Search Results (8,480)

Background/Objectives: Gait impairment is a common finding in multiple sclerosis (MS). Clinicians have used both treadmill and overground walking for its evaluation and treatment. However, there is little evidence that these two types of walking are equivalent. Methods: An incidental finding from another study revealed differences between treadmill and overground walking speed in 24 persons with MS. We compared this to walking speed in healthy controls walking in the same two conditions. Results: Walking speed was significantly reduced on the treadmill relative to overground walking in persons with MS, while there was no difference between the two conditions for controls. Conclusions: Clinicians should consider that treadmill walking may not generalize to overground walking in this population. Full article

Toe-in (inward) and toe-out (outward) foot alignments significantly affect gait, posture, and joint stress, causing issues like abnormal gait, joint strain, and foot conditions such as plantar fasciitis and high arches. Addressing these alignments is crucial for improving mobility and comfort. This study introduces IoTToe, a wearable IoT device designed to detect and monitor gait patterns by using six ADXL345 sensors positioned on the foot, allowing healthcare providers to remotely monitor alignment via a webpage, reducing the need for physical tests. Tested on 45 participants aged 20–25 years with diverse BMIs, IoTToe proved suitable for both children and adults, supporting therapy and diagnostics. Statistical tests, including ICC, DFA, and ANOVA, confirmed the device’s effectiveness in detecting gait and postural control differences between legs. Gait variability results indicated that left leg showed more adaptability (DFA close to 0.5), compared to the right leg which was found more consistent (DFA close to 1). Postural control showed stable and agile standing with values between 0.5 and 1. Sensor combinations revealed that removing sensor B (on the gastrocnemius muscle) did not affect data quality. Moreover, taller individuals displayed smaller ankle angle changes, highlighting challenges in balance and upper body stability. IoTToe offers accurate data collection, reliability, portability, and significant potential for gait monitoring and injury prevention. Future studies would expand participation, especially among women and those with alignment issues, to enhance the system’s applicability for foot health management, safety and rehabilitation, further supporting telemetric applications in healthcare. Full article

Background and Objectives: The aim of this study is to objectively evaluate the effects of a six-week intermittent hypoxic–hyperoxic exposure program on blood pressure, respiratory function, cardiac autonomic nervous activity and C Reactive Protein levels in older adults. Materials and Methods: A double-blinded randomized controlled clinical trial was conducted on twenty-two older adults. Heart rate variability, respiratory function, blood pressure, C Reactive Protein levels and oxygen saturation were measured at two time points: baseline and after 6 weeks of treatment. Results: The maximal inspiratory pressure variable increased significantly in the EG (+7.50 ± 1.72 cmH2O, p < 0.01, ES = 1.17), while no changes were observed in the CG. The LF/HF variable decreased significantly in the EG (−1.23 ± 0.34 n.u, p < 0.01, ES = 1.11), with no significant changes in the CG. The C Reactive Protein variable decreased significantly in the EG (−7.00 ± 3.07 mg/L, p < 0.01, ES = 1.4), with no significant changes in the CG. Conclusions: Six weeks of intermittent hypoxic–hyperoxic exposure was associated with trends toward improvements in blood pressure, respiratory function, cardiac autonomic nervous activity, and C Reactive Protein levels, compared with a placebo application of the same therapy. Full article

