Zachovajevienė, Brigita

To assess the impact of preoperative pelvic floor muscle (PFM) strength on urinary incontinence (UI) after radical prostatectomy (RP).

Introduction. The physiological and anatomical changes that occur during pregnancy can significantly affect the musculoskeletal system and reduce the quality of life for postpartum woman (1, 2). Also, childbirth strongly affects pelvic floor muscle function and is linked to future urinary and fecal incontinence, as well as pelvic organ prolapse (3). The Dynamic Neuromuscular Stabilization (DNS) method, based on neurodevelopmental principles, is a potential approach to reduce the impact of these demanding changes that occur during pregnancy and childbirth due to its focus on sagittal stabilization mechanisms (4). Therefore, the aim of this study was to evaluate the effect of DNS exercises on lumbopelvic functional parameters in postpartum women. Research methods and organization. The Kaunas Regional Biomedical Research Ethics Committee approved the study: Nr. BE-2-92. The study was conducted between November of 2024 and February of 2025 at the "Fiziomedika" Functional Medicine Clinic in Kaunas. All participants signed informed consent forms. Inclusion criteria were postpartum women in the first 5-9 months after giving birth vaginally, age between 20-35 years, first or second birth, no history of pelvic trauma, rheumatic disease, osteoporosis. The study involved 24 participants (83.3% first-time mothers), with a mean age of 29.5 years and 6.5 months postpartum. Participants were examined twice, six weeks apart - before and after the exercise program, which was based on DNS methodology guidelines and functional positions. Participants were instructed to perform this home-based exercise program for six weeks, at least 3–4 times per week, for up to 30 minutes. To ensure participants engagement in the study, they were asked to keep a diary after each exercise session. To assess functional changes in the pelvis and lumbar region relevant indicators were evaluated. A modified Schober test was used to assess lumbar mobility. Pelvic-lumbar stability was assessed using the pressure biofeedback device. Pelvic floor muscle strength was evaluated using a hand-held dynamometer. The static endurance of the back and abdominal muscles was assessed using the McGill tests. The functional state of the pelvic floor muscles was assessed using the questionnaire - Pelvic Floor Distress Inventory Short Form-20 (PFDI-20). Data statistical analysis was performed with IBM SPSS Statistics 30.0.0.0. Dependent samples were compared using Wilcoxon tests. The McNemar test was used to compare qualitative data. Quantitative data are presented as median (xme), minimum value (xmin), maximum value (xmax), and mean (x̄), qualitative data are presented as absolute frequency and percentage - n(%). Differences were considered statistically significant if p<0,05. Results. Lumbar mobility statistically significantly improved (Z=-3,346; p<0,001) by 0,4 cm. The test results at first were 5,5 (3,5-7; 5,3) cm, after DNS 6 (4-7,5; 5,7) cm. Pelvic-lumbar stability statistically significantly (p=0,039) improved. After DNS only 4 (16.7%) of the participants had pelvic-lumbar instability. Abdominal and back muscles static endurance statistically significantly improved (flex: Z=-2,485; p=0,013; ext: Z=-3,245; p=0,001). At first, flexion static endurance was 34 (11-75; 37,1) seconds, after DNS 52 (10-78; 46,3) s. At first, extension static endurance was 41 (15-63; 40,9) s, after DNS 56 (24-73; 51,4) s. Looking at pelvic floor muscle changes - the final score of the questionnaire was statistically significantly reduced after DNS (Z=-3,823; p<0,001). A positive change in functional state of pelvic floor muscles was observed for 19 (79,16%) participants with the greatest effect on urinary incontinence. The incontinence scale score was 31,24 (0-62,50; 26,9) points at the first examination and 6,24 (0-54.16; 16.14) points after. Pubococcygeus m. strenght statistically significantly increased when observed the right (Z=-3,625; p<0,001) and left (Z=-3,795; p<0,001) sides. Right side muscle strenght was 6,3 (3,9-7,3; 6) kg and 6,4 (4,9-8,4; 6,5) kg after DNS. For the left side at first 6,2 (4-7,2; 6) kg and after DNS 6,5 (5-8,3; 6,5) kg. Iliococcygeus m. strength statistically significantly increased when observed the right (Z=-3,606; p<0,001) and left (Z=-2,836; p=0,005) sides. The right side muscle strength before was 6,6 (3,9-7,5; 6,3) kg, after DNS 6,8 (5-8,4; 6,8) kg. The left side muscle strength at first was 6,6 (3,8-7,5; 6,3) kg, after 6,8 (5-8,5; 6,7) kg. Ischiococcygeus m. strength statistically significantly increased when observed both sides (Z=-3,253; p=0,001). Before DNS muscle strength on the right side was 6,1 (4-8; 6,3) kg, after 6,9 (5-8,6; 6,8) kg. On the left side before was 6 (4,3-8,1; 6,2) kg, after DNS 6,9 (5,3-8,7; 6,8) kg. Conclusions. The study showed that dynamic neuromuscular stabilization exercise program improves lumbar mobility, pelvic-lumbar stability, static trunk endurance and pelvic floor muscle strength and function parameters for postpartum woman.

