Search Results (55)

Background: Postural problems such as head forward posture, thoracic hyperkyphosis, and lumbar hyperlordosis, when seen together, further complicate postural control, increasing the importance of comprehensive approaches in treatment. This study aims to examine the effect of 6 weeks of telerehabilitation with web-based exercises and compare the home-based exercises in individuals with postural problems. Trial Design: A Randomized Controlled Study. Methods: A total of 34 volunteers with postural deformity among young adults were randomly divided into telerehabilitation (n = 17) and control (n = 17) groups. Craniovertebral, thoracic kyphosis, and lumbar lordosis angles of all individuals were evaluated with a smartphone application (Clinometer+ Bubble), hamstring and pectoral muscle shortness with a goniometer, and trunk muscle endurance with endurance tests created by McGill and Sorenson. Whilst the tele-rehabilitation group was provided with a video-based exercise program, the control group was advised to follow the same exercise program at home. Exercises were performed 3 days a week for 6 weeks, as 1-h sessions. Participants in the telerehabilitation group were followed up with a synchronized video conference. Results: A significant difference was observed in the telerehabilitation group in muscle shortness and the endurance tests (p < 0.05). Only a significant difference in left (p = 0.03) and right (p = 0.04) muscle shortness was observed in the home exercise group. Significant differences were observed in Craniovertebral and lumbar lordosis angles between groups (p < 0.05), with the telerehabilitation group showing better outcomes. The kyphosis angle, muscle shortness, and endurance test results between groups were found to be similar (p > 0.05). Conclusions: Six weeks of telerehabilitation can improve muscle shortness and trunk endurance in young adults with postural deformities. Both the exercise program using telerehabilitation and the home exercise program were beneficial for individuals with postural problems, with more favorable effects observed in the telerehabilitation group. Full article

This study investigated the effects of a 12-week structured aquatic exercise program incorporating multiple immersion depths on muscle strength, postural alignment, and static balance in middle-aged women. Eighteen women in their 40s were randomly allocated to an aquatic exercise group (AG, n = 9) or a control group (CG, n = 9). The AG participated in a 12-week aquatic exercise program twice weekly in an indoor rehabilitation pool with progressively increased intensity (RPE 11–13 for weeks 1–6 and 14–16 for weeks 7–12) and multiple immersion depths (knee, waist, and xiphoid process levels). The CG was instructed to refrain from moderate-to-vigorous physical activity for 12 weeks. Outcomes included dominant handgrip strength, a 60-s abdominal curl-up test, postural alignment (3D posture analysis), and static balance (single-leg stance test). Data were analyzed using two-way mixed ANOVA. Significant group × time interactions were found for handgrip strength (p = 0.003), 60-s abdominal curl-up performance (p < 0.001), pelvic tilt alignment (p = 0.017), and single-leg stance time (p < 0.001). The AG improved handgrip strength (25.62 ± 2.81 to 27.57 ± 2.13 kg), 60-s abdominal curl-up performance (26.89 ± 2.93 to 41.56 ± 3.05 repetitions), pelvic tilt alignment (10.94 ± 3.46 to 7.63 ± 0.17), and single-leg stance time (29.49 ± 2.81 to 34.65 ± 2.60 s), whereas the CG showed no meaningful changes. No significant interaction effects were observed for head displacement, shoulder asymmetry, hip alignment, or knee alignment (all p > 0.05). These preliminary findings suggest that a structured aquatic exercise program incorporating multiple immersion depths may improve muscle strength, trunk muscular endurance, pelvic tilt alignment, and static balance in middle-aged women compared with a non-exercise control group. However, because this study did not include a fixed-depth aquatic exercise comparator, the findings should not be interpreted as evidence that exercise incorporating multiple immersion depths is superior to fixed-depth aquatic exercise. Full article

