Abstract: WHO International Classification of Functioning Disability and Health provides a biopsychosocial paradigm for understanding, describing, and measuring health. It is both a framework and a system for classifying functioning. In this narrative review, we focus on the ICF-based assessment tools of functioning. First, we introduce the term, as it is defined in the ICF approach, within the ICF model, and we highlight the importance of the assessment of functioning, as the third indicator of health, along with morbidity and mortality. The aim is to provide a picture of the achievements, but also to highlight state-of-the-art and current developments. We focus on the difficulties, doubts, and uncertainties clinicians may face when trying to settle on how, and with the use of which measurement tools, the functioning of their patients should, or could, be measured in accordance with the principles of the WHO approach. We present ICF-based instruments, such as core sets, other WHO tools, connected to the ICF, such as the WHODAS 2.0 and Model Disability Survey, other approaches, based on, and corresponding with, the ICF, e.g. CLINFit, as well as conventional measures of functional independence, and their connections with the ICF approach. Finally, we signal some future challenges and perspectives.

Abstract: The analysis of asymmetries in the countermovement jump (CMJ) is a potentially useful tool for the prevention of injuries in elite soccer players. This study analyzes the relationship between biomechanical asymmetries in the CMJ on landing (% Peak Landing Force Assymetry) and the risk of musculoskeletal injuries. Through the use of force platforms (ForceDecks, Valdperformance) and 4 machine learning models, data from 29 AFC Champions League elite level professional soccer players were analyzed during a regular season (with a total of 1265 jumps analyzed, during the days md+1, md+2 and md-1). The results indicate that the average asymmetries (0.82% +- 13.66) in the peak landing force are not predictive of the risk of injury, while the % Coefficient of variation (323–1827) of that asymmetry was related and could have a predictive nature regarding the risk of injuries. Furthermore, there is a moderate positive correlation (r = 0.447) between % COV Assymetry and the appearance of injuries, which is statistically significant (p = 0.017). The odds ratio of 2.4 indicates that players with higher than average COV asymmetry are 2.4 times more likely to suffer an injury. These findings highlight the importance of the CMJ as part of injury monitoring and injury reduction programs.

Abstract: Background/Objectives: This study explored the lived experiences of individuals with post-COVID condition (PCC) who participated in a 12-week exercise rehabilitation and recovery program (PCCRRP) delivered by a professional football club community trust (FCCT). The aim was to understand the effects of the program on physical function and quality of life (QoL). Methods: A qualitative approach was employed, involving semi-structured interviews with seven participants following the 12-week PCCRRP. Thematic analysis was used to analyse the interview data. Results: Participants reported improvements in exercise capacity, fatigue, and breathlessness, leading to enhanced physical function and QoL. They also experienced improvements in emotional well-being, including increased confidence and reduced anxiety. The program's focus on tailored exercise plans empowered participants to manage their symptoms and regain control over their lives. Conclusions: The PCCRRP delivered by an FCCT had positive effects on the physical function and QoL of individuals with PCC. This highlights the potential of FCCTs in providing effective rehabilitation and support for individuals with PCC.

Abstract: Introduction: Virtual Reality (VR) training indicated a positive training effect of a cognitive-motor intervention method to improve the postural balance and cognition for safer walking. This study aimed to evaluate the training effects of VR training for reducing the risks of falls among older adults with mild cognitive impairment (MCI). Methods: An experimental design was employed to evaluate how the participants attended a full-immersive VR Cave Automatic Virtual Environment (CAVE) training program. Fifty-five participants were randomly assigned into the VR group or the control group. The VR group received 16 training sessions over eight to ten weeks and the control group received a no VR falls prevention program. The primary outcome assessed any falls after the study and the secondary outcomes assessed changes in cognition and executive function, walk speed and balance performances, and the psychological factor such as fear of falling relating to the risk factors of fall. Results: The VR group showed significant greater improvement than the control group on measures of cognitive-motor performance across group and time interaction. However, there were shown inconsistent results in functional mobility and the fall efficacy between the two groups. Conclusion: This study provides promising evidence on the VR CAVE training for reducing the risks of fall among older adults with MCI from Hong Kong. VR technology-based applications are an emerging area in current aged care and rehabilitation services.

