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22 pages, 836 KB  
Review
Artificial Intelligence in the Evaluation and Intervention of Developmental Coordination Disorder: A Scoping Review of Methods, Clinical Purposes, and Future Directions
by Pantelis Pergantis, Konstantinos Georgiou, Nikolaos Bardis, Charalabos Skianis and Athanasios Drigas
Children 2026, 13(2), 161; https://doi.org/10.3390/children13020161 - 23 Jan 2026
Viewed by 297
Abstract
Background: Developmental coordination Disorder (DCD) is a prevalent and persistent neurodevelopmental condition characterized by motor learning difficulties that significantly affect daily functioning and participation. Despite growing interest in artificial intelligence (AI) applications within healthcare, the extent and nature of AI use in the [...] Read more.
Background: Developmental coordination Disorder (DCD) is a prevalent and persistent neurodevelopmental condition characterized by motor learning difficulties that significantly affect daily functioning and participation. Despite growing interest in artificial intelligence (AI) applications within healthcare, the extent and nature of AI use in the evaluation and intervention of DCD remain unclear. Objective: This scoping review aimed to systematically map the existing literature on the use of AI and AI-assisted approaches in the evaluation, screening, monitoring, and intervention of DCD, and to identify current trends, methodological characteristics, and gaps in the evidence base. Methods: A scoping review was conducted in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR) guidelines and was registered on the Open Science Framework. Systematic searches were performed in Scopus, PubMed, Web of Science, and IEEE Xplore, supplemented by snowballing. Peer-reviewed studies applying AI methods to DCD-relevant populations were included. Data was extracted and charted to summarize study designs, populations, AI methods, data modalities, clinical purposes, outcomes, and reported limitations. Results: Seven studies published between 2021 and 2025 met the inclusion criteria following a literature search covering the period from January 2010 to 2025. One study listed as 2026 was included based on its early access online publication in 2025. Most studies focused on AI applications for assessment, screening, and classification, using supervised machine learning or deep learning models applied to movement-based data, wearable sensors, video recordings, neurophysiological signals, or electronic health records. Only one randomized controlled trial evaluated an AI-assisted intervention. The evidence base was dominated by early-phase development and validation studies, with limited external validation, heterogeneous diagnostic definitions, and scarce intervention-focused research. Conclusions: Current AI research in DCD is primarily centered on evaluation and early identification, with comparatively limited evidence supporting AI-assisted intervention or rehabilitation. While existing findings suggest that AI has the potential to enhance objectivity and sensitivity in DCD assessment, significant gaps remain in clinical translation, intervention development, and implementation. Future research should prioritize theory-informed, clinician-centered AI applications, including adaptive intervention systems and decision-support tools, to better support occupational therapy and physiotherapy practice in DCD care. Full article
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16 pages, 926 KB  
Review
Respiratory Physiotherapy in Preterm Neonates with Bronchopulmonary Dysplasia or Respiratory Distress Syndrome: A Comprehensive Review of Clinical Evidence and Therapeutic Implications
by Paula Rodríguez-Roza, Raquel Leirós-Rodríguez, Arrate Pinto-Carral and María José Álvarez-Álvarez
J. Clin. Med. 2026, 15(1), 343; https://doi.org/10.3390/jcm15010343 - 2 Jan 2026
Viewed by 496
Abstract
Background: Preterm birth, affecting more than 13.4 million infants worldwide each year, remains one of the leading causes of neonatal morbidity and mortality. Among its complications, respiratory distress syndrome and bronchopulmonary dysplasia are predominant contributors to prolonged hospitalization and respiratory support needs. As [...] Read more.
