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1.
Preliminary considerations for accessible space missions for all
Irene Di Giulio, Ryan Anderton, Peter Hodkinson, Mike J. Miller-Smith, Marco Vincenzo Narici, Ross D. Pollock, Joern Rittweger, Thomas G. Smith, Neil Tucker, Stephen D. R. Harridge, 2025, review article

Abstract: Asnewspacemissionsarebeingprepared,nowisthetimeforaccessibledesignsandapproaches.In a workshop, we asked attendees to discuss the adjustments for people with disabilities in relation to the established barriers to human spaceflight. Potential challenges were grouped into medical, physiological, subsistence, and technical. These challenges and potential solutions will inform future space missions and the emerging and more diverse field of space tourism.
Keywords: physiological challenges in spacelift, inclusive/accessible spaceflight design, muscle and bone adaptation to microgravity, personalized countermeasures and rehabilitation, barriers for astronouts with disabilities
Published in DiRROS: 13.01.2026; Views: 17; Downloads: 6
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Uptake and effectiveness of outpatient vs. residential cardiac rehabilitation after myocardial infarction : a nationwide analysis
Borut Jug, Zlatko Fras, Tjaša Furlan, Marko Novaković, Jerneja Tasič, Mitja Lainščak, Jerneja Farkaš-Lainščak, Dalibor Gavrić, Irena Ograjenšek, Petra Došenović Bonča, 2025, original scientific article

Abstract: Aims: To estimate the participation in, and the comparative effectiveness of, short-term residential and comprehensive outpatient cardiac rehabilitation (CR), after the latter was introduced in Slovenia by establishing dedicated regional CR centers. Methods: We extracted and analyzed data on all patients hospitalized for myocardial infarction in Slovenia (n = 15,639), focusing on CR participation – either comprehensive outpatient (introduced in 2017) or short-term residential (available throughout the study period 2015–2021). Impact on nation-wide CR participation rates was assessed by interrupted time series analysis; impact on patient-level outcomes (all-cause mortality and cardiovascular hospitalizations) was assessed using Kaplan Meier estimators and ‘doubly robust’ Cox regression with propensity score-derived inverse probability of treatment weighting. Results: Of the 11,815 eligible patients (event-free after 180-day landmark), 3819 (32.3%) attended CR. Nation-wide CR participation rates increased both in level (9.7%, 95% CI 6.3–3.1) and in trend (0.41% per month, 95% CI 0.22–0.60) after outpatient CR was introduced in 2017. After propensity score-based adjustment, participation in either CR was associated with lower event rates (12.8%, 17.2%, and 21.0% at 3-year follow-up for outpatient, residential, and no CR, respectively; p < 0.001). Risk reductions were significant for composite outcomes (outpatient: HR 0.58, 95% CI 0.47–0.70; residential: HR 0.79, 95% CI 0.68–0.93) and all-cause mortality (outpatient: HR 0.56, 95% CI 0.38–0.83; residential: HR 0.59, 95% CI 0.45–0.77), whereas the risk reduction for cardiovascular hospitalizations was only significant for outpatient CR (HR 0.60, 95% CI 0.48–0.74). The incremental cost-effectiveness ratio per life-year gained was €6421 and €7381 for outpatient and residential CR, respectively. Conclusions: Participation in either CR improves outcomes after myocardial infarction, but comprehensive outpatient CR conveys superior risk reductions, primarily through reduced cardiovascular hospitalizations.
Keywords: health services, diseases, rehabilitation, social costs
Published in DiRROS: 05.12.2025; Views: 261; Downloads: 101
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4.
Interplay of anxiety, depression, vascular function, and biomarkers in post-myocardial infarction patients
Jan Kafol, Borut Jug, Mojca Božič Mijovski, Jure Tršan, Daniel Košuta, Marko Novaković, 2025, original scientific article

Abstract: Background and aims: Coronary artery disease (CAD) is a leading cause of mortality. Depression and anxiety are common in CAD patients and negatively affect quality of life, physical functioning, and adherence to cardiac rehabilitation (CR) programs. This study aimed to identify possible associations with clinically relevant parameters, vascular function and blood biomarkers. Methods: Participants were consecutively recruited during cardiac rehabilitation intake visits at the University Medical Centre Ljubljana within 4 months of myocardial infarction (MI). Hospital Anxiety and Depression Scale (HADS) scores were analyzed in relation to endothelial function (assessed with flow-mediated dilation), arterial stiffness, and blood biomarkers (fibrinogen, endocan, and brain-derived neurotrophic factor [BDNF]) in post-MI patients. All vascular and biomarker assessments were performed within 5 days of questionnaire completion and prior to the start of rehabilitation. Results: There were 105 patients included in the study. The median age was 56 years (49–62), and 80.0% of participants were male. Clinically relevant anxiety and depression were present in 29.5% and 21.9% of participants, respectively. Anxiety was significantly associated with younger age, higher body mass index, and increased arterial stiffness, with total HADS scores negatively correlated with age. Endothelial function showed no significant associations with HADS scores. Vital signs showed no significant differences, except for slightly higher systolic blood pressure in those with clinically relevant depression. Fibrinogen levels were significantly higher in participants with anxiety and depression, while endocan and BDNF levels were lower in those with anxiety. Conclusion: Depression and especially anxiety are significantly associated with endothelial function and relevant biomarkers in post-MI patients. However, as HADS is a screening tool and not a diagnostic instrument, and given the study’s observational design, findings reflect associations rather than causality. Routine screening and targeted mental health support within CR programs might improve participation, enhance cardiovascular recovery, and optimize long-term outcomes. These findings underscore the clinical importance of psychological assessment in the early post-MI period and support the integration of mental health evaluation into cardiovascular care.
Keywords: anxiety, depression, cardiac rehabilitation, coronary artery disease, myocardial infarction, pulse-wave velocity, endothelial dysfunction
Published in DiRROS: 24.11.2025; Views: 219; Downloads: 116
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5.
Addressing the paradox of rest with innovative technologies
Rado Pišot, Uroš Marušič, Luka Šlosar, 2025, other scientific articles

