Rehabilitation Methods Research Articles

Clinical experience of the carboxytherapy method in the treatment of patients with temporomandibular joint pain dysfunction syndrome (К07.60)

Objective. Improving the effectiveness of treatment of patients with TMJ PDS myogenic origin. Material and methods. According to the purpose of the study, a group of 10 patients (8 women and 2 men aged 14 to 60 years) was formed with the coincidence of a triad of signs: pain during movements of the lower jaw, a feeling of heaviness and tension in the chewing and facial muscles, restriction of mouth opening. A set of diagnostic measures has been implemented in the following scope: clinical and radiological examination methods, TMJ MRI, ultrasound and surface EMG of the chewing muscles, digital axiography. In the treatment of patients in the study group, the method of invasive carboxytherapy was used, based on dosed injections of CO2 in the projection of trigger points of the masticatory muscles. The research examines the therapeutic value of using of CO2 in the protocol of functional rehabilitation of patients with TMJ diseases of myogenic origin. Results. The analysis of the effectiveness of treatment of patients in the study group was carried out to assess the dynamics of key parameters: the severity of the pain syndrome according to VAS, the magnitude of the IMPACT index values and the magnitude of mouth opening. The severity of pain in patients in the study group, according to average values, decreased by 86% from the initial values, an increase in the amplitude of mouth opening by 28.5%, a decrease in the IMPACT index values by 42.5% from the initial values of hypertonicity of the masticatory muscles, an increase in blood flow speed of superficial temporal artery at 52.5%. Conclusion. The results of the clinical application of the carboxytherapy method in the treatment of patients with TMJ PDS allow us to recommend this method for implementation in the rehabilitation protocols of patients with TMJ PDS of myogenic origin, trismus and hypertonus of the masticatory muscles. Carboxytherapy as a method of etiopathogenetic rehabilitation contributes to the early relief of pain syndrome, normalization of the bioelectric activity of the chewing muscles and restoration the physiological kinematics of the lower jaw’s movements.

Osseointegration: A new approach to improve functional performance of prostheses – a systematic review of the literature

Background: Individuals with amputations experience functional limitations in their daily activities, depending on the level of their injuries. They often encounter problems with socket-based prostheses. Osseointegration is a new method in prosthetic rehabilitation that aims to enhance the performance of amputees and reduce the issues associated with current prostheses. The objective of this review was to assess the advantages and disadvantages of this novel approach in the rehabilitation of amputees. Method: A search was conducted in various databases, including Google Scholar, PubMed, ISI Web of Knowledge, Embase, and Scopus. The search terms used were “osseointegration,” “prosthesis,” and “amputation.” The quality of the studies was evaluated using the Down and Black tool. Results: The search using the aforementioned keywords yielded 18 papers. Out of these, 10 papers focused on the use of osseointegration for lower limb amputations, while 5 papers focused on upper limb amputations. Additionally, 3 papers examined the occurrence of stump infections associated with this method. The quality of the studies ranged from 15 to 20. Conclusion: Based on the available literature, osseointegration addresses some of the challenges associated with socket-based prostheses. Furthermore, it improves the performance of prostheses. However, there are several issues with this method, including high costs, stump infections, and the need for extensive expertise to insert the implant. Further large-scale studies are necessary to determine the various limitations and advantages of this approach for different levels of amputations.

Compare the Effectiveness of Mime Therapy on Facial Synkinesis in Idiopathic and Traumatic Lower Motor Neuron Facial Palsy