Background: Preterm birth, affecting more than 13.4 million infants worldwide each year, remains one of the leading causes of neonatal morbidity and mortality. Among its complications, respiratory distress syndrome and bronchopulmonary dysplasia are predominant contributors to prolonged hospitalization and respiratory support needs. As advances in perinatal care have improved survival, attention has increasingly turned to optimizing respiratory function and reducing complications through non-pharmacological interventions. Respiratory physiotherapy has therefore gained recognition as a valuable adjunct to medical management in this population. Purpose: To provide a comprehensive synthesis of the current clinical evidence regarding respiratory physiotherapy techniques used in preterm neonates with respiratory distress syndrome or bronchopulmonary dysplasia. Summary of Evidence: The available literature describes several physiotherapeutic modalities—including prolonged slow expiration, postural treatment, Vöjta therapy, and gentle mechanical techniques—aimed at improving ventilation, gas exchange, and secretion clearance. Across diverse studies, these interventions have been associated with better oxygenation, improved heart and respiratory rates, shorter mechanical ventilation time, and reduced hospital stay, while showing no relevant adverse effects. Although methodological heterogeneity persists, the consistency of beneficial trends supports their integration into multidisciplinary neonatal care. Conclusions: Respiratory physiotherapy represents a safe and promising therapeutic complement for preterm neonates with respiratory distress syndrome or bronchopulmonary dysplasia. Techniques that combine postural control and controlled expiratory maneuvers appear particularly effective in enhancing pulmonary mechanics and recovery. Future research should focus on standardizing intervention protocols, identifying optimal timing and dosing, and evaluating the long-term respiratory and developmental outcomes of these physiotherapeutic strategies. Full article
(This article belongs to the Section Respiratory Medicine)
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16 pages, 437 KB  
Article
Learning Anatomy in Disruptive Times: Physiotherapy Students’ Perspectives on Blended Pedagogy in Higher Education
by Meredith T. Yeung, Karthik Subramhanya Harve, Cera C. Chiu, Jatinder Singh Kler, Rania Alia Binte Ahmad Lukman and Bernard P. Leung
Trends High. Educ. 2026, 5(1), 4; https://doi.org/10.3390/higheredu5010004 - 31 Dec 2025
Viewed by 359
Abstract
The COVID-19 pandemic necessitated the transition of physiotherapy programmes from traditional face-to-face anatomy teaching to fully online delivery. Studies conducted during this period have documented students’ positive adaptation to online anatomy learning, highlighting benefits such as increased flexibility and reduced stress, while also [...] Read more.
The COVID-19 pandemic necessitated the transition of physiotherapy programmes from traditional face-to-face anatomy teaching to fully online delivery. Studies conducted during this period have documented students’ positive adaptation to online anatomy learning, highlighting benefits such as increased flexibility and reduced stress, while also noting challenges, including diminished practical exposure. Although much of the existing research centres on medical and dental education, there is a relative paucity of studies examining physiotherapy students’ perspectives. In this study, a purposive sample of 53 entry-level physiotherapy students (Years 1–3) completed a questionnaire evaluating their experiences with anatomy education during the pandemic. Responses were compared between groups (Years 1 and 2 versus Year 3) using the Mann–Whitney U test and effect-size calculations. Year 3 students who experienced both face-to-face and online learning preferred practical sessions with silent mentors in the anatomy hall, citing greater active engagement and deeper learning. Conversely, all year groups reported that online assessments, such as the online Objective Structured Practical Examination, were less stressful than traditional formats. Year 1 and 2 students, lacking prior face-to-face practical experience, expressed neutral views regarding online practical components. Overall, while online theory and assessment components were well received, hands-on practical experience remains highly valued for promoting student engagement. These findings support the development of blended anatomy pedagogy that leverages the strengths of both modalities to enhance resilience and adaptability in the face of future educational disruptions. Full article
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16 pages, 424 KB  
Review
Lifestyle and Selected Issues Related to Sexual Health: The Importance of Specialist Care in Balneology, Dietetics, and Physiotherapy
by Agata Puszcz, Paulina Kozłowska, Justyna Wójcik, Anna Morawska, Małgorzata Wójcik, Katarzyna Plagens-Rotman, Monika Englert-Golon, Jakub Mroczyk, Małgorzata Mizgier, Ewa Jakubek, Magdalena Pisarska-Krawczyk, Stefan Sajdak, Klaudyna Madziar, Witold Kędzia and Grażyna Jarząbek-Bielecka
J. Clin. Med. 2026, 15(1), 307; https://doi.org/10.3390/jcm15010307 - 31 Dec 2025
Viewed by 662
Abstract
Background/Objectives: Sexual health is shaped by lifestyle factors alongside biomedical determinants. This review synthesises evidence on physiotherapy, balneology/peloidotherapy, and diet therapy as preventive and therapeutic adjuncts for female sexual dysfunctions and related gynaecological conditions. Methods: A structured narrative review of PubMed [...] Read more.
