The impact of comprehensive spa treatment with the use of a stabilometric platform on postural balance control and functional fitness of patients after a stroke

Agnieszka Nitera-Kowalik, Iwona Sarzyńska-Długosz, Małgorzata Łukowicz, Agnieszka Malec, Robert Owsiński, Wiesław Bujalski

Agnieszka Nitera-Kowalik, Iwona Sarzyńska-Długosz, Małgorzata Łukowicz, Agnieszka Malec, Robert Owsiński, Wiesław Bujalski – The impact of comprehensive spa treatment with the use of a stabilometric platform on postural balance control and functional fitness of patients after a stroke. Fizjoterapia Polska 2022; 22(1); 76-93

Abstract
Introduction. Loss of postural balance control is a symptom that occurs in 60% of stroke patients, limiting patients’ mobility and functional efficiency. The reconstruction of lost functions can be achieved thanks to comprehensive spa treatment with the use of a modern device for the assessment and training of balance – a stabilometric platform.
The objective was to assess the impact of comprehensive spa treatment, including therapy on a stabilometric platform, on balance and functional fitness of stroke patients undergoing rehabilitation at the 21st Military Spa and Rehabilitation Hospital in Busko-Zdrój.
Material and methods. Seventeen patients were examined: 6 patients (35.3%) after a haemorrhagic stroke and 11 patients (64.7%) after an ischemic stroke diagnosed according to ICD-10: I.69, G.81; including 4 (23.5%) women and 13 (76.5%) men. Patients in the study group aged 35 to 70 (58.06 on average) received spa and rehabilitation treatment at the 21st Military Spa and Rehabilitation Hospital in Busko-Zdrój. The examinations were carried out from May 2019 to October 2020 as part of the project “Establishing a research laboratory for methods of rehabilitation of patients with musculoskeletal disorders”. The patients were subject to a comprehensive spa treatment program, extended with objective assessment and exercises on the Alfa stabilometric platform. Selected tests and clinical scales were used for the functional assessment of patients: Timed Up and Go test (TUG test), 10-meter walk test (10 Meter Walk Test), 2-minute walk test (2MWT). The patients were assessed on the day of commencing the spa treatment and after three weeks.
Results. Objective improvement of balance parameters in the stabilometric evaluation after 3 weeks of spa and rehabilitation treatment was noticed in the younger group of patients with right hemiparesis long after a stroke. Patients with left hemiparesis achieved shorter task completion times in the 10MWT and TUG clinical tests. In addition, they covered a longer distance in the 2MWT test.
Conclusions. The program of comprehensive spa and rehabilitation treatment, enriched with training with the use of the Alpha stabilometric platform, had a positive effect on the improvement of balance parameters and gait function in patients long after a stroke. Therapy on a stabilometric platform with the use of biofeedback should be a standard element of therapy in stroke patients.
Key words:
spa treatment, stroke, stabilometric platform
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A contribution to the meta-analysis of the results of evoked potentials examinations performed in acute patients

Ryszard Kinalski, Jan Talar, Małgorzata Łukowicz

Ryszard Kinalski, Jan Talar, Małgorzata Łukowicz – A contribution to the meta-analysis of the results of evoked potentials examinations performed in acute patients. Fizjoterapia Polska 2001; 1(2); 131-134

Abstract
Background. This article presents a selective meta-analysis of published case studies from the years 1988-1999 describing the results of somatosensory tests and evoked motor potentials conducted in the acute phase of stroke. Material and methods. The publications were selected from among those in the MEDLINE data base whose titles were returned by a search for the key words “acute stroke” and “evoked potentials”. A review was also conducted of the regular issues and supplements of Neurologia i Neurochirurgia Polska this same 10-year period. Conclusions. The articles found and analyzed were published in 23 reports from 12 different countries around the world. The tests were often performed within the first 24 hours after the onset of stroke symptoms. The parameters most often evaluated included the amplitudes, latencies, and central conductivity of evoked potentials. The purpose of these examinations was most often to localize the brain lesion, identify early and delayed neuroplasticity, and develop an early prognosis for the recovery of voluntary movements and functional improvement.

