Search Results (36)

Cardiovascular disease (CVD) remains Europe’s leading cause of mortality, responsible for >45% of deaths. Beyond established risk factors (hypertension, diabetes, dyslipidaemia, smoking, obesity), psychosocial elements—depression, anxiety, financial stress, personality traits, and trauma—significantly influence CVD development and progression. Behavioural Cardiology addresses this connection by systematically incorporating psychosocial factors into prevention and rehabilitation protocols. This review examines the HEARTBEAT model, developed by Greece’s first Behavioural Cardiology Unit, which aligns with current European guidelines. The model serves dual purposes: primary prevention (targeting at-risk individuals) and secondary prevention (treating established CVD patients). It is a personalised medicine approach that integrates psychosocial profiling with traditional risk assessment, utilising tailored evaluation tools, caregiver input, and multidisciplinary collaboration to address personality traits, emotional states, socioeconomic circumstances, and cultural contexts. The model emphasises three critical implementation aspects: (1) digital health integration, (2) cost-effectiveness analysis, and (3) healthcare system adaptability. Compared to international approaches, it highlights research gaps in psychosocial interventions and advocates for culturally sensitive adaptations, particularly in resource-limited settings. Special consideration is given to older populations requiring tailored care strategies. Ultimately, Behavioural Cardiology represents a transformative systems-based approach bridging psychology, lifestyle medicine, and cardiovascular treatment. This integration may prove pivotal for optimising chronic disease management through personalised interventions that address both biological and psychosocial determinants of cardiovascular health. Full article

The integration of artificial intelligence (AI) and advanced digital workflows is revolutionising full-arch implant dentistry, particularly for geriatric patients with edentulous and atrophic arches, for whom achieving both prosthetic passivity and optimal aesthetic outcomes is critical. This narrative review evaluates current challenges in intraoral scanning accuracy—such as scan distortion, angular deviation, and cross-arch misalignment—and presents how innovations like the Medit SmartX AI-guided workflow and the Scan Ladder system can significantly enhance precision in implant position registration. These technologies mitigate stitching errors by using real-time scan body recognition and auxiliary geometric references, yielding mean RMS trueness values as low as 11–13 µm, comparable to dedicated photogrammetry systems. AI-driven prosthetic design further aligns implant-supported restorations with facial symmetry and smile aesthetics, prioritising predictable midline and occlusal plane control. Early clinical data indicate that such tools can reduce prosthetic misfits to under 20 µm and lower complication rates related to passive fit, while shortening scan times by up to 30% compared to conventional workflows. This is especially valuable for elderly individuals who may not tolerate multiple lengthy adjustments. Additionally, emerging AI applications in design automation, scan validation, and patient-specific workflow adaptation continue to evolve, supporting more efficient and personalised digital prosthodontics. In summary, AI-enhanced scanning and prosthetic workflows do not merely meet functional demands but also elevate aesthetic standards in complex full-arch rehabilitations. The synergy of AI and digital dentistry presents a transformative opportunity to consistently deliver superior precision, passivity, and facial harmony for edentulous implant patients. Full article

The integration of digital serious games into speech learning (rehabilitation) has demonstrated significant potential in enhancing accessibility and inclusivity for children with speech disabilities. This review of the state of the art examines the role of serious games, Artificial Intelligence (AI), and Natural Language Processing (NLP) in speech rehabilitation, with a particular focus on interaction modalities, engagement autonomy, and motivation. We have reviewed 45 selected studies. Our key findings show how intelligent tutoring systems, adaptive voice-based interfaces, and gamified speech interventions can empower children to engage in self-directed speech learning, reducing dependence on therapists and caregivers. The diversity of interaction modalities, including speech recognition, phoneme-based exercises, and multimodal feedback, demonstrates how AI and Assistive Technology (AT) can personalise learning experiences to accommodate diverse needs. Furthermore, the incorporation of gamification strategies, such as reward systems and adaptive difficulty levels, has been shown to enhance children’s motivation and long-term participation in speech rehabilitation. The gaps identified show that despite advancements, challenges remain in achieving universal accessibility, particularly regarding speech recognition accuracy, multilingual support, and accessibility for users with multiple disabilities. This review advocates for interdisciplinary collaboration across educational technology, special education, cognitive science, and human–computer interaction (HCI). Our work contributes to the ongoing discourse on lifelong inclusive education, reinforcing the potential of AI-driven serious games as transformative tools for bridging learning gaps and promoting speech rehabilitation beyond clinical environments. Full article

