Breaking the 4-hour rule: Multiscale computational modelling redefines post-injection restrictions for botulinum neurotoxin A.

Aim: Although the positive effects of exercise during pregnancy on health are widely recognized, some women do not prefer physical activity during this period. Therefore, the aim of this study was to examine the barriers to exercise participation in postpartum women who did not exercise during pregnancy. Methods: The qualitative descriptive study was conducted with 12 postpartum women who did not exercise during pregnancy, selected by snowball and criterion sampling. In the study, a semi-structured interview form was prepared and conducted with face-to-face and online data collection methods. Content analysis was used to evaluate the data. Results: The factors preventing women from participating in exercise during pregnancy were grouped into five main themes: (1)Safety Concerns: Participants avoided exercising due to concerns that exercise could lead to preterm birth or miscarriage. Most considered light exercises, such as walking, to be safe. (2)Lack of Interest and Habit: The majority of participants did not engage in exercise before pregnancy and lacked interest in it, leading them to refrain from exercising during pregnancy. (3)Fatigue and Weakness: Women who continued working during pregnancy reported being unable to find the energy to exercise due to fatigue. (4)Time Constraints: Most participants reported that long working hours and a demanding work pace left them with no time for exercise. (5)Lack of Information and Support: Participants indicated that they lacked sufficient information about the benefits of exercise during pregnancy and did not receive adequate support from healthcare professionals. Conclusion: In the study, women's negative beliefs about exercise, environmental barriers and social norms were found to be the main reasons for not exercising during pregnancy. These findings suggest that health professionals have an important responsibility to inform and encourage women that exercise is safe and beneficial. Future studies should focus on developing strategies to overcome these barriers.

Background: Menopause is a physiological change in the life of women. Menopausal women require more information about their physical and psychosocial needs. Most interventions for menopause women have focused on educational intervention, physical activity/exercise, healthy diet, stress management. The objectives of the study were to determine the commonly reported menopausal symptoms among middle age women and to correlate identified menopausal problems with coping strategies found in participants. Materials and methods: The cross-sectional observational study was conducted in Chattogram for One year (January 2021 to December 2021). Study population was women of 40 to 60 years who had given consent to participate in this study. They were residing in Chattogram metropolitan city. Using purposive sampling technique, a total number of 109 subjects were included. This study is conducted by using modified MRS questionnaire, to document of 12 symptoms (Divided into somatic, psychological and urogenital domain) commonly associated with menopause. The respondents were divided into two groups, case 59 and control 50. Results: The findings of the study are 84.7% (50) of the respondents are 45-50 years range and15.3% in the age range of 51-60 years in case. The study found that most of the women around 89% are suffering from depression, anxiety, 75% of the study population has joint paint and weakness and lack of confidence about self-wellbeing. 9% presented with hot flashes, 47% with sleep disturbances and 72 % presented with comorbidities. 80% of the respondent expressed their satisfaction in communication with friends and relatives, having rest and taking light exercise like walking, etc. Change in life style, diet and social adjustment in post intervention testing. It indicated that menopausal syndrome of participants was significantly improved in the intervention group compared to the control group (p < 0.001). Conclusion: Proper knowledge and empowerment of menopausal women will guarantee their health. It will also help them to overcome the barriers in health promotion and empowerment. JCMCTA 2025 ; 36 (2) : 161-164

Managing concussions in football: A review of football associations' return-to-play guidance.

The impact of the getting into light exercise for heart failure (GENTLE-HF) randomized controlled trial on physical-psychological outcomes and exercise adherence.

