Search Results (10,147)

Fibromyalgia (FM) affects millions of people around the world, causing widespread physical pain, exhaustion, and psychological disorders. Through this study, we aim to observe the effectiveness of two different rehabilitation programs in reducing the impact of FM on daily functioning and psychological factors. Specifically, we compare a complex conservative program that combines physical therapy and hydrokinetotherapy in a hospital setting with a therapy focused on intrinsic relaxation. Methods: This comparative study involved 63 patients aged between 19 and 69 years diagnosed with FM, divided into two groups: the study group (SG, 32 participants) and the control group (CG, 31 participants). Over 90% of participants are female, 30 in the study group and 28 in the control group. SG followed a conservative physiotherapy combined with thermal water therapy, and CG followed a recovery program through intrinsic relaxation. Participants were evaluated on the first and last day of the rehabilitation program using the Revised Fibromyalgia Impact Questionnaire (FIQR) and the Hamilton Anxiety Rating Scale (Ham—A). The rehabilitation program consisted of 10 sessions conducted over a period of two weeks. Results: After the two-week recovery period, the results showed a significant improvement in both FIQR and Ham—A scores in the study group (p < 0.001). In the control group, there were no significant changes in FIQR variables (p > 0.05), while a significant improvement was observed on the anxiety scale (p < 0.001). Conclusions: The combination of hydrokineto-therapy and physical therapy is more effective in improving the overall condition of patients with FM compared to relaxation. Full article

Learning and understanding of art are increasingly understood as dynamic processes in which emotion and cognition unfold over time. However, classroom-based evidence on how structured temporal intervals and guided prompts reshape students’ emotional experience remains limited. This study addresses these gaps by quantitatively examining changes in emotion over time in a higher education institution. Employing a comparative experimental design, third-year undergraduate art students participated in two structured courses, where emotional responses were captured using an emotion recognition approach (facial expression and self-reported text) during two sessions: initial impression and delayed impression (three days later). The findings reveal a high consistency in dominant facial expressions and substantial agreement in self-reported emotions across both settings. However, the delayed impression elicited greater emotional diversity and intensity, reflecting deeper cognitive engagement and emotional processing over time. These results reveal a longitudinal trajectory of emotion influenced by guided reflective re-view over time. Emotional dynamics extend medium theory by embedding temporal and affective dimensions into TBMA course settings. This study proposes an ethically grounded and technically feasible framework for emotion recognition that supports reflective learning rather than mere measurement. Together, these contributions redefine TBMA education as a temporal and emotional ecosystem and provide an empirical foundation for future research on how emotion fosters understanding, interest, and appreciation in higher media art education. Full article

The quality of initial and continuous training for primary-school teachers is essential to fostering science education and building strong scientific foundations. This qualitative case study, conducted over two consecutive school years in Portugal, examines the impact of a continuous professional development program aimed at addressing gaps in primary teachers’ experimental science teaching. The program took place in the municipality of Penafiel and was organized by a university research team in collaboration with local schools. The program combined face-to-face sessions, in-school support from expert monitors, and the provision of teaching resources. Data were drawn from Individual Final Reflective Reports written by 108 teachers, all of whom participated through mandatory enrollment in the local training initiative. The sample was therefore exhaustive, covering the entire population targeted by the municipality. The reports were analyzed using qualitative content analysis, following an inductive coding process supported by peer validation. NVivo (version 14) software was used to assist in the categorization and management of textual data. The analysis revealed that teachers highly valued the training, particularly highlighting the relevance of the content, the effectiveness of the methodologies, and the training’s practical utility in overcoming classroom challenges. The program enhanced teachers’ confidence in implementing experimental activities and improved their teaching practices. The study underscores the importance of continuous professional development in strengthening teacher qualifications and science education. Limitations include reliance on self-reported reflections, the focus on a single municipality, and the absence of triangulation with classroom observations. Nevertheless, the program demonstrates that combining active methodologies, contextualized classroom support, and resource provision is a promising model for teacher professional development. The implications are relevant for policymakers, training centers, and teacher educators designing continuous professional development initiatives. Future research should explore scalability, longitudinal effects, and the comparative effectiveness of different continuous professional development mode. Full article