Intermittent fasting (IF) is emerging as a heterogeneous neurometabolic intervention with the possibility of changing the course of neurodegenerative diseases. Through the modulation of the gut–brain axis (GBA), cellular bioenergetics (or metabolic) reprogramming, and involvement in preserved stress adaptation pathways, IF influences a range of physiological mechanisms, including mitobiogenesis, autophagy, circadian rhythm alignment, and neuroinflammation. This review critically synthesises current preclinical and early clinical evidence illustrating IF’s capability to supplement synaptic plasticity and integrity, reduce toxic proteins (proteotoxic) burden, and rehabilitate glial and immune homeostasis across models of Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, and amyotrophic lateral sclerosis. The key players behind these effects are bioactive metabolites such as short-chain fatty acids (SCFA) and β-hydroxybutyrate (BHB), and molecular mediators such as brain-derived neurotrophic factor (BDNF). We feature the therapeutic pertinence of IF-induced changes in gut microbiota composition, immune response, and mitochondrial dynamics, and we discuss emerging approaches for merging IF into precision medicine frameworks. Crucial challenges include individual variability, protocol optimisation, safety in cognitively vulnerable populations, and the need for biomarker-guided, ethically grounded clinical trials. Finally, we propose IF as a scalable and flexible intervention that, when personalised and integrated with other modalities, may reframe neurodegeneration from a model of irreversible decline to one of modifiable resilience. Full article

Background and Clinical Significance: Prosthetic rehabilitation in the aesthetic zone of periodontally compromised patients presents a complex clinical challenge, requiring a careful coordination of aesthetic, functional, and biological demands. This case highlights the benefits of digital dentistry, interdisciplinary collaboration, and regular maintenance in achieving long-term success in complex rehabilitations of periodontally compromised patients. Case Presentation: This case report describes the digital minimally invasive rehabilitation of a 39-year-old male patient with Stage III periodontitis, occlusal discrepancies, tooth mobility, and an interincisal diastema. A fully digital workflow—including intraoral scanning, aesthetic previewing, and mandibular motion analysis—was employed to guide diagnosis, treatment planning, and prosthetic execution. Conservative tooth preparations using a biologically oriented approach (BOPT) were combined with customised provisional restorations to support soft tissue conditioning and functional control throughout the provisional phases. Mandibular motion tracking facilitated the design of a personalised anterior guidance to improve occlusion and correct the deep bite. The interincisal diastema was initially maintained then closed during the advanced phase of treatment based on aesthetic simulations and patient preference. One unplanned endodontic treatment was required during the provisional phase, but no other complications occurred. Conclusions: At the four-year follow-up, the patient demonstrated stable periodontal and occlusal conditions, improved clinical indices, and high satisfaction with the aesthetic outcome. Full article

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterised by systemic inflammation and the progressive damage of joints, significantly impacting patients’ quality of life. Managing this condition requires a complex approach that integrates pharmacological and non-pharmacological therapies, alongside psychosocial support and patient education. Aim: This study aims to highlight the importance of an interdisciplinary approach in the treatment of rheumatoid arthritis, focusing on the role of pharmacological therapies, monitoring treatment response, and the involvement of a multidisciplinary team in the effective management of the disease. Methods: The analysis was based on a review of the specialised literature concerning the role of disease-modifying antirheumatic drugs (DMARDs, both conventional and biological), the use of inflammatory markers (CRP and ESR), advanced imaging techniques, and the contribution of various medical specialities to the holistic management of rheumatoid arthritis. A total of 595,900 records were identified, of which 53 studies were ultimately included in the detailed analysis. Relevant studies from fields such as rheumatology, nutrition, psychology, and physical therapy were included. Results: The findings underline that DMARDs, in combination with other pharmacological therapies, remain essential for slowing disease progression. Monitoring treatment response through inflammatory markers and imaging techniques allows for the adjustment of therapeutic strategies and the prevention of complications. An interdisciplinary approach, involving the rheumatologist, general practitioner, physiotherapist, nutritionist, and psychologist, provides significant benefits, such as reducing inflammation, improving joint function, and offering psychosocial support. Conclusions: The effective management of rheumatoid arthritis requires a personalised interdisciplinary approach. Integrating various specialities, along with patient education and psychosocial support, contributes to better disease management, the prevention of disabilities, and improved quality of life. This review is not registered. Full article

