Search Results (822)

Research highlights a growing demand for active, experiential learning methods in higher education, especially in teacher education. While the benefits of parental involvement (PI) are well-documented, Hungary lacks tools to effectively prepare teacher trainees for fostering family–school cooperation. This study addresses this gap by introducing a custom-designed board game as an innovative teaching tool. The game simulates real-world challenges in PI through a cooperative, scenario-based framework. Exercises are grounded in international and national research, ensuring their relevance and evidence-based design. Tested with 110 students, the game’s educational value was assessed via post-gameplay questionnaires. Participants emphasized the strengths of its cooperative structure, realistic scenarios, and integration of humor. Many reported gaining new insights into parental roles and strategies for effective home–school partnerships. Practical applications include integrating the game into teacher education curricula and adapting it for other educational contexts. This study demonstrates how board games can bridge theory and practice, offering an engaging, effective medium to prepare future teachers for the challenges of PI. Full article

Background/Objectives: Physical activity is a cornerstone of diabetes mellitus (DM) management and is strongly recommended in the American Diabetes Association (ADA)’s guidelines. This study aims to investigate the self-reported physical activity levels of individuals with DM in Germany, as well as the barriers and facilitators they encounter. Methods: Individuals with type 1 DM (T1DM) and type 2 DM (T2DM) were asked to fill out an online questionnaire that was partly based on the International Physical Activity Questionnaire (IPAQ). Results: The questionnaire was completed by 338 persons with either T1DM (57.1%) or T2DM (42.9%) (females: 56.2%, males: 42.0%, gender diverse persons: 1.8%) of all age groups (at least 18 years). In total, 80.5% of respondents were aware of the current physical activity recommendations. Among the respondents, 58% reported meeting the recommendations for endurance-type physical activity, while only 30.5% reported meeting those for strength training. The three most frequently cited barriers to physical activity were lack of time, lack of motivation and current state of health. Supporting factors included coverage of costs, availability of exercise programs in close proximity to the patient’s home and target group specific exercise programs. Conclusions: The results imply that many individuals with DM in Germany do not meet ADA’s physical activity recommendations, especially considering that self-reports often overestimate actual behavior. In particular, the actual number of individuals who regularly engage in strength training may be too low. There is a clear need to better communicate the benefits of different forms of physical training and to provide physical activity programs aligned with patients’ individual needs. Full article

Background/Objectives: This study aimed to evaluate the impact of an immersive virtual reality (IVR) program on balance, physical fitness, risk of falling, fear of falling, fatigue, and quality of life in older adults compared with an active control group (ACG). Methods: A total of 44 older adults were randomly assigned to either the IVR group (n = 22) or the ACG (n = 22) for an 8-week period. The IVR group participated in 35-min immersive virtual reality sessions three times a week, whereas the ACG followed a home-based traditional exercise program. Evaluations were conducted both before and after the intervention period. Results: Compared with the ACG, the participants in the IVR group demonstrated significant improvements in balance, upper and lower extremity strength, lower extremity flexibility, fatigue levels, and specific aspects of quality of life such as autonomy and social participation. Treatment satisfaction was also higher in the IVR group. Conclusions: An 8-week immersive virtual reality intervention was effective in improving physical function, reducing fatigue, and enhancing specific domains of quality of life among older adults. Full article

Background/Objectives: This study evaluates the effects of a personalized exercise program on symptoms (pain, fatigue, sleep, cognitive function, physical function), resilience, and health-related quality of life (HRQOL) and compares the effectiveness of in-person versus telehealth delivery. Methods: A secondary data analysis was conducted on two 12-week randomized control pilot studies for solid tumor cancer survivors. One study involved in-person home visits with telephone follow-ups. The second utilized weekly exercise recommendations via a smartphone app. Both studies had control participants who received the standard care. Symptoms, resilience, and HRQOL were measured at baseline and after 12 weeks. Paired t-tests were conducted for intervention effects and ANCOVA for group differences, adjusting for age and education. Results: The analysis included 75 program completers: 15 in-person (iHBE), 38 telehealth (TEHE), and 22 who received standard care. Those receiving exercise interventions reported improvements in physical (t = 3.0, p < 0.01) and mental fatigability (t = 3.1, p < 0.01) at program completion compared to baseline. Comparing the mean changes between participants receiving exercise interventions in-person and via telehealth, there were no significant differences between the two delivery methods except perceived visuo-perceptual cognitive difficulty (F = 3.55, p = 0.027), where telehealth showed a slight advantage. Conclusions: The study provides initial evidence of the effectiveness of a telehealth personalized exercise on fatigability and cognitive difficulty, suggesting it is a potential viable alternative to in-person intervention. Further research with a larger cohort is essential to ascertain the effects of these interventional modalities on cancer-related health outcomes. Full article

