Public Health and Healthcare

Abstract: Background: Postural problems such as head forward posture, thoracic hyperkyphosis and lumbal hyperlordosis, when seen together, further complicate postural control, increasing the importance of comprehensive approaches in treatment. This study aims to examine the effect of 6 weeks telerehabilitation with web-based exercises and compare the home based exercises in individuals with postural problems. Trial Design: A Randomized Controlled Study. Methods: 34 volunteers with postural deformity among young adults were randomly divided into telerehabilitation (n=17) and control (n=1) groups. Craniovertebral, thoracic kyphosis, and lumbal lordosis angles of all individuals were evaluated with a smartphone application (Clinometer+ Bubble), hamstring, and pectoral muscle shortness with a goniometer, and trunk muscle endurance with endurance tests created by McGill and Sorenson. Whilst the tele-rehabilitation group was provided with a videobased exercise programme, the control group was advised to follow the same exercise programme at home. Exercises were performed 3 days a week for 6 weeks, 1 hour session. Participants in the telerehabilitation group were followed up with synconised video conference. Results: A significant difference was observed in the telerehabilitation group in muscle shortness and the endurance tests (p<0.05). Only a significant difference in left (p=0.03) and right (p=0.04) muscle shortness was observed in the home exercise group. Significant differences were observed in Craniovertebral and lumbal lordosis angles between groups (p<0.05), with the telerehabilitation group showing better outcomes. When examined kyphosis angle, muscle shortness, and endurance tests between groups were found to be similar (p>0.05). Conclusions: Six weeks of telerehabilitation can improve muscle shortness and trunk endurance in young adults with postural deformities. Both the exercise program using telerehabilitation and the home exercise program were beneficial for individuals with postural problems, with more favorable effects observed in the telerehabilitation group.

Abstract: Female rugby league performance is influenced by multiple interacting systems; however, the extent to which sensory and autonomic function differentiates playing level remains unclear. This study investigated whether visual, vestibular, somatosensory, and auto-nomic performance differ by playing level and positional group in female rugby league athletes. Elite and sub-elite athletes completed lower-limb proprioception testing using an Active Movement Extent Discrimination Assessment protocol, alongside visual–vestibular and autonomic measures obtained via a virtual-reality eye-tracking system. Bayesian hierarchical models were used to examine the effects of playing level, positional group (adjustables, backs, forwards), and their interaction, with posterior inference based on probability of direction and region of practical equivalence analyses. Interaction effects between level and position were observed for selected variables across somatosensory, vestibulo-oculomotor, and autonomic domains. Elite adjustables demonstrated higher ankle proprioceptive acuity than sub-elite adjustables (PD = 0.94), with additional interaction effects identified for vestibulo-oculomotor time on target (PD = 0.95) and autonomic dilation velocity (PD = 0.98). However, findings were not consistent across positional groups or outcome measures, and substantial within-group variability was evident. Overall, sensory and autonomic performance did not consistently differentiate playing level, suggesting limited utility for cross-sectional discrimination but potential value for longitudinal, individualised athlete monitoring.

Abstract: Physical activity is a safe and effective intervention for chronic musculoskeletal pain. However, a literature search revealed a lack of synthesis of evidence on the extent to which physical therapists in Saudi Arabia incorporate physical activity as part of health promotion in the management of such pain. This review aims to identify, map and report literature related to physical activity for health promotion in people with chronic musculoskeletal pain presenting to physical therapy settings in Saudi Arabia. A six-step approach will be followed to conduct the scoping review. Step 1, the primary research question is: What is the scope and nature of the existing literature in this research area? The secondary research question is: What insights does the existing literature reveal regarding physical therapy clinical practice? Step 2, a comprehensive search will be conducted for relevant literature using the following electronic databases: Scopus, Medline, PubMed, Cochrane library, CINAHL, ScienceDirect and PEDro. In addition, supplementary search methods will be conducted for identifying additional relevant literature via screening process of the reference lists of all included literature and screening process of the included studies of retrieved systematic reviews through electronic databases. A parallel search including the main keywords will also be undertaken on the website of the Saudi Ministry of Health, the website of Saudi Physical Therapy Association, Google and Google Scholar for grey‑literature searching. Step 3, records will be screened by two independent reviewers and managed using Rayan software. Step 4, the nature of included literature, including study characteristics and outcomes where appropriate, will be documented using a data extraction. Step 5, the characteristics and outcomes of included records will be collected, summarised and reported. Step 6, Stakeholders will be consulted to interpret the scoping review findings from their perspective and assess the findings’ relevance and applicability.

