Neurological Physiotherapy

Kompleksowa rehabilitacja chorych na reumatoidalne zapalenie stawów wymaga znajomości patologicznych zjawisk zachodzących w układzie ruchu oraz podejmowania działań profilaktycznych opóźniających niepełnosprawność. Zadaniem zespołu leczącego jest świadoma modyfikacja sposobu zachowań chorego na RZS w celu ułatwienia mu możliwie normalnego życia z przewlekłą chorobą. Omówiono prawidłowe pozycje: spoczynkowe, siedzącą i stojącą oraz zalecane sposoby ich zmiany. Complex patients rehabilitation with rheumatoid arthritis demands acquaintances of pathological phenomena occurring in the system of motion as well as the recommendations on their modifications postponing disabilities. The job of the treatment crew is to modify the RA patient's behaviors in conscious way in order to make the life easier up to some extend curing disease. Proper positions were diseased such as: relax, sitting and standing ones as well as recommended means their changing. A Ad dr re es s d do o k ko or re es sp po on nd de en nc cj ji i: :

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is an acquired immune-mediated neuropathy
characterized by progressive weakness and sensory dysfunction. This case describes a 43-year-old male with
CIDP, complicated by diabetes, hypertension, ischemic heart disease, and MRSA positivity. Physiotherapy
interventions emphasized positioning, range of motion, trunk facilitation, and modified respiratory care under strict
infection-control precautions. After two weeks of therapy, the patient demonstrated preserved joint range, reduced
edema, improved sitting tolerance, and prevention of secondary respiratory complications. This case highlights
the importance of adaptable physiotherapy strategies in neurological patients with concurrent infection risks.

This is the third time this Clinical Note about the influence of colour related to mechanical properties of elastic tape has been updated. There have been more than enough studies showing that colour influences the mechanical properties of tape. In my opinion it would be a waste to research this in more detail, or to aim to develop a tape specific protocol. The outcomes of the various studies found were not surprising, and/or are not applicable in the clinic.

Background: Cervical dystonia (CD), a chronic neurological movement disorder characterized by involuntary muscle contractions in the neck, leads to abnormal head postures, pain, and functional disability. While botulinum toxin injections remain the mainstay of treatment, physiotherapy is increasingly recognized as a complementary approach aimed at improving motor control, reducing pain, and enhancing quality of life. Objective: This narrative review aims to evaluate and synthesize current evidence on the effectiveness of various physiotherapy interventions in the management of cervical dystonia. Methods: A comprehensive literature search was conducted using databases such as PubMed, Scopus, and Google scholar to identify studies published in the last five years that investigated physiotherapy-based interventions for cervical dystonia. Studies were included based on relevance, study design, and outcome measures focusing on motor symptoms, pain, disability, and quality of life. Results: The review identifies a range of physiotherapy approaches including sensorimotor retraining, postural re-education, manual therapy, stretching, strengthening exercises, and task-specific training. Although study designs and intervention protocols vary, the majority of evidence supports physiotherapy as a beneficial adjunct to botulinum toxin therapy. Improvements have been noted in pain reduction, head posture control, and functional mobility, particularly when therapies are individualized and patient-centered. Conclusion: Physiotherapy offers promising benefits in the management of cervical dystonia, particularly when integrated with pharmacological treatment. However, further high-quality randomized controlled trials are needed to establish standardized protocols and long-term outcomes. Clinicians should consider incorporating physiotherapy into multidisciplinary care plans for optimal patient outcomes.

Objective There is a need for reliable and valid clinical assessment tools for quantifying allodynia in neuropathic pain. Allodynography has been proposed as a useful standardized procedure for clinical assessment of mechanical allodynia. This study (www.clinicaltrials.gov NCT02070367) undertook preliminary investigation of the measurement properties of allodynography, a new standardized clinical examination procedure for mapping the area of cutaneous allodynia. Methods Persons with pain in one upper extremity after complex regional pain syndrome, a peripheral nerve injury, or who had recently experienced a hand fracture were recruited for assessment of static mechanical allodynia (based on perception of a 15g force stimulus delivered by Semmes-Weinstein monofilament #5.18 as painful) by two raters at baseline; the assessment was repeated one week later. Results Single-measures estimates suggested inter-rater reliability for allodynography was excellent at an intraclass correlation ...

                The evolution of information technology has exerted great influence on nursing education via new pedagogy of knowledge delivery without time and place restriction. Mobile technology revolutionises nursing education and clinical practice via empowering skills of critical thinking and clinical decision-making through learning. The aim of this study is to evaluate the effectiveness of using mobile messenger (Whatsapp) as an educational supporting tool among nursing students. The study design used is a Cluster Randomized Control Trail. Two nursing colleges were selected. Sample size was 93 participants, 48 from the Kuala Terengganu Nursing College Kuala Terengganu as the intervention group while the control group were recruited among 45 participants from UniSZA Nursing College. There is a significant difference in the level of knowledge between pre and posttest among intervention group (mean difference was -8.70 with a standard deviation 8.42, p-value< 0.001) and 93.8...

