Advances in Rehabilitation Feed

‘Seeing pain differently’: the impact of physiotherapists’ attitudes and treatment beliefs on postural assessment in neck pain – an eye-tracking study

Tue, 31 Mar 2026 00:00:00 GMT

Introduction This study investigated how physiotherapists’ pain treatment orientations (biopsychosocial or biomedical) influence visual postural assessment of individuals with neck pain, using eye-tracking analysis. Material and methods Physiotherapists (n = 30) completed the pain attitudes and beliefs scale and were categorised as predominantly ‘biomedical’ or ‘biopsychosocial’ based on the higher score percentage of the subscales. Eye-tracking data were collected while physiotherapists conducted visual postural assessment of participants with (n = 30) and without (n = 30) neck pain. Results Physiotherapists with a biopsychosocial orientation exhibited (mean [95%CI]) fewer fixation counts in lateral (−2.29 [−3.80; −0.78] n) and posterior views (−5.84 [−7.62; −4.06] n), lower saccade counts in the posterior view (−4.51 [−6.46; −2.56] n) and shorter mean first-time passage on all transitions (ranging from −4.08 [−6.28; −1.88] to −14.09 [−18.64; −9.54] n) than those with a biomedical orientation. However, they demonstrated longer average fixation durations in all views (anterior: 0.02 [0.01; 0.03] seconds, lateral 0.04 [0.02; 0.05] seconds) and posterior 0.04 [0.03; 0.06] seconds). Almost all transition probabilities differed across physiotherapist groups, with specific positive or negative effects observed across transitions. Mean recurrent time was also lower in physiotherapists with Biopsychosocial orientation (−0.30 [−0.53; −0.08] events). Conclusions Biopsychosocial-oriented physiotherapists exhibited more dynamic eye-movement patterns, with faster view transitions and shorter recurrence times, potentially indicating a more holistic approach to postural assessment. Attitudes and beliefs toward pain treatment orientation of physiotherapists, but not the presence of neck pain in patients, significantly influence their visual postural assessment.

Chronic low back pain and sleep disorders in older adults: a cross-sectional study

Tue, 31 Mar 2026 00:00:00 GMT

IntroductionSleep disorders and chronic low back pain (CLBP) are prevalent conditions in older adults and can coexist in a bidirectional relationship. The aim was to investigate the associations between the risk of obstructive sleep apnoea (OSA), excessive daytime sleepiness, sleep quality with pain intensity and functional disability, and to estimate the prevalence of sleep complaints in older adults with CLBP. Materials and methodsA cross-sectional study involving older adults with CLBP aged 60 years and above from primary care was conducted. Data collected included OSA risk (Berlin Questionnaire), excessive daytime sleepiness (Epworth Sleepiness Scale), sleep quality (Pittsburgh Sleep Quality Index), pain intensity (Numerical Pain Rating Scale), functional disability (Roland–Morris Questionnaire) and sleep complaints (Sleep Complaints Questionnaire). We performed descriptive analyses and ran six univariate and multivariable linear regression models (adjusted for potential confounders). ResultsSleep quality was associated with disability, even after adjusting for confounders (0.25 [CI 95%: 0.07–0.43]). Sleep quality was also significantly associated with pain intensity (0.28 [CI 95%: 0.09–0.47]) in univariate analysis. The risk of OSA was associated with pain intensity (0.30 [CI 95%: 0.16–0.72]) and functional disability (0.33 [CI 95%: 0.20–0.75]), but only in univariate analysis. Excessive daytime sleepiness and pain intensity were negatively associated in a multivariable analysis (−0.21 [CI 95%: −0.42, to 0.01]). A prevalence of at least one sleep complaint was found in 96% of participants. ConclusionsPoor sleep quality was associated with disability, and pain intensity appeared to worsen sleep. Routine screening and interventions for sleep problems could help reduce pain, disability and healthcare burden.

