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.

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.

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.

BACKGROUND Approximately 70% to 84% of patients with spinal cord injury (SCI) have varying degrees of bladder dysfunction, which can lead to upper urinary tract complications. Urodynamics is the standard method for evaluating bladder function after SCI. The effect of robot-assisted gait therapy (RAGT) on urinary function is rarely reported in the literature. The aim of this study was to evaluate the changes in urodynamics in SCI patients undergoing RAGT. MATERIAL AND METHODS The study included 35 SCI patients (26 males and 9 females) with neurological impairment at between 3 months and 2 years after injury. Simple randomization was used by tossing a coin. The rehabilitation program was performed for 7 weeks in 30-minute sessions with exoskeleton EKSO-GT or Locomat Pro; while in the control group, a dynamic parapodium was used instead of RAGT. In all patients, at the beginning and the end of therapy, urodynamics were assessed. The parameters, including cystometric bladder capacity (CBC), the first, normal, and strong desire to void (FD, ND, SD), maximum and average flow rate, post-void residual volume (PRV) and compliance, and external urethral sphincter function were analyzed. RESULTS A decreasing trend in micturition time was observed in all patients undergoing RAGT. Compliance in patients with complete SCI did not change, or in some cases decreased (up to 3 ml/cm). In patients with incomplete SCI, flow rates (average and maximum) increased while micturition time decreased. In patients with incomplete injury in the RAGT group, the lowest increases or decreases in CBC, FD, ND, and SD were observed in patients with L-level SCI lesions. CONCLUSIONS The improvement in bladder parameters observed in the study indicates that RAGT should be considered as an option in neurogenic bladder treatment.

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.

Objectives: To investigate whether a Multimodal Rehabilitation Program (MRP) affects the change in visual–spatial abilities, especially attention, information-processing speed, visual–spatial learning, the severity of depression, and strategies for coping with pain in Complex Regional Pain Syndrome (CRPS) participants. Methods: The study was conducted between October 2021 and February 2023, with a 4-week rehabilitation program that included individual physiotherapy, manual and physical therapy, and psychological intervention such as psychoeducation, relaxation, and Graded Motor Imagery therapy. Twenty participants with CRPS and twenty healthy participants, forming a control group, were enlisted. The study was a 2-arm parallel: a CRPS group with MRP intervention and a healthy control group matched to the CRPS group according to demographic variables. Before and after, the MRP participants in the CRPS group were assessed for visual–spatial learning, attention abilities, severity of depression, and pain-coping strategy. The healthy control group underwent the same assessment without intervention before two measurements. The primary outcome measure was Reproduction on Rey–Osterrieth’s Complex Figure Test assessing visual–spatial learning. Results: In the post-test compared to the pre-test, the participants with CRPS obtained a significantly high score in visual–spatial learning (p < 0.01) and visual information-processing speed (p = 0.01). They made significantly fewer omission mistakes in visual working memory (p = 0.01). After the MRP compared to the pre-test, the CRPS participants indicated a decrease in the severity of depression (p =0.04) and used a task-oriented strategy for coping with pain more often than before the rehabilitation program (p = 0.02). Conclusions: After a 4-week MRP, the following outcomes were obtained: an increase in visual–spatial learning, visual information-processing speed, a decrease in severity of depression, and a change in the pain-coping strategies—which became more adaptive.

Spinal cord injuries (SCI) are associated with a range of sexual dysfunctions (SD). This study analyzes the prevalence and severity of SD 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 patients in the subacute phase of SCI. A total of 110 patients with SCI were enrolled in the study. Analyses of primary SD 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. Among participants, 87.65% of men and 83.35% of women reported at least one primary SD. 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). The majority of participants exhibited at least one primary. 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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Yes ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the District Medical Chamber in Szczecin (Poland) (Nr OIL-Sz/MF/KB/452/05/07/2018 Nr OIL-SZ/MF/KB/450/UKP/10/2018). The study was not preregistered before commencement. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable All relevant data are within the manuscript and its Supporting Information files.

PURPOSE: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. METHODS: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. RESULTS: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. CONCLUSION: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.

