International Journal of Physical Therapy Research & Practice
Impact of Patient-Specific, Performance-Driven Rehabilitation Strategies on Treatment Adherence and Clinical Outcomes: A Systematic Review
Background: Individualized, performance-driven rehabilitation systems characterized by dynamic adaptation of exercise dosage, feedback, and progression based on patient-specific performance have emerged as a promising approach to improve adherence and clinical outcomes. However, their effectiveness compared with conventional rehabilitation remains unclear due to heterogeneity in intervention design and clinical populations. Methods: A systematic review was conducted in accordance with PRISMA 2020 and Cochrane Handbook recommendations. Electronic databases, including MEDLINE, Embase, Scopus, Web of Science, and Cochrane CENTRAL, were searched from inception to the final search date (to be inserted). Eligible studies included randomized and non-randomized comparative studies evaluating individualized, performance-driven rehabilitation interventions versus conventional therapy. Primary outcomes were adherence and clinical effectiveness. Study selection, data extraction, and risk-of-bias assessment were performed independently by two reviewers.. Results: A total of 27 studies were included, of which 25 contributed adherence and/or clinical outcome data. Interventions varied from web-based platforms to advanced systems incorporating wearable sensors, real-time biofeedback, and artificial intelligence–driven adaptation. Adherence outcomes demonstrated substantial heterogeneity. Individualized systems generally improved adherence compared with minimal-contact or unsupervised care, with some studies reporting large effects (e.g., 141% vs. 50% adherence; 100% vs. 30% session completion). Significant improvements were observed in functional mobility, exercise capacity, and disease-specific outcomes in several populations, including post-surgical, cardiovascular, and neurological rehabilitation. In highly supervised settings, outcomes were typically comparable between groups. The certainty of evidence ranged from low to moderate, with downgrading primarily due to heterogeneity, risk of bias, and imprecision. Conclusions: Individualized, performance-driven rehabilitation systems demonstrate moderate-certainty evidence for improving adherence in specific contexts and achieving comparable or superior clinical outcomes relative to conventional therapy.
Rehabilitation; individualized therapy; telerehabilitation; adherence; clinical outcomes; digital health.
Copyright (c) 2026 International Journal of Physical Therapy Research & Practice https://creativecommons.org/licenses/by-nc-nd/4.0
Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Arabic COPD Population Screener (A-COPD-PS)
Background: Chronic obstructive pulmonary disease (COPD) remains underdiagnosed globally, particularly in regions with limited access to spirometry. The COPD Population Screener (COPD-PS) is a brief questionnaire designed to identify individuals at risk. Objective: This study aimed to translate, culturally adapt, and validate an Arabic version of the COPD-PS (A-COPD-PS). Methods: A prospective validation study was conducted among 196 Arabic-speaking adults recruited from pulmonology outpatient clinics in Saudi Arabia using a convenience sampling approach. The COPD-PS was translated using forward-backward methodology and expert review. Participants completed the A-COPD-PS, COPD Assessment Test (CAT), and Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F), followed by spirometry. Criterion validity was assessed using Cohen’s κ, sensitivity, specificity, and receiver operating characteristic (ROC) analysis. Construct validity was evaluated through correlations with CAT and FACIT-F. Reliability was assessed using Cronbach’s α and intraclass correlation coefficients (ICC). Results: The A-COPD-PS demonstrated moderate agreement with spirometry (κ = 0.50, 95% CI: 0.33–0.67), with sensitivity of 50% and specificity of 95%. Scores correlated strongly with CAT (ρ = 0.71, p < 0.001) and moderately with FACIT-F (r = 0.61, p < 0.001). The instrument showed excellent internal consistency (Cronbach’s α = 0.979) and test–retest reliability (n=193) (ICC = 0.975, 95% CI: 0.94–0.99). Conclusion: The A-COPD-PS demonstrates acceptable validity and excellent reliability as a screening tool for COPD risk among Arabic-speaking adults. However, its modest sensitivity suggests it should be used to identify individuals requiring further diagnostic evaluation rather than as a standalone diagnostic instrument.
Chronic obstructive pulmonary disease; Pulmonary function test; Questionnaire; Reliability; Validity
Age and Gender Differences in Fracture Patterns at King Fahad Hospital, Al-Baha: A Retrospective Study
Background: Fractures represent a significant public health concern worldwide, contributing to substantial morbidity, healthcare utilization, and economic burden. The distribution and type of fractures vary across demographic groups, particularly with respect to age and gender, reflecting differences in bone density, activity levels, and exposure to trauma. Objective: To examine the association between age and gender and the pattern of fractures among patients presenting to King Fahad Hospital in Al-Baha, Saudi Arabia. Methods: A retrospective cross-sectional study was conducted on 886 patients with radiologically confirmed fractures who presented between January 2023 and January 2024. Data on patient demographics (age and gender) and fracture characteristics (anatomical site and type) were extracted from electronic medical records. Patients were categorized into age groups for comparative analysis. Statistical associations between demographic variables and fracture patterns were assessed using chi-square tests, with a significance level set at p < 0.05. Results: The mean age of patients was 32.94 ± 22.42 years, indicating a wide age distribution, with males accounting for 68.8% of cases. The most frequently observed fractures involved the forearm and elbow (19.5%), followed by the humerus (18.7%) and foot (17.8%). A statistically significant variation in fracture patterns was observed across different age groups (p = 0.001), suggesting age-specific vulnerability to certain fracture types. In contrast, no significant association was found between gender and fracture distribution (p = 0.680), despite the higher overall proportion of male patients. Conclusion: Fracture patterns differ significantly by age but not by gender in this population. These findings underscore the importance of implementing age-specific preventive measures, resource allocation, and clinical management strategies to reduce fracture incidence and improve patient outcomes.
Orthopedic, Fractures, Epidemiology, Age-related differences, Gender differences, Trauma.
