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Search Results (1,496)

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16 pages, 6832 KB  
Article
Evaluation of Muscle Activity and Usability of an Upper-Limb Exoskeleton in Power Grid Maintenance Tasks
by Xu Jin, Yun Wang and Lihua He
Appl. Sci. 2026, 16(14), 6928; https://doi.org/10.3390/app16146928 - 10 Jul 2026
Viewed by 99
Abstract
Power grid maintenance tasks often involve sustained arm elevation, asymmetric upper-limb loading, and repetitive pulling, all of which may increase the risk of work-related musculoskeletal disorders. This study evaluated the effects of a passive upper-limb exoskeleton on muscle activity, subjective fatigue, task workload, [...] Read more.
Power grid maintenance tasks often involve sustained arm elevation, asymmetric upper-limb loading, and repetitive pulling, all of which may increase the risk of work-related musculoskeletal disorders. This study evaluated the effects of a passive upper-limb exoskeleton on muscle activity, subjective fatigue, task workload, and usability in three representative power grid maintenance tasks: insulator installation, insulated rod handling, and hand-chain hoist operation. A randomized crossover design was adopted, and twenty-two healthy young male participants completed all tasks under exoskeleton (EXO) and no-exoskeleton (NoEXO) conditions. Surface electromyography was used to quantify muscle activity, and subjective assessments included Borg CR-10, NASA-TLX, an exoskeleton wearing experience questionnaire, and the System Usability Scale (SUS). In the static tasks, the exoskeleton significantly reduced %MVC of the trapezius, deltoid, and biceps brachii, while in the dynamic task, significant reductions were mainly observed in the deltoid and trapezius during the arm-raising phase. The exoskeleton also reduced local discomfort in the shoulders, elbows, and wrists and improved selected workload dimensions, particularly physical demand and effort. The mean SUS score was 74.2, indicating acceptable usability. These findings suggest that the passive upper-limb exoskeleton can effectively reduce proximal upper-limb loading in power grid maintenance tasks, with the greatest benefit observed in static overhead work. Full article
(This article belongs to the Special Issue Human-Centered Design in Wearable Technology)
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24 pages, 3312 KB  
Article
Real-Time Wearable sEMG Onset Detection and Phase Discrimination of Sit-to-Stand Movement via a Compact Dual-Channel DD-CNN
by Meernah Mohammed Alabdullah, Aiqin Liu, Yiliu Tu and Sheng Quan Xie
Sensors 2026, 26(14), 4375; https://doi.org/10.3390/s26144375 - 10 Jul 2026
Viewed by 117
Abstract
Repeated sit-to-stand and stand-to-sit transitions load the knee extensors and may contribute to work-related musculoskeletal disorders. Reducing this load requires assistive devices and monitoring of knee function, which depend on real-time onset/offset detection and direction-aware classification of each transition. However, no prior wearable [...] Read more.
Repeated sit-to-stand and stand-to-sit transitions load the knee extensors and may contribute to work-related musculoskeletal disorders. Reducing this load requires assistive devices and monitoring of knee function, which depend on real-time onset/offset detection and direction-aware classification of each transition. However, no prior wearable surface electromyographic system has delivered this capability for real-time. This study presents a deep learning method that computes both onset/offset detection and direction discrimination of sit-to-stand and stand-to-sit in a developed wearable surface electromyographic system in real-time. Two ESP32-S3 nodes and a hub record from the vastus lateralis and vastus medialis and run a per-burst convolutional detector, while the hub runs a dual-branch classifier with seventeen handcrafted features. Trained offline on the public Gait120 dataset, the networks are deployed unchanged with embedded-firmware parity to the MATLAB reference. Under leave-one-subject-out evaluation on Gait120, the offline classifier separated each transition with 99.6% accuracy and the detector achieved 96.6% completeness. In real-time recordings from thirty healthy adults, the system retained 85.6% classification and 82.0% detection accuracy, with ≈100 ms latency and a 618 KB network footprint. Results show that a low-power wearable delivers combined detection and phase discrimination in real-time, supporting the potential application in assistive-device control and knee-joint monitoring. Full article
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18 pages, 389 KB  
Article
Burden and Patterns of Oral Diseases and Systemic Comorbidities in Older Adults Attending Primary Care: A Sex- and Age-Stratified Analysis
by Daniel Lopez-Hernandez, Osvaldo Erik Sanchez-Hernandez, Tabata Gabriela Anguiano-Velazquez, Leticia Brito-Aranda, Aline Vanessa Carrera-Vite, Aleli Julieta Izquierdo-Vega, Perla Veronica Salinas-Palacios, Josefina Reynoso-Vazquez, Abraham Espinoza-Perdomo, Nadia Esmeralda Crisantos-Reyes, Christian David Sevilla-Mendoza, Miriam Azucena Gonzalez-Sandoval, Marcos Meneses-Mayo and Arturo Salazar-Campos
Medicina 2026, 62(7), 1325; https://doi.org/10.3390/medicina62071325 - 9 Jul 2026
Viewed by 182
Abstract
Background and Objectives: Oral health is a key but often overlooked component of healthy aging and functional wellbeing in older adults. Population aging, multimorbidity, and social determinants of health interact in order to shape oral disease patterns, particularly in primary care settings. [...] Read more.
