Danilo Esparza

Background/Objectives: To describe changes in motor function (FMA), functional independence (BI), and quality of life (SS-QOL) associated with thermal stimulation in addition to conventional therapy in first-ever stroke. Methods: A case series with 3-month follow-up was conducted in patients during the acute and subacute phases of first-ever stroke. Treatment consisted of thermal stimulation (alternating heat > 45 °C and cold < 15 °C applied to the hemiplegic hand and foot) followed by conventional therapy for 12 weeks (5 sessions/week). Outcomes were assessed at 3 times: baseline (T0), post-treatment (T1), and 3-month follow-up (T2) using the MAS, MRC, FMA, BI, and SS-QOL. Results: In total, 51 post-stroke patients were included (33 women, 18 men; mean age, 59.3 ± 18.5 years). Muscle strength improved significantly across all four evaluated muscle groups from T0 to T1, with gains maintained at T2 (p < 0.0001), while muscle tone showed no statistically significant changes. FMA upper extremity scores increased by 34.88 points (95% CI: 31.85–37.91) and lower extremity scores by 11.00 points (95% CI: 9.56–12.44) at T1 (both p < 0.0001), with gains sustained at T2. The BI improved by 24.71 points (95% CI: 19.40–30.05; p < 0.0001) at T1, with no further significant change at T2. SS-QOL scores increased by 63.90 points (95% CI: 51.60–76.30; p < 0.0001) at T1 and continued to improve at T2 (+78.30 points; 95% CI: 65.90–90.60). All functional outcomes showed large effect sizes at T2 (η² > 0.14). Conclusions: thermal stimulation added to conventional therapy was associated with statistically significant and sustained changes in motor function, functional independence, and quality of life after first-ever stroke, supporting its consideration as a complementary neurorehabilitation strategy.

Introduction: Inclusive education (IE) in Higher Education (HE) has become a global priority, driven by the mandate of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). However, the implementation remains uneven, characterized by fragmented institutional responses and conceptual ambiguities. This article presents an international, critical narrative review of the advances and persistent challenges concerning IE for Students with Special Educational Needs (SEN) and Students with Disabilities (SWDs). Methodology: A narrative review was conducted on international peer-reviewed literature and policy documents published mainly between 2015 and 2025. The analysis is critically structured around six dimensions: (1) conceptualizations of SEN and disability; (2) characteristics and academic trajectories of SWDs; (3) institutional and pedagogical models; (4) the use of digital and assistive technologies; (5) legislative and policy frameworks; and (6) the economic and financial costs associated with inclusion. Key findings: The review confirms a necessary paradigm shift from the reactive Medical Model to the proactive, Rights-Based Model. Universal Design for Learning (UDL) and innovative, student-centered pedagogies are crucial tools for systemic change, supported by the transformative potential of emerging technologies like AI and Virtual Reality for personalization. Despite these advances, a critical gap persists between policy and practice. Major challenges include the persistent lack of faculty readiness to implement UDL effectively, fragmented policy management, and inadequate financial models that treat inclusion as a cost rather than an investment. Conclusion and implications: Achieving genuine equity in HE requires moving beyond minimal legal compliance toward an integrated, systemic commitment. Future research must focus on longitudinal studies measuring the impact of UDL on retention, efficacy of faculty training, and developing robust, bifurcated financial models. The ultimate success hinges on redesigning the educational environment—pedagogically, technologically, and financially—to establish diversity as the institutional norm.

Anxiety disorders affect over 280 million people globally and are associated with cognitive impairment. University students show a particularly high susceptibility, with studies reporting prevalent daily anxiety in this population. Physical activity (PA) has demonstrated efficacy in reducing stress and anxiety, potentially enhancing cognitive function. This scoping review examines existing evidence on the relationship between PA, anxiety symptoms, and academic performance in university students while identifying research gaps. Following PRISMA-ScR guidelines and Arksey and O’Malley’s framework, we analyzed observational and experimental studies from PubMed, Cochrane, Web of Science, and Scopus. A descriptive–analytical approach assessed the effects of exercise on anxiety and academic outcomes. Out of 362 records screened, 27 met the inclusion criteria. Evidence suggests PA interventions across intensity levels may alleviate anxiety symptoms and improve academic performance. However, experimental studies specifically targeting this population remain scarce. Current findings indicate PA interventions may reduce anxiety and potentially enhance academic performance in university students. Further experimental research is required to establish causality and elucidate underlying mechanisms.

This case report examines the impact of robotic-assisted therapy (Lokomat) on functional recovery in a 28-year-old male patient with acute dermatomyositis (DM), an autoimmune inflammatory myopathy causing progressive muscle weakness and disability. The patient underwent 21 sessions of robotic therapy combined with physical therapy, and occupational therapy over seven weeks. Assessments were conducted at baseline, week 10, and week 21 using standardized measures for balance, muscle strength, and functionality. Results demonstrated significant improvements across all domains: balance scores progressed from severe impairment (4/56 Berg, 0/28 Tinetti) to near-normal function (55/56, 24/28, respectively); muscle strength increased from grade 1/5 to 4/5 (MMT-8) in all tested muscle groups; and functionality improved from moderate dependence (59/126 FIM) to complete independence (126/126). The trunk functionality scores showed remarkable recovery from 12/100 to 100/100 (TCT), indicating restored trunk control. Lokomat-assisted therapy combined with conventional rehabilitation effectively improves proximal weakness and postural instability in DM. Robotic therapy enhances motor learning via repetitive movements and reduces therapist workload. Though limited by a single-case design, this study offers preliminary evidence for robotic rehabilitation in DM, previously unexplored. Controlled studies are needed to standardize protocols and validate results in larger cohorts. Advanced technologies show promise for functional recovery in inflammatory myopathies.

