Introduction: Digital transformation has shifted rehabilitation toward hybrid care models where smartphone applications are used as adjunct tools to support monitoring, exercise delivery, engagement, and self-management in physical therapy. Material and method: This systematic review was conducted according to PRISMA 2020 guidelines and included a comprehensive search of PubMed, Scopus, and Web of Science for studies published between 2021 and 2026 using predefined rehabilitation-related keywords. Strict eligibility criteria, structured study selection, and standardized data extraction were applied, and findings were synthesized narratively due to heterogeneity across interventions, populations, and outcomes. Results: The PRISMA-based selection process identified 15 eligible studies from an initial 215 records, encompassing diverse study designs and clinical populations across musculoskeletal, neurological, orthopaedic, rheumatologic, and geriatric rehabilitation. The included studies evaluated smartphone-based interventions, including exercise prescription applications, telerehabilitation platforms, and digital adherence tools, reporting clinical, behavioural, and implementation-related outcomes. Interventions were classified into four categories: exercise prescription applications, telerehabilitation and monitoring systems, behavioural adherence tools, and self-management or educational platforms. Overall, studies reported improvements in physical activity, functional outcomes, pain, and adherence, while neurological and geriatric populations were predominantly evaluated through feasibility and usability outcomes. Discussion: Smartphone-based applications are increasingly integrated as adjunct tools in physical therapy rehabilitation across diverse clinical populations. Their primary benefits relate to improved adherence, engagement, and continuity of care, with the strongest clinical effects reported in musculoskeletal and postoperative rehabilitation, whereas neurological and geriatric applications remain mainly focused on feasibility and usability outcomes. Conclusions: Smartphone-based applications represent a promising adjunct in physical therapy rehabilitation, with effects mainly mediated through behavioural mechanisms that improve adherence, engagement, and continuity of care. Evidence suggests more consistent clinical benefits in musculoskeletal and postoperative populations, whereas neurological and geriatric studies predominantly report feasibility and usability outcomes, reflecting the need for stronger evidence on long-term effectiveness.

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Introduction: Excessive internet use has become a major problem for university students because it interferes with their ability to sleep, which includes insomnia symptoms. Physical therapy students face high vulnerability because their academic demands require them to spend extended periods using screens. Methods: The study used non-probability convenience sampling to recruit 265 undergraduate Doctor of Physical Therapy students from 3 physical therapy institutes of Sukkur, Sindh, Pakistan. The authors used Internet Addiction Test (IAT) and Pittsburgh Sleep Quality Index (PSQI) for their study. The data analysis performed using SPSS version 24. Pearson correlation and one-way ANOVA and chi-square tests used to conduct their analysis which established statistical significance at p < 0.05. Results: The mean age of participants was 21.42 ± 2.48 years. The study recorded a strong positive relationship between IAT scores and PSQI scores (r = 0.701, p < 0.001) which showed that rising internet addiction were significantly associated with reduced sleep quality and increased insomnia symptoms. The research found no significant variations in internet usage between different academic years. (p > 0.05). Conclusion: Excessive internet use was significantly associated with poor sleep quality and insomnia symptoms among undergraduate physical therapy students. The study recommends preventive strategies that should focus on digital health awareness and sleep hygiene.

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Introduction: Lack of physical activity (PA) increases chronic disease risk and reduces physical fitness (PF), posing a public health concern for young adults, including university students. This study aims to assess PA and PF levels in physiotherapy students and compare national and international students. Methods and Materials: A total of 122 healthy physiotherapy students (18-25 years) participated. PA levels were assessed using the International Physical Activity Questionnaire, and PF parameters, including flexibility, muscle endurance, balance, handgrip strength, and maximal performance, were measured. Results: Among participants, 57.5% had high, 38.3% moderate, and 4.2% low PA levels. International students performed significantly better in balance and maximal performance tests than national students (p<0.05), while other PF parameters showed no significant differences. Discussion and Conclusions: The findings show that there is a general similarity in PF levels between national and international students, but international students are superior in terms of balance and maximal performance. These results may indicate the influence of cultural, socioeconomic and environmental factors on PF.

