Search Results (176)

This pilot, randomized, double-blind, placebo-controlled trial investigated the effects of branched-chain amino acids (BCAAs)—provided in a 2:1:1 ratio of leucine:isoleucine:valine—combined with exercise on fatigue, physical performance, and quality of life in older adults. Twenty participants (63% female; BMI: 35 ± 2 kg/m²; age: 70.5 ± 1.2 years) were randomized to 8 weeks of either exercise + BCAAs (100 mg/kg body weight/d) or exercise + placebo. The program included moderate aerobic and resistance training three times weekly. Physical function was assessed using handgrip strength, chair stands, gait speed, VO₂ max, and a 400 m walk. Psychological health was evaluated using the CES-D, Fatigue Assessment Scale (FAS), Insomnia Severity Index (ISI), and global pain, fatigue, and quality of life using a visual analog scale (VAS). Significant group x time interactions were found for handgrip strength (p = 0.03), chair stands (p < 0.01), and 400 m walk time (p < 0.01). Compared to exercise + placebo, exercise + BCAAs showed greater improvements in strength, mobility, and endurance, along with reductions in fatigue (−45% vs. +92%) and depressive symptoms (−29% vs. +5%). Time effects were also observed for ISI (−30%), FAS (−21%), and VAS quality of life (16%) following exercise + BCAA supplementation. These preliminary results suggest that BCAAs combined with exercise may be an effective way to improve physical performance and reduce fatigue and depressive symptoms in older adults. Full article

Background/Objectives: This study evaluates the effects of a personalized exercise program on symptoms (pain, fatigue, sleep, cognitive function, physical function), resilience, and health-related quality of life (HRQOL) and compares the effectiveness of in-person versus telehealth delivery. Methods: A secondary data analysis was conducted on two 12-week randomized control pilot studies for solid tumor cancer survivors. One study involved in-person home visits with telephone follow-ups. The second utilized weekly exercise recommendations via a smartphone app. Both studies had control participants who received the standard care. Symptoms, resilience, and HRQOL were measured at baseline and after 12 weeks. Paired t-tests were conducted for intervention effects and ANCOVA for group differences, adjusting for age and education. Results: The analysis included 75 program completers: 15 in-person (iHBE), 38 telehealth (TEHE), and 22 who received standard care. Those receiving exercise interventions reported improvements in physical (t = 3.0, p < 0.01) and mental fatigability (t = 3.1, p < 0.01) at program completion compared to baseline. Comparing the mean changes between participants receiving exercise interventions in-person and via telehealth, there were no significant differences between the two delivery methods except perceived visuo-perceptual cognitive difficulty (F = 3.55, p = 0.027), where telehealth showed a slight advantage. Conclusions: The study provides initial evidence of the effectiveness of a telehealth personalized exercise on fatigability and cognitive difficulty, suggesting it is a potential viable alternative to in-person intervention. Further research with a larger cohort is essential to ascertain the effects of these interventional modalities on cancer-related health outcomes. Full article

Background/Objectives: Childhood cancer, although relatively rare, has a profound impact on the quality of life of affected children and their families. Technological advances have facilitated the development of mobile applications (apps) aimed at enhancing symptom monitoring and improving communication with healthcare teams. This systematic review aimed to analyse the effect of mobile applications on the health of children with cancer, with a specific focus on health-related quality of life (HRQoL). Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. Searches were performed in PubMed (Medline), CINAHL, Cochrane and Scopus databases using MeSH terms such as Smartphone, Mobile Applications, Child Health, Neoplasms, and Digital Health, with no date restrictions, and including studies published in English, Spanish or Portuguese. We included original research studies that examined the use of mobile apps in paediatric oncology patients. The search was completed in January 2025. Results: Of the 324 records initially identified, 14 studies (mainly pilot studies, early-phase clinical trials, and observational designs) met the inclusion criteria. Interventions commonly focused on symptom tracking (pain, nausea, fatigue), promoting treatment adherence, and delivering educational content. Several studies reported high user acceptance and a potential positive impact on HRQoL, particularly when gamification strategies were incorporated to sustain children’s engagement. Conclusions: Despite the preliminary nature and small sample sizes of most studies, mobile applications appear to be effective in supporting symptom management, communication, and health education in paediatric oncology. Their use may contribute to improvements in HRQoL. Further high-quality research involving younger children and diverse socio-cultural contexts is required to confirm their effectiveness. Full article

