Effect of different exercise types on physical function and psychological status in females with multiple sclerosis: A network meta-analysis.

Unique contributions of heart failure and chronic pain on physical function and quality of life in older adults.

Iron dysregulation and mitochondrial dysfunction in aging: A longitudinal study on mobility decline in low- and high-functioning older adults.

Upper and lower trunk accelerometer-based metrics during gait as predictors of physical function in older adults.

Osteoarthritis (OA) often results in significant degeneration of the knee’s tendons, ligaments, muscles, and joint capsules, frequently resulting in reduced proprioception. Total Knee Arthroplasty (TKA) is a widely used surgical intervention aimed at alleviating pain and improving the Quality of Life (QoL) for individuals with end-stage Knee Osteoarthritis (KOA). However, despite its effectiveness, many patients experience only modest functional improvements following surgery, highlighting the need for enhanced rehabilitation strategies. The present narrative review explores the impact of incorporating balance and proprioceptive training into postoperative rehabilitation for TKA patients, focusing on physical function, pain relief, and overall well-being. The purpose of the present review is to evaluate how proprioceptive and balance training affects physical function, pain management, and general QoL in postoperative rehabilitation for TKA patients. Regaining stability, mobility, and confidence in performing daily tasks is often challenging for individuals who have undergone TKA. Although the procedure primarily addresses structural joint damage and alleviates pain, it does not automatically improve sensory-motor function or neuromuscular coordination, both of which are essential for independent mobility and fall prevention. Findings indicate that early integration of balance and proprioceptive exercises can significantly improve recovery outcomes after TKA, enhancing balance, physical function, and QoL. Techniques such as Progressive Dynamic Balance Training (PDBT), combined kinetic chain exercises, and Neuromuscular Electrical Stimulation (NMES) have demonstrated particular effectiveness. However, variability in study designs and outcome measures underscores the need for standardised rehabilitation protocols. In conclusion, balance and proprioceptive training appear to offer substantial benefits for TKA patients by improving functional outcomes and reducing fall risk. Further research is needed to develop consistent training protocols, examine long-term outcomes, and validate findings in larger and more diverse patient populations.

The evaluation of the levels of physical function in older adults from the perspective of active aging.

Hyperandrogenaemia and Systemic Low-Grade Inflammation in Normogonadotropic Anovulation: A Prospective Cohort Study.

Effects of VR exercise interventions on cognitive function and physical function in older adults: A systematic review and meta-analysis.

Late-night eating may impair sleep quality, with poor sleep negatively affecting quality of life (QoL). As both sleep and eating behaviors are connected to circadian rhythms, interest in "chrono-nutrition", i.e., the timing, frequency and regularity of food consumption, has grown. This study investigated associations between chrono-nutrition and both sleep and QoL in a population-based study enriched with participants with type 2 diabetes. Cross-sectional data from 3463 participants (51 % women, mean age 63.6 years) of The Maastricht Study were analyzed. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (range 0-21, higher scores indicating worse quality), and QoL via the SF-36 mental and physical functioning subscales (range 0-100, higher scores indicating better functioning). Sleep duration and fragmentation were estimated using activPAL accelerometers. Meal frequency and irregularity, time-window of caloric intake, and interval between last meal and bedtime were assessed via a chrono-nutrition questionnaire. Associations with sleep quality and QoL were analyzed using multiple linear regression; associations with sleep duration (<7,7-9,>9 h) and fragmentation (0,<1,>1 breaks/night) were analyzed using multinomial logistic regression, adjusted for sociodemographic, clinical, and lifestyle factors. Higher meal frequency was associated with poorer sleep quality (B (95%CI), 0.90 (0.33, 1.47) for Q2, 1.02 (0.49, 1.54) for Q3, and 0.68 (0.17, 1.20) for Q4, all vs. Q1), and lower mental functioning (-1.24 (-2.22, -0.25) for Q4vs.Q1). Higher meal irregularity was linearly associated with poorer sleep quality (B: 0.33, 0.20, 0.46) and lower physical functioning (B:-0.43, -0.65, -0.21). A longer time-window of caloric intake was associated with poorer sleep quality (0.57 (0.09, 1.06) for Q3 and 0.49 (-0.02, 0.99) for Q4, vs. Q1) and lower physical functioning (-0.17/hour, -0.32, -0.02) Conversely, a longer time-window between last meal and bedtime was associated with better sleep quality (-0.72 (-1.25, -0.19) for Q2 and -0.85 (-1.31, -0.39) for Q4, vs Q1) and higher mental (0.20/hour longer, 0.00, 0.41) and physical functioning (0.29/hour, 0.11, 0.48). There was no effect modification by glucose metabolism status. Higher meal frequency and irregularity were associated with impaired sleep and lower QoL. A longer interval between the last meal and bedtime may benefit sleep and QoL.

