· International title: Balneo and PRM Research Journal / Index name: BALNEO, Publisher: Romanian Association of Balneology / Asociația Română de Balneologie, Website http://bioclima.ro/Journal.htm
Romanian Association of Balneology / Asociația Română de Balneologie, Website http://bioclima.ro/Journal.htm
764 Development of a new composite surface tensiometry parameter for quality evaluation of the maturation process of peloids by contact angle method
With the introduction of the rheological and surface tensiometry approaches, peloids started to be viewed as a geological complex system that needed to be characterized in an integrated way. The development of the Rossi factor revealed variations in the surface free energy of Euganean thermal muds as a function of their quality, conformity, and matura-tion degree. The Rossi factor consents to measuring the contact angle of Fomblin HC/25PFPE Polyperfluoromethylisopropyl Ether by static sessile drop method. The de-velopment of the Kinetic Contact Angle sessile drop methodology, applied to the meas-urement of Fomblin HC/25 PFPE contact angles over time, led to the determination of an integrated surface tensiometry parameter for the evaluation of the maturation process of Euganean thermal peloids, here called the Maturation Mud Index. The Mud Maturation Index is based on the contact angle measurements performed onto peloids surfaces col-lected by Osservatorio Termale Permanente of University of Padova from 2005 to 2010. The Mud Maturation Index has shown a connection to the activity of thermal spas during their pelotherapy season. As a result, this index can serve as a valuable tool for surface tensiometry in assessing the maturation process quality of a peloid based on its level of maturation within the thermal activity of the Euganean Thermal Area in Padova, Italy.
Copyright (c) 2025 Davide Rossi, Nicola Realdon https://creativecommons.org/licenses/by-nc-nd/4.0
761 How do physicians estimate cardiovascular risk in the elderly using E-health - a pilot study
Introduction: Cardiovascular pathology encompasses a wide range of diseases characterized by common risk factors such as atherosclerotic disease, diabetes, and arterial hypertension. These conditions can be effectively mitigated through the adoption of a healthy lifestyle. Additionally, telemedicine, along with other forms of direct or indirect electronic interaction, may play a significant role in the prevention of cardiovascular diseases. Materials and Methods: In order to evaluate the perception of doctors and elderly patients from Bucharest county, as cardiovascular risk and the preventive role of telemedicine means, we created a specific questionnaire. We collected by a online questionnaire: demographic data, level of education, medical software applications used, cardiovascular parameters, telemedicine compliance. The obtained data were processed using Windows Office program. Results: The surveyed doctors performed telemedicine using WhatsApp (in 55% of cases), phone short message text (in 40% of cases). and platform ASSMB (0.5%). Doctors' preferences in telemedicine were to asses the cardiovascular pathology (75%), cognitive disorders (65%), and functional (60%) evaluations. The majority of 50% of patients will resort to alternative consultations (through physical examination and telemedicine) in the future only if it is strictly necessary. Conclusions: Doctors and patients were predominantly women, with the majority residing in the urban environment. Telemedicine was carried out using WhatsApp for doctors and patients. Most doctors believe that telemedicine will improve the doctor-patient relationship and therapeutic compliance and monitoring and consultations will take place at the office and via telemedicine. The majority of patients will resort to alternative consultations methods (physical examination/ telemedicine) in the future when deemed necessary; a significant number of the patients would encompassing both in-person visits and telemedicine options. Keywords: cardiovascular risk; elderly patient; telemedicine.
Copyright (c) 2025 Sorina Maria Aurelian, Justin Aurelian, Simona Isabelle Stoica, Andreea Iulia Vlădulescu-Trandafir, Andreea Zamfirescu, Gelu Onose https://creativecommons.org/licenses/by-nc-nd/4.0
763 Flexible analytic wavelet transform in a EEG based brain com-puter Interface Paradigm: a study in end users with motor di-sabilities
Motor imagery electroencephalogram based brain computer interface systems can help people with disabilities to communicate with an external device and to realize rehabilitation therapies. The paper proposes flexible analytic wavelet transform (FAWT) as feature extraction method. The method was tested on a dataset that contains EEG signals acquired from subjects with motor disabilities. Classifiers linear discriminant analysis (LDA), quadratic discriminant analysis (QDA), k nearest neighbors(kNN), Mahalanobis distance (MD) and support vector machine (SVM) were utilized to classsify the extracted features of right hand motor imagery and feet motor imagery (FEET). The best performance was given by QDA classifier with a classification rate of 97 %, sensitivity 99.65%, specificity 98.47%, kappa coefficient 0.97 and F1 score 0.98. The proposed method shows through the obtained results that can be used and easy to implement for assisting rehabitation on real time BCI systems.
Copyright (c) 2025 Oana- Diana Hrisca-Eva https://creativecommons.org/licenses/by-nc-nd/4.0
762 Medical management of organic psychomotor agitation and neuroreabilitation after revascularised vertebrobasilar stroke
(1) Background: Psychomotor agitation is a behavioral and emotional symptom frequently seen in dementia patients. Vascular dementia has few options for treating non-cognitive symptoms such as agitation and psychotic symptoms. (2) Methods: We present the case of a 71-year-old male who presented in the revascularisation window for confusional syndrome and tetrameric ataxia. The examination revealed: psychomotor agitation, dyscromatopsia, self-disorientation, temporal and spatial disorientation, complex visual hallucinations with Capgras syndrome, facial agnosia, and akinetopsia. (3) Results: Brain CT revealed top of the basilar artery thrombosis which was treated with mechanical thrombectomy and intraarterial thrombosis. Brain imaging revealed constitutive lesions in the occipital lobe, parahippocampal, the lingual gyrus, in the paramedian pontine level, and a cerebellar lesion. The patient developed strategic infarct dementia with severe psychomotor agitation. As a therapeutic approach, the heroic combination that diminished the agitation was: Olanzapine and Levomepromazine (two sedative neuroleptics), Valproate (thymostabiliser), and Diazepam. (4) Conclusions: We emphasize the need for heroic treatment options for severe psychomotor agitation and psychotic agitation in patients with cardiovascular risks such as stroke. In this case, we present our beneficial results with Olanzapine and Levomepromazine. We highlight the need for extensive treatment guidelines for severe cases of psychomotor agitation.
