Physiotherapy Methods Research Articles

Physical therapy options for knee osteoarthritis: A review.

In recent years, osteoarthritis of the knee, a common degenerative joint disease, often occurs in the elderly population. This disease has a significant impact on the quality of life of patients. For treating knee osteoarthritis, physical therapy is highly regarded as a very effective treatment method. This article delves deeply into commonly used physical therapy methods and analyzes their therapeutic effects, cost-effectiveness, and applicability, aiming to find treatments with broader applicability and better cost-effectiveness. The goal is to help a large number of patients effectively alleviate the discomfort caused by knee osteoarthritis, enhance the clinical therapeutic effects, and introduce home treatment methods to reduce financial burdens. The article also compares various physical therapy methods and finds that moxibustion and electrotherapy are more suitable for home use. Other treatment methods provide a reliable scientific basis for patient treatment.

Smart Response Biomaterials for Pain Management.

The intricate nature of pain classification and mechanism constantly affects the recovery of diseases and the well-being of patients. Key medical challenges persist in devising effective pain management strategies. Therefore, a comprehensive review of relevant methods and research advancements in pain management is conducted. This overview covers the main categorization of pain and its developmental mechanism, followed by a review of pertinent research and techniques for managing pain. These techniques include commonly prescribed medications, invasive procedures, and noninvasive physical therapy methods used in rehabilitation medicine. Additionally, for the first time, a systematic summary of the utilization of responsive biomaterials in pain management is provided, encompassing their response to physical stimuli such as ultrasound, magnetic fields, electric fields, light, and temperature, as well as changes in the physiological environment like reactive oxygen species (ROS) and pH. Even though the application of responsive biomaterials in pain management remains limited and at a fundamental level, recent years have seen the examination and debate of relevant research findings. These profound discussions aim to provide trends and directions for future research in pain management.

COMPLEX USE OF PHYSICAL THERAPY MEANS IN THE REHABILITATION OF SCHOOL-AGE CHILDREN WITH POSTURE DISORDERS

Relevance of the research topic. The problem of using physical therapy means in rehabilitation of school-age children with posture disorders becomes especially relevant in the context of the threat of serious spinal diseases, which can negatively affect the health and physical development of children in the future.Purpose and methods of the study. The aim of the work is to reveal the essence of complex use of physical therapy means in rehabilitation of school- age children with posture disorders. The research consisted of the analysis of scientists' works and description of the use of therapy for correction of school-age children's posture. Research methods and statistical analysis. We used both general scientific and special methods of research, namely: analysis, synthesis, structural-functional, description, generalization.Results. The article presents an analysis of the integrated use of physical therapy in the rehabilitation of school-age children with postural disorders. Various methods and techniques of physical therapy aimed at restoring optimal physical functioning and correcting postural defects are described. It is described that the main methods of physical therapy used in rehabilitation are therapeutic physical culture, correction of body position, therapeutic massage, hardening, hydrokinesitherapy and physiotherapy. Particular attention is paid to physical exercises that specialize in correcting specific types of posture disorders. Key findings. It has been shown that symmetrical and asymmetrical exercises, known as corrective exercises, are used to equalize the tone of the trunk muscles and strengthen relaxed muscles, helping to return the spine to its correct position. It has been proven that therapeutic massage, as an effective means of functional therapy, is used at all stages of medical and physical therapy to treat various diseases and injuries. The article analyzes the effectiveness of these methods and their role in achieving positive results in the rehabilitation of children with postural disorders.

