Background: Headache is one of the leading causes of disability in the world. Neck proprioception, pain, and postural control are interconnected in both healthy individuals and those with chronic neck pain. This study examines the effects of proprioceptive training using a gaze direction recognition task on postural stability and pain in cervicogenic headache patients. Methods: Patients with cervicogenic headache (n = 34, age: 35–49 y) were randomized into a control group (CON), receiving only selected physical therapy rehabilitation or to an experimental group (EXP), performing proprioceptive training using a gaze direction recognition task plus selected physical therapy rehabilitation. Both programs consisted of 24, 60 min long sessions over 8 weeks. Postural stability was assessed by the modified clinical test of sensory integration of balance (mCTSIB) and a center of pressure test (COP) using the HUMAC balance system. Neck pain was assessed by a visual analog scale. Results: In all six tests, there was a time main effect (p < 0.001). In three of the six tests, there were group by time interactions so that EXP vs. CON improved more in postural stability measured while standing on foam with eyes closed normalized to population norms, COP velocity, and headache (all p ≤ 0.006). There was an association between the percent changes in standing on foam with eyes closed normalized to population norms and percent changes in COP velocity (r = 0.48, p = 0.004, n = 34) and between percent changes in COP velocity and percent changes in headache (r = 0.44, p = 0.008, n = 34). Conclusions: While we did not examine the underlying mechanisms, proprioceptive training in the form of a gaze direction recognition task can improve selected measures of postural stability, standing balance, and pain in cervicogenic headache patients.

Background/Objectives: As aging leads to a decline in muscle mass, strength, and functional capacity, identifying effective, low-risk interventions for older adults is essential. Blood flow restriction training (BFRT) has gained recognition as a potential substitute for traditional high-load resistance training, offering comparable benefits with reduced mechanical stress. This scoping review explores current BFRT protocols—specifically cuff pressure, training frequency, and duration—and their impact on muscular strength, hypertrophy, and functional capabilities among healthy elderly individuals. Methods: Following PRISMA-ScR and Arksey and O’Malley’s framework, six databases were searched (2010–2024), yielding 13 eligible studies. Data were charted for BFRT parameters, training regimens, and outcomes related to strength, muscle size, and functionality. Risk of bias was assessed using Cochrane guidelines. Results: Low-load BFRT (20–40% 1RM), applied 2–4 times weekly for 6–12 weeks, significantly improved muscle strength, hypertrophy (e.g., quadriceps CSA), and functional performance (e.g., TUG, 6MWT). Cuff pressures ranged from 50 to 80% arterial occlusion pressure (AOP) for the lower limbs and 30–50% above systolic pressure for the upper limbs. Wider cuffs enhanced safety and comfort. BFRT demonstrated comparable or superior outcomes to conventional training in most studies, with minimal adverse effects reported. Conclusions: The existing evidence suggests that BFRT may be a promising intervention for improving muscle health and functionality in older adults; however, future research should focus on standardizing protocols, long-term outcomes, and tailored guidelines to optimize safety and efficacy.

Background: Cervicogenic headache (CEH) is a secondary headache disorder originating from dysfunction in the cervical spine. In addition to pain, individuals with CEH frequently experience disturbances in postural control and sensorimotor integration, which may compromise functional capacity and quality of life. Conventional clinical assessments typically focus on pain intensity and cervical range of motion; however, these measures often fail to capture the multifactorial mechanisms underlying balance impairments in this population. Machine learning (ML) methods offer the ability to integrate multidimensional clinical data and may provide a more comprehensive approach for identifying patterns of postural stability and the factors influencing balance regulation in CEH. Methods: A secondary analysis was conducted using baseline data pooled from three registered randomized controlled trials, comprising 68 independent participants diagnosed by a neurologist according to the International Classification of Headache Disorders, 3rd edition (ICHD-3). Postural Stability Class served as the primary outcome and was derived from quantitative stability scores categorized as High, Moderate, or Low. Predictor variables included demographic characteristics (age, gender), clinical measures (pain intensity, headache frequency, symptom duration, cervical range of motion), and sensorimotor parameters (center-of-pressure sway and gaze accuracy). Five machine learning algorithms—Random Forest, XGBoost, Support Vector Machine, Logistic Regression, and Gradient Boosting—were trained and evaluated using 10-fold cross-validation with procedures implemented to reduce overfitting. Results: The Gradient Boosting classifier demonstrated the best performance, achieving an accuracy of 0.857 and an F1 score of 0.857, with a cross-validated accuracy of 0.802 ± 0.063. Random Forest and XGBoost achieved accuracies of 0.786. Feature importance analysis identified center-of-pressure sway and pain intensity as the most influential predictors of stability classification, followed by cervical flexion range of motion and gaze accuracy. Demographic variables showed minimal contribution to model performance. Conclusions: Machine learning models were able to distinguish different levels of postural stability in individuals with CEH. The findings highlight the central role of pain and sensorimotor control in balance regulation and suggest that predictive analytics may support precision physiotherapy by enabling rehabilitation strategies tailored to individual sensorimotor profiles.

