Physical activity, sedentary behaviour, sleep quality, and anxiety are interrelated factors that play a critical role in physical and mental health. However, limited evidence exists on their associations within the Saudi Arabian context. This study aimed to investigate the relationships between physical activity, sedentary behaviour, sleep quality, and anxiety symptoms among healthy, pain-free adults in Saudi Arabia. A cross-sectional online survey was conducted between December 2024 and April 2025 using validated Arabic versions of the Global Physical Activity Questionnaire (GPAQ), the Brief Pittsburgh Sleep Quality Index (B-PSQI), and the Generalised Anxiety Disorder-7 (GAD-7). The data were analysed using descriptive statistics and multivariable linear regression models. A total of 185 participants (mean age = 33.99 ± 12.57 years; 69.73% female) were included. The average total physical activity was 1730.02 ± 2109.24 MET min/week, and the mean sedentary time was 6.77 ± 4.69 h/day. No significant associations were found between physical activity and either sleep quality or anxiety symptoms. Similarly, sedentary behaviour time was not significantly associated with sleep quality or anxiety symptoms. However, poorer sleep quality was significantly associated with higher anxiety levels. These findings highlight the importance of sleep quality in mental health strategies for healthy adults in Saudi Arabia.

Objective: the aim of this systematic review and meta-analysis was to evaluate the effectiveness of photobiomodulation therapy (PBM) on perineal pain and wound healing following episiotomy. Methods: Electronic databases were searched for randomized controlled trials (RCTs) and non-RCTs investigating PBM after episiotomy. Risk of bias was assessed using RoB 2 for RCTs and ROBINS-I for non-RCTs. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Meta-analyses were performed using random-effects models. Results: Eight studies were included in the systematic review, and six studies were included in the meta-analysis. According to RoB 2, one trial was judged at low risk of bias, two trials raised some concerns, and three trials were at high risk of bias. ROBINS-I showed the serious risk of bias of two non-RCTs. GRADE for both pain and wound-healing outcomes was rated as very low. Meta-analysis of pain showed no significant difference between PBM and control groups (SMD = 0.04; 95% CI −0.60 to 0.68; p = 0.89), with considerable heterogeneity (I² = 91%). For wound-healing outcomes, meta-analysis showed no significant difference (MD = 0.94; 95% CI −0.69 to 2.56; p = 0.26), with substantial heterogeneity (I² = 94%). Conclusions: PBM therapy did not demonstrate a significant benefit for reducing perineal pain or improving wound healing after episiotomy compared with control interventions. Interpretation of these findings should be made cautiously due to small study numbers, substantial heterogeneity, and the inability to perform sensitivity or subgroup analyses, highlighting the need for high-quality RCT with standardized PBM protocols before clinical recommendations can be made.

Knee osteoarthritis (KOA) is a prevalent condition that reduces physical function and quality of life. Physical activity is foundational to KOA management; however, patient engagement and perceptions of treatment remain underexplored, particularly in Middle Eastern populations. This study evaluated physical activity (PA) levels among individuals with KOA and explored their perceptions, awareness, and experiences with management strategies, especially physical therapy. A sequential explanatory mixed-methods design was employed. Quantitative data were collected using the International Physical Activity Questionnaire-Short Form (IPAQ-SF) from 60 adults with physician-diagnosed KOA (mean age 55.5 ± 6.4 years; 50% female) recruited from clinics and community programs in Saudi Arabia. Semi-structured interviews with 24 purposively selected participants further explored experiences and perceptions. Descriptive statistics summarized quantitative data, and thematic analysis guided qualitative interpretation. Ninety percent of participants recorded low PA levels (≤600 MET-min/week), with only 10% achieving moderate or high activity levels. Qualitative themes revealed multiple barriers including emotional distress, logistical difficulties, and misconceptions about KOA as well as facilitators such as family support and patient education. Integration of findings highlighted how contextual and psychosocial factors influence PA engagement. Adults with KOA in this study reported markedly low levels of PA, shaped by cultural, psychological, and environmental factors. Our findings highlight the importance of addressing these barriers through patient-centred education and improved access to physical therapy.

