Health Frontiers: Multidisciplinary Journal for Health Professionals

Technology-Driven Integrated Strategies for Preventing Musculoskeletal Disorders: A Systematic Review of AI, Wearables, and Exoskeletons

2026-07-24T03:41:59+00:00

Background: Musculoskeletal disorders (MSDs) remain a leading cause of global occupational disability, exacerbated by modern workplace digitalization and complex psychosocial stressors.

Objective: To synthesize multidisciplinary evidence on technology-driven ergonomic interventions and propose a comprehensive, integrated framework for proactive MSD prevention.

Methods: A PRISMA-guided systematic review (2010–2024, emphasis 2018–2024) spanning occupational health, ergonomics, industrial engineering, and computer science. The review analyzed systematic reviews, meta-analyses, intervention trials, and technology validation studies.

Results: Advanced technologies including wearable sensors, AI-driven computer vision, exoskeletons, and VR/AR significantly enhance real-time risk assessment and targeted interventions. Wearables and AI enable continuous monitoring, while exoskeletons demonstrate 20–55% reductions in muscle activity. However, methodological heterogeneity, high costs in low- and middle-income countries (LMICs), and evolving ethical frameworks for data privacy limit widespread adoption. Integrated models combining biomechanical, psychosocial, and technological data yield superior, sustainable outcomes.

Conclusion: Sustainable MSD prevention requires holistic, participatory, and technology-enhanced programs. Future research must prioritize longitudinal evaluations, cost-effectiveness in resource-limited settings, and robust ethical data governance to realize the full preventive potential of these innovations.

Capacity-Demand Matching in Workplace Musculoskeletal Health: A Systematic Review of Integrative Ergonomics and Sports Medicine Interventions

2026-07-28T12:43:09+00:00

Background: Work-related musculoskeletal disorders (MSDs) remain the leading cause of global occupational disability, yet traditional interventions typically isolate ergonomic modifications from physical conditioning, producing inconsistent outcomes across sectors.

Objective: To synthesize multidisciplinary evidence and propose an integrative capacity-demand matching framework that simultaneously reduces task exposure and increases worker physical capacity.

Methods: A systematic synthesis of 106 sources spanning occupational health, ergonomics, rehabilitation, and sports medicine literature (1987-2026) across office, healthcare, manufacturing, and manual-labor settings. Evidence was evaluated for risk mechanisms, exposure assessment, intervention effectiveness, return-to-work (RTW) protocols, and economic outcomes.

Results: MSD risk is cumulative and multifactorial, with overhead work demonstrating a 21% increased risk per 1,000 hours of hand elevation above shoulder level, and overtime schedules carrying a 61% higher injury hazard. Multicomponent programs integrating engineering controls, targeted exercise, and structured RTW protocols consistently outperform single-domain interventions. Engineering controls in patient handling show the highest efficacy, while workplace exercise is most effective for neck pain and less consistent for shoulder disorders.

Conclusion: An integrative capacity-demand matching framework provides the most robust defense against workplace MSDs, necessitating a paradigm shift from isolated interventions to coordinated ergonomics-sports medicine strategies embedded within organizational systems.

Deconstructing Injury Malpractice in Youth Football Academies: A Novel Tripartite Empowerment Model for Governance

2026-08-29T13:35:33+00:00

Background: Youth football academies combine adolescent development with intense performance selection, creating high-risk governance environments. Injury malpractice extends beyond clinical negligence, manifesting as suppressed reporting and premature return-to-play (RTP) driven by hierarchical pressures.

Objective: To deconstruct systemic injury malpractice patterns and synthesize a novel "Tripartite Empowerment Model" for academy governance and safeguarding.

Methods: A systematic synthesis of multidisciplinary literature (2000–2025) spanning sport medicine, safeguarding, organizational studies, and ethics, encompassing surveillance cohorts, qualitative studies, and policy analyses.