Background: Combined cognitive and exercise training improves exercise endurance, including submaximal muscular endurance. Its effects on maximal muscular strength have yet to be determined. Accordingly, we tested the effects of combined training on muscular strength (one repetition maximum, 1RM) and endurance (as many repetitions as possible, AMRAP). Methods: Resistance-trained adults (five males, three females) completed ten sessions (four testing, six training) over 4 weeks. In each testing session, they were assessed for bench press 1RM before they completed AMRAP at 50% of initial 1RM. In each training session, they performed five bench press sets (five repetitions at 80% current 1RM), with each set followed by a hard 5 min cognitive task (Time-Load Dual-Back or Color Multi-Source Interference). Ratings of perceived exertion (RPE) were averaged to provide a session RPE. At the end of each session, participants completed a Psychomotor Fatigue Threshold Test and rated mental fatigue. Results: ANOVAs (four testing sessions) showed that combined training increased 1RM (p < 0.001; averaging 8.0 kg or 11% from sessions 1–4) and AMRAP (p < 0.01; 5.1 repetitions or 22%). Moreover, training increased RPE (p < 0.05; 0.3 or 5%) and decreased mental fatigue ratings (p < 0.001; −1.2 or −49%) but did not affect Psychomotor Fatigue Threshold Test reaction times (p > 0.05; 2 ms or 0%). Conclusions: A 4-week training program that combined high-intensity cognitive and resistance exercise tasks improved maximal and submaximal resistance exercise performance. This pilot study provides preliminary evidence that high-intensity combined training can enhance muscular strength and endurance. Full article

Background/Objectives: The main objective of the present study is to assess the short-term effects of Forest Bathing (FB) conducted in a Mediterranean forest on individuals with fibromyalgia (FM) and/or chronic fatigue syndrome/myalgia encephalomyelitis (CFS/ME) on perceived pain, fatigue, state anxiety, positive and negative affect, mood states, and state mindfulness. Methods: A total of 44 participants with FM and/or CSF/ME agreed to participate in this study. The FB session consisted of a 3 km silent walk, lasting three hours and guided by a specialized psychologist and a mountain guide to guarantee the safety of the activity. Paired-sample t-tests were used to analyze the pre–post changes in perceived pain, fatigue, state anxiety, positive and negative affect, mood states, and mindfulness. Results: All reported variables but self-reported pain showed statistically significant pre–post variations after the FB session. Particularly, large-to-very-large improvements in positive and negative affect, state anxiety, tension, depression, anger, and vigor were found. Small-to-moderate effect sizes for fatigue, friendliness, and state mindfulness were also reported. Conclusions: This study provides preliminary evidence of the short-term benefits of FB in individuals with FM and/or CFS/ME, especially on state anxiety and negative affect. Full article

Objectives: The aim of this study was to investigate the potential anatomical and physiological interconnections between the visual system and the cervical muscular system, as well as to examine the role of the visual system in the etiology and manifestation of cervical musculoskeletal pain or discomfort. Methods: A systematic review was conducted following the PRISMA guidelines, using databases such as PubMed, Scopus, Web of Science, CINAHL, and PEDro. The protocol was registered in PROSPERO. The included study designs comprised experimental studies, randomized controlled trials (RCTs), and pilot RCTs. Results: The literature search was conducted between January and May 2025 and yielded 51 studies across all databases. Seven experimental studies were finally included, all of which met the inclusion criteria and presented a mean methodological quality score of 5 on the PEDro methodological quality scale. The studies included data from a total of 308 participants (n = 261; 84.74% females). Subjects in the intervention group reported cervical pain or visual fatigue. Conclusions: Our results indicated a relationship between visual accommodation and increased electromyographic activity of the trapezius muscle, suggesting that accommodative stress may induce cervical muscle fatigue and pain. Full article

Background: Out-of-hospital cardiac arrest (OHCA) survivors and their relatives may face challenges following hospital discharge, relating to mood, cognition, and returning to normal day-to-day activities. Identified research gaps include a lack of knowledge around what type of intervention is needed to best navigate recovery. In this study, we investigate the feasibility and patient acceptability of a new virtual psychoeducational group intervention for OHCA survivors and their relatives and compare it to a control group receiving a digital information booklet. Methods: V-CARE is a comparative, single-blind randomized pilot trial including participants at selected sites of the STEPCARE trial, in the United Kingdom and Sweden. Inclusion criteria are a modified Rankin Scale (mRS) ≤ 3 at 30-day follow-up; no diagnosis of dementia; and not experiencing an acute psychiatric episode. One caregiver per patient is invited to participate optionally. The intervention group in V-CARE receives four semi-structured, one-hour-long, psychoeducational sessions delivered remotely via video call by a trained clinician once a week, 2–3 months after hospital discharge. The sessions cover understanding cardiac arrest; coping with fatigue and memory problems; managing low mood and anxiety; and returning to daily life. The control group receives an information booklet focused on fatigue, memory/cognitive problems, mental health, and practical coping strategies. Results: Primary: feasibility (number of patients consented) and acceptability (retention rate); secondary: satisfaction with care (Client Satisfaction Questionnaire 8 item), self-management skills (Self-Management Assessment Scale) and, where available, health-related outcomes assessed in the STEPCARE Extended Follow-up sub-study including cognition, fatigue, mood, quality of life, and return to work. Conclusions: If preliminary insights from the V-CARE trial suggest the intervention to be feasible and acceptable, the results will be used to design a larger trial aimed at informing future interventions to support OHCA recovery. Full article

