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

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.
• 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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Judo as an alternative rehabilitation method in multiple sclerosis

Katarzyna Wiszniewska, Feliks Jaroszyk, Krystyna Opalko, Małgorzata Wiszniewska

K. Wiszniewska, F. Jaroszyk, K. Opalko, M. Wiszniewska – Judo as an alternative rehabilitation method in multiple sclerosis. Fizjoterapia Polska 2019; 19(1); 30-36

Objective. To evaluate the efectiveness of training judo as a part of a physiotheraphy programme in MS patients
Materials and methodology. 4 female RR-MS patients, aged between 32 and 49, have taken part in a 8-week programme. Their condition was evaluated twice – before and after the therapy. Two surveys have been carried out: one prepared by the authors of the study and Multiple Sclerosis Impact Scale (MSIS-29). In order to evaluate the functional state the following methods have been used: Functional Reach Test, 10 m TW (Time Walking) test and the Lovett test (for the following muscles: rectus femoris, biceps femoris, rectus abdominis, deltoideus).
Results. After the therapy the most persisting ailments decresed considerably. The functional tests showed better results and the patients had a better phycological disposition.
Conclusions. Judo training improved both functional and psychogical condition of the patients in the rehabilitation group. The programme proved to be an alternative form of physiotherapy for MS patients.

Key words:
multiple sclerosis, physiotherapy, judo, physical activity


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Edward Madeyski’s pioneering activities for the development of physiotherapy, physical education and hygiene in Lviv in the years 1870-1906

Sławomir Jandziś, Ewa Puszczałowska-Lizis, Maciej Łuczak

S. Jandziś, E. Puszczałowska-Lizis, Maciej Łuczak – Edward Madeyski’s pioneering activities for the development of physiotherapy, physical education and hygiene in Lviv in the years 1870-1906. Fizjoterapia Polska 2018; 18(4); 130-136

The authors, based on source materials and a few studies, present the activities of Edward Madeyski for the development of physiotherapy, physical education and hygiene in Lviv in the years 1870-1906. This doctor, by profession, and a passionate promoter of gymnastics, physiotherapy, hygiene, dietetics and healthy lifestyle, founded the theoretical basics of physical education. He represented the health-and-hygiene school, was a supporter of “rational gymnastics”, published the first Polish manuals for teaching gymnastics in schools. The main aim of the article is to present E. Madeyski’s little-known activity in the field of physiotherapy which he had been practicing since 1870 in his own Orthopedic Gymnastics Center in Lviv. Therein he treated children with musculoskeletal disorders, mainly with spinal curvatures, with the help of physical factors (therapeutic gymnastics, massage, orthopedic supports). Authors also present E. Madeyski’s activities as a teacher and promoter of physical education and hygiene in Galicia at the turn of the 19th and 20th centuries. His work gave rise to the development of the theory of physical education, gymnastics specialists training and the activity of orthopedic and gymnastic facilities. In recognition of his merits for many years of medical, pedagogical and scientific activity in 1889, the emperor awarded the title of professor to him.

Key words:
physiotherapy, healing gymnastics, history of rehabilitation


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Efficacy of selected physiotherapeutic procedures in the treatment of lumbar spine pain

Tomasz Miśkiewicz, Zbigniew Dudkiewicz, Robert Irzmański, Katarzyna Michalak, Elżbieta Poziomska-Piątkowska

Tomasz Miśkiewicz, Zbigniew Dudkiewicz, Robert Irzmański, Katarzyna Michalak, Elżbieta Poziomska-Piątkowska – Efficacy of selected physiotherapeutic procedures in the treatment of lumbar spine pain. Fizjoterapia Polska 2018; 18(3); 12-28

