Search Results (2,926)

The 15 min city concept seeks to promote health, well-being, and quality of life by ensuring that essential services are located within a 15 min walking or cycling distance from housing and are accessible through sustainable modes of transportation. This study aims to evaluate the compliance of this concept in a developing country context and provide supporting evidence by examining if residing within the 15 min reach to basic services affects perceived health, perceived accessibility, and life satisfaction. To assess pedestrian accessibility in Lahore, Pakistan, we adapted the NEXT proximity index—originally developed as part of the Landscape Metropolis Project in Italy—which scores 15 min access using open data sources. A network analysis was conducted to determine the shortest travel times to various points of interest, including education, transportation, healthcare, shops, restaurants, leisure spaces, places of worship, and financial services. Each hexagonal unit in the study area was assigned an access score proportional to its proximity to these facilities. These access scores were then analyzed using multiple regression models, based on survey data collected from 519 university students regarding their perceived health, perceived accessibility, and life satisfaction. According to the network analysis conducted using WorldPop estimates of Lahore’s population, only up to 30% of the population resides in areas that qualify as a 15 min city for each facility type. Moreover, access to bus stops significantly enhances both perceived accessibility and life satisfaction, while proximity to healthcare services shows the strongest positive association with life satisfaction. Full article

Background/Objectives: Physical examination techniques are commonly used for the diagnosis and evaluation of Arteriosclerosis Obliterans (ASO). However, these methods do not objectively reflect the degree of claudication or functional impairment reported by patients. Moreover, standardized functional metrics to facilitate consistent clinical communication and prognostic assessments among healthcare providers are lacking. This study aimed to identify performance-based functional tests that enable quantitative assessment of symptoms and gait limitation in patients with ASO and to propose them as objective, reproducible clinical indicators. Methods: Fifty-six participants (27 patients with ASO and 29 healthy controls) underwent multiple functional tests, including the Five Times Sit-to-Stand Test (FTSS), six-minute walk test (SMWT), gait speed, Short Physical Performance Battery (SPPB), and grip strength. Test results were compared between the groups and evaluated against ankle-brachial index (ABI) values for diagnostic and functional relevance. Results: Patients with ASO demonstrated significantly lower SPPB scores, slower gait speed, longer FTSS times, and shorter SMWT distances than controls, whereas grip strength did not differ. Random forest and receiver operating characteristic analyses identified the FTSS, SMWT, and gait speed as significant predictors of ASO. Conclusions: The FTSS, SMWT, and gait speed are simple and clinically meaningful performance-based measures that can complement the ABI in the evaluation of ASO. Combining the FTSS with the SMWT and gait speed may provide a more comprehensive and reliable functional assessment and facilitate early screening, guide clinical decision-making, and enable objective evaluation of functional recovery before and after treatment, while improving patient self-assessment and communication among healthcare providers. Full article

