Assessment of the effectiveness of deep electromagnetic stimulation in the treatment of low back pain depending on the area of application

Agnieszka Przedborska, Małgorzata Kilon, Agnieszka Leszczyńska, Małgorzata Misztal, Jan W. Raczkowski

A. Przedborska, M. Kilon, A. Leszczyńska, M. Misztal, J. W. Raczkowski – Assessment of the effectiveness of deep electromagnetic stimulation in the treatment of low back pain depending on the area of application. Fizjoterapia Polska 2019; 19(2); 148-156

Abstract
Introduction. Disturbed mechanism of central stabilization associated with reduced pelvic floor muscle tone may be the cause of low back pain. The aim of the study was to assess the effectiveness of deep electromagnetic stimulation applied in the lumbosacral region or in the pelvic floor muscles in women with low back pain.
Material and methods. The study enrolled 109 women with spinal degenerative disease. Two groups were distinguished: the study group of 45 women who underwent a series of 10 sessions of deep electromagnetic stimulation in the pelvic floor muscles and a comparative group of 64 women in whom the procedure was applied in the lumbosacral region. The effectiveness of the therapy was assessed according to the VAS scale, locomotion and self-care were also evaluated.
Results. VAS scale demonstrated statistically significant reduction in pain intensity in both groups – Me(IQR) respectively: 5 (4-7) before the therapy vs 2 (1-3) afterwards in the study group and 6 (4-7) before the therapy vs 3 (2-4) after the therapy in the comparative group. Functional mobility and ability to perform everyday activities also improved statistically significantly. The obtained results were not long-lasting. In half of the patients the analgesic effect lasted at most 2 months (IQR: 1-4) in the study group and at most 4 months (IQR: 2-6) in the comparative group.
Conclusions. 1. Regardless of the area of application, deep electromagnetic stimulation reduces pain, improves the gait function and self-care of women with low back pain. 2. The analgesic effect of the therapy lasts longer when applying treatment in the lumbosacral region of the spine.

Key words:
low back pain, degenerative disease, pelvic floor muscles, electromagnetic stimulation

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Factors influencing functional performance of patients after hip joint arthroplasty

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

M. Kilon, A. Przedborska, J. Kostka, A. Leszczyńska, J. W. Raczkowski – Factors influencing functional performance of patients after hip joint arthroplasty. Fizjoterapia Polska 2019; 19(2); 122-128

Abstract
Aim. The aim of the study was to assess factors affecting functional status of patients after total unilateral hip arthroplasty.
Material and methods. A total of 50 patients (33 women, 17 men), aged 29-88 years (mean 66,7 ± 13 years) with unilateral hip joint prosthesis were included in the study. The assessment of the balance and gait function was made on the basis of the following tests: Tinetti, Timed Up and Go (TUG) and the two scales test, on the basis of which the Symmetry Index (SI) was calculated. The degree of pain sensation while walking on a flat surface and on stairs and the level of stiffness were estimated using the Likert scale. To assess the ability to perform simple and complex daily activities, the Katz ADL (Activities of Daily Living) and the Lawton IADL (Instrumental Activities of Daily Living) scales were used. Self-assessment of the quality of life was also made on the basis of a numerical rating scale. Moreover, the body mass index (BMI) was calculated.
Results. Age of patients, pain and stiffness determined the majority of test results and functional scales. Patients suffering from more diseases achieved worse results in the Tinetti test. Only the severity of pain while climbing the stairs affected the SI result. Patients reporting more severe pain and morning stiffness were characterized by poorer self-assessment of their quality of life.
Conclusions. Age, pain and morning stiffness affect the functional status and the quality of life of patients with unilateral hip prosthesis. BMI and the time that elapsed since surgery did not affect the patients’ condition.

Key words:
hip joint arthroplasty, quality of life, functional status

 

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Application of high frequency currents in treatment of patients with knee osteoarthritis

Agnieszka Przedborska, Ewa Pomorska, Marcin Świątczak, Małgorzata Staniszewska, Małgorzata Misztal, Jan W. Raczkowski

A. Przedborska, E. Pomorska, M. Świątczak, M. Staniszewska, M. Misztal, J. W. Raczkowski – Application of high frequency currents in treatment of patients with knee osteoarthritis. Fizjoterapia Polska 2018; 18(4); 112-121

