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Advances in Musculoskeletal Physiotherapy

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A special issue of Journal of Functional Morphology and Kinesiology (ISSN 2411-5142). This special issue belongs to the section "Functional Anatomy and Musculoskeletal System".

Deadline for manuscript submissions: closed (30 December 2023) | Viewed by 27862

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Dr. Žiga Kozinc

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Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
Interests: physical therapy; musculoskeletal injuries; injury mechanisms; kinesiology; assessment in sport; assessment in physical therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The purpose of this Special Issue is to collect contributions reporting important milestones in the field of musculoskeletal physiotherapy. Contributions should present the latest developments, innovative approaches, and research findings in the field of musculoskeletal rehabilitation. Insights into the assessment, diagnosis, mechanisms, risk factors, treatment, and management of musculoskeletal conditions are welcome. Papers reporting on emerging trends in the field, such as the integration of multimodal interventions, virtual reality, telemedicine, and digital platforms in musculoskeletal care, which offer valuable insights into their effectiveness, feasibility, and patient acceptance, are particularly welcome.

It is our hope that this Special Issue will serve as a resource to physical therapists, researchers, and healthcare professionals, providing evidence-based knowledge and practical strategies to improve musculoskeletal rehabilitation outcomes. Contributors may cover a wide range of musculoskeletal conditions, from chronic pain syndromes to acute sports injuries. This Special Issue welcomes original research articles, systematic reviews, and clinical case studies with the goal of providing a diverse and multidimensional perspective on musculoskeletal physical therapy. We believe that this collection of articles will reflect the current state of the field and pave the way for future advances in musculoskeletal physical therapy, with the goal of improving rehabilitation outcomes and quality of life for people with musculoskeletal conditions.

Dr. Žiga Kozinc
Guest Editor

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 100 words) can be sent to the Editorial Office for announcement on this website.

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. Journal of Functional Morphology and Kinesiology is an international peer-reviewed open access quarterly 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 1600 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

muscle injury
tendon injury
ligament injury
bone injury
musculoskeletal rehabilitation
sports medicine
movement therapy
physical therapy

Published Papers (11 papers)

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11 pages, 999 KiB

Open AccessArticle

Does Radial Extracorporeal Shockwave Therapy Applied to the Achilles Tendon Influence Ankle Functionality?

by Younglan Joo, Wonjae Choi, Jihye Jung, Hyunjoong Kim, Sungeon Park, Sangbong Lee and Seungwon Lee

J. Funct. Morphol. Kinesiol. 2024, 9(2), 67; https://doi.org/10.3390/jfmk9020067 - 08 Apr 2024

Viewed by 700

Abstract

This study aimed to determine the effectiveness of radial extracorporeal shockwave therapy (rESWT) in enhancing ankle function in patients with Achilles tendon injuries. The choice of rESWT was based on previous success in the treatment of musculoskeletal conditions. The study involved an intervention group that received rESWT, and a control group that received sham therapy. The results revealed that rESWT led to significant improvements in single-leg vertical jump (d = 0.55, p < 0.05), indicating enhanced power generation and ankle functionality that were not observed in the control group. Additionally, the therapy resulted in increased ankle mobility, as observed by improvements in plantar flexion and heel-rise tests. Interestingly, these functional gains were not accompanied by changes in the Achilles tendon stiffness, suggesting that the benefits of rESWT may be more functional than structural. This study highlights rESWT as a promising tool for rehabilitation, particularly following Achilles tendon injuries. The study concluded that, although rESWT appears to improve certain aspects of ankle function, further studies with a larger and more diverse population over a longer period are necessary to confirm these findings and establish comprehensive treatment protocols. Full article

(This article belongs to the Special Issue Advances in Musculoskeletal Physiotherapy)

