Exercise Therapy Research Articles

Strategies to improve recruitment to multimodal group programmes for obesity: a systematic review

Abstract Background The World Health Organization describes obesity as one of the greatest public health challenges in the 21st century. Possible therapies include multimodal (group) programmes with nutrition, exercise, and behavioural therapy elements. However, programme providers often have difficulties recruiting the target groups and motivating them to participate. This systematic review aimed to identify barriers and facilitators as well as strategies to improve recruitment. Methods We systematically searched five databases (Medline, CINAHL, Cochrane, PsycInfo, Web of Science). Based on predefined inclusion criteria, we selected primary studies of different study designs (e.g. [randomised] controlled trials, qualitative studies). We extracted barriers and facilitators as well as recruitment strategies into predefined tables, assessed the quality of the studies and summarised the results narratively. Results Of the 1,082 articles identified, 16 met the inclusion criteria. The main active recruitment strategies were writing directly to potential participants and referrals from health professionals. The most frequently reported passive strategies included media adverts, websites, flyers, social media, and word of mouth. The information on how many people approached actually participated was heterogeneous, which illustrates that recruitment depends on the setting/context and the people involved. Some studies came to contradictory results, e.g., regarding whether passive or active methods are more successful. In most cases, a combination of strategies was recommended. The studies reported numerous recruitment barriers, e.g., lack of staff time, lack of motivation, or fear of discrimination. Conclusions The review provides a broad overview of recruitment methods that can be applied depending on the framework conditions and target groups. The summary of possible barriers can serve as an overview of which aspects could be considered when designing or adapting a programme. Key messages • To improve recruitment to obesity programmes, a combination of several recruitment strategies, including active and passive methods, should be applied. • Results on the “effectiveness” of the strategies were inconclusive, which indicates that the success of methods depends on the context, setting and the people involved.

The effectiveness of various intensity interval training compared to continuous training in patients with heart failure: a systematic review and network meta-analysis

Abstract Background/Introduction Cardiac rehabilitation including exercise therapy is beneficial for improving exercise tolerance, physical function, quality of life (QOL), and life expectancy in patients with heart failure. High-intensity interval training (HIIT) is increasingly reported as a new training modality to improve exercise tolerance more effectively than conventional moderate-intensity continuous aerobic training (MCT). However, the optimal intensity of HIIT for achieving the greatest effects in patients with heart failure remain controversial. Purpose This systematic review and network meta-analysis aimed to examine the effectiveness of HIIT compared to MCT on exercise tolerance in patients with heart failure. Methods We searched for studies published up to 30 January 2024 in Embase, MEDLINE via Ovid SP, PubMed, and the Cochrane Library via Wiley Online Library with no limitations on data, language, or publication status. We included randomised controlled trials comparing the efficacy of HIIT and MCT on peak oxygen uptake (VO2), as a measure of exercise tolerance, aerobic threshold (AT) VO2, ventilatory equivalent of carbon dioxide (VE/VCO2) slope, and QOL. We categorized HIIT into three different intensities [> 80% heart rate max (HRM), 60-80% HRM, < 60% HRM] and compared the outcomes with those of MCT. Results We identified 15 randomised controlled trials with 557 patients from a total of 27,931 records. Our network meta-analysis revealed that the following results of peak VO2 from the comparisons among the three intensities of HIIT and MCT: > 80% HRM (10 studies, mean difference 1.27 ml/min/kg, 95% confidence interval -0.20 to 2.73), 60-80% HRM (3 studies, 1.47, -0.89 to 3.83), < 60% HRM (2 studies, 2.10, -1.22 to 5.43) (Fig. 1). Regarding AT VO2, HIIT at 60-80% HRM demonstrated significant improvements compared to MCT: > 80% HRM (8 studies, 0.18, -0.83 to 1.18), 60-80% HRM (2 studies, 2.50, 0.72 to 4.28), < 60% HRM (2 studies, 1.14, -0.93 to 3.20) (Fig. 2). Regarding VE/VCO2 slope, HIIT at 60-80% HRM also demonstrated significant improvements compared to MCT: > 80% HRM (7 studies, 0.29, -1.89 to 2.47), 60-80% HRM (2 studies, -3.26, -6.18 to -0.35), < 60% HRM (no study). The network meta-analysis did not reveal any significant differences in QOL between the various intensities of HIIT and MCT. Conclusions Our systematic review and network meta-analysis revealed that HIIT prescribed at a sub-maximal intensity, 60-80% heart rate max, is most effective in improving exercise tolerance. Higher intensity does not necessarily yield better outcomes, and future research on interval training should include detailed methodologies that account for the training intensity.Fig.1 Network meta-analysis on peak VO2Fig.2 Network meta-analysis on AT VO2

