Sport training as an alternative form of rehabilitation for heart transplant patients

Dominika Batycka, Grzegorz Mańko, Michał Stachnik

Dominika Batycka, Grzegorz Mańko, Michał Stachnik – Sport training as an alternative form of rehabilitation for heart transplant patients. Fizjoterapia Polska 2001; 1(2); 111-116

Abstract
Background. The goal of this study was to evaluate „sports training” as an alternative to the traditional forms of cardiac rehabilitation for patients in advanced recovery from heart transplant surgery. Sports training is a good, diversified form of therapy, and at the same time plays an additional role in social integration and relief of psychological stress. Material and method. The effectiveness of “sports training” was evaluated in a natural clinical experiment involving 34 patients undergoing rehabilitation in the Cardiovascular Surgery and Transplantation Clinic at the Jagiellonian University’s Collegium Medicum in Cracow. The patients were divided into a control group (K), including 17 patients (15 men and 2 women) who underwent rehabilitation before the implementation of “sports training”, using the traditional form of rehabilitation, and an experimental group (E), also including 17 patients matched by age and sex, who received “sports training”. Results. An analysis of the results obtained demonstrated no statistically significant difference between the outcome under traditional rehabilitation and in “sports training”, including respiratory parameters. Nothing in the results pointed to increased risks associated with sports training. Conclusion. Sports’ training is a good alternative to traditional forms of exercises for patients who are well advanced in recovery from heart transplant surgery.

Key words:
Heart Transplant, sport training, rehabilitation

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Long-term respirotherapy, dishabituation from the respirator, and the rehabilitation process in a patient with marfan syndrome subsequent to surgery on an aortal aneurysm

Dominika Batycka, Grzegorz Mańko, Michał Stachnik, Donata Kołacz

Dominika Batycka, Grzegorz Mańko, Michał Stachnik, Donata Kołacz – Long-term respirotherapy, dishabituation from the respirator, and the rehabilitation process in a patient with marfan syndrome subsequent to surgery on an aortal aneurysm. Fizjoterapia Polska 2001; 1(3); 292-296

Abstract

The purpose of this article is to present the case of a patient with the Marfan syndrome who underwent surgery to repair an aortal aneurysm and his early rehabilitation, with particular emphasis on respiratory therapy. A 32-year-old patient with the Marfan syndrome was admitten to the Cardiovascular Surgery and Transplantology Clinic at the Jagiellonian University’s Collegium Medicum in Cracow, Poland, with suspected delamination of an aneurysm in the ascending aorta. Computer tomography revealed supravalvular dilatation of the ascending aorta along a 5-6 cm segment. Emergency surgery was performed using the Bental de Bono Composite Graft St. Jude Medical 25A method and ingrafting a venous bypass to the RCA. After surgery the patient was “suppressed” for 7 days in a drug-induced coma (low arterial blood pressure must be maintained initially in a patient with a surgically implanted prosthesis to prevent damage to the graft site). On the 8th day an attempt was made to extubate the patient. After ca. 14 hours of spontaneous respirator the patient was reintubed due to respiratory and circulatory insufficiency. On the 13th day when it proved impossible to terminate mechanical ventilation of the patient, a tracheotomy was performed. On the 19th day a successful effort was made to disconnect the patient from the respirator. At present the patient is breathing independently and is undergoing rehabilitation in the Department of Surgery. The article describes the program of early rehabilitation for this patient. The significance of the case for physiotherapy practice will be discussed.

