Search Results (439)

Background/Objectives: The aim of this systematic review was to compare the effectiveness of virtual reality (VR)-based training with conventional exercise programs in improving functional outcomes related to fall risk among older adults with various health conditions. Methods: The review was conducted in accordance with the PRISMA 2020 guidelines and registered in PROSPERO (registration number CRD42022345678). The databases Scopus, PubMed, Web of Science, and EBSCO were searched up to 31 March 2025. Randomized controlled trials (RCTs) were included if they involved participants aged ≥60 years, a VR intervention lasting ≥6 weeks, and a control group performing traditional exercises or receiving usual care. Methodological quality was assessed using the PEDro scale, and a narrative synthesis was performed across four outcome domains: balance, mobility, cognitive function, and fall risk. Results: Seven RCTs were included in the analysis (totaling 664 participants). VR training was found to be at least as effective as conventional exercise in improving balance (e.g., Berg Balance Scale) and mobility (e.g., Timed Up and Go), with some studies showing superior effects of VR. One RCT demonstrated that combining VR with balance exercises (MIX) yielded the greatest improvements in muscle strength and physical performance. Additionally, two studies reported cognitive benefits (e.g., MoCA) and a 42% reduction in fall incidence within six months following VR intervention. The methodological quality of the included studies was moderate to high (PEDro score 5–9/10). Conclusions: VR-based training represents a safe and engaging supplement to geriatric rehabilitation, effectively improving balance, mobility, and, in selected cases, cognitive function, while also reducing fall risk. Full article

Anterior cruciate ligament reconstruction (ACLR) results in prolonged muscle weakness, impaired neuromuscular control, and delayed return to sport. Cross-education (CE), unilateral training of the uninjured limb, has been proposed as an adjunct therapy to promote bilateral adaptations. This scoping review evaluated the functional and neuroplastic effects of CE rehabilitation post-ACLR. Following PRISMA-ScR and JBI guidelines, PubMed, Scopus, Web of Science, and PEDro were searched up to February 2025. A bibliometric analysis was also conducted to report keyword co-occurrence and identify trends in this line of research. Of 333 screened references, 14 studies (price index: 43% and low-to-moderate risk of bias) involving 721 participants (aged 17–45 years) met inclusion criteria. CE protocols (6–12 weeks; 2–5 sessions/week) incorporating isometric, concentric, and eccentric exercises demonstrated strength gains (10–31%) and strength preservation, alongside improved limb symmetry (5–14%) and dynamic balance (7–18%). There is growing interest in neuroplasticity and corticospinal excitability, although neuroplastic changes were assessed heterogeneously across studies. Findings support CE as a feasible and low-cost strategy to complement early-stage ACLR rehabilitation, especially when direct loading of the affected limb is limited. Standardized protocols for clinical intervention and neurophysiological assessment are needed. Full article

Physical activity, particularly when practiced in natural settings, has well-established benefits for overall health, sleep, and body composition. These effects are especially important for postmenopausal women, although research specifically targeting this population remains limited. The study evaluated a 16-week multicomponent outdoor exercise program (cardiorespiratory, strength, balance, coordination, and flexibility training) in postmenopausal women, consisting of three 60 min sessions per week. Participants were non-randomly assigned to an experimental group (EG, n = 55) and a control group (CG, n = 20). Measurements were taken at baseline and after 16 weeks, including body composition, sleep (duration and quality), and connection with nature. No significant differences were observed between groups at baseline. After the intervention, the EG and CG presented significant differences (p ≤ 0.01) in the rates of change in body mass, fat mass (FM; −9.26% and −1.21%, respectively), and visceral fat level (VFL; −13.46 points and −3.80 points). These differences were also observed for the sleep fragmentation index (p ≤ 0.01), but not for connection with nature. A significant interaction effect (p < 0.01) of time × group was observed for %FM, VFL, and appendicular skeletal muscle mass. Exercise duration had an effect (p = 0.043) on participants’ personal and affective identification with nature, and the time × group × medication interaction significantly influenced sleep efficiency (p = 0.034). The exercise program proved effective in reducing total and central adiposity levels; however, it did not lead to improvements in sleep duration, sleep quality, or connection with nature. Full article

