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Search Results (2,492)

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24 pages, 2285 KB  
Review
Oral Rehabilitation and Multidisciplinary Team Approach in Older Adult: A Narrative Review
by Mineka Yoshikawa, Azusa Haruta, Yutaro Takahashi, Shion Maruyama and Kazuhiro Tsuga
Nutrients 2026, 18(3), 410; https://doi.org/10.3390/nu18030410 - 26 Jan 2026
Abstract
Background/Objectives: Oral frailty and hypofunction in older adults are strongly associated with declines in nutritional status, physical function, swallowing ability, and overall health. Isolated interventions usually fail to achieve sufficient improvement since these conditions result from interrelated biological, psychological, and social factors. [...] Read more.
Background/Objectives: Oral frailty and hypofunction in older adults are strongly associated with declines in nutritional status, physical function, swallowing ability, and overall health. Isolated interventions usually fail to achieve sufficient improvement since these conditions result from interrelated biological, psychological, and social factors. Multidisciplinary approaches combining oral management, nutritional support, and physical rehabilitation have shown promise. This narrative review synthesized evidence from 15 studies examining multifaceted interprofessional interventions across hospitals, communities, long-term care facilities, and home-care settings. Methods: A structured search of PubMed and Web of Science (2000–2025) identified original studies assessing oral, nutritional, or physical outcomes in older adults post-interprofessional interventions. Fifteen eligible studies were extracted; the findings were integrated using narrative synthesis owing to design and outcome heterogeneity. Results: Educational multidisciplinary interventions improved oral hygiene, caregiver awareness, and oral motor function. Multidisciplinary rehabilitation and multidomain programs consistently improved tongue pressure, swallowing function, mastication ability, appetite, body composition, activities of daily living, and oral intake resumption. Nutrition support team-delivered interventions reduced aspiration risks and improved oral environment and swallowing function. Community-based programs using munchy meals and combined exercises enhanced oral and physical functions. Social participation provided psychological benefits. Home-care dysphagia rehabilitation enabled 69% of tube-fed patients to resume oral intake. Conclusions: This narrative review supports a triadic, interprofessional approach in geriatric care, highlighting consistent improvements in oral function through integrated oral, nutritional, and rehabilitative interventions. Full article
(This article belongs to the Special Issue Integrated Approach to Oral Health, Rehabilitation and Nutrition)
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28 pages, 710 KB  
Review
Nurse-Led Interventions Targeting Clinical Correlates of Immunosenescence in Older Adults: A Scoping Review
by Gianluca Azzellino, Patrizia Vagnarelli, Ernesto Aitella, Luca Mengoli, Lia Ginaldi and Massimo De Martinis
Medicina 2026, 62(2), 262; https://doi.org/10.3390/medicina62020262 - 26 Jan 2026
Abstract
Background and Objectives: Immunosenescence is a complex biological process associated with aging, characterized by a progressive decline in immune function and increased chronic inflammation (“inflammaging”), with clinical implications such as frailty, functional decline, multimorbidity, and a higher risk of adverse events in older [...] Read more.
Background and Objectives: Immunosenescence is a complex biological process associated with aging, characterized by a progressive decline in immune function and increased chronic inflammation (“inflammaging”), with clinical implications such as frailty, functional decline, multimorbidity, and a higher risk of adverse events in older adults. Nurses in community and primary care settings play a central role in preventive and health promotion interventions that may indirectly influence these processes. However, the available literature remains fragmented. Therefore, this scoping review aims to map and synthesise nursing interventions targeting older adults (≥60 years) that may indirectly influence immunosenescence by acting on its clinical correlates and modifiable determinants, organising the evidence within a four-pillar conceptual framework. Materials and Methods: A scoping review was conducted following JBI methodology and the PRISMA-ScR checklist. We included primary studies on nurse-led interventions in community, home care, primary care, territorial, or long-term care settings. PubMed, Scopus, and Web of Science were searched (English; last 10 years). Interventions were classified into four pillars: nursing nutrition and immunonutrition support, physical activity and exercise support, nursing vaccination coaching, and frailty monitoring and prevention of functional decline. Results: Twenty-five primary studies were included, mostly randomised or cluster-randomised trials in community, primary care, home care, and transitional care settings. Interventions mapped mainly to Pillar 4 and Pillar 2, while Pillar 1 was less frequent and usually part of multicomponent programmes; no primary studies targeted Pillar 3. Overall, effectiveness appeared driven more by intervention intensity and integration than by frailty identification alone: structured, multicomponent nurse-led programmes combining exercise with nutritional and psychosocial components showed the most consistent benefits on frailty, functional outcomes, and well-being, whereas low-intensity preventive consultations and Comprehensive Geriatric Assessment (CGA)-based models often showed limited improvements over usual care. Conclusions: This scoping review highlights the key role of community and primary care nurses in preventive interventions targeting clinical correlates of immunosenescence. Multicomponent nurse-led programmes integrating physical activity, nutrition, and psychosocial support appear most promising for frailty and functional outcomes, while low-intensity interventions show limited effectiveness. No primary studies addressed nurse-led vaccination coaching, representing an evidence gap. Future research should include biological/immunological markers alongside clinical outcomes. Full article
(This article belongs to the Special Issue Personal and Pervasive Health Care for the Elderly)
17 pages, 680 KB  
Article
Obesity Treatment Application Implications of Temporally Sequenced Paths of Theory-Driven Psychological Changes Toward Improvements in Physical Activity and Dietary Behaviors in Women
by James J. Annesi
Nutrients 2026, 18(3), 391; https://doi.org/10.3390/nu18030391 - 24 Jan 2026
Viewed by 41
Abstract
Background/Objectives: Obesity has a high prevalence and is associated with many health risks. Minimal effects from behavioral obesity treatments might be linked to their atheoretical dependence on simply educating participants on healthy eating and increased physical activity/exercise, rather than evolving behavior-change methods through [...] Read more.
