Tag: Michał Kuszewski

The suitability of the „toe-touch” test for functional testing in physiotherapy

Michał Kuszewski, Henryk Knapik, Edward Saulicz, Rafał Gnat, Mirosław Kokosz

Michał Kuszewski, Henryk Knapik, Edward Saulicz, Rafał Gnat, Mirosław Kokosz – The suitability of the „toe-touch” test for functional testing in physiotherapy. Fizjoterapia Polska 2004; 4(4); 378-384

Abstract

Background. The objective of our study was to specify the relationship between selected flexibility parameters and the results of the „toe-touch” test. Material and methods. We examined 190 people from 18 to 51 years of age (ave. 23.8 ± 5.7). In each subject, global flexibility in the sagittal plane was tested with the „toe-touch” test, then the mobility of the upper and lower lumbar spine and both hip joints was examined, as was the range of plantar flexion of the ankle (an indirect indication of the length of the muscles of the dorsal aspect of the leg) and possible shortening of the hamstrings. A Saunders’ electronic goniometer was used to make measurements (in the lower lumbar spine Schober’s measurement was also utilized). The product-moment Pearson’s correlation test was used to estimate connections between parameters. Results. Significant correlations were registered between the results of the toe-touch test and the following parameters: mobility of the upper (r = 0.79) and lower lumbar spine (r = 0.70), shortening of the hamstrings (r = -0.67), mobility of both hip joints (r = 0.36 and r = 0.34), and the range of plantar flexion of both ankle joints (r = 0.33 and r = 0.25). There was no significant connection between the „toe-touch” test and the results of Schober’s measurement. Conclusion. The „toe-touch” test is a quick, simple and reliable way to evaluate the functional status of the lower spine and lower extremities.

Key words:
flexibility parameters, lumbar spinal mobility, crural muscles, plantar flexion of the ankle, shortening of the hamstrings hip mobility
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Biomechanical aspects of modern models of pelvis stability. Part II: symphysis pubis and anterior oblique muscle sling

Rafał Gnat, Edward Saulicz, Mirosław Kokosz, Michał Kuszewski

Rafał Gnat, Edward Saulicz, Mirosław Kokosz, Michał Kuszewski – Biomechanical aspects of modern models of pelvis stability. Part II: symphysis pubis and anterior oblique muscle sling. Fizjoterapia Polska 2006; 6(4); 328-333

Abstract
Biomechanical model of pelvis stability based on self-bracing mechanism contributed to certain discrimination of previous proposals mentioning the pelvic ring and ascribing important stabilizing role to pubic symphysis. However, the paper presents some arguments challenging thesis about complete lack of significance of the symphysis and anterior part of the pelvic stabilising system in process of maintaining stability. Both the symphysis itself as well as anterior oblique muscle sling seem to find their own, meaningful place there. Maybe this role could not be considered primary, but surely it is supplementary one. Observations of biomechanical, clinical and evolutional nature seem to support such a point of view. Spreading of the effective range of self-bracing due to compressive forces acting on the sacroiliac joint and increased friction between its surfaces divides the burden of maintaining stability on bigger number of muscles. The adductor longus that belongs to anterior oblique muscle sling seems to locate its attach-ment in the proper area. Moreover, a view of the pelvis, where the force closure mechanism is executed by posterior muscle slings exclusively brings about compelling impression of shearing forces arising within the sacroiliac joints. Activation of the anterior portion of the stabilizing system heads off the incoming threat immediately. Also assuming the upright body posture resulted in humans in more frequent, in comparison with other species, backward excursions of the centre of gravity. In such conditions the anterior part of the pelvic stabilizing system will always be activated in order to maintain stability.

Key words:
pelvis, symphysis pubis, anterior oblique muscle sling

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Biomechanical aspects of modern models of pelvis stability. Part I: sacroiliac joint and self-bracing mechanism

Rafał Gnat, Edward Saulicz, Michał Kuszewski, Mirosław Kokosz

Rafał Gnat, Edward Saulicz, Michał Kuszewski, Mirosław Kokosz – Biomechanical aspects of modern models of pelvis stability. Part I: sacroiliac joint and self-bracing mechanism. Fizjoterapia Polska 2006; 6(4); 280-288

Abstract
Last two decades of the XXth century brought about significant progress towards recognition of stabilizing mechanisms of kinematic links within human locomotory system. Panjabi formulated his concept concerning stabilizing system of the human kinetic link, scientist from Australia explained the mechanism of stabilization of the lumbar section of the spine, linked its dysfunctions to pain ailments rising in that region of the body and proved the effectiveness of the innovative training system in reduction of severity of such symptoms. Between numerous research in that direction, a biomechanical model of sacroiliac joint stability developed by Dutch scientists from Erasmus University, Rotterdam, is worthy paying attention. This model takes into consideration two coexisting mechanisms that make maintaining stability possible: the form closure and the force closure mechanism. As result of the cooperation between the two an effect of self-bracing of the sacroiliac joint comes into being. The leading idea hidden under the surface of the model is quite similar to the one that ancient architects had in minds while developing the structure of so called roman arch. Here, sacrum plays the role of the keystone and the two femora together with innominates are the columns. After application of quite a small, transversely oriented force, resulting from musculoligamentous system activity the construction remains stable. The objective of the paper is to familiarize reader with details of biological mechanisms that built up foundation for the Dutch model of sacroiliac joint stability.

