Comparison of early and late surgical outcomes of patients after total hip arthroplasty in terms of the type of surgical approach and assessment of the level of fitness

Paweł Zieliński, Rafał Trąbka, Jarosław Amarowicz, Mateusz Curyło, Paweł Kamiński, Magdalena Wilk-Frańczuk, Tomasz Maicki

P. Zieliński, R. Trąbka, J. Amarowicz, M. Curyło, P. Kamiński, M. Wilk-Frańczuk, T. Maicki – Comparison of early and late surgical outcomes of patients after total hip arthroplasty in terms of the type of surgical approach and assessment of the level of fitness. Fizjoterapia Polska 2021; 21(4); 190-203

Abstract
Osteoarthritis is the most common form of human joint pathology. It is estimated that it affects about 6% of the world’s population. In addition to the hand and knee joints, the hip joint is one of the most common joints affected by OA.
The study included 59 randomly selected patients (from a group of over 600 people operated in a similar period) of the Orthopaedics and Rehabilitation Department of the Centre for Rehabilitation and Orthopaedics in Krakow, who underwent THA due to advanced degenerative changes using a cementless prosthesis.
The objective of the study was to compare the early and late outcomes of the procedure (patient’s fitness level and subjective assessment) using the anterolateral (according to Watson-Jones) and lateral (McFarland and Osborne as modified by Hardinge) approach.
The obtained results confirm better outcomes in terms of the abduction strength scale (SO%), HHS, VAS, frequency of the Trendelenburg sign and partially mobility (external rotation) in relation to short-term follow-up (especially after 6 and 12 weeks), but not long-term follow-up (after 24 weeks and 11-12 years).
It was found that people who underwent surgery using the lateral approach (according to Hardinge) recover faster than people who underwent surgery with the use of the anterolateral approach (according to Watson-Jones).
Key words:
arthroplasty, osteoarthritis, hip joint
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Humic acids and their role in the anti-inflammatory effect of peloid

Agnieszka Sobolewska-Samorek, Marlena Warowna, Agata Czępińska, Monika Szewczyk

Agnieszka Sobolewska-Samorek, Marlena Warowna, Agata Czępińska, Monika Szewczyk – Humic acids and their role in the anti-inflammatory effect of peloid. Fizjoterapia Polska 2021; 21(3); 150-155

Abstract
Objective of the work.
The aim of the study was to determine the content of humic acids in the tested peloid.
Material and methods.
The raw material was submitted for physical and chemical tests. The chemical composition of organic substances contained in the tested peloid was analyzed, including the content of humic acids.
Tests results.
The raw material contained 72% of organic substances in dry matter, of which 40% were humic acids. The content of humic acids in the mud from the new B deposit was higher than in the control mud/peloid. K2 mud/peloid was characterized by lower values. The least amount of humic acids was isolated from the control K1 mud/peloid.
Conclusions.
Control peloids, both K1 and K2, showed a much lower content of humic acids and differences were statistically significant compared to the peloid B.
Key words:
Peat, peloid, humic acids, organic ingredients of peloid
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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 efficacy of ultrasound and electrophonophoresis as adjuncts to the treatment of degenerative knee joint disease

Marta Szlachta, Anna Polak, Beata Błaszczyk, Agnieszka Kluszczyńska-Galas, Janusz Kubacki, Piotr Król

Marta Szlachta, Anna Polak, Beata Błaszczyk, Agnieszka Kluszczyńska-Galas, Janusz Kubacki, Piotr Król – The efficacy of ultrasound and electrophonophoresis as adjuncts to the treatment of degenerative knee joint disease. Fizjoterapia Polska 2009; 9(3); 211-222

