Search Results (574)

Beyond the well-established roles of serotonin and calcitonin gene-related peptide (CGRP), the contribution of dopamine (DA) to migraine pathophysiology remains a subject of intense investigation. DA acts as a neuromodulator, functioning both as a homeostatic pain filter and a driver of premonitory and autonomic symptoms. This review provides a comprehensive synthesis of DA’s involvement in migraine, proposing an integrated model that spans from molecular signaling to a systemic phenotype. A comprehensive search of the PubMed database (1976–2026) was performed. The analysis evaluates data across receptor signaling, hypothalamic connectivity (specifically the A11 nucleus), genetic susceptibility markers and advanced neuroimaging studies. Current evidence identifies dopamine as a gatekeeper of the trigeminovascular threshold, with the hypothalamic A11 nucleus serving as a modulatory hub. Within this circuit, DA exerts concentration-dependent effects: high-affinity D2 receptor activation promotes antinociception, whereas low-affinity D1-like receptors facilitate nociceptive signaling. Clinically, this manifests as a “dopaminergic phenotype” characterized by yawning, nausea, and reward-system dysfunction. This phenotype extends beyond migraine, showing links to comorbidities such as restless legs syndrome (RLS) and attention-deficit/hyperactivity disorder (ADHD). DA’s role in migraine is state-dependent and interconnected with CGRP and serotonergic pathways. Recognizing the dopaminergic phenotype is essential for capturing the clinical heterogeneity of the disorder and may pave the way for personalized, mechanism-based therapeutic strategies. Full article

Background/Objectives: Sleep disturbances are common but frequently underrecognized in multiple sclerosis (MS), independently predicting reduced quality of life and worsening fatigue, cognitive impairment, and depression. While pain, nocturia, fatigue, and mood symptoms are established contributors, cardiometabolic, and inflammatory factors remain largely unexplored despite their known links to poor sleep in other populations. This study used interpretable machine learning to determine the relative contribution of disease-related, cardiometabolic, and inflammatory parameters to sleep quality, assessed by the PSQI, in patients with MS. Methods: This cross-sectional, observational, single-center cohort study enrolled adult patients with MS. Sleep quality (PSQI), daytime sleepiness (ESS), and restless legs syndrome severity (IRLS) were assessed alongside clinical, anthropometric, hemodynamic, and laboratory parameters, including inflammatory and metabolic indices. Three regression models, Support Vector Regression (SVR), Random Forest, and XGBoost, were trained on 28 predictors to predict PSQI global scores and evaluated on an internal test set, with feature contributions examined using SHAP analysis. Results: A total of 173 patients with MS were included (mean age 39.66 ± 11.86 years, 69.9% female, 90.2% RRMS), with 48.0% classified as poor sleepers (PSQI > 5) and a mean PSQI score of 6.06 ± 3.47. XGBoost achieved the best predictive performance (test R² = 0.451). SHAP analysis identified IRLS severity as the strongest predictor of PSQI across all three models, followed by EDSS score and depression in the Random Forest and XGBoost models, while daytime sleepiness (ESS) ranked consistently among the top predictors. Cardiometabolic and inflammatory parameters contributed inconsistently, with several showing effects opposite to physiological expectation. Conclusions: Sleep impairment in MS was most strongly associated with restless legs syndrome severity and neurological disability, with depression also contributing in the two best-performing models. Disease-related and symptomatic factors outweighed cardiometabolic and inflammatory contributions. These findings support the value of interpretable machine learning for identifying clinically relevant correlates of sleep quality in MS, though the exploratory design and modest sample size warrant confirmation in larger, independent cohorts. Full article