In this study the objective is to present new strategies of physical therapy in multiple sclerosis based on the latest developments in the field of physiotherapy. The publications on the problem, in the last 5 years, discuss a wide range of methods of physiotherapy that can be used to reduce the degree of disability and alleviate the symptoms associated with the disease. The complexity of the disease, the difficulty in determining the appropriate treatment and a wide range of symptoms require a comprehensive approach to the patient, which would include both pharmacology and neurorehabilitation. Physical therapy, which includes psychotherapy and symptomatic therapy, is regarded nowadays as the best form of treatment for this disease. The kinesiotherapy program in multiple sclerosis is based on a gradation of physiotherapy which assumes a gradual transition from basic movements to more complex ones till global functions are obtained and this is combined with physical procedures. Recent reports indicate the need for aerobic training to be included in the rehabilitation program. The introduction of physical activities, regardless of the severity of the disease, will reduce the negative effects of akinesia, and thus increase the functional capabilities of all body systems.

Clinical Notes 4: Current best practice use of the s-tape application to address excessive drooling and more. July 2025. Updated from 2017. Update includes information from the 2018 NINE YEARS S-TAPE APPLICATION: DEVELOPMENT, UPDATES & STUDIES Report, and the answers to important questions about the s-tape, and all available research since the 1st case studies published in 2009

Introduction: Carcinoma colon in India has a lower incidence compared to the cases in western world. The presentations and clinical profile of colorectal cancer also varies from its western counterpart. We aim to study the demographics and trends of the colorectal cancer cases presented in our institute. Materials and methods: All the patients who presented with colorectal cancer in the department of Surgical Oncology in SAIMS, Indore and who underwent surgery for the same from October 2016 to September 2020 was taken into the study. Conclusion: Colorectal cancer in India varies in certain aspects compared to western population. And the incidence of colorectal cancer in India is slowly rising. It is time to design effective screening programme in suspected population.

1Assistant Professor, Allied Physiotherapy Department, Era University, Lucknow, India 2Consultant Physiotherapist, Physiotherapy Department, Delhi Physiotherapy Clinic, India 3Consultant Physiotherapist, Mobilite Stroke Rehabilitation and Physiotherapy Centre, Punjab, India 4Physiotherapist, PGIMER, Chandigarh, India *Corresponding Author: Shallabh Kumar Singh, Assistant Professor, Allied Physiotherapy Department, Era University, Lucknow, India.

Reflective Signalling is a theory and practice that deals with the problems created by the condition named cerebral palsy. Cerebral Palsy is a condition and a disability that is the outcome of natal and post-natal injury to the cerebellum. In some cases this also occurs in adults due to unusual injury. The injury to the cerebellum leaves scar tissue that blocks brain signals of movement to the spine leading to paralysis of many types depending on the level of injury and scale of the scar tissue. Reflective Signalling tackles this problem by generating signals from the limbs to the brain using the spare tissue within the cerebellum. This eventually creates new connections for the blocked brain signals within the cerebellum, allowing the brain to gain control over the previously paralysed parts of the body.

Background Guillain-Barré Syndrome (GBS) is a rare acute peripheral neuropathic disorder that often necessitates a long course of physiotherapy to regain locomotor function and overall life functioning. Although the efficacy of physiotherapy in GBS is beyond doubt, little is known about the role of culture in patients' compliance and response to therapy. Traditions, roles, poverty, and language significantly impact the completion of rehabilitation and compliance with the recommended regimens. This systematic analysis aims to establish how cultural factors may affect physiotherapy and treatment results in GBS patients. Main body The systematic review synthesized 33 studies, all conducted across various cultures: Indian, Japanese, Brazilian, Egyptian, and American samples. According to the research, family participation, especially in a collectivist culture, enhanced the level of compliance with therapy and improved functional outcomes. In contrast, when familism was low, clients progressed more slowly, supporting the negative correlation between familism and culture type score. Compensated structures were found to be influential, with patient health beliefs continuing to rely heavily on traditional medication over physiotherapy, particularly in the Middle East (Egypt) and South America (Brazil). Additionally, language barriers in multicultural environments, including the USA and Brazil, adversely affected patient engagement with clinicians. Economic challenges, such as financial constraints and limited healthcare access, also hindered rehabilitation enrollment in low socioeconomic areas. Conclusion This review underscores the significant cultural influences on physiotherapy utilization and GBS patients' treatment outcomes. Key factors for enhancing rehabilitation success among Latino populations include six elements of the culturally competent model of practice: family involvement, addressing health beliefs, using interpreters, and minimizing socioeconomic disparities. Further longitudinal and cross-cultural research is needed to develop culturally responsive interventions.