A 79-year-old former marathoner, with memory impairment since age 78, developed increasing stumbling and progressively worsening waddling gait. Three months after gait disturbance onset, she noted mild dysphagia. With declining walking distance and endurance, she presented to our hospital six months after onset, exhibiting frontal signs, Parkinsonism with marked trunk rigidity, and hyperreflexia of the jaw and limbs. L-dopa challenge tests showed no improvement. At seven months post-onset, she had difficulty rising. By nine months, she relied on a walker, and speech disturbance appeared. At 10–11 months, both dysarthria and dysphagia rapidly worsened, she became bed-ridden, and upper limb weakness developed (though she could still use chopsticks). Neurological examination at one year revealed severe dysarthria/dysphagia, four extremity fasciculations and muscle weakness (grade 2 in upper limbs, grade 1 in lower limbs), trunk-dominant rigidity, and hyperreflexia in the jaw and limbs. Brain MRI, specifically susceptibility-weighted imaging, revealed motor band signs. Cerebrospinal fluid study revealed albuminocytological dissociation. Needle electromyography revealed acute denervation and chronic reinnervation in the cranial nerve, cervical, and lumbar areas, which was suggestive of motor neuron disease (MND). Serum anti-GQ1b antibodies were detected. Immunotherapy was followed by mild improvement, which might suggest a reversible component, although definitive pathological overlap remains unconfirmed. This case highlights a diagnostic challenge where an acute immune-mediated neuropathy could potentially be superimposed on a chronic neurodegenerative process. Anti-GQ1b antibodies should be interpreted with caution, as they may reflect either a true clinicopathological overlap with Guillain-Barré syndrome or a secondary phenomenon (epiphenomenon) related to the primary neurodegenerative process. Full article

Abdominal muscles play a crucial role in spinal stability which may be altered by muscular fatigue. To assess the extent of current fatigue, subjective and objective parameters can be used. The aim of the present study was to investigate whether different perceived exertion levels correspond with changes in fatigue-associated electrophysiological parameters of abdominal muscles. For this, 34 healthy participants (17 women) underwent a 10 min static endurance task of their abdominal muscles at 50% upper body weight. Every elapsed minute, perceived exertion was assessed together with changes in electro-physiological parameters. Based on the perceived exertion levels, participants were divided into a “good end” and a “bad end” group. Independent of group, muscular fatigue was identified in all abdominal muscles. In the rectus abdominis muscle this was most pronounced, with different levels between groups and satisfactory correlations between perceived exertion levels and electrophysiological parameters. Thus, electrophysiological signs of fatigue and RPE levels are interchangeable for the rectus abdominis. In contrast and therefore of utmost importance, fatigue of the oblique abdominal muscles is largely unrelated to perceived exertion. Given the key role of these muscles in maintaining trunk stability, prolonged submaximal loads appear to affect their function regardless of mild or intense exertion level. Full article

Background/Objectives: Back pain is increasingly prevalent during childhood and adolescence, often predicting adult spinal disorders. This study aimed to describe sex-specific anthropometric and “Postural Fitness” characteristics in school-aged children and adolescents and to introduce a standardized, field-based assessment protocol for early screening of postural and functional deficits. Methods: This cross-sectional study included a total of 494 students (8–17 years; 50% girls) from 14 schools in Murcia (Spain). Exclusion criteria included diagnosed spinal pathology or major physical injury, lack of signed informed consent, absence on the testing day, and incomplete Postural Fitness assessment. The “Postural Fitness” protocol included assessments of sagittal spinal alignment (inclinometer), hip range of motion (ROM) (inclinometer with an extendable telescopic arm), pelvic tilt (goniometer with a spirit level system), and trunk muscle endurance (chronometer). Tests were conducted in physical education sessions by trained sports scientists. Results: Significant sex-based differences were observed. Boys exhibited greater thoracic kyphosis (40.3 ± 9.6° vs. 36.7 ± 9.2°), reduced hip ROM (passive hip extension (PHE): 16.8 ± 8.1°, passive hip flexion with knee extension (PHFKE): 68.9 ± 8.6°), and more posterior pelvic tilt (104.9 ± 8.4° vs. 99.7 ± 8.1°), whereas girls demonstrated increased lumbar lordosis (35.7 ± 8.6° vs. 31.5 ± 8.5°), greater hip ROM (PHE: 18.5 ± 9°, PHFKE: 77.9 ± 13°), and superior trunk extensor endurance (123.2 ± 74.7 s vs. 106.2 ± 69.8 s). Lateral trunk muscle endurance was higher in boys (48.7 ± 31 s vs. 41.4 ± 24.9 s). Conclusions: The “Postural Fitness” protocol proved feasible in school settings and revealed key sex-based disparities in spinal and neuromuscular profiles. These findings highlight the need for individualized, sex-specific screening and preventive programs to enhance back health during growth. Implementing this protocol may support early identification of modifiable risk factors linked to spinal dysfunction and pain in youth. Full article