Background and Objectives: Musculoskeletal pain (MSP) is highly prevalent among undergraduate students and may originate during early adulthood, increasing the risk of chronicity later in life. Modifiable factors such as reduced muscle flexibility and prolonged sedentary behavior have been proposed as contributors; however, longitudinal evidence among student populations remains scarce. This study aimed to prospectively examine changes in MSP prevalence and hip muscle length over one year and to identify independent predictors of MSP. Materials and Methods: A prospective longitudinal study was conducted among 62 first-year undergraduate students assessed at baseline and at one-year follow-up. MSP was evaluated using a modified Standardized Nordic Questionnaire, and demographic data including physical activity and sitting behavior were recorded. Hamstring and iliopsoas muscle length were measured by passive straight-leg raise and modified Thomas tests, respectively. Changes over time were analyzed using paired t-tests and McNemar tests. Multivariable logistic regression was also performed to identify predictors of MSP at follow-up. Results: Most participants were female (79%, n = 49), with a mean age of 25.8 ± 6.0 years and body mass index of 23.6 ± 4.4 kg/m². Significant reductions in hamstring (p < 0.001; d = −0.55 to −0.70) and iliopsoas muscle length (p < 0.001; d = −1.32 to −1.46) were observed over one year. Health science students manifested a significant decrease in hamstring length over time compared to their counterparts in other programs (p ≤ 0.002). MSP prevalence increased across all body regions, particularly in the low back (46.8% to 71.0%) and cervical spine (46.8% to 61.3%). Baseline MSP was the only independent predictor of MSP at follow-up (upper quadrant: OR = 12.89, 95% CI: 2.38–69.65, p = 0.003; lower quadrant: OR = 6.35, 95% CI: 1.39–28.90, p = 0.018). Conclusions: A significant increase in the prevalence of MSP was observed alongside a reduction in hip muscle length among undergraduate students over a one-year period. The findings suggest that students enrolled in health science programs are more susceptible to musculoskeletal alterations, whereas baseline MSP is a strong predictor of future symptoms. Full article

Background and Objectives: Children with mild intellectual disability (MID) frequently experience difficulties during dental treatment due to increased sensitivity to environmental stimuli and limited cooperation. Sensory-adapted dental environments (SADE) have been proposed as a strategy to improve the dental experience of patients with neurodevelopmental conditions; however, evidence regarding their effectiveness in children with MID remains limited. This randomized clinical trial aimed to evaluate the effects of a sensory-adapted dental environment on pain-related behaviors and treatment cooperation during professional oral hygiene procedures in children with MID and moderate dental anxiety. Materials and Methods: A randomized clinical trial was conducted at the IRCCS Oasi Research Institute (Troina, Italy). A total of 200 children were screened for eligibility. Following the application of the predefined inclusion and exclusion criteria, 160 children (76 males and 84 females; age range: 6–7 years) with a diagnosis of mild intellectual disability (MID) and moderate dental anxiety, assessed using the Corah Dental Anxiety Scale (DAS), were enrolled. Participants were randomly assigned to either a sensory-adapted dental environment (SADE; n = 80) or a regular dental environment (RDE; n = 80). All participants underwent a single session of professional oral hygiene using an ultrasonic scaler. Pain-related behaviors were assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) Scale, whereas cooperation during treatment was evaluated using the Frankl Behavior Rating Scale. Owing to the non-normal distribution of the outcome variables, between-group comparisons were performed using the Mann–Whitney U test. Statistical significance was set at p < 0.05. Results: Participants treated in the SADE showed significantly lower FLACC scores compared with those treated in the RDE (3.10 ± 1.86 vs. 5.05 ± 2.36, p < 0.001), indicating reduced pain-related behaviors during treatment. Moreover, children in the SADE group demonstrated significantly higher Frankl scores than those in the RDE group (2.78 ± 0.48 vs. 2.41 ± 0.84, p = 0.006), reflecting improved cooperation. Sex-stratified analyses confirmed significantly lower FLACC scores in both males and females treated in the SADE. No significant Group × Sex interaction was observed for either outcome, suggesting that the beneficial effects of sensory adaptation were independent of sex. Conclusions: SADE significantly reduced pain-related behaviors and improved cooperation during professional oral hygiene procedures in children with mild intellectual disability and moderate dental anxiety. These findings support the implementation of sensory-adapted strategies in pediatric dental settings to improve treatment experiences and facilitate dental care for children with neurodevelopmental disorders. Full article

