BackgroundEmploying telecommunication systems and digital platforms, athletes can continuously access tailored injury prevention protocols, receive real-time feedback on exercise performance.ObjectiveThis study aimed to assess the feasibility, adherence, and benefits of a digitally administered adaptation of the FIFA 11 + protocol in professional football players.MethodsThis multicenter randomized prospective controlled study involved football players aged 15-40 from Italy and Switzerland, recruited between May 2023 and February 2024. Participants were randomly assigned to either the Intervention group (FIFA 11 + protocol administered digitally) or the Control group (traditional in-person FIFA 11 + protocol). Both groups performed the protocol twice a week for six months. Primary outcomes included the Illinois Agility Test, Slalom Dribbling Test, Multistage 20 m Shuttle Run Test (MSRT), and muscle strength tests for the hamstrings.ResultsFifty-five players participated: 27 in the Intervention group (mean age 20.63) and 28 in the Control group (mean age 20.25). Both groups showed significant improvements in hamstring strength, sprint performance, and MSRT outcomes (p < 0.05). No significant differences were observed between the groups in terms of strength, heart rate response, perceived exertion, or agility (p > 0.05).ConclusionFIFA 11 + protocol has been shown to be effective as the in-person version for improving physical performance and preventing injuries in football players. Further research is needed to explore this approach in broader settings.

BackgroundShoulder stiffness and calcium imbalance could occur once after thyroidectomy among thyroid cancer subjects. There is no idealistic treatment, and the prognosis varies between the affected people.ObjectivesTo investigate the effect of Baduanjin (BDJ) exercises on shoulder dysfunction post thyroidectomy for Thyroid Cancer Patients.MethodEighty patients (41 males and 39 females) were randomly allocated into two groups. Group A (BDJ) included 40 patients who performed (BDJ) with a traditional physical therapy program, and Group B (Control) included 40 patients who underwent only a Traditional Physical Therapy Program. Shoulder dysfunction was measured using the Shoulder Pain and disability index (SPADI), while active shoulder ROM was measured by using ImageJ software, and Total calcium concentrations to evaluate the effectiveness of treatment in both groups. The measurements were taken before and after 12 weeks of treatment. MANOVA was used to compare results within and between groups.ResultsThere were significant improvements regarding (SPADI), shoulder ROM, and calcium concentrations in intervention group A after comparing the mean values before and after treatment (p < 0.05). For pain, BDJ experienced a significant reduction in SPADI scores post-treatment, with a mean change of -10.29, compared to Group B's negligible change. Disability scores also decreased significantly in BDJ, with a mean difference of -5.18. In terms of shoulder range of motion (ROM), BDJ showed improvements across flexion, abduction, external rotation, and internal rotation, with percentage changes of 1.6%, 3.7%, 5.7%, and 7.4% respectively, all with significant p-values. The control group showed minimal changes in these areas. Additionally, the total calcium concentration increased in Group A by 10.5%, while Group B remained relatively unchanged. These outcomes suggest that the treatment was more effective for BDJ across various measures, highlighting significant clinical benefits in pain reduction, functional improvement, and biochemical changes.ConclusionBDJ is an efficient treatment to improve shoulder dysfunction post thyroidectomy for thyroid cancer patients.

BackgroundLow back pain (LBP) is a common condition impacting the lumbar region, leading to significant dysfunction and diminished quality of life. This study focuses on understanding the burden of LBP in China and projects its incidence trends over the next 20 years. Data from the Global Burden of Disease Study 2021 (GBD 2021) was used to conduct the analysis.MethodsThe study employed multiple statistical approaches, including Joinpoint regression analysis, Age-Period-Cohort Model (APCM), Decomposition Analysis, and the Autoregressive Integrated Moving Average (ARIMA) model, to assess the trends in LBP prevalence, incidence, and Disability-Adjusted Life Years (DALYs) in China from 1990 to 2021 and predict future trends through 2041.ResultsIn 2021, LBP affected 628838475 individuals globally, with China accounting for 16% of this burden. Between 1990 and 2021, although the absolute number of LBP cases, incidence, and DALYs increased, the rates per 100000 people decreased. Age-specific analysis indicated LBP onset from age 5, peaking in the 55-59 age group. Females showed higher prevalence, incidence, and DALYs compared to males. Projections suggest the incidence rate will rise from 2343.78 per 100000 people in 2022 to 2560.92 per 100000 in 2041.ConclusionsThe findings highlight the increasing burden of LBP in China, emphasizing the urgent need for targeted prevention and treatment strategies. Future interventions should aim at reducing the impact of LBP to improve overall health and quality of life in affected populations.