Background: This study investigated the biomechanical and physiological demands of the hiking position in Laser sailing, a posture requiring sailors to extend their upper bodies outside the boat to counter wind-induced heeling. This study utilized a mixed-methods approach. Methods: Twenty-two experienced Laser sailors participated in both on-land and offshore assessments. The study combined subjective discomfort ratings, biomechanical measurements, digital human modeling, and muscle activation analysis to evaluate the effects of hiking during and after exertion. Results: A two-way ANOVA showed significant effects by body region and time. The quadriceps, abdominals, and lower back reported the highest discomfort. Key postural angles were identified, including knee and hip flexion, trunk inclination, and ankle dorsiflexion. Muscle activation analysis revealed the highest engagement in the rectus abdominis (46.1% MVC), brachialis (~45%), and psoas major (~41%), with notable bilateral asymmetries. The trunk region had the highest overall activation (28.7% MVC), followed by the upper limbs (~18.7%), while the lower limbs were minimally engaged during static hiking. Conclusions: On-water conditions resulted in greater variability in joint angles, likely reflecting wind fluctuations and wave-induced boat motion. Findings highlight the quadriceps, abdominals, and lower back as primary contributors to sustained hiking, while also emphasizing the importance of targeted endurance training and ergonomic equipment design. These insights can guide training, recovery, and ergonomic strategies to optimize performance and reduce injury risk in Laser sailors. Full article

Background: Diastasis recti abdominis (DRA) is a common postpartum condition typically managed with rehabilitation exercises. Given its high prevalence and postpartum barriers in attending in-person sessions, telerehabilitation may offer a feasible alternative. This small pilot study evaluates the preliminary effectiveness and user satisfaction of a 12-week telerehabilitation exercise program for women with postpartum DRA. Methods: Parous women with DRA participated in a 12-week trunk stabilization program, including synchronous and asynchronous sessions, from April 2024 to May 2025. The primary outcome was satisfaction (Telehealth Usability Questionnaire—TUQ_Greek and two additional custom-made questions). Secondary outcomes included inter-recti distance (IRD), trunk muscle endurance tests, body image (BISS_Greek), and adherence to exercise. Results: Thirteen participants aged 37.54 ± 5.49 completed the pilot intervention. Satisfaction was high (TUQ_Greek = 6.28 ± 0.60), with 84.62% (11/13 subjects) rating telerehabilitation as very satisfactory. Statistically significant reductions in IRD were observed at 2 cm (large effect, d = 1.00; 95% CI [0.12 to 0.47]) and 5 cm (large effect, d = 0.81; 95% CI [0.08 to 0.58]) above the umbilicus (p < 0.05). Post-intervention, most trunk muscle endurance tests improved significantly (p < 0.05) at 4 and 12 weeks (large effect, η² = 0.44 to–0.56). Body image (BISS_Greek) also improved post-intervention (p < 0.05, medium to large effect, d = −0.73; 95% CI [(–1.75 to –0.16]). Mean adherence reached 71.37%. Conclusions: This small pilot supports the feasibility and acceptability of a telerehabilitation program as well as its effectiveness in improving key clinical outcomes. However, since this was a small pilot, generalizability might be limited by the small sample size and should be confirmed in larger studies. Full article

Background: Structured postoperative rehabilitation is not routinely provided for individuals with adolescent idiopathic scoliosis (AIS) after surgery, with physiotherapy typically limited to the immediate inpatient period. Telerehabilitation offers an accessible and supervised option to address persistent functional limitations, pain, and quality-of-life concerns in this population. Objectives: This study aimed to evaluate the effects of a synchronous telerehabilitation program—designed to support post-surgical recovery in individuals with adolescent idiopathic scoliosis (AIS)—on trunk muscle endurance, trunk flexibility, functional capacity, pain severity, perception of appearance, and quality of life. Methods: Thirty-two individuals with AIS, who had undergone surgery 6 months to 2 years prior, were randomly assigned to either an intervention group or a control group. The intervention group participated in a supervised telerehabilitation program twice weekly for eight weeks, while the control group received no exercise intervention. All outcome measures were assessed before and after the intervention. Results: The telerehabilitation group demonstrated significant improvements across all outcome measures compared with the control group (p < 0.05). Post-intervention, the telerehabilitation group had superior trunk muscle endurance, flexibility, and quality-of-life scores, as well as reduced pain intensity (p < 0.05). However, no significant differences were observed between the groups in functional capacity or perception of appearance (p > 0.05). Conclusions: A supervised telerehabilitation program initiated six months after surgery can effectively improve trunk muscle endurance, flexibility, pain intensity, and quality of life in individuals with AIS. These findings emphasize the value of structured post-surgical rehabilitation and raise awareness of the potential benefits of remotely delivered exercise programs in this population. Full article