Pemberian Terapi Latihan dan Edukasi dalam Upaya Meningkatkan Kemampuan Aktivitas Fungsional pada Lansia dengan Osteoarthritis Knee di Puskesmas Rampal Celaket

Osteoarthritis is a joint disorder that develops degeneratively due to chronic inflammation in the joint. Symptoms involve the gradual breakdown of cartilage, osteophyte formation, and changes in the synovial membrane. Osteoarthritis sufferers often experience a decrease in daily activities. In particular, Knee Osteoarthritis is the most common type of Osteoarthritis that causes joint pain and limitation of motion in the knee, characterized by damage to the joint cartilage and Diarthrodial structures. In order for people to prevent Osteoarthritis Knee, it is important to identify the risk factors that can lead to the condition. With this understanding, it is hoped that people can avoid the risk factors as part of prevention efforts. By distributing leaflets and conducting Knee Osteoarthritis examinations and daily activity evaluations on patients, the results showed an increase in functional activity in the elderly after undergoing routine exercise therapy. In conclusion, through this counseling activity, increasing public awareness, especially among the elderly, about the importance of preventing Osteoarthritis Knee. Continuous preventive and curative efforts are needed to reduce the incidence rate of Osteoarthritis Knee in the community.

Effects of metformin phonophoresis and exercise therapy on pain, range of motion, and physical function in chronic knee osteoarthritis: randomized clinical trial

BackgroundKnee osteoarthritis (KOA) is a common musculoskeletal disorder. Therapeutic ultrasound (US) is a safe and effective treatment for KOA. It relieves knee pain and enhances function. Metformin (MF) regulates chondrocytes, hence providing chondroprotection. Furthermore, it efficiently reduces knee articular cartilage degeneration and retards the progression of osteoarthritis. However, the localized administration of MF by phonophoresis for KOA has yet to be studied.PurposeTo assess the possible effects of metformin phonophoresis (MFPH) plus exercise therapy (EX) compared to MFPH alone or the US on knee pain, function, and range of motion (ROM) in chronic KOA patients.MethodsSeventy-eight patients with unilateral mild to moderate chronic KOA were included. Patients were randomly assigned to three groups: group A (MFPH + EX), group B (MFPH alone), and group C (US). The US group used an acoustic-neutral gel, while the MFPH group used a gel containing 1.2% MF. The exercises included hamstring stretches, calf stretches, and knee strengthening exercises. Treatment in the three groups continued for four weeks (three sessions per week). The Visual Analog Scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the goniometer were used to assess knee pain, function disability, and ROM, respectively. All measures were recorded before, 2 weeks, and 4 weeks after the intervention in all groups. Multivariate Analysis of Variance (MNOVA) was performed to compare the effects within and between groups for knee ROM and function disability. The Kruskal-Wallis test and the Friedman test analyzed the pain intensity.ResultsWhen the baseline patient characteristics were compared, there were no significant differences in means of age, gender, body mass index (BMI), or lower limb dominance across the three groups (p > 0.05). After 4 weeks of intervention, clinical outcomes significantly improved in all three groups (p < 0.05). However, patients in the MFPH + EX group improved significantly in all outcomes compared to the MFPH and US groups (p < 0.05).ConclusionPost-treatment results showed a statistically and clinically significant improvement in pain intensity, knee ROM, and function in the MFPH group; however, combining MFPH with exercises is more beneficial in reducing KOA symptoms.Trial registrationClinical Trial Registry at (pactr.samrc.ac.za) database.NO: PACTR202311507335269. Date: November 9, 2023 (retrospectively registered).