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14 pages, 1586 KiB

Open AccessArticle

Exploring 3D Pelvis Orientation: A Cross-Sectional Study in Athletes Engaged in Activities with and without Impact Loading and Non-Athletes

by Georgios Glakousakis, Perikles Kalatzis and Dimitris Mandalidis

J. Funct. Morphol. Kinesiol. 2024, 9(1), 19; https://doi.org/10.3390/jfmk9010019 - 04 Jan 2024

Viewed by 1536

Abstract

Female athletes subjected to various types of impact loading, especially over a long period of time, may experience changes in their pelvic orientation, which may affect their sport performance and increase the likelihood of injury. The aim of the present study was to determine whether female athletes involved in high-impact loading sports (HILS), odd-impact loading sports (OILS), and repetitive non-impact loading sports (NILS) demonstrate changes in pelvis orientation compared to non-athletes (NATH). Pelvic orientation was determined using Euler/Cardan angles, calculated from the coordinates of the right, and left anterior superior iliac spines and pubic symphysis via a novel method. Two-way ANOVA tests showed significant differences between groups for pelvis position in the frontal plane (p < 0.05), with HILS and OILS demonstrating greater pelvic obliquity compared to NILS athletes and NATH. Significant main effects were also obtained for directions within the sagittal plane (p < 0.001). Significant within-group differences were observed in sagittal pelvic position among female athletes engaged in NILS (p < 0.01) and non-athletes (NATH) (p < 0.05), with a greater anterior pelvic tilt compared to posterior. Our findings suggest that pelvis orientation in female athletes across sports is influenced by sport-specific impact loads, potentially affecting performance and injury occurrence. Full article

(This article belongs to the Special Issue Advances in Musculoskeletal Physiotherapy)

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32 pages, 5836 KiB

Open AccessArticle

Āsana for Back, Hips and Legs to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yóga Protocol

by Maria Giovanna Gandolfi, Fausto Zamparini, Andrea Spinelli and Carlo Prati

J. Funct. Morphol. Kinesiol. 2024, 9(1), 6; https://doi.org/10.3390/jfmk9010006 - 22 Dec 2023

Cited by 2 | Viewed by 2287

Abstract

Dental professionals are exposed to significant unavoidable physical stress, and theoretical ergonomic recommendations for a sitting workplace are inapplicable in many dental activities. Work-related musculoskeletal disorders (WMSDs) represent a serious health problem among dental professionals (prevalence: 64–93%), showing involvement of 34–60% for the low back and 15–25% for the hips. Muscle stress; prolonged sitting; forward bending and twisting of the torso and head; unbalanced working postures with asymmetrical weight on the hips and uneven shoulders; and others are inevitable for dental professionals. Therefore, the approach for the prevention and treatment of WMSDs must be therapeutic and compensatory. This project was conceived to provide a Yoga protocol for dental professionals to prevent or treat WMSDs from a preventive medicine perspective, and it would represent a Yoga-based guideline for the self-cure and prevention of musculoskeletal problems. Methods: Specific Yoga positions (āsana, such as Virāsana, Virabhadrāsana, Garudāsana, Utkatāsana, Trikonāsana, Anuvittāsana, Chakrāsana, Uttanāsana, Pashimottanāsana) have been selected, elaborated on and adapted to be practiced in a dental office using a dental stool or the dental office walls or a dental unit chair. The protocol is specifically devised for dental professionals (dentists, dental hygienists and dental assistants) and targeted for the low back, hips and legs (including knees and ankles). The protocol includes Visranta Karaka Sthiti (supported positions) in sitting (Upavistha Sthiti) and standing (Utthistha Sthiti) positions, twisting/torsions (Parivrtta), flexions/forward bend positions (Pashima) and extensions/arching (Purva) for musculo-articular system decompression and mobilization. Results: Over 60 Yogāsana—specifically ideated for back detensioning and mobilization, lumbar lordosis restoration, trunk side elongation, hip release and leg stretches and decontraction—are shown and described. The paper provides a meticulous description for each position, including the detailed movement, recommendations and mistakes to avoid, and the breathing pattern (breath control) in all the breath-driven movements (āsana in vinyāsa). An exhaustive analysis of posture-related disorders affecting the lower body among dental professionals is reported, including low-back pain, hip pain and disorders, piriformis syndrome and quadratus femoris dysfunction (gluteal pain), iliopsoas syndrome, multifidus disorders, femoroacetabular and ischiofemoral impingement, spinopelvic mobility, lumbopelvic rhythm, impairment syndromes, lower crossed syndrome, leg pain, knee pain and ankle disorders. Conclusions: A detailed guideline of āsana for low-back decompression, hip joint destress, piriformis and gluteal muscle release, lumbar lordosis recovery and a spinopelvic mobility increase has been elaborated on. The designed Yogāsana protocol represents a powerful tool for dental professionals to provide relief to retracted stiff muscles and unbalanced musculoskeletal structures in the lower body. Full article

