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This article adheres to UN guidelines concerning the Decade of Healthy Ageing (2021-2030) which aim to improve the lives of the older population. The objective of this study is to show how social dance with artistic-scenic purposes for a socially vulnerable group of older adults (third and fourth age) contributes to active ageing from social and health perspectives. The sample comes from a social group for the over-60s years and forms part of an artistic-community project in which participant observation has been carried out for five years. To obtain more data from the sample group, an "ad hoc" measurement instrument is developed based on a specific literature review on the topic. The results show that dance, group, and stage performance are a vital driver for members. The analysis shows that individual perspectives are higher than group perspectives. The research provides evidence that social dance groups improve motor expressiveness, stimulate the ability to think, memorize and create, among other aspects.

In this study, we frame learning in the tertiary-level contemporary dance class as a process of developing culturally situated shared patterns of skilled action and attention through dynamic engagement with kinetic experience. Extending existing scholarship on dance learning, we adopt the framework of cultural affordances to understand the developmental relationship between physical and general categories of attention during the learning process. Based on qualitative analysis of student and teacher interviews, we contend that the dance classes were laboratories in which cross-domain mapping (physical and general) was leveraged to develop students' kinetic and attentional skills. Understood in this way, the physical concepts and the general concepts worked in a helical fashion, cycling through dynamic engagement with kinetic experience and the development of attentional awareness, not as pure repetition, but as a progression toward more complex, skilled, and nuanced ways of moving.

Musculoskeletal disorders (MDs) represent a global health issue, which can lead to disability. Physical activity (PA) reduces pain and increases physical function among patients with MDs. To promote behavioural changes, it seems important to focus on modifiable factors, such as motivation. Thus, this review aims to assess effects of interventions targeting PA on motivation towards PA. Searches used terms referring to "physical activity", "motivation" and "chronic musculoskeletal disorders" on the databases PubMed, PsychINFO, MEDLINE, EMBASE, PEDro and Web of Science. All types of intervention—including but not limited to RCTs—were eligible for inclusion. Risk of bias was assessed with the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Among 6 489 abstracts identified, there were 387 eligible studies and 19 were included, reporting in total 34 effect sizes. The meta-analysis concerned 1 869 patients and indicated a small effect of interventions on change in motivation towards PA (d = 0.34; 95% CI [0.15; 0.54]; p <.01; k = 33). Behavioural interventions positively impact PA motivation in patients with MDs. In the literature, most studies focused on intervention's effect on fear of movement. Future research should assess other explicit motivational constructs, as well as implicit processes. [ABSTRACT FROM AUTHOR]

Background: This study investigates the effectiveness of a self-developed intelligent monitoring system for home-based knee rehabilitation following total knee arthroplasty (TKA). Methods: In this randomized controlled trial, 120 patients undergoing TKA were divided using random digit allocation. Preoperative and one-month postoperative assessments of knee function, quality of life, and isometric knee extension strength were conducted with the Intelligent Monitoring System. Patients received group-specific rehabilitation instructions pre-discharge and performed exercises for one month. Results: Changes in isometric knee extensor strength on the affected side within one month post-surgery for the brace-monitored rehabilitation group showed a significant decrease three days after surgery compared to one day before surgery. Subsequent measurements taken at postoperative days 5, 7, 14, and 21 indicated a gradual increase in strength, although these increases did not reach statistical significance when compared with previous measurements. One month post-surgery, all groups demonstrated significant improvements in knee joint function and mobility compared to pre-surgery levels. Notably, the brace-monitored group showed statistically significant improvements in 36-Item Short-Form Health Survey (SF-36) scores over the conventional rehabilitation group. Conclusions: The Intelligent Monitoring System provides effective real-time monitoring and guidance for home-based knee rehabilitation post-TKA. It significantly enhances knee joint function, isometric knee extension strength, and quality of life shortly after surgery compared to traditional rehabilitation methods. This system offers a promising approach for improving postoperative recovery in TKA patients. Trial registration: This study was approved by the Medical Ethics Committee of Xiangya Hospital, Central South University (Ethics Approval Number 202209008-2). It was registered with the China Clinical Trial Registry, a primary registry of the World Health Organization's International Clinical Trials Registry Platform (Registration Number ChiCTR2300068852). [ABSTRACT FROM AUTHOR]

The Tendo Unit (TU) and GymAware (GA) are the two most frequently used linear transducers for assessing muscle power in older adults via the sit-to-stand (STS) test. Unlike TU, GA incorporates a sensor mechanism to correct for non-vertical movements, which may lead to systematic differences between devices. The aim of this study therefore was to compare GA to TU for measuring STS power in community-dwelling older adults. Community-dwelling adults (n = 51, aged ≥65 years, 61% female) completed a single chair stand, with peak power measured simultaneously using GA and TU. Participants also completed the pneumatic leg press, 8-Foot Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and self-reported measures of physical function. Intraclass correlations (ICC) were used to assess agreement, and Pearson's correlations were used to assess correlations. The study protocol was prospectively registered on the Open Science Framework. In alignment with our pre-registered hypothesis, peak power demonstrated an ICC of 0.93 (95% CI: 0.88, 0.96). For secondary aims, both transducers showed a correlation greater than 0.8 compared to pneumatic leg press power. For physical performance outcomes, both TU and GA showed similar correlations, as hypothesized: SPPB (r = 0.29 for TU vs. 0.33 for GA), Chair Stands (r = −0.41 vs. -0.38), TUG Fast (r = −0.53 vs. -0.52), mobility questionnaire (r = 0.52 vs. 0.52) and physical function questionnaire (r = 0.44 vs. 0.43). GA and TU peak power showed a high degree of agreement and similar correlations with physical and self-reported performance measures, suggesting that both methods can be used for assessing STS power in older adults. [ABSTRACT FROM AUTHOR]

The multi-tier GW+EDMFT scheme is an ab-initio method for calculating the electronic structure of correlated materials. While the approach is free from ad-hoc parameters, it requires a selection of appropriate energy windows for describing low-energy and strongly correlated physics. In this study, we test the consistency of the multi-tier description by considering different low-energy windows for a series of cubic SrXO3 (X = V, Cr, Mn) perovskites. Specifically, we compare the 3-orbital t2g model, the 5-orbital t2g + eg model, the 12-orbital t2g + Op model, and (in the case of SrVO3) the 14-orbital t2g + eg + Op model and compare the results to available photoemission and X-ray absorption measurements. The multi-tier method yields consistent results for the t2g and t2g + eg low-energy windows, while the models with Op states produce stronger correlation effects and mostly agree well with experiment, especially in the unoccupied part of the spectrum. We also discuss the consistency between the fermionic and bosonic spectral functions and the physical origin of satellite features, and present momentum-resolved charge susceptibilities. [ABSTRACT FROM AUTHOR]

Background: Post-stroke depression (PSD) is a prevalent psychiatric disorder affecting about one-third of stroke survivors, significantly hindering recovery and quality of life. PSD also imposes a substantial burden on caregivers and healthcare systems. Aromatherapy has shown promise in alleviating depression, anxiety, and sleep disorders. This pilot randomized controlled trial aims to assess the feasibility and preliminary efficacy of mixed herb aromatherapy in treating PSD. Feasibility outcomes encompass recruitment, intervention adherence, assessment completion and safety assessment. Secondary outcomes include evaluations of depression, anxiety, cognitive function, sleep quality, quality of life, and brain function using EEG and fNIRS. Methods: This single-blind pilot randomized controlled trial will be conducted at the Second Rehabilitation Hospital of Shanghai, enrolling ninety-nine poststroke patients with PSD. Participants will be randomized into three groups: a Non-Active Control Group receiving standardized rehabilitation therapy, a CBT Group receiving conventional rehabilitation with bi-weekly CBT sessions, and an Aromatherapy Group receiving conventional rehabilitation with daily aromatic inhalation sessions. Interventions will last for four weeks, with efficacy assessed at baseline, post-intervention, and one month post-intervention. Rating scales will be used to measure changes in depression, sleep quality, cognitive function, and quality of life. EEG and fNIRS will specifically be used to measure changes in cerebral cortex activity and their correlations with depression. Feasibility will be evaluated through recruitment, intervention adherence, assessment completion and safety assessment. Discussion: This pilot study highlights the potential of mixed herb aromatherapy inhalation for treating PSD, addressing limitations of CBT by promoting selfmanagement. While demonstrating feasibility through recruitment, adherence, assessment completion and safety assessment, the study also acknowledges limitations such as unequal intervention times, the lack of physical function data. And the use of culturally relevant plant powders may enhance compliance but limits generalizability. Despite these constraints, the study provides valuable preliminary data and insights into the mechanisms of aromatherapy, encouraging further research and development of effective PSD treatments. [ABSTRACT FROM AUTHOR]

