Search Results (483)

Patellofemoral pain (PFP) in athletes is associated with lower-limb kinetic-chain constraints, yet rehabilitation strategies targeting both hip and ankle mobility remain insufficiently examined. This assessor-blinded randomized controlled trial investigated the effects of a 6-week hip and ankle mobility-based rehabilitation program in male collegiate athletes with PFP. Forty-eight participants were assigned using computer-generated 1:1 randomization to an intervention group (n = 24) or a control group (n = 24). The intervention group completed supervised hip and ankle mobility rehabilitation three times weekly, whereas the control group maintained regular sport-specific training only. Co-primary outcomes were pain intensity assessed using a 10-cm visual analog scale (VAS) and knee-related function assessed using the Kujala score. Secondary outcomes included hip rotation range of motion, weight-bearing ankle dorsiflexion, vastus medialis–vastus lateralis (VM–VL) onset timing, Y-Balance Test (YBT) composite score, and countermovement jump (CMJ) height. Significant group × time interactions favored the intervention group for VAS (p < 0.0001; partial η² = 0.436; change difference: −1.54 cm; 95% CI: −2.06 to −1.02) and Kujala score (p < 0.0001; partial η² = 0.285; change difference: 8.00 points; 95% CI: 4.24 to 11.76). Significant interactions were also observed for hip internal and external rotation range of motion, weight-bearing ankle dorsiflexion, VM–VL onset timing during a controlled squat task, and YBT composite score (all p ≤ 0.0405; partial η² = 0.088–0.374). No significant group × time interaction was observed for CMJ height (p = 0.0511; partial η² = 0.080). These findings suggest that, compared with regular sport-specific training alone, adding a supervised hip and ankle mobility-based rehabilitation program may improve pain, knee-related function, targeted mobility outcomes, VM–VL onset timing during a controlled squat task, and dynamic balance in the short term. However, because the control group did not receive an active or attention-matched intervention, these findings should be interpreted as the added effect of the supervised rehabilitation program rather than as definitive evidence of mobility-specific treatment effects. In addition, because patellar tracking, knee kinematics, joint kinetics, and patellofemoral joint loading were not directly measured, the findings should be interpreted as clinical and functional outcome changes rather than direct evidence of a confirmed biomechanical mechanism. Trial registration: NCT07542236. Full article

Background: Severe knee trauma and chronic cruciate ligament insufficiency are commonly accompanied by marked quadriceps femoris (QF) atrophy and weakness. High-load strengthening is often poorly tolerated by patients with compromised joint stability; therefore, low-load blood flow restriction resistance training (LL-BFRT) may serve as an effective alternative. Case presentation: A 38-year-old male presented 27 months after motorcycle-related polytrauma with right knee pain, instability, complete anterior and posterior cruciate ligament ruptures, and partial QF denervation after femoral nerve injury. Before surgery, he completed a supervised 5-week LL-BFRT prehabilitation program (13 sessions). Results: Lean thigh circumference increased by 5.9% proximally and 17.7% distally. Voluntary activation increased from 87.2% to 92.5%, and maximal QF EMG median frequency decreased by 7.4%. Knee extensor isometric and concentric (60°/s) peak torque increased by 52.4% and 36.9%, respectively. QF isometric endurance time increased from 48.5 to 61.8 s. Stair-climbing time decreased from 18.9 to 10.6 s, repetitions in the step-down test increased from 10 to 17, and the Y-balance test composite score increased from 77.7% to 99.4%. Conclusions: Substantial physiological and clinical improvements in QF voluntary activation, maximal strength, endurance, and lower limb function were observed following a short-term LL-BFRT program in a patient with multiple ligament injuries. Changes in lean thigh circumference were consistent with possible improvements in muscle size; however, muscle hypertrophy was not directly assessed. Full article

