Search Results (99)

Background: Race walking, an Olympic discipline, produces an increase in energy cost and a change in the recruitment pattern of muscle fibres compared with running, yet the cardiorespiratory responses of elite race walkers to severe-intensity exercise remain poorly characterised. Objectives: (i) To determine whether exhaustive exercise performed at vΔ50 elicits VO₂max in young elite race walkers, and (ii) to compare the temporal and metabolic profiles of this effort with those of similarly trained runners. Methods: Fourteen elite junior athletes (seven race walkers and seven runners) completed an incremental test to determine velocity at the lactate threshold (vLT), vVO2max, and VO2max, followed by a constant-velocity trial at individual vΔ50 performed to voluntary exhaustion on a 400 m track. Breath-by-breath VO2, heart rate, capillary blood lactate concentration, and time to exhaustion, time limit (Tlim) were measured. Results: At vΔ50 (≈94% vVO2max), the race walkers reached VO2max, with no detectable VO2 slow component (SC) in six of seven participants. In contrast, runners exhibited a significant SC (8 ± 3% of total VO2). The energy cost (EC) was 16% higher in race walking than in running (p < 0.01). Conclusions: In elite junior race walkers, it seems that vΔ50 reliably elicits VO2max primarily due to a high baseline oxygen cost rather than a progressive VO2 SC, contrasting with the kinetic response observed in running. These discipline-specific responses suggest that interval training in race walking should be prescribed using walking-specific thresholds. This study is preliminary, given the small sample size; further studies with larger cohorts are warranted. Full article

Inhaled Treprostinil is the primary treatment of pulmonary hypertension related to interstitial lung disease (PH-ILD). Despite treatment effectiveness in clinical trials, the real-world safety and tolerability of this therapy remains unclear. We conducted a multicenter, retrospective review of adults with PH-ILD who were prescribed inhaled treprostinil. We assessed clinical outcomes, 6 min walk distance (6MWD) and changes in natriuretic peptides (BNP, NT-proBNP), as well as medication tolerance. Eighty-three patients met the inclusion criteria. The 6MWD data was collected but a limited number of patients had results within close proximity to initiation of inhalational treprostinil with only seven patients having assessments within the 3 months prior to initiation as well as 3 months post therapy. Limited 6MWD data is likely due, in part, to coinciding with the COVID pandemic, limiting face-to-face interactions and exercise testing. The majority of our subjects, 63%, had an absolute improvement in their BNP level, over a mean duration of 170 days. However, no significant difference was detected between baseline and follow-up natriuretic peptide levels. Adherence was assessed and the majority (77%) of patients remained on therapy at the time of censoring, with three-quarters (75%) meeting the target dose. Of the 15 patients intolerant to nebulized treprostinil who were transitioned to a dry powder inhaler, the majority (87%) were able to tolerate the other formulation. The medication was well-tolerated with a large percentage of patients remaining on therapy indefinitely and reaching the targeted therapeutic dose. Full article

Objectives: While Pilates exercise is commonly prescribed for chronic low back pain (CLBP), its effect on normalizing the lumbar flexion–relaxation ratio (FRR) remains unclear. This trial examined whether an 8-week Pilates exercise program (PEP) modifies FRR magnitude and side-to-side asymmetry in women with CLBP and explored associations with trunk kinematics, pain, and functional capacity. Methods: In a randomized controlled pre-test–post-test training design, ninety-six women with CLBP (55.8 ± 5.4 y) were allocated to a PEP group (n = 49) or a usual-care control group (n = 47). The PEP included two supervised 60-minute mat sessions per week over eight weeks. Surface electromyography of the right and left erector spinae and trunk flexion range of motion (TFRoM), measured via inertial sensors, were recorded during the standardized flexion–extension task pre- and post-intervention. Pain intensity (Visual Analog Scale) and functional capacity (Low Back Outcome Score, LBOS) were assessed concurrently. Results: Two-way repeated-measures ANOVA revealed no group × time interaction for global FRR (p = 0.454) or TFRoM (p = 0.745). FRR asymmetry increased by 11% in the PEP group (p = 0.033), with no change observed in the controls (p = 0.143). Compared to the controls, the PEP group exhibited a 30% reduction in pain (p = 0.003) and a 13.4% improvement in LBOS (p < 0.001) compared to the control group (all ps > 0.228). Conclusions: An 8-week Pilates intervention reduces pain and improves functional capacity in women with CLBP but does not restore lumbar extensor relaxation. The observed increase in FRR asymmetry may reflect compensatory or maladaptive redistribution. Full article

