Background/Objectives: Illness coherence has been associated with treatment engagement and adherence, but its relationship with exercise adherence and patient-reported outcomes in chronic spinal pain remains unclear. This study examined whether unsupervised exercise adherence mediates the association between baseline illness coherence and patient-reported outcomes and whether this indirect association differs according to the type of intervention received. Methods: A theory-driven secondary analysis was conducted using data from a randomized controlled trial of adults with chronic spinal pain receiving either exercise-only or combined exercise plus diaphragmatic breathing intervention (initially randomized = 183; n = 57/group). Measures included Revised Illness Perception Questionnaire (IPQ-R), Brief Pain Inventory–Short Form (BPI-SF), Hospital Anxiety and Depression Scale (HADS), World Health Organization Quality of Life Instrument, Brief Version (WHOQOL-BREF), and exercise logs. Moderated mediation analyses examined whether the intervention group moderated the indirect associations between baseline illness coherence and patient-reported outcomes through unsupervised exercise adherence. The parent trial was retrospectively registered at ClinicalTrials.gov (NCT07539116) on 12 April 2026. Results: Mean age was 46.95 ± 14.54 and 46.32 ± 15.97 years, and women comprised 40.4% and 47.4% of the exercise-only and combined groups, respectively. Baseline illness coherence was positively associated with unsupervised exercise adherence in the exercise-only group (b = 71.04, p = 0.018). Significant conditional indirect effects of illness coherence on all patient-reported outcomes through unsupervised exercise adherence were observed in the exercise-only group (b = −1.55 to 1.32, ps < 0.05), but not in the combined intervention group (b = −0.59 to 0.32, ps > 0.05). Indices of moderated mediation were significant across all outcomes (all ps < 0.05). No intervention-related adverse events were reported. Conclusions: Diaphragmatic breathing may reduce the relative contribution of illness-related cognitive representations on patient-reported outcomes by introducing additional self-regulatory pathways through which clinical improvement is achieved.

The Traditional Mediterranean Physical Activity (TMPA) pattern, characterized by daily, incidental, and socially embedded movement, represents a core yet understudied component of the Mediterranean lifestyle. Unlike structured exercise, TMPA encompasses activities such as walking for transportation, agricultural work, gardening, household chores, and participation in cultural events. With global declines in functional daily movement and an increase in sedentary behavior, understanding the health impact of TMPA is increasingly relevant. A systematic literature search was conducted across major databases (MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, Scopus, and ProQuest) from inception to present. Of 6037 records identified, 27 studies met all inclusion criteria involving adult populations from Mediterranean countries and reporting physical activity-related health outcomes. Both quantitative and qualitative research, as well as systematic and narrative reviews, were included. A narrative synthesis of the 38 studies was undertaken due to heterogeneity in study design, outcomes, and TMPA definitions. Evidence consistently demonstrated that TMPA contributes to broad physical health benefits, including reduced cardiovascular and all-cause mortality, improved metabolic profiles, healthier body composition, enhanced musculoskeletal strength, and greater functional capacity in older adults. Its integration with other lifestyle pillars, such as diet, rest, and social engagement, appears to amplify these effects. TMPA was also associated with improved mental health outcomes, including reduced depressive symptoms, lower stress, enhanced emotional resilience, and greater life satisfaction. Studies emphasized that the social, outdoor, and culturally meaningful context of TMPA distinguishes its health effects from conventional exercise. However, substantial methodological variability, reliance on self-reported measures, and limited longitudinal research constrain the strength of causal inferences. Conclusions: TMPA emerges as a culturally embedded and sustainable form of daily movement with significant physical and mental health benefits. Its holistic, lifelong nature positions it as a valuable model for public health strategies aimed at counteracting sedentary lifestyles. Future research should prioritize standardized definitions, objective measurement tools, and longitudinal or interventional designs to clarify causal pathways. Incorporating TMPA principles into modern environments may offer innovative, culturally grounded approaches to promoting population health.