Background: Knee osteoarthritis is a prevalent condition, particularly among older adults, characterized by chronic pain, reduced mobility, and significant impacts on quality of life. While treatments such as physical therapy and surgery exist, patient perceptions and understanding of these options play a critical role in treatment decisions and outcomes. However, there is limited research exploring how patient insights and opinions shape their choices, particularly concerning physical therapy. This study aimed to explore the patient perspectives and experiences in physical therapy and treatment choices for knee osteoarthritis. Methods: Semi-structured interviews were conducted in Arabic with 33 participants diagnosed with knee osteoarthritis, comprising 18 males and 15 females, with a mean age of 53 years (SD = 5.67). The interviews were based on a pre-prepared schedule developed specifically for this study. Braun and Clarke’s thematic analysis was applied to identify themes capturing participants' experiences and perspectives on treatment options and challenges. Results: Participants reported that knee pain prompted them to seek treatment, with physical therapy being chosen more frequently than surgical interventions. Awareness of physical therapy's benefits varied; some felt well-informed and supported by healthcare providers, while others encountered misinformation and emotional resistance. Family and community support systems were helpful, but a lack of education on management options caused confusion and frustration. Conclusion: To optimize the treatment outcomes of knee osteoarthritis, it is essential to address patients' emotional, psychological, and educational needs. Coupled with the benefits of physical therapy, such as pain relief and improved mobility, this holistic approach can enhance treatment adherence and significantly improve patients’ quality of life. Healthcare providers should prioritize patient education, emotional support, and tailored interventions to ensure a comprehensive and patient-centered care experience.

Background/Objectives: Disability in chronic low back pain (CLBP) is multifactorial, yet the independent associations of pain, fear-avoidance beliefs, and comorbidity burden with self-reported disability and performance-based walking capacity remain unclear, particularly in Saudi Arabia. This study examined factors independently associated with functional disability and walking capacity in adults with CLBP and explored whether disability was independently associated with walking capacity after accounting for demographic and clinical factors. Methods: This cross-sectional study included 339 adults with CLBP. Functional disability was assessed using the Oswestry Disability Index (ODI), walking capacity using the 6-Minute Walk Test (6MWT), and fear-avoidance beliefs using the physical activity (FABQ-PA) and work (FABQ-Work) subscales of the Fear-Avoidance Beliefs Questionnaire. Comorbidity burden was quantified as an unweighted count of previously diagnosed chronic conditions reported by participants and BMI-defined obesity. Multiple linear regression was used to examine factors independently associated with disability and walking capacity. The disability model included age, sex, pain intensity, FABQ-PA, FABQ-Work, and comorbidity burden. Walking capacity was examined using two models: the first included the same factors, whereas the second exploratory model additionally included ODI to examine whether disability was independently associated with 6MWT distance. Results: Bivariate analyses showed that pain intensity was positively correlated with FABQ-PA and FABQ-Work (r = 0.303–0.355), while ODI was positively correlated with comorbidity burden (r = 0.170). The 6MWT was negatively correlated with pain intensity, FABQ-PA, and FABQ-Work (r = −0.162 to −0.170) and more strongly with ODI (r = −0.550). In the adjusted disability model, comorbidity burden was the only factor independently associated with ODI score, with each additional comorbid condition associated with a 2.30-point higher ODI score (B = 2.296, 95% CI 0.834 to 3.759, p = 0.002). In the first adjusted walking-capacity model, higher pain intensity was independently associated with shorter 6MWT distance (B = −5.108, 95% CI −10.05 to −0.17, p = 0.044), while the other factors were not significantly associated with walking capacity. In the second adjusted walking-capacity model, greater disability was independently associated with shorter 6MWT distance (B = −3.996, 95% CI −4.655 to −3.337, p < 0.001). None of the other factors remained significantly associated with walking capacity in this model. Conclusions: Greater comorbidity burden was independently associated with greater disability in adults with CLBP, while greater disability was strongly associated with poorer walking capacity, highlighting the relevance of comorbidity burden and disability to functional limitations in CLBP.