Consistent Application of Physiotherapy Methods in the Treatment of Patients with Pulmonary Tuberculosis: A Clinical Case

Introduction. One of the problems of domestic phthisiology is the low effectiveness of treatment, which, along with anti-tuberculosis chemotherapy, uses pathogenetic methods, including physiotherapy procedures. The use of several physical factors in the treatment of pulmonary tuberculosis shows great therapeutic effectiveness. However, there are not enough works highlighting the combined effects of physical factors in tuberculosis of the respiratory system, applied in successive courses, taking into account the phase of a specific process and the mechanisms of therapeutic effects of physical methods.The purpose of the study — is to demonstrate the effectiveness of consistent application of physiotherapy methods in the treatment of patients with pulmonary tuberculosis.Materials and methods. The materials of the study were the medical records of the inpatient and the results of a comprehensive examination.Results and discussion. The presented clinical example demonstrates the effectiveness of consistent application of physiotherapy procedures in the complex treatment of a patient with infiltrative pulmonary tuberculosis. After 1 month from the start of treatment, accelerated positive clinical dynamics was noted, cessation of bacterial excretion, partial resorption of infiltrative changes in the lungs, by 2 months — closure of the decay cavities, after 4 months the patient was discharged with minimal radiological changes to continue treatment on an outpatient basis.Conclusion. Consistent application of physical factors can be one of the effective methods of improving the effectiveness of treatment of pulmonary tuberculosis, as demonstrated by the presented clinical examples. Further research is needed to substantiate the effectiveness of the proposed methodology.

Therapeutic effects investigation of physical therapy and pharmacotherapy in the treatment of persistent allergic rhinitis

To investigate the therapeutic effects of physical therapy and pharmacotherapy in the treatment of persistent allergic rhinitis. Methods:192 patients were randomly divided into 3groups, A group 72 cases, B group 70 cases. A and B group were treated with focused ultrasound and radiofrequency ablation respectively under the endoscope and using spraying Mometasone Furoate Nasal Spray for 1month after the operation. Patients of C group use the Mometasone Furoate Nasal Spray and Cetirizine Hydro- chloride Tablets for 1 month. Follow up for 6 months after treatment and evaluate the curative effect with soring method. Results: Total effectiveness was as fllowed:1st months: A group 97.2%, B group 97.1%C group 96.0%;6 months: A group 90.3%, B group 87.1%, C group 64.0%. The curative effect score of three group after the treatment for 1month have no significant difference (P>0.05). Comparing the efficiency of patients in three groups after treatment for 6 months, there was significant difference of stat is tactically significance. The efficiency of A and B group were higher than group C(P<0.05).A group was better than B group with the score of sneezing after the treatment ,the difference was significant(P<0.05).But B group was better than A group with the score of nasal congestion ,the difference was significant(P<0.05).Conclusion: The curative effect of treatment with two physical therapy methods combined with mometasone furoate for persistent allergic rhinitis, the former is better than the latter for sneezing ,but the improvement of nasal congestion is less than the latter. Long-erm therapeutic effect of drug with AR is less than physical therapy in combination with drug. The treatment with focused ultrasound combined with mometasone furoate for persistent AR is worth promoting, especially suitable for medium and severe persistent AR patients.

Effectiveness of improving coordination abilities after cardiac surgery: a review

INTRODUCTION. Bronchopulmonary complications remain the leading cause of postoperative morbidity and prolong the patient’s hospital stay, increasing the cost of treatment. AIM. To study the effectiveness of using coordination training of the mechanics of respiratory movements in cardiac rehabilitation programs during breathing exercises. SEARCH STRATEGY. Through a literature search in the PubMed (Medline) and RISC search engines from January 2019 to December 2023, systematic reviews, meta-analyses and randomized controlled studies were selected of factors influencing the development of postoperative pulmonary complications after open heart surgery with cardiopulmonary bypass, as well as methods behavioral regulation and self-breathing training in cardiopulmonary rehabilitation to assess the effectiveness of reducing the number of pulmonary complications and their severity compared to conventional methods of respiratory cardiac rehabilitation. MAIN CONTENT. Based on an analysis of the literature, it has been suggested that after cardiac surgery, patients experience a decrease in coordination interactions in the work of the inspiratory muscles of the chest, which requires improvement in coordination abilities. The features of compensatory changes in the external respiration system after correction of the coordination interactions of the respiratory muscles in the process of respiratory-cardiac rehabilitation are illustrated, namely in increasing alveolar ventilation due to the improvement of the optimal ratios of thoracic and abdominal types of breathing, optimal synchronous and multiple ratios of the number of respiratory and motor cycles, its frequency and depth, higher efficiency of the respiratory muscles. CONCLUSION. The research results indicate that after completing a course of coordination training, where they developed the skills and abilities to control their breathing, patients who underwent open heart surgery with artificial circulation had a lower severity and incidence of postoperative bronchopulmonary complications, improved blood oxygen saturation and increased tolerance to physical activity compared to traditional methods of physical therapy, while the most pronounced changes are observed under the influence of methods of behavioral regulation of breathing. The obtained results of changes in the function of external respiration make it possible to evaluate the impact of coordination training to control one’s breathing as beneficial for prevention and rehabilitation.

