Timed Up And Go Research Articles

The Efficiency of Insoles on Quality of Life, Functional Balance and Mobility in Elderly People.

Ageing leads to declines in physiological function, impairing mobility, and increasing the risk of falls. Muscle atrophy, particularly in the intrinsic foot muscles, exacerbates these issues. This study evaluates the effects of two types of insoles on balance, mobility, and quality of life in older adults. A controlled clinical trial was conducted with 30 participants aged 60 and older assigned to either a thin rigid heel cup insole (TRHI) or a toe-grip insole (TGI). Primary outcomes, including balance, mobility, and quality of life, were assessed using the Berg Balance Scale, Timed Up and Go (TUG) test, and the SF-36 questionnaire, at baseline and after one month of use. Both groups were comparable at baseline (p>0.05). Significant improvements were observed in the TGI group regarding quality of life, functional balance, and mobility (p<0.05), with pain reductions (p<0.001). While both groups showed within-group improvements, the TGI group demonstrated superior mobility (p<0.05). Both types of insoles improved balance, mobility, and pain in the elderly, with greater benefits for mobility was shown in TGI group. These findings suggest that insoles can effectively enhance balance, reduce fall risk, and improve quality of life and functional independence in elderly individuals.

Influência do medo de cair e da autopercepção de equilíbrio na mobilidade funcional de idosos

Introduction: Falls and fear of falling (FOF) have considerable consequences for older adults’ health, causing physical and psychological limitations that affect daily activities. Self-perception of balance, although little investigated, may interfere with older adults’ motivation and confidence in moving around, impacting their functional independence. Objective: To investigate the association between FOF and self-perceived balance, as well as the influence of these variables on functional mobility. Methods: A total of 152 independent community-dwelling older adults aged 60 to 84 years participated. Participants were assessed for self-perception of balance and FOF, and performed clinical tests: single-leg stance (SLS), Timed Up and Go (TUG), Five Times Sit to Stand (5TSS), and gait speed (GS). Binary logistic regression analyzed the association between FOF and balance self-perception. Multiple linear regression was used to evaluate the association of FOF and balance perception with clinical test performance. Results: FOF was positively associated with TUG (p = 0.013) and negatively with GS (p = 0.004). Balance self-perception was positively associated with SLS (p = 0.001) and GS (p = 0.038), and negatively with TUG (p = 0.004). Conclusion: Both FOF and negative balance self-perception negatively affect functional mobility. However, balance self-perception showed a broader influence on functional test performance, while FOF was only associated with tasks involving changes in the base of support.

Do Pain Duration and Affected Side Affect Balance in Shoulder Pathologies? A Controlled Study.

The study investigated the impact of shoulder pathologies on balance and changes associated with pain duration and affected side.A total of fifty-five individuals were included in this study. Individuals with shoulder pathology were grouped according to the duration of pain and the affected side. Balance evaluation was done using the Timed Up and Go (TUG) test and the One Leg Stand (OLS) test performed on hard and soft ground with open and closed eyes.Pain duration negatively affected dynamic balance, and those with pain for less than six months had better TUG results (p=0.027). Additionally, no significant difference was observed in OLS and TUG tests in relation to the affected shoulder side.Shoulder pathology negatively impacts individuals' dynamic and static balance. As the pain duration due to shoulder pathology increases in individuals, dynamic balance is negatively affected.

Effects of Augmented Reality (AR)-Based Progressive Resistance Exercise on Balance and Physical Self-Efficacy Scale in Elderly Women with Sarcopenia

Purpose This study aimed to investigate the effects of augmented reality (AR)based resistance exercise on balance and physical selfefficacy in elderly women with sarcopenia. Methods Ten women aged 65 years or older with sarcopenia were randomly assigned to either an ARbased resistance exercise group (AREG, n = 5) or a general resistance exercise group (GREG, n = 5). Both groups participated in 50minute exercise sessions, three times per week, for four weeks. Outcome measures included the Functional Reach Test (FRT), Timed Up and Go (TUG), OneLegged Stand Test (OLS), and the Physical SelfEfficacy Scale (PSES). Results Four weeks of ARbased resistance training resulted in significant improvements in balance and physical selfefficacy among sarcopenic older women. Compared to conventional resistance exercise, ARbased training demonstrated superior outcomes in FRT, OLS, and PSES. Although TUG results were not statistically significant, the trend favored ARbased training. These findings suggest that real time visualauditory feedback and interactive task execution may enhance postural control and psychological confidence. ARbased exercise appears to be a feasible and potentially superior intervention for improving balancerelated outcomes in this highrisk population. Further research is needed to confirm longterm effects and transferability to gait and fall prevention. Conclusion Despite improvements in balance and selfefficacy after four weeks of augmented realitybased resistance training in elderly women with sarcopenia, significant differences emerged only in oneleg standing and selfefficacy, favoring the AR group. No betweengroup differences were found in functional reach or timed up and go. These findings suggest that AR training may enhance static balance and psychological outcomes. Future studies should explore longterm and personalized AR interventions to maximize rehabilitation benefits in this population.

