Search Results (186)

Background/Objectives: Pulmonary rehabilitation (PR) is a cornerstone treatment for patients with chronic obstructive pulmonary disease (COPD), yet not all patients achieve clinically meaningful benefits. Evidence on the determinants of short- and long-term responses from real-world settings remains limited. The aim of this study was to quantify response rates to outpatient PR and identify baseline factors associated with achieving minimal clinically important differences (MCIDs) in the walking capacity 6 min walk test [6MWT] or endurance shuttle walk test [ESWT] and patient-reported outcomes (St. George’s Respiratory Questionnaire [SGRQ] or COPD Assessment Test [CAT]) at 10 weeks and 1-year follow-up. Methods: In this retrospective cohort study, data from a PR database (2002–2019) at Copenhagen University Hospital Hvidovre were analysed. Patients with COPD and complete data on one functional outcome ([6MWT] or [ESWT]) and one patient-reported outcome ([SGRQ] or [CAT]) were included. Multinomial regression models assessed associations between baseline variables and response categories. Results: Among 922 patients, 52% achieved clinically meaningful improvement following PR, and 47% of responders maintained these gains at 1 year. Response rates declined over time. Higher baseline symptom burden (CAT and SGRQ) and walking capacity showed mixed associations with short-term response. Younger age was the most consistent predictor of both short- and long-term responses, while higher baseline FEV₁ was associated with sustained improvement at 1 year. Conclusions: Approximately half of patients with COPD benefit clinically from PR, with sustained improvements in nearly half at 1 year, and response is associated with baseline age, symptom burden, and functional capacity, underscoring the need for a more individualised approach to care. Full article

Background and Objectives: Evidence on motor performance in children with autism spectrum disorder (ASD) is scarce and inconsistent. The association of motor impairments with autism severity and intelligence remains insufficiently studied. We aimed to examine motor performance parameters in children with ASD compared with typically developing (TD) peers. Materials and Methods: In this cross-sectional study, a convenience sample of 26 children with ASD, aged 4–10 years, was recruited from specialized centers in KSA, alongside 27 age- and sex-matched TD children. For the ASD group, severity (Childhood Autism Rating Scale, CARS-2) and intelligence quotient (Stanford–Binet Intelligence Scale, SB5) were extracted from medical records. CARS-2 score was utilized to categorize children with ASD into two groups (mild-to-moderate and severe groups). All study children were assessed for gross and fine motor skills using the Movement Assessment Battery for Children-2 (MABC-2), balance, muscle strength, endurance, and flexibility. Results: ASD groups recorded significantly lower scores in all MABC-2 component areas when compared to the TD group (p < 0.001). Aiming and catching percentile was significantly lower in the severe ASD group compared to the mild-to-moderate group (p = 0.05). Furthermore, children with ASD exhibited increased hypermobility, predominantly at the elbow joints, reduced grip strength, shorter distance in the modified 6 min walk test, and lower standing long-jump performance (p < 0.001) when compared to TD group; however, no significant difference was recorded between the ASD groups. Spearman correlation revealed that aiming and catching was negatively correlated with autism severity (CARS-2) (r = −0.38, p = 0.05) and positively with IQ (r = 0.51, p = 0.03). Aiming and catching was positively correlated with grip strength (r = 0.55, p = 0.003), endurance (r = 0.58, p = 0.002), and jump distance (r = 0.44, p = 0.03), while balance was positively correlated with grip strength (r = 0.44, p = 0.02). Conclusions: Children with ASD exhibit significant impairments in gross and fine motor performance compared with TD peers, accompanied by hypermobility, reduced strength, and diminished endurance. Notably, aiming and catching ability correlated with both IQ and autism severity as well as specific motor parameters, suggesting its potential as a clinical marker of motor–cognitive interaction in ASD. Full article

