Reabilitacijos mokslai: slauga, kineziterapija, ergoterapija
Founded in 1999. The journal publishes original research papers on the latest empirical and theoretical research conducted either at the national or international level dealing with various aspects of Rehabilitation, Physiotherapy, Nursing, Occupational Therapy as well as injury and disease prevention.
The Quadruple Threat: Orchestrating Clinical, Research, Education, and Leadership to Elevate Community Health and Wellness
As the global health landscape shifts towards the complex management of chronic, long-term conditions (LTCs), which now account for 75% of global mortality (World Health Organization, 2020), traditional, siloed models of care are proving insufficient for modern integrated professional practice. This paper explores the ‘hourglass’ metaphor of professional development, wherein practitioners often begin their careers with broad, creative visions only to become restricted by a ‘bottleneck’ of economic pressures, policy constraints, and fragmented expertise. To build a future that is truly sustainable for both patients and the workforce, this work argues for a transition from ‘fixers’ of acute injury to ‘Health and Wellness Architects’. The proposed transformative framework – the “Quadruple Threat” – advocates for the intentional, simultaneous orchestration of four essential pillars: Clinical Practice, Research, Education, and Leadership (Chartered Society of Physiotherapy, 2024). By reframing these pillars as a unified, synergistic strategy rather than distinct responsibilities, professionals can emerge from systemic bottlenecks to reclaim a wider space for innovation and sustainable impact. Key themes include the radical evolution of the community clinician through interprofessional education, the necessity of pragmatic implementation science (Bauer & Kirchner, 2020) in real-world community settings to bridge the gap between evidence and practice, and the critical role of leadership in articulating the ‘invest-to-save’ language of health economics. To move beyond theoretical constructs, a strategic roadmap for global application is presented, offering three SMART goals designed as a scalable blueprint for international implementation. These benchmarks focus on creating adaptable frameworks for longitudinal case management, securing formal partnerships with community assets through Memorandums of Understanding (MoUs), and equipping professionals to build ‘Value Portfolios’ that demonstrate fiscal impact to health funders. Ultimately, this framework provides a mandate for professionals worldwide to dismantle silos and ensure that rehabilitation remains a visible cornerstone of national resilience and global community wellness. Keywords: Integrated care; practice education; implementation science; leadership; community rehabilitation
Panel Session 3 – Wellbeing and Sustainable Futures
Copyright (c) 2026 Author(s). Published by Lithuanian Sports University. https://creativecommons.org/licenses/by/4.0
Clinical Evaluation of Kinesio Taping Outcomes in Stage II Cellulite: A Pilot Study
Background. Cellulite is a common aesthetic condition linked to alterations in subcutaneous fat and dermal connective tissue, with possible impairment of microcirculation and lymphatic drainage. Kinesio taping (KT) is used in physiotherapy, but evidence for cellulite management is limited. Aim. To evaluate the effect of KT on stage II cellulite using objective ultrasound measure and clinical parameters. Methods. Thirty-four women with stage II cellulite were randomised to an experimental KT group (n = 17; 39.5 ± 13.3 years) and a control group (n = 17; 45.3 ± 9.3 years). Fan-shaped KT was applied once weekly for four weeks to the thighs and buttocks. Primary outcomes were subepidermal low-echogenic band (LEB) and dermis density assessed by high-frequency ultrasound (DermaLab Combo 4). Secondary outcomes included skin moisture and body composition (BC-418MA). Pre–post changes and between-group differences were analysed; effect sizes were expressed as Cohen’s d. Results. In the KT group, LEB increased from 0.78 ± 0.06 to 0.85 ± 0.05 (p = 0.012, d = 0.62) and dermis density from 0.68 ± 0.07 to 0.75 ± 0.06 (p = 0.008, d = 0.71). Changes in controls were minimal and not significant. Skin moisture showed no meaningful change in the KT group, whereas the control group decreased (15.13 ± 9.38 to 9.83 ± 5.58; p = 0.006). BMI remained stable; a modest reduction in body fat percentage was observed in the KT group. Conclusions. Over four weeks, KT produced moderate improvements in dermal echostructure in women with stage II cellulite, with no systemic effects on body mass. As a pilot study, findings should be confirmed in larger, blinded trials of longer duration. Keywords: cellulite; kinesio taping; skin structure; dermis density
Copyright (c) 2025 Author(s). Published by Lithuanian Sports University. https://creativecommons.org/licenses/by/4.0
Virtual Reality-Based Upper Extremity Rehabilitation in Subacute Stroke: A Pilot Study
Background. Virtual reality (VR) technology has emerged as a promising modality for stroke rehabilitation, yet the relationship between baseline motor function and user experience remains poorly understood. Understanding how motor impairment severity influences VR engagement, satisfaction, and tolerability is crucial for optimising clinical implementation. Aim. This pilot study investigated the relationship between baseline upper extremity motor function and key user experience metrics during VR-based rehabilitation in subacute stroke patients. Methods. Twelve participants with subacute stroke (140 ± 23 days post-onset) completed a single 60-minute VR-based upper extremity training session. Baseline motor function was assessed using the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). Primary outcomes included user satisfaction (User Satisfaction Evaluation Questionnaire), training engagement (movement repetitions per minute), session duration, and adverse events. Results. Participants (8 males, 4 females; age 41.58 ± 14.51 years) demonstrated substantial heterogeneity in baseline motor function (FMA-UE: 18–56 points, mean 39.08 ± 11.36). User satisfaction was consistently high across motor severity levels (22.92 ± 4.29 points). Counterintuitively, a moderate negative correlation emerged between baseline motor function and training engagement (r = –0.445, p = 0.148), with more severely impaired participants achieving higher movement repetition rates. Eight participants (66.7%) completed the full protocol, while four required early termination. Mild to moderate discomfort affected 50% of participants, with higher rates among those with severe to moderate impairments. Conclusions. VR-based upper extremity training demonstrates feasibility and acceptability across motor impairment severities in subacute stroke. The unexpected finding that participants with greater motor deficits exhibited higher engagement challenges conventional assumptions about technology-assisted rehabilitation. These results suggest VR interventions should not be restricted to individuals with preserved motor function, though individualised safety protocols may be necessary for more severely impaired patients. Keywords: stroke rehabilitation; virtual reality; motor function; user experience
Prevalence and Associated Risk Factors for Wrist Pain and Quality of Life Among Auto-Rickshaw Drivers – A Cross-Sectional Study
