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The purpose of this study was to identify the effect of using a rehabilitation program of (massage and therapeutic exercises) on physiotherapy and rehabilitation of patients with spinal disc herniation by such variables as range of motion of the neck, pain level and intensity of disc herniation. The study was conducted on a sample of (12) female lumbar disc herniated patients aging (35-55). They were selected from all the teachers Bent Al Hussein of the Princess Aaisha were treated using the Comprehensive Secondary School for Girls, rehabilitation program of (massage and therapeutic exercises) for three months, three days a week. The researcher employed Meter to measure the moter range, Visual Analogue Scale (VAS) for pain, intensity of disc herniation and suitable statistical treatments like means, standard deviations, and t-test were also used, and Findings revealed :Statistical significant differences at (α ≤0.05) between scores on pre-test and the post-test by the study variables as range of motion of the neck, except bend the neck to the left Statistical significant differences at (α≤0.05) between scores on pre-test and the post-test in the pain level and the intensity of disc herniation. and rehabilitation of patients with spinal disc herniation by such variables as range of motion of the neck, pain level and intensity of disc herniation. The study was conducted on a sample of (12) female lumbar disc herniated patients aging (35-55). They were selected from all the teachers Bent Al Hussein of the Princess Aaisha were treated using the Comprehensive Secondary School for Girls rehabilitation program of (massage and therapeutic exercises) for three months, three days a week. The researcher employed Meter to measure the moter range, Visual Analogue Scale (VAS) for pain, intensity of disc herniation and suitable statistical treatments like means, standard deviations, and t-test were also used, and Findings revealed Statistical significant differences at (α ≤0.05) between scores on pre-test and the post-test by the study variables as range of motion of the neck, except bend the neck to the left Statistical significant differences at (α≤0.05) between scores on pre-test and the post-test in the pain level and the intensity of disc herniation. [ABSTRACT FROM AUTHOR]

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Objective: To compare various exercise modalities' efficacy on migraine frequency, intensity, duration, and disability. Background: Exercise has been shown to be an effective intervention to reduce migraine symptoms and disability; however, no clear evidence exists regarding the most effective exercise modalities for migraine treatment. Methods: A systematic review was performed in PubMed, PEDro, Web of Science, and Google Scholar. Clinical trials that analyzed the efficacy of various exercise modalities in addressing the frequency, intensity, duration, and disability of patients with migraine were included. Eight network meta‐analyses based on frequentist (F) and Bayesian (B) models were developed to estimate the direct and indirect evidence of various exercise modalities. Standardized mean difference (SMD) and 95% confidence (CI) and credible intervals (CrI) were calculated for each treatment effect based on Hedge's g and p scores to rank the modalities. Results: We included 28 studies with 1501 migraine participants. Yoga (F: SMD −1.30; 95% CI −2.09, −0.51; B: SMD −1.33; 95% CrI −2.21, −0.45), high‐intensity aerobic exercise (F: SMD −1.30; 95% CI −2.21, −0.39; B: SMD −1.17; 95% CrI −2.20, −0.20) and moderate‐intensity continuous aerobic exercise (F: SMD −1.01; 95% CI −1.63, −0.39; B: SMD −1.06; 95% CrI −1.74, −0.38) were significantly superior to pharmacological treatment alone for decreasing migraine frequency based on both models. Only yoga (F: SMD −1.40; 95% CI −2.41, −0.39; B: SMD −1.41; 95% CrI −2.54, −0.27) was significantly superior to pharmacological treatment alone for reducing migraine intensity. For diminishing migraine duration, high‐intensity aerobic exercise (F: SMD −1.64; 95% CI −2.43, −0.85; B: SMD −1.56; 95% CrI −2.59, −0.63) and moderate‐intensity continuous aerobic exercise (SMD −0.96; 95% CI −1.50, −0.41; B: SMD −1.00; 95% CrI −1.71, −0.31) were superior to pharmacological treatment alone. Conclusion: Very low‐quality evidence showed that yoga, high‐ and moderate‐intensity aerobic exercises were the best interventions for reducing migraine frequency and intensity; high‐ and moderate‐intensity aerobic exercises were best for decreasing migraine duration; and moderate‐intensity aerobic exercise was best for diminishing disability. Plain Language Summary: Exercise can help improve migraine, but we wanted to know if certain types of exercise are most helpful. We looked at data from many studies that explored different types of exercise for migraine, and we found that people who did moderate‐intensity aerobic exercise had fewer and less severe migraine symptoms. Yoga and higher‐intensity exercise were also helpful in some studies, but more research is needed to help doctors make the best exercise recommendations for their patients. Answer questions and earn CME credit: https://wileyhealthlearning.com/#/online‐courses/433023c3‐b6d6‐4eee‐aad1‐f86253c9afd9 [ABSTRACT FROM AUTHOR]

To compare scapular kinematics and muscle activity among various scapular muscle exercises. A cross-sectional study. A university research laboratory. Eighteen healthy men participated in this study. Three-dimensional scapular kinematics was measured with an electromagnetic motion capture system. Activities of the upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) were measured by using surface electromyography (EMG). In addition, the ratio of LT to the UT (LT/UT) and SA to the UT (SA/UT) was calculated. A repeated one-way analysis of variance and Shaffer's post-hoc analysis were used to detect the differences in each outcome during five exercises. The scapula was rotated upwardly during all exercises except push-up plus. The LT/UT ratio during side-lying external rotation and side-lying flexion were significantly higher than that for scapular plane elevation (P <.05), although the highest activity of the lower trapezius was produced during scapular plane elevation. The activities of the serratus anterior and SA/UT ratio during horizontal adducted elevation and push-up plus were significantly higher than that during scapular plane elevation (P <.05). Horizontal adducted elevation might be more appropriate for increasing scapular upward rotation with high serratus anterior activity and SA/UT ratio than push-up plus. • Scapular kinematics/muscle activity were analyzed while performing exercises. • Horizontal adducted elevation facilitated upward rotation/serratus anterior. • Side-lying flexion facilitated upward rotation/lower trapezius. • Push-up plus facilitated downward rotation/serratus anterior. • Horizontal adducted elevation/side-lying flexion may increase upward rotation. [ABSTRACT FROM AUTHOR]

GERAS DANcing for Cognition and Exercise is a therapeutic dance program for older adults with cognitive or mobility impairments. Using a pre-/posttest study design, we investigated the effect of 12 weeks of dance on the short performance physical battery (SPPB). In 107 participants aged 61–93 (mean 76.1, SD = 7.0; 20% men), over 90% had multifrailty and/or cognitive impairment. The mean attendance rate was 18/24 classes (75%). A substantial minimal clinically important difference (>0.4) occurred for SPPB total (+0.53, SD = 2.04, p =.002) and chair stands (+0.45, SD = 0.92, p <.001). Individuals with baseline SPPB ≤8 points (n = 38)—indicative of sarcopenia and physical frailty—had the most marked improvement (SPPB total: +1.45, SD = 1.97, p <.001; balance: +0.65, SD = 1.27, p =.006; chair stands: +0.68, SD = 0.97, p <.001). GERAS DANcing for Cognition and Exercise may be a promising rehabilitation intervention to improve daily physical function. [ABSTRACT FROM AUTHOR]