Copyright (c) 2025 Antonia Ioana Vasile, Cristina Nica, Cristina Tiu https://creativecommons.org/licenses/by-nc-nd/4.0
760 Motor Tasks Classification Using Phase Locking Value in a BCI Based EEG Paradigm
Brain-computer interface (BCI) is developing very quickly with applications extending to medical and non-medical fields. Electroencephalography (EEG) is used in BCI to detect and analyze brain signals. An approach based on phase synchronization was tested on two datasets (one with EEG signals recorded from 15 healthy subjects and one with EEG signals recorded from 9 subjects with disabilities). Phase locking value was tested as feature extraction method from EEG signals. k-nearest neighbor (KNN) and support vector machine (SVM) classifiers were applied for discrimination between tasks (right hand motor imagery, left hand motor imagery and feet motor imagery). Classification rates above 81% obtained with kNN and 92% achieved with SVM indicate that phase synchronization based method can be exploited in developing BCI systems for controlling and assisting people with upper and lower limb disabilities.
759 The Role of Kinesiotherapy in Enhancing Physical Performance and Self-Esteem: A Prospective Observational Study in Obese Adolescents
(1) Background: Obesity is a multifactorial chronic condition characterized by excessive fat accumulation, which adversely affects health and quality of life. (2) Methods: This prospective observational study aimed to evaluate the impact of a 9-month tailored kinesiotherapy program on physical performance, body composition, and self-esteem in overweight and obese adolescents. Participants were divided into a study group (SG, n=40) and a control group (CG, n=40). The SG engaged in individualized kinesiotherapy sessions, while the CG maintained their usual activities. Both groups received education on the 5-2-1-0 rule for obesity prevention and management. (3) Results indicated significant improvements in the SG, including enhancements in the 6-minute walk distance (6MWD), Timed Up-and-Go test (TUG), and Rosenberg Self-Esteem Scale (all p < 0.001). Notably, BMI and body fat percentage decreased significantly in the SG compared to the CG. Regression analysis revealed strong correlations between body composition, physical performance, and self-esteem improvements, particularly in girls and rural participants, highlighting the intervention's adaptability and effectiveness. Although limited by a relatively small sample size, short duration, and variability in adherence tracking, the study highlights the essential role of individualized physical activity programs in improving health outcomes. (4) In conclusion, the findings from our study emphasize the significant role of individualized kinesiotherapy programs in improving physical and psychological health outcomes in overweight/obese adolescents. By integrating instrumental assessments, such as the BTS system, with subjective evaluations like PAQ-A and the Rosenberg scale, our study highlights the multifaceted impact of physical activity on this vulnerable population.
Copyright (c) 2025 Cristina Popescu, Daniela Matei, Rodica Traistaru https://creativecommons.org/licenses/by-nc-nd/4.0
758 Assessment of frailty, performance and functional independence in patients with periprosthetic fractures associated with total hip arthroplasty
Periprosthetic fractures (PFs) associated with total hip arthroplasty are significant postoperative complications after hip prosthesis implantation surgery. The aim of this study was to evaluate the fragility, performance and functional independence of patients with PFs associated with total hip arthroplasty. Material and Method. A cross-sectional study was conducted between January and October 2024. The 101 patients evaluated were divided into 3 groups: the group consisting of hip arthroplasty patients - named ATS group (n=36), the group consisting of periprosthetic fractures patients - named PF group (n=11), the group consisting of stage III and IV coxarthrosis patients - named OAH group (n=42). Results. Mean scores fall in the range of pre-fragility - mild frailty for ATS and OAH groups (7.098 ± 2.289 vs. 6.939 ± 1.405), with no significant differences between them, while the mean score of PF group falls in the range of moderate-severe frailty (11.727 ± 3.289). Our data analysis suggests a marked impairment of functional independence in more than 90% of PF patients versus 32% of patients in the ATS group and about 20% of patients in the OAH group; about 75% of patients in the PF group have a significant impairment of functional perfomance. Conclusions. Periprosthetic hip fractures are associated with advancing age and increased fragility. Functional performance and independence of patients with periprosthetic fractures, more than 3 months after fracture, is significantly impaired and is associated with frailty status and advanced age.
Copyright (c) 2025 Victor Niculescu, Razvan Ene, Alexandru Lisias Dimitriu, Sebastian Tirla, Cristian Marge, Mircea Gheorghe Pop, Radu Dan Necula https://creativecommons.org/licenses/by-nc-nd/4.0
757 The role of Kegel exercises in reducing involuntary loss of urine in Overactive Bladder and Mixed Urinary Incontinence
Abstract: Objective: This study aimed to evaluate the efficacy of Kegel exercises, or pelvic floor muscle training (PFMT), in reducing symptoms of urinary incontinence among women with overactive bladder (OAB) and mixed urinary incontinence (MUI). Methods: A randomized control trial was conducted with a total of 50 participants (young women ages 18-35) out of which 35 were diagnosed with OAB and 15 with MUI. The participants were monitored for six months: In the first three months received only pharmacological therapy, solifenacin succinate 10 mg per day, and after this period the same group associated to the pharmacological treatment daily Kegel exercises. The primary outcome measured was the reduction in urinary incontinence episodes, while secondary outcomes included changes in quality of life (QoL) and bladder control as assessed by standardized questionnaires. After three months, group demonstrated a reduction in the frequency of urinary incontinence episodes. However, receiving both solifenacin succinate and Kegel exercises showed a statistically significant improvement in urinary control and QoL scores at six months evaluation. Conclusion: These findings suggest that the combination of pharmacological treatment with solifenacin succinate and Kegel exercises is more effective in managing urinary incontinence symptoms associated with OAB and MUI than pharmacological treatment alone. This approach may represent a beneficial strategy for patients requiring enhanced symptom relief.
