Search Results (267)

Background/Objectives: Permanent colostomy requires significant physical and psychological adaptation. Patients often experience reduced physical activity, impaired quality of life, and fear of movement. Current exercise recommendations are inconsistent, and no consensus exists on safe return to activity. This study aims to evaluate the effect of a 12-week home-based graded exercise programme on physical activity, quality of life, kinesiophobia, exercise capacity, and self-efficacy in patients with permanent colostomies. Methods: This randomized controlled trial will recruit 51 adults with permanent colostomies, beginning six weeks post-surgery. Participants will be randomized (1:1) to an intervention or control group. The intervention group will receive a 12-week home-based exercise programme including patient education, resistance and core training, and progressive aerobic walking. The control group will receive standard medical care and an informational leaflet. Primary outcomes include physical activity (steps/day), quality of life (Stoma-QoL), kinesiophobia (Tampa Scale), exercise capacity (6-Minute Walk Test), and self-efficacy (General Self-Efficacy Questionnaire). Follow-up will be conducted at baseline, post-intervention, and six months. Data will be analyzed using intention-to-treat principles with a significance threshold of p < 0.05. Conclusions: This trial will be the first to assess the effects of a structured, home-based graded exercise programme in individuals with permanent colostomies. The findings are expected to provide evidence on the efficacy of exercise for improving physical and psychological outcomes in this population and to inform clinical guidelines for safe, individualized activity resumption. Full article

Background: An unhealthy diet is a major modifiable risk factor for chronic disease, and workplace environments may pose specific barriers to healthy eating. Methods: This single-arm, pre–post workplace intervention assessed short-term changes in perceived dietary barriers (primary outcome) and healthy eating intentions (secondary outcome) among school employees (n = 36; 83.3% women; mean age = 46.8 years). The 60 min participatory session integrated behavioral economics principles, practical nutrition exercises, and psychological strategies designed to enhance self-efficacy, optimism, and resilience. Results: The total perceived barrier score decreased significantly (Δ = −1 [IQR −2 to 0]; the paired Wilcoxon signed-rank test = −4.689, p < 0.001, r = −0.78). Post-intervention (T2), the proportion of participants reporting an intention to prepare healthy meals increased (McNemar’s test, p < 0.001; OR = 10.0, 95% CI 1.8–54.5). The session was rated as highly useful (mean = 8.3/10), and at the three-week follow-up (T3), 91.7% of participants reported maintaining at least one dietary change. Conclusions: Although limited by its single-arm design and short follow-up, this pilot study suggests that a brief, participatory behavioral intervention may be a feasible and acceptable approach to support healthier eating in the workplace. Full article

Self Determination Theory posits that individuals may be more likely to initiate and maintain behaviors tied to intrinsic (vs. extrinsic) motivations and may provide a useful framework for understanding youth participation in novel sports. Using the Intrinsic Motivation Inventory (IMI) and Patient-Centered Assessment and Counseling for Exercise Plus Nutrition (PACE+) surveys, motivation and physical activity habits were explored in 27 children/adolescents (ages 7–16) enrolled in Parkour, an individual, non-competitive youth sport. Fifteen Parkour participants were also interviewed to gain an understanding of their motivations for participating. Study participants had high median IMI subscale scores related to interest/enjoyment (6.71/7) and perceived choice (6.40/7) compared to the whole scale. Similarly median sub-scale Pros and Self-Efficacy scores for physical activity from the PACE+ were high (4.25/5 and 3.91/5, respectively). The themes of autonomy and enjoyment were consistently reported in the qualitative interviews, expanding on the quantitative results. Other themes included appreciation for camaraderie, creativity, and a drive for improvement. These results provide early evidence that Parkour, and similar lifestyle sports, may be tied more to intrinsic than extrinsic motivations and could have potential for adoption and maintenance by youth with low motivation to engage in physical activity to promote healthy behaviors. Full article