Background: The seventh cranial nerve has a core function of regulating emotional displays and speech. Facial paralysis, characterized by the loss of voluntary motor control on one or both sides, is commonly attributed to Bell’s palsy which accounts for 50-75% of cases and trauma responsible for 10-23% of cases. Various rehabilitation methods, including Mime Therapy, are employed to enhance facial muscle function. Objective: This study aims to compare Mime Therapy's impact to reduce the synkinesis of a face in individuals with idiopathic and traumatic lower motor neuron facial nerve palsy. Study Design: Experimental, Comparative Study Study Setting: Physiotherapy OPD, Neurology ward, and ENT ward of Himalayan Hospital, Dehradun Participant: This study involved 30 patients, with 20 in Group A (Idiopathic) and 10 in Group B (Traumatic), all of whom had House-Brackmann Scores of 3-5. The patient’s ages ranged from 20 to 70. Outcome Measure: Two outcome measures were used: House Brackmann Score and Sunnybrook Facial Grading System. Result: A noticeable difference in both outcome measures was observed. In the House Brackmann Score for group A (p-value <0.001) and B (p-value=0.016), In Sunnybrook Facial Grading System for group A (p-value<0.001) and B (p-value=0.002). However, when comparing the post-intervention results of both groups, no distinct variation was found in the outcome variables (p-value>0.05). Conclusion: The study provides evidence demonstrating that Mime Therapy has been successful in effectively reducing Facial Synkinesis in patients with both idiopathic and traumatic LMN Facial Palsy. The results indicate a significant improvement in the condition, suggesting that Mime therapy can be an efficacious treatment approach for this type of facial paralysis. KEYWORDS: Mime Therapy, Facial Synkinesis, Idiopathic LMN Facial palsy, Traumatic LMN facial palsy, Bell’s palsy.

Combined Effect of tDCS and Motor or Cognitive Activity in Patients with Alzheimer’s Disease: A Proof-of-Concept Pilot Study

(1) Background: Alzheimer’s disease (AD) accounts for 70% of dementia cases and with no effective pharmacological treatments, new rehabilitation methods are needed. Motor and cognitive activities and transcranial direct current stimulation (tDCS) have shown promise in stabilizing and enhancing cognitive functions. Objective: we want to investigate the effects of tDCS combined with motor or cognitive activity on cognitive functions in AD patients. (2) Methods: Patients with mild or moderate AD were randomized between anodic tDCS groups (MotA or CogA) and sham tDCS groups (MotS or CogS). They received two weeks of treatment (45 min, five days/week), with the first 15 min using tDCS stimulation on the dorsolateral prefrontal cortex. Cognitive assessments were conducted pre-treatment (T0), post-treatment (T1), and one week after (T2). (3) Results: Twenty-three patients were included. Statistical analysis showed significant differences between anodic tDCS groups (MotA + CogA) and sham tDCS groups (MotS + CogS) with advantages for the first in improving global cognitive status (p = 0.042), selective attention (p = 0.012), and sustained attention (p = 0.012). Further analysis indicated no differences between the two anodic tDCS groups between T0 and T1. (4) Conclusions: combined anodal tDCS with motor or cognitive activity could improve global cognitive state and attention, slowing cognitive decline in AD patients. The trial was registered on Clinical Trials: NCT06619795.

The achilles tendon rupture: A deeper dive into its impact on professional and high-performance athletes

Background: The Achilles tendon rupture (ATR) is an injury that has been detrimental to professional athletes over the years, recently rising to unforeseen heights as the intensity of sports has increased. Methods: To obtain relevant statistics for this paper, a review of prior research, including original research and case studies, was conducted. Digital publications and clinical data were reviewed to dissect factors such as injury causes, operations, current initiatives, the role of technology, and future implications. Results: The data revealed a significant increase in documented ATRs in athletes and the National Football League (NFL) over the years; most recently, these injuries increased from 11 in the 2019-2020 season to 24 in the 2021-2022 season.3 Despite advancements in technology and recovery methods, dynamic changes involving training, conditioning, physicality, and intensity in sports have greatly contributed to the increased rates of injuries. With modernized resources such as advanced testing and rehabilitation procedures incorporating artificial intelligence (AI), specialists continue to search for new ways to treat injury and improve functional outcomes more effectively. Conclusion: This paper examines ATRs in athletes, its risk factors, current surgical methods for treatment, and modern rehabilitation methods. Future research should continue to develop comprehensive assessment and treatment methods to decrease the time to return to play, reduce the risk of re-injuries, and ensure cost-effective standards in implementing advanced rehabilitation modalities.

Measuring the Influence of Industrialization in Deep Energy Renovations: A Three-Case Study Utilizing Key Performance Indicators (KPIs)

Existing buildings in the European Union account for 40% of its energy consumption. To significantly reduce this impact, annual deep energy renovation rates should triple by the end of the 2020s. However, the lack of automation in the construction industry has hindered energy renovation efforts. Horizon Europe’s INPERSO project (Industrialised and Personalised Renovation for Sustainable Societies) aims to create a user-centered energy rehabilitation method based on industrialized technologies and systems, enhancing efficiency and building performance. To bridge the gap between predictions and real-world outcomes, the 22 project partners—using a multi-criteria decision analysis (MCDA) process—devised a list of key performance indicators (KPIs) for evaluating rehabilitation based on economic, energy, environmental, social, and technological factors. Adopting a human-centric approach, these project partners aim to minimize the technologies’ environmental impact while optimizing users’ comfort and experience. The indicators are designed to evaluate performance at every stage of the renovation process, enabling continuous feedback and user engagement and ultimately ensuring that projected energy savings are met throughout the building’s lifespan. The KPIs selected for INPERSO provide a solid framework for evaluating and monitoring sustainable renovation. However, challenges such as administrative reluctance and user disruption must be addressed to further boost the adoption of deep energy renovations.