(This article belongs to the Special Issue Advances in Musculoskeletal Physiotherapy)

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13 pages, 1372 KiB

Open AccessArticle

Association between Fractional Oxygen Extraction from Resting Quadriceps Muscle and Body Composition in Healthy Men

by Rodrigo Yáñez-Sepúlveda, Jorge Olivares-Arancibia, Guillermo Cortés-Roco, Aldo Vasquez-Bonilla, Matías Monsalves-Álvarez, Ildefonso Alvear-Órdenes and Marcelo Tuesta

J. Funct. Morphol. Kinesiol. 2023, 8(4), 149; https://doi.org/10.3390/jfmk8040149 - 26 Oct 2023

Viewed by 1595

Abstract

This study aimed to associate body composition with fractional oxygen extraction at rest in healthy adult men. Fourteen healthy adults (26.93 ± 2.49 years) from Chile participated. Body composition was assessed with octopole bioimpedance, and resting muscle oxygenation was evaluated in the vastus lateralis quadriceps with near-infrared spectroscopy (NIRS) during a vascular occlusion test, analyzing the muscleVO₂, resaturation velocity during reactive hyperemia via the muscle saturation index (%TSI), and the area above the curve of HHb (AACrep). It was observed that the total and segmented fat mass are associated with lower reoxygenation velocities during hyperemia (p = 0.008; β = 0.678: p = 0.002; β = 0.751), and that the total and segmented skeletal muscle mass are associated with higher reoxygenation velocities during hyperemia (p = 0.020; β = −0.614: p = 0.027; β = −0.587). It was also observed that the total and segmented fat mass were associated with a higher area above the curve of HHb (AACrep) during hyperemia (p = 0.007; β = 0.692: p = 0.037; β = 0.564), and that total and segmented skeletal muscle mass was associated with a lower area above the curve of HHb (AACrep) during hyperemia (p = 0.007; β = −0.703: p = 0.017; β = −0.632). We concluded that fat mass is associated with lower resaturation rates and lower resting fractional O₂ extraction levels. In contrast, skeletal muscle mass is associated with higher resaturation rates and fractional O₂ extraction during reactive hyperemia. The AACrep may be relevant in the evaluation of vascular adaptations to exercise and metabolic health. Full article

(This article belongs to the Special Issue Advances in Musculoskeletal Physiotherapy)

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10 pages, 428 KiB

Open AccessArticle

Inertial Sensors and Pressure Pain Threshold to Evaluate People with Primary Adhesive Capsulitis: Comparison with Healthy Controls and Effects of a Physiotherapy Protocol

by Manuela Deodato, Miriam Martini, Alex Buoite Stella, Giulia Citroni, Miloš Ajčević, Agostino Accardo and Luigi Murena

J. Funct. Morphol. Kinesiol. 2023, 8(4), 142; https://doi.org/10.3390/jfmk8040142 - 06 Oct 2023

Viewed by 1264

Abstract

Inertial sensors (IMUs) have been recently widely used in exercise and rehabilitation science as they can provide reliable quantitative measures of range of motion (RoM). Moreover, the pressure pain threshold (PPT) evaluation provides an objective measure of pain sensation in different body areas. The aim of this study was to evaluate the efficacy of physiotherapy treatment in people with adhesive capsulitis in terms of RoM and pain improvement measured by IMUs and the PPT. A combined prospective cohort/cross-sectional study was conducted. Nineteen individuals with adhesive capsulitis (10/19 females, 54 ± 8 years) and nineteen healthy controls (10/19 females, 51 ± 6 years) were evaluated for active glenohumeral joint RoM and PPT on shoulder body areas. Then, individuals with adhesive capsulitis were invited to 20 sessions of a physiotherapy protocol, and the assessments were repeated within 1 week from the last session. The range of motion in the flexion (p = 0.001) and abduction (p < 0.001) of the shoulder increased significantly after the physiotherapy protocol. Similarly, the PPT was found to increase significantly in all the assessed shoulder body areas, leading to no significant differences compared to the healthy controls. IMU and PPT assessments could be used to evaluate the efficacy of physical therapy in people with adhesive capsulitis. Full article

