bims-ricfun 2025-10-12 papers

bims-ricfun

Biomed News

on Rehabilitation ICF

Issue of 2025–10–12
33 papers selected by
Gerardo Amilivia, Médica Uruguaya Corporación de Asistencia Médica

Ultrasound in the management of aromatase inhibitor-associated plantar fasciitis.
The paradise-24 questionnaire: a review of language versions, psychometric evidence, and application in brain disorder.
Development and validation of an ICF-based new scale-Atilim Kinesiophobia Scale: A methodological study.
Diaphragm Thickness and Excursion in Nonspecific Low Back Pain: A Critically Appraised Topic.
Ultrasound innovations in diaphragm assessment: an integrative review of expanding clinical applications.
A qualitative study of risk and resilience for positive life outcomes in neurodivergence using the WHO ICF.
The role of diagnostic nerve blocks in guiding spasticity management - application, efficacy and safety: A scoping review.
A systematic literature review to explore lived experiences with phantom limb phenomenon following a lower extremity amputation: a qualitative synthesis.
Radiological frontiers in understanding paraspinal muscle pathophysiology in chronic low back pain.
Evaluating the diagnostic value of ultrasound in meniscal injury detection: current evidence and future directions.
Gluteal aponeurotic fascial injury and proximal iliotibial band syndrome: Lateral hip pain in female runners.
Implementing Community-based  Non-pharmacological Interventions for  Chronic Low Back Pain: A Realist Perspective  on Challenges, Lessons and Sustainability  from a Randomised Controlled Trial.
Systemic disconnects in musculoskeletal healthcare across the care continuum.
GPS and Smartphone Technology for Real-World Measurement of Community Mobility in Healthcare.
Effects of Taiji Stick exercise on strength, balance, and activities of daily living in older adults: a randomized controlled trial.
Rotator cuff tendinopathy is associated with increased activity score in rheumatoid arthritis.
Amyotrophic lateral sclerosis rehabilitation management and non-pharmacological symptomatic treatment: A review.
Investigation of variations in the innervation of the thenar muscles by the median nerve.
Exercise, an Important Step for Peripheral Nerve Injury Recovery.
Strengthening Physical Medicine and Rehabilitation Departmental Research: Insights from the Association of Academic Physiatrists Research Consulting Program.
THE EFFECTS OF INTRAARTICULAR AND PERIARTICULAR KNEE PAIN MANAGEMENT ON THE REHABILITATION OF PATIENTS WITH KNEE OSTEOARTHRITIS AFTER CEPHALOMEDULLARY FIXATION OF PERTROCHANTERIC FRACTURES.
Pharmacological Interventions for Agitated Behaviors in Patients with Traumatic Brain Injury: An Updated Systematic Review.
Diagnostic accuracy of the head pitch test in benign paroxysmal positional vertigo.
Common Mistakes in Groin Pain Classification.
Exploring the Changes in Pain Quality, Mechanical Allodynia, and Tactile Sensibility in Women With Persistent Postpartum Perineal Pain Treated With Somatosensory Rehabilitation: A Retrospective Case Series.
Rehabilitation of a quadruple amputee with leukemia: A challenging endeavor.
The effectiveness of physiotherapy for chronic headaches in patients with temporomandibular disorders: a systematic review.
Alterations in dynamic balance control over time following botulinum toxin injection for calf hypertrophy.
Relationships Between Physical Activity, Social Interaction, and Sense of Belonging Among Older Adults Living in Community-Based Congregate Housing.
Rethinking pelvic floor muscle training in sexual medicine: who benefits and why? Perspective on "Investigating the role of the pelvic floor muscles in sexual function and sexual responses: a systematic review and meta-analysis".
Anatomical variability in the quadriceps tendon: structural layering and patellar insertion patterns.
Evaluating the role of social support systems in enhancing the well-being of elderly individuals with disabilities.
The bidirectional relationship between social participation, social media use and depressive symptoms: a nationwide longitudinal study.

Expert Opin Drug Saf. 2025 Oct 10.

Ultrasound in the management of aromatase inhibitor-associated plantar fasciitis.

Hasan Ocak, Pelin Analay, Murat Kara, Levent Özçakar.

DOI: https://doi.org/10.1080/14740338.2025.2573798
Neurol Sci. 2025 Oct 07.

The paradise-24 questionnaire: a review of language versions, psychometric evidence, and application in brain disorder.

Luana Karoline Castro Silva, Lidiane Andrea Oliveira Lima, Carla Sabariego, Luana Wendy de Oliveira Sousa, Shamyr Sulyvan de Castro.

   BACKGROUND: The high prevalence of brain disorders and their impact on populations requires a better understanding of how affected individuals function daily. PARADISE-24, a tool based on the biopsychosocial model of the International Classification of Functioning, Disability, and Health (ICF), was designed to assess the impact of brain disorders. However, information on translations, psychometric properties, and its use remains limited.
OBJECTIVE: This systematic review aims to provide an overview of PARADISE-24 translations, psychometric properties, and the brain disorders in which it has been applied as an assessment tool.
METHODS: The PRISMA statement guidelines informed the reporting. A structured literature search was performed until January 2025 in PubMed, APA PsycINFO, Web of Science, and SCOPUS. Two reviewers independently retrieved studies. The studies' methodological quality and the quality of evidence were stated.
RESULTS: From 919 identified studies, twelve articles were included. Five evaluated psychometric measures and seven used PARADISE-24 to identify impacts in individuals with multiple sclerosis, epilepsy, migraine, stroke, schizophrenia, Parkinson's disease, and people with substance use disorders. The results report high level of evidence in internal consistency, construct validity, and responsiveness, and considered moderate evidence available in reliability due to the doubtful methodological quality of the studies. Only one translated version was found.
CONCLUSION: Although the PARADISE-24 questionnaire is one of the first and only that assesses the impact of brain disorders based on the ICF, this questionnaire had only four measurement properties evaluated. More validation studies are needed, as well as encouragement for translating the PARADISE-24 into other languages.

Keywords:  International Classification of Functioning, Disability and Health; Nervous System Diseases; Psychometrics; Psychosocial Functioning

DOI:  https://doi.org/10.1007/s10072-025-08487-y
Medicine (Baltimore). 2025 Oct 03. 104(40): e44834

Development and validation of an ICF-based new scale-Atilim Kinesiophobia Scale: A methodological study.

Naime Uluğ, Ayhan Parmaksiz, Sena Nur Begen, Zehra Can Karahan, Seval Yilmaz, Mehmet Fatih Adali, Sema Nur Aslan, Özgür Selim Uysal, Dudu Melek Er, Öznur Tunca, Erden Kiliç.

  It is important to assess kinesiophobia, which increases the risk of disability by limiting physical activity. In this cross-sectional study, we aimed to develop a scale that assesses kinesiophobia with the multidimensional structure of International Classification of Functioning, Disability and Health (ICF). Atilim Kinesiophobia Scale (AKS) was developed in Turkish by an expert panel using questionnaires replied by 367 subjects. Finally, 38 questions based on the sub-domains of the ICF described by World Health Organization. In the scope of this cross-sectional study content validity and reliability were assessed; construct validity (both convergent and divergent validity) was checked against Tampa Kinesiophobia Scale-17 and Visual Analog Scale. AKS demonstrated good internal consistency and convergent validity, with significant correlations observed with the Tampa Scale for Kinesiophobia-17 (r = 0.478, P < .001). Divergent validity was supported by insignificant correlations with the Visual Analog Scale (r = 0.019, P = .855). The Cronbach alpha coefficient of 0.862 indicates a high level of internal consistency for the AKS. Based on these findings, the final version of AKS was refined to include 4 factors and 14 items, demonstrating good internal validity. We developed and validated the AKS to assess kinesophobia in patients with acute and/or chronic musculoskeletal pain. This new ICF-based scale can be used to assess kinesiophobia; however further studies are required to prove its validity and reliability in other languages.

