Long-term evaluation of the quality of life of patients with osteoarthritis treated conservatively and surgically

Marcin Świątczak, Aneta Nowicka, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski

Marcin Świątczak, Aneta Nowicka, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski – Long-term evaluation of the quality of life of patients with osteoarthritis treated conservatively and surgically. Fizjoterapia Polska 2021; 21(3); 198-204

Abstract
Introduction. Osteoarthritis of the hip joint is one of the most common chronic diseases of the locomotor system. Total hip replacement (THR) is a treatment option of choice alongside conservative treatment. The aim of the study was the long-term assessment of the quality of life of patients after total hip replacement surgery and after conservative treatment.
Material and methods. The study group consisted of 35 patients diagnosed with many years of osteoarthritis of the hip who underwent THR with posterolateral surgical approach. The assessment was carried out at the Department of Orthopedics and Traumatology of the University Teaching Hospital WAM – CSW in Łódź. The control group consisted of 15 patients with long-term osteoarthritis of the hip, treated conservatively. Medical data were obtained from the history of the disease and the author’s questionnaire, while the World Health Organization Quality OF Life (WHOQOL) – BREF questionnaire was used to assess the quality of life.
The obtained results were statistically analyzed with the use of MS Office and the Student’s T-test, considering the results below p <0.05 as statistically significant.
Results. The assessment of domains was similar in both groups, the greatest dissonance was observed in the assessments of the somatic and social domains. Based on WHOQOL-BREF questionnaire, the majority of patients in the study group rated the quality of life from 60% to 70% of the maximum value, the highest psychological sphere, the least somatic. In the control group, the social domain obtained 78% of the maximum value, other domains – 74% of the maximum value.
Conclusions. Patients treated conservatively assessed their quality of life higher in all domains than patients who underwent THR. In both studied groups, the “positive” variant of the answer was the most frequently chosen in the WHOQOL-BREF questionnaire.
Key words:
quality of life, osteoarthrotic hip disease, alloplasty
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Legal protection of the physiotherapist as a profession of public trust

Marcin Mikos, Mateusz Curyło, Marlena Rynkiewicz-Andryśkiewicz, Tomasz Pęcherz, Ewa Kucharska, Jan. W. Raczkowski

Marcin Mikos, Mateusz Curyło, Marlena Rynkiewicz-Andryśkiewicz, Tomasz Pęcherz, Ewa Kucharska, Jan. W. Raczkowski – Legal protection of the physiotherapist as a profession of public trust. Fizjoterapia Polska 2021; 21(3); 194-196

Abstract
Physiotherapists are regarded as one of the medical professions of public trust. The Act on Physiotherapist Occupation establishes physiotherapists as a medical occupation of public trust. Medical professions of public trust, such as doctors, nurses, and paramedics, have special legal protection not available to physiotherapists. The Act on Physiotherapists has not defined the physiotherapist as a civil servant. It directly deprives physiotherapists of special legal protection that is assigned to civil servants.
Key words:
Physiotherapist – medical profession of public trust, legal protection of physiotherapist, civil servant, the danger of practising physiotherapy
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Comparative analysis of the functional status of women with osteoarthritis of the hip or knee joint

Małgorzata Kilon, Agnieszka Przedborska, Joanna Kostka, Jan W. Raczkowski

Małgorzata Kilon, Agnieszka Przedborska, Joanna Kostka, Jan W. Raczkowski – Comparative analysis of the functional status of women with osteoarthritis of the hip or knee joint. Fizjoterapia Polska 2021; 21(3); 134-142

Abstract
Objective. The objective of the study was to compare the level of functional efficiency and factors influencing it in women after the age of 50 with advanced osteoarthritis of the hip (coxarthrosis) or knee (gonarthrosis) joint.
Material and methods. The study included 70 women aged 50–90 years with coxarthrosis (n = 35) or gonarthrosis (n = 35), stage 3 according to the Kellegren-Lawrence scale.
The functional status was assessed based on the Tinetti test and the Two-scales test. The Likert scale rated pain, stiffness, and the difficulty of getting up and putting on socks. The quality of life was assessed using a 100-point scale.
Results. Women with coxarthrosis achieved worse results in the Tinetti test in the part concerning gait (p < 0.01) and balance (p < 0.05). Pain and stiffness determined the results of most tests. Patients with gonarthrosis had greater problems with walking on flat surfaces and with getting up from a chair (p < 0.001). Pain determined difficulties when walking and putting on socks, and stiffness influenced difficulties in walking, standing up, putting on socks, and the results of the Tinetti test.
Conclusions.
1. Stiffness and pain deteriorate functional efficiency in women with coxarthrosis and gonarthrosis.
2. Greater problems with gait and balance occur in women with coxarthrosis, while women with gonarthrosis have greater difficulties with walking on flat surfaces and getting up from a chair.
Key words:
osteoarthritis, hip joints, knee joints, functional efficiency, Tinetti test
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The effectiveness of rehabilitation by exercising central stability of the cervical spine in cognitive phase in patients with neck pain (pilot study)

