Usability of sEMG analysis for the evaluation of the muscles stimulation sequence in the lumbosciatic area in patients suffering from pain in lumbar spine

Karolina Kleist-Lamk, Rita Hansdorfer-Korzon, Stanisław Bakuła, Elżbieta Rajkowska-Labon

K. Kleist-Lamk, R. Hansdorfer-Korzon, S. Bakuła, E. Rajkowska-Labon – Usability of sEMG analysis for the evaluation of the muscles stimulation sequence in the lumbosciatic area in patients suffering from pain in lumbar spine. FP 2014; 14(3); 56-64

Abstract

Aim of the study: 1.  Evaluation of the relationship between the change in the stimulation sequence of muscles in the lumbosciatic area and the occurrence of functional pain in the L section of the vertebral column, as compared to the Janda’s model.
2. Analysis of the differences in the superficial electromyography (sEMG) record of a correct and disturbed pattern of muscle recruitment during the prone hip extension test in two sub-groups of patients: suffering from pain (sub-group A) and without pain (sub-group B).
3. Evaluation of the suitability of the sEMG measurement for making diagnoses in patients with pains in the lumbar section of the vertebral column.
The material and method: For the research, 61 persons were qualified, aged 20-35 years, with the average age 25 years (+/- 6). The tested group was divided into two sub-groups. 33 persons were qualified to sub-group A, and to sub-group B (reference group) 28 persons were qualified. Among the participants, a questionnaire was spread, prepared for the needs of the survey, to be filled in. For testing the sequence of stimulations, the measurements were used which had been obtained from the sEMG record during the Prone Hip Extension (PHE )Test.
Results: The results obtained during the examination of the muscles recruitment pattern in PHE test showed a changed sequence of muscles activation in the Patients from sub-group A vs. these from sub-group B. The results of chi-square test (χ²) confirmed the statistically significant dependence: the persons with pain symptoms in the lumbar spine statistically less frequently showed the correct sequence of muscles engagement:  χ²=5.05,  p=0.041, R= – 0.59 (strong negative dependence).
Conclusions: Changes in the pattern of muscles recruitment during the hip joint extension lead to overloads in the lumbosciatic area, consequently causing pain in the lumbar section. Superficial electromyography, because of the possibility of obtaining the quantitative outcome, is a useful method of evaluating muscles performance.

Key words:
The Janda test, Prone Hip Extension Test, PHE, sEMG, LBP, pain in the lower part of back

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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 Application of Constraint-Induced Movement Therapy in Patients after Stroke

Beata Tyszkiewicz, Agnieszka Drozd, Rita Hansdorfer-Korzon, Maja Nowacka-Kłos

B. Tyszkiewicz, A. Drozd, R. Hansdorfer-Korzon, M. Nowacka-Kłos – The Application of Constraint-Induced Movement Therapy in Patients after Stroke. FP 2017; 17(1); 104-115

Abstract

Each year approximately 10.5 million people worldwide experience their first stroke. This often results in a physical disability. Approximately 70-80% of these suffer from an upper-limb dysfunction of some kind which can substantially restrict day to day functioning. In recent years a number of different forms of post-stroke rehabilitation have been developed many of which aim to harness the phenomenon of neuroplasticity. These include, amongst others, Constraint-Induced Movement Therapy (CIMT), which relies on the active participation of the patient. During intense workouts of the paretic limb, the unaffected limb is immobilized. A number of studies have been conducted which have proven that CIMT (and its modification, mCIMT) is one of the most effective forms of kinesitherapy at improving the function of the paretic upper limb after stroke. CIMT is intended primarily for patients with mild or moderate upper limb paresis and is usually undertaken in the chronic period after cerebral stroke.

Key words:
cerebral stroke, upper limb paresis, neuroplasticity, constraint-induced movement therapy (CIMT)

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Is insulin the only viable option? The role of physical therapy in type 1 and 2 diabetes

Rita Hansdorfer-Korzon, Jacek Teodorczyk, Michał Korzon,
Maja Nowacka-Kłos, Agnieszka Drozd, Karolina Studzińska

R. Hansdorfer-Korzon, J. Teodorczyk, M. Korzon, M. Nowacka-Kłos, A. Drozd, K. Studzińska – Is insulin the only viable option? The role of physical therapy in type 1 and 2 diabetes. FP 2017; 17(1); 80-87

Abstract

Diabetes is a fast becoming one of the most challenging health concerns in the 21st century. Chronic hyperglycemia is the underlying cause of frequent complications such as micro- and macroangiopathy, neuropathy and diabetic foot syndrome. First-line therapy for diabetes includes blood glucose regulation, weight control, self-management, and physical activity. The aim of this article is to highlight the often forgotten fact, that physical therapy forms an integral part of any successful diabetes treatment program. Here, we discuss the recommended guidelines for the use of physical therapy in the treatment of diabetes and diabetes-associated impairments. We examine the benefits and risks associated with this therapy and also evaluate applied kinesiology as potential new treatment.