AimDiabetes mellitus (DM) is a significant risk factor for peripheral nervous system disorders, particularly for polyneuropathy and carpal tunnel syndrome (CTS). In this study, we aimed to find whether there was an association between the severity of peripheral neuropathies and blood sugar regulation in diabetics.MethodWe included 347 diabetic patients who were evaluated in our EMG laboratory. We divided the study population into four subgroups based on the glycemic control as in American Diabetes Association (ADA) classification and three classes in Michigan severity stages of diabetic polyneuropathy (DPNP). Possible associations between demographics, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and the severity of DPNP and CTS were analyzed.ResultsPatients with DPNP had higher levels of FBG and HbA1c (p = 0.002 and p < 0.001, respectively). Similarly, patients with entrapment neuropathy also had higher levels of FBG and HbA1c than those without (p = 0.003 and p = 0.004, respectively). Moreover, higher grades of DPNP and CTS were associated with higher mean levels of FBG and HbA1c (p < 0.05 for all analyses). Patients with more impaired glycemic control, categorized according to the ADA classification of HbA1c, had more severe grades of DPNP and CTS (p < 0.05).ConclusionPatients with more impaired glycemic control experienced more frequent and severe grades of DPNP and/or CTS. This suggests that achieving individualized treatment targets early may help prevent the onset and progression of these peripheral nervous system complications.We recommend using HbA1c as a predictor of the electrophysiological severity of peripheral compression neuropathies in diabetic patients.

BackgroundPeople with transtibial amputation often suffer musculoskeletal deformities in the form of knee osteoarthritis or osteophytosis due to asymmetric movement patterns and often complain of associated symptoms. This study aimed to evaluate the sagittal kinematics of the intact and residual knee in the use of Running-Specific Prostheses (RSP), which are increasing in popularity and use among amputees. Participants were video recorded in the sagittal plane to make measurements using the software's virtual goniometer. The recordings were taken under the following two conditions: 1) walking with Daily-Use Prosthesis (DUP), 2) running with RSP. The peak flexion during swing phase and the initial flexion during stance phase were recorded as angle. Fourteen participants were recruited the study (aged 33.43 ± 1.46 years). The difference in peak knee flexion between the amputated and intact limbs was statistically significant (walking  < 0.001, running  = 0.02). The difference in initial knee flexion in the amputated and intact limbs was statistically significant walking ( = 0.011), but not during running ( = 0.203). According to Symmetry Index, peak knee flexion during running was in the 'good symmetry' interval, while peak knee flexion during walking and initial knee flexion during running were in the 'moderate symmetry' interval. The initial knee flexion during walking was in the 'asymmetric' interval. Running improves symmetry scores including the sagittal position of the knee joint. This suggests that, running at recreational level can be used as a strategy for the stimulation of symmetric movement patterns.

BackgroundChondromalacia patella (CMP) is characterized by cartilage degeneration in the patellofemoral joint, often causing anterior knee pain and impaired knee function.ObjectiveThis study aims to evaluate the effectiveness of manipulative therapy in patients diagnosed with CMP.MethodsIn this prospective randomized study, 40 patients diagnosed with CMP were randomly assigned to the manipulative therapy group or the control group. Both groups underwent strengthening and stretching exercises targeting the knee and hip muscles. Additionally, the manipulative therapy group received manipulative therapy focusing on the thoracolumbar, lumbopelvic, and sacroiliac joints three times a week. Pain intensity was measured using the Visual Analog Scale (VAS), while disability was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Active knee flexion was recorded, muscle performance was evaluated using the Stair Climbing Test (SCT) and Horizontal Jump Test (HJT), and balance was assessed using the Star Excursion Balance Test (SEBT).ResultsBoth groups showed significant improvements in VAS, active knee flexion, WOMAC scores, SCT, HJT, and SEBT outcomes. However, the manipulative therapy group demonstrated significantly greater improvements than the control group in disability (WOMAC scores,  < 0.001, d = 1.93), horizontal jump performance ( = 0.03, d = 1.57), and balance (SEBT outcomes,  < 0.001, d = 1.60).ConclusionBy integrating manipulative therapy with strengthening and stretching exercises targeting the knee and hip muscles, clinicians can offer a multifaceted intervention that addresses the biomechanical and neurophysiological aspects of the condition, enhancing the rehabilitation process and functional recovery in patients with CMP.

