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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Comparison of the effectiveness of certain physical therapy treatments in shoulder pain in patients with degenerative lesions

Magdalena Staniek, Marek Kiljański, Joanna Kałuża-Pawłowska, Patryk Kiljański

M. Staniek, M. Kiljański, J. Kałuża-Pawłowska, P. Kiljański – Comparison of the effectiveness of certain physical therapy treatments in shoulder pain in patients with degenerative lesions. Fizjoterapia Polska 2018; 18(4); 6-13

Abstract

Objective. The objective of this study was to assess the effectiveness of laser therapy in shoulder pain in patients with degenerative lesions. The assessment applied to impact of the respective treatments on such parameters as: pain scale, subjective evaluation of health condition, degree of functionality expressed using measurements of the range of movements of the shoulder joint (flexion, extension, abduction) and of the muscle strength based on Lovett scale before and after treatment.
Materials and methods. The research was conducted on a group of 50 patients aged 60-85, with homogenous diagnosis of: degenerative joint disease. The research was conducted in the County Center of Medical Services in Kielce. All patients were divided into two groups of 25 people. The first one included 17 women and 8 men, while the second one – 15 women and 10 men. The first group underwent three physical therapy treatments, i.e.: ultrasound, magnetotherapy, cryotherapy, while the second one was additionally subject to laser therapy.
Results. The results demonstrated that the applied physical therapy treatments in both groups significantly affected the progression of the parameters examined. A larger difference in improvement of the subjective evaluation of the health condition was recorded in the group of patients that did not undergo laser therapy. The results patients from the other group were better in terms of reduction in pain calculated in the VAS scale and of improvement of the range of movements during abduction and extension. The remaining examined parameters, such as: range of flexion and muscle strength, improved to the same degree in both groups. The only statistically relevant difference was in improvement of the range of abduction among the patients who additionally underwent laser therapy.
Conclusions. The examination conducted proved effectiveness of such physical therapy treatments as: cryotherapy, ultrasounds, magnetotherapy, performed with and without laser therapy, applied in pains of the shoulder area in patients with degenerative lesions. The therapy using a medical laser proved more effective.

Key words:

degenerative joint disease, shoulder, shoulder girdle, medical laser, laser therapy

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Is it worth taking care of Polish medicine at the turn of the 19th and 20th century in the context of the idea of “immediate help”?

Jacek Rytkowski, Marek Kiljański, Zbigniew Śliwiński

Jacek Rytkowski, Marek Kiljański, Zbigniew Ślwiński – Is it worth taking care of Polish medicine at the turn of the 19th and 20th century in the context of the idea of “immediate help”? Fizjoterapia Polska 2018; 18(3); 94-101

 

Abstract
This paper was referring to the legitimacy – of undertaking research (much wider than before) on the history of Polish medicine turn of the 19th and 20th centuries, especially the period of 1918-1939. The text presented also obvious methodological problems that are associated with this task, for example: the problematic and essential questions are insufficient sources (excluding periodicals) for that time. The problems belong to the lack of materials significantly impedes the free work on these issues.
Besides, an important difficulty is the enormous range of meaning of these issues – together three elements are taken to discuss: the turn of the 19th and 20th century, the time before 1918 and the period 1918-1939. However, these issues are interesting enough that it should to take their analysis. This paper also discusses the concept of „emergency” as one of many elements characteristic to the „reborn” Polish medicine.

Key words:
medicine, history of medicine, emergency help, public health

An article published only in Polish, available only in the paper version of the journal

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Comparison of Physical Capacity in Swimming and Non-swimming Children Aged 10-12

Aleksandra Kruk, Joanna Spurek, Marek Kiljański

Aleksandra Kruk, Joanna Spurek, Marek Kiljański – Comparison of Physical Capacity in Swimming and Non-swimming Children Aged 10-12. Fizjoterapia Polska 2018; 18(3); 36-44

Abstract
Objective. The supreme objective of this study was to compare the physical capacity of swimming children and the children that do not do any physical activity, aged 10-12.
Materials and methods. The research was conducted among 60 children, of whom 30 swim regularly and the other half do not exercise physically at all. The research subjects included 13 girls and 17 boys aged 10-12. The study used a questionnaire as well as two exercise tests: Ruffier test and 6-minute march test.
Results. It was noted in the endurance tests that swimming persons had better results than the persons who do not do sports. The Ruffier test demonstrated that the physical performance of swimmers was better at almost every level. The 6-minute march test demonstrated that swimmers are able to cover a longer distance with a smaller effort than the physically passive persons. When analysing the results from the statistical point of view, one may note a relationship between the regularity of physical activity and the degree physical capacity.
Conclusions. The capacity of the children who are physically active is greater than of those who are not. The results are also affected by ways of spending free time and the amount of time devoted daily to activity.

