Abstract: Background: Lee Silverman Voice Treatment (LSVT) BIG is a well-established exercise program in Parkinson’s Disease (PD), but its effectiveness in other neurological disorders is not well studied. This pilot study examined whether LSVT-BIG similarly improves balance and gait in MS patients compared to PD. Methods: A pilot clinical trial was conducted with two participant groups: MS and PD. Assessments were performed before, during, and after the 4-week LSVT BIG intervention, which followed the established PD protocol of one-hour sessions, four consecutive days per week. Balance and gait were evaluated using the mini-Balance Evaluation Systems Test (mini-BESTest), Timed Up and Go (TUG), and Functional Gait Assessment (FGA). Single-leg stance time on firm, foam, and inclined surfaces was also measured. Data analysis was carried out using mixed ANOVA in SPSS v24. Results: Twelve participants completed the study (6 PD, 6 MS). Both groups significantly improved in mini-BESTest, FGA scores, and timed tasks (p < 0.001). Comparable between-group results revealed, with no significant differences between MS and PD groups (p > 0.5). Conclusions: Similar improvements across groups suggest that LSVT-BIG may also benefit patients with MS. Larger randomized trials are needed to confirm its suitability for this population.

Abstract: Background: Maintaining a physical and mental balance in the face of educational, social and behavioral demands requires involvement, perseverance, continuous information and evaluation of evolution. One of the aspects that contributes to maintaining this balance is also socio-professional development during university studies through learning experiences that can shape a more sustainable future. In this sense, the present study aims to nuance the correlations between academic specialization, body composition of students and their living environment. Methods: The assessment of body composition was carried out using bioelectrical impedance analysis on a research sample that included 206 students (105 men and 101 women, average age approximately 20 years). Results: The results obtained indicated a significant correlation between body composition and the field of study. In contrast, regarding the living environment, it did not present a significant influence on the university program of students. Conclusion: These perspectives support a deeper understanding of how we can intervene, through the integration of physical education programs, to promote thinking and practicing physical exercise from the student period in a sustainable way.

Abstract: Non-suicidal self-injury (NSSI) is a significant mental health issue among children and adolescents, characterized by deliberate, self-inflicted harm to body tissue without suicidal intent. NSSI is a robust predictor of later suicide attempts and is commonly linked to various psychiatric comorbidities. Ongoing debate concerns whether NSSI and suicidal behavior should be classified as separate entities or as points along a continuum of self-harm. The continuum perspective underscores the necessity of identifying risk factors that contribute to progression from NSSI to suicidal behavior. This paper reviews current literature on Non-Suicidal Self-Injury (NSSI) and introduces a research project aimed at identifying predictors of transition from NSSI to Suicidal Self-Injurious Behaviour (SSIB) in clinical adolescent populations. The primary objective is to inform the development of early preventive interventions. The study will use a longitudinal design, enrolling adolescents aged 13 to 17 years from primary care and child psychiatry clinics. Eligibility requires meeting the proposed Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for Non-Suicidal Self-Injury (NSSI). The protocol includes structured interviews such as the Self-Injurious Thoughts and Behaviors Interview (SITBI) and the Suicide Attempt Self-Injury Interview (SASII), as well as selfreport instruments including the Suicidal Behaviors Questionnaire-Revised (SBQ-R), Childrenʹs Depression Inventory 2 (CDI-2), Difficulties in Emotion Regulation Scale (DERS), and Youth Self- Report (YSR). These tools will assess self-injury, suicidality, emotional symptoms, emotion regulation, and overall functioning. Assessments will occur at baseline and at 1, 3, and 6 months to monitor changes in risk and resilience. Recognizing Non-Suicidal Self-Injury (NSSI) as part of a continuum of psychopathological development is essential for clinical practice. The anticipated findings from this research may validate NSSI diagnostic criteria, identify critical risk markers for escalation to suicidal behavior, and support the creation of more effective, individualized screening, prevention, and treatment strategies. These advances aim to reduce morbidity and mortality among vulnerable adolescents.