Moderate continuous versus high-intensity interval training on gut dysbiosis and glucagon-like peptide hormone in irritable bowel syndrome

Tue, 31 Mar 2026 00:00:00 GMT

IntroductionRegular physical activity is critical in maintaining or restoring gut microbiota equilibrium, potentially ameliorating gut dysbiosis (GD) associated with obesity. Our objective is to evaluate and compare the impacts of moderate-intensity interval training (MICT) and high-intensity interval training (HIIT) on GD and glucagon-like peptide-1 (GLP-1) levels in patients with irritable bowel syndrome (IBS). Materials and methodsSixty-six participants diagnosed with IBS of both sexes with a body mass index (BMI) of 30–34.9 kg/m2, 30–39 years, prediabetic status and a sedentary lifestyle were randomly and equally assigned into groups A (MICT + low FODMAP diet [LFD]), B (HIIT + LFD) and C (control; LFD only). The intervention lasted for 12 weeks, and training was performed on a treadmill. All groups underwent pre- and post-treatment assessments measuring serum GLP-1 concentrations, faecal short-chain fatty acids (SCFAs), IBS symptom severity (IBS severity scoring system [IBSSS]), quality of life (IBS-QoL questionnaire) and anthropometric parameters, including weight and height. ResultsSignificant improvements in BMI, SCFA levels (acetate, propionate and butyrate), IBSSS and IBS-QoL scores (for all p < 0.001) were observed in Group A. In contrast, Group B exhibited significant increases in GLP-1 levels compared to the other groups (p < 0.001). ConclusionsBoth MICT and HIIT, when combined with an LFD, confer distinct benefits in managing IBS. MICT demonstrated superior effects on reducing BMI, improving SCFA profiles and alleviating symptom severity, while HIIT was more effective in enhancing GLP-1 secretion. These findings support the use of tailored exercise interventions based on individual therapeutic goals in IBS management.

Pelvic floor exercises versus Pilates on urinary incontinence in chronic obstructive pulmonary disease

Tue, 31 Mar 2026 00:00:00 GMT

Introduction Urinary incontinence (UI), characterised by the involuntary discharge of urine, is an escalating health issue, especially common among patients with chronic obstructive pulmonary disease (COPD), with prevalence rates ranging from 34.9% to 49.6%. This study sought to evaluate the efficacy of pelvic floor muscle training (PFMT) versus Pilates exercises in enhancing UI, cough symptoms and quality of life (QoL) in individuals with COPD. Material and methods Sixty patients aged 50 years and above with COPD-related UI were randomly allocated to two intervention groups: Group A (n = 30) underwent PFMT, whereas Group B (n = 30) engaged in Pilates. Both therapies were conducted triweekly for 12 weeks. The outcome measurements comprised the 1-hour and 24-hour pad tests, incontinence severity index (ISI), cough symptom score (CSS) and the incontinence quality of life questionnaire (I-QOL). Results Both groups exhibited substantial enhancements following the intervention (p < 0.001). Group B exhibited more significant decreases in urine leakage – 80.16% in the 1-hour pad test and 66.51% in the 24-hour test – relative to Group A. Group B demonstrated greater reductions in ISI (63.23%) and CSS (74.06%), as well as significant enhancements in cough-related symptoms (296.57%) and I-QOL scores (65.65%). Conclusions Twelve weeks of either PFMT or Pilates significantly enhanced UI and QoL in patients with COPD. Nonetheless, Pilates demonstrated more advantages, suggesting its superior therapeutic efficacy in addressing UI and associated symptoms in this demographic.

Limited evidence examining visual feedback in rehabilitation for generalised knee pain: a scoping review and call for further research

Tue, 31 Mar 2026 00:00:00 GMT

Chronic knee pain is a common source of disability, affecting approximately 20%–40% of adults. Conservative management, particularly physical therapy, is the gold standard for treating generalised knee pain (GKP) and patellofemoral pain (PFP). Current clinical practice guidelines (CPGs) recommend interventions that improve strength and neuromuscular control to treat PFP, but evidence examining visual feedback (VF) is lacking. This scoping review aims to evaluate the impact of VF during closed kinetic chain exercises on pain and biomechanics in individuals with GKP or PFP. A comprehensive search was conducted across six databases for clinical trials published between 2009 and 2024. Eligible studies included adults aged 18–65 years with GKP or PFP, using visual or augmented feedback during closed chain exercises. Outcomes for pain and biomechanical changes were extracted and presented in narrative form. VF was found to reduce joint forces during squatting in subjects with PFP. Changes in joint angles while squatting with VF were inconsistent across two studies. Motor control combined with strengthening showed no clinical improvements except a small decrease in trunk lean. VF showed significant changes in muscle activation for the vastus lateralis and vastus medialis muscles. The limited and inconsistent evidence prevents clear conclusions. Current evidence for VF does suggest changes in joint angles, forces, muscle activity and function. However, more rigorous studies are needed to guide clinical use and confirm the effects of VF when managing knee pain.