Key words:
physical capacity, swimming, movement, physical activity

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Professor Andrzej Zembaty

Sławomir Jandziś, Marek Woszczak, Marek Kiljański, Renata Szczepaniak

FP 2013; 13(4); 57-59

Streszczenie
Rocznica 50-lecia zorganizowanej działalności fizjoterapeutów w Polsce to okazja do przedstawienia sylwetki jednego z wybitnych przedstawicieli naszego zawodu prof. dra hab. Andrzeja Zembatego. Urodził się on 21 kwietnia 1935 roku w Jaśle w rodzinie inteligenckiej. Matka był nauczycielką, ojciec ukończył wydział prawa UJ i pracował jako sędzia w Jaśle a następnie Sanoku. Andrzej Zembaty po zdaniu matury w liceum sanockim rozpoczął studia w warszawskiej AWF, które ukończył w 1958 roku. W 1960 roku rozpoczął pracę fizjoterapeuty w Stołecznym Centrum Rehabilitacji Schorzeń Narządu Ruchu w Konstancinie oraz w 1964 roku jako nauczyciel zawodu w Medycznym Studium Zawodowym w Konstancinie. W 1972 roku, na wniosek prof. Mariana Weissa, dyrektora STOCER i kuratora Zakładu Rehabilitacji w warszawskim AWF-e został zatrudniony na stanowisku starszego asystenta w tymże zakładzie. Powrócił więc na uczelnię, z którą związał większość swojego życia zawodowego. Pełnił w niej następujące funkcję: 1979 – kierownik Zakładu Rehabilitacji Ruchowej, 1982 – pełnomocnik Rektora ds. Powołania Wydziału Rehabilitacji, 1983 – z-ca dyr. Instytutu Nauk Biologicznych, 1984 – 1987- prodziekan ds. studenckich i organizacyjnych w nowo powołanym Wydziale, 1987 – 1990- prodziekan ds. dydaktyki. Ostatnim miejscem działalności zawodowo-dydaktycznej przed przejściem na emeryturę w 1999 roku była AWF w Katowicach, gdzie Profesor kierował Zakładem Kinezyterapii

Słowa kluczowe:
rehabilitacja lecznicza, fizjoterapeuci, historia rehabilitacji


Abstract

The 50th anniversary of the organized activity of physiotherapists in Poland is an opportunity to present the figure of one of the eminent representatives of our profession, prof. Andrzej Zembaty, PhD. He was born on April 21, 1935 in Jasło to an intelligentsia family. The mother was a teacher, my father graduated from the Jagiellonian University law department and worked as a judge in Jasło and then Sanok. Andrzej Zembaty, after passing the final exams at the high school in Sanok, he began studies at the University of Physical Education in Warsaw, which he graduated in 1958. In 1960, he started working as a physiotherapist at the Metropolitan Rehabilitation Center for Motion Disorders in Konstancin and in 1964 as a teacher of the profession at the Medical Vocational College in Konstancin. In 1972, at the request of prof. Marian Weiss, director of STOCER and curator of the Rehabilitation Department at the University of Physical Education in Warsaw, was employed as a senior assistant at the same facility. He returned to the university, with whom he associated most of his professional life. He held the following function: 1979 – head of the Department of Movement Rehabilitation, 1982 – Rector’s representative for the appointment of the Rehabilitation Department, 1983 – deputy director. Institute of Biological Sciences, 1984 – 1987 – vice-dean for student and organizational affairs at the newly appointed Faculty, 1987 – 1990 – vice-dean for didactics. The last place of professional and didactic activity before retiring in 1999 was the University of Physical Education in Katowice, where the Professor headed the Kinesitherapy Unit.

Key words:
Therapeutic rehabilitation, physiotherapists, rehabilitation history

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