Keywords:  ICF; fear of movement; kinesiophobia; pain; scale

DOI:  https://doi.org/10.1097/MD.0000000000044834
J Sport Rehabil. 2025 Oct 07. 1-6

Diaphragm Thickness and Excursion in Nonspecific Low Back Pain: A Critically Appraised Topic.

Brittany Braun, Eleni Petrou, Jennifer Ostrowski.

   CLINICAL SCENARIO: Low back pain is a common musculoskeletal condition, with nonspecific low back pain (NS-LBP) accounting for the majority of cases. NS-LBP lacks a definitive pathological cause, complicating diagnosis and management. Emerging research has identified diaphragm dysfunction, including alterations in thickness and excursion, as a potential factor contributing to NS-LBP. Ultrasound is a noninvasive tool used to measure these diaphragm characteristics and explore their association with NS-LBP.
CLINICAL QUESTION: In patients with NS-LBP, is there a difference in diaphragm thickness and excursion (as measured by ultrasound) compared with healthy controls?
SUMMARY OF KEY FINDINGS: A systematic search yielded 4 high-quality case-control studies assessing diaphragm function in patients with NS-LBP. All 4 studies demonstrated significantly reduced diaphragm thickness in patients with NS-LBP compared with healthy controls. Findings on diaphragm excursion were inconsistent, with 1 study reporting significant differences while 3 showed no differences between groups. Reduced diaphragm thickness and slower changes in thickness were consistently associated with impaired spinal stabilization.
CLINICAL BOTTOM LINE: The evidence indicates a consistent difference in diaphragm thickness between individuals with NS-LBP and healthy controls, suggesting a potential role of diaphragm dysfunction in the pathophysiology of NS-LBP. However, inconsistent findings on diaphragm excursion warrant further investigation.
STRENGTH OF RECOMMENDATION: Based on the Strength of Recommendation Taxonomy, the clinical bottom line is based on grade A evidence for diaphragm thickness while diaphragm excursion is grade B.

Keywords:  chronic back pain; excursion; ultrasound

DOI:  https://doi.org/10.1123/jsr.2024-0466
Eur Respir Rev. 2025 Oct;pii: 250089. [Epub ahead of print]34(178):

Ultrasound innovations in diaphragm assessment: an integrative review of expanding clinical applications.

Ivo Neto Silva, Claire Bennett, José Alberto Duarte, Karim Bendjelid.

INTRODUCTION: Diaphragm dysfunction is prevalent across various patient populations, requiring precise structural and functional assessment. Ultrasound, being bedside-accessible and radiation-free, has gained relevance for evaluating the diaphragm and other respiratory muscle. Recent advancements have introduced novel techniques that have expanding its assessment scope. This review aims to identify emerging ultrasound methods for quantitative diaphragm assessment in adults, emphasising reliability and clinical relevance.
METHODS: A systematic literature search was conducted using keywords related to the diaphragm, ultrasound techniques and innovation. We included original studies on adult participants using innovative ultrasound methods extending beyond conventional assessments. Studies lacking original data, case reports, animal studies and studies on automated analysis techniques were excluded. Screening and data extraction followed a structured process, with one researcher extracting data and a second verifying accuracy. Results were categorised by reliability and by physiological and clinical outcomes.
RESULTS: Of 1411 records screened, 288 full-text articles were reviewed, and 36 studies met inclusion criteria, with four additional studies identified via reference analysis. These studies, published between 2013 and 2024, explored seven innovative techniques: the area method, contrast-enhanced ultrasound, echogenicity/echodensity, excursion of the zone of apposition, shear wave/strain elastography, speckle tracking and pulsed-wave tissue Doppler imaging. Studies focused on both healthy subjects and critically ill, surgical and COPD patients.
CONCLUSIONS: Recent ultrasound advancements enhance diaphragm assessment by evaluating muscle quality, functional mechanical properties and blood flow. These innovative methods also provide alternatives when conventional approaches are limited. Further research is essential to refine protocols, validate clinical applications and standardise assessments for broader implementation.

DOI: https://doi.org/10.1183/16000617.0089-2025
Sci Rep. 2025 Oct 09. 15(1): 35285

A qualitative study of risk and resilience for positive life outcomes in neurodivergence using the WHO ICF.

Melissa H Black, Julie Segers, Emma Moormann, Stephanie Torell, Cecilia Ingard, Sven Bölte.

  Resilience is a dynamic process involving the interaction of multi-systemic individual and environmental factors that operate to protect against adversity and promote positive personal outcomes. Resilience is a topic of interest among groups who commonly experience adversity. Yet, it has received limited attention in the context of neurodivergence (e.g., autism and Attention Deficit Hyperactivity Disorder). This study is part of a larger project investigating the bio-psycho-social factors contributing to resilience in neurodivergence using the World Health Organization's International Classification of Functioning (ICF). Interviews and focus groups were conducted with 69 neurodivergent individuals and/or their loved ones to explore the factors they believe influence risk and resilience for positive life outcomes and well-being. A deductive qualitative content analysis was employed to extract meaningful concepts from the interviews, which we then quantified by linking concepts to the ICF. A range of bio-psycho-social factors contributing to risk and resilience were identified, particularly in the ICF's activity, participation, and environmental domains. Key factors included the immediate family, friends, and community members, as well as recreation and leisure, higher-level cognitive functions, and empowerment. Findings, while preliminary, highlight the need to look beyond individual factors alone, emphasizing the variable and context-dependent nature of resilience in neurodivergence.

Keywords:  ADHD; Autism; International classification of functioning; Neurodevelopmental; Neurodiversity; Strengths-based

DOI:  https://doi.org/10.1038/s41598-025-19154-9
Am J Phys Med Rehabil. 2025 Sep 10.

The role of diagnostic nerve blocks in guiding spasticity management - application, efficacy and safety: A scoping review.

Jia Yi Sandra Lau, Deepali Bang, Yeow Leng Tan, Pei Ling Tan, Jing Chen.

   ABSTRACT: Diagnostic nerve blocks (DNBs) are emerging as valuable tools for assessing and guiding spasticity management, yet their clinical application remains variable and underexplored. This scoping review systematically maps the current literature on the use, efficacy, and safety of DNBs across diverse neurological conditions. Following the PRISMA-ScR guidelines, a comprehensive search of PubMed, Embase, and Web of Science was conducted, identifying 15 studies involving 504 patients with spasticity due to stroke, cerebral palsy, spinal cord injury, traumatic brain injury, and other etiologies. DNBs were predominantly applied to the lower limbs, targeting spastic equinovarus foot and stiff knee gait. Reported outcomes included spasticity scales, joint range of motion, gait kinematics, electromyographic changes, and functional mobility tests. Across studies, DNBs consistently supported clinical decision-making including decisions on botulinum toxin dosages, neurolysis and neurectomy. Their use was also associated with improved goal attainment rates. Adverse effects were infrequent and transient. While most studies were of fair quality, limitations included small sample sizes, absence of blinding or powered calculations. Overall, DNBs represent a safe and valuable tool, enhancing diagnostic precision and facilitating personalized, patient-centered spasticity management. Future high-quality studies are needed to establish standardized protocols and strengthen the evidence for their use in clinical practice.