Copyright (c) 2025 Lucian Șerbanescu, Vadym Rotar, Elena Valentina Ionescu, Alexandra-Ecaterina Ciota, Sebastian Mirea, Paris Ionescu, Andreea Cristina Costea https://creativecommons.org/licenses/by-nc-nd/4.0
756 Comparative analysis of paraclinical parameters in the assessment of osteoporosis: an integrative approach
Background: Osteoporosis is the most common metabolic bone disease with serious physical, psychosocial and economic consequences. It is a chronic, asymptomatic, progressive disease with multifactorial aetiology, characterized by reduced bone mineral density and microarchitectural deterioration of bone tissue; Methods: A retrospective study was conducted, which included an initial cohort of 243 patients hospitalized between January 2023 and December 2023 at the County Emergency Hospital of Sibiu, Clinical Endocrinology Department ; Results: Study results suggest that assessment of bone mineral density (BMD) remains a primary standard in the diagnosis of osteoporosis, as measured by T and Z scores from DXA densitometry. However, biomarkers such as total calcium, ionic calcium, vitamin D, phosphorus, PTH and bone degradation markers (e.g. Beta Crosslaps) play a significant role in assessing bone metabolism and identifying fracture risk; Conclusions: The study highlights the importance of screening in postmenopausal women and the need for calcium and vitamin D supplementation in patients with osteoporosis or osteopenia.
Copyright (c) 2025 Oana Raluca Antonescu , Sinziana Calina Silisteanu , Alina Cristiana Venter , Mihaela Racheriu , Irina Elena Antonescu, Enikő Nemes-Nagy https://creativecommons.org/licenses/by-nc-nd/4.0
755 Evolution of Functional and Paraclinical Markers as Predictive Factors in Pediatric Late-Onset SMA Under Nusinersen Treatment: The Role of CSF pNF-H
Background: Spinal Muscular Atrophy (SMA) is a rare neurodegenerative disease caused by insufficient synthesis of SMN protein, characterized by progressive muscle weakness, atrophy, and complications affecting the respiratory and digestive systems. Disease severity tends to be greater when symptoms manifest at an earlier age. Since 2016, the FDA-approved drug nusinersen has provided a disease-modifying treatment option. Identifying predictive factors for patient outcomes over time remains essential. Methods: This retrospective study analyzed clinical and biological parameters in 42 patients (ages 13–215 months) with SMA types 2 and 3 over the first three years of nusinersen treatment. We assessed pNF-H levels in CSF and serum—neuronal proteins associated with neurodegeneration—as well as serum creatinine levels, a marker of muscle activity, and motor skill scores to evaluate pNF-H’s potential as a predictor of motor development. Results: Elevated pNF-H levels were associated with a lower SMN2 gene copy number and more recent disease onset. Following nusinersen treatment, pNF-H levels stabilized at low values, likely due to basal metabolic activity. Conclusions: In SMA types 2 and 3, higher baseline CSF pNF-H levels correlated with improved performance over time. Additionally, higher serum creatinine levels and smaller changes in pNF-H during the loading phase or various periods of maintenance treatment were associated with better motor development outcomes at two and three years of treatment.
Copyright (c) 2025 Mihaela Badina, Gabriel Cristian Bejan, Corina Sporea, Andrada Mirea https://creativecommons.org/licenses/by-nc-nd/4.0
754 Predictive Clinical-Biological Markers Over the First 3 Years of Nusinersen Treatment in SMA Type 1 Patients
Background: Werdnig-Hoffmann disease, or type 1 Spinal Muscular Atrophy (SMA), is caused by insufficient SMN protein synthesis due to a genetic defect. Symptoms appear within the first 6 months of life, and without ventilatory support, life expectancy averages 2 years. Objective and Methods: This study aimed to monitor pNF-H neurofilament levels in cerebrospinal fluid (CSF) and serum, serum creatinine, and motor performance during nusinersen treatment to evaluate pNF-H as a predictor of motor outcomes. Biological samples and clinical outcomes from 34 participants were analyzed at 6 months, 1 year, 2 years, and 3 years post-treatment initiation. Results: Most patients showed favorable outcomes, with improved motor assessment scores, increased serum creatinine, and decreased pNF-H levels in CSF and serum. Higher baseline pNF-H in CSF was linked to fewer SMN2 gene copies. The largest pNF-H decrease occurred during the nusinersen loading period, stabilizing at low levels through maintenance. Smaller changes in pNF-H from baseline correlated with better motor outcomes and higher serum creatinine at 2 and 3 years. Conclusions: Nusinersen treatment reduced pNF-H levels, reflecting decreased neuronal degradation, increased serum creatinine due to enhanced muscle activity, and improved motor function. High baseline pNF-H in SMA type 1 may indicate a poorer prognosis for motor improvement.