Abstract
Introduction. Endogenous heat is widely used in the treatment of patients with knee osteoarthritis. The development of technology enables new methods of applying high frequency currents.
The purpose of the work is to assess the effectiveness of high frequency currents applied by various methods in the treatment of patients with knee osteoarthritis.
Material and methods. The study was conducted on a group of 111 patients with knee osteoarthritis, of which two groups were distinguished. The studied group consisted of 61 patients subjected to high-frequency therapy using the Thermo TK device. The control group consisted of 50 patients who underwent shortwave diathermy treatment. Assessment of the effectiveness of therapy was carried out on the basis of the VAS scale, Laitinen scale, perimeter and range of motion in the knee joint.
Results. Both groups displayed a statistically significant (p <0.0001) reduction in pain after the therapy according to the Laitinen scale (median (interquartile range IQR), respectively before and after the treatment: in the study group: 7 (6-8) scores vs. 3 (2-6) scores and in the control group: 8 (6-10) scores vs. 3.5 (2-7) scores). In addition, a statistically significant (p = 0.0031) reduction in the frequency of analgesics was observed in the study group. After treatment, in each of the groups, statistically significant (p <0.0001) alleviation of pain symptoms according to the VAS scale was also observed while walking on a flat surface and stairs. Circumference through the knee joint was also decreased (p <0.0001), while the extent of the bending movement significantly increased (p <0.0001). The duration of the analgesic effect in both groups was similar. Conclusions. 1. Regardless of the type of application, high frequency currents reduce pain and improve the range of knee joint motion in patients with osteoarthritis. 2. The analgesic effect of the therapy in both groups was not permanent. Key words: knee joints, degenerative disease, high frequency currents  

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Evaluation of functional status of children with cerebral palsy using selected scales and tests

Małgorzata Kilon, Martyna Ruszkiewicz, Jan W. Raczkowski

M. Kilon, M. Ruszkiewicz, J. W. Raczkowski – Evaluation of functional status of children with cerebral palsy using selected scales and tests. Fizjoterapia Polska 2018; 18(4); 86-93

Abstract
Objective. The aim of the study was to assess the functional status of children with Cerebral Palsy (CP) using selected scales and tests and to analyze the factors affecting the results.
Material and methods. The study involved 33 children diagnosed with CP, aged 4 to 18 years, attending selected rehabilitation centers in the Lodz region. The research tools included: an original questionnaire, the Gross Motor Function Measure (GMFM) and the Gross Motor Function Classification System (GMFCS) to evaluate the gross motor skills and the Manual Ability Classification System (MACS) for fine motor skills.
In the statistical analysis, the influence of quantitative variables on the scale results was determined on the basis of Pearson and Spearman correlation coefficient depending on the distribution. The one-way ANOVA or the non-parametric Kruskal-Wallis test was used to assess the effect of qualitative variables on the functional efficiency of children.
Results. Seven children showed none or extremely low physical fitness. They were children with paralysis of four limbs – tetraparesis. The results of the tests were influenced by the length of pregnancy, birth weight, age and height and verbal-logical contact. No correlation was found between qualitative variables such as gender and coexisting epilepsy. A strong correlation was observed between fine and gross motor activity.
Conclusions. The examined children presented varying levels of functional fitness in the used scales and tests. The number of scores obtained by them was strictly related to the type of CP. Children in better verbal and logical contact achieved better scores in the assessed scales. Subjective assessment of children’s performance according to parents was in compliance with the test results.

Key words:
cerebral palsy, MACS, GMFM, GMFCS

 

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The effect of deep electromagnetic stimulation of pelvic floor muscles on low back pain in female patients with stress urinary incontinence

Agnieszka Przedborska, Małgorzata Kilon, Małgorzata Misztal, Jan W. Raczkowski

Agnieszka Przedborska, Małgorzata Kilon, Małgorzata Misztal, Jan W. Raczkowski – The effect of deep electromagnetic stimulation of pelvic floor muscles on low back pain in female patients with stress urinary incontinence. Fizjoterapia Polska 2018; 18(3); 46-54

Abstract
Objective. The goal of the study was to assess the effect of deep electromagnetic stimulation of pelvic floor muscles on low back pain in women with stress urinary incontinence.
Material and methods. The study was conducted in a group of 85 women with chronic low back pain and coexisting urinary incontinence who underwent 10 deep electromagnetic stimulation sessions of the pelvic floor. The assessment of the effectiveness of the therapy was performed on the basis of the VAS scale, the assessment of the activities of daily living and changes in the severity of symptoms associated with urinary incontinence.
Results. A statistically significant reduction in the severity of low back pain was reported according to the VAS scale – Me (IQR) respectively: 5 (4-7) before vs. 3 (1-4) after the therapy. Functional mobility and ability to perform everyday activities improved statistically significantly. There was also observed a statistically significant reduction in the incidence of urinary incontinence episodes (0% of patients without episodes of incontinence before therapy vs. 47.1% of patients after the treatment) and a decrease in the urine output. However, the obtained effects of the therapy were not long-lasting. In half of the patients, both the analgesic effect and the improvement of urinary incontinence symptoms lasted at most 2 months (IQR: 1-3 months in the case of low back pain and IQR: 1-2 months in the case of stress urinary incontinence).
Conclusions. 1. Deep electromagnetic stimulation of pelvic floor muscles decreases low back pain and reduces symptoms of stress urinary incontinence. 2. The improvement effect is not long-lasting.