Purpose: This research compares the effectiveness of weight-bearing exercise on a rebounder, as well as ankle exercise therapy on biomechanics and quality of life (QoL) in patients with diabetic neuropathic feet. Methods: The present investigation is a clinical trial study with two experimental groups and one control group. A total of 48 women were selected in this study who had diabetes mellitus type 2 with diabetic peripheral neuropathy. Data was collected using the Michigan neuropathy screening instrument, foot health questionnaire, fall efficacy scale international, and QoL questionnaire. The first experimental group (n=16) engaged in rebound exercises for eight weeks, while the second experimental group (n=16) engaged in at-home ankle treatment exercises. The control group (n=16) was not given any particular treatment other than standard care, which consisted of medication, therapy prescribed by the medical team, and instructions for self-care included in a training manual. The data were analyzed using a correlated t-test and an analysis of covariance. Results: The results showed that applying rebound exercises and exercise therapy in exercise groups had a significant effect on the two components of the peak pressure of the medial forefoot area and the peak pressure of the lateral forefoot area of the right and left feet (P=0.05), the risk of falling (P=0.05), dynamic balance (P=0.05), and QoL (P=0.05), but not in the control group after 8 weeks (P

Stiff-person syndrome is rare and disabling autoimmune condition that most frequently affects women, with no real predisposition by race. Diagnosis is often arduous, which is why patients concomitantly suffer from anxiety and depression. To date, drug therapy is based on the use of benzodiazepines, barbiturates, and baclofen. Refractory cases are treated with intravenous immunoglobulin, plasmapheresis, B lymphocyte depletion with rituximab, and even the implantation of intrathecal baclofen devices. Botulinum toxin injection is frequently used, even if it still has an unclear role in the literature. Our case report aims to demonstrate the efficacy of a combined treatment of botulinum toxin and therapeutic exercise in a 65-year-old patient with biceps brachii muscle hypertonia and diffuse spasms of the axial musculature, using rating scales such as the Numeric Rating Scale (NRS) and Modified Ashworth Scale (MAS), joint range of motion (ROM) measurement, and muscle dynamic stiffness mensuration, which is performed by using the MyotonPro®. All the assessments were conducted at the first evaluation (T0), soon after the combined treatment with botulin toxin and therapeutic exercise (T1), three months (T2), six months (T3), and eight months after the botulinum toxin injection (T4). The patient demonstrated benefits for more than 6 months with no side effects. The combined therapy of botulinum toxin and therapeutic exercise had an excellent result in our patient. [ABSTRACT FROM AUTHOR]

Objectives: To examine the effects of acupuncture and therapeutic exercise alone and in combination on temporomandibular joint symptoms in tension-type headache and to evaluate the potential interaction of existing temporomandibular dysfunction on the success of headache treatment. Design: Pre-planned secondary analysis of a randomized controlled, non-blinded trial. Setting: Outpatient clinic of a German university hospital. Subjects: Ninety-six Participants with frequent episodic or chronic tension-type headache were randomized to one of four treatment groups. Interventions: Six weeks of acupuncture or therapeutic exercise either as monotherapies or in combination, or usual care. Follow-up at 3 and 6 months. Main measures: Subjective temporomandibular dysfunction symptoms were measured using the Functional Questionnaire Masticatory Organ, and the influence of this sum score and objective initial dental examination on the efficacy of headache treatment interventions was analyzed. Results: Temporomandibular dysfunction score improved in all intervention groups at 3-month follow-up (usual care: 0.05 [SD 1.435]; acupuncture: −5 [SD 1.436]; therapeutic exercise: −4 [SD 1.798]; combination: −3 [SD 1.504]; P = 0.03). After 6 months, only acupuncture (−6 [SD 1.736]) showed a significant improvement compared to the usual care group (P < 0.01). Subjective temporomandibular dysfunction symptoms had no overall influence on headache treatment. Conclusions: Only acupuncture had long-lasting positive effects on the symptoms of temporomandibular dysfunction. Significant dental findings seem to inhibit the efficacy of acupuncture for tension-type headache. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effectiveness of an online multicomponent intervention called FATIGUEWALK (FaW) compared to treatment as usual (TAU) in patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Method: FaWincluded pain neuroscience education, therapeutic exercise, cognitive restructuring, and mindfulness training. A total of 428 patients with CFS/ME were randomized into two study arms: online FaW plus TAU versus TAU alone. A single-blinded randomized controlled trial was conducted. Validated patient-reported outcome measures of fatigue, pain, anxiety, depression, and physical function were collected at baseline and posttreatment, following the FaW intervention, which lasted 12 weeks. Results: Statistically significant improvements (with small-to-moderate effect sizes) were observed in online FaWversus TAU alone with respect to multidimensional aspects of fatigue (Cohen's d ranging from 0.25 to 0.73) and most secondary outcomes (pain and fatigue intensity, depressive and anxious symptomatology, functional impairment, kinesiophobia, physical functioning). The absolute risk reduction in FaWversus TAU was 19%, 95% confidence interval (CI) [12.19, 25.80] with number needed to treat= 6, 95% CI [3.9, 8.2]. Overall, similar clinical improvements were observed in sensitivity analyses including a subgroup of patients without comorbidity with fibromyalgia (n=70). Conclusions: This is the first study to assess the short-term effectiveness of an online multicomponent intervention added to TAU, compared to TAU alone, for the management of CFS/ME. Further trials, including active control groups with an equivalent treatment dose, and assessing the long-term effectiveness of the online FaW, are warranted. [ABSTRACT FROM AUTHOR]

Purpose: This research compares the effectiveness of weight-bearing exercise on a rebounder, as well as ankle exercise therapy on biomechanics and quality of life (QoL) in patients with diabetic neuropathic feet. Methods: The present investigation is a clinical trial study with two experimental groups and one control group. A total of 48 women... [ABSTRACT FROM AUTHOR]

The evidence-based treatment of patellofemoral pain (PFP) suggests that therapeutic exercise (TE) focused on improving muscle strength and motor control be the main conservative treatment. Recent research determined that the success of the TE approach gets improved in the short term by the addition of neuromodulation via radiofrequency diathermy (RFD). As there is no follow up data, the objective of this research is to assess the long-term effects of adding RFD to TE for the pain, function and quality of life of PFP patients. To this aim, a single-blind randomized controlled trial was conducted on 86 participants diagnosed of PFP. Participants who met the selection criteria were randomized and allocated into either a TE group or an RFD + TE group. TE consisted of a 20 min daily supervised exercise protocol for knee and hip muscle strengthening, while RFD consisted of the application of neuromodulation using a radiofrequency on the knee across 10 sessions. Sociodemographic data, knee pain and lower limb function outcomes were collected. The RFD + TE group obtained greater improvements in knee pain (p < 0.001) than the TE group. Knee function showed statistically significant improvements in Kujala (p < 0.05) and LEFS (p < 0.001) in the RFD + TE group in the short and long term. In conclusion, the addition of RFD to TE increases the beneficial effects of TE alone on PFP, effects that remain six months after treatment. [ABSTRACT FROM AUTHOR]