Background/Objectives: SPINEHealthie is a smartphone-based application enabling remote patient monitoring, care delivery and standardized collection of patient-reported outcome measures (PROMs). This registry-based analysis evaluates patient satisfaction with the platform across a large, heterogeneous spine surgery cohort. Methods: A total of 1729 thoracolumbar spine surgery cases were eligible for analysis. Among these, 881 (50.9%) completed the in-app feedback survey and constituted the primary feedback cohort. The global app experience was categorized as “Very Good” or “Poor”. Clinical outcomes, i.e., the Visual Analogue Scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI) were assessed at baseline and in the postoperative period; Δ denotes the change from baseline to two weeks postoperation. Results: Among feedback responders, 800 patients (90.8%) rated their app experience as “Very Good”, while 80.8% of 639 patients with surgical outcome data reported that the surgery met their expectations. However, app experience and surgical outcome expectations were assessed using different items at different postoperative time points. Among patients whose surgery did not meet expectations, 84.6% rated their app experience as “Very Good”. Patients with a “Very Good” app-experience rating demonstrated significantly greater improvement in back pain (ΔVAS Back pain 2.94 vs. 2.13, p = 0.027), leg pain (ΔVAS Leg pain 3.16 vs. 2.14, p = 0.019) and disability (ΔODI 11.00 vs. 2.41, p < 0.001). In the primary model, older age, shorter follow-up duration and smaller ODI improvement were associated with an unfavorable app experience; only the association with age remained consistent across sensitivity analyses. Conclusions: Among feedback responders, SPINEHealthie was associated with a high proportion of favorable global app-experience ratings. Favorable app-experience ratings remained high, even among patients with unmet surgical expectations or failure to achieve the exploratory two-week ODI-improvement threshold, suggesting that perceived platform value is not solely explained by surgical outcome. Older patients and those with limited functional recovery were identified as subgroups that may benefit from targeted onboarding and engagement strategies. Full article

Objectives: Retrospective comparative cohort study. This study aimed to compare the clinical and radiological outcomes of rigid, dynamic, and hybrid stabilization systems in the surgical management of degenerative lumbar spine disease, with a focus on adjacent segment disease (ASD), fusion-related complications, and postoperative recovery. Rigid fusion techniques provide immediate stability but may increase mechanical stress at adjacent segments, leading to ASD. Dynamic and hybrid constructs aim to preserve more physiological motion, potentially reducing fusion-related complications. Methods: A retrospective analysis was conducted on 86 patients who underwent posterior lumbar stabilization between January 2017 and December 2021. Patients were categorized into four groups based on the surgical technique: Rigid (titanium rod), Dynamic (PEEK rod), Rigid + TLIF (Transforaminal Lumbar Interbody Fusion), and Hybrid (Dynamic + TLIF). Clinical evaluation included the Visual Analog Scale (VAS) for back and leg pain. Radiological assessments comprised segmental and total range of motion (ROM), disc and foraminal height, fusion success, pseudoarthrosis, and the presence of ASD. Results: All surgical approaches resulted in significant postoperative improvement in back and leg pain (p < 0.001). The incidence of ASD was highest in the Rigid + TLIF group (45.5%, p < 0.001) and lowest in the Dynamic (4.8%) and Hybrid (4.2%) groups. Pseudoarthrosis was most frequently observed in the Rigid group (26.3%). The Hybrid group demonstrated favorable outcomes, with a high anterior fusion rate (91.7%) and low rates of ASD and pseudoarthrosis. Conclusions: All stabilization techniques were associated with significant postoperative clinical improvement. In this retrospective cohort, dynamic and hybrid constructs showed lower observed rates of early symptomatic ASD than the Rigid + TLIF construct, while TLIF-treated groups showed higher anterior fusion rates. Because treatment allocation was nonrandomized and adjustment for all potential confounders was not possible, these findings demonstrate associations rather than causal treatment effects. Larger prospective studies with longer follow-up are required to determine whether the stabilization strategy independently influences ASD, fusion, or pseudoarthrosis. Full article

