Search Results (903)

The global rise in nursing home (NH) populations presents substantial challenges, as residents frequently experience physical and cognitive decline, low physical activity, and high fall risk. This study evaluates the effectiveness of the BeSt Age App, a tablet-based, staff-supported mHealth intervention designed to promote physical activity and prevent falls among NH residents. Primary outcomes were fall incidence and fall risk (assessed using Berg Balance Scale [BBS] and Timed Up and Go [TUG]); fear of falling was a secondary outcome. In a cluster-randomized controlled trial across 19 German NHs, 229 residents (mean age = 85.4 ± 7.4 years; 74.7% female) were assigned to an intervention group (IG) or control group (CG). The 12-week intervention comprised twice-weekly, tablet-guided exercise sessions implemented by NH staff. Mixed models and generalized estimating equations were used under an intention-to-treat framework. The IG showed significantly greater improvement in BBS scores than the CG (group × time: F(1, 190.81) = 8.25, p = 0.005, d = 0.22), while group × time changes in TUG performance, fear of falling, and fall incidence were nonsignificant. These findings demonstrate the feasibility of a staff-mediated mHealth approach to fall prevention in NH residents, showing significant improvements in BBS scores as one functional indicator of fall risk, while TUG, fall incidence and fear of falling showed no change. Full article

Background/Objectives: Despite the known benefits of cardiac rehabilitation, it remains underutilized among women. In particular, little is known about the effectiveness of hybrid comprehensive telerehabilitation (HCTR) in women with heart failure (HF). The purpose of this study was to assess effectiveness and safety of HCTR in women with HF. Methods: This analysis formed part of the TELEREH-HF multicenter, randomized trial that enrolled 850 HF patients (NYHA I-III, LVEF ≤ 40%). Patients were randomized 1:1 to HCTR plus usual care (UC) or UC alone. Patients underwent either HCTR (1 week in hospital and 8 weeks at home, five times weekly) or UC with observation. The effectiveness of HCTR was assessed by changes in peak oxygen consumption (VO₂peak), workload duration (t) in cardiopulmonary exercise test and quality of life (QoL) based on Medical Outcome Survey Short Form 36 Questionnaire (SF-36). Measurements were taken before and after intervention/observation. Results: Women constituted 11.5% of the TELEREH-HF study population. Forty women in the HCTR group and 44 women in the UC group completed program and observation, respectively. HCTR resulted in a significant improvement in VO₂peak (13.4 ± 4.3 vs. 14.3 ± 4.6; 95%CI 0.91 [0.05; 1.77], p = 0.038), workload duration (301 ± 162.3 vs. 334 ± 156.6; 95%CI 33 [5; 60], p = 0.022) and SF-36 overall score (85.9 ± 13.6 vs. 89.9 ± 13.5; 95%CI 4.0 [0.6; 7.4], p = 0.024). These favorable results were not observed in the UC group VO₂peak (14.2 ± 4.8 vs. 14.2 ± 4.8; 95%CI 0.02 [−1.20; 1.24], p = 0.971) and SF-36 overall score (89.1 ± 17.4 vs. 89.5 ± 15.8; 95%CI 4.0 [−2.1; 2.8], p = 0.796), except for an increase workload duration (268 ± 138.4 vs. 300 ± 130.1; 95%CI 32 [2; 62], p = 0.036). The HCTR group showed a significantly greater improvement in the physical component of QoL than the UC group. In neither group were there deaths nor major adverse events related to exercise training. Conclusions: Among women with heart failure, hybrid comprehensive telerehabilitation appears safe and leads to statistically significant although moderate improvements in physical capacity and quality of life. However, due to the small sample size, further studies in larger female populations are needed to confirm these findings. Full article