Complex regional pain syndrome (CRPS) is a disabling pain condition, which is distinct from other pain syndromes by the presence of autonomic dysfunction and regional inflammatory changes. Objectives: To explore the impact of pharmacological treatment strategies, specifically scheduled, on-demand dosing regimens versus lack of medical treatment, on pain-related and functional outcomes in rehabilitation for individuals with CRPS. Methods: A total of 32 participants with CRPS were assigned to three treatment groups depending on analgesic treatment during the course of complex rehabilitation. Pre- and post-rehabilitation assessments were conducted using validated measures, including the Numerical Rating Scale (NRS) for pain, the Short-Form McGill Pain Questionnaire (SF-MPQ), PainDETECT, the Disabilities of the Arm, Shoulder, and Hand (DASH), and the Lower Extremity Functional Scale (LEFS). Results: Significant improvements in pain and upper limb function (DASH scores) were observed across all groups (p < 0.05). No statistically significant changes were found in lower limb function (LEFS). Between-group comparisons revealed significant differences in post-treatment pain scores (SFMPQ-B), particularly between groups with a constant treatment regimen and those without treatment. Conclusions: There were no statistically significant changes compared to different treatment regimen groups. The constant treatment group showed slightly better average improvements in pain and disability compared to other groups. Statistically significant improvements in all CRPS patients were observed in pain-related and functional measures.

Complex regional pain syndrome (CRPS) is an idiopathic, highly debilitating chronic disorder with persistent regional pain accompanied by a combination of sensory, motor, and autonomic abnormalities. It is not only difficult to treat but also difficult to study. This scoping review aimed to identify the key clinical and molecular challenges encountered in CRPS research and to examine the assessment tools currently employed. A comprehensive search was conducted across PubMed/Medline, Science Direct, Scopus, Wiley Online Library, and Google Scholar using a combination of free text and MeSH terms related to CRPS, clinical and molecular aspects, neuroinflammation, biomarkers, and research challenges. We analyzed 55 original clinical research papers on CRPS and 17 studies of immunological/biochemical/molecular aspects of CRPS. A significant degree of heterogeneity was observed in the methodologies employed across the reviewed studies. The most frequently reported challenges included difficulties in participant recruitment and controlling confounding factors (reported in 62% of studies), such as the heterogeneity of the patient population, the influence of pain coping strategies and psychological factors, and the impact of sociocultural factors (reported in 62% of studies). Research into diagnostic and prognostic markers for CRPS also faces numerous challenges. Recruiting participants is difficult due to the rarity of the condition, resulting in small sample sizes for studies. In vitro models often fail to replicate the complexity of in vivo inflammation, limiting their applicability. Findings from early CRPS stages may not generalize to chronic CRPS because of differing pathophysiological mechanisms and symptom profiles. Additional obstacles include the disorder’s heterogeneity, difficulties in controlling confounding factors, variability in treatment approaches, and the lack of standardized tools and baseline comparisons. These issues hinder the development of reliable biomarkers and evidence-based treatments. Due to these difficulties, the exact cause of CRPS is still not fully understood, making it difficult to develop effective, specific treatments and conduct targeted research.

Background: The aim of the present study was to analyse the association between neuroticism (one of the Big Five personality traits) and the most common secondary sensorimotor complications occurring in patients after spinal cord injury (SCI), i.e., muscle spasticity (hypertonia) and pain, and to investigate the associations between neuroticism and the effects of conventional rehabilitation (dynamic parapodium) and those using robotic-assisted gait training (RAGT) in this group of patients. In addition, the association of neuroticism with self-efficacy, personal beliefs about pain control, and adopted coping strategies among SCI patients was analysed. These data can be used as a reference for designing effective forms of therapy and support dedicated to this group of patients. Methods and procedures: Quantitative analysis included 110 patients after SCI. The participants were divided by simple randomisation into a rehabilitation group with RAGT and a rehabilitation group with dynamic parapodium therapy (DPT). The following survey instruments were used for data collection: Revised NEO Personality Inventory (NEO-PI-R); Ashworth Scale; the Spinal Cord Independence Measure III (SCIM III); the Walking Index for Spinal Cord Injury II (WISCI-II); the American Spinal Injury Association Impairment Scale (AIS); the Pain Coping Strategies Questionnaire—CSQ; and the Beliefs about Pain Control Questionnaire—BPCQ. Outcomes and results: analyses showed a positive association between neuroticism and spastic tension (rho = 0.39; p < 0.001). Conclusions and implications: the study showed that a high level of neuroticism correlates with a higher level of spasticity, but no such correlation was observed for pain. Additionally, the study did not show a significant correlation between neuroticism and rehabilitation outcome depending on the rehabilitation modality (RAGT vs. DPT). The results underline the importance of carrying out a psychological diagnosis of patients to provide therapeutic support in the rehabilitation process.