Background/Objectives: The aim of this study was to review the clinical course of schwannoma in 176 patients and elucidate the clinical outcome in a patient who received surgical treatment and one who did not. Methods: Between August 2006 and December 2021, 176 patients with solitary and sporadic schwannomas were enrolled in our institution. There were 94 men and 82 women, with a mean age of 57 years. During follow-up, 76 patients received surgical treatment, and the remaining 100 did not. Results: The mean tumor size at initial presentation was 30 mm. The major tumor locations were the thigh, lower leg, upper arm, and forearm. The major nerves affected by the schwannoma were the intramuscular branch, sciatic nerve, and ulnar nerve. At least one symptom in addition to a palpable mass was observed in 133 patients (76%). The variables that indicated surgical treatment were tumor size at initial presentation, age, and any other existing symptoms. After surgery, pain-related symptoms including pain, irradiated pain and tenderness were resolved completely in 42 of 44 patients (95%) who had displayed them preoperatively. Neurological deficit was observed in 26 patients (34%). Among the 26 patients with neurological deficit, neurological sensory deficit was observed in 23 patients, and the remaining three had sensory and motor deficits. Multivariate analysis showed that patients with major nerve schwannoma, those with paresthesia preoperatively, and those who developed preoperative symptoms and had undergone surgery had a higher risk of the development of postoperative neurological deficit. Conclusions: Our findings should be considered while planning surgery and obtaining informed consent. Full article

Background: Lumbar foraminal canal stenosis (LFS) is typically multifactorial: disk height loss and bulging, facet hypertrophy/osteophytes, ligamentous thickening, and post-inflammatory or post-interventional scarring. Methods: To develop and implement a structured system for surgical care in chronic vertebrogenic pain with radicular features attributable to LFS, integrating population-based MRI morphometrics and interventional therapy response profiling, we conducted a single-center, multi-cohort observational study to develop, operationalize, and internally evaluate a quantitative, volume-integrated diagnostic and treatment stratification framework for LFS. Results: A retrospective evaluation of 351 surgically treated patients (2017–2023) was performed to identify structural and clinical drivers of persistent or recurrent pain. Following selective blockades and radiofrequency denervation, radiculopathy regressed in 44.7% of patients, facet-mediated pain improved in 44.0%, and the median pain relief duration was 3–6 months. Oswestry Disability Index (ODI) dynamics after interventional therapy showed significant improvement at 6 months (all p < 0.001). Both groups demonstrated significant improvement in VAS, ODI, and SF-36 scores over time. Endoscopic decompression achieved faster early leg pain relief (VAS leg, p < 0.001 at 6 and 12 months). ALIF resulted in superior long-term back pain control (VAS back, p < 0.001 at 12 and 24 months). At 24 months, pain levels were clinically equivalent between groups, indicating that procedure selection influences pain profile rather than absolute outcome. Conclusions: By integrating quantitative foraminal volume, nerve occupancy, and segmental stability, we demonstrated that treatment success in LFS is not determined by the magnitude of decompression alone, but by the precision of phenotypic matching. Indirect decompression, endoscopic foraminotomy, microsurgical decompression, and fusion-based stabilization each have a rational role when aligned with the biomechanical context rather than applied reflexively. Full article

