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Review article | DOI: https://doi.org/10.31579/2639-4162/339
1 Physical Therapist NDT teacher IBITA, Course Leader and teacher on the Dutch Institute for Allied Health Sciences. Nursing Home “Waelwick” in Ewijk the Netherlands.
2 MSc BSc RMN Lecturer in Mental Health Nursing with Dementia Specialty. University of Cumbria, Bowerham Road, Lancaster, LA1 3JD England
*Corresponding Author: Jan van de Rakt, Physical Therapist NDT teacher IBITA, Course Leader and teacher on the Dutch Institute for Allied Health Sciences. Nursing Home “Waelwick” in Ewijk the Netherlands.
Citation: Jan Van de Rakt, Steve McCarthy-Grunwald, (2026), Balance Measurements and Their Significance, J. General Medicine and Clinical Practice, 9(4); DOI:10.31579/2639-4162/339
Copyright: © 2026, Jan Van de Rakt. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 17 February 2026 | Accepted: 23 February 2026 | Published: 06 March 2026
Keywords: balance; balance-measurements; muscle pattern; trainings-rules; balance-systems and their possibilities
Background/ Aim: Measuring balance is often part of the start of a treatment, especially when we are talking about “fall Prevention” programs, and of course we need to know the state of balance and how the treatment is taking effect. But are we aware that we actually know nothing after these tests?
Design: Looking at a number of balance tests, the conclusion is that many exist and that they can indicate when the values deteriorate to the point that balance is at risk.
Result: Balance measurements can serve as an indicator of balance and of the treatment, but they cannot indicate why the balance is reduced and therefore cannot show what should be done about it.
Discussion and conclusion: Measuring balance is a foundation for identifying deterioration, but once the influence of the tests has been exerted, it becomes essential to examine and test all the indirect and direct systems that control balance. All systems influence each other, but there is only one system that is fast enough to detect and respond in time, and the focus and treatment should be directed there. Such a treatment must comply with training rules but also requires the understanding that not every older adult can meet them, so for some older adults, falls cannot be prevented through training.
Balance is one of the greatest problems that threatens the health care in many countries where the population is aging. In all those countries their goes a lot of money to the treatment of accidents after a balance collapse and therefore there is now also a lot of money needed to “prevent” older people from falling and especially falling with severe impacts. [1,2.,3.4.5.] The effects of this Fall prevention aren’t clear when we look at the numbers of people that are going to hospital after a fall and with a fracture, but is that the right way of interpretation and is the word “prevention” right? [6]. Prevention suggests that it can prevent something, which is actually a utopian idea in the case of falls among the elderly. Delaying fall problems is actually the primary goal, but if training is no longer possible or no longer effective, there is a significant risk if such a person still attempts to exercise. Fries J. [6] conducted a study into how dependent people are on their basic health in order to function optimally in old age, and it became clear that people with less ability, but also less training, clearly have a poorer prognosis, and that progress can still be made in the preliminary phase. We know, for example, that the risk of falling is greater in people with neurological disorders [8,9,10] than in people of the same age without neurological disorders.
Figure 1: Study between athletes (runners) and a control group who did not participate in sports. Both groups were monitored during the final period of their lives to determine what level they could maintain and how healthy they remained.
It is clear that people who participate in sports maintain their abilities for much longer and at a much higher level compared to a control group. However, both groups experience a decline in ability, which is an important factor. Both groups are eligible for fall prevention programmes, with the control group starting much earlier and continuing for longer, but in the end, it will become increasingly difficult to maintain fitness at the desired level and the risk of falling will only increase. This means that there is a limit, but just before that limit there is a lot that can be done, provided we know what the problem is and whether it can be trained or treated. That is why it is very important to go further than just doing a balance test, because then we still do not know much and very often do not know at all why someone falls.
Examples of balance measurements test.
The first example is the Berg Balance Test.
Figure 2: A test consisting of 14 items that start with sitting to standing and continue up to standing on one leg. Basically, it covers everything except that for someone who has had a stroke, it matters which leg is used for the test.
The cut-off point is 45 points, which is a score where there may be a risk of falling.
An increase or decrease of 6 points is a sign of significant change [11-14].
Figure 3: Reaching forward in a standing position requires a certain amount of control, and this control partly determines the distance that can be reached. By reaching along a measuring stick, one can immediately see the achieved distance. By conducting many tests at all ages, an average value emerges that can serve as a standard. This made it possible to identify people who were vulnerable and would decline fairly quickly. Reduced ability to reach has shown increases in future falls with odds ratios of 8.2 if unable to reach at all and 4 if able to reach < 5>Age Men Women 20-40 16,73 inches 14,64 inches 41-69 14,98 inches 13,81 inches 70-87 13,15 inches 10,47 inches
Table 1
So, both tests indicate a limit, with a warning that there is a risk of falling, but do they also say something about the cause?