Background. Wrist pain is a prevalent musculoskeletal complaint among occupational drivers, particularly auto-rickshaw drivers who endure prolonged repetitive wrist movements and extended driving hours. Despite its impact on function and quality of life, specific data on this underserved workforce is limited. Aim. This study aimed to evaluate the prevalence, functional disability, pain severity, and quality of life associated with chronic wrist pain among auto-rickshaw drivers in Greater Noida, India. Methods. A cross-sectional survey was conducted involving 384 male auto-rickshaw drivers. Data collected included demographic and occupational variables, pain severity (Numeric Pain Rating Scale), functional disability (Disabilities of the Arm, Shoulder, and Hand questionnaire), and quality of life (Short Form-36). Descriptive statistics, correlation analyses, and age group comparisons were performed. Results. The mean age was 40.31 ± 11.83 years with a driving experience of 15.47 ± 8.62 years and daily driving hours of 10.57 ± 1.75. The prevalence of chronic wrist pain was notable, with a mean DASH score of 39.14 ± 15.90 indicating moderate disability, and a pain severity mean of 5.05 ± 2.54. Quality of life scores averaged 54.90 ± 14.44. Strong positive correlations were observed between years of driving and both pain intensity (r = 0.546, p < 0.001) and functional disability (r = 0.828, p < 0.001). No significant differences in outcomes were noted across age groups. Conclusion. Chronic wrist pain among auto-rickshaw drivers substantially impairs functional ability and quality of life, with severity correlated to occupational exposure duration. These findings underscore the need for ergonomic interventions and health policies targeting musculoskeletal health in this vulnerable occupational group. Keywords: wrist pain; occupational disease; quality of life; functional status
Comparative Efficacy of Mulligan’s SNAG Technique and Maitland Mobilisation on Pain and Cervical Range of Motion in College Students With Non-Specific Upper Cervical Neck Pain
Background. Non-specific upper cervical neck pain is common among college students due to prolonged screen time, poor posture, and academic stress, impacting daily function and quality of life. Manual therapy techniques such as Mulligan’s Sustained Natural Apophyseal Glides (SNAG) and Maitland mobilisation are frequently used to alleviate symptoms and improve cervical range of motion (ROM). Aim. To evaluate and compare the effects of Mulligan’s SNAG technique and Maitland mobilisation on pain and cervical range of motion in college students with upper cervical neck pain. Methods. This experimental study involved 50 college students (aged 18–28 years) with non-specific upper cervical pain, randomly divided into two groups. Group A received Mulligan’s SNAG with moist heat, and Group B received Maitland mobilisation with moist heat. Interventions were administered on alternate days for three weeks (nine sessions). Pain and cervical ROM were assessed pre- and post-intervention using the Numerical Pain Rating Scale (NPRS) and a universal goniometer. Results. Intragroup analysis showed significant reductions in pain (Group A: mean NPRS score 6.40 to 3.16; Group B: mean NPRS 6.68 to 3.08; p < 0.001) and improvements in right and left cervical rotation ROM (p < 0.001). However, intergroup analysis showed no significant differences post intervention in pain or ROM (p > 0.05). Conclusion: Both Mulligan’s SNAG and Maitland mobilisation are equally effective in reducing pain and improving cervical ROM in college students with non-specific upper cervical pain. Keywords: Mulligan’s Sustained Natural Apophyseal Glides; Maitland mobilisation; manual therapy; non-specific neck pain
Effect of the Otago Exercise Programme Combined With Tai Chi Exercises on Reducing the Risk of Fall in Elderly
Background. Falls are a common and serious concern among older adults, especially women, leading to reduced independence, balance problems, and increased mortality. Exercise interventions such as the Otago Exercise Programme (OEP) and Tai Chi (TC) have individually shown efficacy in reducing fall risk by improving balance, strength, and mobility. Aim. To evaluate the combined effect of the Otago Exercise Programme and Tai Chi on fall risk, balance, and mobility in senior Indian women. Methods. A pre- and post-experimental study was conducted involving 30 women aged 55–70 years, randomised into three equal groups: Otago Exercise Programme only (OEP, 50 minutes/session, 3 times/week), combined Tai Chi and Otago Exercise Programme (OEP + TC, 50 minutes OEP + 30 minutes Tai Chi, 3 times/week), and a control group (walking 30 minutes, 3 times/week). Outcomes were assessed using the Timed Up and Go (TUG) test for mobility, Berg Balance Scale (BBS) for balance, and Falls Efficacy Scale-International (FES-I) to measure fear of falling. Data analyses included paired t-tests for within-group comparisons and one-way ANOVA for between-group differences. Results. Significant improvements were observed in TUG, BBS, and FES-I scores post-intervention in both OEP and OEP + TC groups (p < 0.001). The combined OEP + TC group demonstrated the greatest gains in balance and mobility compared with OEP alone and control groups. Fear of falling was significantly reduced in intervention groups. ANOVA revealed statistically significant between-group differences favouring the combined exercise protocol for TUG and BBS (p < 0.05). Conclusions. Integrating the Otago Exercise Programme with Tai Chi yields superior improvements in balance, mobility, and reduction of fall risk among senior Indian women compared to Otago exercises alone or walking. This combined exercise approach is recommended for fall prevention in elderly populations. Keywords: fall risk; balance; Otago Exercise Programme; Tai Chi
Emotional Eating Behaviour With Physical Activity, Stress, and Depression in Women: A Cross-Sectional Study
Background. Emotional eating, defined as consuming food in response to negative emotions such as sadness, stress, or depression, affects over half of the population and is more prevalent among women, posing risks to both physical and mental health. Aim. This study aimed to characterise emotional eating behaviour in women and examine its associations with sadness, stress, depression, and physical activity across different age groups. Methods. Cross-sectional quantitative study was conducted with 250 women ranging from adolescence to older adulthood. Emotional eating was assessed using the Dutch Eating Behaviour Questionnaire, physical activity was measured using the International Physical Activity Questionnaire, perceived stress was evaluated with the Perceived Stress Scale, and depression was assessed using the Beck Depression Inventory. Results. The majority of participants were aged 17–25 years (83.2%), students (75.6%), and had a normal body mass index (41.6%). Overall, 66% of participants exhibited moderate emotional eating, 42.4% reported moderate physical activity, 74.4% experienced moderate stress, and 38.8% were classified as non-depressed. Significant differences across age groups were observed for stress and depression (p < 0.05), while no significant differences were found for emotional eating and physical activity (p > 0.05). Correlation analyses indicated that emotional eating was not significantly associated with physical activity, but it was significantly associated with stress and depression (p < 0.05). Conclusions. Emotional eating and physical activity do not vary significantly across female age groups, whereas stress and depression do. Emotional eating behaviour is significantly related to stress and depression but not to physical activity. These findings highlight the importance of addressing emotional and psychological factors when considering eating behaviours in women. Keywords: emotional eating; physical activity; stress; depression; women
Capillary Refill Time and Oxygen Saturation as Predictors of Patient Acuity in Emergency Severity Index Triage: A Cross-Sectional Study