Background/Objectives: Non-invasive spinal cord transcutaneous stimulation (scTS) has expanded the therapeutic landscape of spinal cord injury (SCI) rehabilitation, offering potential benefits beyond compensatory approaches to paralysis. Children with SCI are particularly susceptible to developing neuromuscular scoliosis due to trunk muscle paralysis and ongoing skeletal growth, making targeted interventions crucial. As demonstrated in adults and pediatrics with SCI, the ability of scTS to acutely and safely enable an upright posture and trunk control could be leveraged as a therapeutic adjunct. Activity-based locomotor training (AB-LT) alone significantly improves trunk control in children with SCIs; combining it with scTS may enhance outcomes. This pilot study evaluated the safety, feasibility, and cumulative effects of AB-LT combined with scTS on trunk control in children with SCI. Methods: Three children with SCI completed 19 to 64 sessions of combined AB-LT and scTS. Adverse effects were monitored session to session, and trunk control was assessed pre- and post-intervention. Results: Across 130 interventions in three participants, 88.5% of sessions were free from adverse effects. Reported adverse events included autonomic dysreflexia (5.4%), skin redness at electrode sites (4.6%), and headaches (1.5%). No significant impact of scTS on fatigue or central hemodynamic parameters was observed. Post-intervention, all participants demonstrated improved trunk control during quiet and perturbed sitting. Conclusions: These findings provide the first evidence supporting the safety and feasibility of this combinatorial approach in pediatric SCI rehabilitation while emphasizing the importance of monitoring skin integrity and signs of autonomic dysreflexia. This intervention shows potential synergistic benefits, warranting further research to confirm efficacy and optimize therapeutic protocols. Full article

The use of complex human–machine interfaces (HMIs) has grown rapidly over the last few decades in both industrial and personal contexts. Now more than ever, the study of mental workload (MWL) in HMI operators appears essential: when mental demand exceeds task load, cognitive overload arises, increasing the risk of work-related fatigue or accidents. In this paper, we propose a data-driven approach for the continuous estimation of the MWL of professional helicopter pilots in realistic simulated flights. Physiological and operational parameters were used to train a novel machine-learning model of MWL. Our algorithm achieves good performance (ROC AUC score 0.836 ± 0.081, the maximum F1 score 0.842 ± 0.078 and PR AUC score 0.820 ± 0.097) and shows that the operational information outperforms the physiological signals in terms of predictive power for MWL. Our results pave the way towards intelligent systems able to monitor the MWL of HMI operators in real time and question the relevancy of physiology-derived metrics for this task. Full article

Background: Dysarthria is a neuromotor speech disorder that significantly impacts patients’ quality of life. In Chile, there is a lack of culturally validated instruments for assessing dysarthria. This study aimed to cross-culturally adapt the Bogenhausen Dysarthria Scales (BoDyS) into Chilean Spanish and to conduct face and content validation. Methods: The adaptation process included translation and back-translation, followed by validation by a panel of experts. Clarity, format, and length were evaluated, and the Kappa index (KI), content validity index (CVI), and content validity ratio (CVR) were calculated to confirm item relevance. A pilot test was subsequently conducted with ten speech–language pathologists to apply the adapted version to patients. Results: The adaptation process produced a consensus version that preserved the semantic and cultural characteristics of the original scale. The statistical measures (KI = 1.00; I-CVI = 1.00; S-CVI/Ave = 1.00; S-CVI/UA = 1.00; CVR = 1.00) indicated satisfactory levels of agreement. The pilot test demonstrated the scale’s appropriateness and effectiveness for assessing dysarthria within the Chilean context, although some experts recommended reducing task repetition for patients prone to fatigue. Conclusions: The Chilean version of the BoDyS (BoDyS-CL) is a valid and useful tool for evaluating dysarthria in Chile. This study provides a foundation for further research and the systematic implementation of this scale in local clinical practice. Full article