Abstract:

Background: Female dancers experience non-contact anterior cruciate ligament (ACL) injuries at rates comparable to high-risk contact sports, yet laboratory-based marker systems have remained inaccessible for routine screening. Objectives: To compare the accuracy, feasibility, and ACL-risk detection performance of AI-enhanced markerless versus marker-based motion analysis in female dancers. Methods: Following a prospectively registered protocol, we searched PubMed, Scopus, Web of Science, SPORTDiscus, CINAHL, IEEE Xplore, and dance-specific databases from 2015 to November 2025. Eligible studies performed direct head-to-head comparisons during dance-specific tasks (e.g., grand jeté, turnout plié, pointe relevé) in female dancers aged 10–30 years. Primary outcome: root-mean-square error (RMSE) for knee valgus angle. Risk of bias was assessed with ROBINS-I; evidence certainty with GRADE. Results: Twelve studies (n = 456 female dancers, mean age 18.2 years) were included. Markerless systems achieved a pooled RMSE of 2.9° (95% CI 2.1–3.7°, I² = 48%, k = 8) for knee valgus during landings and turnout tasks, with a pooled sensitivity of 84% (95% CI 76–90%) for high-risk profiles. Setup time was reduced by 80–95% and cost by >99% compared with marker-based systems. Certainty of evidence was moderate for accuracy and low for sensitivity. Conclusion: AI-enhanced markerless motion analysis provides clinically acceptable accuracy and unprecedented feasibility for ACL-risk screening in female dancers. Integration into studio-based prevention programmes is now justified and urgently needed. Level of evidence: Level II (systematic review of Level I–II studies).

Abstract:

Objective: The study aimed to evaluate the validity and reliability of the newly developed Low Sit–High Step (LS-HS) Test designed to assess lower-extremity muscle strength in the diagnosis of sarcopenia. Design: The study included 205 participants divided into four groups (possible sarcopenia, sarcopenia, young control, and middle-to-older control). The LS-HS Test was compared across groups, and its ability to distinguish sarcopenia and possible sarcopenia was evaluated. Internal consistency, inter-rater and test–retest reliability, and diagnostic accuracy were assessed to determine the test’s validity and reliability. Results: LS-HS Test scores were higher in participants with possible sarcopenia and sarcopenia (p<0.05). Multinomial logistic regression analysis showed that LS-HS Test performance could predict both possible sarcopenia and sarcopenia (p<0.001). Internal consistency was excellent (Cronbach’s α = 0.938), while inter-rater and test–retest reliability were very high (ICC = 0.998), confirming its reproducibility. ROC analysis demonstrated high diagnostic accuracy in distinguishing both possible sarcopenia and sarcopenia (p<0.01, AUC=0.768, AUC=0.704). Conclusions: The LS-HS Test appears to be a valid, reliable, and practical tool for assessing lower-limb muscle strength and functional decline in the diagnosis of sarcopenia. Its simplicity and clinical applicability suggest that it may serve as a useful option for routine screening and evaluation.

Abstract: This qualitative study examined how a 21-day integrated program fosters interoceptive awareness and mind–body integration among urban adults in mainland China (N = 11). The intervention combined daily nasal breathing regulation, spontaneous mandala drawing, and descriptive journaling, complemented by weekly group sharing. Using a cultural-psychological lens, we investigated how an inward-turning tradition in Chinese culture shapes embodied experience and meaning-making. Applying Interpretative Phenomenological Analysis to diaries, drawings, and focus-group data, we identified three interrelated processes: (1) the refinement of bodily attention; (2) a shift from deliberate control to natural immersion; and (3) the symbolization of feeling through artistic expression and social resonance. Findings indicate that systematic engagement in the “breath–mandala” intervention heightened sensitivity to chest-centered embodied sensations and promoted the integration of bodily experience into personal narratives; a non-goal-directed, relaxed practice style facilitated the transition from control to absorption, activating self-regulatory mechanisms; and non-evaluative awareness deepened flow while supporting cognitive reorganization and reflective capacity. The study delineates a core pathway by which breath-triggered interoceptive work operates within mind–body interventions, offering a theoretical basis and practical direction for tailored regulation programs across diverse populations.