Background/Objectives: Obesity has a high prevalence and is associated with many health risks. Minimal effects from behavioral obesity treatments might be linked to their atheoretical dependence on simply educating participants on healthy eating and increased physical activity/exercise, rather than evolving behavior-change methods through theory-based research. The use of pharmacologic interventions has recently overtaken bariatric surgery in medically based efforts to obtain greater weight losses than through behavioral means. Methods: The present longitudinal observational study aimed to extend earlier treatment-associated findings concerned with the order of emphasizing 3-, 6-, and 9-month changes in the theory-driven psychosocial constructs of self-regulation, self-efficacy, and mood associated with 12-month improvements in weight-loss behaviors. The “parent study” of women with obesity (N = 106) found significant paths through changes in self-regulation → mood → self-efficacy and mood → self-regulation → self-efficacy. In the present extension of that investigation, only those participants who did not already complete recommended physical activity amounts and consume recommended portions of fruits/vegetables at baseline were included (N = 73). Results: Only paths from changes in mood → self-regulation → self-efficacy were significantly associated with 12-month improvements in both physical activity and dietary behaviors. A mean weight change of −5.2 kg, or −5.5% from baseline weight, was found. Baseline scores in emotional eating and anxiety significantly moderated the mood–self-regulation change relationships within the significant paths. Conclusions: Findings suggested that future treatment contents focus on early physical activity-associated improvement in mood because of its association with increased usage of treatment-developed self-regulatory skills. Those skills should then be leveraged because of their association with feelings of ability (i.e., self-efficacy) to overcome lifestyle barriers to weight-loss behavior changes. Further improvements in behavioral obesity treatments should be reconsidered as either stand-alone modalities or, after appropriate testing, as an adjunct to medical means. Full article
(This article belongs to the Section Nutrition in Women)
18 pages, 1766 KB  
Review
Nutritional and Metabolic Interventions to Prevent and Treat Protein–Energy Wasting in Nondialysis CKD—Narrative Review
by Patrícia Kleinová, Blichová Tímea, Vnučák Matej, Karol Graňák, Kollár Andrej, Ševčíková Katarína and Ivana Dedinská
Nutrients 2026, 18(3), 390; https://doi.org/10.3390/nu18030390 - 24 Jan 2026
Viewed by 71
Abstract
Background: Protein–energy wasting (PEW) is a major predictor of morbidity and mortality in patients with chronic kidney disease (CKD), even before the initiation of dialysis. Its multifactorial pathogenesis includes reduced dietary intake, chronic inflammation, metabolic acidosis, hormonal disturbances, and dysbiosis of the gut [...] Read more.