Background and Objectives: Oral health is a key but often overlooked component of healthy aging and functional wellbeing in older adults. Population aging, multimorbidity, and social determinants of health interact in order to shape oral disease patterns, particularly in primary care settings. Understanding age- and sex-specific distributions of oral diseases is essential for informing integrated public health strategies aimed at promoting healthy aging. Materials and Methods: We conducted a cross-sectional population-based analysis using the SIMEF primary care database, including 7386 adults aged 60 years and older, who were attended between January and December 2022. Oral diseases were identified using ICD-10 codes K00–K14. Prevalence estimates were calculated by life decade and sex. Associations were assessed using chi-square tests and sex-stratified analyses. Results: The overall prevalence of oral diseases was 5.2%, with a significant and progressive decline across age groups, from 6.5% in sexagenarians to 1.6% in nonagenarians (p < 0.001). The most prevalent conditions were disorders of teeth and supporting structures (2.6%, 95% confidence interval [95% CI] 2.3–3.0), dentofacial anomalies (2.2%, 95% CI 1.8–2.5), and dental caries (1.7%, 95% CI 1.4–2.0). Women showed a slightly higher prevalence of selected oral and mucosal conditions. Among older adults with oral diseases (n = 384), the most frequent comorbidities were hypertension (40.4% 95% CI 35.7–45.3), type 2 diabetes (29.2% 95% CI 24.7–33.8), and dyslipidemia (21.1% 95% CI 17.2–25.3), with marked sex-specific differences in endocrine, urinary, musculoskeletal, and mental health conditions. Conclusions: Oral disease burden in older adults decreases with advancing age but remains strongly linked to cardiometabolic and systemic comorbidities, reflecting shared risk factors relevant to healthy aging. The observed age- and sex-specific patterns underscore the need to integrate oral health into primary care and public health policies targeting aging populations, supporting comprehensive and equitable strategies for healthy longevity. Full article
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24 pages, 3657 KB  
Review
Platelet-Rich Plasma: Mechanotransduction, Tissue Loading, and Regenerative Repair for Pain Medicine
by Ahmed I. Anwar, Josephine M. Feeney, Joseph B. Delaney, Christopher L. Robinson, Jamal Hasoon and Alan D. Kaye
Biophysica 2026, 6(4), 59; https://doi.org/10.3390/biophysica6040059 - 9 Jul 2026
Viewed by 105
Abstract
Musculoskeletal pain is driven by degenerative conditions such as osteoarthritis or intervertebral disk degeneration. This creates a major burden on health systems and patient quality of life. Platelet-rich plasma (PRP) is an orthobiologic that contains platelets and growth factors which promote angiogenesis, modulate [...] Read more.
Musculoskeletal pain is driven by degenerative conditions such as osteoarthritis or intervertebral disk degeneration. This creates a major burden on health systems and patient quality of life. Platelet-rich plasma (PRP) is an orthobiologic that contains platelets and growth factors which promote angiogenesis, modulate inflammation, and support tissue repair. Mechanobiology is central in the healing process, where mechanical loading regulates cellular behavior through mechanotransduction pathways including integrin/FAK and RhoA/ROCK. This use of signaling pathways allows for regeneration along multiple different tissue types. Evidence suggests that PRP and mechanical loading may act together to promote tissue repair, with PRP-derived signals interacting with biomechanical cues to enhance fibroblast activation, remodeling, and regenerative responses. There is variability in PRP preparation, rehabilitation protocols, and tissue-specific responses, which all highlight the need for a more standardized and guided treatment strategy. Understanding the interplay between PRP-derived biologic signaling and mechanobiologic pathways may help inform the development of more standardized, tissue-specific regenerative treatment strategies and could potentially contribute to improved clinical outcomes in patients with musculoskeletal pain. Full article
(This article belongs to the Special Issue Mechanobiology of Regeneration: From Physical Aspects)
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14 pages, 742 KB  
Article
Integrating Health Belief Model and Human Factors Engineering to Prevent Musculoskeletal Injuries Among Operating Room Nurses: A Quality Improvement Prospective Pilot Study
by Allen Herng Shouh Hsu, Chun Hung Chen, Jui-Ting Wei, Man Ju Wei, Po Chun Lin, Chung Fang Li and Pei-Shan Lee
Healthcare 2026, 14(14), 2046; https://doi.org/10.3390/healthcare14142046 - 8 Jul 2026
Viewed by 149
Abstract
Background: Operating room (OR) nurses are at high risk for work-related musculoskeletal disorders (WMSDs) due to physically demanding tasks and the use of heavy lead aprons. Objectives: This study evaluated the impact of a multidimensional ergonomic intervention on injury prevention awareness, [...] Read more.