Early rehabilitation is essential for restoring functional recovery in patients with stroke, particularly during the early phase of post-acute care (PAC), or the subacute stage. We aimed to evaluate the effectiveness of a 7-week PAC rehabilitation program in improving muscle strength, physical performance, and functional recovery. A total of 219 inpatients with stroke in the subacute stage were initially recruited from the PAC ward of a regional teaching hospital in Northern Taiwan, with 79 eligible patients—within 1 month of an acute stroke—included in the analysis. The program was delivered 5 days per week, with 3–4 sessions daily (20–30 min each, up to 120 min daily), comprising physical, occupational, and speech–language therapies. Sociodemographic data, muscle strength, physical performance (Berg Balance Scale [BBS], gait speed, and 6-minute walk test [6MWT]), and functional recovery (modified Rankin Scale [mRS], Barthel Index [BI], Instrumental Activities of Daily Living [IADL], and Fugl–Meyer assessment: sensory and upper extremity) were collected at baseline, 3 weeks, and 7 weeks. Generalized estimating equations analyzed program effectiveness. Among the 56 patients (70.9%) who completed the program, significant improvements were observed in the muscle strength of both the affected upper (B = 0.93, p < 0.001) and lower limbs (B = 0.88, p < 0.001), as well as in their corresponding unaffected limbs; in physical performance, including balance (BBS score: B = 9.70, p = 0.003) and gait speed (B = 0.23, p = 0.024); and in functional recovery, including BI (B = 19.5, p < 0.001), IADL (B = 1.48, p < 0.001), and mRS (B = −0.13, p = 0.028). These findings highlight the 7-week PAC rehabilitation program as an effective strategy during the critical recovery phase for patients with stroke. Full article

Background/Objectives: This study aimed to compare the effects of low- and medium-frequency NMES, combined with a standard physical therapy (SPT) program, on functional capacity in critically ill patients. Methods: Fifty-four critically ill patients admitted into Intensive Care Unit (ICU) and on mechanical ventilation participated in this randomized, single-blinded, experimental study. Participants were randomly assigned to a Control group, who received a lower limb SPT program; the Low-frequency NMES group received lower limb SPT + NMES at 100 Hz; and the Medium-frequency NMES group received lower limb SPT + NMES at 100 Hz with a carrier frequency of 2500 Hz. The outcomes, encompassing functional capacity in the hospital, included muscle strength, handgrip strength, functional status, degree of independence for activities of daily living, functional and dynamic mobility, quality of life, and total days hospitalized. Results: Both NMES protocols combined with SPT improved functional capacity compared to the control group. Medium-frequency NMES provided additional benefits on dynamic balance, in the degree of independence to perform activities of daily living and quality of life (all p < 0.001) prior to hospital discharge. It also promoted larger gains on functional status prior to ICU discharge and on knee extension strength (both p < 0.05) prior to intermediate care unit discharge. Medium-frequency NMES also enhanced handgrip strength earlier than low-frequency NMES when compared to the control group. Notably, medium-frequency NMES was the only intervention associated with a significant reduction in total hospital stay duration (p < 0.05). Conclusions: Medium-frequency NMES, along with an SPT program in critically ill patients, showed greater benefits on functional capacity during recovery than low-frequency NMES. (Trial registration: This trial is registered on ClinicalTrials.gov: NCT05287919). Implications for rehabilitation: 1. Medium-frequency NMES may enhance physical functionality and quality of life in critically ill patients with ICU-acquired weakness. 2. Medium-frequency NMES can reduce the number of hospitalization days. 3. NMES combined with SPT represents a feasible and effective option for patients unable to engage in active rehabilitation during critical illness. Full article

Dietary protein is an essential macronutrient derived from both plant and animal sources required for muscle building, immune function, and wound healing. However, in the United States, protein consumption worsens as individuals age, with 30% of men and 50% of women over 71 consuming inadequate dietary protein due to a variety of factors, including changes in gut function, loss of appetite, tooth loss, financial concerns, and social isolation. The aim of this review is to underscore the need for increased protein requirements in aging populations, highlight potential barriers, synthesize these protein requirements, and also recommend strategies to meet these increased protein needs. Achieving adequate protein status, especially when facing chronic or acute health concerns, is essential to promote muscle and bone strength (because aging is associated with significant decreases in postprandial muscle protein synthesis), to support immune health (due to immunosenescence), and to maintain a good quality of life. For older adults, the literature suggests that a dietary protein intake of at least 1.0–1.2 g/kg/day is required in healthy, aging populations, and intakes of 1.2–1.5 g/kg/day are necessary for those with chronic or acute conditions. These protein intake recommendations can increase to 2.0 g/kg/day in more severe cases of illness, malnutrition, and chronic conditions. The reviewed literature also suggests that evenly balanced protein distributions of 25–30 g of dietary protein (0.4 g/kg) per meal from animal and plant protein sources alike are sufficient to maximize muscle protein synthesis (MPS) rates in older populations. Additionally, pre-sleep protein feeds of 40 g/night may be another strategy to improve daily MPS and amino acid utilization. Full article