Objectives: This study investigated whether CoQ10 supplementation enhances physical adaptations to high-intensity interval training (HIIT) in muscular strength, power, and physical function in older adults. Method: In a double-blind, randomized controlled trial, 38 adults aged 65–75 were assigned to either a CoQ10 (Females: 8; Males: 11) or placebo (Females: 8; Males: 11) group and completed an 8-week supervised HIIT program. Lower- and upper-body strength (30s 5-repetition chair stand [5XSST], chair standing [30CST], handgrip strength [HGR/L]), balance (single-leg stand [SLS], timed up and go [TUG]), mobility (25-foot walk [25FW]), and aerobic endurance (6-minute walk [6MWT]) were assessed pre- and post-intervention. Results: The CoQ10 group demonstrated significantly greater improvements in 5XSST and 30CST compared to the placebo group (p < 0.05). Both groups showed significant within-group improvements in right and left handgrip strength, SLS, 6MWT, and TUG (all p < 0.001), with no significant between-group differences observed for these outcomes (p > 0.05). No adverse events were reported. Conclusion: While CoQ10 supplementation enhanced improvements in lower-body strength and power, as indicated by the greater gains in 5XSST and 30CST performance compared to the placebo, no between-group differences were observed in TUG, grip strength, or other functional outcomes. This suggests that the performance-related effects of CoQ10 may be more specific to muscular power output and fatigue resistance, rather than general mobility or balance-related tasks. These findings highlight the potential of CoQ10 as a targeted adjunct in exercise for supporting lower-body function and physical performance in older adults. Full article

Background: Obesity during pregnancy increases the risk of adverse maternal and neonatal outcomes, and excessive gestational weight gain (GWG) remains highly prevalent worldwide. Although physical activity (PA) interventions have shown potential benefits, evidence on the optimal type, intensity, and duration of exercise for overweight or obese pregnant women remains limited. Methods: Electronic searches of EBSCOhost, Embase, PubMed and Web of Science were performed through August 2025 to identify randomized controlled trials comparing PA interventions versus usual prenatal care in overweight or obese pregnant women. Two reviewers independently screened studies, extracted data, and assessed risk of bias using Cochrane ROB domains. Continuous outcomes were pooled using inverse-variance meta-analytic methods and heterogeneity was quantified by I². Results: Ten randomized trials (twelve intervention arms) comprising 1150 participants met the inclusion criteria. In the domain of blinding of participants and personnel, three studies (30%) were judged as low risk, while seven (70%) were unclear. PA interventions varied in modality (aerobic, resistance, endurance, walking), setting (clinic, community, home/mHealth), and the intervention period ranges from 10 to 34 weeks. Most interventions (80%) employed moderate intensity, and 30% combined aerobic and resistance training. Results of the meta-analysis showed that the pooled mean GWG was 9.93 ± 5.48 kg in the treatment group and 10.65 ± 5.70 kg in the control group. Overall, PA interventions produced a modest but statistically significant reduction in GWG compared with controls, with negligible between-study heterogeneity (I² = 0%). Conclusions: Tailored, moderate-intensity PA may have the potential to modestly reduce GWG. Although 30% included trials employed combined aerobic and resistance training, current evidence is insufficient to establish whether combined modalities are more effective than aerobic-only or resistance-only interventions. However, the current evidence is limited by small trial sizes, methodological variability and geographic concentration in higher-income settings. Larger, rigorously designed RCTs, including evaluations of digital delivery platforms and carefully supervised higher-intensity protocols, are needed to refine exercise prescriptions and inform clinical guidelines. Full article

Strokes are one of the leading causes of adult disability. There are a wide range of therapies available in stroke care for people with stroke, but there can be wide variations in the effectiveness of these therapies, so it is essential to review and compare them from time to time. In our study, we measured and compared the effectiveness of three high-intensity therapies: an agility training program without technological tools, a virtual reality exergaming training program with a low-cost device, and a high-cost robotic training program using augmented and virtual reality. All three therapies helped to improve the patients’ functional abilities, balance, and gait. On average, endurance increased by 104–177%, balance scores by 36–53%, and gait speed by 5–10% depending on the intervention. Robotic therapy and exergaming facilitate greater improvements in walking speed, step length, and balance-related gait metrics. These findings have profound implications for stroke rehabilitation, advocating for the prioritization of robotic and exergaming interventions over conventional functional therapies, like agility training. Given the limited sample size, the results should be interpreted as preliminary, highlighting the need for further studies with larger cohorts. Full article

