Zaveckas, Vidmantas

This chapter aims to explore the integration of differentiated learning (DL) into physiotherapy practices in both falls prevention and balance training. It highlights the practical applications and the scientific evidence supporting the effectiveness of this approach in reducing the risk of falls in vulnerable groups. This chapter emphasizes the interaction between theoretical foundations and practical application to provide a comprehensive resource for physiotherapists, researchers, and other health professionals.

Non-specific low back pain (LBP) is a major health concern associated with a sedentary lifestyle. Understanding the multifactorial risk factors is essential for developing effective management and prevention strategies.

Introduction. Despite their fundamental role in volleyball biomechanics and injury prevention, shoulder girdle mobility along with trunk stability remain under-researched areas [1]. Evidence suggests that range of motion and stability tests may help identify early neuromuscular imbalances; however, their use in recreational sports is not yet standardized [2]. Given the physical demands of volleyball, implementing sport-specific, evidence-based assessments and preventive strategies is essential for reducing injury risk and optimizing readiness in non-professional settings [3]. This study aims to assess the mobility and stability of the shoulder girdle and trunk in recreational volleyball players. Research methods and organization. The study was conducted from 1 June to 1 November 2024 at the Sports Medicine Clinic of the Lithuanian University of Health Sciences. Ethical approval was granted by the Lithuanian University of Health Sciences Bioethics Center (No. 2024-BEC2-652). Participants were assessed once to examine relationships between selected variables related to the mobility and stability of both the shoulder girdle and trunk. Inclusion criteria: adults aged 18–44, engaged in regular recreational volleyball training for at least one year, and without acute upper limb sports injuries in the past six months. Exclusion criteria: upper limb pain within the last six months. Thirty recreational volleyball players participated—12 men and 18 women. The average age was 24.83(±4.94) years, height 172.90(±8.63) cm, weight 68.83(±9.86) kg, and volleyball experience 4.37(±2.22) years. Goniometry was used to assess active shoulder range of motion, while a measuring tape and two rulers evaluated scapular position and movement. Inclinometry measured trunk range of motion. The Closed Kinetic Chain Upper Extremity Stability Test assessed upper limb function and scapular stability, and the Simple Shoulder Test questionnaire evaluated the shoulder joint condition. A structured self-administered questionnaire was also used. Statistical analysis was conducted using IBM SPSS 30.0. The Shapiro–Wilk test assessed normality (n<50). Quantitative data meeting normality assumptions are presented as mean (m) and standard deviation (SD) – m(±SD). The Wilcoxon signed-rank test was used for non-normally distributed dependent samples, while the paired sample t-test was used for normally distributed paired data. Cohen’s d was calculated to determine effect size. Statistical significance was set at p < 0.05. Results. A statistically significant difference was found in both internal (Z = –4.801; p < 0.001) and external (Z = –4.846; p < 0.001) shoulder rotation between dominant and non-dominant arms at 90° abduction. Internal rotation was greater and external rotation lower on the dominant side. Total rotational range of motion (TROM) did not differ significantly (Z = –0.902; p = 0.367), suggesting compensation between rotation directions. These results reflect sport-specific adaptations linked to repetitive overhead activity in volleyball. A significant difference was also identified in active lateral trunk flexion between the left and right sides (t(29) = 3.721; p < 0.001). The mean amplitude for leftside flexion was 25.75° (±3.42), while for right-side flexion it was 22.35° (±3.12). The effect size (Cohen’s d = 0.679) indicated a moderate strength of effect. Greater left-side flexion could be attributed to the compensatory activation of contralateral trunk muscles during right-handed spiking actions, which was the dominant side for most participants. In the assessment of trunk stability, 30% of participants exceeded expected values in trunk extension, suggesting strength and control in this direction, consistent with the biomechanical demands of volleyball. However, the highest proportion of participants falling below normative thresholds (16.7%) was observed in trunk flexion, indicating potential muscular weakness or control deficits in this direction. A statistically significant difference in scapular stability between the dominant and non-dominant arm was found (t(29) = –10.682; p < 0.001). The protrusion of the scapula on the dominant side was greater (14.68 ± 0.45 mm) than on the non-dominant side (13.02 ± 0.67 mm), indicating reduced scapular control. The effect size was very large (Cohen’s d = 1.95). Despite expectations that the dominant arm would demonstrate greater strength, this finding highlights potential scapular dysfunction due to overuse and muscular imbalance. Conclusions. The study showed that recreational volleyball players exhibited functional asymmetries between dominant and non-dominant sides: internal rotation was greater and external rotation lower in the dominant arm, scapular protrusion was more pronounced, and lateral trunk flexion was greater to the left. These asymmetries reflect sport-specific loading and underscore the need for balanced training and prevention to reduce dysfunction and overuse injuries in recreational volleyball players.