Stroke is a leading cause of disability worldwide. The long-term effects of a stroke depend on the location and size of the affected brain area, resulting in diverse disabilities and experiences for survivors. More than 70% of people experiencing stroke suffer upper-limb dysfunction, which can significantly limit independence in daily life. The growing strain on national healthcare resources, coupled with the rising demand for personalised, home-based rehabilitation, along with increased familiarity with digital technologies, has set the stage for developing an advanced therapeutics system consisting of a wearable solution aimed at complementing current stroke rehabilitation to enhance recovery outcomes. Through a user-centred approach, supported by primary and secondary research, this study has developed an advanced prototype integrating electromyography smart sensors, functional electrical stimulation, and virtual reality technologies in a closed-loop system that is capable of supporting personalised recovery journeys. The outcome is a more engaging and accessible rehabilitation experience, designed and evaluated through the participation of stroke survivors. This paper presents the design of the therapeutic platform, feedback from stroke survivors, and considerations regarding the integration of the proposed technology across the stroke pathway, from early days in a hospital to later stage rehabilitation in the community. Full article

Heart Failure (HF) is a prevalent condition which places a substantial burden on healthcare systems worldwide. Medical management implemented with exercise training (ET) plays a role in prognostic and functional capacity improvement. The aim of this review is to determine the effect of exercise training (ET) on HFpEF and HFrEF patients as well as exercise modality recommendations in frail and sarcopenic subpopulations. Pharmacological therapy structures the cornerstone of management in HF reduced ejection fraction (HFrEF) and aids improved survival rates. Mortality reduction with pharmacological treatments in HF preserved ejection fraction (HFpEF) are yet to be established. Cardiac rehabilitation (CR) and ET can play an important role in both HFrEF and HFpEF. Preliminary findings suggest that CR significantly improves functional capacity, exercise duration, and quality of life. ET has shown beneficial effects on peak oxygen consumption (pVO₂) and 6 min walk test distance in HFrEF and HFpEF patients, as well as a reduction in hospitalisation and mortality rates; however, the limited scope of larger trials reporting on this underscores the need for further research. ET also has been shown to have beneficial effects on depression and anxiety levels. High-intensity training (HIT) and moderate continuous training (MCT) have both shown benefits, while resistance exercise training and ventilatory assistance may also be beneficial. ET adherence rates are higher when enrolled to a supervised programme, but prescription rates remain low worldwide. Larger robust trials are required to determine ET’s effects on HF, as well as the most efficacious and personalised exercise prescriptions in HF subtypes. Full article

Background: Post-COVID-19 Syndrome or long COVID (LC) is a novel public health crisis and, when persistent (>2 years), is a long-term condition. Post-exertional symptom exacerbation (PESE) is a characteristic symptom of LC and can be improved in a structured pacing rehabilitation programme. Aims: To evaluate the effect of an 8-week structured World Health Organisation (WHO) Borg CR-10 pacing protocol on PESE episodes, LC symptoms, and quality of life in a cohort of individuals with long-term LC. Methods: Participants received weekly telephone calls with a clinician to discuss their activity phase, considering their PESE symptoms that week. They completed the Leeds PESE questionnaire (LPQ), C19-YRS (Yorkshire Rehabilitation Scale), and EQ-5D-5L at the beginning of the programme (0 weeks), the end of programme (8 weeks), and at final follow-up (12 weeks). Results: Thirty-one participants (duration of LC symptoms: 29 months) completed the programme. The PESE episodes decreased in number each week (15% fewer each week, 95% CI: 11% to 20%, p < 0.001) and were of shorter duration and milder severity each week. The changes in C19YRS symptom severity and functional disability (0–12 weeks) were statistically significant but not clinically significant. The EQ5D-5L index score change was not statistically significant. Conclusions: A structured pacing protocol effectively reduced PESE episode frequency, duration, and severity but did not produce clinically significant changes in LC symptoms, reflecting the long-term nature of the condition in this cohort. Full article

