Beata Tarnacka

Postural control deficits represent a significant issue for patients with orthopedic conditions, leading to activity limitations and a loss of independence. The aim of this review was to analyze the use of stabilometric platforms in the diagnosis, monitoring, and rehabilitation of these disorders. Nine original studies from the PubMed, PEDro, and Google Scholar databases, involving a total of 565 participants, were analyzed. The publications confirm a dual role of stabilometric platforms: diagnostic (assessment of static and dynamic parameters) and therapeutic (utilization of biofeedback). The reviewed literature demonstrates that stabilometric platform training in orthopedic patients produces improvements in postural control parameters and functional performance.

Osteoarthritis (OA) and other rheumatic diseases are among the leading causes of chronic pain, disability, and reduced quality of life worldwide. Increasing evidence indicates that disturbances in metal homeostasis contribute to the pathogenesis of these disorders through their effects on oxidative stress, immune regulation, cartilage metabolism, bone remodeling, and extracellular matrix degradation. This review summarizes current knowledge regarding the role of essential metals and trace elements, including zinc, iron, copper, magnesium, selenium, and manganese, as well as toxic metals such as cadmium, lead, mercury, and arsenic, with primary emphasis on their involvement in the development and progression of osteoarthritis. Other rheumatic diseases are discussed briefly to provide a comparative perspective. Particular attention is given to the molecular mechanisms underlying metal-mediated pathology, including oxidative stress, ferroptosis, mitochondrial dysfunction, activation of intracellular signaling pathways, and inflammasome activation. The diagnostic and therapeutic potential of metal-related biomarkers, metalomics, and targeted interventions aimed at restoring metal homeostasis are also discussed. Furthermore, current limitations of available studies and emerging research directions, including single-cell technologies, spatial transcriptomics, multi-omics approaches, and personalized medicine, are highlighted. A better understanding of metal homeostasis may improve the identification of novel biomarkers and therapeutic targets, ultimately contributing to more precise diagnosis and individualized treatment strategies for osteoarthritis and other rheumatic diseases.

Background/Objectives: Our aim was to evaluate sleep quality and excessive daytime sleepiness in complex regional pain syndrome (CRPS) and explore their associations with pain characteristics, functional impairment, depressive symptoms, and pain coping strategies. Methods: This pilot exploratory, cross-sectional observational study was conducted at a single tertiary rehabilitation center using a convenience sample of 21 adults with CRPS Type I (n = 17) or Type II (n = 4). Sleep quality and daytime sleepiness were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Pain was assessed with the Numeric Rating Scale (NRS), Short-Form McGill Pain Questionnaire (SF-MPQ), and PainDETECT Questionnaire (PDQ). Limb-specific disability was measured using the Disability of the Arm, Shoulder and Hand (DASH) questionnaire for upper-extremity CRPS (n = 10) and the Lower Extremity Functional Scale (LEFS) for lower-extremity CRPS (n = 11). Psychological factors and central sensitization were assessed via BDI-II, CSQ, and CSI. Results: Poor sleep quality (PSQI > 5) occurred in 81.0% (17/21) of participants (mean PSQI: 10.1 ± 4.1). ESS-defined excessive daytime sleepiness was identified in 47.6% (10/21) of patients (mean ESS: 9.6 ± 5.8). In unadjusted bivariate correlation analyses of the full cohort (n = 21), global PSQI score significantly correlated with NRS pain intensity (ρ = 0.445, p = 0.0431), SF-MPQ sensory pain (ρ = 0.468, p = 0.0325), SF-MPQ affective pain (ρ = 0.461, p = 0.0354), and SF-MPQ total score (ρ = 0.504, p = 0.0199. Conclusions: Sleep disturbances and excessive daytime sleepiness are highly prevalent in CRPS patients in tertiary care. Exploratory unadjusted analyses link sleep quality with pain severity, particularly sensory and affective dimensions. Given the exploratory design and small subgroup sample sizes, larger prospective studies are needed to confirm these findings.