Įvadas. Lėtinis apatinės nugaros dalies skausmas - tai sudėtingas sveikatos sutrikimas, kuris paveikia milijonus žmonių visame pasaulyje ir yra viena iš pagrindinių negalios bei darbingumo praradimo priežasčių. [...].

Low back pain is one of the most frequent medical problems caused by different factors. It is important to evaluate low back pain by choosing the best suited tool for the specific spine condition and pain severity. The Spine Functional Index (SFI) is a relatively new physical functioning-related questionnaire that can be used to assess different aspects of daily activities and movements. The purpose of this study was to cross-culturally adapt the SFI for the Lithuanian language and to determine its psychometric properties of validity, reliability, construct stability, internal consistency and factor structure.

Background: The relationship between posture and low back pain (LBP) remains controversial. Some studies have demonstrated certain relationship between LBP and posture associated with decreased posterior-pelvic tilt, while others report no correlation. The aim of this study was to evaluate the relationship between LBP, subjective functional status and posture in young office workers. Methods: The inclusion criteria: office workers aged 18 to 45 years; sitting at least 20 hours/week; nonspecific LBP >12 weeks, or no back pain in the last 2 years. Exclusion criteria: identified specific causes of LBP, pregnancy, tattoos, and prostheses. All participants completed a form with the information about their age, health status, work specifics, and filled in the Spine Functional Index (SFI) and Visual Analog Scale (VAS). A static registration of the surface topography of the back was performed using the Diers-4D formetric system. A nonparametric Kruskal–Wallis test was applied for four independent samples. The Pearson criterion was applied to the correlation analysis. Significance level a = .05. Results. We studied 75 subjects, 29 men and 46 women, mean age (SD) - 31.6 years (6.7). Subjects were divided into 4 groups: no LBP (16 subjects); LBP only while moving (29 subjects); LBP only in static position (14 subjects); LBP in both circumstances (16 subjects). We found no statistically significant differences between 4 groups in any of posture evaluation parameters. There were no statistically significant correlations between any parameters of the posture and the SFI, VAS Results or age. We found 2 moderate strength relationships between duration of LBP and coronal imbalance (r = 0.334; P = .005), and pelvic torsion (r = 0.301; P = .013). Conclusion: Our study did not demonstrate relationship between LBP, subjective functional status and posture in young office workers.

Introduction. Basketball is an intermittent team sport with frequent transitions between activities performed at different intensities (1). Impaired functions of athlete’s kinematic chain lead to dysfunctions and increase the risk of injury (2). Scapula is important in shoulder complex while throwing a ball as it transfers the force from lower extremities to arms. It is difficult to objectively evaluate scapula due to the position of the shoulder, surrounding muscles and complexity of movements (3). There is a lack of researches analyzing scapular function according age and dominant arm of the throwing athlete. Research aim: to evaluate scapular dyskinesis, dynamic stability and grip strength in male basketball players according to age and dominant side. Research methods and organization: The study was approved by Lithuanian University of Health Sciences Bioethics Center (Nr BEC-SR(M)-146). All participants or their parents (for adolescent basketball players) signed the informed consent form before taking part in this study. Eleven athletes from national youth basketball team and twelve professional basketball players aged 15 to 30, without any upper extremity injuries in the past 1 year, which have not allowed them to train for 2 weeks, were enrolled to this study. The participants were divided into two groups: adolescent basketball players (n=11) aged 16.09 (±0.4) years and with 6.55 (±1.75) years of training period and adult basketball players (n=12) aged 22.17 (±4.11) and with 9.25 (±3.23) years of training period. In order to determine arm dominance, the basketball players were asked to specify the preferred hand to throw a ball. Scapular dyskinesis was evaluated by test described by McClure et al. (2009) (4). The Closed Kinetic Chain Upper Extremity Stability Test (CKCUES) measurements were taken while performing the CKCUES test in order to evaluate upper extremity dynamic stability and proprioception. The grip strength was measured by "Camry " dynamometer in order to confirm whether grip strength is increasing with age. Data was analyzed by using the program SPSS 27.0 and Microsoft Excel for Windows. Non-parametric two independent values were compared with non-parametric Mann-Whitney test, contingency was compared with Fisher’s exact test. The results are presented as median (xme), minimum (xmin), maximum (xmax) value and mean (x̄) – xme (xmin – xmax; x̄). The difference was considered statistically significant when p < 0.05. Results. Scapular dyskinesis. Scapular dyskinesis in the dominant arm was detected in 6 adolescent basketball players (54.5 %) and in 3 adult basketball players (25%). Scapular dyskinesis in the non-dominant arm was detected in 9 adolescent basketball players (81.8%) and in 6 adult basketball players (50%). No significant differences in scapular dyskinesis display were found in the dominant (p=0.214) and non-dominant (p=0.193) sides between the groups. CKCUES test. The final score of the CKCUES test in adolescent basketball players group was 0.16 (0.13-0.17; 0.15) points, in the group of adult players – 0.18 (0.16-0.21; 0.18) points. Adult basketball players had better upper extremity dynamic stability and proprioception compared to adolescent basketball players (U=115.5, p=0.001). […].