Background: Obesity alters metabolic, inflammatory, and immune responses, and acute exercise may affect these parameters differently according to body composition. This study investigated the acute effects of Spartacus exercise on metabolic, inflammatory, and immune markers in adolescent girls with overweight/obesity and normal weight. Methods: In this non-randomized clinical study, sixteen girls with overweight/obesity (BMI: 31.17 ± 3.85 kg/m²) and fourteen normal-weight girls (BMI: 21.93 ± 0.99 kg/m²) performed an intermittent running test (15 s effort, 15 s passive recovery), starting at 7 km·h⁻¹ with 1 km·h⁻¹ increments every 3 min until exhaustion. Blood samples were collected at rest (T0), immediately post-exercise (T1), and 30 min post-exercise (T2). CRP and ESR were assessed at baseline to characterize participants’ inflammatory status, while glucose and leukocyte subpopulations were evaluated to investigate acute exercise responses. Results: Fasting glucose, lipid profile (TC, TG, HDL-C, LDL-C), inflammatory markers (CRP, ESR), and leukocyte subpopulations were assessed. Significant group effects were observed for all metabolic and inflammatory markers, reflecting higher baseline values in participants with overweight/obesity compared with normal-weight participants (p < 0.05). Significant effects of time were found for glucose and leukocytes (p < 0.001), indicating acute exercise-induced changes, along with significant time × group interactions. Participants with overweight/obesity showed greater and more prolonged increases in glucose, total leukocytes, and neutrophils, whereas normal-weight girls returned to baseline within 30 min. Conclusions: Acute high-intensity intermittent exercise induces transient metabolic and immune responses in adolescents, with amplified and prolonged effects in those with obesity. These findings highlight the importance of considering body composition when prescribing exercise programs. Full article

Background: Rotator cuff-related shoulder pain (RCRSP) is a prevalent musculoskeletal disorder treated by physiotherapists. Although international guidelines support active, exercise-based management, little is known about current physiotherapy practices in Cyprus. Aim: To investigate physiotherapy management practices for RCRSP in Cyprus, assess adherence to recommended clinical guidelines, and compare findings with practices in other countries. Methods: A cross-sectional online survey was conducted among Cypriot physiotherapists between June and July 2024. An English case vignette-based questionnaire, adapted from validated international surveys, examined demographics, clinical reasoning, treatment preferences, and guideline adherence. Descriptive statistics summarised responses; chi-square tests and logistic regression identified associations between demographics and clinical decisions. Content analysis was performed on open-ended responses. Results: A total of 143 physiotherapists completed the survey. Most adhered to guideline-recommended care, with 99.3% (n = 142/143) prescribing exercise and 100% (n = 143/143) providing patient education. Conservative management was preferred, with 64.3% (n = 91/143) not recommending imaging, 72.0% (n = 103/143) not recommending injections, and 73.4% (n = 104/143) not recommending surgical referrals. Significant associations were found between special interest in shoulder conditions and recommendations for surgery (χ² = 4.937, p = 0.026) and injections (χ² = 9.143, p = 0.002). Physiotherapists recommending surgery were nearly seven times more likely to suggest MRI (Exp(B) = 6.944, p < 0.001). Conclusions: Cypriot physiotherapists predominantly use exercise and education for the management of RCRSP, aligning closely with international recommendations. Conservative strategies were favoured, with limited use of imaging, injections, and surgical referrals. However, variation in clinical decision-making, particularly regarding referrals and imaging, indicates partial adherence to best practice and highlights opportunities for enhanced guideline implementation and targeted clinical training. Full article

Objective: To evaluate the effect of Physitrack^® on jump performance in handball players through performance, kinematic, and kinetic variables. Material and Methods: A pilot, randomized clinical trial was conducted with male handball players (n = 28). Participants were allocated to either an intervention group (IG), which completed a specific jump-training program, or a control group (CG), which followed a general strengthening program. Both programs were delivered via Physitrack^® over an 8-week period. Vertical jump variables were assessed using force platforms (Hawkin Dynamics^®), along with adherence questionnaires, the Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ), and the System Usability Scale (SUS). Results: Both groups showed significant improvements in jump height, flight time, and peak velocity (p < 0.05), without differences between groups. The IG, additionally, demonstrated improvements not statistically significant in the modified Reactive Strength Index (mRSI), Rate of Force Development (RFD), and power. Mean adherence was moderate, slightly higher in the IG (52.13% vs. 48.98%), with no significant differences between groups (p = 0.74). Physitrack^® received an excellent usability rating (SUS: 83.3/100) and good satisfaction (TSUQ: 3.68/5). These findings should be interpreted with caution given the pilot nature of the study and the limited sample size, which restrict statistical power and the generalizability of results. Conclusions: Physitrack^® is a feasible tool for prescribing home-based exercises and is well rated by users. It does not directly improve adherence but facilitates the implementation of effective programs although the content of the program has a greater influence on performance improvements than the platform itself. Full article

