Sławomir Snela

Background: Family-centered care is a core principle of contemporary pediatric rehabilitation, particularly for children with neurodevelopmental disorders. Conceptual frameworks emphasizing functioning, participation, and contextual factors are essential to operationalize this approach in clinical practice. The International Classification of Functioning, Disability and Health (ICF) and the F-words framework are widely used models aligned with these principles; however, their practical integration remains challenging. Methods: A narrative literature review was conducted using PubMed, Scopus, and Web of Science databases to identify English-language publications (2005–2025) addressing the ICF, the F-words framework, and pediatric neurodevelopmental disability. Results: Thirty-one publications were included. The findings indicate increasing international adoption of both frameworks in pediatric rehabilitation. However, persistent challenges were identified, including conceptual ambiguity between activity and participation domains, limited operationalization of personal factors, overlap between the ICF and F-words constructs, limited standardization, difficulties in outcome measurement, and inconsistent involvement of families in clinical decision-making. Conclusions: The ICF and the F-words framework offer complementary strengths for advancing family-centered pediatric care. A structured dual-layer integration approach may enhance shared decision-making, clarify goal-setting, and improve communication with families. Further methodological refinement and practice-oriented guidance are needed to support consistent clinical implementation.

Background: Family-centered care is a core principle of contemporary pediatric health and rehabilitation, particularly for children with neurodevelopmental disorders. Con-ceptual frameworks that emphasize functioning, participation, and contextual factors are essential for operationalizing this approach in clinical practice. The International Classification of Functioning, Disability and Health (ICF) and the F-words framework are widely referenced models aligned with these principles; however, their practical integration within family-centered pediatric care remains challenging. The objective of this narrative review was to examine how the ICF and the F-words framework are ap-plied in pediatric neurorehabilitation, to identify conceptual and practical limitations, and to explore strategies that may enhance their use in family-centered care. Methods: A narrative literature review was conducted using the PubMed, Scopus, and Web of Science databases. English-language publications published between 2005 and 2025 were identified using keywords related to the ICF, the F-words framework, neurode-velopmental disorders, childhood disability, and cerebral palsy. Eligible sources in-cluded original research articles, systematic, scoping, and narrative reviews, valida-tion studies, expert reports, and clinical practice guidelines. Articles were selected based on relevance to family-centered pediatric care and the integration of the ICF and F-words frameworks. Results: A short summary of the article’s main findings Thir-ty-one publications were included, representing a broad range of theoretical, empirical, and clinical perspectives. The findings indicate increasing use of both the ICF and the F-words framework in pediatric rehabilitation and family-centered care. However, persistent challenges were identified, including conceptual ambiguity, overlap be-tween frameworks, limited standardization, difficulties in outcome measurement, and inconsistent involvement of families in clinical decision-making. Conclusions: The ICF and the F-words framework offer complementary strengths for supporting fami-ly-centered pediatric care. A structured, integrated approach may improve shared de-cision-making, communication with families, and participation-focused care. Further methodological refinement and practice-oriented guidance are needed to support their consistent and effective implementation in everyday clinical settings.

Dystonic cerebral palsy (CP) presents significant challenges due to its complex movement disorders and associated complications. This case report details a unique 12-year longitudinal observation (from birth to 12 years of age) of a patient with severe dystonic CP, highlighting the benefits of an interdisciplinary, structured therapeutic approach. The patient exhibited severe dystonia, motor impairment, and a high risk of musculoskeletal and systemic complications. Diagnosis and treatment were guided by the WHO's International Classification of Functioning, Disability, and Health (ICF) framework, incorporating the "F-words" concept and evidence-based recommendations. An interdisciplinary team collaborated to provide comprehensive, long–term care, including a neurologist, orthopaedist, neurosurgeon, physiotherapist, orthoptist, neuro-logopedist, alternative communication specialist, and psychologist. Over the whole course of treatment, the patient maintained good body structure and function, with no significant pain or respiratory, gastrointestinal, or urinary complications. While the mild range of motion restrictions were observed, the patient achieved independent mobility using assistive technologies and actively participated in school, sports, family activities, and social interactions. However, dystonic movements remained an unresolved challenge. This case underscores the potential of a structured, interdisciplinary approach to enhance the quality of life for individuals with severe dystonic CP. This approach significantly improved the patients' and their families' quality of life across all ICF domains. Our findings highlight the need for national healthcare systems to adopt comprehensive rehabilitation strategies to improve functional outcomes and promote independence in children with CP.

One of the main benefits of using 3D printing in orthopedics is the ability to create custom solutions tailored to a patient’s specific anatomical and functional needs. Conducting a reliable evaluation of the accuracy of the manufacture of anatomical structure models is essential. However, particular standards or procedures still need to be implemented to control the surface quality of anatomical models manufactured using additive manufacturing techniques. Models of pelvic parts made of polylactic acid (PLA) material were manufactured using the Material Extrusion (MEX) additive technique. Subsequently, guidelines were developed to reliably verify the geometric and surface roughness of the 3D printed models using Computer-Aided Inspection (CAI) systems. For this purpose, a measuring arm system (MCA-II) with a mounted laser head and Atos II Triple Scan was used. To inspect surface roughness parameters, procedures were developed for an Alicona InfiniteFocusG4 optical microscope. The results of the geometrical verification of the models are within the tolerance limits of ±0.22 mm to ±0.6 mm. In the case of surface roughness measurement, the highest values for the arithmetical mean height Sa were obtained on the side of the support material, while the smallest values were found along the applied layers. After the metrological control process, the models were used in the planning process for hip surgery.

