Carolina Jiménez-Sánchez

Background/Objectives: Major Depressive Disorder (MDD) is a leading cause of disability, yet physical therapy (PT) is underrepresented in hospital-based psychiatric care. While exercise is a known adjunctive treatment, specific evidence on functional, task-oriented interventions in acute settings remains scarce. This study explored changes in quality of life, depressive symptoms, pain, and self-efficacy in patients with MDD following a specialized hospital-based PT program focused on functional movement and autonomy. Methods: We conducted a prospective pre–post case series in the Short-Stay Psychiatric Unit of the Royo Villanova University Hospital (Zaragoza, Spain). We recruited seven adult patients with MDD via convenience sampling. The intervention consisted of a group-based PT program (two 45 min sessions/week during the hospital stay) utilizing task-oriented functional exercises targeting progressive strength, balance, and motor control designed to enhance self-efficacy through activities of daily living (ADLs), combined with health education. Outcomes included the EQ-5D-3L (quality of life), MADRS (depression), NRS (pain), GSE (self-efficacy), and GCPC-UN-ESU (satisfaction). Results: All seven participants (100%) exhibited a positive upward trend in self-perceived health status via the EQ-VAS (mean increase of 35 points). Six cases (85.7%) showed preliminary positive trends in the anxiety/depression dimension of the EQ-5D-3L, with the mean Single Index Value increasing from 0.310 to 0.683. Reductions in depressive symptom severity were observed in six participants, with several transitioning toward moderate or mild levels. Additionally, four patients reported descriptive reductions in pain intensity and showed favorable shifts in self-efficacy scores. Six participants expressed high satisfaction with the intervention. Conclusions: Integrating a hospital-based functional PT program with standard care may offer preliminary benefits for quality of life and reduce depressive symptoms in MDD patients. These findings suggest that task-oriented PT presents a feasible complementary approach for acute psychiatric admissions, although larger controlled trials are needed to confirm these exploratory results.

Introduction: Colorectal cancer (CRC) is a leading global malignancy, and surgery is frequently followed by complications, functional decline, and reduced quality of life. Multimodal prehabilitation and rehabilitation can improve physical recovery and psychosocial outcomes, but uptake is often limited by logistical and mobility barriers. Asynchronous telerehabilitation offers a flexible, patient - centered, and scalable approach; however, its effectiveness across the perioperative CRC pathway has not been rigorously evaluated. This trial will evaluate a multimodal asynchronous program delivered in prehabilitation and postoperative phases, against a booklet-based usual-care approach reflecting the pre-existing perioperative pathway in the study setting before trial initiation. Methods: This single-blind, parallel-group randomized controlled trial will compare an asynchronous multimodal telerehabilitation program with a booklet-based usual-care program in adults scheduled for elective CRC resection. Fifty-six participants will be randomized 1:1 to the telerehabilitation group (HEFORA platform) or the usual-care control group. The intervention includes a 2-week prehabilitation phase and a 4-week postoperative rehabilitation phase. Assessments will be performed at five time points: baseline (pre-prehabilitation), post-prehabilitation (pre-surgery), post-surgery (pre-rehabilitation), post-rehabilitation, and 3-month follow-up. Outcomes: The primary outcome is functional capacity, measured by the Six-Minute Walk Test distance. Secondary outcomes include muscle strength, body composition, pulmonary function, physical activity, sleep quality, psychosocial variables, health-related quality of life, treatment expectancy, usability, satisfaction, and adherence. Analyses will follow the intention-to-treat principle using longitudinal models and sensitivity analyses for missing data and adherence. Conclusions: This study will provide evidence on the role of asynchronous telerehabilitation in perioperative colorectal cancer care. Positive results could inform clinical guidelines, promote wider adoption of digital rehabilitation strategies, and support a more accessible, patient-centered, and cost-effective approach to oncologic recovery. Trial registration: ClinicalTrials.gov identifier: NCT06593678 .

Background: Parkinson’s disease (PD) is a neurodegenerative disorder characterized by postural instability, which significantly contributes to an increased risk of falls (occurring in 45–68% of persons with PD annually), leading to greater functional dependence, social isolation, and a significant decrease in quality of life. The aim of this randomized clinical trial is to evaluate the effects of an immersive virtual reality (IVR) intervention on static and dynamic balance, gait speed, functional mobility, lower limb strength, and quality of life in people with PD. Furthermore, the study will assess treatment adherence, participant satisfaction, as well as the potential occurrence of adverse effects associated with the application of IVR. Methods: A 10-month, single-blind, two-arm randomized controlled trial will be conducted with participants aged 55–90 years diagnosed with PD and classified between stages 2.5 and 4 on the modified Hoehn and Yahr scale. Participants will be randomly assigned to one of two groups: an experimental group and a control group. The intervention will consist of an 8-session program. The first part of each session, common to both groups, will include a standardized strength training program. In the second part, the experimental group will receive a physical therapy balance program using IVR, while the control group will follow a usual physical therapy balance exercise program. Discussion: This study will examine whether IVR can improve static and dynamic balance rehabilitation in Parkinson’s disease beyond usual physical therapy, addressing real-world motor and dual-task challenges. By providing enriched sensory input and adaptive tasks, the IVR seeks to optimize motor learning and functional mobility. Demonstrating safety and clinically meaningful improvements would support IVR as a scalable and engaging tool to reduce risk of falls and enhance quality of life in PD. Trial registration: ClinicalTrials.gov NCT07274514

