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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Assessment of the impact of sensory integration method on the development of laterality

Natalia Habik-Tatarowska, Paweł Wieczorkowski, Zbigniew Śliwiński

N. Habik-Tatarowska, P. Wieczorkowski, Z. Śliwiński – Assessment of the impact of sensory integration method on the development of laterality. Fizjoterapia Polska 2018; 18(4); 122-128

Introduction. One of the aspects, or factors in the child’s motor development, is the progressive process of laterality, or, in other words, the lateralized preference of his motor activities. Laterality in children is varied in terms of strength and pace of process development. In many activities, harmonious cooperation of the eye, hand and leg is necessary, which is supported by the domination of organs on the same side of the body. Non-permanent laterality becomes the source of disturbances in spatial orientation and visual-motor coordination. In school age children, disruptions in the process of laterality often cause failures in reading and writing, which may lead to the occurrence of emotional disorders.
Purpose of research. The main objective of the conducted research was to assess the impact of the Sensory Integration method on the development of laterality in children.
Material and methods. Forty-six children aged 7-9 were examined. Analyzes of laterality development were made before the start of the Sensory Integration therapy and after six months of its duration. The research was conducted from June 2016 to December 2017. During the six-month period, Sensory Integration therapy included the following types of exercises: polisensoric stimulation, dexterity exercises, visual analysis and synthesis exercises, exercises of auditory and visual sequences, sequential and simultaneous memory exercises, and eye-hand coordination exercises.
Results and conclusions. The analysis of the conducted research indicates an improvement in the development of laterality as a result of the conducted therapy using the Sensory Integration method. The earlier we help the child choose the dominant hand, the sooner they will be ready to understand the speech of the environment and to independently build grammatically correct sentences.

Key words:
laterality, Sensory Integration, children, therapy


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The influence of physical activity on the alignment of metabolic disorders in secondary school students

Magdalena Madej, Zbigniew Śliwiński

M. Madej, Z. Śliwiński – The influence of physical activity on the alignment of metabolic disorders in secondary school students. Fizjoterapia Polska 2018; 18(4); 102-111

Introduction. This work aimed to assess the influence of systematic physical activity on changes in the blood pressure parameters, and thus on metabolism, distribution of fat, percentage of muscle, water, bone mass in students’ bodies and their BMI.
Material and methods. The study comprised 98 students who do not regularly undertake physical activity, as well as 98 students who undertake sport at least 3-4 times per week. Patients were examined individually as per the established pattern: tissue bioimpedance analysis, waist and hip circumference measurement, Martinet endurance test. The ending contains an anonymous lifestyle survey.
Results. Lower mean values of BMI, WHR and fat percentages were recorded among students who regularly practice sports. Those same students also displayed better endurance.
Conclusions. The conducted research clearly prove that systematic physical activity has a beneficial effect on the human body. It guarantees maximum endurance of the body, protects against many metabolic diseases, affects the proportions of body composition and constitutes an inseparable element of well-being.

Key words:
physical activity, metabolism, bioimpedance, BMI, metabolic diseases


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A Current Approach to Postural Care for Patients with Cerebral Palsy

Agata Michalska, Zbigniew Śliwiński, Justyna Pogorzelska, Marek Grabski

Agata Michalska, Zbigniew Śliwiński, Justyna Pogorzelska, Marek Grabski – A Current Approach to Postural Care for Patients with Cerebral Palsy. Fizjoterapia Polska 2018; 18(3); 102-112


Introduction. Rehabilitation is an essential component of therapeutic treatment in cerebral palsy (CP). One of its objectives is to prevent secondary musculoskeletal deformities. The use of various techniques to minimize postural abnormalities and enhance functions is defined as postural care (or postural management). It encompasses proper patient positioning in the lying, sitting and standing positions combined with physical therapy.
Purpose. The purpose of the study is to present a current approach to postural care based on the review of source literature.
Conclusions. No generally accepted recommendations on supporting lying, sitting and standing positions have not been developed under the postural management programme so far. The majority of studies related to this field are conducted on not very numerous groups, with short periods of observations only. Thence it is difficult to assess the effectiveness of the postural management programme, although some study results indicate it as the promising method of neurogenic hip dislocation prevention. Appropriate postural support is deemed to facilitate CP patients’ activity and participation, improve their sense of competency and motivate them to act. Due to changes in equipment designs and new solutions launched, there is an urgent need to continue related research.