Background/Objectives: Community ambulation after stroke depends on locomotor capacity and confidence in everyday environments. We compared functional performance across three community walking levels and identified constructs independently associated with being an independent community walker in individuals with chronic stroke. Methods: Adults admitted to an acute-care general hospital or an inpatient rehabilitation hospital were enrolled. Community walking level was classified by a self-reported questionnaire. Primary constructs were gait speed, gait endurance, and balance self-efficacy measured with standard clinical tests. Additional measures described balance, lower-limb motor function, and task-based mobility. Group differences were examined with one-way analysis of variance with Bonferroni comparisons. Community walking status was modeled with binary logistic regression using forward stepwise selection. Results: Fifty-nine individuals were analyzed. Performance differed across levels. Effect sizes were small, medium, or large overall. Independent community walkers showed faster gait speed, longer walking distance, and higher balance self-efficacy, with the same direction for balance and lower-limb motor scores and shorter times on task-based tests. In univariable models, age, sex, and time since stroke were not associated with independence, whereas assistive device use related to lower odds. In the multivariable model, gait speed, gait endurance, and balance self-efficacy retained independent associations with independent community walking. Other measures were not retained after adjustment. Conclusions: Community walking status in chronic stroke relates most closely to gait speed, gait endurance, and balance self-efficacy. Evaluation can emphasize the 10 m Walk Test, 6 Min Walk Test, and Activities-specific Balance Confidence Scale, with impairment and task-based tests used to guide intervention planning. Full article

Aging entails concurrent declines in physical and cognitive domains, contributing to reduced independence, higher fall risk, and lower quality of life. Understanding how motor performance relates to cognition is crucial for prevention in community-dwelling older adults. This cross-sectional study investigated associations between physical fitness—including strength, endurance, balance, and aerobic capacity—and cognitive outcomes assessed by Trail Making Tests (TMT-A, TMT-B), the Digit Symbol Substitution Test (DSST), and dual-task cost in the Timed Up & Go Test (TUG_DTC). Thirty-four sedentary but cognitively healthy adults aged ≥60 years were evaluated. Quadriceps strength was significantly related to TUG_DTC and executive function (TMT-B), while upper-limb endurance correlated with both attentional and executive measures. Dynamic balance, particularly in posterior directions, was linked to DSST and TMT-B, and 6-min walk test performance was associated with executive functioning and processing speed. TUG_DTC itself showed strong correlations with cognitive outcomes, underscoring its sensitivity to motor–cognitive interference. These findings highlight selective motor–cognitive relationships and suggest that simple, field-based tests may serve as early markers of cognitive vulnerability. Targeting lower-limb strength, balance, and aerobic capacity could represent cost-effective strategies to promote mobility and cognitive resilience in aging populations. Full article

Background/Objectives: Hypertension (HTN) is highly prevalent among middle-aged and older adults in Saudi Arabia, affecting nearly half of those attending primary care clinics. This growing burden contributes not only to cardiovascular disease, but also to functional decline and reduced mobility in aging Saudis. The objective of this paper was to examine the relationship between HTN and objective measures of mobility and endurance in Saudi adults aged ≥50 years, and to assess whether any associations differ by sex. Methods: In a cross-sectional study, 47 hypertensive and 53 non-hypertensive (no chronic disease) community-dwelling adults were recruited from various regions of Saudi Arabia. Participants completed mobility tests (five repetitions of sit-to-stand (5×STS) and timed up-and-go (TUG)) and an endurance test (6 min walk test (6MWT)). Multivariable linear regressions adjusted for age, body mass index, and sociodemographic factors were used to evaluate the association of HTN with each performance measure in men and women separately. Results: Participants with HTN were older (mean 63 vs. 57 years) and had higher BMI than controls (p < 0.05), as well as performing worse on all functional tests: they required more time for 5×STS and TUG, and walked a shorter distance during the 6MWT (all p ≤ 0.003). In sex-stratified analyses, HTN was associated with slower TUG in men (≈2 s longer, p = 0.027), while among women, HTN predicted significantly slower 5×STS (+8.4 s) and TUG (+2.8 s) times, and a 114 m-shorter 6MWT distance (p < 0.05 each). Conclusion: HTN is linked to impaired mobility and endurance in middle-aged and older Saudi adults, with hypertensive women exhibiting particularly pronounced deficits. Future research is needed to determine whether incorporating routine functional assessments and exercise-based counseling into HTN care may help identify and address early declines in physical independence among aging adults. Full article