Background: Accurate assessment of volume status remains a central challenge in hemodialysis (HD). Although bioimpedance spectroscopy (BIS) can quantify fluid compartments, it is time-consuming and requires a lot of personnel. Modern HD machines provide continuous relative blood volume (RBV) monitoring. We examined whether intradialytic RBV dynamics reflect pre-dialysis extracellular fluid (ECW) status to inform personalized fluid management. Methods: In an ancillary, monocentric, prospective study of the SkInDialysis trial (DRKS00036332), 11 maintenance-HD patients underwent three standardized dialysis sessions with simultaneous measurement of RBV and BIS. BIS was performed at five time points per session (pre-HD; 20, 80, and 160 min after the start of HD; and post-HD). Ultrafiltration (UF), RBV, total body water (TBW), ECW, and intracellular water (ICW) were recorded. Results: Mean total UF was 2809 ± 894 mL/session. RBV declined to 94.7 ± 3.1% at 20 min and to 87.6 ± 5.5% by the end of the session. TBW decreased by 2.9 ± 2.7%, driven by ECW reduction (−3.15 ± 2.9%) over ICW (−1.1 ± 1.65%). Cumulative UF correlated with declines in TBW (R² = 0.18; p = 0.02) and ECW (R² = 0.23; p = 0.01) and more modestly with ICW (R² = 0.16; p = 0.04). In contrast, ΔRBV (pre- vs. post-HD) did not correlate with UF, weight loss, or compartmental water changes. Early steady-state RBV at 80 min correlated with pre-HD ECW (R² = 0.19; p = 0.02) and more strongly with the pre-HD ECW/ICW ratio (R² = 0.34; p = 0.001). Conclusions: In this small, repeated-measures cohort, absolute early steady state RBV levels were associated with pre-dialysis ECW and the ECW/ICW ratio, whereas RBV change (ΔRBV) did not track absolute fluid removal. Our data support a time-anchored RBV level as a pragmatic, device-embedded indicator of the pre-dialysis extracellular reservoir. Full article

Background/Objectives: Limited access to mental health services contributes to poorer outcomes among individuals with mental health conditions, including major depressive disorder (MDD). Nurse-led interventions serve as a strategic model of care to improve mental health service delivery and enhance patient outcomes. This project aims to co-design a nurse-led telehealth family psychoeducation (FPE) for MDD and primarily assess its feasibility by evaluating the recruitment and retention rates. Methods: A multi-methods study encompassing a co-design phase (Study Phase 1) and a feasibility study (Study Phase 2). Study Phase 1 will involve semi-structured interviews with individuals with MDD and their families or significant others, as well as surveys and focus groups with mental health professionals to develop telehealth FPE for MDD. Study Phase 2 will evaluate the feasibility and acceptability of the intervention, which comprises three biweekly FPE sessions and a six-week follow-up with patient–family dyads using a single-group pre-post design. The primary outcomes comprise the feasibility and acceptability of intervention. Exploratory secondary outcomes include personal recovery, medication necessity beliefs and concerns, antidepressant adherence, and depression severity, measured at baseline, immediately post-intervention, and at 6-week follow-up using validated measures. Data analysis will primarily involve descriptive statistics and thematic analysis. The TIDieR checklist will be followed in reporting the intervention development. Conclusions: Findings from the proposed study will inform the design and protocol for a future randomised trial of telehealth FPE for improving clinical and non-clinical outcomes in MDD. The feasibility study was prospectively registered with the ClinicalTrial.gov on 8 June 2025 (NCT07014241). Full article

In parallel with technical training on knowledge and skills of task-specific medical or surgical procedures, wide arrays of soft skills training would contribute to obstetric safety in the contemporary healthcare setting. This article, as a service evaluation, explored the effect of a specialty-based Crew Resource Management (CRM) training series that transforms the concept of human factors into sustainable measures in fostering clinical safety culture of the Department of Obstetrics and Gynaecology (O&G) in the Queen Elizabeth Hospital. Within the last decade, a tri-phasic programme has been implemented by an inter-professional workgroup which consists of a consultant anaesthesiologist, medical specialists and departmental operations manager from O&G, a nurse simulation specialist, hospital administrators, and a research psychologist. (1) Phase I identified different patterns of attitudinal changes (in assertiveness, communication, leadership, and situational awareness, also known as “ACLS”) between doctors and nurses and between generic and specialty-based sessions for curriculum planning. (2) Phase II evaluated how these specific behaviours changed over 3 months following CRM training tailored for frontline professionals in O&G. (3) Phase III examined the coping style in conflict management and the level of sustainability in self-efficacy over 3 months following specialty-based CRM training. The findings showed the positive impacts of O&G CRM training on healthcare professionals’ increased attitude and behaviour in “ACLS” by 22.7% at a p < 0.05 level, character strengths in conflict management, and non-inferior or sustained level of self-efficacy under tough conditions in the clinical setting up to 3 months after training. As a way forward, incorporating a scenario-based O&G CRM programme into existing skills-based training is expected to change service framework with an innovative approach. In addition, exploring actual clinical outcomes representing a higher level of organisational impacts can be a strategic direction for further studies on the effect of this practical and educational approach on obstetric safety culture. Full article