(This article belongs to the Special Issue Advances in Musculoskeletal Physiotherapy)

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18 pages, 1413 KiB

Open AccessArticle

The Effects of Pilates Exercise Training Combined with Walking on Cardiorespiratory Fitness, Functional Capacity, and Disease Activity in Patients with Non-Radiologically Confirmed Axial Spondylitis

by Eleni Zaggelidou, Athina Theodoridou, Vassiliki Michou, Helen Gika, George Panayiotou, Theodoros Dimitroulas and Evangelia Kouidi

J. Funct. Morphol. Kinesiol. 2023, 8(4), 140; https://doi.org/10.3390/jfmk8040140 - 04 Oct 2023

Viewed by 1875

Abstract

The objective of the study was to examine the effects of Pilates exercise training combined with walking on cardiorespiratory fitness, functional capacity, and disease activity in patients with non-radiologically confirmed axial spondylitis (nr-axSpA). Thirty patients with nr-axSpA (seven women (90%), with a mean age of 46.07 ± 10.48 years old and C-reactive protein (CRP) 2.26 ± 2.14 mg/L) were randomly divided into two groups: A (n₁ = 15 patients) and B (n₂ = 15 patients). Group A followed a 6-month home-based Pilates exercise training program, while Group B remained untrained until the end of the study. A cardiopulmonary exercise test (CPET), timed up and go test (TUG), five times sit-to-stand test (5×STS), sit-and-reach test (SR), back scratch test for the right (BSR) and the left arm (BSL), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Ankylosing Spondylitis Disease Activity Score (ASDAS) were applied to all patients, both at the beginning and at the end of the study. After 6 months, Group A showed higher values in exercise time by 37.41% (p = 0.001), higher peak oxygen uptake (VO₂peak) by 25.41% (p = 0.01), a higher ratio between oxygen uptake and maximum heart rate (VO₂/HRmax) by 14.83% (p = 0.04), and higher SR by 18.70% (p = 0.007), while lower values were observed in TUG by 24.32% (p = 0.001), 5×STS by 12.13% (p = 0.001), BASDAI score by 20.00% (p = 0.04) and ASDAS score by 23.41% (p = 0.03), compared to Group B. Furthermore, linear regression analysis showed a positive correlation in Group A between BASDAI and 5×STS (r = 0.584, p = 0.02), BASDAI and TUG (r = 0.538, p = 0.03), and ASDAS and 5×STS (r = 0.538, p = 0.03), while a negative correlation was found between BASDAI and VO₂peak (r = −0.782, p < 0.001), ASDAS and SR (r = −0.548, p = 0.03), and ASDAS and VO₂peak (r = −0.659, p = 0.008). To sum up, cardiorespiratory fitness, functional capacity, and disease activity improved after a long-term Pilates exercise training program in patients with nr-axSpA. Full article

(This article belongs to the Special Issue Advances in Musculoskeletal Physiotherapy)

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Review

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31 pages, 627 KiB

Open AccessReview

Effects of Self-Myofascial Release on Athletes’ Physical Performance: A Systematic Review

by Luis Manuel Martínez-Aranda, Manuel Sanz-Matesanz, Ezequiel David García-Mantilla and Francisco Tomás González-Fernández