Aim:The purpose of this study was to explore female patients' experiences regarding systematic exercise compared with low-intensity physical activity in relation to common symptoms and quality of life in RMDs. Methods:A qualitative study was conducted using semi-structured, face to face interviews. Fifteen women with RMDs were recruited; thirteen completed the interviews and were included in the analysis. Interviews lasted approximately 30 minutes and were audio-recorded. Data were analysed using Thematic Analysis following the six-phase approach of Braun and Clarke. Participants were categorised based on self-reported engagement in either systematic exercise or low-intensity physical activity (e.g. walking). NVIVO 15 software was used for data management and analysis. Results:Participants' mean age was 58.3 ±13.38 years. Five a priori thematic areas were explored (pain, fatigue, depression, quality of life and exercise/physical activity), while an additional theme regarding barriers to participation emerged inductively. Most participants reported limited awareness of the distinction between physical activity and exercise. Women engaged in systematic exercise described more favourable experiences regarding symptoms management and quality of life, whereas those performing low-intensity physical activity primarily emphasised psychological benefits. Barriers to participation included physical limitations, fatigue, and motivational factors. Conclusion:From patients' perspectives, systematic exercise and low-intensity physical activity are perceived differently in relation to symptom experiences and quality of life. These differences highlight the importance of individualised, patient-centred exercise counselling for women with RMDs.

The Mediterranean lifestyle has attracted significant research attention in recent years. This lifestyle is supported by several key pillars, including dietary habits, social and spiritual engagement, and physical activity. Although much of the research has focused on the health benefits of the Mediterranean diet, physical activity has received comparatively less emphasis. Nevertheless, physical activity remains a vital component of the Mediterranean lifestyle, deeply embedded in cultural traditions and daily routines. This paper examines the defining features, movement patterns, and cultural foundations of physical activity within the traditional Mediterranean lifestyle. By drawing on historical sources, anthropological studies, and contemporary research, we characterize Traditional Mediterranean Physical Activity (TMPA) as a set of habitual, non-structured movement patterns integrated into daily life. These activities include farming, fishing, manual labor, dancing, and walking for transportation, all reflecting a functionally active lifestyle shaped by environmental and occupational demands. The study also explores how TMPA has evolved and its potential alignment with modern physical activity paradigms. The key components of TMPA include functional movements, outdoor engagement, and communal participation, reflecting a culturally embedded approach to physical activity in Mediterranean societies. This study provides a foundation for understanding TMPA as a distinct movement model shaped by tradition and sustainability and offers insights into how these activity patterns have persisted or adapted in contemporary settings.

Occupational therapy (OT) is vital in improving functional outcomes and aiding recovery for individuals with long-term disabilities, particularly those resulting from neurological diseases. Traditional assessment methods often rely on clinical judgment and individualized evaluations, which may overlook broader, data-driven insights. The integration of artificial intelligence (AI) presents a transformative opportunity to enhance assessment precision and personalize therapeutic interventions. Additionally, advancements in human–computer interaction (HCI) enable more intuitive and adaptive AI-driven assessment tools, improving user engagement and accessibility in OT. This scoping review investigates current applications of AI in OT, particularly regarding the evaluation of functional outcomes and support for clinical decision-making. The literature search was conducted using the PubMed and Scopus databases. Studies were included if they focused on AI applications in evaluating functional outcomes within OT assessment tools. Out of an initial pool of 85 articles, 13 met the inclusion criteria, highlighting diverse AI methodologies such as support vector machines, deep neural networks, and natural language processing. These were primarily applied in domains including motor recovery, pediatric developmental assessments, and cognitive engagement evaluations. Findings suggest that AI can significantly improve evaluation processes by systematically integrating diverse data sources (e.g., sensor measurements, clinical histories, and behavioral analytics), generating precise predictive insights that facilitate tailored therapeutic interventions and comprehensive assessments of both pre- and post-treatment strategies. This scoping review also identifies existing gaps and proposes future research directions to optimize AI-driven assessment tools in OT.

Background and Objectives: The COVID-19 pandemic brought significant challenges across governmental, industrial, and social systems. Additionally, numerous studies have reported a sharp increase in both mental health issues and musculoskeletal disorders worldwide. This study aimed to investigate whether a specific exercise program could alleviate neck and upper back pain symptoms and improve mood state among healthcare and office employees during the post-COVID-19 period. Materials and Methods: This was an unblinded (open label) randomized controlled trial (both the participants and the researchers knew which treatment or intervention was being administered). In total, 40 healthcare employees from a public hospital and 98 remote office employees, all of whom reported neck and upper back pain, were randomly assigned to an experimental (EG) and control group (CG). The experimental groups underwent the same exercise protocol, while their corresponding control groups underwent the assessments only. Pain assessment using the Visual Analogue Scale (VAS) and mood state using the Feeling Scale (FS) questionnaires of the participants were recorded at baseline (pre-intervention) and immediately following the exercise intervention period of 6 weeks (post-intervention). The intervention consisted of 18 exercise sessions conducted over a 6-week period, with remote office workers participating online and healthcare workers attending exercise sessions on site (at the hospital). Statistical analysis was performed using non-parametric Mann–Whitney and Wilcoxon tests, as appropriate. Results: Following the six-week intervention, the percentage of workers in the EG reporting pain decreased significantly (from 75% to 45% for healthcare workers and from 54% to 25% for office employees), whereas no change was observed for their corresponding control groups. Similarly, the mood state of the EGs significantly improved compared with the control groups, as measured between pre- and post-intervention sessions. Conclusions: The COVID-19 period exacerbated stress and musculoskeletal strain, particularly for workers in demanding occupational roles. To mitigate these effects, exercise programs that can be applied while at work should be implemented, as they are effective in enhancing mood and managing neck pain in employees with physical exertion.

