Gianni HLIBOCIANU, Tudor - Andrei BARBUR, Codrut BULZ, Dorina IANC

Rectus femoris tear; rehabilitation; football; return to play; muscle injury.

Introduction: Rectus femoris muscle injuries are relatively uncommon in football compared to other lower-limb muscle strains, yet they can significantly affect athletic performance and return-to-play timelines. Aim: The main objective of this study is to analyze the effect of physiotherapy on the recovery process of a professional football player following a rectus femoris tear, with particular attention to the restoration of functional capacity and the facilitation of a safe Return-to-Play. Material and methods: An eight-week, three-phase physiotherapy program was implemented, focusing sequentially on pain and inflammation reduction, restoration of joint mobility and muscle strength, and sport-specific functional recovery. Clinical evaluations - including pain assessment, manual muscle testing, goniometry, and thigh circumference - along with functional tests such as the Active Knee Extension Test, Squat Test, Single-Leg Hop Test, Reverse Nordic Curl, and Y-Balance Test, were conducted at three time points to track progress. Results: Findings showed progressive improvement across all parameters, with complete pain resolution, normalization of muscle strength, and restoration of functional performance by the final evaluation. The athlete successfully returned to full team training and competitive play within 56 days. Conclusion: This case highlights the effectiveness of a structured, criteria-based rehabilitation approach in achieving a safe and efficient return to sport following rectus femoris muscle injury.

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Ionela-Florina TUDOSIE, Emilian TARCAU, Theodora URSU, Codrut Dan TARCAU, Adrian Titus SERSENIUC URZICA

Manual therapy, herniated cervical disk, trigger points, pain.

Introduction: Musculoskeletal disorders that affect the functionality of different body segments, associated with certain comorbidities, can lead to different imbalances in body systems and apparatus. One of the most common musculoskeletal pathologies, with a huge impact on the physical, social, psychological and quality of life aspects of the individual, as well as on society as a whole, is pain, caused by herniated cervical disc. The importance of recovery is given by the large number of people with disabilities related to neck pain, so that a total of 223 million people are affected worldwide and 22 million live with it for years. One of the most effective and important means of treating neck pain is manual therapy. The forms of manual therapy, used in the treatment of cervical hernias, are joint-oriented (mobilization, manipulation, traction), soft tissue-oriented (forms of massage), neural tissue-oriented (neurodynamic) or mixed (specific exercises). Purpose: The aim of this study was to show the effects of instrumented manual therapy and kinesiotherapy in relieving the symptoms of cervical disc herniation. Material and Method: The study was carried out over 6 weeks on a 54-year-old patient diagnosed with left latero-posterior disk herniation at C3/C4 level of 1.5 mm and at C4/C5 level of 2 mm, he also had hypertension - essential GR II, tricuspid insufficiency GR ½, mean systolic dysfunction VS, mitral insufficiency GR II and sleep apnea, obstructive form, as associated pathologies. The patient was evaluated for cervical pain using VAS scale, cervical spine mobility, functional tests (Appley Test, Spurling Test, Shoulder Abduction Test, Scalen Test, Traction Test and Barre-Lieou Test), Neck Disability Index, as well as the presence of active trigeer points and their pain intensity. The 6-week treatment plan was carried out in 2 stages, the first (for 3 weeks) consisting of relaxation massage, cervical and scapular belt mobilizations, and the second consisting of myofascial instrumented therapy, cervical manual therapy, global postural re-education exercises (Souchard Method) and cervical and scapular belt mobilizations, 3 times a week for 90 minutes. Results: In the first part of the recovery (first 3 weeks) there was little improvement in all the parameters evaluated, but with the introduction of myofascial therapy, manual therapy, postural exercises and mobilizations in the recovery program, the results were significantly improved. Conclusions: The recovery program based on manual therapy techniques had positive effects in treating neck pain, improving joint mobility, deactivation of trigger points, and positive effects on neck disability index in the cervical disc herniation patient studied.

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Shani SELA, Elisha VERED, Leonid KALICHMAN

Stroke, Kinesiotape, function, therapy, upper extremity, activities of daily living.