Abstract: Background/Objectives: Stroke survivors often develop asymmetric gait patterns that may lead to abnormal knee joint loading and potentially increased risk of osteoarthri-tis. This study aimed to investigate differences in knee joint loading between paretic and non-paretic limbs during walking in individuals post-stroke. Methods: Twen-ty-one chronic stroke survivors underwent three-dimensional gait analysis. A modified musculoskeletal model with a specialized knee mechanism was used to estimate medi-al and lateral tibiofemoral contact forces during the stance phase. Statistical Paramet-ric Mapping was used to identify significant differences in joint kinematics, kinetics, and contact forces between limbs. Stepwise regression analyses examined relationships between knee moments and compartmental contact forces. Results: Significant dif-ferences in knee loading were observed between limbs, with the non-paretic limb expe-riencing higher medial compartment forces during early stance (6.7-15.1%, p=0.001; 21.9-30.7%, p=0.001) and late stance (72.3-93.7%, p< 0.001), and higher lateral com-partment forces during pre-swing (86.2-99.0%, p< 0.001). In the non-paretic limb, knee extensor moment was the primary predictor of first peak medial contact force (R²=0.573), while knee abductor moment was the primary predictor in the paretic limb (R²=0.559). Conclusions: Musculoskeletal modeling revealed distinct asymmetries in knee joint loading between paretic and non-paretic limbs post-stroke, with the non-paretic limb experiencing consistently higher loads, particularly during late stance. These findings suggest that rehabilitation strategies should address not only paretic limb function but also potentially harmful compensatory mechanisms in the non-paretic limb to prevent long-term joint degeneration

Abstract: (1) Background: It remains unclear whether cognition influences postural balance in young adults or if stability is primarily maintained through automated motor skills. While previous studies have explored cognition-balance links in older adults and athletes, research on healthy young adults is limited. (2) Methods: This study investigated the relationship between cognitive functions (processing speed, working memory, and inhibition) and postural balance (static and dynamic) in 62 healthy adults (18–50 years). Static balance was assessed using the Sway Medical app, while dynamic balance was measured with the Y Balance Test (YBT). Correlation and regression analyses were performed. (3) Results: No significant associations were found between cognitive function and balance performance, suggesting that postural stability in young adults relies more on automated motor processes than cognition. However, body mass index (BMI) significantly correlated with YBT performance, highlighting the influence of physical attributes on balance control. (4) Conclusions: These findings challenge assumptions regarding cognitive involvement in balance among young adults in routine tasks. Future research should examine whether cognitive demands play a more significant role under increased task complexity, fatigue, or external perturbations. Mobile-based assessments may aid in the early detection of balance deficits, improving interventions in sports and rehabilitation.

Abstract: Motor skills in students can be developed or improved through regular physical activity such as walking in nature, Nordic walking, hiking, cycling and swimming. This study aimed to examine the relationship between motor skills and various anthropometric and health-related factors, and to appraise any differences in motor performance and body mass index (BMI) on a sample of university students from Croatia. A total of 122 students (73 of them in health programs and 49 in non-health programs) aged 18 to 44 years participated in the study. Motor abilities were evaluated using standardized motor tests, while body composition was assessed via bioelectrical impedance analysis, which measured fat tissue, muscle and bone mass, metabolic age, degree of obesity, total body water, and BMI. While the groups were similar in terms of BMI and weight, students in non-health-related study programs had significantly higher values across a wide array of detailed body composition measures, particularly related to fat and muscle mass. Significant negative correlations were observed between body fat percentage and trunk lift performance (r=–0.547, p&lt;0.01), as well as between metabolic age and trunk lift performance (r=–0.444, p&lt;0.01) in health students. In non-health students, the strongest negative correlation was found between body fat percentage and flexibility (r=–0.467, p&lt;0.01). Multiple linear regression analysis revealed that higher muscle mass was a positive predictor of motor performance (β=0.565, p&lt;0.001), while higher fat mass and metabolic age were significant negative predictors (β=–0.858, p=0.049; β=–0.911, p=0.003, respectively). Students with excessive body weight consistently exhibited higher fat mass, metabolic age, as well as poorer motor outcomes. These findings underscore the impact of body composition on motor performance, particularly strength and flexibility, and highlight the need for targeted preventive strategies among university students. The study supports the implementation of early interventions promoting physical activity and healthy body composition to preserve motor abilities and long-term functional health in this critical age group – especially since lifestyle habits formed during university years tend to persist into adulthood.

