Evaluation of physiotherapy results after anterior cruciate ligament reconstruction using the Knee and Osteoarthrosis Outcome Score (KOOS) questionnaire

Sebastian Zduński, Witold Rongies, Marcin Ziółkowski, Tomasz Kozieł, Janusz Sierdziński

S. Zduński, W. Rongies, M. Ziółkowski, T. Kozieł, J. Sierdziński – Evaluation of physiotherapy results after anterior cruciate ligament reconstruction using the Knee and Osteoarthrosis Outcome Score (KOOS) questionnaire. FP 2017; 17(2); 60-70

Abstract

Introduction. In recent years, there has been an increase in the number of knee injuries with subsequent total anteriur ligament injury (ACL). ACL lesions in most cases require specialized surgical and physiotherapeutic treatment. The main goal of rehabilitation is to restore the full function of the knee joint and the entire lower limb. Interest in methods of assessing the outcome of ACL reconstruction procedures has increased recently. A number of questionnaires and scales were developed to assess the outcome of treatment. An example is the Knee and Osteoarthrosis Outcome Score (KOOS).
The aim of the study. Assessment of near and distant outcomes of post-arthroscopic anterior cruciate ligament reconstruction in the selected model of Knee and Osteoarthrosis Outcome Score (KOOS).
Material and methodology. Randomized study included 72 patients with a complete rupture of the ACL identified for operative reconstruction. The study group included 37 patients aged 18 to 60 years (mean 37 ±10.3 years). All subjects in this group were subjected to a physiotherapy for 4 weeks prior to reconstructive surgery. In total, 10 to 12 therapeutic sessions were conducted. The control group included 35 patients aged 18 to 60 years (mean 34 ±10.0 years) who did not perform the preoperative physiotherapy program. The postoperative physiotherapy program was the same in all subjects studied.
Results. There was a statistically significant improvement in the functional assessment of the knee joint after reconstruction of the ACL using the KOOS questionnaire in the Study and Control groups at subsequent measurement points (p < 0.05). Better results in the Study Group were found in almost all subgroups of KOOS (symptoms, stiffness, daily activities, activity, quality of life) 6 and 12 weeks after ACL reconstruction. However, there was no statistically significant difference between the Study and Controlled Group (p > 0.05). There was a statistically significant difference in the “stiffness” of the KOOS scale after 12 weeks (p < 0.05). There was also a statistically significant difference in the SP3 (skipping ability) of the KOOS scale after 12 weeks (p < 0.05).
Conclusions. 1. Obtained results in both examined groups, in terms of functional capabilities evaluated by the KOOS questionnaire after reconstruction, confirm the good quality of performed surgical procedures and physiotherapeutic activities.  2. A better KOOS score in the Study Group indicates the high therapeutic value of preoperative rehabilitation.

Key words:
anteriur cruciate ligament, knee joint, physiotherapy, KOOS questionnaire

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Evaluation of the Efficacy of Local Cryotherapy in Patients with the Degenerative Knee Joint Disease

Marek Woszczak, Katarzyna Bogacz, Magdalena Józefowicz-Korczyńska, Joanna Kałuża-Pawłowska, Jan Szczegielniak

M. Woszczak, K. Bogacz, M. Józefowicz-Korczyńska, J. Kałuża-Pawłowska, J. Szczegielniak – Evaluation of the Efficacy of Local Cryotherapy in Patients with the Degenerative Knee Joint Disease. FP 2017; 17(2); 48-59

