Rehabilitacja i fizjoterapia w świetle przepisów Narodowego Funduszu Zdrowia i Ministerstwa Zdrowia

 Dorota Szczygielska, Teresa Pop, Grażyna Hejda, Marek Kiljański

Dorota Szczygielska, Teresa Pop, Grażyna Hejda, Marek Kiljański – Rehabilitacja i fizjoterapia w świetle przepisów Narodowego Funduszu Zdrowia i Ministerstwa Zdrowia. FP 2013; 13(2); 55-61

Streszczenie

Słowo kluczowe

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Evaluation of combination therapy with the use of low-frequency magnetic field and ultraphonophoresis for patients with chronic osteoarthrits of the knee

Marek Woszczak, Kacper Kucz, Marek Kiljański, Marta Woszczak

M. Woszczak, K. Kucz, M. Kiljański, M. Woszczak – Ocena terapii skojarzonej polem magnetycznym niskiej częstotliwości i ultrafonoforezy u pacjentów z przewlekłą chorobą zwyrodnieniową stawów kolanowych. FP 2013; 13(3); 48-54

Summary
The aim of the study was to evaluate the combination therapy involving low-frequency magnetic field and phonophoresis applied lo patients suffering from osteoarthritis (ICD – M 77).
The assessment of physical condition was made through 6 climbs of a patient onto a 17 centimeire step within 30 seconds, the first step was made with less aching leg.
Thanks to this test the group of patients qualified to the study was homogeneous. The study involved 62 people (47 women, 75 men) aged 41-86, randomly assigned to two comparative groups. The patients’ health was assessed by means of WOMAC scale, Pain Assessment Scale VAS and functional kneeling test. The examination was conducted twice: before the beginning of the treatment and after a series of physiotherapeutic sessions. Group A was treated with the combination therapy including magnetic field and ultraphonophoresis
Group B was treated with low frequency magnetic field in addition, both groups were abo subjected To kinesiotherapy strengthening the four-headed muscle of the femur. For the statistical analysis of the research the Statistical Package for Social Sciences was employed (PASW 78). To check the effectiveness of the therapy in group A the Test of Relevant Statistical Differences t-siudent for paired data was applied.

Key words
osteoarthritis of the knee, low-frequency magnetic field, phonophoresis

 

 

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The situation of physiotherapists after four years of legal regulation of the profession

Marek Kiljański, Dariusz Jasiński

M. Kiljański, D. Jasiński – The situation of physiotherapists after four years of legal regulation of the profession. Fizjoterapia Polska 2019; 19(2); 168-173

Abstract

Introduction. The financial situation of physiotherapists has deteriorated over the last ten years. It was influenced by various factors – law changes, inflation and the lack of adequate financing of rehabilitation in Poland. After the legal regulation of the profession in 2015, physiotherapists are constantly incurring duties, but this does not translate into adequate earnings. The best educated physiotherapists – specialists are also getting less and less valuable in the health care system.
Goal. In this work, we will try to consider: are physiotherapists right, demanding higher wages and can their employers and the healthcare system in Poland afford it.

Key words:
salaries of physiotherapists, finances in health care, nfz, specialists in physiotherapy

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Selective Dorsal Rhizotomy (SDR) – neurosurgical method in treatment of spasticity in CP: the current state of knowledge

Monika Wolska, Marek Kiljański, Witold Rongies

M. Wolska, M. Kiljański, W. Rongies – Selective Dorsal Rhizotomy (SDR) – neurosurgical method in treatment of spasticity in CP: the current state of knowledge. Fizjoterapia Polska 2019; 19(2); 66-75