Background: Protein–energy wasting (PEW) is a major predictor of morbidity and mortality in patients with chronic kidney disease (CKD), even before the initiation of dialysis. Its multifactorial pathogenesis includes reduced dietary intake, chronic inflammation, metabolic acidosis, hormonal disturbances, and dysbiosis of the gut microbiota. Early recognition and targeted management are crucial for preventing muscle loss, functional decline, and adverse outcomes. Methods: This narrative review summarises and integrates current evidence from the literature on nutritional and metabolic interventions to prevent and treat protein–energy wasting in patients with nondialysis chronic kidney disease. Relevant clinical trials, meta-analyses, and experimental studies published up to date were evaluated, focusing on dietary strategies, metabolic modulation, physical exercise, and gut microbiome-targeted therapies. Results: Adequate energy and protein intake remain the cornerstone of PEW management, based on available clinical and observational evidence. Individualised diets emphasising high-quality and plant-based proteins, oral nutritional supplements, and ketoanalogues can attenuate muscle wasting. Correction of metabolic acidosis and inflammation enhances protein anabolism and nitrogen balance. Physical exercise acts synergistically with dietary interventions to preserve muscle mass and function. Novel approaches—such as modulating the gut–kidney axis with pre-, pro-, and postbiotics or supplementing with short-chain fatty acids—show promise in improving metabolic and inflammatory profiles. Conclusions: The management of PEW in nondialysis CKD requires a personalised approach that integrates nutrition, physical activity, metabolic correction and microbiome modulation. Early, coordinated intervention may help to slow the progression of CKD and improve patient survival and quality of life. Full article
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22 pages, 1330 KB  
Systematic Review
Effects of Exercise-Based Telerehabilitation for Knee Osteoarthritis: A Systematic Review and a Study Protocol
by Giacomo Farì, Francesco Quarta, Federica Bressi, Raffaele La Russa, Teresa Paolucci and Andrea Bernetti
Bioengineering 2026, 13(2), 136; https://doi.org/10.3390/bioengineering13020136 - 24 Jan 2026
Viewed by 60
Abstract
Background: Knee osteoarthritis causes considerable pain and disability. Telerehabilitation has emerged as a promising treatment option, especially after the Coronavirus Disease 2019 pandemic, but it still faces challenges regarding solid scientific evidence about its multiple benefits. This systematic review aimed to analyze the [...] Read more.
Background: Knee osteoarthritis causes considerable pain and disability. Telerehabilitation has emerged as a promising treatment option, especially after the Coronavirus Disease 2019 pandemic, but it still faces challenges regarding solid scientific evidence about its multiple benefits. This systematic review aimed to analyze the reported beneficial effects of telerehabilitation based on therapeutic exercise for the management of knee osteoarthritis. Methodsː PubMed, PEDro, Web of Science and Cochrane Library databases were used to identify eligible studies. This review followed the PRISMA guidelines and was registered at PROSPERO (n° CRD42024579836). The selected studies underwent a qualitative assessment using the Modified Jadad Score. Results: Ten studies, including a total of 1354 participants, were included. From the selected studies, a wide variety of outcome measures emerged to evaluate the efficacy of telerehabilitation in the relief of pain and its clinical consequences. Seven studies specifically assessed pain, with four showing significant improvements in pain reduction in the intervention group compared with the control group. Telerehabilitation was found to be more effective or non-inferior to traditional rehabilitation in relieving pain, as reported across various pain scales. Limitations include the heterogeneity of interventions, the exclusion of non-recent studies, and the exclusive focus on therapeutic exercise. Conclusionsː The results of this systematic review suggest that telerehabilitation provides pain relief, improves physical function, and enhances quality of life, while preliminary evidence indicates potential cost-related advantages. However, some studies did not find TR to be superior to control interventions, highlighting mixed evidence. Additional high-quality studies are required to better support this promising rehabilitation approach. Full article
(This article belongs to the Special Issue IoT Technology in Bioengineering Applications: Second Edition)
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23 pages, 959 KB  
Review
Therapeutic Patient Education in Adults with Chronic Lower Limb Musculoskeletal Pain: A Scoping Review
by Carla Vanti, Michael Bianchini, Alessio Mantineo, Francesco Ballardin and Paolo Pillastrini
Healthcare 2026, 14(3), 290; https://doi.org/10.3390/healthcare14030290 - 23 Jan 2026
Viewed by 191
Abstract
Background: Conservative treatment of chronic musculoskeletal pain includes exercise, manual therapy, medications, physical agents/modalities, and Therapeutic Patient Education (TPE). Research on TPE has predominantly focused on spinal pain, so we do not know the extent and scope of clinical research in other [...] Read more.