Efficacy of Tuina Therapy Based on Hip-Knee-Ankle Synergy in the Lower Extremity Kinematic Chain in Patients With Knee Osteoarthritis: Protocol for a Randomized Controlled Trial.

Knee osteoarthritis (KOA) is a progressive degeneration of the knee joint that has the potential to impair the function of the lower extremity. Tuina, as an important component of traditional Chinese medicine (TCM), is a common treatment for KOA. However, the prevailing practice often limits the therapeutic focus to the knee joint, overlooking potential coexisting hip and ankle injuries. Thus, the therapeutic efficacy may not be optimal in these instances. This study aims to evaluate the clinical efficacy of Tuina therapy based on hip-knee-ankle synergy combined with conventional treatment in patients with KOA. It also seeks to explore the potential effects on the lower extremity kinematic chain and provide clinical practitioners with a potentially valuable therapeutic approach. This single-blind randomized controlled trial (RCT) will involve a total of 96 participants with KOA from 1 study center (including 2 branches). Participants will be randomly divided into a conventional treatment (control) group and a Tuina+conventional treatment (intervention) group in a 1:1 ratio. Participants in the control group will receive regular health education, self-administered acupressure, and functional exercise. This routine will be completed in 4 weeks, with a total of 5 sessions planned each week. Participants in the intervention group will receive 8 sessions of Tuina therapy based on hip-knee-ankle synergy (twice a week for 4 weeks), combined with conventional treatment. The primary outcome of this study will be improvement in WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) scores from baseline to 16 weeks. Among the secondary measures, the Key Symptoms and Signs/TCM Syndrome Classification Quantitative Evaluation of KOA and the 11-item Tampa Scale of Kinesiophobia (TSK-11) score will be evaluated from baseline to 16 weeks. The Functional Movement Screen (FMS), the Timed Up and Go (TUG) test, and the Weight Bearing Lunge Test (WBLT) scores will only be evaluated at baseline and 4 weeks. The trial commenced in September 2024 and is expected to conclude in September 2025. As of April 2025, key preliminary steps have been successfully completed. Specifically, the ethical review and clinical trial registration have been finalized. Participant recruitment is proceeding well, with 69 individuals having been enrolled to date. Data collection is currently ongoing, and formal data analysis has not yet been initiated. This RCT aims to contribute to the growing evidence base supporting the necessity of kinetic chain-based integrative diagnosis and treatment, while also evaluating the feasibility of the study protocol and exploring the benefits of manipulative therapy. International Traditional Medicine Clinical Trial Registry ITMCTR2024000293; https://tinyurl.com/4tsszfdu. DERR1-10.2196/75547.

Sarcopenia prevalence and relationship to frailty by measurement method in patients with adult spinal deformity.