Introduction: Post-stroke spasticity is a prevalent motor complication leading to extremity weakness and impaired coordination, significantly affecting daily activities. This study evaluated the efficacy of combining Kinesiotape with occupational therapy in reducing spasticity and enhancing upper extremity functionality in post-stroke patients. Methods: A prospective randomized controlled trial at Shmuel Harofeh Medical Center involved 16 patients randomly assigned (1:1) to an intervention group (Kinesiotape plus occupational therapy) or a control group (occupational therapy alone). Treatment lasted four weeks, five sessions weekly. Assessments occurred pre-intervention, post-intervention, and one-week follow-up using the Modified Ashworth Scale (MAS) for spasticity, Fugl-Meyer Assessment (FMA) for motor function, handgrip dynamometer for grip strength, and Chedoke Arm and Hand Activity Inventory (CAHAI) for hand function. Results: Kinesiotape significantly reduced spasticity versus control post-intervention (u=6.00, p=0.007) and at follow-up (u=1.00, p=0.003). In the Kinesiotape group, spasticity decreased significantly (z=-2.37, p=0.018) from pre-intervention (7.89±3.79) to one hour post-application (5.33±4.06), with significant increases in upper extremity motor function (t=-4.151, p=0.003) from pre- (9.89±16.56) to post-intervention (21.67±20.70) and grip strength (z=-2.023, p=0.043). Conclusion: Combining Kinesiotape with occupational therapy limits spasticity development, improves upper extremity motor function and grip strength, and enhances quality of life in acute stroke patients.

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Denisa Ioana TIBICHI, Doriana CIOBANU, Dorina IANC

Phelan-McDermid syndrome, autism spectrum disorder, physical therapy, gross motor function, primitive reflex integration.

Introduction: Phelan-McDermid syndrome is a neurodevelopmental disorder with a neurological and psychiatric phenotype, as well as various additional features that can vary considerably between affected individuals and in the course of disease development. To date, the diagnosis of this syndrome has been based on the presence of genetic alterations on chromosome 22q13, which encodes the synaptic scaffold protein SHANK3. Aim: The purpose of this paper is to emphasize the role of physical therapy in improving gross motor function and integrating primitive reflexes in children with Phelan-McDermid syndrome, and to compare it with autism spectrum disorder. Material and methods: The study was conducted at the Mihai Neșu Foundation (Oradea) over a period of 4 months and consisted of a therapeutic program twice a week, one hour per day. Two patients aged 6 and 5 years were involved in the study, both presenting similar characteristics, however, the girl with the genetic syndrome displayed more severe features and a more pronounced symptomatology. The intervention involved physical therapy program consisting of thermotherapy and massage of the lower limbs, as well as reducing muscle shortening using the V-plus device. The program also included sensory stimulation with the Z-vibe to activate the speech center, along with kinesthetic interaction using various items such as a feather, small balls, sand, and brush. Interventions also targeted the improvement of gross motor function and the integration of primitive reflexes. Results: Application of muscle-strengthening techniques led to observable improvements in musculoskeletal development. Training of the vestibular system resulted in decreased duration and intensity of nystagmus. Exercises aimed at gross and fine motor functions, as well as daily living activities, showed promising results for future applications. The child with autism spectrum disorder demonstrated greater and more significant progress than the child with Phelan-McDermid syndrome, likely due to the higher complexity and severity of the genetic condition. Conclusion: The research hypothesis was largely confirmed: implementing a 4-month comprehensive rehabilitation program, including thermotherapy, massage, physiotherapy, hydrotherapy, ABA therapy, and speech therapy, promoted muscle development, improvement of gross motor functions and daily living skills, better balance and gait, enhanced vestibular function, and integration of primitive reflexes in children with Phelan-McDermid syndrome and autism spectrum disorder.

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Roxana-Maria GITMAN

Quality of life, physical therapy, prophylaxis, functional capacity, elite handball.

Introduction: Handball is one of the most demanding sports, where attention to the physical condition of athletes must be significantly increased. The present study aims to identify the need for prophylactic methods in athletes who play male performance handball in senior teams. Methods and materials: In this regard, we applied Quality of Life questionnaire, a questionnaire for frequency of trauma and DASH questionnaire for functionality of the upper limb, for a total of 92 performance male players. Results: Data obtained reveal a low level for quality of life, a high frequency of lesion for both upper and lower limb, with a total of 151 lesions for the upper limb and 78 lesions for the lower limb, especially for the dominant ones. Also, joint function for the upper and lower limbs was affected, mostly for dominant shoulder. Conclusions: These results indicate the necessity of physical prophylactic exercises and an organized sports training for male performance players, in order to reduce the negative effects of asymmetric training.