Postural low back pain (LBP) is a non-specific LBP defined as pain or discomfort in low back areas caused by incorrect posture for ages. Most patients only experience mild and moderate pain from low back pain, however, it can cause chronic pain and disability for several groups. This case report aims to investigate the effect of therapeutic exercise on posture and pain in postural LBP. A 37-year-old male presented with LBP for 4 months with Numeric Rating Scale (NRS) 7. Physical examination showed impaired posture, wide base gait, limitation ROM of trunk, reduced breathing count test, muscle spasm at upper and lower back areas, positive in Thomas test, Ely test, and hamstring tightness test. The back pain functional scale (BPFS) was 7. The therapeutic exercise program consisted stretching exercises (neck, upper and lower back, hamstring, rectus femoris, iliopsoas muscle), core strengthening, William’s flexion, McKenzie’s, breathing and chest expansion exercise, alongside proprioceptive exercise. One cycle (eight times) of physical modalities, TENS at paralumbal and USD at paracervical, upper and middle trapezius, rhomboid, sternocleidomastoideus, paralumbal, and insertion of hamstring were given. We evaluated the patient’s condition for about 4 months, and the patient showed a good compliance with improvement in pain score, ROM of the trunk, reduced muscle spasm and tightness, improved posture, gait, breathing, and BPFS. The patient can return to do his job again. This case report is able to demonstrate that therapeutic exercise improves clinical and functional conditions. These findings suggest the clinical implications of therapeutic exercise in patients with postural LBP are beneficial.

Fibromyalgia syndrome (FMS) is characterised by the presence of distributed pain in different areas of the body accompanied by the alteration of some functions such as the activity of the neurovegetative system, the sleep quality, or the presence of fatigue. The present narrative review aims to evaluate some key studies regarding the effects of different therapeutic exercise (TE) modalities on clinical variables of interest in patients with FMS, as well as to discuss some of the possible mechanisms of action of TE in improving pain intensity in patients with FMS. All aerobic, strengthening, and body-mind exercises were shown to bring about changes in the improvement of clinical variables of interest in patients with FMS. In addition, with regard to the improvement of pain intensity, there are different arguments that could explain the hypoalgesic effect of TE (structured in physical, neurophysiological, and psychosocial mechanisms). In conclusion, TE is a clinical tool with great potential for patients with FMS as it may produce hypoalgesia through physical, neurophysiological, and psychosocial mechanisms. All these TE modalities have demonstrated in isolation a remarkable effectiveness in the overall improvement of patients with FMS. However, more research is needed in this field especially on the long-term effects and on the combination of the different training modalities.

Background: In Nigeria, there is a disparity among physiotherapists regarding therapeutic exercise as a core treatment for patients with knee osteoarthritis (OA). The attitudes and beliefs of physiotherapists could influence this. Objective: To investigate Nigerian physiotherapists’ knowledge, attitude, and utilisation of evidence-based therapeutic exercises Design: A mixed-method of cross-sectional survey and focus group discussion. Setting: Secondary and tertiary health institutions in Nigeria Participants: Physiotherapists consecutively sampled from the selected institutions. Main outcome measures: Participants’ knowledge, attitude and utilisation of evidence-based therapeutic exercises for the management of knee OA Results: This study revealed that 81% of physiotherapists in Nigeria had a fair knowledge of evidence-based practice and the efficacy of therapeutic exercises in managing knee OA. Despite this fair knowledge, 95.3% had a poor attitude. The important emerging categories/themes are treatment preference, clinical experience, and strength of evidence. Conclusion: Physiotherapists in Nigeria have a fair knowledge of evidence-based therapeutic exercises in managing patients with knee OA, although there is a poor attitude and disparity between the use and current recommendations. [ABSTRACT FROM AUTHOR]

Managing the painful shoulder in overhead athletes can be difficult because of a lack of time-loss injuries in overhead sports and focusing primarily on either pathoanatomic causes or movement impairments. Although managing the painful shoulder can be challenging, the combination of identifying pathoanatomic causes with movement impairments can provide a more focused rehabilitation approach directed at the causes of shoulder pain. Understanding the potential influence of scapular positioning as well as mobility and/or strength impairments on shoulder pain can help clinicians develop more directed rehabilitation programs. Furthermore, sports-specific methods such as long toss or the use of weighted balls for achieving physiological or performance-based gains have limited empirical evidence regarding their clinical and performance-based benefits, which may impede the rehabilitation process. Applying a comprehensive evaluation approach prior to and throughout the treatment process can assist clinicians with selecting the most appropriate treatment based on patient need. Reconsidering traditional treatments based on existing evidence may help refine the treatment process for overhead athletes with shoulder pain. [ABSTRACT FROM AUTHOR]

Low back pain (LBP) is a significant global health challenge due to its high prevalence, and chronicity and recurrence rates, with projections suggesting an increase in the next years due to population growth and aging. The chronic and recurrent nature of LBP, responsible for a significant percentage of years lived with disability, underscores the need for effective management strategies, including self-management strategies advocated by current guidelines, to empower patients and potentially improve healthcare efficiency and clinical outcomes. Therefore, the aim of this study was to analyze the added value of face-to-face visits in patients with chronic LBP undergoing a self-management program based on therapeutic exercises on pain intensity, disability, quality of life and treatment adherence and satisfaction. A randomized clinical trial was conducted, allocating 49 patients into a experimental group with a mobile health (mHealth) app usage and face-to-face sessions and 49 patients into an active control group without face-to-face sessions. Pain intensity, disability and quality of life were assessed at baseline, 4 weeks postintervention and 12 weeks postintervention. Patients' satisfaction and adherence were assessed at the end of the study. The multivariate general model revealed no statistically significant time × group interaction for any outcome (p > 0.0068) but mental quality of life (p = 0.006). Within-group differences revealed significant improvements for all the clinical indicators (all, p < 0.001). Patients allocated to the experimental group reported greater satisfaction and adherence (both, p < 0.001) compared to the control group. The use of mHealth apps such as Healthy Back® as part of digital health initiatives may serve as a beneficial approach to enhance the management of LBP. [ABSTRACT FROM AUTHOR]