Keywords:  Diagnostic Nerve Block; Local Anesthetics; Scoping Review; Spasticity

DOI:  https://doi.org/10.1097/PHM.0000000000002849
Front Rehabil Sci. 2025 ;6 1667659

A systematic literature review to explore lived experiences with phantom limb phenomenon following a lower extremity amputation: a qualitative synthesis.

Abdullah Ali H Alabdullah, Saeed Saad Alyazidi, Ibrahim Ali Asiri, Hussain Saleh Ali, Sarah Abdullah Almutlaqah, Ahmed Saleh Alzahrani, Saeed Abdulrhman Alzahb, Sumaya Abdullah Alasmari, Dejan Nikolic, Natasa Radosavljevic.

   Objective: In this review we aimed to understand better frequent experiences accompanying phantom limb issues from patients' perspective and accordingly to generate recommendations for clinical practice.
Methods: A systematic literature review approach was utilized and articles meeting the eligibility criteria were critically appraised using the Critical Appraisal Skills Program (CASP). Additionally, a meta-synthesis approach was adopted to combine and analyze the data.
Results: Ten relevant studies were critiqued, key themes were: 1) early Information Provision about phantom Limb Pain (PLP) and Participants' Satisfaction; 2) the PLP's described characteristics; 3) different Emotions and Psychosocial Issues with PLP; 4) the Impact of the PLP on Performing Daily Activities; and 5) the experienced strategies to address the PLP.
Conclusion: The experience of phantom limb varies among individuals with lower limb amputation (LLA); however, for many, PLP significantly affects both physical and psychological well-being, adding an additional burden to the overall experience of amputation. Addressing these challenges should begin with early education, followed by a rehabilitation process that considers individual differences in coping mechanisms. Moreover, patients' preferences should be prioritized when selecting prosthetic devices and determining the most appropriate treatment strategies for managing PLP.

Keywords:  amputation; experience; lower limb; phantom limb; qualitative; review

DOI:  https://doi.org/10.3389/fresc.2025.1667659
Front Med (Lausanne). 2025 ;12 1653876

Radiological frontiers in understanding paraspinal muscle pathophysiology in chronic low back pain.

Xuerou Li, Fuwen Dong, Xiaofei Chen, Xingxin Luo, Wenqi Wang.

   Background: Paraspinal muscles have a profound role in maintaining spinal stability and are often implicated in spinal degenerative conditions as well as chronic low back pain (CLBP). Alterations in these muscles have significant clinical implications for early prevention, treatment strategies, prognosis, and understanding the underlying mechanisms of CLBP. Recent advances in imaging techniques can generate prominent structural and functional characteristics of these muscles.
Objectives: This study is specifically to review recent advancements in imaging techniques focusing on the regenerative and degenerative properties pertinent to paraspinal muscles in the context of CLBP.
Methods: A literature review was executed to ascertain the databases including PubMed, Google Scholar, RelMed, and the National Library of Medicine. The search included studies elucidating recent imaging advancements, fiber-type composition analysis, level/depth-specific muscle characteristics, and clinical applications of novel radiological techniques in evaluating paraspinal muscle morphology and function. We performed this review without comprehensive meta-analysis.
Results: The review identified significant advancements in imaging modalities for assessing paraspinal muscles, including functional MRI (fMRI), quantitative MRI (qMRI), and T2 mapping techniques. Key findings include: Fiber-type composition analysis: Recent studies elucidate the role of depth-dependent fiber-type gradients along with their correlation with muscle function in health and disease. Standardized imaging protocols: The lack of uniform imaging protocols remains a challenge, emphasizing the need for standardization to improve reproducibility and reliability. Radiological advances: Emerging techniques such as advanced fMRI and qMRI enable detailed visualization of muscle structure and function, overcoming limitations of traditional imaging methods. Age-related microvascular changes: age-related microvascular alterations significantly impact paraspinal muscle morphology and can be effectively captured by modern imaging biomarkers.
Conclusion: Advances in imaging techniques have enhanced our understanding of the structural and functional changes in paraspinal muscles associated with CLBP. The integration of imaging biomarkers into clinical practice holds promise for early diagnosis, targeted interventions, and better prognostic evaluations. Future research should focus on developing standardized imaging protocols and further exploring depth-specific properties of paraspinal muscles to enhance clinical outcomes.

Keywords:  chronic low back pain; depth-specific analysis; fiber-type composition; functional MRI; imaging techniques; muscle degeneration; paraspinal muscles; quantitative MRI

DOI:  https://doi.org/10.3389/fmed.2025.1653876
Emerg Radiol. 2025 Oct 09.

Evaluating the diagnostic value of ultrasound in meniscal injury detection: current evidence and future directions.

Reza Gerami, Amir Nezami Asl, Mostafa Shahrezaee, Jalal Kargar, Farshad Riahi.

   PURPOSE: Meniscal injuries are a common cause of knee dysfunction and healthcare utilization, with magnetic resonance imaging (MRI) being the diagnostic gold standard. However, MRI's cost, limited accessibility, and contraindications of MRI have prompted interest in ultrasound (US) as a more affordable, portable, and radiation-free alternative. This review aimed to synthesize the current evidence on the diagnostic accuracy of US for meniscal tears and to define its role alongside MRI and arthroscopy in clinical practice.
METHODS: We conducted a systematic review following the PRISMA guidelines, searching PubMed from January 2020 to March 2025 for English-language studies of adult patients (>18 years) undergoing US assessment of suspected meniscal injuries. Eligible studies used MRI or surgical (arthroscopic or open) findings as reference standards. Two reviewers independently screened the titles, abstracts, and full texts, extracted the study characteristics and diagnostic metrics, and tabulated the results.
RESULTS: Six studies comprising 499 participants met the inclusion criteria. US sensitivity for detecting meniscal tears ranged from 63% to 92.9%, and specificity from 63.6% to100%, with higher performance for medial than for lateral tears. Point-of-care US in emergency settings demonstrated sensitivities up to 92.9% and specificities up to 88.9%. Community-based US yielded specificity ≥97% for medial tears.
CONCLUSION: US exhibits clinically acceptable diagnostic accuracy for meniscal injury, particularly when high-frequency probes and experienced operators are used. However, future research should focus on large-scale standardized trials to refine scanning protocols, quantify learning curves, and develop guidelines for integrating US into meniscal injury trajectories.

Keywords:  Diagnostic accuracy; Knee; Meniscal injuries; Ultrasonography

DOI:  https://doi.org/10.1007/s10140-025-02395-6
PM R. 2025 Oct 11.

Gluteal aponeurotic fascial injury and proximal iliotibial band syndrome: Lateral hip pain in female runners.

Elizabeth L Roux, Violet E Sullivan, Katrina I Coogan, F Joseph Simeone, Adam S Tenforde.

DOI: https://doi.org/10.1002/pmrj.70030
Ann Neurosci. 2025 Oct 05. 09727531251379160

Implementing Community-based  Non-pharmacological Interventions for  Chronic Low Back Pain: A Realist Perspective  on Challenges, Lessons and Sustainability  from a Randomised Controlled Trial.

Babita Ghai, Rajni Sharma, Babina Rani, Akshay Anand.

DOI: https://doi.org/10.1177/09727531251379160
Ann Acad Med Singap. 2025 Aug 29. 54(9): 585-587

Systemic disconnects in musculoskeletal healthcare across the care continuum.

Arun-Kumar Kaliya-Perumal, Oliver Roberts, Bryan Yijia Tan.



Keywords:  aged; chronic disease; health policy; musculoskeletal diseases; patient-centred care

DOI:  https://doi.org/10.47102/annals-acadmedsg.2025139
Digit Biomark. 2025 Jan-Dec;9(1):9(1): 155-170

GPS and Smartphone Technology for Real-World Measurement of Community Mobility in Healthcare.