Two Physiotherapy Methods to Improve the Physical Condition of Children with Autism Spectrum Disorder.

This study presents two simple physiotherapy programs that were implemented for five weeks and showed positive changes in balance, coordination, and motor skills in kindergarteners with ASD. Physiotherapy programs in a gym and games on a smart board with balance plates and an unstable base were applied to improve the physical condition of children with ASD. Thirty children with ASD (4-6 years old) attending special needs kindergarten were enrolled in the study. Three tests were used to assess participants' physical condition before and after the study: the modified Berg Balance Scale, the Imbalance Coordination Sample, and the Bruininks-Oseretsky Motor Proficiency Test (BOTMP). The resulting mean change, calculated from each group's scores, shows that the participants who received physical therapy sessions at the smart board had the greatest change of 1.58 points. It shows that the opportunity to play games on a smart board motivates children with ASD to work harder; therefore, it is a simple and easy way to engage children in different types of physical exercise. A slightly smaller change of 1.51 was obtained in the group that received gym sessions. However, working in the gym was more psychologically challenging for the children with ASD due to their lack of desire and motivation. Both methods are relatively simple and easy to apply at home; therefore, parents can make a significant contribution to improving children's physical condition and that can be an effective tool to assist these individuals with activities in daily life.

ALGORITHM FOR THE APPLICATION OF PHYSICAL THERAPY FOR CRITICALLY ILL PATIENTS IN THE CONDITIONS OF THE DEPARTMENT OF ANESTHESIA AND INTENSIVE CARE UNIT

Aim. Create and justify the algorithm of physical therapy application, which will be used at the early stage of treatment of critically ill patients treated in the transferred anesthesiology and intensive care unit. Materials and methods. The study was conducted during five months of 2023 in two medical and diagnostic centers in Kyiv, Ukraine, in the conditions of the department of anesthesiology and intensive care unit. 80 critically ill patients took part in the study, who were divided into main and control groups of 40 people each. Participants in the main group had physical therapy included in the treatment process, while the control group did not receive such treatment. The sample of patients was based on selection on the basis of indicators of critical condition and the need for treatment in the conditions of the anesthesiology and intensive care unit. Participation in the study varied from 1 to 3 weeks, with the first assessment at the meeting with the physical therapist and the last before discharge or transfer of the patient. Assessment included manual muscle testing and the Richmond Agitation/Sedation Scale, as well as observation for comorbidities. During the research, a developed algorithm for the use of physical therapy for critically ill patients was applied. Results. In the course of the study, a complex of physical therapy methods was used to influence the dynamics of the patients' state of consciousness, the functional strength of the muscles of the upper and lower limbs, as well as to study the frequency and severity of the development of accompanying complications (bedsores, contractures, swellings, deformations, wounds). Data collected from the main and control groups were subjected to comparative statistical analysis. The results of the analysis confirm that the use of the developed algorithm of physical therapy contributed to a significant improvement in the cognitive state of the participants, an increase in functional strength in the muscles of the limbs, and also effectively reduced the risk and severity of comorbidities. This indicates the importance of integrating physical therapy into a comprehensive approach to the treatment of critically ill patients. Conclusions. The proposed approach to the use of physical therapy for patients who are in critical condition and treated in the conditions of the department of anesthesiology and intensive care confirms its high efficiency in the early stages of treatment. Studies show that the use of physical therapy improves the functional state of muscles, improves the cognitive functions of patients, and also helps to prevent the development of concomitant complications that may occur during a stay in the conditions of the anesthesiology and intensive care units.