Background/Objectives: Systemic lupus erythematosus (SLE) is associated with impaired functional capacity, persistent fatigue, and poor health-related quality of life despite advances in pharmacological therapy. Exercise training has been proposed as a non-pharmacological intervention, but its efficacy and safety remain incompletely defined. This systematic review aimed to evaluate the effects of exercise training on functional aerobic capacity and quality of life in adults with SLE. Methods: A comprehensive search of PubMed, EMBASE, Cochrane Library, and PEDro was conducted to identify randomized controlled trials published up to October 2022, in accordance with the PRISMA guidelines. Results: Twelve randomized controlled trials involving 619 participants were included. Exercise interventions were heterogeneous and comprised aerobics, resistance, combined programs, vibration training, home-based protocols, and counseling strategies, with durations ranging from 6 weeks to 12 months. Supervised aerobic and combined interventions consistently improved functional aerobic capacity, while quality of life benefits were reported across several domains, particularly physical health, vitality, and fatigue. Additional positive effects were observed on fatigue, depression, pain, sleep, insulin sensitivity, and self-care ability, without evidence of increased disease activity. Conclusions: Structured exercise is safe and can meaningfully enhance functional capacity and quality of life in patients with SLE, supporting its incorporation into multidisciplinary clinical management. Full article

Background/Objectives: Pain neuroscience education (PNE) has demonstrated efficacy in adults with chronic pain, but the pediatric evidence is still developing, despite its increasingly frequent use. Evidence for the effectiveness of PNE in pediatrics remains fragmented across settings and outcomes, which justifies a systematic evaluation focused on children and adolescents. Methods: Following PRISMA, two reviewers independently screened records (PubMed, Web of Science, PEDro; through 21 July 2025), extracted data, and assessed risk of bias (RoB 2 for randomized controlled trials; NIH/CASP for non-randomized studies). Given the heterogeneity, we conducted a structured narrative synthesis (SWiM) and rated the certainty of evidence with GRADE. PROSPERO: CRD420251062922. Results: Eleven studies met the inclusion criteria. PNE consistently improved pain-related knowledge, with effects maintained at follow-up (moderate certainty); effects on pain intensity, function, and emotional outcomes were small and inconsistent (low certainty), with more favorable patterns when PNE was combined with exercise and/or booster sessions. Digital and gamified formats proved feasible and engaging; parental outcomes showed small improvements where measured. Conclusions: PNE is a promising, low-cost, and scalable component of pediatric chronic pain care, strengthening self-efficacy and adaptive coping. Integration into biopsychosocial, multidisciplinary programs—particularly alongside exercise and family involvement—may optimize outcomes. Larger, standardized trials with long-term follow-up and systematic adverse-event reporting are needed to solidify guidance for clinical practice. Full article

Background/Objectives: Emotional eating is an important factor in the behavioral treatment of obesity, especially in women. Improvements in both exercise frequency and sweets intake have demonstrated positive changes in weight for this subgroup. However, the psychosocial mechanisms of those factors are minimally understood, and any favorable results have largely been transient. Within cognitive-behavioral treatments, increasing self-regulation and self-efficacy have been intervention targets, however, more data on their temporal effects, interrelationships, and specific foci are required to improve weight-loss outcomes. Methods: Women with obesity and either high emotional eating (n = 54) or low emotional eating (n = 52) levels participated in a 6-month cognitive-behavioral treatment. Results: Two models were specified: (a) where change in self-regulation predicted weight losses over six and twelve months mediated by changes in self-efficacy leading to behavioral changes; and (b) where self-efficacy was instead the predictor variable, followed by self-regulation changes. Two significant paths of improvement were observed: (a) a merged measure of self-regulation → eating self-efficacy → sweets intake → weight, and (b) a merged measure of self-efficacy → exercise self-regulation → weight. Predictive strengths were generally unaffected by emotional eating level (high or low). Together, improvements in sweets intake and exercise, but not fruit/vegetable consumption, significantly accounted for weight loss for both groups. Conclusions: The findings suggest that behavioral weight-loss treatments focus first on self-regulation, then on self-efficacy, and target sweets intake and exercise in women with obesity, independent of their emotional eating levels. Full article