Background: Operating room (OR) nurses are at high risk for work-related musculoskeletal disorders (WMSDs) due to physically demanding tasks and the use of heavy lead aprons. Objectives: This study evaluated the impact of a multidimensional ergonomic intervention on injury prevention awareness, compliance, and health outcomes among OR staff. Methods: A prospective quality improvement pilot study was conducted with 33 OR nurses. The intervention, based on the Health Belief Model and Human Factors Engineering, integrated ergonomic education with environmental modifications. Outcomes were assessed via questionnaires, field audits, and sick leave records at baseline, post-intervention, and 6-month follow-up. Results: Awareness scores improved from 68.7% to 98.8% (p < 0.001). Observational audits demonstrated a reduction in non-ergonomic actions from 2227 to 440 (mean deviations per nurse: 111.4 to 22.0, p < 0.001), with improvements sustained at 6 months. Annual sick leave cases decreased from three to one. Conclusions: A multifaceted real-world pilot intervention combining education with system-level engineering was associated with enhancing ergonomic compliance and reducing unsafe behaviors. This approach fosters the self-efficacy necessary for sustainable WMSD risk mitigation in high-intensity clinical settings. Full article
(This article belongs to the Special Issue Health Services, Health Literacy and Nursing Quality)
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21 pages, 9710 KB  
Systematic Review
Contemporary Scurvy in Vulnerable Populations in High-Income Countries: A Systematic Review and Multilevel Meta-Analysis
by Nina Cadeau-Comte, Erika Meléndez-Oliva, Juan Nicolás Cuenca-Zaldívar and Eleuterio A. Sánchez-Romero
Nutrients 2026, 18(14), 2213; https://doi.org/10.3390/nu18142213 - 8 Jul 2026
Viewed by 407
Abstract
Background: Scurvy, a condition caused by vitamin C deficiency, has traditionally been considered eradicated in high-income countries (HICs; World Bank classification). However, emerging evidence suggests its re-emergence within identifiable vulnerability clusters, challenging the conventional assumptions about nutritional adequacy in affluent settings. This [...] Read more.
Background: Scurvy, a condition caused by vitamin C deficiency, has traditionally been considered eradicated in high-income countries (HICs; World Bank classification). However, emerging evidence suggests its re-emergence within identifiable vulnerability clusters, challenging the conventional assumptions about nutritional adequacy in affluent settings. This study aimed to systematically characterize the contemporary clinical and epidemiological profile of scurvy in HICs and quantify its multisystem burden. Methods: A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD420251013454). PubMed, Embase, Web of Science, and Scopus were searched (2012–2025). Case reports, case series, and observational studies reporting clinically or biochemically confirmed scurvy in HICs were included in this review. A multilevel random-effects meta-analysis was performed using restricted maximum likelihood estimation, incorporating robust variance estimation to account for within-study dependence and hierarchical data structures. Multisystem involvement was modeled as a count outcome, and system-specific prevalence was estimated using logit-transformed proportions. Results: Twenty-five studies, including 147 patients, were analyzed. Patients diagnosed with scurvy frequently presented with involvement of multiple organ systems, with a pooled mean of 2.29 affected organ systems per patient (95% CI: 1.62–2.96; I2 = 66.8%), highlighting clinically relevant heterogeneity in presentation. Musculoskeletal involvement was the most frequent clinical domain (OR 1.82; 95% CI: 0.98–3.38), whereas neurological manifestations were significantly less common (OR 0.42; 95% CI: 0.28–0.62; p < 0.001). Age was the only significant moderator, showing a modest inverse association with musculoskeletal involvement (OR 0.97; p = 0.035). Across studies, cases predominantly clustered in pediatric patients with neurodevelopmental disorders, restrictive dietary patterns, medically complex conditions, and psychosocial vulnerability. Conclusions: Scurvy persists in high-income countries as a clinically under-recognized condition occurring predominantly in vulnerable populations with restrictive dietary patterns, neurodevelopmental disorders, and psychosocial vulnerability. The available evidence suggests that contemporary scurvy is frequently associated with multisystem manifestations; however, the contribution of concomitant micronutrient deficiencies cannot be excluded. These findings highlight the need for comprehensive nutritional assessment and targeted nutritional screening in high-risk populations to prevent diagnostic delays and avoidable morbidity. Full article
(This article belongs to the Special Issue Nutrition in Vulnerable Population Groups (2nd Edition))
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25 pages, 985 KB  
Review
The Multidimensional Impact of Traditional Orthopaedic Casting and the Role of Emerging Immobilization Technologies: A Narrative Review
by James Stavitz, Ryan Porcelli and Aatmaja Vachhani
Healthcare 2026, 14(14), 2039; https://doi.org/10.3390/healthcare14142039 - 8 Jul 2026
Viewed by 267
Abstract
Background: Traditional orthopaedic casting has remained the cornerstone of non-surgical fracture management for more than a century. Although plaster and fiberglass casts reliably stabilize fractures, they are associated with physical, psychological, emotional, social, and economic burdens that extend beyond bone healing. Children, older [...] Read more.
