Andreea Ancuța Vataman

Background/Objectives: This study aimed to assess nerve conduction studies (NCS) parameters of the median nerve and abductor pollicis brevis (APB) muscle activity in patients with cervical spondylosis. Additionally, we evaluated longitudinal changes in these parameters at six months following a multimodal rehabilitation treatment. Methods: This quasiexperimental, nonrandomized study included 41 patients with cervical spondylosis and 25 healthy controls. Median nerve conduction studies and semiquantitative surface electromyography (sEMG) of the APB muscle were assessed using a two-channel Neuro-MEP-Micro system (version 2009, Neurosoft Ltd.). The evaluations were performed at baseline in both groups and repeated after six months in the patient group. Pain intensity was assessed using the Visual Analog Scale (VAS). Results: Compared with controls, patients showed reduced compound muscle action potential (CMAP) amplitude (Cohen’s d = 1.53–1.83), slower motor conduction velocity (r = 0.91–0.95), and impaired sEMG amplitude and recruitment pattern of the APB muscle (all adjusted p < 0.001). After application of multimodal rehabilitation treatment, VAS scores decreased significantly (adjusted p < 0.001), and favorable changes in NCS and sEMG parameters were observed, with moderate to large effect sizes (Cohen’s d = 0.56–0.82; r = 0.52–0.86; all adjusted p ≤ 0.006). CMAP amplitude correlated positively with sEMG amplitude and recruitment pattern (ρ = 0.483–0.632, all adjusted p ≤ 0.001). Conclusions: Multimodal rehabilitation treatment may be associated with clinical and electrophysiological improvements, suggesting the complementary value of NCS and sEMG for the evaluation and follow-up of patients with cervical spondylosis. However, because of the nonrandomized uncontrolled design and the absence of longitudinal follow-up in controls, causal treatment effects cannot be inferred.

Background: Youth soccer players are exposed to repeated unilateral loading during a period of rapid growth and neuromuscular maturation. These demands may contribute to postural deviations and inter-limb functional asymmetries that can influence movement control and mechanical efficiency. This study protocol aims to establish a standardized multimodal framework for assessing postural alignment, postural control, lower limb mechanical output, ankle dorsiflexion strength, support-limb neuromuscular activation, and contextual training and recovery variables in licensed youth soccer players aged 13 to 17 years. Methods: This prospective observational study will include 75 male youth soccer players recruited from S.C. Fotbal Club Ripensia Timișoara S.A. The primary outcome is the inter-limb asymmetry index derived from unilateral countermovement jump performance. Secondary outcomes include postural alignment, balance, bilateral jump performance, ankle dorsiflexion strength, and support limb electromyographic activity during the instep kick. Participants will complete a clinical evaluation questionnaire, including demographic, training, and recovery variables. Assessments will be conducted using the GaitON system, Kinvent K-Delta force platforms, K-Myo surface electromyography, and K-Pull dynamometry, before and after a regular training session. Biological maturation will be estimated using the Mirwald maturity offset method. Expected Results: The protocol will allow characterization of inter-limb asymmetries across postural, balance, jump, and electromyographic parameters. Conclusions: This protocol aims to provide a practical and standardized model for functional screening in youth soccer players.

Background: Pectus excavatum (PE) is the most common anterior chest wall deformity in children and adolescents. It may lead to postural adaptations of the trunk and spine and can influence the distribution of the center of gravity. Methods: A total of 35 patients with PE, with a Haller index < 3.25, aged 5–17 years, followed a structured exercise program including postural correction exercises, thoracic mobility exercises, breathing retraining, and trunk extensor strengthening for three months after proper instruction by a specialist. Patients were assessed before and after the intervention. Postural alignment was evaluated laterally (right and left) using the GaitON Posture Analysis System, and static balance was assessed using the PoDATA 2.0 stabilometric platform (Chinesport, Italy), which analyzes plantar pressure distribution and center of pressure (COP) displacement during orthostatic stance. Statistical analysis was performed using paired t-tests and Pearson correlation coefficients. Results: Stabilometric analysis demonstrated a reduction in COP trajectory length, confidence ellipse area, and maximum velocity, indicating improved postural control and reduced sway. Postural analysis revealed statistically significant improvements in head and shoulder girdle alignment. Correlations suggest a potential relationship between segmental alignment and stabilometric parameters and a possible reduction in thoracic hyperkyphosis associated with PE. Conclusions: Postural and stabilometric assessment in PE highlights changes in the analyzed parameters and suggest that a structured exercise program may be associated with improvements in biomechanical function and neuromuscular control. These methods can be integrated into conservative management and therapeutic strategies.

