Diastasis Recti Abdominis Rehabilitation in the Postpartum Period: A Scoping Review of Current Clinical Practice.

INTRODUCTION AND HYPOTHESIS: Despite exercise being the standard approach to diastasis recti abdominis (DRA) rehabilitation, there is no consensus on the most effective exercise routine and adjunct modalities for reducing DRA and improving functional parameters. The present study is aimed at investigating evidence for DRA rehabilitation in postpartum women, as well as knowledge gaps and areas for future research. METHODS: For this scoping review a systematic search was conducted in MEDLINE, AMED, CINAHL, Embase, ScienceDirect, Scopus, and PEDro up to November 2022. Selection criteria included studies investigating exercise therapy interventions both with and without adjunct modalities for postpartum DRA. Sample characteristics, diagnostic criteria, program design, and outcome measures were recorded. Critical appraisal of clinical trials was performed using PEDro classification. RESULTS: Twenty-eight studies were included: 14 clinical trials, 3 case series, and 11 observational studies. DRA exercises that focused on deep and superficial muscles, pelvic floor muscles, respiratory maneuvers, functional exercises, or alternative interventions (yoga, suspension training, hypopressive exercise) and adjunct modalities showed promising results in reducing the inter-recti distance and related dysfunction. However, there was great variability in diagnostic criteria and methods, DRA severity, time post-birth, and exercise program design. CONCLUSIONS: Reviewed studies provide valuable insights into exercise therapy, but it is important to recognize their limitations, as variability in diagnostic criteria, sample characteristics, and exercise program design hinder the generalizability of the findings. Further high-quality research is needed to strengthen the evidence in this area and provide reliable recommendations for clinical practice.

Perampanel as precision therapy in rare genetic epilepsies.

OBJECTIVE: Perampanel, an antiseizure drug with α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor antagonist properties, may have a targeted effect in genetic epilepsies with overwhelming glutamate receptor activation. Epilepsies with loss of γ-aminobutyric acid inhibition (e.g., SCN1A), overactive excitatory neurons (e.g., SCN2A, SCN8A), and variants in glutamate receptors (e.g., GRIN2A) hold special interest. We aimed to collect data from a large rare genetic epilepsy cohort treated with perampanel, to detect possible subgroups with high efficacy. METHODS: This multicenter project was based on the framework of NETRE (Network for Therapy in Rare Epilepsies), a web of pediatric neurologists treating rare epilepsies. Retrospective data from patients with genetic epilepsies treated with perampanel were collected. Outcome measures were responder rate (50% seizure reduction), and percentage of seizure reduction after 3 months of treatment. Subgroups of etiologies with high efficacy were identified. RESULTS: A total of 137 patients with 79 different etiologies, aged 2 months to 61 years (mean = 15.48 ± 9.9 years), were enrolled. The mean dosage was 6.45 ± 2.47 mg, and treatment period was 2.0 ± 1.78 years (1.5 months-8 years). Sixty-two patients (44.9%) were treated for >2 years. Ninety-eight patients (71%) were responders, and 93 (67.4%) chose to continue therapy. The mean reduction in seizure frequency was 56.61% ± 34.36%. Sixty patients (43.5%) sustained >75% reduction in seizure frequency, including 38 (27.5%) with >90% reduction in seizure frequency. The following genes showed high treatment efficacy: SCN1A, GNAO1, PIGA, PCDH19, SYNGAP1, POLG1, POLG2, and NEU1. Eleven of 17 (64.7%) patients with Dravet syndrome due to an SCN1A pathogenic variant were responders to perampanel treatment; 35.3% of them had >90% seizure reduction. Other etiologies remarkable for >90% reduction in seizures were GNAO1 and PIGA. Fourteen patients had a continuous spike and wave during sleep electroencephalographic pattern, and in six subjects perampanel reduced epileptiform activity. SIGNIFICANCE: Perampanel demonstrated high safety and efficacy in patients with rare genetic epilepsies, especially in SCN1A, GNAO1, PIGA, PCDH19, SYNGAP1, CDKL5, NEU1, and POLG, suggesting a targeted effect related to glutamate transmission.

