Search Results (752)

Background: This study investigated whether diaphragmatic breathing intervention could lead to acute improvements in trunk and shoulder mobility and pulmonary function in healthy young adults. Methods: Twenty-six physically active males (aged 24.3 ± 2.0 years, body height of 182.9 ± 6.4 cm, and body weight of 82.8 ± 10.4 kg) were randomly assigned to either an experimental or a control group. The experimental group underwent a 22 min diaphragmatic breathing intervention in a lying position. The control group lay passively, breathing naturally. Mobility assessments (chest expansion, thoracic spine rotation, lateral trunk flexion, and shoulder girdle mobility) and pulmonary function tests (forced vital capacity, forced expiratory volume in one second and their ratio) were conducted before and after the intervention. Results: Only experimental group showed significant improvements after the intervention (p ≤ 0.01) in the chest expansion (+22.2%, ES = 0.62), thoracic spine rotation (+21.7%, ES = 0.76 on the left and +23.3%, ES = 0.84 on the right side), lateral trunk flexion (+11.7%, ES = 0.62 on the left and +15.4%, ES = 1 on the right side), shoulder girdle mobility (+20.2%, ES = 0.44 on the left and +21.5%, ES = 0.38 on the right side), forced vital capacity (+4.7%, ES = 0.39) and reduction (p ≤ 0.01) in ratio between forced expiratory volume in one second and forced vital capacity (−4.6%, ES = 0.47). Conclusion: The results revealed that a 22 min diaphragmatic breathing intervention could immediately improve trunk and shoulder mobility and pulmonary function, likely due to anatomical relationships and more efficient use of respiratory muscles, especially the diaphragm. Full article

Introduction: Chronic primary low back pain (CPLBP) is a prevalent condition in primary care and a leading cause of disability and absenteeism worldwide. Multidimensional approaches may be necessary to achieve physical and mental health benefits in individuals with CPLBP. Objective: The BACKFIT randomized controlled trial aims to evaluate the effectiveness of a multidimensional intervention—combining supervised exercise and mindfulness—on pain, physical fitness, mental health, and functional outcomes in individuals with CPLBP. Hypothesis: Both the supervised exercise program focused on motor control and trunk muscle strength (IG1) and the multidimensional intervention combining supervised exercise with mindfulness training (IG2) are expected to produce significant health improvements in individuals with CPLBP. It is further hypothesized that IG2 will yield greater improvements compared to IG1, both immediately post-intervention and at the two-month follow-up. Design: Randomized controlled trial. Setting: Virgen de las Nieves University Hospital, Granada (Spain). Participants: 105 individuals. Inclusion criteria: Previously diagnosed with CPLBP, aged ≥18 and ≤65 years, able to read and understand the informed consent, and able to walk, move, and communicate without external assistance. Exclusion criteria: serious lumbar structural disorders, acute or terminal illness, physical injury, mental illness, and medical prescriptions that prevent participation in the study. Intervention: Individuals will be randomly assigned to a supervised physical exercise group (2 days per week, 45 min per session), a multidimensional intervention group (same as supervised physical exercise group, and mindfulness 1 day per week, 2.5 h per session) or an active control group (usual care, 2 days per week, 45 min per session). The intervention will last 8 weeks. Main Outcome Measures: Primary outcome: pain threshold, perceived acute pain, and disability due to pain. Secondary measures: body composition, muscular fitness, gait parameters, device-measured physical activity and sedentary behavior, self-reported sedentary behavior, quality of life, pain catastrophizing, mental health, sleep duration and quality, and central sensitization. The groups will undergo pre-intervention, post-intervention, and a 2-month follow-up after a detraining period. Statistical Analysis: Both per-protocol and intention-to-treat approaches (≥70% attendance) will be used. Program effects will be assessed via one-way ANCOVA for between-group changes in primary and secondary outcomes. Conclusions: Given the complex nature of CPLBP, multidimensional approaches are recommended. If effective, this intervention may provide low-cost alternatives for health professionals. Full article