The aetiology and pathophysiology of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have not yet been clarified. Its exact diagnosis is also difficult because it has no biomarkers. This lack of knowledge leads to difficulties in treating the disease. In our work, we are attempting to counteract this problem by analysing the central cellular mechanisms in ME/CFS patients and comparing them with those of healthy individuals. This pilot study provides a small glimpse into the journey of nine people with ME/CFS—more specifically, how their peripheral blood mononuclear cells (PBMCs) responded immediately after a session of whole-body hyperthermia (WBH). The clinical effect of WBH has already been investigated in other studies on the treatment of ME/CFS, and these studies have provided valuable insights into its potential benefits. The present study is concerned with the investigation of cellular parameters, namely autophagy, mitochondrial function and mRNA expression, before and after WBH. The results suggest that ME/CFS patients may have higher autophagy-related protein light chain 3 (LC3)-II levels and increased mitochondrial function compared with healthy individuals. A whole-body hyperthermia session could lead to a reduction in LC3-II levels, resulting in a reversion to the levels observed in healthy donors. In the case of mitochondrial parameters, hyperthermia could lead to an increase in the measured parameters. This pilot study is a continuation of a previously published study in which only the isolated cells of ME/CFS patients and a healthy control group were treated with hyperthermia. Full article

Background/Objectives: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating condition with not fully understood causes, though evidence points to immune system involvement and possible autoimmunity. ME/CFS could be triggered by various infectious pathogens, like SARS-CoV-2; furthermore, a subset of the post-COVID-19 condition (PCC) patients fulfill the diagnostic criteria of ME/CFS. According to the Canadian Consensus Criteria (CCC), the presence of specific symptoms such as fatigue, post-exertional malaise, sleep dysfunction, pain, neurological/cognitive manifestations, and symptoms from at least two of the following categories lead to the diagnosis of ME/CFS: autonomic, neuroendocrine, and immune manifestation. In this study, the patient selection was based on the identification of ME/CFS patients with elevated autoantibodies, regardless of the triggering factor of their condition. Methods: The aim of this study was to identify ME/CFS patients among long COVID patients with elevated autoantibodies. In seven cases, plasmapheresis (PE) and intravenous immunoglobulins (IVIGs) with repetitive autoantibody measurements were applied: four PE sessions on days 1, 5, 30, and 60, and a low-dose IVIG therapy after each treatment. Antibodies were measured before the first PE and two weeks after the last PE session. To monitor clinical outcomes, the following somatic and psychometric follow-up assessments were conducted before the first PE, 2 weeks after the second, and 2 weeks after the last PE: the Schellong test, ISI (insomnia), FSS (fatigue), HADS (depression and anxiety), and EQ-5D-5L (quality of life) questionnaires. Results: There was a negative association between both the β2-adrenergic and M3-muscarinic receptor autoantibody concentration and the quality of life measurements assessed with the EQ-5D-5L questionnaire. Per 1 U/mL increase in the concentration levels of β2-adrenergic receptor antibodies or M3-muscarinic acetylcholine receptor antibodies, the EQ-5D-5L index score [−0.59 to 1] decreased by 0.01 (0.63%) or 0.02 (1.26%), respectively. There were no significant associations between the ISI, HADS, and FSS questionnaires and the β1-adrenergic and M4-muscarinic receptor antibodies titers. Conclusions: After a thorough selection of patients with present autoantibodies, this pilot study found negative associations concerning autoantibody concentration and somatic, as well as psychological wellbeing. To validate these promising feasibility study results—indicating the potential therapeutic potential of antibody-lowering methods—further investigation with larger sample sizes is needed. Full article

Post-COVID-19 condition involves persistent symptoms after acute infection, often linked to dysautonomia, which affects heart rate variability, pain perception, fatigue, and sleep. Superficial neuromodulation has been proposed as a treatment. Objective: To assess the effects of superficial neuromodulation on symptoms, sleep quality, and autonomic function in post-COVID-19 condition patients. Methods: A pilot study was conducted based on a triple-blind randomized controlled trial methodology involving 16 female participants. The experimental group received neuromodulation, while the control group used a placebo device. The intervention spanned 15 sessions over two months. Primary outcomes included heart rate variability, pain threshold, cortisol levels, fatigue, sleep quality, and quality of life, analyzed using repeated-measures ANOVA. Results: Both groups improved over time. Heart rate variability (SDNN) increased in the experimental group (30.42 to 39.11 ms) but decreased in controls (31.88 to 28.73 ms) (p < 0.05). Pain threshold at C5–C6 improved in the experimental group (2.1 to 3.5 kg/cm²) but remained stable in controls (p = 0.032). Fatigue decreased significantly in both groups (p = 0.002). Sleep quality improved, with Pittsburgh Sleep Quality Index scores decreasing similarly in both groups. Cortisol levels increased, with a non-significant trend favoring controls. Conclusions: While improvements were seen, both groups benefited, suggesting a possible placebo effect. Superficial neuromodulation appears safe, but further studies with larger samples are needed to confirm efficacy. Full article