Investigation of Physical Activity Levels and Associated Factors of Greek Older Adults During COVID-19 Pandemic: A Community-Based Cross-Sectional Study.

The purpose of this cross-sectional study was to investigate the self-reported impact of the COVID-19 pandemic on physical activity (PA), anxiety, and depression amongst Greek older adults. Participants were older adults (>60 years) recruited from community centers of Achaia (Open Care Centers for Older Adults), in Western Greek mainland during the period of December 2020-March 2021. The information was gathered through telephone interviews. Questions on social demographics, health history, diagnosis, quarantine, and hospitalization were asked, as well as impact of the pandemic health status and physical activity behavior. The level of PA was assessed via the International Physical Activity Questionnaire (IPAQ) questionnaire, while anxiety and depression via the Hospital and Anxiety and Depression Scale (HADS). The study protocol was approved by the Ethical Committee of the University of Patras. Four-hundred eleven (411) older adults (306 women, 105 men; mean age of 72.47 ± 6.89 years years) completed the survey. About half of the sample (n = 179; 43.5%) reported a decrease in physical activity due to the pandemic and social isolation restrictions. From the total sample, 211 older adults (51.3%) recorded fear of COVID-19 infection and 9 participants (2.1%) reported to have been diagnosed with the COVID-19 infection. The findings of this study demonstrated that PA was associated with place of living (r = 0.55; p ≤ 0.001), incidence of falls (r = 0.45; p ≤ 0.001), COVID-19 infection (r = 0.6; p ≤ 0.001), fear of COVID-19 infection (r = 0.45; p ≤ 0.05), and anxiety (r = 0.5; p ≤ 0.001). In summary, a decline in PA due to COVID-19 pandemic was reported by the majority of Greek older adults. Results of the present study show that the COVID-19 pandemic may have induced PA behavior changes in many older adults, which may accelerate their risk of developing frailty, sarcopenia, and disability. Interventions to improve PA in older adults should take into account social and community factors and should be key components of current and future pandemic plans, particularly for vulnerable groups.

Neuromuscular control of the lower extremities can be better enhanced by applying ankle taping and kinesiological taping rather than elastic bandaging: a randomized control study in amateur soccer players.

[Purpose] This study evaluated the effects of ankle elastic bandaging, taping, and kinesiology taping on the neuromuscular control of the lower extremities before and after their application and after exercise in soccer athletes. [Participants and Methods] Fifty-five amateur soccer players were randomly divided into four research sub-groups either receiving bandaging (n=15), taping (n=15), and kinesiology taping (n=15) on their ankle or serving as controls (n=10). The dynamic stability of the non-dominant limb was assessed through the star excursion balance test (SEBT) in three research conditions: a) before sports taping application, b) after the application, and c) after a 15 min laboratory simulation of soccer activities. [Results] Taping and kinesiology taping improved the dynamic stabilization of the lower limb more statistically significantly than bandaging. The addition of exercise significantly improved the SEBT results in the taping and kinesiology taping more than the bandaging and control groups. [Conclusion] Exercise activates the proprioceptive mechanisms of the lower limb and improves its neuromuscular control. This functional improvement of the lower limb appears to be enhanced after ankle taping and kinesiology taping compared with elastic bandaging and controls.

The Role of Inflammatory Biomarkers as a Diagnostic Tool for Possible Late-Life Cognitive Decline and Dementias.