Background: Pain is among the most problematic aspects of chronic wounds. It adversely affects not only physical function but also social and psychological aspects of life. In concert, these effects can seriously impinge on quality of life. Despite affecting up to 80% of patients with leg ulcers, pain is reported to be under-treated. Methods: A secondary, within-subject controlled study design comparing wound pain intensity using a visual analogue scale of venous leg ulcer patients over 4 weeks receiving different interventions. In total, 29 patients received multi-layer compression over 4 weeks, followed by neuromuscular stimulation (NMES) of the leg muscle pump in addition to compression for a further 4 weeks. Paired comparison was then made of the pain gradient (rate of change in pain) between the two phases. A second cohort of 22 patients received only multi-layer compression throughout both 4-week phases. The trial was reported following the CONSORT guidelines. Results: Introduction of NMES at week 4 was accompanied by a significant increase in the rate of pain reduction over the following 4 weeks. Patients receiving standard care for the second 4-week phase experienced no change in the pain trajectory. Conclusions: 1 Hz NMES of the common peroneal nerve to activate the leg muscle pump is accompanied by an improved pain trajectory in patients with chronic venous leg ulcers. This mirrors the improvement in the rate of reduction in wound size previously reported in the same cohort. Pain is a common feature of chronic wounds and mitigation of pain is likely to have a profound impact on the quality of life of individuals with chronic venous leg ulcers. Full article

Background: Muscle cramps are sudden, painful, and recurrent contractions that may interfere with physical activity and daily life. Although stretching is commonly used to relieve cramps, the effectiveness of neuromuscular electrical stimulation (NMES) has not been fully established. Objective: This study aimed to investigate the effects of NMES on cramp threshold frequency (CTF) and pain intensity in individuals with a history of nocturnal leg cramps without identifiable underlying disorders. Methods: Twenty healthy adults with a history of leg cramps were randomly assigned to either an experimental group (n = 10) or a control group (n = 10). The experimental group received electrical stimulation to both calves using an NMES device, whereas the control group performed lower-extremity static stretching exercises. Both groups participated in an intervention program conducted three times per week for 20 min per session over 4 weeks. CTF was measured using surface electromyography, and muscle cramps were induced using an electrical stimulation device starting at 4 Hz, with the frequency increased by 2 Hz after each stimulation set until cramp onset. Pain intensity was assessed using the Visual Analog Scale (VAS). Within-group and between-group comparisons before and after the intervention were analyzed using paired-samples t-tests and independent-samples t-tests, respectively, with the level of statistical significance set at p < 0.05. Results: Both groups showed significant improvements in CTF and pain intensity after the intervention. However, the NMES group demonstrated significantly greater improvement than the stretching group. The increase in CTF was significantly greater in the experimental group than in the control group (9.20 ± 6.75 vs. 1.80 ± 1.75; t = 3.357, p = 0.007). Likewise, the reduction in VAS score was significantly greater in the experimental group than in the control group (−5.20 ± 0.92 vs. −1.60 ± 0.84; t = 9.128, p < 0.001). Conclusions: NMES may be an effective intervention for increasing cramp threshold frequency and reducing pain in individuals with leg cramps, with greater benefits than lower extremity stretching. Full article

Background/Objectives: The Mini-Mental State Examination (MMSE) often shows ceiling effects in community-dwelling older adults, limiting the detection of subtle functional vulnerability. We examined whether an age-adjusted score derived from the Color Kanji Pick-Out Test (CKPT) app could identify functional heterogeneity among older adults with near-ceiling MMSE scores. Methods: In this cross-sectional study, 155 community-dwelling older adults aged ≥65 years underwent CKPT app assessment. An age-adjusted score (ΔINDEX1) was calculated as the residual from a linear regression of INDEX1 on age, and participants were classified into two groups using a median split. Group differences in cognitive, physical, psychological, and lifestyle variables were examined across 70 indicators retained after consolidation (Spearman’s |r| ≥ 0.75). Effect sizes (rank-biserial r and Cramer’s V) were reported, and false discovery rate (FDR) correction was applied (Benjamini–Hochberg). Results: MMSE scores were uniformly high in both the ΔINDEX1 groups (median 29–30, p = 0.138). Of the 70 indicators, 10 reached uncorrected significance (p < 0.05). After FDR correction, both Timed Up and Go (TUG) time (p < 0.001, r = 0.33, q = 0.029) and maximum walking speed (p = 0.001, r = 0.30, q = 0.044) remained statistically significant. Other uncorrected associations (single-leg stance, step length, usual walking speed, sarcopenia, bodily pain, and BMI) did not survive FDR correction and should be regarded as exploratory. Conclusions: Age-adjusted CKPT app profiling was associated with mobility-related differences in TUG and maximum walking speed, both significant after FDR correction, despite uniformly high MMSE scores. Psychosocial and lifestyle associations were preliminary and require confirmation in future studies. Because ΔINDEX1 was both derived and tested within the same predominantly female sample (86.5% women), these cross-sectional findings require external validation before generalization, particularly in older men. Full article