Abstract
Spasticity constitutes one of the main symptoms of Cerebral Palsy (CP), which has a negative influence on children’s activity, their participation in daily life, and it also impacts their functioning in the society. Chronic spasticity leads to the development of structural lesions in the muscles and in the connective tissue, and it contributes to an intensification of atrophy, rigidity, and finally contractures resistant to pharmacological treatment. Worsening comfort of life and problems with taking care of children with CP constitute other aspects, which justify searching for methods of permanent and effective treatment of spasticity.
The selection of an optimal treatment method for every patient depends on the following: location and extent of the injury, clinical symptoms, patient’s age, and available treatment methods. Selective dorsal rhizotomy (SDR) is a method of surgical treatment of spasticity in children with CP. The procedure is irreversible, and it permanently reduces spasticity. There are still many controversies regarding qualification for the procedure, indications, or short-term and long-term effects. Over the years, there are more and more international clinical studies which confirm the beneficial effect of the procedure in terms of improving the functional state of the patients. The purpose of this paper was to gather and systematize the knowledge about the procedure itself, the qualification criteria, the applied research tools, and the post-surgery physical therapy protocols, as well as to present the effects of surgical treatment.

Key words:
Selective Dorsal Rhizotomy, SDR, physical therapy, spasticity, CP

 

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Compliance to home exercise program (HEP) among subjects under physiotherapy care: Report of a qualitative study

Meshanti Kumarasamy, Narasimman Swaminathan, Marek Kiljański, Zbigniew Śliwiński

M.Kumarasamy, N. Swaminathan, M. Kiljański, Z. Śliwiński – Compliance to home exercise program (HEP) among subjects under physiotherapy care: Report of a qualitative study. Fizjoterapia Polska 2019; 19(1); 70-74

Abstract
This study examined the extent of compliance towards HEP among subjects undergoing physiotherapy sessions in selected clinical settings. The findings of this study would provide insights on the perceived enablers and barriers that influence compliance towards prescribed home exercises.
Methodology. This qualitative inquiry study interviewed twenty subjects – 12 males and 8 females under physiotherapy care at various outpatient musculoskeletal rehabilitation at selected private hospitals and physiotherapy clinics located in the states of Kuala Lumpur and Negeri Sembilan of Malaysia. Subjects’ responses on the perceived opinions and experiences with prescribed home exercises were audio recorded through a semi-structured interview. The responses obtained were analysed further using keyword coding and content analysis.
Results and Analysis. Self-motivation, determination and commitments are the best-explored enablers for active involvement. Barriers that significantly lead to disengagement in home exercises among the participants of this study includes lack of time, work commitments, personal characteristics, disease nature or injury status and ineffective exercise prescriptions.
Conclusion. Content analysis of the recorded responses revealed that the predictors of compliance to home exercises is multifactorial. This study provides a baseline data for understanding the perceived enablers and barriers towards participation in home exercises; these findings will aid the health care professionals in implementing the measures to maximize compliance level among patients undergoing physiotherapy.
Highlights
• Compliance to home exercises are affected by various factors
• Lack of time, work commitments and injury status affect the home exercise compliance
• Self-motivation is the most important enabler for the compliance to HEP
• Nature of the disease affects compliance to HEP

Key words:
home exercise program, physiotherapy, musculoskeletal rehabilitation

 

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Assessment of the effectiveness of therapy using TENS and interferential currents in patients with low back pain

Paulina Wójcik, Joanna Kałuża-Pawłowska, Patryk Kiljański, Marek Kiljański

P. Wójcik, J. Kałuża-Pawłowska, P. Kiljański, M. Kiljański
– Assessment of the effectiveness of therapy using TENS and interferential currents in patients with low back pain. Fizjoterapia Polska 2019; 19(1); 22-29

Abstract
Admission. Lower back pain is one of the most common problems associated with locomotor disorders. They are a serious medical problem, but also due to the prevalence of social and economic problems. Treatment of pain in the lower spine is a comprehensive treatment, includes kinesitherapy, physiotherapy and aims to reduce pain, inflammation and increased muscle tone.
Material and methods. The study involved a group of 60 people with pain in the lower spine. The subjects were divided into two equally 30-person groups. In both groups, physical treatments were used laser therapy and magnetotherapy. In addition, TENS was performed in the first group, while in the second group, interference currents were used. The study used a questionnaire, pain assessment on the VAS scale and the Schober test.
Objective. The aim of the study was to compare the effect of TENS currents and interference currents in terms of reducing pain and increasing the range of motion of the lower spine.
Results. The applied physical treatment had a positive effect on the patients’ condition. Statistical tests have shown a reduction in pain in patients and an improvement in the range of motion in the spine.
Conclusions. TENS currents are a more effective method in the treatment of lower back pain. The results of the research showed that the use of TENS currents allowed to obtain positive effects in the form of increasing the range of spinal mobility, all subjects in this group experienced a reduction in pain.