Gait assessment is key in Parkinson’s disease (PD), but the psychometric properties of common tests like the 6-Minute Walk Test (6MWT) are not fully established. Inertial Measurement Units (IMUs) offer objective gait measures, potentially reducing repeated testing. This study evaluated whether the resampling of the first 2 min of the 6MWT (2’6MWT) reflects full-test performance in 43 early-to-mild PD patients (median age 65) at baseline, 1-year, and 2-year follow-ups. A trunk-mounted IMU recorded distance covered, walking duration, stride length, gait speed, cadence, and symmetry. Analysis focused on participants with complete longitudinal data from a multicenter original cohort of 62. Stride length and gait speed (2’6MWT vs. 6MWT) demonstrated strong correlations (r > 0.98), near-perfect agreement, <5% error, and stability across follow-ups; cadence showed slightly more variability. The analysis of consecutive 2-min intervals of the 6MWT revealed stable stride length and gait speed, with modest decreases in distance and cadence over time. Exploratory associations of 2’6MWT and 6MWT with motor severity and cognitive status were consistent. These results indicate the 2’6MWT is a reliable, time-efficient alternative to the full 6MWT for assessing walking capacity in PD, especially in outpatient or fatigue-prone patients. The full 6MWT remains valuable for detecting subtle endurance- or fatigue-related changes. Full article

(1) Background: Hand and Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) is a high-dose evidence-based neurorehabilitation. This study aims to develop and validate a protocol using three inertial measurement units (IMUs) to objectively document upper and lower extremities’ (UE; LE) motor activity during a HABIT-ILE intervention in chronic stroke adults. (2) Method: Thirteen adults (57.1 y ± 11.3) who completed 65 h of HABIT-ILE (2 weeks, 6.5 h/d) were included. Daily motor activity was recorded with IMUs placed on both wrists and one thigh with nine IMU-derived variables extracted to evaluate motor activity and posture. Each variable was correlated with baseline abilities and day-to-day patterns were observed with subgroup analyses based on baseline dexterity and walking endurance. Day-to-day patterns were highlighted based on mean values and effect size analyses. (3) Results: Only the Magnitude and Use ratios showed high correlations with baseline abilities, with a day-to-day specific pattern highlighted for participants with moderate to good dexterity at baseline. (4) Conclusions: All participants reported a high level of engagement during HABIT-ILE independently of their baseline abilities. Although we could not detect a global trend to document the content of a HABIT-ILE intervention, these exploratory results suggest IMU monitoring to be relevant to characterize therapeutic content. Full article

Background/Objectives: Chronic musculoskeletal pain (CMSKP) affects up to 40% of adolescents and leads to substantial disability, reduced quality of life, and long-term health risks. Physical activity is central to treatment, but adherence to moderate-to-vigorous physical activity (MVPA) is inconsistent. We evaluated higher-resilience constructs—self-efficacy, pain acceptance, motivational stage, and affect—and hypothesized that higher resilience would be associated with greater objectively measured physical activity, better daily functioning, and higher quality of life in adolescents with CMSKP. Methods: Forty-three adolescents (13–18 years) with CMSKP completed measures of physical activity-specific self-efficacy, acceptance (AFQ-Y), motivational stage (PSOCQ-A), and affect (PANAS-C). Participants wore activPAL monitors to assess MVPA, light activity, and sedentary time. Physical function endurance was measured by the six-minute walk test (6MWT) and the Functional Disability Inventory (FDI); quality of life by the Pediatric Quality of Life Inventory (PedsQL). Spearman’s correlations assessed associations among resilience variables, physical activity metrics, 6MWT distance, FDI, and PedsQL. Results: MVPA was correlated positively with 6MWT distance (ρ = 0.48, p = 0.002) and negatively with FDI scores (ρ = −0.56, p < 0.001). Self-efficacy related to higher MVPA (ρ = 0.41, p = 0.009), better endurance (ρ = 0.36, p = 0.017), and lower disability (ρ = −0.38, p = 0.013). Acceptance was correlated with PedsQL total (ρ = 0.45, p = 0.004); motivation (specifically maintenance) scores were correlated with higher quality of life (ρ = 0.33, p = 0.027). Light activity and sedentary time were not significantly linked to functional or psychosocial outcomes. In a step-wise regression, only physical activity self-efficacy for ambulation at school predicted MVPA, B = 1.56, p = 0.008. Conclusions: Resilience constructs—including self-efficacy, acceptance, and readiness to change—were meaningfully associated with MVPA, daily functioning, and quality of life, and may have implications for treatment development. Full article