Background/Objectives: Sexual health is shaped by lifestyle factors alongside biomedical determinants. This review synthesises evidence on physiotherapy, balneology/peloidotherapy, and diet therapy as preventive and therapeutic adjuncts for female sexual dysfunctions and related gynaecological conditions. Methods: A structured narrative review of PubMed and Google Scholar (June–July 2025) was conducted by three independent reviewers using predefined keywords in English and Polish. Case reports, preprints, and studies before 2015 were excluded. From 7322 records, 47 studies met the inclusion criteria for qualitative synthesis. Results: Physiotherapy—particularly pelvic floor muscle training, multimodal manual therapy, neuromuscular electrical stimulation (including PTNS), magnetostimulation, short-wave diathermy, and capacitive–resistive monopolar radiofrequency—was consistently associated with reductions in dyspareunia, chronic pelvic pain, and urinary symptoms, with parallel improvements in sexual function and quality of life. Balneological procedures (brine baths/irrigations, crenotherapy, selected radon/sulphide/iodine–bromine applications) and peloidotherapy demonstrated analgesic, anti-inflammatory, and perfusion-enhancing effects, with signals of benefit in vulvodynia, endometriosis, and infertility support. Dietary measures—higher fruit intake (notably citrus), adequate vitamin D, targeted omega-3 use in PCOS, a Mediterranean dietary pattern, and prudent red-meat limitation—were associated with favourable endocrine–metabolic profiles and, in selected contexts, reduced disease risk. Conclusions: Integrating lifestyle–medicine modalities with standard care may meaningfully prevent and manage female sexual dysfunctions by addressing pain, perfusion, neuromuscular control, and endocrine–metabolic drivers. Implementation frameworks and high-quality trials are warranted to refine indications, dosing, and long-term effectiveness. Full article
(This article belongs to the Section Reproductive Medicine & Andrology)
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11 pages, 403 KB  
Systematic Review
Effect of Preoperative Pelvic Floor Muscle Training on Erectile Dysfunction After Radical Prostatectomy—A Systematic Review
by Vahid Mehrnoush, Dhruv Lalkiya, Nilanga Aki Bandara, Fatemeh Darsareh, Emmanuelle Rousseau, Sara Paziraei, Omar AbdelAziz, Waleed Shabana and Walid Shahrour
Uro 2026, 6(1), 2; https://doi.org/10.3390/uro6010002 - 29 Dec 2025
Viewed by 967
Abstract
Background: The societal effects of prostate cancer are profound. Prostate surgeries remain one of the main treatment modalities in the care of prostate cancer, and one of the common complications associated with this procedure is postoperative erectile dysfunction (ED). ED can have [...] Read more.
Background: The societal effects of prostate cancer are profound. Prostate surgeries remain one of the main treatment modalities in the care of prostate cancer, and one of the common complications associated with this procedure is postoperative erectile dysfunction (ED). ED can have a significant negative impact on men’s quality of life. The included articles from the last systematic review on effect of pre-operative pelvic floor muscle training (PPFMT) on ED after radical prostatectomy (RP) showed mixed findings but recommended the need for better exercise regime to witness better outcome. Therefore, this systematic review aims to provide further evidence from 2018 to understand the impact of PPFMT on postoperative ED and provide latest insights for future research. Methods: A systematic search was conducted on Medline, Embase, CINAHL, and Google Scholar from 2018 to June 2025, with the assistance of a subject-expert librarian. The inclusion criteria include articles which examine the effect of PPFMT on ED post prostatectomy from 2018 to June 2025 and have a minimum of two comparative groups (control vs. case). In addition, non-English articles were excluded from the study. The included articles were further assessed by two independent reviewers using Covidence, and disagreements were resolved by another independent reviewer. Results: A total of 344 articles were located and after removing duplicates, 250 articles remained. Following the abstract and title screening, nine articles were assessed for eligibility. Upon full-text review, three studies (two randomized control trials (RCTs) and one non-RCT) were ultimately included. The two RCTs showed no significant impact of PPFMT on post-operative ED. On the other hand, the non-RCT reported a significant difference in the post-operative ED rate in the case (5%) vs. control (48.6%) group. PPFMT was defined as ten pre-operative physiotherapy sessions in ten consecutive working days using anal biofeedback. Conclusions: The current study, since 2018, reveals mixed findings on the effect of PPFMT on postoperative ED. However, upon reviewing the evidence on the positive role of PPFMT in other fields (e.g., gynecology, general surgery), we noticed that the included studies may be lacking some major components like knowledge assessment, subjective and objective assessment, along with characteristics of sessions (number, duration, intensity, interval to surgery, and biofeedback) that play a crucial role in the effectiveness of the PPFMT in strengthening the pelvic floor muscle and improving the outcomes. Further research with robust designs is warranted. Full article
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28 pages, 1857 KB  
Systematic Review
Impact of Physical Rehabilitation on Endometriosis and Adenomyosis-Related Symptoms: A Systematic Review and Meta-Analysis
by Ángel Rodríguez-Ruiz, Beatriz Sierra-Artal, Mario Lozano-Lozano and Francisco Artacho-Cordón
J. Clin. Med. 2025, 14(23), 8284; https://doi.org/10.3390/jcm14238284 - 21 Nov 2025
Viewed by 1482
Abstract
Objectives: The aim of this study is to summarize recent evidence of the effectiveness of rehabilitation interventions in managing symptoms related to endometriosis and adenomyosis. Methods: The review protocol was registered previously (CRD42022236516). A systematic search was conducted in the Medline, Web of [...] Read more.