Nintendo Wii Balance Board for Rehabilitation in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis
Background: Cerebral palsy (CP), the leading cause of childhood motor disability, is commonly associated with impaired balance, postural control, and functional mobility. Virtual reality–based interventions, including the Nintendo Wii Balance Board, have been increasingly integrated into pediatric neurorehabilitation. However, the overall effectiveness of Wii-based rehabilitation in children with CP remains uncertain. Objective: This systematic review and meta-analysis evaluated the effects of Nintendo Wii Balance Board–based therapy on balance, motor, and mobility outcomes in children with CP. Methods: Randomized controlled trials were identified through a systematic search of major electronic databases, including PubMed, Scopus, Google Scholar, and Web of Science, without publication timeframe restrictions. Eligible studies included pediatric patients with cerebral palsy undergoing Nintendo Wii Balance Board–based rehabilitation, rehabilitation games, or neurological therapy. Outcomes included balance, gross motor function, coordination, motor control, and therapy engagement, measured pre- and post-intervention using standardized clinical scales. Effect sizes were calculated as standardized mean differences (SMDs) with 95% confidence intervals (CIs), and heterogeneity was assessed using the I² statistic. Results: Ten trials involving 257 participants were included. Intervention durations ranged from 8 to 12 weeks and were compared with traditional therapy or no intervention. A meta-analysis of ten studies showed significant improvements in balance favoring Wii-based rehabilitation (SMD = 0.84, 95% CI 0.54–1.15; p = 0.0015), with low heterogeneity (I² = 26%). No significant effects were observed for functional mobility outcomes, including the 1-Minute Walk Test and Timed Up and Go. Individual studies also reported improvements in gross motor function and coordination, as well as increased motivation and engagement. Conclusion: Nintendo Wii Balance Board–based therapy may improve balance outcomes in ambulatory children with cerebral palsy; however, further high-quality randomized trials with standardized protocols are required.
Acute Physiological and Perceptual Responses to Low-Load Blood Flow Restriction versus High-Load Resistance Exercise: A Randomized Crossover Pilot Study
Objective: To compare the acute physiological and perceptual responses to low-load blood flow restriction (LL-BFR) resistance exercise and traditional high-load (HL) resistance exercise in healthy males. Methods: In a randomized crossover design, nine healthy males performed bilateral knee extensions under two conditions: LL-BFR (30% 1RM with blood flow restriction) and HL (80% 1RM without restriction). Each protocol involved three sets of eight repetitions. Growth hormone (GH), creatine kinase (CK), blood lactate, systolic and diastolic blood pressure (SBP, DBP), and rate of perceived exertion (RPE) were measured at rest, during, and after exercise. Data were analyzed using two-way repeated-measures ANOVA. Results: GH increased significantly after LL-BFR (p < 0.0001), but not after HL (p > 0.05). CK increased only after HL at 48 h (p = 0.0034). Blood lactate was higher across sets in HL (p < 0.05). RPE increased similarly in both trials (p > 0.70). SBP increased during both protocols (p < 0.001), while DBP was higher in LL-BFR, particularly after Set 3 (p = 0.0275). Conclusion: LL-BFR induces a greater endocrine response with less muscle damage than HL exercise but increases vascular stress. It may serve as a practical alternative where high loads are contraindicated.
High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in Older Adults With Heart Failure: A Systematic Review of Comparative Randomized Trials
Background: High-intensity interval training (HIIT) has been proposed as a superior alternative to moderate-intensity continuous training (MICT) for improving exercise capacity in patients with heart failure (HF). Early small randomized trials suggested substantial gains in peak oxygen uptake (peak VO₂) and left ventricular ejection fraction (LVEF) with HIIT, but larger multicenter trials have reported neutral findings. Uncertainty persists regarding phenotype-specific effects and clinical relevance in older adults with heart failure. Objective: To systematically evaluate the comparative effects of HIIT versus MICT on exercise capacity and LVEF in older adults with heart failure, and to assess the certainty of evidence across heart failure phenotypes. Methods: A systematic review of randomized controlled trials comparing HIIT and MICT in adults aged ≥60 years with heart failure was conducted in accordance with PRISMA 2020 guidelines. Databases were searched from inception to the final search date without language restriction. Primary outcomes were change in peak VO₂ (mL/kg/min) and LVEF (%). Secondary outcomes included six-minute walk distance (6MWT) and serious adverse events. Random-effects meta-analyses were performed where appropriate. Risk of bias was assessed using the Cochrane RoB 2 tool, and certainty of evidence was evaluated using GRADE. Results: Sixteen comparative randomized studies met inclusion criteria. In heart failure with reduced ejection fraction (HFrEF), pooled meta-analyses demonstrated a modest improvement in peak VO₂ favoring HIIT (mean difference approximately +1.7 to +2.1 mL/kg/min). However, the largest multicenter trial (n=261) showed no significant between-group difference. Pooled improvements in LVEF were small (~3%) and inconsistent across studies. In heart failure with preserved ejection fraction (HFpEF), randomized evidence did not demonstrate superiority of HIIT over MICT, and adjusted analyses suggested exercise volume rather than intensity drove adaptation. Improvements in 6MWT (~28 meters) modestly favored HIIT but approached minimal clinically important thresholds. Serious adverse events were infrequent and comparable between groups under supervised conditions. Certainty of evidence ranged from low (peak VO₂ in HFrEF) to moderate (no important difference in HFpEF; safety outcomes), with downgrading primarily due to inconsistency and small-study effects. Conclusions: In older adults with heart failure, HIIT confers modest improvements in peak VO₂ in HFrEF populations according to pooled analyses, but these advantages are not consistently replicated in large pragmatic multicenter trials and are not observed in HFpEF. Structural improvements in LVEF remain uncertain. Both HIIT and MICT appear safe when delivered under supervision. Exercise prescription should prioritize phenotype-specific considerations, adherence, and sustainability rather than presumed intensity-driven superiority.
Heart failure; high-intensity interval training; moderate-intensity continuous training; peak oxygen uptake; left ventricular ejection fraction; cardiac rehabilitation; HFrEF; HFpEF; systematic review.
Effect of a 6-Week Balance Exercise Program on Fall Risk in Older Adults
Background: Falls in older adults are a leading cause of morbidity, functional decline, and reduced independence. Although balance training is widely recommended, evidence supporting the effectiveness of short-term structured programs in community-dwelling older populations remains limited. Objective: To evaluate the effects of a 6-week supervised balance exercise program on balance performance, functional mobility, and fall-related self-efficacy in community-dwelling older adults. Methods: In this randomized controlled trial, 80 adults aged ≥65 years were allocated to either an intervention group (n = 40) or a control group (n = 40). The intervention group received supervised balance training three times weekly for six weeks, incorporating static, dynamic, functional, and dual-task exercises, while the control group received usual care. Outcomes were assessed at baseline and post-intervention using the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Falls Efficacy Scale–International (FES-I). Between-group differences and within-group changes were analyzed with significance set at p < 0.05. Results: Baseline demographic, clinical, sensory, and fall-history characteristics were comparable between groups. After 6 weeks, the intervention group demonstrated significant improvements compared with controls in balance (BBS: +7.2 ± 3.1 vs +0.2 ± 1.0; mean difference 7.0 points, 95% CI: 6.2–8.2), functional mobility (TUG: −2.4 ± 0.9 s vs −0.1 ± 0.5 s; mean difference 2.3 s, 95% CI: −2.7 to −2.1), and fear of falling (FES-I: −8.1 ± 4.5 vs −0.2 ± 1.0; mean difference 7.9 points, 95% CI: −9.5 to −6.7) (all p < 0.001). No significant changes were observed in the control group. The intervention was well tolerated, with full adherence and no reported adverse events. Conclusion: A 6-week supervised balance exercise program resulted in clinically meaningful improvements in balance, mobility, and fall-related self-efficacy in community-dwelling older adults. These findings support its role as a safe and effective short-term intervention within fall-prevention strategies, although longer-term studies are warranted to determine sustainability of benefits.