Effects of Robot-Assisted Gait Therapy on Urodynamic Changes in the Subacute Phase After Spinal Cord Injury: A Prospective Study - Article abstract #950018

Aging is a multifactorial process marked by a progressive decline in physiological function and increased vulnerability to diseases such as neurodegeneration, cancer, cardiovascular disorders, and infections. A central feature of aging is inflammaging, a state of chronic low-grade inflammation driven by cellular senescence, mitochondrial dysfunction, and oxidative stress. Recently, two regulated forms of non-apoptotic cell death—ferroptosis and cuproptosis—have emerged as critical mechanisms linking redox imbalance, mitochondrial stress, and disrupted metal homeostasis to age-related pathology. Ferroptosis, an iron-dependent process characterized by lipid peroxidation and impaired glutathione peroxidase 4 (GPX4) activity, and cuproptosis, a copper-dependent mechanism associated with protein lipoylation stress, both intersect with aging-related changes in mitochondrial and metabolic function. Importantly, these two forms of cell death should not be viewed as entirely separate pathways but rather as interconnected axes within a broader metal–redox–metabolic network. Disturbances in copper or iron homeostasis, glutathione (GSH)/GPX4 dysfunction, mitochondrial and iron-sulfur (Fe–S) cluster compromise, and enhanced lipid peroxidation may converge to lower cellular survival thresholds, thereby exacerbating oxidative damage, immune dysfunction, and tissue degeneration and ultimately fueling aging and inflammaging. This review offers a unique integrated perspective that situates ferroptosis and cuproptosis within a unified framework of aging biology, emphasizing their roles in age-related diseases and the therapeutic potential of targeting these pathways through nutritional, pharmacological, and lifestyle interventions.

Employment determinants remain a critical yet under-researched factor in the social participation and inclusion of individuals with mobility impairments who use powered mobility devices (PWSMD). This systematic review and individual participant data meta-analysis aims to evaluate employment rates and identify factors influencing employment among PWSMD users. One- and two-stage meta-analyses were conducted, assessing employment status in relation to demographic, health-related and environmental factors. Random-effects models were used to account for between-study heterogeneity. Quality assessment was performed with tools for evidence synthesis provided by Joanna Briggs Institute (JBI). The PRISMA criteria were followed in the review. A systematic search of CINAHL, Embase, Cochrane, PubMed, Scopus and Web of Science databases conducted up to February 2025 identified 19 eligible studies encompassing 443 participants. 46.6% of participants were working at higher rates associated with tertiary education, pre-existing employment, vocational rehabilitation and PWSMD use of more than 10 years. Higher employment rates were also observed in participants younger than 60 years and those with childhood onset disability. No significant correlations were observed with sex, marital status, or residential setting. Higher levels of education, longer duration of PWSMD use, younger age, pre-existing employment and participation in vocational rehabilitation are associated with an increased likelihood of employment among PWSMD users. Sex, marital status and settlement type may not have an impact on employment. Further research is needed to determine most beneficial aspects of vocational rehabilitation and to explore the relationship between disability duration and employment in specific diagnostic groups.

Physiotherapy is a widely used form of treatment of low back pain (LBP) and is important in non- surgical/surgical management of patients with lumbosacral transitional vertebrae (LSTV). This review presents physiotherapeutic management in LSTV patients with LBP. A search was performed in PubMed, Scopus, Embase, Medline, and Google Scholar between November 20 and December 31, 2023. The mean age of patients was 39 years. The patients had an average of 13 sessions, and the average duration of physiotherapy was 3 weeks (frequency of 1–5 sessions/week). The physiotherapy methods used were: manual therapy, mobility training, motor control training, myofascial approach and hot packs, and electrotherapy. Outcome measures were pain scales, range of motion testing, improvement in sleep, return to work, physical activity, or muscle thickness. The reviewed papers described pain reduction, though pain recurrence occurred with varying frequency (1–3 months after therapy). Physiotherapy for LSTV patients should be a first-line treatment, but requires an individualized approach.

Idiopathic inflammatory myopathies (IIMs) are rare autoimmune disorders characterized by muscle weakness. As currently used immunosuppressive treatment presents several limitations, recent investigations focus on elucidating immune and nonimmune molecular mechanisms underlying its pathogenesis. Mitochondrial dysfunctions, endoplasmic reticulum stress, neutrophil dysregulation, and alterations in myokines and cell death pathways have been implicated in IIM pathophysiology. In this paper, the newest therapeutic strategies targeting reactive oxygen species overproduction, neutrophil extracellular traps formation, and pyroptotic and necroptotic pathways together with mitochondrial transplantations will be presented, and their safety and efficacy will be discussed. As physical therapy constitutes an essential part of IIM management, an additional focus will be directed towards molecular mechanisms underlying the effects of exercises in myositis treatment. Furthermore, the interplay between immune and nonimmune mechanisms will be analyzed and the translational challenges and limitations of current studies will be investigated.