Introduction. Patient-reported outcome measures are essential in patient-centered care, especially in non-pharmacological interventions for low back pain (1). Although Oswestry Disability Index is ‘golden standard’ for functional disability evaluation, it has some disadvantages. It is most sensitive for persistent severe pain measurements, and it does not include questions about difficulty moving between positions such as sit to stand (2). The Spine Functional (SFI) is a tool to assess the impact of spinal problems, including pain on everyday activities (3). The aim of this research was to evaluate correlations and differences between various patient-reported outcome measures in adults with non-specific low back pain. Research methods and organization. The study was approved by Kaunas Regional Biomedical Research Ethics Committee. It was a two-stage study. Stage one was performed by translating and cross-culturally adapting the SFI questionnaire to Lithuanian language. This process was performed using the guidelines recommended by the International Society for Pharmacoeconomics and Outcomes Research (4). During stage two volunteers with non-specific, chronic, or subacute low back pain were invited to participate. A total of 123 subjects participated in this study. Median age was 44.5(18-76) years, 70.7% of them were women. The inclusion criteria were age >18 years, symptoms duration–at least 6 weeks, native speakers of Lithuanian. Exclusion criteria were identified structural causes of back pain, infection, inflammatory disease, neurological disease, or any metabolic disorder that may affect low back area, pregnancy, use of analgesics or myorelaxants in the last 12 hours. All volunteers who agreed to participate were introduced to the study design and purpose. They completed two questionnaires: Lithuanian version of Oswestry Disability Index (ODI), Lithuanian version of the Spine Functional Index (SFI), evaluated their pain intensity using Numeric Rating Scale (NRS) and filled in a short form about their age, gender, and health status. The final ODI score is considered as a percentage of the patients’ subjective disability, higher scores on the questionnaire indicate greater levels of perceived disability. On the contrary, higher SFI scores indicate better functional status, therefore in this research the final SFI results were flipped to equate it to ODI final score. Data analysis was performed using IBM SPSS 28.0.1.0 Software. With regards to the relationship between quantitative variables, Spearman’s correlation coefficient was computed. The Wilcoxon test was applied for two dependent samples. Significance level α=0.05. The results are presented as median (Md), minimum (min), maximum (max) values – Md(min-max). Results. Only statistically significant correlations are presented in the results. A medium strength positive relationship was found between NRS score and ODI (r=0.455; p<0.001). […].

This paper presents the pilot study of wobble seat on trunk muscles activity and kinematics. For this study the wobble board and wobble board on bearing surface were used to compare muscles activity and body segments kinematics on these different platforms. Two pelvic motions were performed: anterior – posterior and side to side. During this study the electromyography (sEMG) of trunk muscles and motion capture analysis were done. Results showed that sitting on wobble board placed on bearing surface leaded to increment of the activity of deep muscles with smaller pelvic movement in anterior – posterior pelvic motion.

Introduction. Introduction: In modern society, there has been a growing number of people who spend more and more time at the computer at work or in their free time. Often, chronic neck and shoulder pain in the workplace has socio-economic effects associated with reduced ability to work and reduced quality of life (2). According to Sihawong et al., Muscle balancing and endurance exercises are recommended to reduce chronic neck and shoulder pain (3). Research aim: To evaluate and compare the outcomes of two specialized physiotherapy exercise programs for individuals, who were experiencing neck and shoulder pain. Research methods and organization. With the approval of the Lithuanian University of Health Sciences Bioethics commission (Nr. BEC-SR(M)-172) the research was performed in UAB ,,Kineziterapijos klinika” from 2020-07-01 till 2020-10-10. 24 working-age participants (15 women and 9 men, aged 23 to 52 years) took part in the research, who experienced chronic neck and shoulder area pain, rated 1 to 6 points. Patients were randomly assigned to 2 groups of research of 12 subjects each. They were given one individual session each of 60 minutes. I group - patients were treated by stretching and positional relaxation exercises program with additional imagination exercises using ,,Dynamic alignment through imagery“ by Eric Franklin; II group were treated by the use of stretching and positional relaxation exercises program with additional deep neck muscle activation method with ,,Stabilizer“. The change in result was evaluated after the research by using neck disability index to describe functional independence; by using visual analogic scale VAS to describe pain intensity; by partly using the Hoeger scale to define head, neck and shoulder posture; by using GROC scale to evaluate patient‘s health condition; by using inclinometer to describe head, neck and shoulder area‘s range of motion. Statistical analys [...].