Background/Objectives: Patients undergoing open aortic and valvular surgery often experience postoperative deconditioning, yet research on the role of inpatient cardiac rehabilitation (CR) in this population remains limited. This study aimed to examine the effects of inpatient CR on muscle strength, mobility, psychological well-being, and quality of life in patients recovering from open aortic surgery. Methods: We conducted a retrospective study using the medical records of patients who participated in inpatient CR after open aortic surgery. Functional and psychological outcomes were evaluated using the Medical Research Council (MRC) sum score, Timed Up and Go (TUG) test, Five Times Sit-to-Stand test (5STS), Six-Minute Walk Distance (6MWD), Berg Balance Scale (BBS), Modified Barthel Index (MBI), Patient Health Questionnaire-9 (PHQ-9), and the EuroQol-5D (EQ-5D). Pre- and post-rehabilitation scores were compared to assess changes in functional status, mobility, and quality of life. A post-discharge satisfaction survey was also analyzed. Results: A total of 33 patients were included. Significant improvements were observed in MBI (p < 0.001), MRC sum score (p < 0.001), 6MWD (p < 0.001), BBS (p < 0.001), TUG (p = 0.003), 5STS (p < 0.001), EQ-5D (p = 0.011), and PHQ-9 (p = 0.009) following inpatient CR. Patients with lower baseline mobility (6MWD ≤ 120 m) exhibited greater improvement in MBI (p = 0.034). Of the 33 patients, 26 completed the satisfaction survey; most reported high satisfaction, perceived health improvements, and willingness to recommend the program. Conclusions: Inpatient CR following open aortic and valvular surgery resulted in significant gains in muscle strength, mobility, psychological health, and overall quality of life. Patients with greater initial impairment demonstrated especially notable functional improvement, supporting the value of tailored CR in this population. Full article

Sarcopenia, the progressive loss of muscle mass, strength, and regenerative capacity with age, is driven by interconnected processes such as oxidative stress, chronic inflammation, mitochondrial dysfunction, and reduced activity of muscle stem cells. As the population ages, nutritional strategies that target these mechanisms are becoming increasingly important. This review focuses on nicotinamide (vitamin B3) and pyridoxine (vitamin B6), two essential micronutrients found in functional foods, which play complementary roles in redox regulation, immune balance, and muscle repair. Nicotinamide supports nicotinamide adenine dinucleotide (NAD⁺) metabolism, boosts mitochondrial function, and activates sirtuin pathways involved in autophagy and stem cell maintenance. Pyridoxine, via its active form pyridoxal 5′-phosphate (PLP), is key to amino acid metabolism, antioxidant defense, and the regulation of inflammatory cytokines. We summarize how these vitamins influence major molecular pathways such as Sirtuin1 (SIRT1), protein kinase B (AKT)/mechanistic target of rapamycin (mTOR), Nuclear factor-κB (NF-κB), and Nrf2, contributing to improved myogenic differentiation and protection of the aging muscle environment. We also highlight emerging preclinical and clinical data, including studies suggesting possible synergy between B3 and B6. Finally, we discuss how biomarkers such as PLP, nicotinamide mononucleotide (NMN), and C-reactive protein (CRP) may support the development of personalized nutrition strategies using these vitamins. Safe, accessible, and mechanistically grounded, nicotinamide and pyridoxine offer promising tools for sarcopenia prevention and healthy aging. Full article