Currently, an active debate is underway among the academic community, urban planners, and policymakers regarding optimal models of urban development, given that the majority of the population now resides in cities. One concept under discussion is the 15 min city, which posits that all urban residents should be able to reach key, frequently used services within a 15 min walk or cycle. Although the literature suggests numerous potential benefits, debate persists about whether such cities would be optimal from the standpoint of sustainable development objectives and residents’ quality of life. The ongoing discussion also concerns the extent to which existing cities are capable of aligning with this concept. This is directly linked to the actual spatial distribution of individual services within the city. The literature indicates a research gap arising from a shortage of robust case studies that would enable a credible assessment of the practical implementation of this idea across diverse cities, countries, and regions. This issue pertains to Poland as well as to other countries. A desirable future scenario would involve comprehensive mapping of all cities, with respect to both the spatial distribution of specific services and related domains such as the quality and coherence of linear infrastructure. This article presents an analysis of the spatial accessibility of basic urban services in the context of implementing the 15 min city concept, using the city of Koszalin (Poland) as a case study. This city was selected due to its representative character as a medium-sized urban centre, both in terms of population and area, as well as its subregional functions within Poland’s settlement structure. Koszalin also exhibits a typical spatial and functional layout characteristic of many Polish cities. In light of growing challenges related to urbanisation, climate change, and the need to promote sustainable mobility, this study focuses on evaluating access to services such as education, healthcare, retail, public transport, and green spaces. The use of Geographic Information System (GIS) tools enabled the identification of spatial variations in service accessibility across the city. The results indicate that only 11% of Koszalin’s area fully meets the assumptions of the 15 min city concept, providing pedestrians with convenient access to all key services. At the same time, 92% of the city’s area offers access to at least one essential service within a 15 min walk. Excluding forested areas not intended for development increases these values to 14% and 100%, respectively. This highlights the extent to which methodological choices in assessing pedestrian accessibility can shape analytical outcomes and the interpretations drawn from them. Moreover, given this article’s objective and the adopted analytical procedure, the assumed pedestrian walking speed is the key parameter. Accordingly, a sensitivity analysis was conducted, comparing the reference scenario (4 km/h) with alternative variants (3 and 5 km/h). This approach demonstrates the extent to which a change in a single parameter affects estimates of urban-area coverage by access to individual services reachable on foot within 15 min. The analysis reveals limited integration of urban functions at the local scale, highlighting areas in need of planning intervention. This article proposes directions for action to improve pedestrian accessibility within the city. Full article

Background and Objectives: COVID-19 has been associated with prolonged inactivity and reduced physical performance, even in mild and moderate cases. This study aimed to evaluate changes in functional mobility and gait speed, assessed with the Timed Up and Go (TUG) and 10-Meter Walk Test (10MWT), in patients with mild to moderate post-COVID-19 conditions undergoing a structured rehabilitation program. Materials and Methods: A controlled observational study was conducted on 193 patients (115 women, 78 men) who had recovered from mild to moderate COVID-19. Participants were divided into a rehabilitation group (n = 160) and a control group (n = 33) who did not undergo structured physical therapy. Functional performance was assessed with TUG and 10MWT at admission and at one-year follow-up. Results: Both tests showed significant improvements following rehabilitation. In the rehabilitation group, the proportion of patients classified as functionally independent increased significantly for both the TUG (Cramér’s V = 0.468, p < 0.001) and 10MWT (Cramér’s V = 0.500, p < 0.001). The McNemar test confirmed a moderate within-group improvement for 10MWT (p = 0.001). Older adults (≥60 years) exhibited functional gains comparable to younger participants. A strong association between final TUG and 10MWT categories (Cramér’s V = 0.40, p < 0.001) confirmed the consistency of outcomes. Conclusions: Structured rehabilitation significantly improves balance, gait speed, and functional independence in mild-to-moderate post-COVID-19 patients. These findings highlight that rehabilitation should be integrated into the continuum of post-COVID care, as meaningful recovery is achievable even outside severe cases. Full article

Introduction: Numerous overuse injuries affecting the lower limbs of elite athletes have been associated with biomechanical alterations in plantar loading of the foot. This study aimed to analyze the plantar pressure distribution in elite male soccer players and its relationship with various morphological and functional factors, including foot type, metatarsal and digital alignment, and on-field position. Material and Method: Dynamic foot pressure measurements were obtained from 21 soccer players who participated in the UEFA Champion League. The participants had an average age of 27 years, with an average height of 180.9 cm, weight of 76.9 kg, and BMI of 23.4. An insole system (BioFoot/IBV) with telemetry transmission was employed to record plantar loading patterns during normal gait and running. Results: During the support or contact phase, the central and medial metatarsal areas exhibited the highest peak pressure under both walking and running conditions. When walking, the right foot exerted 13–60% more pressure on the outer metatarsal and toe areas. The left foot experienced up to 13% more peak pressure in the middle metatarsal area. During running, the total pressure difference between the feet ranged from −8% to +19%. The right foot usually had more peak pressure on the heel and first toe. In players with valgus feet, the pressure in the central metatarsal area increased from 1086 kPa (walking) to 1490 kPa (running), representing a 37% increase. Conversely, in players with cavus-varus feet, the pressure in this central area increased from 877 kPa to 1804 kPa, a 105% increase. Conclusions: Foot morphology and playing position significantly influenced the plantar pressure patterns in elite soccer players. The central metatarsal region bears the highest load, particularly during running, with distinct variations across foot types and field positions. These findings highlight the need for individualized biomechanical assessments to prevent overuse injuries and optimize performance. Full article