The objective of this paper was to explore whether inflammatory biomarkers, especially C-reactive protein (CRP) and high-sensitivity CRP (hsCRP), can be used as a diagnostic tool for possible late-life cognitive decline and dementias. Twelve studies were identified since 2010 involving 13,174 subjects, and one study recruited only healthy population. Inflammatory biomarkers CRP and hsCRP were obtained from blood plasma. Cognitive function was measured using the Mini-Mental State Examination (MMSE) as a basic test in 11 studies. Results were conflicted, five studies revealed no significant differences between higher CRP levels and cognitive decline, four studies demonstrated significant association even in healthy population, and three studies showed significant correlation of lower CRP levels to cognitive deficits. Inflammatory reaction is possibly associated with the pathogenesis of some cognitive impairment and dementias; however, as the results were conflicted, further research should be made, including the normal aging factor, both in healthy and in demented or cognitive declined population.

The Efficacy of Manual Therapy in Patients with Knee Osteoarthritis: A Systematic Review.

Background and objectives: Osteoarthritis (OA) is among the most common degenerative diseases that induce pain, stiffness and reduced functionality. Various physiotherapy techniques and methods have been used for the treatment of OA, including soft tissue techniques, therapeutic exercises, and manual techniques. The primary aim of this systemic review was to evaluate the short-and long-term efficacy of manual therapy (MT) in patients with knee OA in terms of decreasing pain and improving knee range of motion (ROM) and functionality. Materials and Methods: A computerised search on the PubMed, PEDro and CENTRAL databases was performed to identify controlled randomised clinical trials (RCTs) that focused on MT applications in patients with knee OA. The keywords used were 'knee OA', 'knee arthritis', 'MT', 'mobilisation', 'ROM' and 'WOMAC'. Results: Six RCTs and randomised crossover studies met the inclusion criteria and were included in the final analysis. The available studies indicated that MT can induce a short-term reduction in pain and an increase in knee ROM and functionality in patients with knee OA. Conclusions: MT techniques can contribute positively to the treatment of patients with knee OA by reducing pain and increasing functionality. Further research is needed to strengthen these findings by comparing the efficacy of MT with those of other therapeutic techniques and methods, both in the short and long terms.

Cross-cultural adaptation and validation of the Greek Version of the SARC-F for evaluating sarcopenia in Greek older adults.

OBJECTIVE: To translate and validate into Greek, the SARC-F questionnaire, a screening tool for sarcopenia. METHODS: Questionnaire was back-translated and culturally adapted into Greek according to guidelines proposed by the World Health Organization. A convenience sample of 197 Greek elderly people (71.6±7.8 years, 68.5% women) was recruited, 64 of which were classified as persons at risk of sarcopenia according to the SARC-F. Internal consistency, test-retest and inter-rater reliability were evaluated. Validity (sensitivity, specificity, predictive positive value and predictive negative value) was assessed against the definition from the European Working Group of Sarcopenia in Older People (EWGSOP2), which is considered gold standard. Receiver-operating characteristic analysis was also performed to calculate the area under the curve. RESULTS: SARC-F demonstrated high internal consistency (Cronbach's alpha of 0.93) and excellent inter-rater and test-retest reliability, with intraclass correlation coefficient (ICC) of 0.91 (95% CI 0.79-0.96), and 0.93 (95% CI 0.91-0.95), respectively. According to the definition of sarcopenia from the EWGSOP2, 53 (26.85) participants were identified as probable sarcopenic and 23 (11.6%) as sarcopenic. Sensitivity of the tool for sarcopenia was 34.4 and specificity was 93.2. Positive predictive values were 26.4 and negative predictive values were 66.6%. CONCLUSION: Τhe SARC-F was successfully adapted into Greek language. The Greek SARC-F revealed low sensitivity but high specificity with EWGSOP2 sarcopenia definitions, indicating that it can detect with precision the absence of sarcopenia.

Effects of the Ergon® instrument-assisted soft tissue mobilization technique (IASTM), foam rolling, and static stretching application to different parts of the myofascial lateral line on hip joint flexibility.