Virtual reality (VR) technologies are increasingly applied in rehabilitation, offering interactive physical and spatial exercises. A major challenge remains the objective assessment of human movement quality (HMQA). This study aimed to identify biomechanical features differentiating correct and incorrect execution of a lateral lunge and to determine the minimal number of sensors required for reliable VR-based motion analysis, prioritising interpretability. Thirty-two healthy adults (mean age: 26.4 ± 8.5 years) performed 211 repetitions recorded with the HTC Vive Tracker system (7 sensors + headset). Repetitions were classified by a physiotherapist using video observation and predefined criteria. The analysis included joint angles, angular velocities and accelerations, and Euclidean distances between 28 sensor pairs, evaluated with Linear Discriminant Analysis (LDA) and SHapley Additive exPlanations (SHAP). Angular features achieved higher LDA performance (F1 = 0.89) than distance-based features (F1 = 0.78), which proved more stable and less sensitive to calibration errors. Comparison of SHAP and LDA showed high agreement in identifying key features, including hip flexion, knee rotation acceleration, and spatial relations between headset and foot or shank sensors. The findings indicate that simplified sensor configurations may provide reliable diagnostic information, highlighting opportunities for interpretable VR-based rehabilitation systems in home and clinical settings. Full article

Osteoarthritis (OA) is a progressive musculoskeletal disorder that affects not only older adults but also younger populations, often leading to chronic pain, joint stiffness, functional impairment, and a decline in quality of life. Non-invasive physical rehabilitation plays a critical role in slowing disease progression, alleviating symptoms, and maintaining joint mobility. However, rehabilitation tools such as compression gloves and manual exercise aids are typically passive and provide minimal real-time feedback to patients or clinicians. Others, such as exoskeletons and soft-actuated devices, can be costly or complex to use. This study presents the design and development of an electrically actuated glove integrated with force and flex sensors, intended to assist individuals diagnosed with Stage 2 OA in performing guided finger exercises. The system integrates a digital front-end application that offers real-time feedback and data visualization, enabling more personalized and trackable therapy sessions for both patients and healthcare providers. Preliminary results from an initial human trial with healthy participants demonstrate that the glove enables naturalistic movement without imposing excessive restriction or augmentation of motion. These findings support the glove’s potential in preserving hand coordination and dexterity, key objectives in early-stage OA intervention, and suggest its suitability for integration into home-based or clinical rehabilitation protocols. Full article

Background/Objectives: Non-traumatic (degenerative) rotator cuff tendinopathy with partial supraspinatus tear (NT-RCTT) is a common source of shoulder pain and disability. Comparative evidence between radial extracorporeal shock wave therapy (rESWT) and multimodal physical therapy modalities (PTMs) remains scarce. Methods: In this single-center randomized controlled trial, 60 adults with MRI-confirmed NT-RCTT were assigned (1:1) to rESWT (one session weekly for six weeks; 2000 impulses per session, 2 bar air pressure, positive energy flux density 0.08 mJ/mm²; 8 impulses per second) or a multimodal PTM program (interferential current, shortwave diathermy and magnetothermal therapy; five sessions weekly for six weeks). All participants performed standardized home exercises. The primary outcome was the American Shoulder and Elbow Surgeons (ASES) total score; secondary outcomes included pain (visual analog scale, VAS), satisfaction, range of motion (ROM), supraspinatus tendon (ST) thickness and acromiohumeral distance (AHD). Assessments were conducted at baseline, and at week 6 (W6) and week 12 (W12) post-baseline. Results: Both interventions significantly improved all outcomes, but rESWT produced greater and faster effects. Mean ASES total scores increased by 31 ± 5 points with rESWT versus 26 ± 6 with PTMs (p < 0.05). VAS pain decreased from 5.2 ± 0.7 to 1.0 ± 0.7 with rESWT and from 5.2 ± 0.8 to 1.7 ± 0.8 with PTMs (p < 0.01). rESWT achieved higher satisfaction and larger gains in abduction, flexion and external rotation. Ultrasound showed reduced ST thickness and increased AHD after rESWT but not after PTMs. No serious adverse events occurred. Conclusions: rESWT yielded superior pain relief, functional recovery and tendon remodeling compared with a multimodal PTM program, with markedly lower treatment time and excellent tolerability. Full article