Background. Rapid physiological assessment in emergency departments (EDs) is essential for accurate triage and timely intervention. The Emergency Severity Index system categorises patients by clinical urgency, yet evidence remains limited regarding the prognostic value of capillary refill time and peripheral oxygen saturation in identifying high-acuity cases. Aim. To examine the relationship between capillary refill time, peripheral oxygen saturation, and patient acuity levels based on Emergency Severity Index triage categories. Methods. This analytical cross-sectional study evaluated medical records of 80 adult patients treated at a pulmonary hospital ED. Capillary refill time, peripheral oxygen saturation, and Emergency Severity Index levels were extracted. Associations were analysed using the Chi-Square test, with statistical significance set at p < 0.05. Prevalence ratios and 95% confidence intervals were calculated. Results. Prolonged capillary refill time exceeding two seconds was significantly associated with higher-acuity Emergency Severity Index levels 1–2 (p < 0.001; prevalence ratio = 19.2; 95% confidence interval: 5.4–68.2). Similarly, peripheral oxygen saturation below 90 percent correlated with higher acuity (p < 0.001; prevalence ratio = 19.9; 95% confidence interval: 4.0–97.8). Conclusions. Capillary refill time and peripheral oxygen saturation are strong physiological predictors of patient acuity in Emergency Severity Index triage. Incorporating these measures into triage protocols may enhance the early identification of critically ill patients, particularly in resource-limited emergency settings. Keywords: capillary refill time; oxygen saturation; triage; Emergency Severity Index; patient acuity
Glasgow Coma Scale as a Correlate of Fall Risk Measured by the Morse Fall Scale in the Emergency Department
Background. Patient falls in the emergency department (ED) represent a serious adverse event. Although the Morse Fall Scale is commonly used for fall risk assessment, its integration with objective neurological measures, such as the Glasgow Coma Scale, in ED settings remains limited. Aim. To investigate the correlation between Glasgow Coma Scale scores and Morse Fall Scale scores in adult ED patients. Methods. A cross-sectional analytical observational study was conducted using medical records of 72 adult patients in the ED. Glasgow Coma Scale scores and Morse Fall Scale scores were extracted from initial nursing assessments. Spearman’s rank correlation was used to evaluate associations, with statistical significance set at p < 0.05. Results. A strong negative correlation was observed between Glasgow Coma Scale scores and Morse Fall Scale scores (r = –0.714, p < 0.001), indicating that lower Glasgow Coma Scale scores were associated with higher Morse Fall Scale scores. The median Glasgow Coma Scale score was 14 (range: 3–15), and the median Morse Fall Scale score was 40 (range: 0–85). Conclusions. Glasgow Coma Scale scores are significantly correlated with fall risk as assessed by the Morse Fall Scale in ED patients. Incorporating the Glasgow Coma Scale into existing fall risk assessment protocols may enhance the identification of patients at higher risk of falls and provide additional clinical guidance for preventive interventions. Keywords: emergency nursing; fall prediction; Glasgow Coma Scale; Morse Fall Scale; patient safety
A Pilot Comparison of Physical and Functional Conditions in 8–9-Year-Old Children Practicing Basketball, Football, Gymnastics, or Dance
Background. Different sports affect children’s physical development in various ways. As the growth spurt begins around age 10, early assessment of 8–9-year-olds is important for injury prevention and safe development. However, there is limited research examining this age group’s physical and functional condition in relation to participation in specific sports. Aim – to evaluate the physical and functional condition of 8–9-year-old children participating in different sports clubs. Methods. The study involved 33 children aged 8–9 (both boys and girls), each attending only one sport (basketball, football, gymnastics, or dance) for at least one year. All participants were injury-free in the past six months and had signed parental consent forms. Physical condition was assessed using the Sit and Reach and Ely’s tests, and functional condition with the Flamingo, Timed Up and Go, and 10 × 5 m shuttle run tests. Results. Children in the gymnastics group showed significantly better flexibility compared to other groups (p < 0.05). No significant flexibility differences were found among football, basketball, and dance groups (p > 0.05). Normative Sit and Reach test performance was achieved by 100% of the gymnastics group, 66.7% basketball, 62.5% football, and 37.5% dance. No statistically significant differences between groups were found in static and dynamic balance (p > 0.05). Most participants demonstrated poor static balance. Moreover, no significant differences between groups were found in agility (p > 0.05); however, only two children, from the football and gymnastics clubs, met the standard for agility. Conclusions. Gymnastics is linked to greater flexibility in 8–9-year-old children, while basketball and football may contribute to rectus femoris muscle shortening. Balance showed no sport-specific differences and was generally poor, and agility seldom reached health-favourable levels. Keywords: functional condition; physical fitness; children; sports clubs
The Effect of Ayurvedic Panchakarma Therapy on Body Mass Index, Blood Parameters, and Quality of Life in Individuals of Different Constitutional Types: A Pilot Study
Background. Panchakarma therapy and Ayurvedic nutrition are traditional interventions increasingly evaluated for their role in metabolic and psychosocial health. However, limited evidence exists regarding their effects when stratified by Prakriti (constitutional) Vata, Pitta, Kapha types. Aim. To evaluate the impact of a 14-day Panchakarma intervention combined with a plant-based Ayurvedic diet on body composition, metabolic markers, and quality of life, stratified by Prakriti type. Methods. A pre–post interventional study was conducted with 12 female participants (mean age 54.2 ± 7.9 years). All underwent a 14-day Panchakarma therapy at a certified Ayurvedic centre, combined with personalised dietary guidance. Body composition, blood markers (glucose and lipid profile), and quality of life (SF-36 questionnaire) were assessed before and after the intervention. Changes were analysed within and between groups, and effect sizes were calculated to estimate clinical significance. Results. Statistically significant improvements were observed in overall quality of life, vitality, mental health, and physical functioning. Body weight, BMI, fat mass, biological age, and fasting glucose decreased significantly. Effect size analyses confirmed clinically meaningful changes, with large effects for glucose reduction and medium effects for BMI and fat mass. Improvements were particularly pronounced among Kapha participants, consistent with their predisposition to metabolic imbalance. Pitta participants demonstrated normalisation of cholesterol values, while Vata participants showed improvements in quality of life domains without statistical significance due to small subgroup size. Conclusions. Panchakarma therapy combined with Ayurvedic nutrition improved physiological and psychosocial outcomes, with the greatest benefits observed among Kapha participants. These findings highlight the importance of individualised, Prakriti-based approaches. Larger and longer-term studies with control groups are needed to confirm these results and further evaluate Ayurveda’s potential as a complementary strategy in modern healthcare. Keywords: Ayurveda; Panchakarma; constitutional types; quality of life; metabolic health
A Comparative Analysis of Lower Limb Muscle Activation and Co-Contraction Patterns During Gait in Individuals With Patellofemoral Pain Syndrome
