Nicolae Lucian MOLDOVAN, Evelyn Karolina MOLDOVAN, Anca-Cristina POP, Dana Ioana CRISTEA, Ioan-Cosmin BOCA

Virtual-assisted therapy, motor games, balance improvement, Wii Balance Board.

Introduction: Children with special educational needs (SEN) often present with balance and mobility deficits that limit their independence. Virtual reality and interactive video games have shown potential as engaging tools in paediatric rehabilitation. Objectives: The aim of this study was to evaluate the effectiveness of a virtual assisted motor game-based intervention, using the Wii Balance Board platform, in improving balance in children with special educational needs (SEN). Methods: Five children with different neuromotor impairments were included in a pre-post intervention design. Over four months, they participated in bi-weekly interactive motor training sessions using virtual games focusing on postural control and functional mobility. Progress was assessed by applying three standardized instruments: Paediatric Balance Scale (PBS), Tinetti Performance-Oriented Mobility Assessment (POMA) and Functional Mobility Scale (FMS), with pre- and post-intervention testing. The analysis was mainly descriptive, given the small sample size. Results: All participants showed improvements in functional balance and overall mobility. PBS and POMA scores showed significant improvements in static and dynamic balance tasks, and FMS scores suggested increased autonomy in usual school movements. Conclusions: The use of virtual-assisted motor games, through the Wii Balance Board, emerges as a viable and attractive option for therapeutic interventions for children with CES. This approach facilitates active involvement and motivation of the participants, contributing to the efficiency of the rehabilitation process.

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Khan MUSLIM, Iqra MUSLIM, Ifra MUSLIM

Stroke, foot dystonia, functional electrical stimulation, foot drop, rehabilitation.

Introduction: Foot dystonia, a frequent complication in stroke patients with foot drop, is traditionally managed with ankle-foot orthosis (AFO). Functional electrical stimulation (FES) offers a dynamic alternative to improve gait. This case report evaluates the effectiveness of FES in a post-stroke patient with foot dystonia. Methods and Materials: A 25-year-old man with left-sided foot dystonia and partial foot drop after a right middle cerebral artery infarct received treatment using the ODFS Pace FES device. Participants in the intervention were asked to stimulate their left dorsiflexors and evertors during walking for 40 minutes each day, 5 days a week, for 6 weeks, along with traditional physiotherapy. Measurements of outcome were made with ROM for the ankle, Berg Balance Scale scores, 10-Meter Walk Test results and the degree to which individuals felt sure or strong while walking. Results: The patient still had difficulties with foot twisting following intervention, but said they felt their stamin There was not much change in ankle range of motion with dorsiflexion at 19° rising to 20° and eversion rising from 40° to 41°. The average speed at which participants walked on the 10MWT improved very slightly, from 0.678 m/s to 0.692 m/s. Conclusions: FES may serve as an adjunctive therapy for post-stroke foot dystonia, enhancing endurance and confidence but with limited impact on dystonic symptoms. Larger, controlled studies are needed to establish its efficacy and optimal protocols.

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Narcis Julien HERLO, Claudiu Octavian BULZAN, Brigitte OSSER, Gabriel Roberto MARCONI

Post-ankle, lesion, evaluate, accurate diagnosis, recovery.

Background: Ankle sprains represent one of the most frequent injuries among athletes, particularly in sports involving contact or rapid directional changes. Despite being considered minor injuries in some cases, inadequate diagnosis or management may lead to chronic instability, reduced performance, or long-term disability. Understanding the clinical and imaging features of these sprains according to variables such as gender, age, type of sport, and injury severity is essential for optimizing prevention and rehabilitation strategies. Methods: This study included athletes presenting with unilateral ankle sprains, assessed both clinically and through imaging investigations (ultrasound and/or MRI). Data were collected on: sex, age, and type of sport practiced,Injury classification: Degree I, II, or III sprain (based on ligament damage), clinical symptoms (pain, swelling,instability) and their correlation with imaging findings. The goal was to identify significant patterns and differences between subgroups to inform better recovery protocols. Results: Ankle sprains were more prevalent in contact sports (e.g., football, basketball) and among younger male athletes,grade II sprains were the most common overall, but females showed a higher proportion of grade I injuries, while males had more grade III cases, especially in high-impact sports,athletes with early imaging diagnosis had significantly faster return-to-play times and fewer recurrences compared to those managed solely based on clinical assessment. Conclusions: Ankle sprains in athletes present variable clinical and imaging patterns based on sex, age, sport type, and injury grade. Accurate diagnosis, especially through early imaging, improves recovery timelines and reduces long-term complications. These findings support the need for sport- and athlete-specific assessment protocols in both injury prevention and rehabilitation planning.

