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Background and Objectives: Tennis involves repetitive high-velocity movements, rapid directional changes, and challenging environmental conditions, exposing players to injury risk. However, injury surveillance data for North African youth players are lacking. This study aimed to determine the frequency, characteristics, and management of tennis-related injuries among competitive Tunisian youth players. Materials and Methods: A cross-sectional study was conducted among players aged 5–18 years from tennis clubs (October 2023–November 2024). Data were collected using researcher-administered questionnaires, incorporating the Oslo Sports Trauma Research Center Overuse Injury Questionnaire and a sport-specialization assessment, following International Olympic Committee guidelines. Results: Among 256 players, 53.5% (n = 137) reported 366 injuries. Lower limbs were most affected (58.5%), followed by upper limbs (32.8%); knees (23.2%), ankles (17.5%), and wrists (10.1%). Muscle/tendon (36.9%), superficial tissue (28.1%), and ligament/joint capsule injuries (27.6%) predominated. Most injuries occurred during practice (74.9%) and hot weather (93.4%). Severe injuries represented 24%, while 29.5% were minor without time loss. Subsequent injuries occurred in 54.6% of injured players, with significantly higher rates in those with incomplete rehabilitation (p < 0.001). Conclusions: The high frequency of recurrent injuries and limited rehabilitation highlight critical gaps in injury management, emphasizing the need for targeted neuromuscular training, accessible rehabilitation, and standardized return-to-play protocols.

Background Current management strategies for plantar fasciitis primarily involve conservative treatments. However, the overall effectiveness of extracorporeal shock wave therapy (ESWT) as a specific intervention for this condition has been a subject of ongoing debate in the medical community and its long term efficacy remains controversial. This study’s objective is to assess the effectiveness of extracorporeal radial shock wave therapy (rESWT) for treating plantar fasciitis treatment compared to physiotherapy combined with ultrasound sessions and to screen for foot disorders implementing baropodometry, in a Tunisian tertiary care rehabilitation department. Methods Patients who presented to the rehabilitation department between November 2022 and November 2023 with Plantar Fasciitis were randomly assigned to the rESWT and the Physiotherapy combined to ultrasound groups. The diagnosis of PF was confirmed by physical examination. X-ray radiography was used to exclude a fracture of the calcaneus. Results Our study included 129 patients diagnosed with plantar fasciitis (PF), who were randomly allocated into two groups: 66 participants received radial extracorporeal shockwave therapy (rESWT), and 63 received physiotherapy combined with ultrasound therapy. The average age of these patients was 50.33 years (SD 10). The majority of participants were female, accounting for 101 individuals (78%). The average Body Mass Index (BMI) across the study group was 29.2 kg/m2. Regarding lower limb conditions, pes cavus (high arches) was the most common, observed in 58 participants (45%), followed by pes planus (low arches) in 47 participants (36%).Both treatment groups showed a significant decrease in Visual Analogue Scale (VAS) scores across all follow-up periods (p<0.001). However, no significant difference was found in the mean VAS scores between the two groups at any point after treatment. Conclusion Both protocols (rESWT and physiotherapy combined to ultrasound) were effective for improving morning pain at short term and midterm follow-up periods. Foot disorders should be initially evaluated and considered while treating. Trial registration This trial is officially registered with the Pan African Clinical Trial Registry under the registration number PACTR202308802969500 first registered on (24/08/2023).

Background: Physical activity provides substantial survival and quality-of-life benefits for cancer survivors, yet participation remains suboptimal globally, particularly in the Middle East and North Africa (MENA) regions. This study represents the first comprehensive examination of physical activity barriers and facilitators among Tunisian cancer survivors. Methods: This cross-sectional study recruited 120 cancer survivors ≥3 months post-chemotherapy completion from University Hospital Farhat Hached, Sousse, Tunisia (October–December 2024). Participants completed validated questionnaires via structured telephone interviews: the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Physical Activity Barriers After Cancer scale (PABAC), the Fatigue Assessment Scale (FAS), and the Patient Activation Measure (PAM-13). Statistical analyses included descriptive statistics, receiver operating characteristic (ROC) analysis, correlation analyses, and multivariable regression modeling with Bonferroni correction for multiple comparisons. Results: Participants (mean age 51.89 ± 10.2 years, 73.9% female) demonstrated significant physical activity declines post-chemotherapy: moderate activity decreased from 31.1% to 1.7% (p < 0.001), median intensity declined from 297 to 44 MET-min/week (p < 0.001). Mean PABAC score was 29.72 ± 5.13, with cognitive barriers predominating (2.85 ± 0.58). Fatigue was universal (100%), with 21% reporting severe fatigue (FAS ≥ 35). Only 26.1% received exercise guidance from healthcare professionals. PABAC demonstrated excellent predictive performance for physical inactivity (AUC = 0.805, 95%CI: 0.724–0.887). Independent predictors of higher barriers included fatigue severity (β = 0.466, p < 0.001), low patient activation (β = −0.091, p = 0.010), and advanced cancer stage (β = 1.932, p = 0.008). Conclusions: Tunisian cancer survivors experience substantial, multidimensional barriers to physical activity, with inadequate healthcare guidance representing a critical system-level gap. Findings support the development of culturally adapted, multidisciplinary interventions that target modifiable cognitive and symptom-related barriers, while enhancing patient activation and healthcare provider engagement.

