Tag: Zbigniew Śliwiński

The effect of early rehabilitation on locomotor function in post-stroke patients – preliminary report

Emil Domański, Magdalena Wilk, Wojciech Kiebzak, Zbigniew Śliwiński

Emil Domański, Magdalena Wilk, Wojciech Kiebzak, Zbigniew Śliwiński – The effect of early rehabilitation on locomotor function in post-stroke patients – preliminary report. Fizjoterapia Polska 2008; 8(1); 83-95

Abstract
Background. Cerebral stroke is defined by the WHO as sudden onset of rapidly developing clinical signs of focal disturbance of cerebral function, with symptoms lasting longer then 24h, or leading to death, caused by changes in the arterial or vascular system of the brain. The aim of this study was to assess the effect to early rehabilitation on the locomotor function in stroke patients. Material and method. A group of 30 patients with hemiparesis within 24h after the onset of stroke and after 14 days of rehabilitation. The locomotor assessment was carried out according to the PNF functional status of muscles and gait patterns. Activities of daily living were evaluated according to the Repty Functional Index (RFI) and the Simple Chart of Locomotor Activities (PKCM). The level of disability was graded to the Rankin scale. For logistic reasons, the study did not include a control group, so that the paper is treated as a preliminary report.Results. Locomotor improvement was achieved in 40% of patients, with reduction in disability in 50%. Improved locomotor function led to urinary function improvement in 50% of patients. Motor dysfunction of the upper limb was reduced thanks to physiotherapy in 40% of patients. Conclusions. Early rehabilitation leads to improved function as defined by the functional status of muscles and hait patterns. The adopted rehabilitation programme resulted in improved functional indepedence evaluated on the basis of the Repty Functional Index (WFR) and Simple Chart of Activities (PKCM). The locomotor improvement resulted in urinary improvement in 50% of patients. Early rehabilitation improved the locomotor function of the paretic upper limb. The conclusions need to be verified in further studies with control groups.
Key words:
cerebral stroke, hemiparesis, early rehabilitation, functional status
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Thermovisual evaluation of temperatures of the upper limbs following cryostimulation in post-stroke patients

Zbigniew Śliwiński, Piotr Płaza, Krzysztof Gieremek, Wojciech Kufel, Beata Michalak, Bartłomiej Halat, Grzegorz Śliwiński, Magdalena Wilk

Zbigniew Śliwiński, Piotr Płaza, Krzysztof Gieremek, Wojciech Kufel, Beata Michalak, Bartłomiej Halat, Grzegorz Śliwiński, Magdalena Wilk – Thermovisual evaluation of temperatures of the upper limbs following cryostimulation in post-stroke patients. Fizjoterapia Polska 2008; 8(1); 23-34

Abstract
Background. Cerebral stroke is a very serious life-threatening condition regardiess of the clinical picture at the onset. In most cases cerebral stroke is a consequence of systemic vascular diseases such as atherosclerosis or hypertension. Material and methods. The study group comprised 103 patients, including 52 post-stroke patients with a paretic upper limb and 51 healthy participants. The group of stroke patients included 18 women and 34 men, while the healthy group consisted of 41 women and 10 men. The mean age of the male patients was 55.6 and of the female patients 66.1 years. The mean age of the control group was 37.2 years. Local cryostimulation was applied to the hand and forearm of the paretic limb in the stroke patients and to the hand the forearm of the right upper limb in the healthy group. The limb was exposed to cold for 6 minutes. The temperatures were measured using an Agema 570 thermovision camera.Results. Subjecting only one forearm to cryotherapy procedures results in a decrease in temperature. In the post-stroke patients the return to the basseline value after the procedure was more rapid. This is possibly connected with more efficient mechanisms protecting the body against loss of warmth, since in this group temperature values were higher. In the control group the temperature in the non-cooled limb decreases by an average of 1.6 st.C, compared to only 1.3 st.C in the stroke patients. Conclusions. The temperatures of an area in the forearm exposed to 6 minutes of cryotherapy were different in the post-stroke patients and in the healthy controls. This is probably attributable to stroke-related brain damage. Contralateralization, i. e. the decline of temperature in the non-cooled limb, occurred both in the post-stroke patients and in the healthy controls. Temperature decreases produced by the exposure of limbs to cold were higher in the stroke patients than in the healthy participants. The temperature returned to baseline more rapidly in the post-stroke patients. The temperature in the cooled limb dod not return to, or exceed, baseline value fifteen minutes after the procedure.
Key words:
cerebral stroke, cryostimulation, thermovision, vascular play
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Autonomia zawodu fizjoterapeuty na przykładzie systemu kształcenia w USA

