Tag: Michał Kuszewski

The suitability of the „toe-touch” test for functional testing in physiotherapy

Michał Kuszewski, Henryk Knapik, Edward Saulicz, Rafał Gnat, Mirosław Kokosz

Michał Kuszewski, Henryk Knapik, Edward Saulicz, Rafał Gnat, Mirosław Kokosz – The suitability of the „toe-touch” test for functional testing in physiotherapy. Fizjoterapia Polska 2004; 4(4); 378-384

Abstract

Background. The objective of our study was to specify the relationship between selected flexibility parameters and the results of the „toe-touch” test. Material and methods. We examined 190 people from 18 to 51 years of age (ave. 23.8 ± 5.7). In each subject, global flexibility in the sagittal plane was tested with the „toe-touch” test, then the mobility of the upper and lower lumbar spine and both hip joints was examined, as was the range of plantar flexion of the ankle (an indirect indication of the length of the muscles of the dorsal aspect of the leg) and possible shortening of the hamstrings. A Saunders’ electronic goniometer was used to make measurements (in the lower lumbar spine Schober’s measurement was also utilized). The product-moment Pearson’s correlation test was used to estimate connections between parameters. Results. Significant correlations were registered between the results of the toe-touch test and the following parameters: mobility of the upper (r = 0.79) and lower lumbar spine (r = 0.70), shortening of the hamstrings (r = -0.67), mobility of both hip joints (r = 0.36 and r = 0.34), and the range of plantar flexion of both ankle joints (r = 0.33 and r = 0.25). There was no significant connection between the „toe-touch” test and the results of Schober’s measurement. Conclusion. The „toe-touch” test is a quick, simple and reliable way to evaluate the functional status of the lower spine and lower extremities.

Key words:
flexibility parameters, lumbar spinal mobility, crural muscles, plantar flexion of the ankle, shortening of the hamstrings hip mobility
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Biomechanical aspects of modern models of pelvis stability. Part II: symphysis pubis and anterior oblique muscle sling

Rafał Gnat, Edward Saulicz, Mirosław Kokosz, Michał Kuszewski

Rafał Gnat, Edward Saulicz, Mirosław Kokosz, Michał Kuszewski – Biomechanical aspects of modern models of pelvis stability. Part II: symphysis pubis and anterior oblique muscle sling. Fizjoterapia Polska 2006; 6(4); 328-333

Abstract
Biomechanical model of pelvis stability based on self-bracing mechanism contributed to certain discrimination of previous proposals mentioning the pelvic ring and ascribing important stabilizing role to pubic symphysis. However, the paper presents some arguments challenging thesis about complete lack of significance of the symphysis and anterior part of the pelvic stabilising system in process of maintaining stability. Both the symphysis itself as well as anterior oblique muscle sling seem to find their own, meaningful place there. Maybe this role could not be considered primary, but surely it is supplementary one. Observations of biomechanical, clinical and evolutional nature seem to support such a point of view. Spreading of the effective range of self-bracing due to compressive forces acting on the sacroiliac joint and increased friction between its surfaces divides the burden of maintaining stability on bigger number of muscles. The adductor longus that belongs to anterior oblique muscle sling seems to locate its attach-ment in the proper area. Moreover, a view of the pelvis, where the force closure mechanism is executed by posterior muscle slings exclusively brings about compelling impression of shearing forces arising within the sacroiliac joints. Activation of the anterior portion of the stabilizing system heads off the incoming threat immediately. Also assuming the upright body posture resulted in humans in more frequent, in comparison with other species, backward excursions of the centre of gravity. In such conditions the anterior part of the pelvic stabilizing system will always be activated in order to maintain stability.

Key words:
pelvis, symphysis pubis, anterior oblique muscle sling

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Biomechanical aspects of modern models of pelvis stability. Part I: sacroiliac joint and self-bracing mechanism

Rafał Gnat, Edward Saulicz, Michał Kuszewski, Mirosław Kokosz

Rafał Gnat, Edward Saulicz, Michał Kuszewski, Mirosław Kokosz – Biomechanical aspects of modern models of pelvis stability. Part I: sacroiliac joint and self-bracing mechanism. Fizjoterapia Polska 2006; 6(4); 280-288

Abstract
Last two decades of the XXth century brought about significant progress towards recognition of stabilizing mechanisms of kinematic links within human locomotory system. Panjabi formulated his concept concerning stabilizing system of the human kinetic link, scientist from Australia explained the mechanism of stabilization of the lumbar section of the spine, linked its dysfunctions to pain ailments rising in that region of the body and proved the effectiveness of the innovative training system in reduction of severity of such symptoms. Between numerous research in that direction, a biomechanical model of sacroiliac joint stability developed by Dutch scientists from Erasmus University, Rotterdam, is worthy paying attention. This model takes into consideration two coexisting mechanisms that make maintaining stability possible: the form closure and the force closure mechanism. As result of the cooperation between the two an effect of self-bracing of the sacroiliac joint comes into being. The leading idea hidden under the surface of the model is quite similar to the one that ancient architects had in minds while developing the structure of so called roman arch. Here, sacrum plays the role of the keystone and the two femora together with innominates are the columns. After application of quite a small, transversely oriented force, resulting from musculoligamentous system activity the construction remains stable. The objective of the paper is to familiarize reader with details of biological mechanisms that built up foundation for the Dutch model of sacroiliac joint stability.