Background: Conservative treatment of chronic musculoskeletal pain includes exercise, manual therapy, medications, physical agents/modalities, and Therapeutic Patient Education (TPE). Research on TPE has predominantly focused on spinal pain, so we do not know the extent and scope of clinical research in other areas, particularly lower extremities. This review aimed to map current research on this topic. Methods: We searched PubMed, PEDro, CINAHL, PsycINFO, and Cochrane Library up to 1 April 2024. We included RCTs on adults with chronic lower limb musculoskeletal pain, written in English, French, Spanish, or Italian. Results: Fifty-two records concerning knee osteoarthritis (n.33), hip and knee osteoarthritis (n.8), hip osteoarthritis (n.3), chronic knee pain (n.3), patellofemoral pain (n.3), and gluteal tendinopathy (n.2) were included. TPE was delivered through self-management, disease-specific information, pain education, and the management of physical activity, load, diet, stress, and sleep. Interventions were both individual- and group-based; delivery methods included in-person intervention, telephone/video calls, and web tools/apps. TPE combined with exercise seemed to be more effective than exercise alone, information/little education, or usual care. The effects of TPE as a stand-alone intervention appeared uncertain. Conclusions: There is considerable variability in TPE in terms of teaching topics, providers, administration methods, and dosage of interventions. Future studies should investigate the effects of TPE in young adult populations and in ankle conditions. They should also investigate the effects of TPE on pain intensity versus pain interference with activities, by deepening TPE effects on disability and quality of life. Full article
(This article belongs to the Special Issue Dysfunctions or Approaches of the Musculoskeletal System)
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14 pages, 618 KB  
Article
Immersive Virtual Reality-Based Exercise Intervention and Its Impact on Strength and Body Composition in Adults with Down Syndrome: Insights from the InDown Pilot Project
by José María Cancela-Carral, Adriana López Rodríguez and Pablo Campo-Prieto
Appl. Sci. 2026, 16(2), 1059; https://doi.org/10.3390/app16021059 - 20 Jan 2026
Viewed by 127
Abstract
This pilot study examined the feasibility, usability, and physiological effects of a high-intensity exercise program delivered through immersive virtual reality (IVR) in adults with Down syndrome (DS). Twenty participants (mean age: 29.85 ± 9.37 years) completed a 12-week intervention using the FitXR exergame [...] Read more.
This pilot study examined the feasibility, usability, and physiological effects of a high-intensity exercise program delivered through immersive virtual reality (IVR) in adults with Down syndrome (DS). Twenty participants (mean age: 29.85 ± 9.37 years) completed a 12-week intervention using the FitXR exergame on Meta Quest 3, with two sessions per week. Usability, safety, and personal experiences were assessed via the System Usability Scale (SUS), Simulator Sickness Questionnaire (SSQ), and Game Experience Questionnaire (GEQ), while body composition and strength were measured using bioelectrical impedance analysis and standardized tests (handgrip dynamometry, Five Sit-to-Stand Test). Results indicated excellent usability (SUS: 92.88–95.03/100), minimal cybersickness (SSQ: 2.12 → 1.98/48), and high adherence (90%). Positive experiences increased significantly, with no negative experiences reported. Lower-limb strength has been considered as a primary outcome, which has shown to improve significantly (p = 0.018; Cohen’s d = 0.89), whereas upper-limb strength and body composition changes were minimal. These findings suggest that IVR-based exercise is a safe, engaging, and feasible strategy for promoting physical activity and enhancing functional strength in adults with DS. Further controlled trials with longer duration and nutritional strategies are warranted to optimize body composition outcomes. Full article
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20 pages, 1226 KB  
Review
Enhancing Performance and Quality of Life in Lower Limb Amputees: Physical Activity, a Valuable Tool—A Scoping Review
by Federica Delbello, Leonardo Zullo, Andrea Giacomini and Emiliana Bizzarini
Healthcare 2026, 14(2), 253; https://doi.org/10.3390/healthcare14020253 - 20 Jan 2026
Viewed by 180
Abstract
Background/Objectives: Lower limb amputation (LLA) negatively affects the physical and psychological health of individuals, leading to a lower quality of life and sedentary lifestyle. The objective of this scoping review is to search for evidence regarding physical activity interventions in individuals with LLA, [...] Read more.
Background/Objectives: Lower limb amputation (LLA) negatively affects the physical and psychological health of individuals, leading to a lower quality of life and sedentary lifestyle. The objective of this scoping review is to search for evidence regarding physical activity interventions in individuals with LLA, investigating improvements in specific outcomes related to quality of life and performance. Methods: PRISMA guidelines—extension for scoping reviews—were used to structure the study. The research was conducted between 26 July 2023 and 30 September 2023; it was structured by defining two PICO questions (P = amputation, I = physical exercise, O1 = quality of life, and O2 = performance) through Pubmed, Cochrane, and Pedro databases. The study included subjects with LLA of any etiology, in prosthetic or pre-prosthetic phase, practicing non-competitive physical activity. The results were then subjected to both qualitative and quantitative analysis. Results: Of the 615 studies identified, 18 were included in the review. They consisted of 6 systematic reviews (SR), 5 RCTs, 4 case–control studies, 1 case report (CR), and 2 cross-sectional (CS). Physical activity (PA) interventions were extremely heterogeneous and were, therefore, categorized into 6 modalities: surveys were the most reported strategies (57%), followed by personalized training (23%), strength training (13%), endurance training (13%), combined training (2%), and gait training (5%). Due to the heterogeneity of the studies, the variety of interventions proposed and the different outcomes registered, there is no evidence that one approach is more effective than another, while each group showed benefits on different specific outcomes. In total, five outcome categories were identified: quality of life was the most frequently analysed (42%), followed by cardiovascular fitness (20%), muscular fitness (14%), gait parameters (13%), functionality and disability (11%). Conclusions: PA represents a valuable strategy for improving performance and quality of life in individuals with LLA, offering a variety of interventions. Although there is no evidence that one strategy is better than the others, each activity has proven to be effective on specific outcomes, therefore, the choice must depend on the patient’s necessities. The preferred option should be the personalization of the training according to individual needs, coupled with long-term planning and remote monitoring. Creating meeting places and supporting occasions for sports activities could be a valid option. Further research could help to clarify the benefits of such interventions and enhance the understanding of how to optimize the management of LLA patients. Full article
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21 pages, 298 KB  
Article
Barriers and Facilitators to Self-Care Behaviors in People Living with Osteoporosis: A Qualitative Descriptive Study
by Vicente Bernalte-Martí, Chiara Tedesco, Mara Tormen, Angela Cuoco, Gianluca Pucciarelli, Ercole Vellone, Maddalena De Maria, Emanuela Basilici Zannetti, Noemi Cittadini, Annalisa Pennini and Rosaria Alvaro
Nurs. Rep. 2026, 16(1), 33; https://doi.org/10.3390/nursrep16010033 - 20 Jan 2026
Viewed by 91
Abstract
Background/Objectives: Self-care is central to chronic illness management and is particularly relevant in osteoporosis to prevent complications and improve quality of life. Grounded in Riegel’s middle-range theory of self-care of chronic illness, the study sought to understand the contextual, emotional, and structural [...] Read more.