Abstract: Background/Objectives: Advanced heart failure is associated with reduced functional capacity and impaired quality of live. Left ventricular assist devices (LVADs) are increasingly used as a long-term treatment option in patients with end-stage heart failure. Despite improvements in hemodynamic function after LVAD implantation, many patients continue to experience limitations in daily functioning. The aim of this study was to evaluate the relationship between physical activity and functional status in patients with LVAD support. Methods: The study included 262 adult participants divided into four groups according to LVAD support and declared physical activity. Functional status and quality of life were assessed using the Short Form-36 Health Survey (SF-36) and the Minesota Living with Heart Failure Questionnaire (MLHFQ). Results: Significant differences were observed between the analyzed groups in both SF-36 and MLHFQ scores. Physically active patients with LVAD achieved the most favorable results, indicating better functional status and lower symptom burden, whereas inactive individuals demonstrated poorer outcomes. Significant correlations were found between physical activity and selected aspects of daily functioning, including walking, climbing stairs, household activities, and carrying groceries. Higher levels of physical activity were associated with better quality of life and fewer functional limitations. Conclusions: Physical activity may positively influence functional status and quality of life in patients with LVAD support. The findings suggest that regular physical activity should be considered an important component of rehabilitation and long-term management in patients with advanced heart failure treated with LVAD therapy.

Abstract: Background/Objectives: To investigate the effects of a 12-week multimodal intervention (MMI [resistance + motor-cognitive dual-task training]) versus a unimodal intervention (UMI [resistance training]) on gait and cognitive performance in people with glaucoma during single-task (ST) and dual-task (DT) walking. Methods: In this randomized controlled pilot study, fifteen glaucoma patients (MMI: n=8, UMI: n=7) completed 24 supervised intervention sessions over 12-weeks. Spatio-temporal gait parameters (stride length, gait velocity, minimum toe clearance [MTC], and their respective coefficient of variance [CoV]) were assessed using inertial measurement units (sampling frequency 100Hz) during ST and DT walking. During DT walking, the participants performed three cognitive tasks: reaction time task, N-Back task, and letter fluency task. Each cognitive task was performed with two levels of difficulty. Repeated measures analysis of covariance (TIME x INTERVENION x CONDITION) was conducted to analyze the data. Results: No significant group or time effects were observed for ST gait or cognitive performance. Independent of intervention, dual-task costs (DTC) improved for MTC (p=0.188,η_p²=0.205) and MTCCoV (p=0.021, η_p²=0.713) over time. UMI showed greater improvements over time than MMI for DTC MTC (p=0.168,η_p²=0.223) and DTC MTCCoV (p=0.047,η_p²=0.407).Conclusion: This pilot study revealed that both MMI and UMI decreased DTC MTC and DTC MTCCoV in glaucoma patients. However, UMI appeared more effective than MMI to improve gait performance in glaucoma patients. Thus, resistance training might be a promising intervention to improve gait performance in glaucoma patients, with the ultimate aim to reduce the risk of falls.

Abstract: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by a decline in functional capacity and increasing limitations in daily activities. Clinical assessment tools provide valuable information on symptom severity but do not fully capture functional capacity. The aim of this study was to determine the usefulness of the Senior Fitness Test (SFT) for assessing functional capacity in patients with PD, depending on met (group A) or did not meet (group B) health-promoting physical activity (PA) recommendations. The study included 74 patients with idiopathic PD classified as Hoehn and Yahr stage II. PA was assessed using ActiGraph GT3X+ triaxial accelerometer and activity diaries, functional capacity using SFT, and symptom severity by MDS-UPDRS scale. Group A achieved significantly better results in all SFT components and had lower MDS-UPDRS scores than group B. The synthetic functional index was higher in the A group (1.28 ± 2.25 vs. -0.64 ± 2.28; p &lt; 0.001), whereas the total MDS-UPDRS score was lower (31.09 ± 4.97 vs. 34.99 ± 5.28; p = 0.022). The results indicate that the SFT may be a useful and practical tool to complement the clinical assessment of patients with PD and may support more individualized rehabilitation planning and monitoring.