Background: Lumbar spondylosis is a frequent cause of chronic low back pain, often associated with radiculopathy. Although imaging evaluation is widely used, it does not always reflect the degree of functional impairment of the nerve roots. Electrophysiological assessments, such as nerve conduction studies (NCS) and surface electromyography (sEMG), can provide additional information on neuromuscular function under conservative treatment. Methods: This quasi-experimental study included 60 patients with lumbar spondylosis and 25 healthy subjects, who underwent clinical, imaging, and electrophysiological assessments. NCS and sEMG parameters were assessed in the patient group before and six months after rehabilitation treatment. The control group was assessed only once, at baseline. We analyzed the nerve conduction velocity of the tibial and peroneal nerves and the sEMG activity of the tibialis anterior muscle bilaterally. Statistical analysis used nonparametric tests, Spearman’s coefficient, and Hodges–Lehmann estimates. Results: Compared to the control group, patients presented increased residual latencies and reduced CMAP amplitude and motor conduction velocity values (p < 0.001). After rehabilitation treatment, significant improvements in NCS parameters were observed, with decreased latencies and increased CMAP amplitude and motor conduction velocity bilaterally (p < 0.001). Also, sEMG amplitude and recruitment pattern scores increased significantly at the 6-month follow-up (p ≤ 0.004). Correlations between electrophysiological parameters and the severity of imaging changes were limited, with modest associations for left tibial latencies (ρ = 0.401–0.467; p < 0.050). Conclusions: In patients with lumbar spondylosis, rehabilitation treatment was associated with functional improvements in nerve conduction velocity parameters and muscle activity.

Context/Objectives: Pectus excavatum (PE), the most common anterior chest wall deformity in children and adolescents, impacts posture and is frequently associated with axial deviations due to biomechanical alterations of the spine and the properties of the involved musculature. Methods: We assessed 35 patients with PE with a Haller index below 3.25, aged between 5 and 17 years, who completed a three months specialized physical exercise program after proper training and instruction by a specialist. All patients were assessed before starting the exercise program and at the end of the treatment. The assessment method used was myotonometry, employing the MyotonPRO device, targeting the trapezius muscle with all three fascicles and the pectoralis major muscle both on the left and the right side, measuring: frequency (Hz), stiffness (N/m), decrement, relaxation time (ms), and the ratio between relaxation time and deformation time (creep). Results: The analysis of myotonometric parameters reveals a pattern of selective adaptation, predominantly involving the left hemibody in most of the groups analyzed, without significant functional imbalances. This asymmetry may reflect either the functional predominance of the left hemibody during participants’ daily activities or increased activation induced by the exercise program; however, by the end of the intervention, bilateral stability was observed in most parameters. Conclusions: A three-month physical exercise program in children and adolescents with PE results in improvements in muscle properties, particularly in the pectoralis major and middle trapezius muscles bilaterally, and contributes to the restoration of functional symmetry, thereby supporting the effectiveness of the exercise program in optimizing neuromuscular control, tissue elasticity, and scapular stability.

Background. Cervical spondylosis is a degenerative disorder of the spine, frequently associated with chronic neck pain, reduced mobility, and functional impairment. Patients develop alterations in muscle tone, stiffness, and elasticity, which further contribute to disability. This study aimed to investigate the effects of a 14-day standardized rehabilitation program on the biomechanical and contractile properties of cervical and scapular muscles in patients with cervical spondylosis. Methods. This study used a single-group pre–post observational design on 23 patients (16 women, 7 men; mean age 61.1 ± 14.2 years) diagnosed with cervical spondylosis. All participants completed a standardized rehabilitation treatment that included cervical mobilization, stretching, isometric exercises, scapular stabilization, electrotherapy, ultrasound, thermotherapy, and balneotherapy. Muscle properties were evaluated bilaterally using the MyotonPRO^® device, measuring frequency, stiffness, decrement, relaxation time, and creep. Assessments were performed in a sitting position for the deltoid, upper trapezius and pectoralis major, both at baseline (T0) and after treatment (T1). Handgrip strength was assessed bilaterally with a handheld dynamometer. Results. The deltoid muscle showed a significant reduction in frequency (14.86 → 13.50 Hz, p = 0.034) and stiffness (306.4 → 256.1 N/m, p = 0.014) on the right side, suggesting normalization of tone and passive resistance. The upper trapezius had a significant bilateral decrease in decrement (p < 0.05), reflecting improved elasticity. The pectoralis major displayed the most consistent adaptations, with increased frequency (right side, p = 0.008), improved relaxation bilaterally (p < 0.05), and significant reductions in decrement and creep (p < 0.01). Handheld dynamometry confirmed increased handgrip strength, with a 5.4% improvement on the left side and 7.6% on the right side. Conclusions. In our study measurable changes in muscle parameters were observed following a rehabilitation program in patients with cervical spondylosis. The integration of myotonometry and dynamometry allowed objective assessment of muscle adaptations supporting the clinical value of individualized rehabilitation strategies.

Pectus excavatum (PE) is the most common deformity of the chest wall seen in children and adolescents. Besides its visible depression of the chest, this condition often causes functional impairments affecting the cardiovascular and respiratory systems, as well as postural issues. Additionally, the aesthetic aspect of the deformity can greatly impact the psychosocial well-being of those affected. This study aims to evaluate the effect of a tailored physiotherapy program on children and adolescents with PE, focusing on musculoskeletal, cardiopulmonary, postural, and balance measures. A total of 35 participants diagnosed with PE will be assessed using four complementary methods: myotonometry with MyotonPRO for the trapezius muscle involving all three fascicles and the pectoralis major muscle on both sides, cardiopulmonary exercise testing on a treadmill (including cardiopulmonary function), postural assessment with GaitOn, and static balance-stabilometry with PoData 2.0. These assessments will be performed before and three months after completing an individualized physiotherapy program, which participants will perform daily after proper instruction from a physical therapist. After three months, the initial and final results will be compared to determine how physical therapy influences treatment outcomes in patients with PE.