Background: Osteoarthritis (OA) of the knee is a highly prevalent and heterogeneous condition. Identifying distinct clinical phenotypes within end-stage knee OA populations may inform tailored preoperative management strategies for individuals awaiting total knee replacement (TKR) surgery. Methods: This cross-sectional study employed exploratory factor analysis to identify clinical presentation patterns among patients with knee OA awaiting TKR in South Africa, using modifiable variables including demographic data, physical examination findings, patient-reported outcomes, and functional measures. Results: Three distinct clinical phenotypes emerged: (1) gait and weight—characterised by poor gait mechanics, obesity, and low self-efficacy; (2) central pain—encompassing central sensitisation, depression, and reduced functional performance; and (3) functional factors—reflecting muscular weakness and functional limitations. Conclusions: This study highlights the heterogeneity in clinical presentations among patients with end-stage knee OA awaiting TKR in South Africa. The identified phenotypes suggest a need for tailored, multidisciplinary preoperative interventions incorporating weight management, pain management, psychological support, targeted exercise programs, and behavioural change strategies to optimise post-surgical outcomes and enhance overall care. Full article

Objective: This scoping review synthesized and mapped the breadth of the existing literature on technological resources used to support individuals undergoing hemodialysis treatment. Methods: Following the methodological guidelines of the Joanna Briggs Institute (JBI) for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist, comprehensive searches were conducted across the following databases: MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Scopus, Scientific Electronic Library Online (SciELO), MedicLatina, and the Cochrane Central Register of Controlled Trials, with no time restrictions. Results: Thirty-nine studies conducted between 2003 and 2023 met the inclusion criteria. These studies covered a range of technological innovations developed specifically for hemodialysis treatment, including virtual reality, exergames, websites, and mobile applications. These technologies were designed with diverse objectives: to facilitate physical exercise, optimize dietary and medication management, improve disease adherence and management, and promote self-efficacy and self-care in patients. Conclusions: The review revealed a wide range of technological resources available to hemodialysis patients. These digital solutions show great potential to transform care by promoting more engaged and personalized health practices. Although this study did not directly assess the impact of these technologies, it provides a solid foundation for future investigations that can explore in-depth how such innovations contribute to effective disease management and improvement in clinical outcomes. Full article

Background: Exercise is known to help with the effects of the menopause, but women from low socioeconomic status (SES) tend to exercise less at this stage of life. Therefore, this study aimed to investigate the physical and psychological effects of a Zumba Gold^® community-based intervention in postmenopausal women from low SES. Methods: Forty-three women were divided into a Zumba Gold^® (ZG) and control (C) group, and participated in pre- and post-testing sessions, separated by a 12-week intervention period. The outcomes measured were: body composition, sit-to-stand (STS), six-minute walk test (6MWT), balance, Short Form Health Survey (SF-12), Multidimensional Fatigue Index (MFI-20), Self-Efficacy for Exercise (SEE), Behavioral Regulations in Exercise (BREQ-2), Hospital Anxiety and Depression Scale (HADS), and Social Connectedness questionnaires. Semi-structured interviews were also performed on 15 ZG participants. Results: The results showed significant improvements in the ZG group only for STS, 6MWT, mental health, fatigue (general, physical, and mental), social connectedness score, and a significantly lower level of amotivation. Zumba Gold^® had positive effects on four main themes: belonging, non-judgmental place, psychological motivational factors, and mind–body connection. Conclusions:This is the first study to show that ZG is beneficial for this population and encourages similar studies on other aspects of the menopause. Full article