Introduction: Home-based cardiac telerehabilitation (HBCTR) is a multidisciplinary intervention aimed at optimizing functional, psychological, and social recovery in patients undergoing percutaneous coronary intervention (PCI). This rehabilitation model serves as an effective alternative to traditional center-based rehabilitation, providing a cost-effective and clinically advantageous approach. Methods: Following PRISMA guidelines, we conducted a systematic literature search across multiple databases (PubMed, CINAHL, Cochrane, Scopus, Web of Science). We included randomized controlled trials (RCTs), cohort, and observational studies assessing telerehabilitation in post-PCI patients. Primary outcomes focused on health-related quality of life (HRQoL) and adherence, while secondary outcomes included functional capacity (6 min walk test, VO₂max), cardiovascular risk factor control, and psychological well-being. Risk of bias was assessed using the Cochrane RoB 2.0 and ROBINS-I tools. Results: A total of 3575 articles were identified after removing duplicates, of which 877 were selected based on title and abstract, and 17 met the inclusion criteria, with strong RCT representation ensuring robust evidence synthesis. HBCTR was associated with significant improvements in exercise capacity, with increases in VO₂max ranging from +1.6 to +3.5 mL/kg/min and in 6 min walk distance from +34.7 to +116.6 m. HRQoL scores improved significantly, with physical and mental component scores increasing by +6.75 to +14.18 and +4.27 to +11.39 points, respectively. Adherence to telerehabilitation programs was consistently high, often exceeding 80%, and some studies reported reductions in hospital readmissions of up to 40%. Wearable devices and smartphone applications facilitated self-monitoring, enhancing adherence and reducing readmissions. Several studies also highlighted improvements in anxiety and depression scores ranging from 10% to 35%. Conclusions: HBCTR is a promising strategy for rehabilitation and quality-of-life improvement after PCI. It offers a patient-centered solution that leverages technology to enhance long-term outcomes. By integrating structured telerehabilitation programs, healthcare systems can expand accessibility, promote adherence, and improve equity in cardiovascular care. Full article

Purpose: We aimed to evaluate the safety and feasibility of a remote electrocardiogram (ECG) monitoring-based cardiac rehabilitation (CR) program during an early postoperative period in patients who underwent cardiac surgery. Methods: Five days after cardiac surgery, patients were referred to a CR department and participated in a low-intensity inpatient CR program while wearing an ECG monitoring device. Prior to discharge, the patients underwent a cardiopulmonary exercise test (CPET) and squat endurance test to determine the suitable intensity and target heart rate (HR) for home-based CR (HBCR). During 2 weeks of the HBCR period after discharge, patients participated in aerobic and resistance exercises. Electrocardiogram data were transmitted to a cloud, where researchers closely monitored them through a website and provided feedback to the patients via telephone calls. Grip strength (GS), 6 min walk distance (6 MWD), EuroQol-5 dimension (EQ-5D), short-form 36-item health survey (SF-36), and Korean Activity Scale/Index (KASI) were measured at three different time points: 5 d post-surgery (T1), pre-discharge (T2), and 2 weeks after discharge (T3). Squat endurance tests and CPET were performed only at T2 and T3. Result: Sixteen patients completed the study, seven (44%) of whom underwent coronary artery bypass graft surgery (CABG). During the study period between T2 and T3, peak VO₂ improved from 12.39 ± 0.57 to 17.93 ± 1.25 mL/kg/min (p < 0.01). The squat endurance test improved from 16.69 ± 2.31 to 21.81 ± 2.31 (p < 0.01). In a comparison of values of time points between T1 and T3, the GS improved from 28.30 ± 1.66 to 30.40 ± 1.70 kg (p = 0.02) and 6 MWD increased from 249.33 ± 20.92 to 387.02 ± 22.77 m (p < 0.01). The EQ-5D and SF-36 improved from 0.59 ± 0.03 to 0.82 ± 0.03 (p < 0.01) and from 83.99 ± 3.40 to 122.82 ± 6.06 (p < 0.01), and KASI improved from 5.44 ± 0.58 to 26.11 ± 2.70 (p < 0.01). In a subgroup analysis, the CABG group demonstrated a greater increase in 6 MWD (102.29 m, p < 0.01) than the non-CABG group. At the end of the study, 75% of the patients expressed satisfaction with the early CR program guided by remote ECG monitoring. Conclusions: Our findings suggest that early remote ECG monitoring-based CR programs are safe and feasible for patients who have undergone cardiac surgery. Additionally, the program improved aerobic capacity, functional status, and quality of life. Full article