Context-based interventions for functionality and social participation in children with cerebral palsy: a scoping review

Tue, 31 Mar 2026 00:00:00 GMT

Context-based interventions (CBIs) have gained increasing relevance in paediatric rehabilitation, as they aim to improve activity and participation by modifying environmental factors that affect functionality in children with cerebral palsy (CP). This review aims to synthesise and present the available evidence on CBIs designed to enhance activity and participation in children with CP. A scoping review was conducted following PRISMA-ScR guidelines. A protocol was registered in the open science framework (OSF: https://doi.org/10.17605/OSF.IO/ZBNYV). A systematic search was performed in PubMed, SCOPUS, Web of Science (WOS), and EBSCO databases between 2014 and 2024. Inclusion criteria focused on intervention studies targeting children with CP (0–13 years) and measuring activity and/or participation. A total of 8367 records were identified; 14 studies were included after screening. Fourteen papers were included, the selected studies addressed home-based interventions involving caregivers and technologies such as exergaming, telerehabilitation, and virtual reality. These strategies showed positive effects on gross motor function, participation, and goal attainment. Although all interventions showed promising results, methodological variability limited direct comparisons. Most studies used tools such as gross motor function measure (GMFM), Canadian occupational performance measure (COPM), paediatric evaluation of disability inventory (PEDI), and goal attainment scale (GAS) to measure outcomes. Contextual interventions were feasible, family-centred, and low-cost, but often required ongoing professional support. CBIs offer a promising approach to enhance activity and participation in children with CP. Their integration into rehabilitation programs may optimise resource use and promote inclusion. Further research is needed to standardise protocols and evaluate long-term effectiveness.

Responses of different physical therapy exercises approaches for improving vitamin D absorption in women

Fri, 26 Sep 2025 00:00:00 GMT

Introduction Vitamin D insufficiency is associated with various diseases and is still prevalent in many countries. Vitamin D nutritional status is often affected by dietary or supplementary intake as well as exposure to sunlight. Different types of exercise can improve absorption of vitamin D in female. Additionally, studies suggesting that exercise may support and increase ratio of vitamin D. Material and methods First, 40 women who were deficient in vitamin D were split into two groups at random: group (A) (20 women) received core stability exercise (CSE), and group (B) (20 women) received whole-body vibration (WBV). The (CSE) group trained three times a week for eight weeks, while (WBV) group trained three times a week for eight weeks. Both groups received a vitamin D supplement, which was determined at a standard dose (880 IU/day). Vitamin D and parathyroid hormone concentrations were measured before and after the eight-week intervention period. Results Both groups' posttreatment levels of vitamin D and parathyroid hormone were significantly higher than their pretreatment levels (p > 0.025). But the level of both hormones were higher with core stability exercise. Conclusions Both the core stability exercise (CSE) and whole-body vibration (WBV) exercises improve blood concentration level of vitamin D and parathyroid hormone. But it was better with core stability exercise.

