Physical Medicine and Rehabilitation

Physical Medicine and Rehabilitation (PMR) is a medical specialty focused on the diagnosis and treatment of musculoskeletal diseases, neurological disorders, and movement limitations. It not only relieves symptoms temporarily; it aims to improve the patient’s quality of life in the long term by restoring movement function.

At Daviva Health Group, Physical Therapy and Rehabilitation specialists provide a holistic, individualized approach for every patient with up-to-date treatment protocols and advanced technology devices.

What Is Physical Therapy and Rehabilitation?

Physical Therapy and Rehabilitation (PMR) is a medical specialty that aims to help individuals who have lost function due to surgery, trauma, chronic disease, or neurological disorders regain movement and live independently.

The main goals of treatment:

• Restore mobility and range of motion
• Increase muscle strength and endurance
• Reduce pain and provide pain management
• Improve balance and coordination
• Support a safe and independent return to daily activities
• Accelerate recovery after surgery and injury

In Which Diseases Is Physical Therapy and Rehabilitation Used?

Musculoskeletal Diseases

• Herniated disc in the lower back and neck
• Muscle and joint pain
• Problems of the knee, shoulder, hip, and elbow
• Osteoarthritis
• Rheumatic diseases (rheumatoid arthritis, fibromyalgia)
• Scoliosis and postural disorders
• Tendinitis, bursitis, and heel spur

Neurological Diseases

• Rehabilitation after stroke
• Parkinson’s disease
• Multiple Sclerosis (MS)
• Peripheral nerve injuries and nerve entrapments

Sports and Post-Trauma Rehabilitation

• Sports injuries (ligament tears, muscle tears)
• Movement limitations after fractures and dislocations
• Postoperative rehabilitation

Pediatric and Developmental Disorders

• Delays in motor development in children
• Cerebral palsy rehabilitation
• Postural and gait disorders

Physical Therapy and Rehabilitation Methods

The treatment program is planned individually by the specialist in physical medicine and rehabilitation according to the patient’s diagnosis, complaints, age, and functional goals.

Electrotherapy and EMG System

Electrotherapy and surface EMG applications are combined on a single platform. Thanks to the EMG module, which measures muscle activity, the effectiveness of treatment is monitored in real time. It is used in TENS, muscle stimulation, and biofeedback applications.

Ultrasound Therapy

With this method, which reaches deep tissue layers through high-frequency sound waves, blood circulation accelerates, muscles and connective tissue relax, inflammation decreases, and tissue healing is supported.

Robotic Laser System (MLS)

The robotic laser system, which applies two different wavelengths simultaneously with MLS technology, provides precise and homogeneous energy distribution over the treatment area. It is used for acute and chronic pain management, tissue repair, and sports injuries.

Tecar Therapy

The capacitive and resistive dielectric therapy method (Tecar) accelerates blood circulation through deep tissue heating, relieves chronic pain and muscle spasm, and supports tissue repair.

ESWT – Shockwave Therapy

Tendon and soft tissue pathologies are treated with high-energy sound waves applied externally to the body. It provides successful results in heel spurs, Achilles tendinitis, tennis elbow, and chronic shoulder pain.

Manual Therapy

Techniques applied directly by hand by a physiotherapist include joint mobilization, soft tissue manipulation, and myofascial release. It is a safe and effective method for both acute and chronic pain treatment.

Exercise Therapy

Individualized exercise programs are planned to improve muscle strength, flexibility, balance, and neuromuscular (muscle-nerve system) coordination. It includes strengthening, stretching, balance training, and functional movement exercises.

Lymph Drainage System

The medical lymph drainage and soft tissue mobilization system, which operates with negative pressure technology, is used in lymphedema, postoperative swelling, scar tissue mobilization (to increase the flexibility of scars formed after surgery, burns, or trauma, reduce their stiffness, and prevent them from adhering to the underlying tissues), and myofascial pain treatment.

Magnetic Stimulation and Incontinence Treatment

Urinary incontinence treatment is performed by stimulating the pelvic floor muscles with a non-invasive magnetic stimulation system. The patient receives treatment comfortably while fully clothed, seated on a special treatment chair.

CPM – Continuous Passive Motion Systems

In the postoperative period, separate CPM systems are used for the knee-hip and shoulder joints to preserve joint range of motion. Controlled early joint movement reduces the risk of stiffness and complications.

Anti-Gravity Treadmill

The anti-gravity treadmill system, which operates with air pressure technology, reduces the load on the joints by supporting body weight. It supports gait training in patients with stroke, MS, and Parkinson’s disease; it also enables early rehabilitation for athletes.

Cardiac Rehabilitation and CPET System

With the cardiac rehabilitation system, heart rhythm is monitored by telemetry during exercise, ECG data are recorded, and blood pressure and SpO₂ are followed simultaneously. With cardiopulmonary exercise testing (CPET), the patient’s functional capacity is objectively measured and an individualized program is planned.

Advantages of Physical Therapy and Rehabilitation

• Pain management: Reduces chronic and acute pain without causing pharmacological dependence.
• Gains in movement and flexibility: Makes daily life easier by increasing joint range of motion and muscle flexibility.
• Strengthening of the musculoskeletal system: Muscle imbalances are corrected, and the risk of future injury is reduced.
• Improved balance and posture: Balance improves with neuromuscular training, and the risk of falls decreases.
• Reduced need for surgery: An appropriate physical therapy program may delay or eliminate the need for surgery.
• Individualized approach: Individual assessment and treatment planning are performed for each patient.
• Support for a healthy lifestyle: Long-term health is supported through exercise prescription and lifestyle recommendations.