Background/Objectives: Self-care is central to chronic illness management and is particularly relevant in osteoporosis to prevent complications and improve quality of life. Grounded in Riegel’s middle-range theory of self-care of chronic illness, the study sought to understand the contextual, emotional, and structural influences shaping self-care in people living with osteoporosis. Aim: The aim of this study was to explore patient-reported barriers and facilitators to self-care behaviors among individuals living with osteoporosis. Methods: A qualitative descriptive design was conducted using in-depth, semi-structured interviews with 20 patients with osteoporosis recruited via convenience sampling. Data were coded deductively and analyzed using Mayring’s qualitative content analysis with a deductive approach. Results: Participants identified several factors related to both barriers and facilitators of self-care behaviors. Four barrier sub-themes emerged: ineffective coping strategies, difficulties in osteoporosis management, inadequate physical activity, and ineffective self-efficacy. Six facilitator sub-themes were identified: self-care management strategies, osteoporosis management after a fracture, osteoporosis control, osteoporosis treatment, exercise, and confidence in one’s ability. Main barriers included fear of falling, ineffective self-efficacy, and poor care continuity, whereas key facilitators included support networks, motivation, and tailored care. Conclusions: Self-care behaviors in individuals with osteoporosis are influenced by emotional, contextual, and structural factors. Person-centered interventions integrating emotional and educational components may strengthen patients’ engagement and enhance self-care behaviors in osteoporosis. Identifying barriers and facilitators enables nurses to design empathetic, tailored strategies that enhance empowerment and disease management. Understanding these factors can improve autonomy for patients and adherence, promoting long-term health outcomes across clinical and community settings. Full article
17 pages, 1073 KB  
Article
From Exhaustion to Empowerment: A Pilot Study on Motor Control-Based Exercise for Fatigue and Quality of Life in Long COVID-19 Patients
by Carmen Jiménez-Antona, Ricardo Moreta-Fuentes, David Varillas-Delgado, César Moreta-Fuentes and Sofía Laguarta-Val
Medicina 2026, 62(1), 210; https://doi.org/10.3390/medicina62010210 - 20 Jan 2026
Viewed by 127
Abstract
Background and Objectives: Long COVID-19 (LC) is a multifaceted condition characterized by persistent fatigue and impaired health-related quality of life (HRQoL). Exercise intolerance and post-exertional symptom exacerbation (PESE) pose challenges for rehabilitation. This study aimed to evaluate the effects of a 12-week [...] Read more.
