Background: Flexible pediatric flatfoot is an anatomical presentation of the foot that is common in children, and its functional impact raises long-term uncertainty. Functional re-education includes strengthening and stretching exercises for the intrinsic and extrinsic musculature of the foot, proposed as an effective conservative treatment. However, to date, there is no systematic review examining its effectiveness in the pediatric population. This systematic review aims to evaluate the effectiveness of functional re-education as a conservative treatment for flexible pediatric flatfoot, determining which exercises are most effective. Methods: A search (PROSPERO: CRD42023391030) was conducted across six databases, resulting in an initial total of 327 studies. Of these, 11 randomized controlled trials (RCTs) met the inclusion criteria, resulting in a sample of 419 children aged 6 to 14 years with a diagnosis of flexible flatfoot. The evaluated studies present variations in diagnostic criteria, types of exercises, and treatment duration. Results: The results indicate that functional re-education is effective in improving the symptomatology and functionality of the foot in children. In particular, exercises targeting the intrinsic musculature proved to be among the most effective treatments, improving the structural development of the medial longitudinal arch. The reviewed literature recommends a minimum treatment duration of eight weeks. Conclusions: Functional re-education represents an effective conservative treatment option for flexible flatfoot in children, positioning it as the treatment of choice for this condition.

Background/Objectives: This study aimed to analyze the relationship between emotional functioning and health status in long-term breast cancer survivors (LTBCSs). Additionally, it sought to identify factors that could influence emotional functioning in this population at least five years after cancer diagnosis. Methods: This cross-sectional observational study included 80 LTBCSs, classified into the following two groups, according to their emotional functioning: those experiencing psychological distress (≤90) and those with satisfactory psychological well-being (≥91). The study examined various factors at least five years post-diagnosis, including sociodemographic and clinical characteristics, health-related quality of life (HRQoL), mood state, self-perceived physical fitness, physical activity (PA) level, pain, and cancer-related fatigue (CRF). ANOVA, Mann–Whitney U, and Chi-square tests were conducted, along with correlation and multiple regression analysis. Effect sizes were calculated using Cohen’s d. Results: Among the 80 LTBCSs, 47.50% reported psychological distress, while 52.50% maintained satisfactory psychological well-being. Participants in the psychological distress group exhibited significantly poorer HRQoL, lower mood, and reduced self-perceived physical fitness, as well as higher levels of physical inactivity, pain, and CRF (p < 0.05). Regression analysis revealed that “role functioning” (β = 0.59; p < 0.01), “cognitive functioning” (β = 0.26; p < 0.01), “self-perceived physical fitness” (β = 0.20; p = 0.02), and “sadness–depression” (β = 0.18; p = 0.04) were significant predictors of emotional functioning (r² adjusted = 0.642). Conclusions: These results emphasize the association between emotional functioning and health status in LTBCSs. Role functioning, cognitive functioning, self-perceived physical fitness, and mood state were identified as relevant factors influencing emotional well-being in this population. Considering these relationships, integrating psychological and physical assessments into survivorship care could support the early detection of at-risk individuals. This approach could also guide interventions to improve their long-term well-being and HRQoL.

Purpose: This study investigated the relationship between different pain levels in the affected arm and health status in long-term breast cancer survivors (LTBCSs) and identified predictors of pain at this stage of long-term survivorship. Methods: A cross-sectional study of 80 participants categorized LTBCSs by pain levels in the affected arm into three groups: no pain (0–0.99), mild pain (1–3.99), and moderate to severe pain (4–10). Variables assessed at least 5 years since diagnosis include pain in the non-affected arm, pain interference, cancer-related fatigue (CRF), physical activity (PA) level, fitness condition, mood state, and health-related quality of life (HRQoL). Results: A total of 36.25% of LTBCSs have no pain, 30% have mild pain, and 33.75% have moderate to severe pain. Furthermore, pain presence was associated with increased pain in the non-affected arm, pain interference, CRF, mood disturbances, and physical inactivity, as well as a decreased HRQoL (all p < 0.05). Regression analysis found “upset by hair loss”, CRF “affective domain”, “dyspnea”, and “alcohol consumption” as significant predictors of higher levels of pain in the affected arm (r² adjusted = 0.646). Conclusions: A total of 63.75% of LTBCSs continue to experience mild to moderate to severe pain in the affected arm, negatively impacting their physical, mental, and emotional health status, with increased pain severity ≥5 years beyond cancer diagnosis. “Upset by hair loss”, CRF “affective domain”, “dyspnea”, and alcohol consumption collectively explain 64.6% of the affected-arm pain level in LTBCSs.