Background: A uncommon autoimmune disease called neuromyelitis Optica spectrum disorder (NMOSD) affects the central nervous system, mainly the spinal cord and optic nerves. Spinal cord involvement frequently results in motor deficits, particularly in the lower limbs, which cause severe functional disability. In order to regain movement and freedom, physiotherapy is essential. With immersive, task-specific training that improves patient engagement and motor recovery, virtual reality (VR) has become a cutting-edge supplement to traditional rehabilitation in recent years. OBJECTIVES: A 40-year-old man with NMOSD presented with bilateral lower limb weakness, decreased balance, and trouble walking. The patient participated in an 8-week physical therapy rehabilitation program that combined VR-based gait and balance training with traditional neurophysiotherapy. In a gamified setting, VR sessions concentrated on dynamic balancing tasks, visualmotor integration, and lower limb movement coordination. METHODS: Pre-and post-intervention assessments using the Berg Balance Scale (BBS), 10-Meter Walk Test (10MWT), and Functional Independence Measure (FIM) revealed marked improvements. BBS improved from 28 to 45, 10MWT time Decreased from 18.5 to 12.4 seconds, and FIM scores showed enhanced independence in mobility and ambulation. The patient also reported increased confidence and motivation due to the interactive nature of VR therapy. CONCLUSION: For case with NMOSD, this instance demonstrates the possible advantages of using virtual reality into physical treatment. In particular, for those with spinal cord involvement, VR-based neurorehabilitation presents a viable, entertaining method to enhance lower limb function, walking, and balance.

Background: A uncommon autoimmune disease called neuromyelitis Optica spectrum disorder (NMOSD) affects the central nervous system, mainly the spinal cord and optic nerves. Spinal cord involvement frequently results in motor deficits, particularly in the lower limbs, which cause severe functional disability. In order to regain movement and freedom, physiotherapy is essential. With immersive, task-specific training that improves patient engagement and motor recovery, virtual reality (VR) has become a cutting-edge supplement to traditional rehabilitation in recent years. OBJECTIVES: A 40-year-old man with NMOSD presented with bilateral lower limb weakness, decreased balance, and trouble walking. The patient participated in an 8-week physical therapy rehabilitation program that combined VR-based gait and balance training with traditional neurophysiotherapy. In a gamified setting, VR sessions concentrated on dynamic balancing tasks, visualmotor integration, and lower limb movement coordination. METHODS: Pre-and post-intervention assessments using the Berg Balance Scale (BBS), 10-Meter Walk Test (10MWT), and Functional Independence Measure (FIM) revealed marked improvements. BBS improved from 28 to 45, 10MWT time Decreased from 18.5 to 12.4 seconds, and FIM scores showed enhanced independence in mobility and ambulation. The patient also reported increased confidence and motivation due to the interactive nature of VR therapy. CONCLUSION: For case with NMOSD, this instance demonstrates the possible advantages of using virtual reality into physical treatment. In particular, for those with spinal cord involvement, VR-based neurorehabilitation presents a viable, entertaining method to enhance lower limb function, walking, and balance.

Balance and postural control impairments are common in patients post-stroke. Vibration interventions are among the recently researched interventions and have been shown to positively affect gait and proprioception post-stroke. This review aimed to determine the efficacy of plantar foot vibration in improving balance and postural control outcomes after stroke. As a first review of this topic, the purpose was to identify current literature limitations and provide recommendations for future research. A systematic search of CINAHL Ultimate, MEDLINE, SPORTDiscus with Full Text, and The Allied and Complementary Medicine Database (AMED) was conducted in April 2025. Due to heterogeneity across outcome measures, a systematic review in the form of a narrative synthesis of results was performed. Methodological quality analysis was assessed using the modified Downs and Black checklist. Eight articles that met the inclusion criteria were identified, 7 of which could be retrieved and used in the narrative synthesis. Results of the narrative synthesis provide evidence to suggest plantar vibration can improve balance and postural control post-stroke, even immediately after treatment and in chronic-stroke patients. Based on different outcome measures, results suggest that dynamic standing balance may benefit more than static standing balance. Current research shows promising results for the beneficial effects of plantar vibration on improving balance and postural control post-stroke. However, high-quality research investigating the effects of vibration frequency and length of plantar vibration treatment is required to determine the optimal treatment approach.

This study explores the integration of genetic analysis, body composition assessment, and artificial intelligence (AI) to develop personalized fitness and nutritional programs. By analyzing genetic variations (e.g., ACTN3, ACE, BDNF) and leveraging AI-driven models, we propose a framework that optimizes training regimens, nutritional strategies, and injury prevention with 87% predictive accuracy for training responses. While genetics provide critical insights, athletic success remains a multifactorial outcome influenced by environment, psychology, and epigenetics. Ethical considerations, including data privacy and model bias, are critically addressed. Preliminary validation demonstrates significant improvements over traditional methods, though longitudinal studies are needed to confirm long-term efficacy.