Key words:
mechanical ventilation, Rehabilitation, Marfan Syndrome
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Problems in physico- and physiotherapy of patients in the course of HIV infection and AIDS infection

Włodzisław Kuliński, Anna Muszyńska, Jerzy Kruszewski

Włodzisław Kuliński, Anna Muszyńska, Jerzy Kruszewski – Problems in physico- and physiotherapy of patients in the course of HIV infection and AIDS infection. Fizjoterapia Polska 2002; 2(1); 68-70

Abstract
In 1989, the first case was diagnosed of the disease later called acquired immune deficiency syndrome (AIDS). According to WHO data, by the end of 1998 over 30 million persons around the world were known to be infected by the human immunodeficiency virus (HIV); every day 16,000 new cases of HIV infection are reported, and several million people have died of AIDS. In Poland, by the end of 1999 several thousand persons had been infected with HIV, of whom several hundred had been diagnosed with AIDS. From the moment of infection to the full development of the disease takes about ten years. AIDS is spreading on an epidemic scale. Pharmalogical treatment is imperfect and only serves to slow the progress of the infection and delay the onset of AIDS. In the development of the disease we observe the appearance of changes in the central and peripheral nervous systems, caused directly by the action of the virus and by the worsening impairment of cell immunity. Multi-focal leukoencephalopathy is found in the brain, and in the peripheral nervous system there are symptoms of sensory polyneuropathy, followed by demyelinating neuropathy and symptoms of damage to multiple peripheral nerves. In practice, peripheral neuropathy occurs in conjection with subacute encephalitis and paresis of the cranial nerves, primarily V, VII and VIII. Lesions in the vicinity of the spinal cord cause weakening of muscle strength, sphincter disorders, and progressive plegia of the limbs. In many patients we also observe symptoms in the joints. In the physico- and physiotherapeutic treatment of these patients we recommend variable low-frequency magnetic fields for subacute encephalitis with involvement of the cranial nerves (the article specifies the parameters for the procedures and the exposure time, also for patients with symptoms of peripheral neuropathy and limb plegia). The possibilities of selective physicotherapy by other means is discussed. Physical therapy procedures are also presented in the course of joint disorders, and kinesitherapeutic procedures are discussed. In the balance of the article the detailed rules for personal hygiene in handling these patients are discussed. The risk of transmitting HIV infection during physio- and physiotherapeutic procedures has been estimated at 5-10%. We have not had much experience in Poland with managing this group of patients. This article should be regarded as an attempt to raise problems which should be solved in cooperation.

Key words:
Physical Medicine, rehabilitation, prevention

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The gait. Part I – the analysis of the gait biomechanics in the rehabilitation

Mirosław Janiszewski, Beata Rechcińska-Roślak, Joanna Błaszczyk-Suszyńska

Mirosław Janiszewski, Beata Rechcińska-Roślak, Joanna Błaszczyk-Suszyńska – The gait. Part I – the analysis of the gait biomechanics in the rehabilitation. Fizjoterapia Polska 2002; 2(4); 311-318

Abstract
In the article the present state of knowledge regarding the gait of human is described. It has been presented what movements are performed in the upper and lower limbs joints while walking and in what position the centre of human gravity is. In the enclosed figures there is stated what biomechanics of the human is like.

Key words:
Gait, Biomechanics, Rehabilitation

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Cardiopulmonary exercise test in patients with congestive heart failure underwent various rehabilitation programs

Aleksandra Kubinyi, Bogumiła Bacior, Wojciech Szot, Kalina Kawecka-Jaszcz

Aleksandra Kubinyi, Bogumiła Bacior, Wojciech Szot, Kalina Kawecka-Jaszcz – Cardiopulmonary exercise test in patients with congestive heart failure underwent various rehabilitation programs. Fizjoterapia Polska 2002; 2(4); 290-299

Abstract
Background. The aim of this study was to assess tolerance of physical exercise in patients with chronic heart failure who were exercised using different model of training. Material and methods. 28 patients (mean age 53.9 ± 9.2) with chronic heart failure (NYHA class II and III) were included into this study. They were divided randomly into three groups, each number 14 patients: group A – patients who were trained according to model with progressive increase of workload, group B – patients who were trained according to interval workload model. Studied groups did not differ among themselves with average age, BMI, NYHA scale, or pharmacological treatment. All patients from groups A and B were rehabilitated during six months time, 3 times per week for 1 hour each time. All patients were submitted to the following examinations before and after six months of training: echocardiography and cardiopulmonary exercise test. Results. In groups A and B we have observed increase in exercise capability, which was more pronounced in group A. This increase was observed as increase in total exercise time when compared to group B (839.1 ± 98.3 sec vs 472.4 ± 39.7 sec, p < 0.0001), and increase in workload (6.28 ± 0.8 MET vs 3.9 ± 0.2 MET p < 0.001). We also observed improve in cardiopulmonary exercise test. After six months we observed significant difference in all parameters of cardiopulmonary exercise test in group A. In group B we observed improvement in parameters VO2peak (15.3 ± 2.1vs 16.5 ± 1.9 ml/kg/min, p < 0.01) and AT (35.8 ± 5.6 vs 44.8 ± 6.6 %, p < 0.01).Conclusions. Systematical exercise training patients with chronic heart failure, especially with the progressive increase of workload exercise model, improve exercise capacity without any negative influence on systolic and diastolic function parameters of left ventricle.