Postural balance and its relationship with physical activity and sleep quality during pregnancy: a multiple linear regression analysis

Thu, 25 Sep 2025 00:00:00 GMT

Introduction Pregnant females are more prone to fall-related trauma than non-pregnant women due to physiological and anatomical changes that alter postural balance (PB). The study aimed to explore relationship of PB with physical activity (PA) and sleep quality (SQ), and identify factors associated with postural instability in pregnancy. Material and methods An analytical cross-sectional survey was conducted among 138 pregnant females. Mean age was 27.20 ± 5.3. PB was objectively assessed through the Biodex Balance System using Overall Postural Stability Index (OAPSI), Fall Risk Test (FRT) and Modified Clinical Test of Sensory Interaction on Balance (m-CTSIB). PA levels and SQ was measured using Pregnancy Physical Activity Questionnaire (PPAQ) and Pittsburgh Sleep Quality Index (PSQI) respectively. Data was analysed using SPSS 21. Results The average scores of OAPSI, FRT and m-CTSIB were 3.04 ± 1.24, 2.74 ± 1.02, 2.10 (1.28), respectively. Out of total, 108 (78.3%) females had poor SQ and l35 (97.8%) females were sedentary. PA had significant weak, and negative correlation with OAPSI (r = 0.22, p = 0.02) and FRT (r = -0.25, p = 0.01). SQ had significant weak, and positive correlation with OAPSI (r = 0.33), FRT (r = 0.47) and m-CTSIB (r = 0.40) with p < 0.001. Regression analysis identified PA, occupation, fall history and sleep efficiency were significant predictors of PB (β = 3.28, p < 0.001). Conclusions Low PA levels and poor sleep quality are found to be associated with postural instability amongst pregnant females. Postural balance is significantly influenced by PA, occupation, sleep efficiency and fall history.

Effect of kinetic control training on pain and craniovertebral angle in symptomatic forward head posture

Fri, 19 Sep 2025 00:00:00 GMT

Introduction Forward head posture (FHP) is a condition where the head shifts anteriorly in the cervical spine's sagittal plane, which affects the activation of the muscles encompassing the shoulder complex as well as scapular mechanics, leading to changes in force couples, tissue overuse, pain, weakness in the deep cervical flexors, and uncontrolled movement of the cervical and shoulder muscles. Material and methods Forty-two participants with symptomatic FHP, aged 18-40 years, were randomly distributed into two equal groups; in the control group (A), 21 participants received conventional physical therapy; in the experimental group (B), 21 participants underwent the same treatment as the control group plus kinetic control exercises (KC). Treatments were conducted three times weekly for four weeks. Craniovertebral angle (CVA) by Photographic Posture Analysis Method, pain severity by Numeric Pain Rating Scale (NPRS), neck function by Neck Disability Index (NDI), and Deep Cervical Flexor Endurance (DCFE) by Craniocervical Flexion Test (CCFT) were evaluated pre- and post-study program. Results Post-intervention, comparisons between groups demonstrated a further significant improvement in NDI and DCFE in group B compared to group A (p < 0.05) across both groups. Conclusions KC is more effective in improving DCFE (motor control) and functional disability than conventional therapy. Both KC and conventional therapy demonstrated equal effectiveness in enhancing CVA and NPRS.

Comparison of aerobic and strength training exercises for restless leg syndrome, sleep quality, and daytime sleepiness in patients with diabetes mellitus: a randomized clinical trial

Tue, 16 Sep 2025 00:00:00 GMT

Introduction Restless Legs Syndrome (RLS) is a common sensorimotor neurological disorder, observed in individuals with Type 2 Diabetes Mellitus (T2DM), especially with diabetic neuropathy. It causes discomfort, impaired sleep, and reduced quality of life. While exercise improves RLS symptoms, few studies directly compared aerobic and strength training in this population. To compare effects of aerobic and resistance training on RLS severity, sleep quality, and daytime sleepiness in adults with T2DM. Material and methods A single-blinded randomized controlled trial recruited 42 adults (aged 40–60 years) with T2DM, ≥ 5 years and RLS based on International Restless Legs Syndrome Study Group (IRLSSG) criteria. Eligibility included lower limb strength ≥ 3+/5 and oral hypoglycemic therapy. Exclusions were severe comorbidities, insulin therapy, injuries, or other sleep disorders. Participants were randomized via sealed envelopes into aerobic (n = 21) or resistance (n = 21) training groups. Both underwent supervised exercise thrice weekly for six weeks. Outcomes were assessed using the International RLS Rating Scale (IRLS), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Paired and independent t-tests were used for analysis. Results Data from 30 participants were analyzed. Groups were comparable at baseline (p > 0.05). Both groups showed significant within-group improvements in IRLS, PSQI, and ESS scores (p 0.05), changes in IRLS and ESS exceeded minimal clinically important difference (MCID) thresholds, supporting clinical relevance. Conclusions Aerobic and resistance training improved RLS symptoms, sleep quality, and daytime sleepiness in adults with T2DM, supporting exercise as beneficial non pharmacological strategy.