J. Funct. Morphol. Kinesiol. 2024, 9(1), 20; https://doi.org/10.3390/jfmk9010020 - 11 Jan 2024

Viewed by 3105

Abstract

Therapists and strength and conditioning specialists use self-myofascial release (SMR) as an intervention tool through foam rollers or massage rollers for soft tissue massage, with the purpose of improving mobility in the muscular fascia. Moreover, the use of SMR by professional and amateur athletes during warm-ups, cool downs, and workouts can have significant effects on their physical performance attributes, such as range of motion (ROM) and strength. The purpose of this study was to analyse the literature pertaining to these types of interventions and their effects found in different physical performance attributes for athletes. A systematic search was carried out using the following databases: PUBMED, ISI Web of Science, ScienceDirect, and Cochrane, including articles up to September 2023. A total of 25 articles with 517 athletes were studied in depth. SMR seems to have acute positive effects on flexibility and range of motion, without affecting muscle performance during maximal strength and power actions, but favouring recovery perception and decreasing delayed-onset muscle soreness. Some positive effects on agility and very short-range high-speed actions were identified, as well. In conclusion, although there is little evidence of its method of application due to the heterogeneity in that regard, according to our findings, SMR could be used as an intervention to improve athletes’ perceptual recovery parameters, in addition to flexibility and range of motion, without negatively affecting muscle performance. Full article

(This article belongs to the Special Issue Advances in Musculoskeletal Physiotherapy)

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13 pages, 758 KiB

Open AccessReview

An Overview of Physical Exercise Program Protocols and Effects on the Physical Function in Multiple Sclerosis: An Umbrella Review

by Martina Sortino, Luca Petrigna, Bruno Trovato, Alessandra Amato, Alessandro Castorina, Velia D’Agata, Grazia Maugeri and Giuseppe Musumeci

J. Funct. Morphol. Kinesiol. 2023, 8(4), 154; https://doi.org/10.3390/jfmk8040154 - 04 Nov 2023

Cited by 1 | Viewed by 1782

Abstract

Multiple sclerosis is a disease that concerns a growing number of people, especially females. There are different interventions proposed for this population, and physical activity is one of them. A proper and well-structured physical activity program can be a cheap, feasible, and practical instrument to help this population improve their quality of life. Consequently, the present study aimed to analyze, through an umbrella review, published articles to evaluate the protocols and the effect of intervention on different types of multiple sclerosis and eventually to propose a standardized intervention for this population. Systematic reviews and meta-analyses of randomized controlled trials on multiple sclerosis and physical activity effects were searched for on the electronic databases PubMed, Web of Science, and Scopus up to 22 December 2022. The quality of the studies included was determined and the results were narratively analyzed. The included studies present heterogeneity in the population, in the study design and protocols, and in the outcomes evaluated. Most of the studies detected positive outcomes on the physical function of people with multiple sclerosis. This study highlights the necessity of future studies on a population with similar characteristics, adopting similar protocols to evaluate their feasibility and validity to make physical intervention prescribed as a medicine. Full article

(This article belongs to the Special Issue Advances in Musculoskeletal Physiotherapy)

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Graphical abstract

20 pages, 1996 KiB

Open AccessReview

The Effects of Massage Guns on Performance and Recovery: A Systematic Review

by Ricardo Maia Ferreira, Rafael Silva, Pedro Vigário, Pedro Nunes Martins, Filipe Casanova, Ricardo Jorge Fernandes and António Rodrigues Sampaio

J. Funct. Morphol. Kinesiol. 2023, 8(3), 138; https://doi.org/10.3390/jfmk8030138 - 18 Sep 2023

Cited by 3 | Viewed by 11670

Abstract

The use of massage guns has become increasingly popular in recent years. Although their use is more and more common, both in a clinical and sports context, there is still little information to guide the practitioners. This systematic review aimed to determine the effects of massage guns in healthy and unhealthy populations as pre- and post-activity or part of a treatment. Data sources used were PubMed, PEDro, Scopus, SPORTDiscus, Web of Science and Google Scholar, and the study eligibility criteria were based on “healthy and unhealthy individuals”, “massage guns”, “pre-activity, post-activity or part of a treatment” and “randomized and non-randomized studies” (P.I.C.O.S.). Initially, 281 records were screened, but only 11 could be included. Ten had a moderate risk of bias and one a high risk of bias. Massage guns could be effective in improving iliopsoas, hamstrings, triceps suralis and the posterior chain muscles’ flexibility. In strength, balance, acceleration, agility and explosive activities, it either did not have improvements or it even showed a decrease in performance. In the recovery-related outcomes, massage guns were shown to be cost-effective instruments for stiffness reduction, range of motion and strength improvements after a fatigue protocol. No differences were found in contraction time, rating of perceived exertion or lactate concentration. Massage guns can help to improve short-term range of motion, flexibility and recovery-related outcomes, but their use in strength, balance, acceleration, agility and explosive activities is not recommended. Full article