According to previous research, young children’s numeracy skills may be scaffolded by practicing on the number line. A number line estimation task (NLET) is often conducted with pen and paper, while linear number games are often implemented on a computer or a tablet. If and how the format—physical or digital—influences the accuracy of the estimations is, however, not well-known. If regarding NLET performance as dependent on specific strategies and hypothesizing that these strategies may be affected by the material used, we may also assume that different materials may either support or hinder children’s learning. In this paper, we explore whether training with a physical versus a virtual NLET game will affect children’s strategies when solving NLETs, and if these strategies relate to the accuracy of the estimations. Sixty-two 6-year-old children played an NLET game (virtual or physical) for three sessions, being scaffolded and guided by a researcher. NLET performance was measured by pre- and post-tests, as well as during the intervention. The results show that even if the condition did not significantly affect the children’s overall numeracy skills, the children in the physical condition did express more advanced strategies during the intervention. These strategies, in turn, predicted NLET performance. Full article

Background: Remote ischemic conditioning (RIC) has shown promise as a neuroprotective strategy, but its application in children with cerebral palsy (CP) remains unexplored. We conducted a randomized controlled trial to evaluate the feasibility, safety, and tolerability of repeated, 6–7 sessions of RIC in children with unilateral CP. Methods: Fifty-one children aged 6–16 years with unilateral CP were randomized (1:1) to receive RIC or sham conditioning on the more affected arm. Primary feasibility outcomes included recruitment metrics, intervention adherence, retention, and protocol fidelity. Safety endpoints included continuous monitoring of oxygen saturation, blood pressure, heart rate, and adverse event incidence. Tolerability was assessed via child-reported pain ratings, conditioning pressure tolerance, skin integrity evaluations, and session adherence. Results: Of 148 children screened, 51 were randomized to RIC (n = 25), sham (n = 26) groups; 48 (94.1%) completed the intervention as allocated. Recruitment yielded 2.04 participants/month. Intervention adherence was 100% in both groups. RIC was well tolerated, with mean pain scores 2.8 ± 3.1 during inflation in RIC and 0.3 ± 0.8 in Sham group. No serious adverse events occurred. Physiological parameters remained stable across 314 conditioning sessions; no clinically significant hypoxemia, blood pressure derangements, or arrhythmias were detected. Minor adverse events (transient erythema, mild discomfort) were rare (2.22%) and self-limiting. Skin integrity was preserved, and no participants required session termination. Conclusions: Repeated RIC is feasible, safe, and tolerable in children with unilateral CP. These findings support the design of future trials using RIC as a priming agent to enhance pediatric neurorehabilitation outcomes. Full article

Background: Preliminary evidence supports high-intensity functional training (HIFT) for improving various health outcomes in non-disabled adults with overweight/obesity. It remains unknown whether HIFT produces similar benefits in individuals who are overweight/obese and also have a mobility disability (e.g., spinal cord injury, multiple sclerosis)—a population disproportionately affected by obesity-related health conditions and systemic barriers to exercise. This pilot study aimed to evaluate the feasibility and preliminary effects of a 24-week HIFT intervention, delivered at community sites by certified trainers, for adults with mobility disabilities (MDs) who were overweight/obese. Methods: Twenty adults with MD and overweight/obesity (self-reported BMI 25–46 kg/m²) enrolled in a 24-week HIFT intervention (3 days/wk, 60 min sessions) delivered at four community-based facilities by certified trainers. Feasibility indicators included recruitment, retention, and attendance; adverse events were tracked. Effect sizes (Cohen’s d) were calculated for changes in obesity-related measures, physical function, work capacity, and psychological measures from baseline to post-intervention. Results: Feasibility targets were met, with a recruitment rate of 72.2%, 76.9% retention, and 80.7% attendance. Thirteen adverse events occurred. Effects on obesity-related measures ranged from negligible to moderate, with stable weight/BMI, reduced waist circumference (45% ≥ 3 cm decrease), decreased body fat, and increased lean mass. Functional outcome effects ranged from small to large and included grip strength, balance, and walking speed. Large improvements were observed for the endurance, speed, work capacity, and self-reported physical function. Conclusions: A community-based HIFT program is feasible and may improve health outcomes in adults with MD and overweight/obesity. Full article