Background: Traditional orthopaedic casting has remained the cornerstone of non-surgical fracture management for more than a century. Although plaster and fiberglass casts reliably stabilize fractures, they are associated with physical, psychological, emotional, social, and economic burdens that extend beyond bone healing. Children, older adults, and individuals with pre-existing vulnerabilities may be disproportionately affected. Despite increasing recognition of these complications, existing orthopaedic literature has historically prioritized radiographic healing and biomechanical stability, with limited synthesis of the broader multidimensional patient impact of traditional casting. Emerging technologies such as light-cured polymer mesh (LCPM) systems and 3D-printed lattice immobilizers have been developed to address these limitations and better align fracture care with patient-centered principles. Methods: A narrative review was conducted using a structured and transparent literature identification approach informed by PRISMA reporting principles; however, this study was not conducted as a formal systematic review and did not include risk-of-bias assessment or quantitative synthesis. A broad search of PubMed, Scopus, Web of Science, and Google Scholar was performed for studies published between January 2000 and July 2025. Search strategies combined MeSH terms and free-text keywords relating to orthopaedic casting, complications, psychosocial impacts, LCPM, and 3D-printed immobilizers. Following duplicate removal and a structured review process, 87 studies were included in the final narrative synthesis. Eligible studies included randomized controlled trials, observational studies, qualitative research, case series, and systematic reviews. Data were synthesized narratively across five domains: physical, psychological, emotional/social, economic, and technological alternatives. Results: Traditional plaster and fiberglass casts were consistently associated with musculoskeletal deterioration, joint stiffness, dermatological complications, and hygiene challenges. Psychological and emotional consequences included cast-induced anxiety, claustrophobia, depressive symptoms, and diminished autonomy. Social participation was frequently reduced due to mobility restrictions and perceived stigma, while economic impacts included hidden out-of-pocket expenses, caregiver burden, lost wages, and disparities in access to follow-up care. In contrast, emerging alternatives demonstrated promising advantages. LCPM systems improved ventilation, comfort, and hygiene, while reducing saw-related anxiety. Preliminary evidence suggests that both LCPM and 3D-printed systems may support improved patient experience and earlier return to selected activities, although larger comparative studies are needed to confirm effects on complication rates and long-term outcomes. Over time, these benefits may help offset higher upfront material costs. Conclusions: Fracture care should be evaluated not only by radiographic healing but also by patient-centered outcomes such as comfort, independence, and quality of life. Traditional casting imposes significant multidimensional burdens, whereas newer technologies such as LCPM and 3D-printed systems may offer a more holistic approach to immobilization while maintaining acceptable fracture stability in appropriately selected patient populations. While current evidence indicates potential physical, psychological, and economic advantages, large-scale comparative trials remain necessary to confirm long-term clinical, psychosocial, and cost-effectiveness outcomes across diverse populations. Future integration of emerging immobilization technologies into clinical practice may support more patient-centered, function-oriented, and cost-conscious approaches to fracture care. Full article
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25 pages, 2163 KB  
Article
Bioinspired Computation for Identifying Joint Compliance in Biomimetic Flexible Manipulators
by Abdelraheim Emad Abdelraheim, Mohamed Nejlaoui and Nasser Ayidh Alqahtani
Biomimetics 2026, 11(7), 474; https://doi.org/10.3390/biomimetics11070474 - 7 Jul 2026
Viewed by 265
Abstract
High-precision robotics is frequently compromised by joint compliance, a factor often over-simplified by traditional rigid-body modeling. This research investigates the structural dynamics of a two-link manipulator, addressing critical discrepancies between experimental data and conventional models. Much like biological musculoskeletal systems, joint flexibility fundamentally [...] Read more.