Odma Êródpiersia to obecnoÊç wolnego powietrza w obr´bie tkanki ∏àcznej Êródpiersia. Cz´sto towarzyszy jej odma podskórna, charakteryzujàca si´ objawem Hammana. Rzadko bywa ona powik∏aniem porodu (cz´stoÊç od 1:2000 do 1:100000 porodów). Objawy zauwa˝alne bywajà zwykle dopiero po porodzie. Celem pracy jest przedstawienie przypadku odmy Êródpiersia z towarzyszàcà odmà podskórnà, które wystàpi∏y podczas naturalnego porodu.

Background
The burden of neurological disorders in China has not been systematically analyzed. We aim to provide a comprehensive estimation of the national and subnational neurological burden across China from the Global Burden of Disease Study (GBD) 2021.
Methods
We assessed burden estimates for 16 neurological disorders by age, sex, and province from 1990 to 2021, with prevalence, death, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs). We performed decomposition analysis to determine contributing factors for DALYs and used the socio-demographic index (SDI) to assess relations with development level.
Findings
In 2021, there were 468.29 million prevalent cases of neurological disorders in China, corresponding to 78.10 million DALYs. Intracerebral hemorrhage was the leading cause of DALYs, followed by ischemic stroke, dementias, and migraine. DALYs of neurological disorders were higher in males than females, peaking at 70–74 years. From 1990 to 2021, the number and age-standardized rate of DALYs significantly decreased for idiopathic epilepsy and subarachnoid hemorrhage, primarily attributed to the reduction in YLLs, while the number of DALYs disproportionately increased for dementias, Parkinson’s disease, and ischemic stroke contributed by population aging. The age-standardized DALY rates of seven neurological disorders had more than 5-fold variation between western and eastern provinces, despite reduced burdens with rising SDI.
Conclusions
Neurological disorders pose a large and growing burden on public health, primarily driven by population aging. Our findings could inform priority setting and targeted strategies to optimize neurological service delivery.

Introdução:O Controlo Postural é um processo neural complexo envolvido na organização da estabilidade e orientação da posição do corpo no espaço. A Instabilidade Funcional (IF) do tornozelo é descrita como uma perceção subjetiva de instabilidade articular, que afeta o controlo postural. Apesar de vários estudos terem investigado os fatores inerentes à IF ainda existe inconsistência nos resultados da literatura sobre os mecanismos envolvidos nesta. Objetivo (s):avaliar os ajustes posturais envolvidos na resposta a uma perturbação externa realizada de forma previsível e imprevisível em indivíduos com IF. Métodos:Estudo observacional analítico transversal, teve uma amostra de 20 indivíduos, que foram divididos em grupo com IF e grupo de controlo. Foi recolhida atividade eletromiográfica bilateral dos músculos longo e curto peroneal (PL e PC), tibial anterior (TA) e solear (SOL) associado a uma perturbação externa aplicada de forma previsível e imprevisível. Os ajustes posturais foram avaliados através da análise do início da atividade muscular, da magnitude global dos ajustes posturais compensatórios e antecipatórios e magnitude das respostas de curta e média latência Resultados: Na perturbação imprevisível não se verificaram diferenças significativas no início da atividade muscular (p>0,05). Enquanto na magnitude das respostas de curta e média latência verificou-se diferenças nos músculos TA (Ia,p=0,000; II, p=0,011), CP (Ia,p=0,029; II, p=0,001) e LP (Ia, p=0,030) entre o membro com IF e o controlo e no LP (II, p=0,011) entre o membro sem IF do grupo com IF e o controlo. Na perturbação previsível observaram-se diferenças nos ajustes posturais antecipatórios (APA) dos músculos TA (p=0,006) e LP (p=0,020) entre o membro sem IF do grupo com IF e o controlo. Conclusão: Os indivíduos com IF apresentam défices na magnitude das respostas de média e curta latência numa perturbação imprevisível e nos APA na perturbação previsível.

This study presents a Self-Supervised Convolutional Neural Network (CNN) model designed for the early detection and classification of rare neurological disorders using brain MRI images. Early identification of these disorders is critical for effective intervention and improved patient outcomes. Our approach leverages self-supervised learning to enhance the model's ability to extract meaningful features from brain MRI data, even with limited labeled samples. The pipeline includes stages such as data preprocessing, augmentation, model compilation, and training, which help improve the model's accuracy and generalization. The model's performance was evaluated using a variety of metrics, including accuracy, precision, recall, and F1-score, showing promising results in distinguishing between "Neurological Disorder" and "No Neurological Disorder" classes. Notably, the model achieved high recall for the disorder class, underscoring its effectiveness in identifying positive cases. This self-supervised CNN framework offers a significant advancement for early classification of neurological conditions in MRI images, especially in scenarios with limited labeled data. Its successful application in this context highlights its potential for clinical integration, providing a valuable tool for neurologists in diagnosing rare disorders early and enhancing patient care.