Cerebellar rTMS for Enhancing Coordination in Patients with Multiple Sclerosis: A Narrative Review

Purpose of Review: Cerebellar repetitive transcranial magnetic stimulation (rTMS) has gained attention as a potential therapeutic intervention for neurological disorders. Recently, there has been growing interest in its use to improve coordination in patients with multiple sclerosis (PwMS). This review aims to examine and discuss the current evidence on the effectiveness of cerebellar rTMS in enhancing motor coordination in individuals with MS. Methods: A comprehensive search of Science Direct, PubMed, and Google Scholar was conducted using keywords such as multiple sclerosis, cerebellar repetitive transcranial magnetic stimulation, coordination, and neurorehabilitation. Articles published from January 2012 to July 2024 were included, and only English-language studies were reviewed. Unpublished manuscripts, conference abstracts, and studies not involving larger scientific investigations were excluded. Results: The findings suggest that cerebellar rTMS, when combined with conventional rehabilitation methods, has the potential to improve coordination in PwMS. However, the available evidence is limited, and larger, more rigorous studies are needed to confirm these findings and establish standardized treatment protocols. Conclusion: Current literature indicates that cerebellar rTMS holds promise as a supplementary intervention for improving coordination in PwMS. Further high-quality trials are required to support its clinical application and to better understand the underlying mechanisms.

Feasibility of a new bicycle ergometer with adjustable pedaling configuration for personalized lower limb rehabilitation

Muscle atrophy due to prolonged immobilization leads to severe dysfunction and progression of disease and injury. This highlights the necessity for early rehabilitation, even during the non-ambulatory stages. As manifestations vary among individuals, target-specific rehabilitation is crucial for achieving optimal outcomes. Conventional bicycle ergometers, despite their wide usage in rehabilitation and sports training, fail to adequately recruit the muscles that predominantly operate in the coronal or axial plane. This is thought to be due to the restriction of pedaling trajectory in the sagittal plane. This study introduces a new bicycle ergometer capable of tilting the pedaling plane and adjusting the pedal orientation, in order to alter muscle recruitment patterns and limb alignments. A biomechanical analysis of eight healthy volunteers suggests that our device can elicit dynamic valgus/varus alignment and alter the axial rotations of the lower extremities. An electromyography analysis revealed a significant increase in the activation of specific muscle groups, particularly the abductors and adductors, suggesting promising results for targeted muscle recruitment. We expect this ergometer to provide a new method for target-specific rehabilitation and the treatment of bedridden patients or those with weak muscles.

The Impact of Virtual Reality as a Rehabilitation Method Using TRAVEE System on Functional Outcomes and Disability in Stroke Patients: A Pilot Study

Background: Stroke is the third leading cause of disability. Virtual reality (VR) has shown promising results in post-stroke rehabilitation. The VR TRAVEE system was designed for the neuromotor rehabilitation of the upper limb after a stroke and offers the ability to track limb movements by providing auditory feedback and visual augmentation. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), aligned with the International Classification of Functioning, Disability, and Health (ICF) principles, is a valid tool for measuring disability regardless of its cause. This study aimed to investigate the feasibility of the VR TRAVEE system in upper limb rehabilitation for stroke patients. Methods: A total of 14 stroke patients with residual hemiparesis were enrolled in the study. They underwent a 10-day program combining conventional therapy (CnvT) with VR rehabilitation. At baseline (T0), the upper limb was assessed using the Modified Ashworth Scale (MAS), active range of motion (AROM), and the Numeric Rating Scale (NRS) for pain. These assessments were repeated after the 10-day rehabilitation program (T1). Additionally, disability was measured using WHODAS 2.0 at T0 and again 30 days after completing the program. Results: Significant improvements were observed in AROM and MAS scores for the shoulder, elbow, wrist, and metacarpophalangeal joints, as well as in the reduction in shoulder pain (p ˂ 0.001). WHODAS scores decreased across all six domains, with a statistically significant improvement in the Cognition domain (p = 0.011). Conclusions: Combining CnvT with VR as a rehabilitation approach enhances motor function in the upper limb. This method has the potential to reduce disability scores and promote neuroplasticity.