Artificial intelligence (AI)-based digital patient twins have the potential to make breakthroughs in research and clinical practices in rehabilitation. They make it possible to personalise treatment plans by simulating different rehabilitation scenarios and predicting patient-specific outcomes. DTs can continuously monitor a patient’s progress, adjusting therapy in real time to optimise recovery. They also facilitate remote rehabilitation by providing virtual models that therapists can use to guide patients without having to be physically present. Digital twins (DTs) can help identify potential complications or failures at an early stage, enabling proactive interventions. They also support the training of rehabilitation professionals by offering realistic simulations of different patient conditions. They can also increase patient engagement by visualising progress and potential future outcomes, motivating adherence to therapy. They enable the integration of multidisciplinary care, providing a common platform for different professionals to collaborate and improve rehabilitation strategies. The article aims to trace the current state of knowledge, research priorities, and research gaps in order to properly guide further research and shape decision support in rehabilitation. Full article

Background: The study aimed to assess the dynamics of changes in the torques of derotating and redressing forces acting on the apexes of deformation curvature arches during active, kyphosis-inducing exercises using the D4S device. Methods: The study group included 12 girls aged 9 to 10 years (age X = 9.36, SD = 1.52; weight X = 31.34 kg, SD = 3.28; height X = 134.23 cm, SD = 8.25). The study was carried out using the D4S interactive spine and posture rehabilitation system with dynamic, personalised stimulation. Measurements were taken during six successive therapeutic visits of each patient, each containing five repeated sets. A single set involved applying pressure on the device heads 20 times for 8 s. For each patient, the resistance head was in the right top (RT) setting, individually adjusted for patient needs. Results: The results showed that the values of the measured moments of the derotating-redressing forces acting on the curvature peak vertebrae ranged from 24.1 N/cm² to 39.9 N/cm². The analysis of the differences in the values of the pressure of the derotating head on the spine in subsequent measurements, accounting for all measurements taken in subsequent cycles of the study, indicates significant variation in pressure values (K-W = 31.0660, p = 0.00029 *). Similar dynamics of changes and variation in the results were noted for the values of the pressure applied with the derotating head in subsequent cycles of the study. In this case, the variation in the results was also statistically significant (K-W = 24.4747, p = 0.00018 *). Conclusions: The values of forces increase slightly with the subsequent series of exercises. The assessment of the value of forces may be an element of optimal and more effective training plans in the therapy discussed. Full article

Background and Objectives: Urinary incontinence (UI) prevalence reaches the 80% rate in female athletes involved in high-impact sports. In this context, although conservative treatment represents the first therapeutic choice, there is still a lack of knowledge on the efficacy of conservative programs in young female athletes. Therefore, the aim of this study was to investigate the role of pelvic floor rehabilitation in the treatment of UI in young nulliparous female athletes. We performed a literature search using PubMed, Medline, Cochrane Library, Web of Science, and Scopus. The selection of articles was conducted using a specific search string: “[((pelvic floor dysfunction) OR (urinary incontinence) OR (dyspareunia) OR (dysuria)) AND ((sport) OR (sports)) AND ((female) OR (woman) OR (women) OR (girl)) AND ((rehabilitation) OR (rehab) OR (pelvic rehabilitation) OR (exercise))]”. The review protocol was registered in PROSPERO with the ID CRD42024559990. A total of 1018 articles were found in all searches of the databases. After removing duplicates, 663 papers were reviewed in terms of title and abstract. Finally, a total of six studies were included in the present review. The results of this review show that conservative treatment with a personalised pelvic floor muscle training program (PFMTP) represents an effective treatment for UI, decreasing urine loss and improving maximum voluntary pelvic contraction; this is linked with an improvement in quality of life and sports performance, in particular when supervised by a physical therapist. Moreover, due to the reluctance of athletes to talk about UI, an educational program should be considered as part of a prevention programme in pre-season training. Full article