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Key words:
low back pain, urinary incontinence, pelvic floor muscles, electromagnetic stimulation

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The impact of BMI value on the Wejsflog index, and the foot pain assessment

Mateusz Curyło, Magdalenna Wilk-Frańczuk,
Marlena Rynkiewicz-Andryśkiewicz, Jan W. Raczkowski

M. Curyło, M. Wilk-Frańczuk, M. Rynkiewicz-Andryśkiewicz, J. W. Raczkowski – The impact of BMI value on the Wejsflog index, and the foot pain assessment. FP 2014; 14(3); 22-34

Abstract

Introduction. The foot is not only the organ having great stability and overload endurance, but also one being a dynamic spring and, due to this feature, functioning as a shock absorber.
Aims of the work
1. Determining if there exists a correlation between Wejsflog index and the body mass of patient;
2. Determining if the body mass is a risk factor for the transverse arch lowering;
3. Determining if the body mass and the structure of the transverse foot arch influence the appearance of the foot pain ailment.
Material and methods. The research was carried out in Krakow in 2012-2013 period. The examined group of the research consisted of 249 patients, including 178 women and 71 men, aged 21-88 (average age of 52 years).
Results. P-value of the chi-square test is less than 0.05, thus the value of Wejsflog index significantly depends on the BMI: the higher the BMI, the more frequently the transverse arch lowering occurs. P-value of the Mann-Whitney test is greater than 0.05, thus the evaluation of the pain strength is statistically not dependent on the Wejsflog index.
Conclusions
1. The influence of the correlation between the body mass index (BMI) and the frequency of occurrence of the transverse foot arch lowering measured by the Wejsflog index has been proven.
2. Increased body mass defined by the body mass index (BMI) as overweight and obesity is a significant risk factor for the transverse foot arch lowering.
3. Increased body mass index as well as the transverse foot arch lowering measured by the Wejsflog index have no influence on the occurrence of the foot pain ailment.

Key words:
body mass index (BMI), Wejsflog index, transverse arch of the foot

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Evaluation of the therapeutic effects in the patients with the glenohumeral joint dysfunction treated according to Brian Mulligan concept and with the pectoral girdle muscle tapping as well as circumarticular injections

Mateusz Curyło, Katarzyna Cienkosz, Jan W. Sosnowski, Andrzej Szczygieł, Irena Szczepańska, Piotr Wróbel, Magdalena Wilk-Frańczuk,  Jan W. Raczkowski

M. Curyło, K. Cienkosz, J. W. Sosnowski, A. Szczygieł, I. Szczepańska, P. Wróbel, M. Wilk-Frańczuk,  J. W. Raczkowski – Evaluation of the therapeutic effects in the patients with the glenohumeral joint dysfunction treated according to Brian Mulligan concept and with the pectoral girdle muscle tapping as well as circumarticular injections. FP 2017; 17(1); 116-124

Abstract

Introduction. Sedentary lifestyle connected with the civilizational development and the work in sitting position cause glenohumeral joints dysfunction, most often in the form of overload-pain ailments.
Purpose of this study. The purpose of this study was to compare the physiotherapeutic effects with the application of mobilization with motion according to Brian Mulligan and the pectoral girdle muscle tapping, and the used circumarticular injections.
Material and Methods. The research included 27 patients. The first group (16 persons) was treated with the circumarticular injections of medicines of the corticosteroids group. In the second group (11 persons) the manual therapy according to Brian Mulligan’s concept and the muscle tapping were used. The examinations were performed before the therapy and after three weeks. The used measurements included the shoulder pain and disability index SPADI, provocative tests HIN, HIB, POP, Job, “painful arc” (70°-120°), “belly–press”, goniometric measurement and the subjective pain feeling at the night time. In order to check if the used therapy type had any effect on the upper limb function improvement, the statistical analysis was made in the variance with a_mixed scheme, where the inter-group factor was the type of therapy, and the intra-group factor was the measurement moment: before and after completion of the therapy. Data were processed using Microsoft Excel and Statistica software.
Results. The applied therapy methods influenced improvement of the glenohumeral joint movement range in both groups. The group 2 had better results in reduction of periodic pain ailments and sleep disturbances.
Conclusions. Both used therapeutic programs improves functioning and reduce pain ailments in the investigated group, however the use of 2 therapeutic techniques in the group 2, according to Mulligan’s concept and the muscle tapping, brought significantly greater improvement in the clinical condition evaluation and in the patients’ subjective assessment.