Background. Patellofemoral pain syndrome (PFPS) is a prevalent musculoskeletal condition that disrupts functional activities like walking and stair climbing due to anterior knee pain. While muscle weakness has traditionally been emphasised, growing evidence suggests that impaired neuromuscular coordination may also play a critical role in PFPS-related gait dysfunction. Aim. This study aimed to compare lower-limb muscle activation patterns and co-contraction behaviour during gait between individuals with PFPS and healthy controls, focusing on both timing and intensity of activation across key knee and ankle muscle groups. Methods. Fifteen PFPS patients and fifteen age- and activity-matched healthy controls walked at a self-selected pace while surface electromyography (EMG) data were recorded from eight lower-extremity muscles. EMG signals were processed to extract normalised peak activation timing, magnitude, and co-contraction indices (CCI) for knee and ankle joints. Between-group comparisons were conducted using independent t-tests and Pearson correlation analyses. Results. The PFPS group exhibited significantly earlier (VL: 13% vs. 100%; RF: 4% vs. 98% of stance, both p < 0.05) and greater peak activation (VL: 0.202 vs. 0.112; RF: 0.109 vs. 0.062, both p < 0.05) in the quadriceps. They also showed delayed hamstring (ST: 100% vs. 3% of stance, p < 0.05) activation and increased medial gastrocnemius amplitude (GM: 0.282 vs. 0.161, p < 0.05). Despite these timing shifts, average CCI values did not differ significantly between groups. However, flexor–extensor activation synchrony was notably higher in PFPS (r ≈ 0.82) compared with controls (r ≈ 0.39). Conclusions. Individuals with PFPS demonstrate altered neuromuscular control during gait, including phase-shifted activation of knee muscles and modified ankle muscle recruitment. These changes may elevate joint stress and contribute to persistent pain. Rehabilitation programmes should emphasise not only muscle strengthening but also retraining of activation timing and coordination to promote more efficient and pain-free gait patterns. Keywords: patellofemoral pain syndrome; gait; electromyography; muscle activation; co-contraction
A Randomised Study of Vocal and Breathing Exercises on Pulmonary Function and Trunk Stability in Female Adults
Background. The effects of breathing exercises and vocal exercises on respiratory function and trunk stability in women remain unclear. Aim. To compare the effects of vocal exercises and breathing exercises on respiratory function and core stability in women. Methods. Fifty women participated in this randomised study. Respiratory function was assessed using thoracic excursion (Th3–4, Th7–8, Th11–12), breath-holding tests, and spirometry (PEF, FVC, FEV1). Trunk stability was evaluated using dynamic neuromuscular stabilisation (DNS) tests and trunk stability assessments with the Stabilizer Pressure Biofeedback device. Participants were randomly assigned to a breathing exercise group or a vocal exercise group. Results. In the breathing exercise group, statistically significant improvements were observed in breath-hold duration, thoracic excursion at Th3–4, Th7–8, and Th11–12, PEF, DNS head, neck, and trunk flexion tests, and trunk stability with right-leg flexion using the Stabilizer device. In the vocal exercise group, significant improvements were observed in thoracic excursion, spirometry parameters (PEF, FVC, FEV1), breath-holding tests, DNS assessments, and trunk stability with left-leg flexion using the Stabilizer device. Between-group comparisons indicated that the vocal exercise group achieved significantly greater improvements in FVC, FEV1, and trunk stability with left-leg flexion. Conclusions. Vocal exercises improved respiratory function, enhanced respiratory muscle strength and endurance, and supported trunk stability in women. Breathing exercises also improved respiratory function, muscle strength, and endurance. While vocal exercises demonstrated a superior effect on lung function (FVC and FEV1) compared to breathing exercises, both interventions had comparable effects on respiratory muscle strength, endurance, and trunk stability. ClinicalTrials.gov Identifier: NCT07175844 Keywords: breathing exercises; vocal exercises; respiratory system; core stability
Sprint Biomechanics Associated With Hamstring Strain Injury in Football: A Systematic Review and Mechanistic Synthesis
Background. Hamstring strain injury (HSI) is one of the most common non-contact injuries in football and frequently occurs during sprinting. Although several studies have examined sprint biomechanics in relation to HSI, findings remain dispersed across epidemiological and laboratory-based investigations, limiting the understanding of how sprint mechanics may contribute to injury risk. Aim. To systematically synthesise evidence regarding the association between sprint biomechanics and HSI in football players, with particular attention to lumbopelvic control, neuromuscular activation, and force-production characteristics. Methods. A systematic review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD420251248990). Searches were performed in Scopus and PubMed. Studies involving football players that investigated sprint-related biomechanical variables and reported injury outcomes or biomechanical indicators associated with HSI were eligible. Due to substantial heterogeneity in study design, biomechanical measurements, and outcome reporting, findings were synthesised narratively. Results. Six studies met the inclusion criteria, including two prospective cohort studies, one case–control study, and three mechanistic laboratory investigations. Prospective evidence suggested that greater gluteus maximus and trunk muscle activation during sprinting were associated with lower HSI occurrence, whereas increased anterior pelvic tilt and thoracic side bending were associated with greater injury susceptibility. Athletes with previous HSI demonstrated larger fatigue-related reductions in horizontal force production during repeated sprinting. Mechanistic studies consistently identified the late-swing and early-stance phases as periods of elevated strain and activation of the biceps femoris long head. Conclusions. Current evidence suggests that impaired lumbopelvic control, altered neuromuscular activation, and reduced horizontal force production may contribute to increased hamstring loading during sprinting in football players. While causal inferences remain limited by the small number and heterogeneity of available studies, integrating epidemiological and mechanistic evidence provides a framework for understanding sprint-related HSI mechanisms and may inform injury prevention and rehabilitation strategies. Keywords: Football performance; hamstring strain injury; horizontal force production; lumbopelvic control; neuromuscular activation; sprint biomechanics
Effects of Medium-Chain Triglyceride and Medium-Chain Fatty Acid Supplementation on Skeletal Muscle Morphology, Metabolism, and Function in Adult Humans and Animals: A Protocol for a Systematic Review and Meta-Analysis
Background. Medium-chain triglycerides (MCT) and medium-chain fatty acids (MCFA) have distinct metabolic properties and may influence skeletal muscle metabolism and function; however, evidence is fragmented and inconsistent. Aim. The aim of this systematic review and meta-analysis is to evaluate the clinically relevant and mechanistic effects of MCFA/MCT supplementation on skeletal muscle morphology, metabolism, and function in adult humans and adult animal models. Data Sources. Peer-reviewed studies will be identified through systematic searches of major electronic databases, and reference lists of included studies will be screened to identify additional relevant publications. Participants and Interventions. Eligible studies will include randomised controlled trials conducted in adult human and adult animal models, comparing the effects of oral MCFA/MCT supplementation with placebo oils, usual diet, or calorie-matched controls. Study Appraisal and Synthesis Methods. Risk of bias will be assessed using RoB 2 for human studies and the SYRCLE tool for animal studies. Where appropriate, random-effects meta-analyses will be conducted; otherwise, findings will be synthesised narratively. The certainty of evidence will be evaluated using the GRADE framework. Human and animal studies will be synthesised and analysed separately to distinguish clinically relevant outcomes from mechanistic evidence and to avoid inappropriate cross-species inference. Conclusions. This protocol outlines a transparent and rigorous approach to synthesising current evidence on MCFA/MCT supplementation and skeletal muscle-related outcomes. The findings are expected to clarify existing evidence gaps and inform future research in nutrition and muscle health. Keywords: Medium-chain fatty acids; skeletal muscle; muscle metabolism; muscle function; randomised controlled trials