Sara Nataletti, Megan K O'Brien, Rachel Maronati, Francesco Lanotte, Shreya Aalla, Christian Poellabauer, Brad D Hendershot, John M Looft, Arun Jayaraman.

   Introduction: A primary goal of physical medicine and rehabilitation is restoring community mobility after injury or illness. However, there is no clinically accepted real-world method to measure community mobility, which fundamentally limits our ability to evaluate treatment effectiveness. This study aimed to develop and validate a digital framework using GPS-enabled smartphones and inertial sensors to monitor community mobility and estimate clinical function in individuals with chronic stroke or lower limb amputation (LLA).
Methods: Ninety individuals with chronic stroke or LLA underwent remote monitoring for 3-9 months. Participants completed standard clinical assessments, and daily mobility data were extracted from GPS and step count features. We conducted four analyses: (1) characterization of group- and individual-level community mobility, (2) evaluation of mobility changes following a mobility-targeted intervention in a single case participant, (3) development of machine-learned models to predict clinical gait outcomes using community data, and (4) estimation of the minimum number of days needed to reliably predict functional outcomes.
Results: Community mobility measures revealed substantial variability both across and within individuals, reflecting diverse functional profiles. In a case study, a participant with LLA demonstrated increased activity and movement diversity following a personalized intervention. Machine-learned models estimated 6-Minute Walk Test and 10-Meter Walk Test scores with clinically acceptable error margins (7-10%) using as few as 14 days of community data. Reliable predictions were achievable with just 3-6 days of monitoring.
Conclusions: GPS- and smartphone-based monitoring offer a feasible and scalable approach to assess real-world mobility. This approach could close a critical gap in the care continuum and enable us to fully evaluate the real-world impact of treatment interventions while also reducing reliance on frequent in-person evaluations.

Keywords:  Clinical outcomes; Community mobility; Continuum of care; Machine learning; Remote monitoring; Telehealth; Wearable sensors

DOI:  https://doi.org/10.1159/000548017
Front Public Health. 2025 ;13 1647055

Effects of Taiji Stick exercise on strength, balance, and activities of daily living in older adults: a randomized controlled trial.

Longfei Cao, Xiaoxiao Dong, Kai Qi, Chunhui Zhou, Aiguo Chen.

   Background: With advancing age, older adults experience an accelerated decline in physical function. The progressive decline not only compromises overall well-being but also precipitates numerous serious complications, including an increased likelihood of falls and bone injuries, and in more advanced stages, a diminished ability to carry out daily tasks independently. Numerous studies have shown that engagement in Health Qigong and Taijiquan exercises contributes to better physical functioning and facilitates the completion of everyday activities in senior populations. The positive outcomes observed in previous studies provide the theoretical foundation and practical basis for the current investigation. An 11-week Taiji Stick exercise regimen was implemented to explore its impact on grip and lower limb strength, dynamic balance, and daily functional activities in older individuals.
Methods: A randomized controlled design was employed. Thirty-five older adults were randomly assigned to either an intervention group or a control group. The intervention group engaged in an 11-week Taiji Stick exercise program, held three times weekly for 45 min per session. Participants in the control group continued with their routine daily activities without receiving any form of intervention. Grip strength was assessed using a portable digital dynamometer. Lower limb muscular strength was evaluated through the Five Times Sit-to-Stand test (5STS), while dynamic balance was measured via the Timed Up and Go test (TUG). The Barthel Index served to examine participant's activities of daily living (ADL).
Results: (1) After the intervention, the experimental group showed no significant change in right-hand grip strength [pre-test: 19.00 (15.65, 24.45), post-test: 19.40 (16.15, 25.20); p = 0.185, |r| ≈ 0.32], whereas the control group exhibited a significant decrease in right-hand grip strength [pre-test: 17.15 (14.18, 23.68), post-test: 16.75 (13.03, 23.48); p = 0.001, |r| ≈ 0.79]. (2) Following the intervention, the experimental group demonstrated significant improvements in lower limb strength [pre-test: 15.00 (13.40, 20.00), post-test:12.30 (9.55, 15.20); p < 0.001, |r| ≈ 0.86], dynamic balance (pre-test: 15.13 ± 4.04, post-test: 11.77 ± 3.42; p < 0.001, ηp 2 = 0.618), as well as in daily living capacity [pre-test: 95.00 (90.00, 100.00), post-test: 95.00 (92.50, 100.00); p < 0.05, |r| ≈ 1.00]. In comparison, the control group experienced a marked decline in lower limb strength [pre-test:16.40 (14.75, 20.85), post-test:17.50 (15.50, 23.25); p < 0.001, |r| ≈ 0.88], as well as a notable deterioration in activities of daily living [pre-test: 95.00 (88.75, 100.00), post-test: 90.00 (80.00, 95.00); p < 0.01, |r| ≈ 0.89], along with a non-significant reduction in dynamic balance was noted (pre-test:17.16 ± 3.92, post-test:17.92 ± 4.70; p > 0.05, ηp 2 = 0.081).
Conclusion: An 11-week Taiji Stick exercise program can effectively enhance lower limb strength and dynamic balance, maintain upper limb strength, show potential to reduce fall-related risks, and improve daily living ability in older adults.
Clinical trial registration: This study was approved for registration by the Chinese Clinical Trial Registry on April 24, 2024 (ChiCTR2400083424).

Keywords:  Taiji Stick; activities of daily living; dynamic balance ability; grip strength; lower extremity strength; older adults

DOI:  https://doi.org/10.3389/fpubh.2025.1647055
Reumatol Clin (Engl Ed). 2025 Oct;pii: S2173-5743(25)00131-5. [Epub ahead of print]21(8): 501947

Rotator cuff tendinopathy is associated with increased activity score in rheumatoid arthritis.

Jorge Medina-Castillo, Rodrigo J Castillo-de la Garza, David Vega-Morales, Jorge A Esquivel-Valerio, Axel A De León-Pérez, Lorenia De La Cruz-Becerra, Alondra Elizabeth Montoya-Montes, Lourdes Gil-Flores, Dionicio Ángel Galarza-Delgado.

   INTRODUCTION AND OBJECTIVE: Rheumatoid arthritis (RA) is often accompanied by musculoskeletal (MS) symptoms, which can hinder the diagnosis of concurrent conditions like rotator cuff tendinopathy (RCT), the most common cause of shoulder pain. Undiagnosed RCT in patients with RA may be associated with higher disease activity scores. This study aimed to assess the difference in these scores between RA patients with and without RCT, considering ultrasound pathological findings.
METHODS: We conducted a cross-sectional, observational, comparative study in patients with shoulder pain who met the 2010 ACR-EULAR classification criteria for RA between January 2022 and January 2023. The measurements of Disease Activity Score based on 28 joints using C-Reactive Protein (DAS28-CRP), Erythrocyte Sedimentation Rate (DAS28-ESR), and the Clinical Disease Activity Index (CDAI) were used to evaluate RA activity, while functional capacity was assessed using the Health Assessment Questionnaire Disability Index (HAQ-DI). The Disabilities of the Arm, Shoulder, and Hand questionnaire (DASHe) and shoulder ultrasound examination was performed to detect the presence or absence of RCT.
RESULTS: Patients with RCT had greater mean scores on DAS28-CRP (5.23, 1.28 vs. 3.08, p<0.001), and DAS 28-ESR (5.43, SD=1.28 vs. 3.66, p<0.001). VAS median scores were higher in the RCT group (70.00 vs. 2.00, p<0.001). By ultrasound 12 patients (21%) had acromioclavicular synovitis. Glenohumeral and acromioclavicular arthrosis was found in both groups. No patients had arthritis in the glenohumeral joint.
CONCLUSION: RA patients with RCT have higher composite index and disease activity scores than those without RCT. An intentional RCT screening should be recommended for those with shoulder pain and elevated disease activity.