[Purpose] This study was aimed to compare the effects of three soft tissue treatments in different parts of the myofascial lateral line (LL) on the hip adduction range of motion (ROM). [Participants and Methods] Thirty university students received Ergon® instrument-assisted soft tissue mobilization (IASTM) treatment, foam rolling, and static stretching on the upper or lower part of the LL on the side of their non-dominant lower limb, while the other body side served as control. The participants received one treatment per week for six weeks with a simultaneous pre-and post-therapy assessment of their hip adduction ROM. [Results] The hip adduction ROM was improved on the intervention side in all experimental groups. The gains were more significant in groups that received the Ergon treatment. All Ergon interventions, as well as foam rolling on the upper part of the LL, led to the greatest hip adduction ROM improvement compared to the control side. No differences were observed between the Ergon groups. [Conclusion] The findings suggest that the implementation of Ergon IASTM, foam rolling, and stretching can produce positive effects on the hip ROM. The Ergon Technique is more effective compared to foam rolling and stretching, irrespective of the application site.

Posterior thigh thermal skin adaptations to radiofrequency treatment at 448 kHz applied with or without Indiba® fascia treatment tools.

[Purpose] This study aimed to evaluate the posterior thigh's skin thermal responses to 448-kHz radiofrequency-based therapy applied either in the form of standard application (Indiba®Activ) or combined soft tissue treatment (Indiba®Fascia treatment). [Participants and Methods] Ten healthy males (22 ± 3 years of age, weight 75.2 ± 4.9 kg, height 178.5 ± 4.7) received four different treatments which included a) Indiba®Activ (IA) radiofrequency treatment, b) Indiba®Fascia (IF), c) Indiba®Activ placebo (IAP) and d) Indiba®Fascia Placebo (IFP) in the posterior thigh of their dominant lower limb, while the non-dominant served as the control. Skin temperature was recorded pre- and post-treatment and every minute until the surface temperature reached pre-treatment levels using a wireless infrared thermometer. [Results] Both radiofrequency-based therapy groups IA and IF led to a significant increase in skin temperature compared to placebo applications. The IF intervention led to an average retention of elevated temperature for 164.2 minutes compared to 54.8 minutes of IA, 23.17 of IFP and 17.6 minutes of IAP. [Conclusion] These findings indicate that radiofrequency treatment at 448 kHz can induce and sustain significant thermal skin adaptations reflecting an increased blood circulation and metabolism of underlying tissues.

Restless legs syndrome/Willis-Ekbom disease prevalence in beta thalassemia patients.

PURPOSE: Both beta thalassemia and restless legs syndrome (RLS) patients share some common pathophysiological characteristics related to iron handling. In the present study, the aim was to explore the prevalence of RLS as well as to explore potential association between the syndrome and various quality of life-related parameters in a sample of beta thalassemia patients. METHODS: One hundred fourteen (age 40 ± 11 yr, 59 M/55F) beta thalassemia patients participated in this cross-sectional descriptive study. Patients were screened for RLS based on the international RLS study group diagnostic criteria as well as a battery of validated questionnaires. RESULTS: The prevalence of RLS in this sample of beta thalassemia patients was zero. The quality of life score was low (78 ± 18). Iron levels were within normal range (191 ± 66 mcg/dL) while ferritin levels were high as expected (1836 ± 225 ng/dL). CONCLUSIONS: Our sample of patients comes from central Greece where the prevalence of RLS in the general population is 4% while in renal failure patients is 27%. To our surprise, there was no presence of RLS among this sample of beta thalassemia patients. The adequate levels of iron and ferritin often seen in these patients could be the reason of the absence of RLS symptoms.

The Effects of Anodal Transcranial Direct Current Stimulation on Working Memory.

