Supporting the treatment of post-traumatic contractures of the elbow by serial casts holding the joint in extreme flexion and extension successively: a case study

Stanisław Junk, Piotr J Biliński, Wojciech Hagner, Jan Talar

Stanisław Junk, Piotr J Biliński, Wojciech Hagner, Jan Talar – Supporting the treatment of post-traumatic contractures of the elbow by serial casts holding the joint in extreme flexion and extension successively: a case study. Fizjoterapia Polska 2003; 3(3); 277-280

Abstract

Background. The treatment of post-traumatic contracture is beset with many difficulties, caused in large part by the anatomical complexity of this joint. Case histories. This article presents three patients treated for persistent post-traumatic contracture of the elbow. The rehabilitation problem consisted in the fact that when extenion was increased, flexion was decreased, and vice versa. In order to overcome this mechanism, which maintained an unchanged range of movement by alternately shifting the extreme positions of flexion or extension, we attempted to increase the total range of movement by using plaster extensors to fix the progress of maximum movement. Plaster casts holding the joint in the maximum, extreme position were changed every two hours. Therapy with physical agents and mild exercises was simultaneously administered. New pairs of double casts were made twice, each time achieving further improvement. Conclusions. In selected cases of contractures resistant to standard rehabilitation procedures, when the use of a redressing rail is impossible, the method of serial casts in alternating extreme redressment as here described should be considered.

Key words:
post-traumatic spasticity, ulnar joint, conservative treatment
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Rehabilitation outcome after surgical reconstruction of the anterior crucial ligament of the knee

Wojciech Hagner, Gabriela Stec, Jan Talar

Wojciech Hagner, Gabriela Stec, Jan Talar – Rehabilitation outcome after surgical reconstruction of the anterior crucial ligament of the knee. Fizjoterapia Polska 2003; 3(4); 331-336

Abstract

Background. Injury to the ligaments and capsule of the knee joint, especially the anterior crucial ligament, leads to joint instability, manifested functionally by unsatisfactory joint mobility and a tendency for the tibial plateau to give way under load. Surgical treatment generally restores stability but the outcome is determined by rehabilitation, focused on recovery of function. The aim of our research was to evaluate outcome one year after surgical reconstruction of the anterior crucial ligament. Material and methods. We tested 20 randomly selected patients under treatment in the Department of Orthopedics and Traumatology of the Motor Apparatus in 2001 after post-traumatic surgical reconstruction of the anterior crucial ligament. The research involved a patient interview that included the pathomechanism of the injury, and a subjective evaluation of the rehabilitation outcome. Results. The most common cause of this injury proved to be sport. Two-thirds of the subjects evaluated the outcome of rehabilitation after surgical reconstruction as good or excellent. Conclusions. The program described here gives good effects in the rehabilitation of patients recovering from surgical reconstruction of the anterior crucial ligament.

Key words:
anterior crucial ligament tears, reconstruction operation, rehabilitation
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Thermographic assessment of radiation induced by cryostimulation of both lower limbs and analysis of changes in children with cerebral palsy

Zbigniew Śliwiński, Zdzisław Zagrobelny, Jan Talar, Piotr Płaza, Bartłomiej Halat, Marek Kiljański

Zbigniew Śliwiński, Zdzisław Zagrobelny, Jan Talar, Piotr Płaza, Bartłomiej Halat, Marek Kiljański – Thermographic assessment of radiation induced by cryostimulation of both lower limbs and analysis of changes in children with cerebral palsy. Fizjoterapia Polska 2003; 3(4); 316-330

Abstract

Background. The authors presented the examine of changes temperature results in the children’s with the cerebral palsy legs, which were registrated during treatment in the Rehabilitation Center in Zgorzelec. Material and methods. The changes temperature were checkted by the camera Agema 570 before the treatment and four weeks later. The spastic tension was checked also using the Mionotometer Szirmai and Ashworth test and Brunstrom test. Spontaneous motorial evaluation and the level motorial development were checked using own scale. Results and conclusions. The results shown that the using the cryostimulation in the treatment children with the cerebral palsy decrease the spastic tension in the legs and the spontaneous motorial evaluation was better, the range of motion in joins also were better after treatment. The termal pictures shown that arterial play in the children’s legs was adapted to the cryogenic temperatures.

