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Innovations in Chronic Patient Management: Monitoring, Evaluation and Rehabilitation

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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Chronic Care".

Deadline for manuscript submissions: closed (15 December 2025) | Viewed by 20064

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Special Issue Editors

Prof. Dr. Araceli Ortiz-Rubio

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Guest Editor

Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
Interests: activity; chronic diseases; neurology; neurodegenerative; occupation; participation; rehabilitation
Special Issues, Collections and Topics in MDPI journals

Dr. Alejandro Heredia-Ciuro

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Guest Editor

Physiotherapy Department, University of Granada, Avenida de la Ilustración, 60, 18016 Granada, Spain
Interests: respiratory diseases; cancer; rehabilitation; physical therapy; exercise; physical activity
Special Issues, Collections and Topics in MDPI journals

Dr. Andrés Calvache-Mateo

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Guest Editor

Physiotherapy Department, Health Sciences Faculty, University of Granada, Granada 18016, Spain
Interests: COVID-19; respiratory disease; physical activity; chronic diseases; physical therapy; rehabilitation

Special Issue Information

Dear Colleagues,

In the healthcare field, the management of chronic patients is a growing concern due to the increase in chronic diseases worldwide. Monitoring plays a key role, with the advent of advanced medical devices and mobile applications that enable real-time tracking of patients' conditions, facilitating early detection of problems and personalized care. Chronic patient assessment has benefited from advances in artificial intelligence and data analytics, allowing for more accurate and predictive assessment of disease progression and response to treatment. In addition, rehabilitation has evolved with innovative therapies, such as tele-rehabilitation and virtual reality, which make recovery more effective and accessible.

This Special Issue aims to collect the latest innovations that are revolutionizing the way these patients are managed. It brings together research and case studies that highlight these innovations and their impact on chronic patients' quality of life. From early detection to effective rehabilitation, emerging technologies and approaches are transforming the way healthcare professionals approach chronic disease. This compilation of knowledge promises to enrich clinical practice and improve the management of chronic patients worldwide.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but not limited to) interventions, evaluations, or monitoring for the management of chronic patients.

I/We look forward to receiving your contributions.

Prof. Dr. Araceli Ortiz-Rubio
Dr. Alejandro Heredia-Ciuro
Dr. Andrés Calvache-Mateo
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 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 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

chronic disease
chronic patient management
rehabilitation
monitoring
evaluation
healthcare

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Published Papers (7 papers)

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13 pages, 260 KB

Open AccessArticle

Psychometric Properties of the Spanish Version of the Swallowing Quality of Life Questionnaire in Fibromyalgia Patients

by Irene Calles-Plata, Araceli Ortiz-Rubio, Laura Pérez-Gisbert, Irene Torres-Sánchez, Andrés Calvache Mateo, Marie Carmen Valenza and Alejandro Heredia-Ciuró

Healthcare 2025, 13(22), 2948; https://doi.org/10.3390/healthcare13222948 - 17 Nov 2025

Viewed by 642

Abstract

Background and Purpose: The Swallowing Quality of Life Questionnaire (SWAL-QoL) is recognized as the gold-standard instrument for assessing the impact of dysphagia on health-related quality of life (HRQoL). However, a validated Spanish version is currently unavailable. Therefore, the aim of this study was to evaluate the psychometric properties of the Spanish adaptation of the SWAL-QoL (SSWAL-QoL) in fibromyalgia patients. Materials and Methods: A cross-sectional study was completed. Participants completed the SSWAL-QoL, the Spanish version of Hospital Anxiety and Depression Scale (HADS), the Spanish version of Short Form12 (SF12), the Spanish version of EQ-5D-3L, and the Spanish version of the Impact Fibromyalgia Questionnaire (FIQ). Construct validity, evaluated through Exploratory Factor Analysis and correlations with related measures, and reliability, estimated via internal consistency, were found to be adequate for the SSWAL-QoL. Results: The results indicated that the psychometric properties of the SSWAL-QoL are adequate and comparable to those of the original instrument. The result of Bartlett’s test of sphericity was 970.573 (df = 55, p < 0.001), and the value of the Kaiser–Meyer–Olkin (KMO) measure of sampling adequacy was 0.857. A total of two factors could be extracted. The reliability was high for the total subscales of the SSWAL-QoL. Differences were found between groups in all included outcomes. Conclusions: The SSWAL-QoL demonstrates satisfactory psychometric properties for its use in a Spanish-speaking population with fibromyalgia. As the first validation of this instrument in this specific population, it provides clinicians and researchers with a reliable and valid tool to assess the impact of dysphagia on HRQoL. Full article