In Indonesia, approximately 40% to 50% of the population experiences sleep disorders, most of whom are elderly. These sleep disorders usually occur simultaneously with other conditions such as physical problems and mental illnesses (depression, anxiety disorders) that can lead to poor sleep quality (Khadijah, 2023). The objective of this study is to determine the relationship between stress levels and sleep quality among the elderly in the Prumnas Lubuklinggau Community Health Centre Working Area in 2025.The research method used was descriptive quantitative research with a cross-sectional approach. The sampling technique used was purposive sampling with a sample size of 62 people.The results of the univariate test analysis showed that a small proportion of respondents (22.6%) had severe stress, while the majority of respondents (51.6%) had poor sleep quality. The results of the bivariate analysis of the relationship between stress levels and sleep quality in the elderly (p-value 0.002) showed that there is a relationship between stress levels and sleep quality in the elderly in the Prumnas Lubuklinggau Community Health Centre Working Area in 2025.The elderly are advised to manage stress by doing relaxation activities such as light exercise, praying, and increasing positive social interactions. Regulating a regular sleep routine, avoiding caffeine consumption at night, and creating a comfortable sleeping environment can also help improve sleep quality, as well as understanding the relationship between stress levels and sleep quality in the elderly in their area. For the research site, this can be used as additional information about the relationship between stress levels and sleep quality in the elderly. For the Faculty of Health Sciences at Dehasen, this can be used as input in planning and developing health intervention programmes to address existing issues related to the relationship between stress levels and sleep quality in the elderly.

Background of study: The aging process in older adults is accompanied by musculoskeletal changes that frequently manifest as joint pain, impairing daily functioning, independence, and overall quality of life. Non-pharmacological interventions are increasingly explored, with tera exercise—a light exercise emphasizing stretching, joint mobility, flexibility, circulation, and relaxation—emerging as a promising approach.Aim : This study aimed to evaluate the effectiveness of tera exercise in reducing joint pain among elderly residents of a private nursing home in Jakarta, thereby providing empirical evidence for its role as a non-pharmacological intervention to improve musculoskeletal health and quality of life.Methods: A quasi-experimental design with a one-group pretest–posttest approach was employed. Using purposive sampling, 20 respondents were recruited. Joint pain levels were measured using the Numeric Rating Scale (NRS) before and after a two-week tera exercise program conducted three times per week. Data were analyzed using the Wilcoxon Signed Rank Test.Result: Prior to the intervention, 10 respondents (50%) reported mild to moderate pain, while 10 respondents (50%) experienced severe to very severe pain. After the intervention, 17 respondents (85%) reported mild to moderate pain, and only 3 respondents (15%) remained in the severe to very severe category. Statistical analysis yielded a p-value < 0.05 and a Z-score of -2.646, indicating a significant reduction in joint pain.Conclusion: Tera exercise is an effective non-pharmacological strategy for alleviating joint discomfort and improving musculoskeletal health among older adults in nursing home settings. However, limitations include the small sample size and absence of a control group. Future studies should employ larger samples, randomized controlled designs, longer observation periods, and examine additional factors such as physical activity, psychological status, and pharmacological therapies.

Exercise therapy aimed at increasing calf muscle pressure can effectively prevent and improve chronic venous insufficiency. However, as the 'frequency, intensity, time, and type' model that is critical in prescribing exercise has not been identified, determining the exact amount and quality of exercise to be prescribed is challenging. Therefore, we conducted a scoping review of exercise therapy for chronic venous insufficiency and mapped the exercise therapy prescriptions provided to these patients. The CENTRAL, CINAHL, MEDLINE, and PEDro databases were searched. Data charting was conducted to categorise the types of exercise into aerobic and resistance exercises, light exercise, and aquatic activity. The intensity, duration, and frequency of each exercise were mapped and summarised as narrative syntheses. Of 594 articles, 27 met the eligibility criteria. Aerobic exercise comprised a frequency of 2-3 times/week; intensity, 12-16 on the Borg scale or 40-70% of the maximum heart rate; time, 20-40min; and type, walking, treadmill, or ergometer. Resistance exercise comprised a frequency of two times per week to every day; intensity: 8-12 repetition maximum; time: 10-25 times × 2-5 sets; and type: elastic band or more. Aquatic activity comprised a frequency of two times per week to every day, time: 15-60min, and type: balneotherapy; exercise intensity could not be specified. In conclusion, these results provide useful information for planning exercise therapy for chronic venous insufficiency and can be used for improving patients' physical performance and quality of life.