Key words:
thermoregulation, local cryotherapy, termovision, spastic tension, spontaneous motorial evaluation
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How to guarantee the patient’s success after shoulder arthroplasty. Part I: qualification and preparation to the surgical operation

Jolanta Kujawa, Jarosław Oborzyński, Jan Talar, Mirosław Janiszewski

Jolanta Kujawa, Jarosław Oborzyński, Jan Talar, Mirosław Janiszewski – How to guarantee the patient’s success after shoulder arthroplasty. Part I: qualification and preparation to the surgical operation. Fizjoterapia Polska 2004; 4(1); 75-78

Abstract

Shoulder arthroplasty is a surgical method of treating joint dysfunction, which is an exchange of destroyed joint surfaces by endoprothesis. Appropriate rehabilitation after shoulder arthroplasty gives patient a chance for regaining complete joint function. However, it is important to perform appropriate patient’s qualification and preparation to the operation. In many scientists’ opinion the shoulder arthroplasty gives better joint function in comparison to use of alternative procedures.

Key words:

shoulder arthroplasty, indication, contraindication to surgery, after-surgery rehabilitation

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Using the MTD control balance platform in intensive PNF-based rehabilitation of patients with various dysfunctions

Grzegorz Srokowski, Anna Srokowska, Wojciech Hagner, Jan Talar, Maciej Dzierżanowski, Urszula Kazimierczak, Ewa Rosa, Mikołaj Kurczewski

Grzegorz Srokowski, Anna Srokowska, Wojciech Hagner, Jan Talar, Maciej Dzierżanowski, Urszula Kazimierczak, Ewa Rosa, Mikołaj Kurczewski – Using the MTD control balance platform in intensive PNF-based rehabilitation of patients with various dysfunctions. Fizjoterapia Polska 2004; 4(1); 58-67

Abstract

The diversity of available strategies enables the choice of the optimal method leading to effective and safe clinical work. One such strategy is the PNF concept, which is characterized by a holistic approach to the patient and his problems. This makes it possible to treat the patient in his/her own environment, using familiar behaviors and situations. This article describes examples of the use of the MTD Control Balance Platform as an auxiliary device in an intensive program of functional exercises based on the PNF concept. Seven patients are described, all treated at the Rehabilitation Clinic of the Rydygier Academy of Medicine in Bydgoszcz. The examples include neurological and orthopedic disorders, as well as sports injuries. Only the patient’s adaptation to independent living is proof of the effectiveness of rehabilitation. This effect can be achieved by conducting therapy in the patient’s own environment, using familiar behaviors and situations. The examples of PNF therapy selected for presentation here, supplemented with the patient’s independent exercising on the MTD Control Platform, satisfy these conditions and can be recommended.

Key words:

holistic approach, functional exercises, feedback

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Role of the physiological antagonism of angiotensin II and laser biostimulation in the modulation of arterial smooth muscle reactivity

Grzegorz Grześk, Magdalena Mackiewicz-Milewska, Jan Talar, Leszek Szadujkis-Szadurski, Irena Bułatowicz

Grzegorz Grześk, Magdalena Mackiewicz-Milewska, Jan Talar, Leszek Szadujkis-Szadurski, Irena Bułatowicz – Role of the physiological antagonism of angiotensin II and laser biostimulation in the modulation of arterial smooth muscle reactivity. Fizjoterapia Polska 2004; 4(2); 143-150

Abstract

Background. The mechanisms of action of laser biostimulation on biological tissue continues to be the object of much scientific research. The positive impact of laser radiation of low and medium power on inhibiting the contraction of blood vessels has already been demonstrated. We decided to investigate the role of angiotensin II in this process. Material and methods. The experiment was performed on isolated tail arteries collected from male Wistar rats. The arteries were first subjected to the effect of phenylephrine (PHE), and then to the effect of laser radiation (10, 30 and 110 mW) in the presence of angiotensin II. Changes in vascular tension were observed and recorded. Results. Laser radiation inhibited the vascular contraction that is typically induced by PHE, proportionally to the power of the laser applied, in both controls and in experimental arteries pretreated with angiotensin II. The KA values calculated for PHE in the presence of angiotensin II and in biostimulated arteries did not differ significantly from controls. Conclusions. Our results suggest that vascular contractility is reduced under the influence of laser biostimulation. The increase in receptor reserve induced by angiotensin II is significantly lowered by the effect of laser biostimulation. Laser biostimulation inhibits the activity of the rennin-angiotensin-aldosterone system by reducing the tissue effects of angiotensin II.