Background: Structured postoperative rehabilitation is not routinely provided for individuals with adolescent idiopathic scoliosis (AIS) after surgery, with physiotherapy typically limited to the immediate inpatient period. Telerehabilitation offers an accessible and supervised option to address persistent functional limitations, pain, and quality-of-life concerns in this population. Objectives: This study aimed to evaluate the effects of a synchronous telerehabilitation program—designed to support post-surgical recovery in individuals with adolescent idiopathic scoliosis (AIS)—on trunk muscle endurance, trunk flexibility, functional capacity, pain severity, perception of appearance, and quality of life. Methods: Thirty-two individuals with AIS, who had undergone surgery 6 months to 2 years prior, were randomly assigned to either an intervention group or a control group. The intervention group participated in a supervised telerehabilitation program twice weekly for eight weeks, while the control group received no exercise intervention. All outcome measures were assessed before and after the intervention. Results: The telerehabilitation group demonstrated significant improvements across all outcome measures compared with the control group (p < 0.05). Post-intervention, the telerehabilitation group had superior trunk muscle endurance, flexibility, and quality-of-life scores, as well as reduced pain intensity (p < 0.05). However, no significant differences were observed between the groups in functional capacity or perception of appearance (p > 0.05). Conclusions: A supervised telerehabilitation program initiated six months after surgery can effectively improve trunk muscle endurance, flexibility, pain intensity, and quality of life in individuals with AIS. These findings emphasize the value of structured post-surgical rehabilitation and raise awareness of the potential benefits of remotely delivered exercise programs in this population. Full article

Background/Objectives: Maintaining proper posture and preventing musculoskeletal pain are essential for the healthy development of young football players. Contemporary concepts of postural control emphasize the importance of the lumbopelvic-hip complex and the activation of deep trunk muscles. This study aimed to evaluate the effects of a structured core stabilization training program on postural parameters and pain reduction in young football players. Methods: A total of 182 male football players, aged 9–15 years, were enrolled and allocated to either the intervention or control group. The 12-week intervention consisted of exercises targeting both local and global trunk stabilizers. Assessments included measurements of spinal curvatures, trunk rotation angles, lower limb loading symmetry, and postural stability using the TMX-127 digital inclinometer (Saunders Group Inc., Chaska, MN, USA) and the Baseline scoliometer (Fabrication Enterprises, Inc. New York, USA). Pain intensity was measured using the Visual Analogue Scale (VAS). Repeated-measures statistical analyses were performed with a significance level set at p ≤ 0.05. Results: The intervention group showed significant improvements in trunk rotational parameters, with reductions in ATR values at C7/Th1 (−0.54°) and L5/S1 (−0.49°). SATR values decreased by −0.28° between the second and third assessments. Symmetry of lower limb loading under eyes-open conditions improved significantly (p < 0.00195). No significant changes were observed in dynamic balance, as assessed by the Y-Balance Test (p > 0.05). Pain intensity decreased from 3.33 to 2.55 on the VAS, reflecting a reduction of 0.78 points. Conclusions: Systematic core stabilization training enhances postural quality and reduces the occurrence and severity of musculoskeletal pain in young football players, with lasting effects—except for postural control under conditions of reduced visual input. This type of training represents an effective physioprophylactic strategy, supporting postural control and lowering the risk of injuries. To maintain these benefits, continued training that incorporates balance and proprioceptive exercises is recommended. Full article

Upper limb (UL) impairment after stroke negatively influences stroke survivors’ quality of life (QOL). This study aims to evaluate, through clinical assessment and accelerometric measures, the efficacy of anodal Transcranial Direct Current Stimulation (a-tDCS) combined with the Graded Repetitive Arm Supplementary Program (GRASP) in post-acute stroke UL rehabilitation. Subjects were enrolled if they were aged ≥18 years and had a first stroke diagnosis, UL motor impairment and adequate trunk control. The subjects underwent combined administration of intensive a-tDCS and GRASP (15 sessions/30 min each). Before and after treatment, a subgroup of subjects was evaluated through wearable accelerometers. A total of 30 subjects were included in this study (mean age 68.34 ± 14.08 years; 19 males/11 females). Medical Research Council (MRC), Hand Grip Strength (HGS), Nine-Hole Peg Test (9HPT), Box and Block Test (BBT) and Fugl-Meyer Assessment-Upper Extremity (FMA-UE) scores significantly improved after treatment. The accelerometric-derived measurements all revealed a significant increase in the affected UL activity as indicated by the Vector Magnitude value. No side effects were reported. In conclusion, an intensive a-tDCS and GRASP application proved to be effective and safe in UL rehabilitation after stroke. The association of accelerometric monitoring might be of paramount importance for the evaluation of UL recovery. Full article