Rehabilitation Outcomes in a Patient with Brachial Plexus Injury and Multiple Comorbidities: A 7-Month Case Study
Background: Brachial plexus injury secondary to prolonged prone positioning during COVID-19 hospitalization has emerged as a recognized complication, particularly in patients with metabolic comorbidities such as diabetes mellitus. Case Presentation: This case report describes the rehabilitation of a 31-year-old left-handed male with diabetes who developed brachial plexus injury following prolonged prone positioning during COVID-19 hospitalization. The patient underwent intensive physiotherapy over seven months, totaling 38 sessions. Clinical assessment included muscle strength testing, range of motion (ROM) measurement, balance evaluation, psychological distress assessment, the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, and the Brachial Assessment Tool (BrAT). At baseline, passive ROM was preserved; however, reduced muscle strength was noted in the shoulder flexors, extensors, abductors, and adductors, as well as in the elbow flexors and extensors. Intervention and Outcomes: A structured and progressive physiotherapy program was implemented. Over the rehabilitation period, improvements were observed in shoulder and elbow muscle strength, functional mobility, pain levels, QuickDASH scores, BrAT scores, and psychological status. Conclusion: This case highlights the multifactorial nature of neurological and functional recovery following brachial plexus injury associated with prolonged prone positioning. Mechanical factors, metabolic comorbidities, lifestyle influences, and psychological status may collectively affect rehabilitation outcomes. Intensive, structured physiotherapy may facilitate meaningful neurological and functional recovery even in complex clinical presentations.
The Impact of Traumatic Brain Injury on Women as Spouses and Partners: A Scoping Review
<span lang="EN-US" style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; font-weight: bold;">Background: <span lang="IT" style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: IT; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Traumatic brain injury (TBI) results in enduring mental and behavioral, and emotional problems that impact both people who experience the injury and their family members. The existing review about TBI effects on women who stay in partner relationships with their spouses remains scarce because women typically become the primary caregivers for their injured husbands. <span lang="EN-US" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; font-weight: bold;">Objective: <span lang="IT" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: IT; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">This review was conducted as a scoping review to combine all available studies that investigated this subjec<span lang="EN-US" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">t. Methods: <span lang="IT" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: IT; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">The review used the Arksey and O’Malley framework to conduct a scoping review which Levac and his team reported following PRISMA-ScR guidelines, later improved through methodological enhancements. The reviewers combined their review findings through a narrative review method.<span lang="IT" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> <span lang="IT" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: IT; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">Following the completion of the search, all articles published before 2010 were excluded by the search filters, and the results were 128 articles on one search, 265 on Google Scholar, and 53 on Taylor Francis Online. In the study, a total of 446 articles were found in the selected databases with a filter applied to restrict the search from 2010 onwards. The articles were then screened based on specific criteria outlined in their titles and abstracts, and any duplicates were removed. After the screening process, 13 articles were identified as meeting the inclusion and exclusion criteria and were selected for full-text reading<span lang="EN-US" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">. Results: <span lang="IT" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: IT; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">While considering the PRISMA-ScR guidelines, five dominant thematic domains were identified: (1) role transformation and caregiving responsibilities, (2) changes in relationship dynamics, (3) emotional and psychosocial impact, (4) social isolation and role overload, and (5) coping, adaptation, and resilience. Across studies, women experienced abrupt and sustained shifts from partner to primary caregiver, accompanied by emotional burden, relational ambiguity, and reduced social participation<span lang="EN-US" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">. Conclusion: <span lang="IT" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: IT; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">There is a lack of research focusing on the well-being of traumatic brain injury (TBI) caregivers following role shifts. This area warrants further investigation on a global scale. <span lang="EN-US" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">The impact of TBI on women's ability to perform their roles as spouses and partners of people who have had TBI and the impact on their daily life requires a special program such as peer support, therapy sessions, and group therapy to reduce caregiver burnout and improve mental health<span lang="IT" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: IT; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> status and provide the needed care and support.
Traumatic brain injury, Women caregivers, Caregiving burden,
Impact of Tai Chi Chuan on Adult Biomechanical Outcomes: A Comparative Evaluation of Postural and Gait Outcomes
Background: Tai Chi Chuan (TCC) has gained increasing attention as a low-impact, multicomponent exercise with potential benefits for biomechanical health in adults. However, evidence regarding its comparative effectiveness against no intervention and other active exercise programs remains dispersed across heterogeneous studies. Objective: To evaluate the effects of Tai Chi Chuan on key biomechanical outcomes in adults, including balance, gait, muscle strength, proprioception, and neuromuscular control, compared with no intervention or active exercise comparators. Methods: A systematic synthesis of controlled studies was undertaken, focusing on adult populations exposed to Tai Chi Chuan interventions of at least four weeks’ duration. Outcomes included balance and postural control, gait parameters, muscle strength and proprioception, and joint kinematics or kinetics. Findings were synthesized narratively due to methodological heterogeneity. Results: Across included studies, Tai Chi Chuan was consistently associated with improvements in balance and postural control, with enhanced performance on validated measures such as the Berg Balance Scale, Timed Up and Go, and single-leg stance. For example, clinically meaningful gains in single-leg stance time were reported (mean differences 3.44–17.07, p<0.05), and increases of approximately 5 seconds were observed in some cohorts (p=0.049). Gait-related outcomes also improved, including faster walking speed, increased stride length, and reduced dual-task cost, with reductions of 17–22% reported in dual-task walking (p<0.001). Muscle strength and proprioception outcomes showed consistent gains, reflected in improved chair-stand performance, arm curls, and grip strength (all p<0.05). Limited evidence from biomechanical studies further indicated reduced lower-extremity muscle co-contraction during gait among Tai Chi practitioners (mean difference −10.1, 95% CI −18.1 to −2.4, p<0.05). Conclusions:Tai Chi Chuan reliably improves key biomechanical outcomes in adults, particularly balance, gait performance, and muscle function. Benefits exceed those observed with no intervention and are generally comparable or superior to other active exercise programs.