High-precision robotics is frequently compromised by joint compliance, a factor often over-simplified by traditional rigid-body modeling. This research investigates the structural dynamics of a two-link manipulator, addressing critical discrepancies between experimental data and conventional models. Much like biological musculoskeletal systems, joint flexibility fundamentally influences the dynamic response of articulated structures. While traditional rigid-joint models accurately capture mode shapes, they yield excessive natural frequency prediction errors with peaks reaching 72%. To bridge this gap, a refined Flexible-Joint Finite Element Model (FJFEM) is developed to mimic adaptive joint compliance. This model is integrated with a bio-inspired computational framework (a Double-Stage Genetic Algorithm Framework (DSGAF)) to identify configuration-dependent joint stiffness across the operational workspace, where experimental frequencies f1 and f2 shift nonlinearly from 25.5 Hz to 44 Hz and 92.2 Hz to 51 Hz, respectively. Experimental validation demonstrates that this evolutionary strategy reduces frequency tracking errors to less than 3.5% across all positions, achieving an average identification routine runtime of 1.8 s. By capturing nonlinear compliance behavior, this framework provides a robust foundation for the design, online calibration, and vibration control of advanced flexible robotic systems. Full article
(This article belongs to the Special Issue Bio-Inspired Computation and Its Applications)
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25 pages, 1220 KB  
Review
Topical Pain Management: An Updated Review of Current Evidence and Emerging Strategies
by Urszula Adamiak-Giera, Patryk Rzeczycki, Magdalena Sawczuk, Oliwia Pęciak and Monika Białecka
J. Clin. Med. 2026, 15(13), 5311; https://doi.org/10.3390/jcm15135311 - 7 Jul 2026
Viewed by 528
Abstract
Introduction: Pain is one of the most common reasons why patients seek medical care, and chronic pain is now recognized as a major health problem worldwide. Better understanding of pain mechanisms has shown the importance of distinguishing nociceptive, neuropathic, and nociplastic pain [...] Read more.
Introduction: Pain is one of the most common reasons why patients seek medical care, and chronic pain is now recognized as a major health problem worldwide. Better understanding of pain mechanisms has shown the importance of distinguishing nociceptive, neuropathic, and nociplastic pain in order to choose the most effective treatment. In recent years, topical analgesics have gained increasing attention because they can provide pain relief directly at the site of application while reducing systemic exposure and the risk of adverse effects. This is especially important in older adults, patients with multiple diseases, and those exposed to polypharmacy. Methods: This narrative review presents the current knowledge on the pharmacology, efficacy, and safety of topical drugs used in pain treatment. Particular attention is given to topical non-steroidal anti-inflammatory drugs (NSAIDs), lidocaine, capsaicin, menthol, and camphor. The review also discusses newer and less established therapies used mainly in neuropathic pain, including topical ketamine, amitriptyline, phenytoin, gabapentin, and clonidine. A structured, non-systematic literature search was conducted using the PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar databases to identify studies evaluating the efficacy and safety of topical analgesic therapies. Results: Current evidence supports topical NSAIDs as first-line therapy for localized musculoskeletal pain and osteoarthritis, while lidocaine and high-concentration capsaicin patches are effective options in focal neuropathic pain. Although several newer topical therapies show promising results, more high-quality clinical studies are still needed. Overall, topical analgesia is an important part of multimodal pain management because it combines analgesic efficacy with a better safety profile compared with many systemic therapies. Conclusions: Taking the aspects discussed in this paper into account, it seems justified to search for new drug combinations that would contribute to effective pain therapy with topical agents. It is recognized that a multimodal approach to pain management, which utilizes drugs with different mechanisms of action, can increase efficacy and reduce the systemic adverse events of the drugs used. The effective and safe treatment of patients with pain, especially neuropathic pain, despite emerging new clinical trials, remains a challenge for clinicians. Full article
(This article belongs to the Section Pharmacology)
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14 pages, 251 KB  
Article
Musculoskeletal Pain and Neuropathic Pain Features Among Individuals with Long COVID and a History of Pain: Characteristics and Impact on Health-Related Quality of Life
by Adam B. Smith, Philip G. Conaghan, Christine Comer, Manoj Sivan and Sarah R. Kingsbury
COVID 2026, 6(7), 118; https://doi.org/10.3390/covid6070118 - 7 Jul 2026
Viewed by 152
Abstract
Background: Post-COVID-19 syndrome or Long COVID (LC) is a multi-system condition characterised by persistent symptoms beyond three months following SARS-CoV-2 infection. Pain, particularly musculoskeletal and neuropathic pain, is commonly reported and may substantially affect functioning and health-related quality of life (HRQoL). However, there [...] Read more.