Marcin Świątczak, Rafał Janiak, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski

Marcin Świątczak, Rafał Janiak, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski – The effectiveness of rehabilitation by exercising central stability of the cervical spine in cognitive phase in patients with neck pain (pilot study). Fizjoterapia Polska 2021; 21(3); 102-112

Abstract
Introduction. In present times, vast majority of patients with back ailments complain about pain in cervical spine area. The use of  exercises based on biofeedback as well as  patient’s full engagement and focus  are designed to restore sufficient control to deep stabilizers of the cervical spine, where  vestibular system plays a crucial role.  The following method is appropriate for patients who experience different types of pain since it will not inflict further damage or exacerbate existing degeneration in that segment.
Purpose of the study. The purpose of this study is to analyze how central stabilization exercises influence stability of the neck in cognitive phase and whether they minimize neck pain, correct and restore overall motor control to effectively improve everyday physical activity and activities of daily living.
Measures and test methods. The subject of this research were patients with neck pain syndrome. The group of participants took part in a three-week program, which involved exercising central stability of the neck. The test measures were: Numeric Rating Scale (NRS), measures of neck mobility, Neck Disability Index, repositioning to neutral spot, as well as The Dartmouth Coop Functional and Health Status Measures for Adults. The patients were examined before and after completing the program.
Results. The study has shown that neck pain decreased by 1.7 points in 80% of the respondents. It has been observed that after the program patients had experienced increased neck mobility by 1 centimeter on average in all ranges of motion. They have also reported improved everyday physical activity and greater physical fitness.
Conclusions. Exercising central stability of the cervical spine in cognitive phase are beneficial for: restoring motor control, relieving neck pain, increasing range of motion of the head, and improving everyday physical activity.
Key words:
central stability, cervical spine, cognitive
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Hand and wrist injuries occurring in regular sport climbers

Marta Schmidt, Aleksandra Krupa, Agnieszka Ciukszo, Arkadiusz Fiedor, Ewa Kucharska, Jan W. Raczkowski, Mateusz Curyło

Marta Schmidt, Aleksandra Krupa, Agnieszka Ciukszo, Arkadiusz Fiedor, Ewa Kucharska, Jan W. Raczkowski, Mateusz Curyło – Hand and wrist injuries occurring in regular sport climbers. Fizjoterapia Polska 2021; 21(3); 86-92

Abstract
In the recent years sport climbing has become more and more popular. As an extreme sport, it is prone to a high degree of injury risk. A particular body part exposed to injuries is the upper extremity.
The aim of this study was to assess the number and types of hands and/or wrists injuries in regular sport climbers. The study was conducted on a group of 468 climbers. The criterion for inclusion was the regularity of conducted trainings, training internship of at least 1 year and the minimum difficulty of covering the distance at the level of VI.1. A proprietary questionnaire was used as a research tool.
As a result of climbing training 84% of examined climbers experienced pain in their palm/wrist area, whereas 67% of respondents suffered hand/wrist damage. The most common hand injuries occurred on the annular ligaments of the fingers (N = 97). It was observed a correlation between annular pulley injury and injuries occurring in the proximity of the III finger (rs = 0.513, p < 0.001) as well as between carpal tunnel syndrome and training experience (rs = 0.355, p < 0.05).
Musculoskeletal system damage and pain is a common problem for climbers. The analysis of the collected data indicated that the longer the training experience is, the higher the injury risk. The third and fourth fingers were the most injured, whereas the most frequent injuries were suffered in annular finger ligament. The collected data indicated the need to educate climbers in prevention and treatment of these specific injuries.
Key words:
sport climbing, sport injuries, hand injuries, climbing training
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Rheumatoid arthritis and rheumatoid foot in physiotherapy

Mateusz Curyło, Marlena Rynkiewicz-Andryśkiewicz, Agnieszka Ciukszo, Damian Szubski, Ewa Kucharska, Jan Czernicki, Jan W. Raczkowski