Abstract: Objectives: This study investigated the interplay between pre- and post-match physiological responses and subsequent emotional changes in elite male water polo players, focusing on differences between official championship (competitive) and non-competitive (training) settings. Methods: Sixteen male Italian Serie C water polo players participated. Salivary biomarkers (cortisol, immunoglobulin A (IgA), and uric acid) were measured, alongside psychological assessments of cognitive anxiety, somatic anxiety, and self-confidence. Measurements were taken before and after both training and competition matches. Results: A significant anticipatory rise in salivary cortisol was observed before competition matches compared to training, highlighting the psychological stress associated with competitive events. Post-match, cortisol levels remained elevated to a greater extent after competition. Salivary IgA levels decreased significantly following both training and competition, with a more pronounced reduction after official matches, and exhibited a negative correlation with cortisol. Salivary uric acid, a marker of oxidative stress, increased post-exercise and was significantly higher after competition. Players reported higher somatic and cognitive anxiety and lower self-confidence before competition compared to training, and pre-competition cortisol levels were positively correlated with both anxiety measures and negatively correlated with self-confidence. Conclusions: These findings highlight the distinct physiological and psychological responses elicited by competitive versus non-competitive settings in water polo, emphasizing the importance of considering the emotional context when monitoring athletes' stress and recovery. The social meaning of competitive contexts may be embodied, impacting stress and immune responses.

Abstract: Background/Objectives: Genitourinary Syndrome of Menopause (GSM) negatively affects quality of life in postmenopausal women, causing sexual dysfunction, vaginal atrophy, and pelvic discomfort. Non-hormonal therapies, such as laser treatments, have emerged as potential alternatives, but evidence comparing intravaginal and extravaginal K-Laser therapy remains limited. The objective is to evaluate the efficacy of intravaginal and extravaginal K-Laser therapy on the symptoms of Genitourinary Syndrome of Menopause (GSM) in postmenopausal women. Methods: In this single-center, randomized, single-blind, placebo-controlled trial, 57 postmenopausal women were randomly assigned to receive either intravaginal and extravaginal K-Laser Cube Plus 30 therapy (n=36) or a simulated control treatment (n=21). The primary outcome was sexual function, measured by the Female Sexual Function Index (FSFI). Secondary outcomes included vaginal pH and pelvic floor muscle function assessed via the PERFECT protocol. Assessments were performed at baseline and after the 6-week treatment period. Results: Fifty-seven women were enrolled, with ten lost to follow-up. After 6 weeks, the treatment group showed significant improvements over the control group in FSFI (mean difference = 6.38; p &lt; 0.001), PERFECT protocol scores (mean difference = 0.78; p = 0.004), CPPQ-Mohedo (mean difference = 5.44; p &lt; 0.001), and Menopause Rating Scale (mean difference = 6.50; p = 0.017). Significant reductions were also observed in vaginal dryness, vulvar dystrophy, and atrophy (p &lt; 0.001). Conclusions: Intravaginal and extravaginal K-Laser therapy is a safe and effective non-hormonal intervention for GSM, improving sexual function, pelvic floor function, and menopausal symptoms.