Background/Objectives: The external validity of sarcopenia screening questionnaires in the elderly has been examined in several conditions but rarely evaluated in patients with rheumatoid arthritis (RA). This study aimed to determine the performance of five Thai versions of sarcopenia screening questionnaires (SARC-F [Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls], SARC-CalF [SARC-F plus calf circumference], MSRA [Mini Sarcopenia Risk Assessment]-7, MSRA-5, and modified MSRA-5 questionnaires) in Thai RA patients, and evaluate the correlations among these instruments. Methods: In this cross-sectional study, consecutive adult RA patients (aged ≥20 years) from an outpatient rheumatology clinic completed the five sarcopenia screening questionnaires listed above. Sarcopenia was defined according to criteria of the 2019 Asian Working Group for Sarcopenia (AWGS). Appendicular skeletal muscle mass, grip strength, and physical performance were assessed using bioelectrical impedance analysis, a hand dynamometer, and a 6 m gait speed test, respectively. The cut-off values used for each sarcopenia screening questionnaire were pre-specified according to their respective established thresholds. Results: Of 299 RA patients (89.0% female, mean age of 61.3 ± 11.6 years, median [interquartile range] disease duration of 12.8 [8.2, 20.0] years), 37.5% and 27.4% of them had sarcopenia and severe sarcopenia, respectively. The areas under the receiver operating characteristic (ROC) curve for the SARC-F, SARC-CalF, MSRA-7, MSRA-5, and modified MSRA-5 questionnaires were 0.60, 0.74, 0.65, 0.62, and 0.65, respectively, with sensitivities of 34.8%, 73.2%, 77.7%, 68.8%, and 72.3% and specificities of 84.5%, 75.4%, 51.3%, 55.1%, and 58.3%, respectively. SARC-F demonstrated moderate correlations with the other questionnaires: SARC-CalF (r = 0.57), MSRA-7 (r = −0.52), MSRA-5 (r = −0.55), and modified MSRA-5 (r = −0.65), all with a p-value of <0.001. Conclusions: Sarcopenia is common among Thai RA patients. SARC-CalF had the best balance of sensitivity and specificity and is likely the most suitable sarcopenia screening questionnaire for Thai RA patients. Full article

Multiple sclerosis is an inflammatory and neurodegenerative disease that leads to motor, cognitive, and sensory impairments, significantly affecting walking and quality of life. This study aimed to analyze the relationship between quality of life and kinematic walking parameters in individuals with multiple sclerosis, as well as to evaluate the influence of fatigue, balance, and cognitive performance on different aspects of quality of life. A cross-sectional observational study was conducted with 32 patients diagnosed with multiple sclerosis with Expanded Disability Status Scale scores of ≤5.5. Quality of life was assessed using the MusiQoL questionnaire, and clinical variables included fatigue (Fatigue Scale for Motor and Cognitive Functions, Borg scale), balance (Berg Balance Scale), and cognitive performance (Trail Making Test). Walking kinematics were analyzed using the Vicon motion capture system to obtain walking speed, step frequency, and joint asymmetry indices. Spearman correlations and linear regression models were applied. Results showed significant correlations between quality of life and walking speed (rho = 0.506), step frequency (rho = 0.508), and knee asymmetry (rho = −0.525), as well as strong associations with cognitive fatigue (rho = −0.796) and balance (rho = 0.635). Regression models explained up to 58.4% of the variance in the Activities of Daily Living dimension. These findings indicate that quality of life in multiple sclerosis is influenced by both clinical and biomechanical factors, highlighting the importance of comprehensive assessments to guide physiotherapeutic interventions. Full article