Objectives: The aim of this study is to summarize recent evidence of the effectiveness of rehabilitation interventions in managing symptoms related to endometriosis and adenomyosis. Methods: The review protocol was registered previously (CRD42022236516). A systematic search was conducted in the Medline, Web of Science, and Scopus databases for studies published up to 23 July 2025 that reported the effects of any rehabilitation intervention in women diagnosed with endometriosis or adenomyosis. Risk of bias was assessed, and meta-analyses were performed. Results: A total of 970 studies were identified, of which 19 reports from 17 trials met the inclusion criteria. Approximately one-third of the trials focused on electrophysical agents, another third on exercise programs, and the remaining studies included manual therapy-based interventions—such as pelvic floor physiotherapy (PFP), or Swedish massage—as well as other modalities. Most trials assessed changes in pain, quality of life (QoL), and mental health, showing consistent improvements following intervention. Additional outcomes evaluated included lumbopelvic impairments, sexual function, and bone mineral density. Meta-analyses of eleven studies on pain and five on QoL revealed significant effects, favoring the intervention groups. Conclusions: This review highlights promising benefits of physical rehabilitation, particularly in patients with endometriosis. A range of approaches—including therapeutic exercise, electrophysical agents, and PFP—may contribute to improvements in endometriosis-related clinical outcomes, especially pain and QoL. Full article
(This article belongs to the Special Issue Endometriosis: Clinical Challenges and Prognosis)
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15 pages, 493 KB  
Systematic Review
Effectiveness of Exercise and Physiotherapy in Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review
by Javier Antonio Tamayo Fajardo and Francisco León Parejo
Healthcare 2025, 13(22), 2973; https://doi.org/10.3390/healthcare13222973 - 19 Nov 2025
Viewed by 2010
Abstract
Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and disabling adverse effect of cancer treatment, affecting up to 65% of patients. It reduces quality of life, increases fall risk, and often leads to chemotherapy dose reduction or discontinuation. Because pharmacological management provides limited [...] Read more.
Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and disabling adverse effect of cancer treatment, affecting up to 65% of patients. It reduces quality of life, increases fall risk, and often leads to chemotherapy dose reduction or discontinuation. Because pharmacological management provides limited relief, non-pharmacological strategies such as exercise and physiotherapy have become increasingly relevant. Methods: A systematic review following the PRISMA 2020 guidelines was conducted to identify randomised controlled trials (RCTs) evaluating exercise and physiotherapy for the prevention or treatment of CIPN. PubMed, Scopus, Web of Science, and Cochrane Library were searched up to May 2025. Methodological quality was assessed with the PEDro scale, and due to heterogeneity, a narrative synthesis was performed. Outcomes included neuropathic symptoms, pain, motor and sensory function, balance, muscle strength, and quality of life. Results: Twenty-six RCTs published between 2017 and 2025 were included. Nineteen assessed exercise-based interventions (aerobic, resistance, sensorimotor, balance, yoga, or multimodal), and seven examined physiotherapy modalities (manual therapy, photobiomodulation, Scrambler therapy, ultrasound, or electrical stimulation). Both approaches improved sensory and motor symptoms, balance, muscle strength, and quality of life. Adherence ranged from 70% to 95%, and no serious adverse events were reported. However, variability in intervention design and outcome measures precluded meta-analysis. Conclusions: Exercise and physiotherapy are safe, feasible, and effective non-pharmacological strategies for managing CIPN. However, heterogeneity in intervention design highlights the need for high-quality RCTs to establish optimal protocols and standardised clinical guidelines. Full article
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19 pages, 2392 KB  
Systematic Review
Identifying Key Factors in Adherence and Dropouts in Active Physiotherapy in Children with Acute Leukemia: A Systematic Review with Meta-Analysis and Meta-Regression
by Laura Ramírez-Pérez and Noelia Moreno-Morales
Healthcare 2025, 13(21), 2766; https://doi.org/10.3390/healthcare13212766 - 30 Oct 2025
Viewed by 745
Abstract
Background/Objectives: Adherence to active physiotherapy programs in children suffering from cancer is essential to enhance the improvement generated by the treatment. Therefore, the main aim of this review was to identify the factors influencing adherence and dropout rates in exercise programs applied [...] Read more.
