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Recent Advances in Exercise-Based Rehabilitation
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Recent Advances in Exercise-Based Rehabilitation

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Biomedical Engineering".

Deadline for manuscript submissions: 10 July 2025 | Viewed by 17512

Special Issue Editors

Prof. Dr. Elias Tsepis

E-Mail Website
Guest Editor
Physiotherapy Department, School of Health Rehabilitation Sciences, University of Patras, 26504 Rio, Greece
Interests: exercise prescription; prevention; biomechanics; physiotherapy assessment methods
Dr. Maria Tsekoura

E-Mail Website
Guest Editor
Physiotherapy Department, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
Interests: exercise science; movement analysis; sarcopenia; geriatric assessmen; musculoskeletal rehabilitation

Special Issue Information

Dear Colleagues,

Physical exercise has evolved from its traditional domain of sports performance enhancement and health promotion into a keystone method for preventive and therapeutic purposes across various pathological conditions. Increasing evidence supports exercise-based rehabilitation (EBR) for acute and chronic injuries, as well as pathologies beyond the traditional musculoskeletal, neurological, and cardiorespiratory focus. Those include cancer, hemodialysis, gynecology, gerontology, mental health, etc. Sophisticated exercise programs keep evolving in light of recent scientific advances and technological novelties, with new methods and equipment being introduced for physical performance monitoring and enhancement. Those novel means and methods comprise the context of the current Special Issue addressed to the modern multidisciplinary rehabilitation team.

Prof. Dr. Elias Tsepis
Dr. Maria Tsekoura
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • exercise therapy
  • therapeutic exercise
  • kinesiotherapy
  • tele-rehab
  • rehabilitation technology

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Published Papers (7 papers)