The aim of this paper was to review the effects of anodal transcranial direct current stimulation (tdcs) on working memory in healthy population. Ten studies were identified involving 319 subjects. Working memory performance was measured using cognitive tasks such as the n-back task, digit span forward or digit span backwards test, Sternberg WM task, the Pacet Auditory Serial Addition Task (PASAT) and the Pacet Auditory Serial Subtraction Task (PASST), verbal and visuospatial tasks and the Operation Span (OSpan) task. All studies showed that anodal tdcs co-administered with cognitive tasks can significantly enhance working memory performance by inducing cortical excitability. Further research should be made towards older population as aging is accompanied with a decline in cognitive abilities and patients with memory deficits to demonstrate whether tdcs can be used as an interventional mean in clinical context as well.

Sarcopenia and Its Impact on Quality of Life.

Sarcopenia is recognized as a major health problem among older adults. This syndrome is associated with serious health consequences in terms of frailty, disability, morbidity and mortality. The aim of this study is to review sarcopenia and its impact on quality of life (QoL). MEDLINE database was searched from January to March 2016 using predefined search terms "sarcopenia", quality of life". Based on extensive literature search, 32 articles were identified while only 6 studies met the inclusion criteria and were associated with sarcopenia and QoL. Quality of life level was measured using generic self-reported tools; the Medical Outcomes Survey Short-form General Health Survey (SF-36) in 4 studies and EuroQol-5D instrument (EQ-5D) in 2 studies. Subjects with sarcopenia demonstrated a significantly high proportion of problems relating to several dimensions of QoL. More studies based on Sarcopenia and QoL are needed. Although the impact of sarcopenia on QoL was assessed in all studies with QoL generic instruments, it would be more insightful to utilise a disease-specific quality of life questionnaire, such as the SarQoL for sarcopenic subjects.

Inter-Rater and Test-Retest Reliability of an Innovative Evaluation Tool: CrossFit Functional Assessment Battery of Tests for the Shoulder Joint.

Background and objectives This study aims to introduce an innovative functional assessment tool designed for CrossFit athletes, to identify a high risk of injury at the shoulder joint. Additionally, the study seeks to examine both inter-rater reliability, which was tested in 40 CrossFit participants, and test-retest reliability, which was assessed in twenty subjects. Methodology CrossFit Functional Assessment Battery for the Shoulder Joint (CrossFit FABS) is a newly created instrument presented for the first time. The evaluation of the performance of its six items aimed to reveal deficits that could contribute to incidents of shoulder injuries. For this purpose, 40 healthy CrossFit participants were concurrently but independently examined by two raters, and twenty healthy adults active in sports were assessed by the main investigator at two different time points. Cohen's kappa coefficient was used to analyze categorical data with an ordinal structure. Results Inter-rater reliability ranged from 0.824 to 1 (P = 0.000) and test-retest reliability was 0.661 to 0.906 (P < 0.001) for each test of CrossFit FABS. A strong to almost perfect correlation was demonstrated for all the variables between the two examiners. Moderate to almost perfect correlation was shown through test-retest procedures. Conclusions The proposed test battery was established as a reliable tool for evaluating performance routines that represent high injury-risk elements for the shoulder joint in CrossFit athletes.

The Feasibilty of the Motor Control Home Ergonomics Elderlies' Prevention of Falls (McHeELP) Programme in Patients with Sarcopenia: A Pilot Study.

Objectives: The objective of this pilot study was to investigate the feasibility of a three month 'Motor control Home ergonomics Elderlies' Prevention of falls' (McHeELP) programme on muscle mass, muscle strength, functionality, balance and fear of falling among older adults with sarcopenia. Methods: A feasibility study of the McHeELP programme was performed in patients with sarcopenia. Primary outcome measures included number of participants; number of participants that showed engagement with the programme; adherence rates; data loss in questionnaires and secondary outcome measures; any adverse events, related or not to the intervention programme. All participants received a home-based motor control exercise programme combined with an ergonomic home modification for 12 weeks. Secondary outcome measures included Hand Grip Strength, Bioimpendance Analysis, Muscle Mass, Functionality and Fear of Falling. Results: Twelve participants, (74.9±5 years), completed the pilot study. Significant differences were recorded before and after the programme on participants' functionality (p < 0.001), balance (p < 0.05) and fear of falling (p < 0.001). Conclusions: The present study revealed that the McHeELP programme is fesasible and that it is possible to implement the programme in clinical practice. The McHeELP programme positively affects functionality, balance and fear of falling. Thus, it seems feasible to conduct a full-scale randomised controlled trial.