Copyright (c) 2025 Mihaela Badina, Andrada Mirea , Corina Sporea, Gabriel Cristian Bejan https://creativecommons.org/licenses/by-nc-nd/4.0
753 Body Composition and Cardiorespiratory Fitness Characteristics Among Female University Students: A Cross-Sectional Study
Background: Obesity and body composition are crucial indicators of health, especially among young adults whose lifestyle changes during university years can impact physical well-being. This study examines obesity levels and body composition parameters in female university students, hypothesizing that they exhibit elevated body fat percentages compared to health standards, likely due to a sedentary lifestyle. A secondary hypothesis posits a correlation between physical activity levels and body composition, anticipating higher fat mass in students with low physical activity levels. Materials: The study included 258 female students, aged 18-23, from seven faculties at the University "Dunărea de Jos" of Galați. Body composition metrics, such as total body water, protein, minerals, body fat mass, skeletal muscle mass, and BMI, were assessed using the InBody 720 (Biospace, Korea). Cardiovascular fitness was evaluated through the Ruffier Test, a widely accepted measure in Europe. SPSS 26 software was used for statistical analysis, applying Skewness and Kurtosis to assess data distribution, while Pearson correlation evaluated relationships between physical activity and body composition. Results: The analysis revealed a significant trend toward elevated fat mass and obesity indicators. The average body fat mass was 32.3%, substantially above the healthy standard of 23%, and 52.3% of participants were classified as having excessive body fat. BMI showed 38% of students in the overweight or obese range. Waist-to-hip ratios highlighted prevalent central adiposity, with a mean of 0.918, exceeding recommended limits for women. A positive correlation was found between lower physical activity and increased fat mass, supporting Hypothesis 2. Conclusion: Findings indicate a high prevalence of obesity-related parameters among female university students, likely linked to lifestyle changes. These results emphasize the importance of health promotion efforts to encourage physical activity and healthy habits in this population, suggesting a role for bioelectrical impedance analysis as a valuable tool in university health assessments.
Copyright (c) 2025 Mădălina-Gabriela Coman, Andreea Maria Adam, Carmen Gheorghe, Mircea Dan Mocanu, Leonard Stoica, Daniel-Andrei Iordan, Ilie Onu, Dragoș Florin Teodor https://creativecommons.org/licenses/by-nc-nd/4.0
752 Preliminary analysis of patient assessment within a study on the impact of hydrokinetotherapy on body composition and metabolic disease risk in an adult population segment
In clinical and research settings, the accurate and reliable evaluation of body composition is necessary. Existing methods present various challenges, either in measurement methodology or in the assumptions they rely on.The purpose of this study is to conduct a preliminary analysis of patient assessment within a study concerning the impact of hydrokinetotherapy on body composition and metabolic disease risk in an adult population segment. Methods: The research was carried out at the Diabetes Ambulatory Clinic of the Suceava County Hospital in January 2024. An essential component of this investigation involves evaluating body composition parameters measured using the Tanita 738 device and assessing metabolic risk factors such as diabetes mellitus, hypertension, and dyslipidemia. In parallel with this research, a hydrokinetotherapy model adapted to this population is proposed for development. Results: The interpretation of BMI data for women aged 40-60 revealed significant variability in this group’s body composition, as was also observed in women aged 61-80. Among women aged 61-80, there was a significant proportion of participants with morbid obesity (BMI ≥ 40). Similarly, the BMI data for men aged 40-60 indicated notable variability in body composition, consistent with the findings for men aged 61-80. Both age groups in men exhibited significant overweight and obesity, highlighting the need for increased attention to weight management and metabolic health among men. Conclusions: The study on body composition and metabolic disease risk among adults aged 40 to 80, participants at the Diabetes Ambulatory Clinic of the Suceava County Hospital, demonstrated significant findings in both women and men. Implementing a 4-month hydrokinetotherapy program indicates an approach aimed at optimizing participants’ health. A personalized approach and careful management of hydrokinetotherapy exercises are necessary. Weight loss through diet and physical exercise is proven to be the most effective treatment strategy for obese and overweight elderly subjects, facilitating the maintenance of muscle mass and promoting functional recovery.
Copyright (c) 2025 Claudiu Cobuz, Sînziana Călina Silișteanu, Maricela Cobuz, Andrei-Ioan Costea, Elena Vizitiu Lakhdari https://creativecommons.org/licenses/by-nc-nd/4.0
751 Validation study of the Boston questionare in patients with carpal tunnel syndrome
A single The Boston Carpal Tunnel Questionnaire is a common tool for evaluating the symptoms and function of patients with carpal tunnel syndrome (CTS). It includes the Functional Status Scale and the Symptom Severity Scale. It has been validated in numerous languages and is the most frequently employed patient-reported outcome measure in CTS. The objectives of this study was to evaluate the acceptability, responsiveness, reliability, and validity of the Romanian version. We conducted a two-parts study: the first part involved the translation and cross-cultural adaptation of the The Boston Carpal Tunnel Questionnaire -Romanian version, while the second part was a prospective cohort clinical study that was designed to psychometrically validate the The Boston Carpal Tunnel Questionnaire. We collected demographic characteristics and The Boston Carpal Tunnel Questionnaire scores for thirty-one patients with CTS and performed descriptive and inferential statistics. Our results showed a very good construct validity and excellent reliability (Cronbach's alpha = 0.79) for Boston Carpal Tunnel Questionnaire -Romanian version and the Kaiser-Meyer-Olkin of 0.732, which is considered acceptable (a value above 0.70 is usually statistically significant for factor analysis). Regarding to Bartlett's Approx sphericity test. Chi-Square 641,401, is statistically significant. In conclussion, Boston Carpal Tunnel Questionnaire is a consistent frequently employed patient-reported outcom that can evaluate the symptom burden of CTS and its effect on the ability to conduct daily activities. The structural validity of the BCTQ was investigated in this study among patients with varying degrees of CTS.