This study evaluated the accuracy of heart rate (HR) measures of a commercial wearable device on tattooed skin and assessed tattoo characteristics associated with HR accuracy. Participants (n = 25) wore a chest strap HR monitor (criterion) and an armband HR monitor (experimental) during rest and self-paced walking and running. Conditions with the experimental device on tattooed and non-tattooed sections of skin were completed, and HR was collected every second and compared via Lin’s correlation (CCC) and the mean absolute percent error (MAPE). Skin tone and tattoo age and intensity were evaluated with HR accuracy. HR from tattooed skin was not accurate during rest (MAPE = 22.9%; CCC = 0.25), walking (MAPE = 7.5%; CCC = 0.68), or running (MAPE = 5.1%; CCC = 0.83). Measures taken on non-tattooed skin were within acceptable standards for accuracy throughout all three conditions (MAPE < 5%; CCC > 0.90). Skin tone was the only characteristic found to contribute to HR accuracy during rest (p = 0.046) and walking (p = 0.045). No variables loaded for running. The presence of arm tattoos affected HR readings, with the greatest inaccuracy occurring at rest. Specific tattoo characteristics did not statistically contribute to HR accuracy, as shown by the regression analysis. More research is needed to clarify how the varied tattoo characteristics affect HR devices. Full article

Objectives: Relatively little research has explored whether gait and cognition are systematically associated within-persons across time, especially in persons living with dementia (PLwD). Understanding a shared mechanism between gait and cognition may help elucidate effective intervention strategies for promoting cognitive and physiological health in PLwD simultaneously. Methods: 33 PLwD enrolled in an 18-month choral intervention employing a measurement-burst design that facilitated up to 9 assessments per person. Three-level multilevel models investigated the time-varying covariation between cognition and gait velocity (indexed using a GAITRite computerized walkway) under both a walk-only and dual-task condition. Results: Significant coupling was observed between gait velocity and MMSE (mini-mental state examination) under the dual-task condition, indicating that, on occasions when an individual’s MMSE was one-unit greater than their personal average, there was a corresponding increase in dual-task gait velocity. Conclusions: This study highlights a shared within-person mechanism through which improvements in cognition may facilitate physiological advantages. Full article

Background: Obesity is a multifactorial disease with significant physical, psychological, and economic impacts on individuals and society. Workers are particularly vulnerable, as obesity is associated with reduced productivity, absenteeism, and premature mortality. Lifestyle interventions combining dietary, physical activity, and behavioural strategies have been investigated as therapeutic approaches in this population. Objective: We aimed to conduct an integrative review assessing the effectiveness of workplace-based obesity treatment models involving dietary interventions, physical activity, and behavioural change. Methods: A search was conducted in PubMed for studies published between 2006 and 2024, with no language restrictions. Eligible studies included experimental or quasi-experimental longitudinal designs involving adult workers. After screening 95 articles, 18 were evaluated in full, and 8 met all inclusion criteria. Data extraction covered study design, intervention type, comparators, outcomes, and methodological quality, assessed using the Newcastle–Ottawa Scale. Results: Half of the included studies reported no significant reduction in body mass index after 6 or 12 months, while the others showed only modest decreases. Nevertheless, all interventions demonstrated improvements in dietary habits (reduced sugar-sweetened beverage intake, increased fruit, vegetable, and fibre consumption), physical activity (increased walking, reduced sedentary behaviour), and behavioural domains (adherence to healthy routines, self-monitoring, and family or employer support). Conclusions: Lifestyle-based workplace interventions for obesity show limited long-term effectiveness in weight reduction but promote healthier lifestyle habits, cardiometabolic health, and more supportive work environments. Future research should include diverse socioeconomic settings, particularly in developing countries, and apply robust designs, longer follow-ups, and innovative strategies to enhance adherence and outcomes. Full article