Key words:
rehabilitation, physical training, chronic heart failure, cardiopulmonary exercise test

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An evaluation of gait disturbances in children undergoing rehabilitation for cerebral palsy

Janusz Nowotny, Krzysztof Czupryna, Jacek Sołtys

Janusz Nowotny, Krzysztof Czupryna, Jacek Sołtys – An evaluation of gait disturbances in children undergoing rehabilitation for cerebral palsy. Fizjoterapia Polska 2003; 3(2); 189-196

Abstract
Cerebral palsy (CP) belongs to the group of dysfunctions in which impairment of the gait function is a constant element. The goal in rehabilitation is to steer the process of compensation in such a way that the gait pattern produces a minimum of disturbances and limitations in locomotion. Objective evaluation is essential for purposes of planning rehabilitation and monitoring outcome. Since the evaluation of gait can be parameterized, the authors have presenting methods for making such an evaluation, concentrating on two types of tests. The possibility of evaluating gate symmetry is presented, based on the use of the Parotec® system, along with evaluation based on analysis of particular gate markers, using the Zebris system. Certain practical remarks are given in the conclusion, essential for planning and managing the course of rehabilitation for children with cerebral palsy.

Key words:
Cerebral Palsy, evaluation of gait disturbances, rehabilitation

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Hospital rehabilitation after implantation of cementless hip endoprosthesis

Ewa Rosa, Wojciech Hagner, Urszula Kazimierczak, Grzegorz Srokowski, Agnieszka Radzymińska

Ewa Rosa, Wojciech Hagner, Urszula Kazimierczak, Grzegorz Srokowski, Agnieszka Radzymińska – Hospital rehabilitation after implantation of cementless hip endoprosthesis. Fizjoterapia Polska 2003; 3(2); 159-163

Abstract
Background. Hip joint alloplasty is a very complicated therapeutic problem. The cooperation of the orthopedic surgeon with they physiotherapist is very important in successful treatment. The aim of current treatment strategies is to restore the function of the hip joint. This article describes the model of rehabilitation treatment we apply in our clinical practice.Material and methods. We examined 18 patients after hip alloplasty using a cementless endoprosthesis, operated in the Orthopedic and Traumatology Clinic of the Medical University of Bydgoszcz, and rehabilitated in the Rehabilitation Clinic of the Medical University of Bydgoszcz. On the basis of differences in limb length, the patients were divided into three subgroups: A) no difference in limb length; B) operated limb shorter; C) operated limb longer.Results. Significant differences among the subgroups were found in terms of the percentage of weight burden on the operated limb.Conclusions. Rehabilitation after hip alloplasty must consider each patient individually. Outcome depends not only on good surgical technique, but also the nature and quality of the rehabilitation program after surgery.