Background: Chronic nonspecific neck pain (CNNP) is a widespread musculoskeletal condition affecting individuals across all age groups. Although cervical stabilization exercises (CSE) and Thai self-massage have each demonstrated therapeutic potential, evidence regarding the effectiveness of the combined applications of CSE and Thai self-massage remains limited. This study aimed to investigate the effects of a combined program of CSE and Thai self-massage (CSTM) on pain intensity (PI), pressure pain threshold (PPT), and neck disability (ND) in young adults with CNNP. Methods: This single-blind randomized controlled trial was conducted at the Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Thailand. Fifty young adults with CNNP were randomly assigned into two groups. The CSTM group performed CSE integrated with Thai self-massage, whereas the control group practiced stretching exercises exclusively. Both groups engaged in their respective programs three times per week for a duration of four weeks. PI, PPT, and ND were assessed at baseline, after four weeks (Week 4), and at a two-week follow-up (Week 6). Results: Both groups showed significant improvements in PI, PPT, and ND (p < 0.05), representing within-group comparisons, at Week 4 and Week 6. Furthermore, between-group comparisons at Week 4 and Week 6 indicated that the CSTM group achieved significantly greater improvements in PI and ND than the control group (p < 0.05). Conclusion: A four-week program combining CSE with Thai self-massage was effective in reducing pain intensity and neck disability in young adults with CNNP, with benefits maintained at short-term follow-up. Trial registration: Thai Clinical Trials Registry (TCTR20231102008), registered on 2 November 2023. Full article

Background/Objectives: Pilates is a form of exercise that benefits people with bodily pain and movement limitations. The Clinical Pilates method assesses a patient through history taking and exercise testing to identify the patient’s problem side and directional preference. This study is a technical report of two case studies to evaluate the feasibility of the Clinical Pilates conceptual framework for the management of neck and shoulder musculoskeletal conditions. Methods: A conceptual framework on the use of the diagnostic bullseye for neck and shoulder movements are presented. To illustrate the application of the framework, two independent case studies with neck and shoulder pain were interpreted. These cases were assessed for upper and lower quadrant movement preferences using the Clinical Pilates method. Patient self-reported outcome measures included the pain numeric rating scale (/10), patient-specific functional scale (/10), and shoulder pain and disability index (%). Results: In both case studies, the clinical outcomes improved by more than 50% from the baseline. These improvements showed that the conceptualized framework is feasible for use among individuals with neck and musculoskeletal conditions. Conclusions: The neck and shoulder diagnostic bullseyes developed provide an extension from existing lower quadrant diagnostic bullseye. The feasibility of the Clinical Pilates method for neck and shoulder conditions was illustrated in the two case studies. Full article

Background and Objectives: Endothelial dysfunction is an early indicator of cardiovascular disease and is commonly assessed using flow-mediated dilation (FMD). Although handheld ultrasound (HHUS) devices improve measurement accessibility, image analysis for conventional flow-mediated dilation (FMD) assessment remains time-consuming and highly operator-dependent. This study aimed to evaluate the between-day test–retest reliability of an AI-assisted brachial artery image analysis workflow integrating HHUS imaging with a YOLO_v12 deep learning model in postmenopausal women. Materials and Methods: Seventeen postmenopausal women aged 55–70 years completed two flow-mediated dilation assessments conducted seven days apart. Brachial artery images were acquired using a standardized FMD protocol with a handheld ultrasound system. An AI-assisted image analysis workflow based on a YOLO_v12 deep learning model was used to automatically measure baseline diameter (D_base), peak diameter (D_peak), absolute FMD (FMD_abs), and relative FMD (FMD%). Between-day reliability was evaluated using intraclass correlation coefficients (ICCs), coefficients of variation (CVs), and Bland–Altman analysis. Results: Good between-day repeatability was observed for baseline and peak diameters, with ICCs of 0.81 and 0.76 and low CVs (3.26% and 3.22%), respectively. Functional vascular outcomes also demonstrated good reliability, with ICCs of 0.81 for FMD_abs and 0.87 for FMD%. However, higher CVs were observed for FMD_abs (17.15%) and FMD% (19.09%), indicating substantial inter-individual variability. Bland–Altman analysis showed a small mean difference for FMD% (0.34%), with no evidence of systematic bias. Conclusions: An AI-assisted HHUS image analysis workflow integrating a YOLO_v12 deep learning model demonstrates acceptable between-day reliability for diameter-based and dilation-based measures of flow-mediated dilation in postmenopausal women. While variability in functional responses exists, the proposed system is feasible for research-oriented vascular assessment, providing a methodological foundation for future validation and clinical translation studies. Full article