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Research

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18 pages, 5123 KiB  
Article
MScope: A Reliable Battery for Functional Status Assessment in Multiple Sclerosis
by Daniel Lisardo, Susana López-Ortiz, Irati Jauregui-Fajardo, José Pinto-Fraga, Celia García-Chico, Alba Chavarría-Miranda, Nieves Téllez and Sergio Maroto-Izquierdo
Appl. Sci. 2025, 15(1), 11; https://doi.org/10.3390/app15010011 - 24 Dec 2024
Viewed by 957
Abstract
Multiple sclerosis (MS) is a neurodegenerative disease that often leads to severe disability. Although exercise, particularly strength training, improves health outcomes in MS, no standardized, reliable tool exists for functional assessment to inform tailored exercise prescriptions and patients’ categorization. This study aimed to [...] Read more.
Multiple sclerosis (MS) is a neurodegenerative disease that often leads to severe disability. Although exercise, particularly strength training, improves health outcomes in MS, no standardized, reliable tool exists for functional assessment to inform tailored exercise prescriptions and patients’ categorization. This study aimed to validate the reliability of the MScope battery, a comprehensive tool incorporating structural, functional, and neuromuscular assessments to objectively evaluate patients with MS. A reproducibility study was conducted with 40 MS patients who completed the MScope battery twice, 72 h apart. Tests included structural (muscle thickness of the vastus lateralis and rectus femoris), functional (sit-to-stand, timed up-and-go, 10 m and six-minute walking test), and neuromuscular tests (isometric strength during the squat and leg extension exercises and handgrip strength). Intraclass correlation coefficients (ICCs), Bland–Altman plots, and the coefficient of variation (CV) were used to evaluate intra- and inter-day reliability. The MScope battery showed high intra- and inter-day reliability, with ICC values ranging from 0.79 to 0.99. Muscle thickness measurements, along with handgrip strength, demonstrated excellent reliability (ICC > 0.9, CV < 5%). Functional tests, including the timed up-and-go, 10 m walk, and sit-to-stand variations, maintained consistent scores (ICC > 0.85, CV < 10%). The six-minute walking test exhibited excellent inter-day reliability (ICC = 0.94, CV < 4%). Neuromuscular assessments showed strong reliability with minor day-to-day variability (ICC = 0.75–0.95, CV < 8%). The battery’s overall consistency supports its use as a reliable tool for assessing functional status in MS patients. Full article
(This article belongs to the Special Issue Recent Advances in Exercise-Based Rehabilitation)
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15 pages, 582 KiB  
Article
Barriers and Facilitators for Therapeutic Green Exercise in Patients with Chronic Conditions: A Qualitative Focus Group Study
by Aristi Tsokani, Theodoros Dimopoulos, Evangelos Vourazanis, Nikolaos Strimpakos, Evdokia Billis, Garyfallia Pepera and Eleni Kapreli
Appl. Sci. 2023, 13(18), 10077; https://doi.org/10.3390/app131810077 - 7 Sep 2023
Cited by 2 | Viewed by 2964
Abstract
Background: Exercise has indisputable advantages for people with chronic conditions. Engaging in physical activity within natural environments, known as green exercise, contributes to both physical and mental well-being. The aim of this study was to investigate the perceptions of people with chronic conditions [...] Read more.
Background: Exercise has indisputable advantages for people with chronic conditions. Engaging in physical activity within natural environments, known as green exercise, contributes to both physical and mental well-being. The aim of this study was to investigate the perceptions of people with chronic conditions and health professionals and the perceived facilitators and barriers to therapeutic green exercise. Methods: This was a qualitative study based on two focus groups. Ethical approval was received, and a thematic analysis was used to analyze the discussions. Results: Seven patients and eight health professionals participated in the study. The thematic analysis yielded thirteen main themes. Safety concerns and inadequate infrastructures were key barriers. Core facilitators were socialization, and multisensory exposure. Conclusions: Patients with chronic conditions and health professionals believe that green exercise improves physical activity engagement, and it would be beneficial if incorporated in the rehabilitation process. There are challenges to overcome to make therapeutic green exercise for people with chronic conditions more accessible. Full article
(This article belongs to the Special Issue Recent Advances in Exercise-Based Rehabilitation)
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18 pages, 913 KiB  
Article
Impact of Exercise Guidance Timing on Physical and Cognitive Function in Older Adults: A Pilot Study
by Sofia Lampropoulou, Anthi Kellari and Vasiliki Sakellari
Appl. Sci. 2023, 13(17), 9526; https://doi.org/10.3390/app13179526 - 23 Aug 2023
Viewed by 1667
Abstract
Guidance through an exercise program improves balance and gait in older adults, but the efficacy of the timing these are given is unclear. The objective of this study is to evaluate the effects of guidance delivery time on balance, gait, falls, and cognitive [...] Read more.
Guidance through an exercise program improves balance and gait in older adults, but the efficacy of the timing these are given is unclear. The objective of this study is to evaluate the effects of guidance delivery time on balance, gait, falls, and cognitive functions. In a single (participants)-blinded clinical trial, a convenient sample of 24 older adults (aged 74 ± 6 years) were separated in two age-matched groups, both of which received a progressive 12-week Otago Exercise Program (OEP) for strength and balance. Group 1 received visual and verbal guidance before the performance of each of the exercises, while group 2 received the visual and verbal guidance only synchronously with the exercises. Balance, gait, fear of falling, and cognitive function were evaluated at baseline, week 6, and week 12 of the program. Fall incidence and exercise adherence were also documented. Significant improvements (p < 0.05) were revealed in all assessed variables post intervention, regardless of the guidance delivery time. Only the mental function and the adherence to the exercise tended to be better when the guidance was given in advance of the exercise execution, but further studies of a bigger sample size and with a control group should be conducted before safe conclusions are extracted. Full article
(This article belongs to the Special Issue Recent Advances in Exercise-Based Rehabilitation)
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Review