Dental implantation in patients with comorbid diseases: yes or no?

Patients with multiple pathologies are a high-risk group, which requires a personalized approach to surgical rehabilitation in dentistry. Inadequate diagnosis of clinical manifestations when a patient is in remission often leads to severe surgical complications. However, modern methods of dental implantation and rehabilitation are possible even in patients with oncology, those who underwent surgical therapy, chemo- or radiotherapy. Gilbert syndrome, one of the risk factors for post-surgery inflammatory complications, is associated with defects in bilirubin metabolism. It inhibits platelet activity. It is a genetic disease leading to a loss of liver enzyme activity and the accumulation of indirect bilirubin that can aggravate the course of other diseases in patients. In acute stages, it is characterized by jaundice of the skin, eyes, and mucosa and is followed by immunosuppression and the post-surgical complications associated with it. A patient with Gilbert syndrome was administered for surgical treatment of a chronic infection and follow-up rehabilitation via dental implantation and reconstruction of the bone. In this case, we faced Gilbert syndrome in association with polycythemia (a myeloproliferative disease in the compensation stage). In such cases, dental implantation cannot be achieved in the complex dental rehabilitation process. Such diseases require special attention from dental surgeons due to possible complications (bleeding, thrombosis, or disseminated intravascular coagulation). In this specific case, the patient belongs to the risk group, and its history, although in remission, is still a contraindication for dental surgery and dental implantation.

Audiological and Subjective Benefits in a Child with Microtia and Atresia After Sequential Bilateral Implantation with Active Bone Conduction Devices: A Case Study

Background: With bilateral hearing loss, the main problems for the patient are speech understanding in noise and, especially in asymmetrical hearing loss, an inability to correctly localize sound sources. There are multiple methods of treatment and rehabilitation for people with conductive hearing loss, and one of them is to use an active bone conduction implant. This case study is designed to evaluate the auditory benefits and sound localization accuracy with active bilateral bone conduction implants—in comparison to unilateral ones—in a patient with congenital bilateral conductive hearing loss caused by a congenital malformation. We assess subjective and audiological benefits (functional, directional hearing, speech comprehension in quiet and noise). Case report: This study describes the results in a 15-year-old patient with bilateral congenital malformation of the outer ears and associated conductive hearing loss who was treated with two Bonebridge active bone conduction implants. Speech recognition ability, hearing thresholds, and sound localization were tested under three conditions: unaided, unilateral on the right-side, and bilateral on both sides. The patient filled in an Abbreviated Profile of Hearing Aid Benefit questionnaire (APHAB) to evaluate limitations in daily life caused by hearing impairment. The results show an improvement in free-field hearing thresholds and the ability to discriminate speech, both in quiet and in noise after implantation. Subjectively, the patient had significantly fewer problems with two implants than with one (or with no implant) in terms of hearing in everyday situations. Conclusions: Unilateral use of the Bonebridge device in a patient with congenital bilateral conductive hearing loss did not provide full benefits. However, bilateral implantation improved speech understanding in noise and sound localization.

