Physical Rehabilitation and Recreational Health Technologies

Rehabilitation burden of injuries in national-level Indian athletics: A prospective cohort study

Shahin Naz Jamali — 2026-02-28

Purpose. Injuries are common in athletics and reduce athlete availability. While injury incidence is well described, less is known about rehabilitation burden – the time from injury onset to unrestricted sports participation – particularly in Indian athletes.

Material & Methods. This prospective cohort study followed 95 national-level track-and-field athletes (56 men, 39 women) over one competitive season (November 2023 – October 2024). Injury surveillance was conducted by physiotherapists using International Olympic Committee (IOC) consensus definitions. Rehabilitation duration was measured from injury reporting until medical clearance for unrestricted participation. Descriptive statistics were used, and rehabilitation burden was calculated as days lost per 1000 athlete-days.

Results. Seventy-seven injuries occurred in 71 athletes (74.7%). Muscle injuries were most frequent (n=25; mean rehabilitation 13 days), whereas tendon, bone stress, and joint injuries required longer recovery. Post-operative injuries (n=3) showed the longest rehabilitation duration (mean 260 days). Severe injuries accounted for 36.4% of cases and required a median of 60 days, compared with 20 days for moderate and 5.5 days for mild injuries. Overuse injuries resulted in substantially greater time loss than acute injuries (mean 87 vs. 12 days). Throwers sustained the highest number of injuries (n=30) and had the longest average rehabilitation duration (mean 70 days). Overall rehabilitation burden was 106 days per 1000 athlete-days, indicating approximately 10% athlete unavailability.

Conclusions. Although muscle injuries are common and short-lived, severe, overuse, and post-operative injuries contribute disproportionately to rehabilitation burden in national-level athletics. Targeted prevention strategies, structured rehabilitation, and adequate physiotherapy resources are essential to reduce athlete unavailability.

Pain relief in plantar fasciitis: phonophoresis versus iontophoresis in guards: a pilot study

Aditi Bhushan — 2026-02-28

Purpose. Plantar fasciitis is a leading cause of heel pain, particularly among individuals engaged in prolonged standing and walking occupations such as security guards. It is now understood as a degenerative fasciosis of the plantar fascia rather than a purely inflammatory condition, involving collagen disorganization and microtrauma at the medial calcaneal 26 management due to their safety and clinical feasibility. Phonophoresis and iontophoresis are commonly used transdermal drug delivery modalities that enhance the local effects of topical agents such as diclofenac through ultrasonic energy and low-intensity electrical currents, respectively. Both techniques aim to provide targeted pain relief while minimizing systemic side effects. Additionally, Muscle Energy Techniques (MET) may further improve outcomes by enhancing flexibility, reducing muscle tightness, and optimizing foot biomechanics. However, evidence comparing the relative effectiveness of phonophoresis and iontophoresis, particularly when combined with MET in occupationally active populations, remains limited. This study, therefore, seeks to address this gap by comparing their effects on pain and quality of life in middle-aged security guards with plantar fasciitis. Objective: to determine Pain Relief in Plantar Fasciitis: Phonophoresis versus Iontophoresis in Guards.

Material & Methods. Thirty security guards with clinically diagnosed bilateral plantar fasciitis were recruited using convenience sampling and randomly allocated into two equal groups in a single-blinded manner using an odd–even allocation method. Group A received MET combined with phonophoresis using diclofenac potassium 6% gel, while Group B received MET combined with iontophoresis using diclofenac potassium 6% gel. Both interventions were administered daily for four weeks under physiotherapist's supervision. Pain intensity, foot function, and quality of life were assessed at baseline and post-intervention using the Visual Analog Scale (VAS), Foot Function Index (FFI), and SF-36 Health Survey Questionnaire, respectively. Data were analyzed using IBM SPSS Statistics version 26.0. (IBM Corp., Armonk, NY, USA) Descriptive statistics were expressed as mean ± standard deviation. Normality was assessed using the Shapiro–Wilk test, and as data were normally distributed, parametric tests were applied. Within-group changes were analyzed using paired t-tests, and between-group differences were evaluated using independent samples t-tests. A p-value <0.05 was considered statistically significant.

Results. Thirty participants were equally allocated to the phonophoresis + MET group (Group A, n=15) and the iontophoresis + MET group (Group B, n=15). Baseline demographic characteristics and pre-treatment outcome measures were comparable between groups (p>0.05). Both groups demonstrated significant within-group improvements in pain (VAS), foot function (FFI), and quality of life (SF-36) following the 4-week intervention (p<0.001). However, post-intervention comparisons revealed significantly greater improvements in Group A compared with Group B across all primary and secondary outcomes. Group A showed a larger reduction in VAS scores (2.58±1.07 vs. 4.75±1.48; p<0.001) and markedly lower post-treatment FFI pain, disability, and activity limitation scores (p<0.001 for all). Quality-of-life outcomes also favored Group A, with greater percentage improvements across all SF-36 domains, particularly physical health limitation and physical functioning. These findings indicate that diclofenac potassium phonophoresis combined with MET was more effective than iontophoresis with MET in reducing pain, improving foot function, and enhancing quality of life in patients with plantar fasciitis.