Objective: To explore the feasibility and acceptability of using an evidence-based Tai Chi intervention to manage the fatigue–sleep disturbance–depression symptom cluster (FSDSC) in female breast cancer patients. Methods: This study reported the feasibility outcomes of a pilot randomized controlled trial (RCT), along with a nested qualitative process evaluation. Seventy-two female breast cancer patients experiencing the FSDSC were randomized into either a Tai Chi group or a control group. The Tai Chi group received an eight-week Tai Chi intervention consisting of two one-hour sessions per week, along with routine care, while the control group received routine care only. The feasibility and acceptability of the study procedure and Tai Chi intervention protocol were assessed by measuring recruitment, referral, retention and drop-out rates, questionnaire completion rates (including the Brief Fatigue Inventory [BFI], Pittsburgh Sleep Quality Index [PSQI], Hospital Anxiety and Depression Scale-Depression [HADS-D], and Functional Assessment of Cancer Therapy-Breast [FACT-B]), intervention adherence, and safety outcomes. The nested qualitative process evaluation consisted of semi-structured interviews conducted among 22 participants to further explore their experiences of participating in this study and practicing Tai Chi. Descriptive data analysis was employed to present the feasibility and acceptability outcomes. Content analysis was employed to analyze the data from the qualitative process evaluation. Results: A total of 72 breast cancer patients were successfully recruited over six months, with a recruitment rate of 79.1%, retention rate of 95.8%, and dropout rate of 4.2%. No missing data was found in the BFI, PSQI, or HADS-D. However, a notable number of missing values were found in the FACT-B, particularly for items related to sexual satisfaction. The Tai Chi intervention demonstrated a high level of feasibility, with an average adherence rate of 86.8%. Only eight participants reported minor discomforts, such as minor musculoskeletal discomfort and dizziness, but they were transient and manageable after stopping Tai Chi practice. Semi-structured interviews with 22 participants highlighted that Tai Chi was experienced to be generally convenient, energy-saving, and low intensity for FSDSC management. Participants also felt that the study questionnaires were comprehensible and straightforward. Many interviewees from the Tai Chi group reported perceiving favorable effects on FSDSC management, as well as overall functional health and well-being. Conclusions: The evidence-based Tai Chi intervention proved feasible, safe, and convenient as a non-pharmacological intervention for managing FSDSC in breast cancer patients. Future large-scale studies are needed to evaluate Tai Chi’s definite effects on improving FSDSC among breast cancer patients. Full article

Background: Recent systematic reviews report a limited number of return-to-work (RTW) interventions for individuals touched by cancer (ITBC), with many falling short in effectiveness and lacking an integrated work-health approach. In response, iCanWork—a theoretically informed, multidisciplinary RTW intervention integrating vocational rehabilitation (VR) and occupational therapy (OT)—was conceptualized and developed to address the gap identified in recent reviews for robust, work-health-focused RTW interventions. Methods: A pilot randomized controlled trial was conducted to explore the feasibility, acceptability, and preliminary work-related outcomes of the iCanWork intervention among 23 ITBC participants randomized to either the intervention or control group. Feasibility was assessed through recruitment, retention, and engagement benchmarks; acceptability was measured using a participant satisfaction survey. Preliminary work-health-related outcomes included RTW status, work ability index (WAI) scores, and health-related quality of life (QoL) domains. Results: Feasibility benchmarks were achieved, with 92% recruitment, 83% retention, and 100% completing at least one VR session. Adherence to the session delivery benchmarks was met by 75% of participants before RTW and 41.7% after RTW. Participants rated the intervention highly for its tailored and supportive approach. Compared to the control group, the iCanWork group showed modest improvements in RTW status, WAI scores (mean change: +2.54), and QoL domains, including fatigue, social roles, and pain interference. Given the small sample size, these exploratory findings should be interpreted as preliminary signals to inform outcome selection for a future trial. Conclusions: iCanWork is a feasible and acceptable RTW intervention for ITBC with early indications of benefit. These findings inform the design and outcome selection for a future, larger trial aimed at evaluating the intervention’s potential to improve RTW outcomes for ITBC. Full article