Spinal cord injuries (SCIs) have major consequences on the patient’s health and life. Voluntary muscle paralysis caused by spinal cord damage affects the patient’s independence. Following SCI, an irreversible motor and sensory deficit occurs (spasticity, muscle paralysis, atrophy, pain, gait disorders, pain). This pathology has implications on the whole organism: on the osteoarticular, muscular, cardiovascular, respiratory, gastrointestinal, genito-urinary, skin, metabolic disorders, and neuro-psychic systems. The rehabilitation process for a subject having SCIs can be considered complex, since the pathophysiological mechanism and biochemical modifications occurring at the level of spinal cord are not yet fully elucidated. This review aims at evaluating the impact of robotic-assisted rehabilitation in subjects who have suffered SCI, both in terms of regaining mobility as a major dysfunction in patients with SCI, but also in terms of improving overall fitness and cardiovascular function, respiratory function, as well as the gastrointestinal system, bone density and finally the psychosocial issues, based on multiple clinical trials, and pilot studies. The researched literature in the topic revealed that in order to increase the chances of neuro-motor recovery and to obtain satisfactory results, the combination of robotic therapy, a complex recovery treatment and specific medication is one of the best decisions. Furthermore, the use of these exoskeletons facilitates better/greater autonomy for patients, as well as optimal social integration.

The musculoskeletal system is affected in over 40% of patients with Coronavirus disease 2019 (COVID-19). There is an increased need for post-acute rehabilitation after COVID-19, especially in elderly people with underlying health problems. The aim of this study was to evaluate the benefits of an early and goal-orientated rehabilitation program using combined approaches, robotic medical devices together with other rehabilitation techniques and therapies, in elderly people after acute COVID-19. Ninety-one patients (62.64 ± 14.21 years) previously diagnosed with severe SARS-CoV-2 infection were admitted to the Medical Rehabilitation Clinical Hospital Baile Felix, Romania, for medical rehabilitation, but only six patients (85.33 ± 3.07 years) met the inclusion criteria and participated in the study. The rehabilitation treatment was complex, performed over 4 weeks, and included combined approaches: exercise therapy, robotic gait training, occupational therapy, and massages. Activity and participation evaluation were performed using the Barthel Index and Functional Independence Measure for activities of daily living (ADLs). Assessments were performed at admission and discharge from the rehabilitation clinic. Lokomat patients’ reports revealed that the patients had improved motor control (with one exception). The measurement of functional ability revealed an improvement in most cases. This study presents some of the first data on outcomes of COVID-19 patients’ musculoskeletal rehabilitation in our country. Early complex medical rehabilitation improved functional independence and autonomy in ADLs in very old patients, post-COVID-19.

The term neurofibromatosis (NF) describes a group of genetic disorders that primarily affect the cell growth of neural tissues. Three clinically and genetically distinct forms of neurofibromatosis have been described: neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis. The inheritance pattern is autosomal dominant for all three types. We present the case of a 57 years old man, admitted to the Medical Rehabilitation Clinical Hospital Baile Felix, Romania, who was diagnosed with spastic tetraparesis, neurofibromatosis type 1, chronic viral hepatitis B and D, hypercholesterolemia, sarcopenia and osteoporosis. The objectives of the rehabilitation treatment were combating pain; preventing and correcting vicious postures at rest and during activity; maintaining or increasing joint mobility; increasing the mobility of the cervical and lumbar spine; decreasing spasticity; increasing strength of paralyzed muscles; improving motor control of paralyzed limbs; transfers re-education, gait re-education; improving breathing; improving ADLs; maintaining autonomy; gaining daily independence; prevention of recurrent complications and increasing the quality of life. The rehabilitation treatment was complex, performed over a period of 2 weeks and included various physiotherapy approaches, hydrokinetotherapy, massage, occupational therapy, robotic devices and virtual reality. It improved the patient's functional independence and quality of life. Innovations in information technology will refine and increase the efficiency, expertise and competence of medical rehabilitation, in order to ensure comfort for the patient and an appropriate and safe therapeutic approach. Keywords: neurofibromatosis, robotic devices, medical rehabilitation,