Background and Objectives: Long COVID-19 (LC) is a multifaceted condition characterized by persistent fatigue and impaired health-related quality of life (HRQoL). Exercise intolerance and post-exertional symptom exacerbation (PESE) pose challenges for rehabilitation. This study aimed to evaluate the effects of a 12-week core-focused plank exercise program on fatigue and HRQoL in women with LC, using validated patient-reported measures. Materials and Methods: A pilot quasi-experimental design was implemented, with non-randomized group allocation. Thirty-nine women with LC were recruited from the Madrid Long COVID Association. Participants were assigned to either an intervention group (n = 20), which completed a supervised plank-based motor control program, or a control group (n = 19), which maintained usual activity. Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS), and HRQoL was measured using the EQ-5D-5L and EQ Visual Analog Scale (EQ-VAS). Body composition was evaluated via bioelectrical impedance analysis. Results: The intervention group showed significant reductions after intervention in the MFIS total scores compared to the control group, particularly in the physical (21.26 ± 6.76 vs. 25.21 ± 6.06; p < 0.001) and psychosocial domains (4.51 ± 0.41 vs. 5.21 ± 0.38; p < 0.001), without triggering PESE. EQ-VAS scores improved significantly (63.94 ± 15.33 vs. 46.31 ± 14.74; p = 0.034). No significant changes were found in body composition parameters, suggesting that benefits were driven by neuromuscular adaptations rather than morphological changes. Conclusions: A core-focused, non-aerobic exercise program effectively reduced fatigue and improved perceived health status in women with LC. These findings support the use of motor control-based interventions as a safe and feasible strategy for LC rehabilitation, particularly in populations vulnerable to PESE, suggesting clinical applicability for the rehabilitation of women with LC. Further randomized trials are warranted to confirm these results and explore long-term outcomes. Full article
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17 pages, 1809 KB  
Article
Short-Term Inspiratory Muscle Training Enhances Functional and Metabolic Health in Older Adults
by Erkan Konca, Coşkun Yılmaz, Serdar Bayrakdaroğlu, Halil İbrahim Ceylan, Ayla Arslan, Hakan Ocak, İzzet Karakulak, Rifat Sarı, Recep Nur Uzun, Hakan Hüseyin Soylu, Levent Ceylan and Raul Ioan Muntean
Healthcare 2026, 14(2), 249; https://doi.org/10.3390/healthcare14020249 - 19 Jan 2026
Viewed by 159
Abstract
Background: Age-related declines in respiratory muscle strength and ventilatory efficiency can impair functional capacity and metabolic health in older adults. Inspiratory muscle training (IMT) has been proposed as a practical intervention to counteract these changes, yet its systemic effects remain unclear. This [...] Read more.
Background: Age-related declines in respiratory muscle strength and ventilatory efficiency can impair functional capacity and metabolic health in older adults. Inspiratory muscle training (IMT) has been proposed as a practical intervention to counteract these changes, yet its systemic effects remain unclear. This study aimed to examine the effects of short-term IMT on functional capacity, diaphragm thickness, and liver tissue characteristics in healthy elderly men. Methods: Thirty community-dwelling men aged 60–80 years were randomly assigned to an IMT or control group. The IMT group performed four weeks of breathing exercises using a POWERbreathe® device at 40% of maximal inspiratory pressure, with a weekly 10% increase in pressure. Pre- and post-intervention assessments included the six-minute walk test (6MWT), diaphragm thickness and liver density via computed tomography, and quality of life (QoL; SF-12). Results: Four weeks of inspiratory muscle training significantly improved diaphragm thickness (11.7%), fatty liver density (FLD) (+16.7%), and six-minute walk performance (+5.3%), with large time × group effects favoring the IMT group. While the physical quality of life showed modest, comparable improvements, mental health outcomes demonstrated a moderate, time-dependent improvement without a significant group-by-time interaction. Conclusions: Short-term IMT improved diaphragmatic function and functional capacity in older men and was associated with favorable changes in a liver-related biomarker; however, given that only a single liver-related metric was assessed, these findings should not be interpreted as evidence of overall improvements in liver health. Full article
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18 pages, 865 KB  
Article
Combined Effects of Gallic Acid Supplementation and Physical Training on Body Composition and Biochemical Parameters in Obese Patients: A Randomized, Double-Blinded, Placebo-Controlled Clinical Trial
by Bruna Kaicy Barbosa, Daniel Vinicius Alves Silva, Gislaine Candida Batista-Jorge, Berenilde Valéria de Oliveira Souza, Antônio Sérgio Barcala-Jorge, André Luiz Sena Guimarães, Alfredo Maurício Batista de Paula, João Marcus Oliveira Andrade and Sérgio Henrique Sousa Santos
Nutrients 2026, 18(2), 311; https://doi.org/10.3390/nu18020311 - 19 Jan 2026
Viewed by 188
Abstract
Background/Objectives: Obesity has been linked to cardiometabolic alterations and deteriorated body composition. Gallic acid, a polyphenol with antioxidant properties, may influence these parameters; however, there is limited clinical data. The aim of this study was to evaluate the effects of gallic acid supplementation [...] Read more.