Introduction and objectivesBrugada syndrome (BS) is a channelopathy associated with an increased risk of sudden cardiac death (SCD). Intense physical activity is a recognised trigger of life-threatening arrhythmias in long QT syndrome, catecholaminergic ventricular tachycardia syndrome and arrhythmogenic cardiomyopathy, but it is believed to be safe in BS. The objective of this study is to assess the impact of regular physical activity on the expression and prognosis of BS.Methods286 consecutive BS patients (aged 39.1±17.8 years old, 70.6% men) were included. Patients were classified according to the level of exercise and main discipline of sport they had practised.Results190 (66.4%) were sedentary, 27 (9.4%) practised light exercise, 59 (20.6%) moderate and 10 (5.3%) intense. Patients engaged in ‘mixed or endurance’ types of exercise were diagnosed earlier than sedentary ones (HR: 2.1; 95% CI: 1.5 to 2.9; p<0.001) and experienced syncope at a younger age (24.9±16.2 vs 37.4±18.2 years; p=0.04). Physical activity was associated with ECG sport-related changes like bradycardia (Δ 6 bpm) and a shorter QTc (Δ 21 ms) and also to a higher ST elevation in right precordial leads (Δ 0.5 mm). Physical activity was not a predictor of arrhythmic events or SCD.ConclusionsRegular physical activity was associated with a younger diagnosis and an earlier occurrence of syncopal episodes. BS patients engaged in ‘mixed or endurance’ sports have ECG changes associated with sport adaptation and higher ST segment elevation. Nevertheless, physical activity was not related to a higher arrhythmic risk in our cohort of patients with BS.

The postpartum period is a critical period susceptible to oxidative stress due to physiological, hormonal, and metabolic changes. One of the main antioxidant enzymes involved in combating oxidative stress is Superoxide Dismutase (SOD). Otaria gymnastics, a form of light physical exercise combining movement, breathing, and relaxation, is believed to increase the body's antioxidant capacity. This study aimed to determine the effect of Otaria gymnastics on SOD levels in postpartum mothers. The study used a quasi-experimental design with a pretest-posttest control group approach. The sample consisted of 30 postpartum mothers divided into an intervention group (n = 15) who performed Otaria gymnastics for 7 days and a control group (n = 15) without intervention. SOD levels were measured using spectrophotometry. The study showed a significant increase in SOD levels in the intervention group of 0.44 U/mL (p = 0.001), while the control group experienced a decrease of 0.16 U/mL (p = 0.021). The intergroup test showed a significant difference (p = 0.000). These findings indicate that Otaria Exercise is effective in increasing SOD levels and strengthening the body's antioxidant defenses in postpartum mothers. Otaria Exercise can be recommended as a simple non-pharmacological intervention in postpartum recovery programs to support maternal health holistically.

The inclusion of vegetable oils in equine diets aims to meet energy demands and replace grains. This study evaluated the effects of pequi oil on apparent digestibility, intake, ingestive behavior, and blood and physiological parameters of horses subjected to physical exercise. Nine male Mangalarga Marchador horses (10 ± 5 years; 390 ± 30 kg) were assigned to three dietary treatments: pequi oil, soybean oil, and no oil. Animals received Jiggs grass hay (Cynodon spp.) as roughage and a commercial concentrate supplemented with oil. The 63-day trial comprised three 21-day periods in a Latin square design. Apparent digestibility was determined by total feces collection, and ingestive behavior was recorded over 24 hours. At the end of each period, horses performed light exercise tests. Physiological parameters and blood samples were collected at rest, immediately after exercise, and 10 and 30 minutes post-exercise to assess enzymatic activity and biochemical concentrations. Pequi oil improved the digestibility of dry matter, crude protein, and neutral detergent fiber without causing adverse effects on the parameters assessed. Therefore, pequi oil can be safely included in the diet of Mangalarga Marchador horses subjected to physical exercises and under semiarid conditions for at least 21 days.