Background/Objectives: Prioritizing diet- or exercise-related self-efficacy and social support with their interactions may improve the effectiveness of interventions aimed at increasing daily fruit/vegetable intake and exercise, thereby reducing the risk of metabolic disorders in abdominally obese women. This study aimed to identify the profiles of diet- or exercise-related self-efficacy and social support among women with abdominal obesity, examine profiles related to insufficient fruit/vegetable intake and exercise, and explore associating factors of these profiles. Methods: A cross-sectional investigation in central south mainland China collected sociodemographic, anthropometric, and health-related variables, diet-related self-efficacy (Diet-SE) and social support (Diet-SS), exercise-related self-efficacy (Exercise-SE) and social support (Exercise-SS), and daily fruit/vegetable intake and exercise. We used latent profile analysis to identify distinct profiles, and binary logistic regression to examine the profiles’ behaviors and associating factors. Results: A total of 327 abdominally obese women were categorized into four profiles of Diet-SE and Diet-SS, and five profiles of Exercise-SE and Exercise-SS. Women in the Diet Dual-Low Group were associated with insufficient daily fruits/vegetables intake. Women in the Exercise Dual-Low Group or Exercise-SS Medium–Low Group were more likely to engage in insufficient daily exercise. Conclusions: Our findings align with previous evidence that women with low diet- or exercise-related self-efficacy and social support are at increased risk for insufficient daily fruit/vegetable intake or exercise. Additionally, medium Exercise-SS is associated with insufficient exercise behaviors, suggesting that interventions targeting healthy exercise should be initiated earlier among women with medium Exercise-SS, rather than waiting for it to decline to low level. Full article

Background/Objectives: Knee osteoarthritis is one of the most significant diseases globally and in Portugal. Despite the availability of international guidelines, there is a lack of tailored, evidence-based recommendations specifically for Portuguese physiotherapists to manage their knee osteoarthritis patients with non-pharmacological and non-surgical interventions. This study aimed to develop a clinical practice guideline that integrates the latest international evidence with local clinical practice data to enhance patient outcomes. Methods: To achieve the objective, a comprehensive search was conducted in November 2024 across major health-related databases, to identify robust and recent evidence regarding the efficacy of non-pharmacological and non-surgical interventions, as well as their usage in the national context. Two key sources were identified: An umbrella and a mixed-methods study. Data from both sources were independently reviewed and integrated through a comparative analysis to identify interventions with robust scientific support and high local acceptability. Recommendations were then formulated and categorized into gold (strong), silver (moderate), and bronze (weak) levels based on evidence quality and clinical relevance. A decision-making flowchart was developed to support guideline implementation and clinical usage. Results: The integrated analysis identified three gold-level interventions, namely Nutrition/Weight Loss, Resistance Exercise, and Self-care/Education. Five silver-level recommendations were Aerobic Exercise, Balneology/Spa, Extracorporeal Shockwave Therapy, Electrical Stimulation, and Manual Therapy. Similarly, five bronze-level recommendations comprised Kinesio Taping, Stretching, Ultrasound Therapy, Thermal Agents, and Walking Aids. Conclusions: This clinical practice guideline provides a context-specific, evidence-based framework for Portuguese physiotherapists managing knee osteoarthritis. By bridging international evidence with local clinical practice, the guideline aims to facilitate optimal patient care and inform future research and guideline updates. Full article

Background: Falls are a major public health concern among older adults, often resulting in injury, functional decline, and reduced quality of life. While handgrip strength (HGS), fall efficacy, and balance confidence have individually been associated with fall risk, their combined predictive value is still underexplored, particularly in physically active older adults. This study aimed to investigate the relationship between HGS, fall efficacy, and balance confidence and their association with fall risk in community-dwelling older adults engaged in regular exercise programs; A cross-sectional study was conducted with 280 participants aged 55 and over from community exercise programs near Lisbon, Portugal. Fall risk was assessed through self-reported falls in the past 12 months. HGS was measured with a dynamometer, fall efficacy using the Falls Efficacy Scale-International (FES-I), and balance confidence using the Activities-specific Balance Confidence (ABC) Scale. Statistical analyses included Spearman correlations and binary logistic regression. Results: Falls were reported by 26.4% of participants. Fall efficacy and balance confidence were significantly associated with fall history, while HGS was not. Fall efficacy was significantly associated with increased fall risk, as indicated by the odds ratio (OR = 3.37, p < 0.001), while balance confidence was negatively associated (OR = 0.95, p < 0.001). HGS was positively correlated with balance and confidence but not with fall incidence. Conclusions: Psychological factors, particularly fall efficacy and balance confidence, play a critical role in fall risk among physically active older adults. However, this study included physically active middle-aged and older adults living in the community, which should be considered when interpreting the generalizability of the results. These findings support the integration of simple, validated psychological assessments into fall prevention strategies in community settings. Full article