Key words:
vascular dilatation, vascular endothelium, adrenoceptors
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The impact of intensive functional rehabilitation on improved sensorimotor control and locomotor capabilities in a patient with spinal cord injury (SCI)

Grzegorz Srokowski, Anna Srokowska, Jan Talar, Wojciech Hagner, Agnieszka Połomska

Grzegorz Srokowski, Anna Srokowska, Jan Talar, Wojciech Hagner, Agnieszka Połomska – The impact of intensive functional rehabilitation on improved sensorimotor control and locomotor capabilities in a patient with spinal cord injury (SCI). Fizjoterapia Polska 2004; 4(3); 272-283

Abstract

Background. Contemporary rehabilitation is developing in many different directions. In view of the scope of research and practice, it is a discipline that joins many sciences sharing a common goal: to help the patient. This task is performed by an interdisciplinary rehabilitation team composed of the attending physician and the physiotherapist, along with other specialists. The constantly growing number of patients and increasing financial constraints are making it essential to seek new therapeutic solutions. One of many possible strategies is the PNF concept. This method is characterized by a holistic approach to the patient, based on behaviors and daily life situations with which the patient is familiar, and using available rehabilitation equipment. Case description. This article presents a case study of a female patient admitted for rehabilitation after a spinal cord injury (SCI) to the Department of Rehabilitation at the Bydgoszcz Medical University. Examples are provided of functional exercises used in the intensive rehabilitation program developed for this patient. The ASIA scale was used to assess outcome, along with functional tests for patients with paraplegia, a modified version of the Barthel test. Conclusions. The successful outcome in this case resulted from the cooperation of the entire therapeutic team, and from the exchange of information regarding the patient’s clinical status and progress in treatment. Close cooperation makes it possible to chose the optimal method, ensuring effective and safe work with the patient.

Key words:
PNF, interdisciplinary approach, rehabilitation team
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The analgesis effectiveness of continuous and fractionated doses of laser radiation in the rehabilitation of patients with chronic pain syndrome in the lumbo-sacral spine

Jolanta Kujawa, Anna Cink, Kamila Gowrys, Ireneusz Pieszyński, Jan Talar

Jolanta Kujawa, Anna Cink, Kamila Gowrys, Ireneusz Pieszyński, Jan Talar – The analgesis effectiveness of continuous and fractionated doses of laser radiation in the rehabilitation of patients with chronic pain syndrome in the lumbo-sacral spine. Fizjoterapia Polska 2004; 4(3); 237-244

Abstract

Background. Due to the complex etiopathogenesis and the diversity of treatment approaches, spinal pain syndromes constitute a serious medical problem. The chronic pain and functional disturbances accompanying discopathy have motivated a search for more effective physiotherapeutic methods, such as McKenzie’s method of biomechanical diagnosis and treatment and laser therapy. The goal of the present study was to evaluate the analgesic effectiveness of continuous and fractionated doses of laser radiation in chronic lumbo-sacral pain syndrome. Material and methods. Our research involved 88 patients with chronic spinal pain syndrome qualified for McKenzie kinesitherapy. All subjects received kinesitherapy according to the authors’ method, selected according to the biomechanical diagnosis, along with 10 laser therapy procedures. Group A (43 patients) received a continuous dose of 9 J per point, while Group B (45 patients) received a fractionated dose of 3J + 6J per point. 37 points in the lumbo-sacral region were irradiated. Results. Group B showed a significantly greater decrease in pain intensity on the VAS scale (0-10 points), and in pain frequency. Both groups were found to have a reduced deficit in range of movement according to the McKenzie Institute lumbar checklist. Conclusions. Laser therapy with fractionated doses proved to be more effective in pain relief than continuous doses. The method of dosing laser radiation had no effect on improved range of movement in the lumbar spine. Biomechanical treatment using the McKenzie method combined with laser therapy significantly reduces pain and improves the range of movement in patients with chronic lumbar pain syndrome.