Key words:
lumbar spine, pain, TENS currents, interference currents

 

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The effect of massage with an electrostatic field of different frequency on the tension of selected skeletal muscles of the shoulder girdle

Patryk Kiljański, Joanna Kałuża-Pawłowska, Krzysztof Gieremek, Marek Kiljański

P. Kiljański, J. Kałuża-Pawłowska, K. Gieremek, M. Kiljański – The effect of massage with an electrostatic field of different frequency on the tension of selected skeletal muscles of the shoulder girdle. Fizjoterapia Polska 2018; 18(4); 138-158

 

Abstract
Objective of the work. The aim of the study is to show whether the electrostatic field massage has an effect on the fall in resting tension of the upper part of the trapezius muscle.
Material and methods. 20 people participated in the study, men and women aged 23-29. The subjects’ lifestyle was varied. The research group consisted of people practicing recreational sports, spending a lot of time in front of a computer or by reading books, as well as people doing casual work. All subjects were characterized by an active lifestyle.
The “Szirmai” myotonometer was used for measuring muscle tone. The Physiomed Deep Oscillation was used for massaging with the electrostatic field. The massage took place in two stages, each one with the use of a field with different frequency, respectively – 50 Hz (test No. 1) and 150 Hz (test No. 2). The interval between the tests was 2-3 weeks.
Results and conclusions. The research shows that electrostatic field massage has an effect on the muscle tone drop at both 50 Hz and 150 Hz. Statistically there was no significant difference in the reduction of muscle tone between 50 Hz and 150 Hz.

Key words:
massage, muscle tone, frequency, Deep Oscillation

 

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Characteristics of injuries and injuries of water polo players

Joanna Kałuża-Pawłowska, Iwona Serwin, Robert Serwin, Marek Kiljański

J. Kałuża-Pawłowska, I. Serwin, R. Serwin, M. Kiljański – Characteristics of injuries and injuries of water polo players. Fizjoterapia Polska 2018; 18(4); 94-101

Abstract
Introduction. Sports injury is usually referred to as contusion. It is an injury that can be experienced during physical activity, of a sporting nature, mainly during training and competitions, causing sports injuries, which results in a temporary or total exclusion from further participation in sports activities.
Objective. The objective of the article is to assess the characteristics of injuries among water polo players.
Material and method. The study was carried out on the basis of the diagnostic survey method developed by the authors, with the consent of the coach and players. The questionnaire contained 20 questions, both open and metric. The questions concerned injuries and physiotherapy. The study involved 52 players of Polish sports clubs aged 15 to 30 who have played water polo for not less than 5 years.
Results. None of the studied players during their career had more than 15 injuries, however 100% of players suffered at least one injury. The most common situation in which players experienced injuries was training in the pool – 75%. After injury, in 42% of cases the examined water polo players unfortunately did not use physiotherapists. The studied water polo players most often suffered an injury of the shoulder joint – 35.1%, 26.4% of fingers, 17.5% of wrists, and 10.5% of elbows.
Conclusions. 1. Most often injuries occurred during training in the pool, which arises from low reliability of warm-ups and exercises being incorrectly performed by the players. 2. The most vulnerable parts of the body are shoulder, wrist and finger joints. 3. Water polo is a contact sport with a high level of the incidence of traumas, causing damage to joint capsules, stressing ligaments and muscles in the above-mentioned parts of the body. 4. Increasing awareness and access to professional physiotherapy will allow athletes to return to fitness levels as before the injury more quickly and prevent further injuries.

