Galina Mratskova

Background: The aim of this review is to present the current possibilities for using low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) in musculoskeletal rehabilitation programs for knee osteoarthritis (KOA). Methods: A narrative review of the scientific literature published in PubMed, Scopus, Web of Science, Cochrane CENTRAL and Google Scholar was conducted. Scientific articles containing information regarding the application of LLLT and/or HILT for musculoskeletal rehabilitation in KOA were searched. This review included observational studies, randomized controlled trials, systematic reviews, and meta-analyses. Results: Data were found indicating a high degree of disability due to degenerative musculoskeletal conditions. This requires the optimization of osteoarthritis management strategies. Evidence of varying levels of significance was identified regarding the benefits of LLLT and/or HILT in reducing osteoarthritis symptoms. However, at this stage, no firm recommendations have been made regarding the inclusion of LLLT and/or HILT in musculoskeletal rehabilitation programs. Conclusions: The use of LLLT and/or HILT therapeutic lasers in musculoskeletal rehabilitation programs may have a positive effect on osteoarthritis by improving tissue trophism and pain reduction, as well as improving range of motion and functional activity, and may also help to reduce the use of pharmacological agents. However, there is no strong recommendations were found for the inclusion of LLLT and/or HILT in osteoarthritis management programs. Therefore, it is necessary to standardize laser therapy protocols and to conduct higher-quality scientific studies in the future that can be easily transformed from a scientifically based achievement into a real applied therapeutic option in clinical practice.

Functional recovery and reduction of disability are the main goals of physical therapy and rehabilitation. In essence, one of the important problems that must be solved during the recovery process is reliable pain management. Often, pain is the cause of incapacitation and reduced quality of life. Untreated acute pain can become chronic, requiring prolonged medical therapy. Physical modalities applied as adjuvant methods can have a number of benefits. They can affect pain symptomatically or, in some cases, pathogenetically by modulating pain sensation, improving local circulation, reducing inflammation, reducing muscle spasm and edema, improving range of motion, etc. Physical medicine uses a number of factors to reduce pain, such as thermotherapy (including cryotherapy), electrical stimulation in pain-relieving parameters, therapeutic ultrasound and extracorporeal shock wave therapy, low-frequency electromagnetic fields, laser therapy, therapeutic exercises, and manual techniques. The potential of natural factors such as hydrotherapy, balneotherapy, and peloid-therapy should not be underestimated.

The aim of this article is to provide a literature review of current approaches and recommendations for medical rehabilitation in stroke patients, with the goal of achieving the best possible outcomes for their condition and improving their quality of life. Materials and Methods: A narrative review was conducted of articles published in the databases available to us (PubMed, ScienceDirect, Google Scholar, PEDro, ResearchGate) that contain information regarding therapeutic management of stroke and, in particular, interventions aimed at motor recovery and improving quality of life. Included in this literature review were: scientific articles, guidelines on stroke and motor rehabilitation, clinical studies, longitudinal clinical studies, controlled clinical studies, systematic reviews, and meta-analyses published before April 2026, covering a ten-year period. Results: Data showing a trend toward higher patient survival rates following acute stroke were identified. For this reason, existing non-pharmacological approaches to motor recovery should be optimized. The rehabilitation process must begin as early as possible. Motor recovery depends on the establishment of motor control and the neuroplastic processes occurring in brain tissue. Rehabilitation is conducted by a rehabilitation team with the patient’s active participation, while monitoring motor rehabilitation potential. Conclusions: Rehabilitation is an essential component of post-stroke treatment. When timely and adequate medical rehabilitation is provided to stroke patients, there is a significant improvement in their overall condition and motor functions, as well as in their independence, self-care, and quality of life.

Background: Transcutaneous electrical nerve stimulation (TENS) is widely used for pain management; however, the optimal stimulation intensity remains uncertain. This preliminary observational study investigated the association between TENS current intensity and immediate analgesic effects in patients with lumbosacral pain. Methods: Fifty-three adults with lumbosacral pain undergoing routine physiotherapy were enrolled. Participants were classified post hoc according to their preferred stimulation intensity into a low-intensity group (L, n = 26), receiving stimulation at approximately the sensory threshold level, and a high-intensity group (H, n = 27), receiving stimulation at the highest tolerated intensity. TENS was delivered using an ASTAR ETIUS device (100 Hz, 100 μs, biphasic symmetrical waveform) for 20 min. Pain intensity was assessed before and immediately after treatment using a 10-point Visual Analog Scale (VAS). Between-group baseline characteristics were compared using the Mann–Whitney U test. Within-group changes were assessed using the Wilcoxon signed-rank test, and associations between current intensity and pain reduction were evaluated using Spearman’s rank correlation coefficient (rs). Results: Baseline demographic and clinical characteristics did not differ significantly between groups. No significant change in pain intensity was observed in Group L. In contrast, Group H demonstrated a significant reduction in VAS scores following TENS (VAS before Mdn = 5, VAS after Mdn = 4, Z = 4.11, p < 0.001, effect size r = 0.88). In this group, higher stimulation intensity was associated with greater pain reduction (r_s = −0.48, p = 0.011). Conclusions: In this study, TENS delivered at the highest tolerated intensity was associated with greater immediate pain relief than stimulation applied near the sensory threshold. Because of the observational design, post hoc group allocation, and lack of randomization, the findings should be interpreted as exploratory and hypothesis-generating. Further randomized controlled trials are needed to determine whether higher stimulation intensities causally improve TENS analgesic efficacy.