There is no consensus on how to diagnose sarcopenia in patients with spine disorders, limiting one's understanding of the relationship among sarcopenia, frailty, and surgical outcomes. The authors characterized the baseline prevalence of sarcopenia in patients with adult spinal deformity (ASD) according to previously established methods. They then examined the intersection between sarcopenia and frailty. This is a retrospective cross-sectional study of preoperative patients with ASD at a single tertiary care center. Muscle function was assessed via hand grip strength, gait speed, and the Timed Up and Go (TUG) test. Bioelectrical impedance analysis was used to determine the skeletal muscle index. Muscle imaging included both CT to determine the psoas muscle index and MRI to assess myosteatosis. Diagnostic thresholds for sarcopenia were taken from the Sarcopenia Definitions and Outcomes Consortium (SDOC) and European Working Group on Sarcopenia in Older People 2 (EWGSOP2) consensus guidelines. Frailty was assessed using the Edmonton Frail Scale (EFS) and the adult spinal deformity frailty index (ASD-FI). Fisher's exact test, Spearman's rank correlation, and UpSet plot analyses were used to compare sarcopenia rates between measurement methods. Correlations between sarcopenia measures and frailty scores were also tested. Between 2023 and 2024, 101 patients with ASD were evaluated for sarcopenia. The mean age was 66.0 years, and 66 patients (65.3%) were female. The percentage of patients meeting SDOC or EWGSOP2 cutoff criteria for sarcopenia based on grip strength, age-normalized grip strength, grip strength/BMI, gait speed, TUG test, or skeletal muscle index ranged from 0% to 74.2%. The distribution of patients meeting each criterion differed significantly for male and female patients (p < 0.0001 for both). Despite this, all functional and imaging-based measures of sarcopenia, except for gait speed, were significantly correlated with each other. Interestingly, many sarcopenic patients were not frail (69.8% per the EFS, 47.5% per the ASD-FI), but nearly all frail patients were sarcopenic (100% per the EFS, 82.2% per the ASD-FI). Sarcopenia measures were not significantly correlated with frailty scores with a few exceptions. The baseline prevalence of sarcopenia in patients with ASD varied widely according to the measurement method (0%-74.2%). Despite this, nearly all measures of sarcopenia were significantly correlated with each other. However, many sarcopenic patients were not frail, and sarcopenia measures largely did not correlate with frailty scores. These results highlight the need for a consensus criterion for sarcopenia in patients with spine disorders.

Relationship of handgrip strength, asymmetries, and calf circumference with functional capacity in individuals with intellectual disabilities: an age group analysis

BackgroundHandgrip strength (HGS) and calf circumference (CC) are key health markers associated with dynapenia and autonomy in the general population. However, their association with functional capacity in individuals with intellectual disabilities (ID) remains unclear. This study aimed to determine the relationship between absolute and relative HGS, upper-limb strength asymmetries, and CC with functional capacity in individuals with ID.MethodsA total of 102 individuals ([31 children: mean age = 9.58 years, SD:1.82]; [30 adolescents: mean age = 14.67 years, SD: 1.34]; [41 adults: mean age = 23.56 years, SD: 5.59]) with mild to moderate ID, from four special education schools in Santiago, Chile, were assessed. HGS and asymmetries were evaluated using dynamometry, while CC was measured anthropometrically. Functional capacity was assessed using the timed up and go (TUG), 5-repetition sit-to-stand (5R-STS), 4 × 10 m agility, and countermovement jump (CMJ) tests. Pearson, Spearman, and linear regression analyses, were applied to examine the relationships.ResultsThe mean values for absolute HGS, relative HGS, absolute asymmetry, percentage asymmetry, and CC were 20.71 kg, 0.35, 1.39 kg, 13.61%, and 33.89 cm, respectively. Functional test averages were 6.51 s (TUG), 10.46 s (5R-STS), 19.43 s (4 × 10 m agility), and 12.47 cm (CMJ). Significant correlations were found between absolute and relative HGS with all functional tests across age groups. Absolute HGS asymmetries correlated with some functional tests in children and adolescents, while percentage asymmetry and CC showed no associations. The very high age-group-specific correlations were TUG (r = -0.73; β = -0.34; R2 = 0.66) in children, agility 4 × 10 m test (r = -0.73; β = -0.26; R2 = 0.66) in adolescents, and CMJ (r = 0.71; β = 27.30; R2 = 0.71) in adults.ConclusionsAbsolute and relative HGS, as well as absolute asymmetries, are key predictors of functional capacity in individuals with ID. Implementing strength training interventions from an early school age is critical to preserving functional capacity in this population.Clinical trialNot applicable.

The relationship between sarcopenia, nutritional status, physical function, and quality of life in elderly cancer patients: a path analysis