Background: Frailty is a multifactorial syndrome; through this study, we aimed to investigate the physiological, psychological, and social factors associated with frailty and frailty worsening in community-dwelling older adults. Methods: We conducted a cross-sectional and longitudinal study using data from the "Community Empowerment and Well-Being and Healthy Long-term Care: Evidence from a Cohort Study (CEC)," which focuses on community dwellers aged 65 and above in Japan. The sample of the cross-sectional study was drawn from a CEC study conducted in 2014 with a total of 673 participants. After excluding those who were frail during the baseline assessment (2014) and at the 3-year follow-up (2017), the study included 373 participants. Frailty assessment was extracted from the Kihon Checklist, while social relationships were assessed using the Social Interaction Index (ISI). Variable selection was performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression and their predictive abilities were tested. Factors associated with frailty status and worsening were identified through the Maximum-min Hillclimb algorithm applied to Bayesian networks (BNs). Results: At baseline, 14.1% (95 out of 673) participants were frail, and 24.1% (90 out of 373) participants experienced frailty worsening at the 3-years follow up. LASSO regression identified key variables for frailty. For frailty identification (cross-sectional), the LASSO model's AUC was 0.943 (95%CI 0.913–0.974), indicating good discrimination, with Hosmer–Lemeshow (H–L) test p = 0.395. For frailty worsening (longitudinal), the LASSO model's AUC was 0.722 (95%CI 0.656–0.788), indicating moderate discrimination, with H–L test p = 0.26. The BNs found that age, multimorbidity, function status, and social relationships were parent nodes directly related to frailty. It revealed an 85% probability of frailty in individuals aged 75 or older with physical dysfunction, polypharmacy, and low ISI scores; however, if their social relationships and polypharmacy status improve, the probability reduces to 50.0%. In the longitudinal-level frailty worsening model, a 75% probability of frailty worsening in individuals aged 75 or older with declined physical function and ISI scores was noted; however, if physical function and ISI improve, the probability decreases to 25.0%. Conclusion: Frailty and its progression are prevalent among community-dwelling older adults and are influenced by various factors, including age, physical function, and social relationships. BNs facilitate the identification of interrelationships among these variables, quantify the influence of key factors. However, further research is required to validate the proposed model. [ABSTRACT FROM AUTHOR]

Objective: To compare the effects a Mediterranean diet (MedDiet) versus the Irish Healthy Eating Guidelines (HEG) on physical function and quality of life in adults with rheumatoid arthritis (RA) in Ireland. Methods: Forty-four adults with RA were randomised (1:1) to the MedDiet or HEG for 12 weeks. The intervention included three video teleconsultations and two follow-up telephone calls facilitated by a Registered Dietitian (RD). Changes in physical function by Health Assessment Questionnaire- Disability Index (HAQ-DI) and quality of life by Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL) were the primary outcomes measured. Secondary outcomes included changes in dietary adherence, physical activity by Yale Physical Activity survey (YPAS), patient-perceived pain and general health, and anthropometric measures. All measurements were administered at baseline and repeated at 6 and 12 weeks. Results: Forty participants completed the study. Participants were primarily females (87.5%), mean age was 47.5 ± 10.9 years. At the end of the intervention, participants in the MedDiet group reported significantly better physical function (p = 0.006) and quality of life (p = 0.037) compared to HEG group. From baseline to 12 weeks, physical function significantly improved in both diet groups, MedDiet (0.9 ± 0.5 to 0.5 ± 0.4 units, p < 0.001) and HEG (1.4 ± 0.7 to 1.0 ± 0.6 units, p < 0.001). Quality of life also significantly improved in the MedDiet (10.1 ± 7.5 to 4.0 ± 4.7 units, p < 0.001) and HEG group (11.25 ± 7.2 to 7.9 ± 6.4 units, p = 0.048). Physical activity improved significantly in the MedDiet (56.7 ± 28.6 to 70.6 ± 33.5 points, p = 0.01) but not within the HEG group despite similar recommendations. Conclusion: Adhering to the MedDiet and Irish Healthy Eating Guidelines resulted in improvements in RA patient-reported outcomes. The changes observed in both diet groups are likely due to the improvement in overall diet quality irrespective of dietary prescription. Trial registration number: NCT04262505. [ABSTRACT FROM AUTHOR]

Patient-reported outcomes (PROs) are essential for understanding the effects of MS and its treatments on patients’ lives; they play an important role in multiple sclerosis (MS) research and practice. We present the protocol for an observational study to prospectively assess the effect of cladribine tablets on PROs and their correlation to disability and physical activity in adults with highly active relapsing MS switching from a first disease modifying drug (DMD) to cladribine tablets in routine clinical practice at study sites in Italy. The primary objective will be to evaluate changes from baseline in the impact of highly active MS on self-assessed physical functioning 52  weeks after the switch to cladribine tablets using the Multiple Sclerosis Impact Scale-29 (MSIS-29). Secondary objectives will include self-assessed psychological impact of highly active MS in daily life and general health after the switch to cladribine tablets as well as changes in cognitive function, anxiety, and depression symptoms. Additional PRO measures will include the Hospital Anxiety and Depression Scale (HADS), the EuroQoL 5-Dimension 5-Level (EQ-5D-5L), the Work Productivity and Activity Impairment Questionnaire: Multiple Sclerosis (WPAI:MS), and the Patient-Reported Outcomes Measurement Information System (PROMIS). Wearable devices will acquire activity data (step counts, walking speed, time asleep, and energy expenditure). Additional clinical, radiological, and laboratory data will be collected when available during routine management. The findings will complement data from controlled trials by providing insight from daily clinical practice into the effect of cladribine tablets on the patient’s experience and self-assessed impact of treatment on daily life. [ABSTRACT FROM AUTHOR]

Knee osteoarthritis (OA) affects millions worldwide, leading to pain and reduced quality of life. Conventional treatments often fail to provide adequate relief, necessitating new therapeutic approaches. This study evaluated the efficacy and safety of genicular artery embolization (GAE) using permanent microspheres in patients with mild-to-moderate knee OA. In this prospective, single-center study, 17 participants underwent GAE. KOOS (Knee injury and Osteoarthritis Outcome Score), WOMAC (The Western Ontario and McMaster Universities Arthritis Index), and IPAQ (International Physical Activity Questionnaire) scores, along with physical performance tests, medication use, and dual-energy X-ray absorptiometry (DEXA) scans, were assessed at baseline and at multiple follow-up points over six months. The primary endpoint, VAS at six months, showed significant improvement (median reduction from 66 mm to 40 mm, p = 0.0004). All pain and function scores, as well as physical performance tests, improved significantly. No clinically relevant changes in medication use or DEXA parameters were observed after six months. Only minor, self-limiting adverse events occurred. This study indicates that GAE is a promising minimally invasive treatment for knee OA, providing significant pain relief and functional improvement. However, further long-term, randomized trials are needed to confirm these findings and establish optimal patient selection criteria. [ABSTRACT FROM AUTHOR]

Evidence suggests that multiple sclerosis (MS) induces a decline in motor and cognitive function and provokes a shift in gut microbiome composition in patients. Therefore, the aim of the study was to explore the effect of dance classes on the motor and cognitive functions and gut microbiota composition of MS patients. In this randomized controlled trial, 36 patients were randomly divided into two groups: the experimental group (n = 18) and the passive control group (n = 18). Supervised rock and roll and sports dance classes were performed for 12 weeks at a frequency of two times a week. Before and after the intervention, fecal samples were taken and the motor and cognitive function assessments were completed. Fecal microbiota were categorized using primers targeting the V3–V4 region of 16S rDNA. Our results revealed significant differences in mobility performance (T25‐FWT), attention and working memory (TMT B), and finger dexterity (9‐HPT) within the experimental group. Furthermore, we reported favorable shifts in gut microbial communities (an increase in Blautia stercoris and a decrease in Ruminococcus torques) within the experimental group. In conclusion, our randomized control trial on the effects of 12‐week dance classes in MS patients found significant improvements in motor and cognitive functions, with further moderate influence on gut microbiota composition. Highlights: This study demonstrated that dance class training improved mobility, leg function performance (T25‐FW), upper extremity function (9‐HPT), and cognitive functions (TMT‐B) in MS patients.An increase in some common and some not yet fully reviewed commensals, for example, Blautia stercoris, Clostridium algidixylanolyticum, Eubacterium xylanophilum, Megasphaera indica, and Parabacteroides faecis, was observed after dance class training in MS patients.This study showed a significant decrease in pathogens, namely Parvimonas micra and Ruminococcus, within the experimental group; on the contrary, we reported an increased relative abundance of other pro‐inflammatory bacteria, Bilophila wadsworthia, within the control group. [ABSTRACT FROM AUTHOR]

Introduction: Avascular Necrosis (AVN) of the femoral head, a condition characterized by the interruption of blood supply leading to bone tissue death, presents significant therapeutic challenges. Recent advancements in orthobiologics, including the use of Autologous Adult Live-Cultured Osteoblasts (AALCO), combined with core decompression, offer a novel approach for managing AVN. This study assesses the efficacy of this treatment modality in improving functional outcomes and hindering disease progression. Materials and methods: This retrospective observational study encompassed 30 patients treated between 2020 and 2023 for idiopathic AVN of the femoral head, grades I to III, who had not responded to conservative treatment. Patients were excluded based on specific criteria including age, secondary AVN causes, and certain health conditions. The treatment involved a two-stage surgical procedure under spinal anesthesia with OSSGROW® for AALCO generation. Post-operative care emphasized early mobilization, DVT prevention, and avoidance of NSAIDs. Outcome measures were evaluated using the Visual Analog Scale (VAS) for pain, modified Harris Hip Score, and annual MRI imaging for up to 36 months. Results: Among 26 patients (41 hips) completing the study, statistically significant improvements in pain and hip functionality were documented, alongside positive radiological signs of osteogenesis in the majority of cases. However, four instances required advancement to total hip replacement due to disease progression. Conclusion: The combination of core decompression and AALCO implantation shows promise as an effective treatment for AVN of the femoral head, with notable improvements in functional and radiological outcomes. This study supports the potential of orthobiologic approaches in AVN treatment, warranting further investigation through comprehensive randomized controlled trials. [ABSTRACT FROM AUTHOR]