Background/Objectives: Adherence to active physiotherapy programs in children suffering from cancer is essential to enhance the improvement generated by the treatment. Therefore, the main aim of this review was to identify the factors influencing adherence and dropout rates in exercise programs applied to children with acute lymphoblastic leukemia. Methods: A systematic review with meta-analysis and meta-regression was conducted. The search was performed using PubMed, Scopus, Embase, SPORTDiscus, and PEDro databases. Eligible studies included randomized controlled trials focusing on determining adherence in active physiotherapy programs compared to standard care. A meta-synthesis was performed together with a random-effects meta-analysis. Furthermore, a proportion meta-analysis was developed, dividing by exercise modality, and a multivariate regression was performed to determine what factors were able to moderate the dropout rates. Results: Thirteen studies were selected, including 654 patients. Of them, 8 studies opt for multicomponent exercise, 3 used strength, and 2 selected virtual reality-based treatment. Overall, dropout rates were similar between groups. However, dropout proportions varied by intervention type, with minor attritions in strength (8.6%) and exergaming interventions (8.7%) compared to multicomponent exercise programs (18.4%). Meta-regression did not identify statistically significant moderators of dropouts. Conclusions: The heterogeneity of the studies in this target population meant that no factor could be identified as a moderator of dropouts, but exercise modality stands out as a potential moderator of adherence. Therefore, future studies should develop and test adherence-enhancing strategies to facilitate clinical implementation. Full article
(This article belongs to the Special Issue Healthcare Resilience and Patient Adherence in Rehabilitation)
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13 pages, 240 KB  
Article
Factors Associated with Radiological Examination of Patients with Non-Specific Low Back Pain
by Asma S. Alrushud, Muteb J. Alqarni, Salman Albeshan, Areej S. Aloufi, Mawaddah H. Aljohani, Mohammed A. Alqarni, Somyah A. Alhazmi, Yazeed I. Alashban and Dalia M. Alimam
J. Clin. Med. 2025, 14(20), 7187; https://doi.org/10.3390/jcm14207187 - 12 Oct 2025
Viewed by 1173
Abstract
Background/Objectives: Non-specific low back pain (LBP), a highly prevalent musculoskeletal condition, may be associated with overuse of radiological imaging, despite clinical guidelines restricting its use to cases with suspected serious pathology. This study investigated demographic, clinical, and physiotherapy-related factors influencing radiological imaging [...] Read more.
Background/Objectives: Non-specific low back pain (LBP), a highly prevalent musculoskeletal condition, may be associated with overuse of radiological imaging, despite clinical guidelines restricting its use to cases with suspected serious pathology. This study investigated demographic, clinical, and physiotherapy-related factors influencing radiological imaging use in patients with non-specific LBP. Methods: A retrospective cross-sectional study included 179 non-specific LBP patients from an outpatient physiotherapy clinic in Saudi Arabia. Patient data were anonymized and retrieved from electronic health records, including demographic, clinical, physiotherapy and imaging information. Independent variables included patient demographics, non-specific LBP characteristics, physiotherapy engagement, and pain-related outcomes. Descriptive, inferential, and multiple linear regression analyses were conducted to identify predictors of radiological imaging. Results: Among the total study sample (n = 179), 159 (88.8%) patients underwent radiological imaging, primarily X-ray (32.4%) and Magnetic Resonance Imaging (8.4%); 48.0% received multiple imaging modalities. Significant predictors of imaging use included gender (p < 0.001), higher body mass index (BMI) (p = 0.012), greater physiotherapist experience (p = 0.019), and presence of comorbidities (p = 0.023). Non-specific LBP medication use was negatively associated with imaging (p = 0.032). Physiotherapy engagement and pain-related outcomes showed no significant impact on imaging use. Conclusions: Gender, BMI, physiotherapist experience, and comorbidities could influence radiological imaging use in non-specific LBP patients. These findings highlight potential biases in imaging referral patterns and reinforce the need for adherence to evidence-based guidelines to prevent unnecessary imaging, reduce healthcare costs, and enhance patient care. Full article
(This article belongs to the Section Nuclear Medicine & Radiology)
17 pages, 551 KB  
Systematic Review
Post-Exercise Recovery Modalities in Male and Female Soccer Players of All Ages and Competitive Levels: A Systematic Review
by Emaly Vatne, Jose M. Oliva-Lozano, Catherine Saenz, Rick Cost and Josh Hagen
Sports 2025, 13(10), 343; https://doi.org/10.3390/sports13100343 - 2 Oct 2025
Cited by 1 | Viewed by 5064
Abstract
Optimal recovery supports health and enhances performance in soccer players, yet the empirical evidence on various recovery strategies in soccer is complex to interpret. This review aimed to summarize the literature on post-exercise recovery modalities in male and female soccer players of all [...] Read more.