Association Between Serum 25-Hydroxyvitamin D Levels and Gross Motor Development in Children With Down Syndrome: An Analytical Cross-Sectional Study
Background. Down syndrome (DS) is associated with delayed gross motor development, and vitamin D deficiency is frequently reported in this population. However, evidence regarding the relationship between vitamin D status and motor development in children with DS is limited. Aim. To examine the association between serum 25-hydroxyvitamin D [25(OH)D] levels and gross motor development in children with DS. Methods. This analytical cross-sectional study included 33 children with DS (13 females and 20 males) aged 1.00–6.56 years (mean age 2.53 ± 1.06 years). Gross motor development was assessed using the Basic Motor Skills (BMS) Test. Serum 25(OH)D concentrations were measured using electrochemiluminescence on a Cobas® e 411 analyser (Roche Diagnostics). Vitamin D status was categorised as deficient (<20 ng/mL), insufficient (20–29 ng/mL), or sufficient (≥30 ng/mL). Associations between vitamin D levels and gross motor milestones were evaluated using Spearman’s rank correlation and group comparisons. Results. Vitamin D deficiency was observed in 36.4% of the participants, 12.1% had insufficient vitamin D levels, and 51.5% had sufficient vitamin D levels. No statistically significant correlations were found between serum 25(OH)D levels and any gross motor milestone (r range −0.172 to 0.292; all p > 0.05). The strongest correlation was observed for adopting a sitting position (r = 0.292), but it was not statistically significant (p = 0.099). Conclusions. Vitamin D deficiency appears to be common in children with DS, while no significant association was observed between serum 25(OH)D levels and gross motor development in this sample. These findings highlight the need for larger, longitudinal studies to further clarify this relationship. Keywords: Down syndrome; 25-hydroxyvitamin D; vitamin D deficiency; gross motor development; children
Effects of a 12-Week Strength Training Programme on Independent Living Skills and Wheelchair Control in Persons With Paraplegia
Background. The effects of strength training on independent living skills in persons with paraplegia are unclear. Aim. To examine the effects of 12-week strength training for increasing upper body strength, independent living skills, and physical condition parameters in persons with spinal cord injury. Methods. Preliminary and post intervention (after 12 weeks) testing were performed. The measurements consisted of the following assessments: the assessment of Functional Independence Measure, the assessment of wheelchair control skills, the assessment of physical parameters (strength, endurance, quickness) using field tests. Fourteen persons with paraplegia after complete thoracic or lumbar spinal cord injury participated in the study. Subjects with paraplegia were divided into intervention (7 participants) and control (7 participants) groups. The participants of the intervention group had one hour per training session in the gym (three times per week). The subjects of the control group had no training during the entire period of research. Results. The 12-week strength exercise programme applied to persons with spinal cord injury improved almost all daily living skills in the intervention group, e.g. transferring (control group post intervention 4.3 ± 0.06, intervention group post intervention 6.5 ± 0.08*), moving skills (control group 3.3 ± 0.24, intervention group 6.2 ± 0.49, p = 0.03). Strength exercises had positive effect on independence in respect of wheelchair moving skills, for example: keeping balance, control group post intervention 1.5 ± 0.28, intervention group post intervention 1.6 ± 0.18, p = 0.04); overcoming bigger obstacles, control group 0.42 ± 0.14, intervention group 1.4 ± 0.30, p = 0.02). The 12-week programme improved maximum hand strength (control group post intervention 66.9 ± 3.09, intervention group post intervention 84.8 ± 3.15, p = 0.02), endurance (control group 1.3 ± 0.15, intervention group 2.3 ± 0.19, p = 0.02), quickness (control group 11.2 ± 0.22, intervention group 16.6 ± 0.51, p = 0.03) of persons with paraplegia. Conclusions. The independent living, wheelchair control skills, and physical condition parameters of the intervention group improved after the 12-week strength training programme. Keywords: Paraplegia; independent living skills; strength training
Methods and Digital Technology Solutions to Monitor Physical Activity in Paediatric Oncology Patients: A Scoping Review Protocol
Physical activity (PA) plays a critical role in supporting recovery and improving overall health outcomes in paediatric oncology patients, who commonly experience cancer and treatment related side effects such as fatigue, reduced muscle strength, decreased cardiorespiratory fitness, and an increased risk of long-term chronic conditions. Despite well-established PA guidelines, many children and adolescents undergoing or recovering from cancer treatment fail to achieve recommended activity levels. Barriers include physical limitations, psychological distress, treatment-related symptoms, and limited availability of structured PA programmes integrated within clinical care. These challenges underscore the need for accessible, feasible, and engaging PA interventions tailored to this vulnerable population. In recent years, digital health solutions have emerged as promising tools to support PA promotion and monitoring. Technologies such as augmented reality, gamification, wearable activity trackers, and mobile health applications offer opportunities for remote monitoring, personalised feedback, and increased motivation. These tools may help overcome traditional barriers by enabling flexible, home-based PA engagement and facilitating real-time data collection. However, the extent to which such digital instruments effectively capture PA behaviours and influence activity levels in paediatric oncology remains unclear. This scoping review aimed to address existing gaps in the literature by systematically identifying and mapping the instruments used to monitor PA in paediatric oncology patients during active cancer treatment. Both conventional methods, including questionnaires and observational measures, and digital approaches, such as wearables and app-based monitoring systems, were examined. By synthesising current evidence, this review seeks to provide an overview of available PA monitoring tools, highlight methodological trends and limitations, and inform future research and intervention development in paediatric oncology care. Keywords: Paediatric oncology; cancer; physical activity monitoring; augmented reality; digital solutions; gamification
Delayed Vestibular Physiotherapy in Chronic Post-Traumatic Vestibulopathy: A Clinical Case Analysis
Background. Head trauma may cause persistent dizziness and impair balance, mobility, daily activities, and quality of life. Although vestibular rehabilitation is usually recommended early after injury, some patients do not receive timely treatment. Therefore, evidence on delayed vestibular physiotherapy remains limited. Aim. To examine the effects of delayed vestibular physiotherapy initiated approximately two years after head trauma. Methods. A single-case interventional clinical analysis was conducted in a 53-year-old male with chronic post-traumatic vestibular complaints. A 13-week home-based vestibular rehabilitation programme was adjusted according to symptoms and clinical response. Assessment included the Dix–Hallpike Test, Motion Sensitivity Quotient, Berg Balance Scale, Tinetti Test, Timed Up and Go Test, tandem standing, and single-leg stance. Measurements were performed at baseline, during follow-up, at the end of the intervention, and again four weeks later. The intervention included Brandt–Daroff exercises, the Epley manoeuvre, gaze stabilisation, and balance training. Results. Positional symptoms gradually decreased and were no longer provoked at the final assessment. Motion sensitivity decreased to 0 and remained unchanged at re-assessment. Balance and functional mobility also improved over time, and the participant reported no dizziness during positional changes, head movements, or daily activities by the end of follow-up. Conclusions. Delayed vestibular physiotherapy was associated with reduced positional symptoms and improved balance, mobility, and daily functioning in this clinical case. Keywords: Vestibular rehabilitation; post-traumatic dizziness; vestibulopathy; delayed intervention