Telemedicine-assisted cardiac rehabilitation: A controlled cohort clinical trial

Introduction. The traditional method of cardiac rehabilitation (CR) recommends continuing physical training at home, but many patients do not follow these instructions and the effectiveness of the rehabilitation program decreases. Thanks to the use of telemedicine technologies, the doctor can remotely monitor the patient’s condition, ensuring the safety and effectiveness of training.Aim. To test the method of organizing telemedicine support for CR of patients who have suffered a myocardial infarction.Materials and methods. During the study, 27 patients underwent CR with telemedicine support, and 26 patients underwent traditional CR. To assess the effectiveness of using telemedicine technologies in CR, the results of the six-minute walk test under the control of an electrocardiogram were assessed using the Accordix telemedicine system (Neurosoft LLC, Ivanovo) before and after the rehabilitation program.Results. After the end of the CR, in the group of patients with telemedicine support, during the six-minute walk test, reliable indicators of an increase in the distance covered were revealed compared to the results of patients in the control group (72 [52; 99.5] m vs. 45 [0.75; 51] m, p < 0.05), restoration of tolerance to physical activity (the ratio of the distance covered to the expected 15 [11.5; 18.5]% vs. 3 [-1.75; 8.75]%, p < 0.05), as well as an increase in the time the pulse stays in the training corridor (15% vs. 0.04%, p < 0.05). Also, in patients in the telemedicine CR group, the number of workouts was significantly higher (14.5 [12.5; 17] vs. 8.5 [4.5; 11.5], p < 0.05).Conclusion. The presented method of conducting CR using telemedicine technologies has shown greater efficiency compared to the traditional approach. Changes recorded using ECG are analyzed by the telemedicine system, ensuring control and safety of physical activity. The use of telemedicine technologies allows the patient to reduce the fear of repeated myocardial infarction and increase adherence to CR.

The Role of Bio-Inspired Soft Robotic Gloves in Stroke Rehabilitation: A Comprehensive Analytical Review

Stroke is a leading cause of long-term disability, with many survivors experiencing impaired motor function. Traditional rehabilitation methods often face limitations in achieving full functional recovery. In recent years, bio-inspired soft robotic gloves have emerged as a promising solution for enhancing stroke rehabilitation, mimicking the natural movement and adaptability of biological systems. This paper provides a comprehensive analytical review of bio-inspired soft robotic gloves designed for stroke rehabilitation, focusing on their development, fabrication methods and therapeutic applications. The primary objective of this review is to evaluate the role of bio-inspired designs in the creation of soft robotic gloves and assess their effectiveness in facilitating motor recovery post-stroke. A systematic analysis of existing literature is conducted, exploring various fabrication techniques, including soft material integration, actuators and sensors, as well as the application of these gloves in clinical and therapeutic settings. Findings from this review reveal that bio-inspired soft robotic gloves show significant potential in improving patient outcomes by enhancing finger and hand movement through assisted motor control. These devices offer advantages in terms of comfort, flexibility and adaptability, allowing for prolonged and intensive rehabilitation sessions. However, limitations remain, such as the high cost of fabrication, challenges in achieving precise motor control and the lack of large-scale clinical trials to validate long-term efficacy. The research has several implications: (1) Theoretical: advancing the understanding of bio-inspired design principles in soft robotics; (2) Methodological: highlighting fabrication techniques that enhance glove performance and user adaptability. This review offers original value by consolidating and analysing recent developments in bio-inspired soft robotic gloves, contributing to both the academic literature and practical applications in stroke rehabilitation. It emphasizes the necessity of future research to address current limitations, especially in optimizing performance and reducing production costs, while enhancing patient outcomes.

Multimodal human computer interaction of wheelchairs supporting lower limb active rehabilitation

Currently, an important challenge in stroke rehabilitation is how to effectively restore motor functions of lower limbs. This paper presents multimodal human computer interaction (HCI) of wheelchairs supporting lower limb active rehabilitation. First, multimodal HCI incorporating motor imagery electroencephalography (EEG), electromyography (EMG) and speech is designed. Second, prototype supporting wheelchair active rehabilitation method is illustrated in details. Third, the preliminary brain-computer interfaces (BCI) and speech recognition task experiments are carried out respectively, and the results are obtained. Finally, discussion is conducted and conclusion is drawn. This study has important practical significance in auxiliary movements and neurorehabilitation for stroke patients.

POSSIBILITIES FOR MEDICAL REHABILITATION IN PATIENTS AFTER HIP ENDOPROSTHETICS

Hip replacement surgery is currently the only effective surgical treatment option for patients with severe forms of degenerative-dystrophic diseases of the hip joint, so the problem of medical rehabilitation of such patients remains very relevant. One of the problems that arise after hip replacement surgery is a violation of the biomechanics of the artificial joint. The leading role in this process is played by the functional state of muscle tissue, which determines the problem of adaptation of the endoprosthesis components and can subsequently cause complications. The solution to this problem lies in timely comprehensive medical rehabilitation, individually selected for each patient, taking into account the characteristics of the postoperative period. Traditional methods of medical rehabilitation, including various methods of therapeutic exercise, natural and preformed physical factors, are undoubtedly effective, as indicated by an extensive scientific evidence base, but despite the proven effectiveness, these methods are time-consuming and require the presence of specialists. Along with traditional methods of medical rehabilitation, new technologies are currently used, including telerehabilitation, digital products based on virtual reality and artificial intelligence, robotic mechanotherapy, the effectiveness of which has been proven by scientific works of domestic and foreign colleagues and is in no way inferior to classical methods of rehabilitation treatment.