Health-related quality of life is central to healthy ageing, yet gender differences among older adults and their underlying determinants are not well understood. We examined gender differences in quality of life in a large cohort of older Australians and the extent to which biopsychosocial factors mediate these differences. We analysed baseline cross-sectional data from the Statins in Reducing Events in the Elderly trial, a randomised controlled trial of community-dwelling Australians aged ≥70years without cardiovascular disease, major physical disability, or dementia. Quality of life was measured across eight domains of the 36-Item Short Form and summarised using the SF-6D index. Gender differences were examined using age-adjusted linear regression, with mediation assessed by the percentage reduction in the association between gender and quality of life after adjusting for individual biopsychosocial factors. Among 9971 participants (52% women; mean age 74.7±4.5years), women scored lower than men in Physical Functioning, Vitality, Mental Health, and Bodily Pain (all p<0.001), but higher in General Health (p<0.001). The SF-6D index was lower in women (mean difference-0.03, p<0.001). Pain severity, depressive symptoms, and histories of osteoarthritis and depression mediated the greatest amount of the gender difference in scores (between 42% and 92%). Older women reported better general health but poorer quality of life than men in most domains. These gender differences were largely attributable to pain and depressive symptoms, both of which are common and modifiable. Targeted management of these symptoms may improve quality of life and reduce gender disparities in later life.

For whom does online social support matter most? Exploring the joint moderating roles of depressive symptoms and physical functioning in the relationship between online social support and quality of life

Growth differentiation factor 15 (GDF15) is a protein that is produced by senescent cells during the aging process. Its level in blood increases with age and is associated with an increased risk of several age-related diseases and mortality. We measured GDF15 level in serum archived 1174 men and women aged between 70 and 79yr in the Health Aging and Body Composition study who had measurements of BMD of the hip, markers of bone turnover (PINP and CTX) and tested for several physical functions (6m gait speed, standing balance and grip strength, BMI, and appendicular lean mass) and falls, and were followed-up for incident fracture. Cox proportional hazard models were used to estimate hip fracture risk by increasing GDF15 quartiles. The mean GDF15 was significantly higher in men than in women (p < .0001) and the level significantly increased with age, slower gait speed, lower standing balance test time, and lower handgrip strength. During 11.5 (SD 4.5)yr of follow-up, 93 (8%) of the participants suffered a hip fracture and the risk was higher among women (p < .015), associated with older age, lower BMI, lower FN and TH BMD, lower appendicular lean mass, and weaker grip strength. In the unadjusted hazard model participants in the highest quartile of GDF15 had a 2-fold increased hip fracture risk (HR 2.12, p < .014) that remained significant after adjustment for age and sex (p < .037). However, the association was no longer statistically significant after adjusting for grip strength (HR 1.8, 95% CI: 0.97-3.34; p < .06). In conclusion, increased GDF15 is a predictor of hip fractures. This relationship might be partially mediated by muscle function and low lean mass but not BMD.

Effects of exercise on health-related fitness and patient-reported outcomes in survivors of head and neck cancer: a systematic review and meta-analysis.

Mitigating loss of lean muscle in GLP-1 and dual GLP-1/GIP agonists: Pipeline opportunities and limitations.

Predictions of Health-Related Quality of Life (HRQoL) outcomes could support realistic recovery expectations after breast cancer (BC) surgery. We aimed to develop and validate prediction models for HRQoL outcomes after BC surgery. We used three datasets of BC patients from Berlin, Germany; Ljubljana, Slovenia; and Rotterdam; Netherlands. We included non-metastasised patients who were surgically treated for an initial diagnosis of BC and completed pre- and postoperative validated questionnaires. We used linear mixed models to analyse 15 domains of the EORTC QLQ-C30 and EORTC QLQ-BR23 over a two-year horizon. Baseline domain score (measured pre-operatively), age, BMI, smoking, TN stage, receptor status, neoadjuvant chemotherapy, axillary surgery and surgery type (breast-conserving, mastectomy, and immediate implant-based reconstruction) were included as predictors. Predictive performance at validation was assessed by the proportion of variance explained (marginal R2; mR2). We included N=795 patients from Germany for development and N=623 from Slovenia and N=417 from Netherlands for validation. The largest proportion of variance was explained by the prediction models for sexual functioning (SF, mR2 35%), physical functioning (PF, mR2 29%), body image (BI, mR2 26%), and cognitive functioning (CF, mR2 25%). The models captured meaningfully different trends over time for different outcomes and surgery types. The predictive performance of the models was largely driven by the baseline domain score. Performance was reasonable at external validation, with r2 values of 19-33% for PF, 10-17% for CF, 15-18% for BI, and 22-28% for SF, although some other outcomes (e.g. breast symptoms and role functioning) showed miscalibration, indicating a need for recalibration. HRQoL after breast cancer surgery can be predicted using simple models with baseline domain scores and surgery type, demonstrating a new opportunity for Patient-Reported Outcome Measures (PROMs) in personalized care.

