Introduction This study aimed to evaluate the effects of ultrasound cavitation on insulin resistance, waist-to-hip ratio (WHR), and abdominal skinfold thickness in women with central obesity. Methods A total of 52 women aged 25–40 years with the mean age of 32.9 ± 4.2 years with central obesity were randomly assigned to either an experimental group (ultrasound cavitation, aerobic exercise, and a low-calorie diet) or a control group (aerobic exercise and a low-calorie diet). Randomisation was computer-generated; outcome assessors were blinded. The intervention occurred twice weekly for 6 weeks. Outcomes were assessed pre- and post-treatment. Insulin resistance was measured using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), abdominal skinfold thickness with Lange callipers, and WHR with a non-elastic tape. Normality was confirmed via the Shapiro–Wilk test, and homoscedasticity was verified. Parametric tests including paired t-tests and multivariate analysis of variance (MANOVA) were applied, with Bonferroni correction used for multiple comparisons. Results The experimental group showed reductions of 23% in HOMA-IR (mean change: −0.64 ± 0.2), 7% in abdominal skinfold thickness (2.4 ± 0.5 mm), and 8% in waist-to-hip ratio (7.5 ± 1.2). In contrast, the control group demonstrated smaller reductions of 5% (0.13 ± 0.2), 0.5% (0.16 ± 0.1 mm), and 0.7% (0.63 ± 0.2), respectively. Between-group differences in all three obesity markers were statistically significant (p < 0.05), favouring the experimental group. Conclusions Ultrasound cavitation, combined with exercise and dietary interventions, significantly improves insulin resistance and central obesity markers. This finding supports its use as a non-invasive metabolic intervention.
Introduction Subacromial pain syndrome (SAPS) is one of the most common causes of shoulder pain and functional limitation in adults. Conservative physiotherapy management includes exercise therapy, manual therapy, patient education, and electrotherapy. This systematic review aimed to summarise and evaluate current evidence on conservative physiotherapy-based treatment approaches for SAPS, with particular focus on pain reduction and functional improvement. Methods A comprehensive search of PubMed, Web of Science, and Google Scholar was performed for studies published between 2020 and 2025. The last database search was conducted on January 15, 2026. Eligible studies included randomised controlled trials, systematic reviews, meta-analyses, and study protocols investigating conservative, non-surgical physiotherapy interventions in adults with SAPS. Primary outcomes included pain, shoulder function, disability, and range of motion. Results Twenty-two studies met the inclusion criteria, including 14 randomised controlled trials, 7 systematic reviews/meta-analyses, and 1 randomised study protocol. Exercise-based treatment consistently showed significant improvements in pain and functional outcomes. Methodological quality of randomised controlled trials ranged from 6 to 8 out of 10 on the PEDro (Physiotherapy Evidence Database) scale. According to AMSTAR-2 (A Measurement Tool to Assess systematic Reviews), two systematic reviews were rated as of high quality, four as of moderate quality, and one as of low quality. Progressive exercise protocols that targeted the rotator cuff and scapular muscles were associated with superior clinical improvements compared to generalised exercise programmes. Scapular stabilisation and motor control exercises demonstrated moderate effectiveness in improving shoulder pain and disability index (SPADI) and range of motion outcomes. Manual therapy provided short-term benefits when combined with exercise. Conclusions Current evidence supports exercise-based physiotherapy for SAPS, with individualised loading and education improving outcomes.