(This article belongs to the Special Issue Advances in Musculoskeletal Physiotherapy)

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Other

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16 pages, 1148 KiB

Open AccessCase Report

Short-Term Benefits from Manual Therapy as an Adjunct Treatment for Persistent Postural-Perceptual Dizziness Symptoms: A Preliminary Prospective Case Series

by Brent A. Harper and Larry Steinbeck

J. Funct. Morphol. Kinesiol. 2024, 9(2), 82; https://doi.org/10.3390/jfmk9020082 (registering DOI) - 03 May 2024

Abstract

Persistent dizziness and balance deficits are common, often with unknown etiology. Persistent Postural-Perceptual Dizziness (3PD) is a relatively new diagnosis with symptoms that may include dizziness, unsteadiness, or non-vertiginous dizziness and be persistent the majority of time over a minimum of 90 days. The purpose of this case series was to investigate short-term outcomes of reducing dizziness symptoms using a manual therapy intervention focused on restoring mobility in the fascia using a pragmatically applied biomechanical approach, the Fascial Manipulation^® method (FM^®), in patients with 3PD. The preliminary prospective case series consisted of twelve (n = 12) patients with persistent complaints of dizziness who received systematic application of manual therapy to improve fascial mobility after previously receiving vestibular rehabilitation. The manual therapy consisted of strategic assessment and palpation based on the model proposed in the FM^® Stecco Method. This model utilizes tangential oscillations directed toward the deep fascia at strategic points. Six males (n = 6) and females (n = 6) were included with a mean age of 68.3 ± 19.3 years. The average number of interventions was 4.5 ± 0.5. Nonparametric paired sample t-tests were performed. Significant improvements were observed toward the resolution of symptoms and improved outcomes. The metrics included the Dizziness Handicap Inventory and static and dynamic balance measures. The Dizziness Handicap Inventory scores decreased (i.e., improved) by 43.6 points (z = −3.1 and p = 0.002). The timed up and go scores decreased (i.e., improved) by 3.2 s (z = −2.8 and p = 0.005). The tandem left increased (i.e., improved) by 8.7 s (z = 2.8 and p = 0.005) and the tandem right increased (i.e., improved) by 7.5 s (z = 2.8 and p = 0.005). Four to five manual therapy treatment sessions appear to be effective for short-term improvements in dizziness complaints and balance in those with 3PD. These results should be interpreted with caution as future research using rigorous methods and a control group must be conducted. Full article

(This article belongs to the Special Issue Advances in Musculoskeletal Physiotherapy)

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12 pages, 5784 KiB

Open AccessCase Report

Multimodal Rehabilitation Management of a Misunderstood Parsonage–Turner Syndrome: A Case Report during the COVID-19 Pandemic

by Fabio Santacaterina, Marco Bravi, Mirella Maselli, Federica Bressi, Silvia Sterzi and Sandra Miccinilli

J. Funct. Morphol. Kinesiol. 2024, 9(1), 37; https://doi.org/10.3390/jfmk9010037 - 23 Feb 2024

Viewed by 1261

Abstract

During the second wave of the COVID-19 pandemic, a young adult presented symptoms that were reported at first evaluation to be a frozen shoulder (adhesive capsulitis). The patient’s history, clinical manifestations related to the onset of pain, unilateral weakness, and physical examination led to a physiotherapy referral. Subsequent instrumental investigations showed an idiopathic brachial neuritis known as Parsonage–Turner Syndrome (PTS). Contrary to recent descriptions in the literature, the patient did not experience PTS either after COVID-19 vaccination or after COVID-19 virus infection. The proposed multimodal treatment, considering the patient’s characteristics, led to a recovery of muscle strength and function of the upper limb, observed even three years after the acute event. The frequency of rehabilitation treatment, the choice of exercises, the dosage, and the methods of execution require further studies in order to define an evidence-based treatment. Full article

(This article belongs to the Special Issue Advances in Musculoskeletal Physiotherapy)

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