Prediabetes is a serious and major global problem afflicting approximately 21% of the world’s population. It is the intermediate stage between normal glucose levels and type 2 diabetes mellitus (T2DM). Prediabetes is associated with major complications including the development of T2DM and increased cardiovascular disease (CVD). It can be easily diagnosed with an inexpensive plasma glucose level and/or a hemoglobin A1c (HbA1c) measurement. The mainstay of treatment is intensive lifestyle (ILS) intervention, including reduction in calories, especially saturated fats, refined carbohydrates, etc., coupled with regular physical activity of 150 min per week since ILS changes, with at least a 5% weight loss, have been shown to reduce progression to T2DM in multiple studies globally. Also, metformin therapy has been shown to prevent the progression to T2DM. In conclusion, serious consideration by guideline committees to classify prediabetes as a disease is highly recommended based on its global burden, easy and cost-effective diagnosis, association with serious conditions of diabetes and CVD, and effective ILS intervention. Therapy targeting those at an especially high risk for T2DM, such as persons with impaired glucose tolerance (IGT), impaired fasting glucose (IFG) with values ≥ 110 mg/dL (6.1 mmol/L), and/or HbA1c ≥ 6.0% (42 mmol/mol) coupled with overweightness or obesity. Full article

Background: Patients with primary central nervous system (CNS) tumors often experience fatigue and sleep disturbances, significantly impacting their quality of life. Exercise has been shown to improve these symptoms in various cancer populations. The aim of this study is to evaluate the effects of different types of exercise on fatigue and sleep in less-investigated CNS tumor patients. Methods: A literature search was conducted in PubMed, Scopus, Cochrane Library, and CINAHL. Eligible randomized and non-randomized studies evaluating exercise interventions in patients diagnosed with primary brain tumors were systematically reviewed, primarily using a narrative synthesis approach. Cancer-related fatigue and sleep-related outcomes were extracted as variables of interest. Where possible [≥2 Randomized Control Trials (RCTs) available for glioma patients], meta-analyses were conducted to assess the overall effects of physical therapy on the above-mentioned outcomes. Results: A total of 15 relevant intervention studies were identified, either RCTs or other types of studies, such as prospective feasibility cohort studies and case studies. A total of 448 participants were enrolled, with the majority diagnosed with glioma. There were single reports on pituitary adenoma after surgery and meningioma patients. In glioma patients, the overall effect of various modality exercise interventions on fatigue was non-significant, reflecting the heterogeneous characteristics of studies with diverse outcomes. However, meta-analysis focusing on combined exercise interventions (aerobic and resistance training) showed a positive effect on reducing fatigue in these patients [Standardized Mean Difference (SMD) = 0.866, p = 0.03]. Fatigue in glioma patients may also improve through yoga and Pilates. Aerobic but not strength exercise seems to improve sleep in glioma patients (SMD = 1.14, p = 0.02). Sleep quality may also improve through yoga and combined exercise. Conclusions: Certain types of exercise appear to effectively reduce fatigue and improve sleep in patients with CNS tumors. Future, well–controlled, multi-arm, larger-scale studies are necessary to resolve discrepancies, as well as to explore long-term outcomes and define factors influencing individualized exercise responses. Full article