Abstract

Introduction. Pain, swelling and deformities of joints are the typical symptoms of a degenerative disease. The disease affects more than 60% of persons over 60 years of age. Due to this condition, every thirteenth person takes painkillers on a daily basis. Etiology of the degenerative knee joint disease comprises most often of micro traumas, injuries, overstrain, previous inflammatory conditions, improper weight distribution and congenital anomalies in the joint structure.
Research Goal. The aim of our study has been to evaluate the efficacy of local cryotherapy in patients with the degenerative knee joint disease.
Materials and Methods. The study has been carried out on a group of 86 persons, 20 to 45 years old, treated in the Rehabilitation Unit of the University Clinical Hospital No. 1 of the Medical University in Łódź. The patients have been randomly assigned to group A (40 persons) and B (46 persons.) In all the patients, there have been diagnosed degenerative changes in knee joints. In the study participated persons professionally active, able to walk.
Prior to application of treatment, all the patients were interviewed, had undergone physical and clinical examinations and were asked to fill out the WOMAC (Western Ontario and McMaster) questionnaire. An important purpose of the interview was to gather information about the patients’ lifestyle, their diet, addictions, physical activity and the potential epidemiological threats arising from the type of work they do.
Before and after completing the cycle of 10 treatment sessions, the patients were also examined physically by visual inspection, palpation, percussion, auscultation, measurements of lengths and perimeters, testing of muscle strength and functional tests. The patients were asked to anonymously fill out a questionnaire.
For all the patients were applied same treatments: ultrasounds, magnetic field, self-assisted exercises, knee joint load relief exercises. The differentiating factor in the study were the knee joint local cryotherapy treatments applied additionally for patients in group B. The evaluation was made on the basis of examinations before and after the physiotherapy treatments.
Results. Based on the examinations it can be concluded, that there has been achieved statistically significant reduction in pain according to VAS in both, group A and group B. There has also been a reduction in exudate and temperature of the joint.. There has also been registered an increase in the mobility ranges. Based on results of the test of Western Ontario and McMaster Universities Osteoarthritis Index, we have also observed an improvement in functional capacities in executing daily activities, i.e. for example climbing/descending stairs or putting on/taking off socks.
Conclusions. While interpreting the results, it has been observed that the degree of improvement in the above listed factors in group B, in which the additional local cryotherapy was applied, was statistically significantly higher than in group A, in which the treatment was not used.

Key words:
cryotherapy, degenerative knee joint disease, physiotherapy

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Compensation Mechanism in Treatment of Idiopathic Scoliosis with the FED Method – Preliminary Results

Sandra Trzcińska, Wojciech Kiebzak, Marek Wiecheć, Zbigniew Śliwiński

S. Trzcińska, W. Kiebzak, M. Wiecheć, Z. Śliwiński – Compensation Mechanism in Treatment of Idiopathic Scoliosis with the FED Method – Preliminary Results. FP 2017; 17(2); 6-14

Abstract

Introduction. The idiopathic background of scoliosis makes it difficult to treat the disorder in a cause and effect way. This gives a starting point for creation of many physiotherapy treatment methods, among them the FED method. It is a new, but a very promising way of the conservative treatment for scoliosis.
Research Goal. The assessment of impact of the FED treatment for reducing the angle of the primary curve (KTR P) and the secondary curve (KTR W) rotation, and the overall rotation of the spine (SDR).
Materials and Methods. In the research participated girls 11 to 15 years old (M = 13.5 ±1.4), with the diagnosed double curve scoliosis of the second degree. In all the patients, there were carried out measurements of the angle of trunk rotation in the primary curve, secondary curve, cervical segment and the scoliosis coefficient was measured with a Zebris apparatus. There was also analyzed the sum of two rotations (SDR) parameter. The above examinations were performed before and after the three week treatment with the FED method.
Results. After the application of the FED treatment method, we have observed statistically significant decrease in the average value of the trunk rotation angle at the levels of primary curve, secondary curve and cervical segment. Similar observations were made in the case of the scoliosis coefficient in Zebris examination. All the examined parameters have shown a significant decrease in the average output values (p < 0.001).
Conclusions. Treatment of double curve scoliosis with the application of the FED method, for the period of 3 weeks, leads to reduction of the rotation angle of the trunk. This reduction applies to both, the primary and secondary curve, the overall rotation angle and the cervical segment. The FED therapy improves the total rotation of the whole spine.In the course of treatment, there occurs decrease in the angle of vertebrae rotation in the cervicothoracic segment.