Optimal recovery supports health and enhances performance in soccer players, yet the empirical evidence on various recovery strategies in soccer is complex to interpret. This review aimed to summarize the literature on post-exercise recovery modalities in male and female soccer players of all ages and competition levels. Following PRISMA guidelines, PubMed, SPORTDiscuss, and Web of Science were systematically searched until 17 October 2023. Randomized controlled trials or within-subjects crossover design studies that examined the effects of post-exercise recovery interventions on physical, psychological, or performance outcomes in soccer players were included. A single reviewer extracted data and assessed study quality using the Physiotherapy Evidence Database (PEDro) scale. Overall, 41 studies were included in the final review. The recovery strategies represented in these studies were organized into the following categories: active recovery, blood flow restriction, cold water immersion, contrast water therapy, compression garments, active cool-down, cryotherapy, cold garments, sleep and daytime nap, pneumatic cooling, foam rolling, mindfulness interventions, nutritional intervention, and static stretching. The findings demonstrated that cold-water immersion consistently improved jump performance and perceptions of fatigue, soreness, and overall well-being. Other recovery strategies, such as active recovery, compression therapy, sleep interventions, and nutrition supplementation, also positively impacted recovery, albeit with varying levels of effectiveness and evidence. However, the studies exhibited heterogeneity in methods, outcome measures, and recovery intervention protocols, posing challenges for generalizability. This review summarizes recovery strategies for soccer players, emphasizing the need for practitioners, coaches, and athletes to individualize interventions based on athletes’ needs, preferences, and competition level. Full article
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11 pages, 481 KB  
Article
Comparing Insomnia and Perceived Stress in Online vs. Frontal Learning: Psychometric Evaluation in a Health Sciences Cohort
by Johanna Andrea Márton, Flóra Busa, Nóra Rozmann, Attila András Pandur, Melinda Petőné Csima and David Sipos
Healthcare 2025, 13(18), 2272; https://doi.org/10.3390/healthcare13182272 - 11 Sep 2025
Viewed by 737
Abstract
Background/Objectives: University students in health sciences are particularly vulnerable to poor sleep quality and elevated stress due to academic and clinical demands. This follow-up study aimed to compare sleep quality and perceived stress levels among health science students during online and frontal [...] Read more.
Background/Objectives: University students in health sciences are particularly vulnerable to poor sleep quality and elevated stress due to academic and clinical demands. This follow-up study aimed to compare sleep quality and perceived stress levels among health science students during online and frontal (in-person) education periods and to examine the influence of behavioral and demographic factors. Methods: A prospective, follow-up design was applied involving students from the University of Pécs, Faculty of Health Sciences, across nursing, radiography, laboratory analytics, paramedicine, and physiotherapy programs. Data were collected via anonymous online questionnaires during two intervals: February–March 2023 (online education) and April–May 2023 (frontal education). The Athens Insomnia Scale (AIS) and Perceived Stress Scale (PSS-10) were used to assess sleep quality and stress, respectively. Internal consistency was evaluated using Cronbach’s alpha (AIS: α = 0.81–0.84; PSS: α = 0.87–0.90). Data were analyzed using descriptive statistics and paired sampled t-tests (p < 0.05). Results: AIS scores were significantly higher during online learning compared to in-person (5.47 ± 2.67 vs. 4.25 ± 2.48; p = 0.001), indicating poorer sleep quality. In contrast, PSS scores were higher during the frontal period (29.48 ± 8.67 vs. 24.31 ± 7.15; p < 0.05). Increased screen time, irregular routines, and lack of physical activity were associated with poorer outcomes. Conclusions: Online education may compromise sleep quality, while in-person learning appears to increase perceived stress. These findings highlight the need for targeted health promotion strategies adapted to different educational modalities. Full article
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5 pages, 224 KB  
Proceeding Paper
Satisfaction with Physiotherapy Care for Individuals with Cystic Fibrosis Across Face-to-Face, Online, and Blended Rehabilitation Settings
by Sofia O. Vieira, Ana Paula Martins, Ângela Pereira, Virgínia Marques, Inês Gano, Filipa Moita de Deus, Margarida Sousa and Sónia Vicente
Med. Sci. Forum 2025, 37(1), 13; https://doi.org/10.3390/msf2025037013 - 27 Aug 2025
Cited by 1 | Viewed by 656
Abstract
This study assessed satisfaction with physiotherapy care for individuals with cystic fibrosis across face-to-face, online, and blended formats at the National Association for Cystic Fibrosis. Forty participants, including patients and legal representatives, reported high satisfaction overall. Key strengths included respectful communication, involvement in [...] Read more.