Purpose: Congenital aniridia is a serious eye disease characterized by absence of iris to various degrees. The aims of this study were to investigate health‐related quality of life (HRQoL) in adults with aniridia and assess the relationships between HRQoL, psychological status, ocular health and obesity. Methods: Twenty‐nine adults with congenital aniridia (48% male, aged 18–79 years) participated. HRQoL was measured with SF‐36 and the EQ visual analogue scale (VAS). The physical (PCS) and mental (MCS) component summaries of the SF‐36 were calculated with higher scores indicating better HRQoL. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Obesity was assessed with the Patient‐Reported Outcomes in Obesity (PROS). Sociodemographic characteristics, genetic variants and ocular and medical health variables were also analysed. Results: The participants scored significantly lower in the general health domain of the SF‐36 than the general population (65.2 vs. 75.3, p = 0.017). The EQ VAS score was also lower in the aniridia group (64.9 vs. 77.9, p = 0.021). Low PCS score was correlated with presence of ocular pain (p = 0.019), high HADS score (p = 0.017) and high PROS score (p = 0.009). Low MCS score was related to higher educational level (p = 0.038) and high HADS score (p < 0.001). High HADS and PROS scores were both related to low EQ VAS scores. Conclusion: Adults with congenital aniridia scored worse on certain measures of HRQoL than the general population. Poorer HRQoL was associated with increased symptoms of anxiety, depression and obesity and with presence of ocular pain. [ABSTRACT FROM AUTHOR]

The priorities of individuals with chronic stroke are not always reflected in clinical practice. This study provides insight into meaningful factors related to long-term motor recovery in stroke survivors. Thirty individuals with chronic stroke participated in semi-structured interviews about movement, recovery, and barriers to and facilitators of mobility and paretic arm use. The interviews were analyzed using inductive thematic analysis. Three categories, the individual, environment, and task, defined five emergent themes. Individual: (1) mindset is a strong and consistent influencer of daily physical activity and overall recovery; (2) severe physical impairment limits physical activity and recovery, regardless of other factors; and (3) a negative perception of disability impacts mindset and willingness to move in public. Environment: (4) social and physical environments influence physical activity and recovery. Task: (5) participation in meaningful activities increases physical activity and promotes long-term recovery. Strategies to incorporate paretic arm use, exercise, and encouragement from others facilitate physical activity. Insufficient paretic limb function, environmental obstacles, and fear are barriers to physical activity. Neurorehabilitation must address the factors that are meaningful to stroke survivors. Building motor capacity is essential and must be integrated with factors such as a positive mindset and proper environment. Individual differences reinforce the need for personalized care. [ABSTRACT FROM AUTHOR]

Basketball demands a sophisticated blend of tactical, technical, physical, and psychological skills, and various methods have been proposed to prepare players for these demands, including resistance training to enhance strength, power, speed, agility, and endurance. Complex training (CT) integrates diverse strength training methodologies by combining heavy-resistance exercises (e.g., squat at 90% of one repetition maximum) with high-velocity movements or plyometrics, both sharing the same biomechanical pattern. However, the optimal application of CT in basketball remains uncertain due to diverse protocols and a lack of consensus in the literature. The aim of this systematic review was to evaluate the acute and chronic effects of CT interventions on physical fitness performance in basketball players and identify the most effective characteristics of moderators. Methods: A bibliographic search was conducted using PubMed, SCOPUS, and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using the PICOS strategy. Results: Fourteen studies met the inclusion criteria, three articles analyzed acute effects, and thirteen analyzed chronic effects. The total number of participants in the studies analyzing acute effects was 50, while for studies examining chronic effects, it was 362. Conclusions: Acutely, CT triggers post-activation potentiation and enhances sprint performance when coupled with brief rest intervals. Over time, these acute improvements contribute to more substantial, long-lasting benefits. Chronic effects of CT improve strength, as evidenced by enhanced 1 RM performance, jumps, sprints, and core muscle strength. [ABSTRACT FROM AUTHOR]

As the global demographic shifts toward an aging population, aging-related problems, particularly in older individuals with dynapenia, are increasingly gaining attention. However, interventional studies focusing on physical and cognitive function and sleep quality in such individuals are limited, indicating a need for further exploration. The present study investigated the effects of whole-body vibration (WBV) training on physical and cognitive function and sleep quality in older people with dynapenia residing in long-term care institutions. This study was a randomized controlled trial. The experimental group underwent WBV training three times a week for 3 months, whereas the control group continued with their regular daily care routine. Statistical analyses were performed using the Traditional Chinese version of SAS Statistics version 9.4. Paired t tests, a one-way analysis of variance, independent t tests, and generalized estimating equation analysis were performed. The results revealed that compared with the control group, the experimental group experienced significant improvements in grip strength, instrumental activities of daily living, cognitive function, and sleep quality in terms of latency and duration. These findings suggest that 3 months of WBV training can effectively enhance physical and cognitive function and sleep quality in older people with dynapenia residing in long-term care institutions. [ABSTRACT FROM AUTHOR]

Sleep is a fundamental biological process that plays a pivotal role in the health and performance of physically active individuals (PAI). Sleep deprivation or poor sleep quality can negatively impact recovery capacity, concentration, coordination, and muscular strength, thereby compromising physical performance and increasing the risk of injuries. Objectives: This narrative literature review aims to examine the scientific evidence on the importance of sleep hygiene for the health and performance of PAI. A search was conducted for studies published on PubMed, Scopus, and Web of Science. Studies that investigated the effect of sleep hygiene on health and performance variables in athletes were included. The literature analysis highlighted that good sleep hygiene, adequate sleep duration (7–9 h per night), high sleep quality, and a regular sleep routine are associated with a range of benefits for the health and performance of PAI, including: (1) improved post-training recovery; (2) reduced risk of injuries; (3) enhanced concentration and attention; (4) improved coordination and muscle strength; (5) better mood and mental well-being; (6) reduced risk of chronic diseases. Sleep hygiene is a key factor for the health and performance of PAI. Implementing a comprehensive and personalized sleep hygiene routine can lead to significant improvements in the quality and quantity of sleep, with positive effects on physical and mental health, and overall well-being of PAI. [ABSTRACT FROM AUTHOR]

Exercise therapy is the first-line intervention recommended for those with chronic musculoskeletal pain (CMP). Smartphone technologies (mHealth) represent a feasible means for exercise prescription and individualization. This systematic review with meta-analysis aimed to identify factors associated with changes in pain and function following mHealth-based exercise therapy in patients with CMP. CINAHL (via EBSCOhost), Embase, PubMed, Scopus, and SPORTdiscus were searched from inception to February 2023. Observational and controlled clinical trials with correlation or regression analysis of factors associated with the effect of mHealth exercise interventions on pain and function were included. The risk of bias, completeness of interventions, spin of information, and certainty in the evidence were evaluated. Eight studies with 51,755 participants were included. Reduced pain intensity after intervention was associated with higher physical function: r (95% CI) = −0.55 (−0.67 to −0.41); I2 = 86%, Tau2 = 0.02; p < 0.01. Meta-regression identified the Body Mass Index (BMI), exercise dose, and completion rate as potential moderators between changes in pain and physical function following mHealth exercise therapy. No association was found between pain and anxiety: r (95% CI) = 0.15 (−0.08 to 0.37); I2 = 87%, Tau2 = 0.02; p = 0.19. Very low certainty in the evidence was observed due to serious concerns regarding the risk of bias, inconsistency, and indirectness. The limited available evidence detracts from the clinical interpretation of the findings. [ABSTRACT FROM AUTHOR]

Background: Patients diagnosed with Parkinson's disease undergo alterations in physical, psychological, and social functionality, with the psychological domain being particularly predisposed to inducing fatigue and depressive symptoms. Understanding the alterations occurring within a patient's body and mind and how these influence their overall quality of life is crucial. Purpose: This study sought to explore the predictive capacity of fatigue severity, the presence of depressive symptoms, and diverse demographic factors on the quality of life among individuals with Parkinson's disease. Methods: A cross-sectional correlational study was conducted at a teaching hospital in southern Taiwan. The research utilized a questionnaire survey to interview 133 study participants, focusing on the Quality of Life Scale, Depression Scale, Fatigue Severity Scale, Social Support Scale, and demographic attributes. Results: A total of 130 valid questionnaires were obtained. The results showed that Hoehn and Yahr stage, fatigue severity, and depression status could predict quality of life, explaining 51.1% of the total variance. These findings suggest that patients at advanced Hoehn and Yahr stages, experiencing more severe fatigue, and exhibiting higher levels of depression, tended to report a lower overall quality of life. Our findings suggest that, in addition to Hoehn and Yahr stage, the severity of fatigue and levels of depression significantly impact the quality of life in individuals with Parkinson's disease. Conclusion: Nurses need to understand the "stressful life events" and the changes in appearance and physical function that patients with Parkinson's disease face due to chronic degenerative diseases. Hence, apart from addressing patients' physiological needs, healthcare professionals should also offer appropriate care for psychological issues, such as depressive symptoms. Encouraging patients to participate in "counseling groups" can further bolster their social support networks, enhancing their overall well-being and addressing comorbidities associated with chronic degenerative diseases. [ABSTRACT FROM AUTHOR]