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Alexandra Ionela PRALA, Luminita Ionela GEORGESCU, Ion MIHAILA, Elena Ioana ICONARU, Stefan TOMA

Stroke rehabilitation, gait recovery, kinesio taping, gait balance.

Introduction: Stroke causes peroneal nerve palsy manifested by weakness in dorsiflexion of the foot. This contributes to the respective gait impairment disrupting the swing phase of the gait cycle. Purpose: Through the proposed recovery program, we want to highlight the importance of using kinesio taping therapy in the specific recovery program to correct abnormal gait patterns in people with drop foot. Materials and Methods: In accordance with the strategy of gait recovery optimization in people with drop foot we conducted a longitudinal study over a period of 4 weeks with gait balance as test parameter. For the assessment of balance, we used the Berg Balance Scale and the Four Step Square Test, and the research group comprises a total of 10 subjects. The subjects were divided into two groups: the control group that received the classic recovery program and the experimental group that received the classic recovery program and the kinesio taping therapy. Results: According to the final evaluation results, the experimental group has made greater progress. Compared to the control group, the experimental group showed a progress rate of 18.2% higher. Results support the hypothesis that the use of kinesio taping helps to optimize gait recovery in people with drop foot after stroke. Conclusions: The correct alignment of the ankle joint during walking can be stimulated and maintained by the kinesio taping technique applied as complementary therapy, and the results obtained during assessing balance while gait support our conclusion.

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Physical activities, dairy consumption, body composition.

Introduction: Milk consumption is frequently debated for its potential role in weight regulation and modulating body composition. This study aimed to investigate the association between milk intake and body composition parameters among physically untrained students, student athletes, and dialysis patients. Methods and Materials: In a cross-sectional design, 110 participants (78 physically untrained students, 17 student athletes, and 15 dialysis patients) were evaluated for body mass index (BMI), adipose tissue percentage, and muscle tissue percentage. Milk consumption frequency was assessed using a structured questionnaire, and statistical analyses - including the Kruskal-Wallis and Mann-Whitney tests, as well as Pearson correlation - were performed to examine intergroup differences and associations. Results: Significant differences in milk consumption were observed among groups, with dialysis patients reporting the lowest frequency. A positive correlation was identified between milk consumption frequency and muscle tissue percentage (r = 0.266, p < 0.01), while a negative correlation was observed between milk consumption and adipose tissue percentage (r = -0.303, p < 0.01). Discussion: These findings suggest that increased milk intake may contribute to a more favorable body composition, potentially through mechanisms related to lipid metabolism and appetite regulation. Conclusions: Although milk consumption appears to be modestly associated with increased muscle mass and reduced adiposity, further research is warranted to elucidate the underlying physiological mechanisms and to determine the long-term effects of milk intake on body composition.

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Klara KALMAN, Doriana CIOBANU, Theodora Florica URSU, Anca Maria DRAGAN

Diastasis recti abdominis, postpartum, women’s health, romanian women.

Introduction: Milk consumption is frequently debated for its potential role in weight regulation and modulating body composition. This study aimed to investigate the association between milk intake and body composition parameters among physically untrained students, student athletes, and dialysis patients. Methods and Materials: In a cross-sectional design, 110 participants (78 physically untrained students, 17 student athletes, and 15 dialysis patients) were evaluated for body mass index (BMI), adipose tissue percentage, and muscle tissue percentage. Milk consumption frequency was assessed using a structured questionnaire, and statistical analyses - including the Kruskal-Wallis and Mann-Whitney tests, as well as Pearson correlation - were performed to examine intergroup differences and associations. Results: Significant differences in milk consumption were observed among groups, with dialysis patients reporting the lowest frequency. A positive correlation was identified between milk consumption frequency and muscle tissue percentage (r = 0.266, p < 0.01), while a negative correlation was observed between milk consumption and adipose tissue percentage (r = -0.303, p < 0.01). Discussion: These findings suggest that increased milk intake may contribute to a more favorable body composition, potentially through mechanisms related to lipid metabolism and appetite regulation. Conclusions: Although milk consumption appears to be modestly associated with increased muscle mass and reduced adiposity, further research is warranted to elucidate the underlying physiological mechanisms and to determine the long-term effects of milk intake on body composition.