Key words:
idiopathic scoliosis, physiotherapy, FED method, compensation mechanism

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Possibilities for respiratory biofeedback aplication in physiotherapy of patients with COPD

Witold Pawełczyk, Janina Bajowska, Bogusława Wójtowicz, Katarzyna Bogacz, Tomasz Sirek, Jan Szczegielniak

W. Pawełczyk, J. Bajowska, B. Wójtowicz, K. Bogacz, T. Sirek, J. Szczegielniak. Possibilities for respiratory biofeedback aplication in physiotherapy of patients with COPD. FP 2013; 13(4); 12-18

Abstract

Background. There are no comprehensive studies of breathing biofeedback. The influence of breathing biofeedback in patients with COPD is unclear.
Study Objective. The aim  of this study was to compare standard physiotherapy with physiotherapy connected to biofeedback exercises with respect to breathing amplitude, 6MWT results and lungs function in patients with COPD.
Measurements. Thirty six patients with COPD were examined. They were divided into two groups. Group A took part in standard physiotherapy. Group B took part in standard physiotherapy and additional biofeedback exercises. Six minute walking test, spirometry and breathing amplitude measurement were conducted.
Results. There was significant improvement of abdominal movement in group B 0,74  (±0,53, p<0,05).
The change of FEV1 in group B was significant. The change was 3,38% (±4,34, p<0,05).
Conclusion
1.This investigation showed the influence of standard physiotherapy connected to biofeedback exercises on abdominal movement.
2.Standard physiotherapy connected to biofeedback exercises is effective in improving FEV1 in patients with COPD.

Key words:
biofeedback, COPD, physiotherapy

Healing gymnastics in activity of gymnastic units on Polish land before 1914

Sławomir Jandziś, Ewa Puszczałowska-Lizis, Marek Kiljański

S. Jandziś, E. Puszczałowska-Lizis, M. Kiljański – Healing gymnastics in activity of gymnastic units on Polish land before 1914. FP 2014; 14(1); 74-84

Abstract

The beginning of organised forms of the healing gymnastics in Poland is connected with the formation of gymnastic units. The first institutions of that kind were formed in Warsaw – Matthesa Teodor Gymnastic Plant (1831), Cracow – Ludwik Bierkowski Gymnastic School (1837), Poznań – Teofil Matecki Gymnastic Plant (1840) and in Lvov – Organopatical Plant of Teodor Bakody (1856). On the base of listed units in Warsaw, Cracow, Poznań and Lvov were formed four first centres of the development of the healing gymnastics on Polish land. Activity of gymnastic units had a significant influence into the more late development of physiotherapy and the medical rehabilitation in Poland. At first healing gymnastics based on German patterns was applied in the plants, and in consecutive years was implemented a Swedish system of the gymnastics of P. H. Ling and method of the mechanotherapy of G. Zandera. The owners of 19th-century gymnastic plants In Poland were doctors and the first specialists in the field of the treatment with the move from outside of the medical world – precursors of contemporary physiotherapists. In this period were also formed the first schools educating physiotherapists in our country.

Key words:
gymnastic plants, history of the rehabilitation, healing gymnastics, physiotherapy

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Impact of elastic therapeutic tape on final effects of physiotherapy in patients with Colles’ fracture

Marcin Krajczy, Jacek Łuniewski, Katarzyna Bogacz, Tomasz Dybek, Piotr Kiczyński, Edyta Krajczy, Anna Szczegielniak, Jan Szczegielniak

M. Krajczy, J. Łuniewski, K. Bogacz, T. Dybek, P. Kiczyński, E. Krajczy, A. Szczegielniak, J. Szczegielniak – Impact of elastic therapeutic tape on final effects of physiotherapy in patients with Colles’ fracture. FP 2014; 14(1); 42-49

Abstract

Background. Fractures of the distal radius constitute a serious clinical problem. It seems that appliance of elastic therapeutic tape may be an effective method of physiotherapy among patients suffering from the forearm’s fracture.Aim of the study. The aim of the study is to assess the impact of selected elastic therapeutic tape applications on physiotherapy’s effects among patients treated conservatively after Colles’ fracture. Material and methods. The study included 38 patients treated in the Rehabilitation Department of Health Care Centre in Nysa in the period from January 2012 until November 2013. Participants were randomly divided into 2 groups. A study group (SG) consisted of 20 patients (16 women and 4 men), while a control group (CG) was composed of 18 patients (15 women and 3 men). Therapy for all of the participants was based on usage of the Hand Tutor device. Additionally, after a preliminary examination, patients from the  study group received selected applications of elastic therapeutic tape as follows: muscular – toning for the wrist’s flexors and ligamentous or corrective for the wrist area. Applications were replaced every 4 days. Physiotherapy lasted 10 days. According to the established protocol, during and after completion of physiotherapy regular checkups were conducted. Results. Elastic therapeutic tape’s applications used in the process of physiotherapy in SG’s patients increased range of motion for both active and passive movements and improved quality of them compared to the patients from CG. It was also observed that deficit of movements (difference between range of passive and active motions) decreased more in the SG’s patients.
Conclusions: 1. In the final study no significant differences has been showed in the studied parameters between the groups. Research has presented wrist’s functions improvement in the frequency of active movements and range of motion in both groups. 2. Significantly higher results in the final examination of the frequency and wrist’s mobility in general were shown in comparison to the initial results.

