The impact of central stabilization exercises and classical massage on the quality of life of people suffering from cervical spine pain

Agnieszka Leszczyńska, Ada Sitek, Agnieszka Przedborska, Marcin Świątczak, Małgorzata Kilon, Katarzyna Glibov


Agnieszka Leszczyńska, Ada Sitek, Agnieszka Przedborska, Marcin Świątczak, Małgorzata Kilon, Katarzyna Glibov – The impact of central stabilization exercises and classical massage on the quality of life of people suffering from cervical spine pain. Fizjoterapia Polska 2023; 23(1); 178-185

DOI: https://doi.org/10.56984/8ZG07B3FB

Streszczenie
Introduction. Pain in the cervical spine affects about 22-70% of the population and the incidence of pain increases with age. Out of different types of therapies, most patients prefer a massage aimed at normalizing muscle tension and reducing pain. However, a comprehensive approach to a patient according to the Kinetic Control concept allows for the assessment of uncontrolled motion and enables the analysis of motion and its function. The assessment of motor errors as well as the re-education of muscle function is an important element in improving the range of motion and reducing pain in the cervical part of the spine.
Aim. Assessment of the impact of classical massage and central stabilization exercises on the quality of life of people with cervical spine pain.
Material and methods. The study covered 40 people (62,5% women, 37,5% men) aged 20 – 70 year who suffered from pain in the cervical spine. Two groups of 20 were formed. Group I was subjected to a series of classical massage, Group II performed exercises of central stabilization. The impact of both therapies was assessed by means of: the author’s own survey, the VAS scale, the NDI-PL form, and the measurement of the range of motion in the cervical spine. Quality of life was assessed using a 100-degree scale.
Results. VAS and NDI scores in both groups are significantly lower after treatment (p < 0,01), but it cannot be concluded that one form of therapy has had a better effect. The range of spine motion which was evaluated in the cervical segment significantly increased (p < 0,01) in both groups. It was noted that in terms of extension, central stabilization exercises proved to be more effective – the scope of extension increased on average by 1,3 units after exercises, whereas after massages only by 0,7 units (p = 0,045). Both therapies demonstrated effectiveness in the domain of general health (p = 0,54) – both massages and exercises (p = 0,01) brought patients a significant improvement.
Conclusions. Both therapies are effective in fighting cervical spine pain, however, better results were obtained in the group performing central stabilization exercises. The quality of life increased significantly in both groups of patients.
Key words:
Kinetic Control, Pressure Bio-Feedback Stabilizer, VAS and NDI scale
Słowa kluczowe:
Kinetic Control, Pressure Bio-Feedback Stabilizer, skala VAS i NDI
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Long-term evaluation of the quality of life of patients with osteoarthritis treated conservatively and surgically

Marcin Świątczak, Aneta Nowicka, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski

Marcin Świątczak, Aneta Nowicka, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski – Long-term evaluation of the quality of life of patients with osteoarthritis treated conservatively and surgically. Fizjoterapia Polska 2021; 21(3); 198-204

Abstract
Introduction. Osteoarthritis of the hip joint is one of the most common chronic diseases of the locomotor system. Total hip replacement (THR) is a treatment option of choice alongside conservative treatment. The aim of the study was the long-term assessment of the quality of life of patients after total hip replacement surgery and after conservative treatment.
Material and methods. The study group consisted of 35 patients diagnosed with many years of osteoarthritis of the hip who underwent THR with posterolateral surgical approach. The assessment was carried out at the Department of Orthopedics and Traumatology of the University Teaching Hospital WAM – CSW in Łódź. The control group consisted of 15 patients with long-term osteoarthritis of the hip, treated conservatively. Medical data were obtained from the history of the disease and the author’s questionnaire, while the World Health Organization Quality OF Life (WHOQOL) – BREF questionnaire was used to assess the quality of life.
The obtained results were statistically analyzed with the use of MS Office and the Student’s T-test, considering the results below p <0.05 as statistically significant.
Results. The assessment of domains was similar in both groups, the greatest dissonance was observed in the assessments of the somatic and social domains. Based on WHOQOL-BREF questionnaire, the majority of patients in the study group rated the quality of life from 60% to 70% of the maximum value, the highest psychological sphere, the least somatic. In the control group, the social domain obtained 78% of the maximum value, other domains – 74% of the maximum value.
Conclusions. Patients treated conservatively assessed their quality of life higher in all domains than patients who underwent THR. In both studied groups, the “positive” variant of the answer was the most frequently chosen in the WHOQOL-BREF questionnaire.
Key words:
quality of life, osteoarthrotic hip disease, alloplasty
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Comparative analysis of the functional status of women with osteoarthritis of the hip or knee joint

