Pathological processes associated with ageing increase the risk of cognitive deficits and dementia. Frailty syndrome, also known as weakness or reserve depletion syndrome, may significantly accelerate these pathological processes in the elderly population. Frailty syndrome is characterized by...

This narrative review explores the multifaceted role of lactate in heart failure (HF), focusing on its diagnostic and prognostic significance in both acute and chronic HF. Lactate functions not only as a marker of hypoperfusion and anaerobic metabolism but also as an active metabolic substrate. In acute HF, elevated lactate levels often signal circulatory insufficiency and predict adverse outcomes. In chronic HF, especially HFpEF, lactate dynamics during exercise reflect metabolic inefficiency and correlate with functional impairment. This review emphasizes the dual nature of lactate and discusses its potential utility in risk stratification and therapeutic guidance.

Individual mobility deficit in older adults induces a variety of medical conditions, diminishing their functional capacity in pursuing activities of daily living. In immobility syndrome patients, such conditions are prone further deterioration through a drastically reduced scope of physical activity, owing mostly to poor self-motivation and the monotonous character of conventional rehabilitation regimens. As evidenced by published research, virtual reality technology solutions in rehabilitation management actually add significantly to patients’ self-motivation, while promoting their active involvement in therapy through visual, auditory, and kinaesthetic stimuli. Effective rehabilitation training aided by virtual reality solutions helps patients acquire specific physical and cognitive skills to be subsequently emulated in the real-world environment. The extra added advantage lies in facilitating such training within patients’ own home environments, combined with online monitoring of their progress, when not personally supervised by a physiotherapist, which also boosts the overall cost effectiveness of the therapeutic management itself. This narrative review appears to be the very first one principally focused on critically comparing individual immobilisation with immobility syndrome, especially through the application of the Authors’ own substantial hands-on therapeutic experience in managing various rehabilitation schemes, specifically aided by diverse virtual reality technology solutions.

Arterial hypertension is one of the world’s leading risk factors for death and disability. With the number of people living with this disease doubling between 1990 and 2019 from 650 million to 1.3 billion, it is a global burden that increases mortality from cardiovascular and kidney diseases. It is extremely important to use all possible diagnostic methods, indicating the possibility of early detection that subsequently leads to effective prevention of disease development. The phenomenon called hypertensive response to exercise (HRE) is one such method. The HRE is defined as a pathological, excessive increase in blood pressure as a result of exposure to the stressor, which is physical exercise. There is no consensus about precise cutoffs in the definition of this condition, which is most commonly diagnosed based on systolic blood pressure (SBP) ≥ 210 mm Hg in men and ≥190 mm Hg in women at peak exercise intensity. The fact that exercise hypotension is a pathologic sign is universally accepted. Accumulating data deliver the information that HRE is also connected to higher overall cardiovascular risk. It was demonstrated that HRE is associated with functional and structural impairment of the left ventricle and the future development of hypertension. HRE should act as a warning signal of increased cardiovascular risk, leading to the need for profound clinical care.

Background: Total Hip Replacement (THR) is a standard treatment for advanced hip osteoarthritis; yet, its effects on gait recovery remain understudied. This study examines gait pattern changes in women undergoing monitored rehabilitation after unilateral THR, using Statistical Parametric Mapping (SPM) to detect significant motion differences over time. Methods: This longitudinal study included 32 women who underwent primary cementless THR. Gait was assessed preoperatively and postoperatively at 6 weeks, 3 months, 6 months, and 12 months using a motion analysis system. Repeated measures ANOVA and post hoc SPM{t} analyses were conducted to evaluate significant gait changes across time points. Results: Significant improvements (p < 0.05) were observed in spatio-temporal parameters. Velocity increased from 0.42 ± 0.10 m/s (Ex1) to 0.72 ± 0.06 m/s (Ex5), stride length from 0.85 ± 0.12 m to 1.15 ± 0.07 m, and step length (involved leg) from 0.32 ± 0.08 m to 0.48 ± 0.05 m. Cycle time decreased from 1.50 ± 0.20 s to 1.22 ± 0.10 s, indicating improved gait efficiency. Post hoc SPM{t} analysis revealed significant kinematic changes in hip flexion-extension, knee flexion, and pelvic tilt, particularly between Ex2 and Ex3. Statistically significant improvements (p < 0.001) were observed in key spatio-temporal parameters. Conclusions: Gait parameters improved significantly within the first year post-THR, with the most pronounced changes occurring between the early and mid-term recovery phases. These findings support the need for targeted rehabilitation strategies in the first six months post-surgery. SPM analysis provides a robust method for detecting subtle gait adaptations, contributing to the refinement of post-THR rehabilitation strategies.

Background: It was hypothesized that the time-appropriate return to a resting heart rate (HR) after cessation of exercise could be a marker for predicting outcomes in patients with heart failure (HF). We aimed to evaluate the prognostic value of HR recovery in functional improvement among adults with severe aortic stenosis undergoing percutaneous aortic valve implantation (TAVI). Methods: We performed a 6 min walk test (6MWT) in 93 individuals before TAVI and 3 months after the procedure. The change in walking distance was calculated. During the pre-TAVI 6MWT, we analyzed the differences between baseline HR, HR at the end of the test, and HR at the 1st, 2nd, and 3rd minute of recovery. Results: After 3 months, 6MWT distances improved by 39 ± 63 m and reached a total of 322 ± 117 m. Multiple linear regression proved the differences between HR after 2 min of recovery and baseline HR in pre-TAVI after a 6MWT was the only significant predictor of waking distance improvement during follow-up. Conclusions: Our study suggests that analysis of HR recovery after a 6MWT may be a helpful and easy parameter to assess improvements in exercise capacity after TAVI. This simple method can help to identify patients in whom no significant benefit in functional improvement can be expected despite successful valve implantation.