Diabetes is one of the leading causes of health losses among the Bulgarian population. Diabetic neuropathy (DN) occurs in at least 34 % of people with type 1 diabetes after 25 years of disease duration and 20 % - 30 % of newly diagnosed patients with type 2 diabetes, increasing to 50 % after 10 years of disease duration. The treatment of DN is challenging. There is growing interest in non-pharmacological forms of treatment. High-power lasers have increasingly been used in the practice of physical and rehabilitation medicine. However, clinical trials testing their effectiveness in DN are scarce. Purpose: The aim of this single blinded, placebo-controlled field trial is to investigate the effect of a multiwave locked system (MLS laser) on sensory perception and electroneurographic parameters of sensory and motor nerves in patients with diabetic sensorimotor neuropathy of lower limbs. Material/Methods: A total of 69 patients were randomly assigned laser treatment (n=41) or placebo treatment (n-28) for three weeks, totaling 9 procedural sessions. Vibration sense was measured three times per session. Neurophysiological evaluations were conducted at baseline and on day 90. Results: On day 21, vibration sense increased bilaterally at all sites in the laser group, with statistically significant differences (p < 0.05 for all sites) compared to the placebo group, persisting through day 90. Nerve conduction velocity and amplitude of the sural, peroneal, and tibial nerves improved by day 90 from baseline, with superior results in the sural nerve. Conclusions: Deep tissue laser therapy can be considered a safe, non-pharmacological adjunct to the standard for managing diabetic neuropathy.

Introduction: Diabetic neuropathy is a chronic microvascular complication and one of the most common complications of diabetes. Diabetes changes mainly the sensory function, most often symmetrically, which facilitates the development of ulcers and they in turn are a prerequisite for the development of diabetic neuro-osteoarthropathy (Charcot’s foot). Neuropathic pain, which often accompanies diabetic polyneuropathy, is still a challenge for conventional pharmacological therapy. The treatment plan also includes a non-pharmacological method of treatment, such as photobiomodulation, which includes lasers. The Multiwave Locked System (MLS) is a class IV near infrared (NIR) diode laser, characterized by combining and synchronizing two emissions with different wavelengths—λ-808 nm in constant mode and λ-905 nm in pulsed mode. Aim: The aim of this study is to investigate the long-term effect of MLS laser radiation in patients with diabetic sensorimotor polyneuropathy. Materials and Methods: Twenty patients of both sexes, diagnosed with type 2 diabetes and diabetic sensorimotor neuropathy, were treated with MLS laser radiation. The high-energy laser M6 from ASA Laser, Italy was used. The therapeutic technique used was in two stages: scanning of the foot (100–175 cm²) of the two lower limbs with MLS fixed, robotic multidiode device (remote method), and treatment of seven fields, on each lower limb, each with an area of 3.14 cm², with MLS single-diode hand applicator (contact method). The therapeutic course included 9 procedures distributed within 3 working weeks, 1 procedure per day, every other day, a total of 3 procedures per week. A short form of the McGill Pain Questionnaire (SF-MPQ-2) was used as a subjective indicator. Nerve conduction parameters were used for objectifying treatment results, namely: distal latency, amplitude of action potential and conduction velocity in sensory nerve, n. suralis and motor nerve, n. peroneus. Results: There is a significant reduction in pain intensity in both men and women immediately after the end of the therapeutic course. The strength of the pain in women, on the 90th day from the beginning of the treatment, does not retain its value from the end of the treatment course, but remains significantly lower than its initial levels. Nerve conduction parameters showed an increase in the amplitude of the action potential, bilaterally for n. suralis and n. peroneus, as well as an increase in the conduction velocity of n. suralis and n. peroneus on the left, on the 90th day. Conclusion: The high-energy MLS laser has the potential to be an effective therapy for painful diabetic neuropathy, as it is able to modify the pain and electroneurographic parameters of peripheral nerve function with lasting effects.

The Pilates system - essence and benefits

Introduction: Autism spectrum disorders (ASD) are a heterogeneous group of neurodevelopmental disorders whose etiology is not fully understood. Due to the lack of validated biomarkers, diagnosis is based on a triad of impairments in social interactions, deficits in verbal and nonverbal communication, and the presence of restricted, repetitive, and stereotyped patterns of behavior. Early identification of ASD is a priority task, given the evidence of the positive correlation between various intervention strategies at an early age with better prognosis in the development and functional adaptation of children with ASD. Aim: The aim of this study is to conduct an analytical evaluation of the rehabilitation interventions implemented to date in children with ASD, focusing on their effectiveness in improving functional skills, behavioral adaptation, and quality of life. Materials and Methods: Analysis of literary sources in the databases PubMed, PubMed Central, Google Scholar for the 2014–2025 period was conducted. Results: There is growing interest in investigating the effectiveness of different therapeutic approaches for children with ASD. The main methods being investigated include behavioral therapies, hydrotherapy, music therapy, art therapy, animal-assisted therapy, and sensory integration. The results of the studies conducted to date reveal the potential of these tools, but are contradictory, which emphasizes the need for further high-quality, controlled studies to establish the long-term effectiveness, sustainability, and applicability of the different methods in real-world clinical settings. Conclusion: The significant heterogeneity in the clinical picture of ASD predetermines a high degree of variability in the rehabilitation needs of affected individuals. This requires the implementation of an individualized therapeutic approach, carried out by a multidisciplinary team.