Małgorzata Kilon, Agnieszka Przedborska, Joanna Kostka, Jan W. Raczkowski

Małgorzata Kilon, Agnieszka Przedborska, Joanna Kostka, Jan W. Raczkowski – Comparative analysis of the functional status of women with osteoarthritis of the hip or knee joint. Fizjoterapia Polska 2021; 21(3); 134-142

Abstract
Objective. The objective of the study was to compare the level of functional efficiency and factors influencing it in women after the age of 50 with advanced osteoarthritis of the hip (coxarthrosis) or knee (gonarthrosis) joint.
Material and methods. The study included 70 women aged 50–90 years with coxarthrosis (n = 35) or gonarthrosis (n = 35), stage 3 according to the Kellegren-Lawrence scale.
The functional status was assessed based on the Tinetti test and the Two-scales test. The Likert scale rated pain, stiffness, and the difficulty of getting up and putting on socks. The quality of life was assessed using a 100-point scale.
Results. Women with coxarthrosis achieved worse results in the Tinetti test in the part concerning gait (p < 0.01) and balance (p < 0.05). Pain and stiffness determined the results of most tests. Patients with gonarthrosis had greater problems with walking on flat surfaces and with getting up from a chair (p < 0.001). Pain determined difficulties when walking and putting on socks, and stiffness influenced difficulties in walking, standing up, putting on socks, and the results of the Tinetti test.
Conclusions.
1. Stiffness and pain deteriorate functional efficiency in women with coxarthrosis and gonarthrosis.
2. Greater problems with gait and balance occur in women with coxarthrosis, while women with gonarthrosis have greater difficulties with walking on flat surfaces and getting up from a chair.
Key words:
osteoarthritis, hip joints, knee joints, functional efficiency, Tinetti test
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The effectiveness of rehabilitation by exercising central stability of the cervical spine in cognitive phase in patients with neck pain (pilot study)

Marcin Świątczak, Rafał Janiak, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski

Marcin Świątczak, Rafał Janiak, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski – The effectiveness of rehabilitation by exercising central stability of the cervical spine in cognitive phase in patients with neck pain (pilot study). Fizjoterapia Polska 2021; 21(3); 102-112

Abstract
Introduction. In present times, vast majority of patients with back ailments complain about pain in cervical spine area. The use of  exercises based on biofeedback as well as  patient’s full engagement and focus  are designed to restore sufficient control to deep stabilizers of the cervical spine, where  vestibular system plays a crucial role.  The following method is appropriate for patients who experience different types of pain since it will not inflict further damage or exacerbate existing degeneration in that segment.
Purpose of the study. The purpose of this study is to analyze how central stabilization exercises influence stability of the neck in cognitive phase and whether they minimize neck pain, correct and restore overall motor control to effectively improve everyday physical activity and activities of daily living.
Measures and test methods. The subject of this research were patients with neck pain syndrome. The group of participants took part in a three-week program, which involved exercising central stability of the neck. The test measures were: Numeric Rating Scale (NRS), measures of neck mobility, Neck Disability Index, repositioning to neutral spot, as well as The Dartmouth Coop Functional and Health Status Measures for Adults. The patients were examined before and after completing the program.
Results. The study has shown that neck pain decreased by 1.7 points in 80% of the respondents. It has been observed that after the program patients had experienced increased neck mobility by 1 centimeter on average in all ranges of motion. They have also reported improved everyday physical activity and greater physical fitness.
Conclusions. Exercising central stability of the cervical spine in cognitive phase are beneficial for: restoring motor control, relieving neck pain, increasing range of motion of the head, and improving everyday physical activity.
Key words:
central stability, cervical spine, cognitive
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Analysis of selected factors affecting rest pain in knee joint osteoarthritis

Beata Olesiak, Agnieszka Przedborska

Beata Olesiak, Agnieszka Przedborska – Analysis of selected factors affecting rest pain in knee joint osteoarthritis. Fizjoterapia Polska 2021; 21(2); 206-214

