Background: Occupational therapy (OT) interventions on activities of daily living (ADL), cognitive functions, and physical function in middle-aged and older people with chronic stroke. Methods: A systematic review search until November 2024 using five generic databases: PubMed/Medline, Web of Science, Scopus, ScienceDirect, and OT seeker. The PRISMA checklist, RoB 2 (Cochrane, London, UK), and GRADEpro (Evidence Prime Inc., Hamilton, CA) tools assessed the evidence’s methodological quality and certainty. The protocol was registered in PROSPERO (code: CRD42024568225). Results: Of 1733 records were identified across the databases, nine studies were analyzed using the PICOS format. The meta-analysis revealed significant improvements in independent performance of activities of daily living (ADL), as measured by the Canadian Occupational Performance Measure (COPM), in favor of the experimental groups (p = 0.03). No significant differences were found for the other variables analyzed. Conclusions: Performance on ADLs improved significantly according to the COPM, whereas no significant improvements in cognitive or physical function were observed among middle-aged and older chronic stroke survivors. Individual studies highlight the potential benefits of OT interventions that combine cognitive, motor, and technological approaches, such as virtual reality and brain stimulation.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Frail older adults face significant barriers to physical activity, and innovative solutions like synchronous telerehabilitation may provide a viable alternative to traditional face-to-face programs. However, less is known about its effectiveness compared to a face-to-face program. Objective: To compare the effectiveness of a synchronous telerehabilitation program versus a face-to-face physical therapy program in the primary outcome (lower body strength, cardiorespiratory fitness) and secondary outcomes (upper limb strength, dynamic balance, static balance, number of steps, functional status and quality of life) in frail older adults Methods: In a randomized, blinded, parallel-group controlled trial, all frail older adults aged 60 years or older of both sexes from the Los Angeles Comprehensive Center for the Older Adults (CIAM, in Spanish) will be invited to participate. A total of 58 frail older adults (aged ≥60 years) meeting eligibility criteria will be randomly assigned to either a synchronous telerehabilitation group (n=29) or a face-to-face physical therapy group (n=29). Participants will engage in 1-hour multicomponent exercise sessions twice weekly for 12 weeks. The tele-rehabilitation group will participate via videoconferencing, supervised remotely by technical staff, while the face-to-face group will attend in-person sessions. Outcomes will include lower limb strength (sit-to-stand test), cardiorespiratory fitness (2-minute step test), upper limb strength (grip strength test), balance (timed get-up-and-go, single-leg stance), quality of life (36-item brief health survey), functional status (functional independence measure), and daily steps (pedometer). Results: We hypothesize that synchronous telerehabilitation will yield equal or superior improvements in both primary and secondary outcomes compared to face-to-face physical therapy in frail older adults. Conclusions: Synchronous telerehabilitation is emerging as a viable and effective alternative to in-person physical therapy for older adults with frailty. This approach has the potential to improve physical condition and functional and quality of life indicators, overcoming geographical and logistical barriers and optimizing therapeutic resources. Clinical Trial: ClinicalTrial.gov ID NCT06784245.

Objective: To analyze the effects of movement representation techniques (MRT) combined with conventional physical therapy (CFT) in people undergoing knee and hip arthroplasty compared to conventional physical therapy alone in terms of results in physical and functionality variables, cognitive function, and quality of life. Methodology: the review was carried out according to the criteria of the PRISMA statement, considering studies in the electronic databases PubMed/Medline, Pubmed Central/Medline, Web of Science, EBSCO, and ScienceDirect. Results: MRT plus CFT generated therapeutic effects in some aspects of the physical variables: 100% pain (7 of 7 studies); 100% strength (5 out of 5 studies); range of motion 87.5% (7 out of 8 studies); 100% speed (1 of 1 study), functional variables: 100% gait (7 of 7 studies); functional capacity 87.5% (7 out of 8 studies); cognitive variables: 100% motor visualization ability (2 out of 2 studies); cognitive performance 100% (2 of 2 studies); and quality of life 66.6% (2 of 3 studies). When comparing its effects with conventional physical therapy, the variables that reported the greatest statistically significant changes were motor visualization ability, speed, pain, strength and gait. The most used MRT was motor imagery (MI), and the average time extension of therapies was 3.5 weeks. Conclusions: movement representation techniques combined with conventional physical therapy are an innocuous and low-cost therapeutic intervention with therapeutic effects in patients with knee arthroplasty (KA) and hip arthroplasty (HA), and this combination generates greater therapeutic effects in physical, functional, and cognitive variables than conventional physical therapy alone.