Background: Diabetic peripheral neuropathy (DPN) is a progressive complication of type 2 diabetes mellitus (T2DM) for which no approved disease-modifying therapy exists. Palmitoylethanolamide/Baicalin (PEA/Bai; Neuridase^®) is a nutraceutical formulation with anti-neuroinflammatory and antioxidant properties; however, real-world evidence on its associations with objective neuropathy biomarkers remains limited; nutraceutical approaches to DPN remain exploratory and adjunctive in the absence of randomised controlled trial evidence of disease modification. Methods: We conducted a single-centre, retrospective, 1:1 matched-cohort study at an Internal Medicine outpatient clinic. Forty-eight T2DM patients with clinically diagnosed DPN who received PEA/Bai supplementation (Neuridase^® group) were matched to 48 untreated controls drawn from a large institutional database, using age, sex, BMI, and diabetes duration as matching variables. Acknowledged a priori limitations include baseline imbalance in neuropathy severity (VAS and ESC) and SGLT2 inhibitor use, reflecting real-world prescribing patterns (confounding by indication) and constituting potential sources of residual confounding that preclude causal inference. The primary outcome was change in VAS neuropathic pain score from baseline (T0) to 6-month follow-up (T6). Secondary outcomes were changes in electrochemical skin conductance (ESC, µS) in hands, feet, and four-limb sum measured by Sudoscan. Results: At baseline, the Neuridase^® group exhibited significantly greater neuropathic burden: higher VAS scores (median 5.5 [IQR 3.8–7.2] vs. 2.0 [0.0–5.0]; p < 0.001) and lower ESC in both hands (53.0 vs. 72.2 µS; p < 0.001) and feet (74.5 vs. 81.0 µS; p < 0.001), reflecting real-world prescribing patterns. Over 6 months, VAS decreased significantly in the Neuridase^® group (5.5→3.0; p < 0.0001; median Δ = −2.5 points, exceeding the clinically important difference), with no change in controls (2.0→2.0; p = 0.85). Differential Sudoscan trajectories were observed: the Neuridase^® group showed significant improvement in hand ESC (53.0→60.0 µS; p = 0.035) and preservation of foot ESC (p = 0.888), while controls exhibited significant deterioration across all three sudomotor indices (hand p = 0.038; foot p = 0.008; four-limb sum p = 0.004). In a complementary categorical pain trajectory analysis, VAS worsening occurred in 31.3% of controls compared with 0% of Neuridase^®-treated patients (p = 0.00022). Among patients with pathological hand ESC at baseline (<60 µS), 27.8% of Neuridase^® patients (n = 36) transitioned to non-pathological values at T6 versus 0% of controls (n = 32; p = 0.001). Conclusions: In a real-world matched cohort, PEA/Baicalin supplementation was associated with clinically meaningful pain reduction and with differential longitudinal sudomotor trajectories compared to matched untreated controls. These exploratory, hypothesis-generating findings from a retrospective non-randomised design are consistent with possible modulatory effects of PEA/Baicalin on objective sudomotor autonomic biomarkers in DPN. Confounding by indication, baseline severity imbalance, and residual confounders including SGLT2 inhibitor use preclude causal interpretation. These observations provide a rationale for adequately powered, prospective, randomised placebo-controlled trials with extended follow-up and structural neuropathy endpoints. Full article

Background/Objectives: Delayed-Onset Muscle Soreness (DOMS) is a common consequence of eccentric exercise, characterized by pain, stiffness, and reduced function. This pilot study aimed to evaluate the effect of a single session of Active Release Technique (ART) on gastrocnemius DOMS in amateur football athletes. Methods: Twelve football athletes participated in a randomized split-body design study. All participants completed a bilateral eccentric heel-raise protocol to induce DOMS. One lower limb from each participant was randomly assigned to the ART group (single 8–10 min session), while the contralateral limb served as a control. Pain intensity was assessed using the Numeric Rating Scale (NRS) and the pressure pain threshold (PPT) was measured at baseline and at 24, 48, and 72 h post-exercise. Results: The ART group demonstrated significantly lower NRS scores at 24 h compared with the control group (p = 0.007, r = 0.77). At 48 and 72 h, NRS scores remained significantly lower (48 h: p = 0.001, d = 1.26; 72 h: p = 0.003, d = 1.11). PPT values were also significantly higher in the ART group at 24, 48 and 72 h (24 h: p = 0.026, d = 0.73; 48 h: p < 0.001, d = 1.42; 72 h: p = 0.006, d = 0.98). Conclusions: A single ART session may reduce pain and increase the pressure pain threshold following gastrocnemius DOMS in amateur football athletes. However, given the pilot design, small sample size, and absence of functional outcome measures, these findings should be interpreted with caution and confirmed in future studies. Full article

