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 radiation (I=810 nm, P=100 mW) on acetylcholinesterase activity in human erythrocytes depending on the manner of energy dosage

Jolanta Kujawa, Magdalena Sadowska, Maria Bryszewska, Ireneusz Pieszyński, Mirosław Janiszewski

Jolanta Kujawa, Magdalena Sadowska, Maria Bryszewska, Ireneusz Pieszyński, Mirosław Janiszewski – The impact of laser radiation (I=810 nm, P=100 mW) on acetylcholinesterase activity in human erythrocytes depending on the manner of energy dosage. Fizjoterapia Polska 2004; 4(2); 136-142

Abstract

Background. The aim of this study was to investigate the impact of different doses and methods of applying low-power laser radiation (810 nm, 125 mW/cm2) on acetylcholinesterase (AChE) activity in human red blood cells. Material and methods. A suspension of human erythrocytes was irradiated with near-infrared laser light (810 nm, 125 mW/cm2) at different energy doses. AChE activity was measured by spectrophotometry. Km and Vmax were estimated with a Lineweaver-Burk graph, and compared with the results obtained for a non-irradiated control sample. Results. Near-infrared low-intensity laser radiation stimulated AChE activity. A fractionated dosage of energy with a larger dose applied first caused a statistically significant increase in AChE activity, more than the same dose applied continuously. Conclusions. Low-intensity near-infrared laser radiation caused AChE activity to change in a manner dependent on energy dose and the manner of energy application. The largest increase in the maximum velocity of the reaction was observed for continuous 9J. When fractionated doses (6J+ 3J and 9J+ 3J) were used, a larger increase in maximal reaction velocity was observed than for the continuous dose of 9 J or 12 J.

Key words:
low-level laser (LLL), fractionated doses, Vmax
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Impact of musical performance on the frequency of postural abnormalities in children

Anna Kluszczyńska, Jolanta Kujawa, Mirosław Janiszewski, Ireneusz Pieszyński

Anna Kluszczyńska, Jolanta Kujawa, Mirosław Janiszewski, Ireneusz Pieszyński – Impact of musical performance on the frequency of postural abnormalities in children. Fizjoterapia Polska 2004; 4(2); 117-128

Abstract

Background. An increased load on components of the musculo-skeletal system caused by musical performance can lead to postural abnormalities and overstraining of the musculo-skeletal system in young performing artists. The aim of our research was to investigate the link over the long term between play on musical instruments by children, the type of musical performance, and disturbances of body posture. Material and methods. Our research involved a group of 113 primary music school pupils. The study was conducted in 1st, 2nd, and 3rd grade pupils, 7, 9 and 11 years of age respectively. The clinical examination consisted of a physical exam and an orthopedic evaluation of the musculo-skeletal system. A questionnaire indicating the type of instrument played and the body posture during play was also used. Results. The postural abnormalities found in this population included scoliotic posture, scoliosis, and thoracic muscle contraction. Many children showed several types of postural abnormalities coexisting. A statistically significant difference in the frequency of postural abnormalities was found, depending on how long the given musical instrument had been played after five years of attendance at the music school. Conclusions. Musical performance may increase the incidence and progression of some body posture disorders in music school pupils. The load imposed by the instrument being played leads to faster development of the clinical symptoms of scoliosis in girls than in boys. The appearance and progression of the body posture disorders may be contingent on how long the musical instrument is played. The progression of clinical symptoms in music school pupils depends on the type of music performance.

Key words:
scoliotic posture, scoliosis, thoracic muscle contracture
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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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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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Evaluation of efficacy of interferential current and ultrasound therapy in patients with spinal pain

Karolina Szulkowska, Magdalena Fronczek, Jolanta Kujawa

Karolina Szulkowska, Magdalena Fronczek, Jolanta Kujawa – Evaluation of efficacy of interferential current and ultrasound therapy in patients with spinal pain. Fizjoterapia Polska 2010; 10(3); 181-192

Abstract
Background. Comparative evaluation of analgesic efficacy of interferential current and ultrasound for the relief of pain radiation to the lower limbs in patients with a chronic spinal pain syndrome in the course of osteoarthritis. Material and methods. The study involved 100 individuals divided into two equal groups. Group A (n=50) patients received 10 ultrasound therapy sessions (0.8 W/cm2, 10 minutes). Group B (n=50) patients received 10 interferential current (IC) treatment sessions (10 minutes, 90-100 Hz). All volunteers completed questionnaires containing 42 questions. A subjective pain evaluation was performed using Visual-Analogue Scale of pain (VAS). The Oswestry Disability Scale was used to evaluate lumbosacral spine dysfunction.Results. The incidence of pain radiating to the buttocks decreased in both groups. In the ultrasound group, there was an insignificant reduction of pain radiation to the posterior part of the thighs, while after interferential current therapy pain radiation decreased by 50%. Pain radiation below the knees was reduced significantly in the group treated with interferential current. Conclusions. Interferential current therapy more effective than ultrasound for the reduction of pain radiation to the lower extremities in patients with chronic low back pain in the course of spondyloarthrosis.
Key words:
interferential current, ultrasound, spinal pain
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