Background: The functional capacity of older adults is a critical determinant of autonomy and quality of life, particularly in low-income populations from remote regions with limited access to health services. This study aimed to characterize the functional fitness (FF) of community-dwelling older adults in the interior of Amazonas, Brazil, stratified by sex and age group. Methods: A cross-sectional study was conducted with 807 older adults (471 females), aged ≥ 60 years, from four municipalities in northern Brazil. The FF was assessed using the Senior Fitness Test (SFT), including measures of strength (30-s Chair Stand Test—CST; 30-s Arm Curl Test—ACT), flexibility (Chair Sit and Reach Test-CSAR, Back Scratch Test-BST), balance/agility (8-Foot Up-and-Go Test—FUG), and aerobic endurance (6-min walk test—6MWT). Descriptive statistics, confidence intervals, and age- and sex-specific percentiles were calculated. Results: Results indicated a progressive decline in FF with advancing age. Males outperformed females in strength and endurance tests, whereas females exhibited better flexibility. Notable reductions in performance were observed after age 75, particularly in CST, ACT, FUG, and 6MWT. Overall, the functional profiles of this population were below international norms, especially among females and individuals aged ≥ 80. The prevalence of overweight was 39.3%, with socioeconomic vulnerability affecting over 90% of participants. Conclusions: Older adults in low-income, remote Amazonian Brazilian communities demonstrate marked functional decline with ageing, influenced by socioeconomic and environmental constraints. These findings highlight the urgency of implementing accessible, community-based interventions focused on physical activity, strength, mobility, and endurance to support healthy ageing in underserved regions. Full article

Background: Preliminary evidence supports high-intensity functional training (HIFT) for improving various health outcomes in non-disabled adults with overweight/obesity. It remains unknown whether HIFT produces similar benefits in individuals who are overweight/obese and also have a mobility disability (e.g., spinal cord injury, multiple sclerosis)—a population disproportionately affected by obesity-related health conditions and systemic barriers to exercise. This pilot study aimed to evaluate the feasibility and preliminary effects of a 24-week HIFT intervention, delivered at community sites by certified trainers, for adults with mobility disabilities (MDs) who were overweight/obese. Methods: Twenty adults with MD and overweight/obesity (self-reported BMI 25–46 kg/m²) enrolled in a 24-week HIFT intervention (3 days/wk, 60 min sessions) delivered at four community-based facilities by certified trainers. Feasibility indicators included recruitment, retention, and attendance; adverse events were tracked. Effect sizes (Cohen’s d) were calculated for changes in obesity-related measures, physical function, work capacity, and psychological measures from baseline to post-intervention. Results: Feasibility targets were met, with a recruitment rate of 72.2%, 76.9% retention, and 80.7% attendance. Thirteen adverse events occurred. Effects on obesity-related measures ranged from negligible to moderate, with stable weight/BMI, reduced waist circumference (45% ≥ 3 cm decrease), decreased body fat, and increased lean mass. Functional outcome effects ranged from small to large and included grip strength, balance, and walking speed. Large improvements were observed for the endurance, speed, work capacity, and self-reported physical function. Conclusions: A community-based HIFT program is feasible and may improve health outcomes in adults with MD and overweight/obesity. Full article