Key words:
diabetes, physical exertion, exercise, benefits in therapy

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Opóźniona diagnoza i leczenie pierwotnego obrzęku limfatycznego kończyn dolnych – studium przypadku / Delayed diagnosis and treatment of primary lymphoedema of lower limbs – case study

Rita Hansdorfer-Korzon, Jacek Teodorczyk, Marcin Gruszecki, Michał Korzon

FP 2016;16(2);42-53

Streszczenie
Leczenie pierwotnego obrzęku limfatycznego stwarza wiele problemów pacjentowi jak i całemu zespołowi medycznemu. Całkowite wyleczenie bowiem z racji uszkodzenia anatomicznych dróg odpływu chłonki nie jest możliwe, a terapia ma na celu jedynie zmniejszenie rozmiarów kończyny, przywrócenie jej funkcji i poprawienie aspektów kosmetycznych. Leczenie jest trudne, wieloetapowe i nawet w przypadku dobrych wyników kosztowne i czasochłonne. Obrzęki pierwotne nie są patologią bardzo częstą, toteż problem związany z ich diagnostyką i leczeniem pozostaje często na marginesie zainteresowania lekarzy. W przeciwieństwie do dobrze zorganizowanej pomocy, jaką otrzymują chorzy z obrzękiem w obrębie kończyn górnych (głównie po leczeniu chirurgicznym raka sutka) możliwości rozpoznania, diagnostyki i wdrożenia postępowania usprawniającego u osób z idiopatyczną postacią obrzęku limfatycznego kończyn dolnych są istotnie ograniczone. Chociaż w ostatnich latach intensywnie propagowana jest wiedza dotycząca zasad stosowania terapii przeciwzastoinowej nadal w wielu ośrodkach wdrażana jest nieprawidłowo. Nieleczony lub niewłaściwie leczony obrzęk staje się nieodwracalny wskutek rozplemu tkanki łącznej, czym różni się od obrzęków na innym podłożu. Narastający obrzęk doprowadzający do stopniowej deformacji i zaburzeń funkcji kończyny, wpływa negatywnie na stan psychiczny pacjenta. Późne rozpoznanie, kosztowne, uciążliwe i długotrwałe leczenie, którego efekt jest niejednokrotnie niezadawalający wpływa istotnie na jakość życia chorego. W pracy przedstawiono jeden z licznych przypadków pacjentek z rozpoznanymi późno i nieprawidłowo leczonymi obrzękami pierwotnymi, które mają być ilustracją typowych zaniedbań w dążeniu do ustalenia diagnozy i wdrożenia leczenia w tej jednostce chorobowej. Podkreślono także rolę badania LS jako złotego standardu w diagnostyce obrzęków pierwotnych i jej ograniczonej przydatności w ocenie skuteczności leczenia.

Słowa kluczowe:
obrzęk limfatyczny, pierwotny wrodzony obrzęk limfatyczny, rehabilitacja, limfoscyntygrafia


Abstract
Treatment of lymphoedema is problematic for the patient and the entire medical team. Complete recovery, because of anatomical damage to the outflow tract of lymph, is not possible and the therapy is intended only to reduce the size of the limb, restore its function and improve the cosmetic aspects. Treatment is difficult, multistage, unpredictable and even if results are good, expensive and time consuming. Primary lymphoedema is not common disease, so the problem of its diagnosis and treatment is often on the margins of medical concern. In contrast to the well-organized support received by patients with secondary oedema of the upper, diagnosing and implementation of rehabilitation in patients with idiopathic lymphoedema of the lower limbs are significantly limited. Although in recent years is intensely propagated knowledge of the principles of anticongestive therapy, it is still is implemented incorrectly in many centers. If left untreated or improperly treated swelling becomes irreversible as a result of proliferation of connective tissue, what differs from cases of oedema not associated with lymphatics damage. Increasing swelling will lead to progressive deformity and dysfunction of limbs and negatively affects the mental state of the patient. Late diagnosis, costly, cumbersome and long-term treatment with the often unsatisfactory effect significantly affect quality of life. The paper presents one of many our cases of patients with late diagnosed and improperly treated primary lymphoedema and is an illustration of the typical negligence in establishing the diagnosis and initiation of treatment in this disease entity.

Key words:
lymphedema, primary congenital lymphedema, rehabilitation, lymphoscintigraphy

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