Background: Boswellin® Super is a standardized extract of Boswellia serrata Roxb gum resin, standardized to contain 30% 3-acetyl-11-keto-ß-boswellic acid along with other ß-boswellic acids (BSE). A randomized, double-blind, placebocontrolled clinical trial was conducted at two doses of BSE to understand its safety and efficacy in supporting joint health and improving mobility and symptoms of osteoarthritis (OA) of the knee. Methods: Based on the inclusion/exclusion criteria, 105 newly diagnosed participants with degenerative hypertrophy OA were recruited and randomized into Placebo, BSE-150 mg or BSE-300 mg (n = 35 in each group) to receive either 150 mg or 300 mg BSE or a placebo tablet twice a day for 90 days. All the participants were evaluated for pain and physical function using the standard tools including the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne Functional Index (LFI), EuroQol-5 Dimension (EQ-5D) quality of life, 6-min walk test at day 0, days 5, 30, 60 and 90 of treatment. Additionally, the circulating levels of inflammatory biomarkers, tumor necrosis factor-a (TNFa), high-sensitive C-reactive protein (hs-CRP), and interleukin-6 (IL-6) were evaluated. Safety was evaluated by blood biochemical, hematological analysis, urinary analyses and by monitoring adverse events throughout the study. Results: Ninety-eight subjects completed the study. Improvements in pain scores were observed as early as 5 days after the start of the supplement in the BSE-150 and BSE-300 groups. By 90 days, the VAS pain score reduced by 45.3% and 61.9%, WOMAC-total score improved by 68.5% and 73.6% in the BSE-150 and BSE-300 groups respectively. WOMAC pain (70.2%, 73.9%, WOMAC stiffness (65.6%,68.9%), WOMAC function (68.8%,74.2%), LFI severity (50%,53.3%), decreased and EQ5D (56.9%, 62.9%) and distance walked in 6 minutes (21.2%, 21.9%) improved in the BSE-150 and BSE-300 groups in 90 days. Further, the levels of TNFa, hs-CRP, and IL-6 were found to decrease in the serum in BSEsupplemented participants. No significant adverse events were recorded during the study. Conclusion: The study confirms that Boswellin® Super can be used as a safe and effective supplement to support joint health and mobility in the management of osteoarthritis. [ABSTRACT FROM AUTHOR]

This study explored the association of physical activity (PA) from different dimensions including intensity, frequency, duration, and volume with possible sarcopenia (PSA), and established the PA cut-off value to identify PSA in middle-aged and older adults. The data in this study were from the China Health and Retirement Longitudinal Study in 2015. There were 7,957 adults aged over 45 years in the analysis. PA was assessed using a modified version of the International Physical Activity Questionnaire Short Form. Muscle strength and physical performance were measured to define PSA. Results showed that men spending at least 3 days each week, more than 10 min each time on vigorous-intensity PA, or a minimum of 933 Mets on total PA each week had a lower risk of PSA. In women, spending at least 3 days each week, more than 30 min each time on moderate-intensity PA, or taking at least 6 days each week, more than 120 min each time on low-intensity PA, or a minimum of 933 Mets on total PA each week was associated with a lower risk of PSA. In older adults (≥ 65 years), spending at least one day each week, more than 30 min each time on vigorous-intensity PA, or taking a minimum of 933 Mets on total PA each week was linked with a decreased risk of PSA. However, no significant associations were found between any PA dimensions and PSA in middle-aged adults (45–64 years). A receiver operating characteristic analysis showed that the PA cut-off value was 695 and 693 Mets each week for predicting PSA for men and women. The findings suggested that the intensity, frequency, duration, and weekly volume of PA is associated with the risk of PSA in middle-aged and older adults, and the association largely depends on sex and age. The PA cut-off value may be an early indication for a higher risk of sarcopenia. [ABSTRACT FROM AUTHOR]

Background: Stroke affects long-term physical and cognitive function; many survivors report unmet health needs, such as pain or depression. A hospital-led follow-up service designed to address ongoing health problems may avoid unplanned readmissions and improve quality of life. Methods: This paper outlines the protocol for a registry-based, randomised controlled trial with allocation concealment of participants and outcome assessors. Based on an intention-to-treat analysis, we will evaluate the feasibility, acceptability, potential effectiveness and cost implications of a new tailored, codesigned, hospital-led follow-up service for people within 6–12 months of stroke. Participants (n = 100) from the Australian Stroke Clinical Registry who report extreme health problems on the EuroQol EQ-5D-3L survey between 90 and 180 days after stroke will be randomly assigned (1:1) to intervention (follow-up service) or control (usual care) groups. All participants will be independently assessed at baseline and 12–14-week post-randomisation. Primary outcomes for feasibility are the proportion of participants completing the trial and for intervention participants the proportion that received follow-up services. Acceptability is satisfaction of clinicians and participants involved in the intervention. Secondary outcomes include effectiveness: change in extreme health problems (EQ-5D-3L), unmet needs (Longer-term Unmet Needs questionnaire), unplanned presentations and hospital readmission, functional independence (modified Rankin Scale) and cost implications estimated from self-reported health service utilisation and productivity (e.g. workforce participation). To inform future research or implementation, the design contains a process evaluation including clinical protocol fidelity and an economic evaluation. Discussion: The results of this study will provide improved knowledge of service design and implementation barriers and facilitators and associated costs and resource implications to inform a future fully powered effectiveness trial of the intervention. Trial registration: ACTRN12622001015730pr. Trial sponsor: Florey Institute of Neuroscience and Mental Health, 245 Burgundy Street, Heidelberg, VIC, 3084, PH: +61 3 9035 7032 [ABSTRACT FROM AUTHOR]

Background: The management of Spinal Muscular Atrophy (SMA) requires a multidisciplinary treatment approach, wherein rehabilitation constitutes an integral element. In this study, we examined the effects of rehabilitation among Chinese SMA patients and assessed the real-world efficacy of rehabilitation interventions. Methods: We conducted a cross-sectional online survey on SMA patients from June 9, 2023, to June 30, 2023, through the Meier Advocacy & Support Center using data from the Center's database and electronic questionnaires. The rehabilitation situation of the participants over the past 14 months were investigated. Logistic binary regression was used to analyze the relationship between Pediatric Quality of Life Inventory(PedsQL™) scores and rehabilitation. Result: A total of 186 questionnaires were finally analyzed. Only 29 patients did not rehabilitated in the past 14 months. A significant correlation between age and type of rehabilitation, as well as between age and duration of rehabilitation. Patients receiving no rehabilitation or solely home-based rehabilitation exhibited a higher median age of 8.4 compared to those undergoing standard rehabilitation or a combination of standard and home-based rehabilitation, with a median age of 4.9 (z-score = -4.49, p-value < 0.001). In addition, long-term rehabilitation (OR = 0.314, 95%CI = 0.106–0.927, p = 0.04) were negatively correlated with lower PedsQL™ Neuromuscular Module scores, and PedsQL scores in the long-term rehabilitation group were higher than those in the short-term and no-rehabilitation groups (54.2 ± 15.1 vs. 45.9 ± 14.4 and 42.3 ± 14.3, p = 0.01), with the most significant difference observed in the physical function section (59.0 ± 15.8 vs. 46.8 ± 15.2 and 45.6 ± 15.9, p < 0.01). Mobility and exercise (OR = 0.26, 95%CI = 0.08–0.81, p = 0.02), as well as assistive technology (OR = 0.28, 95%CI = 0.10–0.82, p = 0.02), were independently associated with a lower score in a negative direction. Conclusion: The study found that long-term rehabilitation was linked to higher PedsQL scores in SMA patients, highlighting the need for standardized rehabilitation programs to enhance function and quality of life. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the non-linear evolution of position-specific physical and technical performance indicators across different tactical formations in the Chinese Super League (CSL) from the 2015 to the 2021 seasons. Match data were collected from 800 games played in six common formations (3-5-2, 4-3-3, 4-2-3-1, 4-4-2, 3-4-3, and 4-1-4-1). Players were classified into five positions: central defenders (CD; match observations = 2,219), fullbacks (FB; match observations = 2,060), central midfielders (CM; match observations = 2,786), wide midfielders (WM; match observations = 1,587), and forwards (FW; match observations = 1,680). Generalized additive models (GAMs) were constructed to analyze the nonlinear evolution trends in position-specific physical and technical performance across seasons and formations. The results showed that the total distance covered by CDs in the 3-5-2 formation showed a non-linear upward trend from the 2015 to 2021 seasons (R2 = 0.3, p = 0.006); FBs in the 3-4-3, 4-1-4-1, and 3-5-2 formations exhibited non-linear upward trends in number of sprints and sprint distance from the 2015 to 2021 seasons (R2 = 0.189–0.448; P < 0.03, respectively); the high-speed running of FWs in the 4-2-3-1 formation displayed a non-linear decline trend from the 2015 to 2021 seasons (R2 = 0.477; P < 0.001); CMs in the 4-2-3-1 formation demonstrated a non-linear increasing trend in the ball retention percentage (R2 = 0.369; p = 0.001); WMs in the 4-4-2 formation showed a non-linear decreasing trend in ball retention percentage and passes from the 2015 to 2021 seasons (R2 = 0.259–0.29; P = 0.006, respectively). These findings revealed non-linear evolutionary trends in physical and technical performances across positions and formations, providing an in-depth understanding of the changing match demands placed on players during matches. This enables the optimization of training and tactics by developing targeted strategies tailored to meet the specific requirements of different formations and playing positions. [ABSTRACT FROM AUTHOR]

The authors discuss a study on the effects of exercise therapy on disability, mobility, and quality of life in the elderly with chronic low back pain. They highlight issues in the study that they believe severely impact its results such as the primary and secondary endpoints of the study and the risk of bias in the articles included in the meta-analysis.