Key words:
Evoked Potential, sacute stroke, meta-analysis

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The modulating effects of laser radiation on the extra- and intracellular Ca2+ store and vascular resistance in the perfused tail artery of the rat

Leszek Szadujkis-Szadurski, Jan Talar, Krzysztof Wiśniewski, Wiesław Tomaszewski, Małgorzata Łukowicz, Rafał Szadujkis-Szadurski

Leszek Szadujkis-Szadurski, Jan Talar, Krzysztof Wiśniewski, Wiesław Tomaszewski, Małgorzata Łukowicz, Rafał Szadujkis-Szadurski – The modulating effects of laser radiation on the extra- and intracellular Ca2+ store and vascular resistance in the perfused tail artery of the rat. Fizjoterapia Polska 2002; 2(1); 11-20

Abstract
Background. Low-level laser radiation modulates many cell functions, but the operating mechanism of its effects has not been sufficiently explained. Our research indicates that these effects are closely with impact on the cellular signaling system, where the ion receptors and channels play a central role.Material and method. The research involved perfused rat tail arteries based on two independent experimental models: model I, in which only the intracellular Ca2+ ion store is ised in the contraction reaction of arterial smooth muscle tissue, and model II, in which the extracellular poor is used. In model I only phenylephrine (an agonist of the alpha-1-adrenergic receptor) elicits contraction, whereas in model II both phenylephrine and BAY K8644 elicit contractions. These models were used to study the impact of low-power laser radiation (10-110 mV).Results. Our research indicated that phenylephrine causes an increase in perfusion pressure as a result of mobilizing the both the intracellular and extracellular stores of Ca2+ ions. The increased perfusion pressure obtained in this way is maintained for ca. 20-30 minutes. The exposure of arteries to laser radiation (10-110 mV) in a manner dependent on the radiation power reduces this reaction. BAY K8644, acting directly on the L-type Ca2+ ion channels, under these conditions does not cause an increase in perfusion pressure. After the intracellular store of Ca2+ ions is emptied, the increased perfusion pressure reactions to phenylephrine and BAY K8644 can be triggered by supplementing the missing CaCl2 in EGTA-Krebs fluid without Ca2+. The exposure of arteries to similar laser radiation reduces the reactions of arteries to phenylephrine and has no impact on the reactions triggered by BAY K8644. The L-NAME inhibitor NO – synthase effectively protects the arteries against the modulating effect of laser radiation.Conclusions. The results obtained here confirmed the association between the effect of laser radiation the contraction reaction of arteries triggered by phenylephrine and NO synthesis. A comparison to the effect of phenylephrine with BAY K8644 suggests that the effect of modulating the arteries’ reactions is conditioned by binding of G protein with the receptor. This suggestion is consistent with the fact that is no inhibiting action of laser radiation on the direct effect of BAY K8644.

Key words:
Phenylephrine, perfusion pressure, BAY K 8644, NO synthesis

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Membrane and cellular effects of red laser radiation on human erythrocytes sensitized with Zn-phthalocyanine

Ilya Zavodnik, Leu Zavodnik, Jolanta Kujawa, Jan Talar, Maria Bryszewska, Małgorzata Łukowicz, Iwona Pyszczek

Ilya Zavodnik, Leu Zavodnik, Jolanta Kujawa, Jan Talar, Maria Bryszewska, Małgorzata Łukowicz, Iwona Pyszczek – Membrane and cellular effects of red laser radiation on human erythrocytes sensitized with Zn-phthalocyanine. Fizjoterapia Polska 2002; 2(2); 145-153