Background: Prolonged obesity in children can lead to a gradual decline in postural stability due to changes in biomechanics, musculoskeletal function, and neuromuscular control. Early interventions may help address these issues. This exploratory study examined the potential influence of Thai massage on postural stability in children with overweight and obesity. Methods: This study employed a quasi-experimental, comparative design and was conducted at the Pa Tueng Sub-district Health Promoting Hospital, Chiang Rai, Thailand. A total of 58 children meeting the criteria for overweight or obesity were systematically assigned to either the Thai massage group or the control group based on the order in which they were recruited. The Thai massage group received 45 min full-body Thai massage sessions combined with stretching exercises twice a week for six weeks (a total of 12 sessions), while the control group was advised to perform daily stretching exercises at home. Postural stability was assessed by measuring sway path length and sway velocity during double-leg and single-leg stances with eyes closed, both before and after the intervention. Results: While no statistically significant differences were found between the groups, the Thai massage group exhibited a non-significant trend toward reduced sway path length and sway velocity, whereas the control group showed a significant increase in both measures (p < 0.05), indicating a decline in postural stability over time. Conclusions: These findings suggest that Thai massage showed a potential trend toward stabilizing postural stability in children with overweight and obesity; however, the between-group differences were not statistically significant. As an exploratory study, further research with longer intervention durations and follow-up assessments is needed to determine whether clinically meaningful effects can be established. Full article

Background/Objectives: This study aimed to assess the impact of a physio-feedback exercise program (PEER) on the static balance of community-dwelling older adults. Methods: A clustered randomized controlled trial involving community-dwelling older adults (≥60 years of age) in the Central Florida area was conducted. Participants were randomized by research site into either (1) an 8-week exercise intervention program consisting of group-based and at-home exercises, along with a discussion with a researcher regarding their physiological health before and after the intervention period, or (2) a control group. Static balance outcomes included anterior–posterior root mean square (AP RMS), medial-lateral RMS (ML RMS), sway speed variability, and sway area measured using the Balance Tracking System (BTrackS) at baseline (T1), post-intervention (T2), one-month post-intervention (T3), and three months post-intervention (T4). Results: Among 373 community-dwelling older adults (mean age = 74.3 ± 7.1 years), a trend towards short-term improvement of sway area was observed for the intervention group, as seen through a small, marginally significant reduction in sway area at T2 (standardized β = −0.07; p = 0.050). However, the trend dissipated during post-intervention follow-up periods (T3 and T4). Sway speed variability significantly increased for the intervention group at T4 (standardized β = 0.10; p = 0.014). Conclusions: The PEER intervention may need to increase the total duration of the intervention, the frequency of the weekly exercise sessions, and the amount of standing stance exercises during the group-based and at-home exercise sessions to elicit improvements in static balance among older community-dwelling adults. Full article

Background/Objectives: Recent preclinical studies suggest that acute exercise induces immune modulation, enhances tumor blood perfusion, and is associated with reduced tumor growth. Adding exercise to immunochemotherapy treatment (ICT) has been proposed as a strategy to increase treatment effectiveness. The ERICA trial (NCT04676009) aimed to assess the feasibility of acute aerobic exercise performed immediately before the administration of ICT in patients with metastatic non-small cell lung cancer (mNSCLC) and to explore hypothesis-generating outcomes related to physical fitness and patient-reported outcomes. Methods: Newly diagnosed mNSCLC patients were randomly assigned (2:1) to the exercise or control group. The exercise intervention included supervised acute exercise before each of four ICT cycles plus a 3-month home-based walking program with an activity tracker and step goals. The feasibility of the exercise protocol was assessed through adherence, acceptability, tolerability, and safety. Clinical, physical, and patient-reported outcomes were assessed at baseline and after 3 months. Results: Twenty-six patients (mean age 60.6 years; SD 10.65) participated, with an 87.5% acceptance rate. In the exercise group (n = 17), 80.9% of participants completed the acute exercise sessions, with a median interval of 38 min [IQR, 20–60] between exercise and ICT. No exercise-related adverse effects were reported. After 3 months, 60% of participants in the exercise group were classified as active and maintained their step goals. Self-reported measures suggest that maintaining physical fitness is favorable for reducing fatigue and insomnia, and therefore improving quality of life. Conclusions: Acute exercise performed immediately before each ICT administration in patients with mNSCLC appears feasible and safe. Full article