BackgroundExercise addiction (EA) is increasingly recognized as a behavioral disorder. Physicians in Physical Medicine and Rehabilitation (PMR), who prescribe and practice exercise regularly, may represent a vulnerable group.ObjectiveThis study aimed to evaluate EA and related factors in PMR physicians.MethodsIn this web-based cross-sectional survey (January-February 2025), 143 PMR physicians participated. The questionnaire included sociodemographic and occupational data and the validated Turkish version of the Exercise Addiction Scale (EAS). The EAS consists of 17 items rated on a five-point Likert scale, yielding scores of 17-85. Cut-off values classify participants as normal (17), low risk (18-34), at risk (35-51), addicted (52-69), or severely addicted (70-85). The Turkish validation demonstrated high reliability (Cronbach's α = 0.88). Statistical analyses were performed using R (version 4.4.0), including descriptive statistics and ordered logistic regression.ResultsOf 143 participants, 103 (72.0%) were female and 40 (28.0%) male, with a mean age of 36.9 ± 10.6 years. According to EAS, 17.5% were low risk, 64.3% at risk, and 18.2% addicted. Logistic regression identified weekly exercise frequency (odds ratios [OR]: 8.17 for 1-2 days, 9.92 for 3-5 days, 20.75 for >5 days), medical experience (OR: 0.20 for >10 years), and workplace (OR: 3.45 for secondary hospitals) as significant predictors (p < 0.05).ConclusionEA risk is high among PMR physicians. Awareness and preventive strategies are required, and further studies should explore additional risk factors.

ObjectiveThe Fatty Liver Index (FLI) is a non-invasive algorithm that estimates the presence of hepatic steatosis based on body mass index (BMI), waist circumference, triglycerides, and gamma-glutamyl transferase (GGT). In recent years, FLI has been increasingly recognized for its associations with various metabolic disorders. Whether FLI is linked to low back pain (LBP) remains unclear. This study aims to explore the association between FLI and LBP.MethodsParticipants from the NHANES 1999-2004 survey were included. LBP was defined by self-reports. FLI was calculated from metabolic indicators using a standard formula. Logistic regression models assessed the association between FLI and LBP, adjusting for potential confounders, with restricted cubic splines to check for nonlinearity. Subgroup analyses and sensitivity analyses using multiple imputation for missing data were also conducted.ResultsA total of 5339 participants were included. Higher FLI levels were significantly associated with increased odds of LBP. For each 20-unit increase in FLI, the risk of LBP increased by 9% (OR = 1.09, 95% CI: 1.03, 1.14, P = 0.0017). The highest quartile of FLI had a 42% higher risk of LBP compared to the lowest quartile (OR = 1.42, 95% CI: 1.13, 1.79, P = 0.0029). Subgroup analysis showed a stronger association among individuals with lower physical activity levels. Sensitivity analyses confirmed robustness.ConclusionsHigher FLI values corresponded to an increased risk of LBP, especially in individuals with lower physical activity. Further studies are needed to validate this relationship.

IntroductionReduced ankle dorsiflexion range of motion (ADROM) is a risk factor for lower extremity injuries, and weight-bearing measurements are known to better reflect functional movement. This study aimed to determine the concurrent validity and the intra- and inter-rater reliability of a smartphone application (SA, The Angle Meter app) for measuring ADROM during the weight-bearing lunge test (WBLT).MethodsA reliability and validity study was conducted involving 57 participants. Three raters (two experienced and one novice) assessed ADROM using the SA in two separate sessions, in a randomized order. All measurements were concurrently recorded on video, and a two-dimensional video analysis (Kinovea software) was used as the reference standard. A total of 342 measurements were analyzed for concurrent validity, 114 for inter-rater reliability, and 57 for intra-rater reliability. Pearson's correlation coefficient (r), intraclass correlation coefficient (ICC 2,1), standard error of the estimate (SEE), Bland-Altman analysis, standard error of measurement (SEM), and minimum detectable change at 95% confidence (MDC) were used for analysis.ResultsThe SA demonstrated excellent concurrent validity (r = 0.98; SEE = 0.92°; ICC = 0.977; 95% CI: 0.966-0.983), with limits of agreement from -1.80° to 1.47°. Intra-rater reliability was high across all raters (ICC range: 0.83-0.86), including the novice. Inter-rater reliability was also good (ICC = 0.846; SEM = 1.65°; MDC = 4.57°).ConclusionThe Angle Meter app is a valid, reliable, and practical tool for assessing ADROM during WBLT, even when used by novice raters.