Abstract: Background: Wearable technologies enable continuous, ecologically valid monitoring of physiological responses to therapeutic interventions in real-world settings. Yoga-based physiotherapy is increasingly integrated into preventive and rehabilitative healthcare due to its potential effects on autonomic regulation, sleep, and psychological well-being. Objective: This study aimed to evaluate the effects of a short-term yoga-based physiotherapy intervention on objective physiological parameters and subjective health-related quality of life, and to assess the feasibility and limitations of wearable device-based monitoring in ecological conditions. Methods: A prospective within-subject observational study was conducted in 30 healthy adults over a four-week period, including a two-week control phase followed by a two-week intervention phase. During the intervention, participants performed daily 10–15-minute yoga-based physiotherapy sessions incorporating breathing exercises, postural control, and relaxation techniques. Continuous monitoring of heart rate (HR), heart rate variability (HRV), stress index, and sleep duration was performed using Garmin wearable devices. Health-related quality of life was assessed using the SF-36 questionnaire. Paired t-tests were applied to compare phases (p < 0.05). Results: The intervention led to a significant reduction in heart rate (74.06 ± 5.0 vs. 71.39 ± 5.2 bpm; p = 0.024) and a significant increase in sleep duration (6.55 ± 0.8 vs. 7.04 ± 0.7 h; p = 0.044). HRV showed a non-significant increase (50.13 ± 10.2 vs. 54.80 ± 9.8 ms; p = 0.086), while stress levels remained unchanged (p = 0.661). SF-36 results indicated significant improvements in physical functioning, role-physical, vitality, and mental health, alongside small but significant declines in bodily pain and role-emotional domains. Conclusions: Short-term yoga-based physiotherapy induces measurable improvements in cardiovascular regulation and sleep, with domain-specific effects on quality of life. Wearable devices offer valuable tools for real-world physiological monitoring; however, discrepancies between objective and subjective outcomes highlight the need for multimodal assessment approaches in rehabilitation research.

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Background: Knee osteoarthritis (KOA) alters the performance of daily activities, such as stair negotiation, by compromising lateral stability and neuromuscular control. This pilot study evaluated the feasibility of a 10-week Dynamic Neuromuscular Stabilization (DNS) program and explored preliminary biomechanical changes during stair ascent and descent in middle-aged women with KOA. Methods: Twenty-six participants were randomly assigned to a DNS group (n = 13) or a control group (n = 13). The DNS group completed a 10-week intervention (twice weekly). Feasibility was assessed via recruitment, retention, and adherence. Primary outcomes were mediolateral (ML) center of pressure (COP) parameters, while secondary outcomes included anteroposterior (AP) COP parameters and lower limb range of motion (ROM). Effect sizes (η²_p) were estimated using 3D motion analysis and force plates. Results: The intervention showed high potential feasibility, with 100% recruitment and retention rates and 98.5% compliance. No adverse events occurred. Large effect sizes were observed for reduced ML COP velocity (ascent: η²_p = 0.79; descent: η²_p = 0.62) and RMS (descent: η²_p = 0.16). Secondary outcomes, including AP COP parameters and joint ROM (increased sagittal flexion and decreased coronal instability), also demonstrated large effect sizes. Conclusions: This pilot study suggests that progressive DNS training is a safe and potentially feasible intervention for patients with KOA. The preliminary effect sizes observed in COP control and lower kinetic chain mechanics provide promising evidence that may serve as foundational data for designing future large-scale clinical trials to definitively verify efficacy.

Abstract: Background: A wellplanned health workforce is essential for achieving highquality, equitable rehabilitation services. In Kuwait, physiotherapy services have expanded over the past decade, yet little is known about longterm workforce trends, gender and nationality imbalances, or the impact of the COVID19 pandemic. This study provides the first comprehensive 14year analysis of physiotherapy workforce dynamics and service utilisation within Kuwait’s Ministry of Health. Methods: A retrospective descriptive study was conducted using Ministry of Health annual physiotherapy workforce and serviceutilisation reports (2011–2024). Data included workforce size, gender, nationality, rank, educational qualifications, and physiotherapy service activity across specialized and general hospitals. Descriptive statistics, linear regression, and interrupted timeseries (ITS) analyses were used to examine longterm trends and COVID19–related changes. and physiotherapy service activity. Results: The physiotherapy workforce increased from 567 in 2011 to 1,078 in 2024, a rise of 90%. Growth was driven mainly by Kuwaiti and non-Kuwaiti females, resulting in a strongly feminised workforce by 2024. In contrast, Kuwaiti male physiotherapists declined by 28.8%. Workforce density increased modestly from 1.85 to 2.19 physiotherapists per 10,000 population, remaining below international benchmarks. Educational qualifications improved, with PhD-trained physiotherapists increasing from 2 to 23. Interrupted time-series analysis showed a significant pandemic-related decline in service utilisation, particularly in Kuwaiti outpatient activity. Significant post-pandemic recovery was observed in selected service streams. Conclusion: Kuwait’s physiotherapy workforce expanded substantially, but workforce density remained below global benchmarks and gender and nationality imbalances persisted. Future planning should strengthen national recruitment, equitable workforce distribution, and digital and tele-physiotherapy models.