The first objective of this study is to examine the relationship between different levels of physical activity (PA) and the health status of long-term breast cancer survivors (LTBCSs) who have survived ≥5 years beyond diagnosis. The second aim is to identify potential predictors of long-term PA levels in this population. An 80-participant cross-sectional study categorized LTBCSs by PA levels: insufficiently active (very low ≤3 metabolic equivalent task (MET), low 3.1-7.4 MET) and sufficiently active (≥7.5 MET). Variables assessed included PA, pain, self-perceived physical fitness, cancer-related fatigue (CRF), comorbidities, mood, and health-related quality of life (HRQoL). ANOVA, Mann-Whitney U, and Chi-square tests were performed, along with Spearman's correlation and multiple regression analysis. Cohen's d and Cramér's V were used to calculate effect sizes. 66.25% of LTBCSs were insufficiently active, with 17.25% classified as sedentary (≤1.5 MET). In the first objective, and compared to sufficiently active survivors, insufficiently active LTBCSs reported higher levels of pain, breast symptoms, dyspnea, moderate-to-severe CRF, sadness/depression, and anger, along with lower levels of happiness, general fitness, speed/agility, role functioning, and HRQoL (p < 0.05). In the second objective, the regression analysis found "future perspective" (β = 0.314; p < 0.01) and "insomnia" (β = -0.288; p = 0.02) to be significant predictors of higher PA levels (r² = 0.224). Insufficiently active LTBCSs had higher pain, symptoms, CRF, and mood disturbances, with decreased happiness, self-perceived physical fitness, and HRQoL. Future research should focus on interventions that target improving PA levels and managing factors such as "future perspective" and "insomnia," as they are significant predictors of PA adherence. These findings underscore the importance of incorporating PA into rehabilitation programs to enhance overall well-being and HRQoL in LTBCSs.

Purpose: To explore the association between anxiety levels and health outcomes in long-term breast cancer survivors (LTBCSs) and to identify predictors of anxiety in this population. Methods: A multicenter cross-sectional study was conducted with 80 LTBCSs, categorized into two groups based on their anxiety levels: low anxiety (≤3.4) and high anxiety (≥3.5). The analysis focused on variables assessed at least five years after diagnosis, including sociodemographic and clinical data, mood, cancer-related fatigue (CRF), pain, self-perceived physical fitness, physical activity (PA), and health-related quality of life (HRQoL). ANOVA, Mann–Whitney U, and chi-square tests were conducted, along with correlation and multiple regression analysis. Effect sizes were calculated using Cohen’s d. Results: Among the participants, 46.25% exhibited higher anxiety levels. This group showed significantly worse mood, self-perceived physical fitness, and HRQoL and elevated CRF and pain (p < 0.05). Regression analysis identified “total CRF” (β = 0.51; p < 0.01) and “cognitive functioning” (β = −0.24; p = 0.02) as significant predictors of higher levels of anxiety (r² adjusted = 0.470). Conclusions: Anxiety significantly impacts multiple dimensions of health in LTBCSs. Total CRF and cognitive functioning are key predictors of anxiety. These findings have direct clinical implications: routine psychological and physical assessments should be integrated into survivorship care to identify individuals at risk and inform targeted interventions to enhance long-term well-being and HRQoL.