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Chronic low back pain (LBP) has been hypothesized to involve lumbar instability, yet the roles of hamstring strength and hip mobility remain underexplored. While earlier studies focused on hamstring tightness, this study examined how these factors are strongly associated with pain and disability in young adults with lumbar instability. A case-control study was conducted on 129 participants (67 symptomatic, 62 asymptomatic) aged 18–35 years. Hamstring strength was assessed using the NordBord dynamometer, while hip mobility was measured using a goniometer. Pain intensity and disability were evaluated using the Numeric Pain Rating Scale and Oswestry Disability Index. Hamstring strength showed a strong negative correlation with pain (r = -0.71, p < 0.001) and disability (r = -0.72, p < 0.001). Regression analysis confirmed hamstring strength and hip mobility as key correlates of LBP severity. Cutoff values were determined for hamstring strength (Female: 178.0 N; Male: 197.5 N), hip internal rotation (Female: 23°; Male: 18°), and hip extension (Female: 21°; Male: 19°). Hamstring strength and hip mobility are key correlates of pain and disability in young adults with clinically defined lumbar instability. Candidate thresholds showed apparent in-sample discrimination and should be interpreted as hypothesis-generating rather than diagnostic.

Previously unknown exposures of silicified serpentinites have been documented within the Szklary Massif, which is a fragment of the tectonically dismembered Central Sudetic Ophiolite (NE Bohemian Massif). On the basis of textural, mineralogical and chemical differences, two types of silicified serpentinites have been distinguished in this study (Type I and Type II). Type I is characterized by well-preserved primary minerals cut by numerous veinlets filled with microscale euhedral quartz crystals. Studied samples of Type I are enriched in silica (from 62 to 69 wt.% SiO2) and depleted in magnesium (from 10 to 19 wt.% MgO) in comparison to serpentinized peridotites from the Szklary Massif. Type II is almost exclusively composed of amorphous or poorly crystalline silica, with microquartz aggregates being the most abundant form. Silicified serpentinites of Type II show extremely high values of silica (from 83 to 90 wt.% SiO2) and low magnesium concentrations (from 4 to 8 wt.% MgO). Both types of silicified serpentinites have elevated content of REE and many other trace elements generally regarded as incompatible. We infer that the earlier silicification event was caused by the percolation of Si-rich hydrothermal fluids derived from igneous rocks, which intruded this area from ca. 380 to 330 Ma. A subsequent silicification event is the result of silica remobilization during intense chemical weathering under tropical conditions, which could have occurred between Late Cretaceous and Miocene.

Background: Recovery following incomplete spinal cord injury (iSCI) remains challenging, with conventional rehabilitation often emphasizing compensation over functional restoration. As most new spinal cord injury cases preserve some motor or sensory pathways, there is increasing interest in therapies that harness neuroplasticity. Robotic exoskeletons provide a promising means to deliver task-specific, repetitive gait training that may promote adaptive neural reorganization. This feasibility study investigates the feasibility, safety, and short-term effects of exoskeleton-assisted walking in individuals with degenerative iSCI. Methods: Two cooperative male patients (patients A and B) with degenerative iSCI (AIS C, neurological level L1) participated in a four-week intervention consisting of one hour of neuromotor physiotherapy followed by one hour of exoskeleton-assisted gait training, three times per week. Functional performance was assessed using the 10-Meter Walk Test, while gait quality was examined through spatiotemporal gait analysis. Vendor-generated surface electromyography (sEMG) plots were available only for qualitative description. Results: Patient A demonstrated a clinically meaningful increase in walking speed (+0.15 m/s). Spatiotemporal parameters showed mixed and non-uniform changes, including longer cycle, stance, and swing times, which reflect a slower stepping pattern rather than improved efficiency or coordination. Patient B showed a stable walking speed (+0.03 m/s) and persistent gait asymmetries. Qualitative sEMG plots are presented descriptively but cannot support interpretations of muscle recruitment patterns or neuromuscular changes. Conclusions: In this exploratory study, exoskeleton-assisted gait training was feasible and well tolerated when combined with conventional physiotherapy. However, observed changes were heterogeneous and do not allow causal or mechanistic interpretation related to neuromuscular control, muscle recruitment, or device-specific effects. These findings highlight substantial inter-individual variability and underscore the need for larger controlled studies to identify predictors of response and optimize rehabilitation protocols.