Introduction: Sleep disorders are common in older adults, and quality of life is often diminished due to gradual declines in physical and mental abilities. Among the treatment strategies routinely applied in older adults, comprehensive health resort treatment is considered a promising option because of its multifaceted nature and low risk of adverse effects. Objective: The primary objective of this study was to evaluate the impact of comprehensive health resort treatment on insomnia and quality of life in older adults. The secondary objective was to examine whether treatment-induced changes in these parameters were associated with participants’ age. Material and Methods: The study group consisted of 83 participants (14 men and 69 women) with a mean age of 71.94 ± 6.00 years who underwent a 21-day comprehensive, individually tailored health resort treatment for degenerative joint disease. Insomnia was assessed using the Athens Insomnia Scale. Health-related quality of life was evaluated with the European Quality of Life Five Dimensions—Five Levels (EQ-5D-5L) instrument. Assessments were conducted twice: upon admission to and discharge from the sanatorium. Results: The mean Athens Insomnia Scale (AIS) score at baseline was 6.97 ± 6.21 across all participants. Following treatment, the AIS score decreased to 4.78 ± 4.95 (p < 0.0001). The baseline mean EQ-5D-5L index was 0.956 ± 0.064. After health resort treatment, the mean EQ-5D-5L index increased to 0.969 ± 0.042 (95% CI: 0.006 to 0.022; p = 0.001). Age was not associated with the magnitude of changes in the AIS score, EQ-5D-5L index or EQ-5D-5L VAS in the studied population. Conclusions: Comprehensive health resort treatment was associated with improvements in insomnia severity and quality of life in older adults, with similar changes observed across age groups. These findings suggest that comprehensive health resort treatment may be a beneficial component of geriatric health care.

The aim of this article is to provide a literature review of current approaches and recommendations for medical rehabilitation in stroke patients, with the goal of achieving the best possible outcomes for their condition and improving their quality of life. Materials and Methods: A targeted review was conducted of articles published in the databases available to us (PubMed, Science Direct, Google Scholar, PEDro, Research Gate) that contain information regarding therapeutic management of stroke and, in particular, interventions aimed at motor recovery and improving quality of life. Included in this literature review were: scientific articles, guidelines on stroke and motor rehabilitation, clinical studies, longitudinal clinical studies, controlled clinical studies, systematic reviews, and meta-analyses published before April 2026, covering a ten-year period. Results: Data showing a trend toward higher patient survival rates following acute stroke were identified. For this reason, existing non-pharmacological approaches to motor recovery should be optimized. The rehabilitation process must begin as early as possible. Motor recovery depends on the establishment of motor control and the neuroplastic processes occurring in brain tissue. Rehabilitation is conducted by a rehabilitation team with the patient’s active participation, while monitoring motor rehabilitation potential. Conclusion: Rehabilitation is an essential component of post-stroke treatment. When timely and adequate medical rehabilitation is provided to stroke patients, there is a significant improvement in their overall condition and motor functions, as well as in their independence, self-care, and quality of life.

The aim of this report is to present the significance of osteoarthritis in occurrence and development of certain cardiovascular diseases, and the potential benefits of physical medicine therapeutic interventions for their prevention and treatment. MATERIALS AND METHODS: A review was conducted of available scientific sources containing data on the impact of osteoarthritis on cardiovascular diseases and the role of rehabilitation in their prevention and treatment. RESULTS: The review revealed evidence of a mutual connection between osteoarthritis and certain cardiovascular diseases. There are scientific data indicating common risk factors such as age, obesity, and genetics. Another mechanism affecting the cardiovascular system is the use of medication to control osteoarthritis symptoms. Non-steroidal drugs prescribed to reduce pain and inflammation may lead to cardiac damage. Pain from osteoarthritis reduces physical activity and leads to increased intake of pharmacological agents. Physical activity and therapeutic exercises can have a positive effect both on osteoarthritis and on accompanying cardiovascular conditions. CONCLUSION: The potential impact of osteoarthritis on cardiovascular diseases is a focus of attention in recent years. Due to the presence of common risk factors and pathogenic mechanisms, research continues for potential therapeutic effects of physical modalities application for prevention and control of their progression.

A low-frequency and low-intensity pulsed electrostatic field is applied as a treatment method in Rehabilitation Medicine. The technique is known as Deep Oscillation® therapy. At present, it has been established that the therapeutic effects of the electrostatic field on the tissues depend on the field frequency (5–250 Hz). The advantage of the method is the operation with a low amperage of 5–7 μA and a bipolar form of the wave. Deep Oscillation® was originally created to improve tissue lymphatic drainage. Subsequently, it was found that it reduces acute and chronic pain, improves blood and lymph circulation in the region of application, and reduces edema and fibrosis. In addition to this, tissue elasticity, joint mobility, and the condition of muscle and nerve tissue are improved. The aim of this research project is to investigate the therapeutic impact of a low-frequency and low-intensity pulsed electrostatic field in patients with symptomatic knee osteoarthritis.