BackgroundThe effects of changes in cervicothoracic posture on respiratory and exercise capacity in healthy young adults are still debated.ObjectiveThis study aimed to investigate the effect of cervicothoracic posture on respiratory muscle strength and upper extremity function and to compare according to the activity levels in healthy young adultsMethodsNinety-three healthy young adults were included in this study. Cervicothoracic posture, including the craniovertebral angle, cervical lordosis angle, forward shoulder angle (FSA), and thoracic kyphosis angle, was assessed using the photographic method. Chest wall mobility, respiratory muscle strength, upper extremity function, physical activity level, and severity of fatigue were assessed. Pearson's correlation analysis revealed significant associations between respiratory muscle strength and cervicothoracic posture, as well as anthropometric measures. Multiple linear regression identified independent predictors of MIP and MEP, adjusting for potential confounders such as smoking.ResultsThe FSA demonstrated a weak but statistically significant correlation with both maximum inspiratory pressure (MIP) (r = -0.248, p = 0.021) and maximum expiratory pressure (MEP) (r = -0.219, p = 0.041). Axillary circumference measurements demonstrated a near-significant association with MEP (B = 4.93, p = 0.059). Upper extremity function did not correlate with cervicothoracic posture (p > 0.005). The MEP was significantly associated with fatigue severity (B = - 0.02, β = - 0.323, p = 0.022). Activity level was associated with MEP, chest mobility and fatigue (p < 0.05).ConclusionCervicothoracic posture does not affect respiratory muscle strength or upper-extremity function in healthy young adults. The MEP is influenced by axillary chest mobility and affects fatigue. Activity is important for the respiratory health of healthy young adults.

BackgroundCore endurance and lower limb strength are frequently targeted in sports performance and injury prevention programs, However, their independent and combined influence on dynamic balance remains inadequately understood among collegiate football players.ObjectiveTo examine the relationships among core endurance, lower limb isometric strength, and dynamic balance performance in collegiate male football playersMethodsSixty healthy athletes (aged 18-25 years) completed core endurance tests, isometric strength assessments using handheld dynamometry for the hip, knee, and ankle, and the Modified Star Excursion Balance Test (mSEBT). Pearson's correlation and multiple linear regression analyses were conducted to examine associations and identify predictors of dynamic balance. Multiple linear regression focused on posteromedial reach score of the right leg as the primary outcome.ResultsLeft ankle invertor strength had significant positive correlations with posteromedial (r = 0.47, p < 0.001) and posterolateral (r = 0.37, p = 0.004) SEBT reach distances, while trunk flexor endurance was a statistically significant inverse predictor of balance performance (β = -0.456, p = 0.001). The final regression model explained 20.4% of the variance in posteromedial reach performance (adjusted R² = 0.150, p = 0.008).ConclusionThese findings underscore that dynamic balance in collegiate football players may depend more on specific distal joint strength and neuromuscular coordination than on overall core endurance, highlighting the importance of targeted ankle invertor and dynamic core stability training for injury prevention.

Background/ObjectivesMusculoskeletal pain limits function and quality of life worldwide. This study investigated whether Extracorporeal Magnetotransduction Therapy (EMTT) improves pain and physical function in patients with degenerative joint diseases and enthesopathies.MethodsIn this single-center, randomized, double-blind, placebo-controlled trial, 126 patients with >6 weeks of pain from knee osteoarthritis, rotator cuff enthesopathy, or lumbar spondyloarthrosis were randomized to EMTT (80 mT, 8 Hz, 10,000 pulses/session) or sham therapy once weekly for eight weeks. The primary outcome was quality of life measured by the SF-12 Physical (PCS) and Mental (MCS) Composite Scales. Secondary outcome was pain on the Visual Analog Scale (VAS). Differences were analyzed using the Wilcoxon-Mann-Whitney test and Mann-Whitney estimator.ResultsBaseline PCS, MCS, and VAS were comparable between groups. At six weeks, EMTT led to significantly higher PCS (42.9 vs. 38.6, p < 0.001) and lower VAS pain (2.8 vs. 4.3, p < 0.001), with effects persisting at 12 weeks (PCS 45.5 vs. 38.7; VAS 2.2 vs. 4.2; all p < 0.001). MCS showed no significant differences. Mild discomfort and skin redness occurred more often with EMTT.ConclusionsEMTT appears effective in improving physical function and reducing pain in degenerative musculoskeletal conditions, with minor side effects.