Background: Proximal lower-extremity muscle strengthening is an important conservative intervention for patellofemoral pain syndrome (PFPS), as these muscle groups play critical roles in femoral stabilization and knee valgus control. However, evidence remains limited regarding the effectiveness of muscle strengthening in improving lower-extremity axial alignment through modulation of femoral neck anteversion, femoral internal rotation, and tibial external rotation. Therefore, the present study aimed to determine whether a strengthening protocol targeting the quadriceps and hip external rotator and hip abductor muscles could improve knee alignment and reduce bone torsion in young adults with patellofemoral pain syndrome. Methods: This prospective interventional cohort study implemented a muscle strengthening protocol in ten university students with PFPS. Outcomes included femoral neck anteversion angle (FNA), tibial tubercle–trochlear groove distance (TT–TG), tibial external torsion angle (TET), and the knee Q-angle, assessed via 3D reconstruction of computed tomography (3D-CT) images. Pre- and post-intervention data were analyzed using the Shapiro-Wilk test for normality and repeated-measures ANOVA (p < 0.05; 95% confidence interval). Results: Muscle strengthening improved lower-limb axial alignment, with reductions observed across all measures post-intervention. Mean changes were 0.68 ± 1.26° for FNA (p = 0.0626); 1.51 ± 0.97 mm for TT–TG (p = 0.0001); 1.38 ± 3.36° for TET (p = 0.2231); and 1.14 ± 1.52° for the Q-angle. Statistically significant improvements were observed for TT–TG and the Q-angle. Conclusions: Proximal muscle strengthening improved knee valgus and axial lower-limb alignment, as evidenced by significant reductions in Q angle and TT–TG distance. Reductions in femoral neck anteversion (FNA) and tibial external torsion angle (TET) were observed. However, these differences were not statistically significant. These findings support muscle strengthening as a noninvasive strategy for improving lower-limb alignment in individuals with patellofemoral pain syndrome. Full article

Background and Objectives: Many patients suffer from chronic pain of the shoulder, neck, upper back, and/or arm. They may be diagnosed with fibromyalgia, complex regional pain syndrome, myofascial pain, thoracic outlet, subacromial pain, cervical radiculopathy, cervicogenic headaches, post-mastectomy pain, and/or occupational shoulder disorder. The pectoralis minor (PM) is the only muscle of the scapula controlled by the lower trunk of the brachial plexus. In the Human Disharmony Loop (HDL), this neurologic asymmetry produces persistent protraction of the scapula. Protraction deforms the scapula’s connections, generating headaches and neck stiffness, upper back tightness, shoulder weakness, and hand numbness. We hypothesize patients with the above who meet HDL diagnostic criteria will benefit from PM tenotomy with brachial plexus neurolysis (PM+ICN). Materials and Methods: Patients diagnosed with the above disorders who also met HDL criteria of medial coracoid tenderness and scapula protraction on exam underwent PM+ICN, with secondary neurolysis after 3 months if needed. Clinical neuropathy was diagnosed via the scratch-collapse test. Outcomes included self-reported Visual Analogue Score pain scores, active shoulder abduction range of motion (ROM), prevalence of occipital headaches. Results: N = 318 patients were included. Average age was 51; 68.0% were female. Following treatment, average pain decreased from 7.3/10 to 2.1/10 (p < 0.001), average shoulder ROM increased from 96 to 170 degrees (p < 0.001), and occipital headaches decreased from 76.7% to 1.6% (p < 0.001). Scapular protraction normalized from 98.8% static to 92.5% none (p < 0.001). Overall, 17% required subsequent neurolysis, chiefly of the axillary, radial, and ulnar nerves. The pain reductions were statistically indistinguishable across all diagnoses (p = 0.709, I² = 0.02%). Average follow-up was 22 months. Conclusions: PM+ICN significantly reduced self-reported pain and headaches in select intractable patients. The PM pathologizing the scapula may constitute a shared anatomic mechanism that contributes to chronic pain across heterogenous disorders of the upper limb. Full article

Upper limb disorders, including carpal tunnel syndrome (CTS), are a common cause of pain, functional limitations, and reduced quality of life. Increasing attention has been directed toward the role of inflammatory and angiogenic mediators in the pathophysiology of CTS and their potential relationship with patient-reported functional outcomes. The aim of this study was to evaluate selected cytokines as potential markers of upper limb disability assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. This cross-sectional study included 55 patients with idiopathic CTS referred for surgical treatment. Functional impairment was assessed using the DASH questionnaire, and concentrations of selected inflammatory and angiogenic mediators—IL-4, IL-6, MCP-1, TNF-α, VEGF, and fraktalkine—were measured in synovial tissue samples; these markers were selected based on their established roles in inflammation, angiogenesis, and nociceptive modulation relevant to CTS pathophysiology. VEGF was identified as a significant predictor of DASH category (p = 0.032), with higher concentrations associated with a lower likelihood of severe upper limb dysfunction. In contrast, higher TNF-α levels were associated with an increased risk of severe disability (p = 0.031). Other cytokines did not demonstrate significant associations with functional impairment. These findings suggest that selected inflammatory and angiogenic mediators were associated with the severity of functional disability in CTS and warrant investigation in prospective longitudinal studies to clarify their potential role alongside patient-reported outcome measures. Full article