Abstract: Objectives: To determine which cognitive domains predict dynamic balance performance in older adults to guide targeted cognitive-motor interventions to enhance balance and reduce fall risk. Methods: This cross-sectional study used hierarchical multiple regression to analyze relationships between cognitive domains and dynamic balance among 62 community-dwelling older adults (≥65 years). Balance was assessed using the Y Balance Test (YBT) and Timed Up and Go Test (TUG), while cognitive function was measured using the Mini-Mental State Examination (global cognition), Stroop Test (inhibition), N-back Test (working memory), and Deary-Liewald Reaction Time Test (processing speed). Statistical analyses were conducted using SPSS, with significance set at p < 0.05. Results: Although all cognitive domains correlated with dynamic balance, regression analyses indicated that only global cognition and inhibition were significant predictors. Specifically, global cognition significantly predicted both TUG and YBT performance, whereas inhibition uniquely predicted YBT performance (all p < 0.05). Conclusions: Our findings indicate that global cognition and inhibition are key cognitive predictors of dynamic balance in older adults. Assessing these domains could identify individuals at risk of impaired balance, facilitating the design of targeted, personalized cognitive-motor interventions. Future research should investigate cognitively enriched exercise programs, including digital therapeutics and wearable technologies, to effectively target these cognitive domains, enhance balance outcomes, and promote sustained physical activity adherence in aging populations.

Abstract: Yoga demonstrates systemic physiological benefits, but its molecular mechanisms remain unclear. This multi-omics study explores transcriptomic and immune dynamics following yoga intervention. Analyzing the GSE44777 dataset, we identified 1,260 differentially expressed genes enriched in lipid metabolism, atherosclerosis, and cancer pathways. Protein-protein interaction networks revealed HBEGF, SQLE, and BCL6 as immune-metabolic hubs. A nomogram incorporating HBEGF/SQLE predicted neuropathic pain with high accuracy (AUC = 0.831). Yoga significantly reduced neutrophil infiltration (p < 0.001) and enhanced monocyte-CD4+ T cell coordination. HBEGF emerged as a dual-functional hub linking antibacterial immunity to inflammasome activation. Competitive endogenous RNA (ceRNA) network analysis uncovered HBEGF regulation by hsa-miR-29a-3p and lncRNAs, suggesting post-transcriptional control. These findings elucidate yoga’s role in reprogramming immune-metabolic networks through transcriptional and ceRNA-mediated mechanisms, supporting its application in precision prevention of cardiovascular diseases, cancer, and neuropathic pain.

Abstract: Aims: to measure whether subjects with high (HBAT) and low activation of brown adipose tissue (LBAT) showed acute differences in energy expenditure during and after 30-minutes of high intense interval training. Methods: Forty professional soccer athletes were invited to participate in the study, of which 37 started the protocol and 35 completed it. This was an acute, double-blind, case-control, quasi-experimental study design. Activation of BAT was estimated to be using infrared thermography. All participants were divided into four groups and compared by condition: (a) HBAT-CAF; (b) HBAT-PLA; (c) LBAT-CAF; and (d) LBAT-PLA. They performed 30 min of high-intensity interval training (HIIT) which included four sets of 4-minute of running in a speed corresponding at 90–95% of HRmax, each followed by a 3-minute active recovery interval at 60–70% of HRmax and 30 min of passive recovery. During exercise and recovery, breath-to-breath spirometry was performed and energy expenditure (EE), carbohydrates (g/day), fats (g/day) and proteins (g/day) were measured. Results: HBAT showed higher EE at all measurement times (p≤0.01) in the CAF condition and at all measurement times in the PLA condition (p≤0.001). For fat catabolism, the CAF condition showed a significant difference between conditions, with CAF showing higher catabolism at 60 min [36.5 g/day (0.8; 137.2); p=0.047] compared to PLA. For PTN catabolism, the HBAT-CAF condition, minutes 40, 50, and 60 showed a significant difference compared to the other measurement times (p≤0.023 for all comparisons). Conclusion: After high-intensity interval exercise with CAF supplementation, both HBAT and LBAT subjects experience a significant increase in EE during exercise and recovery compared to baseline. Basal BAT activity did not affect the rate of CHO and FAT oxidation, although a higher rate of PTN utilization was observed in the HBAT-CAF group.