Abstract
Background. There is increasing interest in photosensitizing dyes, used as effectors in photodynamic therapy and photosterilization of biological fluids. The plasma membrane of the cell appears to be the principal site of photodamage. The photohemolytic activity of the sensitizer can be used as a parameter of the dye’s photodynamic toxicity. The aim of the present study is to further characterize the mechanism(s) of cell damage caused by exposure to red laser (670 nm) emission in human erythrocytes sensitized by Zn-phthalocyanine, and to evaluate the role of different cell components in erythrocyte photostability. Material and methods. We measured the effect of various erythrocyte treatments on cell damage induced by laser irradiation: „light” and post-irradiated „dark” hemolysis, cellular glutathione oxidation, membrane lipid peroxidation, and membrane protein oxidation. Results. Laser irradiation of red blood cells sensitized by Zn-phthalocyanine caused the oxidation of membranous protein tryptophan and cysteine residues, fluidization of the membrane lipid bilayer, and lipid peroxidation. The rate of „light” hemolysis significantly increased with increasing pH from 6.8 to 8.5, and after cell membrane perturbations by alcohols or in the presence of dithiotreitol, which is thought to reduce thiol groups oxidized by photosensitization. Conclusions. Membrane lipid peroxidation, the thiol groups of membrane proteins, and intracellular glutathione oxidation do not participate in hemolysis induced by red light. Membrane band 3 proteins play a significant role in erythrocyte photostability.

Key words:
photosensitizing dyes, photohemolysis, photodynamic toxicity

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The gram-negative microorganisms isolated from patients treated at the department and clinic of rehabilitation at the Rydygier Medical University of Bydgoszcz

Eugenia Gospodarek, Beata Ulatowska, Ewa Kruszyńska, Jan Talar, Małgorzata Łukowicz

Eugenia Gospodarek, Beata Ulatowska, Ewa Kruszyńska, Jan Talar, Małgorzata Łukowicz – The gram-negative microorganisms isolated from patients treated at the department and clinic of rehabilitation at the Rydygier Medical University of Bydgoszcz. Fizjoterapia Polska 2002; 2(3); 209-215

Abstract
Background. The aim of the study was to evaluate the occurrence of Gram-negative bacteria isolated from patients hospitalised in the Department and Clinic of Rehabilitation at the Rydygier Medical University in Bydgoszcz. Materials and methods. The material of the analysis was 533 clinical samples collected from patients hospitalised in 2000-2001. The study included 366 Gram-negative bacterial strains isolated from clinical materials. Bacterial identification was based on their morphological characteristics. The species were identified with ID32E and ID32GN tests (bioMérieux). The isolates were screened for antimicrobial susceptibility by the disk-diffusion method.Results. It was isolated 366 strains, 101 (27.6%) in 2000 and 265 (72.4%) in 2001. The rods belonging to Enterobacteriaceae family were amounted to 65.0%, nonfermentative rods – 27.9%, Neisseria spp. – 4.1%, Haemophilus spp. – 1.6%, and Moraxella catarrhalis – 1.4%. The most frequently were identified Proteus spp. (25.4%), Escherichia coli (23.8%), Pseudomonas spp. (17.2%), Acinetobacter spp. (13.1%), Klebsiella spp. (7.4%), Serratia spp. (3.8%). All the Enterobacteriaceae strains were susceptible to imipenem. In 2000 91,1% of these rods were susceptible to cefepime and 81,7% in 2001. A percentage of the sensitive strains to norfloxacin reached in 2000 73.2%, to ciprofloxacin – 69,5%. In 2001 a percentage of the susceptible strains to quinolones decreased to about 50%. During that period among the nonfermentative rods to imipenem were susceptible 95.7% i 85.5% strains, to netilmicine – 65.2% i 62.7%, and to cefepime – 22.2% i 59.1%, respectively. We have found 38 (10.4%) strains which produced ESBLs. These enzymes the most often were identified in K. pneumoniae (31.6%) strains. The b-lactamase AmpC was affirmed in 10 (2.7%) strains. Conclusions. From among Gram-negative bacteria most frequent isolated the Enterobacteriaceae rods. The Proteus sp. and E. coli. strains were predominant bacteria. All strains of these bacteria were susceptible to imipenem.