Up and Go-test. Tinetti One-leg St.
Figure 3, 4, and Photo 1: Up and Go test, Test de Tinetti, one leg standing with at the top with closed eyes [17-22].
Again, testing where you can read from the result what the balance power is; once again there is a cutoff point indicating: 'this is where it can/becomes dangerous!'
Special attention for the Senior fitness test (Rikli and Jones [23,24], because it is much more comprehensive and indicates the level of both men and women of different ages. Here we can see differences and it becomes possible to identify deficiencies and therefore better target treatment. Certainly, the combination of various tests therefore makes the other tests redundant, especially since the aforementioned tests are included. Because of the results for different ages, the threshold is much clearer and fairer for each person in terms of gender and age, but this still represents the average. And although we have come closer to understanding the why, we still do not really know why balance ability is lower and near the threshold, nor do we know which treatment is best.
Figure 5: Standing up as fast as possible in 30 seconds. Figure 6: Bend the elbow with a weight as much as possible.
Figure 7: Mobility for the shoulders and important for the ADL.
Figure 8. 6: Minutes walking test (cardio-pulmonal) Figure 9. Step-test, one leg standing item.
Figure 10: Reach test to the feet, an item to observe the mobility. Figure 11. Up and Go test.
Figure 12 and 13: The results by man and woman is thus an average number what the tests are, of course, a clear indication of where a person scores lower, and they certainly provide some clues about where someone scores less well, but again, it is not possible to clearly determine after testing where the problem lies and what can be done about it. That means the investigation needs to go in-depth to find the right cause. Guidelines consistently highlight a number of essential elements that need to be tested to obtain a complete picture, but the equilibrium system has various mechanisms that can trigger the system, yet these mechanisms are unable to restore balance within the required time [25-27].
Items that always must be assessed by balance training/assessment are:
1. Eyes /ears. The scanning ability of the eyes to the environment is important for building alertness, but in older adults, we often see that this scanning ability is used primarily to observe where the feet should be placed, which means that objects further away are not seen. This is therefore an adjustment to another issue, namely that the sensation and perception in the feet are not optimal.
2. Dizziness. Dizziness presents an additional problem, as it causes the vestibular system to provide incorrect information, requiring the brain to perform extra work to recalibrate the body in space, whereas the process should ideally occur the other around.
3. Mobility and Balance sec. At the end of this list.
4. Incontinence. The tension and increased attention cause risks to be taken more quickly, and also the phenomenon that the pressure on the sphincter muscles rises rapidly compared to a lying position.
5. Medication. It is clear that careful consideration must be given to their effects, as low blood pressure can cause dizziness, but also delay reactions or even reduce muscle tension [28].
6. Home and environment factors [29]. These factors often indicate that balance checking has become more difficult and that an update of the home and environment is necessary, and the aids are already is use.
7. Pain [30]. The impact of pain on movement is significant and can therefore hinder balance recovery.
8. Inflammations [31]. Inflammation also has a negative effect on our balance ability.
9. Tone, especially pathological tone [32,33]. We see pathological tone in neurological disorders, and measuring this tone is therefore essential to know what influence it has, especially on movement speed. Particularly in balance recovery, speed is an essential element and can thus be decisive. The measurement is performed passively and often in an “rest”-position, and then it appears that this increase in not so necessary. The difference between measurement in the sitting or standing position of the elbow was significant higher [33]. Higher tonus in elbow is a sign of higher tonus in the entire back of the torso and one of the reasons why walking backward often can end in a fall [35].
Ad.3. Mobility and Balance sec. [27] This is the central system capable of detecting and responding well within time. The detection involves weight shift and approaching limits, and the reaction of muscles patterns creates a counter-movement to correct it. All other systems require more time and are therefore actually used to detect danger and make correction unnecessary and/or to keep the system extra alert. This system monitors the borers and intervenes, but at the same time, the system is at its sharpest when things “almost” go wrong at the border and everything must be brought out to restore balance on the spot or with an excursion- step.
Figure 14: This figure shows how the information about weight change is transmitted from bottom to top, and the times are indicated when the information and reaction reach the specific points. The weight shift and especially the perception under the feet are therefore essential information for this system, so testing that input is essential.
The limit of balance is monitored by applying an inhibitory strategy with the possibility of a stepping strategy. Here, we already see the first adjustments with aging (around 40). A simple ankle strategy is no longer sufficient and both the hip (back) strategy must be employed to enable a stepping strategy [36,37].