Background: The prevalence of pre-frailty is notably high among maintenance hemodialysis (MHD) patients. Pre-frailty, an early and reversible condition between non-frailty and frailty, can lead to adverse outcomes such as increased unplanned hospital admissions and a higher risk of other chronic diseases. Early identification and intervention of pre-frailty in MHD patients are crucial. This study aimed to establish a simple and effective model for screening and identifying MHD patients at high risk of pre-frailty by using 50 kHz-Whole Body Phase Angle (PhA) measured by bioelectrical impedance analysis (BIA), hand grip strength (HGS), the Five-Times-Sit-to-Stand Test (FTSST), and laboratory parameters, with a specific focus on gender differences. Methods: This prospective cross-sectional study was conducted from September to December 2023 at the Wenjiang Hemodialysis Center in the Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China. A total of 244 MHD patients, including 130 males and 114 females, were enrolled, comprising 128 non-frail and 116 pre-frail individuals. Data were collected prospectively, including demographic information, physical measurements, and laboratory test results. All participants provided informed consent before enrollment. The FRAIL scale (FS) was used to assess pre-frailty in MHD patients. Grip strength was measured using an electronic grip strength tester, physical function was assessed using the Five-Times-Sit-to-Stand Test, and whole-body phase angle was measured using the InBody S10 device. Results: A total of 244 MHD patients with a mean age of 53.75 ± 0.90 years were enrolled, including 130 males with a mean age of 54.12 ± 1.26 years and 114 females with a mean age of 53.32 ± 1.29 years. ROC curve analysis showed that in male patients, the AUC of PhA for predicting pre-frailty was 0.919, with a sensitivity of 94.5% and specificity of 91.3%, and a cutoff value of 6.05°; in female patients, the AUC of PhA was 0.870, with a sensitivity of 70.5% and specificity of 90.6%, and a cutoff value of 5.25°. The AUC of FTSST for screening pre-frailty in male patients was 0.827, with a sensitivity of 62.3% and specificity of 96.2%, and a cutoff value of 12.95 s; in female patients, the AUC of FTSST was 0.784, with a sensitivity of 67.3% and specificity of 84.0%, and a cutoff value of 12.95 s. Additionally, in male patients, the combination of PhA and FTSST resulted in an AUC of 0.930, with a sensitivity of 96.4% and specificity of 81.3%; in female patients, the AUC was 0.911, with a sensitivity of 78.7% and specificity of 92.5%. Conclusion: PhA measured by BIA, in combination with the Five-Times-Sit-to-Stand Test, serves as an effective screening tool and predictor of pre-frailty in MHD patients. The combination of PhA and FTSST shows enhanced diagnostic value in female patients, while PhA alone is sufficient for predicting pre-frailty in male patients. Trial registration: Chinese Clinical Trial Registry (ChiCTR2100051111), registered on 2021–09-13. [ABSTRACT FROM AUTHOR]

Data describing the three-dimensional structure of physical networks is increasingly available, leading to a surge of interest in network science to explore the relationship between the shape and connectivity of physical networks. We contribute to this effort by standardizing and analyzing 15 data sets from different domains. Each network is made of tube-like objects bound together at junction points, which we treat as nodes, with the connections between them considered as links. We divide these networks into three categories: lattice-like networks, trees, and linked trees. The degree distribution of these physical networks is bounded, with most nodes having degrees one or three. Characterizing the physical properties of links, we show that links have an elongated shape and tend to follow a nearly straight trajectory, while a small fraction of links follow a winding path. These typical node and link properties must be reflected by physical network models. We also measure how confined a link is in space by comparing its trajectory to a randomized null model, showing that links that are central in the abstract network tend to be physically confined by their neighbors. The fact that the shape and connectivity of the physical networks are intertwined highlights that their three-dimensional layout must be taken into account to understand the evolution and function of physical networks. [ABSTRACT FROM AUTHOR]

Objectives: In this six-year follow-up study, we used patient-reported outcome measures (PROMs) to compare values at baseline, at 18 months, and at six-year follow up from the CycloME and the RituxME trials. Methods: Based on the hypothesis that ME/CFS in a subgroup of patients is a variant of an autoimmune disease, we performed two clinical trials between 2014 and 2017. The RituxME trial was a randomized, double-blind and placebo-controlled phase III trial of 151 patients, assessing the B-cell depleting antibody rituximab. The CycloME trial was an open-label phase II trial of 40 patients using intravenous cyclophosphamide. Here we report six-year follow-up from both trials, using the Short Form 36 Physical Function (SF-36 PF) and DePaul short form (DSQ-SF) questionnaires. Result: Of the patients available after six years, 75.7% of RituxME and 94.4% of CycloME patients participated. In the RituxME rituximab group, the mean SF-36 PF scores were 32.9 at baseline, 42.4 at 18 months and 45.5 at six years. In the placebo group, the mean SF-36 PF scores were 32.3 at baseline, 45.5 at 18 months and 43.1 at six years. In the CycloME trial, mean SF-36 PF increased from 35.4 at baseline to 54.4 at 18 months, and 56.7 at six years. At six-year follow-up, 44.1% of cyclophosphamide-, 27.6% of rituximab- and 20.4% of placebo-treated patients had an SF-36 PF ≥ 70, and further, 17.6%, 8.6% and 7.4% of the corresponding patient groups had an SF-36 PF ≥ 90, which is within normal range. In terms of worsening at six years, 5.9% of cyclophosphamide-treated, 10.3% of rituximab-, and 14.8% of placebo-treated patients had a drop in SF-36 PF of 20 points or more from baseline. There were no serious unexpected adverse reactions. Conclusions: After six years, 44.1% of the cyclophosphamide group scored an SF-36 PF of at least 70, and 17.6% of at least 90, suggesting that cyclophosphamide in a subgroup may modulate the disease course in a beneficial way. However, cyclophosphamide carries toxicity concerns and should not be used for ME/CFS patients outside clinical trials. Rather, these data should encourage efforts to better understand the disease mechanisms and to search for targeted and less toxic immune modulatory treatment for this patient group. [ABSTRACT FROM AUTHOR]

Introduction: Action observation (AO) and motor imagery (MI) are cognitive processes that involve mentally rehearsing and simulating movements without physically performing them. However, the need for the evidence to support influence of imagery on performance is increasing. This study aims to investigate the impact of combining motor imagery with action observation on athletes' performance and performance perception. Method: Using a pre-test post-test design with a factorial setup, participants were randomly assigned to experimental and control groups. A pre-research power analysis determined the sample size, resulting in 21 voluntary participants (10 male). Opto Jump device recorded drop jump performance measurements, while participants predicted their performance post-motor imagery and action observation practices. The experimental group underwent an 8-week AOMI intervention program, involving 24-minute motor imagery sessions during video observation thrice weekly. Post-test measurements were taken after the intervention. Results: Results indicated no significant performance increase in the experimental group post-intervention, yet the group showed enhanced performance estimation following the video observation, but not in motor imagery condition. Conversely, this improvement was absent in the control group. Discussion: Although AOMI intervention didn't enhance physical performance, it has positively affected athletes' perception toward their performance. The findings are discussed in relation to existing literature. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic urged all healthcare providers to collaborate to defeat this mortal infection. SARS-CoV-2 almost hits the respiratory system and may have subsequent serious complications like pulmonary embolism and multi-organ damage. Objective: To illustrate the rehabilitation program challenges encountered by physiotherapists in clinically managing hospitalized COVID-19 patients. The goal was to preclude the need for invasive mechanical ventilation and to improve the patient's oxygen saturation and general health. Methods: In this retrospective case-series study, we described the physiotherapy strategies implemented for 14 COVID-19 patients during the hospitalization period at an Egyptian governmental quarantine hospital. Results: The rehabilitation program was customized by physiotherapists to accommodate the specific circumstances, conditions, and acquired complications of individual patients. Patients were under the care of physiotherapists in both the COVID ward and ICU. Overcoming challenges such as patient reluctance, co-morbidities, and the effects of aging was a task faced by these healthcare professionals. Consequently, the program had to be modified to suit the unique needs of each patient. These tailored programs encompassed techniques such as percussion, positioning, range of motion, circulatory exercises, and respiratory exercises. The patients exhibited positive responses to their designated physical therapy program, experiencing improvements on various levels based on the progression of their individual cases. Conclusion: Physiotherapy has a major role in improving patient complications after being infected with COVID-19. In this desperate pandemic era, physiotherapists gave hospitalized patients support both psychologically and physically. [ABSTRACT FROM AUTHOR]

Introduction: Walking stands as the most prevalent physical activity in the daily lives of individuals and is closely associated with physical functioning and the aging process. Nonetheless, the precise cause-and-effect connection between walking and aging remains unexplored. The epigenetic clock emerges as the most promising biological indicator of aging, capable of mirroring the biological age of the human body and facilitating an investigation into the association between walking and aging. Our primary objective is to investigate the causal impact of walking with epigenetic age acceleration (EAA). Methods: We conducted a two-sample two-way Mendelian randomization (MR) study to investigate the causal relationship between walking and EAA. Walking and Leisure sedentary behavior data were sourced from UK Biobank, while EAA data were gathered from a total of 28 cohorts. The MR analysis was carried out using several methods, including the inverse variance weighted (IVW), weighted median, MR-Egger, and robust adjusted profile score (RAPS). To ensure the robustness of our findings, we conducted sensitivity analyses, which involved the MR-Egger intercept test, Cochran's Q test, and MR-PRESSO, to account for and mitigate potential pleiotropy. Results: The IVW MR results indicate a significant impact of usual walking pace on GrimAge (BETA = − 1.84, 95% CI (− 2.94, − 0.75)), PhenoAge (BETA = − 1.57, 95% CI (− 3.05, − 0.08)), Horvath (BETA = − 1.09 (− 2.14, − 0.04)), and Hannum (BETA = − 1.63, 95% CI (− 2.70, − 0.56)). Usual walking pace is significantly associated with a delay in epigenetic aging acceleration (EAA) (P < 0.05). Moreover, the direction of effect predicted by the gene remained consistent across RAPS outcomes and sensitivity MR analyses. There is a lack of robust causal relationships between other walking conditions, such as walking duration and walking frequency, on EAA (P > 0.05). Conclusion: Our evidence demonstrates that a higher usual walking pace is associated with a deceleration of the acceleration of all four classical epigenetic clocks acceleration. Key messages: In recent years, observational studies have found that there is a correlation between walking and aging, but the specific relationship is not clear We used a Mendelian randomization approach to test the causal effect of walking and sedentarism on epigenetic clock acceleration Mendelian randomization studies have found that faster walking speed may delay physiological aging through causal analysis at the genetic level [ABSTRACT FROM AUTHOR]

