Articles

Effectiveness of the SYNCHRONIZE + Brief Intervention in Improving Mediterranean Diet Adherence, Nutritional Quality and Intake Pattern in Persons with Fibromyalgia and Chronic Fatigue Syndrome

2026-04-17T07:53:48Z

Effectiveness of the SYNCHRONIZE + Brief Intervention in Improving Mediterranean Diet Adherence, Nutritional Quality and Intake Pattern in Persons with Fibromyalgia and Chronic Fatigue Syndrome Carrasco Querol, Noèlia; Cabricano-Canga, Lorena; Bueno Hernández, Nerea; Martín Borràs, Carme; Queiroga Gonçalves, Alessandra; Vila-Martí, Anna; Ribot, Blanca; Solà, Judit; Valls-Llobet, Carme; Caballol i Angelats, Rosa; Monteso-Curto, Pilar; Castro Blanco, Elisabet; Pozo Ariza, Macarena; Carreres Rey, Sandra; PLA PAGÀ, LAURA; Dearos Sanchís, Mònica; Fernández-Sáez, José; Dalmau Llorca, Maria Rosa; Aguilar Martín, Carina Background: Multidisciplinary lifestyle interventions are being researched to treat fibromyalgia. However, the impact of nutrition as a key treatment component is little studied. This study aimed to evaluate the effectiveness of the SYNCHRONIZE + lifestyle multidisciplinary intervention in improving adherence to the Mediterranean diet, nutrition quality and dietary intake pattern in persons with fibromyalgia and chronic fatigue syndrome. Methods: A pragmatic randomized clinical trial was conducted in primary care. Data were collected using the 17-item energy-restricted Mediterranean Adherence Screener (er-MEDAS), the food frequency questionnaire (sFFQ) and the 24 h recall questionnaire (24 HR), in addition to chrono-nutritional, anthropometric, and body composition data, at baseline and 3-, 6-, and 12- month follow-up visits, and statistically analyzed. Results: A total of 158 participants were evaluated. Results showed the effectiveness of the intervention in improving adherence to the Mediterranean diet. The adherence depended on the group-time interaction being positive and significant at 3 and 6 months post-intervention in the INT group and on the participant age and educational level. Specifically, the intake of legumes, fruits, vegetables, nuts and blue fish was increased, while the intake of sweets and pastries, butter and cream and red and processed meat was reduced. Furthermore, the intake of chips and candies was also reduced, and the consumption of fermented food (yogurts, cheese, kefir) increased. Thus, general diet quality improved. Interestingly, the intake of key nutrients such as protein and iron increased. Furthermore, the number of night eaters was decreased significantly. Muscle mass index was also improved in the intervention group. These results were maintained in the medium to long term. Conclusion: SYNCHRONIZE + is a brief, low-cost, multidisciplinary intervention effective in improving adherence to the Mediterranean diet and improving nutritional and dietary intake patterns in persons with fibromyalgia and chronic fatigue syndrome. Further evaluation of the effect on quality of life and symptoms is needed.

Effects of Exercise-Based Telerehabilitation Programs on Functional Recovery and Related Outcomes After Stroke: A Systematic Review

2026-04-10T02:00:33Z

Effects of Exercise-Based Telerehabilitation Programs on Functional Recovery and Related Outcomes After Stroke: A Systematic Review Casas Rodriguez, Yaiza; López-de-Celis, Carlos; Rodríguez-Rodríguez, Sergi; Nicolás-Sola, Maria; Inglés Martínez, Gala; Escribà i Salvans, Anna Background/Objectives: Stroke is a leading cause of long-term disability, resulting in motor and functional impairments that compromise independence and quality of life. Telerehabilitation offers a promising solution by providing remote, continuous, and accessible post-stroke therapy. This systematic review examined the effects of telerehabilitation on functional capacity, mobility, balance, and quality of life in stroke survivors. Methods: A systematic search was conducted following PRISMA guidelines and registered in PROSPERO (CRD420251169784). Searches in PubMed, Cochrane Library, PEDro, Web of Science, Scopus and CINAHL ultimately identified randomized controlled and quasi-experimental trials from the last decade involving adult stroke patients receiving exercise-based telerehabilitation. Methodological quality was assessed using Joanna Briggs Institute tools and Cochrane risk of bias evaluation. Twenty-one studies with a total of 1067 participants were included, featuring supervised tele-sessions, autonomous exercises, caregiver-assisted training, and hybrid approaches. Results: Results demonstrated significant improvements in functional capacity, motor performance, balance, and quality of life, comparable to conventional rehabilitation. Additional benefits included enhanced self-efficacy, treatment adherence, and caregiver satisfaction. Overall risk of bias was low, though participant blinding was unfeasible. Conclusions: Telerehabilitation may represent a strategy for post-stroke recovery, with studies suggesting outcomes comparable to conventional face-to-face rehabilitation while enhancing accessibility and psychosocial well-being. However, further well-designed, standardized trials with longer follow-up periods are required to confirm its clinical effectiveness.