Tai Chi Chuan; biomechanics; balance; gait; muscle strength; postural control; proprioception; older adults; systematic review; rehabilitation
Effectiveness of Manual Therapy in the Management of Sacroiliac Joint Pain and Disability: A Narrative Review
Background: Sacroiliac joint pain and disability is a significant and expensive condition that drives up healthcare expenses. Ten to twenty-five percent of people who suffer low back pain (LBP) have SIJ listed as a contributing factor. Objective: The purpose of this review is to investigate the use of manual therapy for the management of SIJ syndrome, identify any gaps in the literature on the topic, and offer suggestions for future research in the area. Methods: This study was conducted as a narrative review. A search for relevant studies in English has been conducted across several databases, including PubMed NCBI, Trip Medical Database as well as PEDro – Physiotherapy Evidence Database, for randomized controlled trials (RCTs) published from 1992 to July 2024. The search included the use of manual therapy in SIJ dysfunction and pain management. Results: Nine RCTs were included. Manual therapy was shown to be the preferable course of treatment for pain and function disability when compared to alternative forms of therapy Conclusion: All of the studies in this review demonstrated the effectiveness of manual therapy in treating SIJ patients' pain and improving their functioning.
manual therapy, Sacroiliac joint pain, sacroiliac joint
Association Between Cigarette Smoking and Selected Health-Related Physical Fitness Indicators in Young Bahraini Men: A Pilot Cross-Sectional Study
Background: Cigarette smoking is a major global health issue, but its effects on health-related physical fitness among young adults in the Middle East—particularly in Bahrain—are not well studied. Most existing research focuses on older or Western populations. This study fills that gap by investigating the association between smoking status and BMI, pulmonary function (FVC), and functional capacity (6MWT) among male university students in Bahrain, a population for which localized evidence is currently lacking. Methods: Forty-one men aged 18–26 years were classified as smokers (n=20) or non-smokers (n=21). Standardized protocols were used for anthropometry, spirometry, and 6MWT. Exercise habits were assessed via a questionnaire. Between-group differences were estimated using unpaired t-test, with effect sizes and 95% confidence intervals reported. Results: The results showed that there were no significant differences between smokers and non-smokers in all measured parameters. The P values were 0.545, 0.885, and 0.278 for BMI, FVC, and 6MWT respectively. For the physical activity and exercising status, among the smoker's group, 50% never exercised, 15% had occasional exercise, and 35% had regular planned exercising. Among the non-smokers group, 19% never exercised, 24% had occasional exercise, and 57% had regular planned exercise. Conclusion: This study offers the first evidence from Bahrain on smoking and physical fitness in young men, indicating that lifestyle behaviors may differ despite unaffected short-term physiological measures and underscoring the need for early preventive strategies and longitudinal research to assess long-term effects.
Cigarette smoking, Physical fitness, Young adults, Bahrain; Pulmonary function, Exercise behavior.
The Effect of Vitamin D Supplementation on Pediatric Skeletal Muscle Strength: A Systematic Review
Background. Vitamin D plays a key role in calcium absorption and contributes to several physiological functions. While serum vitamin D levels are positively associated with skeletal muscle strength, the effect of supplementation on pediatric skeletal muscle strength remains unclear. Purpose. To systematically review the literature on the effect of vitamin D supplementation on muscle strength in the pediatric population. Method. This systematic review included only randomized controlled trials (RCTs) that investigated vitamin D supplementation and assessed muscle strength in healthy children or adolescents before and after the intervention. Non-experimental studies and trials involving additional supplementation were excluded. Results. This review was registered in PROSPERO (CRD42022314030). Five RCTs studies met the inclusion criteria, with excellent methodological quality on the PEDro scale. A total of 747 participants (mean age 12.6 years; two-thirds female) were included. VitD insufficiency was common at baseline but improved in most participants after supplementation. Only handgrip strength was measured in all studies, except one that assessed knee muscle strength. Overall, VitD supplementation did not significantly improve muscle strength, except in one trial involving premenarchal girls with VitD deficiency, where handgrip strength improved. Conclusion. Vitamin D supplementation may be beneficial in improving muscle strength among premenarchal girls with vitamin D deficiency, possibly through suppression of parathyroid hormone (PTH).
Vitamin D, Supplementation, Pediatric, Children, Muscle, Strength.
Copyright (c) 2025 International Journal of Physical Therapy Research & Practice https://creativecommons.org/licenses/by-nc-nd/4.0
Quality of Life Amongst Saudi Physiotherapists: A Review of Burnout, Job Satisfaction and Work-Related Well-Being
Background. Physiotherapists are integral to the development of Saudi Arabia's healthcare system; however, their quality of life (QoL) and work-related well-being have not been comprehensively examined. Identifying determinants such as job satisfaction, burnout, workload, cultural adaptation, and professional recognition is critical to maintaining a resilient, motivated workforce. Method. This narrative literature review synthesised evidence regarding QoL among physiotherapists in Saudi Arabia. Systematic searches of PubMed, Scopus, Web of Science, and Google Scholar (2010–2025) identified English-language empirical studies conducted in Saudi Arabia or involving cross-national comparisons. Study selection adhered to a PRISMA-style process with independent validation. Data were systematically extracted on study design, sample characteristics, QoL measures, and key outcomes, and findings were synthesised thematically within national and global contexts. Results. Fourteen studies met the inclusion criteria. Saudi physiotherapists reported moderate to high occupational stress, primarily due to heavy workloads, ambiguous career progression, and inconsistent organisational support. Expatriate physiotherapists, who represent a significant portion of the workforce, encountered additional challenges related to cultural adjustment, communication, and inconsistent orientation practices. International comparisons revealed similar QoL concerns globally, although healthcare reforms under Vision 2030 present unique contextual influences in Saudi Arabia. Significant gaps persist in national data regarding burnout prevalence, mental well-being, and work-life balance. Conclusion. The QoL of physiotherapists in Saudi Arabia is influenced by the interplay of workload, organisational, and cultural factors. Strengthening professional support, career development opportunities, and workforce policies may enhance well-being and retention. Further large-scale, methodologically robust studies are necessary to inform evidence-based workforce planning and policy.