Background: Post-COVID-19 syndrome or Long COVID (LC) is a multi-system condition characterised by persistent symptoms beyond three months following SARS-CoV-2 infection. Pain, particularly musculoskeletal and neuropathic pain, is commonly reported and may substantially affect functioning and health-related quality of life (HRQoL). However, there is limited detailed characterisation of pain phenotypes and their differential impact on outcomes in LC. This study aimed to (i) characterise pain associated with LC, (ii) identify factors associated with pain type and severity, and (iii) examine its impact on HRQoL, physical activity, and work. Methods: A cross-sectional survey was conducted among adults with clinician-diagnosed or self-reported LC who reported current or previous joint, muscle, or nerve pain. Participants completed validated patient-reported outcome measures including the C19-YRS, Nordic Musculoskeletal Questionnaire, Pain Detect Questionnaire (PD-Q), Musculoskeletal Health Questionnaire, and EQ-5D-5L. Participants were classified into neuropathic, nociceptive, or ambiguous pain groups based on PD-Q scores. Descriptive analyses, group comparisons, and backward stepwise ordinary least squares regression were used to examine factors associated with overall pain (PD-Q Total). Results: Among 198 participants (73% female; mean age 52 ± 12.7 years; mean LC duration 2.4 years), 96% reported new or worsened pain following COVID-19 infection, with muscle pain (87%), joint pain (84%), and nerve pain (66%) most frequently reported. PD-Q scores suggestive of neuropathic pain were identified in 28% of participants and were associated with significantly greater pain intensity, symptom burden, functional impairment, and lower HRQoL (p < 0.05). These participants reported higher average pain scores across all body regions and greater radiating pain (76%) compared to other groups. Functional disability and anxiety were significant factors associated with pain severity. Conclusions: Pain is highly prevalent in LC, with neuropathic pain representing a distinct and more severe phenotype associated with substantial functional and quality-of-life impacts. This study provides novel comparative evidence on pain phenotypes and their differential burden, highlighting the need for targeted pain assessment and management strategies in LC. Full article
(This article belongs to the Section COVID Clinical Manifestations and Management)
26 pages, 2002 KB  
Review
Polymer Microneedles for Localized Drug Delivery in Musculoskeletal Tissue Regeneration
by Seihyun Park, Dohee Kim, Hongyoon Kim, Inseon Kim and Seunghun S. Lee
J. Funct. Biomater. 2026, 17(7), 325; https://doi.org/10.3390/jfb17070325 - 6 Jul 2026
Viewed by 466
Abstract
Musculoskeletal (MSK) disorders—osteoporosis, osteoarthritis, rheumatoid arthritis, intervertebral disc degeneration, tendinopathy, and skeletal muscle injury—contribute the largest share of years lived with disability worldwide. Conventional therapy relies on systemic dosing or repeated intra-articular and peri-tissue injections, which suffer from off-target toxicity, poor lesional bioavailability, [...] Read more.
Musculoskeletal (MSK) disorders—osteoporosis, osteoarthritis, rheumatoid arthritis, intervertebral disc degeneration, tendinopathy, and skeletal muscle injury—contribute the largest share of years lived with disability worldwide. Conventional therapy relies on systemic dosing or repeated intra-articular and peri-tissue injections, which suffer from off-target toxicity, poor lesional bioavailability, and low adherence. Polymer microneedles (MNs)—micron-scale projections of biodegradable, dissolving, hydrogel-forming, or composite polymers—have rapidly matured into a versatile platform for minimally invasive, spatially localized, and temporally programmable delivery of small molecules, biologics, nucleic acids, extracellular vesicles, and cells to MSK tissues. This review synthesizes 2018–2026 advances in polymer MN systems engineered specifically for MSK regeneration. We classify dominant polymer chemistries and MN architectures; map fit-for-purpose across bone, cartilage, joint, intervertebral disc, tendon, and skeletal muscle; and survey “smart” MN designs that exploit reactive oxygen species, pH, mechanical, triboelectric, optogenetic, and ultrasonic triggers. We close with a concise conclusion and forward perspective that identifies the key design levers—hybrid MN–scaffold combination products, stimuli-responsive platforms tuned to the MSK micro-environment, and cell- and EV-loaded formats—most likely to have clinical impact. Full article
(This article belongs to the Special Issue Polymers for Drug Delivery and Drug Release Systems)
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29 pages, 7954 KB  
Review
Evolving Landscape of Regenerative Therapies: Cell-Based and Cell-Free Approaches for Chronic Low Back Pain
by Courtney E. Bartlett, Pareeshe Bansal, Siddhant Bhattacharya, Abhi Dhote, Bruna B. Nicoletto, Joana R. N. Lemos and Rahul Mittal
J. Clin. Med. 2026, 15(13), 5235; https://doi.org/10.3390/jcm15135235 - 4 Jul 2026
Viewed by 173
Abstract
Background: Chronic low back pain (CLBP) is the leading cause of years lived with disability globally, affecting over 600 million individuals. Intervertebral disc degeneration (IVDD) is a principal structural contributor, yet conventional treatments, including pharmacotherapy, physical therapy, and surgical intervention, do not reverse [...] Read more.