ObjectiveThis study investigates the associations between sarcopenia and quality of life in elderly cancer patients, with nutritional status and physical function as potential mediators. It also explores the interactions among sarcopenia, nutritional status, and physical function.MethodsA cross-sectional study was conducted among 275 elderly cancer patients. Sarcopenia was assessed using the criteria of the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Nutritional status was evaluated using the Nutritional Risk Screening 2002 (NRS-2002) tool, along with serum albumin, prealbumin levels, and body mass index (BMI). Physical function was assessed using the 6-minute walk distance (6MWD), gait speed, and Timed Up and Go (TUG) test. All functional indicators were standardized into z-scores. Quality of life (QOL) was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Structural equation modeling (SEM) was used to analyze the relationships among sarcopenia, nutritional status, physical function, and QOL.ResultsMultivariate analysis indicated that sarcopenia, nutritional status, and physical function together explained 54% of the variance in quality of life. Path analysis showed significant associations through the following pathways: (1) Sarcopenia → Nutritional status → quality of life (22.0%); (2) Sarcopenia → Physical function → quality of life (17.07%); (3) Sarcopenia → Nutritional status → Physical function → quality of life (6.09%).ConclusionSarcopenia, nutritional status, and physical function are significantly associated with quality of life in elderly cancer patients. Physical function mediates the associations between both sarcopenia and nutritional status. Early detection and comprehensive interventions targeting sarcopenia, nutrition, and physical function are essential for improving patient outcomes. Future strategies should be individualized to address the complex needs of this population.Clinical trial numberNot applicable

The effects of dual-task training on inflammatory biomarkers, physical performance, fatigue, and quality of life in patients with multiple sclerosis.

The effects of dual-task training on inflammatory biomarkers, physical performance, fatigue, and quality of life in patients with multiple sclerosis.

Prevalence and clinical impact of alpha-synuclein pathology in idiopathic normal pressure hydrocephalus: Insights from RT-QuIC assay.

Prevalence and clinical impact of alpha-synuclein pathology in idiopathic normal pressure hydrocephalus: Insights from RT-QuIC assay.

Evaluation of the frequency of falls and risk factors in psoriatic arthritis and rheumatoid arthritis.

Evaluation of the frequency of falls and risk factors in psoriatic arthritis and rheumatoid arthritis.

Effectiveness of various exercise types in reducing fall risk among older adults with diabetic peripheral neuropathy: A systematic review and meta-analysis.

Effectiveness of various exercise types in reducing fall risk among older adults with diabetic peripheral neuropathy: A systematic review and meta-analysis.

A Single Preoperative Low Dose of Dexamethasone is Efficacious in Improving Early Postoperative Pain, Function, Nausea, and Vomiting After Primary Total Knee Arthroplasty: A randomized, Double-Blind, Placebo-Controlled Trial

A Single Preoperative Low Dose of Dexamethasone is Efficacious in Improving Early Postoperative Pain, Function, Nausea, and Vomiting After Primary Total Knee Arthroplasty: A randomized, Double-Blind, Placebo-Controlled Trial

Orthotics and Prosthesis Management in Nicolaides-Baraitser Syndrome

ABSTRACT Introduction The research aimed to increase the quality of life in this rare disease by including orthotic and prosthetic treatment approaches, which are not found in the literature, in the treatment protocol of a child with Nicolaides-Baraitser syndrome (NCBRS) diagnosis who has multiple congenital anomalies. In addition to the anomalies seen in different parts of the body of the patient with NCBR, there are deformities and anomalies in the limbs. It was planned to design and produce the most suitable prosthesis and orthosis for the child by making clinical prosthetic and orthotic evaluations. Method Orthoses were produced using two different methods: traditional fabrication and 3D printing. Functional and satisfaction outcomes were measured. Results The Pediatric Balance Scale scores were 36 with the polypropylene knee-ankle-foot orthosis (PP-KAFO) and 30 with the 3D-printed knee-ankle-foot orthosis (3D-KAFO). The timed up and go (TUG) scores were 24.7 seconds with the PP-KAFO and 23.5 seconds with the 3D-KAFO. Pediatric Reach Test results showed similar forward reach for both devices, with slight differences in lateral reach directions. Stride length and stride time increased, while cadence and walking speed decreased with the PP-KAFO compared with the 3D-KAFO. According to the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) survey, satisfaction levels ranged from “more or less satisfied” to “very satisfied,” with total satisfaction being equal for both KAFO conditions. Conclusions There is no difference between the 3D-printed orthosis and PP-KAFO in patient satisfaction with NCBRS in the functional tests. Clinical Relevance Orthoses produced with 3D printers can be used instead of orthoses produced using traditional methods. However, larger sample groups are needed.

Exercise rehabilitation with tailored support for exercise adherence for people with vertebral fragility fractures is more effective than standard rehabilitation: the OPTIN randomised controlled trial.