Quality of Life, Physiotherapists, Saudi Arabia, Job Satisfaction, Burnout, Vision 2030
Barriers to Cardiac Rehabilitation in Saudi Arabia: A Scoping Review
<span lang="EN-US" style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; font-weight: bold;">Background: <span lang="EN-US" style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">Cardiac rehabilitation (CR) is considered a cornerstone of secondary prevention for cardiovascular disease (CVD); however, it remains underutilized and underdeveloped in Saudi Arabia. Objective: This scoping review aimed to analyze the existing evidence on barriers affecting the implementation and participation in CR programs across Saudi Arabia. Methods: A comprehensive search was conducted in MEDLINE, PubMed, Google Scholar, and ScienceDirect for studies published between 2015 and 2025. Eight national studies were included, examining perspectives from physicians, nurses, physiotherapists, and patients. Data were thematically analyzed and categorized into four domains—service delivery and policy, workforce and training, awareness and culture, and patient-related factors—classified under two levels: system and personal. Results: Findings from eight included studies revealed system-level barriers, including a shortage of CR centers, insufficient workforce training, fragmented policies, and limited funding. Personal-level barriers included low awareness, cultural constraints, and patient-related factors such as fatigue, anxiety, comorbidities, and limited access. Together, these challenges delay the normalization of CR within cardiac care pathways. Conclusions: A coordinated national framework is needed to integrate CR into post-cardiac care, supported by professional training, sustainable funding, and culturally sensitive public engagement. The most urgent priorities include establishing national CR guidelines, expanding workforce development pathways, and improving awareness of CR among patients and healthcare providers. Addressing these barriers is essential to expanding CR services, enhancing patient outcomes, and aligning healthcare priorities with Saudi Arabia’s Vision 2030 goal of an equitable and prevention-oriented healthcare system.
Cardiac Rehabilitation; CR; Barriers; Saudi Arabia; Cardiovascular Disease; Scoping Review.
Rehabilitation Professionals’ Perception of Differences in Development and Clinical Manifestations Between Right and Left Hemiplegia in Children
Background. Hemiplegic cerebral palsy presents with lateralized impairments that may influence developmental outcomes. While literature suggests lesion laterality affects domains such as language and spatial awareness, clinical consensus remains unclear. Purpose. To determine whether rehabilitation professionals observe differences in development or functional outcomes between right and left hemiplegia in children. Method. A cross-sectional survey of licensed pediatric rehabilitation professionals was conducted. Quantitative data were analyzed using descriptive statistics, Chi-square test and logistic regression. Qualitative responses were thematically analyzed. Results. 63.3% of total (n=49) pediatrics rehabilitation professionals report perceiving difference between hemiplegia types. Right hemiplegia was significantly associated with speech and language difficulties with a 61.3% of all participants. Motor deficits were the most commonly observed domain with 74.2% of participants. Cultural factors, such as religious emphasis on right-hand use, were noted to influence rehabilitation outcomes. Conclusion. The findings of this study, supported by previous literature, reinforce the hypothesis that developmental and functional differences are perceived between left and right hemiplegic cerebral palsy. Rehabilitation specialists should adopt a holistic approach that considers both lesion severity and cultural norms influencing perceptions of development and function. Integrating neurobiological and sociocultural factors is essential for individualized rehabilitation strategies.
Knowledge of Physiotherapists in Saudi Arabia About Lee Silverman Voice Treatment BIG Therapy for Parkinson's Disease: A Cross-Sectional Study
Background. Parkinson's disease (PD) is a widespread and challenging to diagnose the neurological condition. Tremor, rigidity, and slowness of movement are all symptoms of Parkinson's disease, which is caused by gradual neuronal loss in the substantia nigra and other brain areas. Physical therapy has the ability to enhance walking, balance, muscle strength, and fall reduction, according to growing evidence. The Lee Silverman Voice Treatment BIG (LSVT BIG) therapy is a Parkinson's disease rehabilitation approach. LSVT BIG therapy enables people with Parkinson's disease to utilize their bodies more normally. Purpose. The purpose of this study is to see how much knowledge physiotherapists in Saudi Arabia have about LSVT BIG therapy. Method. A cross-sectional study utilizing a survey to assess the knowledge of physical therapists in Saudi Arabia. It was disseminated via WhatsApp to one thousand physical therapists. The main outcomes were the extent of awareness regarding the LSVT Big method for individuals with Parkinson's disease. Data analysis. Statistical Package for Social Studies was used to analyze the data. The Chi-square test and Fisher's exact test were used for categorical variables. Results. In the current study, 263 male and female physical therapists completed the survey, males represented 63.9% of the participants, and 62% were in the age group of 24 to 30 years. The majority (84.8%) were Saudi. Only 12.5% of the physical therapists in this study were aware of the LSVT-Big therapy, and only 30.3% have ever attended the course or received a certificate. Conclusion. In Saudi Arabia, physical therapists had limited awareness and knowledge about the LSVT BIG therapy. Additional effort is required to train physical therapists about the benefits of the LSVT BIG therapy and how to use it with Parkinson's patients.
Lee Silverman Voice Treatment BIG (LSVT BIG)
Role of Physical Therapy in Postural Management to Prevent Hip Dislocation in Children with Spastic Cerebral Palsy
Background: Cerebral palsy (CP) is a neurological disorder characterized by motor impairments stemming from non-progressive brain anomalies. A primary concern in children with spastic CP is hip migration, which can progress to subluxation or dislocation, particularly in non-ambulatory patients. Objective: This narrative review explores the efficacy of physical therapy approaches within postural management programs in preventing hip dislocation in children with spastic CP. Methods: Literature published between 1990 and 2022 is reviewed across databases—namely, PubMed, EDLINE, CINAHL, AMED and Google Scholar. Results: The review highlights diverse interventions, including passive stretching, weight-bearing exercises, standing devices, orthotic aids and the Vojta method, that underestimate the importance of early, individualized and multidisciplinary management in children with spastic CP. While some conservative strategies show promising outcomes, the evidence remains limited and of variable quality. Moreover, the studies have been heterogeneous in design, outcome measures and intervention protocols. Overall, the review indicates the need for tailored programs early in life, especially for children whose motor function is classified as Gross Motor Function Classification System levels IV and V, emphasizing the essential role of physiotherapists in preventive care. Conclusion: Early, tailored physiotherapy and postural management programs play a critical role in mitigating hip displacement in children with spastic CP. Strengthening interdisciplinary collaboration and standardizing intervention protocols are essential to both improving clinical outcomes and advancing the evidence base for conservative management strategies.