Existing buildings in the European Union account for 40% of its energy consumption. To significantly reduce this impact, annual deep energy renovation rates should triple by the end of the 2020s. However, the lack of automation in the construction industry has hindered energy renovation efforts. Horizon Europe’s INPERSO project (Industrialised and Personalised Renovation for Sustainable Societies) aims to create a user-centered energy rehabilitation method based on industrialized technologies and systems, enhancing efficiency and building performance. To bridge the gap between predictions and real-world outcomes, the 22 project partners—using a multi-criteria decision analysis (MCDA) process—devised a list of key performance indicators (KPIs) for evaluating rehabilitation based on economic, energy, environmental, social, and technological factors. Adopting a human-centric approach, these project partners aim to minimize the technologies’ environmental impact while optimizing users’ comfort and experience. The indicators are designed to evaluate performance at every stage of the renovation process, enabling continuous feedback and user engagement and ultimately ensuring that projected energy savings are met throughout the building’s lifespan. The KPIs selected for INPERSO provide a solid framework for evaluating and monitoring sustainable renovation. However, challenges such as administrative reluctance and user disruption must be addressed to further boost the adoption of deep energy renovations. Full article

Background: GaitSmart (GS) is a sensor-based digital medical device that can be used with the integrated app vGym to provide a personalised rehabilitation programme for older people undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). This study aimed to determine whether the GS intervention used in the rehabilitation of older people undergoing THA or TKA is potentially cost-effective compared to the current standard of care (SoC). Methods: Decision-analytic modelling was conducted to estimate the cost-effectiveness over a seventeen-week time horizon from an NHS perspective. UK clinical and cost data from the GaitSmart randomised clinical trial was used to obtain the input parameters, and a sensitivity analysis was performed to address uncertainties. Results: Over a seventeen-week time horizon, GS incurred cost savings of GBP 450.56 and a 0.02 gain in quality-adjusted life years (QALYs) compared to the SoC. These results indicate that GS is the dominant intervention because the device demonstrated greater effectiveness and lower costs. Probabilistic sensitivity analyses confirm the robustness of our results. Conclusions: GS appears to offer short-term efficiency benefits and demonstrates cost-effectiveness for the improvement in gait in people undergoing THA or TKA, compared to the SoC. Full article

Movement sonification has emerged as a promising approach for rehabilitation and motion control. Despite significant advancements in sensor technologies, challenges remain in developing cost-effective, user-friendly, and reliable systems for gait detection and sonification. This study introduces a novel wearable personalised sonification and biofeedback device to enhance movement awareness for individuals with irregular gait and posture. Through the integration of inertial measurement units (IMUs), MATLAB, and sophisticated audio feedback mechanisms, the device offers real-time, intuitive cues to facilitate gait correction and improve functional mobility. Utilising a single wearable sensor attached to the L4 vertebrae, the system captures kinematic parameters to generate auditory feedback through discrete and continuous tones corresponding to heel strike events and sagittal plane rotations. A preliminary test that involved 20 participants under various audio feedback conditions was conducted to assess the system’s accuracy, reliability, and user synchronisation. The results indicate a promising improvement in movement awareness facilitated by auditory cues. This suggests a potential for enhancing gait and balance, particularly beneficial for individuals with compromised gait or those undergoing a rehabilitation process. This paper details the development process, experimental setup, and initial findings, discussing the integration challenges and future research directions. It also presents a novel approach to providing real-time feedback to participants about their balance, potentially enabling them to make immediate adjustments to their posture and movement. Future research should evaluate this method in varied real-world settings and populations, including the elderly and individuals with Parkinson’s disease. Full article