Parkinson's disease (PD) is a progressive neurodegenerative disorder primarily characterized by the degeneration of dopaminergic neurons in the substantia nigra, leading to motor impairments such as tremors, bradykinesia, and postural instability. It also affects cognitive functions, contributing to difficulties in movement control and nonmotor symptoms, including cognitive decline, sleep disturbances, and emotional dysregulation. Although pharmacological treatments provide symptomatic relief, there is limited evidence regarding the effectiveness of non-pharmacological interventions in improving both motor and cognitive outcomes. This case report details the physiotherapy management of a 72-year-old male patient with stage 3 PD, highlighting a structured 14-week physiotherapy program that targeted balance, coordination, and cognitive function. The intervention, which incorporated personalized exercises and cognitive training, resulted in significant improvements in tremor frequency, postural control, and cognitive function. Remarkably, the patient demonstrated a progression from Hoehn and Yahr stage 3 to stage 1, suggesting that intensive physiotherapy can have a profound impact on both motor control and overall quality of life (QOL). This case is notable for its novel approach in combining physical therapy with cognitive interventions in a PD patient, a strategy not widely reported in existing literature. Given the lack of curative treatments for PD, the findings underscore the critical role of non-pharmacological interventions, such as physiotherapy, in improving both motor and non-motor outcomes in PD patients. This report highlights the potential for intensive, individualized physiotherapy programs to promote neuroplasticity and significantly enhance patient outcomes, offering new insights into holistic PD management.

Peripheral facial paralysis (PFP) is a common condition where oxidative stress (OS) is involved in the pathophysiology of facial paralysis, inhibiting peripheral nerve regeneration, which can be featured in Bell’s palsy, Ramsay Hunt syndrome and Lyme disease. The current standard care treatments lack consensus and clear guidelines. Hence, the utilization of the antioxidant immunomodulator photobiomodulation (PBM) can optimize clinical outcomes in patients who are unresponsive to standard care treatments. Our study describes three unique cases of chronic PFP of various origins that were unresponsive to standard care treatments, but achieved a significant and complete recovery of facial paralysis following PBM therapy. Case presentations: Case #1: a 30-year-old male who presented with a history of 12 years of left-side facial paralysis and tingling as a result of Bell’s palsy, where all the standard care treatments failed to restore the facial muscles’ paralysis. Eleven trigger and affected points were irradiated with 1064 nm with an irradiance of ~0.5 W/cm2 delivered with a collimated prototype flat-top (6 cm2) in a pulsed mode, with a 100 μs pulse duration at a frequency of 10 Hz for 60 s (s) per point. Each point received a fluence of 30 J/cm2 according to the following treatment protocol: three times a week for the first three months, then twice a week for another three weeks, and finally once a week for the following three months. The results showed an improvement in facial muscles’ functionality (FMF) by week two, whereas significant improvement was observed after 11 weeks of PBM, after which the House–Brackmann grading scale (HBGS) of facial nerve palsy dropped to 8 from 13 prior to the treatment. Six months after PBM commencement, electromyography (EMG) showed sustainability of the FMF. Case #2: A five-year-old female who presented with a 6-month history of severe facial paralysis due to Lyme disease. The same PBM parameters were utilized, but the treatment protocol was as follows: three times a week for one month (12 consecutive treatment sessions), then the patient received seven more sessions twice a week. During the same time period, the physiotherapy of the face muscles was also delivered intensively twice a week (10 consecutive treatments in five weeks). Significant improvements in FMF and sustainability over a 6-month follow-up were observed. Case #3: A 52-year-old male who presented with severe facial palsy (Grade 6 on HBGS) and was diagnosed with Ramsay Hunt syndrome. The same laser parameters were employed, but the treatment protocol was as follows: three times a week for three weeks, then reduced to twice a week for another three weeks, then weekly for the next three months. By week 12, the patient showed a significant FMF improvement, and by week 20, complete FMF had been restored. Our results, for the first time, showed pulsed 1064 nm PBM delivered with a flat-top handpiece protocol is a valid and its treatment protocol modified, depending on the origin and severity of the condition, which is fundamental in optimizing facial paralysis recovery and alleviating neurological symptoms. Further extensive studies with large data are warranted to validate our PBM dosimetry and treatment protocols.

Background Complex regional pain syndrome (CRPS) is a chronic pain disorder often affecting the extremities following trauma or stroke, classified into type 1 (without nerve injury) and type 2 (with nerve injury). It manifests as persistent pain, sensory disturbances, and motor dysfunction, particularly in post-stroke patients. Despite its prevalence, effective management remains a challenge, necessitating a multidisciplinary approach. Method Descriptive and inferential statistical analyses were conducted. The mean and standard deviation were calculated for numerical data, and changes over time were assessed using paired t-tests, with statistical significance set at p < 0.05. A 95% confidence interval was reported for key outcome measures to ensure result reliability. Case presentation This report examines a 55-year-old male post-stroke patient with left hemiparesis and complex regional pain syndrome (CRPS), experiencing pain in the left shoulder, wrist, and proximal interphalangeal (PIP) joints, along with functional limitations. He underwent mirror therapy combined with a structured home exercise program over nine sessions. Pain levels, measured by the Numerical Pain Rating Scale (NPRS), decreased from 4/10 at rest and 6/10 on movement to 2/10 at rest and 4/10 on movement. ROM significantly improved, with shoulder flexion increasing from 30 to 128° (p = 0.01, 95% CI: 0.005, 0.02), extension from 20 to 30° (p = 0.02), wrist extension from 15 to 32° (p = 0.03), and PIP flexion from 60 to 90° (p = 0.01), with full extension restored (p = 0.04). Circumferential swelling reduced from 23.5 to 21.5 cm, and DASH scores improved from 77.2 to 36.4%. These findings confirm the clinical effectiveness of mirror therapy in enhancing ROM, reducing pain, and improving function in post-stroke CRPS rehabilitation. Conclusion The case illustrates the efficacy of early mirror therapy in managing CRPS in post-stroke patients, highlighting its potential to alleviate pain and enhance functional recovery. Early intervention is crucial in improving outcomes for CRPS patients, emphasizing the need for timely and comprehensive rehabilitation strategies.