Fibromyalgia is a chronic syndrome characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and emotional changes, significantly affecting quality of life, especially in women. Therapeutic massage has been used as a complementary approach to manage muscle pain, promoting relaxation, reducing muscle stiffness, and improving functionality. This study aimed to analyze the effects of therapeutic massage on muscle pain relief in women with fibromyalgia, identify the most commonly applied techniques, and assess their impact on quality of life and associated symptoms such as fatigue, anxiety, and sleep disorders. A qualitative literature review was conducted, critically analyzing nine articles published between 2021 and 2025, selected from SciELO, LILACS, PubMed, and Google Scholar. Results show that techniques such as moderate-pressure massage, Swedish massage, myofascial release, and deep gliding provide pain relief, increased range of motion, improved muscle flexibility, better sleep quality, and enhanced emotional well-being. Combining massage with light exercises enhances its effects, promoting treatment adherence and greater functional independence. In conclusion, therapeutic massage is a safe, effective, and low-cost intervention, representing an important complementary strategy in managing fibromyalgia in women, contributing to improvements in physical and emotional well-being and overall quality of life.

Cardiovascular and metabolic health are influenced by the circadian system, which regulates 24-hour rhythms across numerous physiologic processes. Disruptions to circadian rhythmicity can adversely affect cardiometabolic function and health. Given the importance of circadian health to overall human health, this scientific statement provides an overview of the circadian system and key behavioral factors that can synchronize or desynchronize these rhythms, including light exposure, food intake, physical exercise, and sleep timing. We also summarize the literature on associations between circadian health and cardiometabolic health indicators, such as excessive weight, type 2 diabetes (T2D), hypertension, and cardiovascular disease. We discuss strategies to improve circadian health and reduce circadian disruptions, focusing on interventions that target the key synchronizers of circadian rhythms and involve appropriate timing of exposure to these synchronizers. These include morning bright light exposure and avoidance of light at night, as well as appropriately timed sleep, meals, and exercise. Clinicians, researchers, policymakers, and the public should recognize the role of circadian rhythms in maintaining and promoting cardiometabolic health and focus on identifying modifiable behaviors that can improve them.

In today’s modern era, learning activities are no longer a daily routine for many students. Feelings of laziness and boredom that arise during the learning process require special attention in order to find the best solutions for creating a comfortable and enjoyable learning atmosphere. This study aims to systematically review the effect of ice breaking activities on improving students’ learning concentration in the context of classroom learning. Using a systematic literature review method, the references used consist of scientific publications from the period 2021 to 2025. Out of a total of 24 articles identified, a screening process was carried out and 4 articles were excluded. Subsequently, 20 full-text articles were assessed for eligibility, but 14 did not meet the criteria, leaving 6 articles included in the final review. The results of a systematic literature review indicate that the implementation of ice breaking significantly influences the improvement of students' learning concentration at the primary education level. Based on the six articles analyzed, ice breaking has been proven effective in restoring focus, fostering enthusiasm, and creating an active and enjoyable classroom atmosphere. Activities such as educational games, light exercises, and chants help reduce boredom and increase student participation. Overall, ice breaking is not merely a filler activity but an important learning strategy that can enhance students' motivation, concentration, and learning effectiveness.

Regular engagement in physical activity is recognized as an effective prevention strategy for both cognitive and physical decline. We developed MyEveryCise, an exercise program that uses an activity of daily living as a cue to encourage regular physical exercise. This exploratory study assessed the effectiveness of MyEveryCise in increasing the persistence in light exercise in twenty persons with low physical activity in a one-month intervention. Using the physical activity questionnaire, we observed a significant increase in the frequency and duration of light physical exercise after the intervention, suggesting that MyEveryCise is a useful method to maintain a daily exercise routine.