Key words:
Colles’ fracture, physiotherapy, elastic therapeutic tape, biofeedback, Hand Tutor

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Restoration of hand function as a result of physiotherapy program used in patients after surgical decompression of the ulnar nerve in the groove

Krzysztof Jamka, Szczechowicz Jakub, Marek Pieniążek

K. Jamka, J. Szczechowicz, M. Pieniążek – Restoration of hand function as a result of physiotherapy program used in patients after surgical decompression of the ulnar nerve in the groove. FP 2014; 14(4); 52-62

Abstract

The aim of this study was to evaluates selected parameters of hand function in patients after surgical release of the ulnar nerve in the groove and its restitution under the influence of the applied program of physiotherapy.
Material and methods. The study included 19 patients (9 women and 10 men) after surgical decompression of the ulnar nerve in the groove. The research was conducted two times, at the beginning of rehabilitation (study examination 1) and after finishing rehabilitation programm (study examination 2). Examinations included measurements of muscle strength (grip hand and precise grips), superficial feeling (two-point discrimination test) and active mobility of the wrist, thumb and fingers II- V of the hand, which was used for calculation of loss of hand function in accordance with the Swanson’s methodology.
Results. A statistically significant restitution of hand function under the influence of the applied program of physiotherapy was noted. Indicators of improvement in muscle strength were important both in the grip hand and in precise ones. It was also showed a significant improvement in sensation to the ulnar and median nerve.
Conclusions. Adequate selected physiotherapy program allows a significant restoration of hand function in patients after surgical release of the ulnar nerve in the groove.

Key words:
ulnar nerve, physiotherapy, functional restitution

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The effect of carrying out the ‘Test of Infant Motor Performance’ on parental attitudes towards Down syndrome infants during the therapeutic process

Anna Kloze, Grażyna Brzuszkiewicz-Kuźmicka, Agnieszka Stępień, Jolanta Stępowska, Agata Kuźmicka, Małgorzata Łukowicz

A. Kloze, G. Brzuszkiewicz-Kuźmicka, A. Stępień, J. Stępowska, A. Kuźmicka, M. Łukowicz – The effect of carrying out the ‘Test of Infant Motor Performance’ on parental attitudes towards Down syndrome infants during the therapeutic process. FP 2014; 14(4); 34-45

Abstract

Introduction. An initial pre-rehabilitation assessment of motor development is an integral part of physiotherapy for a Down syndrome (DS) child. A precise evaluation of the child and the involvement of the family are prerequisite for effective support of an infant presenting developmental disorders. Test of Infant Motor Performance is a research tool used to evaluate posture and movement patterns in the first months of a patient’s life. The TIMP construction enables the assessment of the basic repertoire of the child’s intrinsic activity occurring in response to environmental stimuli. This paper aims to assess the effect of TIMP on the attitudes of parents and carers of Down syndrome children.
Research material and methods. The study comprised 64 patients with Down syndrome (full trisomy of the 21st chromosome pair), aged 2 – 17 weeks with an average age of 9.4 weeks (SD+/- 4.5). Following the TIMP, parents of both Down syndrome children and infants in the control group completed the author’s questionnaire regarding the educational value of the test. The questionnaire consisted of 10 questions evaluating the research method, including TIMP availability for carers.
Results. The results of Test of Infant Motor Performance performed on Down syndrome infants have demonstrated that neurodevelopmental disorders were recorded in children with Down syndrome, compared to healthy children.
Conclusions. The the results of the questionnaire indicate that parents believe TIMP to be safe and child friendly; they acknowledge that the test validates confidence in the specialist and facilitates the inclusion of parents of Down syndrome infants in the therapeutic process.