BackgroundCurrently, the evidence for the effectiveness of exercise in patients with rheumatoid arthritis (RA) is controversial.ObjectiveTo determine the effectiveness of high-intensity exercise on physical function and disease activity in patients with RA.MethodsThis systematic review was prospectively registered with PROSPERO (CRD42022332312). Electronic searches were performed in MEDLINE, Web of Science, EMBASE, SCOPUS, CINAHL, SPORTDiscus, Epistemonikos, and LILACS databases from inception to September 2025. Randomised clinical trials that evaluated the effectiveness of high-intensity exercise on physical function and disease activity in patients with RA were included. The selection of studies, data extraction, and risk of bias assessment were performed by two independent reviewers.ResultsEleven clinical trials met the eligibility criteria. For the comparison of high-intensity exercise versus supervised or unsupervised low-intensity exercise, there was no significant difference between groups: the standard mean difference (SMD) was 0.03 (95% CI, -0.15 to 0.20;  = 0.77) for physical function, and 0.06 (95% CI, -0.13 to 0.25;  = 0.53) for disease activity at 20-24 weeks. Conversely, high-intensity exercise was significantly more effective in improving knee extensor muscle strength (SMD = 0.30; 95% CI, 0.13 to 0.48;  < 0.001) and aerobic capacity (SMD = 0.35; 95% CI, 0.15 to 0.55;  < 0.001) than supervised or unsupervised low-intensity exercise at 20-24 weeks. No adverse events related to the interventions were reported in any of the included studies.ConclusionHigh-intensity exercises compared to supervised or unsupervised low-intensity exercise did not significantly improve self-reported physical function and disease activity in patients with RA. In addition, high-intensity exercise is safe and effective in significantly improving extensor muscle strength and aerobic capacity in this population. According to the GRADE approach, the quality of evidence was very low to high. More clinical trials are needed to confirm these findings.

PurposeTo examine impact of kinesthetic and visual motor imagery (MI) training on balance, cervical proprioception, and function in mechanical neck pain patients.MethodsFifty-three patients were assessed for eligibility. Nine patients were excluded for different reasons, and the remaining forty-four were randomly allocated into two groups (study and control). The patients were assessed pre- and post-treatment for cervical proprioception, neck mobility, balance, and pain using cervical joint position sense error (JPSE) test via overhead laser pointer, neck disability index (NDI), multidirectional reach test (MDRT), and visual analogue scale for pain (VAS-P), respectively. The study group (N = 22) received kinesthetic and visual MI training and a conventional physical therapy program, while the control group (N = 22) received a conventional program. Both groups received three sessions per week for four weeks. Both the statistical analyzer and the patients were blinded, and the study was registered in clinicaltrials.gov ID: XXXXXX.ResultsForty-four patients were included in the study and were randomly assigned to equal groups. Following intervention, the two groups' comparison demonstrated improvement with a significant decrease in the neck JPSE, NDI, and VAS-P and an increase in MDRT scores in the study group more than in the control one, while within-group comparison, there was a significant decrease in the neck JPSE, NDI, and VAS-P, and an increase in MDRT scores post-intervention compared with that of baseline in both groups (p < 0.05).ConclusionMI training with biofeedback is an effective therapeutic intervention for enhancing balance, neck position sense, and decreasing mechanical neck pain.