Overwinter Syndrome (OWS) affects grass carp (Ctenopharyngodon idellus) aquaculture in China, causing high mortality and economic losses under low temperatures. Failure of antibiotic therapies shows limits of the ‘low–temperature–pathogen’ model and shifts focus to mucosal barrier dysfunction and host–microbiome interactions in OWS. We compared healthy and diseased grass carp collected from the same pond using histopathology, transcriptomics, proteomics, and metagenomics. This integrated approach was used to characterize intestinal structure, microbial composition, and host molecular responses at both taxonomic and functional levels. Results revealed a three-layer barrier failure in OWS fish: the physical barrier was compromised, with structural damage and reduced mucosal index; microbial dysbiosis featured increased richness without changes in diversity or evenness, and expansion of the virobiota, notably uncultured Caudovirales phage; and mucosal immune dysregulation indicated loss of local immune balance. Multi-omics integration identified downregulation of lysosome-related and glycosphingolipid biosynthesis pathways at transcript and protein levels, with disrupted nucleotide metabolism. Overall gut microbial richness, rather than individual taxa abundance, correlated most strongly with host gene changes linked to immunity, metabolism, and epithelial integrity. Although biological replicates were limited by natural outbreak sampling, matched high-depth multi-omics datasets provide exploratory insights into OWS-associated intestinal dysfunction. In summary, OWS entails a cold-triggered breakdown of intestinal barrier integrity and immune homeostasis. This breakdown is driven by a global restructuring of the gut microbiome, which is marked by increased richness, viral expansion, and functional shifts, ultimately resulting in altered host–microbe crosstalk. This ecological perspective informs future mechanistic and applied studies for disease prevention. Full article

In this study, a high-performance MoS₂-based strain-gauge pressure was sensor fabricated entirely below 80 °C, enabling direct integration onto flexible polyethylene terephthalate (PET) substrates. The sensor comprised a three-layer MoS₂ channel (~2 nm) patterned via dry transfer and O₂/Ar plasma etching, interfaced with Cr/Au electrodes. This wafer-scale and cost-effective fabrication route preserves the crystallinity of the film and prevents substrate degradation. The sensor achieved a gauge factor of ~104 under compression, representing a fifty-fold improvement over conventional metal foil gauges (~2), with a linear response across both compressive and tensile regimes. Mechanical robustness was confirmed through repeated bending and tape adhesion tests, with no degradation in electrical performance. When configured as a Wheatstone bridge, this device exhibits normalized sensitivity suitable for real-time monitoring, with response and recovery times below 200 ms. These results establish O₂/Ar-plasma-patterned MoS₂ architectures as a scalable, cost-effective platform for next-generation flexible sensors, outperforming metal-foil technology in applications including seat-occupancy detection, wearable physiological monitoring, and tactile interfaces for soft robotics. Full article

Background/Objectives: Lower extremity injuries represent a major health concern in elite snowsport disciplines, where high mechanical loads, complex movement patterns, and demanding environmental conditions substantially increase injury risk. Understanding injury incidence and burden in this population is essential for developing sport- and sex-specific prevention strategies. This retrospective study determined lower extremity injury incidence and burden among elite snowsport athletes. Methods: Ninety-nine Turkish National Snowsport Teams Training Camp athletes (34 females; 65 males) consented to a review of their medical records for injury incidence. Overall, sex- and sport-specific injury incidence (number/10,000 h) and burden (weeks missing/10,000 h) were calculated. Results: Overall, medial tibial stress syndrome (MTSS) was the highest burden (9.5 ± 38.7), and ankle sprain (1.7 ± 0.4) was the highest-incident injury. However, injury incidence and burden patterns differed by sex and sport. Notably, medial tibial stress syndrome (MTSS) showed comparable incidence in female and male athletes but resulted in a substantial injury burden in both sexes, reflecting prolonged time-loss from training and competition and indicating a meaningful negative impact on athletic performance. Specifically, the highest-burden injury for women was anterior cruciate ligament (ACL) rupture (16.2 ± 64.5), and for men the most common injury was MTSS (9.7 ± 40.7). For cross-country skiers, MTSS had the highest burden and incidence. For all other sports, and across sexes, ankle sprain was the highest incidence injury—women (1.3 ± 3.0), men (2.0 ± 4.5), biathletes (2.3 ± 5.7), Alpine skiers (2.8 ± 4.5), ski jumpers (1.6 ± 3.1), and snowboarders (3.2 ± 4.7)—plus the highest-burden injury for biathletes (6.9 ± 14.3) and ski jumpers (6.0 ± 14.0). The highest burden injury for Alpine skiers was ACL damage (34.3 ± 87.2), and for snowboarders it was knee collateral ligament injury (27.8 ± 78.6). Moreover, patellar tendinitis, hamstring strains, calf strains, Achilles ruptures, anterior tibial pain, meniscus tears, and hip injuries were frequently observed in injury patterns. Conclusions: Ankle sprains were the most frequent lower extremity injury in elite snowsport athletes, whereas medial tibial stress syndrome (MTSS) and anterior cruciate ligament (ACL) injuries accounted for the greatest injury burden. Injury incidence and burden differed by sex and snowsport discipline. Full article