Background: There is a critical need for feasible, non-equipment based, safe, and cost-effective exercise interventions to promote muscle strength, dynamic postural balance, and independent mobility in adolescents with cerebral palsy (CP) or spina bifida (SB). Objectives: This study aimed to examine the feasibility and preliminary response of a novel exercise program: Functionally Loaded High-Intensity Circuit Training (FUNHIT) and conventional High-Intensity Circuit Training (HIT) in adolescents with CP/SB. Methods: Enrolled participants were allocated to FUNHIT or HIT or Controls in our randomized control trial. The interventions were delivered 2×/week × 4 weeks. Feasibility was assessed through process, operational, and scientific metrics. Outcome measures included maximum walking speed, Four Square Step Test (FSST), Timed Up and Go (TUG) and its dual-task variants, Lateral Step-Up Test (LSUT), Fear of Falling (FoF) and physical activity (PA) questionnaires. Results: We tested 5 participants (1 CP, 4 SB) in our study. Recruitment and retention rates were acceptable (63% enrollment, 100% retention and adherence). FUNHIT (n = 2) participants showed improvements in maximum walking speed (8–12%), FSST (15–29%), LSUT (22–33%), and TUG (4%). The HIT participant (n = 1) demonstrated improved TUG dual-task performance (40%) and FSST (30%) only. Control participants (n = 2) had varied changes (from 0–24%) in mobility, strength, balance. No adverse events were reported. Participants successfully followed (100%) the prescribed exercise dosage over the four-week period. Conclusions: FUNHIT and HIT are feasible and safe interventions for adolescents with ambulatory CP and SB who retain motor function, showing promising preliminary improvements in muscle strength, dynamic balance, and independent mobility. Our findings need to be validated in larger samples. Full article

This study aimed to evaluate the effects of exercise on vascular flow-mediated dilation (FMD) in patients with heart failure (HF) and to identify the optimal exercise model for this population. A comprehensive search was conducted in the Web of Science, Scopus, PubMed, Embase, and Cochrane databases, including data published up to 18 August 2025. A meta-analysis was conducted to calculate standardized mean difference (SMD) and 95% confidence interval. Eleven studies met the inclusion criteria, comprising 224 participants in the intervention groups and 185 participants in the control groups. The results demonstrated that exercise significantly improved FMD (SMD = 1.14, p < 0.0001). Subgroup analysis showed that aerobic exercise (SMD = 1.25, p < 0.0001), intervention period ≤ 8 weeks (SMD = 2.19, p < 0.00001) Intervention frequency > 3 times per week (SMD = 2.82, p < 0.00001) and each intervention duration < 60 min (SMD = 1.22, p = 0.01) were the most effective in improving FMD in patients with HF. This meta-analysis indicates that aerobic exercise performed more than three times per week, for sessions under 60 min and over an intervention period of up to 8 weeks, is associated with meaningful improvements in FMD in HF patients. These findings offer clear and actionable guidance for clinicians when prescribing exercise to support vascular health in this population. Full article

An important aspect of medical rehabilitation using exoskeletons is objective monitoring of the effectiveness of the exercise program. This control is most often manual and relies on the attention of a rehabilitation physician, but advanced rehabilitation systems also use computer vision technology. Topological skeletons generalize large areas of digital images, representing a virtual internal framework of the analyzed object. The patient and the exoskeleton are described either as a set of spatially disparate (but not explicitly related to either the patient or the exoskeleton) topological skeletons, or as branches of a single topological skeleton which does not allow for objective monitoring of joint displacements. A method to solve this problem for medical rehabilitation using an upper-limb exoskeleton is proposed. It includes the following stages: (I) identifying the exoskeleton, as well as upper and lower parts of the patient’s body; (II) independent construction of three topological skeletons (separately for the exoskeleton and for the upper and lower parts of the patient’s body); (III) their integration. This approach allows for accurate, real-time analysis of movements in the upper-limb joints and prompt notification to the rehabilitation physician of any significant deviations in the technique of performing prescribed exercises. Full article