Abstract
Introduction. Knee pain is a clinical sign of osteoarthritis and an ongoing inflammatory process in the joint. Aim of the thesis. The purpose of this study was to evaluate the effect of BMI and degradative changes in patellofemoral joint cartilage on the level of knee pain at rest. Material and methods. The study group consisted of 150 patients with patellofemoral joint cartilage lesions. The classification of cartilage degradation according to Outerdridge was done by ultrasound. The level of pain at rest was assessed according to the VAS scale. The data was collected with usage of a self-made study protocol. Results. There was no statistically significant correlation between BMI and VAS pain complaints (rho = 0.099, p = 0.228). There was also no statistically significant correlation between degradative changes in the cartilage of the patellofemoral joint and the level of pain on the VAS scale (rho = 0.076, p = 0.353). Conclusions. BMI does not affect the severity of knee joint pain at rest. The extent of cartilage wear in the patellofemoral joint does not correlate with knee pain during physical inactivity.
Key words:
rest pain, femoropatellar joint, gonarthrosis, knee joint, Body Masse Index (BMI)
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Evaluation of therapeutic effectiveness of diathermy in patients with degenerative disease of the lumbar spine

Agnieszka Przedborska, Jan W. Raczkowski, Małgorzata Misztal

Agnieszka Przedborska, Jan W. Raczkowski, Małgorzata Misztal – Evaluation of therapeutic effectiveness of diathermy in patients with degenerative disease of the lumbar spine. Fizjoterapia Polska 2021; 21(2); 70-76

Abstract
Introduction. Diathermy is one of the stimuli used in treatment of degenerative spine disease. Endogenous heat alleviates the symptoms of the disease. Diathermy treatments differ due to wave size and electromagnetic vibration frequency. Objective. Evaluation of the effectiveness of diathermy generated by short waves and radio waves in the treatment of patients with degenerative disease of the lumbar spine. Material and methods. The research was carried out on a group of 68 people with degenerative disease of the lumbar spine, divided into two groups. The study group consisted of 36 people who underwent therapy with radio waves using the Thermo TK device. The comparison group consisted of 32 people who underwent shortwave diathermy treatments. Therapeutic effectiveness was evaluated on the basis of pain assessment according to the VAS scale and the Laitinen pain scale as well as the range of motion measured with the Schober test and the Thomayer test. Results. In both groups, a statistically significant (p <0.0001) pain reduction after therapy according to the Laitinen pain scale was observed (Me (IQR) before and after therapy , respectively: in the study group: 6.5 (5-9) scores vs. 4 (3-5.5) scores and in the comparison group: 6 (5-8) scores vs. 4 (3-5) scores) and according to the VAS scale – in the study group: 6 (5-7.5) scores vs. 4 (3-4) scores and in the comparison group: 6 (5-7.5) scores vs. 3 (3-5) scores. The Thomayer test and the Schober test results also improved significantly in each group. Conclusions. Regardless of the wavelength generating endogenous heat, both treatments reduce pain and improve the range of motion of the lumbar spine in patients with degenerative spine disease.
Key words:
spine, degenerative disease, diathermy, radio waves
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Gilios elektromagnetinės stimuliacijos efektyvumo įvertinimas gydant nugaros (stuburo-juosmens) skausmus, priklausomai nuo gydymo taikymo vietos

Agnieszka Przedborska, Małgorzata Kilon, Agnieszka Leszczyńska, Małgorzata Misztal, Jan W. Raczkowski

A. Przedborska, M. Kilon, A. Leszczyńska, M. Misztal, J. W. Raczkowski – Assessment of the effectiveness of deep electromagnetic stimulation in the treatment of low back pain depending on the area of application. Fizjoterapia Polska 2019; 19(2); 148-156