The aim of this study was to analyze the effects of a 24-week low-load, low-volume resistance training (RT) program combined with plyometric exercises on the physical performance of U-15 male soccer players. Thirty-two young soccer players were divided into a strength training group (STG) and a control group (CG). The STG added two RT sessions per week—using moderate loads (45–60% 1RM) and a low number of repetitions per set—combined with plyometrics to their regular soccer training, while the CG continued with only the field soccer training. Performance assessments (a running sprint test, a countermovement jump, and a progressive loading test in a full squat exercise) were conducted before and after each of three 8-week periods. Significant ‘time × group’ interaction in favor of STG was observed for T20 (p < 0.05), CMJ (p < 0.001), and all variables (p < 0.001) assessed during the full squat exercise. Significant changes between groups were observed in T10 (Post 1 and Post 3, p < 0.05), CMJ (Post 1, Post 2, and Post 3, p < 0.05–0.001), and all strength variables (Post 1, Post 2, and Post 3, p < 0.05–0.001). The findings of this study suggest that a training program based on weightlifting with light loads for a few repetitions per set combined with jumps and sprint exercises, in addition to regular soccer training, induces greater and earlier improvements in strength and sport-related actions (jumping and sprinting), compared with only field soccer training. Coaches and strength-conditioning coaches should consider using RT with low loads and low volume and performing each repetition as fast as possible as an effective stimulus to improve physical performance in key match-determining actions efficiently. Full article

Background/Objectives: Impaired balance and general mobility are common complications of Parkinson‘s disease (PD) and are largely caused by bradykinesia and hypokinesia. Although previous studies have shown that patients can increase the speed and amplitude of movement with training, apathy, which is also common among people with PD, reduces this prospect. Training with light pods was originally developed for athletes to enhance agility in a way that is motivating. However, this type of training could be ideal for individuals with PD and possibly reduce bradykinesia and its effects. This study used a longitudinal interventional design without a control group to explore the effects of a four-week agility training with light equipment on balance and general mobility in patients with PD, as well as to assess motivational properties. Methods: Seven individuals with PD of the motor subtype “akinetic–rigid” participated in this study. Each participant received training three times per week for four weeks. The training session consisted of five rounds; in each round, participants had to turn off 20 lights. Measurements were performed one and a half weeks before training, at the beginning of the program, and at the end of the program. Balance was assessed with Mini-BESTest, general mobility with Timed Up and Go (TUG), transfer skills with 5× Sit to Stand, walking speed with the 10 m walking test, and the ability to turn on a spot with the 360° Turn Test. Motivational aspects of training were assessed after each training session, with scoring on a scale of 0–10. Results: The training significantly improved overall balance (p < 0.001), especially reactive postural control, sensory orientation, and dynamic gait, while anticipatory balance remained unchanged. Turning ability improved, but mobility, transfer ability, and walking speed did not. Motivation remained consistently high across participants. Conclusions: A four-week light-based agility training program can improve balance and turning ability in people with PD and appears to be motivating. However, no clear effects were found for general mobility, transfer skills, or walking speed. Given the small sample size and absence of a control group, these findings should be interpreted with caution. Full article

While existing research highlights a positive association between computational thinking (CT) and self-regulation (SR) skills, limited attention has been given to the embodied and social processes within CT activities that support young children’s executive functions (EFs)—key components of SR. This study investigates how preschoolers develop basic and higher-order EFs, such as focused attention, inhibitory control, causal reasoning, and problem-solving, through their engagement with a tangible programming toy in teacher-guided small groups in a university-affiliated preschool. Informed by a we-syntonicity framework that integrates Papert’s concepts of body/ego syntonicity and Schutz’s “we-relationship”, we conducted a multimodal microanalysis of video-recorded group sessions. Our analysis focuses on two sessions, the “Obstacle Challenge” and “Conditionals”, featuring four excerpts. Findings reveal that children leverage bodily knowledge and empathy toward the toy—named Rapunzel—to sustain attention, manage impulses, reason about cause-effect, and collaborate on problem-solving. Three agents shape these processes: the toy, fostering collective engagement; the teacher, scaffolding learning and emotional regulation; and the children, coordinating actions and sharing affective responses. These findings challenge traditional views of SR as an individual cognitive activity, framing it instead as an embodied, social, and situated practice. This study underscores the importance of collaborative CT activities in fostering SR during early childhood. Full article