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Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive, preventable, and treatable respiratory disease strongly associated with tobacco exposure. Because its clinical expression is heterogeneous, rehabilitation planning requires assessment beyond spirometry. Methods and materials: This retrospective observational study included 767 patients with COPD evaluated between October 2014 and January 2021 in the Pneumology Department of the "Victor Babes" Infectious Diseases Hospital, Timisoara, Romania. Patients were divided according to smoking status into current smokers (n=337) and former smokers (n=430). COPD diagnosis was based on specialist clinical assessment and spirometric evidence of airflow obstruction; post-bronchodilator FEV1/FVC (reported as BPI in the database) <0.70 was used as the reference criterion according to GOLD recommendations. Demographic data, body mass index, spirometric parameters, CAT, mMRC, exacerbations, and comorbidities were analysed. Results: The cohort included 593 men and 174 women, aged 37-92 years. Mean age was 63.5 ± 9.5 years and mean BMI was 28.6 ± 6.7 kg/m2. Mean forced vital capacity (FVC) was 2.78 ± 1.02 L, mean forced expiratory volume in one second (FEV1) was 1.69 ± 0.72 L, and mean FEV1% was 58.87 ± 20.57%. Current smokers had slightly higher mean FVC and FEV1 values than former smokers, without statistically significant spirometric differences. Former smokers reported higher CAT scores (24.8 ± 6.9 vs. 23.1 ± 7.0; p<0.001) and mMRC scores (2.79 ± 0.66 vs. 2.63 ± 0.67; p<0.001), indicating a greater symptom burden. Arterial hypertension was the most frequent comorbidity (n=514), followed by heart failure (n=147), diabetes mellitus (n=120), and pulmonary neoplasm (n=62). Exacerbations were present in 404 patients (53%). Conclusion: In this cohort, smoking status was associated with small spirometric differences, whereas former smokers reported greater symptom burden. Multidimensional assessment combining spirometry, CAT, mMRC, smoking exposure history, comorbidity screening, and individualized pulmonary rehabilitation is essential in COPD management.

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Background: Physiotherapists are actively involved in promoting physical activity and may influence patients’ exercise-related behaviours through education, exercise prescription, and personal example. This study investigated the relationship between physiotherapists’ physical activity levels and patients’ motivation toward exercise within the framework of Self-Determination Theory (SDT). Methods and materials: A cross-sectional correlational study was conducted involving 15 physiotherapists and 45 patients. Physiotherapists’ physical activity levels were assessed using the International Physical Activity Questionnaire–Short Form (IPAQ-SF), while patients’ exercise motivation was evaluated using the Treatment Self-Regulation Questionnaire (TSRQ). For the correlational analyses, patient motivation scores were aggregated at the physiotherapist level. Associations between variables were examined using Kendall’s tau-b correlation coefficient. Results: Physiotherapists with higher physical activity levels were associated with more favourable patient motivational profiles. A significant positive association was identified between physiotherapists’ physical activity level and patients’ autonomous motivation (τ = 0.451, p = 0.041). Significant negative associations were observed between physiotherapists’ physical activity level and controlled motivation (τ = −0.511, p = 0.019), as well as amotivation (τ = −0.887, p < 0.001). Weekly MET scores showed similar patterns, being negatively associated with controlled motivation (τ = −0.468, p = 0.017) and amotivation (τ = −0.846, p < 0.001). The strongest associations were observed for amotivation. Conclusion: Higher levels of physiotherapist physical activity were associated with higher autonomous motivation and lower levels of controlled motivation and amotivation among patients. These findings highlight the potential contribution of physiotherapists’ own health behaviours to exercise motivation and engagement in rehabilitation.

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Background: Parkinson's disease (PD) represents a neuro-degenerative disorder which progresses through time characterized by bradykinesia, rigidity, tremor and postural instability. Virtual reality (VR) based rehabilitation offers an interactive method that helps users to enhance their balance and motor skills. Objective: To compare the effectiveness of VR-based rehabilitation with conventional physical therapy in improving balance and reducing fall risk in individuals with PD. Methods: At Shadman Medical Centre in Lahore, researchers will perform a single-blinded (assessor-blinded) randomized controlled trial. The study will recruit 62 participants who have PD between the ages of 45 to 65 through convenience sampling, then divide them into two groups through random assignment (1:1). Group A will receive VR-based rehabilitation treatment whereas Group B will receive conventional physiotherapy. Both groups will participate in three weekly sessions that will last for eight weeks. The research team will assess balance through their primary outcome which uses the Mini-BESTest assessment tool. The secondary outcomes of the study will be measured through Timed Up and Go (TUG) assessment and gait parameters and Falls Efficacy Scale assessment of fall risk. The researchers will conduct assessments at three different times which include baseline and post-intervention and follow-up. The researchers will analyze data with SPSS version 24 while setting significance at p value less than 0.05. Conclusion: Virtual reality may provide a promising adjunct to conventional physical therapy for improving balance and reducing fall risk in individuals with PD.