Key words:
discopathy, McKenzie method, kinesitherapy, biomechanical diagnostics
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The impact of laser biostimulation combined with diclofenac inunction on treatment outcome in patient with gonarthrosis

Jolanta Kujawa, Jan Talar, Kamila Gworys, Przemysław Gworys, Jarosław Oborzyński, Ireneusz Pieszyński, Mirosław Janiszewski

Jolanta Kujawa, Jan Talar, Kamila Gworys, Przemysław Gworys, Jarosław Oborzyński, Ireneusz Pieszyński, Mirosław Janiszewski – The impact of laser biostimulation combined with diclofenac inunction on treatment outcome in patient with gonarthrosis. Fizjoterapia Polska 2004; 4(3); 185-193

Abstract

Background. In patients with chronic knee pain and degenerative gonarthrosis, a wide range of physical agents are used, along with local application of non-steroid anti-inflammatory and analgesic drugs in gel or cream form. The evaluation of the clinical and functional status associated with changes in muscle tension and blood flow in the knee region can be facilitated by thermovisual tests, which measure the intensity of infrared radiation to determine skin temperature differences. Material and methods. 99 successive patients diagnosed with gonarthrosis and knee pain persisting > 6 weeks were enrolled. All patients were randomly assigned to one of three groups: Group A (n=32), who received laser biostimulation; Group B (n=35), who received the same laser procedures, and were also instructed to use sodium diclofenac (Voltaren gel) as an inunction on the affected joint; and Group C (n=32), a comparison group. We evaluated pain intensity using the VAS scale, and measured temperature distribution with thermograms performed twice in all patients, before and after treatment. Results. Significant reductions in pain intensity and frequency were observed in groups A and B, but Group B showed significantly greater improvement. In both experimental groups, thermograms showed normalization of temperature distribution. Conclusions. An improper temperature distribution along the lower extremity and around the patella was observed in patients with knee pain syndrome. The application of laser biostimulation in gonarthrosis produces temperature normalization in the irradiated tissues and reduced pain symptoms, which was more pronounced when combined with externally applied sodium diclofenac gel.

Key words:
low intensity laser therapy, thermovision, Pain Management
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Evaluating the activity of catalase (CAT) and superoxide dismutase (SOD-1) in blood platelets exposed to the electromagnetic field emitted in automobiles

Andrzej Buczyński, Krzysztof Pacholski, Jan Talar, Maria Dziedziczak-Buczyńska, Anna Jerominko

Andrzej Buczyński, Krzysztof Pacholski, Jan Talar, Maria Dziedziczak-Buczyńska, Anna Jerominko – Evaluating the activity of catalase (CAT) and superoxide dismutase (SOD-1) in blood platelets exposed to the electromagnetic field emitted in automobiles. Fizjoterapia Polska 2004; 4(4); 385-390

Abstract

Background. Blood platelets play an important role in many physiological and pathological processes. Their dysfunction may lead to serious illness or death. Numerous exogenic factors may have an adverse impact on platelet metabolic processes by affecting enzymatic reactions. The aim of our study was to determine how catalase (CAT) and superoxide dismutase (SOD-1) are modified by the exogenic electromagnetic field (EMF) occurring in a motor vehicle.Material and methods. Suspensions of human blood platelets were used for this investigation. The suspensions were exposed to EMF with the appropriate characteristics in a specially prepared test stand. Catalase (CAT) and superoxide dismutase (SOD-1) activity were measured in the experimental suspensions and in a control group 30, 60 and 90 min after exposure. Results. A significant increase in catalase activity was observed 30 and 60 min after the exposure. The level of the investigated enzymes decreased 90 min after the exposure, as compared to the control group. A significant decrease in SOD-1 activity was observed at each time point in which the suspension was exposed to EMF, as compared to the control group.Conclusion. The registered changes in catalase oxidative activity point up the active role of this enzyme in platelet defense against the effects of the electromagnetic fields emitted by automobile electronics. The decreased platelet antioxidative efficiency noted during the experiment may be connected with SOD-1 activity reduction.

Key words:
enzymatic reactions, platelet metabolism, anti-oxidative action
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