Views about the clinical, diagnostic and comprehensive treatment of plantar fasciitis: a review

INTRODUCTION. One of the problems in modern podiatry is plantar fasciitis. According to population studies, more than two million patients are treated for plantar fasciitis each year in the United States, 1 in 10 people will develop heel pain during their lifetime, and 1 % of visits to podiatrists are related to heel pain. Plantar fasciitis occurs in approximately 10 % of the general population, with 83 % of these patients being active working adults between the ages of 25 and 65. The high prevalence of plantar fasciitis in the population necessitates the search and development of new and effective methods for its recognition and treatment. AIM. Generalization of literature data on the mechanisms of development of plantar fasciitis, methods of diagnosis and treatment. MATERIALS AND METHODS. The databases PubMed, Scopus and the electronic scientific library eLIBRARY were searched for articles using the keywords: “plantar fasciitis”, “plantar fasciosis”, “heel pain”, “heel spur”. Search depth — 10 years. Publications related to the diagnosis and treatment of PF were selected. During the study, 40 publications were selected, the content of which, to one degree or another, corresponded to the purpose of this study. RESULTS AND DISCUSSION. Pain syndrome in the area of the heel bone is the main reason for seeking medical care in patients with plantar fasciitis. Currently, there are several approaches to the treatment of plantar fasciitis: conservative and surgical treatment. Conservative treatment is represented by methods of manual therapy, physical therapy, and physical therapy. Surgical methods include various variants of resection of the bony outgrowth of the calcaneal region and other interventions. CONCLUSION. Treatment of plantar fasciitis requires a multidisciplinary approach to treatment, as no single treatment method is universal. Conservative treatment of patients with plantar fasciitis should be comprehensive. Due to the high prevalence of plantar fasciitis in the population, the introduction of new treatment techniques and the development and use of a unified patient management tactic can improve patient outcomes and quality of life. Among other surgical methods, the use of RFD has a positive effect in patients with PF refractory to conservative therapy and is the least invasive method among surgical methods.

Сurrent medical rehabilitation methods for patients after carpal tunnel syndrome surgical treatment: a review

INTRODUCTION. Carpal tunnel syndrome is one of the most common tunnel syndromes types and ranks sixth in the all-occupational diseases’ registry. The high interest in this pathology and its’ postoperative management peculiarities study is due to the disease widespread prevalence, social significance, often unsatisfactory surgical treatment results and a long hand function restoration period. The purpose of this work was to study modern concepts of postoperative rehabilitation of patients with carpal tunnel syndrome. SOURCE SEARCH METHODOLOGY. When preparing the review, open electronic databases of scientific literature were used: PubMed, ClinicalTrials.gov, eLibrary.ru. The search for medical literature data was carried out using the following keywords: “rehabilitation”, “carpal tunnel syndrome”, “carpal tunnel syndrome”, “median nerve”, “compressive neuropathy”. The criteria for inclusion in the analysis of literature sources were: randomized controlled clinical trials, systematic reviews and meta-analyses. Preference was given to publications over the past 5–10 years. DISCUSSION. The article presents the most commonly used techniques in the postoperative management of patients with carpal tunnel syndrome, discusses the mechanisms of their action and prospects for the development of this area. The review discussed the following rehabilitation methods: a wide range of methods of hardware physiotherapy, manual therapy, kinesiotaping, manual lymphatic drainage, as well as the possibilities of physical therapy and robotic mechanotherapy. Despite the high level of development of medicine, the long process of rehabilitation of these patients remains an important problem, while the clinical effectiveness of a wider range of proposed techniques still remains poorly understood. Some of the most promising methods of rehabilitation of patients after surgical treatment for carpal tunnel syndrome are methods of robotic mechanotherapy and extracorporeal shock wave therapy. CONCLUSION. For the effective use of the described techniques as part of the postoperative rehabilitation of patients with carpal tunnel syndrome in clinical practice, further research and study of their long-term effects, as well as comparison of their effectiveness with the aim of the most complete and rapid restoration of the function of the affected hand, is necessary.