Key words:
painful shoulder syndrome, manual therapy, physiotherapy

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Evaluation of the lumbar spine pain syndromes frequency of occurrence among office and physical workers

Mateusz Curyło, Alicja Bielańska,  Jan W. Raczkowski

M. Curyło, A. Bielańska,  J. W. Raczkowski – Evaluation of the lumbar spine pain syndromes frequency of occurrence among office and physical workers. FP 2017; 17(1); 28-36

Abstract
Purpose of this study. The purpose of this study was to investigate frequency of the lumbar spine pain syndromes in the group of persons that perform office work and physical work. The pain effect on the investigated everyday lives was also evaluated.
Material and methods. The research was conducted using the Revised Oswestry Low Back Pain Disability Scale. The questions included in the questionnaire concerned everyday life activities. The questioned persons also subjectively assessed the pain intensity and the intensity change.
Conclusions. The ailments relating to the lumbar spine section appear in different occupations and they affect the workers’ everyday lives. More difficulties in the everyday life appear among the office workers, where the pain restricts their walking, lying or sleeping. Implementation of some physical activity reduces the ailments.

Key words:
lumbar spine section, physical work, office workers

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Rehabilitation treatment of 11-years-old boy with Pierre Robin Syndrome – a case study

Izabela Wilmańska, Jan W. Raczkowski

I. Wilmańska, J. W. Raczkowski – Rehabilitation treatment of 11-years-old boy with Pierre Robin Syndrome – a case study. FP 2017; 17(1); 6-13

Abstract

Goal. The aim of the study was to describe a patient with Pierre Robin Syndrome (PRS), with delayed psychomotor development and evaluation of the patient after the physiotherapy procedure.
Materials and Methods. The authors describe an 11-year-old patient suffering for Pierre Robin syndrome with muscle weakness and severe perinatal loads. The patient postural strength was evaluated by testing the antigravity muscles. The gait effectiveness was measured by using a 10 m walk test and physical performance using Ruffie’s test.
Results. Intensive rehabilitation, well-chosen exercises and accurately set of kinesitherapeutic objectives have well affected the condition of a patient with developmental deficits, which is a Pierre Robin syndrome.
Conclusions. In supporting children with rare disorders such as Pierre Robin syndrome it is necessary to take the earliest possible rehabilitation. Patient care should be long-term and should be interdisciplinary.

Key words:
Pierre Robin syndrome, psychomotor retardation, muscular weakness

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Evaluation of body balance in patients with transverse flat foot and the related falls

Sylwia Czesna, Jan W. Raczkowski

S. Czesna, J. W. Raczkowski – Evaluation of body balance in patients with transverse flat foot and the related falls. FP 2015; 15(3); 90-96

Abstract

Introduction. Transverse flat foot is a very often occurring foot defect, the most common in women wearing high-heeled shoes. It is the most common cause of musculoligamentous foot failure, which increases the risk of falls, threatening the efficiency of adults and the elderly. The ability to maintain a balance results from proper functioning of the so-called deep sensation of the human body, psychophysical coordination and strong muscles. Muscle weakness especially of lower limbs increases the risk of imbalance, thereby jeopardizing the fall. Improper passing burden on a flat foot makes it more difficult to maintain balance.
Material and methods. The study included 28 patients with transverse flat foot and 21 patients with normal foot arch at the age of 52±11.5
Results. Analysis of the tested parameters revealed that disturbances to maintain the balance with the transverse flat foot occurs in 68% (n= 9) subjects, and only 32% (n=9) of the test was within the normal range. In contrast, in patients with a normal arch feet imbalance occurs in 29% (n=6) subjects and 71% (n=15) subjects were in the standard range.
Conclusions. In this study it was we demonstrated that imbalance in patients with transverse flat foot is of 2:1 higher than in patients with normal arch feet. The results show that people with the transverse flat foot are more vulnerable to imbalances which result in falls.

Key words:
transverse flat foot, balance, motor coordination

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