Figure (15 -22): At or beyond the boundary, a reaction is required in trunk and fee. Falling forward: trunk backward and on the toes. Falling backward; trunk forward and forefeet up. Falling sideways; an elongation in the trunk/hip beyond the lateral limit of the foot. These actions are necessary to gain time for a weight shift to one leg. Falling forward: place free leg to the forward, backward fall free leg to the back, and sideways, cross and then shorten trunk/hip to place the free leg far outside. Here we see the first problems in the adaptation process due to various changes in body and muscle patterns. This element, which is fundamental for optimal balance control, will never be clearly revealed in all balance tests.
Balance adjustments. This starts much earlier than most people realize, and that is possible because the balance system has so many possibilities, but more frequent falls can also be related to reaching the limit of the adjustments. Every change can affect balance, and the system will immediately seek a solution, which ranges from- more eyes on the ground, walking with an aid, etc.
Figure 23: A body that “collapses” and changes shape due to aging. A fairly normal process and not an immediate reason for balance problems.
Of course not, because these people actually still perform reasonably well on all balance tests since they adapted their system. However, this adaptation does have consequences for muscle patterns and muscle power. Observe the red line starting at the ear and then going vertically downward. Normally, it falls in or behind the heel, but if the trunk flexes more due to changes in the spine, such as lumbar stenosis (44-49% of older adults between 60 and 70 years old [40]), this line first ends in the middle of the foot and, in the last figure, even in the toes. This has major consequences for the posture and, in particular, muscle activity. If the left side in figure 23 is actually relatively relaxed, the back of the neck, from the calf to the back, will have to work much harder and more consistently to prevent a forward fall. Walking in this position will therefore require a quick foot placement with immediate power in the plantar flexors to regain control, and heel strike and roll-off will no longer occur because there is no time for it. This means that the muscles in the back are trained, but the muscles in the front will lose their power. Postural control is back under control, but balance control, and especially control at or beyond the limit, becomes a major challenge.
Falling forward, for example, when stumbling, is almost impossible to prevent because so much of the torso is already in front of the hip. Falling backward becomes very difficult, but if it does happen, dorsiflexion strength is negligible, and especially with neurological conditions, the back is too stiff to expect more flexion. Falling sideways is precisely the compensation because the spine can barely achieve optimal extension and shortening due to the flexion. Therefore, care is taken to remain within the base of support while maintaining independence, and they perform quite well in tests as long as they are allowed to remain within the base of support. This is where the problems arise when muscle patterns are no longer complete, or perception is impaired, and/or selectivity (pathological tone) is impaired, in which case we see a lower score on balance tests.
Photo 2: The gentleman still scores well on the Berg Balance Scale, but the woman is around the cutoff point. His confidence in movement is also clearly much higher. She has difficulty with proper positioning and a static examination [Statiek 41-44] clearly showed “gaps” in her muscle patterns, preventing her from building the same stability as her husband, who, despite his posture, had full control. He was asked often asked to let go of his arms, but that is poor advice, as this technique makes posture and balance control easier.
So, when the tests become more difficult, we may be “too late” to still do anything to improve the muscle pattern for balance, as shown the research by Robinovitch et al., [45]. That research showed that people living in long-term care facilities usually fell due to incorrect weight shifting (41%) with stumbling in second place (21,1%). Of course, treatment is still possible here, but the effect will be poor. Therefore, in addition to these balance tests, we should actually check everything, but especially the muscle patterns. By testing these muscle patterns, it becomes possible timely identify where a “mistake” occurs in detection and reaction, and nit makes it possible to train this according to the training rules [46-48]. Thus, balance tests can never find the reason why balance deteriorates.
How then to test the muscle patterns and how to train?
The practical technique “statiek” developed by G. Worm [41] requires practical training before investigative ability is optimal and can actually be used immediately as a training possibility. Muscle pattern training should comply as much as possible with task-specific [50] training and with training rules where fatigue of the muscle pattern is an essential stimulus to improve coordination and power. And task-specific training therefore requires, in balance training, situations in which limits are explored and even exceeded, and practicing in water [51-57] should actually be the first option. And this actually applies to everyone who needs training. The group that still notices that they sometimes fall, up to people who are able to maintain their balance with aids, and especially the group with pathological tone.
Picture 1 and 2: “Statiek technique” at the front at hip and shoulder height. To keep the situation safe, there is a table behind, yet this can again have a disadvantage because sometimes people focus too much on it. Of course, this can also be done by the therapist in a standing position, but from a seated position it often provides more safety.
Picture 3 and 4: “Statiek Technique from behind”. The same safe situation applies here, and the handling (front, back, and sideways) must be never “comprehensive”. So, no thumb on the front when pulling forward, because this gives everyone information, and everyone will very quickly use that point as an extra “stabilization point”, which will cause the entire test to fall.