As compared to the other stroke-related therapies Mirror therapy (MT) in the stroke rehabilitation can be used in all type of stroke survivors (severe and non-severe) visual stimulus is being used for initiating a desirable motor response in limbs of the stroke patient. Literature shows that MT has considerable measurable effects on the motor impairments, visuospatial neglect, sensory impairment and pain/discomfort. This paper is a review of the current perspective and understanding on the MT in the rehabilitation of the stroke survivors. An electronic data base search across the Pub Med, Google Scholar, and Science direct, Cochrane etc. generated 3871 result. Based on the inclusion criteria's set for the study, 35 studies were included in this review after the systematic filtration of the papers. The collected data were divided on the basis of the it's (MT) application in the stroke rehabilitation, its intervention's mode, dosage, type of control and outcome assessment. We found that majority of the selected studies were intervened for motor impairment mostly in the stroke survivors within the upper limb. Studies were categorized in to groups based on the intervention between chronic and acute phase stroke with the therapy duration 1-8 weeks. Across all the selected studies MT showed significant motor improvement than the sensory improvement in the stroke survivors. The effectiveness and feasibility of MT has been reported (both for the patients and staff) and commonly used therapeutic approach in the rehabilitation of the post-stroke survivors in all stroke's stages. However, ADLs based longer term effectiveness of MT and on overall health needs to be further investigated and documented.

Introduction : stroke is reported to be the third cause of death worldwide. Many studies have showed that their case-fatality rate is very high, especially in sub-Saharan Africa. There have been few studies on stroke mortality and its determinants in Cameroon. This study examines the vital and functional prognosis of stroke and its determinants in a tertiary care hospital in Cameroon. Methodology : A prospective study was carried out for six months at the Douala Laquintinie Hospital. Patients with a diagnosis of stroke, with CT-Scan confirmation were recruited and followed up during hospitalization, at one and three months. The deaths and predictors were recorded. Multivariate logistic regression was used to identify independent predictors of mortality. Results : Mean age of the 120 patients (53% male) was 60.5 ± 12.78 years. The case fatality rate was 26.7% at one month and 31.7% at 3 months. On multivariate analysis, the predictors of mortality were Glasgow coma scale less than 8/...

The study's goal was to compare and evaluate the benefits of deep friction massage and ultrasonic therapy (US) vs extracorporeal shockwave therapy (ESWT) for people with lateral epicondylitis. This double-blind, parallel-arm randomized clinical trial was conducted after ethical approval on a sample of 80 subjects with lateral epicondylitis. Participants were enrolled based on predefined eligibility criteria. They were randomly allocated to groups A and B. Group A received ESWT, while Group B received the US combined with deep friction massage. Data was collected using the Numeric Pain Rating Score (NPRS) and Patient-rated tennis elbow evaluation questionnaire (PRTEE) at baseline, at 3rd, and at 7th week of treatment. On the basis of the normality of the data, a non-parametric test was applied to evaluate between-group and within-group differences. P value ≤ 0.05 was considered significant. There was a significant difference between groups (p < 0.001). Comparisons of PRTEE scores at 3rd week and 7th week of intervention were found significant for both groups (p < 0.001). While considering between-group comparisons based on percentile scores of PRTEE at baseline, 3rd and 7th week of intervention, in group A Median (IQR) at the baseline was 24.00 (5.00), at 3rd week, 10.00 (5.00) and 7th week was 1.50 (2.50) and in group B Median (IQR) at the baseline was 25.00 (4.00), at 3rd week 19.50 (4.50) and at 7th week was 11.50 (2.50). The results were significant in both groups (p = 0.000), but between-group analysis revealed that ESWT is more effective in patients with lateral epicondylitis. Keywords Tennis elbow, Pain, Physiotherapy, Patient-rated tennis elbow evaluation questionnaire Lateral epicondylitis is one of the common ailments in the elbow region, affecting 1-3% of the adult population every year 1. The common presentation of epicondylitis is in the form of elbow pain caused by inflammation or degeneration of the Common extensor tendon, usually due to repeated activity. Female gender, smoking history, repeated activity and ipsilateral scapulothoracic dysfunction are common associated factors 2,3. The clinical examination, functional impairment, and positive provocation tests like Cozen's test and Mills's test form the

This work involved human subjects or animals in its research. Approval of all ethical and experimental procedures and protocols was granted by the Ethics Committee of the University of Applied Sciences Campus Vienna under EK Nr. 97/2022, and performed in line with the Declaration of Helsinki.