This study explores how Speech and Elocution Training (SET) activates language potential and fosters career-oriented development among higher vocational students through self-efficacy mechanisms. Through qualitative interviews with four vocational graduates who participated in SET 5 to 10 years ago, the research identifies three key findings. First, SET comprises curriculum content (e.g., workplace communication modules such as hosting, storytelling, and sales pitching) and classroom training using multimodal TED resources and Toastmasters International-simulated practices, which spark language potential through skill-focused, realistic exercises. Second, these pedagogies facilitate a progression where initial language potential evolves from nascent career interests into concrete job-seeking intentions and long-term career plans: completing workplace-related speech tasks boosts confidence in career choices, planning, and job competencies, enabling adaptability to professional challenges. Third, SET aligns with Bandura’s four self-efficacy determinants; these are successful experiences (including personalized and virtual skill acquisition and certified affirmation), vicarious experiences (via observation platforms and constructive peer modeling), verbal persuasion (direct instructional feedback and indirect emotional support), and the arousal of optimistic emotions (the cognitive reframing of challenges and direct desensitization to anxieties). These mechanisms collectively create a positive cycle that enhances self-efficacy, amplifies language potential, and clarifies career intentions. While highlighting SET’s efficacy, this study notes a small sample size limitation, urging future mixed-methods studies with diverse samples to validate these mechanisms across broader vocational contexts and refine understanding of language training’s role in fostering linguistic competence and career readiness. Full article

Physical activity plays a critical role in health and well-being, particularly during students’ academic development. This study explores the relationship between self-efficacy and physical activity among physiotherapy students, recognizing self-efficacy as a key factor influencing exercise behavior. Despite awareness of physical activity’s benefits, academic demands may hinder participation, reducing confidence in maintaining an active lifestyle. A total of 244 physiotherapy students (mean age 24.44 ± 7.56 years) completed the General Self-Efficacy Scale (GSES) and the International Physical Activity Questionnaire—Short Form (IPAQ-SF). The results showed that the self-efficacy scores ranged from 17 to 40, with a mean of 30.44 (±3.93), indicating moderate to high levels. In terms of activity, 40.3% of students reported sufficient activity (high level), 51.7% reported moderate activity (meeting minimum guidelines), and 8.05% reported insufficient (low) activity. Self-efficacy positively correlated with age (r = 0.199, p < 0.01) and education level (r = 0.191, p < 0.01), and negatively with employment (r = –0.171, p < 0.05). Physical activity was significantly associated with self-efficacy (r = 0.217, p < 0.01). These findings underscore the importance of fostering self-efficacy to promote physical activity, highlighting the need for targeted strategies within academic settings to support student well-being and healthier lifestyle choices. Full article

Voice disorders occur frequently in schoolteachers. The aim of the present cross-sectional study involving 124 German teachers was to investigate whether singing, voice training, and high self-efficacy are protective factors for vocal health. Furthermore, vocal self-concept was examined as a potential mediator explaining this relationship. Participants were assigned to the cases group if they had a clinically significant finding in voice examinations consisting of video laryngoscopy (VLS), auditory assessment (RBH), and the Voice Handicap Index (VHI) were assigned to the cases group. Psychosocial assessments comprised questions about singing activities and participation in voice training as well as validated questionnaires regarding self-efficacy (LSWS) and vocal self-concept (FESS). Group comparisons and mediation analyses were conducted. Analyses revealed a decreased risk of voice problems for teachers who sing regularly (OR: 0.442, p = 0.038). Furthermore, the absence of voice problems was associated significantly with higher self-efficacy ratings (t(113) = 1.71, p = 0.045). Both associations were mediated by vocal self-concept ratings (singing: ab = −0.422, 95%-CI [−1.102, −0.037]; self-efficacy: ab = −0.075, 95%-CI [−0.155, −0.022]). Participation in voice training in the past did not reduce the risk of voice problems significantly. The presented data suggest that regular singing and self-efficacy should be promoted in health care and prevention programs. Since no impact of sporadic participation in voice training activities on the occurrence of voice problems was found, efforts regarding the transfer of regular vocal exercises into daily life need to be intensified. Full article