Analysis of Nurses’ Workload in a Therapeutic Profile Department
Background. The goal of healthcare institutions is to provide high-quality and safe services to patients. Nursing workload in hospitals is discussed worldwide, as it affects the quality of patient care. Studies show that a low number of nursing staff is associated with a negative impact on patient health. Aim. To assess the workload of nurses working in the Internal Medicine Department of Hospital X in Lithuania. Methods. The study was conducted at the Hospital X. Patient case histories were used in the study, including patients who were treated in the Hospital X from 1 January 2023 to 1 August 2023. Seven hundred and eleven nursing histories were included in the study. A quantitative study, data collection and analysis were performed. The workload of nurses in the Internal Medicine Department of the Hospital X is a multifaceted and essential aspect that requires careful consideration. Results. The average working time of nurses in the entire department, including time spent with the patient, assessed according to the NAS methodology, and performing nursing procedures was 526,099.2 hours (over a 7-month period). It was found that on average, one nurse had to complete 35,073.3 hours’ worth of nursing work over a 7-month period. The hours would equate to 48 months if the tasks were performed according to global recommendations for the duration of nursing procedures. Conclusions. It was found that the workload of nurses is very high. Nurses must perform actions and procedures in less time than they are allocated. Keywords: Nurses; workload; therapeutic; nursing activities score methodology
The Role of Physiotherapy Methods in the Management and Prevention of Upper Extremity Injuries in Professional Pianists: A Scoping Review
Background. Professional musicians are at significant risk of upper limb injuries, as prolonged practice and intensive playing increase the likelihood of musculoskeletal disorders and overuse injuries, particularly in pianists. Altenmüller and Kopiez (2010) demonstrated that chronic upper extremity injuries and pain syndromes resulting from intensive piano practice can be successfully treated using multimodal therapy, including physiotherapy, psychotherapy, and modifications of playing technique, enabling musicians to fully restore performance skills. However, there is a notable lack of scientific literature and knowledge regarding physiotherapy interventions for professional pianists, particularly concerning injury management and preventive strategies. Aim. To obtain and compile current evidence on physiotherapy processes and methods used for the management and prevention of upper extremity injuries in professional pianists, and to explore the scope of available approaches in this field. Methods. A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology. A systematic search was performed in PubMed, Web of Science, EBSCOhost, MEDLINE Ultimate, and ProQuest. Additional sources included books and relevant publications. The PCC framework was applied: Participants – pianists with piano-related upper extremity injuries; Concept – physiotherapy plans and methods for injury management and prevention; Context – clinical, educational, and home settings. Publications in English from the past 50 years were included. Results. A scoping review on the management and prevention of upper extremity injuries in pianists included English-language publications from the past 50 years, along with additional relevant sources. Of 54 identified studies, 45 met the inclusion criteria. The findings indicate that primary risk factors are biomechanical overload, improper technique, and poor ergonomic habits. Conclusions. Physiotherapy plays a significant role in both the management and prevention of upper extremity injuries in pianists. Injury management and prevention involve adhering to ergonomic principles, physiotherapy, and learning proper technique from an early age. Collaboration between educators and healthcare professionals is essential for the long-term health and career sustainability of pianists. Keywords: Physiotherapy; injury prevention; musculoskeletal disorders; biomechanical overload injuries; isometric strength exercises
Stigma as a Barrier to Mental Health Treatment: Insights From Lithuanian Nurses
Background. Mental health stigma remains a significant barrier to accessing and sustaining mental health care globally. In Lithuania, stigma is especially prevalent and may influence patient outcomes even within healthcare institutions. Aim. To examine the level of knowledge, attitudes, and experiences of stigma among general practice nurses working with patients who have mental health disorders. Methods. A cross-sectional quantitative study was conducted between September and December 2024 using an anonymous online survey distributed through nursing-focused Facebook groups. A total of 280 general practice nurses participated. The questionnaire assessed knowledge about mental health stigma, attitudes towards individuals with mental illness, and experiences of stigma in clinical practice. Data was analysed using descriptive statistics and Chi-Square tests. Results. Few respondents reported a high level of knowledge about mental health stigma, and many had not received any relevant training. While most nurses expressed neutral or positive attitudes, stigmatising views regarding treatment adherence and social perceptions were still present. A majority reported that patients frequently experience discrimination. Educational background and prior training were associated with more accurate knowledge and reduced stigma. Conclusions. There is a critical gap in mental health stigma awareness and training among nurses in Lithuania. Despite generally positive attitudes, persistent stigma continues to affect patient care. Targeted educational interventions are urgently needed to improve knowledge, reduce discrimination, and enhance treatment outcomes. Keywords: Mental health; stigma; nursing; patient care; attitudes
Lumbar Traction in Low Back Pain: The Experience of Lithuanian Physiotherapists
Background. Lumbar traction is widely discussed in international literature; however, little is known about its use among physiotherapists in Lithuania. This study aimed to evaluate the prevalence, application practices, and influencing factors associated with lumbar traction use among Lithuanian physiotherapists. Aim. To evaluate the prevalence, application practices, and influencing factors associated with lumbar traction use among Lithuanian physiotherapists. Methods. A mixed-methods approach was used, including an analysis of scientific literature and a quantitative questionnaire survey of practicing physiotherapists in Lithuania. Descriptive statistics were used to summarise responses, associations between categorical variables were tested using the Chi-Squared Test, and effect sizes were quantified using Cramér’s V. Results. The historical and clinical analysis confirmed that lumbar traction has evolved from primitive spinal stretching techniques into a modern therapeutic method used to reduce pain, improve spinal function, and decrease mechanical pressure on affected tissues. Survey data showed that 12% of Lithuanian physiotherapists use lumbar traction. Education exhibited the strongest association with lumbar traction use (Cramér’s V = 0.316), indicating a moderate effect size. However, no statistically significant associations were identified. Lithuanian physiotherapists most frequently apply manual traction in the supine position, commonly selecting low traction forces (20–30% of body weight). Compared with international practice, lumbar traction is used less frequently in Lithuania, though similarities exist in preferred techniques and the influence of education on clinical decision-making. Conclusions. Lumbar traction remains a recognised treatment modality for low back pain, though its clinical uptake in Lithuania is limited. Application patterns indicate a preference for manual, low-force traction, and education appears to play an important role in determining its use. Further research with larger samples is needed to clarify influencing factors and align national practice with international trends. Keywords: Lumbar traction; physiotherapy; low back pain; spinal rehabilitation; clinical practice
