Tag: Tomasz Wolny

An evaluation of the rehabilitation for patients recovering from knee joint trauma surgically treated by internal osteosynthesis

Paweł Ryngier, Edward Saulicz, Rafał Gnat, Tomasz Wolny

Paweł Ryngier, Edward Saulicz, Rafał Gnat, Tomasz Wolny – An evaluation of the rehabilitation for patients recovering from knee joint trauma surgically treated by internal osteosynthesis. Fizjoterapia Polska 2001; 1(4); 369-375

Abstract
Background. When the knee joint is immobilized, the sliding of joint surfaces is quickly reduced, primarily as a result of the periartricular contraction of the soft tissues (especially the articular capsule). This kind of mechanical imbalance between gliding and rolling is additionally strengthened by the disturbance of muscle equilibrium, both between different muscle groups (the femoral quadriceps and the ischio-crural muscles) and within the thigh muscle itself (between the vastus medialis and the rectus femoris). In the latter case, this status may also lead to the physiological route of knee-cap slide. In view of the complex arthromechanics of the knee joint and the proper distribution of muscle strength for its functioning, the purpose of our research was to study the impact of selected techniques of manual therapy and some of the motion patterns of the PNF method on improving the activity of the knee joint patients with injuries in the vicinity of this joint surgically treated by internal osteosynthesis. Material and methods. The study involved two groups of 17 people who were treated surgically for injuries to the vicinity of the knee joint. After a period of immobility the active mobility of this joint was assessed in all patients, along with the strength of the muscles functionally connected with the knee joint and subjective pain complaints. The studied patients from both groups underwent routine rehabilitation. Selected traction and mobilization techniques for the knee joint were additionally introduced for the patients from the main group, with exercises based on the notion of post-isometric relaxation and some motion patterns taken from PNF models. Results. The statistical analysis of the quantitative data we acquired pointed to a larger range of improvement in the mobility of the knee joint, associated with a somewhat larger simultaneous increase in the strength of the evaluated muscle groups among the patients from the main group.

Key words:
Immobilization, kinesitherapy, manual therapy

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The efficiency or the Hanke Method in the correction of scoliosis in the light of selected radiological parameters

Tomasz Wolny, Edward Saulicz, Dagmara Molicka

Tomasz Wolny, Edward Saulicz, Dagmara Molicka – The efficiency or the Hanke Method in the correction of scoliosis in the light of selected radiological parameters. Fizjoterapia Polska 2002; 2(1); 35-39

Abstract
Background. The Hanke Method, also known as „E-Technik” (Entiwicklungskinesjologischer Technik), is among the less wellknown methods used to treat neuromuscular disorders. Since the elements of methods with a strictly neurophysiological mechanism of action are rarely used in corrective procedures, and the possible efficiency of these elements is typically stated in purely descriptive form, the aim of this article is to trace the impact of the Hanke method on the changes in selected parameters of the radiological evaluation of malformation. Material and methods. The research involved a group of 17 children and youth aged 7-15 (x = 10,1 +/- 2,7) with clinical and radiological symptoms of scoliosis. With only one exception these were first-degree malformations. Before and after a 10-month period of rehabilitation enhanced by certain elements of the Hanke method, X-ray photographs were subjected to evaluation. The Cobb angles, the costovertebral angles, and the Harrington indexes were calculated. All the data collected in this way were statistically analyzed. Results. The reduction of the angular value of primary curvature, associated with the simultaneous leveling out of differences in the costovertebral angles on the concave and convex sides, was obtained in 11 cases (64,7% of the subjects). Only in one case was distinct progress of malformation noted (5o). Conclusions. The results obtained point to the considerable therapeutic value of the Hanke method. The possibility of direct control over reflex reactions, leading in effect to normalization (symmetrization) of muscle tension constitutes the hallmark effects obtained by the application of methods for stimulating by reflex the neurophysiological mechanisms for controlling body posture require further thorough research.

Key words:
E-Technik, neuromuscular disorders, muscle tone, Posture

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Efficacy of the PNF method in rehabilitation for activities of daily living in late post-stroke patients

Tomasz Wolny, Edward Saulicz, Rafał Gnat

Tomasz Wolny, Edward Saulicz, Rafał Gnat – Efficacy of the PNF method in rehabilitation for activities of daily living in late post-stroke patients. Fizjoterapia Polska 2009; 9(1); 51-60

Abstract
Background. Our increasing knowledge on the complexity of CNS injuries and mechanisms of neuronal plasticity indicates that the traditional approach to rehabilitation of stroke patients is no longer adequate. Appropriate stimulation of the central nerv-ous system to promote neuromuscular plasticity is crucial for the restoration of normal function. Rehabilitation based on PNF (Pro-prioceptive Neuromuscular Facilitation) significantly improves ADL functional performance of post-stroke patients. Materiał and methods. A total of 64 stroke patients were randomly divided into two groups. ActMties of daily living were eval-uated by means of the ‘Repty’ Functional lndex, which includes: self-service, sphincter control, mobility locomotion and communi-cation. Throughout the study period (their stay at the Neurological Rehabilitation Ward for a mean of 21 days), all patients received comprehensive rehabilitation, with Group A receiving conventional rehabilitation and Group B receMng also indMdual kinesiother-apy based on the PNF method. Results. Analysis of yariance showed significant differences in the following domains of the ‘Repty’ Functional lndex: self-service (p=0.0015), locomotion (p=0.0279), and total score (p=0.0032). No significant differences were found in the remaining domains (sphincter control, mobility and communication). Conclusions. PNF-based rehabilitation of late post-stroke patients significantly improved their ADL functional performance with respect to self-service and locomotion.
Key words:
PNF, physiotherapy, activities of daily-living
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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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Direct and short-term effects of mobilization with movement according to B. Mulligan in patients with non-specific pain & overload conditions of the shoulder girdle