Abstract
Background. The study aimed to evaluate the efficacy of ultrasound and Ketonal (ketoprofen) electrophonophoresis as adjuncts to the treatment of degenerative knee joint disease. Materiał and methods. Forty-six persons randomly assigned to two groups were investigated. Group A consisted of 23 per-sons aged 53-72 years. Group B comprised 23 patients whose age ranged from 54 to 60 years. The knee joint rangę of motion and muscle strength were assessed in all patients immediately before treatment and on completion ofa course of physical thera-py Group A was treated with ultrasound (1 MHz; 0.5-1.0 W/cm2; 20%; 1-3 min/cm2), while Group B was subjected to electropho-nophoretic treatment (0.1 mA/cm2; 1 MHz; 0.5-1.0 W/cm2; 20%; 1-3 min/cm2; 2% Ketonal). A total of 10 procedures were admini-stered to each patient over two weeks. Results. The knee-joint rangę of motion and strength ofthe knee flexors and extensors improved significantly in both groups after treatment in comparison to baseline values. There was no statistically significant inerease in the muscle strength ofthe knee rotators. An inter-group comparison of treatment effects showed that the ranges of the passive and active flexion, passive and active extension and strength of the flexor and extensor muscles of the knee joint had inereased morę significantly in group B than in group A. Conclusions. The treatment applied in both comparative groups was effective. Electrophonophoresis led to slightly better treatment outeomes than ultrasound.
Key words:
degenerative disease, ultrasound, electrophonophoresis, knee joint
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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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Assessment of the effectiveness of local cryotherapy in treatment of gonarthrosis

Joanna Fidut-Wrońska, Robert Latosiewicz, Karolina Janikowska, Krzysztof Sokołowski

Joanna Fidut-Wrońska, Robert Latosiewicz, Karolina Janikowska, Krzysztof Sokołowski – Assessment of the effectiveness of local cryotherapy in treatment of gonarthrosis. Fizjoterapia Polska 2012; 12(3); 241-250

Abstract
The purpose of the study was to compare the effect of cryotherapy combined with other physical therapy methods. The study group consisted of 50 patients with gonarthrosis, treated by means of local cryotherapy and other physical therapy methods. The control group included 38 matched patients with gonarthrosis, treated with the same physical therapy methods, but without cryotherapy. Evaluation methods were based on the authors` tailored questionnaire, VAS scale and WOMAC questionnaire. The physical examination consisted of the measurements of body height and weight, the range of motion (ROM) in the knee joints and knee circumference and a series of functional tests. The results indicate that ROM of the knee joints increased by 11.3° in the study group and by 3.1° in the control group. The circumference was reduced by 1.1 cm in study group and by 0.4 cm in control group. The value of WOMAC index was diminished by 17.3% in the study group and by 11.9% in control group. After the treatment, the study group covered 8.7 stairs more during ascending and 9.2 more during descending whereas the control group covered 3.9 and 4.3 stairs respectively. Similarly, after the treatment patients from the study group did 5.5 squats more compared to 1.7 squats performed by the control group subjects. Cryotherapy combined with other physical therapy methods in treatment of gonarthrosis has better effects than application of physical therapy methods only, without cryotherapy.
Key words:
arthrosis, physical therapy, gonarthrosis, Cryotherapy
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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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Efektywność wybranych zabiegów fizjoterapeutycznych w leczeniu dolegliwości bólowych odcinka lędźwiowo-krzyżowego kręgosłupa

Tomasz Miśkiewicz, Zbigniew Dudkiewicz, Robert Irzmański, Katarzyna Michalak, Elżbieta Poziomska-Piątkowska

Tomasz Miśkiewicz, Zbigniew Dudkiewicz, Robert Irzmański, Katarzyna Michalak, Elżbieta Poziomska-Piątkowska – Efficacy of selected physiotherapeutic procedures in the treatment of lumbar spine pain. Fizjoterapia Polska 2018; 18(3); 12-28