Cerebral palsy; Hip dislocation; Postural management; Physical therapy; Gross Motor Function Classification System.
Efficacy of Harness-Supported Treadmill Training Without Body-Weight Unloading on Balance and Mobility After Stroke
Background: Gait impairment is one of the most debilitating consequences of stroke, often restricting mobility, independence, and community reintegration. Treadmill-based gait training enhances neuroplasticity through repetitive, task-specific practice. However, body-weight-support systems are costly and not always available in routine rehabilitation. This study investigated the efficacy of harness-supported treadmill gait training without body-weight unloading compared with conventional overground therapy in individuals with post-stroke hemiplegia. Methods: Thirty adults (aged 40–60 years) with first-ever unilateral middle cerebral artery stroke and mild-to-moderate hemiparesis (Orpington Prognostic Score < 5.2) were randomly allocated to two groups: (1) conventional Bobath-based overground gait training, or (2) treadmill gait training with overhead harness support (no unloading). Both interventions were administered for 20 minutes, three times per week, over six weeks. The Stroke Rehabilitation Assessment of Movement (STREAM), Berg Balance Scale (BBS), and 10-Meter Walk Test (10MWT) served as primary outcome measures. Data were analyzed using independent t-tests, and effect sizes (Cohen’s d) were calculated. Results: Both groups showed significant within-group improvements (p < .01), but the treadmill group demonstrated superior gains in motor recovery and balance: STREAM (+6.20 ± 2.18 vs. +3.73 ± 2.16; p = .005; d = 1.17), BBS (+8.00 ± 4.19 vs. +4.20 ± 2.81; p = .025; d = 0.98), and gait velocity (+0.126 ± 0.035 m/s vs. +0.097 ± 0.025 m/s; p = .025; d = 0.90). All participants completed the program without adverse events, confirming excellent safety and adherence. <span style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-GB; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; font-weight: bold;">Conclusion:<span style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-GB; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;"> Harness-supported treadmill gait training without body-weight support significantly enhances balance and mobility in post-stroke hemiplegia. The approach offers neuroplasticity-driven functional gains comparable to more sophisticated body-weight-supported or robotic systems, while remaining low-cost, safe, and easily implementable in routine clinical practice<span lang="EN-US" style="font-size: 10.0pt; mso-ascii-font-family: Aptos; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Aptos; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">.
Stroke rehabilitation; Treadmill gait training; Neuroplasticity; Balance recovery; Harness support; Central pattern generators; Motor relearning; Task-specific training
Functional Outcomes After Bilateral Versus Unilateral Total Knee Arthroplasty: A Retrospective Cohort Study in Saudi Arabia
Background: Osteoarthritis (OA) is a chronic degenerative joint disease that often leads to pain, stiffness, and functional disability. Total Knee Arthroplasty (TKA) remains the most effective surgical treatment for end-stage OA. This study aimed to compare the clinical and functional outcomes of patients undergoing unilateral and bilateral TKA in a tertiary rehabilitation setting in Saudi Arabia. Methods: This retrospective cohort study included 265 patients (≥35 years; both sexes) who underwent primary TKA at Sultan Bin Abdualziz Humanitartian City (SBAHC) Between 2016 and 2020. Clinical and functional data—including pain intensity (Visual Analog Scale), range of motion (goniometric assessment), muscle strength (Manual Muscle Testing), and functional independence (Functional Independence Measure, FIM)—were extracted from medical records at three time points: preoperatively, before discharge, and 3–6 months post-discharge. Results: The mean age of the patients was 67.1 ± 8.0 years, with females comprising 66.8%. Postoperatively, there was a significant reduction in pain scores (p < 0.001) and improvement in knee flexion and extension (p < 0.001). Muscle strength and FIM scores improved significantly across all patients, irrespective of age, gender, or postoperative complications. The percentage improvement in total FIM was greater in unilateral TKA patients (63.9%) compared with bilateral TKA patients (48.7%). Conclusions: Both unilateral and bilateral TKA patients demonstrated significant improvements in pain, joint mobility, muscle strength, and functional independence following a high-intensity rehabilitation program, with greater functional gains observed among unilateral TKA patients.
Total Knee arthroplasty, Rehabilitation, Functional outcomes, Range of motion.
Misdiagnosis of Greater Trochanteric Fracture in a Young Adult: A Case Report
Background: Misdiagnosis remains a major clinical challenge, even when patients are initially assessed by multiple healthcare providers. Musculoskeletal injuries, particularly hip trauma, require rigorous screening, careful differential diagnosis, and the use of appropriate imaging. Case Presentation: A 26-year-old Bahraini male developed acute left hip pain following a fall from a horse. Initial emergency department evaluation, including plain radiographs, did not reveal a fracture, and he was treated conservatively with analgesics and NSAIDs. Despite repeated consultations, his pain persisted, and he was referred to physiotherapy with a provisional diagnosis of “hip pain.” During physiotherapy assessment, several red flags were identified, including a traumatic mechanism of injury, persistent pain, limping gait, and lack of improvement with prior management. Further imaging confirmed a fracture of the greater trochanter fracture. Discussion: Greater trochanteric fractures are rare and frequently overlooked on plain radiographs. MRI is considered the gold standard for detecting occult hip fractures. Early recognition is essential, as inappropriate treatment—such as physiotherapy under a misdiagnosed label—may result in fracture displacement, prolonged disability, or surgical intervention. Conclusion: This case highlights the importance of independent diagnostic evaluation, even when patients arrive with prior referrals. Comprehensive screening and timely imaging (if needed) are critical to avoid misdiagnosis and ensure optimal patient outcomes.
The Impact of 3D-Printed Technology on Functional Performance in an Individual with C2 Spinal Cord Injury: A Case Report
This case report describes the use of a 3D-printed wheelchair joystick to improve functional performance in an individual with incomplete traumatic spinal cord injury at C2. A 29-year-old man presented with complete tetraplegia and no residual upper extremity function following a traffic accident, rendering him unable to operate manual or electric wheelchairs. To address this limitation, a joystick adapted for residual shoulder movements was developed using fused deposition modeling with polylactic acid material. After training, the patient achieved proficiency in maneuvering the wheelchair, as assessed with the Functional Independence Measure, enabling safe navigation and increased engagement in daily activities. This case illustrates how 3D-printed assistive devices can enhance functional autonomy and community participation in individuals with high cervical spinal cord injury.