Due to rapid technological advancements, remote patient monitoring (RPM) technology has gained traction in recent years. While the effects of specific RPM interventions are known, few published reviews examine RPM in the context of care transitions from an inpatient hospital setting to a home environment. In this systematic review, we addressed this gap by examining the impacts of RPM interventions on patient safety, adherence, clinical and quality of life outcomes and cost-related outcomes during care transition from inpatient care to a home setting. We searched five academic databases (PubMed, CINAHL, PsycINFO, Embase and SCOPUS), screened 2606 articles, and included 29 studies from 16 countries. These studies examined seven types of RPM interventions (communication tools, computer-based systems, smartphone applications, web portals, augmented clinical devices with monitoring capabilities, wearables and standard clinical tools for intermittent monitoring). RPM interventions demonstrated positive outcomes in patient safety and adherence. RPM interventions also improved patients' mobility and functional statuses, but the impact on other clinical and quality-of-life measures, such as physical and mental health symptoms, remains inconclusive. In terms of cost-related outcomes, there was a clear downward trend in the risks of hospital admission/readmission, length of stay, number of outpatient visits and non-hospitalisation costs. Future research should explore whether incorporating intervention components with a strong human element alongside the deployment of technology enhances the effectiveness of RPM. The review highlights the need for more economic evaluations and implementation studies that shed light on the facilitators and barriers to adopting RPM interventions in different care settings. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has led to approximately 3.5 million cases in Romania, causing systemic inflammation and over 200 symptoms affecting various body systems. This complexity has challenged rehabilitation systems, necessitating personalized plans tailored to each patient's illness stage and impairment level. The ISPRM-developed ClinFIT COVID-19 instrument, aligned with the ICF categories, assists in assessing patients during acute, post-acute, and long-term phases. Objective: This study aimed to evaluate and assess functional impairments in post-COVID-19 patients in Romania, with a secondary goal of generating rehabilitation directions. Methods: Data were collected from patients at two Bucharest medical centers, including those with persistent symptoms post-acute phase. Participants were assessed using the adapted ClinFIT COVID-19 instrument, and descriptive statistics were applied. Conclusions: Findings revealed diverse functional impairments in physical, psychological, and social domains among post-COVID-19 patients, with severe impairments more common in those with long-term COVID-19. Complete impairment in complex movement and paid work was noted, affecting one-third of salaried employees and forcing some to retire. In the acute phase, the most frequent functional impairments were sleep, attention, pain sensation, and exercise tolerance functions. In contrast, the most severely affected functions were exercise tolerance and mobility joint functions. Age did not positively correlate with any of the analyzed functions. In the post-acute phase, sleep, energy, and drive functions remained the most frequently affected functions, while the most severely affected was, by far, the moving around function. In the post-acute period, respiratory and respiratory muscle functions strongly correlated with all tasks related to physical activity. In the long COVID-19 phase, remunerative employment was the most severely affected function, while attention functions remained the most frequently affected, similar to the acute phase. The ClinFIT COVID-19 instrument effectively captured these impairments, underscoring the need for comprehensive rehabilitation strategies. [ABSTRACT FROM AUTHOR]

Instrumenting the six-minute walk test (6MWT) adds information about gait quality and insight into fall risk. Being physically active and preserving multi-directional stepping abilities are also important for fall risk reduction. This analysis investigated the relationship of gait quality during the 6MWT with physical functioning and physical activity. Twenty-one veterans (62.2 ± 6.4 years) completed the four square step test (FSST) multi-directional stepping assessment, a gait speed assessment, health questionnaires, and the accelerometer-instrumented 6MWT. An activity monitor worn at home captured free-living physical activity. Gait measures were not significantly different between minutes of the 6MWT. However, participants with greater increases in stride time (ρ = −0.594, p < 0.01) and stance time (ρ = −0.679, p < 0.01) during the 6MWT reported lower physical functioning. Neither physical activity nor sedentary time were related to 6MWT gait quality. Participants exploring a larger range in stride time variability (ρ = 0.614, p < 0.01) and stance time variability (ρ = 0.498, p < 0.05) during the 6MWT required more time to complete the FSST. Participants needing at least 15 s to complete the FSST meaningfully differed from those completing the FSST more quickly on all gait measures studied. Instrumenting the 6MWT helps detect ranges of gait performance and provides insight into functional limitations missed with uninstrumented administration. Established FSST cut points identify aging adults with poorer gait quality. [ABSTRACT FROM AUTHOR]

Knowledge about a patient's physical fitness can aid in medical decision-making, but objective assessment can be challenging and time-consuming. We aimed to investigate the concordance of self-reported health status and physical functioning with the 6 minute walking distance (6MWD) as objective measure of physical performance. The prospective characteristics and course of heart failure stages A/B and determinants of progression (STAAB) cohort study iteratively follows a representative sample of residents of the city of Würzburg, Germany, aged 30–79 years, without a history of heart failure (HF). The 6MWD was measured in 2752 individuals (aged 58 ± 11 years, 51% women) from a population-based cohort under strictly standardized conditions. Self-reported health status and physical functioning were assessed from items of the short form 36 (SF-36). After the respective classification of self-reported health status and physical functioning into 'good', 'moderate', and 'poor', we determined the association of these categories with 6MWD by applying a generalized linear model adjusted for age and sex. Prevalence of self-reported good/moderate/poor general health and physical functioning was 41/52/7% and 45/48/7%, respectively. Mean 6MWD in the respective categories was 574 ± 70/534 ± 76/510 ± 87 m, and 574 ± 72/534 ± 73/490 ± 82 m, with significant sex-specific differences between all categories (all p < 0.001) as well as significant differences between the respective groups except for the categories 'moderate' and 'poor' health status in men. This cross-sectional analysis revealed a strong association between self-reported health status and physical functioning with the objective assessment of 6MWD, suggesting that physicians can rely on their patients' respective answers. Nevertheless, sex-specific perception and attribution of general health and physical functioning deserve further in-depth investigation. Decision-making based on self-reported health requires prospective evaluation in population-based cohorts as well as adult inpatients. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease due to an autoimmune chronic inflammatory response, yet the etiology is currently not completely understood. It is already known that physical activity plays an essential role in improving quality of life, especially in neuropathological conditions. The study was aimed to investigate the possible benefits of high-intensity interval training (HIIT) in bone and lipid metabolism markers, and neuromotor abilities in MS patients. 130 participants were recruited; 16 subjects with MS met the inclusion criteria and were included in the data analysis. The patients were randomly assigned to two groups: a Control group (CG) (34.88 ± 4.45 yrs) that didn't perform any physical activity and the Exercise group (EG) (36.20 ± 7.80 yrs) that performed HIIT protocol. The training program was conducted remotely by a kinesiologist. It was performed three times a week for 8 weeks. At the beginning (T0) and the end of the study (T1) physical function tests, bone remodelling markers, and lipid markers analyses were performed. After 8 weeks of training the wall squat (s) (T0 = 27.18 ± 4.21; T1 = 41.68 ± 5.38, p ≤ 0.01) and Time Up and Go test (s) (T0 = 7.65 ± 0.43; T1 = 6.34 ± 0.38 p ≤ 0.01) performances improved; lipid markers analysis showed a decrease in Total (mg/dl) (T0 = 187.22 ± 15.73; T1 = 173.44 ± 13.03, p ≤ 0.05) and LDL (mg/dl) (T0 = 108 ± 21.08; T1 = 95.02 ± 17.99, p < 0.05) cholesterol levels. Additionally, the levels of osteocalcin (µg/L), a marker of bone formation increased (T0 = 20.88 ± 4.22; T1 = 23.66 ± 6.24, p < 0.05), 25-OH Vitamin D (µg/L) improved after 8 weeks (T0 = 21.11 ± 7.11; T1 = 27.66 ± 7.59, p < 0.05). HIIT had an effect on lower limb strength and gait control, improved bone formation, and lipid management, in MS patients. [ABSTRACT FROM AUTHOR]

Three-dimensional (3D) bioprinting belongs to the wide family of additive manufacturing techniques and employs cell-laden biomaterials. In particular, these materials, named "bioink", are based on cytocompatible hydrogel compositions. To be printable, a bioink must have certain characteristics before, during, and after the printing process. These characteristics include achievable structural resolution, shape fidelity, and cell survival. In previous centuries, scientists have created mathematical models to understand how physical systems function. Only recently, with the quick progress of computational capabilities, high-fidelity and high-efficiency "computational simulation" tools have been developed based on such models and used as a proxy for real-world learning. Computational science, or "in silico" experimentation, is the term for this novel strategy that supplements pure theory and experiment. Moreover, a certain level of complexity characterizes the architecture of contemporary powerful computational resources, known as high-performance computing (HPC) resources, also due to the great heterogeneity of its structure. Lately, scientists and engineers have begun to develop and use computational models more extensively to also better understand the bioprinting process, rather than solely relying on experimental research, due to the large number of possible combinations of geometrical parameters and material properties, as well as the abundance of available bioprinting methods. This requires a new effort in designing and implementing computational tools capable of efficiently and effectively exploiting the potential of new HPC computing systems available in the Exascale Era. The final goal of this work is to offer an overview of the models, methods, and techniques that can be used for "in silico" experimentation of the physicochemical processes underlying the process of 3D bioprinting of cell-laden materials thanks to the use of up-to-date HPC resources. [ABSTRACT FROM AUTHOR]