Małgorzata Starczyńska, Wojciech Kiebzak, Zbigniew Śliwiński

Małgorzata Starczyńska, Wojciech Kiebzak, Zbigniew Śliwiński – Autonomia zawodu fizjoterapeuty na przykładzie systemu kształcenia w USA. Fizjoterapia Polska 2008; 8(2); 217-222

Streszczenie
Uzyskanie autonomii zawodowej potwierdzającej specjalistyczną wiedzę i umiejętności zawodowe jest podstawą działań podejmowanych przez stowarzyszenia fizjoterapeutów działających w USA. Pomimo faktu, iż większość stanowych aktów prawnych daje pacjentom możliwość bezpośredniego skorzystania z oceny i leczenia przez fizjoterapeutów, nie ma aktu prawnego, który jednoznacznie formułowałby zakres autonomicznej praktyki. Stowarzyszenie Fizjoterapii Amerykańskiej (American Physical Therapy Association – APTA) pełni wiodącą rolę w dbaniu o jakość kształcenia i praktykowania fizjoterapeutów. Zdefiniowana przez Zarząd Dyrektorów APTA autonomiczna praktyka opiera się na profesjonalizmie, odpowiednim poziomie kształcenia i możliwości bezpośredniego dostępu pacjenta do usług fizjoterapeutycznych. W USA istnieje kilka ścieżek edukacyjnych pozwalających uzyskać zawód fizjoterapeuty. Dynamiczna natura praktyki fizjoterapeutycznej wpływa na ewaluację programów nauczania. Większość programów zapewnia kształcenie na poziomie magisterskim lub zawodowym doktoranckim. Stopień doktora fizjoterapii uzyskiwany w toku kształcenia nie jest równoznaczny z akademicką nominacją fizjoterapeutów. Programy studiów doktoranckich stanowią 79,4% spośród wszystkich akredytowanych programów kształcących fizjoterapeutów. Przeznaczone są w szczególności dla doświadczonych pracowników klinik, podnoszą umiejętności kliniczne w konkretnej dziedzinie. Finałem ukończenia akredytowanego programu przygotowującego do zawodu fizjoterapeuty jest przystąpienie do Państwowego Egzaminu Fizjoterapii (National Physical Therapy Examination – NPTE). Ogólnokrajowy wynik zdania egzaminu ustalany jest przez Federację Stanowych Władz Fizjoterapii (Federation of State Boards of Physical Therapy – FSBPT). Podniesieniu kompetencji służy również ukończenie specjalizacji klinicznej. Amerykański Zarząd Specjalizacji Fizjoterapii (American Board of Physical Therapy Specialities – ABPTS) oferuje uzyskanie specjalizacji w kilku obszarach zainteresowań, w najbliższej przyszłości również w nowym zakresie jakim jest zdrowie kobiet. Wyrazem dbałości o jakość usług fizjoterapeutycznych jest konieczność ponownej recertyfikacji specjalistów klinicznych po 10 latach.
Słowa kluczowe
fizjoterapia

Model of professional activity of psychologist in the Rehabilitation Department in Zgorzelec

Teresa Karadimitris, Wojciech Kufel, Beata Michalak, Bartłomiej Halat, Marta Kopa, Zbigniew Śliwiński

Teresa Karadimitris, Wojciech Kufel, Beata Michalak, Bartłomiej Halat, Marta Kopa, Zbigniew Śliwiński – Model of professional activity of psychologist in the Rehabilitation Department in Zgorzelec. Fizjoterapia Polska 2008; 8(2); 206-216