Conclusions. Diclofenac potassium phonophoresis combined with muscle energy techniques appears to be more effective than iontophoresis in reducing pain and improving foot function and quality of life in middle-aged individuals with plantar fasciitis, particularly those exposed to prolonged occupational standing. The superior improvements observed across physical, emotional, and functional domains support phonophoresis as a promising, non-invasive adjunct in the conservative management of chronic heel pain. Further large-scale, long-term randomized trials are warranted to confirm these findings and optimize treatment protocols for occupational populations.

«Why do I have to continue?»: The problem of motor learning for students with disabilities in an electronic format

Andrii Yefremenko — 2026-02-28

Purpose. The adaptability of the format of teaching people with disabilities is key to an effective educational process in the field of physical education and sport. The article highlights the results of a study on the effectiveness of e-learning for students with disabilities who are training to become sports coaches. The aim was to determine the effectiveness of motor learning for students with disabilities in an electronic format.

Material & Methods. In a quasi-experimental intervention (lasting 12 weeks), the total number of participants who successfully completed the training was 78 (without sex stratification) aged 18.96±0.90 years, from which four specific groups were formed (two intervention groups and two control groups): EG1 (n=6) – student athletes with disabilities (sensorineural hearing impairment); EG2 (n=6) – students with disabilities (orthopedic or neurological disorders of the musculoskeletal system, including the use of orthoses or wheelchairs); CG1 (n=36) – student athletes without health limitations; CG2 (n=30) – students in the main health group. A critical review of the literature was conducted, followed by the development of a model of inclusive athletics training in electronic format, based on the use of social cognitive and determination theories. Psychodiagnostics of motivation and engagement in educational activities were carried out. Self-assessment of cognitive and physical load was carried out. Motor testing was carried out using simplified versions of running, jumping and throwing exercises. The amount of load was assessed using RPE. The physiological response of the body to physical training loads was assessed using freely dosed load tests with the calculation of VO2max.

Results. A significant increase in intrinsic motivation, engagement and integration into the online community was observed in participants in EG1 and EG2 during the intervention period, accompanied by the maintenance of high scores six weeks after the end of the intervention. In EG1, there was an improvement in external motivation and a decrease in amotivation directly during the intervention, but these parameters did not differ notably from the baseline six weeks after the end of the programme. Cognitive load and RPE scores in the intervention groups remained stable. The physical condition of participants in EG1 and EG2, in particular the estimated VO₂max and motor test results, improved considerably and remained stable after the end of the active phase of the study, although less pronounced stability of results was observed in EG2. Participants in CG1 and CG2 showed significant changes in all measured parameters, with the exception of motivation, which remained relatively stable during the study period.

Conclusions. The study confirmed the effectiveness of implementing an inclusive e-learning model (using athletics as an example) for students with disabilities. It was found that digital support for autonomy, competence, and social connectedness may allow physical barriers to be levelled and significantly increases intrinsic motivation through the construction of individual educational trajectories. Prospects for further research are related to the implementation of scales for monitoring achievements and studying the professional identity of future coaches in an inclusive digital space.

A bibliometric analysis of studies addressing rehabilitation in martial arts

Yuriy Tropin — 2026-02-28

Purpose. The scientific novelty of this study lies in the identification and structured interpretation of thematic clusters that characterize the contemporary research landscape of rehabilitation in martial arts. To conduct an analytical review of publications devoted to the problem of rehabilitation in martial arts using the VOSviewer software tool in the PubMed database.

Material & Methods. To create the study sample as of December 31, 2025, a bibliometric analysis of data from the PubMed database was performed. The search was conducted using the key phrase “rehabilitation in martial arts”. Publications from 2001 to 2025 were analyzed. VOSviewer version 1.6.19 was used, applying keyword analysis and direct citation analysis with the construction of bibliometric maps, cluster density visualization, and citation weights.

Results. Using VOSviewer 1.6.19, a total of 1111 publications were identified. All publications were written in English. A substantial increase in the number of publications was observed in each five-year period, which can be explained by the growing interest in and popularization of research on rehabilitation in martial arts. Overall, 4713 researchers from 2943 organizations studied rehabilitation issues across various martial arts disciplines. The publication activity of 1049 authors with a link strength greater than zero was analyzed. These authors were grouped into 41 clusters, characterized by 5333 links with a total link strength of 6836. The most productive authors were Tsang W. (25 publications), Wayne P. (23), Li F. (21), Tao J. (19), Chen L. (17), Huang J. (15), Yen G. (14), Franchini E. (13), and Wang C. (13). For network visualization, 371 elements (keywords) were selected and grouped into 9 clusters. The network included 14701 links with a total strength of 67,750. The most prominent research topics were centered around the keywords “humans”, “male”, “martial arts”, “adult”, “female”, “aged”, “tai ji”, “exercise”, “treatment outcome” and “quality of life”. Overlay visualization demonstrated a clear evolution of scientific research: from general assessment of functional status and risk prevention (early stage), through the implementation of specialized rehabilitation methods (transitional stage), to individualized physical rehabilitation programs with an emphasis on motor activity control and exercise tolerance (modern stage).