Objective: The objective of the study was to investigate the relationship between the level of physical activity and body composition, and the levels of motor skills and strength in overweight and obese men. Methods: The research involved 64 men. Body composition, physical activity, motor control, Motor Control Test (MCT), and strength variables were evaluated. Body composition was assessed by DXA, and the participants were classified into two groups according to the percentage of total fat mass: greater and less than 27.65%. Physical activity was assessed using accelerometry, and motor control was measured with posturography, which provided a composite score of motor performance and postural control effectiveness. Strength was assessed using hand, leg, and back dynamometers. Results: The participants with a higher percentage of body fat had a lower DSI (Dynamic Strength Index) (p < 0.001) and significantly reduced PAL (physical activity level) and energy expenditure (p < 0.001). No significant differences were found in the muscle strength of the upper limbs (p = 0.06) and lower limbs (p = 0.419). With regard to MCT, there was a significant difference between groups in the backward direction (p = 0.041), with the group with the highest percentage of body fat showing lower values. Conclusions: Individuals with a higher percentage of body fat tend to have lower levels of strength, physical activity, and energy expenditure, which can lead to impaired balance. The findings highlight the need for targeted interventions to improve body composition and levels of strength and physical activity, with a positive impact on general health and quality of life. Emphasis should be placed on improving physical activity levels in male individuals with a higher percentage of fat mass to improve their body composition and dynamic strength levels, which are beneficial to life, particularly to help improve postural control. Full article

Background and Objectives: Arthrogenic muscle inhibition (AMI) is a key neurophysiological barrier to effective rehabilitation in individuals with chronic ankle instability (CAI). The primary objective of this narrative review is to explore the role of arthrogenic muscle inhibition (AMI) in chronic ankle instability (CAI) and to critically appraise neurophysiological and rehabilitative strategies targeting its resolution. Although peripheral strengthening remains a cornerstone of treatment, the roles of spinal and cortical modulation are increasingly recognised. Materials and Methods: A narrative review was conducted to examine recent clinical trials targeting AMI in CAI populations. A structured search of MEDLINE, Web of Science, Scopus, Cochrane Central, and PEDro was performed. Five studies were included, encompassing peripheral, spinal, and cortical interventions. The outcomes were grouped and analysed according to neurophysiological and functional domains. Results: Manual therapy combined with exercise improved pain, strength, and functional mobility. Fibular reposition taping transiently enhanced spinal reflex excitability, while transcranial direct current stimulation (tDCS) over the primary motor cortex significantly modulated corticospinal excitability and voluntary muscle activation. Improvements in subjective stability, dynamic balance, and neuromuscular responsiveness were observed in the majority of the five included studies, although methodological heterogeneity and short-term follow-ups limit generalisability. Conclusions: Multimodal interventions targeting different levels of the neuromotor system appear to be more effective than isolated approaches. Integrating manual therapy, sensorimotor training, and neuromodulation may optimise outcomes in CAI rehabilitation. Future trials should focus on standardised outcome measures and long-term efficacy. Full article

Background and Objectives: This study aims to investigate the relationship between isokinetic knee strength and competition performance in elite male ski mountaineering sprint athletes and to identify strength parameters that predict performance and contribute to injury prevention. Materials and Methods: Thirteen male athletes participating in the Ski Mountaineering Turkey Cup final stage were included. Isokinetic knee flexion (FLX) and extension (EXT) strength of dominant (DM) and non-dominant (NDM) legs were measured at angular velocities of 60°/s and 180°/s using the DIERS-Myolin Isometric Muscle Strength Analysis System. Competition performance was evaluated using the ISMF scoring system. Data were analyzed using SPSS 26.0 with Pearson correlation and multiple regression analyses after normality, linearity, and homoscedasticity checks. Results: Strong positive correlations were found between hamstring strength at high angular velocities (180°/s) and performance (DM FLX: r = 0.809; NDM FLX: r = 0.880). Extension strength showed moderate correlations at low velocities (60°/s) (DM EXT: r = 0.677; NDM EXT: r = 0.699). Regression analysis revealed that DM FLX at 180°/s and DM EXT at 60°/s explained 49% of performance variance (Adj. R² = 0.498). For NDM legs, only 180°/s FLX was a significant predictor (β = 1.468). Conclusions: High-velocity hamstring strength plays a critical role in ski mountaineering sprint performance, particularly during sudden directional changes and dynamic balance. Quadriceps strength at low velocities contributes to prolonged climbing phases. Moreover, identifying and addressing bilateral strength asymmetries may support injury prevention strategies in elite ski mountaineering athletes. These findings provide scientific support for designing training programs targeting explosive hamstring strength, bilateral symmetry, and injury risk reduction, essential for optimizing performance in the 2026 Winter Olympics sprint discipline. Full article

