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New Approaches in Invasive and Non-Invasive Rehabilitation: From Basic Science...
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New Approaches in Invasive and Non-Invasive Rehabilitation: From Basic Science to Clinical Intervention—Second Edition

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 10 March 2027 | Viewed by 4400

Special Issue Editors

Dr. Jacobo Rodríguez-Sanz

E-Mail Website
Guest Editor
Department of Medicine, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain
Interests: ultrasound; invasive physiotherapy; neuromodulation; percutaneous electrolysis; dry needling; anatomy
Special Issues, Collections and Topics in MDPI journals
Dr. Carlos López-de-Celis

E-Mail Website
Guest Editor
Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, 08017 Sant Cugat del Vallès, Spain
Interests: ultrasonography; physiotherapy; rehabilitation; physical therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to invite you to contribute to this Special Issue entitled "New Approaches in Invasive and Non-Invasive Rehabilitation: From Basic Science to Clinical Intervention—Second Edition". This Special Issue seeks to address the growing interest in innovative strategies within the field of rehabilitation and will cover both invasive and non-invasive techniques.

Recent years have witnessed a remarkable evolution in therapeutic approaches aimed at restoring function and enhancing tissue healing which has been driven by advances in basic science, imaging technology, and evidence-based clinical practice. From percutaneous interventions and electrotherapies to manual therapy and exercise-based programs, the integration of minimally invasive strategies has transformed the rehabilitation landscape.

This area of research is especially relevant in the context of musculoskeletal, neurological, and post-surgical rehabilitation, where early and effective interventions can significantly improve patient outcomes. By bridging the gap between laboratory findings and clinical applications, this Special Issue aims to stimulate a multidisciplinary dialogue and promote the development of effective, targeted, and patient-centered therapies.

This Special Issue aims to explore and disseminate novel and emerging approaches within invasive and non-invasive rehabilitation, with a special focus on translating findings from basic science into clinical practice. The goal is to enhance our understanding and the effectiveness of therapeutic strategies that support functional recovery, pain reduction, and tissue regeneration.

The subject of this Special Issue is fully aligned with the scope of this journal, as it includes the advancement of healthcare through innovative clinical research, translational studies, and novel therapeutic applications. By combining experimental, mechanistic, and clinical perspectives, this Special Issue will appeal to a broad readership including physiotherapists, physicians, researchers, and healthcare professionals involved in rehabilitation science.

We particularly encourage contributions that integrate biological mechanisms with clinical efficacy, bridging laboratory studies with patient-oriented care.

Original research articles and comprehensive reviews are welcome in this Special Issue. Submissions may address, but are not limited to, the following themes:

  • Ultrasound-guided interventions in rehabilitation.
  • Invasive techniques such as dry needling, percutaneous electrolysis, or neuromodulation.
  • Manual therapy approaches and their clinical outcomes.
  • Exercise-based interventions for musculoskeletal or neurological recovery.
  • The integration of basic science into clinical rehabilitation protocols.
  • Minimally invasive surgical techniques and their rehabilitation implications.
  • Imaging and biomechanical analysis in therapeutic monitoring.
  • Translational models in clinical regenerative rehabilitation.

We look forward to receiving your contributions.

Dr. Jacobo Rodríguez-Sanz
Dr. Carlos López-de-Celis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ultrasound
  • invasive techniques
  • manual therapy
  • exercise
  • minimally invasive surgery

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Related Special Issue

Published Papers (4 papers)