Key words:
Down syndrome, TIMP, physiotherapy

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The physiotherapeutic estimation of the act of temporal-mandibular joints among students of Medical University of Gdańsk

Maciej Krzyżanowski, Rita Hansdorfer-Korzon, Elżbieta Rajkowska-Labon

M. Krzyżanowski, R. Hansdorfer-Korzon, E. Rajkowska-Labon – The physiotherapeutic estimation of the act of temporal-mandibular joints among students of Medical University of Gdańsk. FP 2014; 14(4); 14-22

Abstract

Aim of the study. 1. Evaluating the activity of temporomandibular joints manifesting features of dysfunction in students of the Medical University Gdańsk, 2. Quantitative analysis of the disorders occurring in temporomandibular joints. 3. Proving the correlation between the investigated parameters and the analysed dysfunctions in temporomandibular joints
The materials and research method. For the examination, 40 students in the age of 19 to 27 years (21 women and 19 men) were classified, representing the average age of 23 years.  For the needs of this study, a card of patient examination had been constructed. The evaluation covered, among others, such parameters as: the mobility range of the jaw, the Rozencwaig’s dyskinesia index, the movement of the joint head during the jaw abduction, acoustic symptom, pain index, the presence of trigger points, the cervical spine mobility range.  The obtained results were subjected to statistical analysis with the application of Statistica 10 software .
Results. Analysis of the investigated parameters revealed that dysfunctions of mobility range, at least in one direction, occur in 87,5% (n=35) of the examined persons. The Rozencwaig’s dyskinesia index was proven in 37,5% (n=15). Asymmetric movement of the joints heads occurred in 67,5% (n=27) of the examined persons; and the disorders of the jaw guiding track and the presence of the acoustic symptom were revealed in 80% (n=32) out of the total 40 of the examined persons. Among 57,5% (n=23) of the examined, the presence of trigger points was revealed within the masseter and the temporalis muscles, or in one of them. Dysfunction of the temporomandibular joints correlates, among others, with a reduction of the mobility range in the cervical spine, with acoustic symptoms and presence of parafunctions.
Conclusions. A significant percentage of the temporomandibular joints dysfunctions was observed among students. Attention was attracted by the high percentage of people performing parafunctions. Correlations statistically significant for the temporomandibular joints were proven.

Key words:
temporomandibular joint, dysfunction, physiotherapy

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The original naturopathy treatment method practiced by doctor Apollinary Tarnawski in Kosovo during the period 1893-1939

Sławomir Jandziś, Andżelika Pleśniak, Stanisław Zaborniak,
Marek Kiljański

S. Jandziś, A. Pleśniak, S. Zaborniak, M. Kiljański – The original naturopathy treatment method practiced by doctor Apollinary Tarnawski in Kosovo during the period 1893-1939. FP 2015; 15(1); 74-80

Abstract

This article is a result of the analysis of source materials which were, among others, files of Galicia spas, information from tourist guides, advertising brochures, as well as daily and medical publications of the Galician period. The aim of the study was to present the original method of naturopathy applied by dr Apollinary Tarnavski in the years 1893-1939 in his own clinic in Hutsul-Kosovo. Both the method and its foundations are original and can be used by those interested in the problem of the evolution of physiotherapy and physical medicine.
Dr A. Tarnavski’s healing system was based on the use of outdoor activity in the form of gymnastics (especially respiratory), hiking, sports and physical work in the garden. This therapy was supplemented by water treatments based on the Kneipp method, inhalation, drinking procedures, as well as sun and air bathing. No less important factor was the medicinal vegetarian diet and even starvation. Cigarettes and alcohol were banned in the clinic, and drugs were used only in special cases. The philosophy behind dr A. Tarnawski’s methods was not only treatment, but also teaching the people to lead a healthy and hygienic lifestyle. Dr A. Tarnavski’s method was enormously popular in Poland and drew to his clinic many eminent personalities, such as artists, writers, professors, journalists and even the clergy.
Based on his experience, ideological assumptions, the knowledge gained from his trips to the national and international clinics, dr A. Tarnavski developed an original method due to which he should be perceived as the precursor of modern naturopathy, he is also the precursor in the prevention of civilization hazards and geriatric rehabilitation in Poland. Despite the passing of many years, his methods are still valid.

Key words:
history of medicine, physiotherapy, healing gymnastics, physical medicine

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