Core stability is fundamental to posture, balance, and force transmission throughout the kinetic chain. Although traditionally associated with athletic performance, emerging research highlights its broader applicability to recreational fitness. This study investigates the effects of an eight-week core training program on muscle hypertrophy, static balance, and neuromuscular control in recreationally active, non-athletic adults. Participants will undertake a structured intervention comprising progressive triads targeting core stability, strength, and power. Assessment methods include surface electromyography (EMG), ultrasound imaging, three-dimensional force plates, Kinovea motion analysis, and the Satisfaction With Life Scale (SWLS) questionnaire. Expected outcomes include enhanced core muscle activation, improved static balance, and increased core-generated force during overhead medicine ball slam trials. Additionally, the intervention aims to facilitate hypertrophy of the transverse abdominis, internal oblique, and lumbar multifidus muscles, contributing to spinal resilience and motor control. This protocol bridges gaps in core training methodologies and advances their scalability for recreational populations. The proposed model offers a structured, evidence-informed framework for improving core activation, postural stability, muscle adaptation, movement efficiency, and perceived quality of life in recreationally active individuals. Full article

Background: The efficacy of postoperative exercise rehabilitation after spine surgery is controversial, and a protocol for exercise treatment and detailed outcomes based on functional activity have not yet been established. This study aimed to determine the efficacy of exercise rehabilitation after lumbar spine surgery. Methods: A prospective, randomized controlled trial was conducted in 40 patients who underwent lumbar spine surgery (20 patients each in the exercise and control groups) for 12 weeks. Clinical outcomes were assessed using the visual analog scale (VAS) for pain and EuroQol-5 Dimensions 5-Level version (EQ-5D-5L). Body proportions, including body mass index, total muscle mass, and body fat percentage were analyzed. Functional activity was evaluated based on the range of motion of the lumbar spine, strength and endurance of lumbar flexion/extension, flexibility, 6 min walking test, single-leg stance, coordination, and gait pattern analysis. Results: The exercise group showed significantly greater improvement in VAS for pain (66.67% versus 20.00%, p < 0.001) and EQ-5D-5L (45.56% versus 20.00, p = 0.039) compared to the control group. Serial assessment revealed significant improvement in strength of lumbar flexion/extension, 6 min walking test, single-leg stance, coordination, and gait patterns in the exercise group compared to the control group. In particular, the single-leg stance time for the affected leg improved more markedly in the exercise group (280.9% versus 48.7%, p < 0.001). Conclusion: Tailored postoperative exercise after lumbar spine surgery is effective in reducing pain and enhancing functional recovery, including strength and balance. Full article

Background: Interventions involving Olympic combat sports, such as Taekwondo (TKD) and Boxing (BOX), represent innovative approaches for promoting health in older people. Elastic bands training (EBT), by contrast, is a safe and cost-effective method that has demonstrated positive effects on functional physical parameters in this population. This study aimed to compare the effects of TKD and BOX interventions, relative to EBT, on body composition and physical function in Chilean older women. Methods: This randomized controlled trial comprised three parallel groups: TKD (n = 10), BOX (n = 10), and EBT (n = 10). Participants in each group underwent pre- and post-intervention assessments following two 60 min sessions per week over an eight-week period. Results: Multiple comparisons revealed significant advantages for EBT over TKD and BOX in maximal isometric handgrip strength for both the dominant (p < 0.001; d = 0.967, large effect) and non-dominant (p < 0.001; d = 0.641, moderate effect) hands. Conversely, significant improvements in Timed Up-and-Go performance were observed in the TKD and BOX groups compared to EBT (p < 0.001; d = 2.071, large effect). All groups showed significant within-group improvements in the 30 s chair stand test (p < 0.001; d = 0.095, large effect). No significant changes were found in body fat percentage, fat-free mass, back scratch test, sit-and-reach test, or 2 min step test across groups. Conclusions: Although no substantial differences were observed between groups for most variables, TKD and BOX interventions significantly reduced Timed Up-and-Go times, whereas EBT enhanced maximal isometric handgrip strength in both hands. These findings highlight the distinct functional benefits of each intervention modality for older Chilean women. 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