Copyright (c) 2025 Alin Ciubotaru, Lenuța Bîrasnu , Roxana Covali, Emanuel Matei Roman , Ioan Alexandru Chirap-Mitulschi , Mihaela-Dana Turliuc https://creativecommons.org/licenses/by-nc-nd/4.0
750 Narrative Review of the Morphofunctional Underpinnings and Comprehensive Rehabilitation Strategies for Smartphone-addicted University Students
The widespread availability of mobile phones has contributed to a high prevalence of digital addiction worldwide. Smartphone addiction or problematic smartphone use (SA/PSU) has become a widespread issue, especially among university students. Due to concerns about SA/PSU and cyber addiction in young people, research has focused on the structural and functional effects on the brain and the behavioral consequences of spending too much time on mobile phones. This review investigates the impact of excessive smartphone use on this demographic group's physical and mental health. Methods An advanced search on PubMed based on primary keywords, clustered in syntactic associations looked for academic work focusing on: ((((smartphone addiction) and (problematic smartphone use)) and (students) and (Physical exercises)) and (Physical Activity). The relationship (((smartphone addiction) and (problematic smartphone use) and (systematic review) identified 22 papers, published between 2016 and 2024, 16 of which were during the Covid era and post-pandemic periods (2020-2024). Smartphone overuse-induced alterations in cerebral gray matter were observed in four trials. The beneficial influence of physical activity on smartphone addiction was emphasized in 11 publications (selected 9) identified by the advanced search with the syntactic relationship. Discussion The narrative review offers a comprehensive overview of effective strategies for addressing SA/PSU. This includes utilizing exercise and psychological interventions to combat digital addiction. Furthermore, studies have looked into the potential benefits of physical exercise and specific strategies addressing these issues. Engaging in physical activity may help offset the negative effects of SA/PSU, and targeted strategies are necessary for preventing and treating these problems in young people.
Copyright (c) 2025 Lucia Ana-Maria Anghelescu, Aurelian Anghelescu, Gelu Onose https://creativecommons.org/licenses/by-nc-nd/4.0
749 Non-invasive Physiotherapeutic Approaches in Biliary Dyskinesia
Background: Biliary dyskinesia seems to be an enigmatic, idiopathic but important pathology in terms of recurrent abdominal pain in the right upper quadrant, under the right costal border, in patients who feel the symptoms despite the non-detection of gallstones or tumors. The pathology can be the result of an improper response to hormonal stimulation, hypoactivity of the nerves that innervate the gallbladder or ineffective contraction of the sphincter of Oddi. Objective: The application of a non-invasive physiotherapy treatment with interference current, aiming to stimulate the motility of the gallbladder walls, resulting in a physiological activity but also an increase in the pain threshold. Periodic evaluations of the patients' condition to determine their condition. Increasing the quality of life of affected patients. Material and method: In the study undertaken, the patients were subjected to a constant treatment with interference current therapy, following both the reaction to and the recording of possible adverse effects on the treatment of the late application, which appeared after the therapy. Results: Consistent positive results were obtained in increasing the motility of the gallbladder in the medium and long term, decreasing the dysfunctional discomfort, considerably decreasing the pain threshold level of the patients, increasing the patients' quality of life with the resumption of productive activities. Conclusions: The application of interference current in biliary dyskinesias reveals an increased efficiency both after the first cure and after consecutive cures consistently applied at 5-month intervals for long-term effects and removing the perspective of a possible surgical intervention. Reducing pain and disconfort, increasing the quality of life of the affected patients is a wish fulfilled in the treated patients.
Copyright (c) 2025 Elena Costescu, Gabriela Calin, Vlad Țîrlea, Mihaiela Camelia Țabrean https://creativecommons.org/licenses/by-nc-nd/4.0
748 Integrating Clinimetric and Psychometric Approaches in Enhancing Osteoarthritis Care
Osteoarthritis (OA) is a degenerative joint disease that is typically associated with weight-bearing joints, such as the hips and knees, and is defined by the progressive deterioration of cartilage. The effective treatment of OA is contingent upon the accurate assessment of its clinical and psychological effects. In the present work, we aim to compile the most recent evidence regarding the clinimetric and psychometric evaluations of OA, with a particular emphasis on the hip and knee, a topic still insufficient approached. The WOMAC and KOOS are among the clinimetric instruments that offer valuable insights into physical function, stiffness, and pain. By integrating clinimetric and psychometric tools, a comprehensive approach to managing OA is provided, which identifies both physical and mental health need. The significance of these combined evaluations in enhancing treatment adherence and improving patient outcomes is underscored by the present review. Moreover, treatment and recovery options still have limitations that need to be addressed. Additional research is required to elucidate the psychometric properties of quality-of-life measures and postural control assessments. Future research should concentrate on the development of more comprehensive and robust tools that assess all facets of OA, thereby facilitating personalized interventions that address the multifaceted character of this debilitating disease.
Copyright (c) 2025 Roxana Maria Sânziana Pavel, Andrei-Flavius Radu, Carmen Nistor Cseppento, Cosmin-Mihai Vesa, Anamaria Lavinia Purza, Delia Mirela Tit, Ada Radu, Simona Gabriela Bungau https://creativecommons.org/licenses/by-nc-nd/4.0
747 Calcium and vitamin D: roles, interactions and nutritional programming for bone development
The contributions of calcium and vitamin D in optimal bone development have been widely studied in the biomedical field, including in rodent models, utilizing reference diets. Additionally, studies have emphasized the interrelation between calcium, vitamin D and other hormones as it pertains to osseous tissue function, as well as the role that signaling pathways play in bone synthesis and resorption. Recently, it has been reported in literature that rodent diets consisting of lower amounts of either calcium or vitamin D than the reference diets may lead to favorable bone growth. This review will describe the properties of calcium and vitamin D, their roles on bone formation, their interactions with parathyroid hormone, osteocalcin and the function of bone signaling pathways. Additionally, this review will outline the components of rodent reference diets and suggest possible dietary modifications that ensure healthy bone development.