Simple Summary: Stifle injury is common in the companion dog population, often leading to reduced weight bearing due to pain or joint instability, affecting neuromuscular control, balance, and proprioception. Earlier studies have reported the benefits of rehabilitation after stifle injury, though the specific effects of most exercises are unknown and predicting outcomes is challenging. In this randomized and controlled study, we investigated the effects of a 12-week progressive therapeutic home exercise protocol on static body weight distribution between hindlimbs, balance control, pain-related disability, and stifle function in 33 dogs diagnosed with stifle injury after 12 weeks of home exercise. An intervention and a control group both followed a standard rehabilitation protocol for stifle injury, with the intervention group also following a progressive therapeutic exercise protocol. The results indicate that the progressive therapeutic exercise protocol improved static body weight distribution between hindlimbs, pain-related functional disability, and stifle function. The effects were statistically significant, with intermediate to strong effects. There was a small but nonstatistically significant positive effect on balance control with the therapeutic exercise protocol, perhaps due to the rather small sample group and unvalidated method of measurement. We suggest studying balance control in dogs with stifle injuries more thoroughly in future studies. Stifle injury is common in the companion dog population, affecting weight bearing, neuromuscular control, and balance. Therapeutic exercises after stifle injury seem to be effective, but high-quality research evaluating the effects is lacking. This randomized controlled trial evaluated the effects of a 12-week progressive therapeutic home exercise protocol on three-legged standing, targeting balance and postural- and neuromuscular control and disability in dogs with stifle injury. Thirty-three dogs with stifle injury were randomly allocated to intervention (n = 18) and control groups (n = 15), both receiving a standard rehabilitation protocol. Additionally, the intervention group received a progressive therapeutic exercise protocol. The outcome measures were static body weight distribution between hindlimbs, balance control, the canine brief pain inventory, and the Finnish canine stifle index. Both groups improved after the intervention period, but the group using the progressive therapeutic exercise protocol improved to a greater extent regarding static body weight distribution between the hindlimbs (I: median = 2.5%, IQR = 1.0–4.5; C: median = 5.5%, IQR = 3.0–8.8), pain-related functional disability (I: median = 0.0, IQR = 0.0–0.2; C: median = 0.9, IQR = 0.1–1.8), and stifle function (I: median = 25.0, IQR = 9.4–40.6; C: median = 75.0, IQR = 31.3–87.5), with intermediate to strong effects. These clinically relevant results indicate that this home exercise program can improve hindlimb function and restore neuromuscular control. [ABSTRACT FROM AUTHOR]

BACKGROUND: Self-corrective exercise is commonly used in the training protocol of patients with adolescent idiopathic scoliosis (AIS). The muscle activation pattern during symmetrical and overcorrection exercises is then explored to guide the treatment. OBJECTIVE: To compare the paraspinal muscle activity during three self-corrective positions and the habitual standing in AIS. METHODS: Thirty-three adolescents with double curved scoliosis were examined. The curve type and Cobb's angle were determined from their whole spine X-ray. They adopted habitual standing, symmetrical correction and two overcorrected positions (O1 and O2). The surface electromyography (EMG) was monitored on both sides of paraspinal muscles at the apex areas of scoliotic curves. The EMG ratio between sides was inferred as the corrective effect. RESULTS: All three self-correction positions produced greater EMG ratios compared with the habitual standing. The greatest EMG ratios were observed during the O1 position at the thoracic curve and the habitual standing at the lumbar curve. Participants with different subtypes of curves exhibited similar patterns of EMG ratios. CONCLUSION: From the biomechanical viewpoint, all three self-corrective positions possibly provided therapeutic effects for the scoliotic body regardless of the subtype of scoliosis curves. The O1 position seemed to be most effective for the adjusting activation of thoracic paraspinal muscles. The symmetrical corrective position is otherwise recommended for adjusting the lumbar muscle activation. [ABSTRACT FROM AUTHOR]

Context: Gluteus medius (GMed) weakness is a common impairment seen across multiple lower-extremity pathologies. Greater GMed weakness is moderately associated with greater frontal plane motion, often termed dynamic knee valgus during functional tasks which may increase risk of lower-extremity injury. Neuromuscular electrical stimulation (NMES) superimposed to targeted muscles has emerged in clinical practice; however, NMES superimposed to the GMed in unknown. It is essential to assess the safety, credibility, and expectancy of NMES superimposed to the GMed prior to implementation in clinical practice. The objective of this study was to evaluate feasibility, safety, credibility, and expectancy of improvement with a 2-week intervention with or without NMES to the GMed in females with dynamic knee valgus. Design: Feasibility study. Methods: A total of 22 adult females with dynamic knee valgus (age = 21.8 [1.4] y, mass = 76.9 [18.8] kg, height = 1.7 [0.1] m) completed a 2-week intervention with NMES or a sham treatment superimposed to the GMed during all therapeutic exercises. Feasibility was assessed by recruitment and completion rate, while safety was assessed by the total number of adverse events. Treatment credibility and expectancy was assessed with the Credibility Expectancy Questionnaire. Mixed-measure analysis of variance were used for statistical analysis (P ≤ .05). Results: Recruitment was completed in 5 months with 100% completion rate and no adverse events. There was no difference in treatment credibility between groups (NMES = 23.7 [2.3], sham = 21.7 [3.4], P = .12); however, the NMES group demonstrated a greater expectancy score (NMES = 20.0 [3.8], sham = 15.9 [5.1], P = .045). Conclusion: Resistance training with NMES superimposed to the GMed is a feasible and safe intervention that resulted in greater expectance of success. Clinicians may consider superimposing NMES to the gluteal muscles when addressing muscle weakness in individuals with dynamic knee valgus. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to understand the image, perception, and beliefs regarding the role of the physiotherapist in the field of mental health physiotherapy, both among the professional community and other multidisciplinary teams. Methods: An observational phenomenological qualitative study through the administration of an ad hoc survey comprising both categorical and open-ended as well as quantitative questions was conducted. Results: A total of 368 responses were analysed. The participants comprised 78.4% women with a mean age of 37.5, an average professional experience of 14.33 years, and 88.3% practicing physical therapists. From the qualitative analysis conducted, three categories emerged in relation to the obtained responses: (a) functions with codes of "improving quality of life" and "intervening in physical pathologies"; (b) objectives with codes of "Improving quality of life", "Intervening in physical pathologies", "Functional rehabilitation", "Health promotion", and "Intervening in mental disorders"; and (c) image with codes "unfamiliarity", "holistic vision", "necessity", and "importance". Regarding the tools, the findings highlight a strong focus on physical exercise interventions due to their well-established benefits. Cognitive strategies like therapeutic relationships and cognitive–behavioural techniques were also prominent. Additionally, embodiment techniques involving movement, relaxation, breathing, and voice usage were notable. Lastly, manual therapy and physical agents formed another distinct category. Conclusions: The vision and role of this professional profile were unknown to the respondents. Despite being perceived as having a holistic view of the patient and being considered an essential need, the actual image remains vague. However, there is significant interest, indicating a promising future, although the lack of specialized training is noted. Therefore, the need for specialized education and awareness campaigns among professionals in the mental health field is highlighted. [ABSTRACT FROM AUTHOR]