Keywords:  Artritis reumatoide; Comparative study; Dolor de hombro; Estudio comparativo; Rheumatoid arthritis; Rotator cuff tendinopathy; Shoulder pain; Sinovitis; Synovitis; Tendinopatía del manguito rotador

DOI:  https://doi.org/10.1016/j.reumae.2025.501947
Int J Clin Pharmacol Ther. 2025 Oct 09.

Amyotrophic lateral sclerosis rehabilitation management and non-pharmacological symptomatic treatment: A review.

Yuetong Shan, Wei Jing, Haihan Zhang, Yizhou Liu, Shangyu Wei, Feifei Wu, Weidong Pan.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that lacks effective treatment options for the prevention of progression. Relieving swallowing difficulties, reducing breathing difficulties, and alleviating muscle spasms are essential to improving the quality of life in patients with ALS. Many symptoms can be treated clinically with medication; however, the evidence level of related research is relatively low. Rehabilitation management can aid in improving various functional impairments and enhancing quality of life. This review introduces and describes the relevant evaluations of rehabilitation and nonpharmacological symptomatic treatment methods for functional disorders from the perspectives of motor and nonmotor symptoms. This review may promote the popularization of ALS rehabilitation management and provide an additional reference for ALS treatment.

DOI: https://doi.org/10.5414/CP204744
Surg Radiol Anat. 2025 Oct 09. 47(1): 227

Investigation of variations in the innervation of the thenar muscles by the median nerve.

Erdinç Acar, Mehmet Yılmaz, Yusuf Kıratlıoğlu, Halil İbrahim Acar, Mehmet Armangil, İbrahim Tekdemir.

   INTRODUCTION: This study aims to investigate the anatomical variations in the median nerve and its branches, specifically focusing on their distribution to the muscles and the points at which they enter the muscles. In addition, the branching level of the ramus muscularis of the median nerve supplying the thenar muscles was examined to explore potential correlations with carpal tunnel syndrome. Understanding these variations is crucial for minimizing iatrogenic nerve damage during surgical procedures in the carpal tunnel region.
METHODS: Dissections were conducted on 15 forearm and wrist specimens, including 8 right-sided cadavers and 7 left-sided cadavers. The muscle branch entry levels into the thenar region were measured, and the nerve was classified according to Lanz's classification system during the opening of the flexor retinaculum. Parameters such as the height of the first branch of the median nerve relative to the z-line (interstyloid line), the relationship of the nerve's muscular branch to the flexor retinaculum, the level of entry of the muscle branch into the muscle (relative to the z-line), muscle length, and the ratio of the entry level of the first branch to muscle length were examined.
RESULTS: Four types of median nerve branching were observed according to Lanz's classification. The extraligamentous type was the most common, found in 53% of the specimens. In preligamentous types, the branches emerged on average 13.37 ± 5.69 mm inferiorly, except for those relative to the z-line. The entry level of the muscle branch into the muscle was most frequently located in the upper third of the thenar region. The average length of the thenar region was measured to be 11.40 ± 1.02 mm. The high frequency (53%) of the extraligamentous type in our study aligns with the findings in the general literature. However, the discovery of an additional preligamentous accessory motor branch in 46% of cases is a noteworthy observation, highlighting a higher rate than previously documented.
CONCLUSION: These branching patterns suggest the need for careful consideration of accessory branches during surgical procedures in the carpal tunnel region. In particular, during carpal tunnel surgeries, it is recommended to assess the relationship between the motor branch of the median nerve and the flexor retinaculum before releasing it, as variations in branching could have implications for surgical outcomes.

Keywords:  Carpal tunnel syndrome; Median nerve; Thenar muscle

DOI:  https://doi.org/10.1007/s00276-025-03735-4
J Integr Neurosci. 2025 Sep 22. 24(9): 38086

Exercise, an Important Step for Peripheral Nerve Injury Recovery.

Ziwei Zhang, Jielun Huang, Hu Zhang, Jiawen Shen.

  Peripheral nerve injury is a relatively common clinical condition that predominantly results from sensory, motor, and nutritional disorders. These can be due to aging, external forces, diseases, or changes in physical and chemical environments. Although interventions, including relevant drugs and surgeries, have led to advancements in peripheral nerve repair, achieving complete recovery remains a challenge. Untimely treatment and rehabilitation can lead to lifelong disabilities and neurological pain. Exercise is a low-cost intervention that plays an active role in the rehabilitation of patients with many diseases, including peripheral nerve injuries. This narrative review, conducted in accordance with the Scale for the Assessment of Narrative Review Articles guidelines, synthesized evidence from searches of PubMed, Scopus, Web of Science, and Google Scholar databases to summarize the molecular mechanisms of exercise and adjuvant therapies in peripheral nerve injury rehabilitation and the synergistic benefits of combined exercise and adjuvant therapy for peripheral nerve repair. This study revealed that the combination of exercise with either physical therapy or traditional Chinese medicine yielded superior therapeutic outcomes for peripheral nerve injuries attributable to aging, pathological conditions, and environmental factors. These benefits appear to be mediated by the suppression of oxidative stress and inflammatory responses, upregulation of neurotrophic factor expression, activation of autophagic pathways, modulation of endocrine homeostasis, and promotion of vascular network reconstruction. Furthermore, this study provides a theoretical foundation and a potential research direction for elucidating the targeted molecular mechanisms through which exercise ameliorates peripheral nerve injury.

Keywords:  combined modality therapy; exercise therapy; peripheral nerve injuries; physical therapy modalities; rehabilitation; sports medicine

DOI:  https://doi.org/10.31083/JIN38086
Am J Phys Med Rehabil. 2025 Sep 10.

Strengthening Physical Medicine and Rehabilitation Departmental Research: Insights from the Association of Academic Physiatrists Research Consulting Program.

Qing Mei Wang, Stephen Lencioni, Thiru Annaswamy, Allison Bean, Justin Huber, Dinesh Kumbhare, Sheng Li, Sabrina Paganoni, John-Ross Rizzo, Paul Scholten, Stacy Suskauer, Randel Swanson, Amy Schnappinger, John Whyte, W David Arnold.

   ABSTRACT: Clinical and translational research are important for healthcare and the growth of medical specialties. Physical Medicine and Rehabilitation (PM&R) offers many opportunities for research, but research growth in PM&R is lacking, and research resources and productivity vary across academic PM&R departments across North America. The Physiatric Research Consulting Program (PRCP) was developed by the Association of Academic Physiatrists (AAP) to provide customized recommendations to enhance research capacity and productivity in PM&R departments. This report outlines the three components of the PRCP, including a Pre-Visit Needs Assessment, an In-Person Visit, and a Post-Visit Follow-up Final Report. The report also provides a qualitative assessment of the impact of the PRCP, with general themes of feedback, site visit evaluations, and final report evaluations. The PRCP was found to be valuable in identifying gaps and needs for PM&R departments, providing outside perspectives, and energizing faculty toward research growth in their departments.

Keywords:  Physical Medicine and Rehabilitation; research consulting; research development

DOI:  https://doi.org/10.1097/PHM.0000000000002769
Acta Clin Croat. 2024 Dec;63(3-4): 678-683

THE EFFECTS OF INTRAARTICULAR AND PERIARTICULAR KNEE PAIN MANAGEMENT ON THE REHABILITATION OF PATIENTS WITH KNEE OSTEOARTHRITIS AFTER CEPHALOMEDULLARY FIXATION OF PERTROCHANTERIC FRACTURES.