ObjectiveThis study evaluated the validity of the HALO™ digital goniometer compared to the Cervical Range of Motion (CROM™) device for assessing cervical range of motion (ROM) in a sample of 20 patients with cervicogenic headache (CGH).MethodsROM was measured simultaneously using both devices across six movement planes at two time points, at baseline and 4 weeks later. Intraclass correlation coefficients (ICCs) were used to assess agreement, and Bland-Altman analyses evaluated measurement bias.ResultsResults showed excellent to good agreement between the HALO™ and CROM™ for most movements (ICC = 0.880 to 0.994), with flexion, extension, and left rotation demonstrating excellent reliability (ICC > 0.9). Left side flexion and right rotation showed good agreement (ICC = 0.888 and 0.880, respectively), while right side flexion had lower (moderate) agreement (ICC = 0.688, 95% CI [-0.073 to 0.902]). Bland-Altman analysis indicated that the HALO™ tended to slightly overestimate ROM in several directions, with statistically significant yet clinically negligible (<5° difference) biases for flexion, side flexion, and right rotation, indicating that the clinical interchangeability between the two devices may be limited for these movements.ConclusionThe HALO™ demonstrated good validity compared to the CROM™ for measuring cervical ROM in individuals with CGH. Both its portability and ease of use make it a viable alternative. However, variability observed in side flexion and the modest sample size suggest that caution is warranted, and further validation in larger and more diverse populations is needed before it can be considered interchangeable with the CROM™.

BackgroundWorldwide, medical students frequently have low back pain (LBP); the rigorous study schedules and training requirements of their program place them at increased risk.ObjectivesTo determine the prevalence and profile of LBP among medical students in Jordan, and to examine its associations with demographics, physical activity, and sleep quality.MethodsA cross-sectional study was conducted among 252 undergraduate medical students (63% female, aged 18-24 years, with a mean height of 1.7 ± 0.1 m and a mean weight of 66.1 ± 13.1 kg). Participants were recruited from public and private medical schools (February-April 2025). Data on LBP were collected (12-month prevalence, duration, impact, and associated symptoms). Widely validated instruments were used; the Nordic Musculoskeletal Questionnaire for assessing musculoskeletal symptoms, the International Physical Activity Questionnaire for evaluating physical activity levels, and the Sleep Quality Scale provides a measure of subjective sleep quality. Analyses were performed using IBM SPSS; chi-square and logistic regression were used to identify the associations between variables.ResultsThe 12-month prevalence of LBP was 69%, higher in females (72.3%) (p = 0.18). Basic-level students reported a significantly higher prevalence (76.1%) (p = 0.04). Among those with LBP, 48.3% reported activity limitations, and 79.3% reported poor sleep quality. Logistic regression identified academic level (OR = 0.489, p = 0.03) and poor sleep (OR = 2.207, p = 0.01) as predictors.ConclusionLBP is common among Jordanian medical students and is significantly associated with academic level and poor sleep. Promoting awareness of posture, exercise, and healthy sleep habits may help reduce the burden of LBP in this population.

BackgroundPregnancy induces spinal changes that are generally expected to resolve by the end of the puerperium. However, the mode of delivery may influence this recovery.PurposeThis study aimed to assess pain-free active lumbar spine range of motion (ROM) in postpartum women following Cesarean birth (CB) or vaginal birth (VB), compared to women who had never been pregnant.MethodsA cross-sectional analytical study included 66 women divided into three groups: Group A (n = 25, CB women), Group B (n = 16, VB women), and Group C (n = 25, controls). Lumbar ROM, including flexion, extension, bilateral side bending, and axial rotation, was measured using bubble inclinometers between the 6th and 12th postpartum weeks.ResultsThe Kruskal-Wallis test showed significant differences were found among the groups in extension ROM (P = 0.002) and bilateral side bending ROM (P = 0.002 right, 0.004 left). Post-hoc analysis showed that CB women had significantly decreased extension ROM than controls (P = 0.001), and significantly decreased right and left side bending compared to both VB (P = 0.009, 0.013) and control groups (P = 0.010, 0.014). No significant differences were observed in flexion (P = 0.877) or axial rotation (P = 0.412 right, 0.753 left).ConclusionCB women exhibited persistent limitations in lumbar extension and side bending ROMs beyond the puerperium, possibly due to scar restrictions and core muscle weakness rather than pregnancy itself. VB women demonstrated spinal mobility more comparable to controls, suggesting VB may be more favorable for postpartum spinal recovery.