Introduction Adolescent idiopathic scoliosis (AIS) is commonly treated with physiotherapeutic scoliosis-specific exercises such as the Schroth method. However, evidence regarding the short-term effects on sagittal spinal alignment in patients with mild curves remains limited. Methods This prospective pilot study evaluated the effects of a 3-week Schroth physiotherapy program on sagittal spinal curvatures in girls with mild AIS (Cobb angle < 25°). Fourteen participants aged 10–16 years completed daily 45-minute supervised sessions. Thoracic kyphosis, lumbar lordosis, and sacral slope were assessed using a Rippstein plurimeter before and after the intervention. Statistical analysis included paired t-tests or Wilcoxon signed-rank tests depending on the distribution of differences. Results Thoracic kyphosis increased significantly from 14.29 ± 7.71° to 23.07 ± 6.41° (mean difference 8.79°, 95% CI 5.25–12.32; p < 0.001; Cohen’s d = 1.43). No statistically significant changes were observed in lumbar lordosis (p = 0.142) or sacral slope (p = 0.068; Holm-adjusted p = 0.136). Conclusions A short-term Schroth physiotherapy program may contribute to the normalisation of thoracic sagittal alignment in girls with mild AIS. Further controlled studies with larger samples are required to confirm these findings.
Introduction Chronic neck pain (CNP) is a prevalent condition that compromises quality of life and functional performance. The neck disability index (NDI) is widely used to assess neck-related disability, yet updated psychometric evidence for Spanish-speaking populations with CNP is limited. This study aimed to validate the Spanish NDI and evaluate the psychometric performance of a shortened clinical form in adults with CNP. Methods A cross-sectional study was conducted in adults with CNP referred to physical therapy (n = 123). Participants completed the Spanish NDI. Construct validity was assessed through exploratory factor analysis (EFA) using Spearman correlations and principal components extraction assuming a one-factor solution, with a 0.40 loading criterion. Sampling adequacy was verified with the Kaiser–Meyer–Olkin index. Internal consistency was examined with Cronbach’s alpha. Confirmatory factor analysis (CFA), using a robust maximum likelihood estimator, evaluated the model fit of the best-performing item set. Model fit indices included the Comparative Fit Index (CFI), Tucker–Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA), and Standardized Root Mean Square Residual (SRMR). Results A one-factor structure emerged in the EFA, with items S1 (pain), S2 (personal care), S3 (lifting), S4 (reading), and S10 (recreation) showing the strongest loadings. Removing low-loading items improved internal consistency (α = 0.71 vs. 0.64 for the full scale). The CFA supported the reduced 5-item model, demonstrating satisfactory fit (CFI = 0.99, TLI = 0.97, RMSEA = 0.04, SRMR = 0.04), supporting the structural validity of the instrument for assessing disability in individuals with CNP. Conclusions The Spanish NDI demonstrated adequate construct validity in adults with CNP. The shortened 5-item version showed improved internal consistency and strong model fit, offering a clinically efficient alternative for rapid disability screening. Further validation in different populations and clinical contexts is recommended.
Introduction Robot- and sensor-based interventions are increasingly used in postoperative rehabilitation, but their clinical effects after total hip arthroplasty (THA) remain unclear. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance, we searched PubMed, Embase, CINAHL, Scopus, and Web of Science databases for randomised controlled trials evaluating robot- or technology-assisted physiotherapy delivered in the postoperative phase after THA. Three reviewers independently screened records, extracted data, and assessed the risk of bias using the Cochrane tool. Results From 181 records, three trials met eligibility criteria. Interventions included an exoskeleton (Hybrid Assistive Limb), a visualized loading-control robot combined with conventional rehabilitation, and an electromyography-based (EMG-based) rehabilitation robot. Compared with conventional rehabilitation, robot- or technology-assisted interventions showed signals of short-term benefits in pain, hip range of motion (particularly hip extension), functional scores, and walking endurance in some studies, whereas walking speed and maximal strength outcomes were inconsistent. Quality of life improved in one trial despite no between-group difference in maximal strength. Conclusions Evidence for the efficacy of robot- or technology-assisted postoperative rehabilitation after THA is limited and heterogeneous. Current trials suggest potential early benefits for selected outcomes, but firm conclusions are precluded by a small number of studies, variability in devices and dosing, and short follow-up. Well-designed, adequately powered trials with standardised outcomes are needed.