Background: Spinal cord injuries (SCI) are associated with a range of sexual dysfunctions that impede both sexual fulfillment and reproductive capability. This study analyzes the prevalence and severity of sexual problems following SCI-classified as primary, secondary, and tertiary dysfunctions-and examines their relationships with three key components of sexual quality of life: sexual activity, sexual interest, and sexual satisfaction in both male and female patients in the subacute phase of SCI (i.e., within two years post-injury). Methods: A total of 110 patients with SCI were enrolled in the study. Analyses of primary sexual dysfunctions included 91 participants, while 81 were included in subsequent analyses. Data collection tools comprised: the International Spinal Cord Injury Male Sexual Function Basic Data Set (Version 2.0), the International Spinal Cord Injury Female Sexual Function Basic Data Set , the Ashworth Scale, SCIM III, the Numeric Rating Scale for Pain (NRSP), the Depression Assessment Questionnaire (KPD), the State-Trait Anxiety Inventory (STAI X-1), and numerical and verbal scales measuring subjective physical sexual attractiveness and the three domains of sexual quality of life. Additional data were gathered on bladder sphincter function, cardiac status, autonomic dysreflexia, and sleep apnea. Results: Among participants, 87.65% of men and 83.35% of women reported at least one primary sexual dysfunction. In men with AIS A classification, a negative correlation was observed between ejaculatory dysfunction and sexual activity (rho = -0.50, p = 0.028). In men with AIS B, C, or D, orgasmic dysfunction negatively correlated with both sexual satisfaction (rho = -0.41, p = 0.024) and sexual activity (rho = -0.45, p = 0.012), while reflex erection was positively correlated with sexual interest (rho = 0.45, p = 0.007). Functional independence post-SCI (SCIM III) among men with AIS B, C, or D was associated with higher levels of sexual activity (rho = 0.31, p = 0.047). In AIS A men, a significant positive correlation was found between walking independence (WISCI II) and sexual interest (rho = -0.43, p = 0.031). Among AIS A women, spasticity severity negatively correlated with both sexual satisfaction (rho = -0.74, p = 0.036) and sexual activity (rho = -0.80, p = 0.017). At the tertiary level, anxiety in women negatively correlated with sexual activity (rho = -0.79, p = 0.021 and rho = -0.84, p = 0.036), and with sexual satisfaction in AIS A women (p = 0.081). In AIS B, C, or D men, depression was associated with reduced sexual satisfaction (rho = -0.37, p = 0.017), and both anxiety and depression correlated negatively with sexual interest (rho = -0.38, p = 0.012 and rho = -0.47, p = 0.002, respectively). A strong positive correlation was identified between subjective sexual attractiveness and all three domains of sexual quality of life: interest (rho = 0.75), activity (rho = 0.82), and satisfaction (rho = 0.48) (p ≤ 0.001 for all domains). Moreover, increased age and longer time since injury among women were associated with greater reflex genital arousal dysfunction. In men, advancing age correlated with increased reflex erectile dysfunction. Interestingly, in AIS B, C, or D men, a longer duration post-injury was linked to fewer psychogenic erectile dysfunctions. Conclusion: The majority of participants exhibited at least one primary sexual dysfunction. Across all three domains of sexual quality of life, individuals with SCI scored significantly lower than the general population. Statistically significant associations were found between these domains and primary sexual dysfunctions, as well as secondary and tertiary SCI-related symptoms affecting sexual health.

Total knee arthroplasty is an extensive orthopedic surgery for patients with severe cases of osteoarthritis. This surgery restores the range of motion in the knee joint and allows for pain-free movement. Advancements in medical techniques used in the surgical zone and implant technology, as well as the management of operations and administration for around two decades prior, have hugely improved surgical outcomes for patients. In this study, advancements in TKA were examined through exploring aspects such as robotic surgery, new implants and materials, minimally invasive surgery, and post-surgery rehabilitation. This paper entails a review of the peer-reviewed literature published between 2005 and 2025 in the PubMed and Google Scholar databases. For predictors, we incorporated clinical relevance together with methodological soundness and relation to review questions to select relevant research articles. We used the PRISMA flowchart to illustrate the article selection system in its entirety. Since robotic surgical and navigation systems have been implemented, surgical accuracy has improved, there is an increased possibility of ensuring alignment, and the use of cementless and 3D-printed implants has increased, offering durable long-term fixation features. The trend in the current literature is that minimally invasive knee surgery (MIS) techniques reduce permanent pain after surgery and length of hospital stays for patients, though the long-term impact still needs to be established. There is various evidence outlining that the enhanced recovery after surgery (ERAS) protocols show positive results in terms of functional recovery and patient satisfaction. The integration of these new advancements enhances TKA surgeries and translates them into ‘need of patient’ procedures, ensuring improved results and increases in patient satisfaction. The aim of this study was to perform a comprehensive analysis of the existing literature regarding TKA advancement studies to identify current gaps and problems.