Fungi of the genus Trichoderma show strong potential as biological control agents (BCAs) against grapevine trunk diseases (GTDs) through mechanisms like antibiotic metabolite production and lytic enzymes. This study evaluated the biocontrol activity of four native Trichoderma strains—T. gamsii T065 and T071, T. carraovejensis T154, and T. harzianum T214—against Phaeoacremonium minimum, Phaeomoniella chlamydospora, and Diplodia seriata. Culture filtrates obtained at 8, 16, and 24 days post-incubation were tested using antibiogram and mycelial inhibition assays. Strains T071, T154, and T214 effectively inhibited D. seriata, while T154 and T214 also suppressed P. chlamydospora. Nevertheless, the limited effectiveness of all filtrates against P. minimum suggests that antibiosis is not the predominant mechanism involved in its control. These findings highlight the potential of specific Trichoderma strains and incubation times to directly control GTD pathogens and support the development of scalable biocontrol solutions. Full article

Illegal logging is a major threat to tropical forests; however, control mechanisms and efforts to combat illegal logging have not effectively curbed fraud in the production chain, highlighting the need for effective methods to verify the geographic origin of timber. This study investigates the application of multi-elemental analysis combined with Principal Component Analysis (PCA) to discriminate the provenance of tropical timber in the Brazilian Legal Amazon. Wood samples of Hymenaea courbaril L. (Jatobá), Handroanthus sp. (Ipê), and Manilkara huberi (Ducke) A. Chevalier. (Maçaranduba) were taken from multiple sites. Elemental concentrations were determined via Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and CA was applied to evaluate geographic differentiation. Significant differences in elemental profiles were found among locations, particularly when using the intermediate disk portions (25% to 75%), and especially the average of all five sampled portions, which proved most effective in geographic discrimination of the trunk. Elements such as Ca, Sr, Cr, Cu, Zn, and B were especially important for spatial discrimination. These findings underscore the forensic potential of multi-elemental wood profiling as a tool to support law enforcement and environmental monitoring by providing scientifically grounded evidence of timber origin. Full article

This study aimed to evaluate the feasibility of using serious games for the (tele)rehabilitation of children with disabilities affected by the Ukrainian war. Additionally, it provides requirements for technologies that can be used in war-affected areas. Structured interviews and Likert scale assessments were conducted on-site and remotely with patients of the tertiary care facility in Ukraine. All participants used the telerehabilitation platform for motor and cognitive training. Nine serious games were employed, involving trunk tilts, upper limb movements, and head control. By mid-September 2023, 186 positive user experiences were evident, with 89% expressing interest in continued engagement. The platform’s accessibility, affordability, and therapeutic benefits were highlighted. The recommendations from user feedback informed potential enhancements, showcasing the platform’s potential to provide uninterrupted rehabilitation care amid conflict-related challenges. This study suggests that serious games solutions that suit the sociopolitical and economic context offer a promising solution to rehabilitation challenges in conflict zones. The positive user experiences towards using the platform with serious games indicate its potential in emergency healthcare provision. The findings emphasize the role of technology, particularly serious gaming, in mitigating the impact of armed conflicts on children’s well-being, thereby contributing valuable insights to healthcare strategies in conflict-affected regions. Requirements for technologies tailored to the context of challenging settings were defined. Full article

Introduction: Hip abductor strength is essential for pelvic stability, lower limb alignment, and injury prevention. Weaknesses of the gluteus medius and minimus contribute to various musculoskeletal conditions. Lateral band walks and monster walks are elastic resistance exercises commonly used to target the hip abductors and external rotators in functional, weight-bearing tasks. Therefore, the aim was to summarize the current evidence on the biomechanics, muscle activation, and clinical applications of lateral and monster band walks. Methods: This narrative review was conducted following the SANRA guideline. A comprehensive literature search was performed across PubMed, Scopus, Web of Science, and SPORTDiscus up to April 2025. Studies on the biomechanics, electromyography, and clinical applications of lateral band walks and monster walks were included, alongside relevant evidence on hip abductor strengthening. Results: A total of 13 studies were included in the review, of which 4 specifically investigated lateral band walk and/or monster walk exercises. Lateral and monster walks elicit moderate to high activation of the gluteus medius and maximus, especially when performed with the band at the ankles or forefeet and in a semi-squat posture. This technique minimizes compensation from the tensor fasciae latae and promotes selective gluteal recruitment. Proper execution requires control of the trunk and pelvis, optimal squat depth, and consistent band tension. Anatomical factors (e.g., femoral torsion), sex differences, and postural variations may influence movement quality and necessitate tailored instruction. Full article