Introduction. The aim of the study was to evaluate the functional outcomes in degenerative disc disease patients by the type of herniation. Methods. The study covered 48 individuals (28 females and 20 males) aged 18-35 years who were found with a degenerative disc disease in lumbar spine (protrusion or extrusion according to the American Society of Neuroradiology). The participants were divided into two groups by the type of herniation: the protrusion and the extrusion group. The functional outcome was assessed with the Oswestry Disability Index (ODI) questionnaire and the Numeric Rating Scale (NRS). Results. Statistically significant differences were shown in ODI scores in both groups. The extrusion group demonstrated a 7.6% higher level of functional disability related to lumbar spine pain when compared with the protrusion group. The NRS results were not statistically significant between the groups. A statistically significant difference was observed between the groups during standing position, during sleep and in sex life. Respectively a 27%, 32%, and 28% greater number of individuals in the extrusion group reported problems related to these three daily activities when compared with the protrusion group. Conclusions. Our study results revealed statistically significant differences in general ODI scores between the groups. Moreover, patients with protruded lumbar disc showed better outcomes in routine activities when compared with the extrusion group.

Introduction The purpose of this study was to evaluate the relationship between the severity of cognitive impairment and the results of stabilographic tests in elderly patients with cognitive impairment. Methods The study involved 42 participants aged 62–84 (mean 73.4 ± 6.7) years. The assessment of cognitive status was carried out with the Mini-Mental State Examination (MMSE). Included were subjects who obtained a score below 27, which is the cut-off score between the absence and presence of cognitive impairment. Postural stability was evaluated by using a force platform which registered the shifts of the centre of pressure (CoP) in the sagittal and frontal plane during two 32-second trials of quiet stance on a hard surface, with eyes open and with eyes closed. The CoP sway parameters were analysed. Results In the eyes-open test, we obtained a weak negative correlation of the MMSE and the mean radius of the CoP sway (r = –0.37; p < 0.05). Considering the values achieved in each plane, a statistically significant correlation was observed in all the parameters analysed in the sagittal plane. The eyes-closed test revealed a clear negative correlation between the MMSE results and all the studied parameters. Conclusions A significant relationship between the severity of cognitive impairment and the results of stabilographic parameters were noted. A negative correlation between the stabilographic parameters and the MMSE scores showed a linear deterioration of postural stability which progresses along with the decrease in cognitive functions.

Background/Objectives: Outpatient stroke rehabilitation is expanding as inpatient episodes shorten. Virtual reality (VR) exergaming can extend practice and standardize progression, but setting-specific effectiveness and implementation factors remain unclear. This scoping review mapped VR exergaming in outpatient stroke care and identified technology typologies and functional outcomes. Methods: Guided by the JBI Manual and PRISMA-ScR, searches of MEDLINE, Embase, CENTRAL, Scopus, and Web of Science were conducted in April 2025. The study included adults post-stroke undergoing VR exergaming programs with movement tracking delivered in clinic-based outpatient or home-based outpatient settings. Interventions focused on functional rehabilitation using interactive VR. Results: Sixty-six studies met the criteria, forty-four clinic-based and twenty-two home-based. Serious games accounted for 65% of interventions and commercial exergames for 35%. Superiority on a prespecified functional endpoint was reported in 41% of trials, 29% showed within-group improvement only, and 30% found no between-group difference; effects were more consistent in supervised clinic programs than in home-based implementations. Signals were most consistent for commercial off-the-shelf and camera-based systems. Gloves or haptics and locomotor platforms were promising but less studied. Head-mounted display interventions showed mixed findings. Adherence was generally high, and adverse events were infrequent and mild. Conclusions: VR exergaming appears clinically viable for outpatient stroke rehabilitation, with the most consistent gains in supervised clinic-based programs; home-based effects are more variable and sensitive to dose and supervision. Future work should compare platform types by therapeutic goal; embed mechanistic measures; strengthen home delivery with dose control and remote supervision; and standardize the reporting of fidelity, adherence, and cost.

This study aimed to evaluate the differences in patient satisfaction between telerehabilitation and traditional face-to-face rehabilitation and to identify the impact of personality traits on patient satisfaction with the remote form of rehabilitation. Eighty participants with musculoskeletal pain were recruited for the study. The telerehabilitation group (n = 40) completed a single remote session of rehabilitation, whereas the traditional rehabilitation group (n = 40) completed a single face-to-face session. After therapy, each participant was asked to complete a tailored satisfaction survey using Google Forms. The Health Care Satisfaction Questionnaire (HCSQ) and the International Personality Item Pool-Big Five Markers-20 (IPIP-BFM-20) were used as outcome measures. Considering the results of patient satisfaction with healthcare service, there were no statistically significant differences between telerehabilitation and traditional rehabilitation groups in the total HCSQ score and its subscales. For the complete HCSQ, agreeableness, conscientiousness, and extraversion were essential predictor variables, accounting for 51% of the variance in patient satisfaction. In conclusion, there were no differences in patient satisfaction between telerehabilitation and traditional rehabilitation groups. In the telerehabilitation group, higher agreeableness levels and lower conscientiousness and extraversion level could predict patients’ satisfaction with telerehabilitation.