Information Needs and Preferences on Cancer-Related Symptoms Among Children with Cancer and Their Parents: A Systematic Review
Objective<span style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-GB; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; font-style: italic;">: <span style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-GB; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">This study aimed to explore information needs and preferences of children with cancer and their parents about cancer-related symptoms. Methods: A systematic review of the literature was conducted using five databases and citation searches. The quality of eligible studies was assessed with the Mixed Methods Appraisal Tool. Results: Thirty studies were included (N=256 children and N=1778 parents/guardians). Children’s perspectives on their information needs were under examined and different from their parents. Both children and parents required more information about symptoms and late effects. Associations between participants’ characteristics and their information needs about symptoms and late effects were inconclusive. Parents preferred to receive information from doctors, in verbal and written formats, more than from online sources. Conclusions: Children with cancer and their parents need more tailored information about symptoms and late effects. Further research is required to identify how best to support individualized information needs and delivery preferences of children with cancer and their parents.
Effect of Supervised Physical Therapy Interventions on Functional Mobility and Quality of Life in Breast Cancer Survivors During Post-Treatment Rehabilitation: A Systematic Review
<span style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-GB; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; font-weight: bold;">Background: <span style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-GB; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">Breast cancer survivors frequently experience reduced physical capacity, fatigue, upper-limb dysfunction, and impaired quality of life (QoL) following treatment. Exercise and physiotherapy-based rehabilitation programs are increasingly prescribed, but the magnitude and consistency of their benefits remain under debate. Objective: This systematic review aimed to evaluate the effectiveness and safety of supervised exercise and physiotherapy interventions on functional mobility, muscular strength, fatigue, upper-limb function, and QoL in breast cancer survivors. Methods:A comprehensive literature search of PubMed, Scopus, Web of Science, Cochrane CENTRAL, and ClinicalTrials.gov was conducted up to March 2025. Randomized controlled trials (RCTs) comparing supervised exercise or physiotherapy interventions with usual care, waitlist, or non-exercise controls in adult breast cancer survivors were included. Data were extracted on intervention characteristics, participant demographics, outcomes, and adverse events. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and certainty of evidence was graded using GRADE. Results: Twenty-two RCTs involving 2,260 participants were included. Interventions encompassed aerobic, resistance, and combined programs; water-based therapy; yoga; manual therapy; and multimodal rehabilitation, with durations ranging from 3 weeks to 12 months. Significant improvements in cardiorespiratory fitness were observed across 18 trials, with VO₂<span style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-GB; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">max gains of 2.5–<span style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-GB; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">4.8 mL/kg/min and six-minute walk distance improvements of 35–<span style="font-size: 10.0pt; font-family: 'Aptos',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-font-kerning: 0pt; mso-ligatures: none; mso-ansi-language: EN-GB; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">90 meters. Muscular strength improved by 10–25% in 12 studies, with resistance training demonstrating the largest effects. QoL increased significantly in 15 trials, with improvements exceeding clinically meaningful thresholds (+7.5 to +10 points on validated scales). Fatigue was reduced in nine RCTs, with moderate pooled effect sizes (SMD ≈ –0.35). Seven trials reported enhanced upper-limb function and range of motion following supervised stretching, strengthening, or manual therapy. No serious intervention-related adverse events were reported. Conclusions: Supervised exercise and physiotherapy interventions are safe and effective in improving fitness, strength, QoL, fatigue, and upper-limb function among breast cancer survivors. Findings support their integration into survivorship care plans, with combined aerobic-resistance programs demonstrating the broadest benefits. Further large-scale RCTs with longer follow-up are warranted to confirm sustained outcomes.
breast cancer survivors, exercise, physiotherapy, quality of life, fatigue, functional mobility, systematic review.
Platelet-Rich Plasma for Musculoskeletal Disorders: A Critical Review of Therapeutic Evidence and Clinical Utility
Objective: Platelet-Rich Plasma (PRP) therapy has emerged as a prominent modality in musculoskeletal medicine due to its autologous nature and potential to enhance tissue healing through growth factor release. Although widely adopted, clinical outcomes exhibit variability across studies. Therefore, this review critically evaluates the therapeutic efficacy and methodological quality of PRP applications in musculoskeletal disorders, focusing on tendinopathies, cartilage degeneration, acute muscle injuries, and anterior cruciate ligament (ACL) repair. Methods: A structured narrative synthesis was conducted using 11 peer-reviewed studies published between 2014 and 2025. These included randomized controlled trials, meta-analyses, systematic reviews, and retrospective analyses. Methodological quality was assessed using AMSTAR 2 and SANRA tools, with thematic synthesis organized by condition type. Results: PRP demonstrated short-term benefits in pain reduction and functional improvement, particularly in tendinopathies and mild-to-moderate osteoarthritis. Leukocyte-poor PRP (LP-PRP) and PBMNC-enriched formulations showed superior outcomes. However, evidence for cartilage regeneration, ACL repair, and acute muscle injuries remains inconclusive due to protocol variability and moderate risk of bias. Conclusion: PRP therapy offers selective clinical utility in musculoskeletal care, especially for chronic tendinopathies and early-stage osteoarthritis. Standardization of PRP protocols, long-term outcome studies, and identification of patient-specific predictors are essential to optimize its therapeutic role.
A Review of Falls Among Older Adults in Saudi Arabia: Risk Factors, Outcomes, and Prevention Strategies
Falls among older adults in Saudi Arabia pose a significant and growing public health concern, with studies reporting prevalence rates exceeding 47%. These events contribute to physical injuries and psychological distress, longer hospital stays, and rising healthcare costs. This narrative review synthesizes recent findings on the prevalence, underlying risk factors, outcomes, and strategies aimed at preventing falls in this population. Key contributors to fall risk in Saudi Arabia were found to include both intrinsic factors, such as chronic health conditions, limited mobility, obesity, vision problems, mental health issues, and polypharmacy, and extrinsic factors like environmental hazards and inadequate safety measures. Despite growing awareness and various preventive efforts, initiatives such as environmental modifications, the use of assistive devices, and closer hospital monitoring, falls remain common across both community and healthcare settings. The literature points to several effective interventions, including personalized risk assessments, home and facility modifications, medication management, structured exercise programs, and better training for caregivers and medical staff. However, a noticeable gap remains between what is known and what is actually implemented. This underscores the urgent need for stronger implementation of fall prevention strategies. Moving forward, a coordinated, multimodal approach tailored to Saudi Arabia’s healthcare system is essential to reduce fall-related incidents and improve the well-being of older adults.