The electrocardiogram (ECG) signal plays a crucial role in medical diagnosis, home care, and exercise intensity assessment. However, traditional ECG monitoring devices are difficult to blend with users’ daily routines due to their lack of portability, poor wearability, and inconvenient electrode usage methods. Therefore, utilizing reusable and cost-effective flexible bioelectrodes (with a signal-to-noise ratio of 33 dB), a miniaturized wearable system (MWS) is proposed for unconstrained ECG monitoring, which holds a size of 65 × 52 × 12 mm³ and a weight of 69 g. Given these compelling features, this system enables reliable and high-quality ECG signal monitoring in individuals’ daily activities, including sitting, walking, and cycling, with the acquired signals exhibiting distinguishable QRS characteristics. Furthermore, an exercise intensity classification model was developed based on ECG characteristics and a fully connected neural network (FCNN) algorithm, with an evaluation accuracy of 98%. These results exhibit the promising potential of the MWS in tracking individuals’ physiological signals and assessing exercise intensity. Full article

Background/Objectives: Robot-led rehabilitative exercise offers a promising avenue to enhance the care provided by exercise specialists (ESs). ESs, such as physical and occupational therapists, prescribe exercise regimens to clinical populations to improve patients’ adherence to prescribed exercises outside the clinic, such as at home. Collaborative efforts among roboticists, clinical ESs, and patients are essential for developing interactive, personalized exercise systems that meet each stakeholder’s needs. This work builds upon research involving individuals with Parkinson’s disease (PD) that evaluated a robotic rehabilitative exercise system designed to address strength and flexibility deficits. Methods: To complement the findings of our previous work in people with PD (PWP), we conducted a pilot user study in which 11 ESs evaluated a novel robot-led exercise system for PWP, focusing on perceptions of the system’s efficacy and acceptance. Utilizing a mixed-methods approach, including technology acceptance questionnaires, task load questionnaires, and inductively coded semi-structured interviews, we gathered comprehensive insights into ES perspectives and experiences after interacting with the system. Results: Findings reveal a broadly positive reception, which highlights the system’s capacity to augment traditional rehabilitative exercise for PD, enhance patient engagement, and ensure consistent exercise support. We also identified two key areas for improvement: incorporating more human-like feedback systems and increasing the robot’s ease of use. Conclusion: This research emphasizes the value of incorporating robotic assistants into rehabilitative exercise for PD, offering insights that can guide the development of more effective and user-friendly rehabilitation technologies. Full article

Background: This scoping review aims to map and summarise physical therapy interventions specifically targeting gait and balance in individuals with Charcot-Marie-Tooth disease (CMT), highlighting commonly applied strategies, methodological limitations, and clinical implications. Charcot-Marie-Tooth disease (CMT) is a hereditary neuropathy characterised by progressive motor and sensory impairment, often resulting in reduced mobility, muscle weakness, balance deficits, and fatigue. Although pharmacological options remain limited, rehabilitation is increasingly recognised as a key component of disease management. However, the scope, type, and effectiveness of rehabilitative interventions in CMT remain poorly mapped. Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR guidelines. Five databases (PubMed, Cochrane, PEDro, Scopus, and Web of Science) were systematically searched up to March 2024. Studies were eligible if they involved participants with CMT undergoing rehabilitation interventions aimed at improving functional outcomes. Data extraction focused on study characteristics, methods, outcome measures, and results. Results: Eleven studies met inclusion criteria, comprising case reports, cohort studies, and two randomised controlled trials. Interventions included aerobic training, strength and balance exercises, videogame-based home programmes, and multidisciplinary rehabilitation. Most studies reported improvements in walking capacity (e.g., 6MWT, 10MWT), postural balance (e.g., BBS), and lower limb strength (e.g., MRC, dynamometry). Some also showed positive changes in fatigue and quality of life, though data were limited. Methodological heterogeneity and small sample sizes limited comparability and generalisability. Conclusions: Rehabilitation appears to yield meaningful improvements in key functional domains in people with CMT. Tailored, multimodal interventions show promise, though long-term benefits remain underexplored. Future research should adopt standardised protocols and outcome measures to better define best practices and optimise patient care. Full article