Sciatic neuropathy is most commonly attributed to spinal or muscular causes, whereas vascular-related compression remains underrecognized. We report a case of sciatic nerve entrapment caused by an anomalous inferior gluteal artery in the deep gluteal region, who presented with persistent right gluteal and posterior thigh pain for more than two years, refractory to multiple conservative treatments. Physical examination demonstrated marked allodynia and a well-defined Tinel-like sign, with radiating symptoms extending to the lower limb, suggesting a peripheral etiology. High-resolution ultrasonography identified an aberrant inferior gluteal artery, which crossed over and compressed the sciatic nerve, forming an accompanying artery of the sciatic nerve. Doppler imaging confirmed the vascular nature of the structure, while long-axis views demonstrated focal nerve compression with segmental swelling. Magnetic resonance imaging further corroborated the diagnosis. Ultrasound-guided hydrodissection using 5% dextrose and lidocaine was performed, resulting in significant symptom relief. Pain scores improved from 7 to 3 after treatment, with resolution of symptoms at two-month follow-up. This case highlights a rare neurovascular cause of sciatic nerve entrapment and underscores the importance of ultrasonography in identifying anatomical variations. Recognition of vascular contributions to deep gluteal syndrome may improve diagnostic accuracy and guide targeted interventions. Full article

Objectives: The aim of this paper is to determine whether leg kinematics and the normal force generated during the stance phase of running differed between (i) long-distance runners with medial tibial stress syndrome (MTSS) or (ii) long-distance runners who were asymptomatic at baseline testing but developed MTSS compared to asymptomatic control participants. Methods: Lower-limb kinematics, normalised stance-phase forces and spatiotemporal outcome variables were compared between the limbs of MTSS symptomatic long-distance runners (n = 11) and matched asymptomatic controls (n = 11). Outcome variables were also compared between the limbs of long-distance runners who were asymptomatic at baseline but developed MTSS (n = 4) compared to asymptomatic control limbs. Results: In the case-control comparison, MTSS symptomatic participants demonstrated slower running speeds but no differences in stance-phase normal forces or kinematics compared to asymptomatic controls. In the case study, participants who developed MTSS during the study displayed substantially lower normal forces, less plantar flexion and a more vertical tibia than the asymptomatic controls. Conclusions: The slower running speeds observed among the MTSS symptomatic participants may be pain-related or reflect reduced plantar flexor propulsive capacity. The development of MTSS by Participants 1 and 2, despite lower normal forces and plantar flexion compared with asymptomatic controls, suggests that the tibial load tolerance may vary among individuals. Furthermore, the peak stance-phase force appears to have limited utility as a standalone screening tool for MTSS injury risk. Finally, further prospective research is required to investigate plantar flexor function, propulsive force capacity and the risk of MTSS development to substantiate these findings. Full article

Background: Gait performance (spatiotemporal and kinetic parameters), physical function (range of motion [ROM] and muscle strength), quality of life (QOL), and other patient-reported outcome measures (PROMs) are interrelated in patients with hip osteoarthritis (HOA). However, the latent structure of these multifaceted factors remains unclear. Therefore, this study aimed to identify the latent factors underlying these multiple indices and investigate their associations. Methods: A total of 33 women with unilateral HOA were included in this study. Gait performance was evaluated using a three-dimensional motion analysis system to extract gait speed, step length, cadence, peak joint power for each phase (hip joint: H1_peak–H3_peak; ankle joint: A1_peak–A2_peak), and corresponding joint work (hip joint: H1_work–H3_work; ankle joint: A1_work–A2_work). Physical function was assessed by measuring the ROM and muscle strength of the hip and ankle on the affected side. Patient-reported QOL was assessed using the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ). Factor analysis was performed, with the number of factors fixed at four. Results: The Kaiser–Meyer–Olkin measure was 0.64, indicating “mediocre” sampling adequacy. Factor 1 (comprehensive gait performance) included gait speed, step length, cadence, H2_peak, H3_peak, A1_peak, and hip/ankle strength. Factor 2 (Lower Limb Support in Early Stance and Control of the Stance-to-Swing Transition) included H1_peak, A2_peak, H1_work, A2_work, and ankle dorsiflexion ROM. Factor 3 (functional relationship between the hip and ankle joints) included H2_work, H3_work, hip ROM, and ankle plantarflexion strength. Factor 4 represented the JHEQ subscales: Pain, Movement, and Mental. These four factors explained 73.21% of the total variance. Conclusions: Gait impairment in women with HOA exhibits a multidimensional factor structure encompassing physical function (muscle strength and ROM), biomechanical control of gait (joint power and work), and gait performance (spatiotemporal parameters). Furthermore, gait-related factors may constitute a domain independent of QOL as assessed by PROMs. Full article