Abstract: The paradox of rest lies in its dual nature: essential for recovery yet potentially harmful when prolonged. Prolonged physical inactivity (PI) significantly contributes to non-communicable diseases (NCDs). Studies show nearly a third of adults worldwide were insufficiently active in 2022, with the economic costs of PI projected to reach INT$520 billion by 2030. Bedrest models have illuminated the rapid onset of insulin resistance, general functional decline and muscle atrophy associated with PI, particularly in hospitalised older adults. Innovative technologies, such as extended reality (XR), offer promising solutions for mitigating the effects of PI and can enhance non-physical rehabilitation techniques such as motor imagery and action observation. These technologies provide immersive, personalised therapeutic experiences that engage multiple senses, transforming passive recovery into an active process and addressing both the physical and cognitive consequences of inactivity. Results of bedrest study showed significant preservation of muscle mass, improved strength and enhanced insulin sensitivity in the intervention group compared to controls. These findings highlight the potential of XRbased strategies in addressing structural and functional declines during inactivity. As part of the Interreg VI-A Italia-Slovenija project X-BRAIN.net, advanced XR-equipped active rooms were developed to aid post-stroke rehabilitation in acute care settings. XR technologies, particularly VR, have shown promise in providing dynamic and adaptable therapeutic environments that facilitate early and targeted interventions. Future advancements focus on integrating XR with brain-computer interfaces (BCIs) and synchronised visual-haptic neurofeedback, enhancing sensorimotor cortical activation and improving rehabilitation outcomes. Comprehensive multimodal approaches, including nutritional, physical and non-physical interventions, are emerging as effective strategies to personalise and optimise patient recovery.
Keywords: physical inactivity, functional and cognitive decline, rehabilitation, extended reality, multimodal interventions
Published in DiRROS: 05.03.2025; Views: 573; Downloads: 349
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6.
Developmental trajectories of motor imagery in relation to physical fitness in children aged 7 to 14 years : a ǂ1-year follow-up study
Luka Šlosar, Katarina Puš, Uroš Marušič, 2025, original scientific article

Abstract: Motor imagery (MI) is fundamentally linked to the motor system. It improves motor learning and optimizes motor actions without physical execution, highlighting its unique role in rehabilitation programs and motor performance. Understanding the developmental trajectories of MI and the factors influencing its variability across ages could enable more effective, age-specific strategies for pediatric rehabilitation. This study assessed 65 children aged 7 to 14 years at two time points 1 year apart. MI ability was assessed using the Movement Imagery Questionnaire for Children, and physical fitness was evaluated using the SLOfit testing battery. Among the three perspectives assessed; internal visual imagery (IVI), external visual imagery (EVI), and kinesthetic imagery (KI), KI was unique in not correlating with age at both time points. The development of MI perspectives varied between athletes and non-athletes, with non-athletes showing a decline in IVI compared with athletes. This differential was further evidenced by significant differences in KI between the groups at the second assessment, with a similar trend observed at the first assessment. Of the physical fitness tests, only the 600-m run correlated consistently with KI at both assessments. Our findings suggest that regular participation in sports significantly affects KI performance, highlighting the importance of sports participation for the development of MI abilities in children. Future research should examine additional assessment points in different age groups and sport experience to better understand the development of MI and its potential implications for pediatric rehabilitation.
Keywords: motor imagery, physical fitness, childhood development, pediatric rehabilitation
Published in DiRROS: 28.10.2024; Views: 870; Downloads: 492
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7.
Early medical rehabilitation after neurosurgical treatment of malignant brain tumours in Slovenia
Nataša Kos, Boris Kos, Mitja Benedičič, 2016, review article

Keywords: malignant brain tumour, surgery, early rehabilitation
Published in DiRROS: 09.05.2024; Views: 1118; Downloads: 554
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8.
Enhancing balance in Parkinson’s disease patients : a comprehensive literature review on the efficacy of exercise in an enriched environment
Ana Ponebšek, Friderika Kresal, Luka Šlosar, 2023, review article