Stem Cell and Cellular Therapies

Our specialist, who has doctoral training in stem cells and tissue engineering, integrates these advanced treatment methods into clinical practice in the treatment of musculoskeletal diseases.

What Is Stem Cell Therapy?

Stem cells are special cells that can transform into different cell types in the body and play a critical role in the repair of damaged tissues. Stem cell therapies applied in musculoskeletal diseases aim to support the regeneration of damaged cartilage, tendon, ligament, and bone tissue to achieve lasting improvement. In cases of chronic pain and tissue damage that do not respond to traditional treatment methods, they may be considered before surgery or as an alternative to surgery.

Areas of Application

• Cartilage Damage and Osteoarthritis: Stem cell applications support tissue regeneration in cartilage wear in the knee, hip, and shoulder joints.
• Tendon and Ligament Injuries: In chronic tendinitis and partial tears, cellular therapies help restore tissue integrity.
• Osteoporosis: It can be used in combination with medical treatment by activating mechanisms that support bone formation.
• Sports Injuries: It shortens the return-to-sport period by accelerating healing in muscle, tendon, and ligament injuries.
• Chronic Pain and Degenerative Diseases: Cellular regeneration methods can be applied in addition to conventional treatments.

Applied Methods

**PRP (Platelet-Rich Plasma)

Plasma rich in growth factors, obtained from the patient’s own blood, is applied to the damaged area and strengthens the natural tissue repair process. It is precisely guided to the target tissue under ultrasound guidance. The growth factors in PRP — especially PDGF, TGF-β, VEGF, and IGF-1 — directly stimulate tissue regeneration, vascularization, and cell proliferation.

Growth Factor Applications

Growth factors, the signaling molecules that guide tissue repair, may be applied in concentrated and purified form for specific indications. Fibroblast growth factor (FGF), epidermal growth factor (EGF), and bone morphogenetic proteins (BMP) are among the main factors used in these applications. They directly target cellular activity in the regeneration of cartilage, tendon, and bone tissue.

Exosomal Therapies

Exosome therapies, one of the most up-to-date and rapidly developing areas of regenerative medicine, are based on the therapeutic use of nanosized vesicles that regulate intercellular communication. Exosomes carry growth factors, microRNAs, and signaling proteins, programming cells in the target tissue toward repair and regeneration.

Advantages of stem cell-derived exosomes:

• Since they do not contain cells, the risk of an immune reaction is extremely low
• Their clinical safety profile is high due to standard production and storage conditions
• They act through growth factor release and regulation of gene expression
• They show promising results in cartilage degeneration, tendon injuries, neuropathic pain, and chronic inflammation
• A synergistic effect can be achieved when combined with PRP and other cellular methods

**Stromal Vascular Fraction (SVF)

SVF, obtained from adipose tissue and rich in stem cells and growth factors, shows a strong regenerative effect in joint cartilage, tendon, and soft tissue injuries. With its high concentration of mesenchymal stem cells, endothelial progenitor cells, and growth factors, it broadly supports tissue repair.

**Bone Marrow Aspirate Concentrate (BMAC)

The stem cell concentrate obtained from the patient’s own bone marrow is used especially in cartilage and bone injuries. The mesenchymal stem cells and hematopoietic progenitor cells it contains play a direct role in the regeneration of bone and cartilage tissue.

Why Ultrasound-Guided Application?

All cellular therapy applications are performed under ultrasound imaging guidance:

• The therapeutic substance reaches the target tissue exactly
• Surrounding structures are not damaged
• Procedure safety and effectiveness are maintained at the highest level
• Treatment outcomes can be documented and monitored

Our Technological Infrastructure

Daviva Health Group has a modern rehabilitation infrastructure equipped with CE-certified, up-to-date model devices in line with international standards.

• Cardiac Rehabilitation System: Heart rhythm is monitored by telemetry during exercise, ECG data are recorded in real time, and blood pressure and SpO₂ are followed simultaneously.
• Cardiopulmonary Exercise Test (CPET): The patient’s exercise capacity, oxygen consumption, and respiratory functions are measured with the highest precision, grounding the rehabilitation program in science.
• Electrotherapy and EMG System: TENS, muscle stimulation, and biofeedback applications on a single platform.
• Tecar Therapy: Increases blood circulation through deep tissue heating, relieves chronic pain, and supports tissue repair.
• Robotic Laser (MLS): A precise robotic laser system that applies two wavelengths simultaneously.
• Lymph Drainage System: Lymphedema and soft tissue treatment with negative pressure technology.
• Magnetic Stimulation: Non-invasive magnetic stimulation for incontinence and neuromuscular rehabilitation.
• CPM Devices: Postoperative continuous passive motion systems for the knee-hip and shoulder joints.
• Anti-Gravity Treadmill: Early gait rehabilitation by reducing joint load with air pressure technology.
• Wireless Muscle Stimulator: Muscle strengthening and pain management with multichannel wireless electrostimulation.