Copyright (c) 2025 Ana Zastulka, Simona Clichici, Bogdan Culic, Nadina-Liana Pop, Cristian-Doru Olteanu, Cristian Delcea, Lavinia Ioana Sabău, Teodora Mocan https://creativecommons.org/licenses/by-nc-nd/4.0
746 Pes Planus Level and Foot Pain Affect Selected Performance Parameters: A Study on Team Sport Athletes
Aims to investigate the relationship between pes planus (PP) with foot pain (FP) and performance in team sport athletes. Correlational research was adopted to reveal the relationship between PP with FP and performance. There were 84 athletes were involved in this research. Measurement of PP with footprint test (FT), FP with knee pain intensity-visual analogue scale (KPI-VAS) and performance with items 30m sprint (30ms), modified agility t-test (MATT), counter movement jump (CMJ), standing stock balance test (SSBT). We observed that FT-PP variable has a moderate negative correlation with FP-KPI-VAS (p = 0.003), which shows that PP significantly causes foot pain. In CMJ (p = 0.035) and SSBT (p = 0.004) there is a moderate negative correlation, which shows that the PP level reduced the level of power and balance. Meanwhile, there is a moderate positive correlation with 30mS (p < .001), and MATT (p < .001), which shows that the level of PP will reduce the level of running speed and agility. At the same time, FP-KPI-VAS had a small negative correlation with 30mS (p = 0.017), MATT (p = 0.017) and CMJ (p = 0.048). Finally, FP-KPI-VAS was found to have a large positive correlation with SSBT (p < .001). Thus, we confirm that PP is significantly correlated with FP and performance related to 30ms, MATT, CMJ, SSBT in team sports athletes
Copyright (c) 2025 Irma Febriyanti, Hari Setijono, Fransisca Januarumi Marhaendra, Heryanto Nur Muhammad, Fatkhur Rohman Kafrawi, Faridha Nurhayati, Afifan Yulfadinata, Fifukha Dwi Khory, Ahmet Kurtoğlu, Amayra Tannoubi, Karuppasamy Govindasamy, Edi Setiawan https://creativecommons.org/licenses/by-nc-nd/4.0
745 Therapeutic Effects of Superinductive Magnetic Filed on Low Back Pain
Low back pain is one of the major public health problems, with approximately 1 in 3 adults experiencing an episode of low back pain during their lifetime. The aim of this study was to evaluate the effect on pain and physical function of a therapeutic protocol including analgesic electrotherapy, lumbar deconstrictor manual therapy and kinetic therapy and the superinductive magnetic field therapy. Patients were divided into two groups of 20 and 20 respectively. Group 1 was treated with the conventional protocol, while the second group received in adition the superinductive magnetic field therapy. Pain was assessed by VAS scale at admission and every 2 days, and functional deficit was assessed by the Fingertips to floor (FTF) test at admission, at 6 days and at discharge at 12 days. The Activities of Daily Living (ADL) scale was also used to assess physical function at admission and discharge. 40 patients (24 female, 16 male), average age 61 years ( ± 5.7), average BMI of 32.11± 7.38 SD, kg participated and their data were analyzed. An average percentage decrease in VAS was noticed after the 12 days of treatment of 67% for group1 and of 88% for group 2. The deficit in FTF was also better in group 2 (FTF= 16+5cm ) compared to FTF=22+3 in the control group. On ADL assessment, no significant differences were noted. Superinductive magnetic field therapy is effective in the treatment of low back pain relieving pain syndrome and improving physical function.
Copyright (c) 2025 Razvan Dragoi, Marius Nicolae Popescu, Daniel Popa, Ramona Andriș, Dan Corneliu Blendea https://creativecommons.org/licenses/by-nc-nd/4.0
744 Progressively complex neurorehabilitation: from a severe coma to a vegetative state, minimal consciousness ... and the Phoenix bird survives and is reborn from its ashes
Abstract: Background: Romania has the highest rate of car accidents and deaths per million inhabitants in the European Union, primarily due to poor driving and substandard road conditions. Victims of car accidents often present with complex medical cases involving multiple injuries across various organs, frequently leading to severe complications. Case report. With the approval of the patient's family and the Ethics Committee (no. 19348/25.04.2024) at the Neuromuscular Rehabilitation Clinic, Emergency Hospital "Bagdasar-Arseni," a case study was conducted. A 22-year-old man without a previous medical history suffered severe polytrauma as a result of a road accident. He was transferred to the Neuromuscular Rehabilitation Clinic in a vegetative state (after multiple fractures of the skull base and visceral cranium, with 3 points GCS), atlantoaxial subluxation (requiring cervical collar immobilization), rib fractures, drained hemothorax, near-complete atelectasis of the left lung, status post-pericardial effusion. The medical intervention involved a multifaceted pharmacological approach. Focal intramuscular injections of botulinum toxin targeted specific muscles significantly alleviated spasticity. Special robotic orthoses were used to correct postural abnormalities and maintain the favorable effects of the botulinum toxin. The patient received a personalized and complex nursing rehabilitation program including tracheal stoma management, nutritional support through IV infusions and percutanous gtrostomy (PEG) feeding, re-education of deglutition, intermittent urinary catheterization, and positioning on a special mattress to prevent pressure ulcers. The kinesiotherapy was progressively adapted to the neurologic and general condition. The patient had slight improvements in motor and cognitive abilities, resulting in simple voluntary gestures and affective response schemes. In time, he progressed to a minimally conscious state; he responded to verbal stimuli through blinking and reactive adequate affective mimic in the context of persistent expressive aphasia. He was safely discharged at home. Our main functional objective is the patient’s reinsertion into his family. Ad vitam prognosis and ad functionem outcomes are guarded. Ad laborem prognosis is nil. The patient was periodically reassessed for further rehabilitative care. Conclusions: This case emphasizes the importance of a complex multidisciplinary and patient-centered approach in managing post-traumatic vegetative status following a road traffic accident. The Phoenix symbolically takes steps toward fulfilling its destiny - to survive and gradually rise from its ashes Keywords: vegetative state; spasticity; tetraparesis; traumatic brain injury; botulinum toxin; neurorehabilitation
Copyright (c) 2025 Andreea-Iulia Vlădulescu-Trandafir, Aurelian Anghelescu, Ana-Andreea Cristea, Gelu Onose https://creativecommons.org/licenses/by-nc-nd/4.0
Romanian Congress of Physical Medicine and Rehabilitation and Balneology, Timișoara, 01-05 September 2023 - Congress Abstracts
Copyright (c) 2023 Constantin Munteanu https://creativecommons.org/licenses/by-nc-nd/4.0
743 Non-invasive rehabilitation in Morbus Ledderhose disease, methods, techniques, efficiency
: Background: The abnormal proliferation of the fibrous tissue in the plantar fascia, Morbus Ledderhose is a non-malignant thickening of the deep connective tissue of the foot, a relatively rare pathology that intensely affects patients through marked pain and functional impotence. Rehabilitation treatments are poorly presented in the litera-ture. Objective: To apply a non-invasive physiotherapeutic treatment which leads to consistent results in reducing pain, reducing the size of nodules or even their disap-pearance, the functional resumption of the foot, an increase in the life quality of affect-ed patients. Material and method: In the study, patients were divided into 2 groups: G1 received treatment consisting of shockwave therapy complemented with SIS therapy, G2 received treatment consisting of ultrasound, laser therapy, kinesiotherapy, massage, excluding the application of shockwave therapy and SIS. Some of the patients associate comorbidities such as type II diabetes, Dupuytren’s disease or, more rarely, with Pey-ronie’s disease (penile fibromatosis). Results: Important positive results have been ob-tained: a considerable decrease in the pain level of patients, the dissipation of con-sistency and decrease in the size of plantar nodules, an increase in the life quality of the patients with the resumption of productive activities. Conclusions: The treatment with shock waves and super inductive system has an increased efficiency both following the first cure and after various consecutive cures applied consistently at 6 months or may-be even faster, at 4-5 months, if necessary, if the pathology advances faster by intensify-ing fibrosis.