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Research

20 pages, 932 KB  
Article
Associations Between Active Myofascial Trigger Points, Electromyographic Activity and Kinesiophobia in Chronic Non-Specific Neck Pain
by Julián Müller-Thyssen-Uriarte, María Orosia Lucha-López, César Hidalgo-García, Rocío Sánchez-Rodríguez, Lucía Vicente-Pina, Loreto Ferrández-Laliena, Sofía Monti-Ballano, Pierre Vauchelles-Barré and José Miguel Tricás-Moreno
Healthcare 2026, 14(10), 1427; https://doi.org/10.3390/healthcare14101427 - 21 May 2026
Viewed by 158
Abstract
Introduction: Chronic non-specific neck pain (CNSNP) is a prevalent condition where active myofascial trigger points (A-MTrPs) are commonly detected in cervical muscles and may be associated with altered electromyographic activity (EMGact). However, their association with EMGact during functional tasks remains unclear. Objectives [...] Read more.
Introduction: Chronic non-specific neck pain (CNSNP) is a prevalent condition where active myofascial trigger points (A-MTrPs) are commonly detected in cervical muscles and may be associated with altered electromyographic activity (EMGact). However, their association with EMGact during functional tasks remains unclear. Objectives: This study aimed to explore this relationship, hypothesizing that A-MTrPs in cervical muscles would be associated with altered EMGact. Methods: An analytical cross-sectional exploratory study was conducted in 52 patients with CNSNP. Surface EMGact of the sternocleidomastoid (SCM), anterior scalene (AS), and upper trapezius (UT) muscles was recorded during the craniocervical flexion test (CCFT) and an isometric shoulder abduction task (ABD-90). Linear mixed-effects models were constructed to identify factors associated with EMGact. Age, pain intensity, pain duration, analgesic dose, anti-inflammatory dose, and kinesiophobia score were included as covariates, while gender, physical activity level, and the presence or absence of A-MTrPs were included as categorical factors. Results: At the 22 mmHg CCFT level, analgesic consumption was positively associated with peak EMGact and average AS activation (B = 0.791 and B = 0.223, respectively) and with SCM peak EMG act (B = 0.510). At the same level, kinesiophobia was associated with average SCM EMGact (B = 0.231). At the 26 mmHg CCFT level, average AS activation remained positively associated with analgesic consumption (B = 0.148) and SCM without A-MTrPs was associated with lower EMGact compared to SCM with A-MTrPs. At the 30 mmHg CCFT level, kinesiophobia was negatively associated with average EMGact of AS. In the UT muscle, during ABD-90, kinesiophobia was negatively associated with both peak (B = −0.378) and average EMGact (B = −0.132). Conclusions: The presence of A-MTrPs may be related to SCM EMGact during CCFT in individuals with CNSNP, while analgesic consumption and kinesiophobia also could be associated with cervical muscles EMGact during functional tasks. Full article
(This article belongs to the Special Issue New Approaches in Invasive and Non-Invasive Rehabilitation: From Basic Science to Clinical Intervention—Second Edition)
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14 pages, 4334 KB  
Article
Influence of Time, Intensity, and Total Dose Parameters on the Ultrasound Effects of Percutaneous Electrolysis: An In Vitro Experimental Study
by Miguel Malo-Urriés, Jacobo Rodríguez-Sanz, Sergio Borrella-Andrés, Isabel Albarova-Corral, Erik Garcia-Ribell, José Antonio Gaitán-Villena and Carlos López-de-Celis
Healthcare 2026, 14(4), 516; https://doi.org/10.3390/healthcare14040516 - 18 Feb 2026
Viewed by 671
Abstract
Objective: This study aimed to quantitatively analyze the influence of time, intensity, and total dose parameters on the electrolytic effect induced by percutaneous electrolysis on cadaveric patellar tendons and to determine the relationship between these parameters and the ultrasound-based quantitative response using [...] Read more.
Objective: This study aimed to quantitatively analyze the influence of time, intensity, and total dose parameters on the electrolytic effect induced by percutaneous electrolysis on cadaveric patellar tendons and to determine the relationship between these parameters and the ultrasound-based quantitative response using the UZ_eDose tool. Methods: An in vitro experimental study was conducted on cadaveric patellar tendons. A total of 45 unique combinations of percutaneous electrolysis were applied, corresponding to 15 different application times (0 to 1200 s) and three intensities of galvanic current (0.1 mA, 1 mA, and 3 mA). The electrolytic effect was quantified immediately after each application using UZ_eDose. Additionally, ultrasound visibility was recorded as a binary variable (visible or non-visible). Descriptive graphical analysis, Spearman and point-biserial correlation tests, and multiple linear regression models were conducted to explore relationships between parameters and outcomes. Results: The intensity of current showed the strongest positive correlation with the UZ_eDose values (ρ = 0.606, p < 0.001), particularly when considering only cases with maintained ultrasound visibility. The total dose was also positively correlated with UZ_eDose (ρ = 0.486, p = 0.001), whereas time alone showed no significant correlation. Loss of ultrasound visibility was significantly associated with longer application times, higher intensities, and greater total doses (p < 0.001). Multiple linear regression models confirmed the predominant role of intensity in predicting the electrolytic effect, explaining up to 62.7% of the variance when excluding non-visible cases. Conclusions: The electrolytic effect, as quantified by UZ_eDose, is primarily influenced by the intensity of the current and the cumulative dose applied. However, excessive intensities and durations can lead to gas saturation, compromising ultrasound visibility. These findings suggest that both intensity and time should be carefully balanced to maximize the therapeutic effect while preserving imaging control, supporting the use of ultrasound-based quantification tools for optimized, individualized dosimetry. Full article