Abstract: Neurodegenerative disease comprises a variety of progressive disorders that target the brain and central nervous system. These disorders are characterized by the rapid degeneration of neurons and neurological functions that lead to motor impairment and the deterioration of the quality of life of an individual. Currently, the traditional interior design solutions are static and often fail to adapt to the changing needs of patients with progressive neurological conditions. This is where technology, particularly augmented reality offers new possibilities to combat these conditions and make life easier for the patients. Therefore, this review assimilates the application of augmented reality in the field of healthcare, especially with regard to neurodegenerative diseases. The objective of the research was to understand how augmented reality could assist in the treatment or alleviation of patients suffering from such diseases. Most neuro-degenerative diseases cannot really be cured, so doctors end up prescribing medication and tasks that help a little but not really make the condition of the patients any better. The possibility of using augmented reality technology is highlighted not only for the patients but also for their caregivers. The various applications of AR including, rehabilitation therapy, cognitive therapy, and remote monitoring are also discussed. Therefore, augmented reality facilitates a shift in therapy from a static clinic- based approach to a more dynamic-interactive model.

Abstract: Purpose: This study examined the acute effects of High-Intensity Interval Training (HIIT) and prolonged endurance training (ET) on heart rate variability (HRV) in elite Greco-Roman wrestlers. A secondary aim was to assess the usefulness of HRV in opti-mizing recovery strategies by monitoring post-exercise changes. Methods: Using a longitudinal crossover design, 13 elite male wrestlers completed two training protocols separated by a 15-day washout period. HRV variables were recorded at baseline, pre-exercise, during training, and 24 hours post-exercise. Data were analyzed with a linear mixed model (LMM) and Bonferroni-adjusted post hoc comparisons. Results: A significant main effect of Timepoint was found for all HRV parameters (SDNN, RMSSD, LF/HF ratio, and overall HRV), indicating marked reductions during exercise fol-lowed by partial recovery after 24 hours. A significant effect of Training Type was ob-served for SDNN. Post hoc analysis showed a significantly greater suppression of overall HRV during HIIT compared to ET (p = .012, Cohen’s d = 0.82). Despite these differences, both protocols demonstrated similar recovery patterns at 24 hours. Conclusion: Both HIIT and ET induced acute decreases in HRV, with HIIT causing a more pronounced decline. Nevertheless, HRV recovery after 24 hours was comparable between the two training modalities.

Abstract: Background: Physical activity is a recommended first‑line treatment for the management of chronic low back pain, yet adherence to structured exercise often remains poor due to pain, fear, fatigue, and contextual barriers. Snacktivity™, which promotes brief, frequent bouts of movement embedded in daily routines, has emerged as a potentially feasible alternative. However, it remains unclear how, why, and for whom Snacktivity supports engagement in physical activity for people living with chronic low back pain. Objective: To develop and refine programme theories explaining how Snacktivity‑type interventions support physical activity engagement and related outcomes in adults with chronic low back pain. Methods: A realist review was conducted following RAMESES standards. Initial programme theories were developed and iteratively refined through synthesis of quantitative, qualitative, and mixed‑methods evidence from Snacktivity and related sedentary‑reduction interventions in low back pain and other adult populations in order to test developed programme theories. Evidence was analysed to identify context–mechanism–outcome configurations. Results: A total of four studies met the inclusion criteria for Snacktivity-type studies related to low back pain and were included to develop and test the initial programme theories. This was then supported by 38 studies that contributed evidence to programme theory refinement. Five refined programme theories were supported. Snacktivity appears to enable engagement by lowering perceived burden and threat rather than eliminating fear, generating mastery experiences that enhance self‑efficacy, and reducing symptom interference through brief, distributed activity. Education and coaching components supported meaning‑making by reframing movement as legitimate and achievable, while environmental cues and routines promoted habit formation. Psychosocial outcomes (confidence, mood, vitality) and habit formation improved more consistently than performance‑based outcomes, and engagement was sustained even when pain or fatigue persisted. Conclusions: Snacktivity functions as a participation‑enabling intervention rather than traditional exercise prescription. Its effectiveness for chronic low back pain is explained by psychosocial and contextual mechanisms that support psychological safety, mastery, and habit formation. These findings support a shift from dose‑response exercise models toward interventions that prioritise feasibility, meaning, and sustained participation in daily life.