Blood Flow Restriction Training and Its Use in Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis

Background/Objectives: Anterior cruciate ligament (ACL) reconstruction (ACLR) is often followed by significant muscle atrophy and subsequent loss of strength. Blood flow restriction training (BFRT) has recently emerged as a potential mode of rehabilitation to mitigate these effects. The goal of this systematic review was to evaluate the efficacy of BFRT in functional recovery when compared to traditional rehabilitation methods. Methods: A literature review was conducted across July and August 2024 using multiple databases that reported randomised controlled trials comparing BFRT to traditional rehabilitation methods. Primary outcomes were changes to thigh muscle mass and knee extensor/flexor strength with secondary outcomes consisting of patient-reported functional measures (IKDC and Lysholm scores). The RoB-2 tool was used to assess the risk of bias. Results: Eight studies met the inclusion criteria; however, substantial heterogeneity prevented a meta-analysis being conducted for the primary outcomes. Three out of the five studies measuring muscle mass reported significant (p < 0.05) findings favouring BFRT. There was variation amongst the strength improvements, but BFRT was generally favoured over the control. Meta analysis of the secondary outcomes showed significant improvements (p < 0.05) favouring BFRT despite moderate heterogeneity. Conclusions: BFRT shows promise for maintaining muscle mass and improving patient reported outcomes following ACL reconstruction. However, the high risk of bias limits the strength of these conclusions. Further high-quality research needs to be conducted to establish optimal BFRT protocols for this cohort and to determine if BFRT has a place in ACL rehabilitation.

Exploring the Impact of Game Elements and Technological Platforms on Dementia Rehabilitation: A Scoping Review

One effective strategy to improve the quality of life for people with dementia (PWD) is rehabilitation, though patients often show reluctance due to the disease’s effects. A trending motivational approach is gamification. However, most research in this field has focused on the medical or technical aspects of system development, with less attention given to the role of game elements in the patient experience. In this study, a scoping review based on the PRISMA method was conducted on gamified rehabilitation systems, focusing on gamification elements, and interaction with technological platforms. By reviewing 46 studies, we extracted game elements based on the gamification pyramid, technological platforms, and rehabilitation methods, and compared them with previous studies on PWD interactions. This analysis identified opportunities and challenges for future research. Additionally, nine factors to improve user experience in the design of gamification systems for dementia rehabilitation were presented based on the review results.

Rebuilding Stability: Exploring the Best Rehabilitation Methods for Chronic Ankle Instability.

Background: Chronic Ankle Instability (CAI) is a common condition characterized by repeated episodes of ankle "giving way" and impaired balance, leading to functional limitations. Various rehabilitation techniques, including balance training, proprioceptive exercises, whole-body vibration (WBV), and novel approaches like stroboscopic vision, are used to address these deficits. This review evaluates the effectiveness of different rehabilitation interventions for CAI management. Methods: A review was conducted by analyzing 11 randomized controlled trials that investigated the impact of balance and proprioceptive training programs on CAI. The primary outcomes assessed were the Star Excursion Balance Test (SEBT), Cumberland Ankle Instability Tool (CAIT), and Foot and Ankle Ability Measure (FAAM). Methodological quality was assessed using the PEDro scale, and the risk of bias was evaluated with the ROB 2 tool. Results: All rehabilitation interventions demonstrated significant improvements in SEBT, CAIT, and FAAM scores. However, no single intervention was found to be consistently superior. Traditional balance training, strength exercises, BAPS, and WBV all provided meaningful functional gains. Stroboscopic vision training showed similar effectiveness compared to conventional approaches. The evidence supports a combination of balance and strength training for optimal recovery. Conclusions: Balance and proprioceptive exercises are effective in managing CAI, with improvements in both dynamic stability and subjective outcomes. No intervention stands out as the best, but personalized programs incorporating various methods are recommended. Future research should explore the long-term effects and potential synergies of combined interventions.