Abstract: Background: Anterior cruciate ligament (ACL) injuries disproportionately affect female football players, with rates up to 5-8 times higher than in males. Traditional marker-based motion analysis provides high-fidelity biomechanics for ACL risk screening but is lab-bound and costly. Emerging AI-enhanced markerless systems offer scalable alternatives for field-based prevention, yet comparative evidence is fragmented. Objectives: To systematically review and meta-analyze the accuracy, feasibility, and ACL risk prediction of AI-enhanced markerless versus marker-based motion analysis in female football players.Data sources: We searched PubMed, Scopus, Web of Science, SPORTDiscus, and IEEE Xplore from January 2015 to November 2025, supplemented by gray literature and hand-searching.Study eligibility criteria: Randomized controlled trials, cohort studies, and validation studies comparing AI-driven markerless (e.g., computer vision pose estimation) and marker-based (e.g., optical motion capture) systems for kinematic/kinetic outcomes in female football players aged 12-35 years. Outcomes included ACL risk metrics (e.g., knee valgus angle, ground reaction forces) and validity (e.g., RMSE). Participants and interventions: Female football athletes (amateur to elite); interventions were motion analysis approaches during tasks like cutting or landing.Study appraisal and synthesis methods: Two reviewers independently screened and extracted data using covidence.org; risk of bias assessed via ROBINS-I. Random-effects meta-analysis pooled mean differences in RMSE using inverse-variance methods; heterogeneity via I² and τ².Results: From 452 records, 18 studies (n=912 females) were included. Markerless systems showed comparable accuracy to marker-based gold standards (pooled MD RMSE 2.4° [95% CI 1.7-3.1°], I²=52%, 12 studies for knee angles). Markerless excelled in feasibility (e.g., 90% reduction in setup time). ACL risk prediction sensitivity was 86% (95% CI 78-92%) for markerless vs. 92% for marker-based (5 studies). Evidence quality was moderate (GRADE). Limitations of evidence: Few direct head-to-head trials in football-specific tasks; potential publication bias (Egger's p=0.08); underrepresentation of diverse ethnicities.Interpretation: AI-enhanced markerless motion analysis is a valid, feasible alternative to marker-based systems for ACL injury prevention screening in female football, supporting integration into programs like FIFA 11+. Hybrid approaches may optimize real-world implementation.

Abstract: Background: Proximal hamstring injuries involving the biceps femoris–semitendinosus (BF–ST) conjoint tendon are clinically challenging, yet the prognostic impact of full-layer conjoint tendon (CT) injuries remains unclear. This study aimed to determine whether CT involvement prolongs the time to return to play (RTP) compared with isolated BFLH or ST injuries. Methods: A prospective cohort of 41 university rugby players with acute proximal BF–ST complex injuries was evaluated using standardized physical examination, ultrasonography, and MRI. Injuries were classified by Type (I: full-layer CT; II: BFLH-only; III: ST-only), Zone (A–E), and Grade (0–3). RTP was defined as full participation in team training or competition. RTP differences among Types and, within Type I, across Zones and Grades were analyzed using appropriate parametric or non-parametric tests. Results: Type I injuries required significantly longer RTP (11.4 ± 4.8 weeks) than Type II (5.3 ± 2.4 weeks) or Type III (4.0 ± 1.7 weeks). In Zone C, bilateral involvement of both BFLH and ST resulted in longer RTP than unilateral BFLH injury. Within Type I, Zone A (origin detachment) showed the longest RTP (20 weeks), exceeding Zones B and C. Higher Grades were also associated with prolonged recovery. Conclusions: Full-layer CT injuries represent a distinct clinical entity with markedly delayed RTP compared with isolated BFLH or ST injuries. Classification that distinguishes CT involvement provides useful prognostic information and may enhance RTP planning in athletes.