Introducción: La prevalencia del autismo se ha incrementado significativamente. También, se ha evidenciado que las artes marciales son una intervención efectiva en el control de la sintomatología de niños, niñas y adolescentes con TEA. Sin embargo, no existen revisiones enfocadas en sintetizar esta evidencia. Objetivo: Sintetizar la información existente sobre las características de los programas de artes marciales y sus efectos sobre rasgos autistas en niños y adolescentes. Metodología: Revisión sistemática que se adscribe a la declaración Prisma 2020. La búsqueda de información se realizó en las bases de datos Scielo, PubMed, Pedro, Cochrane Library, ProQuest, Springer Link, Web of Science y ScienceDirect. Se seleccionaron Ensayos clínicos aleatorizados y no aleatorizados. Resultados: Las artes marciales como intervención terapéutica tuvieron efectos beneficiosos estadísticamente significativos en conductas estereotipadas 100% (5 de 5 estudios), interacción social 100% (3 de 3 estudios), manejo de las emociones 100% (3 de 3 estudios), regulación de la conducta 75% (3 de 4 estudios), problemas conductuales 75% (3 de 4 estudios) y dificultad para comunicarse 75% (3 de 4 estudios). El arte marcial más utilizado como programa de intervención fue el karate. Conclusión: Las áreas más evaluadas en los rasgos autistas son las conductas estereotipadas, problemas conductuales, interacción social y dificultad de la comunicación. Finalmente se observó que los programas de artes marciales tuvieron efectos favorables en rasgos autistas en áreas de habilidades conductuales, habilidades sociales y habilidades comunicativas. Palabras clave: Autismo; Artes Marciales; Deportes de combate; Karate. Introduction: Over the years, there has been an increase in the prevalence of Autism. It has been shown that martial arts are an effective intervention in controlling the symptoms of children and adolescents. However, there needs to be reviews that focus on synthesizing this evidence. Objective: Synthesize the current information on the effects and characteristics of carrying out martial arts programs and their effects on autistic traits in children and adolescents. Methodology: Systematic review that adheres to the Prisma 2020 declaration. The search was carried out in the Scielo, PubMed, Pedro, Cochrane Library, ProQuest, Springer Link, Web of Science, and ScienceDirect databases, and randomized and non-randomized clinical trials were selected. Results: Martial arts as a therapeutic intervention had statistically significant beneficial effects on stereotyped behavior 100% (5 of 5 studies), social interaction 100% (3 of 3 studies), emotion management 100% (3 of 3 studies), regulation of behavior 75% (3 of 4 studies), behavioral problems 75% (3 of 4 studies) and difficulty communicating 75% (3 of 4 studies). The most widely used martial art as a therapeutic intervention program was karate. Conclusion: The most evaluated areas in autistic treats are stereotyped behaviors, behavioral problems, social interaction, and communication difficulties. Finally, it was observed that the martial arts programs had favorable effects on ASD symptoms in behavioral, social, and communication skills. Key words: Autism; Martial Arts; Combat Sports, Karate.

Introduction Antioxidants have emerged as potentially beneficial options. Present in both foods and supplements, these molecules can neutralize free radicals and modulate inflammatory processes, both of which are implicated in the pathophysiology of osteoarthritis. Although the results of antioxidants have been promising, the current evidence remains heterogeneous and sometimes inconsistent. Therefore, it is necessary to integrate and critically analyze the available data. Objective This systematic review protocol with meta-analysis aims to describe the methodology necessary to analyze the effects of antioxidant intervention compared with usual medical care on pain, physical function, and quality of life in people with osteoarthritis. Methods In conducting this literature synthesis, a comprehensive search will be executed across the Medline databases via PubMed, Scopus, Web of Sciences, ScienceDirect, and EBSCO to identify randomized clinical trials that satisfy the predetermined eligibility criteria. Primary outcomes, including pain, physical function, and quality of life, and secondary outcomes, such as clinical modifications, will be analyzed. The quality of the selected studies will be evaluated using the ROB-2 risk of bias tool, and the certainty of the evidence will be assessed through the GRADE method. A meta-analysis will be conducted using either a fixed- or random-effects model, depending on the degree of heterogeneity. Heterogeneity will be assessed using the I 2 statistic. If the outcome assessment method is homogeneous, the mean difference (MD) with a 95% confidence interval will be utilized; otherwise, the standardized mean difference (SMD) will be employed to calculate the effect size. Discussion Osteoarthritis imposes a substantial clinical and socioeconomic burden, and antioxidants are increasingly recognized as potential adjuvants owing to their safety and anti-inflammatory properties. The findings of this systematic review and meta-analysis based on this protocol will aid in determining the extent of the impact of antioxidant consumption in pertinent clinical practice. PROSPERO registration: CRD420251035393