Abstract
Introduction. Disturbed mechanism of central stabilization associated with reduced pelvic floor muscle tone may be the cause of low back pain. The aim of the study was to assess the effectiveness of deep electromagnetic stimulation applied in the lumbosacral region or in the pelvic floor muscles in women with low back pain.
Material and methods. The study enrolled 109 women with spinal degenerative disease. Two groups were distinguished: the study group of 45 women who underwent a series of 10 sessions of deep electromagnetic stimulation in the pelvic floor muscles and a comparative group of 64 women in whom the procedure was applied in the lumbosacral region. The effectiveness of the therapy was assessed according to the VAS scale, locomotion and self-care were also evaluated.
Results. VAS scale demonstrated statistically significant reduction in pain intensity in both groups – Me(IQR) respectively: 5 (4-7) before the therapy vs 2 (1-3) afterwards in the study group and 6 (4-7) before the therapy vs 3 (2-4) after the therapy in the comparative group. Functional mobility and ability to perform everyday activities also improved statistically significantly. The obtained results were not long-lasting. In half of the patients the analgesic effect lasted at most 2 months (IQR: 1-4) in the study group and at most 4 months (IQR: 2-6) in the comparative group.
Conclusions. 1. Regardless of the area of application, deep electromagnetic stimulation reduces pain, improves the gait function and self-care of women with low back pain. 2. The analgesic effect of the therapy lasts longer when applying treatment in the lumbosacral region of the spine.

Key words:
low back pain, degenerative disease, pelvic floor muscles, electromagnetic stimulation

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Veiksniai, turintys įtakos pacientų su klubo sąnario endoproteze funkciniam efektyvumui

Małgorzata Kilon, Agnieszka Przedborska, Joanna Kostka, Agnieszka Leszczyńska, Jan W. Raczkowski

M. Kilon, A. Przedborska, J. Kostka, A. Leszczyńska, J. W. Raczkowski – Factors influencing functional performance of patients after hip joint arthroplasty. Fizjoterapia Polska 2019; 19(2); 122-128

Abstract
Aim. The aim of the study was to assess factors affecting functional status of patients after total unilateral hip arthroplasty.
Material and methods. A total of 50 patients (33 women, 17 men), aged 29-88 years (mean 66,7 ± 13 years) with unilateral hip joint prosthesis were included in the study. The assessment of the balance and gait function was made on the basis of the following tests: Tinetti, Timed Up and Go (TUG) and the two scales test, on the basis of which the Symmetry Index (SI) was calculated. The degree of pain sensation while walking on a flat surface and on stairs and the level of stiffness were estimated using the Likert scale. To assess the ability to perform simple and complex daily activities, the Katz ADL (Activities of Daily Living) and the Lawton IADL (Instrumental Activities of Daily Living) scales were used. Self-assessment of the quality of life was also made on the basis of a numerical rating scale. Moreover, the body mass index (BMI) was calculated.
Results. Age of patients, pain and stiffness determined the majority of test results and functional scales. Patients suffering from more diseases achieved worse results in the Tinetti test. Only the severity of pain while climbing the stairs affected the SI result. Patients reporting more severe pain and morning stiffness were characterized by poorer self-assessment of their quality of life.
Conclusions. Age, pain and morning stiffness affect the functional status and the quality of life of patients with unilateral hip prosthesis. BMI and the time that elapsed since surgery did not affect the patients’ condition.

Key words:
hip joint arthroplasty, quality of life, functional status

 

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Zastosowanie prądów wielkiej częstotliwości w leczeniu pacjentów z chorobą zwyrodnieniową stawów kolanowych

Agnieszka Przedborska, Ewa Pomorska, Marcin Świątczak, Małgorzata Staniszewska, Małgorzata Misztal, Jan W. Raczkowski

A. Przedborska, E. Pomorska, M. Świątczak, M. Staniszewska, M. Misztal, J. W. Raczkowski – Application of high frequency currents in treatment of patients with knee osteoarthritis. Fizjoterapia Polska 2018; 18(4); 112-121