Maki Grle, Stefan Moro, Damir Franjić, Dajana Vladić, Robert Karlović, Ivana Grle, Jerko Prlić.

  The gold standard for pertrochanteric fractures is closed reduction with traction and intramedullary osteosynthesis. A significant number of patients report knee pain after surgery, which could be associated with gonarthrosis and traction. In this research we wanted to determine if managing knee pain affects the rehabilitation of patients. There were three groups: the first group received a post-operative intra-articular (IA) injection containing methylprednisolone with lidocaine; the second group received the same combination periarticularly (PA); and the control group did not receive any form of injection. We measured the Visual Analogue Scale (VAS) score on the 3rd and 12th postoperative days, as well as six weeks after surgery. We measured knee range of motion (ROM) on the 12th postoperative day and six weeks after surgery. We calculated the Harris Hip Score (HHS) on the 3rd day and six weeks postoperatively. There were 27 patients. Preoperative Kellgren-Lawrence and VAS pain scores were similar. The IA group demonstrated the lowest VAS pain score after six weeks. ROM did not improve between groups on the 12th day and six weeks postoperatively. HHS was best in the IA group after 6 weeks. Injection of methylprednisolone with lidocaine into the knee improved postoperative rehabilitation in patients with knee osteoarthritis undergoing ipsilateral cephalomedullary fixation for a pertrochanteric fracture.

Keywords:  Knee injection; Knee osteoarthritis; Knee pain; Pertrochanteric fracture; Skeletal traction

DOI:  https://doi.org/10.20471/acc.2024.63.03-04.28
J Neurotrauma. 2025 Oct 06.

Pharmacological Interventions for Agitated Behaviors in Patients with Traumatic Brain Injury: An Updated Systematic Review.

Tal Klimenko, Marie-Michèle Briand, Christophe Dumais, Yorgios Alexandros Cavayas, Francis Bernard, Caroline Arbour, Lisa Burry, Marc Perreault, Marie-Julie Potvin, David Williamson.

  The aim of this updated systematic review was to assess the efficacy and safety of pharmacological agents in the management of agitated behaviors following traumatic brain injury (TBI). We updated a 2019 systematic review, which originally included 21 studies, by performing a search strategy in MedLine, Embase, PsychInfo, Cinhal, Directory of Open Access Journals, and Latin American and Caribbean Literature on Health Sciences Literature (up to Jan 7th, 2025) for evidence on the risks and benefits of nine medication classes used to control agitated behaviors following TBI. We included all randomized controlled trials, quasi-experimental and observational studies examining the effects of medications administered to control agitated behaviors in TBI patients. Of the 58 studies screened in full-text, 11 additional studies were added to the 21 original studies for a total of 32 studies. Of these new studies, three studies evaluating dexmedetomidine suggested some potential benefits in reducing agitation. New studies on risperidone, olanzapine, carbamazepine, and valproic acid failed to show efficacy compared with control groups. Among studies identified in the first review, propranolol did reduce intensity of agitation but not its frequency. In conclusion, there remain insufficient data to recommend the use of any medications for the management of agitation following TBI. Dexmedetomidine may have potential benefit in an acute setting, and the benefits of antipsychotics, carbamazepine, and amantadine remain unclear. Beta-blockers and valproic have shown benefits, but results are inconsistent. More studies in the acute, rehabilitation, and outpatient settings are needed to assess the efficacy and safety of pharmacological agents for the management of agitated behaviors.

Keywords:  acute recovery; agitation; pharmacological intervention; systematic review; traumatic brain injury

DOI:  https://doi.org/10.1177/08977151251381347
Acta Otorrinolaringol Esp (Engl Ed). 2025 Oct 05. pii: S2173-5735(25)00086-9. [Epub ahead of print] 512288

Diagnostic accuracy of the head pitch test in benign paroxysmal positional vertigo.

Mayada Elsherif, Alia E L Karaksy, Dalia Eldeeb, Mirhan Eldeeb.

   INTRODUCTION AND OBJECTIVES: The diagnostic accuracy and reliability of the head pitch test in differentiating between different types of BPPV require further investigation. Studying the diagnostic accuracy of the head pitch test in BPPV diagnosis can aid in the development of targeted management strategies for patients presenting with BPPV METHODS: All patients who complained of positional vertigo for seconds underwent complete videonystagmography test using ICS Chartr 200 VNG/ENG system (Otometrics, Denmark) including : spontaneous nystagmus, complete occulomotor test battery, then the head pitch test was performed in two positions: first the patient's head was bent 90 degrees forwards, then 60 degrees backwards for approximately 1 minute each. If nystagmus was observed, its direction was recorded1. All patients then underwent gold standard tests for positional vertigo including both Dix-Hallpike maneuver and the supine roll tests.
RESULTS: The sensitivity (true positive cases) was defined as the head pitch (HPT) test being positive and showing the correct nystagmus for different categories of BPPV. The sensitivity of the experimental HPT was compared to the gold standard tests (100% sensitive) for diagnosis of different categories of vertical canal and lateral canal BPPV. It was highest (100%) for Lateral Cupulolithiasis patients (n = 12) and Anterior canal Canalithiasis (n = 3) and lowest (68%) for Typical Posterior Canalithiasis patients (n = 68).
CONCLUSION: This study supports the addition of the head pitch test in the routine assessment of patients with positional vertigo. As it could shorten the examination time and decrease the repositioning maneuvers which may cause severe autonomic symptoms.

Keywords:  BPPV; Dix Hallpike test; Head pitch test; Supine roll test; VPPB; prueba de Dix Hallpike; prueba de balanceo supino; prueba de cabeceo

DOI:  https://doi.org/10.1016/j.otoeng.2025.512288
Semin Musculoskelet Radiol. 2025 Oct;29(5): 720-732

Common Mistakes in Groin Pain Classification.

Tatiane Cantarelli Rodrigues, Gilberto Amado Rodrigues da Cunha Filho, Abdalla Skaf, André Fukunishi Yamada.

Groin pain is a common issue in athletes, and an accurate diagnosis is crucial for effective management. The complexity of the groin's anatomy, including the pubic symphysis and adductor muscles, makes diagnosing injuries in this area challenging. Additionally, the maturation of the pubic apophysis, particularly in adolescent athletes, can lead to conditions like apophysitis that are often misdiagnosed as other groin injuries. A major challenge is the inconsistent terminology, with terms like "athletic pubalgia" and "sports hernia" used interchangeably, causing confusion. The 2015 Doha Agreement helped standardize the classification of groin pain into adductor-, iliopsoas-, inguinal-, and pubic-related types. This review highlights common mistakes in imaging interpretation, particularly in diagnosing adductor- and pubic-related groin pain. Magnetic resonance imaging is a key tool, offering superior soft tissue detail that is crucial for accurate diagnosis, but misinterpretation remains common. This review will help clinicians and radiologists improve diagnostic accuracy and thus ultimately enhance patient outcomes.

DOI: https://doi.org/10.1055/s-0044-1800851
Cureus. 2025 Sep;17(9): e91834

Exploring the Changes in Pain Quality, Mechanical Allodynia, and Tactile Sensibility in Women With Persistent Postpartum Perineal Pain Treated With Somatosensory Rehabilitation: A Retrospective Case Series.

Isabelle Quintal, Laurence Goulet, Joseph-Omer Dyer, Daniel Bourbonnais, Mélanie Morin.

