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In chronic nonspecific low back pain (CNLBP), an integrated approach is effective, which must include kinesitherapy. Unfortunately, in our country, kinesitherapy is not always used in CNLBP, ineffective methods of therapy are often used. The article presents an observation of a 55-year-old female patient who suffered from CNLBP. Magnetic resonance imaging of the lumbar spine revealed protrusions up to 4 mm at the level of L4-L5, L5-S1 segments, which were regarded as the cause of back pain. The patient was prescribed non-steroidal anti-inflammatory drugs (NSAIDs), ointments at the place of residence, limitation of physical activity was recommended, which did not have a significant positive effect. In a specialized neurological center, during manual examination, the patient showed signs of lesion of the right sacroiliac joint (SIJ), and with diagnostic and treatment blockade (with anesthetics and corticosteroids) of the right SIJ, an almost complete temporary regression of pain was noted. The patient was explained the causes of pain, the role of SIJ lesions, prolonged physical inactivity and static loads as the causes of CNLBP, the safety and effectiveness of kinesitherapy. Movalis® (meloxicam) was used as an NSAID at 15 mg per day. The patient underwent exercises to activate the gluteal muscles, rectus abdominis muscles, strengthen the back of the thigh, relieve tension from the square muscles of the lower back, and relax the hip flexor muscles. Techniques for controlling the neutral position of the spine and the walking pattern were worked out. Within 10 days, the pain completely disappeared, functional disorders on the Oswestry scale decreased from 34% to 10%. Over the next 3 months, the patient regularly performed therapeutic exercises, avoided static loads, her physical activity increased from 10 to 26 points, back pain did not bother her. The issues of the effectiveness of kinesitherapy in CNLBP are discussed. It is noted that in CNLBP, regularity of physical exercises, exclusion of abrupt and excessive movements, and static loads are of leading importance. Walking represent a highly effective method of treatment and prevention of CNLBP and should be combined with other methods of kinesitherapy. The efficacy and low risk of complications from the use of meloxicam in patients with CNLBP not only from the gastrointestinal tract, but also from the cardiovascular system are noted. The use of kinesitherapy in complex therapy can help many patients with CNLBP, in whom it has not been previously used.

Background: Cerebral palsy is the leading cause of physical disability in pediatric age. The search for new methods and improvement of old rehabil- itation techniques is ongoing, due to low efficacy of the latter. Aim: To assess the efficacy of a func- tional programmed electrical muscle stimulation as a part of combination treatment of patients with cerebral palsy in the form of spastic diplegia. Materials and methods: We analyzed the results of treatment of 71 children with cerebral palsy and spastic diplegia, who had been randomized into two groups depending on the type of treatment. In the first group, the patients (n = 38) received a course of functional programmed electric stim- ulation in combination with other non-medical treatment methods. The second group (n = 33) underwent a usual course of electrical stimula- tion in combination with non-medical treatment, similar to that in the first group. The third group (control) included 41 children without cere- bral palsy. Clinical and instrumental parameters were assessed in all study participants. Results: After the course of combination treatment in the group 1, the tonus of m. gastrocnemius was de- creased significantly by 41%, that of the posterior group of femur muscles by 43%, adductor group of femur muscles by 36%. In the group 2, the re- spective parameters decreased by 24, 21 and 21%. Muscle power endurance was increased signifi- cantly in patients of both groups: that of long back extensors by 12.5 and 6.2 sec, of m. rectus abdomi- nis by 10.6 sec and 5.2 sec, of gluteal muscles by 9.3 and 4.6 sec, of m. quadriceps by 19.8 and 7.2 sec, of m. anterior tibialis by 12.1 and 4.6 sec, respec- tively. After the treatment, the active movement volume in the large joints of lower extremities in the group 1 patients improved as follows: by 15.6° in hip joints, by 11.1° in knee joints and by 10.6° in ankle joints. In the second group the correspond- ing values were 7.4° in hip joints, 5.1° in knee joints and 4.8° in ankle joints. The differences for all pa- rameters were statistically significant (p < 0.05), be- ing significantly better in the group 1. Conclusion: The course of the functional programmed electri- cal muscle stimulation at walking, compared to the usual electrical stimulation in spastic diplegia patients is significantly more effective in reduction of the spastic muscle tonus of the lower extremi- ties. It improves power endurance of the weak legs and trunk muscles, increases the volume of active movements in big joints of the lower extremities.