Importance of Sports Activity for the Better Mental Health of the Indian Student

Physical activity, beyond its well-documented benefits for physical health, plays a crucial role in enhancing mental well-being. Research suggests that individuals with sedentary lifestyles exhibit higher morbidity rates and increased healthcare expenditures. In response to these challenges, exercise therapy is often recommended as an effective intervention for maintaining mental health. Empirical studies have consistently established a positive connotation between physical activity and various mental health outcomes. Notably, nonclinical investigations highlight that regular exercise significantly enhances self-concept and body image. This review aims to summarize current physiological and psychological mechanisms by which exercise contributes to mental well-being. One of the primary physiological pathways involved is the regulation of the hypothalamus-pituitary-adrenal (HPA) axis, which plays a serious role in stress reply. While exercise has been shown to alleviate indications of depression and anxiety, its effects appear to be more pronounced in clinical populations than in the general public. Multiple theoretical models have been projected to explicate the relationship between physical fitness and mental health.

Assessing the impact of immersive virtual reality technology on the psychological recovery of patients with Parkinson’s disease depression: study protocol of a randomized controlled trial

Background and aimDepression in Parkinson’s disease (DPD) has a high incidence rate among patients with Parkinson’s disease (PD). It is a common nonmotor symptom of PD that seriously affects the quality of life of patients. Thus, improving DPD is important for improving the quality of life of patients. Psychotherapy for depression is limited for many reasons, and only a few patients are able to benefit from this therapy. Several studies have demonstrated that relaxation therapy, playing, and exercise therapy are effective treatments for depression. In recent years, virtual reality (VR) has rapidly developed as a form of rehabilitation due to its immersive characteristics and accessibility. It has also been applied in the psychological treatment of phobia and anxiety. However, no relevant research on the treatment of DPD has been conducted using VR. This study aims to assess the effects of immersive VR-assisted training on patients with DPD.MethodsThis single-blind randomized controlled trial will recruit 74 patients with DPD. The patients will then be randomly allocated into two groups. The patients in the VR group (n = 37) will receive VR-assisted training (40 min) three times a week for 8 weeks. The patients in the non-VR training group (n = 37) will receive treatment as usual. The outcome measures will be assessed before intervention, and after 8 weeks, 3 months, and 6 months of the intervention. The primary outcomes will include the Hamilton Depression Scale-24. The secondary outcomes will include the 36-Item Short-Form Health Survey questionnaire, neuroinflammation factors (brain-derived neurotrophic factor, interleukin-6, and C-reactive protein), and functional magnetic resonance imaging.DiscussionThe traditional treatment of depression has limited resources and requires a lot of time and energy. It is not suitable for patients with PD having mobility difficulties and residing in remote areas. VR can make up for limitations in traditional treatment methods. An advantage of VR is that it makes patients more invested in active participation. This study may provide an improved method for the clinical treatment of patients with DPD, which is suitable for clinical decision-making and future practice.Trial registrationThe study has been registered in the Chinese Clinical Trial Registry ChiCTR2200065843, November 16, 2022.https://www.chictr.org.cn/showproj.html?proj=174551{2a and 2b}

Sports Medicine Protocols: Guide to Injury Management and Rehabilitation

Sports medicine protocols are crucial manuals that provide evidence-based methods for managing injuries, recovering from surgeries, and maximising performance for athletes of all skill levels. Sports medicine professionals can use these protocols as standardised frameworks to evaluate, diagnose, and treat sports-related injuries. They can also be used to help make safe and efficient return-to-play choices. This paper offers a thorough review of sports medicine practices, including important elements like injury evaluation, treatment options, physical therapy exercises, and criteria for returning to the game. This research tries to improve the understanding and application of sports.