Key words:
sacroiliac joint, form closure, force closure, self-bracing effect

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Subjective assessment of the effects of different approaches to rehabilitation of patients after cerebral stroke

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Michał Kuszewski, Andrzej Myśliwiec

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Michał Kuszewski, Andrzej Myśliwiec – Subjective assessment of the effects of different approaches to rehabilitation of patients after cerebral stroke. Fizjoterapia Polska 2009; 9(3); 223-231

Abstract
Background. Paying attention to the individual needs of the patient during treatment planning is becoming an important element of contemporary rehabilitation of post-stroke patients. The patient should not only be the recipient, but also a co-author of the programme of rehabilitation administered to him or her. The study hypothesis was that the type of rehabilitation treatment would influence the patient’s subjective evaluation of the effects of rehabilitation. Material and methods. The study involved a group of 64 stroke patients. All subjects were divided randomly into three groups (A, B and C). Subjective assessment of the efficacy of rehabilitation was based on a specially prepared questionnaire. Patients were followed up for about 21 days, during which period they were administered comprehensive rehabilitation. Group A received traditional post-stroke therapy. The rehabilitation programme for Group B included individual kinesiotherapy based on the PNF method. The programme for Group C comprised individual kinesiotherapy based on the PNF method supplemented with tensing neuromobilisations of peripheral nerves of the paretic upper extremity. Results. Overall, the highest average number of points (x = 11.5394), corresponding to the most marked subjective impro -vement, was recorded in Group C, while the least marked effect was noted in Group A (x = 8.1751). Conclusions. The subjective assessment of the effects of rehabilitation treatment correlated significantly with the type of rehabilitation administered.
Key words:
self-assessment, physiotherapy, stroke, therapeutic effects
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The role of passive stiffness of the hamstring muscies in body stability processes

Michał Kuszewski, Edward Saulicz, Andrzej Myśliwiec, Tomasz Wolny

Michał Kuszewski, Edward Saulicz, Andrzej Myśliwiec, Tomasz Wolny – The role of passive stiffness of the hamstring muscies in body stability processes. Fizjoterapia Polska 2009; 9(3); 195-201

Abstract
Two closely interrelated concepts of the biokinematic link have emerged in recent years. One of them divides human muscies functionally into stabilizing and motor ones, while the other concept describes three closely cooperating subsystems which, in a normal individual, function to secure an adeąuate level of stabilization. Each ofthese concepts can be linked with the notion of passive muscle stiffness. However, the majority of publications concerning stabilization processes seems to attach little importance to this property This paper introduces the concepts of development and role of increased passive stiffness of the hamstring muscies in the stabilization process. Basing on neurophysiological mechanisms, the authors present the latest research results, the mechanisms behind increased passive stiffness and ways of reducing it.
Key words:
stability, muscle stiffness, ACL, LPH complex
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Effectiveness of PNF method in improving symmetry of lower extremity loading in late-stage post-stroke patients

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Andrzej Myśliwiec, Michał Kuszewski

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Andrzej Myśliwiec, Michał Kuszewski – Effectiveness of PNF method in improving symmetry of lower extremity loading in late-stage post-stroke patients. Fizjoterapia Polska 2010; 10(4); 263-270

Abstract
Early comprehensive multidisciplinary rehabilitation is crucial for achieving satisfactory results in the conservative management of post-stroke patients. Gait re-education is a major goal in post-stroke rehabilitation regardless of how much time has elapsed since the stroke. The study hypothesis was that therapy based on PNF (Proprioceptive Neuromuscular Facilitation) would significantly improve loading symmetry of the lower limbs, thus enabling faster restoration of the support and locomotor function and improving gait efficiency in post-stroke patients. A total of 64 stroke patients were randomly divided into two groups. A Loading Symmetry Index (LSI) of the lower limbs was calculated basing on data recorded in the ‘two-scales’ test. Patients were followed up for a mean of 21 days (during which they stayed at a Neurological Rehabilitation Ward). Group A received conventional rehabilitation while Group B also received individual kinesiotherapy based on the PNF method. Analysis of variance showed significant differences in LSI values (interaction: group x measurement – p=0.0075). Post hoc Tukey test revealed significant intra-group differences in Group B (p=0.0002). There were no significant intra-group differences in Group A or significant differences between the groups. PNF-based rehabilitation of late-stage post-stroke patients significantly improved loading symmetry of the lower extre – mities.
Key words:
PNF, physiotherapy, symmetry, Locomotion
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Influence of proprioceptiveneuromuscular facilitation (PNF) on the degree of spasticity in late-stage stroke patients