Aim of the study. The aim of the study was to evaluate the effectiveness of selected sets of physiotherapeutic procedures for pain in the lumbosacral segment caused by degenerative disease.
Materials and Methods. The study involved 45 patients with pain syndromes within the lumbosacral spine, who underwent a series of physiotherapy treatments. The subjects were divided into four groups. Three groups were divided depending on the applied sets of physiotherapy treatments, while the fourth group (comparative) were those taking only non-steroidal anti-inflammatory drugs (NSAIDs) for the duration of a series of treatments in the remaining groups. The patients were examined using the questionnaire of their own questionnaire, the SF-36 questionnaire (vol.2) of the short questionnaire version (Poland version), Lovett test, Laitinen scale and diagnostic tests (Laseque, Bragard, Thomayer). The tests were carried out immediately before the treatment series and two weeks after its completion.
Results. The subjects were aged 45-65. 71.1% were women and 28.9% were men. 13.3% of people were physically active. Spinal osteoarthritis was the cause of pain in all patients participating in the study. In the research group, a statistically significant difference was found between the results of the severity of pain, the level of muscle strength and the quality of life measured before physiotherapy and 2 weeks after its completion. In 90% of people participating in the procedures, an increase in muscle strength was obtained, whereas in the control group only in 6%. The improvement of the ranges of mobility in the discussed section of the spine concerned 46.6% of the subjects participating in the treatment series. In the comparison group, none of the patients improved their range of motion.
Conclusions. Physiotherapeutic treatments have a positive effect on the reduction of pathological symptoms of the lumbosacral spine. They have a positive effect on improving the quality of life, muscle strength, ranges of mobility and reducing or completely removing pain. Regardless of the applied set of physiotherapeutic treatments, they worked better than the intake of non-steroidal anti-inflammatory drugs by patients.

Key words:
physiotherapy, degenerative disease, lumbosacral segment, non-steroidal anti-inflammatory drugs

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Physiotherapy in HIV/AIDS infected patients – case presentation, principles of prevention

Włodzisław Kuliński

W. Kuliński – Physiotherapy in HIV/AIDS infected patients – case presentation, principles of prevention. Fizjoterapia Polska 2018; 18(3); 6-10

Introduction. The first cases of the disease known as acquired immune deficiency syndrome (AIDS) were described in 1981. According to the WHO, more than 35 million people worldwide have been diagnosed with HIV since then. The number of HIV-infected individuals in Poland is estimated at 35 000. The disease is associated with changes involving, among others, the central and peripheral nervous system and the musculoskeletal system. Patients are referred for physical treatment due to lower limb paresis, disturbed sphincter function and coordination as well as acute articular pain.
Material and methods. The paper presents physical treatment and rehabilitation conducted in HIV-infected patients with these problems. The principles of preventing HIV infection in the staff of the Division performing the procedures are also described together with HIV infection prophylaxis.
Conclusion. The principles of prevention and timely preventive measures may help the staff avoid HIV infection.

Key words:
HIV/AIDS infection, physiotherapy, principles of prevention


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Physiotherapy after combined surgically ankylosis crural-tarsal and crural-calcaneal interlocking retrograde nail in patients with chronic pain in extensive deformation

Jarosław Pasek, Tomasz Stołtny, Michał Pyda, Marek Kawecki, Daniel Spyrka, Michał Benedykt Białek, Alina Ostałowska, Sławomir Kasperczyk, Bogdan Koczy

J. Pasek, T. Stołtny, M. Pyda, M. Kawecki, D. Spyrka, M. B. Białek, A. Ostałowska, S.Kasperczyk, B. Koczy – Physiotherapy after combined surgically ankylosis crural-tarsal and crural-calcaneal interlocking retrograde nail in patients with chronic pain in extensive deformation . Fizjoterapia Polska 2018; 18(2); 52-57


Patella stiffness is performed in situations when the panel of surgical procedures aimed at restoring the support function of the limb in the extensive deformation of the lower leg with pantalarne chronic pain syndrome has been exhausted. In the years 2010-2017, 31 comprehensive patella stiffness were performed. Treatments were performed in 27 men and 4 women, who underwent pre and post-operative physiotherapy and selected physiotherapy treatments. The work discusses the necessary information about comprehensive patella stiffness and details of the physiotherapeutic treatment of these patients.

Key words:
degenerative joint disease, physiotherapy, interlocking regressive (retrograde) nail, crural pseudarthrosis, combined surgically ankylosis

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Analysis of injuries of musculo-ligamentous-skeletal system occurring among handball players and physiotherapy treatment

Sławomir Motylewski, Walenty Trandasir, Katarzyna Michalak, Elżbieta Poziomska-Piątkowska

S. Motylewski, W. Trandasir, K. Michalak, E. Poziomska-Piątkowska – Analysis of injuries of musculo-ligamentous-skeletal system occurring among handball players and physiotherapy treatment. Fizjoterapia Polska 2018; 18(2); 24-30