EFFECTIVENESS OF SACRAL RELEASE TECHNIQUE COMBINED WITH CONVENTIONAL PHYSIOTHERAPY FOR MANAGING DYSMENORRHEA: A CASE STUDY

Background: Dysmenorrhea (menstrual cramps) is a common gynecological condition with painful menstruation as its main symptom. It negatively influences women’s quality of life and hampers their productivity and activities. While the exact etiology is unknown, increased prostaglandin levels and myofascial trigger points are thought to play a role. This study investigated the effectiveness of combining sacral release technique, a myofascial release therapy, with conventional physiotherapy for treating dysmenorrhea symptoms. Methods: A 23-year-old woman with clinically diagnosed primary dysmenorrhea was treated with a rehabilitation protocol consisting of sacral release technique, deep breathing exercises, and static stretching over the course of her menstrual period. Outcomes were measured pre- and post-intervention using the Numerical Pain Rating Scale (NPRS) and Menstrual Distress Questionnaire (MEDI-Q). Results: Subsequently after the intervention all outcome indices indicated significant improvement for the patient. NPRS scores reduced from 6 to 4 indicating less pain intensity while broad MEDI-Q total score went down from 64 to 39 signifying improved menstrual symptoms along with distress due to periods in addition to over-all quality regarding daily living associated with menses. Conclusion: In Conclusion, combining sacral release technique, and traditional physiotherapy methods of deep breathing and stretching were effective in alleviating symptoms of woman during menstrual flow, reducing pain and improving quality of life for the mentioned patient. These findings indicate that having a sacral release along with other modalities may become another intervention in treating dysmenorrhea. Keywords: Dysmenorrhea, sacral release technique, Pain Management, conventional physiotherapy, case study.

Physiotherapy for patients with depression: Recent research progress.

Depression, a common mental illness, seriously affects the health of individuals and has deleterious effects on society. The prevention and treatment of depression has drawn the attention of many researchers and has become an important social issue. The treatment strategies for depression include drugs, psychotherapy, and physiotherapy. Drug therapy is ineffective in some patients and psychotherapy has treatment limitations. As a reliable adjuvant therapy, physiotherapy compensates for the shortcomings of drug and psychotherapy and effectively reduces the disease recurrence rate. Physiotherapy is more scientific and rigorous, its methods are diverse, and to a certain extent, provides more choices for the treatment of depression. Physiotherapy can relieve symptoms in many ways, such as by improving the levels of neurobiochemical molecules, inhibiting the inflammatory response, regulating the neuroendocrine system, and increasing neuroplasticity. Physiotherapy has biological effects similar to those of antidepressants and may produce a superimposed impact when combined with other treatments. This article summarizes the findings on the use of physiotherapy to treat patients with depression over the past five years. It also discusses several methods of physiotherapy for treating depression from the aspects of clinical effect, mechanism of action, and disadvantages, thereby serving as a reference for the in-depth development of physiotherapy research.

