Search Results (371)

Essential tremor (ET) negatively affects neuromuscular control and hand function in older adults. Resistance exercise may enhance musculoskeletal and functional capacity, yet its modality-specific effects in ET remain unclear. This study compared the effects of home-based and aquatic resistance training on tremor severity, manual dexterity, and handgrip strength in older adults with ET. Twenty-seven participants were randomly assigned using block randomization to a home-based resistance exercise group (HBREG; n = 9), an aquatic resistance exercise group (AREG; n = 9), or a control group (CG; n = 9). Both intervention groups completed an 18-session resistance exercise program, with initial sessions supervised and subsequent sessions performed independently under regular monitoring. Tremor severity (FTMTRS), manual dexterity (Nine-Hole Peg Test), and handgrip strength were assessed pre- and post-intervention. Within-group changes were analyzed using the Wilcoxon signed-rank test and between-group differences using the Kruskal–Wallis test with Bonferroni-adjusted Mann–Whitney U tests (p < 0.05). Both HBREG and AREG demonstrated significant improvements in drawing and pouring tremor tasks, manual dexterity, and handgrip strength compared with the control group, with large effect sizes across outcomes. No significant differences were observed between the two exercise modalities, and no improvement occurred in the highest-difficulty spiral-B task. These findings indicate that both home-based and aquatic resistance training are safe and effective non-pharmacological strategies for reducing tremor severity and enhancing upper-extremity function in older adults with ET. Full article

Background: Postpartum mental health challenges are increasingly recognized as a major public health concern, particularly during the early months after childbirth when emotional vulnerability is heightened. Although aerobic exercise is known to be associated with mood improvement, few large-scale studies have examined the acute psychological effects of a single exercise session in postpartum women, especially in contexts where environmental barriers restrict opportunities for physical activity. Methods: A total of 628 postpartum mothers (2–6 months postpartum) residing in a snowbound region of northern Japan participated in a single-session indoor bounce-based aerobic exercise program. Mood states were assessed immediately before and after the session using the validated Japanese short-form Profile of Mood States (POMS). Open-ended comments were also collected and analyzed thematically. Results: Paired analyses demonstrated significant acute improvements in key mood domains. Tension–Anxiety decreased (mean difference −7.91, 95% CI [−8.82, −7.00]; d = −0.68), and Anger–Hostility decreased (−4.61, 95% CI [−5.40, −3.82]; d = −0.45), while Vigor increased (11.82, 95% CI [10.47, 13.17]; d = 0.69) (all p < 0.001). In contrast, Depression–Dejection showed no significant change (−0.33, 95% CI [−1.30, 0.64]; p = 0.613). Conclusions: A single session of indoor bounce-based aerobic exercise was associated with immediate improvements in emotional well-being among postpartum women, particularly in anxiety-related and activation-related mood states. Because this exercise modality can be performed safely at home and is well suited to regions where outdoor physical activity is restricted, it may represent an accessible strategy for supporting postpartum mental health. Future research should examine longitudinal effects, controlled designs, and optimal program frequency to determine sustained benefits. Full article

Background/Objectives: Oral frailty and hypofunction in older adults are strongly associated with declines in nutritional status, physical function, swallowing ability, and overall health. Isolated interventions usually fail to achieve sufficient improvement since these conditions result from interrelated biological, psychological, and social factors. Multidisciplinary approaches combining oral management, nutritional support, and physical rehabilitation have shown promise. This narrative review synthesized evidence from 15 studies examining multifaceted interprofessional interventions across hospitals, communities, long-term care facilities, and home-care settings. Methods: A structured search of PubMed and Web of Science (2000–2025) identified original studies assessing oral, nutritional, or physical outcomes in older adults post-interprofessional interventions. Fifteen eligible studies were extracted; the findings were integrated using narrative synthesis owing to design and outcome heterogeneity. Results: Educational multidisciplinary interventions improved oral hygiene, caregiver awareness, and oral motor function. Multidisciplinary rehabilitation and multidomain programs consistently improved tongue pressure, swallowing function, mastication ability, appetite, body composition, activities of daily living, and oral intake resumption. Nutrition support team-delivered interventions reduced aspiration risks and improved oral environment and swallowing function. Community-based programs using munchy meals and combined exercises enhanced oral and physical functions. Social participation provided psychological benefits. Home-care dysphagia rehabilitation enabled 69% of tube-fed patients to resume oral intake. Conclusions: This narrative review supports a triadic, interprofessional approach in geriatric care, highlighting consistent improvements in oral function through integrated oral, nutritional, and rehabilitative interventions. Full article