Results: Analysis reveals that malpractice stems from weak disclosure systems rather than medical ignorance. Under-reporting, fueled by athletes' fear of losing playing time, is the central harm pathway. Heterogeneous RTP criteria and passive surveillance further exacerbate injury recurrence. The evidence strongly supports reconstructing governance around three domains: (1) confidential athlete symptom-reporting and meaningful assent, (2) protected medical triage authority free from coaching interference, and (3) transparent organizational accountability through mandatory RTP audits and parent inclusion.

Conclusion: The synthesized Tripartite Empowerment Model offers a critical framework to dismantle performance-driven silence. By empowering athletes to disclose, protecting clinicians to decide, and obliging clubs to transparently audit decisions, academies can bridge the gap between formal policy and lived practice, fulfilling their fundamental duty of care.

Beyond Cortisol: Developmentally Moderated Endocrine Dysregulation, Hormonal Coupling, and Metabolic Shifts in Adolescent Psychological Stress

2026-07-24T03:30:31+00:00

Background: Adolescence concentrates internalizing disorder emergence alongside pubertal reorganization of stress-sensitive endocrine systems. The prevailing view of stress as uniformly elevating cortisol fails to explain heterogeneous findings across diverse adolescent samples.

Objective: To synthesize evidence linking psychological stress to endocrine outcomes in adolescence and determine whether "hormonal imbalance" reflects fixed excess/deficit or developmentally moderated dysregulation and cross-axis uncoupling.

Methods: A critical evidence synthesis of 66 records (observational, longitudinal, experimental, limited intervention) prioritized 2015–2025 cortisol research and 2010–2025 pubertal work. Findings were triangulated by chronicity, pubertal stage, sex, assay modality, and confounder control, graded using an ordinal confidence rubric. Meta-analytic pooling was precluded by heterogeneity.

Results: The most reproducible signal of adolescent stress is altered cortisol patterning (elevated evening levels, flatter diurnal slope), with recent-onset symptoms driving hyperreactivity and chronic symptoms causing blunted responses. Additionally, early adversity attenuates normal cortisol-DHEA coupling, while thyroid and metabolic alterations remain plausible but heavily confounded by sleep, adiposity, and pubertal maturation.

Conclusion: Adolescent stress-associated endocrine imbalance is best conceptualized as non-linear, puberty- and sex-modulated loss of endocrine coordination. Clinical assessment should prioritize chronicity, pubertal staging, sleep, adiposity, and repeated diurnal sampling over single biomarker cutoffs

Beyond Single-Setting Care: A Hub-and-Spoke Multisectoral Model for Metabolic Syndrome Prevention Integrating Lifestyle, Digital, and Policy Interventions

2026-08-11T17:05:17+00:00

Background: Metabolic syndrome requires sustained multisectoral interventions, yet single-setting clinical approaches often fail to maintain long-term behavioral adherence and biomarker improvements, particularly for lipid and glycemic markers.

Objective: To synthesize cross-sectoral evidence and propose a scalable, integrated prevention model addressing both clinical and environmental determinants of cardiometabolic risk.

Methods: A comprehensive synthesis of randomized trials, quasi-experiments, pragmatic studies, and meta-analyses spanning primary care, workplace, community, school, digital-health, and policy contexts.

Results: Multicomponent lifestyle programs combining diet, physical activity, and structured coaching consistently reduce waist circumference, blood pressure, and BMI, while variably improving fasting glucose and lipids. Community and workplace settings prove vital for reaching underserved populations. While digital tools enhance scalability, they require human support to sustain long-term gains. Consequently, a "hub-and-spoke" architecture emerged: primary care as the risk-identification hub, linked to community and workplace spokes for sustained behavioral delivery, reinforced by digital tools and upstream environmental policies.

Conclusion: Multisectoral health promotion effectively prevents metabolic syndrome when structured as a coordinated hub-and-spoke system. Prioritizing human-supported, culturally tailored behavioral interventions across integrated sectors yields the most scalable and equitable long-term cardiometabolic benefits.