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Maria Elena ABRUDEANU, Constantin CIUCUREL, Luminita GEORGESCU, Elena Ioana ICONARU, Teodor Catalin CONSTANTINESCU, Georgeta IONESCU

SARS-CoV-2, COVID-19, residential care, mental health, rehabilitation.

Introduction: The COVID-19 pandemic heightened vulnerabilities for individuals with disabilities, limiting access to care and essential services. This study examines its impact on institutionalized individuals, caregivers, and care centers, emphasizing the challenges posed by reduced physical activity and the resulting negative effects on health. It identifies key issues and provides insights to improve future crisis responses. Material and method: This cross-sectional study employed a mixed-methods approach, integrating quantitative and qualitative analyses to assess the impact of COVID-19 on institutionalized individuals with disabilities, caregivers, and residential centers, using structured questionnaires and interviews at both institutional and resident levels. Results: The research, conducted across three residential centers in Arges County with 231 beneficiaries (96 males, 135 females, ages 19-97 years), found that the pandemic significantly affected the mental health and daily routines of residents, especially those with severe psychiatric disorders. The reduced physical activity further contributed to muscle deconditioning and frailty among beneficiaries, exacerbating their health risks. Meanwhile, staff managed stress and adapted to care requirements. Discussion: This study reveals the COVID-19 pandemic's negative impact on residents with disabilities in residential centers, emphasizing the effects of isolation and reduced physical activity. Key insights highlight the importance of maintaining physical engagement, communication, and adaptable care strategies to mitigate the impact of these limitations. Conclusions: The pandemic impacted individuals with mental disabilities differently, with isolation affecting psychological health, especially for those with schizophrenia. Family support and communication helped maintain stability. Caregiver stress was high, but support and collaboration alleviated some challenges. Reduced physical activity and increased sedentary behavior among both residents and caregivers worsened health, highlighting the need for better crisis preparedness.

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Esra DOGRU HUZMELI, Eren LEKESİZ, Yasemin KARAASLAN, Sureyya DAMAR ORENLER, Zekiye Ipek KATIRCI KIRMACI, Kezban BAYRAMLAR, Busra AKINCI, Esra CELIK, Yusuf Sinasi KIRMACI, Esra ALDIRMAZ, Lamia NECCAR, Mahperi KAYMAZ, Elif Dilara DURMAZ, Merve KURUCU, Halil OGUT, Nilufer CETISLI KORKMAZ, Tulin DUGER

Telerehabilitation, earthquakes, Türkiye, rehabilitation.

Introduction: Access to physiotherapy and rehabilitation (PTR) services was very difficult during the February 6, 2023 earthquakes in Türkiye. A telerehabilitation (TR) team was established to help disaster victims by recognizing their urgent health needs. This study aimed to determine whether TR could be used as a viable solution in situations where it is difficult to provide traditional face-to-face PTR services during an earthquake. Materials and Methods: Within the TR team, volunteer physiotherapists reached out to disaster victims and planned weekly treatments. The diagnoses of the disaster victims include cerebral palsy, peroneal nerve injury, drop foot, hand extensor tendon injury, muscle contusion, soft tissue injury, left wrist fracture, disc herniation, hemiparesis, facial paralysis, temporomandibular joint dysfunction, severe back pain, and asthma. PTR services were provided with TR. Patients' satisfaction with TR was evaluated on a scale of 0-10. Results: A total of 25 earthquake victims contacted the TR team to receive rehabilitation. Fifteen patients successfully completed the TR process. The average number of TR sessions received by the patients was 4±3.48 days. The satisfaction level of 14 patients with the treatment was 9.5±1.02 out of 10. Conclusions: Accessing rehabilitation services during a disaster is a challenging task. When hospitals face challenges in providing healthcare services, leveraging technology through TR can be a viable solution. This study demonstrates that PTR services can be successfully delivered online during disasters.

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