To investigate whether an exercise rehabilitation programme with integrated adherence support would be more effective than exercise alone. Two-arm, individually randomised controlled trial with concealed allocation, assessor blinding and intention to treat analysis. One hundred twenty-six people over 55 years with at least one vertebral fragility fracture and back pain; 63 per group. Both arms received progressive exercise rehabilitation including strength, posture and balance exercises. Additionally, the intervention arm received an integrated exercise adherence intervention that utilised a motivational interviewing approach, goal setting and ≥ 3 behaviour change techniques to support exercise behaviour. The primary outcome was the Timed-Up and Go (TUG) at 12 months. Secondary outcomes included quality of life (QUALEFFO-41), thoracic kyphosis, standing balance (functional reach: FR), muscle strength (timed loaded standing: TLS) and walking exercise capacity (6-min walk: 6MW). At 12 months, 57 intervention and 55 control participants were analysed. Clinically relevant, statistically significant gains were seen favouring the intervention group in TUG mean 10.1 (SE 0.38) seconds versus mean 12.9 s; effect size, 2.1 s; 95% CI, - 3.1 to - 1.0 s; p = 0.000) and 6MW mean 354.6 (SE 6.6) m versus control 325.7 (SE 6.9) m, effect size 24.5 m, 95% CI, 5.7 to 43.4 m, p = 0.011). There were no significant differences in the other outcome measures and no related adverse events. This RCT found integrated, additional support for exercise behaviour within a programme of physiotherapy rehabilitation for people with VFF provided greater benefits to lower extremity function, balance and walking at 12 months as measured by the TUG and 6MW tests.

Metabolomic Profiling Identifies Early Biomarkers of Frailty, Balance Impairment, and Fall Risks in Older Adults.

The global aging population poses significant challenges to healthcare, with frailty, balance impairment, and fall risks being prominent issues. However, the conventional clinical assessments often fail to detect early signs of these conditions. This study aimed to explore the potential of Metabolomics in early identification of biomarkers related to frailty, poor balance, and fall risks in older adults. We analyzed plasma samples from 110 participants aged 25 to 98 years using untargeted metabolomic analysis. Clinical assessments, including Instrumental Activities of Daily Living (IADL), Morse Fall Risk Scale, Timed Up and Go (TUG), Fried Frailty Criteria, etc., were performed. We examined the correlation between metabolomic results, aging-related blood tests, and clinical assessments. Statistical analysis and pathway analysis were used to identify key metabolic alterations. The metabolomics analysis identified 914 metabolites matching in the human metabolome database, with 293 metabolites significantly correlated with age. Metabolomic profiles showed distinct alterations in older adults, with significant metabolic changes observed in the Old-Old group, particularly in pathways related to Lipid Metabolism, Sphingolipid Signaling, and Fatty Acid Metabolism. A new age classification based on metabolic profiles revealed significant differences in frailty risks across groups, with metabolic signatures linked to poor balance and fall risks. Metabolomics offers a promising approach to identify early biomarkers of frailty, balance impairment, and fall risks in older adults. The integration of metabolic profiles with clinical assessments could lead to more precise and personalized healthcare interventions, improving fall prevention strategies and frailty management. Future studies with larger cohorts are needed to validate these findings and explore the clinical utility of Metabolomics in aging-related healthcare.

INTERCONNECTED HIP JOINT PARAMETERS, FUNCTIONAL MOBILITY, AND QUALITY OF LIFE IN PATIENTS WITH DEVELOPMENTAL DYSPLASIA OF THE HIP: A CROSS-SECTIONAL STUDY

Objective: This study aimed to determine the relationships between hip joint parameters, functional mobility, and quality of life in patients with DDH. Methods:This cross-sectional study involved 35 patients suffering from DDH. Functional mobility was measured with the timed up and go (TUG) test. Hip joint parameters were assessed for range of motion (ROM), abduction, and internal/external rotation. Quality of life was assessed via the Short Form-36 (SF-36) Health Survey. Pearson correlation analysis was conducted to establish variable relationships, considering a statistical significance of p &lt; 0.05. Results: A strong positive correlation, r = 0.683, p &lt; 0.01, was found between the right and left hip ROMs. Fixed flexion contracture was significantly associated with both fixed abduction (r = 0.592, p &lt; 0.01) and limb length discrepancy (r = 0.350, p &lt; 0.05). Avascular necrosis (AVN) showed a strong correlation with limb length discrepancy (r = 0.655, p &lt; 0.01). There was no significant relationship between sex and hip joint parameters (p &gt; 0.05). The average TUG test time was 14.65 seconds (SD = 2.98), indicating a moderate level of functional disability. Conclusions:This study revealed significant associations between hip joint parameters, mobility, and quality of life in DDH patients, emphasizing the need for early intervention. Key findings include bilateral hip symmetry, contracture-related limb discrepancies, and AVN impacts, highlighting the importance of multidisciplinary care to improve outcomes. Keywords:Developmental Dysplasia of the Hip, Functional Mobility, Quality of Life, Range of Motion, Avascular Necrosis, Limb Length Discrepancy, Public Health