Mateusz Curyło, Marlena Rynkiewicz-Andryśkiewicz, Agnieszka Ciukszo, Damian Szubski, Ewa Kucharska, Jan Czernicki, Jan W. Raczkowski – Rheumatoid arthritis and rheumatoid foot in physiotherapy. Fizjoterapia Polska 2021; 21(2); 172-183

Abstract
Rheumatic diseases are not fatal, but they result in shorter life expectancy of the patients suffering from them. This applies to all inflammatory rheumatic diseases, especially rheumatoid arthritis (RA). Rheumatic diseases, in which most of all the joint inflammatory process develops with progressive joint damage, are the cause of patients’ disability, prevent patients from working and everyday functioning, also at home, and affect all aspects of social life. The objective of rehabilitation in RA is to relieve pain, reduce or inhibit inflammation, and maintain the proper functioning of the locomotor system while slowing down or ceasing structural lesions in the joints.
Key words:
Rheumatoid arthritis, RA, rheumatoid foot, disability, orthopaedic equipment
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Evaluation of therapeutic effectiveness of diathermy in patients with degenerative disease of the lumbar spine

Agnieszka Przedborska, Jan W. Raczkowski, Małgorzata Misztal

Agnieszka Przedborska, Jan W. Raczkowski, Małgorzata Misztal – Evaluation of therapeutic effectiveness of diathermy in patients with degenerative disease of the lumbar spine. Fizjoterapia Polska 2021; 21(2); 70-76

Abstract
Introduction. Diathermy is one of the stimuli used in treatment of degenerative spine disease. Endogenous heat alleviates the symptoms of the disease. Diathermy treatments differ due to wave size and electromagnetic vibration frequency. Objective. Evaluation of the effectiveness of diathermy generated by short waves and radio waves in the treatment of patients with degenerative disease of the lumbar spine. Material and methods. The research was carried out on a group of 68 people with degenerative disease of the lumbar spine, divided into two groups. The study group consisted of 36 people who underwent therapy with radio waves using the Thermo TK device. The comparison group consisted of 32 people who underwent shortwave diathermy treatments. Therapeutic effectiveness was evaluated on the basis of pain assessment according to the VAS scale and the Laitinen pain scale as well as the range of motion measured with the Schober test and the Thomayer test. Results. In both groups, a statistically significant (p <0.0001) pain reduction after therapy according to the Laitinen pain scale was observed (Me (IQR) before and after therapy , respectively: in the study group: 6.5 (5-9) scores vs. 4 (3-5.5) scores and in the comparison group: 6 (5-8) scores vs. 4 (3-5) scores) and according to the VAS scale – in the study group: 6 (5-7.5) scores vs. 4 (3-4) scores and in the comparison group: 6 (5-7.5) scores vs. 3 (3-5) scores. The Thomayer test and the Schober test results also improved significantly in each group. Conclusions. Regardless of the wavelength generating endogenous heat, both treatments reduce pain and improve the range of motion of the lumbar spine in patients with degenerative spine disease.
Key words:
spine, degenerative disease, diathermy, radio waves
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Assessment of the impact of prosthetic foot support flexibility on gait in a patient after lower limb amputation at thigh level

Mateusz Curyło, Agnieszka Ciukszo, Marcin Zaczyk, Damian Szubski, Łukasz Strzępek, Bolesław Karwat, Jan W. Raczkowski

Mateusz Curyło, Agnieszka Ciukszo, Marcin Zaczyk, Damian Szubski, Łukasz Strzępek, Bolesław Karwat, Jan W. Raczkowski – Assessment of the impact of prosthetic foot support flexibility on gait in a patient after lower limb amputation at thigh level. Fizjoterapia Polska 2021; 21(2); 56-63

