Neuro Biomechanical Rehabilitation

Neurobiomechanical Rehabilitation (NBM) is a comprehensive, individualized rehabilitation program aimed at reducing pain and functional limitations, restoring mobility, muscle function, neuromuscular control, and the patient's ability to perform movements required for daily, occupational, and sports activities.

The program is developed based on a clinical and functional assessment, taking into account the nature and duration of symptoms, pain location, range of motion, muscle strength and tone, neuromuscular control, exercise tolerance, and existing functional limitations.

Depending on the clinical situation, the program may combine active rehabilitation methods - therapeutic exercises, functional and neuromuscular training, mobility work, and motor control training - with BTL device-based physiotherapy technologies, individually selected when appropriate indications are present.

The fundamental principle of NBM is not to focus solely on the painful area, but to work toward restoring the patient's movement and function.

Neurobiomechanical Rehabilitation (NBM) is an individualized functional rehabilitation program, not a standalone device-based procedure.

Active rehabilitation forms the foundation of the program. TECAR, SIS, HILT, RSWT, and FSWT are used as complementary technologies only when appropriate indications for their application are present.

The goal of the program is not only symptom control but also the gradual restoration of movement, functional abilities, and tolerance to the physical demands of daily, occupational, or sports activities.

Indications

KNT33 may be considered as part of conservative rehabilitation for patients with musculoskeletal pain and/or functional impairments when specific rehabilitation goals have been established following a clinical assessment.

The program may be used, in particular, for:

• nonspecific lumbosacral pain;
• neck pain and functional limitations;
• myofascial pain and muscle tension;
• restricted joint mobility;
• adhesive capsulitis (“frozen shoulder”) - as part of comprehensive rehabilitation;
• shoulder complex pain syndromes;
• certain tendinopathies and enthesopathies;
• lateral and medial epicondylalgia;
• plantar fasciopathy (“heel spur”);
• certain sports-related and overuse injuries of muscles and tendons;
• functional impairments following musculoskeletal injuries - at the appropriate stage of rehabilitation;
• the need to restore muscle function, strength, motor control, and exercise tolerance;
• certain disorders of muscle tone and neuromuscular function - following an appropriate medical assessment.

Procedure

Before starting the program, a clinical and functional assessment is performed, based on which the specialist determines the rehabilitation goals, necessary methods, and the sequence of their application.

Program components and their roles

Clinical and Functional Assessment

Assessment of pain, range and quality of movement, muscle function, neuromuscular control, exercise tolerance, and functional limitations; establishment of rehabilitation goals and an individualized rehabilitation plan.

Therapeutic Exercises / Functional Rehabilitation

Restoration of mobility, muscle strength and endurance, neuromuscular control, coordination, exercise tolerance, and functional movements.

BTL TECAR / TR-Therapy - Radiofrequency Therapy

A complementary method for pain management, addressing muscle tension and soft tissues; may be combined with manual and movement-based techniques.

BTL SIS - High-Intensity Electromagnetic Therapy

Pain management, muscle relaxation, and neuromuscular stimulation - depending on the clinical objective and selected protocol.

BTL HILT - High-Intensity Laser Therapy

A complementary physical therapy method primarily used for pain management in certain musculoskeletal disorders and painful conditions.

BTL RSWT - Radial Shock Wave Therapy

Radial shock waves; used when indicated for certain chronic tendinopathies and enthesopathies.

BTL FSWT - Focused Extracorporeal Shock Wave Therapy

Focused shock waves targeting a specific area at a selected depth; used when indicated for certain chronic tendinopathies, enthesopathies, and some conditions associated with calcifications.

Not all methods are used for every patient. Device-based technologies are selected individually, taking into account the clinical situation, indications, and contraindications.

Limitations

Since NBM is a combined rehabilitation program, the safety of each selected method - TECAR, SIS, HILT, RSWT, or FSWT - is assessed separately according to the characteristics of the specific physical modality.

The number of procedures, their frequency, intensity, and combination of methods are not standardized for all patients.

The rehabilitation plan is individualized and may be adjusted depending on the clinical situation, exercise tolerance, symptom progression, and changes in functional status.

Contraindications

Since NBM is a combined rehabilitation program, there is no single list of contraindications applicable to all its components.

Before prescribing device-based therapies, the specialist assesses the presence of conditions that may influence the choice of technology, including:

• implanted electronic medical devices;
• metallic implants and their location;
• pregnancy;
• active oncological diseases;
• acute infectious conditions;
• skin lesions or disorders in the intended treatment area;
• sensory impairments;
• diseases and conditions associated with an increased risk of bleeding;
• use of anticoagulants and other medications relevant to the selected procedure;
• recent injuries and surgical interventions.

The presence of these conditions does not constitute a universal contraindication to the entire NBM program. The suitability of each method is determined individually in accordance with its indications, contraindications, and the medical equipment's instructions for use.

Advantages

• A comprehensive, individualized rehabilitation program aimed at reducing pain and functional limitations.
• Restoration of mobility, muscle function, neuromuscular control, and the patient's ability to perform daily, occupational, and sports movements.
• Combination of active rehabilitation methods with BTL device-based physiotherapy technologies when appropriate indications are present.
• Individual selection of methods based on the clinical situation, indications, and contraindications.
• Possibility of adjusting the rehabilitation plan according to exercise tolerance, symptom progression, and changes in functional status.
• Gradual restoration of movement, functional abilities, and tolerance to the physical demands relevant to the patient.