Faculty of Philosophy

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A MULTIDIMENSIONAL FRAMEWORK FOR PSYCHOMOTOR REHABILITATION AND INCLUSIVE EDUCATION IN CHILDREN WITH CEREBRAL PALSY
(University St. Kliment Ohridski - Bitola, 2026-05-07)
Arsovski, Denis
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Zhivkovikj, Gabriel
This research used an interdisciplinary model that integrates psychomotor rehabilitation with inclusive education for students with cerebral palsy. The research revealed the need for individualized, specific rehabilitation that supports functional independence and active participation in learning environments. A case study design was used including a nine-year-old girl with spastic diplegic cerebral palsy attending a regular school. Standardized instruments such as the Gross motor function classification system, Manual ability classification system, Modified Ashworth scale, and Pediatric evaluation of disability inventory were used. Cognitive, communicative, social and emotional functioning were assessed through classroom observations, evaluations, and interviews. The results showed moderate motor limitations and dysarthric speech but preserved visual perception, motivation, and symbolic understanding. Environmental and systemic barriers such as fragmented rehabilitation services and insufficient interprofessional collaboration limited her progress. The results clarify the relevance of coordinated, family-centered intervention integrating rehabilitation, education, and social support to improve inclusion and general development in children with cerebral palsy.
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Demographic influences on sustainable mobility adoption in rehabilitation
(Surabaya Physical Medicine and Rehabilitation Journal, 2025-08)
Arsovski, Denis
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Prodanovska Stojchevska, Viktorija
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Jovanovska, Tanja
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Filov, Izabela
Background: The integration of sustainable mobility within rehabilitation combines environmental and health-focused strategies to reduce the carbon footprint of healthcare and improve the results of the patients. This approach shows the need for environmentally friendly transport options such as walking, cycling, public transport, and carpooling within various rehabilitation programs. Aim(s) (including purpose setting): This study aimed to explore the influence of demographic factors such as age, gender, and mobility restrictions on the willingness of patients to adopt sustainable mobility options during rehabilitation treatment. Material and methods: A cross-sectional survey design was used, with 85 participants receiving rehabilitation. Data were collected with a structured electronic questionnaire consisting of demographic data and attitudes toward different sustainable transport methods. Statistical analyses included Chi-Square tests, analysis of variance with post-hoc Tukey, independent samples t-tests, Mann-Whitney tests, and two-way analysis of variance to assess the main and interaction effects. Result: Younger participants within 18-30 years and female participants showed a higher willingness to use public transport compared to older age groups and male participants (analysis of variance p = 0.008, η² = 0.13; t-test p < 0.01, d = 0.72). No significant interaction between age and gender was found, suggesting additive effects. Conclusions: Demographic factors can affect sustainable mobility preferences in rehabilitation, necessitating individualized interventions to improve the adoption. Programs should consider age, gender, and mobility limitations to promote sustainable transport. Defining these factors can improve rehabilitation outcomes and support environmental sustainability goals. Future research should investigate long-term impacts and the role of additional variables such as socioeconomic status and infrastructure.
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Student Perceptions of Online Learning in Physiotherapy
(Medical Rehabilitation, 2025-07)
Arsovski, Denis
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Introduction: The COVID-19 pandemic increased the scope for online lessons in physiotherapy, a profession with hands-on practice and direct interaction. While digital platforms provide accessibility and flexibility, they also introduce some challenges, affecting the quality of education. Objectives: Objectives: The aim of this study is to investigate the perceptions of physiotherapy students for online learning, with focus on its advantages, challenges and preferred future directions in the education of physiotherapy students. Methods: Methods: In the present study, 122 physiotherapy students from educational institutions in North Macedonia and Bulgaria were included in this research. Data were collected via an online questionnaire that allows to assess demographics, the perceived benefits, challenges and preferences regarding blended learning. Quantitative data were analysed with descriptive statistics, chi-square tests and analysis of variance with post-hoc comparisons. Qualitative responses showed further information about the experience of the students with online learning. Results: Results: Students showed a preference for blended learning models with combination of online and in-person education. On line learning was valued for its flexibility and accessibility, but the challenges such as limited personal training, technical difficulties and reduced teacher-student interaction were noted. Satisfaction levels varied across academic years (p<0.001) with younger students reporting higher satisfaction than advanced students, who required more practical training. Key barriers were insufficient digital tools and digital literacy. Conclusion: Conclusion: While online learning improves accessibility, it must be integrated with in-person training for competency in clinical skills. Future research should be focused on digital literacy, technical support and interactive content for optimising blend ed education in physiotherapy
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Advancing forward: The role of functional electrical stimulation in enhancing lower limb function in children with cerebral palsy
(Futurity Medicine, 2025-06)
Arsovski, Denis
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Jovanovska T.