Background: Chronic low back pain (CLBP) is the leading cause of years lived with disability globally, affecting over 600 million individuals. Intervertebral disc degeneration (IVDD) is a principal structural contributor, yet conventional treatments, including pharmacotherapy, physical therapy, and surgical intervention, do not reverse the underlying degenerative pathology. Regenerative medicine has introduced a spectrum of biological therapies for IVDD, including cell-based mesenchymal stromal cell (MSC) therapy, platelet-derived products such as platelet-rich plasma (PRP) and platelet lysate, extracellular vesicle-based approaches using MSC-derived extracellular vesicles (EVs), and secretome-based therapies using MSC-derived secretomes. However, these approaches have largely been studied in isolation, without a unified framework to compare their respective advantages and limitations in CLBP secondary to IVDD. Accordingly, this narrative review aims to provide an integrated and comparative evaluation of these regenerative strategies within a single translational and clinical context. Methods: For this narrative review, PubMed, Scopus, and Web of Science were searched from January 2000 to January 2026 using terms combining regenerative modalities with intervertebral disc degeneration, and chronic low back pain. Randomized controlled trials (RCTs), prospective cohort studies, systematic reviews, and preclinical studies with translational relevance were included. Results: Intradiscal MSC therapy has demonstrated safety across multiple phase I–III trials, but two recent landmark RCTs (RESPINE and the Mesoblast phase III trial) failed to meet primary efficacy endpoints, highlighting the gap between preclinical promise and clinical outcomes. PRP has the largest clinical evidence base, with level II evidence supporting short- to medium-term pain relief for discogenic pain, although standardization remains a critical barrier. Platelet lysate, MSC-derived EVs, and MSC-derived secretomes show compelling preclinical data, including extracellular matrix restoration, anti-inflammatory modulation, and attenuation of nucleus pulposus cell apoptosis, but remain at early translational stages for spinal applications, with no completed RCTs. The hostile disc microenvironment (avascular, hypoxic, acidic, and nutrient-poor) poses unique challenges for all regenerative modalities, differing fundamentally from other musculoskeletal applications. Conclusions: The studies included in this narrative review suggest that no single regenerative modality has yet shown consistent and unequivocal efficacy for CLBP secondary to IVDD across clinical trials. Cell-free approaches offer manufacturing, scalability, and safety advantages over cell-based therapies, but lack clinical validation. Future progress requires standardized preparation protocols, disc-specific delivery systems, patient phenotyping strategies, and rigorously designed comparative clinical trials. This narrative review provides a framework for researchers and clinicians to evaluate these therapies in context rather than isolation. Full article
(This article belongs to the Section Clinical Rehabilitation)
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14 pages, 986 KB  
Article
CT-Based Three-Dimensional Volumetric Analysis of Posterior and Lateral Malleolar Fragments in SER-Type Trimalleolar Ankle Fractures: Correlation and Reproducibility Study
by Ruhat Ünlü, Barış Yılmaz, Hasan Emirhan Usta, Hamit Çağlayan Kahraman, Gülşah Yıldırım and Celaleddin Bildik
Tomography 2026, 12(7), 101; https://doi.org/10.3390/tomography12070101 - 4 Jul 2026
Viewed by 163
Abstract
Background: Posterior malleolar fractures are commonly assessed using two-dimensional measurements and morphology-based classification systems. However, ankle fracture morphology is inherently three-dimensional, and the reproducibility of CT-based volumetric segmentation for malleolar fracture fragments has not been sufficiently established. Objectives: This study aimed to evaluate [...] Read more.
Background: Posterior malleolar fractures are commonly assessed using two-dimensional measurements and morphology-based classification systems. However, ankle fracture morphology is inherently three-dimensional, and the reproducibility of CT-based volumetric segmentation for malleolar fracture fragments has not been sufficiently established. Objectives: This study aimed to evaluate the relationship between lateral and posterior malleolar fragment volumes in homogeneous supination–external rotation (SER)-type trimalleolar ankle fractures and to assess the intraobserver and interobserver reproducibility of a manual CT-based three-dimensional volumetric segmentation workflow. Methods: This retrospective musculoskeletal imaging study included 71 patients with SER-type trimalleolar ankle fractures who underwent preoperative computed tomography (CT). Posterior and lateral malleolar fracture fragments were segmented on thin-slice axial CT images using a standardized manual contour-based slice-by-slice workflow. Fragment volumes were calculated using dedicated volumetric imaging software. The association between lateral and posterior malleolar fragment volumes was assessed using Spearman correlation and multivariable linear regression analyses. Measurement reproducibility was evaluated using intraclass correlation coefficients for absolute agreement [ICC(A,1)] and Bland–Altman analyses. Results: The median lateral and posterior malleolar fragment volumes were 8.63 cm3 (interquartile range [IQR], 7.18–10.71) and 2.64 cm3 (IQR, 1.88–4.24), respectively. A weak but statistically significant positive correlation was observed between lateral and posterior malleolar fragment volumes (Spearman rho = 0.313, p = 0.008). In multivariable linear regression analysis, lateral malleolar fragment volume remained independently associated with posterior malleolar fragment volume after adjustment for age, sex, and body mass index (B = 0.316, standardized β = 0.39, p = 0.002). Intraobserver and interobserver reproducibility were excellent for all volumetric measurements, with ICC(A,1) values ranging from 0.996 to 0.999. Bland–Altman analyses demonstrated low mean bias and narrow limits of agreement across all comparisons. Geometric agreement was also excellent, with Dice similarity coefficient values ranging from 0.93 to 0.96 across intraobserver and interobserver segmentation comparisons. Full article
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31 pages, 6499 KB  
Article
A Frequency-Aware Dual-Stream Deep Learning Framework for Athlete Workload Monitoring and Injury Risk Assessment: A Multi-Dataset Validation Study in Professional Team Sports
by Jinnian Tong and Peng Gao
Sensors 2026, 26(13), 4228; https://doi.org/10.3390/s26134228 - 3 Jul 2026
Viewed by 369
Abstract
The accumulation of training and competition loads represents a critical determinant of musculoskeletal injury risk in professional team sports, yet contemporary monitoring systems remain limited by their reliance on single-domain temporal analysis that overlooks the multi-scale rhythmic patterns inherent in athletic workload signals. [...] Read more.