Ischemic stroke is one of the leading causes of death and disability. As the currently used neurorehabilitation methods present several limitations, the ongoing research focuses on the use of non-invasive brain stimulation (NIBS) techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). NIBS methods were demonstrated to modulate neural excitability and improve motor and cognitive functioning in neurodegenerative diseases. However, their mechanisms of action are not fully elucidated, and the clinical outcomes are often unpredictable. This review explores the molecular processes underlying the effects of TMS and tDCS in stroke rehabilitation, including oxidative stress reduction, cell death, stimulation of neurogenesis, and neuroprotective phenotypes of glial cells. A highlight is put on the newly emerging therapeutic targets, such as ferroptotic and pyroptotic pathways. In addition, the issue of interindividual variability is discussed, and the role of neuroimaging techniques is investigated to get closer to personalized medicine. Furthermore, translational challenges of NIBS techniques are analyzed, and limitations of current clinical trials are investigated. The paper concludes with suggestions for further neurorehabilitation stroke treatment, putting the focus on combination and personalized therapies, as well as novel protocols of brain stimulation techniques.

INTRODUCTION:Ankylosing spondylitis is chronic progressive disease, which decrease functions of musculoskeletal system including chest area. Those changes influences respiratory mechanics, worsen conditions of proper ventilation of lungs. OBJECTIVES:Rating of functional and respiratory parameters and dependence between them at patients with ankylosing spondylitis. MATERIALS & METHODS:The study included 45 patients with diagnosed ankylosing spondylitis. Chest and upper limbs mobility, resting spinal curvature alignment were assessed, and respiratory parameters were measured in a plethysmographic chamber JAGGER MasterScreen Body. RESULTS:Ankylosing spondylitis patients had lower respiratory parameters especially sReff, and FRC. Restriction of chest and upper limbs mobility was also demonstrated. Forward head extension was observed based on the occipital wall test. Correlations between functional parameters and correlations between functional and respiratory parameters were shown, in particular MIP, MEP, sReff, Rtot, TLC, ERV. CONCLUSIONS:The study confirmed a decrease in functional and respiratory parameters in the examined patients with ankylosing spondylitis compared to the applicable standards. A significant relationship was found between functional parameters in the upper body and respiratory parameters, which worsen with increasing thoracic dysfunction. The obtained results indicate the directions of therapy that should be taken into account to improve respiratory parameters and reduce respiratory dysfunction in these patients. Chest-focused physiotherapy appears to be an important element in improving function in patients with ankylosing spondylitis.

Regaining greater independence in performing daily activities constitutes a priority for people with tetraplegia following spinal cord injury (SCI). The highest expectations are connected with the improvement of hand function. Therefore, it is so important for the clinician to identify reliable and commonly applicable prognostic factors for functional improvement. The aim of this study was to conduct an analysis to assess the impact of initial functional factors on the clinical improvement in patients during early neurological rehabilitation (ENR). This study assessed 38 patients with complete SCI aged 17–78 who underwent ENR in 2012–2022. The analysis included the motor score from the AIS (MS), the Barthel Index (BI) and the SCIM scale values at the beginning of the ENR program and after its completion. During ENR, patients achieved a statistically significant improvement in MS, BI and SCIM. The initial MS and the level of neurological injury constituted the predictors of functional improvement during ENR. Significant statistical relationships were observed primarily in the correlations between the initial MS and BI, and the increase in the analyzed functional scales of SCI patients. Higher initial MS may increase the chances of a greater and faster functional improvement during ENR.

A disease associated with malfunction of the MYH3 gene is characterised by scoliosis, contractures of the V fingers, knees and elbows, dysplasia of the calf muscles, foot deformity and limb length asymmetry. The aim of this study was to identify the cause of musculoskeletal deformities in a three-generation Polish family by exome sequencing. The segregation of the newly described c.866A>C variant of the MYH3 gene in the family indicates an autosomal dominant model of inheritance. The detected MYH3 variant segregates the disease within the family. The presented results expand the MYH3 disease spectrum and emphasize the clinical diagnostic challenge in syndromes harbouring congenital spine defects and joint contractures.