Abstract
The professional activity of a clinical psychologist in a rehabilitation departament requires a general knowledge of psychology as well as familiarity with departament-specific issues. There exist a variety of models for the professional activity of a psychologist in rehabilitation. The practice in the Rehabilitation Departament in Zgorzelec is closest to the developmental model’, according to which disability represents a predisposition to experience various problems in life and rehabilitation is the process of interaction between a disabled person and a specialist in a rehabilitation and physiotherapy. This model regards the patient as a partner in the rehabilitation process. Psychologists in a rehabilitation departament need to undertake different activities in the therapy of children and in the treatment of adults. Work wit children (and their carers) includes diagnosis, therapy, stimulation of development, psychoeducation and support for the parents. The psychologist also collaborates with educational institutions: schools and kindergartens that the patients attend as well as the Psychological and Pedagogical Counseling Centre, whose activities aim to support the children’s development. In the case of adult patients with CNS damage, the psychologist begins work with a neuropsychological diagnosis and follws with exercises to restore the affected functions. The basic activity in work with patients suffering from musculoskeletal pain is psychoeducation, which covers the concept of disease, connection between stress and the functioning of the body, identification of needs and skills required to satisfy them, work with emotions and relaxation training.
Key words:
model of professional activity, psychological diagnosis, psychotherapy, psychoeducation
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Assessment of the effect of high-tone power therapy in rehabilitation of stroke patients

Zbigniew Śliwiński, Piotr Płaza, Krzysztof Gieremek, Wojciech Kufel, Beata Michalak, Bartłomiej Halat, Grzegorz Śliwiński, Magdalena Wilk

Zbigniew Śliwiński, Piotr Płaza, Krzysztof Gieremek, Wojciech Kufel, Beata Michalak, Bartłomiej Halat, Grzegorz Śliwiński, Magdalena Wilk – Assessment of the effect of high-tone power therapy in rehabilitation of stroke patients. Fizjoterapia Polska 2008; 8(2); 197-205

Abstract
Background. High-tone power therapy is a new method of nerve and muscle stimulation with electric current of a frequency corresponding to the acoustic band of electric oscillation between 4 400 Hz to 12 300 Hz. The usa of two pairs of electrodes serves to generate a dynamic electric field deep inside the tissues. The aim of the study was to assess upper limb function in hemiparetic stroke patients who undrwent high-tone power therapy in the course of rehabilitation. Materials and methods. The study group consisted of 16 men aged 46-72 years (mean 54) and 4 women aged 67-74 years (mean 71) who had suffered strokes of various aetiologies. Arm function was determined on the basis of grip strength testing, ranges of motion (ISOM) and spasticity level (Ashworth scale). Results. Grip strength increased with simultaneous improvement in angular ranges of motion in the radiocarpal joint of the paretic limb. Spastic tone in the limb decreased by 0.35 on the Ashworth scale. Analysis of linear measurements revealed statistically significant changes of circumferences only at the upper arm level. Conclusions. Comprehensive physiotherapy including horizontal therapy performed in stroke patients produced significant functional improvements in the paretic upper limb. High-tone power therapy is well tolerated by hemiparetic patients with despite the long duration of the procedure.
Key words:
Ashworth test, high-tone power therapy, hoSti-Scan stimulation, secondary effect
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Standard of Radiological Scoliosis Assessment in Zgorzelec Rehabilitation Centre

Wojciech Kufel, Bartłomiej Halat, Beata Michalak, Zbigniew Śliwiński

Wojciech Kufel, Bartłomiej Halat, Beata Michalak, Zbigniew Śliwiński – Standard of Radiological Scoliosis Assessment in Zgorzelec Rehabilitation Centre. Fizjoterapia Polska 2008; 8(3); 344-350

Abstract
Present-day physiotherapeutic practice requires the therapist to be able to assess radiographs. University syllabuses in physiotherapy take this into account and students acquire this knowledge. However, there are a number of physiotherapy practitioners working at health care facilities who do not participate in post-graduate training but work with scoliotic children. Our aim is therefore to present a standard of functional and radiographic assessment of patients with scoliosis adopted in the Rehabilitation Centre in Zgorzelec. The radiograph is the fundamental tool of medical diagnostic imaging. A radiograph used for scoliosis assessment should show the entire spine, including the iliac ala and the femoral joints. It should be taken in the AP and lateral views, with the patient in a standing position. Radiographs complying with these requirements make it possible to determine scoliosis characteristics (type, Risser sign, Cobb angle, vertebral rotation angle, kypho-lordotic index, etc.), according to which appropriate physiotherapeutic management is chosen. Radiological work-up is essential for the assessment of scoliosis and for therapeutic management planning. It also allows an objective evaluation of the progress of rehabilitation. Moreover, radiographs can also be used to monitor the time course of scoliosis. Treating scoliosis without an obtaining x-ray images is like driving a car at night with the headlights switched off!
Słowa kluczowe
scoliosis, x-ray image
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Usefulness of Kinesiology Taping in post-stroke patients rehabilitated with the PNF method. Preliminary report