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This study evaluated the validity of the leg stiffness metric provided by the Stryd running power meter against the Morin (2005) sine-wave spring-mass model. Twenty-three highly trained trail runners (11 women) completed a 12-min uphill time trial at +12% grade and one hour of submaximal level running. Leg stiffness was calculated from contact time, flight time, running speed, and leg length using the Morin’s method, and compared with Stryd values. Agreement was assessed following the Dhahbi and Chamari Level-1 analytical framework, including intraclass correlation coefficient (ICC_2,1), Bland-Altman analysis, mean absolute percentage error (MAPE), and paired t-tests. Stryd and Morin estimates showed excellent agreement in both conditions: uphill running: ICC_2,1 = 0.96 (95%CI: 0.91–0.98), bias = −0.02 kN·m⁻¹, limits of agreement (LoA) = [−0.61, 0.58] kN·m⁻¹, MAPE = 2.5% (p = 0.803), and level running: ICC_2,1 = 0.97 (95%CI: 0.93–0.99), bias = −0.04 kN·m⁻¹, LoA = [−0.62, 0.54] kN·m⁻¹, MAPE = 2.6% (p = 0.505). The Stryd sensor provides valid leg stiffness estimates in highly trained trail runners on both level and inclined terrain. The negligible systematic bias and narrow limits of agreement support the use of Stryd for leg stiffness monitoring in field and laboratory settings.

Abstract: Oculomotor dysfunction is an eye movement disorder frequently experienced in patients with Parkinson’s disease. While this neurodegenerative disorder is often characterised by tremors, rigidity and slow movement, many patients tend to experience visual symptoms during its early stages and this can exacerbate cognitive symptoms when visual tasks become more demanding. This review provides an update on the recent advances in the neurorehabilitation of oculomotor dysfunction, and it uses a sensory-motor integration framework for understanding the vision-related symptoms and the functional challenges imposed on the patient’s activities of daily living. This is categorized in terms of visual sensory, visual motor, visual perceptual, cognitive processing, and psychosocial challenges, and this understanding is vital for accurate diagnosis, monitoring, and implementing effective strategies to improve their visual function and overall quality-of-life. By fostering interdisciplinary collaboration, healthcare professionals can take proactive steps to address the vision-related challenges faced by patients with Parkinson’s disease and effectively manage the challenges faced by patients with Parkinson’s disease.

Abstract: Periprosthetic joint infection (PJI) remains a major limitation of joint arthroplasty, driven by the absence of localized, continuous diagnostics and controllable in vivo therapy during the spacer interval. Here, we introduce a theranostic implant platform that integrates sensing, communication, and light-based intervention within a temporary joint spacer. The SmartSpacer enables real-time intra-articular monitoring, combining high-resolution temperature sensing (± 0.1 °C), optical imaging, and spectral detection of bacterial activity down to ~10³ CFU ml⁻¹. We establish a translation-oriented framework that maps wavelength-dependent antimicrobial effects onto implant-level constraints. Within this framework, visible blue light provides continuous suppression of bacterial growth, while ultraviolet radiation enables rapid bactericidal action via pulsed, spatially confined exposure. These modalities operate within implant-compatible energy budgets and without measurable thermal load, enabling sustained and repeatable intervention. Continuous multimodal sensing enables longitudinal tracking of infection dynamics, transforming diagnostics from static assessment to predictive monitoring. By linking localized sensing with controllable therapy, the SmartSpacer converts the spacer interval from a passive waiting phase into an active treatment window. This work defines a system-level strategy for implant-based infection control and establishes a foundation for future feedback-driven, closed-loop therapeutic systems.