Introduction. Injuries in team games are an inseparable part of today’s sport. For every athlete it is connected with a decrease in exercise capacity, need for medical help and economic consequences. Professional rehabilitation of athletes, after a traumatic event, requires work with a physiotherapist with high skills and extensive experience and the use of modern physical therapy equipment. The lack of one of those factors can lead to further loss of health by the player, prolonged rehabilitation and thus delayed return to the game
Aim. The aim of the study was to assess the type and frequency of injuries occurring among professional female handball players and the type and methods of treatment used after the injury.
Material and methods. The studied group consisted of 19 women aged 18-31 years, playing handball for at least 5 years. All of the subjects played in the first team of Korona Handball Club in Kielce. In the study a diagnostic survey method was used.
Results. The study showed that 100% of players suffered from at least one injury connected to their professional sports activity. Most often the injury occurred while landing – 33.9%, fouls – 21.4% and throws – 19.6%. 12.5% (7) of the occurred traumas required surgery and the remaining 87.5% ended in conservative treatment. In spite of the fully recovery from the injury, a large proportion of the players – 68.4% were feeling discomfort after the resumption of training and during the matches.
Conclusions. The most common injuries of professional handball female players are sprains and dislocations of the lower limbs. Most athletes undergone conservative physiotherapy treatment including kinesiotherapy and wide range of physical therapy modalities.

Key words:
handball, sports injuries, physiotherapy

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The use of deep water running in physiotherapy – possibilities and restrictions

Wojciech Cieśla, Krzysztof Gieremek, Jarosław Drabik, Tomasz Cieśla

FP 2013; 13(3); 28-33

Bieganie w głębokiej wodzie – Deep Water Running (DWR) jest od lat 80-tych ubiegłego stulecia w wielu krajach Europy zachodniej i Ameryki Płn. dość powszechnie stosowanym sposobem przeciwdziałania zmniejszaniu wydolności organizmu. Ten rodzaj treningu był i jest szczególnie chętnie stosowany u sportowców, którzy doznali obrażeń ciała wykluczających ich czasowo z normalnych treningów wymagających obciążania aparatu kostno-stawowego. Wieloletnie doświadczenia lekarzy, fizjoterapeutów pokazują, że umiejętnie zastosowany trening biegowy w wodzie, posiada szereg zalet, które mogą być wykorzystane również u osób borykających się takimi problemami zdrowotnymi, jak np.: choroba zwyrodnieniowa stawów, otyłość czy zaburzenia koordynacji ruchów. DWR stosowany jest w kilku ośrodkach leczniczych i rehabilitacyjnych w naszym kraju, lecz Iiczba ich jest niewielka. Z uwagi no zalety prozdrowotne tego rodzaju treningu zasługuje on na przybliżenie jego zalet i wad oraz no krótką charakterystykę głównych założeń metodycznych.

Słowa kluczowe:
terapia w wodzie, bieg w głębokiej wodzie, fizjoterapia


Deep Water Running, as a common way to counteract the decreasing cardio-pulmonary efficiency of body, has been known in many West European and North American countries since 1980s. This type of training was and still is willingly used by sportsman who due to injuries were temporarily excluded from normal trainings with a load of bone-joint apparatus.
Long-standing experiences of doctors and physiotherapists show that the skillfully applied Deep Water Running’s training has a lot of advantages, which can be also used by people suffering from such health problems as joints’ degeneration, obesity or physical coordination disorder. Only in a few health and rehabilitation centers in Poland the Deep Water Running is implemented. Due to health benefits of this type of training, it deserves an outline of its advantages and disadvantages as well as a brief description of the main methodological assumptions.

Key words:
water therapy, deep water running, physiotherapy

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Shaping ethical attitude of physiotherapist

Magdalena Rusin, Wojciech Kiebzak, Marek Kiljański, Michał Dwornik, Zbigniew Śliwiński