Tendons are among the most frequently affected structures in musculoskeletal disorders. Polynucleotides (PNs) have been proposed to promote tendon regeneration by enhancing collagen synthesis and reducing inflammation. This retrospective clinical study aimed to evaluate the clinical effects of PNs injections in patients with different kinds of tendinopathy (mostly gluteal tendinopathy, biceps brachii tendinopathy and Achilles tendinopathy), focusing on pain reduction and functional improvement. Sixty-eight patients with clinically diagnosed tendinopathy received three peritendinous injections of a PNs-based medical device at baseline (T0), two weeks (follow-up 1), and four weeks (follow-up 2) post-T0. Follow-up assessments were conducted at follow-up 1, follow-up 2-, eight- and 24-weeks post-follow-up 2. The primary outcome was pain reduction measured by the numerical rating scale (NRS). Secondary outcomes included pain-related functional limitation (VAS-function), the Clinical Global Impression-Improvement scale, and patient satisfaction on a 5-point Likert scale. A mean NRS and VAS-function reduction of, respectively, -1.76 ± 0.08 and -1.74 ± 0.07 were found per follow-up, with statistically significant improvements over time. At the final follow-up, 88% of patients reported being "satisfied" or "very satisfied" with the treatment. The results support the efficacy and safety of PNs treatment in patients with tendinopathies, as it led to significant improvements in pain and function. Further high-quality clinical studies are needed to validate these findings.

BackgroundNon-specific low back pain (NSLBP) has been associated with proprioceptive deficits that may also affect the knee joint.ObjectiveThis study aimed to examine knee proprioception in young adults with NSLBP and to assess dynamic postural stability using the Biodex Balance System (BBS). It further explored whether gender influences these outcomes.MethodsEighty-eight participants, aged 18 to 26 years with a body mass index under 30 kg/m² and diagnosed with NSLBP, were recruited. They were assigned to male (n = 44) and female (n = 44) groups. Assessments included the Oswestry Disability Index (ODI), knee joint repositioning error (JPE) measured with a digital inclinometer, and dynamic balance evaluated with the BBS. The BBS provided overall stability index (OSI), anterior-posterior index (API), and medial-lateral index (MLI) scores. Statistical analyses were performed using SPSS with significance set at p < 0.05.ResultsThere were no significant gender differences in JPE (males: 30.97 ± 3.62; females: 30.28 ± 5.42, p > 0.05) or ODI. BBS outcomes, however, showed elevated OSI (4.2 ± 1.1 compared with 2.5 ± 0.5 in healthy controls, p < 0.01), API (3.8 ± 0.9 compared with 2.0 ± 0.4, p < 0.01), and MLI (3.5 ± 0.8 compared with 1.8 ± 0.3, p < 0.01), indicating impaired dynamic balance. No significant gender differences were observed in BBS indices.ConclusionNSLBP significantly impairs dynamic knee proprioception, as demonstrated by BBS findings. Gender did not influence proprioceptive performance in this cohort.

ObjectiveMedication adherence is crucial for effective treatment and long-term outcomes in rheumatoid arthritis (RA). The Compliance Questionnaire of Rheumatology (CQR) is a widely used self-report tool for evaluating adherence. This study aimed to validate the Turkish versions of the CQR-19 and its short form, the CQR-5, in RA patients, in order to support the assessment of treatment adherence in this population.MethodsA cross-sectional study was conducted at a tertiary care center with patients who were diagnosed with RA according to the 2010 ACR/EULAR classification criteria and who had been receiving treatment for at least one year. Participants completed the Turkish versions of the CQR-19 and CQR-5. Objective adherence was assessed via prescription refill data and pill counts. Construct validity was evaluated using Confirmatory and Exploratory Factor Analyses. Internal consistency was assessed with Cronbach's alpha. Criterion validity was examined through correlations between CQR scores and objective adherence rates.ResultsA total of 155 participants had a mean age of 57.4 ± 12.4 years, with 87% being female. The CQR-19 showed a two-factor structure (KMO = 0.927, Bartlett's test p < 0.0001), while the CQR-5 demonstrated a unidimensional structure with good model fit. Internal consistency was high (α = 0.9248 for CQR-19; α = 0.8599 for CQR-5). CQR scores correlated significantly with objective adherence (p < 0.0001), supporting criterion validity.ConclusionsThe Turkish versions of the CQR-19 and CQR-5 are valid, reliable tools for assessing medication adherence in RA patients and suitable for use in clinical and research settings.