Marginal Bone Loss and Clinical Evaluation of Angled Implants: A Retrospective Study

Aim: The volume of the edentulous crest and its proximity to critical anatomical structures are important limiting factors for implant surgery. Surgical procedures with complications can be avoided by placing angled implants. The aim of this clinical study was to evaluate marginal bone loss and the complications of angled implants. Materials and Methods: Fifty-eight dental implants were examined in 32 patients (16 females, 16 males) with cone beam computed tomography (CBCT) images from patients with angled implants and complete edentation. The marginal bone loss in angled implants that were functional for 15 to 30 months was evaluated according to factors such as implant angle, connection type, opposing arch restoration type and planning of superstructure restoration. Marginal bone loss measurements were recorded from CBCT sections. Results: It was determined that 3.44% of the implants placed had an inclination of less than 15°, 75.86% had an inclination between 15° and 30° and 20.68% had an inclination of more than 30°. While there was no marginal bone loss on the mesial and distal surfaces, the average marginal bone loss was 0.66 on the buccal surfaces and 0.93 in the lingual region. Only one of the implants examined failed. No pain or infection was observed in any of the implants examined. Conclusion: According to the results of this retrospective clinical study, further clinical studies with larger sample sizes are needed to evaluate angled implants supported by full arch fixed prostheses as a predictable and valid treatment method in the prosthetic rehabilitation of edentulous jaws.

SPECIFICS OF PHYSICAL REHABILITATION OF CHILDREN WITH CEREBRAL PALSY

Cerebral palsy (CP) is an umbrella term that covers a group of diseases that manifest themselves mainly in impaired movement, balance and posture. The number of children affected by this disease is constantly growing around the world. Today, cerebral palsy is one of the most common forms of childhood disability, affecting approximately 2-3 children per 1000 births. Purpose. to analyse and systematise the specifics of physical rehabilitation of children with cerebral palsy. Materials and methods. To achieve the objectives of the study, the researchers analysed scientific literature and systematised information using electronic databases such as PubMed, Google Scholar and others. Research results. The main approaches and methods of physical rehabilitation for children with cerebral palsy are traditional physiotherapy, hydrotherapy, botulinum therapy, robotic systems and therapy using virtual reality technologies. The main aspects of physiotherapy are assessment and planning, improving mobility and correcting posture, rehabilitation after surgery, and involvement in everyday life. Hydrotherapy uses the therapeutic properties of water to improve the physical functions and general well-being of children with this disease. The methods of hydrotherapy include swimming, exercises in a hydromassage pool, therapeutic exercises in water, and physiotherapy techniques. Botulinum toxin therapy (BT) is a spasticity treatment with the highest level of scientific evidence, which has been used for ~30 years in patients with cerebral palsy (CP). Botulinum toxin type A is used during botulinum therapy, which is a neurotoxin that blocks the transmission of nerve impulses to the muscles. This leads to a temporary weakening of the muscles, which helps to reduce spasticity and alleviate symptoms. Robotic systems and virtual reality (VR) technologies are innovative approaches used to rehabilitate children with cerebral palsy (CP). These technologies offer new opportunities to improve physical function and quality of life for children. Conclusions. Among a large number of traditional methods of physiotherapy, scientists highlight the high efficiency of Bobath therapy in the physical rehabilitation of children with cerebral palsy. This is also confirmed by the research of Vitalia Kashuba and Bozhena Bukhovets, who developed a physical rehabilitation programme that included Bobath therapy. Hydrotherapy, or water therapy, is an important part of the rehabilitation of children with cerebral palsy. It uses the healing properties of water to improve the physical functions and overall well-being of children with this disease. Research by Aikaterini Bayraktariadou, Konstantinos Chandolias and others demonstrates that hydrotherapy, either as an individual treatment or in combination with a standard exercise programme on land, can significantly contribute to improved mobility, increased exercise endurance and a better quality of life. Botulinum toxin is widely used in the rehabilitation of children with cerebral palsy. A study by Farid Hareb and others shows that botulinum toxin therapy can be an effective method for improving the quality of life of children with cerebral palsy, helping to reduce spasticity and improve their motor function. Also, robotic technologies and VR have recently been actively introduced into the physical rehabilitation of children with cerebral palsy. Research by Hyun Cho Chang, Menekseoglu Ahmet Kivanc, and Rocio Llamas-Ramos confirms the feasibility of combining traditional physiotherapy with robotic systems and virtual reality.