Background: Major depressive disorder is a mood disorder with significant psychological and physical symptoms that can lead to disability and other severe consequences. This disorder is influenced by both genetic and environmental factors, causing neurotransmitter imbalances and inflammation. Given mayor depressive disorder’s high prevalence and impact, it is crucial to implement a health promotion and intervention program aimed at this disorder. Investigating the feasibility of physical therapy, including therapeutic exercise and health education, compared to psychiatric and psychological approaches is an essential component of this program and of improving the quality of life for patients affected by mayor depressive disorder. Methods: A concurrent nested mixed-methods study with quantitative dominance will be conducted. The quantitative study will be a quasi-experimental pilot study with a pre-post design. This study will additionally include a qualitative narrative design. Initial and post-intervention evaluations will include sociodemographic and clinical data. Quantitative data will be collected using the EQ-5D-3L, MADRS, NRS, GSE, and GCPC-UN-ESU questionnaires. These tools assess health status, depression severity, pain intensity, self-efficacy, and satisfaction levels. Qualitative data will be collected from focus groups with 6–8 participants. The question guide for patients will cover their experiences with their illness and intervention, while the guide for professionals will cover their perceptions of patient management and observed barriers and facilitators. All participants will receive the same evidence-based intervention over 3–6 weeks, with 2 weekly sessions of approximately 45 minutes each. Each session will consist of therapeutic exercise and health education to improve patients’ physical condition and self-management skills. Discussion: This study aims to evaluate the feasibility and acceptability of a physiotherapy intervention program for MDD patients. It will also provide preliminary insights into the effects on quality of life, pain, and self-efficacy, which will inform the design of a future definitive trial. The findings from this research will provide valuable scientific insights and a basis for guiding health-care policymakers on the potential inclusion of physical therapy in clinical practice guidelines and standard hospital treatments for major depressive disorders. Clinical Trial registration: NCT06983405.

Telerehabilitation has become an important tool for the recovery of coronavirus disease (COVID-19) patients, allowing treatment to be continued remotely for this and other pathologies. Self-efficacy plays a key role in motivating and ensuring adherence to these programs. The aim of this study was to evaluate the effects on self-efficacy (GSES) and sport motivation (BRSQ-36) and analyze the correlation between self-efficacy and physical condition after a program composed of therapeutic exercises and education. This pilot randomized controlled trial included 35 post-discharge COVID-19, with two groups: an asynchronous telerehabilitation and a booklet-based rehabilitation groups who undertook a 12-week intervention of therapeutic exercise and education.. The telerehabilitation group showed better results in all variables analyzed, with moderate and large clinical changes in overall motivation d = 0.8, but no significant changes. At the 3- and 6-month follow-up, statistically significant differences in self-efficacy were found in favor of the telerehabilitation group (3-m, p = 0.025, d = 0.76); 6-m, p = 0.007, d = 0.79). The telerehabilitation group showed better results in 'Extrinsic Motivation' (3-m, p = 0.037, d = 0.75; 6-m, p = 0.010, d = 0.94) and 'Identified Regulation' (3-m, p < 0.001, d = 1.09; 6-m, p = 0.005, d = 0.49) after 3- and 6-month follow-up. . In all patients, a direct correlation was found between self-efficacy and meters walked in the six minutes' walk test (6 MWT) (p = 0.022; R² = 0.149), '30 STST and 30' ACT (p = 0.002; R² = 0.261; p = 0.017; R² = 0.160), respectively; an inverse correlation was found after three months with the fatigue variable (p < 0.001; R² = 0.2858) and after six months (p < 0.001; R² = 0.2889). The findings highlight the potential of asynchronous telerehabilitation to improve self-efficacy and extrinsic motivation in a short period of time, which could facilitate better adherence to rehabilitation programs and improve physical condition. However, the results seem to be limited in the long term.