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Magdalena BUGHIRICA GEORGESCU, Anca Maria DRAGAN

Online physical therapy, parents, COVID-19 pandemic.

Background: The period marked by the COVID-19 pandemic has reshaped society, forcing a breakthrough in digital transformation. Adaptation to the new reality has led to the constant use of online technology in all instructional-educational and therapeutic school activities. The physiotherapy activity also had to change. The parents suddenly became active and responsible in the child's therapeutic activity. Physiotherapists have reconfigured their therapy methods so that students can continue their therapeutic activity outside the school of physiotherapy. Material and method: The study was conducted in the school year 2020-2021. The research is quantitative based on a questionnaire on a sample of convenience (n = 45). The research included parents whose children were included in the physical therapy program. Results: The less used Internet connection tool was the computer. It should be emphasized that, beyond the opportunities offered by technology, the most preferred form of communication is face-to-face: 71% stated that they strongly and very much prefer this channel of collaboration. Beyond face-to-face communication, the most preferred communication channels are the video type: recordings of the therapist explaining the session to be performed or the use of online platforms, such as Zoom. Conclusion: For approximately one in three participants in the research, the implementation of therapeutic tasks with the child at home during the Covid-19 pandemic was considered to be largely and to a large extent difficult.

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Denis ARSOVSKI, Bojana PETRESKA, Viktorija PRODANOVSKA STOJCHEVSKA

Adolescent idiopathic scoliosis; PSSE-Schroth exercises; physiotherapy; postural balance; spinal deformities; scoliosis.

Introduction: Adolescent idiopathic scoliosis is a three-dimensional deformity of the spine that impairs physical function, posture, and quality of life. Conservative treatment options, especially PSSE-Schroth exercises, are gaining increasing clinical relevance. However, evidence from Southeastern Europe remains limited. Objectives: To assess the clinical efficacy of a standardized PSSS-Schroth program on posture, pelvic symmetry, and functional status in adolescents with idiopathic scoliosis through a prospective, clinically applicable observational study. Methods and materials: This single-center study included 16 participants (12 women, 4 men; mean age 18.6 ± 12.4 years) with idiopathic scoliosis (Cobb angle ≤ 40°) who underwent 3-6 months of individualized PSSE-Schroth under the supervision of a certified physiotherapist. Outcome measures included clinical postural assessment, pelvic imbalance, functional mobility, and limited radiographic evaluation. Descriptive statistics and subgroup analyses were used to assess pre-intervention outcomes. Results: Participants demonstrated significant improvements in scapular symmetry, trunk alignment, and reduction in rotational deformity, as documented by clinical photographs and functional reassessment. Although full radiographic follow-up was limited, individual case comparisons demonstrated stability or regression of curve severity in those who adhered to the exercises. The majority of adolescents (81.25%) demonstrated postural correction regardless of the use of a prosthesis. Statistical analysis showed a potential relationship between the Riser grade and the type of scoliosis (p = 0.057). No significant age or gender differences were observed in the pelvic alignment categories. Discussion: This study showed that a structured PSSE-Schroth program can improve posture and trunk symmetry in persons with idiopathic scoliosis, even within a relatively short intervention period. These results are well connected with existing evidence supporting the conservative role of PSSE-Schroth in scoliosis treatment, although the lack of a control group and small sample size limit the generalizability. Conclusions: This study defines the value of PSSE-Schroth exercises in the conservative treatment of idiopathic scoliosis. Despite methodological limitations, the results show that PSSE-Schroth can produce measurable improvements in posture and spinal alignment, even in a short treatment period. Further research is needed to confirm these findings and optimize standardized protocols.

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Tudor - Andrei BARBUR, Simone RUSCETTA, Natalia - Erzsebet KRISTALI, Doina TRANGA, Mihai - Vasile BARA, Dorina IANC

Posture, bone mineralization, body composition, muscle strength, water polo players.