Abstract: Background/Objectives: The aim of this study was to assess the effects of cold water immersion (CWI) post-eccentric muscle contraction exercise on skin temperature, pain score, Maximum Voluntary Isometric Contraction (MVIC), muscle damage, and muscle mechanical properties. Methods: Twenty-seven male participants (age 20.6±0.6; body mass 69.4±8.1; body fat % 13.7±4.3) were divided into three groups: whole body CWI group (n=9), lower body CWI group (n=9), and control group (n=9). Results: Significant effects were observed in skin temperature (p=.001) and interactions between treatment and time (p=.001). MVIC showed a time effect (p=.001). Pain scale analysis indicated significant effects for treatment (p=.001), time (p=.001), and their interaction (p=.049). Creatine kinase (CK) and lactate dehydrogenase (LDH) showed time effects (p=.001), with LDH also showing an interaction effect (p=.027). Tensiomyography (TMG) results for Dm showed time and interaction effects (p=.001), while Tc had a time effect (p=.044). Conclusions: Whole-body immersion was most effective for reducing skin temperature. Lower limb immersion improved MVIC, CK, and Dm the most. The control group showed significant improvements in pain scale, Tc, Tr, and LDH. Lower limb immersion or active movement is recommended for recovery after high-intensity running training.

Abstract: Background and Clinical Significance: Colorectal cancer (CRC) remains a global health challenge with significant postoperative complications and functional declines. Telerehabilitation offers an accessible alternative to improve preoperative physical condition and postoperative recovery. Case Presentation: Five CRC patients scheduled for laparoscopic surgery participated in an asynchronous telerehabilitation multimodal program, including two weeks of prehabilitation and four weeks of postoperative rehabilitation. Delivered via a digital platform with remote physiotherapist support, the intervention improved functional capacity and muscle strength preoperatively, with partial recovery noted post-surgery. Conclusions: Integrating telerehabilitation into the CRC surgical pathway is feasible and may enhance functional outcomes and quality of life. Further studies are required to confirm these preliminary findings.

Abstract: Background: This study investigated the impact of walking football on functional health and well-being outcomes in rural older adults and explored their participation experiences. Methods: This multi-methods study saw 13 older adults (7 males/6 females, 63.2±9.4 years) complete 1-hour of walking football per week for six weeks. Pre- and post-intervention, participants underwent assessments of body mass and height as well as assessments of functional fitness using the Senior Fitness Testing Battery. On completion of the walking football intervention, all participants joined in a semi-structured focus group interview to explore their health and psychosocial of participation. Results: Statistically significant increases, with small effect size, were observed in body mass and BMI (p&lt;0.05). Furthermore, statistically significant improvements (p&lt;0.05), with small-to-large effect sizes, were observed for several functional health outcomes. Thematic analysis focus group data identified three themes that captured the participants’ experiences, including: (1) “Opportunity to jump back in with what we can physically do”, (2) Social connection and feeling “part of something bigger”, and (3) “It’s how our brain is engaged”. Conclusions: Rural older adults experience physical, social, cognitive and psychological health and well-being improvements from participating in a walking football program.

Abstract: Background/Objectives: To the best of the authors' knowledge, the different injury mechanisms of the hamstring muscle group have not been defined in detail in men's professional football. For this reason, the aim of this study is to determine the mechanisms and contextual patterns associated with hamstring muscle group injuries in professional male football players in competition, using a systematic video analysis method. Methods: video recordings of official matches from two consecutive seasons (2017/18 and 2018/19) of the Spanish First Division of Football (LaLigaTM) were used for this research. The process to determine the moment of injury was carried out by two independent evaluators using an ad hoc observation tool and, subsequently, all relevant data were collected to detail the specific patterns of injury events observed. Results: 78 cases of hamstring injuries were included for the final analysis of specific patterns. The most outstanding results were that, 1) although the sprint-related pattern (SP) is predominate (54%; 42 cases), the combined pattern 2 (COMB2) is another mechanism that appears frequently (26%; 20 cases), 2) within the SP, curved runs show a greater number of cases (52% of SP; 22 cases), 3) the majority of the injuries occur without contact (83%; 65 cases) and with the presence of the ball (88%; 69 cases), and, finally 4) the most injured positions were fullbacks/wingbacks (28%; 22 cases), central defenders (27%; 21 cases) and wingers/wide midfielders (23%; 18 cases). Conclusions: SP remains the most frequent pattern in hamstring injuries, however, the present study presents other mechanisms that are also quite common and should be considered, such as, curvilinear runs in SP, and COMB2.