Key words:
hospital infections, antibiotic resistance, Enterobacteriaceae, nonfermentic rods, ESBLs

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The impact of high-frequency continuous-wave ultrasound on the fluidity of human erythrocyte membranes

Iwona Pyszczek, Małgorzata Łukowicz, Marta Cychner, Jolanta Kujawa, Jan Talar

Iwona Pyszczek, Małgorzata Łukowicz, Marta Cychner, Jolanta Kujawa, Jan Talar – The impact of high-frequency continuous-wave ultrasound on the fluidity of human erythrocyte membranes. Fizjoterapia Polska 2003; 3(2); 175-179

Abstract
Background. The aim of this study was to investigate the effect of high-frequency continuous-wave ultrasound (1 MHz) on the fluidity of the lipid bilayer in human erythrocytes. Material and methods. Red blood cell suspensions in PBS (obtained from healthy donors) were irradiated at 37°C for 10 min with 1 MHz continuous-wave ultrasound, using a range of intensities equivalent to those employed by the ultrasonic devices used in physicotherapy (0.2-1.0 W/cm2). The fluidity of the lipid bilayer in human erythrocyte membranes was measured using a new method: spectrofluorimetry. Results. Our results indicate that sonication with ultrasonic intensity > 0.7 W/cm2 induced a slight decrease in the fluidity of the lipid bilayer in human erythrocytes. Conclusions. The reported results suggest that high-frequency continuous-wave ultrasound has a biomodulating impact on human erythrocytes, especially at the membrane level.

Key words:
ultrasounds, human erythrocytes, lipid bilayer fluidity

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The mechanisms of functional hyperemia in spinal nerves

Jacek Przybylski, Artur Stolarczyk, Łukasz Sawionek, Klaudiusz Papierski, Małgorzata Łukowicz

Jacek Przybylski, Artur Stolarczyk, Łukasz Sawionek, Klaudiusz Papierski, Małgorzata Łukowicz – The mechanisms of functional hyperemia in spinal nerves. Fizjoterapia Polska 2003; 3(2); 164-174

Abstract
Background. The purpose of this research was to examine the impact of the stimulation of heat and pain receptors on the surface of the sole of the foot on the quantity of blood flow in the sciatic nerve in rat and rabbit. An attempt was also made to examine the phenomenon of reactive hyperperfusion in the sciatic nerve of both species in subjects with experimentally evoked diabetes and in rats with genetically conditioned hypertension (SHR). Material and methods. The experiments were performed on 180 male rats of natural strain, 20 male Okamoto-Aoki rats with genetically conditioned hypertension (SHR), and 28 rabbits. The rats were anesthetized with chlorohydrate, 32 mg/kg, administered peritoneally, while the rabbits were anesthetized by intramuscular administration of ketamine (20 mg/kg) and xylazine (5 mg/kg). During the experiment the animals’ temperature was controlled. An ALF21 flow meter was used to measure flow in the sciatic nerve. Results. An increased o thermode temperature to 70°C caused no statistically significant changes in either the volume of blood flow in the sciatic nerve or the vascular resistance in this nerve. When the temperature exceeded 70°C there was a significant decline in the vascular resistance in the sciatic nerve, accompanied by a significant increase of blood flow in this vascular region. A further thermode temperature increase did not cause any intensification of changes in these parameters. The dependency between the volume of the thermal stimulus and the response of the sciatic vessels did not differ in either rats or rabbits. The application of a painful stimulus on the surface of the sole of the foot caused a significant increase in flow in the ipsilateral sciatic nerve. This vascular reaction disappeared after the KATP channels were blocked, as well as nitrous oxide synthase. The phenomenon of functional hyperperfusion in the sciatic nerve in response to a painful stimulus did not occur in the animals with experimentally induced diabetes or in the rats with genetically conditioned hypertension. Conclusions. 1. Increased bioelectrical activity in spinal nerves causes reactive hyperemia. 2. Reactive hyperemia in spinal nerves is associated with excitation of thin C fibers. 3. The disappearance of reactive hyperemia in response to a pain stimulus is a sensitive sign of neuropathy. 4. One of the factors responsible for reactive hyperemia is the opening of ATP-dependent potassium channels.