Integrating Biomechanical, Physiological, and Psychosocial Dimensions in Ergonomic Injury Prevention: A Multidisciplinary Review and Technological Framework

2026-09-19T14:19:03+00:00

Background: Occupational musculoskeletal disorders (MSDs) remain a critical global health and economic burden, driven by complex, synergistic interactions between biomechanical, physiological, and psychosocial risk factors. Traditional interventions often fail to address this multifaceted nature, leading to inconsistent long-term outcomes.

Objective: This study aims to critically synthesize current evidence on ergonomic interventions across diverse sectors and propose a comprehensive, integrated framework for sustainable occupational injury prevention.

Methods: We conducted a systematic literature review spanning foundational ergonomic research from the 1980s to emerging Industry 4.0 technologies in the 2020s. The review integrated multidisciplinary domains including occupational health, biomechanics, organizational psychology, and computer science evaluating systematic reviews, controlled trials, and biomechanical modeling studies.

Results: The analysis reveals that while mechanical aids and anthropometric workstation redesigns effectively mitigate immediate biomechanical strain, their long-term efficacy is highly dependent on organizational commitment and psychosocial support. Furthermore, while emerging technologies such as artificial intelligence (AI) and wearable sensors significantly enhance real-time posture and fatigue monitoring, they currently lack the integration of psychosocial stress indicators, limiting their holistic preventive potential.

Conclusion: Achieving sustainable injury prevention requires a paradigm shift toward multidisciplinary, context-specific interventions. Future frameworks must seamlessly combine biomechanical redesign, participatory ergonomics, and advanced technological feedback, while explicitly integrating psychosocial risk management to ensure long-term efficacy across both traditional and high-risk underrepresented sectors.

Association of Physical Activity and Total Cholesterol with VO2Max in Middle-Aged Women: A Cross-Sectional Study

2026-08-11T09:17:00+00:00

Background: Declining cardiorespiratory fitness in women over 45 is linked to aging, hormonal changes, low physical activity, and elevated cholesterol, which collectively impair oxygen consumption (VO?Max). Physical activity may enhance cardiorespiratory efficiency, while high cholesterol can compromise oxygen distribution through vascular dysfunction.

Objective: To examine the relationship between physical activity and total cholesterol levels, both partially and simultaneously, with VO?Max in women aged over 45 years in Malang City.

Methods: A quantitative cross-sectional study following STROBE guidelines recruited 20 women aged over 45 via purposive sampling. Physical activity was measured using the IPAQ, total cholesterol via a digital capillary analyser, and VO?Max via the 6-Minute Walk Test. Data were analysed using descriptive statistics, Kolmogorov–Smirnov normality test, linearity tests, Pearson correlation, and multiple correlation.

Results: Physical activity was strongly and positively correlated with VO?Max (r = 0.785; p < 0.001). Total cholesterol was weakly and negatively correlated with VO?Max (r = ?0.287; p = 0.220), a non-significant association. Simultaneously, physical activity and total cholesterol showed a strong relationship with VO?Max (R = 0.790; R² = 0.624; p < 0.001), with physical activity contributing the dominant unique variance (54.2%) compared with total cholesterol (0.8%).

Conclusion: Physical activity is the primary determinant of VO?Max in women over 45, while total cholesterol shows a weak, non-significant negative association. Together, both variables explain 62.4% of VO?Max variance. Interventions should prioritise structured physical activity programmes integrated with lipid management.

Age and Healthy Lifestyle Motivation Drive Uric Acid Levels in Pre-Older and Older Adults: A Cross-Sectional Analysis in Urban Indonesia

2026-09-06T10:07:58+00:00

Background: Population aging is associated with metabolic disorders, including elevated serum uric acid levels. Beyond biological aging, behavioral and psychosocial factors may influence health outcomes, yet their relationships with uric acid in community populations remain underexplored.

Objective: This study aimed to analyze the relationship between age, motivation for a healthy lifestyle, and family support with serum uric acid levels among pre-older and older adults in Sumbersari Urban Village, Malang City, Indonesia.