  Background Persistent postpartum perineal pain (PPPP) is a prevalent condition characterized by provoked, unprovoked, or mixed pain. Somatosensory rehabilitation has shown significant effects in alleviating provoked pain, and, more specifically, mechanical allodynia, in other populations. Therefore, this method could be a promising approach for the treatment of PPPP. This study aims to describe changes in pain quality, mechanical allodynia, and tactile sensibility in women with PPPP treated with somatosensory rehabilitation. Methodology This retrospective case series describes the use of a somatosensory rehabilitation method applied to the treatment of PPPP. This intervention mainly involved tactile stimulation to treat pain, mechanical allodynia, and tactile sensibility. The study included individual outcomes of nine eligible patients treated with this method. Outcome measures included pain quality (Questionnaire de la douleur Saint-Antoine), surface (allodynography with a 15.0-g monofilament), and severity of mechanical allodynia (Rainbow Pain Scale), as well as tactile sensibility (pressure perception threshold, static two-point discrimination test, vibration perception threshold). Results All patients showed a reduction in pain quality score and resolution of mechanical allodynia in the vulva, defined by the criteria of no significant exacerbation of pain upon touch with a 15.0-g Semmes-Weinstein monofilament. Sensibility assessments revealed an improvement in tactile hypoesthesia in the area of the skin where allodynia was previously present. Conclusions This study shows promising results for the use of somatosensory rehabilitation in the treatment of PPPP. Further randomized controlled studies are needed to investigate its efficacy in this population.

Keywords:  allodynia; dyspareunia; genito-pelvic pain/penetration disorder; postpartum pelvic girdle pain; somatosensory rehabilitation; tactile sensibility

DOI:  https://doi.org/10.7759/cureus.91834
Prosthet Orthot Int. 2025 Oct 01. 49(5): 559-564

Rehabilitation of a quadruple amputee with leukemia: A challenging endeavor.

Badarinath Athani, Ijaz N Pillai, Deepak Prasad J, Aneeta Shaji.

  Making a person with quadruple amputation walk again is a challenging task for the rehabilitation team. Quadruple amputation secondary to symmetrical peripheral gangrene is a rare clinical scenario posing challenges in rehabilitation. Literature regarding rehabilitation of persons with multiple amputations is limited. This case describes the rehabilitation of a 57-year-old lady suffering from acute myeloid leukaemia who underwent quadruple amputation. She had undergone bilateral transtibial and bilateral transradial amputation after vasopressor-induced symmetrical peripheral gangrene. In view of expected guarded level of functional independence, ambulatory independence was the primary goal at admission to Department of PMR. The various steps taken in rehabilitation and modifications made to assistive devices are described in this article. Challenges faced during various phases of training, and subsequent ambulation are detailed in this article. Overcoming limitations, the client was made to be an indoor ambulator with appropriate prostheses and mobility aids. She was partially independent for activities of daily life after in-patient rehabilitation. The background of leukaemia and subsequent chemotherapy also affected the rehabilitation of this patient. Although various studies have described cases of quadruple amputation rehabilitation achieving functional independence and ambulation, the absence of specific guidelines and protocols make rehabilitation of persons with multiple amputations inefficient. This case study also shows the need for personalized goal setting for persons with multiple amputations. Realistic goal setting, psychological counselling, and an interdisciplinary approach are imperative in rehabilitation of persons with quadruple amputation. Flexible functional scales specific to persons with multiple amputations are necessary to evaluate such persons objectively. Studies with larger sample size, longer follow-ups, and comprehensive review of existing literature are needed to standardize rehabilitation of quadruple amputation and evaluate the various factors that may affect rehabilitation outcome.

Keywords:  leukemia; multiple amputations; rehabilitation; rehabilitation outcome; surgical

DOI:  https://doi.org/10.1097/PXR.0000000000000401
Front Rehabil Sci. 2025 ;6 1647927

The effectiveness of physiotherapy for chronic headaches in patients with temporomandibular disorders: a systematic review.

Charlène Quilghini, Julian Lefflot, Kim Buchholtz.

   Background: Chronic headaches (CH) affect approximately 1 billion people globally, with women having three to five times higher prevalence. The estimated cost in Europe is €173 billion. Recent studies suggest a strong link between chronic headaches and temporomandibular disorders (TMD), which are characterized by orofacial pain, temporomandibular joint symptoms, and limited mandibular movement. Physiotherapy for these disorders often involves addressing muscle spasms through massage, trigger point therapy, and active stretching.
Objective: This systematic review aimed to assess the effectiveness of temporomandibular joint (TMJ) physiotherapy for patients with chronic headaches (CH) and temporomandibular disorders (TMD).
Methods: A systematic literature search was performed in January 2025 using the PICOS framework and relevant MeSH terms across the PubMed, PEDro, and Cochrane databases. Two reviewers independently screened studies, with a third reviewer resolving disagreements. Five randomized controlled trials (RCTs) met the inclusion criteria. Data extraction and study characteristics were analyzed, and the risk of bias was assessed using the Cochrane RoB2 tool.
Results: The review identified five studies, suggesting that physiotherapy may benefit these patients. Three studies showed significant improvements in headache intensity and frequency following TMJ or orofacial physiotherapy. One study favored the control group, and one showed no significant difference. However, variability in study quality, therapist roles, and poorly reported interventions limited comparability and prevented meta-analysis. The findings point to potential benefits of physiotherapy for managing chronic headaches and TMD but underscore the need for more standardized research.
Conclusion: This review highlights the potential of multidisciplinary treatments for patients with chronic headaches and temporomandibular disorders. However, due to the variability in treatment protocols and outcome measures, further research is needed to confirm these findings and standardize protocols for more reliable and consistent results.

Keywords:  conservative care; headaches; orofacial pain; systematic review; temporomandibular pain

DOI:  https://doi.org/10.3389/fresc.2025.1647927
Gait Posture. 2025 Sep 30. pii: S0966-6362(25)00721-0. [Epub ahead of print]123 109994

Alterations in dynamic balance control over time following botulinum toxin injection for calf hypertrophy.

Shang-Hsi Lin, Ting-Ming Wang, Tung-Wu Lu.

   BACKGROUND: Botulinum toxin type A (BoNT-A) injection into the gastrocnemius muscle is widely used to reduce calf hypertrophy, particularly for aesthetic purposes. However, given the essential role of the gastrocnemius muscle in propulsion and postural control during walking, weakening this muscle may subtly affect dynamic balance.
RESEARCH QUESTION: Does gastrocnemius BoNT-A injection alter whole-body balance control during level walking over time?
METHODS: Fifteen healthy female adults received BoNT-A injections to bilateral gastrocnemius. Participants were assessed at baseline, 1 month, and 3 months post-injection. Measurements included shank circumferences and volume, temporospatial gait parameters, COM-COP inclination angles (IA), and their rate of change (RCIA) in both sagittal and frontal planes.
RESULTS: Shank volume showed a statistically significant reduction at one month and three months post-injection. Temporospatial parameters, including step length, cadence, and speed, remained statistically unchanged. While COM-COP IA in both planes was preserved, RCIA increased significantly in the sagittal plane during the first and second half of double limb support (p = 0.033 and 0.050) and in the frontal plane during early single limb support (p = 0.038). These findings suggest subtle changes in dynamic balance control, even without observable gait temporospatial deviations.
SIGNIFICANCE: This study highlights that gastrocnemius BoNT-A injections, although preserving basic gait performance, can compromise fine-tuned balance regulation during walking. Clinicians should consider the implications for postural stability, particularly in populations at risk of falls. Future studies should assess the combined effects of footwear (e.g., high-heels) and uneven terrains on post-injection gait balance control.