Effectiveness of concentric and eccentric strengthening program on pain and functional performance in patellofemoral pain syndrome among sprinters – A pilot study

Background. Patellofemoral pain syndrome (PFPS) is a common musculoskeletal disorder that primarily affects athletes, particularly those who engage in repetitive knee flexion and extension. Collegiate sprinters are especially susceptible to PFPS because certain strokes, including the freestyle and breaststroke, demand repetitive lower-limb actions. The estimated prevalence of PFPS in elite athletes is 35.7%, 28.9% in adolescents, and 13.5% in the military. PFPS affects individuals across various age groups, with a general population prevalence rate of 23%. Muscle imbalances surrounding the knee joint, especially weakness of the quadriceps muscles, which are essential for patellar stabilization, are frequently linked to PFPS. Strengthening exercises can be broadly divided into concentric and eccentric modalities, although different rehabilitation strategies may be applied. This study aims to compare the influence of concentric and eccentric strengthening programs on pain levels and functional performance in collegiate sprinters diagnosed with PFPS. Objective. To compare the effectiveness of changes in functional performance and pain following both concentric and eccentric exercises in PFPS among collegiate sprinters. Materials and methods. A total of 24 participants were allocated into two groups using a convenient sampling method: group A (n = 12) and group B (n = 12). Group A received concentric exercise, while group B underwent eccentric exercise for three weeks. Materials required included a chair, stopwatch, clear floor space, and measuring tape to ensure accurate assessment and execution of exercises. Outcome measures included the Numeric Pain Rating Scale (NPRS) to assess pain levels and the Timed Up and Go (TUG) test to evaluate functional mobility and balance. Results. Statistical analysis of the quantitative data showed no statistically significant difference between group A and group B, with a p-value of &lt; 0.0001. Both groups demonstrated considerable improvement post-intervention in pain and functional performance; however, no significant difference was found between the groups. Therefore, both concentric and eccentric strengthening programs appear equally effective in managing patellofemoral pain syndrome among collegiate sprinters. Conclusions. According to this study's findings, concentric exercises with therapeutic ultrasound (group A) and eccentric exercises with therapeutic ultrasound (group B) are similar in effectiveness in lowering pain and improving functional performance in collegiate sprinters with patellofemoral pain syndrome.

Comparative effects of sensory motor and virtual reality interventions to improve gait, balance and quality of life MS patients