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

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/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

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

Background: Approximately one quarter of community-dwelling older adults experience at least one fall each year. Falls can result in soft tissue injuries, fractures, or even death. Given this high prevalence, it is essential to identify fall-related risk factors, develop predictive models, and prescribe effective exercise-based interventions to prevent falls. Objective: To analyze risk factors, predictors, and therapeutic interventions for falls in older adults. Methods: A literature search was conducted in SCIELO, PUBMED, and PEDro databases between 15–20 October 2025. Inclusion criteria comprised peer-reviewed, open-access studies in English published from 2020 onward. Findings were categorized into three domains: (1) fall risk factors, (2) predictive models, and (3) exercise-based interventions. Twenty studies met the inclusion criteria. Results: Falls among older adults arise from multifactorial interactions involving physical, clinical, cognitive, and social factors such as impaired mobility, comorbidities, polypharmacy, and cognitive decline. Lower-limb strength and functional performance are key determinants of fall risk. Current predictive models show limited accuracy, with fall history as the strongest predictor. Exercise-based interventions, particularly multicomponent and home-based programs, improve balance, strength, and mobility but show variable effects on fall rates. The absence of standardized parameters for exercise prescription limits the development of evidence-based guidelines. Conclusions: Falls in older adults are multifactorial events influenced by physical and cognitive decline. Predictive models remain imprecise, and although exercise interventions improve functional outcomes, their impact on reducing falls is inconsistent. Standardized exercise protocols are needed to optimize fall prevention strategies. Full article

Objective: To evaluate the effect of Physitrack^® on jump performance in handball players through performance, kinematic, and kinetic variables. Material and Methods: A pilot, randomized clinical trial was conducted with male handball players (n = 28). Participants were allocated to either an intervention group (IG), which completed a specific jump-training program, or a control group (CG), which followed a general strengthening program. Both programs were delivered via Physitrack^® over an 8-week period. Vertical jump variables were assessed using force platforms (Hawkin Dynamics^®), along with adherence questionnaires, the Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ), and the System Usability Scale (SUS). Results: Both groups showed significant improvements in jump height, flight time, and peak velocity (p < 0.05), without differences between groups. The IG, additionally, demonstrated improvements not statistically significant in the modified Reactive Strength Index (mRSI), Rate of Force Development (RFD), and power. Mean adherence was moderate, slightly higher in the IG (52.13% vs. 48.98%), with no significant differences between groups (p = 0.74). Physitrack^® received an excellent usability rating (SUS: 83.3/100) and good satisfaction (TSUQ: 3.68/5). These findings should be interpreted with caution given the pilot nature of the study and the limited sample size, which restrict statistical power and the generalizability of results. Conclusions: Physitrack^® is a feasible tool for prescribing home-based exercises and is well rated by users. It does not directly improve adherence but facilitates the implementation of effective programs although the content of the program has a greater influence on performance improvements than the platform itself. Full article

Background: Stroke is the leading cause of physical disability in adults in Catalonia. Despite this, there is a lack of evidence of physiotherapy interventions on functional capacity during the chronic phase of the pathology. This multicenter clinical trial will be conducted with a sample size of 75 participants. Objectives: The objective of the study is to evaluate the effectiveness of a therapeutic exercise program in physiotherapy using telerehabilitation to optimize functional recovery and quality of life in people with chronic stroke, and to determine its impact on adherence to the exercise program. Methods: This is a multicenter randomized controlled trial. Three parallel groups will be compared, and two will undergo the same type of therapy. A control group (CG) will perform conventional intervention in primary care. There will be two experimental groups; (EG1) will perform document-guided therapeutic exercises at home and (EG2) will perform therapeutic exercises at home guided by a telerehabilitation program. The outcomes to be measured are degree of independence of a person in their activities of daily living, assessed by the Barthel Index, motor function, muscle tone of the affected limbs, muscle strength of the affected limbs, balance, gait efficiency, perception of musculoskeletal pain, perception of fatigue, risk of falls, perception of quality of life, and the perception of perceived subjective change after treatment. These outcomes will be evaluated at baseline (T0), at ten weeks (T1) (end of the intervention), and at 18 weeks (T2). The study duration per patient will be 18 weeks (a ten-week intervention, followed by an eight-week intervention follow-up). The analysis will be performed using a mixed linear model (ANOVA 3X3) and significance level p < 0.05. Full article