Background: The purpose of this study was to evaluate the effects of a structured barefoot walking program on menopausal symptoms, sleep quality, stress, and quality of life in middle-aged women experiencing menopausal symptoms. Methods: A quasi-experimental design with a nonequivalent control group and pretest-posttest was used. Community-dwelling women aged 45 to 65 years residing in Wonju, Republic of Korea, were recruited and assigned to either an experimental (n = 29) or control group (n = 31). The intervention consisted of 12 weeks of barefoot walking (three times per week, 60 min per session). Outcome measures included the Menopause Rating Scale (MRS), Verran and Snyder–Halpern Sleep Scale, Stress Response Inventory, and WHOQOL-BREF. In addition, changes in participants’ body composition before and after the intervention were assessed using a bioelectrical impedance analyzer (InBody 770). Data were analyzed using the Mann–Whitney U test, repeated measures ANOVA, ANCOVA, and other relevant statistical methods, with the level of significance set at p < 0.05. Results: Compared with the control group, the experimental group showed significant improvements in menopausal symptoms (z = −5.59, p < 0.001), stress (z = −3.58, p < 0.001), and quality of life (z = −3.47, p = 0.001). A significant time-by-group interaction effect was observed for sleep quality (F = 7.53, p = 0.008). No significant changes were found in body composition. Conclusion: Barefoot walking represents a promising, low-cost, community-based intervention for alleviating menopausal symptoms, enhancing sleep quality, reducing stress and improving quality of life in middle-aged women experiencing menopausal symptoms. Further randomized controlled trials are warranted to confirm these findings. Full article

Background: Exertional oxygen desaturation (SpO₂ ≤ 88%) during the six-minute walk test (6MWT) is a key prognostic marker in interstitial lung disease (ILD), yet access to the test is often limited in clinical practice. Developing simple, bedside tools to identify patients at risk may support early risk stratification and guide clinical decision-making. Methods: We conducted a retrospective, real-world cohort study in a tertiary referral center between January 2024 and July 2025, including 150 patients, of whom 67.33% (101 patients) were using supplemental oxygen. Clinical and physiological data collected within 30 days of the 6MWT were analyzed. The primary outcome was exertional hypoxemia, defined as peripheral oxygen saturation (SpO₂) ≤ 88% at the end of the test. Four predictive approaches were evaluated: multivariable logistic regression, stepwise logistic regression, and a simplified clinical score (0–3). The simplified score assigned one point for each of the following: forced vital capacity (FVC) ≤ 61% predicted, diffusing capacity for carbon monoxide (DLCO) ≤ 53% predicted, and presence of chronic cough. Model performance was assessed by receiver operating characteristic (ROC) curves, sensitivity, specificity, predictive values, and risk stratification. Results: The simplified score demonstrated robust discriminative performance, comparable to more complex statistical models, with high sensitivity and acceptable specificity. A threshold of ≥2.0 points identified patients at high risk for exertional desaturation with 100% sensitivity and 0.66 specificity. Observed desaturation risk increased progressively across score categories: 17.1% for scores 0–1 (low risk), 58.6% for score 2 (intermediate risk), and 95.1% for score 3 (high risk). Conclusions: Compared with multivariable models, the simplified 0–3 clinical score—based on widely available variables (FVC ≤ 61%, DLCO ≤ 53%, and chronic cough)—maintained similar predictive performance (AUC 0.82) with greater operational simplicity. Owing to its high sensitivity and bedside applicability, it represents a promising screening tool for identifying patients at high risk of exertional desaturation, particularly when the 6MWT is unavailable. Full article