To empirically compare the discriminant capacities of three outcome measurement instruments for assessment of physical functioning for psoriatic arthritis (PsA): HAQ-DI, SF36-PF and SF36-PCS. We applied a network meta-analysis technique in a sample of randomized trials (RCTs) for PsA. For randomized comparison, we calculated net effect size estimates for each outcome measurement instrument using standardized mean differences (SMDs); positive values indicated a beneficial effect of the intervention compared to the control groups. We analyzed the differences between outcome measurement instruments at the trial level by applying a multiple-treatment meta-analysis to compare the SMDs within and across randomized comparisons for each outcome measurement instrument. From 42 articles (31 RCTs), 57, 18, and 18 randomized comparisons enabled a direct comparison between HAQ-DI and SF36-PCS (difference in SMDs: 0.057, 95 % confidence interval, CI: 0.003 to 0.110), SF36-PF and SF36-PCS (difference in SMDs: 0.101, 95 % CI: 0.018 to 0.184); and HAQ-DI and SF36-PF (difference in SMDs:0.059, 95 % CI:0.142 to 0.024), respectively. The network meta-analysis technique confirmed that both HAQ-DI and SF36-PF were more responsive to change than SF36-PCS, with differences between SMDs of 0.057 (95 % CI: 0.003 to 0.110) and 0.109 (95 % CI: 0.032 to 0.185), respectively. No difference in discriminatory capacity between HAQ-DI and SF36-PF was noted. HAQ-DI and SF-36-PF were equally responsive to change and superior to SF36-PCS in PsA RCTs. We illustrated a new method for quantitative comparison of the performance of different outcome measurement instruments for a particular domain.

Effects of respiratory muscle training on respiratory function, exercise capacity and quality of life in people with multiple sclerosis: a systematic review and meta-analysis.

Neurofibromatosis type1 with plexiform neurofibromas (NF1-PN) can cause substantial clinical morbidity, yet the overall humanistic burden in adults remains poorly characterized. This study assessed health-related quality of life (HRQoL), in addition to clinical characteristics, among adults with symptomatic NF1-PN. A cross-sectional survey was conducted among adults with NF1-PN in the USA. The survey included the following patient-reported outcome (PRO) measures: PAin INtensity Scale for Plexiform Neurofibromas (PAINS-pNF), Pain Interference Index (PII-pNF), PN quality of life measure (PlexiQoL), Patient-Reported Outcomes Measurement Information System (PROMIS), Pediatric Quality of Life Inventory (PedsQL), Work Productivity and Activity Impairment (WPAI-CIQ), and EQ-5D-5L. Among 120 participants (mean age 41.8years, 46.7% female), 80.0% reported experiencing pain and fatigue. Over half of patients reported moderate-to-severe chronic (51.7%) and spike (83.3%) tumor pain (PAINS-pNF: mean chronic pain = 3.6 ± 2.5; mean spike pain = 6.3 ± 3.2), with considerable interference with daily activities (PII-pNF: mean = 3.1 ± 1.6). PROMIS scores indicated worse outcomes than the general population for physical function (38.4 ± 7.7), depression (59.0 ± 9.2), anxiety (60.1 ± 9.5), and fatigue (59.0 ± 10.2). Only 12.5% were employed, with 50.8% reporting disability. Among employed individuals, work productivity loss averaged 39.3% ± 30.7. Overall daily activity impact was high (55.5% ± 22.5). The mean EQ-5D-5L utility score was 0.38 ± 0.39, with 69.2% reporting moderate-to-extreme pain/discomfort and 57.5% reporting moderate-to-extreme anxiety/depression. Adults with symptomatic NF1-PN experience substantial disease burden across multiple domains, including high prevalence of pain, impaired physical and psychological functioning, reduced work productivity, and low health utility scores. These results highlight the need for integrated pharmacological, psychological, and rehabilitation interventions to support overall patient well-being.

The Impact of Prehabilitation on Postoperative Outcomes in Colorectal Cancer: A Meta-Analysis of Randomized Controlled Trials.

Impacts of non-pharmacological interventions on post-intensive care syndrome: An umbrella review of systematic reviews and meta-analyses of randomized controlled trials.