ABSTRACTIntroductionThe term “Mediterranean lifestyle” has gained increasing prominence in recent years, yet a specific definition remains elusive. In response, the Mediterranean Lifestyle Medicine Institute Board of Directors convened a multidisciplinary panel comprising international experts and leaders in lifestyle medicine. Their goal was to review existing literature and formulate a consensus definition of the “traditional Mediterranean lifestyle (tMedL),” referring to the historical way of living of the people in the Mediterranean region. This paper presents the agreed consensus statement and a comprehensive holistic definition of the term “traditional Mediterranean lifestyle.”MethodsMajor medical and social sciences electronic databases from inception to February 2023 were searched, employing keywords relevant to the Mediterranean lifestyle and its constituent elements (diet, physical activity, sleep, stress, socialization). Subsequently, definitions for each pillar were created and synthesized to derive a comprehensive definition of the “traditional Mediterranean lifestyle.”ResultsThis proposed definition received ratification from the Mediterranean Lifestyle Medicine Institute's expert working group during the First International Mediterranean Lifestyle Medicine Conference held in June 2023 on the island of Leros, Greece. “The traditional Mediterranean lifestyle is characterized by its diverse and adaptable nature. Key facets encompass conviviality, lifelong social connectedness, purposeful living, strong community and familial bonds, harmony with nature and the environment, profound spirituality, adherence to religious practices, preservation of local customs, resilience cultivated through adversity, and a commitment to moderation across all spheres of life.”ConclusionsThis definition comprehensively outlines the primary lifestyle factors ingrained in Mediterranean inhabitants across generations. Its holistic nature furnishes a crucial conceptual framework for directing lifestyle medicine practitioners in assisting patients to mitigate diseases, promote overall well‐being, devise research initiatives to investigate the health ramifications of this lifestyle, and inform curriculum development.

In recent years the number of people who exercise every day has increased dramatically. More precisely, due to COVID period many people have become recreational runners. Recreational running is a regular way to keep active and healthy at any age. Additionally, running is a popular physical exercise that offers numerous health advantages. However, recreational runners report a high incidence of musculoskeletal injuries due to running. The healthcare industry has been compelled to use information technology due to the quick rate of growth and developments in electronic systems, the internet, and telecommunications. Our proposed intelligent system uses data mining algorithms for the rehabilitation guidance of recreational runners with musculoskeletal discomfort. The system classifies recreational runners based on a questionnaire that has been built according to the severity, irritability, nature, stage, and stability model and advise them on the appropriate treatment plan/exercises to follow. Through rigorous testing across various case studies, our method has yielded highly promising results, underscoring its potential to significantly contribute to the well-being and rehabilitation of recreational runners facing musculoskeletal challenges.

BACKROUNDNew training methods are constantly used to improve the ability of skeletal muscles to develop strength.OBJECTIVEThe aim of the present study was to investigate the effect of half-squat training with free weights and flywheel device on isokinetic knee muscle strength for well-trained amateur soccer players.METHODSForty eight players were randomly divided into three groups (n= 16 each): Desmotech Training group (DT), Free Weight Training group (WT) and one Control Group (CON). DT and WT performed an eight-week half-squat training program, with two sessions per week. The DT group performed training with a flywheel device. Isokinetic concentric-eccentric strength assessments of the knee extensors-flexors muscle groups were performed at different angular velocities (60, 180 and 240∘/s).RESULTSThe eight-week training program improved all the isokinetic joint moment indicators examined in the DT and WT groups (p< 0.01). The DT group achieved higher performances at all the isokinetic parameters examined, however, without statistically significant differences to the WT group.CONCLUSIONSFlywheel-based exercise is an effective training method and is suggested to be used to strengthen the lower limbs of soccer players.

Apply It! By reading this article, the fitness professional who leads Internet-based livestreaming programs in open platforms will: • Learn how to lead a safe, effective, and enjoyable livestreaming group exercise program for exercisers of all levels and of different musculoskeletal conditions. • Understand the particularities of livestreaming training sessions that are shot in nonprofessional settings ( i.e. , at home) to build them in the most professional way.

