The healthcare providers caring for children with life-threatening illnesses experience considerable compassion fatigue. The purpose of this study was to describe the feelings and emotions of professionals working in an interdisciplinary pediatric palliative home care team. A qualitative case study was conducted, comprising 18 participants. A purposeful sampling technique approach was used including the home-based interdisciplinary pediatric palliative team. Data were collected via semi-structured interviews and researchers’ field notes. A thematic analysis was performed. Two themes emerged: (a) changing life for the better, which described how professionals value life more and helping children and families provides compassion satisfaction, which is comforting and explains their dedication to care; (b) adverse effects of work highlighted the emotional burden of caring for children with life-limiting or life-threatening illnesses, which can affect their job satisfaction and may lead to burnout, showing how experiencing in-hospital child deaths with suffering leads professionals to develop an interest in specializing in pediatric palliative care. Our study provides information on possible causes of emotional distress in professionals caring for children with life-threatening illnesses and highlights strategies that can help them to reduce their distress.

Background: Recent scientific interest has focused on exploring the potential relationships between fatigue, respiratory function and balance in multiple sclerosis (MS) subjects. While some studies suggest that fatigue may impact respiratory function and postural stability, the exact nature of these associations remains under investigation. Ultrasound imaging is increasingly being used to examine the structural and functional characteristics of core muscles, aiming to better understand how these variables might be interconnected. Understanding these associations is crucial for developing targeted interventions to enhance overall physical performance in this population. This study examines the relationship between fatigue, respiratory function, balance, and ultrasound variables of abdominal musculature in MS.Methods: A cross-sectional study was conducted involving 27 subjects diagnosed with MS, comprising 17 females and 10 males. Study variables were: fatigue (Modified Fatigue Impact Scale—MFIS); respiratory function (Forced Vital Capacity—FVC and Forced Expiratory Volume in the first second—FEV1); balance (Berg Balance Scale—BBS and Trunk Impairment Scale Dynamic—TIS DYN); and ultrasound measurements of abdominal and diaphragmatic musculature. Correlations were analyzed using Spearman’s correlation, with a statistical significance level of p < 0.05.Results: Significant correlations were found between respiratory function and balance scores. FVC showed a moderate correlation with BBS (r = 0.443), while FEV1 had a high correlation with BBS (r = 0.500) and a moderate correlation with TIS DYN (r = 0.427). MFIS showed a moderate negative correlation with BBS (r = −0.402). The strength and function of the central abdominal musculature, particularly the internal oblique, were crucial for trunk stability and postural control.Conclusion: These findings highlight the interplay between respiratory function, balance, fatigue, and abdominal muscle morphology in MS, emphasizing the potential benefits of interventions targeting respiratory function to improve balance and reduce fatigue, ultimately enhancing quality of life in this population.

To evaluate the efficacy of aquatic therapy in improving balance, gait speed, and fall risk in patients with stroke. MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PubMed, Scopus, Web of Science, and Physiotherapy Evidence Database were searched for studies published from 2013 to October 2024. Experimental studies comparing aquatic therapy with conventional rehabilitation, land-based interventions, or no intervention. The primary outcome was balance, assessed using the Berg Balance Scale. Secondary outcomes included gait speed and fall risk. Study design characteristics, number of participants, interventions characteristics, and outcomes were extracted. Twenty-seven interventional studies with 1134 participants (236 women and 225 men approximately) were included in the systematic review, among which 19 contributed to the meta-analysis. Ages ranged from 49.5 to 69.1 years. The time since injury varied from approximately 30 days to 5.4 years. Risk of bias of included studies was assessed using Cochrane Risk of Bias tool 2. Aquatic therapy significantly improved balance (Berg Balance Scale: MD, −5.10; 95% CI, −8.85 to −1.36; P=.008), gait speed (MD, −5.10; 95% CI, −8.85 to −1.36; P=.008), and reduced fall risk (MD, −4.38; 95% CI, −7.17 to −1.59; P=.002). Subgroup analyses based on session frequency (>20 sessions vs 10-20 sessions) showed similar effects. This meta-analysis suggests that aquatic therapy may be effective in enhancing balance and gait speed and in reducing fall risk among individuals with stroke; however, these findings should be interpreted with caution because of the high heterogeneity observed across studies.