Quality of life in sarcopenia measured with the SarQoL questionnaire: A meta-analysis of individual patient data.

Age-related sarcopenia, resulting from a gradual loss in skeletal muscle mass and strength, is pivotal to the increased prevalence of functional limitation among the older adult community. The purpose of this meta-analysis of individual patient data is to investigate the difference in health-related quality of life between sarcopenic individuals and those without the condition using the Sarcopenia Quality of Life (SarQoL) questionnaire. A protocol was published on PROSPERO. Multiple databases and the grey literature were searched until March 2023 for studies reporting quality of life assessed with the SarQoL for patients with and without sarcopenia. Two researchers conducted the systematic review independently. A two-stage meta-analysis was performed. First, crude (mean difference) and adjusted (beta coefficient) effect sizes were calculated within each database; then, a random effect meta-analysis was applied to pool them. Heterogeneity was measured using the Q-test and I2 value. Subgroup analyses were performed to investigate the source of potential heterogeneity. The strength of evidence of this association was assessed using GRADE. From the 413 studies identified, 32 were eventually included, of which 10 were unpublished data studies. Sarcopenic participants displayed significantly reduced health-related quality of life compared with non-sarcopenic individuals (mean difference = -12.32; 95 % CI = [-15.27; -9.37]). The model revealed significant heterogeneity. Subgroup analyses revealed a substantial impact of regions, clinical settings, and diagnostic criteria on the difference in health-related quality of life between sarcopenic and non-sarcopenic individuals. The level of evidence was moderate. This meta-analysis of individual patient data suggested that sarcopenia is associated with lower health-related quality of life measured with SarQoL.

Cross-cultural adaptation of the Greek version of post-COVID-19 Functional Status Scale: assessment of non-hospitalised post-COVID-19 survivors.

The objective of the study was to translate and validate into the Greek language and setting the Post-COVID-19 Functional Status (PCFS) scale. Greeks aged ≥18 years who recovered form COVID-19 (≥ 14 days since diagnosis), were invited to participate. This cross-sectional study followed international guidelines regarding the translation process (forward and backward) and the evaluation of the PCFS. Reliability was assessed by test-retest analyses using the intraclass correlation coefficient (ICC) and 95%CI. For the validation, all participants completed the European Quality of Life-5 (EQ-5D-5L), and the Hospital Anxiety and Depression Scale (HADS) questionnaire. 82 adults (49 females, aged 40.2 ± 6.1) participated in the study. The Greek version of the PCFS demonstrated excellent test-retest reliability, with an ICC of 0.9 (95% CI 0.90- 0.95). The Cronbach's alpha value was 0.9, indicating good internal consistency. The PCFS score was strongly correlated with the EQ-5D-5L (r=0.6, p≤0.001) and weakly correlated with the HADS (r=0.41;p≤0.001). The Greek version of the PCFS was successfully adapted into Greek and is recommended to be used across clinical settings and research.

Reliability and clinical applicability of lower limp strength using an enhanced paper grip strength.