Key words:
Hip Joint, cementless endoprosthesis, rehabilitation

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Satisfaction of life and acceptance for the disease with patients under replacement therapy – kidney transplantation

Monika Lewandowska, Izabela Korabiewska, Dariusz Białoszewski, Leszek Pączek, Joanna Juskowa

Monika Lewandowska, Izabela Korabiewska, Dariusz Białoszewski, Leszek Pączek, Joanna Juskowa – Satisfaction of life and acceptance for the disease with patients under replacement therapy – kidney transplantation. Fizjoterapia Polska 2003; 3(2); 153-158

Abstract
Background. The quality of life of the patients after renal graft transplanted is not only medical, but also a social problem. One of the suggested ways of their treatment is a holistic approach to their rehabilitation, as well as analysis of their evaluation of life conditions. Material and methods. The research involved 20 patients after renal graft transplanted, during the process of physiotherapy. This group has been scrutinized during a questionary examination (incluling SWLS, AIS) and also during a specified standard questionary. The received results have been statistically analysed according to interpretation standard adapted to Polish conditions.Conclusions and Results. The conducted examinations showed, the usefulness of the scrutiny thanks to which high interpreting results have been accomplished. The results show the acceptance of poor health conditions by the patients and low level of life satisfaction caused by the end-stage of their renal failure.

Key words:
Quality of Life, renal graft, rehabilitation

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The thermogram of cervical spinal pain syndrome as an attempt to objectivize pain

Bożena Jasiak-Tyrkalska, Bogusław Frańczuk, Janusz Otfinowski

Bożena Jasiak-Tyrkalska, Bogusław Frańczuk, Janusz Otfinowski – The thermogram of cervical spinal pain syndrome as an attempt to objectivize pain. Fizjoterapia Polska 2003; 3(3); 250-255

Abstract

Background. This paper describes the features of thermovisual images in cervical spinal pain syndrome and their variability over the course of rehabilitation, and makes an effort to specify the interdependence of these characteristics and pain relief. Material and methods. Thermovisual tests were performed on 71 patients in rehabilitation for cervical spine pain syndrome.Results. The thermovisual image of the cervical spinal region in patients with pain syndrome is different from that of healthy persons. It is characterized by considerable asymmetry of temperature and increased hyperthermia in the neck and shoulders. Over the course of rehabilitation a distinct evolution could be seen in the direction of temperature symmetry in this region. Conclusion. There is a significant correlation between pain relief and the features of the thermovisual image.

Key words:
thermovision, pain, rehabilitation
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Evaluation of the structures of shoulder joint at patients with hemiparesis after the apoplexy during rehabilitation

Andrzej Kwolek, Teresa Pop, Jacek Gwizdak, Krzysztof Kołodziej, Dorota Korab, Grzegorz Przysada

Andrzej Kwolek, Teresa Pop, Jacek Gwizdak, Krzysztof Kołodziej, Dorota Korab, Grzegorz Przysada – Evaluation of the structures of shoulder joint at patients with hemiparesis after the apoplexy during rehabilitation. Fizjoterapia Polska 2003; 3(3); 224-230

Abstract

Background. Functional disorder of the shoulder joint on the paretic side is among the more common post-stroke complications. Rehabilitation can be hindered by the associated pain, limited joint mobility, and muscle distension during the period of flaccid paresis (or plegia). The purpose of our study was to evaluate certain shoulder joint structures in post-stroke patients in inpatient rehabilitation, to compare the structural image of the shoulder joint in the affected and healthy limbs, and to identify the impact of rehabilitation on the tested joint structures. Material and methods. In a group of 40 post-stroke patients we performed ultrasonographic examination of the shoulder joints. The study group included patients who were hospitalized from December 2000 to March 2001 in the Department of Rehabilitation at Voivodeship Hospital no. 2 in Rzeszów, Poland. Examinations were performed on the first and last day of hospitalization. Results. Pathological changes were found in the shoulder joints. Over a 3-4-week rehabilitation period some improvement was noted. Conclusions. Changes in shoulder joint structure in post-stroke patients with hemiparesis occur more often on the paretic side (esp. thinning of the rotator cone, the deltoid muscle, and the tendon of the long head of the shoulder biceps, calcification, subluxation in the shoulder joint, and fluid in the bursae). Comprehensive hospital rehabilitation has a positive impact on the tested shoulder joint structures. Ultrasonography is a good method for evaluation of the anatomical structures of the shoulder joint in patients with hemiparesis.

Key words:
Shoulder Joint, Rehabilitation, Ultrasonography
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