The impact of contextual effects in exercise therapy for low back pain: a systematic review and meta-analysis

BackgroundLow back pain is the leading cause of global disability for which exercise therapy is a widely recommended treatment. Research indicates that contextual factors may also influence treatment outcomes in low back pain. Examples include the patient-therapist relationship and other treatment-related circumstances that affect patient expectations. By focusing on the specific treatment effect, clinical trials often ignore the effect of contextual factors, thereby contributing to the so-called efficacy paradox. This means that treatment effects observed in clinical practice are often greater than those reported in clinical trials.This systematic review aims to investigate the proportion of improvement in pain and disability that can be attributed to contextual effects in the outcome of exercise therapy for patients with low back pain.MethodsA meta-analysis was conducted. PubMed, Embase, and the Cochrane database were searched for eligible articles reporting randomized controlled trials that compared exercise therapy to placebo interventions. Risk of bias was assessed with the Revised Cochrane Risk of Bias Tool. Outcomes of interest were pain and disability. Meta-analysis was carried out to calculate the proportion attributable to contextual effects for both pain and disability. The body of evidence was assessed using the GRADE methodology.ResultsEight studies met the inclusion criteria and were included in the meta-analysis. Five studies were rated as having a moderate risk of bias and two studies had a low risk of bias. Proportion attributable to contextual effects was 0.60 (95% CI 0.40–0.89) for pain and 0.69 (95% CI 0.48–1.00) for disability. Certainty of the evidence as assessed with the GRADE methodology was low.ConclusionsA large extent of pain and disability improvement after exercise therapy in low back pain is attributable to contextual effects although this conclusion is based on low certainty evidence.

Comparison of active release technique and post-isometric relaxation in treatment of plantar fasciitis among traffic police wardens: a quasi-experimental study

BackgroundPlantar fasciitis (PF) is a common cause of chronic foot pain that leads to functional limitations in individuals. There has been recent research on plantar fasciitis, but no studies have compared the effects of the active release technique and post-isometric relaxation in patients to determine which manual therapy technique improves foot pain and function.ObjectiveThis study aimed to compare the effectiveness of the active release technique and post-isometric relaxation on proximal foot pain and functional status and to assess muscular tightness among patients with traffic police wards and plantar fasciitis.MethodsA quasi-experimental study (pre-test, post-test) was conducted in the Physiotherapy Department of Police Hospital, Gujranwala, Pakistan, between October 2022 and April 2023. We included 30 consecutively aged 25- to 60-year-old symptomatic police wardens diagnosed with planter fasciitis, who complained of pain on walking and standing for more than 3 months and met the inclusion criteria. They were equally assorted into two groups (n = 15 in each group) using convenient sampling. Group A received an active release exercise technique, group B received a post-isometric relaxation technique, and the participants in both groups received a similar baseline treatment protocol that consisted of calf stretching and stretching of the plantar fascia (5 repetitions and holding for 15 s). In the outcome measures, we included the Foot Function Index to assess the function of the foot and the Visual Analog Scale to examine the pain intensity measured during rest. The participants in both groups performed the selective protocol 3 days per week for 3 weeks, and we calculated the results at baseline and on the third day of the third week. We analyzed the data using SPSS software version 24 (IBM Corp., Armonk, NY). We compared within-group differences in the VAS score and FFI using paired t tests and analyzed between-group differences in the VAS score and FFI before and after performing the ART and PIR using independent t tests.ResultsThe 8-week intervention therapy revealed a demographic age mean and standard deviation of 36.60 ± 6.11 for group A and 35.60 ± 4.85 for group B. Within-group analysis demonstrated a significant decrease in VAS (pain) score following ART intervention (1.80 ± 0.862, p < 0.01) compared to PIR (6.07 ± 0.884). Between-group analysis indicated a significant reduction in FFI (disability) scores for group A (30.33 ± 3.200, p < 0.03) compared to group B (56.93 ± 4.773). Moreover, ART intervention exhibited significant improvement in VAS scores (p < 0.05), with 95% CI [1.49, 2.11]. The mean difference in FFI scores was substantially greater in the ART group (86.00 to 30.33) compared to the PIR group (p > 0.05), suggesting non-significant differences.ConclusionThe active release exercise intervention is more effective than post-isometric relaxation in improving pain and foot function disability in patients with plantar fasciitis. The present study aimed to help physical therapists choose the most efficient manual therapy exercise intervention to improve functional limitations.