Ensuring that older adults perform chair-based exercises (CBEs) correctly is essential for improving physical outcomes and reducing the risk of injury, particularly in home and community rehabilitation settings. However, evaluating the correctness of movements accurately and objectively outside clinical environments remains challenging. In this study, camera-based methods have been used to evaluate practical exercise quality. A single-camera system utilizing MediaPipe pose estimation was used to capture joint angle data as twenty older adults performed eight CBEs. Simultaneously, surface electromyography (sEMG) recorded muscle activity. Participants were guided to perform both proper and commonly observed incorrect forms of each movement. Statistical analyses compared joint angles and sEMG signals, and a support vector machine (SVM) was trained to classify movement correctness. The analysis showed that correct executions consistently produced distinct joint angle patterns and significantly higher sEMG activity than incorrect ones (p < 0.001). After modifying the selection of joint angle features for Movement 5 (M5), the classification accuracy improved to 96.26%. Including M5, the average classification accuracy across all eight exercises reached 97.77%, demonstrating the overall robustness and consistency of the proposed approach. In contrast, high variability across individuals made sEMG less reliable as a standalone indicator of correctness. The strong classification performance based on joint angles highlights the potential of this approach for real-world applications. While sEMG signals confirmed the physiological differences between correct and incorrect executions, their individual variability limits their generalizability as a sole criterion. Joint angle data derived from a simple single-camera setup can effectively distinguish movement quality in older adults, offering a low-cost, user-friendly solution for real-time feedback in home and community settings. This approach may help support independent exercise and reduce reliance on professional supervision. Full article

Background/Objectives: Excess body weight is a global public health problem. This study aimed to identify differences in food-related behaviors and physical activity among healthy weight, overweight, and obese adult individuals in Poland. Particular attention was paid to health inequalities among analyzed groups. Methods: This was a secondary data analysis of a dataset generated by the public institution in Poland, within a representative cross-sectional study among working adults (aged 18–64 years) in December 2024. A total of seven different questions on lifestyle-related behaviors were analyzed. Results: A total of 4714 adults were included in the analysis, of which 47.0% had a healthy weight (BMI 18.5–24.9), 34.2% were overweight (BMI 25–29.9), and 18.9% were obese (BMI 30–39.9). People aged 45–64 had almost 6 times higher odds of belonging to the overweight group compared to people aged 18–24 (OR = 5.7; 95% CI: 4.34–7.49). Men were more likely to be overweight (OR = 1.69; 95% CI: 1.47–1.95), as were rural residents (OR = 1.21; 95% CI: 1.05–1.39). The overweight group was more likely to monitor the number of steps taken during the day (OR = 1.42; 95% CI: 1.19–1.71) and limit carbohydrates in the diet (OR = 1.39; 95% CI: 1.1–1.75). The group with a healthy weight was distinguished by eliminating products containing preservatives/artificial colors (OR = 0.76; 95% CI: 0.63–0.91) and performing home exercises, such as yoga or Pilates (OR = 0.68; 0.55–0.84). The obese group relative to the overweight group was more likely to perform regular exercise at least three times a week (OR = 1.5; 95% CI: 1.09–2.06), taking care for the presence of dietary fiber in the daily diet (OR = 1.35; 95% CI: 1.04–1.75) but also not paying much attention to one’s diet (OR = 1.23; 95% CI: 1.01–1.5). Conclusions: This study pointed out differences in lifestyle, especially food-related behaviors and physical activity among different BMI groups. Full article

Background: Patients with spinal cord injuries, in addition to rehabilitation in specialized facilities, often continue physical therapy at home. At that time, they become highly exposed to indoor pollutants, which can affect the effectiveness of the recovery program and human health. Methods: Thus, the present study presents the monitoring of indoor air quality in a residential facility where a patient with spinal cord injuries undergoes post-traumatic recuperative physical activity. Such a study is useful for ensuring good air quality for the optimal development of a rehabilitation program with the possibility of screening the indoor air quality of the home by the physiotherapist and even by the patient themselves, in the simplest way possible using low-cost equipment. Thus, 11 indoor air quality parameters were monitored for a period of 18 weeks, using low-cost equipment. An air purifier was put into operation for a period of one week to identify differences in the safety of the indoor environment for physical activities. Results: The results indicate an environment with frequent exceedances of the international standards in force for several indicators. After installing the purifier, the air quality stabilized and a much safer and more efficient environment for carrying out the recovery activities was established. Conclusions: Thus, the process of monitoring and optimizing indoor air quality stands as a fundamental requirement for home rehabilitation because it establishes a secure controlled environment that supports recovery in any residential setting. Full article