Wilson disease, or hepatolenticular degeneration, is a rare autosomal recessive disorder resulting from mutations in the ATP7B gene on chromosome 13, leading to defective copper metabolism. The disease primarily affects the liver and basal ganglia of the brain, with a broad spectrum of symptoms that include hepatic dysfunction, neurological disturbances, and psychiatric manifestations. Diagnosing Wilson disease poses significant challenges due to its varied presentation and the overlap with other conditions. The diagnostic process typically involves a combination of clinical evaluation, biochemical testing, liver biopsy, and genetic screening. Early identification and management are critical to preventing the fatal progression of the disease. This review provides an in-depth analysis of the pathogenesis, clinical manifestations, and current diagnostic approaches for Wilson disease, emphasizing the importance of a multidisciplinary approach in managing affected patients.

Prima parte. Tipologia VATA
Gli asana, nello hatha yoga, possono contribuire a riequilibrare una temporanea alterazione dei dosha, tenendo presente che è la differente modalità di esecuzione, in particolare, a rendere le stesse posture adatte a Vata, Pitta e Kapha.

Conservative treatment of spine disease with acupuncture involves using acupuncture to stimulate healing, reduce pain, and improve function. Presently, No method or treatment is considered ideal for handling spine problems. Acupuncture is scientific, effective, and without any side effects. Moreover, Acupuncture treatment can be continued with other therapies without any interaction. Several studies based on systematic reviews show a short-term clinically relevant reduction of pain in Chronic Lower back pain. World Health Organization anticipated that spinal problems would be common in elderly people. Hence,these acupuncture treatments can provide the best results with other ongoing Western medicines. Studies also suggested that post-operative care could give the best and quickest outcomes if acupuncture treatments were administered with Western treatment. Huge clinical trials with long-term follow-ups need to be declared to the level of choice of treatment.

It is my hope by uploading this dissertation, which I have modified from its original submission for my doctorate in theology that it will be helpful to the reader. It includes a thorough  exegesis of 1 Corinthians 13. This chapter is now analyzed by two methods, as containing a chiasm and by a revealing outline. This paper also takes note of the Greek article occurring in some critical passages of the New Testament. Often the presence or absence of the article before "Spirit" will indicate whether the word is referring to the person of the Holy Spirit or to the gifts or power of the Holy Spirit.

El amor romántico se manifiesta de manera compleja, variando en su naturaleza según las relaciones que se establecen, presentando una cualidad única en cada vínculo. Este tipo de amor puede entenderse como un proceso profundamente biológico y dinámico, en el cual están involucradas diferentes neurohormonas que actúan a nivel cerebral. Las técnicas de neuroimagen, como la fRMN y las PET, proporcionan un acceso sin igual a la red cerebral asociada con el amor romántico humano. Interpretarlas es uno de los mayores desafíos científicos de la actualidad. El presente trabajo tiene como objetivo hacer un aporte a la comprensión del sustrato neurobiológico del amor romántico. Se partirá de algunas conceptualizaciones acerca de la temática, que incluyen fundamentalmente una perspectiva neuroquímica, de áreas cerebrales y de comportamientos consecuentes. Se desarrollan algunas definiciones de amor y los tipos de amor, de los que el amor romántico es uno de ellos. Además, se desarrolla brevemente la teoría del apego, y el apego en parejas desde el enfoque de la biología evolutiva, sobre la neuroquímica del amor, con la intención de facilitar la comprensión de los estudios de neuroimágenes y sus implicancias. Se exploran distintas investigaciones neurocientíficas del amor romántico, excluyendo investigaciones en modelos animales, aunque cabe destacar que estas constituyen la base teórica del estudio en personas. El énfasis está puesto en los correlatos de neuroimágenes y bioquímicos de este estado subjetivo.

Introducao: o Acidente Vascular Encefalico (AVE) e uma disfuncao hemodinâmica neurologica que pode ser isquemico (AVEi) ou hemorragico (AVEh). Essa patologia pode trazer incapacidades e o obito, portanto a fisioterapia e importante na reabilitacao. O objetivo do estudo e relatar sobre o AVE, suas complicacoes e descrever o tratamento a um paciente vitima de AVEh. Metodos: relato de experiencia descritivo, sem financiamento. Os colaboradores da pesquisa sao constituidos pela equipe do Ambulatorio Neurofuncional da Unidade de Assistencia em Fisioterapia e Terapia Ocupacional (UEAFTO). O registro de dados consta na ficha de avaliacao do setor, com toda anamnese. Resultados e discussao: paciente A. R. L., sexo masculino, 34 anos, com sequela pos AVEh e aneurisma, resultando em perda de forca no hemicorpo esquerdo e deficit de equilibrio. Os objetivos do tratamento voltaram-se ao ganho de forca muscular e de equilibrio. As condutas terapeuticas propostas foram: cinesioterapia ativa-resis...