Introduction. Rugby is an intense and contact-based sport with very high popularity worldwide. It is one of the team sports that causes the most injuries. With the continuous improvement of sports functional research, as athletes' physical and psychological indicators change, injury prevention measures, exercises, and methods also evolve (1). Currently, the dynamic neuromuscular stabilization (DNS) system is frequently applied in sports, and it would be beneficial to understand the benefits of this method for changes in athletes' functional movements (2,3). Research aim was to assess the change in functional indicators of individuals actively playing rugby, applying dynamic neuromuscular stabilization. Research methods and organization. The research was approved by Lithuanian University of Health Sciences Bioethics Center (2024-BEC2-470). The study conducted from August till September 2024 in ,,Prorehab“ clinic. Selection criteria: men, actively playing rugby at least twice a week for no less than two years: age 18-35 years, without any active trauma. In the study participated 30 players. The participants were randomly assigned into two groups of 15: regular warm-up common components – mobility drills, dynamic stretches, jogging, sprints. DNS warm-up – re-establish ideal movement patterns, improve joint centration, alignment, enhance core stability and neuromuscular control. Age in group with DNS was 25.7±5.78 years and without - 26.2±5.9 years. The participants were tested twice: before the intervention and after it. Before every rugby training session, all players performed a general warm-up for 5 minutes. DNS warm-up group did the DNS warm-up exercises for 15 min (on all four with knee lifted 3 sets of 40 sec, crawling 2 sets of 10 steps forward and back, bear 2 sets of 10, supine rolling to sides 2 sets of 10, high sit with leg movements 2 sets of 10, dead-bug 3 sets of 10) and another group - just a regular rugby-based warm-up 15 min. The total intervention lasted for 5 weeks, 3 times a week. The following tests were used to evaluate the participants and assess their data: Functional movement assessment scale (FMS), Y balance test for the lower extremities - for dynamic stability and balance testing, Agility T-test. The Wilcoxon test (Z) was applied to examine two dependent samples. For two independent samples, the non-parametric Mann-Whitney Wilcoxon test (U) was used. Data are presented as median (xme), minimum value (xmin), maximum value (xmax), and arithmetic mean (m). A statistically significant difference is considered when p < 0.05. Results. In the DNS warm-up group, dynamic stability improved: left leg before 96.7 (81-121; 97.4) score, after 100 (86-126; 101.1) score; Z=-3.297 p<0.001, right leg before 99.3 (74-124; 96.56 score, after 99 (78-126; 98.66) score, Z=-3,297; p<0,001. In the regular warm-up group, dynamic stability improved: left leg before 96.8 (82-107; 96.7) score, after 100 (88-110; 99.1) score; (Z=-3.408, p<0.001), right leg before 97.3 (80-106; 96.45) score, after 100 (87-108; 98.4) score, Z=-3.408, p<0.001. Analysis revealed no significant difference between the groups, neither before (left leg (U=106.5; p=0.803), right leg (U=107; p=0.830)), nor after the program - left leg (U=112; p=0.983), right leg (U=110.5; p=0.943). In the DNS warm-up group, functional movements improved: before 12(10 - 14; 12.13) score, after 13(10 - 14; 12.6) score, Z=-2.333; p=0.031. In the regular warm-up group, functional movements' results showed no change: before 13(10 - 14; 12.53) score, after 13(10

• 14; 12.73) score, Z=-1.732; p=0.250. Analysis revealed no significant difference between the groups, neither before (U=92.5; p=0.409), nor after the program (U=108; p=0.861). In the DNS warm-up group, agility improved: before 10.79(10.20 – 11.87; 10.83) sec., after 10.46(10.11 – 11.75; 10.61) sec., Z=-3.410; p<0.001. In the regular warm-up group, agility result also showed improvement: before 10.97(10.34 – 11.76; 11.04) sec., after 10.87(10.15 – 11.42; 10.89) sec., Z=-3.409; p<0.001. Analysis revealed no significant difference between the groups before (U=70.5; p=0.083), but after the program results showed a significant difference (U=62; p=0.036). Conclusions. The application of only rugby-based warm-up and warm-up based on dynamic neuromuscular stabilization improved the dynamic balance and agility. More expressed agility changes were observed in DNS warm-up group. Functional movements improved only in the DNS warm-up group of individuals actively playing rugby.

Introduction. Introduction. Low back pain (LBP) is a more common musculoskeletal disorder. (1) Biomechanical disturbances are widely believed to be the likely cause of LBP due to changes in the soft tissue structure around the spine. (2) Structural changes in the longitudinal arch of the foot result in changes in loading along the midfoot and plantar arch, resulting in altered biomechanics of the ankle, knee, hip, and spine. Compensatory movements in the lower structures put too much stress on the lumbar and pelvic region, which leads to the development of LBP (3) The aim. To assess the correlations between low back pain and functional indicators of young people with changes in the longitudinal arch of the foot. [...].