Background: Radiculopathy originating from a previously fused lumbar segment is a clinically relevant but often underrecognized problem. Progressive foraminal stenosis may develop due to postoperative structural changes, leading to mechanical irritation of the exiting nerve root. Transforaminal endoscopic lumbar foraminotomy (TELF) is a minimally invasive option, but its role in this setting is not well defined. Methods: In this retrospective cohort study, we included 36 consecutive patients who underwent TELF for symptomatic foraminal stenosis at a previously fused segment between 2020 and 2023. Clinical outcomes were assessed using the visual analog scale (VAS) for leg pain, Oswestry Disability Index (ODI), and modified MacNab criteria, with follow-up of up to 2 years. Radiographic and intraoperative findings were reviewed to explore the underlying mechanisms. Results: The mean VAS score improved significantly from 8.36 preoperatively to 2.00 at 2 years, and the mean ODI decreased from 70.9% to 16.8%. According to the modified MacNab criteria, 86.1% of the patients achieved excellent or good outcomes. Intraoperative findings revealed fibrotic or hypertrophic foraminal stenosis in 86.1% patients (n = 31), whereas 13.9% of patients (n = 5) showed pedicle screw-related nerve root irritation. Five patients experienced transient postoperative dysesthesia, and no postoperative instability was observed. Conclusions: Radiculopathy at the fused segment is primarily caused by progressive mechanical foraminal compromise after fusion. TELF provides effective symptom relief through direct decompression and may serve as a less invasive alternative to revision fusion in selected patients. Full article

Background/Objectives: To determine whether ESS provides superior clinical, radiologic, or perioperative outcomes compared with non-ESS surgical strategies in lumbar spondylolisthesis. Methods: We conducted a PRISMA-guided systematic review and meta-analysis comparing ESS with non-ESS strategies specifically for lumbar spondylolisthesis. PubMed, Web of Science, Scopus, and CENTRAL were searched from inception to December 2025, plus reference-list screening. Primary outcomes were mean change in VAS back pain, VAS leg pain, and Oswestry Disability Index (ODI); secondary outcomes included radiologic measures (disc height, lumbar lordosis angle, fusion rate) and perioperative outcomes (blood loss, operative time, length of stay, complications). Results: Eighteen studies (16 retrospective cohorts, 1 RCT, 1 case–control) involving 1200 patients with lumbar spondylolisthesis (2019–2025) were included. ESS showed no significant differences versus non-ESS in mean change in VAS back pain (13 studies; MD −0.07), VAS leg pain (14 studies; MD 0.08), or ODI (12 studies; MD 0.51). No statistically significant differences were detected in radiological outcomes (disc height, lumbar lordosis angle, and fusion rate). ESS was associated with reduced blood loss (MD −132.98) and shorter hospital stay (MD −2.86 days), with no difference in operative time (MD 3.96) or postoperative complications (RR 0.86). Subgroup analyses compared endoscopic fusion with MIS fusion, open fusion, and non-endoscopic decompression. Endoscopic versus MIS fusion showed lower blood loss (MD: −50.9 mL) and shorter hospital stay (MD: −1.4 days) but longer operative time (MD: +17.2 min), with no differences in clinical outcomes. Comparisons involving decompression and open fusion were limited by the small number of studies and should be considered exploratory. Conclusions: For lumbar spondylolisthesis, no statistically significant differences were detected between ESS and non-endoscopic approaches in pain, disability, radiologic outcomes, or complication rates, with potential perioperative advantages in blood loss and length of stay. However, these findings should be interpreted cautiously because the available evidence is predominantly retrospective, procedurally heterogeneous, and affected by substantial variation in follow-up duration. Full article