Background/Objectives: Left/right discrimination (LRD) training is increasingly being used in the treatment of chronic low back pain (CLBP). However, it is unclear whether trunk LRD-performance is impaired in CLBP patients and whether clinical parameters are related to LRD-performance. Therefore, this cross-sectional study aimed to examine (1) whether LRD-performance differs between CLBP patients and pain-free individuals; (2) whether these differences depend on the low back pain (LBP) history in pain-free individuals; (3) if clinical factors are related to LRD-performance; (4) whether LRD-task difficulty influences these results. Methods: Participants included 150 pain-free persons (107 with no LBP-history; 43 with past LBP) and 150 patients with CLBP. All participants performed the LRD-task in a simple and complex condition. Outcomes were reaction time and accuracy. Results: CLBP patients were significantly slower (Cohen’s d = 0.47 to 0.50, p < 0.001) and less accurate (Cohen’s d = 0.30 to 0.55, p < 0.001) than pain-free individuals without LBP-history, but not compared to those with past LBP (Cohen’s d reaction time = 0.07 to 0.15, p = 0.55; Cohen’s d accuracy = 0.03 to 0.28, p-value = 0.28). All participant groups were slower and less accurate in the complex condition, but between-groups differences were independent of task difficulty. Linear mixed models showed that older age and lower education were independently associated with less accuracy. When controlling for demographics, pain intensity, disability, fear of movement, pain-related worry and pain duration were not related to LRD-performance in patients with CLBP. Conclusions: Patients with CLBP showed impaired trunk LRD-performance compared to pain-free persons without LBP history, but not compared to those with past LBP. When controlling for demographics, clinical parameters were not related to LRD-performance in patients with CLBP. Our findings indicate that LRD-performance may remain impaired after recovering from LBP. Full article

Waterborne transportation serves as a critical pillar of trunk-line freight systems, offering unparalleled advantages in transport capacity, energy efficiency, and cost-effectiveness. As cargo throughput demands escalate, optimizing lock capacity becomes imperative. This study investigates ship sinkage dynamics through computational fluid dynamics (CFD) simulations for a representative inland cargo vessel navigating the Three Gorges on the Yangtze River. We develop a predictive sinkage model that integrates four key hydrodynamic parameters: ship velocity, draft, water depth, and bank clearance, applicable to both open shallow water and lockage conditions. The model enables determination of maximum safe drafts for lock transit by analyzing upstream/downstream water levels and corresponding chamber depths. Our results demonstrate the technical feasibility of enhancing single-lock cargo capacity while maintaining safety margins. These findings provide (1) a scientifically grounded framework for draft control optimization, and (2) actionable insights for lock operation management. The study establishes a methodological foundation for balancing navigational safety with growing throughput requirements in constrained waterways. Full article

Background/Objective: Bridging stent optimal choice in fenestrated and branched endovascular aortic repair (f/bEVAR) is under investigation. This systematic review and meta-analysis studied the outcomes of the BeGraft peripheral and peripheral PLUS as bridging stents in f/bEVAR. Methods: The methodology was pre-registered to the PROSPERO (CRD420251007695). Following the PRISMA guidelines and PICO model, the PubMed, Cochrane and Embase databases were searched for observational studies and randomized control trials, in English, from 2015 to 2025, reporting on f/bEVAR patients using the second-generation BeGraft peripheral or the BeGraft peripheral PLUS balloon expandable covered stent (BECS; Bentley InnoMed, Hechingen, Germany) for bridging. The ROBINS-I assessed the risk of bias and GRADE the quality of evidence. Target vessel technical success, occlusion/stenosis, endoleak Ic/IIIc, reintervention and instability during follow-up were primary outcomes, assessed using proportional meta-analysis. Results: Among 1266 studies, eight were included (1986 target vessels; 1791 bridged via BeGraft); all retrospective, except one. The ROBINS-I showed that seven were at serious risk of bias. According to GRADE, the quality of evidence was “very low” for primary outcomes. Target vessel technical success was 99% (95% CI 98–100%; I² = 12%). The mean follow-up was 20.2 months. Target-vessel instability was 3% (95% CI 2–5%; I² = 44%), occlusion/stenosis was 1% (95% CI 1–4%; I² = 8%) and endoleak Ic/IIIc was 1% (95% CI 0–3%; I² = 0%). The estimated target-vessel reintervention was 2% (95% CI 2–4%; I² = 12%). Celiac trunk, superior mesenteric and renal artery instability were 1% (95% CI 0–16%; I² = 0%;), 1% (95% CI 0–5%; I² = 14%) and 4% (95% CI 2–7%; I² = 40%), respectively. Conclusions: The BeGraft peripheral and peripheral PLUS BECS performed with high technical success and low instability when used for bridging in f/bEVAR. Cautious interpretation is required due to the very low quality of evidence. Full article