Influence of Constraint-Induced Movement Therapy (CIMT) on Acute Post-Stroke Rehabilitation: Upper Extremity Function Recovery and Inclusion in Activities
Background. Constraint-induced movement therapy (CIMT) is widely used in post-stroke rehabilitation and has a positive effect on motor and functional recovery of the affected hand. However, there are insufficient data on the effectiveness of the CIMT method in early post-stroke rehabilitation. Identification of the most effective methods in different periods of recovery after stroke would allow the prioritisation of rehabilitation treatment and create opportunities to achieve the best results. Aim. To evaluate the effectiveness of the CIMT method on motor recovery, functional capacity, and involvement in activities of the affected hand during early post-stroke rehabilitation (four weeks after stroke). Methods. The study included 18 patients participating in an inpatient post-stroke rehabilitation programme, who were randomly divided into two groups: Group I – the CIMT method was applied in addition to conventional rehabilitation five times per week for 14 days; Group II (control group) – the conventional rehabilitation programme was applied. Assessment instruments included the Wolf Test, Fugl-Meyer Assessment-Upper Extremity (FMA-UE), dynamometry, Nine-Hole Test (9ST), FNT, ADL / IADL tests and Mini-Mental State Examination (MMSE). Results. During the two-week rehabilitation programme, application of the CIMT method resulted in a statistically significantly higher motor and functional improvement and more active involvement of the affected upper extremity (UE) in daily activities (p < 0.05), compared with conventional rehabilitation. Conclusions. Even during a short two-week period of the early post-stroke rehabilitation, CIMT provides strong evidence of effectiveness in improving upper limb motor, functional recovery, and increasing involvement in activities. Keywords: Upper extremity function; performance of activities; involvement in activities; movement restriction therapy
Impact of the FIFA 11+ Injury Prevention Programme on Dynamic Balance Performance in Football Players: A Systematic Review and Meta-Analysis
Background. Even though FIFA 11+ helps lower injury chances in football, findings on how it affects balance during movement remain unclear. What little exists has not been combined in a way that truly compares results across studies – no solid summary of data yet exists. Aim. This work looks at how well the FIFA 11+ method helps football players stay balanced during movement. Evidence from multiple studies was gathered and compared carefully. Methods. A literature search was conducted in the SCOPUS database following PRISMA guidelines. Four eligible studies were selected based on specific criteria, including the use of the FIFA 11+ programme and validated balance tests. Data were synthesised using a random-effects model in Review Manager (RevMan 5.4), with analyses centred on post-intervention outcomes and pre–post differences in dynamic balance performance, to ensure comprehensive evaluation. Results. The pooled analysis of post-intervention values demonstrated a standardised mean difference (SMD) of 0.36 (95% CI −0.18 to 0.89; p = 0.54) for anterior SEBT performance of the dominant leg, indicating no statistically significant difference between the FIFA 11+ and control groups. Heterogeneity was negligible (I² = 0%), suggesting high consistency across studies. In contrast, analysis based on pre–post change scores revealed a significant improvement in favour of the FIFA 11+ group (MD = 5.00 cm, 95% CI 3.29 to 6.71; p < 0.00001). As this outcome was derived from a single study, heterogeneity could not be assessed. Overall, the findings indicate that the effects of FIFA 11+ on dynamic balance are more sensitively detected through change-score analysis than through post-intervention comparisons alone. Conclusions. FIFA 11+ might boost how well players stay balanced during movement, based on before-and-after studies, yet score differences alone do not always show it. How much impact occurs depends on how old they are, how often they do it, and whether they actually follow through with each drill. Keywords: FIFA 11+; dynamic balance; football; injury prevention; meta-analysis
Foot and Nail Care in Palliative Care: Experiences of Diabetes Care Nurses
Background. Palliative care patients with diabetes mellitus often experience foot and nail complications that affect their quality of life and increase the risk of infections and amputations. Proper foot care is an essential component of comprehensive nursing; however, in Lithuania, these services remain fragmented and insufficiently integrated into the provision of palliative care. Aim. To reveal the characteristics of foot and nail care in palliative care for patients with diabetes mellitus. Methods. A qualitative study was conducted using a semi-structured interview method. The study involved nine female participants – general practice nurses with a specialisation in diabetes nursing – who provide foot and nail care services to palliative care patients. Results. The qualitative study revealed that diabetes nurse specialists face challenging working conditions, difficulties related to patients’ physical conditions, a lack of knowledge and training, and limited collaboration with other healthcare professionals. Despite these challenges, they demonstrate adaptability, apply creative solutions, and value the importance of interdisciplinary teamwork. The study also highlighted the need to integrate podiatrists into palliative care teams and to establish clearer regulations for foot care services. Conclusions. To improve the quality of palliative care, it is essential to strengthen the competencies of diabetes nurse specialists, ensure access to specialised training, enhance interdisciplinary collaboration, and integrate podiatrists into the healthcare system. These measures would help reduce the risk of complications and improve patients’ quality of life. Keywords: Palliative care; diabetes mellitus; foot care; diabetes nurse specialist; podologist
Effects of Different Breathing Methods on Intraocular Pressure, Ocular Haemodynamics, and Cardiovascular Responses During Push-Ups and the Plank Exercise