Background: Acute compartment syndrome (ACS) is a limb-threatening surgical emergency most commonly associated with fractures or high-energy trauma. Non-fracture-related ACS in athletes is uncommon and may lead to delayed diagnosis. Repetitive blunt trauma during combat sports has rarely been described as a potential mechanism. Case Methods: The case concerns a 21-year-old elite-level kickboxing athlete who developed acute compartment syndrome of the left lower leg following repeated calf kicks sustained during sparring. The patient presented with rapidly progressive calf pain, swelling, compartment firmness, paresthesias and weight bearing difficulties. CT angiography demonstrated diffuse edema of the posterior compartments associated with a large intramuscular soleus hematoma without active arterial bleeding. Results: In view of the severity of the symptoms and the characteristic clinical presentation, an emergency fasciotomy was performed in operating room. Progressive closure was achieved using the vessel loop shoelace technique, allowing gradual tension-free closure. Wound healing progressed without infection, and physiotherapy was introduced with joint mobilization. The patient achieved full functional recovery after 6 months. Conclusions: This case illustrates an atypical etiology of ACS—repetitive targeted calf strikes—and underscores the importance of early recognition even in the absence of fracture or major trauma. Clinical vigilance remains paramount, and prompt surgical intervention is critical to prevent irreversible muscle and nerve damage. Awareness of such mechanisms is particularly relevant for clinicians managing athletes in combat sports. To our knowledge, this is the first documented case of ACS secondary to repeated calf kicks in kickboxing. Full article

Background: Body perception disturbances (BPDs) are highly prevalent in chronic limb pain, manifesting as hostile feelings towards the limb, reduced sensory–motor function, and altered limb ownership. Various questionnaires and tests assess BPD, but their interrelation and associations with limb disability remain underexplored. This study aimed to evaluate BPD assessments, examine whether they capture overlapping or distinct aspects of BPD, and determine their associations with upper- and lower-limb disability. Methods: This observational cross-sectional study included 92 participants with chronic limb pain. Participants completed BPD questionnaires (Bath-BPD, Neurobehavioral) and tests (Laterality Recognition, Fingers/Toe Perception, Human Figure Drawing), along with clinical pain measures and the symptom severity index. Dependent outcomes were upper- and lower-limb disability. Results: Cluster analysis grouped all measures into ‘High’ and ‘Low’ BPD severity clusters, with overall cluster quality rated as fair (silhouette = 0.40). The Neurobehavioral questionnaire emerged as the primary contributor to the cluster structure (silhouette = 1). The ‘High’ BPD cluster showed significantly greater symptom severity (t(63) = −4.13, p < 0.001). Pain severity, Bath-BPD questionnaire, and symptom severity were significantly associated with upper-limb disability (p < 0.001), whereas pain intensity alone accounted for 24% of lower-limb disability variance. Conclusions: Despite the diversity of BPD assessments, the clustering pattern suggests a partial convergence between measures, though a weak cohesiveness of BPD tests indicates that they capture partially distinct aspects of body perception. BPD questionnaires were associated with upper-limb disability, whereas lower-limb disability was associated with pain intensity. These findings emphasize the importance of assessing BPDs in musculoskeletal care and suggest their potential role as indicators of symptom severity. Full article