This study assessed satisfaction with physiotherapy care for individuals with cystic fibrosis across face-to-face, online, and blended formats at the National Association for Cystic Fibrosis. Forty participants, including patients and legal representatives, reported high satisfaction overall. Key strengths included respectful communication, involvement in decision-making, scheduling flexibility, and therapist support. Face-to-face care received the highest ratings, though privacy, understanding, and engagement were consistently strong across all modalities. The results highlight the importance of patient-centred approaches and suggest that high-quality care can be delivered effectively across different treatment formats, reinforcing satisfaction as a key indicator of healthcare quality and effectiveness. Full article
10 pages, 594 KB  
Article
Perspectives of Physiotherapists on Immune Functioning in Oncological Rehabilitation in the Netherlands: Insights from a Qualitative Study
by Anne M. S. de Hoop, Karin Jäger, Jaap J. Dronkers, Cindy Veenhof, Jelle P. Ruurda, Cyrille A. M. Krul, Raymond H. H. Pieters and Karin Valkenet
Appl. Sci. 2025, 15(15), 8673; https://doi.org/10.3390/app15158673 - 5 Aug 2025
Viewed by 994
Abstract
Oncology physiotherapists frequently provide care for patients experiencing severe immunosuppression. Exercise immunology, the science that studies the effects of exercise on the immune system, is a rapidly evolving field with direct relevance to oncology physiotherapists. Understanding oncology physiotherapists’ perspectives on the subject of [...] Read more.
Oncology physiotherapists frequently provide care for patients experiencing severe immunosuppression. Exercise immunology, the science that studies the effects of exercise on the immune system, is a rapidly evolving field with direct relevance to oncology physiotherapists. Understanding oncology physiotherapists’ perspectives on the subject of immune functioning is essential to explore its possible integration into clinical reasoning. This study aimed to assess the perspectives of oncology physiotherapists concerning immune functioning in oncology physiotherapy. For this qualitative research, semi-structured interviews were performed with Dutch oncology physiotherapists. Results were analyzed via inductive thematic analysis, followed by a validation step with participants. Fifteen interviews were performed. Participants’ ages ranged from 30 to 63 years. Emerging themes were (1) the construct ‘immune functioning’ (definition, and associations with this construct in oncology physiotherapy), (2) characteristics related to decreased immune functioning (in oncology physiotherapy), (3) negative and positive influences on immune functioning (in oncology physiotherapy), (4) tailored physiotherapy treatment, (5) treatment outcomes in oncology physiotherapy, (6) the oncology physiotherapist within cancer care, and (7) measurement and interpretation of immune functioning. In conclusion, oncology physiotherapists play an important role in the personalized and comprehensive care of patients with cancer. They are eager to learn more about immune functioning with the goal of better informing patients about the health effects of exercise and to tailor their training better. Future exercise-immunology research should clarify the effects of different exercise modalities on immune functioning, and how physiotherapists could evaluate these effects. Full article
(This article belongs to the Special Issue Novel Approaches of Physical Therapy-Based Rehabilitation)
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24 pages, 743 KB  
Review
Surgical Treatment, Rehabilitative Approaches and Functioning Assessment for Patients Affected by Breast Cancer-Related Lymphedema: A Comprehensive Review
by Paola Ciamarra, Alessandro de Sire, Dicle Aksoyler, Giovanni Paolino, Carmen Cantisani, Francesco Sabbatino, Luigi Schiavo, Renato Cuocolo, Carlo Pietro Campobasso and Luigi Losco
Medicina 2025, 61(8), 1327; https://doi.org/10.3390/medicina61081327 - 23 Jul 2025
Cited by 2 | Viewed by 3965
Abstract
Introduction: Breast cancer therapy is a common cause of lymphedema. The accumulation of protein-rich fluid in the affected extremity leads to a progressive path—swelling, inflammation, and fibrosis—namely, irreversible changes. Methods: A scientific literature analysis was performed on PubMed/Medline, Scopus, Web of Science (WoS), [...] Read more.