Background: Motor impairments limit the functional abilities of patients after stroke; it is important to identify low-cost rehabilitation avenues. The aim of this study is to determine the effectiveness of thermal stimulation in addition to conventional therapy for functional recovery in post-stroke patients. Methods: An electronic search was performed in the MEDLINE, Scopus, Web of Science, EMBASE, CINAHL, SPORTDiscus, Epistemonikos, LILACS, and PEDro databases. The eligibility criterion was randomized clinical trials that analyzed the clinical effects of thermal stimulation plus conventional therapy. Two authors independently performed the search, study selection, data extraction, and risk of bias assessment. Results: Eight studies met the eligibility criteria, and six studies were included in the quantitative synthesis. For thermal stimulation plus conventional therapy versus conventional therapy alone, the mean difference (MD) for function was 6.92 points (95% CI = 4.36–9.48; p < 0.01), for motor function was 6.31 points (95% CI = 5.18–7.44; p < 0.01), for balance was 4.41 points (95% CI = −2.59–11.4; p = 0.22), and for walking was 1.01 points (95% CI = 0.33–1.69; p < 0.01). For noxious thermal stimulation versus innocuous thermal stimulation, the MD for activities of daily living was 1.19 points (95% CI = −0.46–2.84; p = 0.16). Conclusions: In the short term, adding thermal stimulation to conventional therapy showed statistically significant differences in functional recovery in post-stroke patients. The quality of evidence was high to very low according to GRADE rating. The studies included varied in the frequency and dosage of thermal stimulation, which may affect the consistency and generalizability of the results. A larger quantity and a better quality of clinical studies are needed to confirm our findings. PROSPERO registration: CRD42023423207.

Background: Several studies have shown that pulmonary telerehabilitation (PTR) improves respiratory capacity. However, there is little evidence of its effectiveness in youth with post-COVID-19 conditions (PCC). This study analyzed the effects of a PTR program on young adults with PCC. Methods: Sixteen youths were randomly assigned to a control group (CG) or an experimental group (EG), with eight participants each. The EG participated in a PTR program that included twelve remote, asynchronous four-week sessions with diaphragmatic breathing and aerobic exercises. Vital signs (SpO₂, HR, RR, BP), physical capacity (sit-to-stand test), cardiorespiratory capacity (6-Minute Walk Test), and perceived exertion (Borg scale) were assessed in both groups. Results: Statistical analyses showed a significant decrease in RR and HR (p < 0.012) and an increase in SpO₂ (p < 0.042), physical (p < 0.012), and respiratory (p < 0.028) capacity. Perceived effort decreased significantly in both groups (CG: p < 0.006; EG: p < 0.001) only for physical but not for cardiorespiratory capacity (p < 0.106). There were no statistical changes registered in BP (p > 0.05). Conclusions: The PTR program, which includes respiratory and aerobic exercises, is feasible and effective in improving physical and cardiorespiratory capacity in young people with PCC, as well as reducing HR, RR, and dyspnea.

The objective of this study was to analyze the effects of a pulmonary telerehabilitation (TR) program in young adults with post-COVID-19 syndrome. The information of sixteen students' medical files were analyzed and allocated to one of two groups (control=CG/experimental=EG). Twelve TR sessions were performed distantly and asynchronously at the EG patients' homes during 4-weeks. The program included diaphragmatic pattern breathing and aerobic exercises. The parameters: i) vital signs (oxygen saturation "SpO2", heart rate "HR", respiratory rate "RR" and blood pressure "BP"; ii) physical capacity “Sit-to-stand test”; iii) cardiorespiratory capacity “6-Minute Walk Test”; and iv) perceived effort "Borg scale" were assessed in both groups. The statistical analyses showed a significant decrease of RR and HR (p < 0.012) accompanied by a significant increase in SpO2 (p < 0.042), physical (p < 0.012) and respiratory (p < 0.028) capacity. The perceived effort decreased significantly in both groups (CG: p < 0.006; EG p < 0.001) only for physical but not for cardiorespiratory capacity (p < 0.106). There were no statistical changes registered in BP (p > 0.05). The current study suggests that a TR program that involves breathing and aerobics exercises is feasible and effective in treating post-COVID-19 syndrome in young patients.

Previous studies suggest that craniofacial manual lymphatic drainage (MLD) facilitates brain fluids clearance, reducing intracranial pressure and reabsorbing chronic subdural hematoma. This study aimed to explore the effect of craniofacial MLD in combination with pharmacological treatment for improving cranial pain intensity, vital signs, and cerebral edema (Hounsfield units, HUs) in moderate traumatic brain injury (mTBI). Patient 1 received pharmacological therapy, while patient 2 received both pharmacological and craniocervical MLD treatment. Patient 2 showed decreased cranial pain intensity and systolic blood pressure (66%–11.11%, respectively) after two 30 min daily sessions of treatment for three days. HUs in the caudate nucleus of both hemispheres (left 24.64%–right 28.72%) and in the left temporal cortical gray matter increased (17.8%). An increase in HU suggests a reduction in cerebral edema and vice versa. For patient 1, there were no changes in cranial pain intensity, but a slight increase in the systolic blood pressure was observed (0%–3.27%, respectively). HUs decreased in the temporal cortical (14.98%) and caudate nucleus gray matter (9.77%) of the left and right cerebral hemispheres (11.96%–16.74%, respectively). This case study suggests that craniofacial MLD combined with pharmacological treatment could reduce cerebral edema, decrease head pain intensity, and maintain vital signs in normal physiologic values in patients with mTBI.