This research aims to evaluate whether a basketball-specific warm-up (Basket-Up) provides immediate benefits in terms of the essential physical performance requirements of basketball and to compare these effects to those obtained from FIFA 11+. In total, 95 highly trained basketball athletes (49 women, 46 men), aged between 13 and 17, were randomly divided to either perform the FIFA 11+ program (n = 48) or the Basket-Up program (n = 47). Immediate evaluation encompassed the assessment of vertical jump (countermovement jump), agility (Lane Agility Test), and 20 m sprint. A two-way mixed analysis of variance was conducted with time (preintervention and postintervention), sex (men and women), and training group (FIFA 11+ and Basket-Up) as the within- and between-participant factors, respectively. Agility (p < 0.001, F = 66.759) and jumping (p < 0.001, F = 78.062) outcomes exhibited significant differences between pre- and postintervention values in both groups. Basket-Up agility values were significantly higher than those from FIFA 11+ (p = 0.001, F = 12.998). The implementation of a specific basketball warm-up program (Basket-Up) appears to be both safe and effective in enhancing immediate athletic performance among highly trained young basketball athletes. Moreover, the effects of this program are comparable to those obtained by a nonspecific basketball warm-up (FIFA 11+) in terms of sprint and jumping performance but demonstrate superiority in agility outcomes, favoring the Basket-Up program. [ABSTRACT FROM AUTHOR]

Chlorich®EnergyBoost, a water extract obtained from Chlorella sorokiniana, has been proposed to enhance physical performance and provide anti-fatigue effects. This study assessed the impact of Chlorich®EnergyBoost supplementation on physical performance and its anti-fatigue properties. Twenty-four mice were allocated into four groups: (1) the control group receiving only water,;(2) the 1X group (49.2 mg/kg/day); (3) the 2X group (98.4 g/kg/day); and (4) the 5X group (246 g/kg/day). All groups were orally administered the supplements for four consecutive weeks. The evaluation included grip strength, swimming endurance, an exhaustion test, and serum biochemistry analysis. Additionally, the study examined the bioactive peptides through matrix-assisted laser desorption/ionization mass spectrometry (MALDI-TOF MS) and conducted bacterial reverse mutation and acute oral toxicity tests for safety assessment. The findings indicated that Chlorich®EnergyBoost supplementation led to a significant reduction in serum lactate levels by 14.08% to 22.54% and blood urea nitrogen levels by 12.23% to 16.76%, an increase in the lactate clearance rate by 0.28 to 0.35, an enhancement of muscle glycogen storage by 1.10 to 1.44-fold, and hepatic glycogen storage by 1.41 to 1.47-fold. These results demonstrated dose-dependent effects. MALDI-TOF analysis revealed the expression of dihydrolipoamide dehydrogenase and superoxide dismutase. Both the bacterial reverse mutation and acute oral toxicity tests showed no adverse effects. [ABSTRACT FROM AUTHOR]

Background: Osteoking has been extensively used for the treatment of knee osteoarthritis (KOA). However, it is lack of high-quality evidence on the clinical efficacy of Osteoking against KOA and the comparison with that of nonsteroidal anti-inflammatory drugs (NSAIDs). Aims: To evaluate the efficacy and safety of Osteoking in treating KOA. Methods: In the current study, a total of 501 subjects were recruited from 20 medical centers, and were divided into the Osteoking treatment group (n = 428) and the NSAIDs treatment group (n = 73). The Propensity Score Matching method was used to balance baseline data of different groups. Then, the therapeutic effects of Osteoking and NSAIDs against KOA were evaluated using VAS score, WOMAC score, EQ-5D-3L and EQ-VAS, while the safety of the two treatment were both assessed based on dry mouth, dizziness, diarrhea, etc. Results: After 8 weeks of treatment, the Osteoking group was compared with the NSAIDs group, the VAS score [2.00 (1.00, 3.00) vs. 3.00 (2.00, 4.00)], WOMAC pain score [10.00 (8.00, 13.00) vs. 11.00 (8.00, 16.00) ], WOMAC physical function score [32.00 (23.00, 39.00) vs. 39.07 ± 16.45], WOMAC total score [44.00 (31.00, 55.00) vs. 53.31 ± 22.47) ], EQ-5D-3L score [0.91 (0.73, 0.91) vs. 0.73 (0.63, 0.83) ] and EQ-VAS score [80.00 (79.00, 90.00) vs. 80.00 (70.00, 84.00) ] were improved by the treatment of Osteoking for 8 weeks more effectively than that by the treatment of NSAIDs. After 8 weeks of treatment with Osteoking, the VAS scores of KOA patients with the treatment of Osteoking for 8 weeks were reduced from 6.00 (5.00, 7.00) to 2.00 (1.00, 3.00) (p < 0.05), which was better than those with the treatment of NSAIDs starting from 2 weeks during this clinical observation. Importantly, further subgroup analysis revealed that the treatment of Osteoking was more suitable for alleviating various clinical symptoms of KOA patients over 65 years old, with female, KL II-III grade and VAS 4-7 scores, while the clinical efficacy of NSAIDs was better in KOA patients under 65 years old and with VAS 8-10 scores. Of note, there were no differences in adverse events and adverse reactions between the treatment groups of the two drugs. Conclusion: Osteoking may exert a satisfying efficacy in relieving joint pain and improving life quality of KOA patients without any adverse reactions, especially for patients with KL II-III grades and VAS 4-7 scores. [ABSTRACT FROM AUTHOR]

Objective: To determine if estimates of functional muscle strength from a novel progressive lateral-step-up test (LSUT) are feasible, reliable, and related to physical activity in children with cerebral palsy (CP). Design: Cross-sectional; test-retest reliability Subjects/Patients: Children with CP and typically developing control children (n = 45/group). Methods: An LSUT with 10, 15, and 20 cm step heights was completed. It was repeated 4 weeks later in 20 children with CP. A composite score of LSUT was calculated based on the step height and number of repetitions completed. Physical activity was assessed using monitors worn on the ankle and hip. Results: Only 4 (13%) of the children with CP were unable to complete a lateral step-up repetition without assistance. All children were able to complete at least 1 repetition with assistance, though more than twice as many children with CP required assistance at 15 and 20 cm step heights than at the 10 cm step height (p < 0.01). Children with CP had 59 to 63% lower LSUT performance, 37% lower physical activity assessed at the ankle, and 22% lower physical activity assessed at the hip than controls (all p < 0.01). The intra-class correlation coefficient ranged from 0.91 to 0.96 for LSUT performance at the different step heights and was 0.97 for the composite score. All LSUT performance measures were positively related to ankle physical activity in children with CP (r range = 0.43 to 0.47, all p < 0.01). Only performance at 20 cm and the composite score were positively related to hip physical activity (r = 0.33 and 0.31, respectively, both p < 0.05). The relationship between the LSUT performance and physical activity at both the ankle and hip increased when age and sex were statistically controlled (model r range = 0.55 to 0.60, all p < 0.001). Conclusion: Estimates of functional muscle strength from a novel progressive LSUT are feasible, reliable, and positively related to physical activity in children with CP. [ABSTRACT FROM AUTHOR]

Background: The increasing popularity of hypoxic training as a training method to improve physical performance indicates the need to study the effects of this type of intervention on blood morphological and rheological indices, since the adaptive changes that follow such training mainly affect blood indices. In this study, the effects of a 4 weeks of intermittent hypoxic training on blood morphological and rheological indicators in physically active men were assessed. Methods: Forty-eight young, physically active men, participated in the study. Participants were randomly divided into three groups: two training groups and a control group without intervention (CTRL). Each group consisted of 16 participants. Training groups performed interval training (three times per week, 4 weeks, 12 workouts) under different conditions: in hypoxia (IHT; fraction of inspired oxygen (FiO2) = 14.4%) or in normoxia (NT; FiO2 = 20.9%). The control group performed only two workouts 4 weeks apart. Blood was taken during the first and last training session at rest, and 3 minutes after training. Results: After the last training session, there was a significant increase in mean corpuscular volume and a decrease in mean corpuscular haemoglobin concentration measured at rest only in the IHT group. There was also a significant decrease in resting aggregation amplitude for the IHT and CTRL groups. There was no difference in change of post-exercise plasma volume between first and last training session. Conclusion: The applied intermittent interval training in conditions of normoxia and hypoxia had no significant impact on resting aggregation parameters. This suggest that training under hypoxic conditions does not cause adverse rheological changes. [ABSTRACT FROM AUTHOR]

Background: Pre-frailty is associated with increased healthcare utilization. Over the past decade, public health interventions such as community-based exercises to target pre-frailty have been increasingly studied. However, the effects of community-based exercises on clinical outcome measures amongst community-dwelling older adults with pre-frailty remain unclear. This review aims to better understand the effects of community-based exercise on physical function, cognition, quality of life and frailty status in community-dwelling pre-frail older adults. A secondary objective was to investigate the optimal exercise parameters on clinical outcomes. Methods: Searches of MEDLINE, CINAHL, Google Scholar and Web of Science databases were conducted. Articles were included if they were randomized controlled trials (RCTs), and excluded if the participants consist of less than 50% pre-frail community-dwelling older adults. Meta-analyses (where possible) with either a fixed- or random- effect(s) model, standardized mean difference (SMD), odds ratio (OR) and tests of heterogeneity were performed. Multivariable meta-regression was performed to identify predictors of statistically significant outcome measures. The risk of bias was assessed using the modified Cochrane Risk-of-Bias tool. Results: Twenty-two RCTs with 900 participants in the experimental group and 1015 participants in the control group were included. When compared to minimal intervention, community-based exercises significantly improved lower limb strength (10 RCTs, 384 participants in the experimental group and 482 participants in the control group) with SMD 0.67 (95% CI 0.29 to 1.04), and lower limb function (5 RCTs, 120 participants in the experimental group and 219 participants in the control group) with SMD 0.27 (95% CI 0.03 to 0.51). Those who have received community-based exercises were more likely to reverse from pre-frailty to healthy state (OR = 2.74, 95% CI 1.36 to 5.51) (6 RCTs, 263 participants in the experimental group and 281 participants in the control group). The frequency of exercise sessions was a significant predictor of the effect size for gait speed (P<0.05). Conclusions: Community-based exercise intervention is superior to minimal intervention for improving health status in pre-frail older adults. This has implications on the implementation of community-based exercise intervention by healthcare providers and policymakers. Other: Nil funding for this review. PROSPERO registration number CRD42022348556. [ABSTRACT FROM AUTHOR]