Copyright (c) 2025 Elena Costescu https://creativecommons.org/licenses/by-nc-nd/4.0
742 Effects of acupuncture and related techniques in temporomandibular disorders (TMD): A systematic review
Acupuncture has shown promise as a therapeutic option in temporomandibular disorders (TMD). Its benefits include pain relief, reduction of muscle tension and improvement of jaw function. Several alternative approaches, including dry needling and laser acupuncture, were also reported to improve TMD symptoms. This review aims to summarise the most recent studies available on these alternative therapies for TMD. An electronic literature search was conducted in 3 databases, PubMed, Web of Science, and Scopus, in order to identify articles on acupuncture, dry needling, or laser acupuncture. Search development, process, and two-step article selection were conducted by independent researchers. Data was extracted regarding study characteristics, population characteristics, acupuncture points or techniques used, and assessment methods for diagnosis and effects. Out of 431 identified results, 20 were selected for inclusion. We identified 11 studies on acupuncture, 3 studies on laser acupuncture and 6 studies on dry needling. Most studies showed improvement of TMD symptoms post-intervention, assessed by pain scales and maximum mouth opening. Overall, most studies showed promising results for acupuncture as an alternative, minimally invasive treatment method for TMD. When compared to controls or placebo, acupuncture, and related techniques result in significant relief of TMD symptoms.
Copyright (c) 2024 Ana-Maria Condor, Ana Maria Paraschiv, Ioana Niculae, Rares Buduru, Andreea Kui, Marius Negucioiu, Smaranda Buduru https://creativecommons.org/licenses/by-nc-nd/4.0
741 Hippotherapy Used in Medical Recovery
Hippotherapy, also known as equine-assisted therapy, falls into the category of alternative therapies that involve human-horse interaction for therapeutic purposes. Horse therapies are especially used for children with various physical, cognitive, and emotional disorders. They can also be successfully used with adults and the elderly. The horse's movement is what stimulates the development of motor skills, balance, and coordination. Direct interaction with the horse, including caring for it, riding, and other related activities, is effective in developing social, emotional, and cognitive skills in both children and adults, as well as in the elderly. Hippotherapy encourages self-confidence, concentration, and motor coordination, making it suitable for people who are anxious, antisocial, depressed, have language difficulties, or low self-esteem. Studies highlight that the presence of horses changes the frequency of the human brain, with subjects becoming more aware and focused when around horses. Horses help therapy beneficiaries stay connected to the present, becoming more aware of their experiences. Additionally, patients learn to pay more attention to the feelings and nonverbal language transmitted by the being they come into contact with. Numerous studies show that horseback riding improves balance, coordination, and reflexes, induces muscle relaxation, reduces spasticity, increases joint mobility, and improves respiratory function and blood circulation. The main objective of the paper is to identify therapies that use horses for patients diagnosed with various conditions, the benefits of these therapies on patients' motor skills, and their effects on patients' mental state. Additionally, we aim to identify horse-related activities that enhance concentration, help address behavioral issues, and facilitate patients' integration into social groups.
Copyright (c) 2024 Iustina Condurache , Irina Duduca , Andrei Gheorghita , Anisia Nechita, Cezar Mucileanu , Mariana Rotariu https://creativecommons.org/licenses/by-nc-nd/4.0
740 Interesting, oftentimes even trendy! Attitudes of medical students regarding spa medicine
The popularity of balneology and medical climatology among medical students has scarcely been investigated but may represent a pertinent topic for the field. Methods: A survey was conducted among 53 German medical students (80% female; mean age 22.5 years; 39% pre-clinical stage) on attitudes and interest in spa medicine, their associations with the German terms ‘Kur’ (cure) and ‘Kurortmedizin’ (spa medicine; health resort medicine) and their own health behaviour. Associations with cures were recorded using a visual analogue scale (vas). Results: A majority (72%) of the sample indicated support for the inclusion of more information about spa medicine in university curricula. Spa medicine is associated with older individuals, but with less association to overweight and psychiatric patients. The data for the statements "a spa treatment is up-to-date" and "spa treatment is effective" exhibited a normal distribution in the sample. A significant proportion of respondents reported practicing thermal baths, healthy nutrition, sauna, and Kneipp medicine themselves. Implications: The majority of medical students classified spa medicine as interesting and relevant and do not see it as old-fashioned. This interest should be encouraged in university teaching. Interesting points of reference also arise in relation to predictors of career choice among future physicians.