Background/Objectives: To analyze the parent-perceived quality of life (QoL) in children with cerebral palsy (CP) and to study the relationship between sociodemographic and clinical factors and this perception, under the perspective of the International Classification of Functioning, Disability and Health (ICF). Methods: A cross-sectional study was conducted with 95 participants (ages 5–19 years) with CP. Participants’ parents were asked about sociodemographic and clinical characteristics and compiled Cerebral Palsy Quality of Life (CP-QoL) and Pediatric Disability Inventory-Computer Adaptive Test (PEDI-CAT). Participants were assessed and classified into the following functional domains: gross motor function (GMFM-88, GMFCS), manual ability (MACS), eating and drinking abilities (EDACS), and communication function (CFCS). Correlations between CP-QoL domains and variables were investigated using Spearman’s correlation coefficient and multivariate predictive models were used to investigate the variables predicting CP-QoL scores for each domain. Results: A total of 95 children with a mean age of 12.4 ± 3.5 years (range 5–19 years) were included. Participants demonstrated moderate-high GMFM-88 level (228.8 ± 44.7) and high functional performance across PEDI-CAT domains: Activity (57.2 ± 5.1), Mobility (63.1 ± 5.6), and Social/Cognitive (70.2 ± 4.3). Parent-perceived QoL was significantly higher when children did not require AFOs, botulinum toxin, or recent hospitalizations, and lower among children who attended physical therapy >2 h/week. Moderate correlations were consistently found between the ‘Feelings about Functioning’ domain and functional variables, being positive for GMFM-88 and all PEDI-CAT domains, and negative for GMFCS, MACS, EDACS and CFCS. That domain of CP-QoL was best explained by the regression model (R² = 0.619, p < 0.001), with the combination of three variables: GMFM-88, PEDI-CAT Activity and PEDI-CAT Social/Cognitive. Among them, PEDI-CAT Activity was the strongest predictor (β = 0.1436). Conclusions: In children with CP, to enhance family well-being, interventions should prioritize social participation and carefully balance the intensity and frequency of therapy against family burden and daily life demands, as QoL is primarily driven by manual ability and functional performance. Full article

This quantitative observational study with pre–post design aimed to examine joint-specific kinematic adaptations and the relationship between trunk stability and spatiotemporal gait parameters following intensive robotic rehabilitation. A total of 12 neurological patients completed 16 sessions of gait training using the Tecnobody Smart Gravity Walker. Pre- and post-training kinematic data were collected for bilateral hip and knee flexion–extension, trunk flexion–extension, trunk lateral flexion, and center-of-gravity displacement. Waveforms were normalized to 100% stride. Paired t-tests assessed pre–post differences, and correlations examined associations between trunk stability and gait performance. Significant increases were found in right hip flexion–extension (t = 3.44, p < 0.001), trunk flexion–extension (t = 9.49, p < 0.001), and center-of-gravity displacement (t = 15.15, p < 0.001), with reduced trunk lateral flexion (t = –8.64, p < 0.001). Trunk flexion–extension correlated with gait speed (r = 0.74), step length (r = 0.68), and stride length (r = 0.71); trunk lateral flexion correlated with cadence (r = 0.66) and stride length (r = 0.70). Intensive robotic rehabilitation improved trunk and hip kinematics, supporting trunk stability as an important biomechanical correlate of gait recovery. Sensor-derived metrics revealed strong neuromechanical coupling between postural control and locomotion in neurological patients. Full article