High-intensity resistance training (RT) improves strength via neuromuscular adaptations but also heightens fatigue, potentially limiting gains. Whether post-exercise, home-based hot-bathing, with or without light-exercise, reduces these limitations and enhances neuromuscular adaptations remains unknown. The aims were: 1) to investigate whether home-based hot-bathing improves muscle strength gain and peripheral/central conditions in response to short-term high-intensity RT, and 2) assess whether combining hot-bathing with light exercise augments these benefits, both in healthy young men. Across two experiments and one supplementary group comparison, 43 young men were assigned to shower (no hot-bathing; n = 10), hot-bathing (40℃, n = 10), hot-bathing + light-exercise (n = 11), or shower + light-exercise (n = 12). Participants completed five sessions of isometric knee-extension training at 75% maximal voluntary contraction (MVC) over two weeks. MVC of the knee extensor, electrically evoked knee extension torque, and voluntary activation (VA) as indices of peripheral and central conditions were measured pre- and post-intervention. Compared with shower, hot-bathing produced larger MVC gains (p = 0.027; d = 0.92 vs 0.36) and mitigated declines in tetanus torque assessed via electrical stimulation after RT (p < 0.05). VA did not change significantly in any group. Adding light-exercise to hot-bathing did not further improve strength or peripheral/central conditions. However, light-exercise without hot-bathing decreased VA (p = 0.021). Post-exercise, home-based hot-bathing effectively enhanced muscle strength gains and mitigated peripheral fatigue following high-intensity RT. Additional light-exercise conferred no further benefit and might actually increase central fatigue if not combined with hot-bathing. Hot-bathing may serve as a practical recovery strategy to optimize adaptations following intensive RT in healthy young men.

Aging is a process of increasing age that involves a decline in the body's ability to repair itself, leading to psychological problems, physical, mental, and socioeconomic decline. Older adults often experience joint problems that interfere with their activities and independence. Knee osteoarthritis (OA) is one of the main causes of knee pain in the elderly, characterized by degeneration of joint cartilage, stiffness, and limited movement. This condition has an impact on the decline in quality of life and independence of the elderly. The prevalence of joint disease in Indonesia is quite high, especially in people over the age of 55. OA is more common in women due to hormonal, anatomical, and physical activity factors. This activity aims to provide physiotherapy education on prevention, non-pharmacological treatment, and simple exercises to support knee function in elderly people with OA. The educational activity was carried out at the Cantewa Health Center, Mojolangu, Malang City, with 15 participants (1 male, 14 females). The methods used included interactive lectures, discussions, and demonstrations of quadriceps strengthening exercises and knee muscle stretching. The results of the activity showed an increase in participants' understanding of risk factors, symptoms, and simple exercises in the prevention and management of knee OA. This activity has implications for increasing the awareness of the elderly to perform light physical exercises regularly as a strategy to maintain knee joint health. Community-based physiotherapy education is expected to be carried out continuously.