Radiologic and histopathologic effects of favipiravir and hydroxychloroquine on fracture healing in rats

Fracture healing is a process in which many factors interact. In addition to many treatments, physical and biological therapy methods that affect different steps of this process, there are many biological and chemical agents that cause fracture union delay. Although the number of studies on fracture healing is increasing day by day, the mechanism of fracture healing, which is not fully understood, still attracts the attention of all researchers. In this study, we aimed to investigate the effects of favipiravir and hydroxychloroquine used in the treatment of COVID-19. In this study, 48 male Wistar rats weighing 300 ± 50 g were used. Each group was divided into eight subgroups of six rats each to be sacrificed at the 2nd and 4th weeks and evaluated radiologically and histologically. Favipiravir (group 1), hydroxychloroquine (group 2), favipiravir + hydroxychloroquine (group 3), and random control (group 4) were used. A statistically significant difference was observed between the 15th day histological scoring averages of the groups (p < 0.05). Although there was no statistically significant difference between the 15th day radiological score distributions of the groups (p > 0.05), we obtained different results in terms of complete bone union distributions and radiological images of the fracture line. Although favipiravir has a negative effect on fracture union in the early period, favipiravir may have a positive effect on fracture union in the late period. We did not find any effect of hydroxychloroquine on fracture union.

КОНСЕРВАТИВНЫЕ МЕТОДЫ ЛЕЧЕНИЯ ГРЫЖ МЕЖПОЗВОНКОВЫХ ДИСКОВ

In the modern world, herniated intervertebral discs are one of the most common pathologies, often occurring among the working-age population. Protrusion of the intervertebral disc beyond the cross-section of the vertebra can lead to severe pain (even disability) due to mechanical compression of the nerve root and, with extrusion of the nucleus pulposus, inflammatory reactions. Thus, to date, pain syndrome that has developed as a result of a hernia occurs in 9% of the world's population. Thus, the treatment of intervertebral hernias is one of the pressing problems of the modern world. Radical treatment - surgical, is associated with a number of complications and does not always lead to the desired results. For this reason, surgical treatment should be carried out only if conservative methods are ineffective, among which physiotherapy occupies a special place. The purpose of this work is a literary analysis of physiotherapy methods currently used for the treatment of herniated intervertebral discs and to determine their place in the complex therapy of this pathology. The review examines the nature of intervertebral hernias, some of the physiological reactions they cause, in particular, the mechanisms of pain syndrome formation are indicated. We also described in detail the main methods of physiotherapy currently used for herniated intervertebral discs, such as electrophoresis, balneological procedures, spinal traction; the mechanisms of their influence on the damaged intervertebral disc are indicated, allowing to eliminate or reduce the intensity of the pain syndrome; The need for an integrated approach in the treatment of the pathology under study was determined.

Anti-aging technologies and physiotherapy innovations

Abstract. At present, aesthetic anti-aging programs have acquired a new semantic content, since, on the one hand, they demonstrate the modern level of development of medicine and, on the other hand, the unity of external aestheticism with the somatogenic status of patients, both men and women. The purpose of the study was to improve the quality of anti-aging medical and aesthetic care for patients with varying degrees of age-related structural changes in the skin of the face and body, by including a combined anti-aging program with the use of injectable carboxytherapy, platelet-rich plasma (PRP), exercise therapy, a dietary program, and nutritional support (trace elements of zinc, copper, selenium, vitamins B and D) in the treatment protocol. Patients and methods: 114 patients (56 men and 58 women) with involutive face / body skin changes were studied. Prior to the combined anti-aging program, all patients underwent an anthropometric assessment (body mass index — BMI), dermatological control (dermatoscopy, ballistometry, corneometry, cutometry), and an assessment of antioxidant functions according to liquid chromatography and mass spectroscopy (superoxide dismutase — SOD, total antioxidant function index). Simple open-label randomization made it possible to divide men and women into homogeneous comparable groups: group I (n = 30) received injectable carboxytherapy along the cosmetic lines of the face and in the décolleté; group II (n = 30) received platelet-rich plasma in the form of platelet therapy in the specified areas; group III (the study group, n = 32) were treated with a combined technique including simultaneous PRP and injectable carboxytherapy; group IV (the control group, n = 22) had basic facial and body care, without physiotherapy methods. The statistical data analysis was carried out in Microsoft Office Excel (2017) and SPSS statistical processing (PASW Statistics version, 2018). Parametric (the linear correlation method, the Students test) and non-parametric methods (the Spearman»s rank correlation coefficient, the Wilcoxon and Mann-Whitney Test) were used. The differences were considered significant at p &lt; 0.05. Results: after the combined therapy, there was a significant increase in the hydration index of the facial skin by 13.2 ± 1.2 standard units, an increase in the level of elastin by 9.4 ± 2.9 standard units, a decrease in the depth of wrinkles by 1.4 points, correction of superoxide dismutase values from 135 [133; 137] ng / mL to the physiological norm of 112.4 [111.9; 112.9] ng /mL (p &lt; 0.01), and an improvement in the overall antioxidant function of the blood.