Key words:
postural managment, cerebral palsy

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Is it worth taking care of Polish medicine at the turn of the 19th and 20th century in the context of the idea of “immediate help”?

Jacek Rytkowski, Marek Kiljański, Zbigniew Śliwiński

Jacek Rytkowski, Marek Kiljański, Zbigniew Ślwiński – Is it worth taking care of Polish medicine at the turn of the 19th and 20th century in the context of the idea of “immediate help”? Fizjoterapia Polska 2018; 18(3); 94-101


This paper was referring to the legitimacy – of undertaking research (much wider than before) on the history of Polish medicine turn of the 19th and 20th centuries, especially the period of 1918-1939. The text presented also obvious methodological problems that are associated with this task, for example: the problematic and essential questions are insufficient sources (excluding periodicals) for that time. The problems belong to the lack of materials significantly impedes the free work on these issues.
Besides, an important difficulty is the enormous range of meaning of these issues – together three elements are taken to discuss: the turn of the 19th and 20th century, the time before 1918 and the period 1918-1939. However, these issues are interesting enough that it should to take their analysis. This paper also discusses the concept of „emergency” as one of many elements characteristic to the „reborn” Polish medicine.

Key words:
medicine, history of medicine, emergency help, public health

An article published only in Polish, available only in the paper version of the journal

Review of literature on the application of Kinesio Taping (KT) in internal diseases: in surgery, cardiology and pulmonology

Marcin Krajczy, Katarzyna Bogacz, Jacek Łuniewski, Zbigniew Śliwiński, Dagmara Gąbka, Jan Szczegielniak

M. Krajczy, K. Bogacz, J. Łuniewski, Z. Śliwiński, D. Gąbka, J. Szczegielniak – Review of literature on the application of Kinesio Taping (KT) in internal diseases: in surgery, cardiology and pulmonology . Fizjoterapia Polska 2018; 18(2); 32-42


Introduction. So far, there have been few materials on Kinesio Taping (KT), in particular those meeting the criteria of scientific fact-based materials. The available literature includes articles on the possibility of using KT, but the results presented are not unequivocal. Some hypotheses and theories are contradictory, and many of them are not supported with any study results, and the conclusions presented seem questionable.
Objective. The objective of this study is to present the current state of knowledge of the possibility to apply the KT method in internal diseases: in cardiology and pulmonology.
Material and methods. The first stage was conducted from October to November 2017. It included preliminary selection aimed at identifying the works on the possibility of applying dynamic taping. The second stage of the research was conducted from December 2017 to January 2018, and consisted in a detailed analysis of the selected works on application and assessment of effects of dynamic taping in surgery, pulmonology and cardiology.
Results. When assessing the effects of KT in internal diseases in cardiology and pulmonology, the effects were classified as poor effects (PE), effects (E) and anti-effects (AE), when the results of the trial do not confirm the therapeutic activities. 2 E were discovered in assessing the effects of KT in surgery (2 articles). 3 E were discovered in the study of application in pulmonology (3rd article). No articles of the A reference level, concerning application of KT in cardiology.
Conclusions. Three conclusions were formulated on the basis of analysis of the source materials:
1. There has been a recent progress in the research into the possibility of applying dynamic taping in physical therapy, including in internal diseases: pulmonology and cardiology.
2. There are few prospective, randomized trials associated with application of dynamic taping, conducted on a large enough group of patients.
3. Few articles in the literature that explain the principles of DT, meet the criteria of research based on scientific facts.