Streszczenie
Cel pracy. Celem pracy była ocena efektywności wybranych zestawów zabiegów fizjoterapeutycznych na dolegliwości bólowe występujące w odcinku lędźwiowo-krzyżowym spowodowane chorobą zwyrodnieniową.
Materiały i Metody. W badaniu wzięło udział 45 pacjentów z zespołami bólowymi w obrębie odcinka lędźwiowo-krzyżowego kręgosłupa, którzy poddani byli serii zabiegów fizjoterapeutycznych. Badani zostali podzieleni na cztery grupy. Trzy grupy podzielono w zależności od zastosowanych zestawów zabiegów fizjoterapeutycznych, natomiast czwartą grupę (porównawczą) stanowili badani pobierający tylko i wyłącznie niesteroidowe leki przeciwzapalne (NLPZ) przez okres trwania serii zabiegów w pozostały grupach. Chorzy zostali przebadani za pomocą kwestionariusza ankiety własnego autorstwa, kwestionariusza SF-36 (vol.2) wersji skróconej 11. pytaniowej (wersja Polska), użyto także testu Lovetta, skali Laitinena oraz testów diagnostycznych (Laseque’a, Bragarda, Thomayera). Badania były przeprowadzone bezpośrednio przed podjęciem serii zabiegowej oraz dwa tygodnie po jej zakończeniu.
Wyniki. Badani byli w wieku od 45-65 lat. 71,1% stanowiły kobiety, a 28,9% mężczyźni. 13,3% osób było aktywnych fizycznie. Choroba zwyrodnieniowa kręgosłupa była przyczyną dolegliwości bólowych u wszystkich pacjentów biorących udział w badaniach. W grupie badawczej wykazano istotną statystycznie różnicę pomiędzy wynikami stopnia nasilenia bólu, poziomu siły mięśniowej oraz jakości życia mierzonymi przed fizjoterapią oraz 2 tygodnie po jej zakończeniu. U 90% osób biorących udział w zabiegach uzyskano zwiększenie siły mięśniowej, natomiast w grupie porównawczej jedynie u 6%. Poprawa zakresów ruchomości w omawianym odcinku kręgosłupa dotyczyła 46,6% badanych biorących udział w serii zabiegowej. W grupie porównawczej żaden z pacjentów nie uzyskał poprawy zakresu ruchomości.
Wnioski. Zabiegi fizjoterapeutyczne mają pozytywny wpływ na ograniczenie objawów chorobowych odcinka lędźwiowo-krzyżowego kręgosłupa. Oddziałują one korzystnie na poprawę jakości życia, siły mięśniowej, zakresów ruchomości oraz zmniejszenie, bądź całkowite usunięcie dolegliwości bólowych. Niezależnie od zastosowanego zestawu zabiegów fizjoterapeutycznych działały one lepiej, niż przyjmowanie samych niesteroidowych leków przeciwzapalnych przez pacjentów.

Słowa kluczowe:
fizjoterapia, choroba zwyrodnieniowa, odcinek lędźwiowo-krzyżowy, niesteroidowe leki przeciwzapalne

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Fizjoterapia w przebiegu kompleksowego usztywnienia pantalarnego gwoździem śródszpikowym (odpiętowym) u chorych z przewlekłym zespołem bólowym w rozległej deformacji

Jarosław Pasek, Tomasz Stołtny, Michał Pyda, Marek Kawecki, Daniel Spyrka, Michał Benedykt Białek, Alina Ostałowska, Sławomir Kasperczyk, Bogdan Koczy

J. Pasek, T. Stołtny, M. Pyda, M. Kawecki, D. Spyrka, M. B. Białek, A. Ostałowska, S.Kasperczyk, B. Koczy – Physiotherapy after combined surgically ankylosis crural-tarsal and crural-calcaneal interlocking retrograde nail in patients with chronic pain in extensive deformation . Fizjoterapia Polska 2018; 18(2); 52-57

Streszczenie
Usztywnienie pantalarne wykonuje się w sytuacjach kiedy wyczerpany został panel zabiegów operacyjnych mających na celu przywrócenie funkcji podpórczej kończyny w rozległej deformacji podudzia z przewlekłym zespołem bólowym. W latach 2010-2017 wykonano 31 kompleksowych usztywnień pantalarnych. Zabiegi przeprowadzono u 27 mężczyzn i 4 kobiet u których wdrożono przed- i pooperacyjną fizjoterapię oraz wybrane zabiegi fizykoterapeutyczne. W pracy przedstawiono niezbędne wiadomości dotyczące kompleksowego usztywnienia pantalarnego oraz szczegółowo omówiono postępowanie fizjoterapeutyczne u tych chorych.

Słowa kluczowe:
artrodeza pantalarna, choroba zwyrodnieniowa, fizjoterapia, gwóźdź śródszpikowy (odpiętowy), staw rzekomy podudzia

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