(This article belongs to the Special Issue New Approaches in Invasive and Non-Invasive Rehabilitation: From Basic Science to Clinical Intervention—Second Edition)
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11 pages, 660 KB  
Article
Recovery Time of Electrical Sensory, Motor, and Pain Thresholds: A Pilot Study Towards Standardization of Quantitative Sensory Testing in Healthy Population
by Izarbe Ríos-Asín, Miguel Malo-Urriés, Jorge Pérez-Rey, Marta García-Díez, Lucía Burgos-Garlito and Elena Bueno-Gracia
Healthcare 2025, 13(19), 2492; https://doi.org/10.3390/healthcare13192492 - 1 Oct 2025
Cited by 2 | Viewed by 1469
Abstract
Background/Objectives: Electrical threshold testing (ETT) offers a promising method for assessing somatosensory function. Despite its growing use, fundamental aspects such as the physiological recovery time required between repeated threshold measurements remain poorly understood. This gap is critical when evaluating sensory, motor, or pain [...] Read more.
Background/Objectives: Electrical threshold testing (ETT) offers a promising method for assessing somatosensory function. Despite its growing use, fundamental aspects such as the physiological recovery time required between repeated threshold measurements remain poorly understood. This gap is critical when evaluating sensory, motor, or pain thresholds (EST, EMT, EPT) in pre–post designs or rapid intra-session protocols. The aim is to investigate the short-term recovery dynamics of electrical thresholds following electrical threshold testing, and to determine the minimum interval required for values to return to a stable baseline. Methods: In this pilot, repeated-measures study, 10 healthy adults (20 upper limbs) underwent three progressive stimulation trials (sensory, motor, and pain). Electrical thresholds were assessed at fixed recovery intervals (0–120 s), with duplicate measurements at each time point. Stability was defined as the absence of significant differences between repeated measures. Results: EST stabilized rapidly after sensory or motor stimulation, showing no significant differences beyond 0 and 15 s, respectively. Within pain stimulation, EST recovered at 60 s. EMT showed immediate recovery with motor stimulation and required longer recovery with pain stimulation, with stabilization observed at 90 s. EPT exhibited the highest variability, with the smallest time-dependent differences observed immediately after the first assessment. Conclusion: Recovery time after electrical stimulation varies by threshold type and intensity of the stimuli. EST and EMT can be reliably reassessed immediately after sensory and motor stimulation, respectively. However, when stimulation reaches EPT level, EST requires 60 s to recover and EMT needs 90 s. EPT demonstrates higher variability, indicating the need for further investigation. These findings support the implementation of standardized recovery intervals in ETT and underscore the importance of interpreting EPT results with caution during rapid assessments. Full article
(This article belongs to the Special Issue New Approaches in Invasive and Non-Invasive Rehabilitation: From Basic Science to Clinical Intervention—Second Edition)
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20 pages, 1273 KB  
Article
Safety and Anatomical Accuracy of Dry Needling of the Quadratus Femoris Muscle: A Cadaveric Study
by Marta Sánchez-Montoya, Jaime Almazán-Polo, Néstor Vallecillo Hernández, Charles Cotteret, Fabien Guerineau, Domingo de Guzman Monreal-Redondo and Ángel González-de-la-Flor
Healthcare 2025, 13(15), 1828; https://doi.org/10.3390/healthcare13151828 - 26 Jul 2025
Cited by 1 | Viewed by 1534
Abstract
Introduction: Deep dry needling (DDN) is commonly applied in physiotherapy to treat musculoskeletal pain. The quadratus femoris (QF) muscle, located in the ischiofemoral space (IFS), represents a clinically relevant yet anatomically complex target. However, limited evidence exists on the safety, accuracy, and reliability [...] Read more.
Introduction: Deep dry needling (DDN) is commonly applied in physiotherapy to treat musculoskeletal pain. The quadratus femoris (QF) muscle, located in the ischiofemoral space (IFS), represents a clinically relevant yet anatomically complex target. However, limited evidence exists on the safety, accuracy, and reliability of non-ultrasound-guided DDN in this region. Aims: To assess the safety and accuracy of a standardized, non-ultrasound-guided DDN approach to the QF muscle, and to evaluate the intra- and inter-rater reliability of key procedural outcomes. Additionally, to determine the agreement between ultrasound imaging and anatomical dissection as validation methods for needle placement. Methods: An experimental cross-sectional study was conducted on five fresh cadavers (n = 24 approaches) by two physiotherapists with different DN experience. A standardized dry needling protocol was executed without ultrasound guidance, and anatomical and procedural variables were documented. Reliability (intra/inter-rater) was assessed for needle size, sciatic nerve (SN) puncture, IFS targeting, and overall success. In a subset, needle placement was validated through ultrasound and subsequent dissection. Results: The IFS was reached in 70.8% of procedures, and the SN was punctured in 16.7%. Inter-rater reliability for needle size was poor (κ = 0.04). Agreement between ultrasound and dissection was excellent for the ischiofemoral location and success (100%) and moderate for non SN puncture (90%; κ = 0.62). Conclusions: The standardized protocol demonstrated moderate accuracy and revealed a relevant clinical risk when targeting the quadratus femoris muscle. While inter-rater reliability was limited, agreement between ultrasound and dissection methods was high, supporting their complementary use for validating needle placement in anatomically complex procedures. Full article
(This article belongs to the Special Issue New Approaches in Invasive and Non-Invasive Rehabilitation: From Basic Science to Clinical Intervention—Second Edition)
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