Introduction: Colorectal cancer (CRC) is a leading global malignancy, and surgery is frequently followed by complications, functional decline, and reduced quality of life. Multimodal prehabilitation and rehabilitation can improve physical recovery and psychosocial outcomes, but uptake is often limited by logistical and mobility barriers. Asynchronous telerehabilitation provides a flexible, patient-centred and scalable solution, yet its effectiveness across the perioperative CRC pathway has not been rigorously evaluated. This trial will test a multimodal asynchronous programme, delivered in prehabilitation and postoperative phases, against a standard leaflet-based approach. Methods: This single-blind, parallel-group randomized controlled trial comparing an asynchronous, multimodal telerehabilitation program with a leaflet-based standard program in adults scheduled for elective CRC resection. Fifty-six participants will be randomized 1:1 to telerehabilitation (HEFORA platform) or control. The intervention spans a 2-week prehabilitation phase and a 4-week postoperative phase. Assessments occur at five time points: baseline (pre-prehabilitation), post-prehabilitation (pre-surgery), post-surgery (pre-rehabilitation), post-rehabilitation, and 3-month follow-up. Outcomes: The primary outcome is functional capacity (Six-Minute Walk Test distance). Secondary outcomes include muscle strength, body composition, pulmonary function, physical activity, sleep quality, psychosocial measures, health-related quality of life, treatment expectancy, usability, satisfaction, and adherence. Analyses will follow the intention-to-treat principle with appropriate models for repeated measures and sensitivity analyses for missing data and adherence. Conclusions: This study will provide essential evidence on the role of asynchronous telerehabilitation in perioperative colorectal cancer management. Positive results could inform clinical guidelines, promote wider adoption of digital rehabilitation strategies, and drive a more accessible, patient-centered, and cost-effective approach to oncologic recovery. Trial registration: ClinicalTrials.gov identifier: NCT06593678 Ethics approval: Aragón Clinical Research Ethics Committee (PI23/557).

Physiotherapy is challenged to be a profession with competencies in humanized skills and aptitudes. The need to integrate the learning of sustainable soft skills and humanistic education into higher education curricula has recently been emphasized to improve the capabilities of future healthcare professionals. Our objective was to psychometrically evaluate the Invisible Care, Well-being, Security, and Autonomy (CIBISA) scale in the context of physiotherapy through a pilot study involving students undertaking a degree in physiotherapy. The Delphi method was used over two rounds, and a focus group was convened to achieve a consensus on the adaptation of the CIBISA nursing scale to assess physiotherapy (CIBISA-F). For the psychometric validation of the CIBISA-F scale, the data-collection instruments used were the adapted CIBISA-F scale and two more validated scales related to soft skills. The scales were answered by 25 students at three different times, twice before the start of the clinical placements and once after. The results showed high internal consistency (α = 0.911), adequate reliability according to a Brand–Altman plot, and an adequate construct validity and sensitivity in comparison to other tools. The results of the present study suggest that this version of the CIBISA-F scale is a useful and reliable tool for measuring humanization skills in healthcare and physiotherapy students during their clinical placements, ensuring high-quality education.

Background: Major depressive disorder is a mood disorder with significant psychological and physical symptoms, leading to disability and severe consequences. It is influenced by genetic and environmental factors, causing neurotransmitter imbalances and inflammation. Given the high prevalence and impact, it is crucial to implement a health promotion and intervention program. Investigating the efficacy of physical therapy, including therapeutic exercise and health education, compared to psychiatric and psychological approaches, is essential to improve the quality of life for these patients. Methods: A concurrent nested mixed-methods study with quantitative dominance will be conducted. The quantitative study will be a quasi-experimental pilot study with a pre-post design. Additionally, this study includes a qualitative narrative design. Initial and post-intervention evaluations will include sociodemographic and clinical data. Quantitative data will be collected using the EQ-5D-3L, MADRS, NRS, GSE, and GCPC-UN-ESU questionnaires. These tools assess health status, depression severity, pain intensity, self-efficacy, and satisfaction levels. Qualitative data will be collected from focus groups with 6-8 participants. The question guide for patients will cover experiences with illness and intervention, while the guide for professionals will cover perceptions of patient management and observed barriers and facilitators. All participants will receive the same evidence-based intervention over 3 to 6 weeks, with 2 weekly sessions of approximately 45 minutes each. Each session will consist of Therapeutic Exercise and Health Education to improve physical condition and self-management skills. Discussion: This study aims to fill the knowledge gap on the effectiveness of physical therapy interventions for quality of life, pain, and self-efficacy in hospitalized patients with major depressive disorder. It will evaluate the impact of therapeutic exercise and health education, alongside standard psychiatric, psychological, and nursing treatments. The findings will provide scientific insights and guide healthcare policy makers to incorporate physical therapy into hospital treatments for major depressive disorder. Clinical Trial registration: NCT06983405