Physical therapy involves a set of factors and methods that affect the biological processes in the body. It is widely used, relatively inexpensive, non-invasive, and easy to apply. Physiotherapy is also used in the treatment of patients with carpal tunnel syndrome (CTS). This syndrome represents the most common compressive mononeuropathy of the upper limb and leads to significant disability. Hence, its successful treatment leads to significant benefits for both the patient and society. There is no established algorithm for the use of physical therapy in these patients. In this publication, we present the physiotherapeutic methods used for the treatment of CTS both before and after surgical treatment.

AIM: Evaluation of the effect of a novel physical therapy method - post-isometric relaxation taping (PIR-taping) - compared with the effect of a conventional postisometric relaxation (PIR) in the treatment of outpatients with myofascial pain as a result of muscle spasm and shortening of static muscles, resulting in muscle imbalance. PATIENTS AND METHODS: The study recruited 320 outpatients with myofascial pain due to muscle spasm and shortening, resulting in muscle imbalance in one of 8 kinetic segments. We treated randomly 8 groups of 20 patients by PIR and 8 matched groups by PIR-taping. The treatment consisted of one procedure daily (PIR or PIR-taping) with duration of 10 minutes for 10 working days. The pain was assessed by a visual analogue scale before and after each procedure. RESULTS: The pain decreased significantly after the treatment course in each group (p < 0.05), but no difference was found between any pair of groups (p > 0.05). The pain before the next PIR procedure tended to increase in comparison with the pain after a previous one, unlike the pain in PIR-taping treatment which tended to decrease. Pain intensity after PIR procedure decreased significantly compared with the pain after a previous one (p < 0.05), while in PIR-taping - after two previous procedures (p < 0.05). Treatment with PIR increased pain significantly during the weekends (p < 0.05), while in treatment with PIR-taping the pain decreased insignificantly during the weekends (p > 0.05). The pain reduced significantly after PIR procedure (p < 0.05), as well as after PIR-taping procedure (p < 0.05). The pain after PIR procedure was significantly lower than that after PIR-taping procedure (p < 0.05), although the pain before PIR procedure was statistically equal with the one before PIR-taping procedure (p > 0.05). CONCLUSION: Despite the better short-term effect of PIR versus PIR-taping, there was no difference between the final results of both methods, due to the continuous (24-hour) effect of PIR-taping.

Background: Muscle latency is an often-overlooked factor contributing to increased implant wear and higher rates of hip and knee osteoarthritis. Latency reduces the protective role of muscles against external joint loads during movement initiation, leading to cumulative microtrauma. This study investigates whether preliminary quadriceps contraction can mitigate these adverse effects during early rehabilitation after arthroplasty. Materials and methods: The study was conducted in two university hospitals in Sofia, Bulgaria, including 46 patients (mean age 63.76 ± 9.49 years): 25 with hip arthroplasty and 21 with knee arthroplasty. Participants were randomly assigned to a control group (n = 25; 13 hip, 12 knee: standard postoperative advice) or an experimental group (n = 21; 12 hip, 9 knee: standard advice plus preliminary quadriceps contraction). Primary outcome: pain intensity (VAS). Secondary outcomes: range of motion (ROM, %), manual muscle testing (MMT, %), thigh circumference difference (cm), and success rate of preliminary quadriceps contraction (%). Results: Both groups improved after one month (p < 0.05), but the experimental group showed significantly greater improvement (p < 0.05). Higher success rates of preliminary quadriceps contraction correlated with greater improvements in all outcomes (p < 0.05). Conclusions: Preliminary quadriceps contraction enhances standard postoperative advice by reducing pain, improving mobility and muscle strength, and reducing hypotrophy during early rehabilitation after hip and knee arthroplasty. Patients should be encouraged to perform it consistently, even when pain subsides.

The aims of this study were to compare the effectiveness of computerized versus conventional exercises, and to determine their optimal frequency, intensity, and duration after a total hip arthroplasty (THA), due to a lack of consensus. One hundred and ten patients (age 66.09±10.4 years), with unilateral or bilateral THA for osteoarthritis, were randomly divided into three groups: 1st group (n=34) performed computerized home exercises, 2nd group (n=34) – conventional supervised exercises, and 3rd (control) group (n=42) – without interventions. The outcomes (on the day before surgery, and on the 7th, 14th, and 30th day after surgery) were: Harrison Hip Score (HHS); frequency, intensity, and duration of the exercises. HHS results showed significant improvement in all groups – the weakest for the third group, better for the second one, and the best for the first group (P<0.05). All results improved if exercise frequency (more than 5 times daily), intensity, and duration increased (P<0.05). In conclusion, this study demonstrates that the computerized approach is an effective alternative to the conventional one in the rehabilitation of patients after THA. Optimal recommendations should include frequency of exercises more than 5 times daily, with high intensity, and long duration, regardless of the approach – computerized or conventional. To reach such frequency, it is necessary to perform the exercises independently, and not only under supervision.

Carpal tunnel syndrome (CTS) refers to the compression or tension over the median nerve at the level of the wrist and represents the most commonly encountered compression mononeuropathy. It is diagnosed significantly more often in individuals, whose work involves similar, repetitive movements. The condition affects approximately 4–6% of the active population. Its social aspect stems from the significant deterioration of patients' professional and private life, which, in a high percentage of cases, leads to a change in profession. Multiple surgical and conservative treatment approaches have been described. The literature proposes a general recommendation for compliance with prophylactic interventions and a specific mobilization regimen but a consensus on the subject has not yet been achieved. In our study, we followed 45 patients diagnosed with CTS who reported pain and altered sensation, over a period of 6 months. The patients were divided into three groups which were randomly assigned to different treatment modalities. All patients received the same prophylactic interventions with regard to the physical load and exercises, which were to be followed individually over the course of the study. At the end of the study, the obtained data were analyzed statistically and we reported a correlation between patient improvement and the frequency of the exercises.

Cardiac rehabilitation is a set of coordinated activities aimed at positively influencing the underlying cause of cardiovascular diseases and ensuring the best possible physical, mental and social conditions so that patients can restore or maintain optimal functioning in the community through their own efforts and, through improved health behaviors, slow or reverse the progression of the disease. Cardiac rehabilitation is suitable for all patients with cardiovascular disease, including those who have experienced a cardiovascular event, after cardiac catheterization and those after heart surgery for heart valve replacement or bypass surgery. The cardiovascular rehabilitation program involves a team effort of a cardiologist, physiotherapist, kinesitherapist, nutritionist, psychologist and others, who have a common goal – strengthening the patient‘s health and returning to self-confidence to cope with everyday life. Its main advantage is that it is a cheap method, accessible for administration by health systems, safe for patients, with proven long-term positive effects on the health of patients. IT helps them recover faster after a cardiovascular incident or after heart surgery. Cardiac rehabilitation is an integral part and a major component of preventive cardiology that allows for the non-invasive identifi cation of functional disorders of the cardiovascular system, assessment of their extent, and planning of measures for their control and secondary prevention.