The accumulation of training and competition loads represents a critical determinant of musculoskeletal injury risk in professional team sports, yet contemporary monitoring systems remain limited by their reliance on single-domain temporal analysis that overlooks the multi-scale rhythmic patterns inherent in athletic workload signals. This study introduces FDTM (frequency-aware dual-stream temporal model), a deep learning framework that jointly encodes time-domain dependencies and frequency-domain spectral signatures from digital athlete monitoring streams to predict individual injury risk over a forward-looking seven-game horizon. The framework integrates a stacked bidirectional long short-term memory branch augmented with temporal self-attention pooling, a spectral encoding branch employing discrete Fourier transform decomposition across high-frequency (weekly), mid-frequency (bi-weekly), and low-frequency (seasonal) bands, and a cross-modal gated attention fusion module that adaptively balances temporal and spectral representations conditioned on player context. We evaluate FDTM on three heterogeneous public sports datasets spanning basketball (NBA game-log corpus 2013–2023), Australian rules football (AFL Player Workload Dataset), and soccer (SoccerMon open monitoring corpus), comprising 612 athletes and 247,830 player-game observations across ten competitive seasons. FDTM achieves AUC-ROC values of 0.858, 0.833, and 0.821 on the three datasets respectively, outperforming the strongest deep-learning baseline (FEDformer) by 2.0 to 3.3 percentage points and the strongest non-spectral baseline (TCN) by 3.2 to 4.5 percentage points while maintaining a Brier score below 0.04. Ablation studies confirm that the spectral branch contributes 5.1 percent to overall discriminative performance. SHAP attribution analyses identify high-frequency weekly components as the dominant injury-relevant signal, followed by low-frequency seasonal trends and the cumulative acute-to-chronic workload temporal feature, with gating-weight visualizations revealing dynamic modality contributions consistent with established sports science theory. Direct spectral analysis of the raw workload signal confirms that injury-preceding windows exhibit significantly elevated weekly-band power across all three datasets (Mann–Whitney U test, p < 1 × 10−7), and the architectural advantage is shown to be robust across 30 independent training seeds. These findings suggest that frequency-aware modeling may serve as a transferable methodology for sports engineering applications in injury prevention, return-to-play planning, and individualized rehabilitation, pending further external validation in female athletes and additional team sports. Full article
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10 pages, 3371 KB  
Proceeding Paper
mHealth-Based Wearable System for Real-Time Monitoring and Prevention of Spinal Postural Disorders
by Catalina Luca, Robert Fuior, Radu-George Ciorap, Doru-Ionut Andritoi, Ovidiu Popa and Calin-Petru Corciova
Eng. Proc. 2026, 148(1), 4; https://doi.org/10.3390/engproc2026148004 - 30 Jun 2026
Viewed by 162
Abstract
Musculoskeletal disorders caused by poor posture are a major global health concern, contributing to spinal deformities and chronic pain. This study presents a mobile health (mHealth) enabled smart orthosis for real-time monitoring and correction of spinal posture. The wearable system integrates inertial measurement [...] Read more.
Musculoskeletal disorders caused by poor posture are a major global health concern, contributing to spinal deformities and chronic pain. This study presents a mobile health (mHealth) enabled smart orthosis for real-time monitoring and correction of spinal posture. The wearable system integrates inertial measurement units along the spine to capture curvature data, processed through computational models to detect postural deviations. A connected mobile application enables real-time feedback, continuous monitoring, and remote assessment. Laboratory validation demonstrated reliable sensor performance. The proposed mHealth solution supports early diagnosis, long-term monitoring, and prevention of posture-related disorders, promoting personalized spine care and patient engagement in daily life. Full article
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