Individualized exercise therapy is crucial for effective postoperative rehabilitation. However, a widely accepted, standardized framework for measuring individual exercise capabilities after lumbar spine surgery (LSS) is lacking. This study aimed to develop a novel Exercise Rehabilitation Functional Group (ERFG) classification system to enable systematic, individualized rehabilitation after LSS. Eight exercise parameters and two clinical factors were assessed in 428 volunteers within 12 weeks of single-segment LSS to establish reference data for the ERFG. The study cohort included 411 participants (mean age 67.10 ± 11.60; 128 males and 283 females) with an average postoperative interval of 42.96 ± 20.25 days. Key metrics included lumbar spine ROM (mean 74.24 ± 25.30°), trunk muscle strength (mean 15.71 ± 5.14 kg), trunk muscle endurance (mean 95.80 ± 35.66 s), whole-body flexibility (mean 3.30 ± 10.65 cm), cardiopulmonary capability (mean 433.91 ± 118.75 m), gait with affected single leg (mean 36.26 ± 5.98%), single-leg balance (median 13.60 s), coordination capability (mean 8.21 ± 3.23 s), EuroQol 5-Dimension 5-Level score (mean 9.39 ± 4.17), and visual analog scale for low back pain (mean 3.78 ± 2.55). Data were categorized into five grades using Cajori’s five-grade mathematical method. Significant correlations were observed between the eight exercise parameters and two clinical factors. This study established a foundational framework for standardizing baseline exercise capabilities after LSS. This ERFG system may provide a basis for individualized rehabilitation strategies to enhance patient outcomes. Full article

Background: Children with idiopathic toe-walking (ITW) may experience difficulty during postural tasks and are more likely to perceive physical activity as difficult and challenging. This study aimed to compare postural control and muscle endurance in children with ITW and healthy controls. Methods: This cross-sectional study was conducted with 16 children with ITW (age, 10.88 ± 2.06) and 16 age-matched controls (age, 11.69 ± 1.99). Postural control was evaluated with the tests of the Biodex Balance System (postural stability, limits of stability, and modified clinical test of sensory interaction in balance) and the Balance Error Scoring System, which assesses static balance in six different conditions. Muscle endurance tests were the 1-min sit-to-stand test, the 30-sec sit-up test, and the Biering-Sorenson test. Results: There was a significant difference between the two groups in the postural stability (P < .05), limits of stability (P < .01), and modified clinical test of sensory interaction in balance (P < .01) tests of the Biodex Balance System as well as the firm surface (P = .032), foam surface (P < .001), and total surface (P < .001) scores of the Balance Error Scoring System. Although there was a significant difference between the two groups in the 1-min sitto- stand test (P = .016), no differences were found in the 30-sec sit-up test (P = .896) or the Biering-Sorenson test (P = .506). Conclusions: This comparative study showed that children with ITW had decreased postural control compared with their healthy peers. Although the lower-extremity muscle endurance of children with ITW was weaker than that of their peers, no difference was observed in terms of trunk muscle endurance. Full article

Physical education students participated in this study to explore maturity status (MAT), chronological age (CA), and sex-specific trunk muscle endurance differences. Method: Static and dynamic trunk endurance were assessed using five field-based tests. The main results show differences in all trunk endurance tests according to CA and MAT, with greater performance being found at an at older CA or higher MAT. With respect to CA and sex, differences were only found in the DEE test and from the age of 14 onwards, where boys performed better than girls. In addition, interactions were also found between sex and MAT, where boys classified as having circa- and post-peak height velocity performed better than girls in all tests. Physical fitness appears to be particularly sensitive to MAT, so it is important to consider biological maturation when assessing physical fitness rather than the CA factor commonly used in international fitness batteries for children and adolescents. Full article

Introduction: Information on the long-term maintenance of short-term exercise fitness gains measured by field-based tests is scarce in older adults. This study aimed to investigate short- and long-term changes in various physical fitness parameters after an 8-week exercise program. Methods: In this longitudinal study, a total of 265 participants (62% women; mean age 71.4 ± 4.7 years) completed a field-based test battery of 12 fitness tests (22 parameters) at 2 pre-tests and 1 post-test following an 8-week exercise program (2 sessions/week, combining aerobic and strength activities) in 2 consecutive years. The tests assessed muscle endurance, muscle strength, cardiorespiratory fitness, and motor fitness. Results: Significant short-term improvements were observed, e.g., in isometric trunk flexion and extension endurance (21–37%) for both sexes in both years. Lower-body muscular endurance improved in the first year (9–12%) for both sexes, while cardiorespiratory fitness (6-min walk test) improved only for men in both years (3%). No changes were seen in submaximal cycle test heart rates or any balance tests in any year. Most fitness parameters did not significantly decrease during the 9-month inter-intervention period, with a few exceptions in trunk strength and walking distance. Conclusions: This study demonstrates physical fitness improvements in older adults following short-term exercise interventions and that some of these improvements were maintained long term, whereas a few of these physical fitness test improvements decreased significantly over 9 months in older adults. Full article