Background/Objectives: Knee osteoarthritis (OA) is a prevalent degenerative joint disorder associated with pain, impaired proprioception, and reduced physical function. While closed kinetic chain exercises (CKCEs) are commonly prescribed to enhance joint stability, their weight-bearing nature may exacerbate symptoms. Graded weight-bearing exercises (GWBEs) using anti-gravity treadmill training provide a novel approach to reduce joint loading while maintaining functional mobility. This study aimed to evaluate the effectiveness of GWBEs compared with CKCEs and open kinetic chain exercises (OKCEs) on pain, function, proprioception, and quadricep strength in patients with knee OA. Methods: Forty-five adults aged 40–60 years with radiographically confirmed knee OA were randomized into three groups: (1) GWBE + OKCE, (2) CKCE + OKCE, or (3) OKCE alone. Interventions were conducted three times per week for six-weeks. Outcomes included pain (Visual Analogue Scale), physical function (Western Ontario and McMaster Universities Osteoarthritis Index, 6-Minute Walk Test), proprioception (joint repositioning error at 45°), and quadriceps strength (isokinetic peak torque at 60°, 120°, and 180°/s). Results: All groups demonstrated significant improvements in pain and function (p < 0.05). Proprioception improved in the GWBE + OKCE and CKCE + OKCE groups but not in the OKCE group. No significant changes were observed in quadriceps strength across groups. The GWBE + OKCE group showed significantly greater improvements in pain, function, and proprioception compared to both comparator groups (p < 0.05). Conclusions: GWBE combined with OKCE is more effective than CKCE + OKCE and OKCE alone in improving pain, function, and proprioception in patients with knee OA. Full article

Background: This randomized controlled trial aimed to assess the effects of a yearly Multi-Component Exercise Training (MCET) program performed within the hospital setting on the functional capacity and Health-Related Quality of Life (HRQoL) of inpatients with psychotic disorders. Methods: Forty-eight inpatients of a public Psychiatric Hospital with a diagnosis of psychosis participated in the study and were randomly assigned to two groups: (i) the intervention group (mean age: 46.6 ± 13.2) and (ii) the control group (mean age: 47.7 ± 8.9). The MCET program consisted of moderate-intensity aerobic exercise (AE), Pilates exercises, and strengthening, balance, corrective and flexibility exercises, using rubber bands, mobility sticks and balls. Sessions were implemented three times per week over a 12-month period and each group session lasted for 30–45 min. The primary outcomes of the study included functional capacity and HRQoL. Functional capacity was assessed through measurements of strength (using handgrip and leg dynamometer), balance, and body positioning, while HRQoL was evaluated using the 36-Item Short Form Health Survey (SF-36). Results: At the end of the treatment, participants in the intervention group demonstrated significantly increased lower and upper extremity muscle strength by 35.9% (p < 0.01) and 23.6% (p < 0.01), respectively, improved balance by 18.1% (p < 0.001), and enhanced sit-and-reach and sit-to-stand results by 47.6% (p < 0.001) and 18.2% (p < 0.001), respectively, as well as increased distance covered at 6MWT by 26.2% (p < 0.001). Regarding the HRQoL, all the parameters of the SF-36 were improved, including general and mental health (p < 0.05), physical (p < 0.001) and social function (p < 0.05), physical (p < 0.01) and emotional roles (p < 0.01) and vitality and bodily pain (p < 0.001 and p < 0.05, respectively). The Physical Component Summary score (PCS) was enhanced significantly (p < 0.001), while the Mental Component Summary score (MCS) remained unchanged. Compliance with the 1-year ET program was 80%. Conclusions: The findings of the study indicated that a 1-year moderate-intensity MCET performed three times per week was safe, well accepted and efficient in improving physical functioning and HRQoL among inpatients with psychotic disorders. These results suggest that structured exercise interventions could be prescribed as add-ons to the pharmacological treatment for psychotic disorders. Full article

Background/Objectives: We aimed to test whether home-based low-intensity interval training (LIIT) could be equally or more effective than traditional continuous walking advice (TWA) in a population hospitalized and healed from severe COVID-19. Methods: This pragmatic nonrandomized controlled trial (NCT04615390) enrolled patients admitted to intensive care units due to COVID-19 who at discharge from the hospital were given a choice between either a home-based LIIT program or TWA. The former received a structured LIIT walking (1:1 walk:rest ratio per 10 times) to be performed at a prescribed progressively increasing speed maintained with a metronome. The latter received TWA according to the guidelines (30 min or moderate intensity activity, 5 days/week). Outcome measures, collected at baseline, at the end of the 3-month training and at the 6-month follow-up, included 6 min walking distance (primary), lower limb strength, quality of life, depression and cognitive status. Results: From a total of 85 enrolled patients, 69 of them (LIIT n = 32; TWA n = 37) completed the study. Home exercise was safely executed with an 82% adherence for the LIIT group and 64% adherence for TWA. After the 3-month program, both groups significantly improved the 6MWD (LIIT: +87 m vs. TWA +42 m; p < 0.001) with a significant difference that was also maintained at follow-up (LIIT: +138 m vs. TWA +69 m; p < 0.001). No other significant between-group differences were noted. However, patients in the LIIT group significantly improved in the majority of the outcomes, while patients of TWA improved in only the primary outcome and the physical component of quality of life. Conclusions: Compared with TWA, LIIT walking was feasible, safe and associated with more favorable multidimensional recovery in COVID-19 survivors after hospitalization for severe pneumonitis. Full article