Abstract: The Pilates breathing technique is theorized to improve neuromuscular efficiency, but its specific effects on peripheral muscles have not been thoroughly investigated. This study evaluated how Pilates breathing influences the neuromuscular efficiency of the biceps brachii muscle during submaximal elbow flexions compared to regular breathing. Fifty-eight healthy adults without prior experience with the Pilates Method of Exercise performed concentric and eccentric elbow contractions at 20%, 40%, and 60% of their maximal voluntary isometric contraction under two breathing conditions: the specialized Pilates breathing pattern (executing movements exclusively during expiration) and normal breathing patterns. Muscle activity was measured using surface electromyography, with neuromuscular efficiency quantified as the relationship between muscle electrical activity and force production. The results revealed significantly improved neuromuscular efficiency during Pilates breathing at all tested intensity levels, with the most substantial enhancement observed at 60% of maximal effort. The eccentric phase of movement demonstrated more efficiency gains than the concentric phase. These findings indicate that the distinct breathing pattern used in Pilates can independently enhance neuromuscular performance in the biceps brachii. The study suggests that incorporating Pilates breathing techniques could benefit rehabilitation programs and strength training regimens to optimize muscle function and movement efficiency. Additional research is recommended to examine long-term effects and practical applications in clinical and athletic settings.

Abstract: This study examined the impact of different breath-holding conditions on iliopsoas and other hip flexor muscle activity in individuals with chronic ankle instability (CAI). It has been hypothesised that impaired diaphragmatic function influences iliopsoas activation, potentially contributing to motor control deficits in patients with CAI. Eleven adults with a history of chronic ankle sprain participated in this study. Maximal isometric hip flexion was assessed under three breath-holding conditions: end-expiration, end-inspiration, and the intermediate state. Surface electromyography was used to record the muscle activity of the iliopsoas, rectus femoris, sartorius, and tensor fasciae latae, while the peak hip flexion torque was measured using an isokinetic dynamometer. Under the end-inspiration condition, iliopsoas activity on the affected side was significantly lower than that on the control side (P < 0.05). However, no significant differences were observed between the affected and control sides in the activity of the other hip flexor muscles or the peak hip flexion torque across breath-holding conditions. This study highlights the association between reduced iliopsoas activity during end-inspiration and compromised diaphragmatic function in patients with CAI. Future research should explore dynamic movement tasks and larger sample sizes to elucidate neuromuscular mechanisms further and refine rehabilitation strategies.

Abstract: Background: Optimal health requires self-direction for exercise regime consistency. Yet, boredom with constancy may result in abandoning regular exercise. Productive conservation of an exercise practice regards experiencing psychological flow, a concept originated by psychologist Csikszentmihalyi. A scoping review of post-2020 publications investigates the research range on this topic. This review differs from and adds to others investigating flow in exercise alone by focusing on continuing the exercise program for optimal health regarding boredom aversion. Method: Searched following the PRISMA guidelines for scoping reviews are “Csikszentmihalyi, flow, exercise, boredom”. Excluded are reviews, books, reports missing any keywords, non-English reports, reports not based on research studies, and research published before 2020. Results: The results of the primary database searches (and their final returns) are OVID (3), ProQuest (0), PubMed (0), Scopus (0), and Web of Science (0). The search of Google Scholar (8) is as a supplementary database. Included are research studies containing all the keywords. Conclusions: Boredom is found impossible when experiencing psychological flow in an exercise program and can lead to changes in the exercise program to create an evolution of flow commensurate with the participant’s skill level. In the case of COVID-19, the required adjustments involved a successful consideration of imposed limitations. The exercise regime must be neither excessive nor extreme to promote optimal health while accounting for differences in skill level and gender. Future scoping research should involve a research team, and future studies should include the date and location of the research to permit more accurate comparisons.