Introduction: To explore physiotherapist and patient experiences with, and acceptability of, a 12‐week physiotherapist‐guided combined strength and aerobic physical activity exercise programme for hip osteoarthritis (OA). Methods: A qualitative study using semi‐structured interviews with 13 people with hip OA and four physiotherapists. Patients underwent a 12‐week home exercise programme customised by weekly visits with one of the four physiotherapists. The programme aimed for patients to participate in 150 min of moderate‐intensity aerobic physical activity, and 20–30 min of strengthening exercise 2–3 times per week in concordance with American College of Sports Medicine (ACSM) dosage guidelines. Following the programme, patients and physiotherapists participated in individual semi‐structured interviews to explore the acceptability of the exercise programme and barriers and facilitators to participation. Data were audio‐recorded, transcribed and analysed using a thematic approach. Results: Five over‐arching themes (supporting subthemes) were identified from both patient and physiotherapist interviews: (i) positive outcomes (functional improvements, pain relief, empowerment through experience, commitment to continue); (ii) combined benefits of aerobic and strength exercises (complimentary effects, strengthening exercises key); (iii) valuing support from the physiotherapist (personalised care, skill performance feedback, coach effect, accountability); (iv) motivation and opportunity for exercise (positive symptom loop, integration into daily routine, prior exercise experience, Fitbit motivation); and (v) time‐consuming commitment (physiotherapy visit frequency, travel inconvenience, time for exercise). Conclusions: Experiences of participants in this study indicate that, although time‐consuming, a combined aerobic physical activity and strengthening programme prescribed at ACSM dosage guidelines is acceptable and confers positive outcomes in individuals with hip OA. [ABSTRACT FROM AUTHOR]

The goal of the trial was to examine the effects of adding electromyographic biofeedback (EMG-BF) to the conventional program of physiotherapy after total hip arthroplasty (THA) on functional recovery and quality of life. The trial was designed as a prospective, interventional, single-blinded randomized controlled study. Ninety patients were randomized into an experimental group (EG) (n = 45; mean age 63.9 ± 8.8) and control group (CG) (n = 45; mean age 63.9 ± 9). All patients received 21 days of physiotherapy which consisted of therapeutic exercise (land-based and aquatic), electrotherapy, and education. Electromyographic biofeedback was added to a portion of the land-based exercise in EG. The Hip Disability and Osteoarthritis Outcome Score (HOOS), Numeric Rating Scale (NRS), Short Form Health Survey-36 (SF-36), use of a walking aid, 30 s chair stand test (CST) as well as the Timed Up and Go (TUG) test were used for outcome measurement. A higher proportion of the participants in both groups did not need a walking aid after the intervention (p < 0.05). All participants improved their 30 s CST and TUG results (p < 0.001), as well as their NRS and HOOS scores (p < 0.05). No significant differences between the groups were found. There were no additional benefits from adding EMG-BF to the conventional physiotherapy protocol. [ABSTRACT FROM AUTHOR]

The mean goal of this paper is to describe the design and control approach of an exoskeleton for rehabilitation of the disuse muscular atrophy of a human arm. This work includes three main parts: Firstly, the exoskeleton model wes design by Autodesk Inventor 3D software. Secondly, the dynamic simulation of the designed exoskeleton model attached to the human arm was performed using OpenSim software and its Matlab API extension, and finally a robust control law was simulated in order to ensure tracking of the rehabilitation trajectories applied by the exoskeleton to the human arm. OpenSim software makes it possible to simulate movements with musculoskeletal models, namely, the human arm. Rehabilitation in this case consists in a precise exercises given by the therapist. In our case, it is the repetitive trajectories given to the exoskeleton that must be controlled. A sliding mode controller was used since it is a robust control and ensures the best solutions to uncertainty issues. Through simulation, we tested some rehabilitation reference trajectories for the elbow and shoulder. The controller ensures high performances in terms of trajectory tracking in the presence of initial errors and also in the presence of model parameter errors. That showed the effectiveness of the exoskeleton control. [ABSTRACT FROM AUTHOR]

The purpose of this review is to assess available literature in relation to the effectiveness of therapeutic exercise in preventing medial tibial stress syndrome and navicular drop in active populations. This review contains primary research articles which adhered to the following inclusion criteria: randomised controlled trials, sample populations at risk of medial tibial stress syndrome, includes therapeutic exercise intervention, outcomes measuring medial tibial stress syndrome incidence or navicular drop. Exclusion criteria: combined therapeutic exercise with other therapeutic modalities, included participants with pre-existing symptomatic medial tibial stress syndrome or other lower limb injuries. Databases used included: CINAHL Complete, Scopus, EmCare (Ovid), Medline (Ovid), PubMed and SPORTDiscus. PEDro scale and NHMRC levels of evidence were used to assess methodological quality and risk of bias. Nine articles met eligibility criteria for review and were appraised for methodological quality. Moderate to high methodological quality was reported for the included studies. Six studies reported significant reductions in medial tibial stress syndrome risk or navicular drop when exposed to therapeutic exercise interventions. Effective interventions included intrinsic foot muscle, gluteal and lower leg strengthening as well as balance, plyometric and flexibility exercises. Three studies reported no significant effect of therapeutic exercise on medial tibial stress syndrome or navicular drop when compared to controlled interventions. Findings for therapeutic exercise in the prevention of medial tibial stress syndrome and correction of navicular drop are promising and provide basis for its practical application; however, the quality of the available literature limits the generalisability of outcomes. Further research needs to be conducted into the effectiveness of therapeutic exercise in medial tibial stress syndrome prevention. [ABSTRACT FROM AUTHOR]

This narrative review explores the complex relationship between aerobic exercise (AE) and neuropathic pain (NP), particularly focusing on peripheral neuropathies of mechanical origin. Pain, a multifaceted phenomenon, significantly impacts functionality and distress. The International Association for the Study of Pain's definition highlights pain's biopsychosocial nature, emphasizing the importance of patient articulation. Neuropathic pain, arising from various underlying processes, presents unique challenges in diagnosis and treatment. Our methodology involved a comprehensive literature search in the PubMed and SCOPUS databases, focusing on studies relating AE to NP, specifically in peripheral neuropathies caused by mechanical forces. The search yielded 28 articles and 1 book, primarily animal model studies, providing insights into the efficacy of AE in NP management. Results from animal models demonstrate that AE, particularly in forms like no-incline treadmill and swimming, effectively reduces mechanical allodynia and thermal hypersensitivity associated with NP. AE influences neurophysiological mechanisms underlying NP, modulating neurotrophins, cytokines, and glial cell activity. These findings suggest AE's potential in attenuating neurophysiological alterations in NP. However, human model studies are scarce, limiting the direct extrapolation of these findings to human neuropathic conditions. The few available studies indicate AE's potential benefits in peripheral NP, but a lack of specificity in these studies necessitates further research. In conclusion, while animal models show promising results regarding AE's role in mitigating NP symptoms and influencing underlying neurophysiological mechanisms, more human-centric research is required. This review underscores the need for targeted clinical trials to fully understand and harness AE's therapeutic potential in human neuropathic pain, especially of mechanical origin. [ABSTRACT FROM AUTHOR]