The consumption of water with very low mineral content (W-VLMC; water with total dissolved solids below 50 mg/L), despite limited and inconsistent evidence and the resulting knowledge gaps, has not been associated with health risks for the general population. However, certain population subgroups (those eating very unbalanced diets or avoiding certain foods, engaged in prolonged periods of fasting, and/or doing prolonged or strenuous exercise as well as pregnant or breastfeeding women) should be mindful of maintaining sufficient intake of all essential minerals through their food if regularly using this type of water as their main beverage. The rapid expansion of water filtration systems—often producing W-VLMC—creates a timely and valuable opportunity to advance research on the health implications of W-VLMC intake. As these systems become increasingly common in educational settings and homes, children represent a subgroup experiencing rising exposure to W-VLMC. Additional studies are needed to assess the health effects of such exposure from early childhood. A complementary yet contrasting perspective is that the use of water intended for human consumption—with stringent quality control standards—and natural mineral waters—inherently pure, thus eliminating the need for filtration—with higher mineralization in both types of water, may provide an additional dietary source of essential minerals, especially for all the population subgroups mentioned above. Full article

Rehabilitation robots are a leading solution towards bridging the gap between the growing number of rehabilitation patients requiring therapy and the limited availability of healthcare professionals. However, existing robotic systems are often bulky and expensive, limiting their ability to provide widespread, repetitive, and intensive exercises. This paper presents the development of an impedance-based control strategy designed to provide safe and compliant upper-body passive and active exercises on the low-cost PlanAID robot, which is built using consumer-grade components. The system’s functionalities are evaluated using a high-precision force sensor. Results show that the PlanAID exhibits performance comparable to seminal devices such as the MIT-Manus, achieving a similar applicable reaction force target of 28 N and reflected inertia of 1.1 kg. Although the overall performance is comparable, the low-cost PlanAID prototype suffers from reduced coupled stability margins, limiting the maximum achievable virtual spring constant to 1100 N/m. Despite this limitation, the stiffness values required in practical applications remain low, suggesting that the PlanAID could potentially be a viable candidate for real-world rehabilitation. Initial user feedback was obtained through a preliminary qualitative trial involving healthy subjects. Full article

Background: Simulation-based laparoscopic training increasingly relies on portable, low-cost platforms that support home-based practice, but detailed descriptions of reproducible, do-it-yourself (DIY) trainers and their educational potential remain limited. Methods: We updated a low-budget laparoscopic simulator constructed from an inexpensive plastic container, wood components, a low-cost webcam, and plywood task pads modeled on Fundamentals of Laparoscopic Surgery (FLS) exercises. We then conducted informal qualitative usability testing in which 10 residents and 5 fellows from general surgery, gynecology, and urology used the simulator at home for one week and completed an eight-item feedback form plus free-text comments on assembly, ergonomics, realism, and educational value. Results: All participants successfully assembled and used the simulator; most described set-up as easy or intuitive, reported adequate image quality and lighting, and considered the platform useful for practicing depth perception, bimanual coordination, and cutting and suturing tasks. Feedback emphasized low cost, portability, and cross-specialty applicability, with only minor suggestions such as adjustable camera height or increased base weight. Conclusions: This DIY laparoscopic simulator could be assembled and used in a home-based setting, and trainees reported favorable usability and perceived educational value. More structured validation studies addressing face, content, and construct validity are needed to define its potential role within contemporary surgical curricula. Full article

Background/Objectives: Thyroidectomy is a common endocrine procedure associated with postoperative musculoskeletal symptoms such as neck stiffness, pain, and reduced cervical mobility. These sequelae, though often underrecognized, can impair recovery and quality of life. Rehabilitation strategies, including stretching, manual therapy, and kinesio taping, have emerged as potential adjuncts to enhance postoperative outcomes. This scoping review aimed to map and synthesize current evidence on postoperative rehabilitation interventions following thyroidectomy, focusing on stretching exercises, manual therapy, and kinesio taping. Methods: Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a comprehensive search identified studies evaluating physical therapy interventions in adult thyroidectomy patients. Fourteen studies published between 2005 and 2025 met the inclusion criteria, encompassing randomized trials, quasi-experimental designs, and one retrospective cohort study. Interventions were delivered in early postoperative settings and included supervised or home-based programs. Results: Neck stretching and range-of-motion exercises consistently demonstrated benefits in pain reduction, cervical mobility, and functional recovery. These low-cost interventions were feasible for early implementation and continuation post-discharge. Evidence for kinesio taping was mixed, with some studies reporting short-term symptom relief and others showing no significant effect. Manual therapy, assessed in a single large cohort, showed promise when combined with stretching, though its independent efficacy remains unclear. Conclusions: Structured rehabilitation—particularly stretching and mobility exercises—may enhance recovery after thyroidectomy. Kinesio taping and manual therapy appear beneficial as adjunctive measures but require further validation. The findings underscore the need for standardized protocols and high-quality trials to optimize postoperative care and long-term outcomes. Full article