Aim: Post-COVID condition (PCC) is largely considered the biggest public health emergency in recent times. The role of exercise therapy in PCC is currently unknown, and evaluative studies are currently lacking in this area. This study therefore aimed to evaluate the effects of a football club community trust exercise rehabilitation programme on physical function and quality of life in individuals with PCC. Method: A mixed-methods retrospective design was employed, utilising a framework to assess the programme’s reach, effectiveness, adoption, implementation, and maintenance (RE-AIM). Quantitative data (questionnaires and physiological assessments) were collected at baseline, 6 weeks, and 12 weeks during the programme, and at 6 months post-intervention (n = 7). Qualitative data were gathered through semi-structured focus groups at week 12 (n = 7) and 12 months (n = 5) post-intervention. Quantitative data and qualitative data were analysed using repeated measures ANOVAs and thematic analysis, respectively. Results: The programme led to significant improvements in physical function, including increased six-minute walking distance (6MWT, p < 0.001), one-minute sit-to-stand repetitions (1MSST, p < 0.035), and lung function (spirometry; MIP: p = 0.048, MEP: p = 0.024). Participants also reported enhanced QoL (HRQoL-14, p = 0.004), reduced anxiety (GAD-7, p = 0.008) and depression (PHQ-9, p = 0.008), and increased confidence and self-efficacy. The programme was well-received, with participants valuing the supportive environment and personalised approach. Conclusions: Football community trust exercise rehabilitation programmes can effectively improve physical function and quality of life in individuals with PCC, offering a promising model for community-based rehabilitation. Further studies are needed with larger sample sizes to assess the scalability of similar programmes. Full article

Background: Schizophrenia is a complex psychiatric disorder that requires both pharmacological and behavioral treatment and is often accompanied by multimorbidity. Physical activity supports overall health and plays an important role in preventing and managing both somatic and mental disorders. This study aimed to evaluate the impact of an Adapted Physical Activity program using Nordic Walking (AAF-NW) on the quality of life of patients with schizophrenia, depending on the number of steps taken during an eight-week intervention, and to assess its influence on body composition and posture. Methods: A prospective, single-center pilot study was conducted using a pre–post experimental design and direct participatory observation. Eighteen patients from a psychiatric hospital (16 men, 2 women; mean age 43.9 years) completed the intervention. Quality of life (WHOQOL-BREF), musculoskeletal pain (Nordic Musculoskeletal Questionnaire), and subjective exercise intensity (Borg scale, 6–20) were assessed. Measurements were taken before and after the program. All continuous variables (step counts, anthropometric measures, and WHOQOL scores) were tested for normality using the Shapiro–Wilk test and visual inspection of histograms and Q–Q plots. Depending on distribution, parametric or non-parametric tests were applied, with results quantified using appropriate test statistics, effect sizes, and p-values to ensure methodological rigor and transparency. Results: No systematic increase in the number of steps was observed during the training period. A non-significant improvement in quality of life was noted, along with significant reductions in body weight and waist circumference. Conclusions: Regular, structured AAF-NW group activities may potentially support the rehabilitation and treatment process in psychiatric hospitals when implemented on a continuous basis. Although improvements were observed, the findings are exploratory and should be interpreted with caution. Further studies on larger, more homogeneous samples are needed to confirm these preliminary results. Full article

The 15-minute city (15MC) model has gained increasing attention as a framework for promoting sustainable urban living by ensuring that essential services, including urban green spaces (UGSs), are accessible within short walking or cycling distances. UGSs play a vital role in public health, social interaction, and environmental resilience, yet questions remain about how equitably they are distributed and accessed in cities. This study assesses proximity and accessibility to UGSs in Porto, Portugal, through the lens of the 15MC. The methodology combined a GIS-based spatial analysis of walking and cycling catchments with a complementary questionnaire to capture user perceptions and travel behaviors. Results show that, while 84% and 100% of residents live within a 15-minute walking and cycling distance of a UGS, respectively, accessibility remains uneven, particularly for walking. Large peripheral parks contribute significantly to provision but remain less accessible to central neighborhoods, and cycling to UGSs is marginal due to fragmented and insufficient infrastructure, and residual cycling use. Subjective findings mirrored the spatial analysis, highlighting dissatisfaction with cycling conditions and only moderate satisfaction with pedestrian environments. The study emphasizes the need for integrated planning that improves local connectivity, infrastructure quality, and spatial equity to fully realize the 15MC vision. Full article