Millimetric wave (MMW) therapy was discovered in the 1970s' in USSR countries and used clinically for their hypoalgesic properties in various pain pathologies. Subsequently, these hypoalgesic properties were related to a central nervous system response following peripheral stimulation, mainly involving secretion of endorphins, as well as other neurotransmitters such as parasympathetic, DOPA, etc... In the more recent past (after 2010), the development of miniaturized solutions has allowed the personal use of MMWs-outside medical structures-in the management of chronic pain, and in particular neuroplastic or nociplastic pain, independently of any etiology. We report here on two cases of fibromyalgia, in which these two contributions to pain are involved. In each case, the patients experienced the use of a portable, wristband designed MMW system. The deliberate use of the device was first intended for wellness or stress relief purposes. The notion of the non-specificity of MMWs on chronic pain is discussed at the end of the article.

Guillain-Barré syndrome (GBS) is a complex autoimmune disorder characterized by acute onset of motor weakness, often following an infectious illness. The pathophysiology of GBS involves a multifaceted interplay between immune mechanisms and environmental factors, leading to demyelination or axonal degeneration.
This systematic review aims to elucidate the autoimmune mechanisms underlying the various subtypes of GBS, including acute infammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor and sensory axonal neuropathy (AMSAN), and Miller Fisher syndrome (MFS). A thorough literature search identifed 71 studies published between 2010 and 2024 that provided insights into the immunopathological features, clinical implications, and future directions for research. Key fndings indicate that specifc autoantibodies, such as anti-GM1 and anti-GQ1b, are associated with distinct subtypes of GBS, contributing to the disease’s heterogeneity. Understanding these autoimmune mechanisms is crucial for improving diagnostic accuracy, therapeutic strategies, and prognostic indicators in GBS. This review highlights signifcant gaps in current research, emphasizing the need for further studies to explore the genetic and environmental factors that infuence GBS  susceptibility and the role of vaccinations in triggering autoimmune responses.

Respiratory conditions pose significant challenges in critical care settings, particularly in managing patients who require mechanical ventilation in the intensive care unit (ICU). While mechanical ventilation is crucial for saving lives, it can also lead to complications such as impaired lung function and secretion retention. To address these issues, various physiotherapy techniques have been employed to enhance respiratory function and promote mucus clearance. These include manual techniques like expiratory rib cage compression (ERCC) and respiratory neuro-facilitative methods such as intercostal stretch (ICS), anterior basal lift (ABL), proprioceptive neuromuscular facilitation (PNF), and vertebral pressure (VP). A literature review was conducted, analyzing studies that evaluated the effectiveness of ERCC, ICS, ABL, PNF, and VP in patients on mechanical ventilation. The review focused on outcomes related to respiratory function, lung expansion, oxygen saturation, mucus clearance, and overall patient health. The data were collected, analyzed, and compared across different studies to assess the relative effectiveness of each technique. The review found that ICS, ABL, and VP significantly improved lung expansion and rib cage mobility, while PNF techniques, such as rhythmic initiation, enhanced respiratory muscle coordination and oxygen saturation. ERCC was particularly effective in promoting mucus clearance and improving respiratory mechanics in mechanically ventilated patients. The findings highlight the importance of personalized physiotherapy strategies in optimizing respiratory care for critically ill patients. Further research is recommended to refine these techniques and develop standardized protocols for their application in clinical practice.

Wilson disease is a rare inherited autosomal recessive genetic disorder caused by abnormal copper accumulation in the body, particularly involving the brain, liver, eyes, and other vital organs. This is also known as hepatolenticular degeneration. It primarily affects the liver and basal ganglia of the brain, but it can affect other vital organs too. It results from a mutation in the gene encoding the Wilson disease protein (ATP7B). It results from a mutation in the gene encoding the Wilson disease protein (ATP7B). A healthy body excretes extra copper through urine after the liver filters it out. Wilson&#39;s disease prevents the liver from effectively removing the excess copper. The extra copper then builds up in organs such as the brain, liver, and eyes; which is the reason why symptoms are usually related to the brain and liver. One of the 23 chromosomes in humans, chromosome 13, has a gene that causes Wilson&#39;s disease. For six months, a 12-year-old kid with Wilson&#39;s dise...

W związku z częstością wypadków komunikacyjnych zwiększa się ryzyko urazów kończyn u dzieci z towarzyszącymi uszkodzeniami nerwów obwodowych. Zadaniem lekarzy zaopatrujących dziecko jest odtworzenie funkcji uszkodzonego narządu. Każda z metod mogących przyspieszyć lub w jakimś stopniu polepszyć efekt terapeutyczny wydaje się warta rozważenia.