Key words:
functional hyperemia, Spinal Nerves, pain receptors

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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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The treatment ofdecubitus ulcers in patients with brainstem injuries hospitalized in a rehabilitation departament

Maria Czternastek, Jarosław Markowicz, Andrzej Podhrebelny, Edward Szymkowiak, Małgorzata Łukowicz

Maria Czternastek, Jarosław Markowicz, Andrzej Podhrebelny, Edward Szymkowiak, Małgorzata Łukowicz – The treatment ofdecubitus ulcers in patients with brainstem injuries hospitalized in a rehabilitation departament. Fizjoterapia Polska 2004; 4(1); 40-46

Abstract

Background. Patients who are unconscious after traumatic brain injury, as well as those with para- and tetraplegia, are at high risk for the formation of decubitus ulcers. Even small ulcerations can cause the patient’s clinical status to deteriorate, and require proper conservative treatment and/or surgery. The present article presents methods for the surgical treatment of decubitus ulcers in patients with brainstem injuries. Material and methods. Twelve patients with brainstem injuries are presented, in whom pressure sores had developed, due to neglect in nursing care prior to their admission to our center. Preparatory procedures were initiated while the patient was still comatose; as soon as the danger had passed, surgical treatment was initiated. Various techniques were used, depending on the localization and extent of ulceration. In most cases (85%) musculo-cutaneous flaps were used to fill the defect after excision of the ulcers; this led to good blood supply to the hypoxic tissues, good cushioning of the places affected by pressure, and quick healing. Results. The techniques used here produced relatively quick healing (ca. 21 days) without complications in eleven cases. In one patient, admitted with multiple bedsores, treatment time was considerably prolonged due to complications (ca. 10 weeks). Conclusions. The cooperation of a multidisciplinary treatment team led to good preparation of patients for surgery. The techniques used here provided complete healing of all the decubitus ulcers treated. Specialists in rehabilitation and physiotherapy should be thoroughly familiar with the basic principles and possibilities of preventing decubitus ulcers, as well as the available methods of conservative and surgical treatment.

Key words:
bed sores, pressure sores, tetraplegia, paraplegia, coma, plastic surgery
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The neurogenic and metabolic regulation of blood flow in spinal nerves

Jacek Przybylski, Artur Stolarczyk, Łukasz Sawionek, Jacek J. Klawe, Małgorzata Łukowicz, Gunther Hildelbrandt

Jacek Przybylski, Artur Stolarczyk, Łukasz Sawionek, Jacek J. Klawe, Małgorzata Łukowicz, Gunther Hildelbrandt – The neurogenic and metabolic regulation of blood flow in spinal nerves. Fizjoterapia Polska 2004; 4(1); 1-7

Abstract

Background. The function of peripheral nerves depends upon an intact blood supply, but the mechanisms regulating blood flow through the blood vessels supplying peripheral nerves remain largely unclear. The aim of the present study was to examine the effect of stimulation of arterial and central chemoreceptors and unloading of arterial baroreceptors on sciatic nerve blood flow. In addition, we attempted to evaluate the role of hypoxemia and hypercapnia as local metabolic factors involved in the regulation of blood flow in the sciatic nerve of the rat. Material and methods. The study was carried out on 55 male Wistar rats with the body weight ranging from 300g to 350g. Sciatic nerve blood flow was measured, using a laser Doppler flowmeter, in anaesthetized rats at various arterial blood pressures and during hypercapnia and hypoxemia. Results. We found that sciatic nerve blood vessels do not exhibit autoregulation. Stimulation of arterial and central chemoreceptors did not result in any significant changes in sciatic nerve vascular resistance. During a decrease of mean arterial pressure, there was an increase in vascular resistance in sciatic nerve, which was abolished by pharmacological sympathectomy but not by alpha-adrenergic blockade. Conclusions. Our findings provide evidence that PaO2 and PaCO2 do not influence vasa nervosum resistance in the sciatic nerve.

Key words:
Sciatic Nerve, hypercapnia, hypoxemia, autoregulation, rat
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