Keywords:  Balance control; Botulinum toxin; Calf hypertrophy; Gait analysis; Inclination angle

DOI:  https://doi.org/10.1016/j.gaitpost.2025.109994
J Aging Phys Act. 2025 Oct 09. 1-9

Relationships Between Physical Activity, Social Interaction, and Sense of Belonging Among Older Adults Living in Community-Based Congregate Housing.

Ashley McCurdy, John C Spence, Carminda G Lamboglia, Jodie A Stearns, Karen K Lee.

   BACKGROUND: Little is known about what factors influence the relationship between physical activity (PA) and sense of belonging. We examined relationships between different forms of PA, social interaction, and belonging among older adults living in community-based congregate housing.
METHODS: One hundred and fifty-five participants living in community-based congregate housing in Edmonton, Alberta completed a survey. Participants provided information about demographics; self-reported PA (gardening, active transportation, and recreational PA); objectively measured PA (moderate-to-vigorous PA, light PA, step cadence); frequency of interaction; and neighborhood belonging. A series of regression analyses examined associations between PA, social interaction, and belonging.
RESULTS: Gardening was associated with a sense of belonging, while active transportation and recreational PA were not. Moderate-to-vigorous PA and step cadence showed negative relationships of questionable practical significance, while light PA showed no relationships. Moderate-to-vigorous PA, gardening, and active transportation predicted more frequent social interactions outside of (but not inside) housing complexes. The relationship between gardening and belonging was not significant when social interaction was added to the model.
CONCLUSIONS: Our findings demonstrate the importance of contextual factors-including type or domain of PA and setting-in considering the association between PA and sense of belonging among older adults.
IMPLICATIONS: Practitioners and decision makers may consider community gardening to promote PA and connections among older adults in community-based congregate housing. Prospective research is needed to understand if, and how, belonging may be fostered for other domains and types of PA in this population (e.g., quality of interaction as a mediator).

Keywords:  active recreation; connectedness; cross-sectional; seniors; social connections

DOI:  https://doi.org/10.1123/japa.2024-0328
J Sex Med. 2025 Oct 09. pii: qdaf287. [Epub ahead of print]

Rethinking pelvic floor muscle training in sexual medicine: who benefits and why? Perspective on "Investigating the role of the pelvic floor muscles in sexual function and sexual responses: a systematic review and meta-analysis".

Georgia Walker, Lysnara Lial, Zaki Almallah, Omer Raheem.



Keywords:  pelvic floor rehabilitation; sexual dysfunction; sexual medicine

DOI:  https://doi.org/10.1093/jsxmed/qdaf287
Knee. 2025 Oct 08. pii: S0968-0160(25)00241-8. [Epub ahead of print]57 345-352

Anatomical variability in the quadriceps tendon: structural layering and patellar insertion patterns.

Hyun Jin Park, Seong-Kyu Choi, Hongtae Kim, Mi-Sun Hur.

   PURPOSE: The quadriceps tendon is a complex anatomical structure that is crucially involved in knee stability and extension by transmitting forces from the quadriceps muscles to the patella. This study investigated anatomical variability in the quadriceps tendon of elderly Korean cadavers, focusing on the structural layering and muscle contributions at its patellar insertion.
METHODS: Sixty-three quadriceps tendon specimens from 35 Korean cadavers were dissected to assess the composition and arrangement of the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), and vastus intermedius (VI).
RESULTS: The quadriceps tendon configurations were categorized into four distinct types based on the pattern of muscle layering: Type 1, a trilaminar structure with the RF as the superficial layer, the VM and VL combined as the middle layer, and the VI as the deepest layer (8/20, 40 %); Type 2, a multilayered arrangement with RF insertions merging with the VM and VL (8/20, 40 %); Type 3, comprising the RF, VL, and VI, with no contribution from the VM (3/20, 15 %); and Type 4, consisting solely of the RF and VI (1/20, 5 %). In terms of tendon ratios, the combined vastus muscles (VM + VL) were 1-3 times larger than the RF and VI in 50 of 63 specimens, while 12 specimens displayed ratios as high as 4-6 times.
CONCLUSION: These data suggest that adjusted approaches that account for individual anatomical differences may improve outcomes in surgical procedures involving the knee.

Keywords:  Quadriceps tendon; Rectus femoris; Vastus intermedius; Vastus lateralis; Vastus medialis

DOI:  https://doi.org/10.1016/j.knee.2025.09.004
Disabil Rehabil Assist Technol. 2025 Oct 09. 1-21

Evaluating the role of social support systems in enhancing the well-being of elderly individuals with disabilities.

Min Li.

   OBJECTIVE: The global rise in ageing populations has led to an increase in physical disabilities, challenging health, social care, and psychological support systems. In China, where the elderly population is the largest worldwide, these challenges are amplified by shifting family dynamics, urban migration, and insufficient community resources. As disability levels rise with age, supporting the psychological well-being of older adults becomes critical. While previous studies emphasise the positive effects of social support on elderly well-being, they often treat ageing and disability separately or focus narrowly on physical health. Little research has explored how different types of social support-subjective, objective, and utilisation-interact with internal coping mechanisms such as psychological resilience, particularly in culturally specific contexts like China.
METHODS: This study examines how these forms of social support affect the well-being of older adults with disabilities, highlighting the mediating role of resilience. A structured survey involving 300 participants aged 60 and above was conducted across urban and rural regions in China. Using linear regression and path analysis, results were analysed.
RESULTS: Results show that all three types of support significantly enhance well-being. Psychological resilience was identified as a partial mediator, with subjective support being the most influential factor.
CONCLUSION: These findings underscore the importance of integrating both external and internal resources in eldercare strategies. The study offers valuable evidence for developing inclusive policies that promote emotional health and resilience among China's ageing population, addressing both their physical limitations and psychological needs.

Keywords:  Ageing population; elderly well-being; objective support; physical disabilities; psychological resilience; social support systems; subjective support; support utilisation

DOI:  https://doi.org/10.1080/17483107.2025.2568945
BMC Public Health. 2025 Oct 06. 25(1): 3311

The bidirectional relationship between social participation, social media use and depressive symptoms: a nationwide longitudinal study.

Ting Zheng, Xiao Zheng, Benli Xue, Shujuan Xiao, Lingli Yang, Xinyi Zhang, Chengyu Chen, Xinru Li, Mengjie Zhang, Yanming Liao, Yuyang Li, Chichen Zhang.

   BACKGROUND: Improving the mental health and digital divide issues is crucial for promoting active aging. This study aimed to examine the bidirectional relationship and intricate mechanisms between social participation, social media use, and depressive symptoms among a nationwide sample of Chinese older adults.
METHODS: We utilized data from two waves (2018, 2020) of the China Health and Retirement Longitudinal Survey, which included 4928 older adults aged 60 years and above. We Used a cross-lagged model to examine the bidirectional relationship between social participation, social media use, and depressive symptoms.
RESULTS: In two years, social media use competency and social participation frequency can be predicted bidirectionally, and social media use competency and depressive symptoms can also be predicted bidirectionally. However, there is no cross-temporal bidirectional relationship between social participation frequency and depressive symptoms. Depressive symptoms can predict social participation frequency two years later, while social participation frequency cannot directly predict depressive symptoms. The mediation analysis indicated that social media use competency played a complete mediating role between social participation frequency and depressive symptoms.
CONCLUSIONS: Continuous social participation may enhance social media use competency and alleviate depressive symptoms in older adults. Social media use may alleviate the decrease in social participation frequency and increase in depressive symptoms in older adults. Therefore, social media can be an effective tool to promote the integration of the older adults into society and alleviate negative emotions.

Keywords:  Depressive symptoms; Digital divide; Health management; Older adults; Social media use; Social participation

DOI:  https://doi.org/10.1186/s12889-025-24629-5