Background: Cystic fibrosis (CF) is an autosomal recessive disease. It affects multiple organ systems, including the liver, leading to CF‐related liver disease (CFLD). It was noted that CFLD in Egyptian children with CF is more common than in non‐Egyptian people with CF (pwCF). This study aimed to determine the incidence of CFLD and the potential risk factors for developing CFLD in Egyptian children. The correlation between CFLD and the various genotypes prevalent in Egyptian CF children will be discussed. In addition, comparison of CFLD in Egyptian and non‐Egyptian CF patients will be presented.Methods: This cross‐sectional study included 50 pwCF from Ain Sham University's Pediatric Pulmonology Clinic in Children's Hospital, Cairo, Egypt. The sweat chloride test and genetic studies were done at the time of diagnosis. Additionally, all subjects underwent detailed history taking, laboratory investigations, clinical assessment, and pelvic abdominal ultrasound for evaluation of hepatic involvement.Results: One‐third of the Egyptian children with CF were found to have liver disease. The following independent risk factors for developing CFLD were identified as: male sex, severe genetic mutation (class I and II), long duration of CF disease, early onset of the CF, pancreatic insufficiency, as well as history of meconium ileus. In addition, diabetes mellitus and severe lung disease were proven to significantly increase the risk of developing CFLD.Conclusion: CFLD is common in Egyptian pwCF. CFLD's risk factors are similar to other reported research from other countries in the region.

Background: Cervicogenic headache is characterized by unilateral headache potentially stemming from cervical spine mechanical dysfunction. Research indicates that proprioceptive exercises, specifically gaze direction recognition (GDR), are found to be effective in reducing cervical joint position error and enhancing the quality of cervical afferent signals to the central nervous system. Purpose: This study aimed to evaluate proprioceptive training’s impact on headache pain intensity, functional limitation, and neck motion range in individuals experiencing cervicogenic headache. Subjects and methods: This study employed a randomized controlled design involving 40 participants with cervicogenic headache between 35 and 49 years of age, divided equally into two groups. CONT (control) received only conventional physical therapy interventions, while EXPR (Experimental) underwent both proprioceptive training and standard physical therapy. Both programs consisted of 24, 60–70 min long sessions over 8 weeks. Assessment tools included the Numeric Rating Scale for headache pain, the Neck Disability Index for functional limitation evaluation, and a cervical range of motion (CROM) device for mobility assessment. Results: Statistical analysis showed that headache pain and disability level significantly decreased (P = 0.0001) post-intervention in both groups, with superior outcomes in EXPR. Similarly, cervical mobility significantly improved (p = 0.0001) in both groups following treatment, with EXPR demonstrating greater enhancements. Conclusions: Gaze direction recognition exercise (GDR) is effective in reducing headache pain severity, and disability level, and increasing cervical ROM in subjects with Cervicogenic headache. Trial registration: Approval was granted on 29 February 2024. (PACTR202402489039282), available at https://pactr.samrc.ac.za/.

Background: Cervicogenic headache (CGH) is frequently associated with altered cervical sensorimotor control, reduced range of motion and impaired postural stability. Prior work has shown that proprioceptive retraining with gaze direction recognition (GDR) can reduce pain and improve postural stability in CGH and chronic neck pain. Purpose: To examine whether adding a GDR-based proprioceptive training to standard physiotherapy reduces headache frequency and duration and improves postural balance (COP path length) in CGH patients. Methods: Thirty-eight participants with CGH (aged 35–49 years) were randomly assigned to receive either standard physiotherapy (Control, n = 19) or physiotherapy plus GDR proprioceptive training (Treatment, n = 19) for 8 weeks (3 sessions/week). Outcomes measured pre- and post-intervention included headache frequency (attacks/month), headache duration (hours/attack), and center-of-pressure (COP) path length during quiet standing. Results: Multivariate analyses revealed significant effects of time and group × time interaction (Wilks' Λ = 0.142, F (3,30) = 60.55, P < 0.001; Wilks' Λ = 0.193, F (3,30) = 41.77, P < 0.001), indicating greater improvements in the treatment group. Follow-up ANOVAs showed significant time and interaction effects for COP path length ( F (1,32) = 186.0, P < 0.001; F (1,32) = 130.0, P < 0.001), headache duration ( F (1,32) = 16.0, P = 0.00035; F (1,32) = 7.43, P = 0.010), and headache frequency ( F (1,32) = 11.7, P = 0.002; F (1,32) = 7.61, P = 0.010). Groups did not differ at baseline. Conclusion: Adding GDR-based proprioceptive training to standard physiotherapy produced greater improvements in headache burden and markedly improved postural balance compared with standard physiotherapy alone.