Introduction: The sport-specific movements of water polo influence the postural characteristics of the players, favoring injuries that occur at the joint or muscle level. Objectives: The primary aim of this study was to examine the prevalence of postural deficiencies among athletes in the National Water Polo Super League. Secondary objectives included assessing bone mineral density, analyzing body composition, and evaluating muscular strength, with a particular focus on the trunk and shoulder muscle groups. Material and method: The study included 12 water polo players from the University Sports Club Oradea. The evaluation of the subjects was structured along four main dimensions: posture (using a 3D global postural system), muscle strength (with a wireless hand-held dynamometer), body composition (using the bioelectrical impedance method), and bone mineralization (using a calcaneal quantitative ultrasound device). Results: From the perspective of postural status, asymmetries were observed between the two sides of the body, along with postural deficiencies affecting the spinal column, knees, and feet. Regarding bone and muscular status, the presence of osteopenia was identified, indicating bone demineralization with 67% of them showing signs of osteopenia, while at the same time, slight muscle imbalance was observed. Conclusion: It can be stated that all athletes presented at least one postural deviation, the most common asymmetries being between tat the acromia and superior iliac spines level, with slight muscle strength imbalance at the shoulder level. Regarding the bone mineralization, the presence of osteopenia was identified in the majority of athletes.

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Titilope Oluwatobiloba AJEPE, Oladunni Caroline OSUNDIYA, Favour Oluwaseun OKUNADE, Toluwani Paul ORISAJO, Joseph Olaoluwa ADUNOLA

Prediction, cardiorespiratory function, handgrip strength, upper limb, dexterity, community dwelling, older adult.

Background: Aging results in a steady decline in fine motor skill, upper limb and cardiorespiratory functionality. In low resource communities, determining upper limb function may be useful. This study aimed at predicting cardiorespiratory function using handgrip strength (HGS) and upper limb dexterity (ULD) of older adults. Materials and methods: This survey involved 101 older adults from Lagos State, Nigeria. Cardiovascular parameters were assessed with blood pressure monitor and respiratory parameters with spirometer. Dominant HGS and ULD were assessed with block and box test and Jamar hand dynamometer respectively. Spearman correlation was used to determine the relationship between HGS, ULD and cardiorespiratory parameters. Regression analysis was carried out to predict the cardiorespiratory parameters using HGS and ULD. Results: Hand grip strength was related to respiratory parameters (FVC: r = 0.50, p = 0.001, FEV1: r= 0.52, p = 0.001, PEFR: r = 0.41, p = 0.001) but not cardiovascular parameters. ULD was related to all respiratory parameters (FVC: r = 0.21, p = 0.036, FEV1: r = 0.33, p = 0.001, PEFR: r = 0.43, p = 0.001 and systolic blood pressure (r = -0.19, p = 0.047) and pulse pressure (r = -0.29, p = 0.004). Regression analysis showed that in addition to age, sex and BMI, HGS predicted all respiratory parameters (p = 0.001 (FVC), 0.001 (FEV1), 0.001 (PEFR)). ULD did not predict respiratory parameters (p value = 0.560 (FVC), 0.062 (FEV1), 0.076 (PEFR)) but predicted pulse pressure (p = 0.038). Conclusions: Respiratory parameters of older adults can be inferred from their HGS but not ULD.

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Anca-Cristina POP, Ghita Catalin POPDAN, Mustafa GUVEN, Ioan-Cosmin BOCA, Dana Ioana CRISTEA

Chronic nonspecific low back pain, École du Dos Mail 14, functional disability, motor control rehabilitation, patient education.