Aims: The purpose of this study was to clarify the prevalence of diabetic foot lesions and their association with lower-limb amputations and/or foot ulcers. Materials and Methods: In this cross-sectional study, 968 patients with diabetes were surveyed. Diabetic foot lesions were defined according to the broad national criteria, which encompass both mild abnormalities and more advanced conditions. Based on this definition, foot lesions were assessed using a questionnaire comprising the following 10 items: a history of lower-limb amputations, a history of treatment of foot lesions, numbness/loss of sensation/pain, skin discolorations, skin symptoms, nail abnormalities, foot ulcers/gangrene, foot deformities, foot infection, and intermittent claudication. Logistic regression analysis was used to examine risk factors for foot lesions. Area under the curve (AUC) of the number of foot lesions for lower-limb amputations or foot ulcers/gangrene was calculated using the receiver operating characteristic curve (ROC) analysis. Results: Approximately two-thirds of the patients had at least one type of diabetic foot lesion. Logistic regression analysis revealed that women, past or current smoking, a history of cardiovascular disease, and nephropathy were associated with the risk of diabetic foot lesions. According to the ROC analysis, the optimal cut-off point of number of diabetic foot lesions was three for identifying patients with a history of lower-limb amputation and/or the presence of foot ulcers or gangrene (AUC 0.80 (95% CI, 0.70–0.91), p < 0.01). Conclusions: Diabetic foot lesions are common in patients with diabetes and the prevalence of diabetic foot lesions was higher in patients with a history of lower-limb amputations and/or the presence of foot ulcers or gangrene. Early detection and care of diabetic foot lesions are necessary to prevent lower-limb amputations and foot ulcers. Full article

This study evaluated the test–retest reliability, standard error of measurement (SEM), and minimal detectable change (MDC) of frontal plane projection angles (FPPAs) across five single-leg tasks in individuals with patellofemoral pain (PFP). Two-dimensional video data was collected from ten individuals with predominantly unilateral PFP. Participants performed single-leg squat, single-leg landing, single-leg hop, forward step-down, and lateral step-down across two testing sessions. FPPAs were measured at peak knee flexion for each task, including trunk lean angle, knee FPPA, hip FPPA, and dynamic valgus index. Test–retest reliability was assessed using intraclass correlation coefficients (ICCs). Our findings indicate that test–retest reliability and measurement error for trunk and lower limb FPPA varied across tasks in individuals with PFP. The lowest ICC was observed for hip FPPA, particularly during single-leg squat and lateral step-down tasks. Among the five tasks tested, the single-leg squat appeared to be the most demanding task, demonstrating the lowest ICCs, and highest SEM and MDC values across all four outcome measures (trunk lean angle, knee and hip FPPAs, and dynamic valgus index). The dynamic valgus index consistently showed larger SEM and MDC values than isolated hip or knee FPPAs, likely reflecting compounded measurement errors across segments. These findings provide preliminary insights, though confirmation in larger samples in persons with PFP is warranted. Full article

Objectives: This study sought to assess quality of life (QoL) in Slovak breast cancer survivors and examine its association with treatment modalities and sociodemographic factors. Methods: This cross-sectional observational study included 244 Slovak female breast cancer survivors (stages IA–IIIC). Participants were aged 25–85 years, ECOG 1–2, without synchronous malignancies or severe comorbidities. Data were collected using the EORTC QLQ-C30 and breast cancer-specific module. Results: Mean global health status/QoL indicated a moderate QoL level (51.67). Emotional and cognitive functioning were relatively preserved, whereas social and role functioning were more impaired. The most prominent symptoms included insomnia, fatigue, dyspnoea, and pain. Breast cancer-specific domains showed relatively high body image scores but marked impairment in sexual activity and future perspective. Severe symptoms included hair loss, upper limb problems and systemic side effects of therapy. Significant differences were observed across functional domains and symptoms (p < 0.001). Chemotherapy was associated with better role functioning (p = 0.011), lower pain (p = 0.043) and insomnia (p = 0.012), but also with higher levels of hair loss (p = 0.003); however, these findings should be interpreted with caution due to potential confounding factors. Radiotherapy was associated with higher social functioning, body image and future perspective (p = 0.007 for all), but also with increased breast symptom severity (p = 0.044). Sociodemographic factors, particularly place of residence and education level, were significantly associated with overall QoL. Conclusions: Slovak breast cancer survivors report moderate overall QoL, with emotional and cognitive functioning relatively preserved, but social, role and sexual domains impaired. Treatment modalities and sociodemographic factors are associated with differences in specific QoL domains, highlighting the need for targeted, context-sensitive supportive care. The findings also underscore the importance of oncology nursing in survivorship care, particularly in addressing physical, social and sexual domains and key symptoms such as insomnia, fatigue and pain. Targeted psychosocial and educational support, along with culturally sensitive QoL assessment, may help improve patient-centred outcomes in breast cancer survivors in Central and Eastern Europe. Full article