Post-dengue fatigue syndrome: A comprehensive review of an emerging clinical entity

Post-dengue fatigue syndrome (PDFS) is an emerging clinical entity characterised by persistent, debilitating fatigue and other symptoms following acute dengue infection. This review synthesises current evidence on the epidemiology, clinical features, pathophysiology and management of PDFS. Studies suggest that 20–25% of hospitalised dengue patients may develop PDFS, though population-based incidence is likely lower. Risk factors include older age, female sex and possibly host genetic factors. The hallmark symptom is profound fatigue, often accompanied by musculoskeletal pain, cognitive difficulties, sleep disturbances and mood changes. While some patients recover within weeks, others experience symptoms persisting for months or years. The pathophysiology of PDFS remains unclear but may involve persistent immune activation, hypothalamic-pituitary-adrenal axis dysfunction and autonomic nervous system disturbances. Diagnosis is based on the clinical history and exclusion of alternative causes. Management typically involves a multidisciplinary approach, including patient education, graded exercise therapy, cognitive behavioural therapy and symptomatic treatment. However, evidence for specific interventions is limited. Prognosis is variable, with some patients experiencing prolonged disability. Significant research gaps remain, including the need for standardised diagnostic criteria, biomarkers and controlled trials of potential therapies. As dengue’s global burden increases, further investigation of PDFS is crucial to improve recognition and develop evidence-based treatments for this impactful sequela of dengue infection.

The Effectiveness of Deep Breathing Exercise Therapy on Oxygen Saturation among Patients with Ischemic Stroke

Ischemic stroke is an abnormality of central nervous system function in which blood flow decreases significantly, causing hypoxia. This systemic hypoxemia should be avoided; therefore oxygen saturation is monitored in the acute phase. One of the interventions that can be done in order to increase oxygen supply is by deep breathing exercise. The purpose of this study was to determine the effectiveness of deep breathing exercise therapy to increase oxygen saturation on patients with ischemic stroke. This study is a quasi-experimental study with one group pre-posttest design that has been implemented in the neural room of RSUP Dr. M. Djamil Padang with a sample of 16 patients with ischemic stroke who have fulfilled the inclusion criteria. Data was collected directly by measuring oxygen saturation of patients with ischemic stroke before and after a deep breathing exercise intervention. The data were processed by computer and analyzed as univariate and bivariate. Normality test results show the data is not normally distributed so that the analysis used is non-parametric test by using Wilcoxon test. The results showed that deep breathing exercise therapy was effective in increasing oxygen saturation level of patients with ischemic stroke with p = 0,000 so it can be recommended that this therapy can be used as one of the nursing interventions on patients with ischemic stroke to increase the oxygen saturation level.

Expert opinion on heat therapy for teenagers' musculoskeletal pain management.

Among children and adolescents, up to 40% will experience musculoskeletal pain (MP), which can significantly impair functional ability, reduce quality of life, cause emotional distress, and lead to sleeping disorders for both patients and their families. The first-line treatment often involves pharmacological interventions, even though there is a lack of evidence supporting the efficacy or the safety of this approach in this specific age group. Recent guidelines recommend the implementation of preventative strategies and physical tools as the first option to minimize the use of medications. We aimed to provide an expert opinion on the use of heat therapy for MP management in young patients. This paper is the result of a virtual advisory board held by the authors in order to discuss and provide an expert opinion about the use of heat therapy in MP in children and adolescents. MP is a significant burden affecting children and adolescents. While non-steroidal anti-inflammatory drugs are currently the first-choice treatment of acute and chronic MP in children and adolescents, avoiding or reducing them in such patients is advisable, to reduce side effects and to prevent the development of chronic pain and medication overuse headaches. Heat therapy can be an additional treatment option due to its ability to promote muscle relaxation, enhance blood circulation, and modulate nociceptors with a good safety profile. MP in children and adolescents is a common condition that should be approached multidisciplinary, including information, therapeutic exercise and physical therapies like hot or cold therapies. Future studies should be conducted to evaluate the safety, efficacy and indications of each treatment in MP.