(This article belongs to the Special Issue Innovations in Chronic Patient Management: Monitoring, Evaluation and Rehabilitation)

10 pages, 213 KB

Open AccessArticle

Type 2 Diabetes Mellitus and Obstructive Sleep Apnoea Syndrome in the Elderly

by Lucía Ortega-Donaire, Sebastián Sanz-Martos, María Fernández-Martínez, Cristina Fernández-Martínez and Ganna Ovsyeyenko

Healthcare 2025, 13(11), 1266; https://doi.org/10.3390/healthcare13111266 - 27 May 2025

Cited by 1 | Viewed by 2271

Abstract

Introduction: Older people with sleep disturbances also have other chronic pathologies that may interfere with these disturbances. One of the comorbidities that is frequently present is type 2 diabetes. Objective: This research aims to find out whether type 2 diabetes mellitus present in elderly people affects the level of severity of obstructive sleep apnoea syndrome (OSAS). Methodology: A cross-sectional descriptive study was carried out on a sample of 134 elderly people who attended the Sleep Unit of Andalusia’s Door Hospital in Jaen, who were diagnosed with OSAS and classified according to severity. A total of 34 participants had a diagnosis of diabetes mellitus at the time of the study. Results: There were significant differences in the severity of obstructive sleep apnoea syndrome between participants with and without type 2 diabetes mellitus, with the former having higher scores (p < 0.01). Participants with a BMI that classified them as obese had more severe apnoea than those with a normal weight at the time of the study (p = 0.043). Discussion: This study, focused exclusively on older adults, demonstrates an association between type 2 diabetes mellitus and a greater severity of OSAS. Using polysomnography (PSG) as the gold standard, we identified a significant relationship between obesity and severe OSAS. Furthermore, the connection between OSAS, type 2 diabetes mellitus, and CPAP use highlights the importance of a comprehensive approach in this population. Full article

(This article belongs to the Special Issue Innovations in Chronic Patient Management: Monitoring, Evaluation and Rehabilitation)

11 pages, 599 KB

Open AccessArticle

Assessment of Muscular Strength and Functional Capacity in Smoker Population Without Any Diagnosed Respiratory Disease: A Cross-Sectional Study

by Christophe Thibon, Gilles Caty, Sophie Gohy, Frank Aboubakar Nana and Gregory Reychler

Healthcare 2025, 13(5), 493; https://doi.org/10.3390/healthcare13050493 - 24 Feb 2025

Cited by 1 | Viewed by 2281

Abstract

Introduction: Smoking is a risk factor for chronic obstructive pulmonary disease (COPD) and lung cancer. In addition to pulmonary damages, peripheral muscle impairments are present in this population. Pulmonary limitation is observed in smokers before disease diagnosis, but functional capacity limitations are uncertain, contrary to patients who have already been diagnosed. The aim of this study was to compare muscular strength and endurance between non-smoker and smoker populations without any diagnosed respiratory disease. Method: This cross-sectional study assessed subjects without diagnosed respiratory disease in terms of physical capacity using two tests (one-minute sit-to-stand test (STST) and Jamar dynamometer test (JDT)). Results: The sample consisted of 147 subjects. The number of repetitions and the muscle strength were lower in the smoker than in the non-smoker population (28.5 ± 8.7 vs. 33.5 ± 8.2 (p < 0.001), and 38.2 ± 10.1 vs. 42.4 ± 10.5 (p = 0.04), respectively). The relative change in heart rate during STST was lower in the smokers compared to the non-smokers (p = 0.01). No significant differences were found based on gender. Conclusions: Smokers without alcohol or drug dependence and without diagnosed lung disease exhibit non-clinically but statistically reduced muscular strength and endurance. Their heart rate response to exercise is also reduced. Full article

(This article belongs to the Special Issue Innovations in Chronic Patient Management: Monitoring, Evaluation and Rehabilitation)

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14 pages, 645 KB

Open AccessArticle

Severity Matters: How COVID-19 Severity Impacts Long-Term Effects on Symptoms, Physical Activity and Functionality—An Observational Study

by Laura Pérez-Gisbert, Concepción Morales-García, José Antonio Sánchez-Martínez, María Victoria González-Gutiérrez, Marie Carmen Valenza and Irene Torres-Sánchez

Healthcare 2025, 13(3), 333; https://doi.org/10.3390/healthcare13030333 - 6 Feb 2025