Conclusions. Using the VOSviewer software, a bibliometric analysis of publications indexed in the PubMed database was conducted, revealing a steady increase in scientific interest in rehabilitation in martial arts, as evidenced by a significant growth in the number of publications over the analyzed period. A high level of international scientific cooperation was identified, reflected in the wide range of authors, institutions, and interdisciplinary links. The analysis of bibliometric maps made it possible to identify nine key thematic clusters encompassing sports, clinical, psychosocial, and preventive aspects of rehabilitation. The leading research directions focus on recovery from sports injuries, improvement of the functional state of the musculoskeletal system, quality of life, and mental health. Overlay visualization confirmed the evolution of scientific approaches – from basic functional and clinical studies to contemporary individualized physical rehabilitation programs with load control. The obtained results confirm the need for further research aimed at integrating rehabilitation measures directly into the structure of the training process, as well as at developing scientifically grounded models of long-term athletic recovery.

Rehabilitation program with controlled load progression as a means of correcting pain and mobility of the lumbar spine in case of L5–S1 disc degeneration

Oleh Olkhovyi — 2026-02-28

Purpose. To develop and evaluate the effectiveness of a physical rehabilitation program of reparative-regenerative orientation in individuals with degenerative changes in the L5–S1 intervertebral disc in terms of reducing pain and improving functional mobility of the lumbar spine.

Material & Methods. A pilot study was conducted with the participation of 25 individuals with clinically and instrumentally confirmed degenerative changes in the L5–S1 disc (mean age 38.3±6.2 years), who provided written informed consent. The study was performed in accordance with the provisions of the Declaration of Helsinki. The intensity of the pain syndrome was assessed using a visual analog scale (VAS) separately in the standing, sitting and moving positions. Mobility and flexibility of the lumbar spine were determined by the “forward tilt” test, the Schober test and the active back extension index (in degrees). The rehabilitation program lasted 13 weeks and was implemented in the format of a six-day training microcycle with one recovery day. The central element was a modified decompression-stabilization exercise without external weighting with a clearly regulated progression from 1 to 10 repetitions per day. Descriptive statistics and the Wilcoxon test for related samples (p<0.05) were used for statistical analysis.

Results. After completing the program, a significant decrease in pain intensity according to VAS was recorded in all functional positions: in the standing position – from 5.55±0.99 to 3.86±1.18 cm (p<0.001), in the sitting position – from 4.84±0.91 to 3.93±0.87 cm (p<0.001), in movement – from 4.84±0.91 to 3.92±0.65 cm (p<0.01). A significant improvement in flexibility and mobility indicators was noted: a decrease in the distance when leaning forward from 28.71±13.47 to 18.05±11.24 cm (p<0.01), an increase in the Schober test score from 6.45±1.63 to 7.35±1.01 cm (p<0.05), and an increase in active back extension from 14.63±6.31° to 21.95±4.37° (p<0.001).

Conclusions. The program of physical rehabilitation of reparative-regenerative orientation provides a reliable reduction of pain syndrome and improvement of mobility and flexibility of the lumbar spine in individuals with degenerative changes of the L5–S1 disc. The proposed approach can be considered as a safe and effective strategy of non-drug rehabilitation of this category of patients.

Evaluation of Transcranial Magnetic Stimulation for Detecting Subclinical Neuroplastic Changes in Newly Diagnosed Leprosy Patients without Peripheral Neuritis

Anshika Singh — 2026-02-28

Purpose. Leprosy is a chronic infectious disease predominantly affecting peripheral nerves, often leading to sensory and motor deficits. Early detection of neuroplastic changes before clinical manifestations may improve diagnosis and rehabilitation. Transcranial magnetic stimulation (TMS) is a non-invasive tool capable of assessing corticospinal excitability and detecting subclinical central nervous system involvement.

Material & Methods. A cross-sectional study was conducted involving 51 newly diagnosed leprosy patients aged 18–45 years without clinical signs of peripheral neuritis and 51 age- and sex-matched non-leprosy (healthy) controls. Resting motor thresholds and motor evoked potential (MEP) amplitudes were measured bilaterally in four hand muscles: the first dorsal interosseous, abductor pollicis brevis, extensor pollicis brevis, and abductor digiti minimi, using TMS and electromyography.

Results. Leprosy patients exhibited significantly elevated motor thresholds across all examined muscles compared with controls (e.g., right first dorsal interosseous mean threshold 65.2 vs. 55.1, p<0.0001). Concurrently, MEP amplitudes were markedly reduced in the leprosy group (e.g., right abductor pollicis brevis 36.75 vs. 74.35, p<0.0001), indicating decreased corticospinal excitability and early neuroplastic changes despite absence of clinical peripheral neuritis.

Conclusions. TMS may detect early subclinical corticospinal pathway dysfunction in newly diagnosed leprosy patients without peripheral neuritis, highlighting its potential as a sensitive diagnostic and monitoring tool for neuroplastic alterations in leprosy.