Introduction: Breast cancer therapy is a common cause of lymphedema. The accumulation of protein-rich fluid in the affected extremity leads to a progressive path—swelling, inflammation, and fibrosis—namely, irreversible changes. Methods: A scientific literature analysis was performed on PubMed/Medline, Scopus, Web of Science (WoS), the Cochrane Central Register of Controlled Trials (CENTRAL), and the Physiotherapy Evidence Database (PEDro) from inception until 30 June 2024. Results: Breast cancer-related lymphedema (BCRL) is indeed an important healthcare burden both due to the significant patient-related outcomes and the overall social impact of this condition. Even though lymphedema is not life-threatening, the literature underlined harmful consequences in terms of pain, infections, distress, and functional impairment with a subsequent and relevant decrease in quality of life. Currently, since there is no cure, the therapeutic approach to BCRL aims to slow disease progression and prevent related complications. A comprehensive overview of postmastectomy lymphedema is offered. First, the pathophysiology and risk factors associated with BCRL were detailed; then, diagnosis modalities were depicted highlighting the importance of early detection. According to non-negligible changes in patients’ everyday lives, novel criteria for patients’ functioning assessment are reported. Regarding the treatment modalities, a wide array of conservative and surgical methods both physiologic and ablative were analyzed with their own outcomes and downsides. Conclusions: Combined strategies and multidisciplinary protocols for BCRL, including specialized management by reconstructive surgeons and physiatrists, along with healthy lifestyle programs and personalized nutritional counseling, should be compulsory to address patients’ demands and optimize the treatment of this harmful and non-curable condition. The Lymphedema-specific ICF Core Sets should be included more often in the overall outcome evaluation with the aim of obtaining a comprehensive appraisal of the treatment strategies that take into account the patient’s subjective score. Full article
(This article belongs to the Section Surgery)
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15 pages, 551 KB  
Review
Virtual and Augmented Reality for Chronic Musculoskeletal Rehabilitation: A Systematic Review and Exploratory Meta-Analysis
by Theodora Plavoukou, Pantelis Staktopoulos, Georgios Papagiannis, Dimitrios Stasinopoulos and George Georgoudis
Bioengineering 2025, 12(7), 745; https://doi.org/10.3390/bioengineering12070745 - 8 Jul 2025
Cited by 2 | Viewed by 2770
Abstract
Background: Chronic musculoskeletal disorders (CMDs) represent a leading cause of global disability and diminished quality of life, and they are often resistant to conventional physiotherapy. Emerging technologies such as virtual reality (VR), augmented reality (AR), and exergaming are increasingly used to enhance rehabilitation [...] Read more.
Background: Chronic musculoskeletal disorders (CMDs) represent a leading cause of global disability and diminished quality of life, and they are often resistant to conventional physiotherapy. Emerging technologies such as virtual reality (VR), augmented reality (AR), and exergaming are increasingly used to enhance rehabilitation outcomes, yet their comparative effectiveness remains unclear. Objective: To systematically evaluate the effectiveness of VR, AR, and exergaming interventions in improving pain, function, balance, and psychological outcomes among adults with CMDs. Methods: This systematic review and exploratory meta-analysis followed PRISMA 2020 guidelines and was prospectively registered (PROSPERO: CRD42024589007). A structured search was conducted in PubMed, Cochrane CENTRAL, Scopus, and PEDro (up to 1 May 2025). Eligible studies were randomized controlled trials (RCTs) involving adults (≥18 years) with CMDs receiving VR, AR, or exergaming-based rehabilitation. Risk of bias was assessed using the PEDro scale and the Downs and Black checklist. Where feasible, standardized mean differences (SMDs) for pain outcomes were pooled using a random-effects model. Results: Thirteen RCTs (n = 881 participants) met the inclusion criteria. Interventions spanned immersive VR, AR overlays, exergaming platforms (e.g., Kinect, Wii), and motion-tracking systems. Pain, function, and quality of life improved in most studies. An exploratory meta-analysis of eight RCTs (n = 610) yielded a significant pooled effect favoring VR/AR interventions for pain reduction (SMD = −1.14; 95% CI: −1.63 to −0.75; I2 = 0%). Exergaming showed consistent improvements in physical performance, while immersive VR was more effective for kinesiophobia and psychological outcomes. AR was underrepresented, with only one study. Risk of bias was generally low; however, publication bias could not be excluded due to limited funnel plot power (n < 10). Conclusions: VR, AR, and exergaming are effective adjuncts to conventional rehabilitation for CMDs, improving pain and function with high patient adherence. Nevertheless, gaps in long-term data, economic evaluation, and modality comparison persist. Future RCTs should address these limitations through standardized, inclusive, and longitudinal design. Full article
(This article belongs to the Special Issue Intelligent Systems for Human Action Recognition)
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