Key words:
sacroiliac joint, form closure, force closure, self-bracing effect

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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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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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USG-feedback – nowość w polskiej fizjoterapii

Tomasz Wolny, Edward Saulicz, Andrzej Myśliwiec, Michał Kuszewski, Mirosław Kokosz

T. Wolny, E. Saulicz, A. Myśliwiec, M. Kuszewski, M. Kokosz  – USG-feedback – nowość w polskiej fizjoterapii. FP 2012; 12(4); 293-304

Streszczenie

Ultradźwięki w fizjoterapii są wykorzystywane od dawna, ale do tej pory ich użycie wiązało się z procesem terapeutycznym. Znajdują one zastosowanie w leczeniu zespołów bólowych, w przebiegu chorób zwyrodnieniowych stawów obwodowych i kręgosłupa, nerwobólach, zespołach przeciążeniowych tkanek miękkich oraz po urazach sportowych. Wykorzystanie
ultra dźwięków w celach diagnostycznych oraz jako wspomaganie ćwiczeń (sonofeedback) jest nową jakością, która zaczyna w fizjoterapii polskiej stawiać pierwsze kroki i wzbudzać pewne kontrowersje natury formalno-prawnej jak również merytorycznej. Duża wartość stosowania USG w fizjoterapii jest związana przede wszystkim z tym, że pozwala na dynamiczną ocenę różnych tkanek w czasie rzeczywistym zarówno w spoczynku, jak i podczas ruchu. Jest doskonałym narzędziem pozwalającym na doprecyzowanie diagnozy funkcjonalnej oraz wychwycenie przeciwwskazań do terapii. Jego wykorzystanie zarówno w diagnostyce funkcjonalnej, jak i w terapii poprawia kliniczną analizę układu kostno-stawowo-mięśniowego, co zresztą podkreśla i zaleca wielu autorów. Wykorzystanie USG w fizjoterapii niesie korzyści zarówno dla fizjoterapeutów, jak i dla ich pacjentów. Dla fizjoterapeutów, gdyż pozwala na poprawę skuteczności i efektywności programu terapeutycznego oraz wzrost jakości świadczonych usług dla pacjenta, ponieważ będą leczeni na znacznie wyższym poziomie.

Słowo kluczowe

USG, sonofeedback, fizjoterapia

Analiza związku między jakością postawy i zgryzu u dzieci i młodzieży

Anna Gogola, Edward Saulicz, Małgorzata Matyja, Andrzej Myśliwiec, Agata Tuczyńska, Michał Kuszewski, Aneta Gutowska

A. Gogola, E. Saulicz, M. Matyja, A. Myśliwiec, A. Tuczyńska, M. Kuszewski, A. Gutowska – Analysis of the relationship between the quality of body posture and occlusion in children and adolescents. FP 2015; 15(2); 52-58

Streszczenie
Cel. Postawa ciała stanowi integralną całość, więc ukształtowanie stawów skroniowo – żuchwowych teoretycznie powinno odpowiadać jakości pozostałych składowych narządu ruchu. W związku z tym założeniem podjęto próbę oceny postawy ciała w grupach wyznaczonych względem wad zgryzu.
Materiał i metody. Zbadano 336 dzieci, w tym 173 dziewczynki i 163 chłopców w wieku od 8 do 14 lat. Wszyscy badani poddani zostali ocenie jakości postawy metodą punktową Kasperczyka oraz ocenie zgryzu według skali opracowanej przez Emmerich-Popłatek.
Wyniki. Uzyskano istotne zróżnicowanie (p<0,01) wartości średnich oceny postawy ciała w porównaniu między grupami bez wad i z wadami zgryzu. Następnie poddano analizie wszystkie składowe oceniane metodą punktową Kasperczyka i dokonano weryfikacji, czy wykazują one związek z jakością zgryzu. Stwierdzono istotny związek wad zgryzu z asymetrycznie i protrakcyjnie ustawionymi barkami (p=0,03) oraz odstającymi od płaszczyzny pleców łopatkami (p=0,03).
Wnioski. Jakość postawy ciała dzieci z wadami zgryzu jest istotnie gorsza w porównaniu do dzieci bez wad zgryzu. W porównywanych grupach uzyskano istotne zróżnicowanie w zakresie ustawienia barków i łopatek.

Słowa kluczowe:
wada postawy, wada zgryzu

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