The aim of this study was to describe and update current knowledge of manual therapy accuracy in treating cervical and lumbar radiculopathy, to identify the limitations in current studies, and to suggest areas for future research. The study was conducted according to PRISMA guidelines for systematic reviews. A comprehensive literature review was conducted using PubMed and Web of Science databases up to April 2020. The following inclusion criteria were used: (1) presence of radiculopathy; (2) treatment defined as manual therapy (i.e., traction, manipulation, mobilization); and (3) publication defined as a Randomized Controlled Trial. The electronic literature search resulted in 473 potentially relevant articles. Finally, 27 articles were accepted: 21 on cervical (CR) and 6 in lumbar radiculopathy (LR). The mean PEDro score for CR was 6.6 (SD 1.3), and for LR 6.7 (SD 1.6). Traction-oriented techniques are the most frequently chosen treatment form for CR and are efficient in reducing pain and improving functional outcomes. In LR, each of the included publications used a different form of manual therapy, which makes it challenging to summarize knowledge in this group. Of included publications, 93% were either of moderate or low quality, which indicates that quality improvement is necessary for this type of research.

Abstract Telerehabilitation (TR) seems to be an encouraging solution for the delivery of cognitive treatments in patients with neurological disorders. This study was aimed to analyze and synthesize the evidence on the efficacy of cognitive TR interventions in patients with neurological diseases, compared with conventional face-to-face rehabilitation. From a total of 4485 records, 9 studies met the inclusion criteria for qualitative analysis. At the end of the process, 7 studies remained for quantitative analysis. By comparing TR with face-to-face treatments for cognitive impairments, we assessed improvements in global cognitive domain (Mini Mental State Exam) (MD = −0.86; 95% CI −2.43, 0.72, I2 = 0%), in learning and memory domains (SMD = 0.26, 95% CI −0.22, 0.74, I2 = 24%), in verbal fluency (SMD = 0.08, 95% CI −0.47, 0.62, I2 = 0%), and in executive functions (i.e., problem-solving, central processing speed and working memory) (SMD = 0.38, 95% CI 0.06, 0.71, I2 = 0%). In all the included studies, improvement in the performance of the TR groups was comparable to that achieved through face-to-face intervention. Significant differences between those two modalities of providing treatments were observed for working memory and total executive function comparison, in favor of TR. The results of this study can sustain the efficacy of TR and its application for the treatment of neurological patients, especially when treated for executive function impairments.

•This overview addresses the evidence supporting the efficacy of VR interventions in psychiatric disorders.•In anxiety/phobias, virtual reality can be used as supportive therapy, not a replacement for traditional treatments.•In pain management, it is emphasized using virtual reality instead of traditional medication therapy.•There is a lack of standardization of the hardware and the software used in virtual reality therapy. Virtual reality (VR) is being used more and more often as a therapeutic tool in psychology or psychiatry. In recent years, VR interventions appear more extensively also in disorders such as depression, anxiety and phobia. However, there has yet to be a comprehensive synthesis and critical review of the literature to identify future directions to advance the field in this area. To broadly characterize the literature to date on the application of VR in psychiatric disorders by conducting a systematic review of reviews, describe the limitations of existing research, suggest avenues for future research to address gaps in the current literature and provide practical recommendations for incorporating VR into various treatments for psychiatric disorders. PubMed and Web of Science databases were searched for reviews on VR use in psychiatric disorders (e.g. various pain perceptions, post-traumatic stress disorder, phobias, attention deficit hyperactivity disorder, psychosis, depression). The methodological quality of each literature review was assessed using AMSTAR. The original search identified 848 reviews, of which 70 were included in the systematic review of reviews. Broadly, the literature indicates that various VR interventions could be useful in different psychiatric disorders. This study provides evidence supporting the positive impact of VR therapy in psychiatric disorders. However, the impact is defined differently according to the studied area. Nevertheless, due to the continuous development of VR hardware and software, it is essential to conduct further research in the area of psychiatric disorders, especially as no review has concluded that VR does not work.