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Andrzej Myśliwiec, Michał Kuszewski

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Andrzej Myśliwiec, Michał Kuszewski – Influence of proprioceptiveneuromuscular facilitation (PNF) on the degree of spasticity in late-stage stroke patients. Fizjoterapia Polska 2011; 11(1); 1-8

Abstract
The complex pathophysiology of spasticity depends on the interaction between facilitation and inhibition of spinal and supraspinal neural centres and pathways. Contemporary medicine has developed several methods to treat spasticity. However, none of them has offered superior efficacy. This study aimed to investigate differences in the degree of spasticity between patients subjected to traditional post-stroke rehabilitation and rehabilitation based on the PNF method.A total of 64 stroke patients were enrolled. They were randomly divided into Group A and Group B. The modified six-grade Ashworth scale was used to evaluate the level of spasticity. During a 21-day follow-up, all subjects underwent intensive comprehensive rehabilitation. Group A received traditional stroke therapy. Group B received kinesiotherapy based on the PNF method.Both groups demonstrated significant improvements. In Group A, the degree of improvement in the final examination was 1.8% compared to baseline. In Group B, an improvement of 7.8% was registered already after the first session. The degree of improvement at the end of treatment was 16.86%. No significant inter-group differences were noted at baseline. The final evaluation showed significant differences.A regimen based on the PNF method resulted in greater reduction in spasticity than the traditional approach.
Key words:
spasticity, PNF, physiotherapy, Stroke, Therapeutic effects
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USG-feedback – novelty in Polish physiotherapy

Tomasz Wolny, Edward Saulicz, Andrzej Myśliwiec, Michał Kuszewski, Mirosław Kokosz

T. Wolny, E. Saulicz, A. Myśliwiec, M. Kuszewski, M. Kokosz  – USG-feedback – nowość w polskiej fizjoterapii. FP 2012; 12(4); 293-304

Abstract

Ultrasounds have been used in the physiotherapy for a long time, however up till now their application was connected with the therapeutic process. They are applied in the treatment of pain syndromes, in the course of degenerative diseases of peripheral and spinal articulations, neuralgia, soft tissue overload syndromes and after sport injuries. The ultrasound application for diagnostic purposes, as well as support for exercises (sonofeedback), is a new approach which takes its first steps in the Polish physiotherapy and arouses some controversies of the formal-legal as well as factual nature. The great value of the USG application in physiotherapy is primarily connected with the fact that it makes it possible to dynamically assess various tissues in real time at rest as well as during movement. It is a perfect tool to specify the functional diagnosis and to detect contraindications for a therapy. Its application both in a functional diagnosis as well as in a therapy improves the clinical analysis of the osteo-articulo-muscular system which is emphasized and recommended by many authors.
Applying the USG in physiotherapy is beneficial, both for the physiotherapists and their patients. For the physiotherapists – because it improves the efficiency and effectiveness of the therapy program and increases in the range of provided services and for the patients becouse of a significantly higher level of treatment.

Keywords

Ultrasonography, sonofeedback, physiotherapy

Analysis of the relationship between the quality of body posture and occlusion in children and adolescents

Anna Gogola, Edward Saulicz, Małgorzata Matyja, Andrzej Myśliwiec, Agata Tuczyńska, Michał Kuszewski, Aneta Gutowska

A. Gogola, E. Saulicz, M. Matyja, A. Myśliwiec, A. Tuczyńska, M. Kuszewski, A. Gutowska – Analysis of the relationship between the quality of body posture and occlusion in children and adolescents. FP 2015; 15(2); 52-58

Abstract

Purpose. Body posture constitutes integral whole, so the formation of the temporomandibular joints should hypothetically correspond to the remaining parts of motor organ. On account of this assumption, an attempt was made to assess the body posture in groups according to presence of malocclusion.
Material and methods. 336 children were examined including 173 girls and 163 boys aged 8-14. All the subjects underwent assessment of the body posture with use of Kasperczyk’s point classification and assessment of the occlusion according to scale drawn up by Emmerich-Popłatek.
Results. There was significant diversification (p<0.01) of mean value of body posture assessment between groups – with and without malocclusions. All parts assessed with use of Kasperczyk’s point classification were analyzed and tested if there was a connection with the quality of occlusion. A statistically significant connection of malocclusion was found with shoulders set asymmetrically and protractionally (p=0.03) and the shoulder blades standing out from the back surface (p=0.03).
Conclusions. Quality of body posture of children with malocclusions is significantly worse comparing to children without malocclusion. In the compared groups there was significant diversity of shoulders and shoulder blades setting.

Key words:
faulty posture, malocclusion

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