Background. Modern sedentary lifestyle increases the risk of ocular disorders, while participation in resistance and bodyweight training continues to grow among young adults. Previous studies indicate that exercise-induced changes in intraocular pressure and ocular haemodynamics depend on exercise type, intensity, and breathing strategy, particularly during isometric efforts and the Valsalva manoeuvre (VM). However, evidence regarding the ocular and cardiovascular effects of different breathing techniques during common bodyweight exercises remains limited. Aims. To evaluate the effects of different breathing techniques on intraocular pressure (IOP), ocular and systemic haemodynamics, pain, fatigue, and intensity perception during push-ups and the plank exercise. Methods. The study included 40 physically active men and women (mean age 24.2 ± 5.1 years). Participants were tested before exercise, immediately after exercise, and at 5, 10, and 15 minutes after exercise. Retinal microcirculation was assessed using an “Optomed Aurora” eye fundus camera, IOP was measured with an “Icare” tonometer, arterial pressure was measured using an “Omron BP742N” Series 5 device, subjective muscle fatigue and pain were evaluated using a Visual Analogue Scale (VAS), and exercise intensity was assessed using the Borg Scale. Results. During the static plank exercise, mean arterial pressure (MAP) increased by approximately 4% while breathing, whereas no increase and a slight decreasing trend was observed during the VM. Dynamic push-ups induced a 3–6% increase in MAP immediately after exercise, followed by a decrease at 10–15 minutes after exercise, particularly during the VM. Changes in IOP depended on exercise type: static exercises caused only a slight decrease, whereas push-ups resulted in a more pronounced, transient reduction in IOP, especially at 5–10 minutes after exercise. Dynamic exercises also had a greater effect on the arteriovenous ratio (AVR), due to increased sympathetic nervous system activation. Subjective sensations such as pain, fatigue, and tremor were minimal during the plank exercise, whereas during push-ups the VM tended to increase effort, although the differences were not statistically significant. Conclusions. Dynamic exercises such as push-ups induce greater systemic and ocular physiological responses than static exercises, and the VM amplifies haemodynamic fluctuations and the subjective perception of effort. Changes in ocular parameters (IOP, AVR) are small, temporary, and primarily dependent on exercise type. Keywords: Valsalva manoeuvre; push-ups; plank-exercise; mean arterial pressure; intraocular pressure; retinal microcirculation
Changes in Physical Fitness, Physical Activity, and Sleep Among Adolescents During a Riflemen Summer Camp: A Pilot Study
Background. Physical health of adolescents is increasingly challenged by sedentary lifestyles and insufficient physical activity in a technology-driven society. Structured, physically demanding summer camps may help improve youth physical fitness, activity levels, and sleep, but evidence on Lithuanian Riflemen summer camps is lacking. Aim. To determine the effects of a Riflemen summer camp on adolescents’ physical fitness, physical activity, and sleep parameters. Methods. Twelve adolescents (age 13.8 ± 1.2 years) attending their first Riflemen summer camp participated in the study. Physical activity (daily step count) and sleep duration were monitored with Xiaomi Mi Smart Band 6 bracelets for seven days before the camp, throughout the seven-day camp, and for seven days after the camp. Physical fitness (90–90 Test, Apley Scratch Test, Sit-To-Stand, Partial Curl-Up, and Single-Leg Stance Test – eyes closed) was assessed on the first and last day of the camp. Results. After the camp, significant improvements were observed in abdominal and lower-limb muscle strength, static balance, and shoulder mobility (p < 0.05). Mean daily steps during the camp reached approximately 12,000, almost double the pre-camp level (~6,500; p < 0.05). Post-camp step counts significantly decreased (p < 0.05) and did not differ from baseline (p > 0.05). Sleep duration shortened during the camp (p < 0.05), whereas after the camp both total and deep sleep time were significantly longer than before the camp (p < 0.05). Conclusions. A structured seven-day Riflemen summer camp may induce short-term changes in adolescents’ physical fitness, daily step counts, and subsequent sleep duration. Keywords: Adolescents; summer camp; physical fitness; physical activity; sleep duration
Association of Problematic Internet Use With Movement Proficiency, Physical Activity, and Cognitive Abilities in Adolescents
Background and Aim. Problematic internet use (PIU) is a growing public health concern among adolescents, with potential impacts on physical and cognitive development. Given the importance of physical activity and movement proficiency for healthy development, understanding their relationship with problematic internet use is essential. This study aimed to examine the associations between problematic internet use, movement proficiency, physical activity, and cognitive ability in adolescents. Methods. This study included 550 adolescents aged 10–18 years in Pakistan to examine associations between problematic internet use, movement proficiency, physical activity, cognitive ability, and BMI. Measures included PRIUSS, BOT-2, Raven’s matrices, and MVPA, with analyses using t-tests, correlation, and regression. Results. The mean age of participants was 13.07 ± 2.04 years, with a mean PIU score of 24.53 ± 9.71; 45.1% were classified as high risk. The mean movement proficiency score was 120.46 ± 17.80, and the mean cognitive ability score was 4.49 ± 2.62. Adolescents with high PIU showed significantly lower physical activity and movement proficiency (p < .01). PIU was negatively correlated with movement proficiency (r = –.18, p < .001) and positively correlated with BMI (r = .13, p = .002). Regression analysis identified movement proficiency (β = –.23, p < .001) and BMI (β = .19, p < .001) as significant predictors of PIU, while cognitive ability showed a weak but significant association (β = .09, p = .046). Conclusions. Problematic internet use is associated with lower movement proficiency and higher BMI in adolescents. Based on these findings, the next phase of the study introduces a targeted physical activity intervention for high-risk students to reduce the negative effects of problematic internet use by improving physical activity levels and movement proficiency. Keywords: Problematic internet use; movement proficiency; physical activity; school-based physical activity interventions; adolescents
Oral Presentations 3 – Technology, Neuroscience, and Human Performance
Adaptive Regulation in Precision Sport: A Multimodal Study of Cognitive, Autonomic, and Motor Integration
Background and Objective. Self-regulation under performance demands is essential in precision sports such as shooting and archery. While previous research has examined cognitive, physiological, or motor aspects of performance separately, limited evidence exists on their integrated adaptation within an embodied performance framework. This study aimed to investigate how cognitive performance, autonomic regulation, and fine motor control adapt across a structured training period, and whether such training enhances performance stability under controlled auditory pressure as a novel environmental constraint. Methods. Eight athletes (age: 35.2 ± 15.7 years) from precision sports participated in a longitudinal within-subject study. Assessments were conducted at baseline, after Training Block 1 (mid-assessment), and after Training Block 2 (final assessment). Multimodal measurements included Heart Rate Variability (HRV, RMSSD) for autonomic regulation, Automated Neuropsychological Assessment Metrics (ANAM) for cognitive performance, and Dexterity Performance Assessment (DPA) for fine motor control. During the final assessment, a controlled auditory pressure condition was introduced during the variable target task (DPA) to evaluate performance stability under environmental constraint. Results. Cognitive performance measured by ANAM showed improved reaction time (2,186.95 ± 84 ms; −5.30%, p < 0.001), while DPA results indicated reduced variability in dexterity performance (94 ± 2; −3.03%, p < 0.001. Physiologically, HRV (RMSSD) increased from 16.33 to 23.33 ms (p < 0.05), suggesting improved autonomic regulation across the training period. Together, these findings indicate coordinated improvements across cognitive, autonomic, and motor domains during the structured training period. Conclusions. The results suggest that structured training may enhance integrated regulation of cognitive, autonomic, and motor systems in precision sport athletes, as reflected by faster reaction time, increased HRV, and reduced motor variability. Performance was maintained under a controlled auditory pressure condition, indicating stable task execution under environmental constraint. These findings highlight the potential utility of multimodal assessment for evaluating integrated adaptations and performance readiness in precision sports. Keywords: Dexterity; embodied cognition; archery; shooting; high performance