Correction of immune disorders under the influence of pharmacotherapy and extracorporeal magnetic stimulation with patients after surgical treatment of prostate adenoma

BACKGROUND: The course of benign prostatic hyperplasia is associated with immunological disorders at the systemic and local level. Despite the wide arsenal of pharmacological agents for the treatment of benign prostatic hyperplasia, some patients undergo surgical treatment. Postoperative management programmes should be aimed at reducing the risks of complications, including infectious-inflammatory complications. In this regard, the inclusion of immunomodulatory pharmacotherapy and therapeutic physical factors in the course of reconstructive treatment is reasonable and justified. AIM: To study the role of the complex effect of pharmacotherapy and extracorporeal magnetic stimulation in the correction of immune disorders with the patients after surgical treatment of benign prostatic hyperplasia. MATERIALS AND METHODS: There have been observed 88 patients after surgical treatment of benign prostatic hyperplasia, who underwent a medical rehabilitation at stages II and III. At stage II 43 patients in the comparison group underwent standardized drug therapy, individual exercise therapy; in the main group 45 patients additionally were prescribed immunomodulatory therapy with Tameritis. At stage III the patients of the comparison group continued pharmacotherapy, exercise therapy, and transrectal magnetic therapy; in the main group 45 patients were additionally prescribed extracorporeal magnetic stimulation. A method of enzyme-linked immunosorbent assay was used to study the content of interleukins (IL); IPSS-QOL (International Prostate Symptom Score – Quality-of-Life) and SF-36 (The Short Form-36) were used to assess the quality of life. Confidence level (р) 0.05. RESULTS: After the second inpatient stage of rehabilitation the patients of the main group after surgical treatment of benign prostatic hyperplasia had a decrease the level of pro-inflammatory IL by 47.5% on average (p 0.01) with an increase in the level of anti-inflammatory IL-10 by 36.2% (p 0.01). After the III outpatient rehabilitation stage, a positive dynamics significantly increased and amounted to 63.2% (p 0.01) and 51.9% (p 0.01), reaching the normative values in the population. It should be noted that the achieved results have been preserved in a long time. In the comparison group the positive dynamics was significantly lower (p 0.05; p 0.01) in all the cases after the II and III stages of rehabilitation. The patients of the main group were observed a decrease in the severity of urinary disorders (p 0.01), restoration of quality of life (p 0.05) according to IPSS-QOL and SF-36 questionnaires at significant inter-group values (p 0.05) with the same confidence. CONCLUSION: The integrated use of pharmacotherapy and extracorporeal magnetic stimulation with the patients after surgical treatment of benign prostatic hyperplasia provides significant correction of immune disorders, restoration of physical and mental health.

Combined Exercise and Nutritional Therapy Improves Physical Functions and Activities of Daily Living in Patients With Multimorbidity Undergoing Convalescent Rehabilitation: A Case Report

Combined Exercise and Nutritional Therapy Improves Physical Functions and Activities of Daily Living in Patients With Multimorbidity Undergoing Convalescent Rehabilitation: A Case Report

The effect of recreational therapy application on fatigue in hemodialysis patients: a randomized clinical trial

BackgroundChronic Kidney Disease (CKD) is a progressive disorder that often leads to End-Stage Renal Disease (ESRD), necessitating hemodialysis (HD) treatment. Fatigue is a prevalent and debilitating symptom among HD patients, significantly affecting their quality of life. Recreational Therapy (RT) is a therapeutic recreational service designed to maintain and restore a person’s level of performance and independence in daily activities. This study aimed to evaluate the effect of a smartphone-based recreational therapy intervention on fatigue in hemodialysis patients.MethodsThis randomized controlled trial was conducted on HD patients at a hospital in Mashhad, Iran. The intervention group received a custom-designed recreational therapy mobile application, including music, comedy, exercise, and educational content. The control group received standard care. Fatigue was assessed using the Multidimensional Fatigue Inventory (MFI-20) before and after the 30-day intervention.ResultsA total of 72 patients (36 per group) participated in the study. The intervention group demonstrated a significant reduction in overall fatigue scores and improvements across various fatigue dimensions, including general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation, compared to the control group (p < 0.001).ConclusionThe smartphone-based recreational therapy intervention effectively reduced fatigue in hemodialysis patients. This approach could be a valuable complementary strategy for managing fatigue in this population. Further research is needed to explore the long-term sustainability of these benefits and the intervention’s impact on other patient-reported outcomes.Trial registrationThis study was registered in the Iranian Registry of Clinical Trials (no. IRCT20220803055608N1) on 29/08/2022.