Worldwide, osteoarthritis (OA) is the most common cause of joint pain in older people. Many factors contribute to osteoarthritis’ development and progression, including secondary osteoarthritis’ underlying causes. It is important to note that osteoarthritis affects all four tissues: cartilage, bone, joint capsule, and articular apparatus. An increasingly prominent area of research in osteoarthritis regulation is microRNAs (miRNAs), a small, single-stranded RNA molecule that controls gene expression in eukaryotes. We aimed to assess and summarize current knowledge about the mechanisms of the action of miRNAs and their clinical significance. Osteoarthritis (OA) is affected by the interaction between miRNAs and inflammatory processes, as well as cartilage metabolism. MiRNAs also influence cartilage cell apoptosis, contributing to the degradation of the cartilage in OA. Studies have shown that miRNAs may have both an inhibitory and promoting effect on osteoporosis progression through their influence on molecular mechanisms. By identifying these regulators, targeted treatments for osteoarthritis may be developed. In addition, microRNA may also serve as a biomarker for osteoarthritis. By using these biomarkers, the disease could be detected faster, and early intervention can be instituted to prevent mobility loss and slow deterioration.

Background: The study aimed to assess the reliability, validity, and responsiveness of the Polish version of Knee Outcome Survey Activities of the Daily Living Scale (KOS-ADLS) in a group of patients after arthroscopic reconstruction of the anterior cruciate ligament (ACL). Methods: The study was a longitudinal study with repeated measures. One hundred and twelve subjects who qualified for arthroscopic ACL reconstruction (mean age = 31.8 years) were initially enrolled in this study. The Polish version of KOS-ADLS and Short Form-36 v. 2.0 (SF-36) were used. Results: The Polish version of KOS-ADLS in subjects after ACL rupture demonstrated excellent internal consistency (Cronbach’s alpha for KOS-ADLS- total = 0.91), and test–retest reliability using the intraclass correlation coefficient (ICC-total = 0.98). The standard error of measurement (SEM) value was 0.81 and the minimal detectable change (MDC) was 2.23 for KOS-ADLS-total. The validity analysis showed a moderate and low correlation between KOS-ADLS and different domains of SF-36 from r = 0.354 between KOS-ADLS activity and the physical component scale (PCS) of SF-36: to r = 0.206 between KOS-ADLS activity and the mental component scale (MCS) of SF-36. Conclusions: The Polish version of KOS-ADLS turned out to be a reliable, valid and responsive self-reported outcome measure, allowing for the self-assessment of symptoms and function related to the knee joint impairment after ACL reconstruction. Therefore, the scale can be applied in clinical practice and research.

Currently, medicine uses typical industrial structure techniques, including reverse engineering, data processing, 3D-CAD modeling, 3D printing, and coordinate measurement techniques. Taking this into account, one can notice the applications of procedures used in the aviation or automotive industries based on the structure of Industry 4.0 in the planning of operations and the production of medical models with high geometric accuracy. The procedure presented in the publication shortens the processing time of tomographic data and increases the reconstruction accuracy within the hip and knee joints. The procedure allows for the partial removal of metallic artifacts from the diagnostic image. Additionally, numerical models of anatomical structures, implants, and bone cement were developed in more detail by averaging the values of local segmentation thresholds. Before the model manufacturing process, additional tests of the PLA material were conducted in terms of its strength and thermal properties. Their goal was to select the appropriate type of PLA material for manufacturing models of anatomical structures. The numerical models were divided into parts before being manufactured using the Fused Filament Fabrication technique. The use of the modifier made it possible to change the density, type of filling, number of counters, and the type of supporting structure. These treatments allowed us to reduce costs and production time and increase the accuracy of the printout. The accuracy of the manufactured model geometry was verified using the MCA-II measuring arm with the MMDx100 laser head and surface roughness using a 3D Talyscan 150 profilometer. Using the procedure, a decrease in geometric deviations and amplitude parameters of the surface roughness were noticed. The models based on the presented approach allowed for detailed and meticulous treatment planning.

MiRNA expression profile in serum of osteoarthritis patients

Introduction: Osteoarthritis (OA) is a widely prevalent joint disease leading to motor disability and pain. However, appropriate indicators for identifying patients at risk for this progressive disease, identifying molecular events for detecting early phases of the disease, or biomarkers to screen for treatment responses are lacking. Micro RNAs (miRNAs), which play crucial roles in OA, could be potential biomarkers of OA. Because circulating miRNA levels reflect the disease state, they may be useful for OA screening and as diagnostic tools, reducing the need for invasive procedures and minimizing the cost of current diagnostic methods. Materials and methods: The expression levels of 18 microRNAs (let-7e-5p, miR-21-5p, miR-93-5p, miR-101-3p, miR-103a-3p, miR-130a-3p, miR-146a-5p, miR-16-5p, miR-193b-3p, miR-199a-3p, miR-210-3p, miR-222-3p, miR-22-3p, miR-27a-3p, miR-27b-31a, miR-335-5p, miR-454-3p, and miR-98-5p) were analyzed by quantitative real-time polymerase chain reaction in the cartilage tissues and serum samples of 28 OA patients and were compared to those of 2 healthy controls. Results: Expression of microRNA-146a-5p was significantly upregulated in the cartilage (P = 0.006) and serum (P = 0.002) of OA patients. The expression levels of miR-146a-5p in the serum were positively correlated with those in the cartilage (Pearson correlation coefficient R = 0.32; P = 0.002). Conclusion: miR-146a-5p was significantly overexpressed in patients with OA, both in the articular cartilage tissue and serum, with a positive correlation between the levels in both types of samples. Therefore, the miR-146a-5p serum level could reflect the molecular processes in the cartilage, suggesting its clinical utility as a biomarker for OA management. Implementing a noninvasive biomarker using serum miRNAs involves the analysis of the misregulated miRNAs linked to the cartilage pathology.