Key words:
review of literature, kinesiology taping, surgery, cardiology, pulmonology

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An assessment of analgestic effects of vibroacoustic therapy in treating pains of umbosacral spine in office workers

Marlena Drężewska, Aleksander Sieroń, Zbigniew Śliwiński

FP 2013; 13(3); 8-13

Wstęp. Celem pracy była ocena efektów analgetycznych terapii wibroakustycznej w leczeniu dolegliwości bólowych części lędźwiowo-krzyżowej kręgosłupa u pracowników biurowych.
Materiał i metody. Badaniami objęto 52 kobiety, które były pracownikami biurowymi w Ostrołęce. W wieku 34-58 lat z przewlekłymi dolegliwościami bólowymi części lędźwiowo-krzyżowej kręgosłupa o etologii przeciążeniowej i/ lub zwyrodnieniowej. Pacjentki zostały poddane 10-dniowej terapii wibroakustycznej za pomocą urządzenia *VITAFON-T. Do oceny efektów terapii zastosowano analogową skalę bólu VAS oraz zmodyfikowany kwestionariusz wskaźników bólu wg Laitinena.
Wyniki. Odnotowano istotną statystycznie różnicę w średniej wartości oceny bólu przed i po terapii (p<0,05). Średnia bólu przed terapią w skali VAS miała wartość 5,81, zaś po Terapii 3,38. Suma wszystkich punktów uzyskanych w kwestionariuszu wg Laitinena przed terapią wynosiła 316, po terapii - 194. Wnioski. Uzyskane wyniki sugerują, iż terapia wibroakustyczna jest skuteczna w osiąganiu efektów analgetycznych w leczeniu dolegliwości bólowych części lędźwiowo-krzyżowej kręgosłupa u pracowników biurowych. Słowa kluczowe: Terapia wibroakustyczna, skala VAS, kwestionariusz Laitinena


Introduction. The objective of the research was to assess analgesic effects of vibroacoustic therapy in treating pain in the lumbosacral spine among office workers.
Materials and methods. The participants of the research were 52 female office workers from Ostroleka, aged 34-58, with chronic pain of lumbosacral spine caused by overstrain and/or spondylosis. The patients underwent 10-days vibroacoustic therapy which was conducted by means of VITAFON-T device. To assess the effects of the therapy there was used VAS analogue pain scale and a modified pain rates according to Laitinen questionnaire.
Results. There was noted a substantial statistic difference in the average value of pain assessment before and after therapy (p<0.05). The mean value of pain before therapy according to VAS scale amounted to 5.81, and after therapy it constituted 3,38. The total score obtained from the Laitinen questionnaire amounted to 316, and after therapy - 194. Conclusions. The obtained results indicate that the vibroacoustic therapy is effective in achieving analgesic effects in the treatment of pain in the lumbosacral spine among office workers. Key words: vibroacoustic therapy, VAS scale, Laitinen quesfionnaire

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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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Evaluation of the effects of dynamic taping in changing the selected motor characteristics in hypermobile dancers

Marlena Skwiot, Zbigniew Śliwiński

M. Skwiot, Z. Śliwiński – Evaluation of the effects of dynamic taping in changing the selected motor characteristics in hypermobile dancers; Fizjoterapia Polska 2018; 18(1); 14-24


Introduction. Dynamic taping is enjoying ever-growing popularity as an effective aid for treating injuries both in professional and non-professional dancers. The aim of the study was to evaluate the effectiveness of the application of dynamic taping in improving the selected motor characteristics in hypermobile dancers. Materials and methods. The study included a total of 46 female concert dancers between 18 and 25 years of age (M = 20.06, SD = 2.67), specialized in jazz dancing, who had been diagnosed with joint hypermobility syndrome using the Sachs scale. Within the examined group, dynamic taping was applied following the screening tests, and the applications were changed three times (every 7 days) during the therapy. The observed changes in motor characteristics were assessed using the muscle flexibility tests, the muscle strength measurements performed with a dynamometer and the hip joint mobility measurements carried out with a digital inclinometer. Results: The application of dynamic taping produced statistically significant results in the restoration of normal muscle flexibility. The analysis results confirmed the effectiveness of applying dynamic taping in increasing muscle strength as well as active mobility range of the hip joint in dancers (p < 0.05). Findings: The multidisciplinary physical therapy of dancers should include a variety of techniques and methods, with particular emphasis on the appropriate selection of dynamic taping applications. The increase in muscle tone with the simultaneous increase in the active mobility range of the hip joint and the reduction of subjective pain sensation confirm the beneficial impact of dynamic taping on the changes of motor characteristics related to the joint hypermobility syndrome. Key words: dancing, hypermobility, dynamic taping

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