Abstract: Background and objective. Low back pain (LBP) is one of the most prevalent musculoskeletal disorders globally, significantly impacting quality of life across diverse populations. Despite its association with middle-aged and older populations, evidence indicates that LBP is increasingly prevalent among younger age groups. Health science students are considered a potential risk factor for LBP; however, longitudinal studies are scarce. This study aims to determine the risk factors for LBP among health science students over a 2-year follow-up. Methods. One hundred ninety-seven of the third-class health science students (Nursing, Physiotherapy, Medical laboratory science, and Emergency Medical services) were contacted (May 2024). A self-administered modified version of the Standardized Nordic Questionnaire, and data about sedentary and physical activity behavior, as well as LBP/ or stress scores, were recorded. Results. A total of 172/197 (87.3%) respondents completed the questionnaire in the 2-year follow-up. Mean age of 25 ±3.5 (years) and body mass index (BMI) value of 23.5 ± 4.3 (kg/m2). About 49% (n= 84) and 20 % (n=34) of the participants had 1-month LBP and functional disability, respectively. No association was found between health science programs and the presence of 1-month LBP (χ²= 0.55, P>0.05). The logistic regression analyses found that males had a significantly lower likelihood of having LBP (OR 0.25, P = 0.03). Conclusions. This study shows a high prevalence of 1-month LBP (48.8%) among health science students at Zefat Academic College. LBP was over time, gender-dependent, and health science-independent. Keywords: Health science, students, low back pain, stress, females.

Abstract: Objectives Telerehabilitation has emerged as a crucial modality in light of recent global challenges such as the COVID-19 pandemic. We examined the effectiveness of a mobile health telerehabilitation intervention developed for older adults with frailty and conducted an article search on this topic in the context of Japan. Methods Six participants received a nursing care telerehabilitation intervention (Rehab Studio) that included exercise training videos. The participants were aged ≥65 years, had no history of dementia or psychiatric disorders, and had mild-to-moderate care needs. For 1 month, the participants received 1-h live online rehabilitation sessions with real-time communication with rehabilitation specialists. The quality of life (QoL) (EuroQol 5 dimensions 5-level [EQ-5D-5L] and self-rated health scores were recorded before and after the intervention and analysed to determine whether the service was effective. Data were analysed using paired t-tests. Results Significant differences were found in the total EQ-5D-5L and self-rated health scores (p< 0.05). The mean EQ-5D-5L score increased from 0.63±0.13 before the intervention to 0.77±0.14 after the intervention (p=0.010), while the mean self-rated health score increased from 66.0±18.0 to 83.3±10.3, respectively (p=0.019). Conclusions The telerehabilitation intervention is safe and can improve the QoL. However, the effectiveness of the intervention needs to be further investigated in patients with poor performance in activities of daily living. Telerehabilitation could help reduce the burden of nursing care in ageing societies with declining birthrates.

Abstract: The integration of artificial intelligence (AI) into sports injury prediction presents both promising advancements and significant ethical challenges. This study addresses the critical necessity of evaluating AI’s role in safeguarding athlete health while simultaneously protecting their privacy. The primary objective is to investigate ethical concerns related to data privacy, fairness, accountability, and transparency in AI-driven injury prediction models. Employing a systematic review and qualitative analysis, this research examines recent AI applications in sports, emphasizing machine learning methods for injury risk assessment. Key findings highlight the substantial benefits of AI in proactive injury prevention, improving athlete care and performance. However, ethical issues such as the risk of biased algorithms, unauthorized data use, and unclear accountability mechanisms persist. The study concludes with recommendations for rigorous data protection protocols, transparent AI frameworks, and informed consent processes to uphold athletes’ rights. A significant innovation of this work is the incorporation of explainable AI models that enhance trust and ethical compliance, aligning with statistical measures like sensitivity analysis and model validation techniques favored by contemporary editors. These approaches ensure robust, fair, and ethical AI applications in sports medicine, fostering safer athletic environments.