Purpose: This systematic review explores the effectiveness of functional electrical stimulation in improving lower limb motor function, gait dynamics, and related physical outcomes in individuals diagnosed with cerebral palsy. It addresses inconsistencies across intervention protocols while identifying the clinical value of functional electrical stimulation in modern rehabilitation. Methodology: An extensive literature search was conducted using PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar for research papers published between 2005 and 2025. After screening 128 initial records, five studies met the inclusion criteria after screening and full-text review. Included studies involved participants with cerebral palsy who received lower limb functional electrical stimulation compared to conventional therapy or no intervention. A qualitative synthesis was performed based on key outcome domains such as gait, muscle strength, spasticity, and postural control. Results: Functional electrical stimulation interventions were associated with improvements in gait speed (12–20%), stride length (up to 15%), and gross motor function scores (by 8–10 points). Protocols included 30–60 minute sessions, 3–5 times per week over 8–12 weeks. Outcomes varied depending on the subtype of cerebral palsy, age, stimulation type, and adherence. Studies using functional electrical stimulation during walking or cycling showed the highest gains in functional mobility and satisfaction. However, limitations included small sample sizes, heterogeneity in study design, and short follow-up durations. Scientific novelty: This review synthesizes updated evidence regarding lower limb functional electrical stimulation parameters and patient characteristics. It also discusses emerging trends in individualized and home-based applications Conclusion: Functional electrical stimulation presents valuable strategy for improving motor performance in cerebral palsy, particularly for lower limb function. Future research should prioritize protocol standardization, large-scale trials, and long-term effects to support clinical integration of functional electrical stimulation into personalized rehabilitation plans.
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Feeding challenges, dietary adaptations, and nutritional support in individuals with cerebral palsy
(Hrvatska revija za rehabilitacijska istraživanja, 61(1), 65–75, 2025-06-20)
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Arsovski, Denis
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Joldeska, Elizabeta
Abstract: Background: Cerebral palsy is a neurodevelopmental disorder that affects movement, muscle tone, and motor skills, often causing feeding difficulties. Individuals with cerebral palsy experience dysphagia, prolonged meal durations, and increased dependency on caregivers for feeding assistance. It is important to understand the relationship between mobility impairments, feeding dependency, and dietary adaptations for optimising nutritional intake and quality of life. Objective: This research aims to analyse the feeding difficulties faced by individuals with cerebral palsy, assess the influence of mobility limitations on feeding dependency, and examine dietary adaptations required to ensure adequate nutrition. Methods: A cross-sectional study, involving 37 participants with cerebral palsy, was conducted using caregiver-reported questionnaires. Variables examined include mobility status, feeding dependency, meal duration, dietary preferences, and feeding methods. Statistical analyses (χ² tests, Mann-Whitney U tests, and Kruskal-Wallis tests) were used to determine the relationship between feeding dependency, nutritional intake, and mobility impairments. Results: The results showed correlation between mobility limitations and feeding dependency (χ² = 42.83, p < 0.001). Participants with greater mobility impairments were more likely to consume blended or liquid diets and experience prolonged meal durations (H = 20.03, p < 0.001). Caregiver support played an important role in feeding adaptation and efficiency. Conclusion: Feeding difficulties in individuals with cerebral palsy are influenced by mobility impairments and dietary adaptations. The study focuses on the need for individualised nutritional plans, assistive feeding tools, and structured meal environments. Multidisciplinary approaches with speech therapists, dietitians, and occupational therapists are important for feeding independence and improving general health outcomes in individuals with cerebral palsy
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The impact of massage therapy on upper extremity function in children with cerebral palsy
(Timişoara Physical Education and Rehabilitation Journal, 2024-12-03)
Arsovski, Denis
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Introduction. Cerebral palsy is a neurological condition that reduces motor function, leading to difficulties with upper extremity movements. Massage therapy, known for reducing muscle tension and promoting relaxation has gained attention as a rehabilitation method. However, limited research focuses on its effectiveness in children with cerebral palsy. Aim. This study evaluates the impact of massage therapy on upper extremity function in children with cerebral palsy, focusing on the relationship between therapy frequency, duration and functional outcomes. Methodology. A quantitative, cross-sectional design was applied, collecting data from 28 children aged 3 to 18 years through structured questionnaires. The outcomes measured included improvements in range of motion, spasticity reduction, pain relief and quality of life. Data were analyzed using ANOVA and Kruskal-Wallis H tests to assess the significance of therapy characteristics. Results. Children receiving therapy 2–3 times per week for more than 12 months showed significant improvements in range of motion (F(2,14) = 4.91, p = 0.024), spasticity reduction (F(3,16) = 3.44, p = 0.042) and pain relief (F(2,14) = 7.41, p = 0.006). Increased therapy frequency was also associated with better performance in daily tasks and improved quality of life (H(2) = 8.15, p = 0.017). Conclusion. Massage therapy is an effective intervention for improving upper extremity function and quality of life in children with cerebral palsy. Future research with randomized trials is recommended to validate these findings and explore long-term benefits.

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