Introduction: Chronic neck pain is a prevalent condition that challenges physical therapists (PTs) due to its multifactorial etiology. Differential diagnosis is crucial for identifying the underlying causes and providing appropriate interventions. However, the extent to which PTs apply and understand differential diagnostic criteria remains unclear. This study aimed to evaluate the knowledge, attitudes, and behaviors of PTs in France regarding the differential diagnosis of chronic neck pain. Materials and Methods: An online questionnaire was designed to assess PTs’ beliefs, attitudes, knowledge, and clinical application of differential diagnostic criteria in chronic neck pain. The survey was distributed nationwide and included questions regarding demographic data, theoretical knowledge, practical application, and perceived barriers. A total of 80 responses were collected and analyzed using descriptive and inferential statistics. Results: The results revealed moderate levels of theoretical knowledge among participants, with 62% correctly identifying key criteria for differential diagnosis. However, only 45% reported consistently applying these criteria in clinical practice. Common barriers included time constraints (70%), lack of access to advanced diagnostic tools (55%), and insufficient training (40%). Attitudes towards the importance of differential diagnosis were predominantly positive, with 85% recognizing its relevance for improving patient outcomes. Conclusions: This study highlights a gap between PTs’ knowledge and the practical application of differential diagnosis criteria in chronic neck pain. Addressing barriers such as training and resource availability could enhance clinical practices. Future efforts should focus on integrating these competencies into professional development programs to improve diagnostic accuracy and patient care.

Background/Objectives: Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD) is a frequent complication of chronic kidney disease, characterized by altered bone mineral density and mineral–hormonal metabolism. Therapeutic exercise may help attenuate these alterations, but evidence remains limited. This systematic review and meta-analysis evaluated the effects of therapeutic exercise on bone mineral density and mineral–bone and hormonal biomarkers in adults with CKD, focusing on CKD-MBD-related outcomes. Methods: Following a PROSPERO-registered protocol (CRD420251245021), Scopus, PubMed, Cochrane Central Register of Controlled Trials CENTRAL, and Web of Science were searched from inception to January 2026. Randomized controlled trials, including pilot randomized controlled trials, comparing therapeutic exercise with usual care or non-exercise control conditions in adults with CKD were included. Methodological quality and risk of bias were assessed with the PEDro scale and RoB 2, respectively. Results: Six studies involving 398 participants were included. Most interventions lasted 22 to 24 weeks and used resistance or combined aerobic and resistance exercise across inpatient and outpatient settings. Qualitative synthesis suggested improvements in femoral neck and lumbar spine bone mineral density and favorable biomarker changes. The assessed outcomes included femoral neck and lumbar spine BMD, calcium, phosphorus, sclerostin, PTH, FGF23, and klotho. Meta-analysis showed significant effects favoring therapeutic exercise for bone mineral density (MD = 0.05; 95% CI: 0.03 to 0.06; p < 0.00001; I² = 39%), mineral and bone-related biomarkers (SMD = 0.71; 95% CI: 0.42 to 0.99; p < 0.00001; I² = 75%), and hormonal biomarkers (SMD = 1.32; 95% CI: 0.88 to 1.77; p < 0.00001; I² = 85%). Conclusions: Therapeutic exercise may have beneficial effects on bone mineral density and selected mineral and hormonal biomarkers in adults with CKD. However, confidence in these findings is limited by the small number of studies, differences in CKD stage and exercise protocols, methodological limitations, risk of bias, and substantial heterogeneity in several pooled analyses. No definitive conclusions can currently be drawn regarding the optimal exercise modality, dose, or effects across CKD stages.

Background/Objectives: Heart rate variability (HRV) is widely used to monitor autonomic responses to training and match load in professional soccer, but the evidence is heterogeneous and its added value remains debated. This systematic review aimed to synthesize and critically appraise prospective longitudinal observational studies on HRV monitoring in male professional and semi-professional soccer players. Methods: The review followed PRISMA 2020 and was registered in PROSPERO (CRD420261533316). PubMed, Scopus and Web of Science were searched from inception to September 2026. Two reviewers independently selected studies and extracted data; methodological quality was assessed with the Newcastle–Ottawa Scale (NOS). Owing to heterogeneity, a narrative synthesis was conducted. Results: After duplicate removal, 489 records were screened and eight studies (109 players; mean ages 18.7–26.6 years) were included: six during the competitive season and two during pre-season. NOS scores ranged from 6 to 8 out of 9, with confounder control as the main weakness. Time-domain vagal indices predominated (RMSSD in three studies, Ln-RMSSD in three). Reductions in RMSSD/Ln-RMSSD were associated with accumulated fatigue and high training loads, whereas increases in RMSSD and SD1 accompanied fitness gains during pre-season. RMSSD also related to match performance. One study linked an elevated LF/HF ratio to fatigue and muscle injury, although respiratory control was rarely reported. Conclusions: Short-term morning RMSSD/Ln-RMSSD, interpreted against individual baselines, appears the most consistent HRV marker, whereas spectral indices require cautious interpretation. Heterogeneity, small samples and limited confounder control prevent firm conclusions. Standardized protocols and multidimensional monitoring frameworks are needed.

Background: Chronic pain remains a primary driver of global disability and impaired quality of life. While digital conversational agents (CAs) have emerged as scalable tools for symptom monitoring and self-management via patient-reported outcome measures, their clinical efficacy remains poorly synthesized. This systematic review and meta-analysis aimed to evaluate the impact of CA-based interventions on PROMs in adults with chronic pain. Methods: A systematic review and meta-analysis was conducted following PRISMA 2020 guidelines. PubMed, Scopus, and Web of Science were searched from inception to 22 October 2025. Eligible studies were RCTs including adults with chronic pain and evaluating fully automated CA interventions, such as digital coaching or messaging programs. PROMs related to pain, well-being, disability, and work-related outcomes were extracted. Continuous outcomes were synthesized using standardized mean differences (SMDs) with 95% confidence intervals (CIs). Results: Five RCTs involving 572 participants were included. Interventions were self-guided, digitally delivered, and lasted 4 to 12 weeks. The overall pooled analysis suggested a potential benefit of CA-based interventions on PROMs (SMD = −0.43; 95% CI −0.55 to −0.31; p < 0.00001), although heterogeneity and risk of bias across studies warrant cautious interpretation. Improvements were observed particularly in pain intensity, although evidence for other outcomes was less consistent, with some studies reporting benefits in quality of life, fear of movement, and well-being. Conclusions: CA-based interventions may have potential as adjuncts in chronic pain management; however, the current evidence is limited and should be interpreted with caution due to heterogeneity and risk of bias across studies. These tools may represent a scalable solution for supporting remote symptom monitoring and self-management within digital health frameworks, although further high-quality evidence is required.