Copyright (c) 2024 Alexander M. Rapp, David Lerch https://creativecommons.org/licenses/by-nc-nd/4.0
739 Ozone therapy vs. classical treatment in musculoskeletal disorders
With aging and weight gain, the population is significantly overweight and faces additional pressure on vertebral and peripheral joints (ankles, knees, hips, shoulders), which affects muscles, tendons, ligaments, and nerves. Muscle contraction, translated by pain, sends the patient to the doctor. Lumbar and cervical spine disorders occur in 70-80% of the world's population during their lifetime. They are a major problem because they reduce the quality of life and increase the costs borne by health services and patients. There are multiple therapeutic options, both classic medication and alternative treatment, to combat pain for a longer or shorter period. Relief or suppression of pain, the dominant symptom in the manifestations of degenerative arthritic diseases, is an important goal of treatment, ultimately improving the quality of life. Patients, for various reasons, frequently seek alternative therapies, especially to surgical treatment. Finding the most comprehensive treatment is often a challenge. If we consider the benefit that a treatment (therapy) should bring to the health condition, then an individualized therapeutic plan must be chosen. A retrospective study on the effects of ozone and platelet-rich plasma (PRP) treatment compared to classic medication shows the role of ozone therapy in pain relief and the beneficial effect of this therapy, especially in combination with PRP, over a longer period.
Copyright (c) 2024 Maricela Dragomir, Claudiu Mereuță, Carmen Gheorghe https://creativecommons.org/licenses/by-nc-nd/4.0
737 Complex case of multiple sclerosis with multiple demyelinating locations
Multiple sclerosis (MS) is a chronic inflammatory disorder with an unpredictable progression that affects the central nervous system and has significant emotional, social, and professional implications. The therapeutic approach is multifactorial and requires complex management coordinated by a specialized, multidisciplinary team over the long term. Current non-pharmacological treatment strategies under study, which may improve the course of the disease, focus on the gut microbiome and include the administration of probiotics and fecal transplantation. This study presents a case of secondary progressive multiple sclerosis in a young patient, with rapidly progressive evolution despite ongoing background therapy. The study analyzed literature data regarding both medical rehabilitation programs used in secondary progressive multiple sclerosis and other therapeutic strategies that can improve the quality of life. Medical rehabilitation has no proven impact on disease progression but can enhance the quality of life for patients with multiple sclerosis through spasticity management, improved mental health, increased mobility, and muscle strength. These therapeutic strategies can improve involvement in professional activities and participation in social and family life for patients with multiple sclerosis.
Copyright (c) 2024 Cristina-Mădălina Lungu, Doinița Oprea, Bianca Georgescu, Liliana-Elena Stanciu, Elena-Valentina Ionescu, Mădălina-Gabriela Iliescu https://creativecommons.org/licenses/by-nc-nd/4.0
738 Spa Center as the Economic Engine of the Municipal Busi-ness Ecosystem: Case of Banja Koviljača Organizational Network
This paper addresses the role of the Spa Health Resort as the Economic Engine of the Mu-nicipal Business Ecosystem. Usualy a single larger enterprise drives the local economy at the municipal level, and in the case of Serbia that company has often been from heavy in-dustries. For many transitional economies, local communities have been supported by the main municipal organization, identified in the literature under the terms economic engine, anchor, driver, powerhouse, catalyst, hub or lifeline. Most literature defines it as a compa-ny that plays a pivotal role in propelling municipal economic growth and development, acting as the source of economic stability and resilience within the municipality. Our re-search is based on dataset gathered from the Serbian Chamber of Commerce, extracted from the annual financial and business reports of 80,737 companies and sole entrepre-neurs in Serbia from 2013 to 2022 and supplemented by detailed insights into business reports of hypothesized economic engine. Our findings support the hypothesis that Spe-cialized Rehabilitation Hospital Banja Koviljaca's acts as economic engine for the region. Conclusion is that investment in balneo industry returns mutlifold benefits of different categories to the community and the state.
Copyright (c) 2024 Aleksandar Jokić, Mladen Čudanov https://creativecommons.org/licenses/by-nc-nd/4.0
733 Multi-faced profile of PTH excess-related secondary osteoporosis: customized therapy and rehabilitation approach
Many causes of secondary osteoporosis have been identified; endocrine types (such as those linked to male hypogonadism, Cushing’s syndrome, acromegaly, thyrotoxicosis, primary hyperparathyroidism, etc.) represent one of the most challenging ailments since a personalized approach of the endocrine disease is simultaneous required. We aimed to introduce the case of a senior lady who was diagnosed with secondary osteoporosis that was associated with primary hyperparathyroidism and a conservative approach was decided, from anti-osteoporosis drug and calcium lowering agents to the physical rehabilitation and lifestyle recommendations. She also presented double unilateral adrenal incidentaloma and a pituitary incidentaloma as well as a suspected ovarian cyst that she further declined to investigate. Mitigating the non-surgical management in primary hyperparathyroidism showcase (in addition to the zoledronic acid for both osteoporosis and hypercalcemia) a complex program of rehabilitation that included a diet intervention in terms of an adequate hydration and a personalized nutrition for kidney stones primary and secondary prevention, mild physical exercise, avoidance of calcium supplements and keeping a daily chole-calciferol replacement.
Copyright (c) 2024 Claudiu Nistor , Oana-Claudia Sima , Mihai Costachescu , Mihaela Stanciu , Mădălina Gabriela Iliescu , Mihai-Lucian Ciobica, Florina Ligia Popa , Mara Carsote https://creativecommons.org/licenses/by-nc-nd/4.0