Acute and long-term effect of specific and non-specific exercises in patients with chronic neck pain: A protocol for a randomized controlled trial.

Exercise therapy is the most common approach for people with chronic neck pain (CNP). Although well-established, it remains unknown which type of exercise is the best for treating this condition. Moreover, pain processing can play a role in the persistence of pain and in the response to interventions. Thus, the aim of this randomized controlled trial is to compare the acute and long-term effects of two exercise protocols (specific and non-specific) on pain and pain processing in individuals with CNP. One hundred and ten participants aged between 18 and 65years who have had non-specific neck pain for more than 3months will be recruited. They will be randomized and allocated into two groups (specific exercises and non-specific exercises) and both groups will perform an exercise programme twice a week for 8weeks. Both programmes are divided into two progressive and individualized phases. The primary outcomes are change in pain intensity after 8weeks of exercise and exercise-induced hypoalgesia, and secondary outcomes are pressure pain threshold, temporal summation of pain, conditioned pain modulation, the Neck Disability Index, the Baecke Physical Activity Questionnaire, and the Global Perception of Change Scale. Outcomes will be assessed at baseline, after 8weeks of intervention, and at 6-month follow-up.

Research trends in exercise therapy for the treatment of pain in postmenopausal osteoporosis over the past decade: A bibliometric analysis.

Postmenopausal osteoporosis (PMOP) is the most common form of primary osteoporosis among women, and the associated pain often drives patients to seek clinical intervention. Numerous studies have highlighted the unique clinical benefits of exercise therapy (ET) in alleviating PMOP-related pain. However, bibliometric analyses examining collaboration, development trends, and research frontiers in the field of ET for PMOP pain remain scarce. To explore the research trends in ET for pain treatment in PMOP patients over the past decade. All scholarly works were meticulously sourced from the Science Citation Index-Expanded within the prominent Web of Science Core Collection. Utilizing the capabilities of CiteSpace 6.2.R5, we conducted a thorough analysis of publications, authors, frequently cited scholars, contributing nations, institutions, journals of significant citation, comprehensive references, and pivotal keywords. Additionally, our examination explored keyword cooccurrences, detailed timelines, and periods of heightened citation activity. This comprehensive search, from 2014 through 2023, was completed within a single day, on October 11, 2023. In total, 2914 articles were ultimately included in the analysis. There was a rapid increase in annual publication output in 2015, followed by stable growth in subsequent years. Boninger, Michael L, is the most prolific author, whereas Ware JE has the most citations. The United States' global influence is significant, surpassing all other nations. The University of California System and Harvard University are the most influential academic institutions. J Bone Joint Surg Am is the most influential journal in this field. "Spinal cord injury" is the keyword that has garnered the most attention from researchers. The developmental pattern in this field is characterized by interdisciplinary fusion, with different disciplines converging to drive progress. The academic development of the field of ET for pain in PMOP has matured and stabilized. Clinical management and rehabilitation strategies, along with the mechanisms underlying the relationship between ET and bone resorption analgesia, continue to be the current and future focal points of research in this field.

Non-Pharmacological Exercise Randomized Controlled Trials in Alzheimer's Disease.

This narrative review aimed to summarize evidence on responses to exercise in pre-clinical Alzheimer's disease (AD) and on how long-term exercise programs work to improve neuropsychiatric symptoms and cognitive performance. We conducted a narrative review of the body of research on the benefits of long-term exercise programs in improving cognitive performance and reducing neuropsychiatric scores in patients with AD. Long-term exercise therapy appears to improve blood flow, increase hippocampal volume, and promote neurogenesis in patients with AD. Higher levels of physical activity are associated with a lower chance of developing the disease, and most prospective studies have shown that physical inactivity is one of the most prevalent modifiable risk factors for the development of AD. Exercise appears to be beneficial in improving cognitive function, a neuropsychiatric symptom of AD. Exercise has been shown to have fewer side effects, such as non-pharmacological effects and better adherence than medication. In this review, experts provided a snapshot and authoritative summary of evidence for non-pharmacological exercise in patients with AD based on the best synthesis efforts, identified the main knowledge gaps and relevant barriers, and provided directions for future research. Furthermore, experts in randomized trial designs provided practical details and recommendations for researchers working in this area, underscoring the importance of relevant topics.