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Introduction: Craniosacral Therapy is a method of manual, non-invasive, very gentle therapy, used to evaluate and treat the craniosacral system, a system that consists of membranes and cerebrospinal fluid that surrounds and protects the brain and spinal cord. The therapist uses a light touch generally of five grams, with which he releases the restrictions in the craniosacral system to improve the functioning of the central nervous system, causing relaxation at both the somatic and mental levels. Objective: This study aimed to determine whether a therapeutic program that uses craniosacral Therapy is more effective than a program consisting of physiotherapy in the subjects with cervical pain and migraines included in this study. Methods: From a group of 30 patients, 15 subjects with neck pain were randomly chosen to receive a craniosacral therapy intervention for a period of 2 weeks and another 15 subjects have received physiotherapy. We have used Visual Analogue Scale evaluation methods based on which we can determine the effectiveness of our programs. Results: Statistical analysis has shown that there are significant differences between pre- and post-test between the experimental and control groups. Conclusions: In our study, craniosacral therapy has better results in reducing the level of pain in patients with cervical pain and migraine. These results need to be considered by therapists to better understand and involve this concept for beneficial effects in treating patients with cervical pain arising from various causes.

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Introduction: The shoulder joint is extremely complex and highly mobile, which makes it vulnerable to injury, particularly in sports involving overhead movements. The purpose of this study was to highlight the importance of a comprehensive therapeutic approach to the post-traumatic shoulder in athletes, with the aim of restoring upper limb functionality. Methods: The study examined a 20-year-old male athlete who experienced multiple shoul-der subluxations, ultimately requiring surgical intervention. The six-month rehabilitation program consisted of physiotherapy, TECAR therapy, and Kinesio taping. Assessment in-cluded measurements of mobility, pain, muscle strength, and functional disability. Results: Significant improvements in shoulder mobility were observed: flexion increased from 55° to 160°, extension from 22° to 40°, abduction from 70° to 175°, and external rotation from 0° to 42°. Muscle strength evolved from F3- to F5 across various movements. Pain levels decreased markedly: daytime from 6 to 2, effort-related pain from 8 to 6, and nocturnal pain from 5 to 1. Functional capacity improved from an initial score of 30 (poor functionali-ty) to 82 (good functionality). Conclusions: Postoperative rehabilitation goals include reduc-ing pain, restoring full range of motion, recovering muscle strength, and improving joint stability, all of which contribute to the functional restoration of the shoulder. The thera-peutic approach combining physiotherapy, TECAR therapy, and Kinesio taping led to re-duced pain, increased range of motion, improved muscle strength, and enhanced joint sta-bility. Integrating multiple therapeutic methods played a key role in the patient’s recovery, highlighting the value of a comprehensive rehabilitation strategy in similar cases.

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Introduction: Mothers of children with disabilities often face persistent emotional, physical, and financial challenges that increase their risk of stress and depression. In Nigeria, these burdens are compounded by limited support systems, socio-cultural stigma, and economic hardship. As primary caregivers, mothers frequently manage demanding responsibilities with minimal assistance. Perceived social support can buffer stress and improve mental health; however, its role among Nigerian mothers of children with disabilities remains underexplored. Therefore, this study aimed to examine the relationship between perceived social support, parental stress, and depression among mothers of children with disabilities. Methods: A cross-sectional survey was conducted among 128 mothers using purposive sampling across three hospitals in Ibadan, Nigeria. The Parental Stress Index-Short Form, Center for Epidemiologic Studies Depression Scale, and Multidimensional Scale of Perceived Social Support were used to examine the relationship among perceived social support, parental stress, and depression. Data were analyzed using Chi-square and Kruskal–Wallis tests. Results: Approximately 57% of mothers experienced significant stress, and 50.8% were at risk of developing clinical depression. Perceived social support was significantly associated with depression and parental stress. Conclusions: Strengthening social support systems may help reduce psychological distress among mothers of children with disabilities.

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Introduction: Earthquakes can disrupt access to healthcare and alter health-seeking behavior, potentially altering the profile of neurology outpatient referrals. Methods and materials: This retrospective study analyzed de-identified, admission-based data from Hatay Mustafa Kemal University Neurology Outpatient Clinic using ICD-10 diagnostic codes, comparing the pre-earthquake period (January 4th, 2021 - February 5th, 2023) with the post-earthquake period (February 6th, 2023 - February 14th, 2025). Results: A total of 185,329 admissions were evaluated (108,524 pre-earthquake and 76,805 post-earthquake). The gender distribution was similar between periods, while admissions among older adults declined after the earthquake. Compared with the pre-earthquake period, the post-earthquake period showed proportional increases in epilepsy, migraine, vertigo/dizziness, and polyneuropathy/neuropathy, with a slight increase in multiple sclerosis; in contrast, proportional decreases were observed for overall pain presentations, anxiety disorders, Alzheimer's disease/dementia, Parkinson's disease, and cerebrovascular diseases. Discussion and conclusions: The February 6, 2023, earthquake was associated with a measurable shift in neurology outpatient referral patterns. These findings support the need for targeted, data-informed post-disaster neurological service planning.

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For citation: Calisir, T., Tasdemir, N. (2026). Changes in Neurology Referrals Before and After the Earthquake: A Retrospective Review. Romanian Journal of Physical Therapy. 32(56),29-39.
https://www.doi.org/10.61215/RJPT.2026.32.56.29