Additive Effect of Free Walking Exercise on Liver Enzymes, Fatigue Severity, Triglycerides, and Sleeping Quality in Obstructive Sleep Apnea Patients with Non-Alcoholic Fatty Liver: Randomized Controlled Trial

Tue, 09 Sep 2025 00:00:00 GMT

Introduction Besides dyslipidemia, insulin resistance, and/or glucose intolerance, nonalcoholic fatty liver disease (NAFLD) - an excessive accumulation of fats/lipoproteins (mainly triglycerides) in the hepatic tissues - is one of common obstructive sleep apneainduced metabolic complications. Studies assessing the efficacy of the first-line therapy, continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) and NAFLD report conflicting findings. This study aimed to investigate the efficacy of free walking exercise in OSA patients with NAFLD. Material and methods Forty moderate-to-severe OSA patients with NAFLD were randomly assigned to a CPAP group (n = 20) or a group of CPAP plus free walking program (aerobic exercise group, n = 20). The forty patients used the 4-hour night CPAP daily. In the group that received CPAP plus a free daily walking program. Pittsburgh Sleep Quality Index, serum alanine and aspartate transaminases, body mass index (BMI), fatigue severity scale, serum triglycerides, and Epworth sleepiness scale were assessed before and after 12 weeks. Results Except for the BMI of the group of CPAP only, within-group analysis showed a statistical improvement in OSA patients' outcomes in both groups [p < 0.001 for all outcomes of both groups, except p-value of serum triglycerides (p = 0.025)], still, these improvements were high in the group of CPAP and free walking. Statistically improved outcomes (p < 0.05) were reported for the group of CPAP and free walking after comparing post-values of outcomes between groups. Conclusions Adding free walking to CPAP maximize therapeutic gains of CPAP in OSA patients with NAFLD.

A novel respiratory muscle trainer to enhance pulmonary strength in wheelchair athletes: a pilot randomized controlled study

Tue, 26 Aug 2025 00:00:00 GMT

Introduction Wheelchair athletes often face challenges related to respiratory function due to the high physical demands of the sport and limitations in core muscle engagement. This study introduces a novel Respiratory Muscle Trainer (RMT) device, designed to enhance endurance and overall performance in this population by strengthening the respiratory muscles, and evaluates its effectiveness for improving sports performance in athletes with wheelchairs. Materials and methods A pilot randomized controlled trial study was conducted among wheelchair athletes. Twelve participants were divided into an intervention group (n = 6) using the respiratory muscle trainer and a control group (n = 6) performing conventional training, for four weeks. The RMT device provided adjustable resistance for both inspiration and expiration, promoting progressive overload training. The outcomes comprised maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), forced vital capacity (FVC) and forced expiratory volume in first second (FEV1). Results The intervention group showed significant improvements in MIP (from 62.3 ± 12.4 to 75.6 ± 10.8 cmH2O) and MEP (from 78.5 ± 15.2 to 90.2 ± 12.7 cmH2O) compared to the control group (p < 0.05). Improved pulmonary function was noted, as indicated by FVC and FEV1 (mean differences of 0.2 L and 0.3 L). Functional performance measures such as changes in wheelchair propulsion efficiency and endurance during sport-specific tasks represent functional outcomes related to cardiovascular and muscular performance. Conclusions The RMT device effectively improved respiratory muscle strength and functional capacity in wheelchair athletes. Its incorporation into training regimens may enhance performance and respiratory efficiency, contributing to better competitive outcomes.