Introduction and Objective. The Rehabilitation Definition for Research Purposes (RDRP), published in 2022 by Cochrane Rehabilitation, addresses discrepancies resulting from the multiplicity and heterogeneity of rehabilitation definitions hitherto used in the contexts of science, health, and social/legal aspects. The RDRP, based on the paradigm of the International Classification of Functioning, Disability, and Health, provides clear-cut criteria for what rehabilitation includes and excludes. The final version of the RDRP achieved broad agreement among global stakeholders. Materials and Method. The translation methodology satisfied recommendations established by the Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists. The translating group was composed of representatives of all professions constituting the rehabilitation team reflecting the specifics of the practice of rehabilitation, persons with disability, and linguist professionals. Results. The article presents the Polish version of the RDRP, established through consensus among a broad representation of professions involved in rehabilitation and end users of rehabilitation. Conclusions. RDRP may aid 1) researchers carrying original research and compiling original reports, by helping them to correctly define rehabilitation interventions; 2) authors of review papers, by providing clear-cut criteria for papers being considered for inclusion as concerned with rehabilitation; 3) those responsible for developing rehabilitation programmes in health care; 4) clinicians, in making decisions related to prevention, diagnosis and treatment.

Wilson’s disease (WD) is inherited in an autosomal recessive manner and is caused by pathogenic variants of the ATP7B gene, which are responsible for impaired copper transport in the cell, inhibition of copper binding to apoceruloplasmin, and biliary excretion. This leads to the accumulation of copper in the tissues. Copper accumulation in the CNS leads to the neurological and psychiatric symptoms of WD. Abnormalities of copper metabolism in WD are associated with impaired iron metabolism. Both of these elements are redox active and may contribute to neuropathology. It has long been assumed that among parenchymal cells, astrocytes have the greatest impact on copper and iron homeostasis in the brain. Capillary endothelial cells are separated from the neuropil by astrocyte terminal legs, putting astrocytes in an ideal position to regulate the transport of iron and copper to other brain cells and protect them if metals breach the blood–brain barrier. Astrocytes are responsible for, among other things, maintaining extracellular ion homeostasis, modulating synaptic transmission and plasticity, obtaining metabolites, and protecting the brain against oxidative stress and toxins. However, excess copper and/or iron causes an increase in the number of astrocytes and their morphological changes observed in neuropathological studies, as well as a loss of the copper/iron storage function leading to macromolecule peroxidation and neuronal loss through apoptosis, autophagy, or cuproptosis/ferroptosis. The molecular mechanisms explaining the possible role of glia in copper- and iron-induced neurodegeneration in WD are largely understood from studies of neuropathology in Parkinson’s disease and Alzheimer’s disease. Understanding the mechanisms of glial involvement in neuroprotection/neurotoxicity is important for explaining the pathomechanisms of neuronal death in WD and, in the future, perhaps for developing more effective diagnostic/treatment methods.

Introduction and Objective. Surface electromyography (sEMG) measurements are a valid method for sublesional muscle activity following spinal cord injury (SCI). In the literature there are few reports evaluating the effect of robotic assisted gait training (RAGT) on the sEMG properties change in SCI patients. The aim of this study was to evaluate the influence of RAGT on observed change of sEMG, and in 64 incomplete SCI patients in the sub-acute stage in relation to functional scales. Materials and Method. In the presented single-centre single arm, single-blinded study, the patients were divided into two groups: experimental group with RAGT (exoskeleton EKSO-GT or Locomat-Pro) and the control group with dynamic parapodium training (DPT). The therapy was conducted in two cycles of three weeks for six days a week, with a seven day break between cycles. Obtained measurements were averaged peak muscle amplitude (AMA) in sEMG and maximal torque (MT) on Luna apparatus (muscle strength testing) and functional scales. Results. Statistically significant differences between S0 and S1 were only observed for the change in MT values at the knee joint during extension, and positively correlated with American Spinal Injury Association Impairment Scale, lower limb motor score, and functional scales. A statistically increased value of the Walking Index for Spinal Cord Injury (WISCI-II) and motor score after rehabilitation relative to the initial value, was seen after RAGT in comparison to patients with DPT, but AMA did not differ between patients. Conclusions. sEMG did not provide sufficient information about SCI outcome after RAGT rehabilitation.