Association between chronic neck pain, disability, and Physical Activity among Healthcare Workers: A Cross-Sectional Study
BACKGROUND: Chronic neck pain is a prevalent musculoskeletal condition among healthcare workers, often contributing to absenteeism, reduced productivity, and career dissatisfaction. Despite their vulnerability due to high occupational demands, the relationship between neck pain, disability, and lifestyle factors such as physical activity remains insufficiently explored in this group. OBJECTIVE: This study aimed to investigate the association between chronic neck pain, disability, and physical activity levels among healthcare workers. METHODS: A cross-sectional survey was conducted among healthcare workers at Prince Sultan Military Medical City. Participants completed a structured questionnaire that included demographic and health data, the Numerical Pain Rating Scale (NPRS) for pain intensity, the Neck Disability Index (NDI) for disability, the extended Nordic Musculoskeletal Questionnaire, and the International Physical Activity Questionnaire (IPAQ). Descriptive statistics and Pearson correlation analyses were performed. RESULTS: Thirty healthcare workers (83% female) from multiple professions participated. The mean chronic neck pain score was 5.10 (SD = 1.81), and the mean NDI score was 20.25 (SD = 9.73). A high physical activity level was reported by 70% of participants. Significant correlations were observed: a moderate positive correlation between neck pain and disability (r = 0.64, p < 0.01) and a fair positive correlation between neck pain and physical activity (r = 0.45, p < 0.05). CONCLUSIONS: Chronic neck pain appears prevalent among healthcare workers and is moderately associated with disability. Interestingly, higher pain levels were also correlated with higher physical activity, warranting further investigation. Given the small sample size, findings should be interpreted cautiously. Larger, longitudinal studies are recommended to understand risk factors better and to guide preventive and occupational health strategies.
chronic neck pain, healthcare workers, Neck Disability Index (NDI), physical activity, occupational health
Optimizing Osteoarthritis Care: A Review of Multimodal Physical Therapy on Long Term Patient’s Outcome
Background: Osteoarthritis (OA) is a prevalent, chronic musculoskeletal condition and a leading cause of pain, functional limitation, and reduced quality of life, especially among older adults. Traditional physical therapy (PT) for OA typically emphasizes exercise routines and symptom relief strategies. However, growing attention is being directed toward multimodal physical therapy (MPT)—an integrative approach that combines manual therapy, structured exercise, and patient education. This comprehensive model seeks to address not only the physical impairments associated with OA but also the behavioural and educational components that influence long-term disease management. Method: A systematic review was conducted using the Semantic Scholar database. Studies were included if they involved adult populations with OA, used MPT interventions, had a comparator group receiving standard PT or usual care, included a follow-up of at least six months, and reported outcomes related to pain, function, or quality of life. Ten eligible studies were identified, including randomized controlled trials and one systematic review. Result: Of the ten studies, five reported that MPT led to significant short-term improvements in pain and function compared to standard care. However, long-term findings were mixed. Only three studies showed sustained benefits beyond 12 months, while four reported no significant differences between MPT and standard PT over time. Manual therapy was found to be particularly effective in the short term but showed inconsistent long-term value across studies. Conclusion: MPT appears to offer superior short-term outcomes in OA management compared to standard PT. Nonetheless, its long-term benefits remain inconclusive. More high-quality, long-term studies with adherence tracking and patient subgroup analysis are needed to fully assess the sustained value of MPT and to determine which individuals are most likely to benefit from this multimodal approach.
Evaluating the Feasibility and Acceptability of Nintendo Switch-Based Exergaming for Enhancing Physical Activity in Children with Down Syndrome: A Pilot Study
Objective: Nintendo Switch-based exergaming is increasingly used in therapeutic settings. This study aimed to determine whether selected Nintendo Switch games are feasible and engaging for children with Down syndrome (DS). Methods: This interventional pilot study included a convenience sample of 11 children diagnosed with DS. it involved a 40-minute exergaming session using a Nintendo Switch console with ten games (two sports and eight Family Trainer) that required weight shifting and stepping tasks based on previous studies. After the session, the validated Video Game Applicability Questionnaire was used to evaluate usability, engagement, and enjoyment of the selected games using a five-point visual Likert scale. Results: Data from 11 children (7 females), aged 10.45 ± 1.75 years, were analyzed. Games such as Timber Trail (M = 4.96, SD = .07), Log Leaper (M = 4.94, SD = .12), Jump Rope (M = 4.92, SD = .12), Sprint Challenge (M = 4.90, SD = .18), and Head on Hurdler (M = 4.90, SD = .18) received consistently high ratings for usability, engagement, and enjoyment, while others such as Mine Cart Adventure (M = 1.16, SD = .40), Mountain Boarder (M = 1.32, SD = .28), Mole Madness (M = 1.77, SD = .97), Golf (M = 1.77, SD = .76), and Soccer (M = 2.19, SD = .44) were rated lower scores across all domains. Conclusion: Several games showed potential for therapeutic exergaming in children with DS, emphasizing the need for further research and long-term trials.
Association Between Patient Lifting Systems and Musculoskeletal Disorders Among Nurses in Saudi Arabia: A Cross-Sectional Study
Background: This cross-sectional study investigated the association between the use of patient lifting systems and the prevalence of musculoskeletal disorders (MSDs) among nurses in Saudi Arabia. It also examined the influence of lifting frequency, ergonomic knowledge, and sociodemographic factors. Methods: An electronic survey was distributed to 51 nurses between January and June 2023. The survey collected data on sociodemographic, patient lifting system usage frequency, and MSDs using the Nordic Musculoskeletal Questionnaire (NMQ) and the Visual Analogue Scale (VAS). Chi-square tests assessed associations, and logistic regression identified significant MSD risk factors. Results: Among the 51 nurses (mean age = 35.64 years), 35.3% used lifting systems sometimes, 37.3% rarely, and 15.7% never. A total of 25.5% reported insufficient ergonomic training. Frequent use of hoists was significantly associated with lower MSD prevalence (p < 0.001). Logistic regression showed that younger age (OR = 1.628, p = 0.020) and female gender were predictors of higher MSD risk. Lower back pain was the most reported issue (63%), but its severity was lower among nurses who regularly used lifting devices. Conclusion: Frequent use of patient lifting systems was associated with a lower prevalence and severity of MSDs, particularly lower back pain. However, inconsistent use and inadequate ergonomic training may limit their protective benefits. Healthcare facilities should prioritize training and encourage routine use of lifting systems to mitigate MSD risk among nursing staff.