Streszczenie
Wstęp. Ciepło endogenne jest powszechnie stosowane w leczeniu pacjentów z chorobą zwyrodnieniową stawów kolanowych. Rozwój technologii umożliwia nowe sposoby aplikacji prądów wysokiej częstotliwości.
Celem pracy jest ocena skuteczności prądów wielkiej częstotliwości aplikowanych różnymi metodami w leczeniu pacjentów z chorobą zwyrodnieniową stawów kolanowych.
Materiał i metody. Badania przeprowadzono na grupie 111 osób z chorobą zwyrodnieniową stawów kolanowych, spośród których wyodrębniono dwie grupy. Grupę badaną stanowiło 61 osób poddanych terapii prądami wysokiej częstotliwości z wykorzystaniem urządzenia Thermo TK. Grupę porównawczą stanowiło 50 osób, poddanych zabiegom diatermii krótkofalowej. Ocenę skuteczności terapii przeprowadzono na podstawie skali VAS, skali Laitinena, obwodu i zakresu ruchu w stawie kolanowym.
Wyniki. W obu grupach stwierdzono po terapii istotne statystycznie (p < 0,0001) zmniejszenie dolegliwości bólowych wg skali Laitinena (mediana (zakres międzykwartylowy IQR) odpowiednio przed i po terapii: w grupie badanej: 7 (6-8) pkt vs 3 (2-6) pkt oraz w grupie porównawczej: 8 (6-10) pkt vs 3.5 (2-7) pkt). Dodatkowo, w grupie badanej zaobserwowano istotne statystycznie (p = 0,0031) zmniejszenie częstości stosowania leków przeciwbólowych. Po terapii w każdej z grup odnotowano również istotne statystycznie (p < 0,0001) złagodzenie dolegliwości bólowych wg skali VAS podczas chodzenia po płaskiej powierzchni i po schodach. Zmniejszeniu uległ także obwód przez staw kolanowy (p < 0,0001), natomiast istotnie zwiększył się zakres ruchu zgięcia (p < 0,0001). Czas trwania efektu analgetycznego w obu grupach był podobny.
Wnioski. 1. Bez względu na rodzaj aplikacji, prądy wysokiej częstotliwości wpływają na zmniejszenie dolegliwości bólowych oraz poprawę zakresu ruchu stawów kolanowych u pacjentów z chorobą zwyrodnieniową. 2. Efekt przeciwbólowy terapii w obu grupach nie był trwały.

Słowa kluczowe:
stawy kolanowe, choroba zwyrodnieniowa, prądy wielkiej częstotliwości

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Wpływ głębokiej stymulacji elektromagnetycznej mięśni dna miednicy na dolegliwości okolicy lędźwiowo-krzyżowej kręgosłupa u pacjentek z wysiłkowym nietrzymaniem moczu

Agnieszka Przedborska, Małgorzata Kilon, Małgorzata Misztal, Jan W. Raczkowski

Agnieszka Przedborska, Małgorzata Kilon, Małgorzata Misztal, Jan W. Raczkowski – The effect of deep electromagnetic stimulation of pelvic floor muscles on low back pain in female patients with stress urinary incontinence. Fizjoterapia Polska 2018; 18(3); 46-54

Streszczenie
Cel pracy. Celem pracy jest ocena wpływu głębokiej stymulacji elektromagnetycznej mięśni dna miednicy na dolegliwości okolicy lędźwiowo-krzyżowej kręgosłupa u kobiet z wysiłkowym nietrzymaniem moczu.
Materiał i metodyka. Badania przeprowadzono na grupie 85 kobiet z przewlekłym zespołem bólowym okolicy lędźwiowo-krzyżowej i współistniejącym nietrzymaniem moczu, które poddano serii 10 zabiegów głębokiej stymulacji elektromagnetycznej dna miednicy. Ocenę skuteczności terapii przeprowadzono na podstawie skali VAS, oceny funkcji dnia codziennego i zmian nasilenia objawów związanych z nietrzymaniem moczu.
Wyniki. Po terapii zaobserwowano istotne statystycznie zmniejszenie stopnia nasilenia dolegliwości bólowych kręgosłupa wg skali VAS – Me(IQR) odpowiednio: 5 (4-7) przed terapią vs 3 (1-4) po terapii. Istotnej statystycznie poprawie uległa także zdolność poruszania się oraz aktywność codzienna. Zaobserwowano również istotne statystycznie zmniejszenie się częstości występowania epizodów nietrzymania moczu oraz zmniejszenie się ilości traconego moczu. Uzyskane efekty terapii nie były długotrwałe. U połowy pacjentek zarówno efekt analgetyczny, jak i poprawa dolegliwości związanych z nietrzymaniem moczu utrzymywały się co najwyżej 2 miesiące (IQR: 1-3 miesięcy dla ZBK i IQR: 1-2 miesiące dla WNM).
Wnioski. 1. Głęboka stymulacja elektromagnetyczna mięśni dna miednicy wpływa na zmniejszenie dolegliwości bólowych okolicy lędźwiowo-krzyżowej kręgosłupa i zmniejszenie objawów wysiłkowego nietrzymania moczu. 2. Utrzymujący się efekt poprawy nie jest długotrwały.

Słowa kluczowe:
ból kręgosłupa lędźwiowego, nietrzymanie moczu, mięśnie dna miednicy, stymulacja elektromagnetyczna

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