BackgroundIndividualized rehabilitation after acute Achilles tendon rupture (AATR) repair is important. The aim of this study was to evaluate and compare the short-term clinical effects of different rehabilitation processes following open surgery for AATR based on ultrasonography (US) monitoring.MethodsThis retrospective cohort study included 80 patients (mean age, 32.0 ± 4.4 years) who underwent open surgery for AATR repair between March 2022 and May 2023. The patients were categorised into two groups (ultrasound-guided rehabilitation group, UR, and conventional rehabilitation group, CR) according to whether postoperative rehabilitation relied on US monitoring. All patients received the same suture technique and immobilisation duration; they were clinically examined at 2, 4, 6, 8, 10, 12, 14, and 16 weeks postoperatively, with a final follow-up at a mean of 18.8 months. The primary outcome was the recovery time for the one-leg heel-rise height (OHRH). Secondary outcomes included the time required to return to range of motion(ROM) and light exercise (LE), the clinical function scores, and complications. Data regarding the surgical duration, the visual analogue scale (VAS) score for pain, the Achilles tendon Total Rupture Score (ATRS), and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score were also collected.ResultsThe recovery times for OHRH (11.6 ± 2.1 vs. 12.1 ± 1.4) and LE (17.2 ± 1.7 vs. 18.3 ± 2.2) were significantly shorter in group UR than in group CR (P < 0.05). The VAS scores decreased over time, reaching 0 in both groups by 10 weeks. ATRS and the AOFAS Ankle-Hindfoot scale score increased across both groups over time, showing significant between-group differences from 4 to 14 weeks(36.2 ± 9.7 vs. 28.4 ± 5.7; 61.0 ± 12.3 vs. 52.2 ± 6.8; 76.1 ± 9.7 vs. 69.7 ± 5.1; 87.2 ± 8.4 vs. 82.1 ± 4.6; 93.8 ± 5.8 vs. 91.6 ± 4.0; 96.7 ± 2.8 vs. 96.1 ± 2.0; P < 0.05) and 4 to 8 weeks (67.6 ± 7.9 vs. 60.1 ± 4.8; 77.8 ± 11.7 vs. 68.9 ± 7.4; 94.9 ± 9.8 vs. 92.9 ± 7.9; P < 0.05). The mean scores were better in group UR than in group CR. Three re-ruptures (3.8%) were observed, and all complications were resolved at the last follow-up, with no significant between-group differences.ConclusionsRehabilitation under ultrasonography monitoring may be a promising strategy to optimize early functional recovery after AATR repair for young people with high demands for sports.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13018-025-06282-1.

Depressive disorder is a mental disorder that can affect life emotionally, physically, socially and is often accompanied by somatic symptoms that can mislead the diagnosis, especially in middle-aged women who are prone to experiencing psychosocial stressors. Epidemiological research shows that about 10-15% of women in middle age can experience depression. and often accompanied by somatic symptoms that can mislead the diagnosis, especially in middle-aged women who are prone to experiencing psychosocial stressors. This report discusses a 42-year-old woman with moderate depressive episodes and somatic symptoms (F32.11) after losing both of her parents to Covid-19. Patients experience fatigue easily, loss of interest, difficulty sleeping with nightmares, anxiety in the afternoon or cloudy weather, decreased appetite, and physical complaints in the form of abdominal pain and heart palpitations. The diagnosis was upheld according to the criteria of PPDGJ III. Management is provided comprehensively through pharmacological therapy (fluoxetine 50 mg once a day and Merlopam 2 mg once a day) as well as non-pharmacological therapy in the form of supportive psychotherapy, family education, light exercise recommendations, and increased social interaction. This integrative approach has been proven to reduce emotional and physical symptoms, improve sleep quality, and help prevent recurrence.

ABSTRACTIntroduction:Diabetes, cardiovascular diseases, metabolic syndrome, and cancer are prevalent among the elderly, significantly impacting their health-related quality of life (HRQOL). Physical activity, including yoga and light exercise, has been shown to improve various health outcomes. This meta-analysis aimed to evaluate the effect of yoga and light exercise interventions on HRQOL in older adults.Methods:A systematic search was conducted across PubMed, Cochrane Library, and Google Scholar databases up to March 2024. We included all published randomized controlled trials (RCTs) assessing the impact of yoga and light exercise interventions among elderly populations. Data extraction followed a standardized protocol, and statistical analyses were performed using RevMan 5 software. We calculated mean differences and odds ratios to compare intervention and control groups. A fixed-effects model was applied to assess the overall efficacy of interventions.Results:The findings demonstrated that yoga therapy significantly improved several dimensions of quality of life in the elderly, including cognitive function and sleep quality. Additionally, the interventions were effective in reducing psychological issues such as anxiety, depression, and stress.Conclusion:Our meta-analysis provides evidence supporting the beneficial role of yoga and light exercise in enhancing physical and psychological well-being among older adults.