Abstract: Various physiotherapeutic methods and approaches play a significant role in the treatment of patients with Parkinson’s disease, including the use of enriched environments. Virtual reality (VR) as a type of enriched environment has the potential to create multiple sensory experiences and feedback, influencing various aspects of the patient’s information processing and response. The suitability for home use and the considerable impact on motivation highlight its advantages over alternative approaches. The objective of this review is to investigate the impact of VR-based exercise on balance outcomes among individuals with Parkinson’s disease. The inclusion criteria consisted Parkinson’s disease. The comparable improvements in balance observed between the experimental and control groups signify the potential effectiveness of VR-based exercises. This underscores the encouragement for further development in this technology, particularly focusing on fully immersive VR environments, which may yield superior effects in enhancing balance among individuals with Parkinson’s disease. of randomized controlled trials (RCTs) that examined the effects of exercise in a VR environment on individuals’ static and dynamic balance outcomes. In order to gather relevant studies, we conducted a comprehensive search across three databases. From a dataset of 625 records, we conducted a comprehensive full-text screening based on specific inclusion and exclusion criteria. This process resulted in the inclusion of 14 RCTs in our review. The emerging evidence regarding exercising in a VR environment does not definitively prove its superiority over standard exercise routines. However, studies have demonstrated that both the experimental and control groups showed comparable improvements in enhancing static and dynamic balance among individuals with
Keywords: virtual reality, Parkinson's disease, balance, rehabilitation
Published in DiRROS: 16.04.2024; Views: 1037; Downloads: 599
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9.
Physical therapy of rotator cuff injuries of olympic weightlifters – a systematic literature review
Janez Konjar, Živa Vida Arko, 2023, review article

Abstract: From an injury-rate standpoint, Olympic weightlifting is a relatively safe sport. Despite that, a large number of repetitions, the ballistic nature of the lifts and the high forces sustained by the shoulder joint during their execution can lead to shoulder inju-ries, specifically rotator cuff injuries. The purpose of this paper was to investigate the scientifically proven physiotherapy methods and what their indications are when deal-ing with rotator cuff injuries of Olympic weightlifters.A qualitative literature review method was used, and the following online databases were included: PubMed, Scopus, Wiley, and PEDro in ResearchGate. The keywords in the literature search were: rotator cuff, shoulder, injury, physiotherapy, sport, weight-lifting and Olympic weightlifting. The final analysis included fully published and ac-cessible research papers in English from 2012 onwards, focusing on the physiotherapy of rotator cuff injuries.In total, 16 research papers were included in the final review. Management of rota-tor cuff injuries is a complex process, especially in sports with overhead movements. We found that the success and effectiveness of the physiotherapy process can be im-proved through a proper combination of kinesiotherapy, physical agent modalities, manual methods and other forms of therapy. The choice of the specific methods and their duration depends on the pathology of the individual injury. Further research focusing on Olympic weightlifting is needed to create precise and conclusive guidelines for rehabilitation, especially for sport specific phases occurring later in the rehabilitation process.
Keywords: Olympic weightlifting, rotator cuff, rehabilitation, injuries, physiotherapy
Published in DiRROS: 16.04.2024; Views: 1134; Downloads: 590
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10.
Health aspects of aerobic interval training in the rehabilitation of patients with cardiovascular diseases : a sysematic review
Tamara Ilić, Doroteja Rančić, Stefan Stojanović, Ismail Ilbak, 2023, review article

Abstract: Purpose: The aim of this study was to review the literature analyzing the effects of aerobic interval training in the rehabilitation of cardiovascular patients.Methods: Research data was collected considering the inclusion and exclusion cri-teria of the research studies published in English. In order for the study to be included in the analysis, it had to meet the following criteria: year of publication (2004–2022), respondents were people with cardiovascular disease, and the studies included in this review must contain data on disease, training programme and outcomes. Papers with-out full texts available and systematic review studies were excluded. The first search identified 71 articles. In the initial assessment carried out in accordance with the inclu-sion and exclusion criteria, 15 articles were found suitable and were included in the study, while 20 studies were excluded for being duplicates, 28 studies excluded for not having the full text available and eight for non-compliance. Results: The reviewed materials indicate that aerobic interval training has an im-pact on VO2 max, functional abilities, VO2 peak and functional capacity in the reha-bilitation of cardiovascular diseases, especially in the elderly. The duration of the pro-gramme in most studies has a similar time range from 10 to 16 weeks. The programmes that showed the best effects are related to aerobic interval training, from 2 to 3 times per week with moderate (50–60% of VO2 max) or high intensity (80–90% of VO2 max). Conclusion: Studies indicate that properly dosed physical activity contributes to a better lifestyle for people with cardiovascular diseases. All 15 studies showed positive effects of aerobic interval training in cardiovascular disease rehabilitation.
Keywords: aerobic exercise, interval training, rehabilitation, cardiovascular diseases
Published in DiRROS: 16.04.2024; Views: 932; Downloads: 587
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