Objectives: To compare the acute effects of upper cervical manipulation (CM) and manual massage (MM) to simulated CM (Sham) and Control conditions (Control) on heart rate variability (HRV) and blood pressure (BP) responses in women with non-elevated BP. Methods: A single-blind, four-arm, parallel-group, randomized, crossover, placebo-controlled trial recruited 15 apparently healthy women with non-elevated BP who visited the lab on four occasions with 48 h intervals to ensure adequate washout between interventions. A Latin square randomization approach was employed to assign participants to one of four experimental conditions: (1) Control: Rest without intervention; (2) CM: Bilateral high-velocity, low-amplitude manipulation of the upper cervical spine (C0–C2); (3) MM: A single 120 s session of MM release applied unilaterally to the anterior and posterior thigh, posterior lower leg, and lumbar musculature; or (4) Sham: Mimicking the positioning used in CM without the application of thrust manipulation. In each experiment, HRV, systolic and diastolic BP were measured at rest (Baseline) and every 15 min for 60 min after each intervention. All procedures were performed in the morning to avoid any confounding circadian rhythm effect on HRV and BP. Results: We found significant increases within conditions for RMSSDms (Control: Post-0 (p = 0.032), Post-15 (p = 0.023); Sham: Post-15 (p = 0.014); CM: Post-15 (p = 0.027)); SDNNms (Control: Post-45 (p = 0.037); CM: Post-45 (p = 0.014) and Post-60 (p = 0.019)); PNN50% (CM: Post-0 (p = 0.044), Post-15 (p = 0.044) and Post-45 (p = 0.019)); LF Power (ms2) (CM: Post-60 (p = 0.001)), and LF/HF ratio (MM: Post-60 (p = 0.022). Conclusions: Although no statistically significant between-condition differences were detected, within-condition changes with moderate-to-large effect sizes suggest potential clinical relevance of CM and MM. These preliminary findings emphasize the importance of effect sizes and may indicate greater translational significance in populations with non-elevated cardiovascular risk. Full article

Dynamic mobilization exercises (DME) are an effective strategy to prevent musculoskeletal injuries and promote back health in sport horses. Previous studies focused mainly on multifidus muscle cross-sectional area, with limited data on locomotion and adaptation timing. This study evaluated locomotor changes using accelerometry, over 8 weeks of DME application in 14 sedentary horses: a DME group (n = 8) performing 10 different DME (3 neck flexions, 1 neck extension and 3 lateral bending exercises to each side), 5 repetitions of each DME per session, 3 sessions/week, and a control group (n = 6), that continued with their daily routine activities without any other training. During the study period, all horses were housed in medium-sized paddocks. Accelerometric measurements were performed at walk and trot before intervention, 2 h and 24 h after a DME session, and at 2, 4, 6, and 8 weeks. The DME group showed significant increases in dorsoventral displacement and dorsoventral and mediolateral activities from week 4, at both walk and trot, which then stabilized. Longitudinal activity increased from week 2 on trot and from week 4 at walk. Locomotor symmetry and stride length improved at week 6, while stride frequency decreased at week 8; velocity remained unchanged. These findings indicate that DME enhances dorsoventral, mediolateral and longitudinal activities, producing longer, more symmetrical strides. Overall, DME appears to promote more symmetrical movement patterns. Full article

Background: Optimizing training load and recovery is crucial for achieving peak performance in competitive wrestling, a sport characterized by high physical, technical, and psychological demands. Methods: This study compared the effects of two different training programs—one emphasizing high-intensity interval training (HIIT) sessions and the other based on traditional volume-oriented training—on both competitive performance and autonomic regulation measured by heart rate variability (HRV). A total of 24 elite wrestlers were divided into two equal groups, each following a different weekly training regimen over a 3-month period. HRV was recorded using a wearable 3-channel ECG Holter before training, immediately after training, and during recovery phases (up to 2 h post-exercise). HRV parameters were analyzed to assess training-induced stress and recovery status. Competitive performance was evaluated using official national championship scores and ranking positions. Results: Both training programs improved competitive performance, the HIIT-based regimen induced greater short-term suppression of parasympathetic activity (RMSSD: −32% vs. −14%; HF power: −40% vs. −18%) and increased sympathetic dominance (LF/HF: +56% vs. +22%) after training. Wrestlers in the HIIT group achieved a mean competition score of 17.92 ± 4.50 points, compared to 15.08 ± 6.26 points in the volume-oriented group. These acute autonomic shifts may provide a higher readiness for intense and explosive actions, which is advantageous in short and dynamic matches. In contrast, the volume-oriented program induced smaller acute autonomic changes but showed a slower recovery to baseline. Conclusions: These findings suggest that HRV-derived measures can serve as sensitive indicators of training load tolerance, recovery capacity, and stress susceptibility in combat sports athletes. This study highlights the value of integrating HRV monitoring into the periodization of combat training to individualize the load, prevent overtraining, and optimize performance outcomes. Full article