The impact of a sports initiation program on quality of life, satisfaction, and self-efficacy in activities of daily living in individuals with spinal cord injury

Fri, 08 Aug 2025 00:00:00 GMT

Introduction The aim of the study was to assess the impact of a structured sports initiation program for individuals with Spinal Cord Injury (SCI) on quality of life, satisfaction, and self-efficacy in activities of daily living, based on a quasi-experimental pre-post test format. Materials and methods The program was developed in collaboration with a multidisciplinary team. The participants were allowed to try six different Paralympic sports (Para archery, Para athletics, Boccia, wheelchair tennis, Para swimming, and wheelchair fencing) over a 14-week period. The following outcome measures were tested at T0 (baseline) and T1 (14 weeks after): the Trunk Control Test (TCT), Spinal Cord Independence Measure III Self Report (SCIM), Short Form Health Survey 36 (SF-36), Moorong Self Efficacy Scale and the Wheelchair Use Confidence Scale for Manual users (WheelCon-M). The data was analysed using Wilcoxon’s rank test. Results Of the included participants, 66.8% demonstrated lesion D3 and D9, while 46.7% had complete SCI. Significant improvements were observed for measures of functional independence, quality of life, self-efficacy and wheelchair use confidence, but not trunk control. Conclusions The functional sports initiation program achieved encouraging results for people with SCI; it promoted not only functional improvements, particularly in the management of assistive devices, but also improvements in perceived independence, health-related quality of life, self-efficacy in daily activities, and wheelchair use confidence. The program enables participants to engage in challenging and motivating activities that simultaneously foster participation, social integration, well-being and enjoyment.

Change of direction profile in parabadminton: the role of impairment type and anthropometric factors

Wed, 30 Jul 2025 00:00:00 GMT

Introduction Parabadminton (PBd), introduced at the 2020 Paralympics, accommodates athletes with diverse physical impairments, and differing degrees of physical and physiological performance. As such, there is a need for tailored assessments to refine classification procedures and training strategies. The aim of this study is to evaluate change of direction (COD) performance across sport classes and examine the influence of anthropometric factors on performance in PBd athletes. Materials and methods The study included 79 PBd athletes, classified as wheelchair (WH1, WH2) or standing (SL3, SL4, SU5, SH6). All had official classifications and prior competition experience. Data collection included demographics, skinfold measurements, and arm muscle area (AMA) assessments. The COD test simulated gameplay to measure times, fatigue index, and mechanical power. Data from different sport classes were compared using the Kruskal-Wallis test and MANCOVA, controlling for covariates like age, body mass index (BMI), and practice time. Results Significant differences in COD performance were observed between sport classes, except for the fatigue index. Large effect sizes (f2 ≥ 0.702) were found for worst time, mean time, and best time, with post hoc tests identifying multiple differences between wheelchair and standing classes. Smaller differences (f2 = 0.058) were noted for total power, primarily between standing and wheelchair groups. MANCOVA analysis found BMI, height, practice time and AMA to be significant predictors of COD performance, depending on sport class and type of impairment. Conclusions Anthropometric factors, particularly height, age, body mass, and practice time, influence COD performance in PBd athletes. These findings highlight the relevance of sport class differences and underscore the need for training programs that address functional and physical distinctions.

Variations in mood, sleep and physical performance during a training microcycle before a parataekwondo competition

Tue, 22 Jul 2025 00:00:00 GMT

Introduction Parataekwondo is a recent addition to the Paralympic program, and research on training and preparation remains limited. This study aimed to compare training load, sleep, mood, and physical performance in elite para-athletes during the 14 days prior to a national parataekwondo competition. Material and methods Four Brazilian national team para-athletes were monitored over 14 consecutive days. Sleep was assessed daily using Actigraphy. On days 1, 5, 8, and 12, the athletes were evaluated using the Brazilian Mood Scale (BRUMS), Countermovement Jump (CMJ), Multiple Frequency Speed of Kick Test (FSKTmult), and Psychomotor Vigilance Test (PVT). After training, the Rating of Perceived Exertion (RPE) was recorded. The significance level was set at p ≤ 0.05. Results No significant changes were observed in RPE (p = 0.07), training time (p = 0.52), arbitrary units (p = 0.24), CMJ (p = 0.22), reaction time (p = 0.46), or lapses over time (p = 0.44). However, the number of kicks in the FSKTmult was significantly higher on day 12 compared to day 1 (p = 0.04). Total Sleep Time (TST) and Sleep Efficiency (SE) significantly decreased in the second week (TST: p = 0.04; SE: p = 0.05), while mood remained stable, with an iceberg profile. Conclusions Despite a reduction in sleep duration and quality, the data indicate that mood, reaction time, and general physical performance remained stable, and sport-specific performance improved. These findings highlight the importance of monitoring sleep and performance during pre-competition periods.