Background/Objectives: Obesity has been linked to cardiometabolic alterations and deteriorated body composition. Gallic acid, a polyphenol with antioxidant properties, may influence these parameters; however, there is limited clinical data. The aim of this study was to evaluate the effects of gallic acid supplementation combined with physical exercise in obese individuals. Methods: A randomized, double-blind, placebo-controlled clinical trial with 150 participants recruited and divided into eight groups according to nutritional status (eutrophic or obese), supplementation (gallic acid 200 mg/day vs. placebo), and physical exercise (trained vs. untrained) for 12 weeks. Body composition, anthropometry, and serum biomarkers were assessed before and after the intervention. Data were analyzed using repeated-measures ANOVA. Results: A total of 107 participants completed the final assessment. A reduction in waist-to-hip ratio was observed in the obese group trained and supplemented with gallic acid (supplement × time interaction: p = 0.031). There was a reduction in waist circumference (supplement × physical exercise × time interaction: p = 0.041) and a reduction in skinfold thickness at the pectoral (p = 0.044) and abdominal (p = 0.036) sites. Fat-free mass showed a tendency to increase in the supplemented trained obese group (p = 0.054). In biochemical markers, an increase in albumin was identified in the supplement × time interaction (p = 0.043), especially in the trained obese group. Conclusions: The combination of gallic acid and physical exercise promoted improvements in abdominal adiposity and body composition markers, with favorable biochemical effects. Full article
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25 pages, 856 KB  
Article
Immediate Effect of Whole-Body Vibration Exercise Performed in Vertical Versus Side-Alternating Displacement Modes on Physiological Parameters, Perception of Effort, Strength and Functionality in Adults with Obesity
by Aline Reis-Silva, André Luiz Bandeira Dionizio Cardoso, Ana Carolina Coelho-Oliveira, Daniel Batouli-Santos, Gabriel Siriano Damasceno dos Santos, Jennyfer Silva Mazini, Ana Gabriellie Valério-Penha, Alessandra Andrade-Nascimento, Marcia Cristina Moura-Fernandes, Redha Taiar, Alessandro Sartorio, Danúbia da Cunha de Sá-Caputo and Mario Bernardo-Filho
Diagnostics 2026, 16(2), 316; https://doi.org/10.3390/diagnostics16020316 - 19 Jan 2026
Viewed by 175
Abstract
Background: Obesity, defined as an abnormal accumulation of body fat, is becoming a global epidemic. Individuals with obesity may present with increased abdominal fat, which is associated with hypertension, altered respiratory mechanics, higher resting heart rate, and may contribute to an increased [...] Read more.
Background: Obesity, defined as an abnormal accumulation of body fat, is becoming a global epidemic. Individuals with obesity may present with increased abdominal fat, which is associated with hypertension, altered respiratory mechanics, higher resting heart rate, and may contribute to an increased cardiovascular risk. Physiological parameters, such as heart rate, blood pressure, respiratory rate, and oxygen saturation, can change hours before the occurrence of a clinically relevant adverse event. Thus, physiological parameters can be considered good predictors of clinical deterioration. Obesity is also associated with physical dysfunctions that can impair physical performance. The non-pharmacological therapeutic strategy for the treatment of obesity involves lifestyle modifications, including a healthy diet and regular physical exercise. Whole-body vibration (WBV) exercise, a type of physical activity, has demonstrated benefits in several specific populations, including obese individuals. Objectives: The objective of this study was to evaluate the immediate effects of a single whole-body vibration (WBV) exercise session, consisting of 15 sets, using a vibration platform (VP) with alternating vertical or lateral displacement, on physiological parameters, perceived exertion, strength, and functionality in obese adults. Methods: Seventy-two obese adult participants were randomly divided into three groups (vertical group, alternating lateral group, and placebo group). Physiological parameters were assessed before, during, and after the intervention, in addition to perceived exertion, functionality, and muscle strength. Results: When comparing the results before and after the intervention, the heart rate–pressure product increased significantly in the alternating lateral group (p = 0.005), and heart rate increased significantly (p = 0.0001) and then decreased significantly (p = 0.030) only in the alternating lateral group. Post hoc analysis revealed a significant increase in perceived exertion in the lateral alternation group, from the period before the intervention to the 10th set (p = 0.006) and from the period before to the period after the intervention (p = 0.011). In the vertical group, a significant increase was observed from the period before the intervention to the 10th set (p = 0.020). Conclusions: In conclusion, considering all the findings of this study, whole-body vibration (WBV) exercise promoted some immediate changes in physiological parameters and perception of effort in obese adults. WBV exercise with the alternating vibration platform induced significant fluctuations in heart rate and increased the heart rate–blood pressure product, although with values within the normal range. Perception of effort increased in all groups. Considering the absence of discrepant changes in physiological parameters, impact on the cardiovascular system, and fatigue, the WBV exercise intervention in side-alternating or vertical vibration vibratory platforms can be considered a viable non-conventional exercise option for the obese population. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
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26 pages, 885 KB  
Review
Personalized Nutrition Through the Gut Microbiome in Metabolic Syndrome and Related Comorbidities
by Julio Plaza-Diaz, Lourdes Herrera-Quintana, Jorge Olivares-Arancibia and Héctor Vázquez-Lorente
Nutrients 2026, 18(2), 290; https://doi.org/10.3390/nu18020290 - 16 Jan 2026
Viewed by 266
Abstract
Background: Metabolic syndrome, a clinical condition defined by central obesity, impaired glucose regulation, elevated blood pressure, hypertriglyceridemia, and low high-density lipoprotein cholesterol across the lifespan, is now a major public health issue typically managed with lifestyle, behavioral, and dietary recommendations. However, “one-size-fits-all” [...] Read more.