FP 2013; 13(4); 51-56

Powszechne zasady i postawy etyczne funkcjonujące we współczesnej medycynie są tematem wielu dysput społecznych, w których, oprócz etyków, filozofów, lekarzy, biorą udział także fizjoterapeuci. Każdy z nich przedstawia swój punkt widzenia, który wielokrotnie jest zbieżny. Zarysowujące się różnice stanowisk dotyczą w pewnym stopniu konsekwencji zastosowania zasad deontologii w konkretnych sytuacjach zawodowych.
Kształtowanie postaw w procesie edukacji akademickiej jest zadaniem trudnym
i długotrwałym. Na dalsze formowanie postawy etycznej absolwenta fizjoterapii duży wpływ ma rodzaj wykonywanej pracy. Choć fizjoterapeuta rozpoczynający pracę zawodową posiada ukształtowaną postawę, będzie ona nadal podlegała pozytywnym lub negatywnym modyfikacjom środowiska. W społeczności fizjoterapeutów pożądaną postawą powinna być postawa etyczna, która charakteryzuje się trwałością i stanowi jeden ze składników ludzkiej osobowości, ludzkiego usposobienia.
Celem niniejszego opracowania jest zwrócenie uwagi na czynniki kształtujące postawę etyczną zarówno studenta fizjoterapeuty, jak i dyplomowanego fizjoterapeuty. Postawa ta, łącząca komponent emocjonalny, behawioralny i oceniający, powinna być zrównoważona i pełna społecznej dyscypliny, społecznej użyteczności, społecznego zaangażowania, społecznej otwartości, tolerancji, poszanowania godności, szacunku dla życia i zdrowia. Jej wypracowane wzorce to zachowania opiekuńcze, pełne odpowiedzialności, współodczuwania, poszanowania własności, z umiejętnością przekazywania rzetelnej informacji i z umiejętnością pracy zespołowej. Wynikiem takiej postawy ma być optymalizacja efektów postępowania leczniczego oraz budowanie prestiżu zawodu fizjoterapeuty.

Słowa kluczowe:
fizjoterapia, postawa etyczna, edukacja humanistyczna


Common behavioural and ethical patterns existing in modern medicine are subject to many social debates in which physiotherapist, alongside ethicists, philosophers and doctors, have their say. All of them express their points of view, which more often than not, coincide. The differences in opinions constitute the consequences of applying deontology in certain professional cases. Forming behavioural patterns in the process of academic studies is a hard and long-lasting task. Further development of ethical attitudes of a physiotherapist will be influenced by work. Even though physiotherapists embark upon their professional paths with already formed attitudes, these will be prone to further changes, both negative and positive, depending on the environment.

Key words:
physiotherapy, ethical stance, humanistic education

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Professional culture versus physiotherapist’s culture

Wojciech Kiebzak, Magdalena Rusin, Zbigniew Śliwiński, Michał Dwornik, Marek Kiljański

FP 2013; 13(4); 44-50

Rola społeczna fizjoterapeuty nie sprowadza się tylko do posiadania instrumentalnej, profesjonalnej wiedzy, jaką się posługuje, wysokiej kultury osobistej, ale także wymaga od niego postępowania humanistycznego i etycznego. Fizjoterapeuta we współpracy z członkami całego zespołu leczącego, stwarza warunki do zapewnienia swoim pacjentom optymalnego powrotu do zdrowia.
Kształcąc się, podnosząc swoje kompetencje zawodowe, przynależąc do stowarzyszeń zrzeszających fizjoterapeutów, budując wieź z innymi reprezentantami tej profesji rozwija się świadomość i tożsamość zawodową. Wspólne dążenie do jednolitych standardów kształcenia, tworzenie wzorców osobowych, kultury zawodowej, zasad etycznych, wpływa na profesjonalizację ich grupy, a profesjonalizacja to gwarant jakości świadczeń fizjoterapeutycznych i właściwego podejścia do pacjenta.
Celem niniejszego opracowania jest przedstawienie fizjoterapii jako profesji,
a fizjoterapeuty, jako profesjonalisty, człowieka doskonale przygotowanego do pracy
z człowiekiem chorym, potrzebującym, członka zespołu rehabilitacyjnego (terapeutycznego), terapeuty – humanisty, który swojego pacjenta traktuje jako summum bonum medycyny.

Słowa kluczowe:
fizjoterapia, kultura zawodu, kultura osobista, etyka, profesja


The social role of a physiotherapist must not be reduced to displaying instrumental professional knowledge and propriety; it demands from a physiotherapist to employ humane and ethical streak in his or her practice. A physiotherapist, in collaboration with the whole medical team, creates proper conditions for full recovery. Physiotherapists develop professional identity and awareness by furthering their education, raising their professional competence, belonging to physiotherapist associations and building bonds between other representatives of this profession. What influences the level of professionalism of the group and all the same determine the quality of physiotherapeutic services and a proper approach towards the patient are mutual attempt to standardise education, create role models as well as professional culture and ethical values. The aim of this study is to present physiotherapy as a profession, and the physiotherapist both as a professional who has the highest level of professional command to treat the ill and needed, and as a member of the rehabilitation (therapeutic) team – a humanist who treats a patient as a summum bonum of medicine.

Key words:
physiotherapy, professional culture, propriety, ethics, profession

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