Changes in body composition among female athletes using a levonorgestrel-releasing intrauterine system in preparation for the Paris 2024 Paralympic Games: an descriptive study

Tue, 17 Jun 2025 00:00:00 GMT

Introduction Lean mass (LM) is linked to improved training outcomes and competitive success; as such, body composition assessments play a crucial role in athletic performance. Evidence suggests that body composition may be affected by oral contraceptive use, which is employed by many athletes to manage or suppress menstruation. The levonorgestrel-releasing intrauterine device (LNG-IUD), a progestin derived from 19-nortestosterone, has been associated with increases in fat-free mass. Given its potential impact on body composition, this study aimed to evaluate the effects of LNG-IUD use on Paralympic athletes preparing for the Paris 2024 Paralympic Games. Materials and methods A prospective, descriptive study was conducted over one year with 10 Paralympic athletes who chose a 19.5 mg levonorgestrel intrauterine device as their contraceptive method for the Paris 2024 Games. Body composition was assessed using the DXA Lunar Prodigy Advance before the insertion of the IUD and one year after its use. The variables analysed were fat mass, lean mass, body fat percentage, lean mass percentage, and bone mass. Results The mean age was 23 ± 3 years. Three athletes had intellectual disabilities, three had visual impairments and four physical disabilities. After one year using the hormonal intrauterine device, lean tissue mass increased from 40.9 kg to 41.8 kg (p < 0.04). Fat mass decreased from 15.0 kg to 14.4 kg (p = 0.14). Bone mineral density increased from 1.25g/cm2 to 1.26g/cm2 (p = 0.46). Conclusions The 19.5 mg LNG-IUD was associated with increased lean tissue mass in athletes, suggesting potential benefits for body composition in preparation for the Paris 2024 Paralympic Games.

Validation of LEXO® end-effector robot-assisted training in patients with gait deficits after central nervous system diseases: a descriptive cross-sectional study

Tue, 17 Jun 2025 00:00:00 GMT

Introduction Multiple interventions to improve gait function after Central Nervous System (CNS) disorders have shown efficacy. High-intensity, repetitive, activity-specific training is beneficial for gait rehabilitation, with end-effector robot-assisted gait training (RAGT) devices becoming more significant. This study evaluates the new LEXO® end-effector RAGT device for patients with walking impairment due to CNS disorders in an outpatient setting. The aim is to describe the effects of the LEXO® robotic system on functional independence and gait parameters. Material and methods In a descriptive observational cross-sectional case series, 50 patients with gait deficits due to CNS disorders underwent 20 sessions of RAGT using LEXO®, each lasting 10 to 45 minutes. Outcome measures included functional independence (Functional Independence Measure (FIM) and Barthel Index (BI)), quality of life (Euro-Qol-5D (EQ-5D) and Stroke Impact Scale (SIS)), walking endurance (6 Minute Walk Test (6MWT)), fall risk (Time Up and Go (TUG)), and gait parameters (speed, cadence, and stride length) measured with PABLO®. Results Significant improvements (p = .000) were observed in functional independence and quality of life. Endurance (p = .000) and fall risk (p = .018) also improved. Statistically significant differences were noted in gait parameters: walking speed (p = .000), cadence (p = .010), and stride length (p = .007). Conclusions Training with the LEXO® device may improve functional independence, quality of life, endurance, and gait parameters (walking speed, cadence, and stride length) and reduce fall risk in people with CNS disorders. These promising results warrant further validation through additional research studies.

