An original method for analyzing thermo-images as an objective supplement to diagnosis outcome evaluation in knee pain syndrome

Jolanta Kujawa, Jarosław Oborzyński, Kamila Gworys, Mirosław Janiszewski, Małgorzata Łukowicz

Jolanta Kujawa, Jarosław Oborzyński, Kamila Gworys, Mirosław Janiszewski, Małgorzata Łukowicz – An original method for analyzing thermo-images as an objective supplement to diagnosis outcome evaluation in knee pain syndrome. Fizjoterapia Polska 2003; 3(4); 375-383

Abstract

Background. This article presents a technique for analyzing thermovision images by calculating the knee-limb temperature index (KLTI). The usefulness of this technique for diagnosis and outcome evaluation is assessed. Material and methods. 41 patients with knee pain syndrome in 67 joints were examined, along with 30 healthy controls. The intensity of knee joint dysfunction was evaluated on a 0-30 point scale according to a specially developed test the sheet. Results. In the control group, the KLTI was in the range from -1.4°C to -0.2°C; the range from -1.31°C to -0.5°C was the norm for 90% of the population. In the experimental group, the KLTC place from -0.5°C to +1.8°C. The differences between the KLTI values in the two groups was statistically significant. There was also correlation between the intensity of dysfunction and the KLTI. In the experimental group the values were lower after treatment. Conclusions. The KLTI is a highly specific and sensitive instrument for evaluating knee pain syndrome. The technique described here is a valuable diagnostic supplement, objectivizing outcome evaluation in these patients.

Key words:
thermovision, knee pain syndrome, physiotherapy
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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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How to guarantee the patient’s success after shoulder arthroplasty part II: post-surgery rehabilitation

Jolanta Kujawa, Jarosław Oborzyński, Mirosław Janiszewski

Jolanta Kujawa, Jarosław Oborzyński, Mirosław Janiszewski – How to guarantee the patient’s success after shoulder arthroplasty part II: post-surgery rehabilitation. Fizjoterapia Polska 2004; 4(2); 176-182

Abstract

In the opinion of many authors, surgical reconstruction of the shoulder enables optimal recovery of functionality. The problem of post-surgical rehabilitation remains a point of however, due to differences of opinion regarding the optimal time to commerce rehabilitation, the order which exercises are introduced, and the need to modify physiotherapeutic procedures. Long-term cooperation within the treatment team and good cooperation with the patient can guarantee a positive rehabilitation outcome. The rehabilitation program should be individually tailored and modified at each stage of treatment. On the basis of a review of the literature and their own experience, the authors have developed a basic post-surgical rehabilitation program, which enables the recovery of optimal joint function. The article is illustrated by photographs showing the proposed exercises.

Key words:
early rehabilitation,kinesitherapy, physicotherapy
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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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Thermovisual imaging in diagnostics and outcome monitoring in disorders of the knee

Jolanta Kujawa, Jarosław Oborzyński, Kamila Gworys, Joanna Błaszczyk-Suszyńska, Mirosław Janiszewski

Jolanta Kujawa, Jarosław Oborzyński, Kamila Gworys, Joanna Błaszczyk-Suszyńska, Mirosław Janiszewski – Thermovisual imaging in diagnostics and outcome monitoring in disorders of the knee. Fizjoterapia Polska 2004; 4(4); 323-330

Abstract

Background. This article presents an analysis of prospective studies completed to date on the application of thermovisual imaging in the diagnosis and outcome monitoring of disorders of the knee joint. Material and methods. Three prospective studies were analyzed. Thermovisual exams were performed on the knees in a group of 170 patients with pain symptoms and 45 patients without knee pain. The intensity of the pain and joint dysfunction were evaluated on the basis of results from the Visual Analogue Scale (VAS), a specially developed patient chart, and the Knee-Leg Temperature Index (KLTI). Results. In the control group, the KLTI ranged from -1.5°C to -0.1°C. In the experimental group, the KLTI was between -1.8°C and +1.8°C before treatment, as compared to a range from -1.6°C to +1°C after treatment. Statistical analysis showed that the level of perceived pain and degree of dysfunction correlated with changes in the KLTI.Conclusions. The application of thermovisual examination with calculation of the KLTI is a valuable supplement in the evaluation of outcome in knee disorders. The sensitivity and specificity of the KLTI is high in knee pain syndrome. The method used to analyze the thermovisual image should be modified when there are disease conditions that may alter the skin surface temperature distribution in the lower extremity.

Key words:
knee pain, Visual Analogue Scale, Knee-Leg Temperature Index (KLTI)
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