Zbigniew Śliwiński, Marta Kopa, Bartłomiej Halat, Beata Michalak, Wojciech Kufel, Henryk Racheniuk, Magdalena Wilk, Marcin Krajczy, Jan Szczegielniak

Zbigniew Śliwiński, Marta Kopa, Bartłomiej Halat, Beata Michalak, Wojciech Kufel, Henryk Racheniuk, Magdalena Wilk, Marcin Krajczy, Jan Szczegielniak – Usefulness of Kinesiology Taping in post-stroke patients rehabilitated with the PNF method. Preliminary report. Fizjoterapia Polska 2008; 8(3); 325-334

Abstract
Background. Physiotherapy employs a number of kinesiotherapeutic methods based on understanding the course of the development- and movement-related neurophysiological processes, with PNF being one of the methods. Rehabilitation of stroke patients produces better results if different methods are combined, e. g. PNF and KT. Material and methods. The study involved 15 post-stroke patients, including 10 men and 5 women, aged 39-72. Each subject was examined once. Two muscle tone tests according to the Ashworth scale and three functional tests of the paralyzed upper extremity (prior to the therapy, on completion of PNF therapy and following functional KT application) were performed. The upper extremity function test consisted in the subject picking up an object. The distance [cm] between the object and the table surface was measured. Each patient underwent a 45-60 minute rehabilitation session using the PNF method. Additionally, KT was applied onto the radiocarpal joint extensor muscles.Results. Muscle tone according to the Ashworth scale did not change. The mean functional test results [cm] were as follows: 3.8 prior to the therapy, 6.6 post-PNF, and 7.8 post-KT. In two subjects the functional test results did not change, whereas the upper extremity function in the remaining 13 subjects improved after PNF therapy. A marked improvement was observed following the application of KT. In 10 patients, the additional KT application considerably facilitated PNF-based rehabilitation. Conclusions. A combined PNF and KT therapy contributes to improvement of function in the paralyzed extremity. Functional KT application proved to be useful and to facilitate PNF rehabilitation, and so the two modalities may and even should be combined. Although the patients were only subjected to a single PNF session, the function of the upper extremity improved. An even more marked improvement was observed following the functional application of KT. Muscle tone according to the Ashworth scale did not change significantly on completion of the therapy. However, it did not have a decisive influence on the positive results of the functional tests. We did not observe a correlation between the combined PNF and KT therapy and the duration of the post-stroke period was.
Key words:
Kinesiology Taping applications, PNF method, cerebral stroke
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Vojta Screening Tests in children with CNS damage and functional applications of Kinesiology Taping

Zbigniew Śliwiński, Bartłomiej Halat, Beata Michalak, Wojciech Kufel, Marta Kopa, Jacek Łuniewski, Katarzyna Bogacz, Marcin Krajczy, Jan Szczegielniak

Zbigniew Śliwiński, Bartłomiej Halat, Beata Michalak, Wojciech Kufel, Marta Kopa, Jacek Łuniewski, Katarzyna Bogacz, Marcin Krajczy, Jan Szczegielniak – Vojta Screening Tests in children with CNS damage and functional applications of Kinesiology Taping. Fizjoterapia Polska 2008; 8(3); 317-324