A preliminary study on the employment of inertial sensors for wheelchair basketball classification: an investigation into sensor positioning

Tue, 10 Jun 2025 00:00:00 GMT

Introduction Previous studies have explored the use of inertial sensors to evaluate wheelchair basketball athletes and support their classification processes; however, prior studies have primarily used sensors positioned on wheelchairs, and overlooked trunk and wrist placements, which are key areas for classification. This study investigates the optimal placement of sensors on bodies and wheelchair frames among athletes. Material and methods Ten athletes from different basketball classes were recruited. Three inertial sensors were positioned on the trunk, right wrist, and rear region of the wheelchair. The athletes completed the 20-meter speed test and the Illinois agility test. Data on acceleration and speed (inc. data skewness, kurtosis, and RMS) across three axes (x, y, z) were compared with functional classes. Results The 20-meter speed test identified six significant correlations in the anteroposterior axis (n = 6), including three accelerometer variables and one gyroscope. In contrast, the Illinois agility test identified twelve (n = 12), including accelerometer data (e.g., linear acceleration, r = −0.86, p < 0.01) and gyroscope data (e.g., angular velocity, r = −0.77, p < 0.01). The strongest correlations were demonstrated by sensors on the wheelchair (n = 8), followed by the wrist (n = 6) and trunk (n = 4). The anteroposterior axis presented the most correlations (n = 12). Conclusions Our findings highlight the importance of sensor placement, test type, and movement axis in athlete classification. The wheelchair appears to be the most suitable location for IMU sensors, providing valuable data to distinguish movement patterns between low- and high-class athletes in the classification process.

Efficacy of Pilates training on dynamic balance in flexible flatfoot

Tue, 15 Apr 2025 00:00:00 GMT

Introduction Flatfoot is a very common musculoskeletal deformity. This study aimed to examine the impact of Pilates training on dynamic balance and quality of life in individuals with flexible flatfoot. Material and methods A pre-post randomized controlled design was employed. Forty-four physical therapy students were randomly recruited, with ages ranging from 18 to 21 years and body mass index between 18.5 and 25 kg/m2. They were categorized into two groups which underwent the following five-week interventions. The experimental group (A) performed daily short foot exercises (SFE), consisting of three sets of ten repetitions performed for three minutes, together with a Pilates programme consisting of two 30-minute training sessions per week: each exercise was performed for 10 repetitions held for 5s, with a 10 to 20s rest between exercises, and a 45s rest interval between sets. The control group (B) only performed SFE. In both groups, foot posture was evaluated with the navicular drop test, dynamic balance with Balance Check 636 stability tester (Dr. Wolff, Arnsberg, Germany), and quality of life with the FFI questionnaire, before and after treatment. Results A significant difference existed between pre and post measurements in both groups for all assessed variables; better results were noted for Group A (p < 0.001). Conclusions In individuals with flexible flatfoot, the combination of Pilates training with SFE enhances dynamic balance and quality of life to a greater degree than SFE alone.

Effect of remote myofascial intervention on musculoskeletal health and functional performance: a systematic review

Tue, 15 Apr 2025 00:00:00 GMT

Objectives Fascia plays a crucial role in maintaining bodily function and life. It transmits mechanical stresses faster than muscles. This paper reviews recent randomized controlled trials (RCTs) concerning range of motion (ROM), pain and function with the aim of evaluating the effectiveness of remote myofascial intervention (RMI). Methods A systematic search was conducted in PubMed, CINAHL, EMBASE, Scopus, and Web of Science until September 2024. Studies were screened using PRISMA guidelines. Data extracted included sample size, participant age, intervention type, treatment area, outcome measure and results. Results Nineteen RCTs and cross-over trials met the inclusion criteria. Study quality was assessed using PEDro scores. Intervention durations ranged from 30 seconds to four minutes across one to three sets, with evaluations conducted from pre-test to up to four weeks post-test. Variables measured included ROM, Pain Pressure Threshold (PPT), tissue elasticity, and interceptive sensitivity. The review was registered in PROSPERO (CRD42024589547). Discussion RMI appears effective for improving flexibility and pain, but optimal implementation remains uncertain. Most studies highlight the role of viscoelastic properties and neural receptor stimulation in force transmission through myofascial chains; however, their relative contributions remain unclear. Further research is needed to assess the impact of RMI on musculoskeletal conditions, exploring a broader range of outcome variables.