US-affiliated Island nations and territories are home to diverse populations, including substantial Indigenous communities who have extensive exposure to marine and geoscience content, with some of their knowledge sustained through heritage practices. Despite this demographic presence, Indigenous peoples of the Pacific remain notably underrepresented in STEM fields, particularly in the geosciences and marine sciences. Beyond an equity gap in participation, this underrepresentation reflects broader issues of epistemic and representational justice, raising questions about whose knowledge is validated and whose voices are legitimized in scientific spaces. This study examines how Pacific university bridge programs support Indigenous islander participation in authentic STEM research, with particular focus on climate adaptation, environmental change, and marine science contexts. Through qualitative interviews with Micronesian participants in the SEAS (Supporting Emerging Aquatic Scientists) Islands Alliance, we analyzed STEM identity development as students navigated cultural and scientific identities. Findings emphasize the critical importance of sustained, mentored engagement in real-world scientific inquiry that meaningfully connects to ongoing research agendas and community well-being, rather than simulated classroom exercises. The study offers insights into the multifaceted influences affecting student participation and pathways through STEM. Full article

Adherence to exercise-based cardiac rehabilitation (CR) is essential for preventing and managing cardiovascular disease (CVD). Participation in CR reduces all-cause mortality by 27% and cardiac deaths by 31% and lowers rehospitalization rates while also improving functional capacity and quality of life. However, many patients do not start, complete, or maintain CR, resulting in reduced functional abilities, a higher risk of recurring events, and poorer long-term outcomes. This narrative review summarizes patterns of adherence to exercise and CR in CVD, with a specific focus on sex- and gender-related differences in referral, participation, and completion. We synthesize evidence on biological, psychological, and social barriers that limit engagement and describe emerging strategies, such as technology-enabled and home-based programs, multidisciplinary care, and family-centered models, to enhance adherence. Finally, we propose a practical, gender-aware framework for CR design and delivery that can be adjusted and evaluated across diverse healthcare settings to guide clinical practice and future research. Full article

Background and Objectives: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that affects postural alignment, function, and quality of life. Telerehabilitation has emerged as a promising approach to enhance accessibility and continuity of exercise-based treatment in AIS. This study aimed to compare the effects of telerehabilitation-supported home exercise programs with standard home exercises on posture, pain, body image, and quality of life in adolescents with mild AIS. Materials and Methods: Forty adolescents aged 10–18 years with mild AIS (Cobb angle 10–25°, Risser 0–3) were randomly assigned to two groups: study (n = 20) and control (n = 20). Both groups performed an 8-week home-based exercise program. The study group additionally received weekly online supervision by a physiotherapist. Outcomes included pain severity (VAS), posture (New York Posture Assessment Scale), body image (Walter Reed Visual Assessment Scale), and quality of life (SRS-22 questionnaire). Statistical analyses were performed using non-parametric tests, with a significance level of p < 0.05. Results: Twenty-nine participants completed the study (15 in the study group, 14 in the control group). Significant improvements were observed in the study group in SRS-22 total, pain, and function subscores, as well as posture scores (p < 0.05). In the control group, only the satisfaction subscore improved significantly (p < 0.05). No significant changes were detected in body image (WRVAS) in either group. Between-group comparisons showed greater overall clinical gains in the study group despite similar exercise adherence rates. Conclusions: Supervised telerehabilitation enhances the effectiveness of home-based exercise programs in adolescents with mild AIS by improving postural alignment, reducing pain, and increasing functional capacity and quality of life. Telerehabilitation represents an accessible and efficient complementary strategy for managing AIS when in-person supervision is limited. Full article