This study investigated the impacts of online and face-to-face Mat Pilates training in adults with persistent symptoms of long COVID on health outcomes. Forty-nine patients (52 ± 5.85 yr.) diagnosed with long COVID related to fatigue symptoms were randomly included in three groups: online Mat Pilates training (n = 16), face-to-face Mat Pilates training (n = 15), and a control group (n = 18) without training. Mat Pilates training was conducted three times a week for 12 weeks. Fatigue, functional capacity, anthropometrics, body composition, and cardiometabolic markers were assessed before and after the interventions. Two-factor Generalized Estimating Equation analyses identified significant differences with Bonferroni post hoc testing (p < 0.05). After the intervention, only the face-to-face Mat Pilates training group had an improved total, physical and mental fatigue, trunk isometric strength, upper limb muscle endurance strength, and aerobic capacity (p < 0.05). No changes were found in fat mass, muscle mass, free fat mass, % of fat, body mass, body mass index, or waist and hip circumferences. No significant changes were observed in blood glucose, glycated hemoglobin, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, or blood pressure (p > 0.05). Our results highlight the potential of face-to-face Mat Pilates training as an effective intervention to mitigate persistent symptoms of long COVID related to fatigue and functional capacities. Full article

Background/Aim: University students are a particularly vulnerable population, as they spend increasing amounts of time sitting, which poses a major threat to their musculoskeletal health and posture. The aim of this cross-sectional study was to investigate gender differences in the relationships between physical activity (PA) and sedentary behavior, spinal curvatures and mobility, the endurance and balance of the trunk muscles, and the possible presence of non-specific low back pain (NS-LBP) in young adults aged 18–25 years. Methods: A total of 139 students completed all required tests. Results: Male students engaged in significantly more PA related to recreation, sports and leisure and were significantly more likely to be hyperkyphotic than female students. The more the male students participated in sports, the more pronounced the thoracic kyphosis. Female students had significantly more pronounced lumbar lordosis and anterior pelvic tilt that correlated with lumbar lordosis. Female students generally had significantly higher trunk extensor endurance and more balanced trunk musculature than males. NS-LBP correlated with PA in female students who generally had higher levels of NS-LBP than male students, with a statistically significant difference between those who practiced the most PA. Conclusions: Our results suggest that female students practice less PA and have pronounced lordosis and trunk extensor endurance, in contrast to males who practice more PA and have pronounced trunk flexor endurance and hyperkyphosis. Our findings suggest that more PA should be encouraged but implemented with caution and as an individualized gender-specific approach to prevent postural deformities and chronic musculoskeletal disorders, including NS-LBP. Full article

Background: Subjective rating scales of perceived exertion are often used to quantify effort levels during various endurance exercises, particularly submaximal tasks. The aim of the current study was to determine whether predictive conclusions can be drawn from perceived exertion levels surveyed at the start of defined submaximal endurance tasks. Methods: In this study, healthy participants performed a 10-min endurance task at 50% of their upper body weight, targeting either the back muscles (n = 47, 24 women) or abdominal muscles (n = 32, 17 women). At the end of each minute, participants were asked to rate their perceived exertion (RPE) using the 14-points Borg Scale. Based on their initial and final RPE levels, and for each muscle group separately, participants were divided into subgroups reflecting low (good start/good end) and high (bad start/bad end) strain levels. These values were then compared over the duration of the exercise. Comparisons of RPE levels between subgroups were made using the Mann-Whitney U-test for independent samples, with Bonferroni-Holm correction to account for multiple comparisons. Results: Overall, strain levels increased throughout the duration of the exercise. For the abdominal muscles, the difference between the two RPE groups remained constant over time: participants with good start/end ratings consistently showed different strain levels from those with bad start/end ratings, regardless of whether the grouping was based on initial or final exertion levels. In contrast, for the back muscles, the initial grouping showed a crossover in strain values: by the end of the task, participants in the good start group tended to report higher strain than those in the bad start group. No differences were found in initial RPE values when the grouping was based on final exertion levels. Conclusions: For endurance tasks involving the abdominal muscles, initial strain levels have strong predictive value, whereas this is not the case for the back muscles. Because back muscles are frequently loaded, continuous monitoring of RPE levels is necessary to prevent unexpected task failure, as initial RPE values are not predictive. In contrast, RPE values of 11 or higher on the 14-points Borg scale predict complete exhaustion or even premature task failure with high certainty for abdominal muscle exercises, while lower RPE levels indicate that exercise intensity can be increased. Full article