Abstract: Chronic pain remains a major challenge in healthcare despite advances in pharmaceutical management. Growing recognition of the biopsychosocial complexity of chronic pain has highlighted the need for approaches that reflect this multidimensional experience. Complementary therapies, used alongside mainstream treatments, are increasingly popular, yet evidence supporting their efficacy is limited. Randomised controlled trials (RCTs) have not generated findings sufficient to influence policy or practice, potentially because their outcome measures fail to capture what matters most to patients. A keyword search of Ovid Medline, PubMed, the Cochrane Collaboration, and National Institute for Health and Care Excellence guidance from 2010 onwards identified contemporary chronic pain guidelines and systematic reviews. Our narrative synthesis examines current approaches to chronic pain management, the prevalence of complementary therapy use, and the evidence underpinning efficacy. We critically consider whether RCT designs and reductionist outcome measures are appropriate for evaluating holistic interventions. We argue that the distinctive features of complementary therapies must be understood as potential mediators of change. Shifting focus from narrow efficacy testing towards evaluating meaning, patient responses, and perceived utility may provide more relevant insights. Developing programme theories and logic models can clarify how complementary therapies work and guide the selection of suitable outcome measures for future research.

Abstract: Background/Objectives: Body posture and temperament share common neurophysiological determinants related to muscle tone regulation, motor activity and behavioural reactivity. Despite this shared biological basis, posture has primarily been investigated within biomechanics and medicine, whereas temperament, in psychology. Integrating these perspectives may not only improve psychomotor development understanding, but also provide a foundation for more individualised preventive and rehabilitation strategies. The study aim was to analyse the relationship between body posture and temperament types in adolescents and determine posture type prevalence in the sagittal plane, particularly focusing on potential clinical relevance. Methods: The study included 272 students aged 16-17 years. Body posture was assessed using the DIERS Formetric III 4D system based on rasterstereography, enabling non-invasive three-dimensional spinal curvature analysis. Nine posture types were identified based on thoracic kyphosis and lumbar lordosis parameters. Temperament traits were evaluated using the Pavlovian Temperament Survey, assessing excitation and inhibition strength, and mobility of nervous processes. Statistical analyses included descriptive statistics and chi-square tests, with significance at p < 0.05. Results: Normal spinal curvature configuration was observed in 27.6% of participants, while 72.4% presented deviations. The most common pattern was reduced thoracic kyphosis combined with normal or reduced lumbar lordosis, indicating predominance of flattened physiological spinal curvatures. Melancholic temperament was the most frequent type in both groups (40.1% in participants with abnormal posture and 37.3% in those demonstrating normal posture). No statistically significant associations between posture type and temperament were found in the majority of configurations (p > 0.05). A significant relationship was identified between reduced thoracic kyphosis and increased lumbar lordosis (p = 0.024), with predominance of melancholic and sanguine types (40% each). A significant result was also observed for increased thoracic kyphosis with reduced lumbar lordosis (p = 0.001); however, this finding should be interpreted cautiously due to the small sample size. Conclusions: Adolescent body posture is characterised by high variability and predominance of abnormal patterns. Relationship between posture and temperament appear selective rather than general. Temperament may act as a modulating factor in postural regulation, particularly in specific spinal curvature configurations. These findings suggest incorporating temperamental characteristics into postural assessment may support development of more individualised prevention and rehabilitation strategies in adolescents.

Abstract: Wearable systems for rehabilitation monitoring often rely on complex sensor configurations and produce outputs that are difficult to interpret. This limits their practical use. This study investigates whether movement-quality assessment can be achieved accurately and transparently using a reduced set of signals. Using wearable sensor data from lower-limb rehabilitation tasks performed under correct and intentionally erroneous conditions, we extracted a small set of rotation-based features and evaluated them within a supervised ML framework. The results show that these features can reliably distinguish correct from incorrect movement, with classification accuracy around 0.70, while preserving clear biomechanical interpretation. Reduced sensor configurations retained, and in some cases improved, performance, with balanced accuracy reaching 0.947 and 0.917 in the examined tasks. A proof-of-concept real-time formulation further showed that movement deviations can be detected early within repetitions, while limiting false feedback on correct executions to approximately 9%. Overall, the findings show that movement-quality assessment can be achieved with minimal sensing, while also supporting early error detection and practical feedback. These properties are relevant to wearable rehabilitation systems, including IoT applications that depend on efficient sensing, interpretable analysis, and timely feedback.