Unlocking the potential of exosomes: a breakthrough in the theranosis of degenerative orthopaedic diseases.

Degenerative orthopaedic diseases pose a notable worldwide public health issue attributable to the global aging population. Conventional medical approaches, encompassing physical therapy, pharmaceutical interventions, and surgical methods, face obstacles in halting or reversing the degenerative process. In recent times, exosome-based therapy has gained widespread acceptance and popularity as an effective treatment for degenerative orthopaedic diseases. This therapeutic approach holds the potential for "cell-free" tissue regeneration. Exosomes, membranous vesicles resulting from the fusion of intracellular multivesicles with the cell membrane, are released into the extracellular matrix. Addressing challenges such as the rapid elimination of natural exosomes in vivo and the limitation of drug concentration can be effectively achieved through various strategies, including engineering modification, gene overexpression modification, and biomaterial binding. This review provides a concise overview of the source, classification, and preparation methods of exosomes, followed by an in-depth analysis of their functions and potential applications. Furthermore, the review explores various strategies for utilizing exosomes in the treatment of degenerative orthopaedic diseases, encompassing engineering modification, gene overexpression, and biomaterial binding. The primary objective is to provide a fresh viewpoint on the utilization of exosomes in addressing bone degenerative conditions and to support the practical application of exosomes in the theranosis of degenerative orthopaedic diseases.

A Comprehensive Review: Robot-Assisted Treatments for Gait Rehabilitation in Stroke Patients.

Robot-assisted gait training (RAGT) is at the cutting edge of stroke rehabilitation, offering a groundbreaking method to improve motor recovery and enhance the quality of life for stroke survivors. This review investigates the effectiveness and application of various RAGT systems, including both end-effector and exoskeleton robots, in facilitating gait enhancements. The selection process for this comprehensive analysis involved a meticulous review of the literature from databases such as PubMed, the Cochrane Library, and EMBASE, focusing on studies published between 2018 and 2023. Ultimately, 27 studies met the criteria and were included in the final analysis. The focus of these studies was on the various RAGT systems and their role in promoting gait and balance improvements. The results of these studies conclusively show that patients experience significant positive effects from RAGT, and when combined with other physiotherapy methods, the outcomes are notably superior in enhancing functional ambulation and motor skills. This review emphasizes RAGT's capability to deliver a more customized and effective rehabilitation experience, highlighting the importance of tailoring interventions to meet the specific needs of each patient.

Video-based exergaming versus conventional rehabilitation on balance in pediatric brain tumor survivors: a randomized clinical trial