Background/Objectives: The aim of this study was to assess the accuracy of TMD patients’ adherence to treatment recommendations, given in writing, based on an anonymous survey. Methods: The study material included a group of 80 patients of both sexes, aged 21 to 45 years, who came for prosthetic treatment due to symptoms of TMD at the Department of Prosthetics and Orthodontics, Jagiellonian University Medical College in Krakow. Axis I of the DC/TMD was used in the diagnosis of dysfunction. The study used an anonymous questionnaire survey, which asked specific questions regarding the reliability of the implementation of the therapeutic recommendations contained in the written treatment instructions, given to patients at the first diagnostic visit. The questionnaire survey was completed by patients once, at the second visit, which was routinely made after 4 weeks. Results: The analysis showed that the most frequent adherence of respondents was to physiotherapy treatments. The same number of patients (57.5% each) used sleep hygiene, stress management, and maintenance of dental arch dislocation during the day. More than half of the subjects used orthopaedic pillows during sleep and performed daily relaxation exercises. Less than half of the subjects (46.3–47.5%) used hot compresses on the masticatory muscles, took prescribed supplements, controlled the position of the jaw, and used an occlusal splint at the required time. Conclusions: The results of the study indicate a low percentage of adherence to the recommendations made by the doctor. Full article

Background/Objectives: Getting up from the floor is an important functional skill for independence in older adults but is not often assessed clinically. The purpose of this study was to investigate how floor-to-stand transfer (FTS) ability is related to self-report measures and five-time sit-to-stand (5XSTS) performance, as well as compare peak joint angles during common FTS strategies and lower extremity demands between the 5XSTS and a commonly instructed FTS strategy. Methods: Thirty-four community-dwelling older adults completed self-report measures and performed the 5XSTS, a FTS in a self-selected manner, and an instructed FTS strategy. Biomechanical analysis of the lower extremities was used to determine peak joint angles, moments, and powers during study tasks. Correlation analyses were used to determine associations between FTS time and self-report scores, 5XSTS time, and lower extremity demands during the 5XSTS. One-way analysis of variance (ANOVA) and Kruskal–Wallis tests were used to determine the differences in self-report measures, 5XSTS performance, and FTS time between self-selected FTS strategies. Lower extremity demands between the 5XSTS and the instructed FTS strategy were compared with Wilcoxon Signed-Rank tests. Results: Self-report measures were not associated with FTS time or different between FTS strategies. Knee flexion was greater in the roll-over compared to the quadruped strategy (p < 0.001). Ankle and hip demands were greater during the instructed FTS, and knee demands were greater during the 5XSTS (p < 0.001) when comparing the tasks. Conclusions: The study findings may improve clinical decision-making related to FTS assessment and interventions in older adults. Prescribing exercises with greater hip and ankle demand than the 5XSTS may help maximize FTS ability. Full article

Rotator cuff tears are common in individuals over 40, and physical therapy is often prescribed post-surgery. However, access can be limited by cost, convenience, and insurance coverage. CuffLink is a telehealth rehabilitation system that integrates the Strengthening and Stabilization System mechanical exerciser with the interACTION mobile health platform. The system includes a triple-axis accelerometer (LSM6DSOX + LIS3MDL FeatherWing), a rotary encoder, a VL530X time-of-flight sensor, and two wearable BioMech Health IMUs to capture upper-limb motion. CuffLink is designed to facilitate controlled, home-based exercise while enabling clinicians to remotely monitor joint function. Concurrent validity and test–retest reliability were used to assess device accuracy and repeatability. The results showed moderate to good validity for shoulder rotation (ICC = 0.81), device rotation (ICC = 0.94), and linear tracking (from zero: ICC = 0.75 and RMSE = 2.41; from start: ICC = 0.88 and RMSE = 2.02) and good reliability (e.g., RMSEs as low as 1.66 cm), with greater consistency in linear tracking compared to angular measures. Shoulder rotation and abduction exhibited higher variability in both validity and reliability measures. Future improvements will focus on manufacturability, signal stability, and force sensing. CuffLink supports accessible, data-driven rehabilitation and holds promise for advancing digital health in orthopedic recovery. Full article