Background/Objectives: Spinal cord injury represents a devastating neurological condition affecting approximately 27 million individuals globally, with particularly severe impacts on sexual function. Sexual dysfunction in SCI patients is multifactorial, with prevalence rates reaching 80–90% across different populations. In low- and middle-income countries, sexual health remains critically neglected in rehabilitation settings due to cultural barriers, inadequate healthcare infrastructure, and limited clinician training. Tunisia, with an estimated 31,000 SCI cases, lacks comprehensive data on sexual dysfunction prevalence and healthcare communication patterns in this vulnerable population. Based on identified research gaps, our study aimed to (i) assess the prevalence and severity of sexual dysfunction among Tunisian SCI patients using validated assessment tools, (ii) identify clinical and demographic factors associated with sexual dysfunction, and (iii) evaluate the current state of sexual health communication and rehabilitation services. Methods: A cross-sectional observational study was conducted at Sahloul University Hospital, Sousse, Tunisia, between July and September 2025. Fifty-one adults with chronic SCI (≥12 months post-injury) were recruited through consecutive sampling. Sexual function was assessed using the International Index of Erectile Function (IIEF) for men and the Female Sexual Function Index (FSFI) for women. Additional assessments included demographic data, injury characteristics using the American Spinal Injury Association Impairment Scale, pain evaluation, functional status, psychological well-being, and sleep quality. Statistical analysis included descriptive statistics, Spearman correlations, and significance testing (p < 0.05). Results: Sexual dysfunction affected 84.3% of participants (43/51), with 88.5% of men experiencing moderate-to-severe erectile dysfunction (median IIEF: 12 [7–36.25]) and 80% of women reporting sexual dysfunction (median FSFI: 7.2 [4–24.25]). Severe dysfunction (FSFI ≤ 10) was present in 56% of female participants. Sexual dysfunction correlated significantly with urinary incontinence (p = 0.045) and with measures of functional independence, including SCIM-III (ρ = 0.466, p = 0.016) and FIM (ρ = 0.569, p = 0.002) among men, and SCIM-III (ρ = 0.469, p = 0.018) and FIM (ρ = 0.495, p = 0.012) among women, indicating moderate positive associations between sexual and functional outcomes. Only 11.5% of men achieved normal erectile function (IIEF ≥48). Psychological factors (HAD-S) and pain scores (NRS, DN4) were not significantly associated with sexual function. A total of 92% of patients reported never discussing sexual health with their healthcare providers, and 100% lacked access to dedicated sexual rehabilitation services, underscoring severe care and communication gaps in the Tunisian SCI rehabilitation system. Conclusions: Sexual dysfunction is highly prevalent among Tunisian spinal cord injury patients and is closely associated with reduced functional independence and urinary issues. Despite its significant impact, sexual health remains largely neglected in rehabilitation care. These findings highlight an urgent need to integrate sexual health into national rehabilitation protocols through provider training, multidisciplinary services, and culturally sensitive education. Systematic sexual health assessment and rehabilitation should be considered essential to improving the quality of life and restoring dignity for affected individuals.

Determining the needs to access to rehabilitation structures is essential for developing effective improvement strategies. The objective of this study was to determine the percentage of unmet needs to admission to rehabilitation and their associated factors. It is a cross sectional study in the inpatient rehabilitation department Sahloul Hospital of Sousse, tertiary care center including all requests to admission. Patient demographics, diagnoses, admission decisions, and post-decision outcomes were collected for each request. Of 329 admission requests, 316 were eligible. The mean patient age was 45 years, with a male-to-female ratio of 0.84. Most requests originated from the hospital's outpatient department, neurology, and orthopedics. Among all requests, 40.5% were not admitted. Non-neurological diagnoses and patient residency were associated with non-admission. Patients with non-neurological conditions and those residing outside the city had twice the risk of non-admission. At one month, 63% of non-admitted patients experienced functional decline, and 18% were lost to follow-up. Unmet needs to admission in rehabilitation structures is high due to lack of beds. This is leading of inequity of access to such important phase of care more. This study highlighted throwing the example of physical and rehabilitation department the gap of needs and the capacity of inpatient rehabilitation facilities. Healthcare policies should prioritize increasing rehabilitation bed availability in all regions of the country.