Abstract
Objective. The article presents the results of experimental studies, the main objective of which was to determine how the degree of flexibility of the lower limb prosthesis support system impacts the pattern of secondarily learned gait in a patient after amputation. Material and methods. The study was carried out on a patient (35-year-old man) after lower limb amputation at the level of 1/3 of the proximal femur, who followed a previously planned walking path. Inclusion criteria: gender F and M, amputation at 1/3 of the proximal femur, age below 40, traumatic amputation, average level of activity, use of a prosthesis for at least one year. Exclusion criteria: age over 40, amputations below 1/3 of the proximal femur, amputations for vascular reasons, activity level below average, use of a prosthesis for under one year. During the study, the patient was equipped with three support systems corresponding to three degrees of flexibility of the prosthetic foot (soft, medium, hard). Biomechanical data during gait was collected using FlexinFit by Sensor Medica for assessing the pressure between the foot and the inside of the shoe. Results. In the entire gait cycle, the support phase on the healthy limb was the longest. The hard support system generates the greatest asymmetry of the transferred loads between the limbs. In this support variant, the difference in load between the healthy limb and the amputated limb was 1,330 kg/m2, which represented an asymmetry of 21%. In terms of load distribution, the best support was medium support – medium support flexibility, for which the difference in load between the healthy limb and the amputated limb was 770 kg/m2, which was an asymmetry of 12%. Conclusions. When designing a prosthesis for people after lower limb amputation, it is crucial to correctly adjust its features to the individual needs of each patient (adjusting prosthesis kinematics, adjusting support system stiffness), so that gait is possibly closest to normal with low energy demand.
Key words:
lower limb amputation, gait analysis, prosthetic gait, prosthetic rehabilitation
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Following the recommendations concerning pulmonary rehabilitation by parents of children with cystic fibrosis

Oktawia Kuna, Halina Woś, Bożena Kordys-Darmolińska, Agnieszka Ciukszo, Jacek Durmała, Zbigniew Śliwiński, Marcin Mikos, Jan W.Raczkowski, Mateusz Curyło

Oktawia Kuna, Halina Woś, Bożena Kordys-Darmolińska, Agnieszka Ciukszo, Jacek Durmała, Zbigniew Śliwiński, Marcin Mikos, Jan W.Raczkowski, Mateusz Curyło – Following the recommendations concerning pulmonary rehabilitation by parents of children with cystic fibrosis. Fizjoterapia Polska 2021; 21(1); 178-186

Abstract
Introduction. When performed according to the most recent standards, rehabilitation and nebulization enable the prevention of progression of cystic fibrosis.
Aim. The aim of the study was to assess the parents’ knowledge concerning the disease, education of pro-health attitudes, taking care of pulmonary rehabilitation equipment, and following the recommendations on how to perform inhalations correctly.
Materials and methods. Seventy-four parents with at least one child affected by cystic fibrosis participated in a survey, where we applied our own questionnaire.
Results. A majority of the parents claim to possess knowledge about the disease and to be familiar with the specialist terminology; however, a control question does not confirm that. Only 50% of the respondents take advantage of a positive influence of physical effort on the respiratory function, whereas 50% of the children assume incorrect positions during nebulization, and merely half of the parents maintain nebulization equipment in the right way.
Conclusions. Parents still need further education concerning their children’s condition, the principles of their rehabilitation, hygiene, the ways of properly maintaining the equipment, as well as dosing the suitable amount of physical activity on a daily basis.
Key words:
cystic fibrosis, rehabilitation, nebulization, physical activity, education
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Complications in the course of the A(H1N1) influenza virus infection in the form of rhabdomyolysis – case study

Oktawia Kuna, Agnieszka Ciukszo, Mateusz Curyło, Ewa Kucharska, Zbigniew Śliwiński, Jan W. Raczkowski

Oktawia Kuna, Agnieszka Ciukszo, Mateusz Curyło, Ewa Kucharska,
Zbigniew Śliwiński, Jan W. Raczkowski – Complications in the course of the A(H1N1) influenza virus infection in the form of rhabdomyolysis – case study. Fizjoterapia Polska 2021; 21(1); 6-12

Abstract
In the course of rhabdomyolysis, breakdown and necrosis of muscle fibres occur, and the toxic content of cells leaks into the systemic circulation. In adult patients, the causes of rhabdomyolysis may include injuries, crushing as a result of accidents, prolonged immobilization, high voltage electric shock; while in children, in particular the youngest children, viral infections constitute the most common cause. Based on the analysis of the collected literature, no standardization of physiotherapeutic treatment in paediatric patients with rhabdomyolysis was found. The objective of the study is to present a case of a 5-year-old boy with a complicated course of the A(H1N1) influenza virus infection, as a result of which he required physiotherapeutic and orthotic treatment adapted to the patient’s clinical condition and functional abilities. Treatment of paediatric patients with rhabdomyolysis is symptomatic. Pharmacotherapy and rehabilitation affect the maintenance of and/or increase in the range of mobility in the joints, and the use of orthoses helps maintain therapeutic effects.
Key words:
rhabdomyolysis, influenza complications, children rehabilitation
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