Cross Transfer” (CT) refers to the enhancement of performance of a non-trained limb after unilateral training of its opposite homologous limb. Another concept that sometimes is investigated when examining CT is “asymmetrical transfer” (AT), term that implies that the magnitude of transfer is not even for the two directions (i.e. from dominant to non-dominant limb and vice versa). While the existence of AT for strength or skills is already investigated, according to our knowledge previous research has not examined if laterality has an influence on the magnitude of CT of flexibility (CToF) in the lower limbs. The aim of the present study was to examine if a unilateral application of Foam Roller (FR) to the ankle plantar flexors of female exercisers would cause a CToF to their untrained limb and if leg dominance has an influence on the magnitude of CToF (i.e. if the CToF is greater from the dominant to the non-dominant limb or vice versa). According to the statistical analysis, the FR protocol used was effective in increasing the participants’ ipsilateral and contralateral ankle range of motion (ROM) independently of limb dominance, indicating that when referring to CToF through FR the transfer will probably occur symmetrically. This finding adds to the literature new data about CToF of the lower limbs in relation to laterality. If these results could be expanded by future researches and could be established that unilaterally injured persons benefit from CToF independently of limb dominance, that would be a major contribution to the field of rehabilitation.

The aim of the present study was to determine the time course changes in hand grip strength performance and hand position sense in novice climbers after one bout of two minutes continuing climbing on an artificial vertical wall. In addition, the rate of perceived fatigue of the participant felt right after the trial was recorded. Sixty five novice climbers aged 20 to 22 years (age 20.50 +/- 0.65 years), were randomly assigned into two training groups with different tests protocols, the Grip strength test group (n=23), versus Joint position sense test group (n=14), and two control groups (n=14 each). The training protocol included one bout of two minutes continuing climbing on an artificial wall for both training groups whereas the control groups did not receive any kind of training during the study. Subjects were pre and post-tested for the selected variables. Statistical analysis showed that the grip strength was significantly decreased only for the training group F(6,216) = 30.460, p<.0005, partial eta 2=.489. Similarly, the rate of perceived exertion changed significant F(2,563, 41,001) = 24.397, p<.0005, partial eta 2 = 0.604, with the training group to be more tired than the control after two minutes continuing climbing. Also, the wrist position sense of training group significantly deteriorated at post-test with F(3,78)=2,977, p<.05, partial eta 2 = .103. In conclusion, the performance of novice climbers is affected by hand grip strength performance and joint position sense of the hand. In addition it was required almost ten minutes of rest for partial recovery. These variables can be addressed through training design giving attention to those physical abilities.

Firefighters participate in activities with intense physical and psychological stress.To examine the correlation between work-related injuries (WRIs), burnout and post-traumatic stress disorder (PTSD) symptoms in firefighters.The method used for the recording of the elements was the collection of self-report anonymous questionnaires, the completion of which was optional. The questionnaires used were: (i) a WRIs questionnaire, (ii) the Maslach Burnout Inventory (MBI) and (iii) the Impact of Event Scale-Revised-Greek version. Descriptive statistics along with univariate and multivariate logistic regression analyses were applied.The study population consisted of 3289 firefighters. There was a significant association between WRIs, burnout syndrome, PTSD symptoms and age, work experience and physical condition. Relationships were found between PTSD symptoms, the MBI-emotional exhaustion dimension and WRIs and between MBI-depersonalization dimension and PTSD symptoms. The most traumatic event was the 'dealing with death or rescue of a child' and the top stress factor was 'depression about the responsibility for quality of victims' life'.The occupational obligations may be responsible for the psychological and musculoskeletal problems experienced by firefighters. Early recognition and response to psychosomatic issues in firefighters is of high importance.

ΣΥΜΒΟΥΛEΥΤΙΚΗ ΣΤΗΝ ΑΠΟΚΑΤΑΣΤΑΣΗ [ΔΗΜΟΚΡΙΤEΙΟ ΠΑΝEΠΙΣΤΗΜΙΟ ΘΡΑΚΗΣ, ΣΧΟΛΗ EΠΙΣΤΗΜΗΣ ΦΥΣΙΚΗΣ ΑΓΩΓΗΣ ΚΑΙ ΑΘΛΗΤΙΣΜΟΥ, ΤΜΗΜΑ EΠΙΣΤΗΜΗΣ ΦΥΣΙΚΗΣ ΑΓΩΓΗΣ ΚΑΙ ΑΘΛΗΤΙΣΜΟΥ]