Ask the person to respond immediately and appropriately to a light pressure(pull). Clearly show that your hands (lumbrical grip) go to the hip, and often someone will already start responding, which gives us an indication that he/she understands the task. The pressure is very slight, so notice what happens: adjusted counterpressure-immediate, too late, too much, or a combination- and whether it is the same on the left and right. Also, how does that counterpressure feel? Is it a “board”, completely under control, and if so, let the pressure (pull) increase and feel and observe?
Does the reaction increase properly and are there indications that measures are taken when the limit reached? Reaction for: dorsiflexion of both feet (is it the same in terms of time, speed, and strength) and simultaneously flexion in the trunk n (left and right equally fast and equally far), furthermore at the limit there is a weight shift to one leg and is it always the same leg. And is the stepping strategy optimal. Reaction behind: plantar flexion and trunk/hip extension, and what is the reaction at the end and is the stepping strategy optimal. The phenomena that a reaction to light pressure can be addressed with an optimal “board” response, but any hesitation is a sign that something is functioning less well somewhere, which can be in detection and/pr response. Through repetition, it is also possible to feel whether the person has reserve and improves their reaction, or if there is clearly something missing. For example, if one leg is consistently later or too late, this can be a sign of a joint problem, incomplete muscle pattern, leg length difference, or pathological tone. A consistently delayed but still good “board” reaction may indicate a perception problem. The “brake” reaction at the limit, if there are differences, calls for further investigation of, among other things, muscle pattern and tone. Pathological tone often does not seem to test task-specific, but test (photo 3) provides best insight.
Photo 3: Lifting one leg requires stabilization and control of the other leg and its corresponding diagonal [59,60].
When the neurological system is damaged, extension from the hip to the heel with dorsiflexion is often no longer optimal, and we see a pathological extension synergy with less control and plantar flexion. With maximum resistance, this also indicates how severely the system is damaged.
Pathological synergies will usually show a weight shift away from the leg and, of course, the characteristic extension synergy movement of adduction and internal rotation, starting in the hip. “Statiek technique” sideways, as show in the figures 5 and 6, perform this with one hand on one side and do not use the other hand on the opposite side for safety, because almost everyone will use that hand, makes the test meaningless. Again, start with the movement toward the hip/shoulder and observe the reaction: usually, there is already movement before any pressure is applied. Start with light pressure and keep in mind that the hip (greater trochanter) is at or even outside the lateral edge of the foot, so the reaction should occur immediately at that level. If that “board” is not immediately there, this points to a perception problem, but if it has been there for an while, it is also a muscular inability and is resolved by the other leg. So immediately band above the lateral edge of the foot, after that the pressure can be increased up to limit.
Picture 5 and 6: The “statiek technique” sideways with one hand.
The sideways reaction must immediately from a “board” at the height of the lateral edge of the foot. At the moment the sideways pressure becomes so high that the limit is reached, the hip extends far over the lateral edge and the foot tilts, the torso lengthens, and the free leg crosses to then become the support point for an additional sideways step.
NBpow we know how complete the muscle patterns are and we can also train in an adapted way to bring coordination and power up to level or improve them. Task=specificity is essential in balance training, so ensure optimal safety and consider practicing in water. This is necessary for people with neurological disorders because, due to gravity, the damaged brain must make this adjustment, and thus an essential component of balance control and balance recovery is speed, which is not possible with high muscle tone. In water, this high muscle tone is no longer necessary, and some of the speed can also be incorporated into task-specific training, and water will respond with resistance at increased speed, which can again be used for power training, fall training, but also perception training.
Rolling out some form of training for the elderly to better protect them against the consequences of falls requires the right timing and reaching the right people at the right moment. It is clear that this is very difficult, which is why the idea of using balance tests to indicate to people that they are at risk, as well as asking about their history of falls, is very logical. From there, one can start training to improve balance.
Unfortunately, the name “fall prevention” suggests that these programs are capable of preventing falls, which is a bit of an overstatement. Balance tests indicate that there may be a problem, but they do not reveal what that problem is, which means that the balance assessment has only really just begun, and the balance tests are only able to indicate that it is not optimal and whether training has produced results or not. A good treatment examines everything (including all the senses), but the essential elements are the muscle patterns that are fundamental for maintaining/restoring balance, and this system has often been working for years to optimally adapt to the changing and aging body and “learn” from these adaptations. Because that also provides the first signal that there is a limit to that balance control/restoration. Particularly the detection and the response b (muscle patterns) remain the foundation for reacting in time, and that requires training that adheres to training principles and also honesty toward the person if this is no longer achievable.
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The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