Cited by 4 | Viewed by 2296

Abstract

Background/Objectives: The existing literature has described the common symptoms and long-term effects of coronavirus disease (COVID-19). However, there is a lack of detailed information on how different degrees of disease severity affect survivors differently. This study aims to fill that gap by evaluating the symptoms, physical activity, and functionality of COVID-19 survivors across a spectrum of severity levels, comparing them with those of healthy individuals. Methods: An observational study was carried out following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria and checklist. Participants were divided into 5 groups based on COVID-19 severity according to the World Health Organization classification: healthy (COVID-19-negative), mild (symptomatic without pneumonia or dyspnoea), moderate (pneumonia and dyspnoea without hospitalisation), severe (severe pneumonia requiring hospitalisation), and critical (severe pneumonia with admission to the intensive care unit). Descriptive variables, symptoms (Fatigue Borg Scale, Fatigue Impact Scale, Fatigue Severity Scale, Dyspnoea Borg Scale, Visual Analogue Scale, Hospital Anxiety and Depression Scale, and European Quality of Life-5 Dimensions), physical activity (the International Physical Activity Questionnaire) and functionality (Patient-Specific Functional Scale, Short Physical Performance Battery, Arm Curl test, and 2 min step test) were measured. Results: A total of 304 participants were included: healthy (n = 42), mild (n = 143), moderate (n = 49), severe (n = 52), and critical (n = 18) COVID-19 patients. The impact of COVID-19 on surviving patients varies significantly with the severity of the disease. The results show that the hospitalisation time, age, and comorbidities of the patients are greater in those with a greater severity of the disease. Patients with more severe COVID-19 also experience greater frailty, dysphagia, fatigue, dyspnoea, and pain. Additionally, those with severe cases have poorer overall health, reduced physical activity, and diminished functionality. No evidence of post-COVID-19 anxiety or depression is found in the sample, even considering the timeframe between the negative test and the assessment. Conclusions: Patients with higher COVID-19 severity (severe or critical) experience more symptoms than those with lower COVID-19 severity (mild or moderate). Additionally, those with severe cases have poorer overall health, reduced physical activity and diminished functionality. Register: Clinicaltrials.gov: NCT05731817. Full article

(This article belongs to the Special Issue Innovations in Chronic Patient Management: Monitoring, Evaluation and Rehabilitation)

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23 pages, 1252 KB

Open AccessProtocol

Feasibility of “DiverAcción”: A Web-Based Telerehabilitation System for Executive Functions Training in Children and Adolescents with ADHD—Longitudinal Study Protocol

by Marina Rivas-García, Carmen Vidal-Ramírez, Abel Toledano-González, María del Carmen Rodríguez-Martínez, Esther Molina-Torres, José-Antonio Marín-Marín, José-Matías Triviño-Juárez, Miguel Gea-Mejías and Dulce Romero-Ayuso

Healthcare 2026, 14(3), 323; https://doi.org/10.3390/healthcare14030323 - 27 Jan 2026

Viewed by 1164

Abstract

Background: Attention Deficit Hyperactivity Disorder (ADHD) is associated with executive function deficits—such as planning, organization, and prospective memory—that impair autonomy and daily functioning, increase family stress, and create challenges in educational contexts. These consequences underscore the need for accessible and ecologically valid interventions addressing the cognitive, familial, and educational dimensions. Traditional approaches often lack ecological validity, and pharmacological treatment shows a limited impact on functional cognition. Objectives: This protocol outlines a feasibility study of DiverAcción, a web-based telerehabilitation system designed to enhance functional cognition through interactive and gamified tasks integrated into a comprehensive healthcare programme. Methods: A quasi-experimental feasibility study before and after the study will recruit 30 participants aged 9 to 17 years with ADHD. The study comprises an initial face-to-face session for instructions and baseline assessment (T0), followed by twelve supervised online sessions over six weeks. Therapeutic support is provided via integrated chat, email, and two scheduled videoconference check-ins. Feasibility Outcomes: include recruitment, adherence, retention, usability (SUS), acceptability (TAM), satisfaction, user-friendly design, therapeutic alliance (WAI-I), and professionals’ attitudes toward technology (e-TAP-T). Exploratory Measures: include parental self-efficacy (BPSES), parenting stress (PSI-4-SF), ADHD symptomatology (SNAP-IV), executive functioning (BRIEF-2), time management (Time-S), emotional regulation (ERQ-CA), prospective memory (PRMQ-C), and health-related quality of life (KIDSCREEN-52). Analyses emphasize descriptive statistics for feasibility metrics (recruitment, adherence, retention, dropout and fidelity). Assessments are conducted post-intervention (T1) and at three-month follow-up (T2) and analyzed relative to baseline using repeated-measures ANOVA or Friedman tests, depending on data distribution. Conclusions: This feasibility protocol will provide preliminary evidence on the usability, acceptability, and implementation of DiverAcción. Findings will guide refinements and inform the design of a subsequent randomized controlled trial. Full article