Abstract: Introduction: Fragmented practices need more interprofessional education. The development of interprofessional simulation in health careers has advanced undergraduate training in teamwork, roles, responsibilities, decision-making, and ethics. The study aims to analyze the effects of participating in a clinical simulation pilot on self-efficacy for interprofessional learning in health students. Methods: Final-year students from speech therapy, physical therapist, and occupational therapy programs participated in three consecutive interprofessional clinical simulation scenarios and were compared with a control group. All students completed the Self-Efficacy Scale for Interprofessional Experiential Learning. Scale scores were compared using the Mann-Whitney U test. This study was approved by the ethics committee (No. 149-22) of Universidad San Sebastián. Results: Twelve students participated in the study group and twelve in the control group. Significant differences were observed in the two dimensions of the self-efficacy scale: professional interaction (p< 0.001) and interprofessional team assessment and feedback (p< 0.001), with the study group scoring higher than the control group. Conclusions: Students participating in interprofessional simulation have higher self-efficacy for experiential learning than those not participating in the professional interaction and interprofessional team assessment and feedback dimensions. Confirms the effectiveness of interprofessional simulation as an educational strategy.

Abstract: Background and Objectives: Evidence-based practice (EBP) is vital for delivering effective pa-tient-centered physiotherapy care. However, how physiotherapists understand and use EBP remains largely unknown. This nationwide study explored the awareness, knowledge, and day-to-day applica-tion of EBP, shedding light on the individual and professional factors that help or hinder its adoption. Materials and Methods: This nationwide cross-sectional study involved 2,966 physiotherapists across diverse regions of India and different professional settings (private clinics, government hospitals, home care, and academia). Participants completed an online survey using the Evidence-Based Practice Ques-tionnaire (EBPQ) to assess their knowledge, attitudes, and skills. Internal consistency. was analyzed using Cronbach’s alpha, and multiple linear regression was used to identify the EBP predictors. Re-sults: The EBPQ showed good reliability (Cronbach’s alpha = 0.789). Overall, private-clinic physio-therapists (mean ± SD = 104.41 ± 9.82) and home care therapists (104.38 ± 9.16) scored highest on EBP, while those in government hospitals (101.83 ± 9.23) reported lower scores. Among the eight regions across India, Rajasthan achieved the highest EBP scores (104.20 ± 9.80) and other regions within a range from (104.20 ± 9.80 103.3 ± 9.30). Those with doctoral degrees outperformed all other groups (105.18 ± 10.20). Regression models (adjusted R² ≤ 0.044, p < 0.001) revealed that working in private settings (B = 0.958, p = 0.029) or in specific states (e.g., Chhattisgarh: B = 14.71, p = 0.030) predicted better EBP scores. Conclusions: Indian physiotherapists’ engagement in self-reported EBP was shaped by where they worked, their educational background, and region-specific factors. Private practitioners and those with PhD degrees appear to report high EBP. Tailored strategies ranging from local resource improvements to targeted professional education could foster more consistent and robust use of EBP, ultimately benefiting patients across India.

Abstract: Nordic exercises aim to enhance physical abilities and prevent injuries; however, their applicability across different sports remains unclear. This study aims to analyze their effects across various sports disciplines. Objective: To analyze the effects of Nordic exercises on the lower limbs and their relationship with absolute strength and vertical jump in various sports disciplines (football, athletics, basketball, sport climbing, cycling and taekwondo). Method Quasi-experimental study involving 122 athletes (mean age 18±3 years): football (n=24), athletics/speed (n=20), sport climbing (n=20), basketball (n=24), taekwondo (n=14) and cycling (n=20); classified into a control group CG (n=57) and an experimental group EG (n=65). Results: Dominant absolute strength at baseline (12.4±0.51 kg) and post-intervention (14.5±0.98 kg) increased significantly, particularly in basketball (P < 0.05); vertical jump of the initial (42.4±1.2kg) and final (45.8±1.5kg) EG, with a significant difference in all modalities between before and after (p≤0.05), except in cycling and taekwondo; no major changes were found in the GC. Conclusion: Nordic exercises are recommended as part of training to improve levels of vertical jump and vertical jump with emphasis on the modalities of football, basketball, athletics/speed and sport climbing, being applicable to increase absolute strength in basketball.