Individuals with High-Functioning Autism present impairments in communication, social interaction, and motor development. A low level of motor skills, namely difficulties in gross and fine mobility, and in motor control, discourage individuals with High-Functioning Autism from being involved in physical activities, resulting in fewer opportunities for social interaction. There is not much evidence available about the effects of regular swimming exercise and/or aquatic therapy on health promotion in adults with High-Functioning Autism. An adult male (22 yrs) diagnosed with High-Functioning Autism participated in a combined 6-month swimming and aquatic therapy program (two sessions/week, 60 min each). The pre- and post-intervention assessments consisted of physical fitness, balance, functional ability, and psychomotor tests. The post-intervention assessments showed improvements in the standing long jump (+100%), hand grip force (+71.7%), bend arm hang test (+123.1%), and the physiological parameters in the 6 min walk test (+10.2%). On the opposite, decrements in the sit-up (−12%) and sit-and-reach test (−6.3%) were observed. It was noted that the participant frequently lost interest and focus quickly, resulting in the abandonment of the exercise. Conclusively, there is a great need for further research on this topic examining a larger adult population. [ABSTRACT FROM AUTHOR]

This perspective paper illustrates the usefulness of explicitly integrating motor learning terminology with evolving therapeutic approaches. Physiotherapy specific scoliosis exercises (PSSEs) include a growing number of approaches to scoliosis management and serve as an example of this integration. Three quintessential patient cases (a young hypermobile adolescent, a post-pubescent teen, and an adult with childhood diagnosis of scoliosis) serve to contrast the clinical decision-making process for a PSSE plan of care when organized within a motor learning framework. As intervention approaches evolve, aligning the unique terminologies from different schools of thought with motor learning constructs would provide a common language for clinicians, academics and researchers to facilitate comparison of approaches and organize intervention care plans. Linking a motor learning framework and terminology to PSSE may facilitate comparison of PSSE treatment approaches by clinicians, academics, and researchers, as well as advance the global quality of care for patients with scoliosis. [ABSTRACT FROM AUTHOR]

To evaluate the effectiveness of "Physio-EndEA", a multimodal nine-week supervised exercise intervention, on quality of life, pain, and lumbopelvic impairments in women with endometriosis unresponsive to conventional therapy. Parallel-group randomized controlled trial. Outcomes were measured at baseline, post-intervention, and at 1 year. Two Public University Hospitals. This trial included 31 women with endometriosis (N=31) randomly allocated to "Physio-EndEA" group (n=16) or control group (n=15). Four participants dropped out of the study for causes unrelated to the intervention. The "Physio-EndEA" program consisted of a 1-week lumbopelvic stabilization learning phase followed by an 8-week phase of stretching, aerobic, and resistance exercises focused on the lumbopelvic area. It was sequentially instructed and supervised by a trained physiotherapist (with volume and intensity progression) and adapted daily to the potential of each participant. Control group received the usual treatment stipulated by their gynecologist. The primary outcome was quality of life. Secondary outcomes were pain intensity, pressure pain thresholds, pain-related catastrophic thoughts, abdominal and back strength, lumbopelvic stability, and muscle architecture. Adherence rate was 90.6% and mean (±standard deviation) satisfaction was 9.44±0.73 out of 10. No remarkable health problems were reported during the trial. In comparison with controls, the quality of life was improved post-intervention and at 1 year in the Physio-EndEA group with large effect sizes (d>0.80). This group also evidenced: a reduced intensity of dyspareunia, catastrophic thoughts; an increase in pelvic, lumbar, and distal pressure pain thresholds; increases in abdominal and back strength and lumbopelvic stability; and increased thickness of transversus abdominis (right side) and width of lumbar multifidus (left side). A 9-week program of multimodal supervised therapeutic exercise is a feasible and effective intervention to improve QoL in women with endometriosis. This program also offers benefits in terms of pain/sensitization and lumbopelvic impairments. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic pushed physicians to modify conventional practices to reduce the exposure and risk of infection among patients and health workers. Telemedicine is one of the safest methods, and telerehabilitation could prevent the sequelae of COVID-19. A quasi-experimental study with randomized sampling without masking/blinding was conducted. The study was conducted from August 2021 to March 2022 at Hospital A in Pekanbaru, Hospital B in Jayapura, and Hospital C in Jakarta, Indonesia. A total of 27 patients were recruited and divided into control and intervention groups. The control group was given conventional education on therapeutic exercise at home, while the intervention group was shown educational videos about therapeutic exercise at home. The comparison of all functional outcomes between the two groups after the intervention showed a significant difference. The intervention group improved more than the control group, except for the fatigue severity scale. Most of the responses showed that this video was feasible and useful and did not need to be supervised by health workers. Therapeutic exercise educational videos can be an option to deliver rehabilitation programs for post-COVID-19 hospitalized patients.

Stiff-person syndrome is rare and disabling autoimmune condition that most frequently affects women, with no real predisposition by race. Diagnosis is often arduous, which is why patients concomitantly suffer from anxiety and depression. To date, drug therapy is based on the use of benzodiazepines, barbiturates, and baclofen. Refractory cases are treated with intravenous immunoglobulin, plasmapheresis, B lymphocyte depletion with rituximab, and even the implantation of intrathecal baclofen devices. Botulinum toxin injection is frequently used, even if it still has an unclear role in the literature. Our case report aims to demonstrate the efficacy of a combined treatment of botulinum toxin and therapeutic exercise in a 65-year-old patient with biceps brachii muscle hypertonia and diffuse spasms of the axial musculature, using rating scales such as the Numeric Rating Scale (NRS) and Modified Ashworth Scale (MAS), joint range of motion (ROM) measurement, and muscle dynamic stiffness mensuration, which is performed by using the MyotonPro®. All the assessments were conducted at the first evaluation (T0), soon after the combined treatment with botulin toxin and therapeutic exercise (T1), three months (T2), six months (T3), and eight months after the botulinum toxin injection (T4). The patient demonstrated benefits for more than 6 months with no side effects. The combined therapy of botulinum toxin and therapeutic exercise had an excellent result in our patient.

The evidence-based treatment of patellofemoral pain (PFP) suggests that therapeutic exercise (TE) focused on improving muscle strength and motor control be the main conservative treatment. Recent research determined that the success of the TE approach gets improved in the short term by the addition of neuromodulation via radiofrequency diathermy (RFD). As there is no follow up data, the objective of this research is to assess the long-term effects of adding RFD to TE for the pain, function and quality of life of PFP patients. To this aim, a single-blind randomized controlled trial was conducted on 86 participants diagnosed of PFP. Participants who met the selection criteria were randomized and allocated into either a TE group or an RFD + TE group. TE consisted of a 20 min daily supervised exercise protocol for knee and hip muscle strengthening, while RFD consisted of the application of neuromodulation using a radiofrequency on the knee across 10 sessions. Sociodemographic data, knee pain and lower limb function outcomes were collected. The RFD + TE group obtained greater improvements in knee pain (p < 0.001) than the TE group. Knee function showed statistically significant improvements in Kujala (p < 0.05) and LEFS (p < 0.001) in the RFD + TE group in the short and long term. In conclusion, the addition of RFD to TE increases the beneficial effects of TE alone on PFP, effects that remain six months after treatment.