Background: Sarcopenia is characterized by low muscle mass and strength, as well as impaired physical performance. Older adults with sarcopenia experience decreased cardiorespiratory fitness. Physical exercise is recommended for the prevention and treatment of sarcopenia. Virtual reality (VR) exercise was introduced to improve physical activity. However, the effect of VR on cardiorespiratory function in older adults with sarcopenia has not been fully explored. This study aimed to explore the effects of home-based VR aerobic exercise combined with resistive exercise on cardiorespiratory performance in community-dwelling older adults with sarcopenia. Subjects and Methods: In a randomized controlled trial, 53 older adults with sarcopenia were divided into a home-based VR (n = 26) and a control group (CG; n = 27). The VR program combined aerobic and resistance exercises, performed three times per week for 12 weeks, while the CG received knowledge regarding the benefit of exercise and continued with their regular daily activities. All participants were required to undergo respiratory muscle strength and functional capacity tests before and after the 12-week intervention. Two-way mixed repeated ANOVA was conducted to compare within and between groups in cardiorespiratory performance. Results: The home-based VR exercise group showed significant improvement in pre-post (i.e., maximal inspiratory pressure (12.96 ± 1.49 cmH₂O), maximal expiratory pressure (13.73 ± 1.72 cmH₂O), functional capacity (28.32 ± 3.48 m), and between-group (maximal expiratory pressure (F (1,51) = 10.446, p = 0.002, np² = 0.170). In contrast, the CG displayed a reduction in maximal expiratory pressure (−3.93 ± 1.69 cmH₂O, p = 0.024) and functional capacity (−10.39 ± 3.42 m, p = 0.004) after the 12-week program. Conclusions: The home-based VR program provides older adults with sarcopenia an alternative exercise modality that can improve their cardiovascular performance. Full article

Rotator cuff tears are common in individuals over 40, and physical therapy is often prescribed post-surgery. However, access can be limited by cost, convenience, and insurance coverage. CuffLink is a telehealth rehabilitation system that integrates the Strengthening and Stabilization System mechanical exerciser with the interACTION mobile health platform. The system includes a triple-axis accelerometer (LSM6DSOX + LIS3MDL FeatherWing), a rotary encoder, a VL530X time-of-flight sensor, and two wearable BioMech Health IMUs to capture upper-limb motion. CuffLink is designed to facilitate controlled, home-based exercise while enabling clinicians to remotely monitor joint function. Concurrent validity and test–retest reliability were used to assess device accuracy and repeatability. The results showed moderate to good validity for shoulder rotation (ICC = 0.81), device rotation (ICC = 0.94), and linear tracking (from zero: ICC = 0.75 and RMSE = 2.41; from start: ICC = 0.88 and RMSE = 2.02) and good reliability (e.g., RMSEs as low as 1.66 cm), with greater consistency in linear tracking compared to angular measures. Shoulder rotation and abduction exhibited higher variability in both validity and reliability measures. Future improvements will focus on manufacturability, signal stability, and force sensing. CuffLink supports accessible, data-driven rehabilitation and holds promise for advancing digital health in orthopedic recovery. Full article

Background/Objectives: Supervised pulmonary rehabilitation (PR) is effective in improving cardiorespiratory fitness in non-hospitalised individuals with long COVID. However, there is limited evidence regarding PR-induced improvements in cardiorespiratory parameters in previously hospitalised COVID-19 survivors. This study aimed to investigate the effect of a hybrid PR programme (outpatient followed by a digital intervention) on exercise tolerance, cardiorespiratory adaptations, functional capacity and quality of life outcomes in previously hospitalised COVID-19 survivors. Methods: Forty-two patients (age (mean ± SD): 57 ± 12 yrs) with excessive fatigue due to long COVID (FACIT score (26 ± 10) were allocated to PR (n = 27) or usual care (UC) (n = 15) 140 ± 75 days from hospital discharge. PR consisted of 8 outpatient sessions (twice weekly for 4 weeks) followed by 24 home-based sessions (3 times/week for 8 weeks). Patients in the UC group were instructed to be physically active. Exercise tolerance was assessed by cardiopulmonary cycling testing to the limit of tolerance. Results: Following the completion of the hybrid PR programme, peak work rate (WRpeak) and peak oxygen uptake (VO₂peak) were, respectively, improved in the PR group by 19 ± 10 Watt (p = 0.001) and by 2.4 ± 3.0 mL/kg/min (p = 0.001). Furthermore, in the PR group, the 6 min walk distance was increased by 72 ± 69 metres (p = 0.001). FACIT and mMRC scores were also improved in the PR group by 15 ± 10 (p = 0.001) and by 1.4 ± 1.0 (p = 0.001), respectively. In the UC group, only the mMRC score was improved by 0.7 ± 1.0 (p = 0.008). Conclusions: The application of a hybrid PR programme was beneficial in improving cardiorespiratory exercise fitness, functional capacity and quality of life in previously hospitalised COVID-19 survivors. Full article