Słowa kluczowe:
water polo, sports injury, physiotherapy in sport

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Comparison of the impacts of classic massage and Lomi Lomi Nui massage on the mental and physical condition of the patient

Agata Gajos, Marek Kiljański

A. Gajos, M. Kiljański – Comparison of the impacts of classic massage and Lomi Lomi Nui massage on the mental and physical condition of the patient. Fizjoterapia Polska 2018; 18(4); 38-49

Abstract
The objective of this study is comparison of the impacts of classic massage and Lomi Lomi Nui massage in treating stress-induced mental and physical tiredness. Another objective is to compare the impact of massage on body hydration and on the level of extracellular water.
Materials and methods. The study covered 30 persons aged 25 – 65.
The patients were divided into 2 groups. Group I included 15 people (7 women and 8 men) who underwent a classic massage. Group II included 15 people (7 women and 8 men) who underwent a Lomi Lomi massage.
Before the massage, the body mass and height were measured in both groups, and then the patients underwent bioelectrical impedance analysis for the purpose of measuring body hydration and the level of extracellular water.
After the massage, impedance was measured again for the purpose of determining the difference in results after the massage. The patients were then asked to fill in a questionnaire including a question about the effectiveness of massages in decreasing mental and physical tiredness and about the impressions during and right after the massage.
Results. Both massages are effective in alleviating the symptoms of stress-induced mental and physical tiredness. The results were not statistically relevant.
The classic massage resulted in reduction in pain and muscle stiff muscles, while the Lomi Lomi massage affected the emotional aspects – the patients were relaxed, the harmony between spirit
and body was recovered, which was statistically relevant. The results of bioelectrical impedance analysis indicate that the massages affected body hydration
and the level of extracellular water. The comparison of arithmetic means of results indicated that the classic massage demonstrated a greater relationship than the Lomi Lomi massage, which was statistically relevant.

Key words:
Stress, medical massage, bioelectrical impedance

 

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Assessment of the effectiveness of local laser therapy in treatment of gonarthrosis. Work on habits

Paulina Kozieł, Marek Kiljański

P. Kozieł, M. Kiljański – Assessment of the effectiveness of local laser therapy in treatment of gonarthrosis. Work on habits. Fizjoterapia Polska 2018; 18(4); 26-33

Abstract
Introduction. Gonarthrosis is one of the most frequent diseases of the locomotor system. It is characterized not only by destruction of joint cartilage, but also by lesions in the subchondral bone layer, in the synovial membrane, joint capsule and periarticular structures. It leads to damage to the anatomical structure of the joint and to debilitation of its function which is so important in everyday functioning. Local laser therapy is one of the treatments applied in fighting with gonarthrosis. That procedure has anti-inflammatory, analgesic and edema-reducing effects. The objective of this study is to assess the results of local laser therapy, its impact on the scope of mobility and painfulness in patients suffering from gonarthrosis.
Materials and methods. The study covered 50 persons, suffering from gonarthrosis, divided into two groups, control group and study group, each with 25 members. The control group, with 19 women and 6 men, was subject to the following physical therapy procedures: cryotherapy, magnetotherapy and TENS currents. The study group, with 19 women and 6 men, was additionally subject to local laser therapy. All the persons were subject to a series of 10 procedures, from Monday to Friday, for two weeks. Before the series of procedures and right after completion thereof, the patients filled out anonymous surveys which contained the VAS pain scale, there were conducted mobility measurements of the knee joint flexure in the sagittal plane and linear measurements of the knee joint circumference.
Results. The results from both groups were subject to statistical analysis. After treatment, in both groups an improvement was noted in knee joint mobility, a decrease in knee joint circumferences and a decrease in the level of pain measured with the VAS scale in comparison with the condition from before treatment. The group with added local laser therapy demonstrated better mobility ranges and smaller knee joint circumferences.
Conclusions. Local laser therapy is an effective procedure applied in treatment of gonarthrosis. The level of pain decreased both in the control group and in the study group. The decrease was greater in the control group. The difference was statistically relevant In both groups, an improvement in knee joint mobility was observed. More improvement was noted in the study group. The difference was statistically relevant The knee joint circumference decreased both in the control group and in the study group. The decrease was greater in the study group. The difference was statistically relevant.

Key words:
gonarthrosis, local laser therapy

 

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