Postural instability and dizziness are commonly observed in people with multiple sclerosis (PwMS). The aim of this systematic review was to evaluate the evidence for the use of vestibular rehabilitation, in comparison with other exercise interventions or no intervention, to treat balance impairments and dizziness in PwMS. An electronic search was conducted by two independent reviewers in the following databases: MEDLINE (Pubmed), Scopus, the Physiotherapy Evidence Database (PEDro), Web of Science (WOS), Lilacs, CINHAL and the Cochrane Database of Systematic Reviews (CDSR). A quality assessment was performed using the PEDro scale and the Cochrane Risk of Bias Tool. When possible, the data were pooled in a meta-analysis (95%CI). This systematic review followed the PRISMA guideline statement and was registered in the PROSPERO database (CRD42019134230). Seven studies were included, with a total of 321 participants analysed. Compared with no intervention, vestibular rehabilitation was more effective for balance development (SMD = 2.12; 95% CI = 0.49, 3.75; p = 0.01; I² = 89%) and dizziness symptoms improvement (SMD = −17.43; 95% CI = −29.99, −4.87; p= 0.007; I²= 66%). Compared with other exercise interventions, improvements in favour of the experimental group were observed, but statistical significance for the differences between groups was not reached.

The objective of this study was to characterize the changes of muscle tone, stiffness, and thickness of upper and lower limb muscles in stroke survivors. Forty patients with subacute or chronic stroke and 31 controls were included and measured using myotonometry (MyotonPRO), with multiple site assessments at muscle belly (MB) and musculotendinous (MT) locations of the biceps brachii and gastrocnemius muscles. Muscle thickness (ultrasonography) was obtained for each muscle. Upper and lower limb motor performance was evaluated with the Fugl–Meyer Assessment for Upper Extremity and the Functional Ambulance Category. Overall, muscle tone and stiffness were significantly higher at MT than at MB sites. Among stroke patients, differences between the paretic and nonparetic limb were found for the biceps brachii, with lower muscle tone, stiffness, and thickness of the paretic side (all, p < 0.05). There were weak to moderate correlations between mechanical (myotonometry) and structural (ultrasound) muscular changes, regardless of the post-stroke stage. This suggests that myotonometry and ultrasonography assess similar, although different, constructs and can be combined in the clinical setting. Their discriminative ability between the paretic and nonparetic sides and between participants with and without stroke differs depending on the muscle, the functional level, and the stroke stage.

Diabetic peripheral neuropathy (DPN) is the primary complication in patients with diabetes mellitus, characterized by loss of sensation and function in the lower limbs. Virtual reality (VR) and/or sensory feedback (FB) therapy has shown positive effects in other neurologic conditions such as stroke. However, consensus regarding their effectiveness in the DPN population is lacking. This study aims to analyze existing scientific evidence about the effects of VR and/or FB on improving gait and balance and reducing the risk of falls in patients with DPN (pwDPN). A thorough search was conducted in scientific databases including PubMed, Scopus, and EMBASE, up until November 2023. CMSQ, the PEDro scale, and the Cochrane Collaboration’s tool were used to assess the methodological quality and risk of bias of the studies. A total of 10 studies were selected for qualitative analysis, with three contributing information to the meta-analysis. The combined results suggest a positive trend in favor of VR and FB rehabilitation; however, significant differences were not observed in balance (SMD = −0.81, 95% CI = −1.90, 0.29; p = 0.15; I² = 86%) or gait speed improvements (MD = −1.05, 95% CI = −2.96, 0.85; p = 0.28; I² = 89%). Therefore, further randomized controlled studies are still needed to achieve stronger conclusions regarding the benefits of VR and/or FB in pwDPN.

Parkinson's disease is a disorder with a growing prevalence that significantly reduces the quality of life of those affected. This review aims to analyze the effects of whole-body vibration on Parkinson's disease symptoms. A systematic search was carried out in PubMed, CINHAL, EMBASE, and the Cochrane Library for randomized clinical trials studying the use of whole-body vibration interventions involving more than one session on Parkinson's Disease related symptoms. The Cochrane Risk of Bias Assessment Tool-2 was used to assess the methodological quality and the GRADE and TIDierR evaluated the certainty of the evidence and replicability of studies. Extracted data was pooled in meta-analysis. Six studies met the selection criteria. The TIDieR scores indicated high replicability. Whole-body vibration interventions improved static balance compared to active controls. No differences were found for gait speed, functional mobility, or motor symptoms. There were high concerns about the risk of bias and the certainty of the evidence. Whole-body vibration showed no better effect than controls to improve Parkinson's disease symptoms, except for static balance. No clinical recommendations can be made due to the low number of studies and serious methodological issues.

Background/Objectives: Therapeutic adherence remains a critical challenge in the management of chronic conditions, yet most research has focused on pharmacological adherence from the perspective of physicians and pharmacists. The views of non-physician healthcare professionals—particularly physiotherapists, podiatrists, psychologists, and nurses—remain underrepresented. This study aims to explore how these four healthcare disciplines perceive the factors influencing therapeutic adherence, the strategies they use to support it, and how they address patient resilience in clinical practice. Methods: An exploratory qualitative study was conducted using semi-structured interviews with 32 healthcare professionals (8 per discipline) recruited through purposive sampling across diverse care settings across Spain. Data were analyzed using reflexive thematic analysis following a hybrid deductive–inductive approach. Quality criteria were applied in accordance with the standards proposed by Lincoln and Guba. Results: Three thematic domains emerged. Patient-related factors, especially motivation, health literacy, illness beliefs, and socioeconomic constraints, emerged as central determinants across all disciplines. Health system barriers, particularly limited consultation time and fragmented continuity of care, also constituted significant barriers. Discipline-specific strategies ranged from the teach-back technique and customized visual aids in nursing and podiatry to functional goal-setting and group-based dynamics in physiotherapy and expectation-setting and digital follow-up in psychology. Resilience was consistently described as a key mediating factor enabling patients to sustain adherence despite adversity. Conclusions: Therapeutic adherence is a multifactorial and discipline-sensitive phenomenon. The complementary strategies identified across professions support the value of coordinated interdisciplinary approaches. Resilience-informed interventions and profession-specific adherence training represent promising directions for improving clinical practice and professional education.

This study aimed to determine the validity of digital vascular auscultation for the assessment of changes in the radial pulse in healthy subjects, using Doppler sonography as a validated test referent. Sixty-one non-symptomatic subjects (mean age of 52.5 ± 16.1 years) were assigned and evaluated under one of the following conditions: In condition 1, blood flow of the radial artery was not modified; for condition 2, blood flow of the radial artery was modified using a pressure sleeve around the humerus. The radial pulse was then measured three times with each diagnostic tool by three different blinded evaluators. Both instruments demonstrated a high association between the identification of blood flow modifications or not and the assigned condition (p < 0.001). A strong concordance between the two devices when detecting the “changes” or “no changes” in blood flow was demonstrated (k = 0.936, p < 0.001). Stethoscope sensitivity was 95%, and specificity was 99%. In conclusion, digital vascular auscultation seems to be a valid technique to examine blood flow changes of the radial artery in non-symptomatic subjects, and it could be useful for physical therapists when combined with provocative tests for the screening of possible thoracic outlet syndrome in patients.