Clinical diagnosis and management of spinocerebellar Ataxia in a resource-constrained setting: a case report from Eastern Nepal

Introduction: Spinocerebellar ataxias (SCA) are a diverse group of neurodegenerative disorders with autosomal dominant inheritance, primarily affecting the cerebellum and its connections. Diagnosis typically involves genetic testing, but in resource-limited settings, clinical and neuroimaging assessments become critical. This case report highlights the role of non-genetic methods in diagnosing SCA and outlines management strategies in such settings. Case Presentation: A 41-year-old male presented with a two-year history of progressive gait imbalance, headache, and abnormal speech. He had a family history of similar symptoms in two siblings, but no significant past medical history. Clinical examination revealed scanning speech, dysmetria, and a broad-based gait. Clinical and neuroimaging findings, including cerebellar atrophy, led to a diagnosis of SCA in the absence of genetic testing. Patient management with speech, occupational, and physical therapies, showed gradual improvement. Discussion: SCA, characterized by cerebellar atrophy and a range of clinical symptoms, is typically diagnosed through genetic testing, but clinical and imaging assessments are crucial when genetic resources are limited. This case illustrates that a comprehensive clinical evaluation, including neuroimaging, can support the diagnosis of SCA even without genetic testing. Strategic management emphasizing symptomatic relief and functional improvement through a multidisciplinary approach, including regular follow-up and personalized therapy, are crucial, as evidenced by the timely improvement observed in our case. Conclusion: In resource-limited settings, a comprehensive clinical and neuroimaging assessment is essential for diagnosing Spinocerebellar Ataxia when genetic testing is not feasible. Effective management through multidisciplinary therapies can improve patient outcomes, underscoring the need for innovative strategies to enhance diagnostic and treatment capabilities in such environments.

Back pain exercise therapy remodels human epigenetic profiles in buccal and human peripheral blood mononuclear cells: an exploratory study in young male participants.

With its high and increasing lifetime prevalence, back pain represents a contemporary challenge for patients and healthcare providers. Monitored exercise therapy is a commonly prescribed treatment to relieve pain and functional limitations. However, the benefits of exercise are often gradual, subtle, and evaluated by subjective self-reported scores. Back pain pathogenesis is interlinked with epigenetically mediated processes that modify gene expression without altering the DNA sequence. Therefore, we hypothesize that therapy effects can be objectively evaluated by measurable epigenetic histone posttranslational modifications and proteome expression. Because epigenetic modifications are dynamic and responsive to environmental exposure, lifestyle choices-such as physical activity-can alter epigenetic profiles, subsequent gene expression, and health traits. Instead of invasive sampling (e.g., muscle biopsy), we collect easily accessible buccal swabs and plasma. The plasma proteome provides a systemic understanding of a person's current health state and is an ideal snapshot of downstream, epigenetically regulated, changes upon therapy. This study investigates how molecular profiles evolve in response to standardized sport therapy and non-controlled lifestyle choices. We report that the therapy improves agility, attenuates back pain, and triggers healthier habits. We find that a subset of participants' histone methylation and acetylation profiles cluster samples according to their therapy status, before or after therapy. Integrating epigenetic reprogramming of both buccal cells and peripheral blood mononuclear cells (PBMCs) reveals that these concomitant changes are concordant with higher levels of self-rated back pain improvement and agility gain. Additionally, epigenetic changes correlate with changes in immune response plasma factors, reflecting their comparable ability to rate therapy effects at the molecular level. We also performed an exploratory analysis to confirm the usability of molecular profiles in (1) mapping lifestyle choices and (2) evaluating the distance of a given participant to an optimal health state. This pre-post cohort study highlights the potential of integrated molecular profiles to score therapy efficiency. Our findings reflect the complex interplay of an individual's background and lifestyle upon therapeutic exposure. Future studies are needed to provide mechanistic insights into back pain pathogenesis and lifestyle-based epigenetic reprogramming upon sport therapy intervention to maintain therapeutic effects in the long run.