Background/Objectives: Hip arthroscopy is a minimally invasive procedure with rare complications that can occur due to air entry outside the joint space. Case Presentation: A 19-year-old patient underwent right hip arthroscopy with attempted joint venting. The next morning, she had pain in her right leg, neck, and chest with paresthesias over her hands and feet. A subsequent emergency department physical exam revealed crepitation of the lower extremities, abdomen, chest, and neck caused by air entrance during arthroscopy. The patient also reported blurred near vision. Additionally, the pupils were fixed, did not accommodate, and were dilated at 7 mm. Computed tomography scans revealed subcutaneous emphysema, pneumoperitoneum, pneumomediastinum, and cervicofacial emphysema. Magnetic resonance imaging of the brain revealed a Chiari I malformation. The patient received four hyperbaric oxygen treatments. By the fourth treatment, near visual acuity had improved, but far visual acuity had worsened. Vision had returned to normal eight days after discharge. Conclusions: It is proposed that the patient’s reduced near vision, accommodation paralysis, and fixed and dilated pupils were brought about by pneumomediastinum and cervicofacial emphysema, inhibiting the ability of the pupils to constrict, causing bilateral mydriasis and accommodation paralysis for near targets. Additionally, the subsequent transient myopic shift is a known complication of hyperbaric oxygen therapy, which increases the refractive index of the crystalline lens. Full article

Background: Although early mobilization has been shown to improve clinical outcomes after intensive care unit (ICU)-acquired weakness, its implementation remains limited in routine clinical practice. This study aimed to evaluate the feasibility, safety, and preliminary clinical outcomes of a mobile application-based rehabilitation program in non-ambulatory patients during the early ward phase following ICU discharge. Methods: This prospective single-arm pilot trial included adult patients (≥19 years) who had received ICU care and demonstrated limited ambulatory function, defined as Functional Ambulatory Category (FAC) ≤3. Participants received an individualized, application-guided exercise program comprising two daily sessions over two weeks. Primary outcomes were programmatic feasibility, safety, and patient satisfaction. Rehabilitation compliance was quantified using application usage logs and categorized as high (≥50%) or low (<50%). Secondary functional outcomes, such as Medical Research Council Sum Score (MRC-SS), ICU Mobility Scale, FAC, muscle strength measures, health-related quality of life, and pain scores, were assessed at baseline, week 1, and week 2. Results: Of the 25 initially enrolled patients, 5 dropped out due to clinical status changes or transfers, yielding a retention rate of 80.0%. For the 20 analyzed patients (mean age 52.7 ± 13.9 years; 45% male), the overall mean rehabilitation compliance was 40.6%. No serious adverse events related to the intervention were reported, and overall patient satisfaction and application usability were high. Progressive increases in exercise intensity and training levels were observed throughout the intervention period. Significant improvements over time were found in MRC-SS, ICU Mobility Scale, FAC, grip strength, health-related quality of life, and pain scores (all p < 0.05). Although compliance-based recovery trajectories were confounded by small subgroup sizes and baseline clinical imbalance, exploratory analyses nonetheless identified statistically significant time × compliance interaction effects for MRC-SS and straight leg raise performance. Conclusions: This pilot study demonstrates that a mobile application-based rehabilitation program is a feasible and safe approach to implement in deconditioned patients after ICU discharge. These preliminary functional recovery trajectories provide encouraging signals, suggesting that this digital platform may serve as a potential adjunct to conventional care. Rigorous, randomized controlled trials are required to confirm its definitive clinical efficacy and scalability. Full article