Abstract: To analyze the differences in body mass index (BMI) and functional fitness tests between women with and without frailty, and secondarily to determine whether frailty is related to functional fitness performance in elderly women. Methodology: A cross-sectional study was conducted in 69 women aged 60 to 85 years. Weight, height and body mass index (BMI) were assessed. The Senior Fitness Test battery was used to assess functional fitness. Frailty was assessed through the Kihon Checklist (KCL) questionnaire. Results: There were significant differences (p< .05) between women with and without frailty in the sit to stand up from a chair, biceps curl and 2.44m agility tests. There were no significant differences between both groups in age, BMI, chair trunk flexion, 6-minute walk, 2-minute walk, right and left hand grip strength (p>.05). Significant positive correlation was determined between age and frailty (r=.359, p=.003). However, negative correlations were ob-served with functional fitness tests, including sitting and rising from a chair, biceps curl, trunk flexion in chair, join hands behind back, 2.44 m agility, 6-min walk, and right hand- grip strength, with values ranging from r = -.386 to r = -.268. No significant correlation was found with the walk test. Conclusion: The study showed significant differences in BMI and functional fitness tests between women with and without frailty. As women age, frailty increases and functional fitness decreases, especially in key tests, which may be useful in assessing fall risk and functional status in women aged 65-85 years.

Abstract: The global rise in nursing home (NH) populations presents substantial challenges, as residents frequently experience physical and cognitive decline, low physical activity, and high fall risk. This study evaluated the effectiveness of the BeSt Age App, a tablet-based, staff-supported mHealth intervention designed to promote physical activity and prevent falls among NH residents. In a cluster-randomized controlled trial across 19 German NHs, 229 residents (mean age = 85.4 ± 7.4 years; 74.7% female) were assigned to an intervention group (IG) or control group (CG). The 12-week intervention comprised twice-weekly, tablet-guided exercise sessions implemented by NH staff. Primary outcomes were fall incidence and fall risk (Berg Balance Scale [BBS], Timed Up and Go [TUG]); fear of falling was secondary. Mixed models and generalized estimating equations were used under an intention-to-treat framework. The IG showed significantly greater improvement in BBS scores than the CG (group × time: F(1,190.81) = 8.25, p = .005), while changes in TUG performance, fear of falling, and fall incidence were nonsignificant. The intervention improved balance, a key component of fall risk, but did not reduce fall frequency within the study period. These findings demonstrate the feasibility and short-term functional benefits of a staff-mediated mHealth approach to fall prevention in NH residents.

Abstract: Background: Approximately one quarter of community-dwelling older adults experience at least one fall each year. Falls can result in soft tissue injuries, fractures, or even death. Given this high prevalence, it is essential to identify fall-related risk factors, develop predictive models, and prescribe effective exercise-based interventions to prevent falls. Objective: To analyze risk factors, predictors, and therapeutic interventions for falls in older adults. Methods: A literature search was conducted in SCIELO, PUBMED, and PEDro databases between October 15–20, 2025. Inclusion criteria comprised peer-reviewed, open-access studies in English published from 2020 onward. Findings were categorized into three domains: (1) fall risk factors, (2) predictive models, and (3) exercise-based interventions. Twenty studies met the inclusion criteria. Results: Falls among older adults arise from multifactorial interactions involving physical, clinical, cognitive, and social factors such as impaired mobility, comorbidities, polypharmacy, and cognitive decline. Lower-limb strength and functional performance are key determinants of fall risk. Current predictive models show limited accuracy, with fall history as the strongest predictor. Exercise-based interventions, particularly multicomponent and home-based programs, improve balance, strength, and mobility but show variable effects on fall rates. The absence of standardized parameters for exercise prescription limits the development of evidence-based guidelines. Conclusion: Falls in older adults are multifactorial events influenced by physical and cognitive decline. Predictive models remain imprecise, and although exercise interventions improve functional outcomes, their impact on reducing falls is inconsistent. Standardized exercise protocols are needed to optimize fall prevention strategies.

