resting limb, increases persisted after exercise and passive recovery. Between-limb differences were significant only in the TECAR group. TMG analysis revealed a non-significant but large-effect increase in contraction delay (Td) post-exercise, followed by significant reductions after both interventions. In the left limb, Td changes were not significant. For maximal displacement (Dm), both VMO and VLO muscles demonstrated a significant decrease post-exercise and a marked recovery after both therapies. Other TMG parameters (Ts, Tc, Tr) showed no significant changes. Conclusions. Both TECAR and VT effectively enhanced neuromuscular recovery after eccentric exercise. TECAR demonstrated a modest but consistent advantage, particularly in normalizing muscle recruitment and restoring mechanical properties, making it suitable in contexts requiring rapid recovery. VT, however, remains a more accessible and cost-effective modality. These findings support the application of both techniques in sports recovery, while highlighting the need for further research in professional athletes and diverse exercise settings to optimize regeneration strategies and reduce injury risk. Full article

Background: Multiple sclerosis (MS) is the most prevalent neurological disorder in young adults, characterised by physical, psychological and cognitive dysfunction. Exercise training is a safe management strategy. Healthcare providers (HCPs) acknowledge deficiencies in awareness, counselling strategies, and resources that prevent them from promoting and prescribing this effective treatment. We implemented an online evidence-based educational programme and evaluated the effect, acceptability, appropriateness, and feasibility of the programme in improving HCP confidence, knowledge, and attitudes towards remote exercise prescription to persons with MS. Methods: Physiotherapists and exercise physiologists were recruited and received the educational programme (online theory and 16-week experience of prescribing to persons with MS). Participants’ confidence, knowledge and attitudes towards exercise prescription, as well as their professional quality of life, were our primary outcomes—baseline (T1), immediately post-online theoretical learning (T2), post-application with clients (T3; approximately 16 weeks after T2), and at 12-month follow-up (T4). We gathered participants’ acceptability, appropriateness, and feasibility evaluation at T2, T3 and T4. We analysed the effect on primary outcomes using generalised linear mixed models, with secondary and evaluative outcomes analysed as counts and qualitative themes. Results: Of 40 participants who provided baseline data, 24 completed the theoretical programme, and 16 completed the experiential programme. Self-confidence improved significantly (|βs| ≥ 1.27, SEs ≤ 0.31, |zs| ≥ 5.28, ps < 0.001), with large effect sizes (percentage change: 256.8–479.4%). Some theoretical domains framework-based domains have improved, such as beliefs about skills to prescribe evidence-based principles. Participants expressed high satisfaction with the programme and showed increased delivery of implementation behaviour change strategies. Conclusions: An online evidence-based education programme for MS care improved HCPs’ self-confidence, perceived skills and delivery of evidence-based exercise behaviour-based prescription. Full article

Background: Arm swing exercise (ASE) is a simple and accessible form of physical activity that has been reported to reduce disease risk and enhance overall health across various populations. In alignment with the World Health Organization’s recommendations for promoting physical activity, ASE requires no specialized equipment or professional supervision. However, systematic evidence on its health benefits remains limited. Objective: This systematic review and meta-analysis aimed to assess the effects of ASE on body composition, glycemic control, cardiovascular health, and musculoskeletal outcomes. Methods: A comprehensive systematic search was conducted in four major databases, including PubMed, Embase, Scopus, and the Thai-Journal Citation Index Center, covering studies published from inception to October 2024. Articles published in both English and Thai were included. Two independent reviewers screened and selected eligible randomized controlled trials and quasi-experimental studies. Methodological quality was assessed using the JBI critical appraisal tool, and meta-analyses were performed using Stata software (version 18), presenting mean differences (MD) with 95% confidence intervals (CI). Results: Thirteen studies were included, comprising eight randomized controlled trials and five quasi-experimental studies, with intervention durations ranging from 5 to 24 weeks. The ASE significantly reduced waist circumference (MD = −4.76; 95% CI: −8.36 to −1.17; and p < 0.05), hemoglobin A1C (MD= −0.80%; 95% CI: −1.19 to −0.40; and p < 0.001), fasting blood glucose (MD = −17.62 mg/dL; 95% CI: −25.93 to −9.32; and p < 0.05), and diastolic blood pressure (MD = −9.74 mmHg; 95% CI: −17.84 to −1.65; and p < 0.05). The ASE showed a non-significant reduction in systolic blood pressure (MD = −3.65 mmHg; 95% CI: −10.37 to 3.08; and p = 0.29). Additionally, the ASE significantly increased high-density lipoprotein cholesterol (HDL-C) levels (MD = 6.96 mg/dL; 95% CI: 2.20 to 11.71; and p < 0.05). Conclusions: This study, representing the first systematic review and meta-analysis focusing on ASE, demonstrates that ASE is an effective intervention for improving body composition, glycemic control, and cardiovascular health. Given its simplicity, low cost, and broad applicability, ASE could serve as a practical public health strategy to promote health and prevent chronic diseases across diverse populations. Full article