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28 pages, 1543 KiB  
Review
The Current State of Virtual Reality in the Management of Musculoskeletal Conditions and Associated Chronic Pain: Terminology, Technology, and Associations
by Manca Opara Zupančič and Nejc Šarabon
Appl. Sci. 2025, 15(5), 2564; https://doi.org/10.3390/app15052564 - 27 Feb 2025
Viewed by 508
Abstract
Virtual reality (VR) demonstrates significant potential to improve rehabilitation outcomes for musculoskeletal conditions and associated chronic pain. However, the field faces notable challenges, including inconsistent terminology, a lack of specialized/comprehensive software solutions, and an overwhelming variety of hardware options, which can make it [...] Read more.
Virtual reality (VR) demonstrates significant potential to improve rehabilitation outcomes for musculoskeletal conditions and associated chronic pain. However, the field faces notable challenges, including inconsistent terminology, a lack of specialized/comprehensive software solutions, and an overwhelming variety of hardware options, which can make it difficult for healthcare professionals without technical expertise to identify the most suitable tools for clinical use. This article explores the current state of VR in the rehabilitation of musculoskeletal conditions and chronic pain, focusing on terminology discrepancies, available hardware and software solutions, and key professional associations shaping the field. A review of the current state of terminology is essential to address inconsistencies that risk perpetuating misuse and to facilitate clearer communication. Building on this review, we propose a conceptual framework for understanding VR that aligns more closely with the capabilities of current VR technology. A comprehensive overview of VR hardware and software can assist healthcare professionals in selecting appropriate technologies for clinical practice, guide researchers in designing interventions, and inform developers on unmet needs in the field. Furthermore, understanding key professional associations provides valuable direction for those engaged in virtual rehabilitation, enabling them to access resources, foster collaboration, and stay informed about the latest advancements in the domain. This review addresses the significant confusion regarding the understanding of VR, particularly in relation to its classification based on levels of immersion. Accordingly, it proposes a framework that contributes to a standardized approach to understanding VR. Additionally, it highlights the lack of VR solutions tailored to the needs of patients with musculoskeletal conditions and associated chronic pain, emphasizing the necessity for further development in this area. Full article
(This article belongs to the Special Issue Recent Advances in Exercise-Based Rehabilitation)
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24 pages, 689 KiB  
Review
Effects of Physical Exercise on Substance Use Disorder: A Comprehensive Review
by Roberto Montón-Martínez, Ismael Castellano-Galvañ, Alba Roldán, Alejandro Javaloyes, Iván Peña-González, José Manuel Sarabia, Diego Pastor and Manuel Moya-Ramón
Appl. Sci. 2025, 15(3), 1481; https://doi.org/10.3390/app15031481 - 31 Jan 2025
Viewed by 967
Abstract
Physical exercise has emerged as a promising complementary intervention for individuals with substance use disorders (SUD). This comprehensive review examines the neurobiological, psychological, and social benefits of exercise in improving quality of life (QOL), mental health, sleep quality, craving, physical fitness, and cognitive [...] Read more.
Physical exercise has emerged as a promising complementary intervention for individuals with substance use disorders (SUD). This comprehensive review examines the neurobiological, psychological, and social benefits of exercise in improving quality of life (QOL), mental health, sleep quality, craving, physical fitness, and cognitive function among individuals with SUD. Aerobic exercises, particularly those of moderate intensity, demonstrate a consistent efficacy in reducing anxiety, depression, and cravings, while also enhancing cardiovascular health and psychosocial well-being. Strength training and concurrent programs provide additional benefits for muscular and cognitive function, although their effects on mental health are less consistent. Mind–body disciplines like yoga and Tai Chi offer accessible entry points for individuals with low baseline fitness but exhibit variable outcomes, especially in sleep and craving management. High-intensity interval training (HIIT) shows potential for craving reduction and cardiovascular improvements but may pose challenges for individuals with low initial fitness. This review underscores the importance of tailored, well-structured programs that align with participants’ needs and capabilities. Future research should prioritize standardizing protocols, incorporating technological tools, and exploring hybrid intervention models to maximize adherence and therapeutic impact. Physical exercise remains a vital, multifaceted tool in comprehensive SUD rehabilitation strategies. Full article
(This article belongs to the Special Issue Recent Advances in Exercise-Based Rehabilitation)
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30 pages, 1105 KiB  
Review
A Strong Core for a Strong Recovery: A Scoping Review of Methods to Improve Trunk Control and Core Stability of People with Different Neurological Conditions
by Giorgia Marchesi, Greta Arena, Alice Parey, Alice De Luca, Maura Casadio, Camilla Pierella and Valentina Squeri
Appl. Sci. 2024, 14(11), 4889; https://doi.org/10.3390/app14114889 - 5 Jun 2024
Cited by 2 | Viewed by 4021
Abstract
Objective: The purpose of this scoping review is to provide valuable insights for clinicians and researchers for designing rehabilitative interventions targeting the trunk and core for individuals who have experienced traumatic events, such as stroke or spinal cord injury, or are grappling with [...] Read more.
Objective: The purpose of this scoping review is to provide valuable insights for clinicians and researchers for designing rehabilitative interventions targeting the trunk and core for individuals who have experienced traumatic events, such as stroke or spinal cord injury, or are grappling with neurological diseases such as multiple sclerosis and Parkinson’s disease. We investigated training methods used to enhance balance, trunk control, and core stability. Methods: We conducted an extensive literature search across several electronic databases, including Web of Science, PubMed, SCOPUS, Google Scholar, and IEEE Xplore. Results: A total of 109 articles met the inclusion criteria and were included in this review. The results shed light on the diversity of rehabilitation methods that target the trunk and core. These methods have demonstrated effectiveness in improving various outcomes, including balance, trunk control, gait, the management of trunk muscles, overall independence, and individuals’ quality of life. Conclusions: Our scoping review provides an overview on the methods and technologies employed in trunk rehabilitation and core strengthening, offering insights into the added value of core training and specific robotic training, focusing on the importance of different types of feedback to enhance training effectiveness. Full article
(This article belongs to the Special Issue Recent Advances in Exercise-Based Rehabilitation)
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Other