Abstract
Background. The manifestations of CNS disorders, whether it is spasticity, athetosis, ataxia, or any other, are not visible shortly after birth. They usually develop during the first 4 months of life. They can only be elicited in challenge tests, including kinesiological diagnostic work- up according to V. Vojta.Aim – to define the effect of Kinesiology Taping functional application in children with central coordination disorders. Material and Methods. The study involved 28 patients from the Inpatient Rehabilitation Centre of the Multi-speciality Independent Public Health Care Facility in Zgorzelec (10 boys and 18 girls aged 6-10 months). The mean age of the group was 8 months.Results. Changes in the subjects’ postural reactivity were produced in the course of Vojta kinesiological tests. The difference between the number of pre- and post-Kinesiology Taping abnormal reactions [%] was statistically significant for 3 out of the 7 reactions tested. The mean number of abnormal reactions was 3.12 out of 7 reactions tested. The post-KT results improved inasmuch as the number of abnormal reactions decreased on average by 1 to 2.14 abnormal reactions out of the 7 reactions tested.Conclusions. Children tolerate the therapy of Kinesiology Taping very well. KT produces changes in the spatial arrangement of body parts and improves spatial reactivity, as was observed in the Vojta tests. The Traction Response test showed body axis correction in asymmetric children. The suspension test according to Collis revealed that the application of KT on the hand exerted an effect on muscle tone.
Key words:
Vojta screening tests, Kinesiology Taping
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Assessment of thermal effects of kinesiology tape application

Henryk Racheniuk, Jan Szczeielniak, Katarzyna Bogacz, Sławomir Zator, Jacek Łuniewski, Grzegorz Skiba, Zbigniew Śliwiński

Henryk Racheniuk, Jan Szczeielniak, Katarzyna Bogacz, Sławomir Zator, Jacek Łuniewski, Grzegorz Skiba, Zbigniew Śliwiński – Assessment of thermal effects of kinesiology tape application. Fizjoterapia Polska 2008; 8(3); 310-316

Abstract
Background. This work presents the results of a thermovisual analysis of 20 patients subjected to a single Kinesiology Tape application to the lumbosacral region. The Y muscle technique was used for thermovisual assessment. Material and methods. The study involved a group of 20 volunteers, students of Opole Technical University, including 16 women and 4 men, at an average age of 21 years. The subjects had previously reported intermittent low back pain. The surface temperature of the area where Kinesiology Tape was applied was measured three times: before taping, at one hour after taping and 24 hours after the KT application. Results. The biggest increase in surface temperature was observed in centrally located Area 1, where mean temperature increased by 1.27°C while mean temperature increases in lateral test areas were 0.6°C. Temperature increases in test areas located directly on the tapes were 0.3°C. These values fall within thermovisual camera statistical error range. Conclusion. The highest temperature increase was observed in the central test area. The values of temperature increases of the lateral test areas and those located directly on the tape fell within the thermovisual camera statistical error range.
Key words:
Kinesiology Taping, thermovision, physiotherapy
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The effect of oblique abdominal muscle applications of Kinesiology Taping on the symmetry of pelvic movements

Michał Dylewski, Marek Sójka, Tomasz Senderek, Zbigniew Śliwiński, Wojciech Hagner

Michał Dylewski, Marek Sójka, Tomasz Senderek, Zbigniew Śliwiński, Wojciech Hagner – The effect of oblique abdominal muscle applications of Kinesiology Taping on the symmetry of pelvic movements. Fizjoterapia Polska 2008; 8(3); 290-298

Abstract
Background. Asymmetrical pelvis position is believed to be a cause of such conditions as low back pain syndromes or scoliosis. The positioning and mobility of the pelvis depend mainly on the tension of the muscles in this area. This paper attempts to evaluate the effect of Kinesiology Taping (KT) application on the symmetry of work of the iliac bones. Material and methods. The subjects were people aged between 18 and 65 years without pain syndromes, with asymmetric pelvis position. The subjects were divided into an investigational group (indications to apply KT to OAM) and a control group (no such indications). KT applications for the investigational group were chosen according to KT testing results, while in the control group KT was applied randomly. Assessments of pelvic bone movement were performed twice, before and just after KT application, using an ultrasound-based 3D motion analysis system (ZEBRIS CMS HS). Movements of the lumbar spine and iliac bones were assessed in flexion and extension with the patient in the standing position. Analysis of the results was concerned with the following parameters: symmetry of iliac bone movement and mobility of the lumbar spine before and after KT application.Results. Following KT application, the investigational group demonstrated a significant (p <0.05) improvement of iliac bone movement symmetry with regard to all parameters. The results were significantly better in the investigational group compared to the control group (p <0.05).Conclusions. Oblique abdominal muscle applications of Kinesiology Taping, when used in accordance with the principles of Kinesiology Taping and based on KT tests, substantially improve the symmetry of pelvic movement.
Key words:
Kinesiology Taping, oblique abdominal muscles, asymmetrical pelvis position
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