Background and Objectives: Frail patients after open-heart surgery often experience worse treatment outcomes in improving physical performance and muscle strength. As the functional recovery of frail patients after open-heart surgery is slower, conventional rehabilitation is frequently insufficient to achieve treatment goals. Therefore, the inclusion of additional exercise interventions in cardiac rehabilitation is becoming more relevant. The aim of this study was to assess and compare the effectiveness of additional exercise interventions—multicomponent and computer-based programs—applied along with conventional cardiac rehabilitation in improving the functional capacity and strength of frail patients after open-heart surgery. Materials and Methods: The population of this single-center, three-arm, parallel-group, randomized controlled trial comprised 153 frail patients aged more than 65 years who underwent open-heart surgery. All patients were randomized into three groups: control (CG, n = 51), intervention 1 (IG-1, n = 51), and intervention 2 (IG-2, n = 51). All groups received conventional rehabilitation program six times/week, while the IG-1 additionally received the multicomponent dynamic training program 3 times/week, and the IG-2, the combined computer-based program 3 times/week. The primary outcome measure was change in the Short Physical Performance Battery (SPPB) score. Secondary outcome measures included the 6 min walk distance (6MWD), peak workload, grip strength, and leg press. Primary and secondary outcome measures were assessed before and after cardiac rehabilitation. Results: A total of 138 patients completed rehabilitation (46 in each group), and their data were included in the main analysis that followed a per-protocol approach. Although significant differences in the primary outcome—the SPPB score—were found in each group while performing within-group comparisons (p < 0.001), no significant pre-to-post rehabilitation differences were observed compared to all three groups (p = 0.939), and the effect sizes were small. Regarding secondary outcome measures, within-group comparison revealed significant differences in all parameters of all groups (p < 0.05), except for the grip strength of both hands in the IG-1. Between-group comparisons showed that the pre-to-post 6MWD difference between the CG and the IG-1 was significant (p = 0.014), but the effect size was small (ES = 0.240). Moreover, significant pre-and-post leg press 1RM differences (p < 0.001) were found between the CG and the IG-1 as well as between the CG and the IG-2 with the effect sizes being moderate (ES = 0.480) and large (ES = 0.613), respectively. Conclusions: Within-group comparison showed that all three rehabilitation programs are effective in improving almost all parameters of physical performance and muscle strength in frail patients after open-heart surgery. However, between-group comparisons indicated that computer-based interventions were more effective in improving leg press 1RM with a large effect size, while multicomponent training resulted in more effective gains in the 6MWD, although with a small effect size. These findings suggest that in clinical practice, computer-based exercise programs may be more suitable for patients with muscle weakness, while multicomponent exercise programs may be for those with reduced endurance. Full article

Background: Bone metastases are a common complication in patients with advanced cancer. These patients often experience a decline in physical function and autonomy, particularly in the ability to perform Activities of Daily Living, and structured movement-based interventions may represent an important supportive strategy. The aim of this study is to describe the available evidence regarding the impact of physical activity and exercise interventions on functional status and ADL performance in patients with bone metastases. Methods: A systematic literature review was conducted in PubMed, Scopus, Embase, Web of Science, and CINAHL database up to March 2025 and reported according to PRISMA guidelines. Eligible studies included adults (≥18 years) with confirmed bone metastases who underwent physical activity interventions designed to enhance functional status and ADLs. Studies’ methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools, selected according to study design. Results: Eleven studies were included: four randomized controlled trials, four quasi-experimental studies, one randomized feasibility trial, one cross-sectional observational study, and one case report. Despite heterogeneity in intervention type, duration, and outcome measures, most studies reported improvements in physical function, including mobility, muscle strength, walking capacity, and endurance, as well as enhanced performance in ADLs and reductions in fatigue. No serious adverse events were reported. Conclusions: Structured physical activity appears safe and may improve function and independence in patients with bone metastases. These findings support the integration of individualized exercise programs into multidisciplinary supportive care. Full article