Effectiveness of Telerehabilitation-Based Therapeutic Exercise on Functional Capacity in Chronic Stroke: Study Protocol for a Multicenter Randomized Controlled Trial

2026-04-10T02:00:27Z

Effectiveness of Telerehabilitation-Based Therapeutic Exercise on Functional Capacity in Chronic Stroke: Study Protocol for a Multicenter Randomized Controlled Trial Casas Rodriguez, Yaiza; López-de-Celis, Carlos; Inglés Martínez, Gala; González-Tova, Lidia; Martínez-González, María Benilde; Barayazarra López, Izaskun; Escribà i Salvans, Anna Background: Stroke is the leading cause of physical disability in adults in Catalonia. Despite this, there is a lack of evidence of physiotherapy interventions on functional capacity during the chronic phase of the pathology. This multicenter clinical trial will be conducted with a sample size of 75 participants. Objectives: The objective of the study is to evaluate the effectiveness of a therapeutic exercise program in physiotherapy using telerehabilitation to optimize functional recovery and quality of life in people with chronic stroke, and to determine its impact on adherence to the exercise program. Methods: This is a multicenter randomized controlled trial. Three parallel groups will be compared, and two will undergo the same type of therapy. A control group (CG) will perform conventional intervention in primary care. There will be two experimental groups; (EG1) will perform document-guided therapeutic exercises at home and (EG2) will perform therapeutic exercises at home guided by a telerehabilitation program. The outcomes to be measured are degree of independence of a person in their activities of daily living, assessed by the Barthel Index, motor function, muscle tone of the affected limbs, muscle strength of the affected limbs, balance, gait efficiency, perception of musculoskeletal pain, perception of fatigue, risk of falls, perception of quality of life, and the perception of perceived subjective change after treatment. These outcomes will be evaluated at baseline (T0), at ten weeks (T1) (end of the intervention), and at 18 weeks (T2). The study duration per patient will be 18 weeks (a ten-week intervention, followed by an eight-week intervention follow-up). The analysis will be performed using a mixed linear model (ANOVA 3X3) and significance level p < 0.05.

Incorporating sedentary behaviour for identifying risk of type 2 diabetes: Implications for primary care

2026-04-10T02:00:30Z

Incorporating sedentary behaviour for identifying risk of type 2 diabetes: Implications for primary care Alòs Colomer, Francesc; Puig Ribera, Anna; Bort Roig, Judit; Chirveches-Pérez, Emilia; Berenguera, Anna; Martin-Cantera, Carlos; Colomer Cugat, Maria Angeles Introduction: Type 2 diabetes mellitus (DM2) is one of the main public health threats of the 21st century. Half of the people with DM2 worldwide are not diagnosed. The high prevalence, underdiagnosis and complications of diabetes highlight the need for identifying people at risk. Sedentary behaviour (SB) or prolonged sitting is a major predisposing risk factor for the increasing prevalence of DM2. Incorporating SB measures into clinical practice systems for identifying individuals more likely to have DM2 should be considered. Objective: To develop a mathematical model for clinical practice that allows early identification of office employees at risk of DM2 based on objective data on SB. Methods: A cross-sectional study with a cross-validation procedure was conducted. Anthropometric variables (sex, age and body mass index, BMI), sleep time (hours; measured by ActivPAL3M devices), and SB patterns (sedentary breaks and time spent in sedentary bouts of four different lengths; measured by ActivPAL3M devices) of two groups of office employees (adults with and without diabetes) were compared. Eighty-one participants had DM2 and 132 had normal glucose metabolism (NGM). The risk of having DM2 was modelled using generalized linear models (GLM), particularly a logistic regression model. Results: Five non-invasive clinical variables that were significantly correlated to DM2 with no collinearity were included in the mathematical model: sex, age, BMI, sleep time (hours) and sedentary breaks < 20 minutes (number/day). The validated model correctly classified 94.58 % of the participants with DM2 and 97.99 % of participants with NGM. The sensitivity was 94.58 % and the specificity 97.99 %. Additionally, the model allowed the design of a preventive tool to recommend changes in the SB pattern based on the participant's anthropometric profile, aiming to reduce the risk of developing DM2 in office employees. Conclusion: This study highlights the importance of incorporating SB measures in primary care clinical practice. Our mathematical model suggests that including SB could enhance the early identification of adults at risk of DM2. Further research is needed to validate these findings and assess the practical application of the mathematical model in clinical practice.