Methods: An analytic observational cross-sectional study was conducted following STROBE guidelines, involving 50 respondents aged 46–78 years. Data were collected through questionnaires and point-of-care uric acid testing. Statistical analysis included Spearman correlation, Mann-Whitney U test, and multivariate logistic regression with significance set at p < 0.05.

Results: The mean age was 62.7 ± 8.5 years, with median uric acid levels of 6.3 mg/dL. Age showed a significant positive correlation with uric acid levels (rho = 0.559; p < 0.001). Low motivation for a healthy lifestyle was significantly associated with higher uric acid levels (OR = 8.42; 95% CI: 3.21–22.05; p < 0.001). Family support showed no significant association (OR = 1.15; 95% CI: 0.45–2.94; p = 0.768). Multivariate analysis confirmed age and motivation as independent predictors.

Conclusion: Age and healthy lifestyle motivation are significant determinants of serum uric acid levels, while family support's influence appears indirect. Community-based programs should prioritize regular health monitoring and motivation-enhancing interventions for aging populations.

Self-Motivation and Educational Level Are Associated With Blood Glucose Levels in Older Adults: A Cross-Sectional Study

2026-09-06T14:52:14+00:00

Background: Aging populations face increasing risks of impaired glucose metabolism. Self-motivation and educational attainment may influence health behaviors that support glycemic control, yet their community-level associations remain underexplored in Indonesian older adults.

Objective: To analyze the relationships between healthy life motivation and educational level with blood glucose levels among older adults in Sumbersari Urban Village, Malang City.

Methods: A quantitative cross-sectional study following STROBE guidelines was conducted among 50 older adults selected through purposive sampling. Data on motivation, education, and capillary blood glucose were collected. Bivariate analyses used Mann-Whitney U test and Spearman rank correlation with significance at p<0.05.

Results: Most participants had low motivation (72.0%) and senior high school education (48.0%). Median blood glucose was 132.00 mg/dL (range 77-399). Blood glucose differed significantly between motivation groups (median 146.0 vs 123.5 mg/dL; p=0.032). Educational level showed a strong negative correlation with glucose levels (?=-0.775; p<0.001)

Conclusion: Self-motivation and educational level are significantly associated with blood glucose levels among older adults. Strengthening motivation and providing targeted health education should be integrated into community-based promotive and preventive programs for healthy aging.

Menstrual Duration and Pad Replacement Frequency Predict Anemia Risk in Adolescent Girls: A Multivariate Cross-Sectional Analysis

2026-09-06T05:28:39+00:00

Background: Anemia affects over 500 million adolescent girls globally, with menstruation representing a modifiable contributor to iron depletion. Despite the biological plausibility linking menstrual bleeding patterns to hemoglobin status, evidence integrating multiple menstrual characteristics within multivariate predictive frameworks remains scarce, particularly in community-based populations of low- and middle-income countries

Objective: To examine the independent associations between menstrual characteristics and anemia risk among adolescent girls, controlling for nutritional and sociodemographic confounders.

Methods: A community-based cross-sectional study was conducted among 75 adolescent girls in Ganjaran Village, Malang, Indonesia, following STROBE guidelines. Hemoglobin levels were measured via digital hemoglobinometry, and menstrual characteristics were assessed through structured questionnaires. Bivariate associations were evaluated using Spearman's correlation and independent t-tests, while multivariate logistic regression was applied to estimate adjusted odds ratios (aOR) for anemia (Hb < 12 g/dL).

Results: The prevalence of anemia was 57.3%. Menstrual duration >7 days (aOR = 6.42, 95% CI: 1.85–22.31, p = 0.003), sanitary pad replacement >5 times/day (aOR = 4.18, 95% CI: 1.32–13.26, p = 0.015), and irregular menstrual cycles (aOR = 2.94, 95% CI: 1.08–8.02, p = 0.035) were independent predictors of anemia. Low dietary iron intake and non-adherence to iron supplementation further amplified risk.

Conclusion: Menstrual bleeding patterns, particularly duration and frequency of pad replacement, independently predict anemia risk beyond nutritional factors. Integrating menstrual history into adolescent anemia screening programs may enable earlier identification of at-risk populations.