Introduction: asthma is the most common inflammatory disorder of the lower airways during childhood. It is manifested by dyspnea, expiratory flow limitation, wheezing and coughing. The aim of physiotherapy is to reduce the frequency of episodes and the intensity of symptoms, maintaining good ventilatory mechanics and avoiding overload of the respiratory musculature. Objective: to analyze the effects of therapeutic exercise in minor asthmatic patients in terms of improvement of asthma symptoms. Material and method: a literature search was performed in January 2022 in PubMed, PEDro, Cinahl, Medline, Scopus, Web of Science and LILACS. The descriptors "Asthma", "Asthma/rehabilitation", "Asthma/therapy", "Exercise Therapy" and "Therapeutic Exercise" were used, applying as inclusion criteria their publication in the last 10 years, that they were Randomized Clinical Trials, published in English or Spanish and that the patients were under 18 years of age. Results. eight valid articles were obtained after applying the eligibility criteria. The selected studies develop different physiotherapy interventions by means of therapeutic exercise in children and adolescents with asthma, with the aim of treating the disease. The variety of complementation of aerobic training with other types of training stands out; with aerobic training alone being the most commonly used technique. Conclusion: there is a great diversity in the application of therapeutic exercise in asthmatic patients under age, finding beneficial results in many of the variables, and controversy in other variables such as pulmonary function or quality of life. [ABSTRACT FROM AUTHOR]

Background: lipoedema is a disease in which there is a pathological and excessive fat deposition in the subcutaneous cellular tissue. This pathology is chronic and progressive occurring bilaterally and symmetrically. The proposed treatment is oriented to the signs and symptoms presented by each patient and should be approached in a multidisciplinary manner. Objective: to analyse the existing literature on the role of physiotherapy in the treatment of lipoedema.Material and method: A search was carried out in January 2022 on existing publications in PubMed, Medline, CINAHL, PEDro, WOS and Scopus. Inclusion criteria were established for articles to be in English, and exclusion criteria were those that did not fit the objective, repeated articles and systematic reviews and metaanalyses. Results: we evaluated the methodological quality of the 8 articles and analysed the composition and characteristics of the intervention in each of them. The most repeated therapies are complex decongestive therapy and the intermittent pneumatic compression technique. In all the studies where they have been used, positive results have been found. Conclusions: even with the little existing scientific evidence on the exact treatment of the disease, in most of the physiotherapy treatments applied, significant improvements were achieved in terms of volume, pain, functionality and other variables analysed. Therefore, further research is necessary to increase the level of evidence in this field and to be able to determine a really specific and effective treatment. [ABSTRACT FROM AUTHOR]

Pelvic floor rehabilitation should be considered within a multidisciplinary diagnostic-therapeutic approach with a dual goal: therapeutic and preventive. The tools available today for pelvic floor rehabilitative intervention in urinary incontinence are: therapeutic exercise, education, biofeedback, functional electrical stimulation, and aids. This article explores the use of biofeedback (BFB) in physiotherapy treatment. BFB transforms a feature of a biological activity that is not perceived by the patient into an amplified signal, either audible or visual: feedback, which is a way for the patient to learn the muscle contraction of the pelvic floor muscles. BFB is a safe and well-tolerated rehabilitation intervention methodology for patients. [ABSTRACT FROM AUTHOR]

In this study, therapeutic exercise, physical rehabilitation, physical activity and exercise dependence of students were investigated in the Department of Physical Therapy and Rehabilitation. The research aims to determine metaphors and scale values using the pattern research model and survey model from quantitative research methods. The research group consists 178 physiotherapy and rehabilitation department students at Bandırma Onyedi Eylül University Physiotherapy and Rehabilitation Department. The analysis shows that they discovered 38 subjects for therapeutic exercise, 30 for physical rehabilitation, and 3 subjects for physical activity. The categories perceived by the students of the Department of Physical Therapy and Rehabilitation for therapeutic exercise are divided into "entertainment effect", "physical effect", "psychological effect", "treatment" and "imperative", physical effect on physical rehabilitation, "psychological effect", "treatment" and "physiological and psychological effect" for physical activity. In addition, the analysis of the quantitative research method of the students of Department of Physical Therapy and Rehabilitation concluded that the study of physical activity dependence varies according to gender and age, and there is no difference in class variability. Studying the thoughts of the students of the Department of Physical Therapy and Rehabilitation, we find that there are physiological and psychological effects for physical activity and rehabilitation, and that exercise makes individuals feel stronger and more vigorous, increasing their quality of life. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether combination of corticosteroid subdeltoid injections and physiotherapy was more effective than either treatment alone in chronic subacromial bursitis. Design: Prospective, three-arm randomised controlled trial. Setting: Rehabilitation department of an academic hospital. Subjects: Patients with chronic subacromial bursitis. Interventions: Patients were divided into corticosteroid injection (N = 36), physiotherapy (N = 40) and combined (N = 35) groups. Two corticosteroid subdeltoid injections in corticosteroid group, 8-week physical therapy emphasising on therapeutic exercise in physiotherapy group, and combined both treatments in combined group. Main outcome measures: The primary outcome measures were pain visual analogue scale and Shoulder Pain and Disability Index at 8 weeks after finishing treatment. The secondary outcome measures were active range of motion, Shoulder Disability Questionnaire, Western Ontario Rotator Cuff Index, patient's evaluation of treatment effect, and symptom recurrence. Results: Group comparison showed significant statistical difference in shoulder flexion (P < 0.003) and patient's evaluation of treatment effect (P < 0.001). The time and group interactions comparison revealed significant statistical differences in pain score (P < 0.024), external rotation (P < 0.044) and patient's evaluation of treatment effect (P < 0.001). The above statistics were in favour of the corticosteroid and combined groups rather than physiotherapy group. The percentage of recurrence was 36.1, 7.5 and 17.1 in the corticosteroid, physiotherapy and combined groups, respectively (P < 0.001). Conclusion: Corticosteroid subdeltoid injection, or combined with physiotherapy, was superior to physiotherapy alone, but the recurrence rate was least in the physiotherapy group. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore patients' experience of patellofemoral pain (PFP), in order to help improve the mutual understanding between the patient and the physiotherapist and consequently enhance the efficacy of treatment. A qualitative study design with focus groups was used to explore patient experience prior to the implementation of the therapeutic exercise program, during its duration, and up to twelve months after its conclusion. Patients provided a detailed description of their lifestyle prior to the enrollment in the therapeutic exercise program, their experience of the therapeutic exercise program and the behavioral changes that remained after its conclusion. Three main themes emerged from our data: 1) PFP characteristics and the impact of PFP on daily life; 2) experience with the therapeutic exercise program; and 3) changes in PFP and daily behaviors following the therapeutic exercise program. Our findings suggest that a targeted therapeutic exercise program effectively reduces short- and long-term PFP and enhance overall well-being. Further research is needed to investigate the effects of different therapeutic exercise programs with a focus on the role of self-motivation. [ABSTRACT FROM AUTHOR]