Multiple sclerosis (MS) is a neurological disorder that affects the central nervous system, causing inflammation and damage to the myelin sheath, leading to balance and gait impairments. Sensory-motor (SN) and virtual reality (VR) interventions have shown promise in addressing these balance issues by engaging all three components of the balance control systems. This study aimed to compare the effectiveness of sensory-motor and virtual reality training on the functional status and quality of life of MS patients. In this study, 36 MS patients receiving Rituximab therapy with an Expanded Disability Status Scale (EDSS) of 2 to 6 were randomly assigned to three groups: SN (n = 10), VR (n = 8), and a control group (n = 10). The SN and VR groups underwent 8 weeks of intervention, with 3 sessions per week, while the control group continued routine care. Assessments using the Timed Up and Go (TUG) test, the Timed 25-Foot Walk (T25FW) test, the Multiple Sclerosis Quality of Life 54 Instrument (MSQOL54), and the Pittsburgh Sleep Quality Index (PSQI) were conducted at baseline and after 8 weeks. Significant within-group improvements were observed in both SN and VR groups for primary outcomes, including the T25FW (P = 0.002 for SN; P = 0.001 for VR) and TUG (P = 0.005 for SN; P = 0.001 for VR), as well as secondary outcomes such as overall (P < 0.001 for both), physical (P < 0.001 for both), and mental (P < 0.001 for both) MSQOL-54 components, and PSQI (P < 0.001 for SN; P = 0.046 for VR). However, no significant differences emerged between SN and VR groups for primary outcomes, except for PSQI, which favored SN (P = 0.02). Compared to the control group, the SN group demonstrated significant improvements in primary outcomes—T25FW (P < 0.001) and TUG (P = 0.01)—and secondary outcomes, including overall (P < 0.001), physical (P < 0.001), and mental (P = 0.002) MSQOL-54 components, and PSQI (P = 0.007). Similarly, compared to the control group, the VR group demonstrated significant improvements in the T25FW (P = 0.02) and TUG (P = 0.05) tests, as well as in secondary outcomes, including overall (P = 0.005), physical (P = 0.003), and mental (P = 0.01) MSQOL-54 components. However, no significant improvement in PSQI was observed (P = 0.9). This study highlights the significant transformative potential of integrating VR and SN interventions as innovative therapeutic modalities for addressing critical motor impairments, specifically balance and gait, in individuals with MS. By employing task-oriented paradigms, dual-task methodologies, and multisensory frameworks, these interventions not only yield substantial improvements in functional mobility and quality of life but also represent a groundbreaking synthesis of immersive, technology-driven motivation with the pragmatic adaptability of evidence-based SN techniques. Further longitudinal investigations are warranted to delineate their sustained effects, refine their application in broader MS populations, and assess their scalability to establish patient-centered, cost-effective, and outcome-driven neurorehabilitation models.

Effect of telemedicine-supported structured exercise program in patients with chronic low back pain: a randomized controlled trial

BackgroundStructured exercise programs delivered via telemedicine have the potential to benefit patients with chronic low back pain (CLBP). However, evidence-practice gaps exist, such as low exercise adherence and lack of attention to the mental health of CLBP, so further research is needed to investigate the impact of telemedicine-supported structured exercise program on patients with CLBP.ObjectivesTo compare the clinical outcomes of patients with CLBP following a telemedicine intervention versus usual care therapy.Materials and methodsAn open label, randomized controlled trial (RCT) was conducted over eight weekly sessions. Participants with CLBP were randomly assigned to either the Experimental Group (EG) or the Control Group (CG) in a 1:1 ratio, using a randomized numeric table. The EG received an intervention consisting of patient education, health coaching, and structured exercise program delivered through mobile health (mHealth) apps. The CG received usual care therapy, including patient education and paper handouts describing home exercises. The outcome measures included disability, pain intensity, mental health status, quality of life, walking ability, and exercise adherence. These were evaluated using the Roland Morris Disability Questionnaire (RMDQ), the Numerical Rating Scale (NRS), Depression-Anxiety-Stress Scale (DASS21), 12-item Short Form Health Survey (SF-12), Time Up and Go (TUG), and Exercise Adherence Rating Scale (EARS), respectively. Linear mixed-effects model analysis was conducted at baseline, after 4 weeks (during treatment), and after 8 weeks (post-treatment), adhering to the principles of intention-to-treat (ITT) analysis.ResultsThe study included a total of 78 participants, with 39 randomly assigned to each group. Changes were significantly different between groups at 8 weeks in disability (estimated value: −3.96, 95% CI: −5.45 to −2.47, P < 0.001), pain (estimated value: −1.69, 95% CI: −2.14 to −1.24, P < 0.001) and the physical health dimensions of quality of life (estimated value: 4.5, 95% CI: 1.29 to 7.71, P = 0.006). However, there were only within-group differences at 8 weeks in mental health status (estimated value: −3.81, 95% CI: −4.99 to −2.63, P < 0.001), mental health dimensions of quality of life (estimated value: 5.01, 95% CI: 2.9 to 7.13, P < 0.001), walking ability (estimated value: −0.92, 95% CI: −1.17 to −0.68, P < 0.001), and exercise adherence (Z: 1.91, P = 0.06) over time.ConclusionThis study suggests that a telemedicine-based structured exercise program is more effective than usual care therapy in improving disability, pain, and physical health dimensions of quality of life in patients with CLBP. Furthermore, the telemedicine program is equally effective as usual care therapy in enhancing mental health status, mental health dimensions of quality of life, walking ability, and exercise adherence. These findings indicate that implementing such a program could reduce the burden on patients with CLBP.Trial registrationThis trial was registered at China Clinical Trial Registration Center with the identifier ChiCTR2300071560.