Patients with Parkinson’s disease (PD) need to receive adequate information to manage their disease. However, little is known about how information provision affects patients.To conduct a scoping review of the literature on the relationship between content, timing, manner of delivery, and source of PD-specific information on the one hand, and patient outcomes on the other.All literature reporting about original data and published until April 2024 in peer-reviewed journals was searched in MEDLINE (Ovid), Embase (Ovid) and PsychInfo (Ovid). Subsequently, data were extracted and synthesized.40 publications describing the effects of information provision or patients’ evaluation thereof were retrieved. Four categories of patient outcomes were described, namely 1) evaluation and experience of information provision; 2) physical functioning; 3) psychosocial well-being; and 4) quality of life. In intervention studies, patients generally valued the provided information. Findings from cross-sectional and qualitative studies showed the importance of tailoring information to individuals’ needs and capabilities. Due to variation in study designs and outcomes, no unambiguous conclusions could be drawn regarding the relationship between information and outcomes.This scoping review identified how PD patients acquire information and revealed a lack of systematic research into the effect of information on patient outcomes. Future studies should assess 1) what information is currently provided by clinicians; 2) what additional information might be beneficial to provide; and 3) how information can be effectively aligned to benefit patients. This will eventually yield insight into how information might optimally empower PD patients. [ABSTRACT FROM AUTHOR]

Individuals with neuromuscular disorders display a combination of motor control deficits and lower limb weakness contributing to knee extension deficiency characterized by exaggerated stance phase knee flexion. There is a lack of evidence for long-term improvement of knee extension deficiency with currently available clinical treatment programs. Our previous work testing a wearable robotic exoskeleton with precisely timed assistive torque applied at the knee showed immediate increases in knee extension during walking for children with cerebral palsy, which continued to improve over an acute practice period. When we applied interleaved assistance and resistance to knee extension, we observed improvements in knee extension and increased muscle activation indicating the potential for muscle strengthening when used over time. There is a need for additional, high-quality trials to assess the impact of dosage, intensity and volume of training necessary to see persistent improvement in lower limb function for these patient populations. This randomized crossover study (ClinicalTrials.gov: NCT05726591) was designed to determine whether 12 weeks of overground gait training with a robotic exoskeleton outside of the clinical setting, following an initial in clinic accommodation period, has a beneficial effect on walking ability, muscle activity and overall motor function. Participants will be randomized to either complete the exoskeleton intervention or continue their standard therapy for 12 weeks first, followed by a crossover to the other study component. The primary outcome measure is change in peak knee extension angle during walking; secondary outcome measures include gait speed, strength, and validated clinical scales of motor function and mobility. Assessments will be completed before and after the intervention and at 6 weeks post-intervention, and safety and compliance will be monitored throughout. We hypothesize that the 12-week exoskeleton intervention outside the clinical setting will show greater improvements in study outcome measures than the standard therapy. [ABSTRACT FROM AUTHOR]

Post‐exercise hot (HWI) and cold (CWI) water immersion are popular strategies used by athletes in a range of sporting contexts, such as enhancing recovery or adaptation. However, prolonged heating bouts increase neuroendocrine responses that are associated with perceptions of fatigue. Fourteen endurance‐trained runners performed three trials consisting of two 45‐min runs at 95% lactate threshold on a treadmill separated by 6 h of recovery. Following the first run, participants completed one of HWI (30 min, 40°C), CWI (15 min, 14°C) or control (CON, 30 min rest in ambient conditions) in a randomised order. Perceived effort and recovery were measured using ratings of perceived exertion (RPE) and the Acute Recovery and Stress Scale (ARSS), whilst physiological responses including venous concentrations of a range of neuroendocrine markers, superficial femoral blood flow, heart rate and rectal temperature were measured. Exercise increased neuroendocrine responses of interleukin‐6, adrenaline and noradrenaline (all P < 0.001). Additionally, perceptions of overall recovery (P < 0.001), mental performance capacity (P = 0.02), physical performance capability (P = 0.01) and emotional balance (P = 0.03) were reduced prior to the second run. However, there was no effect of condition on these variables (P > 0.05), nor RPE (P = 0.68), despite differences in rectal temperature, superficial femoral blood flow following the first run, and participants’ expected recovery prior to the intervention (all P < 0.001). Therefore, athletes may engage in post‐exercise hot or cold‐water immersion without negatively impacting moderate‐intensity training sessions performed later the same day. [ABSTRACT FROM AUTHOR]

Background: Magnesium is a micronutrient and an intracellular cation responsible for different biochemical reactions involved in energy production and storage, control of neuronal and vasomotor activity, cardiac excitability, and muscle contraction. Magnesium deficiency may result in impaired physical performance. Moreover, magnesium plays an important role on delayed onset muscle soreness after training. Thus, physically active individuals and sport specialists have to pay attention to magnesium supplementation (MgS). However, the type, timing and dosage of magnesium intake are not well elucidated yet. Hence, we aimed to systematically review the literature regarding the effects of MgS on muscle soreness in physically active individuals. We focused exclusively on MgS, excluding those studies in which magnesium was administered together with other substances. Methods: Three electronic databases and literature sources (PUBMED, SCOPUS and Web of Sciences-Core Collection) were searched, in accordance with PRISMA guidelines. After the database search, 1254 articles were identified, and after excluding duplicates, 960 articles remained. Among these, 955 were excluded following the title and abstract screening. The remaining 5 articles were screened in full text and 4 study met the eligibility criteria. Results: These studies showed that MgS reduced muscle soreness, improved performance, recovery and induced a protective effect on muscle damage. Conclusion: To reach these positive effects, individuals engaged in intense exercise should have a Mg requirement 10–20% higher than sedentary people, to be taken in capsules and 2 h before training. Moreover, it is suggested to maintain magnesium levels in the recommended range during the off-season. Systematic review registration: PROSPERO registration number: CRD42024501822. [ABSTRACT FROM AUTHOR]

Background: Body weight unloaded treadmill training has shown limited efficacy in further improving functional capacity after subacute rehabilitation of ischemic stroke patients. Dynamic robot assisted bodyweight unloading is a novel technology that may provide superior training stimuli and continued functional improvements in individuals with residual impairments in the chronic phase after the ischemic insult. The aim of the present study is to investigate the effect of dynamic robot-assisted versus standard training, initiated 6 months post-stroke, on motor function, physical function, fatigue, and quality of life in stroke-affected individuals still suffering from moderate-to-severe disabilities after subacute rehabilitation. Methods: Stroke-affected individuals with moderate to severe disabilities will be recruited into a prospective cohort with measurements at 3-, 6-, 12- and 18-months post-stroke. A randomised controlled trial (RCT) will be nested in the prospective cohort with measurements pre-intervention (Pre), post-intervention (Post) and at follow-up 6 months following post-intervention testing. The present RCT will be conducted as a multicentre parallel-group superiority of intervention study with assessor-blinding and a stratified block randomisation design. Following pre-intervention testing, participants in the RCT study will be randomised into robot-assisted training (intervention) or standard training (active control). Participants in both groups will train 1:1 with a physiotherapist two times a week for 6 months (groups are matched for time allocated to training). The primary outcome is the between-group difference in change score of Fugl-Meyer Lower Extremity Assessment from pre-post intervention on the intention-to-treat population. A per-protocol analysis will be conducted analysing the differences in change scores of the participants demonstrating acceptable adherence. A priori sample size calculation allowing the detection of the minimally clinically important between-group difference of 6 points in the primary outcome (standard deviation 6 point, α = 5% and β = 80%) resulted in 34 study participants. Allowing for dropout the study will include 40 participants in total. Discussion: For stroke-affected individuals still suffering from moderate to severe disabilities following subacute standard rehabilitation, training interventions based on dynamic robot-assisted body weight unloading may facilitate an appropriate intensity, volume and task-specificity in training leading to superior functional recovery compared to training without the use of body weight unloading. Trial Registration: ClinicalTrials.gov. NCT06273475. Trial status: Recruiting. Trial identifier: NCT06273475. Registry name: ClinicalTrials.gov. Date of registration on ClinicalTrials.gov: 22/02/2024. [ABSTRACT FROM AUTHOR]

Background: Radiofrequency ablation is an effective treatment modality in the symptomatic treatment of knee osteoarthritis. Our aim was to compare the efficacy of radiofrequency ablation of the superomedial and inferomedial genicular nerves (2 branches) with the superolateral, superomedial, and inferomedial genicular nerves (3 branches) and to show whether the 2-branch procedure is inferior to the 3-branch procedure. Methods: This study is a prospective, randomized, single-blind clinical study. Eligible participants were randomized into 2 groups: group A, which applied the procedure to the superomedial and inferomedial genicular nerves, and group B, which applied it to the superomedial, superolateral and inferomedial genicular nerves. Pain was evaluated with the numerical rating scale, quality of life with the Short Form-36 (SF-36), and disability with the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index before, and at 1 and 3 months after the procedure. Results: A total of 41 patients were included. There were no differences between the groups except for the SF-36 physical health sub-score at baseline. A significant improvement was seen in the numeric rating scale (NRS) score, SF-36 sub-scores, WOMAC Index total, as well as pain and physical function scores in both groups, though no significant difference was detected between the groups during follow-up. Conclusions: Although we were unable to establish the noninferiority of conventional radiofrequency ablation (CRFA) applied to 2 branches to CRFA applied to 3 branches, in this trial, significant and similar improvement was observed in NRS, WOMAC total, pain, and physical function and SF-36 scores in both groups. [ABSTRACT FROM AUTHOR]