Background: Pelvic floor dysfunction, more prevalent in women but affecting both genders, impairs sphincter control and sexual health, and causes pelvic pain. Pelvic floor muscle (PFM) training is the first-line treatment for urinary incontinence, supported by robust evidence. Rehabilitative ultrasound imaging (RUSI) serves as a visual biofeedback tool, providing real-time imaging to enhance PFM training, motor learning, and treatment adherence. Aim: This narrative review evaluates the role and efficacy of RUSI in pelvic floor rehabilitation. Method: A comprehensive search of PubMed, Cochrane, and MEDLINE was conducted using keywords related to pelvic floor rehabilitation, ultrasound, and biofeedback, limited to English-language publications up to July 2025. Systematic reviews, meta-analyses, and clinical trials were prioritized. Results: Transperineal and transabdominal ultrasound improve PFM function across diverse populations. In post-prostatectomy men, transperineal ultrasound-guided training enhanced PFM contraction and reduced urinary leakage. In postpartum women with pelvic girdle pain, transabdominal ultrasound-guided biofeedback combined with exercises decreased pain and improved function. Ultrasound-guided pelvic floor muscle contraction demonstrated superior performance compared to verbal instruction. Notably, 57% of participants who were unable to contract the pelvic floor muscles with verbal cues achieved a correct contraction with ultrasound biofeedback, and this approach also resulted in more sustained improvements in PFM strength. Compared to other biofeedback modalities, RUSI demonstrated outcomes that are comparable to or superior to those of alternative methods. However, evidence is limited by a lack of standardized protocols and randomized controlled trials comparing RUSI with other modalities. Conclusions: RUSI is an effective visual biofeedback tool that enhances outcomes of PFM training in pelvic floor rehabilitation. It supports clinical decision-making and patient engagement, particularly in cases where traditional assessments are challenging. Further research, including the development of standardized protocols and comparative trials, is necessary to optimize the clinical integration of this method and confirm its superiority over other biofeedback methods. Full article

Background/Objectives: Low back pain (LBP) is one of the most prevalent musculoskeletal disorders globally, significantly impacting quality of life across diverse populations. Despite its association with middle-aged and older populations, evidence indicates that LBP is increasingly prevalent among younger age groups. Health science students are considered a potential risk factor for LBP; however, longitudinal studies are scarce. This study aims to determine the risk factors for LBP among health science students over a 2-year follow-up. Methods: One hundred ninety-seven of the third-class health science students (Nursing, Physiotherapy, Medical laboratory science, and Emergency Medical services) were contacted in June 2024. A self-administered modified version of the Standardized Nordic Questionnaire, and data about sedentary and physical activity behavior, as well as 1-month LBP (lasting at least 12 h and numeric rating scale > 5) and stress scores, were recorded. Results: A total of 172/197 (87.3%) respondents completed the questionnaire at the end of the 2-year follow-up. The mean age was 25 ± 3.5 (years) and body mass index (BMI) value 23.5 ± 4.3 (kg/m²). About 49% (n = 84) and 20% (n = 34) of the participants had 1-month LBP and functional disability, respectively. No significant association was found between health science programs and the presence of 1-month LBP (χ² = 0.55, p > 0.05). The logistic regression analyses found that males (OR = 0.269, p = 0.005) and a history of pain frequency (OR = 3.377, p = 0.001) had a significant association with LBP over time. Conclusions: This prospective study shows a high prevalence of 1-month LBP (48.8%) among health science students at Zefat Academic College. LBP was significantly related to sex (female) and pain frequency, but not to health science students. We believe that implementing ergonomic and educational strategies is recommended for this population. Full article