Objective: The purpose of the study is to determine the effectiveness of transcranial direct current stimulation (tDCS) combined with aerobic exercise in the short, medium, and long term. Methods: Two-arms triple-blind randomized controlled trial. Thirty-eight subjects with a diagnosis of nonspecific chronic low back pain. Experimental group will receive real-tDCS and aerobic exercise and control group will be treated with sham tDCS and aerobic exercise. Pain intensity, pressure pain, disability, kinesiophobia, quality of life, catastrophism, heart rate variability, and critical flicker fusion frequency will be measured before and after each session and at 3- and 6-month follow-up. Discussion and Conclusion: This study introduces the novel measurement of heart rate variability and cortical arousal to explore their potential in understanding the effects of tDCS on pain modulation. Trial Registration: ClinicalTrials.gov ID NCT05830851. Date of registration: April 14, 2023.

Recent studies on neurodynamics have shown beneficial effects on the musculoskeletal system and peripheral nerve physiology. Hence, the application of neurodynamics in people who have suffered an acquired brain injury has the potential to improve their functionality to perform daily activities. This study aimed to assess the immediate effects of a single session of median nerve neurodynamics versus a placebo intervention on the affected upper limb (UL) in patients with acquired brain injury (ABI). A single-blind randomised clinical trial was conducted with 24 participants, divided into an experimental group (n = 12) and a control group (n = 12. Outcomes measures included grip strength (dynamometer), spasticity (Modified Ashworth Scale), pain (algometer and Visual Analogue Scale), range of motion (goniometer), and surface electromyography. Statistically significant improvements were observed in the experimental group in terms of reduced spasticity in the triceps and carpal flexors, and increased wrist flexion and extension range of motion. Additionally, modulation of muscle activity was detected in the triceps, biceps, and wrist flexors and extensors. In contrast, changes in grip strength and pain perception were not statistically significant. Although a downward trend in grip strength was noted in both groups, this observation should be interpreted cautiously and does not imply a therapeutic benefit without further functional corroboration. These findings suggest that neurodynamics may produce short-term neuromuscular effects in ABI patients, particularly in muscle tone and joint mobility. However, further research is needed to determine the clinical relevance and sustainability of these effects. Clinical trial registration number: Clinicaltrials.gov (NCT04652934). Date of first trial registration 03/12/2020.

Background/Objectives: To analyze the parent-perceived quality of life (QoL) in children with cerebral palsy (CP) and to study the relationship between sociodemographic and clinical factors and this perception, under the perspective of the International Classification of Functioning, Disability and Health (ICF). Methods: A cross-sectional study was conducted with 95 participants (ages 5–19 years) with CP. Participants’ parents were asked about sociodemographic and clinical characteristics and compiled Cerebral Palsy Quality of Life (CP-QoL) and Pediatric Disability Inventory-Computer Adaptive Test (PEDI-CAT). Participants were assessed and classified into the following functional domains: gross motor function (GMFM-88, GMFCS), manual ability (MACS), eating and drinking abilities (EDACS), and communication function (CFCS). Correlations between CP-QoL domains and variables were investigated using Spearman’s correlation coefficient and multivariate predictive models were used to investigate the variables predicting CP-QoL scores for each domain. Results: A total of 95 children with a mean age of 12.4 ± 3.5 years (range 5–19 years) were included. Participants demonstrated moderate-high GMFM-88 level (228.8 ± 44.7) and high functional performance across PEDI-CAT domains: Activity (57.2 ± 5.1), Mobility (63.1 ± 5.6), and Social/Cognitive (70.2 ± 4.3). Parent-perceived QoL was significantly higher when children did not require AFOs, botulinum toxin, or recent hospitalizations, and lower among children who attended physical therapy >2 h/week. Moderate correlations were consistently found between the ‘Feelings about Functioning’ domain and functional variables, being positive for GMFM-88 and all PEDI-CAT domains, and negative for GMFCS, MACS, EDACS and CFCS. That domain of CP-QoL was best explained by the regression model (R² = 0.619, p < 0.001), with the combination of three variables: GMFM-88, PEDI-CAT Activity and PEDI-CAT Social/Cognitive. Among them, PEDI-CAT Activity was the strongest predictor (β = 0.1436). Conclusions: In children with CP, to enhance family well-being, interventions should prioritize social participation and carefully balance the intensity and frequency of therapy against family burden and daily life demands, as QoL is primarily driven by manual ability and functional performance.