Background: Metabolic syndrome, a clinical condition defined by central obesity, impaired glucose regulation, elevated blood pressure, hypertriglyceridemia, and low high-density lipoprotein cholesterol across the lifespan, is now a major public health issue typically managed with lifestyle, behavioral, and dietary recommendations. However, “one-size-fits-all” recommendations often yield modest, heterogeneous responses and poor long-term adherence, creating a clinical need for more targeted and implementable preventive and therapeutic strategies. Objective: To synthesize evidence on how the gut microbiome can inform precision nutrition and exercise approaches for metabolic syndrome prevention and management, and to evaluate readiness for clinical translation. Key findings: The gut microbiome may influence cardiometabolic risk through microbe-derived metabolites and pathways involving short-chain fatty acids, bile acid signaling, gut barrier integrity, and low-grade systemic inflammation. Diet quality (e.g., Mediterranean-style patterns, higher fermentable fiber, or lower ultra-processed food intake) consistently relates to more favorable microbial functions, and intervention studies show that high-fiber/prebiotic strategies can improve glycemic control alongside microbiome shifts. Physical exercise can also modulate microbial diversity and metabolic outputs, although effects are typically subtle and may depend on baseline adiposity and sustained adherence. Emerging “microbiome-informed” personalization, especially algorithms predicting postprandial glycemic responses, has improved short-term glycemic outcomes compared with standard advice in controlled trials. Targeted microbiome-directed approaches (e.g., Akkermansia muciniphila-based supplementation and fecal microbiota transplantation) provide proof-of-concept signals, but durability and scalability remain key limitations. Conclusions: Microbiome-informed personalization is a promising next step beyond generic guidelines, with potential to improve adherence and durable metabolic outcomes. Clinical implementation will require standardized measurement, rigorous external validation on clinically meaningful endpoints, interpretable decision support, and equity-focused evaluation across diverse populations. Full article
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14 pages, 808 KB  
Article
The Effects of 24 Weeks Sensorimotor Training on Balance, Physical Function, and Pain in Women with Knee Osteoarthritis
by Caterina Mauri, Charles James Steward, Attilio Parisi, Mathew Hill, Sara Severoni, Claudia Cerulli and Elisa Grazioli
Sports 2026, 14(1), 43; https://doi.org/10.3390/sports14010043 - 16 Jan 2026
Viewed by 349
Abstract
Background: Osteoarthritis (OA) is a common degenerative joint disease that often leads to impaired postural control, pain, and reduced physical function. Exercise is considered a first-line treatment, with sensorimotor training being an effective approach for managing OA. However, the optimal method of sensorimotor [...] Read more.
Background: Osteoarthritis (OA) is a common degenerative joint disease that often leads to impaired postural control, pain, and reduced physical function. Exercise is considered a first-line treatment, with sensorimotor training being an effective approach for managing OA. However, the optimal method of sensorimotor training for individuals with OA has not yet been established. Thus, the aim of this study was to compare the effects of a 24-week Gyrokinesis method (GK) versus Pilates (PL) intervention on balance control, function, pain and kinesiophobia in women with knee OA. Methods: Twenty women (aged 60 ± 7 years) with grade 2 or 3 knee OA were assigned to either GK (n = 12) or PL (n = 8). Both groups trained twice weekly for 24 weeks. Pre- and post-intervention assessments included postural sway parameters (RMS, velocity, frequency), physical function tests (e.g., TUG, Sit-to-Stand), flexibility, pain (Brief Pain Inventory), kinesiophobia (Tampa Scale), and quality of life (SF-36). Results: GK resulted in significantly greater improvements than PL in postural sway mean velocity AP right (GK −53.85% vs. PL −20.17%), AP left (GK −43.48% vs. PL +13.45%), and ML left (GK −40.18% vs. PL +37.95), pain reduction (GK −82.5% vs. PL −33.3%), and physical function (Sit-to-Stand: GK +75.9% vs. PL +3.7%; TUG: GK −16.4% vs. PL −13.8%; Step Test right: GK +34.2% vs. PL +19.9%; Step Test left: GK +41.4% vs. PL +18.1%) (all, p < 0.05). No significant between-group differences were observed for kinesiophobia or SF-36 scores (both, p > 0.05). Conclusions: Gyrokinesis method may be more effective than Pilates in enhancing balance, reducing pain, and improving physical function in women with knee OA. These findings support the use of the Gyrokinesis method in rehabilitation programs for individuals with OA. Full article
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