Introduction. One of the main problems after pregnancy is diastasis of the rectus abdominis muscles (DRA) (1). DRA can to lead changes in abdominal muscle function, pelvic floor muscle dysfunctions such as incontinence and pelvic organ prolapse, and lower back pain (2).These days, a neuromuscular technique widely used by physiotherapists is Dynamic Neuromuscular Stabilisation (DNS) (3). DNS helps to restore ideal muscle coordination of the integrated stabilisation system by promoting a whole-body, global, motor pattern necessary to maintain posture and control spinal stability (4). Aim: To assess the effect of DNS on the functional status of the thoracic and trunk muscles in women after pregnancy with diastasis of rectus abdominis muscles. [...].

Tyrimo pagrindimas. Motoriniai įgūdžiai yra pagrindiniai veiksniai, padedantys vaikams žaisti, bendrauti su kitais, ir daro įtaką jų vėlesnei socialinei aplinkai su bendraamžiais. Prastas arba netipinis motorinis vystymasis gali būti svarbus veiksnys, prisidedantis prie kalbos, socialinio bendravimo ir supratimo bei socialinės sąveikos problemų, būdingų kai kuriems neurologinio vystymosi sutrikimаms. Tikslas. Įvertinti vaikų, turinčių sulėtėjusią kalbos raidą, funkcinės būklės rodiklius bei jų sąsajas. Metodai. Tyrime dalyvavo 30 vaikų (4–6 metų) su nustatyta sulėtėjusia kalbos raida. Siekiant įvertinti vaikų funkcinius rodiklius, kuriems nustatyta sulėtėjusi kalbos raida, naudojami šie ištyrimo instrumentai: stambioji (bendroji) motorika vertinama TGMD-2 testu, pusiausvyra – modifikuota Berg‘o skale, „stotis ir eiti“ testu, koordinacija tirta – pusiausvyros koordinacijos nereikalaujančiais mėginiai (pagal Schmitz 1988), o smulkioji motorika vertinama standartizuotu testu, sudarytu remiantis Ozereckio tyrimo metodika. Rezultatai. Vaikams, turintiems sulėtėjusią kalbos raidą, sunku atlikti šuolį atsispiriant viena koja, šuolį dideliu žingsniu, kamuolio mušinėjimo užduotis. Objekto kontrolės gebėjimai buvo žemesni nei lokomotoriniai gebėjimai. Atliekant statinės pusiausvyros užduotis sunkiausia stovėti ant vienos kojos bei stovėti pėda prieš pėdą. Jaunesniems vaikams, turintiems sulėtėjusią kalbos raidą, buvo nustatyta prastesnė statinė bei dinaminė pusiausvyra ir koordinacija. Žymus smulkiosios motorikos sutrikimas nustatytas daugiau kaip dešimtadaliui vaikų, turinčių sulėtėjusią kalbos raidą. Išvados. Vaikų, turinčių sulėtėjusią kalbos raidą, stambioji motorika daro reikšmingą įtaką lokomotoriniams ir objekto kontrolės gebėjimams, dinaminė pusiausvyra susijusi su statine pusiausvyra bei pusiausvyros nereikalaujančia koordinacija, o smulkioji motorika lemia gebėjimą objekto kontrolei.

Introduction. During gameplay basketball athletes may execute approximately 40-60 short sprints, 40 jumps, and 100 high-intensity basketball-specific movements that require multidirectional power, speed and agility (1). Athletes who have high-intensity training and experience overtraining can experience various health problems as a result. Literature reviews of scientific research state that certain health risk factors are characteristic of athletes: overwork, injuries, and burnout affect the appearance of anxiety, stress, depression, and poorer sleep quality (2). The aim of the study: to determine the changes in the physical capability, fatigue and stress indicators of young female basketball players before and after competition. [...].

Introduction. Back pain is a leading cause of disability worldwide, the prevalence ranged 70- 80% and majority suffers from chronic pain, when the cause of pain is unknown (1-2). Studies show that breathing function is related to the musculoskeletal system of the lumbar spine and low back pain (3-5). Dynamic neuromuscular stabilization is a neuromuscular rehabilitation method based on physiological development, which can be used for assessing posture, torso stability, breathing function and to correct problems (6). Thus, the aim of this research is to evaluate changes in parameters of the respiratory system and functional indicators of torso, applying dynamic neuromuscular stabilization for individuals with chronic nonspecific low back pain. [...].

Introduction. Non-specific low back pain (NSLBP) is a common condition that affects many people, especially amateur cyclists and runners. NSLBP does not have a clear cause, but it may be related to poor lumbar stability, altered breathing patterns, reduced lung function, and impaired diaphragm mechanics (1). Muscle strength and endurance are components related to respiratory muscle function. Strength and endurance are considered conventional functions for performing activities optimally (2). The aim of the study was to evaluate relationships between respiratory and torso strength endurance indicators and lower back pain in male amateur runners and cyclists. [...].