Introduction: Chronic non-specific low back pain (CNSLBP) is a leading cause of global disability. While both conventional therapeutic exercises (CTE) and structured educational methods, such as the École du Dos Mail 14 are used in rehabilitation, few studies have directly compared their functional outcomes. Objective: To compare the short-term effects of École du Dos Mail14 and CTE on disability, motor control, and spinal mobility in patients with CNSLBP through a randomized controlled trial. Methods: Twelve participants (mean age: 61.1 ± 12.7 years) with CNSLBP were randomized into two groups: Group A (CTE) and Group B (École du Dos). Outcomes included the Oswestry Disability Index (ODI), fingertip-to-floor (FTF), lateral flexion, and the Luomajoki Movement Control Test. Mann-Whitney U tests and Cohen's d were used to assess group differences and effect sizes. Results: The École du Dos group showed clinically meaningful improvements in ODI (8.0% vs. 23.0%, p = 0.054, d = 1.4) and Luomajoki scores (1.17 vs. 2.67, p = 0.164, d = 1.1). Mobility gains (FTF, lateral flexion) were similar between groups (p>0.05). Conclusion: This pilot trial is among the first to functionally compare École du Dos and CTE in CNSLBP. Although statistical significance was limited, the École du Dos method demonstrated favorable trends and large effect sizes in disability and motor control, supporting its potential clinical relevance. Further studies with larger samples are warranted.

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Anca-Paula CIURBA, Cristina AUR, Ribana LINC

Balneary therapy, gynecological pathologies, Bihor County, hydro-mineral.

Introduction: The beneficial effects of balneotherapy on gynecological conditions are due to the physical-chemical properties of thermo-mineral waters, through external and internal applications. Objective: This study highlights the localities in Bihor County that have hydro-mineral resources with physio-chemical properties, aimed at therapeutic indications in the management of gynecological pathologies. Methods: A bibliographic study was carried out on the effect of balneotherapy in gynecological conditions, preceded by the identification, selection and centralization of the localities in Bihor County that have balneary resources valued in gynecological pathologies. Results: Out of the total of 81 localities with hydromineral resources found in Bihor County, the hydromineral resource is exploited for balneotherapeutic purposes only in six localities (Băile Felix, Băile 1 Mai, Băile Tinca, Sarcău, Marghita, Ștei), of which only four localities have resources hydrominerals with therapeutic indications aimed at gynecological conditions (Băile Felix, Băile 1 Mai, Marghita, Băile Tinca, Sarcău). Conclusions: The balneary treatment certainly has its own, primary, but also complementary role in the treatment of chronic gynecological diseases and is increasingly recommended. However, future studies would be necessary to refer to gynecological pathologies and the influence that the properties of thermal waters can have on them.

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Constantin CIUCUREL, Mariana TUDOR, Elena Ioana ICONARU

Diabetic peripheral neuropathy, questionnaire development, validation, correlational analysis, patient care.

Introduction: The aim of this study is to develop and validate a questionnaire that evaluates the impact of diabetic peripheral neuropathy (DPN) on quality of life and functional capacity in older adults, while also exploring correlations between clinical factors and DPN severity to guide personalized treatment strategies. Methods and materials: A systematic literature review identified key symptoms of DPN, leading to the development of the 20-item Questionnaire for the Assessment of the Impact of Diabetic Peripheral Neuropathy (QAIDPN). The QAIDPN evaluates neuropathic pain, sensory changes, balance difficulties, functional limitations, and overall quality of life using a Likert scale (0-4). It was piloted with 56 DPN patients (mean age 72.45 ± 5.72 years) to assess internal consistency. Correlational analyses examined relationships between questionnaire outcomes and age, sex, diabetes duration, and highest recorded blood glucose level (HRBGL). Results: The QAIDPN demonstrated high internal consistency (Cronbach's alpha = 0.93), indicating excellent agreement among the items. QAIDPN scores significantly correlated with HRBGL (r = 0.80, p ≤ 0.001), diabetes duration (r = 0.64, p ≤ 0.001), and age (r = 0.56, p ≤ 0.001). Discussion: This study developed and validated the QAIDPN, a novel tool for assessing DPN's effects in older adults. Covering a wide range of domains, it provides valuable insights into DPN’s impact on quality of life and functional capacity. QAIDPN is a reliable method for evaluating DPN, aiding in the development of therapeutic algorithms to improve patient outcomes. Our correlational analysis identified significant associations between QAIDPN scores and clinical outcomes such as HRBGL, diabetes duration, and age (p ≤ 0.001), guiding targeted treatment strategies for DPN. Conclusions: The development and validation of the QAIDPN enhance clinical research and practice by providing a reliable method for evaluating DPN and serving as a foundation for creating targeted physical therapy algorithms aimed at improving patient outcomes.

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