The enhanced paper grip test (EGPT) quantitatively assesses lower limb strength. EGPT assesses the hallux grip force by reacting a pulling force derived from a card, being positioned underneath the participant's hallux. This study aimed to investigate the repeatability and clinical applicability of the EPGT for assessing foot muscle strength. EPGT force was measured using a dynamometer. The reliability of the measurement of EPGT force was assessed by having two examiners performing the test on the same group of healthy adults. Clinical applicability was assessed in community-dwelling adults of both genders. EPGT force was recorded for both feet using the same standardised protocol for all participants. Regarding reliability, 20 healthy adults aged 23.04±5.5 years participated in the present study. The EGPT demonstrated good to excellent test-retest (ICC1,2 0.8 to 0.86) and interrater reliability (ICC1,2 0.82 to 0.88). A convenience sample of 15 community-dwelling adults (71.6±7.8 years, 68.5% women) was recruited for clinical applicability testing. All participants performed the test with mean score 15±5.7 N. EPGT is a reliable measurement of the hallux grip force strength and can be used for clinical and research purposes.

The effectiveness of blood flow restriction training in cardiovascular disease patients: A scoping review.

Therapeutic exercise is integral to the comprehensive rehabilitation of patients with cardiovascular disease and, as such, is recommended by the American Heart Association as a valuable and effective treatment method for such patients. The type of exercise applied to these patients is aerobic and resistance exercise with mild intensities and loads to avoid overloading the cardiovascular system. Blood flow restriction exercise is a novel exercise modality in clinical settings that has in many studies a similar effect on muscle hypertrophy, strength, and cardiovascular response to training at a 70% strength level without blood flow restriction. Since this exercise mode does not require high-intensity loads, it can be a safe method for improving muscle strength, cardiovascular endurance, and functionality in cardiovascular patients. Given that, the objective of this review is to assess and summarize existing evidence for the use of blood flow restriction in cardiovascular patients. A scoping review of existing clinical trials was conducted. Eleven studies were examined that suggested the use of blood flow restrictions in cardiovascular patients to achieve improvements in muscle strength, functionality, and cardiovascular parameters such as blood pressure decrease.

Risk of sarcopenia, fear of COVID-19, anxiety, depression and physical activity levels: Associations across patients on hemodialysis within Greece.

Objectives: The purpose of this multicenter cross-sectional study was to investigate the association between SARC-F, fear of COVID 19, anxiety, depression and physical activity in patients undergoing hemodialysis. Methods: This study was conducted in 3 hemodialysis centers in Greece during the period of the COVID-19 pandemic. Sarcopenia risk was assessed using the Greek version of SARC-F (≥4). Demographic and medical history were collected from the patient's medical charts. The participants were also asked to fill the Fear of COVID-19 Scale (FCV-19S), the Hospital Anxiety and Depression Scale (HADS), and the International Physical Activity Questionnaire (IPAQ) questionnaire. Results: A hundred and thirty-two (132) patients on hemodialysis (92 men, 70.75±13.14 years) were enrolled. Sarcopenia risk (utilizing the SARC-F) was found in 41.7% of patients on hemodialysis. The average duration of hemodialysis was 3.94±4.58 years. The mean score values for SARC-F, FCV-19S and HADS were 3.9±2.57, 21.08±5.32, and 15.02±6.69, respectively. The majority of patients were physically inactive. The SARC-F scores were strongly associated with age (r=56; p<0.001), HADS (r=0.55; p<0.001), levels of physical activity (r=0.5; p<0.001), but not with FCV-19S (r=0.27; p<0.001). Conclusion: A statistically significant relationship was recorded between sarcopenia risk and age, anxiety/depression and levels of physical inactivity in patients on hemodialysis. Future studies are necessary in order to evaluate the association of specific characteristics of patients.

Frailty: future prospectives in rehabilitation medicine.

Modern rehabilitation is based on the International Classification of Functioning, Disability and Health (ICF). We will discuss this Classification process in frailty. Frailty is defined as a condition of reduced functional reserve, a state of vulnerability that involves poor recovery of homeostasis and increased susceptibility to stressor mechanisms, with consequent difficulty in returning to the previous condition of balance. Rehabilitation of frailty is reported in the ICF, although, its consensus is not sufficiently addressed due to its recent identification and the limited available information regarding how it should be formulated. Thus, the aim of the present article is to present the current evidence-based rehabilitation strategies applied in management of frailty.