Abstract:

Background: Lipedema is a chronic condition whose public awareness and detection is constantly growing, yet without strongly validated therapeutic opportunities. Objectives: Given the need to direct lipedema patients toward appropriate management approaches and the demand for new studies and methods, this invetigation aimed to assess the effects of a combined treatment consisting of extracorporeal shock wave therapy (ESWT), manual lymphatic drainage (MLD), intermittent pneumatic compression (IPC), and lifestyle recommendations compared to a 5-week control period prior to treatment in patients with lipedema. Methods: Retrospective evaluation of patients undergoing a 5-week control period with lifestyle recommendations followed by a 5-week treatment period (10 sessions) with a standardized protocol including ESWT, MLD and IPC. Circumference measurements at three designated points on the lower extremities were recorded at the start and end of the control period, and before and after treatment. Results: Data from 55 female patients (age: 46.9 ± 11.9 years, body mass index [BMI]: 29.54 ± 7.33 kg/m²) who completed both the control and treatment periods were included. Analysis of measurement changes over time showed significant improvements in 3 of 6 measured points during the control period, with no significant changes at other levels. In contrast, significant improvements were observed at all levels after treatment (p < 0.01). Conclusion: The combined use of ESWT, MLD, IPC, and lifestyle recommendations was found to be an effective method for managing lipedema treatment. Further studies on the relative impact of each and everyone of these 3 therapeutic components are encouraged.

Abstract:

Background and Objectives: The Quick Speech-in-Noise test is a widely used clinical tool for assessing an individual’s ability to understand speech in the presence of background noise. Building on this framework, the present study aimed to develop a Speech-in-Noise Test for European Portuguese (SiN-EP), specifically adapted for native speakers of European Portuguese. The goal was to create a reliable and linguistically appropriate tool to evaluate speech perception under realistic listening conditions. Materials and Methods: The development of the SiN-EP involved several stages. Sentences were drafted to reflect natural speech patterns and reviewed by native speakers for clarity and grammatical correctness. Selected sentences were recorded by a female native speaker in a controlled environment. The recordings were then combined with multi-talker babble noise at varying levels to simulate different listening situations, ranging from easy to challenging. A pre-test was conducted in a free field setting at 65 dB SPL with fifteen young adults with normal hearing. Participants listened to and repeated each sentence, and their responses were used to refine the test materials. Results: Participants understood the sentences clearly and consistently across all listening conditions, showing that the SiN-EP effectively reflects speech perception in noise. The final version included thirteen lists of six sentences, carefully designed to maintain natural phonetic balance and realistic speech structure. Conclusion: The SiN-EP represents a significant advancement in evaluating speech understanding in noise for Portuguese-speaking populations. This standardized and linguistically adapted test provides valuable information about auditory performance and supports both clinical assessments and research on hearing and auditory processing challenges.

Abstract: Background: The consequences of video games have been a hotly debated topic in recent decades. While the media tend to focus on and publicize the alleged negative effects of video games, the empirical literature continues to research to illustrate the benefits of playing certain types of video games. With this paper we want to highlight the utility of virtual reality technology for improving reaction time. Methods: In the intervention program we used the Oculus Quest 2 HMD (Head Mounted Display) device (Facebook Technologies, LLC. 1 Hacker Way, Menlo Park, CA 94025, USA). To assess simple and complex reaction time we used the Deary-Liewald reaction time test. Results: Subjects in the experimental group showed statistically significant improvements (p < 0.05) between initial and final testing in reaction time tests. Subjects in the experimental group showed statistically significant improvements (p < 0.05) at the final test compared to the control group in simple and complex reaction time tests. Conclusions: With the development of technology, new opportunities have arisen to reduce reaction time using state-of-the-art technology such as virtual reality. Virtual reality by specific means - exergames or active video games, as they are also called, can be used as physical exercises and can be used as a mean to improve reaction time.