Objective: To investigate the incidence of subsequent lumbar spine, hip, and ankle-foot injuries after a diagnosis of patellofemoral pain. Design: Retrospective cohort study. Setting: Military Health System. Participants: Individuals (n = 92,319) ages 17–60 diagnosed with patellofemoral pain between 2010–2011. Interventions: Therapeutic exercise. Main Outcome Measures: Frequency of adjacent joint injuries in the 2-year period after initial patellofemoral pain injury, and hazard ratios (HR) with 95% confidence interval (CI) and Kaplan–Meier survival curves for risk of adjacent joint injury based on receiving therapeutic exercise for the initial injury. Results: After initial patellofemoral pain diagnosis, 42,983 (46.6%) individuals sought care for an adjacent joint injury. Of these, 19,587 (21.2%) were subsequently diagnosed with a lumbar injury, 2837 (3.1%) a hip injury, and 10,166 (11.0%) an ankle-foot injury. One in five (19.5%; n = 17,966) received therapeutic exercise which reduced the risk of having a subsequent lumbar (HR = 0.78, 95% CI 0.76–0.81), hip (HR = 0.93, 95% CI 0.87–0.98) or ankle-foot (HR = 0.86, 95% CI 0.83–0.90) injury. Conclusion: The results suggest that a high number of individuals with patellofemoral pain will sustain an adjacent joint injury within 2 years although causal relationships cannot be determined. Receiving therapeutic exercise for the initial knee injury reduced the risk of sustaining an adjacent joint injury. This study helps provide normative data for subsequent injury rates in this population and guide development of future studies designed to understand causal factors. [ABSTRACT FROM AUTHOR]

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Background: Exercise is one of the most recommended management strategies by treatment guidelines for fibromyalgia (FM); however, the mechanism through which exercise improves pain in FM is still unknown. Objective: We aimed to summarize the hypothesized theoretical mechanisms for the pain-relieving effects of exercise in people with FM. Eligibility Criteria: Randomized controlled trials (RCTs) in English reporting mechanisms for pain-relieving effects of exercise in the 'Introduction' and 'Discussion' sections and significant within- group or between-group effects of exercise interventions were included. Sources of Evidence: We searched the databases Ovid MEDLINE(R), EMBASE, CINAHL, COCHRANE, Sports Discuss, and AMED with the keywords: exercise and fibromyalgia until December 2021. Charting Methods: Two authors independently performed title/abstract, full-text review, and data abstraction using a data abstraction form. The hypothesized mechanisms from individual studies were grouped into three categories. Results: The literature search resulted in 2147 studies, out of which 220 studies were considered for full-text review. A total of 50 RCTs proposing 29 unique mechanisms for the pain-relieving effects of exercise were included. These mechanisms were divided into three categories: physical, neuro-physiological, and psychological. The neuro-physiological category was further subdivided into exercise-induced hypoalgesia (EIH), pain sensitization, the autonomic system, the immune system, the endocrine system, and miscellaneous categories. The most frequently hypothesized mechanisms were EIH (n = 15), autonomic modulation (n = 7), improved sleep (n = 6), muscle oxygenation (n = 6), self-efficacy (n = 5), mental health (n = 4), and benefits of the aquatic environment (n = 12). While all exercise interventions involved FM patients, most of the supporting evidence for these mechanisms was cited from previous studies conducted on healthy samples. No studies performed analyses to demonstrate causal associations between the mechanisms and outcomes. Conclusion: Multiple mechanisms were hypothesized for the positive influence of exercise in people with FM. Future studies using causal analyses, such as mediation analysis, are recommended to validate these mechanisms. [ABSTRACT FROM AUTHOR]

This randomized controlled trial aims to investigate the effect of 12 weeks of therapeutic exercise on cognitive function and daily activities in patients with mild Alzheimer's disease (AD). A total of 171 patients with mild AD from the Amarousion Day Care Center of the Alzheimer Society of Athens and the Athens General Hospital "G. Gennimatas" were randomly divided into three groups. Group A (aerobic and resistance exercise, n = 57), group B (resistance exercise, n = 57), and group C (control group, n = 57). Group A followed a weekly program consisting of 5 days with 30 min walking and 3 days with resistance exercises for about 45 min. Group B followed only a resistance exercise program, the same as group A. Group C did not participate in any exercise program. After the intervention, cognitive function was assessed with the Cognitive Examination-Revised (ACE-R), Trail Making Test A-B (TMT A-B), and Digit Span Test Forward and Backward (DST F-B) and daily activities with the instrumental activities of daily living scale (IADLs). A significant intervention effect was observed for all outcome measures (global cognitive function and instrumental activities of daily living). ANCOVA Bonferroni corrected post hoc tests revealed that the aerobic and resistance group improved compared to the control group on all measurement scales. The resistance group also showed an improvement compared to the control group. No significant effects were found between the aerobic and resistance group and the resistance group in any of the outcome measures. [ABSTRACT FROM AUTHOR]

Context: Hamstring strain is a common injury to the lower limbs. Early intervention in the acute phase aids with restoring hamstring function and prevents secondary related injury. Objective: To systematically review and summarize the effectiveness of exercise-based interventions combined with physical modalities currently used in athletes with acute hamstring injuries. Data Sources: Five databases (EMBASE, Medline, Cochrane Library, SPORTDiscus, and Web of Science) were searched from inception to July 2021. Study Selection: A total of 4569 studies were screened. Nine randomized controlled trials (RCTs) on the effect of therapeutic exercise programs with and without physical agents in athletes with acute hamstring injuries were identified for meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 1. Data Extraction: The studies were screened, and the evidence was rated using the PEDro scale. Nine RCTs with PEDro scores ranging between 3 and 9 were included and extracted pain intensity, time to return to play (TTRTP), and reinjury rate in the study. Results: Loading exercises during extensive lengthening were shown to facilitate TTRTP at P < 0.0001 but did not prevent recurrence (P = 0.17), whereas strengthening with trunk stabilization and agility exercise did not reduce the duration of injury recurrence (P = 0.16), but significantly reduced the reinjury rate (P < 0.007) at a 12-month follow-up. The results of the stretching programs and solely physical modalities could not be pooled in the statistical analysis. Conclusion: The meta-analysis indicated that a loading program helps athletes to return to sports on a timely basis. Although strengthening with trunk stabilization and agility exercise cannot significantly reduce recovery time, the program can prevent reinjury. The clinical effects of stretching programs and pure physical modality interventions could not be concluded in this study due to limited evidence. PROSPERO Registration: CRD42020183035. [ABSTRACT FROM AUTHOR]