Mirosław Kokosz, Witold Sodel, Edward Saulicz, Tomasz Wolny, Andrzej Knapik

Mirosław Kokosz, Witold Sodel, Edward Saulicz, Tomasz Wolny, Andrzej Knapik – Direct and short-term effects of mobilization with movement according to B. Mulligan in patients with non-specific pain & overload conditions of the shoulder girdle. Fizjoterapia Polska 2009; 9(4); 301-311

Abstract
Background. Pain and overload conditions ofthe shoulder girdle are a complex problem for physiotherapists. Various manuał therapy techniąues are used to reduce the patienfs complaints. The aim ofthe work was to compare direct and short-term effects ofmobiliza-tions with movement on pain intensity and shoulder rangę of motion. Material and methods. The participants were divided into two groups of 20. Mobilizations with movement (Mulligan techniąues) were performed in the experimental group, while the control group carried out standard mobilizing and strengthening exercises. Changes in rangę of motion of shoulder girdle elevation through flexion and elevation through abduction and pain intensity were evaluated. The data were statistically elaborated. Results. More rapid and morę distinct reduction in pain and ROM improvement were obsen/ed in the experimental group. Conclusions. Mobilizations with movement applied to patients with overload-related pain of the shoulder girdle produce morę beneficial direct and short-term therapeutic effects.
Key words:
shoulder girdle, Mulligan approach, effectiveness
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Evaluation of the effectiveness of Butler’s neuromobilisations in reducing disorders of stereognosis of impaired upper extremity in late-stage stroke patients

Tomasz Wolny, Edward Saulicz, Rafał Gnat

Tomasz Wolny, Edward Saulicz, Rafał Gnat – Evaluation of the effectiveness of Butler’s neuromobilisations in reducing disorders of stereognosis of impaired upper extremity in late-stage stroke patients. Fizjoterapia Polska 2010; 10(2); 95-102

Abstract
Background: A review of contemporary literature indicates that the rehabilitation of stroke patients is chiefly based on reeducation and compensation techniques addressing motor deficits, even though pure motor hemiparesis occurs very rarely. We assumed that tensional neuromobilisations of the impaired upper extremity in late-stage post-stroke patients influence disorders of stereognosis (tactile perception of natural objects)Material and method: The study involved a group of 64 stroke patients. The subjects were divided randomly into two subgroups (A and B). To assess tactile perception, all patients had to identify 10 commonly used objects by touch. During the 21-day follow-up, all patients were subjected to comprehensive rehabilitation. The therapeutic programme for Group A included selected physical modalities and individual kinesiotherapy based on the PNF method. The treatment in Group B additionally included tensional neuromobilisations of peripheral nerves of the impaired upper extremity. Results: Analysis of variance showed significant variation only for the test measurement factor (p <0.01), which was due to significant intra-group differences in Group B (p<0.05; Tukey test).Conclusions: The greatest improvement in the assessment of the tactile perception of everyday objects was obtained in the group which received PNF therapy supplemented with neuromobilisations of peripheral nerves of the impaired upper extremity.
Key words:
stereognosis, physiotherapy, stroke, therapeutic effects
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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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Strength and kinesthetic differentiation of deep muscles stabilizing lumbar spine in low back subclinical pain complaints

Mirosław Kokosz, Edward Saulicz, Tomasz Wolny, Mariola Saulicz, Andrzej Myśliwiec, Łukasz Gębala, Oliwia Mokrus, Paweł Linek

Mirosław Kokosz, Edward Saulicz, Tomasz Wolny, Mariola Saulicz, Andrzej Myśliwiec, Łukasz Gębala, Oliwia Mokrus, Paweł Linek – Strength and kinesthetic differentiation of deep muscles stabilizing lumbar spine in low back subclinical pain complaints. Part 1. Fizjoterapia Polska 2012; 12(2); 101-112

Abstract
Background. Lumbar spine pain is one of the most frequent malfunctioning of the locomotor system. The aim of this article was to examine whether there is a co-relationship between the preliminary, subclinical symptoms of pain and the strength and kinesthetic differentiation of deep muscles stabilizing the lumbar spine in the lower section of spine. Material and methods. Appearance of pain in lumbar spine was taken as an independent variable. The average intensity of the ailment was 8.81 points (±3.68) in the Oswestry scale in 52 subjects. The second group composed of 48 persons who, at the time of the examination, felt no pain in the low back. Both groups were matched regarding the basic parameters: age, body weigh, height, level of physical activities and sex. Results of tests carried out with the use of pressure stabilizer in the supine and prone positions constituted the dependent variables. Results. Statistical analysis showed that there are significant dependencies between the presence of pain and strength and kinesthetic differentiation in the prone position. No such dependencies were registered in the supine position. Conclusions. Weakness of the deep stabilizing muscles is characteristic for persons with perceived minor lumbar spine pain. The ability to differentiate pressure force is also disturbed. It seems that an examination performed in a prone position is useful in detecting the above changes.
Key words:
Low Back Pain, muscular stabilization, Proprioception
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