Background and Objectives: Cerebral palsy (CP) is a non-progressive neurological disorder characterized by motor impairments such as spasticity and poor postural control. Among these, trunk control plays a critical role in maintaining balance and enabling functional mobility. Since spasticity is known to interfere with motor coordination and posture, evaluating its response to trunk-focused interventions may offer additional clinical insights. This systematic review and meta-analysis evaluated the effectiveness of trunk-focused interventions on trunk control, gross motor function, balance, and spasticity. Materials and Methods: A systematic search was conducted in PubMed, Embase, Web of Science, MEDLINE, and CINAHL for randomized controlled trials (RCTs) published in the last 10 years up to 11 April 2023. Studies targeting trunk-specific interventions in children with CP were included. Meta-analyses were performed using RevMan 5.3, calculating standardized mean differences (SMDs) with 95% confidence intervals (CIs). Study quality was assessed using the PEDro scale. Results: Fifteen RCTs involving 454 children were included. Trunk control improved significantly (SMD = 3.67; 95% CI: 3.10–4.25; I² = 0%). Gross motor function showed a small but significant improvement (SMD = 0.49; 95% CI: 0.06–0.92; I² = 44%). Balance exhibited a large, though not statistically significant, effect (SMD = 0.90; 95% CI: −0.00 to 1.79; I² = 81%). Subgroup analysis indicated that interventions performed more than four times per week produced a significant effect on balance (SMD = 0.54; 95% CI: 0.08–1.01). Only one study assessed spasticity and found no group difference. Conclusions: Trunk-based interventions significantly improve trunk control and gross motor function in children with CP. While improvements in balance were inconsistent, higher-frequency interventions yielded more favorable results. Further research is warranted to clarify effects on spasticity and optimize intervention protocols for clinical application. Full article

Background: The present study aimed to determine whether the protocolized use of pneumatic splints within neurodevelopmental therapeutic approaches produces a positive effect on sensorimotor impairments of the hemiplegic upper extremity in patients. Methods: A randomized clinical single-blind trial was conducted. Stroke patients were recruited and randomized into an experimental group, which completed a treatment protocol of splinting plus physiotherapy for 45 min per session, two sessions per week for four weeks; or a control group, which received the same type of conventional physiotherapy treatment for the same period of time. The patients were evaluated by Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) and the Trunk Control Scale. Secondary variables were Mini-BEStest, the modified Ashworth scale for ankle flexors, and computerized measurements of upper limb functional parameters performed by Armeo Spring^® robotic systems and Amadeo^®. All variables were measured pre- and post-treatment. Results: Twenty stroke patients with subacute and chronic stroke completed the protocol. Mann–Whitney U tests showed statistically significant differences between groups for the FM sensation variable (Z = −2.19; p = 0.03). The rest of the variables studied in the comparison between the two study groups did not present statistically significant differences (p > 0.05). Conclusions: The use of air splints in combination with physiotherapy treatment produced improvements in exteroceptive and proprioceptive sensitivity in post-stroke adult patients in the subacute and chronic phases. Full article

Soil compaction is a critical challenge in perennial fruit production, limiting root growth, water infiltration, and nutrient uptake—factors essential for climate-resilient and sustainable orchard systems. In subtropical Asian pear (Pyrus pyrifolia Nakai) orchards under the annual top-working system, intensive machinery traffic exacerbates subsurface hardpan formation and tree performance. This study evaluated the effectiveness of pneumatic subsoiling, a minimally invasive method using high-pressure air injection, in alleviating soil compaction without disturbing orchard surface integrity. Four treatments varying in radial distance from the trunk and pneumatic application were tested in a mature orchard in central Taiwan. Pneumatic subsoiling 120 cm away from the trunk significantly reduced soil penetration resistance by 15.4% at 34 days after treatment (2,302,888 Pa) compared to the control (2,724,423 Pa). However, this reduction was not sustained at later assessment dates, and no significant improvements in vegetative growth, fruit yield, and fruit quality were observed within the first season post-treatment. These results suggest that while pneumatic subsoiling can modify subsurface soil physical conditions with minimal surface disturbance, its agronomic benefits may require longer-term evaluation under varying moisture and management regimes. Overall, this study highlights pneumatic subsoiling may be a potential low-disturbance strategy to contribute to longer-term soil physical resilience. Full article