Abstract: Background: Physical exercise has emerged as a promising intervention for depressive disorder, yet its efficacy and optimal implementation remain under investigation. Ob-jective: To thoroughly assess the effectiveness of structured physical exercise as a con-ventional treatment for adults with depressive disorder. Methods: Adhering to PRISMA 2020 guidelines, a comprehensive literature search was conducted across PubMed/MEDLINE and institutional multi-databases. Peer-reviewed randomized controlled trials (RCTs) published between 2010 and 2025, studying adults diagnosed with depressive disorder under supervised exercise interventions, were se-lected. Methodological rigor was ensured through two independent reviewers. The in-fluence of moderating variables (workload and the instrument used to evaluate depres-sive disorder: instrument) was analyzed using meta-regression, and the pooled effect size was estimated using both frequentist and Bayesian meta-analyses. Results: From 15,542 screened records, 20 RCTs met the inclusion criteria. Workload accounts for 60% of the variance in the effect size, and instrument accounts the 15%. Supervised physical exercise significantly reduced depressive symptoms (standardized mean difference = 0.80; 95% CI: 0.57–1.03; I² = 59%). Robust Bayesian meta-analysis confirmed the consistency of these findings. Conclusion: Physical exercise serves as a valuable complement to traditional therapies for adults diagnosed with depressive disorder, resulting in clinically significant reductions in depressive symptoms.

Abstract: Shoulder injuries are highly prevalent in tennis due to repetitive unilateral loading and the asymmetrical demands of the sport. Preventive protocols often focus on scapular stabilizers, yet evidence on muscle recruitment patterns during unilateral elastic re-sistance exercises remains limited. This study compared trapezius activation and asymmetry in tennis players (n = 16) and non-tennis athletes (n = 23) during unilateral scapular retraction exercises at 45° and 90° of shoulder abduction. Surface electromyog-raphy recorded bilateral activity of the middle and lower trapezius using a validated wireless system. Repeated-measures ANOVA was applied to examine the effects of angle, dominance, side, and athlete type. Results showed significantly greater activation at 90° compared to 45° (p < 0.05) and pronounced interlimb asymmetries between dominant and non-dominant sides (p < 0.01). Tennis players exhibited higher non-dominant trapezius activation, suggesting compensatory adaptations to repetitive unilateral strokes, whereas non-tennis athletes demonstrated more symmetrical recruitment. These findings high-light the role of elastic resistance exercises in selectively engaging scapular stabilizers, addressing sport-specific asymmetries, and reducing injury risk in overhead athletes.

Abstract: Adapted exercise and sport are increasingly prescribed across clinical, community, and inclusive settings, yet persistent heterogeneity in intervention design, reporting, and evaluation limits replication and large-scale implementation. This methodological paper introduces a pragmatic, standardized, and scalable framework that unifies the full intervention cycle, from risk screening and functional/psychosocial assessment to individualized prescription (FITT-VP), supervision and monitoring, outcome tracking, and reporting/knowledge translation. The framework specifies a core assessment battery (e.g., 6MWT, TUG, 30-s Chair Stand, handgrip; PROMs such as FACIT-F, FACT-G/EORTC QLQ-C30, HADS), operational rules for dose, intensity, and progression across aerobic, resistance, balance/mobility, and mind–body modalities, and decision thresholds based on MCIDs, safety triggers, and adherence milestones. A core outcome set covers functional, clinical, and psychosocial domains, complemented by process indicators (adherence, fidelity, adverse events) and implementation metrics (reach, adoption, feasibility, cost, maintenance). Illustrative use-cases in oncology, metabolic/cardiovascular disease, chronic respiratory conditions, and neurological disorders show how stratification rules, modality mix, and monitoring intensity are tailored across populations, including progression to adapted and inclusive sport. By merging exercise science with implementation frameworks (RE-AIM, TIDieR, CERT) in a single, reusable pipeline, the model strengthens transparency, reproducibility, and person-centered delivery, while creating a practical learning system (routine capture of dose, adherence, adverse events, reach/adoption) for continuous improvement and multi-site synthesis. Overall, it offers a deployable blueprint for clinicians, kinesiologists, researchers, and decision-makers to design, monitor, and report adapted exercise and sport programs with greater fidelity, comparability, and policy relevance.