Balance problems are widely reported in Pediatric Brain Tumor Survivors (PBTS) due to tumor localization and the side effects of medical treatment. This study investigates the effects of conventional versus video-based games exercise training (exergaming) on balance in PBTS. The present study was a randomized controlled trial. The study included 23 PBTS who were randomized to a Video-Based balance exergaming Group (VBG) or Conventional balance exercise training Group (CG). In both groups, the interventions were targeted to the balance function and balance exercise training was administered twice a week for 8 weeks. VBG exercised using selected Nintendo Wii Fit Plus® balance games while CG received a specially designed balance training using conventional physiotherapy methods. The primary outcome was the balance tests (Timed Up and Go and Nintendo® Wii™ Center of Gravity: COG), and the secondary outcomes were the functional tests (10-m walking, 2-min walking, 5-step climb/descent/times), and disease effect test (PedsQL Brain Tumor Module). The outcomes were assessed before and after the intervention. At baseline, no significant clinical and outcome assessment differences existed between both groups except for COG (p = 0.0495). After training, overall scores for balance, functional, disease effect tests significantly improved in VBG (p < 0.05) while progress observed in CG was not significant (p > 0.05). Video-based balance exergaming was found effective and more so than conventional balance exercise training in PBTS. Greater effectiveness of exergaming is thought to be due to increased motivation and effort of the children who are more attracted to gaming than conventional exercising. Exergaming could be beneficial both in clinical and home settings with physiotherapist supervision and may reduce the costs of treatment while improving their health-related quality of life.

The Efficacy of Extracorporeal Shockwave Therapy Compared with Compression Therapy in Healing Venous Leg Ulcers.

Background: Innovative methods of physical therapy delivered via modern medical devices have significantly extended the possibility of applying conservative treatments in healing venous leg ulcers. The primary objective of this study was to compare the therapeutic efficacy of selected mechanical physical therapies (intermittent pneumatic compression vs. radial extracorporeal shockwave vs. focal extracorporeal shockwave) vs. standard care in the treatment of venous leg ulcers over a 4-week period. Materials: This study included 69 patients, comprising 45 females (65%) and 24 males (35%), with a mean age of 67.1 ± 8.6 years (range: from 52.0 to 80.0 years). Methods: The patients were allocated into four groups: the IPC group was treated with intermittent pneumatic compression therapy, the R-ESWT group was treated with radial extracorporeal shockwave therapy, the F-ESWT group was treated with focal extracorporeal shockwave therapy, and the SC group was treated with standard care. Results: After one month of therapy, the median percentage decrease in wound total surface area after treatment was as follows: in the IPC group, there was a 52.9% decrease (range: 3.3-100%); in the R-ESWT group, there was a 31.6% decrease (range: 2.4-95.8%); in the F-ESWT group, there was an 18.0% decrease (range: 1.9-76.1%); and in the SC group, there was a 16.0% decrease (range: 1.5-45.8%). Conclusions: All the studied therapies caused a statistically significant reduction in the surface area of venous leg ulcers. The best results were observed with the intermittent pneumatic compression, while the radial and focal extracorporeal shockwave therapies appeared less effective. The standard care alone turned out to be the least effective. Our results did not show statistically significant changes in the values of RBC deformability at the investigated shear rates.

EXPERIENCE OF RESORPTION OF LUMBAR SPINE HERNIAS

Background. In most cases, the reduction in pain and clinical manifestations is associated with a decrease in the size of the hernia or its resorption, which is the natural process of reduction or complete disappearance of the hernia without the need for surgical intervention. Currently, there are several intensive physical therapy methods that influence the process of hernia resorption, making conservative treatment preferable. Materials and methods. At the «Expert Neuro» clinic, as part of a prospective observational study from 2023 to 2024, 30 patients with a confirmed diagnosis of “herniated intervertebral discs of the lumbar spine” were analyzed based on the results of magnetic resonance imaging. The main group of patients received conservative treatment using modern high-intensity physiotherapy methods, the control group received classical methods of conservative treatment. Results. According to magnetic resonance of the spine, 3 patients developed resorption of a herniated intervertebral disc. In all patients, radiculopathy symptoms improved after 1 month and lower back pain symptoms improved after 2 to 3 months. Conclusion. According to our clinical experience and relevant literature, sequestered disc herniations have a high rate of resorption. Pathophysiological processes of inflammation and regeneration are the main mechanisms of this phenomenon. Conservative management of such patients in the absence of definitive surgical indications should not be underestimated.