(This article belongs to the Special Issue Innovations in Chronic Patient Management: Monitoring, Evaluation and Rehabilitation)

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15 pages, 1099 KB

Open AccessSystematic Review

Effectiveness of Physical and Therapy Interventions for Non-ICU Hospitalized Pneumonia Patients: A Systematic Review of Randomized Controlled Trials

by Takako Tanaka, Yorihide Yanagita, Tatsuya Morishita, Fumiya Nagata, María Granados Santiago, Laura López-López and Marie Carmen Valenza

Healthcare 2025, 13(12), 1444; https://doi.org/10.3390/healthcare13121444 - 16 Jun 2025

Cited by 2 | Viewed by 5918

Abstract

Background: Pneumonia is a leading cause of hospitalization worldwide, particularly among older adults and individuals with comorbidities. Physical therapy is increasingly recognized as a key component in improving health-related outcomes. The aim of this systematic review and meta-analysis was to evaluate the effectiveness of physiotherapy in patients with non-complicated hospital pneumonia. Methods: A systematic review and meta-analysis were conducted to determine the impact of physical therapy on clinical outcomes in non-ICU (Intensive Care Unit) pneumonia patients compared with usual care. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in PROSPERO (CRD42024565419). PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched to identify randomized controlled trials from their inception to July 2024. The Cochrane Risk of Bias Tool version 2.0 (RoB 2) and the Downs and Black checklist were used for quality assessment. A quantitative synthesis was performed using the Review Manager (RevMan) version 5 software program. Results: We selected nine studies, which included 1349 hospitalized non-ICU pneumonia patients. The results showed significant differences in favor of physical therapy interventions compared to usual care, with a reduction in length of hospital stay (p = 0.009). Also, there were significant differences in dyspnea levels (p < 0.00001). Conclusions: Physical therapy interventions may contribute to a reduced length of hospital stay and improved dyspnea levels in hospitalized non-ICU pneumonia patients. Full article

(This article belongs to the Special Issue Innovations in Chronic Patient Management: Monitoring, Evaluation and Rehabilitation)

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19 pages, 1381 KB

Open AccessSystematic Review

Respiratory Muscle Strength Training in Parkinson’s Disease—A Systematic Review and Meta-Analysis

by Irene Navas-Garrido, Javier Martín-Núñez, Julia Raya-Benítez, María Granados-Santiago, Alba Navas-Otero, Laura López-López and Marie Carmen Valenza

Healthcare 2025, 13(10), 1214; https://doi.org/10.3390/healthcare13101214 - 21 May 2025

Cited by 5 | Viewed by 4114

Abstract

Background/Objectives: The aim of this review was to evaluate the effectiveness of respiratory muscle strength training in patients with Parkinson’s disease (PD). Methods: A systematic review and meta-analysis of randomised controlled trials (RCTs) was performed on PubMed, Web of Science, and Scopus databases. We included RCTs that evaluated the effectiveness of respiratory muscle training in patients with PD versus no intervention, sham treatment, or a different type of intervention. Quality assessment and risk of bias were assessed using the Downs and Black scale and the ROB2 tool. Results: Finally, 10 studies were included. The methodological quality of the studies was “good” in most of the studies, with results ranging from 21 to 25. In terms of risk of bias, six of them indicated low risk and four of them showed unclear risk of bias. Data were pooled and a meta-analysis of maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP), and voluntary peak expiratory flow rate (PEFR) was performed. Meta-analysis indicated a significant overall effect of respiratory muscle strength training on MEP (MD = 17.08; 95% CI = 2.32, 31.84; p = 0.02) and on voluntary PEFR (MD = 1.50; 95% CI = 0.51, 2.48; p = 0.003). However, results in the meta-analysis showed a non-significant overall effect of respiratory muscle strength training on MIP (MD = 1.69; 95% CI = −11.91, 16.29; p = 0.82). Conclusions: The synthesis of evidence presented in this systematic review and meta-analysis underscores the potential of respiratory muscle strength training as an effective means of increasing MEP and PEFR in patients with PD. Full article

(This article belongs to the Special Issue Innovations in Chronic Patient Management: Monitoring, Evaluation and Rehabilitation)

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