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22 pages, 738 KiB  
Systematic Review
The Effectiveness of Pelvic Floor Muscle Exercise with Biofeedback in Women with Urinary Incontinence: A Systematic Review
by Aikaterini Evangelia Matsi, Evdokia Billis, Sofia Lampropoulou, Sofia A. Xergia, Maria Tsekoura and Konstantinos Fousekis
Appl. Sci. 2023, 13(23), 12743; https://doi.org/10.3390/app132312743 - 28 Nov 2023
Viewed by 5149
Abstract
Urinary incontinence affects approximately 200 million people worldwide. The objective of this study was to investigate the effect of pelvic floor muscle (PFM) training with biofeedback (BF) in women with urinary incontinence in comparison to PFM training alone. The primary outcome was PFM [...] Read more.
Urinary incontinence affects approximately 200 million people worldwide. The objective of this study was to investigate the effect of pelvic floor muscle (PFM) training with biofeedback (BF) in women with urinary incontinence in comparison to PFM training alone. The primary outcome was PFM strength with secondary outcomes being the severity of incontinence, other PFM parameters, quality of life (QoL), social life, satisfaction and adherence to treatment. Randomized controlled trials (RCTs) published from 2005 to 2023 in PubMed, MEDLINE, Scopus and Google Scholar were searched and evaluated with the PEDro scale. Nine moderate and two high methodological quality RCTs were selected. There was a statistically significant improvement in all parameters. In five studies, muscle strength and the severity of incontinence were statistically better in the BF group compared to the non-BF group. In most studies, no differences were found for QoL and social life between the groups. For adherence to treatment, the results were ambiguous. Τhe remaining variables (endurance, precontraction, function, adherence and satisfaction) had few studies to support the results. There was moderate level evidence that the group utilizing PFM exercises with BF showed significant improvements in the management of urinary incontinence. Concerning muscle strength and the severity of incontinence, findings were inconclusive, as only in some studies the results were statistically better in the BF group compared to the non-BF group. Full article
(This article belongs to the Special Issue Recent Advances in Exercise-Based Rehabilitation)
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