Physiotherapy in patients with implanted cardiac pacemakers

Joanna Pająk, Rafał Młynarski, Jacek Durmała, Włodzimierz Kargul, Michał Plewa, Zbigniew Nowak

Joanna Pająk, Rafał Młynarski, Jacek Durmała, Włodzimierz Kargul, Michał Plewa, Zbigniew Nowak – Physiotherapy in patients with implanted cardiac pacemakers. Fizjoterapia Polska 2006; 6(3); 245-250

Abstract
Since the implantation of the first cardiac pacemaker in 1958 by Ake Sening and Rune Elmqvista, there has been gigantic progress in this field of medicine including both the range the equipment and the techniques of implantation. Today electrotherapy is a rapidly developing field of invasive cardiology. Cardiac pacemaker implantation is a very common procedure. Its popularity has increased year by year because the number of indicators is higher. This operation is often the only chance for patients suffering from heart rhythm disorders. In spite of the propagation this treatment method, rehabilitation of these patients is still underestimated. Meanwhile the role of the rehabilitation, as shown in some research, can be as crucial as properly programming the pacemaker. Special attention should paid to patients with implanted rate response devices. Our research shows that patients who are actively rehabilitated after the implantation procedure can get back to normal life more easily and that the number of complications which are connected with patients’ inability to understand of this method is lower. Cooperation between doctors and physiotherepeutists should be a standard. Unfortunately in the most cases it is only a theory. Meanwhile our experiences bring us in creation of standard procedures which are, in spite of patients’ opinion, very useful. There are many questions and queries connected both equipment and rehabilitation process of these patients. It must us to write this publication, where in complex form, implantation of cardiac pacemaker, characteristic of implanted patients and rehabilitation procedures were presented according to our and other authors opinion.

Key words:
physiotherapy, cardiac pacemaker, activity sensor

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Methods of physiotherapy in treatment of intervertebral disc’s pathology in lumbar part of spine

Przemysław Lisiński, Agnieszka Jachowska, Włodzimierz Samborski

Przemysław Lisiński, Agnieszka Jachowska, Włodzimierz Samborski – Methods of physiotherapy in treatment of intervertebral disc’s pathology in lumbar part of spine. Fizjoterapia Polska 2006; 6(3); 222-227

Abstract
Background. Physiotherapy is very often the first step in a treatment of back pain. The aim of kinesis therapy is a probe of a damaged disc reposition. Beside of this kinesis therapy improve an elasticity of ligaments and makes stronger a paravertebral muscles. Physical therapy procedures plays significant role in a pain treatment in subjective categories of course. Material and methods. All participants of that study were selected by clinical examination and analyses of accessory investigations. Clinical examination was repeated after twenty days of treatment by different physiotherapeutic procedures. So forty patients were included in a treatment. Status of health was calculated by typical orthopedic procedure and total pain pattern questionnaire. The aim of study was to state if physiotherapy is useful method of pain treatment and to compare effects different groups of procedures. Results. All participants of that study state positive effects of a treatment which was used during twenty days. A majority of them described pain after a treatment as a small discomfort or did not feel pain at all. Beside of these findings they concluded that a frequency of pain appearance depressed in near all analyzed cases. Conclusion. Back pain caused by disc derangement positively responded on physiotherapeutic procedures. A selection of particular methods is not so important in effectiveness categories. The treatment is the most successful when kinesis therapy and physical therapy are joined.

Key words:
pain, lumbar spine, physiotherapy

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Attitude of physiotherapists towards elderly patients with mental and behavioural disorders

Joanna Szczepańska, Joanna Kowalska, Grażyna Greń, Marek Woźniewski

Joanna Szczepańska, Joanna Kowalska, Grażyna Greń, Marek Woźniewski – Attitude of physiotherapists towards elderly patients with mental and behavioural disorders. Fizjoterapia Polska 2006; 6(3); 216-221

Abstract
Background. To verify whether cognitive deficits and mood disorders of older inpatients negatively influence the attitudes of physiotherapists towards them. Material and methods. Examination in Geriatric Rehabilitation Unit. 52 patients (78± ,4 years) and 7 physiotherapists. Cognitive status and mood of the patients were examined using the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS) respectively. GDS was performed only in patients with MMSE 15. The therapists filled an anonymous questionnaire concerning the quality of working with particular patients. This enabled the following division: group (P+) patients working with whom the physiotherapists evaluated as pleasant, group (P-) patients who were negatively evaluated by the physiotherapists as working with them was difficult and tiresome. Results. In group (P-) MMSE values were significantly lower than in group (P+), and they were 15,2±7,5 vs. 23,1±3,7 respectively (p=0,0) and GDS values were significantly higher in comparison with group (P+), and they were 21,3±4,8 vs. 14,6±5,9 respectively (p=0,0). Conclusions. The patients evoking negative attitudes of physiotherapists (impatience, irritability, aversion) had mainly severe cognitive deficits (MMSE<19) and severe depressive symptoms (GDS>20). This may be an additional factor decreasing effectiveness of physiotherapy in this group of patients.

Key words:
cognitive impairment, depression, elderly persons, physiotherapy

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Medical massage in dysmenorrhoea

Krzysztof Kassolik , Waldemar Andrzejewski, Piotr Wojtoń, Klara Sadowska, Agnieszka Cichoszewska

Krzysztof Kassolik , Waldemar Andrzejewski, Piotr Wojtoń, Klara Sadowska, Agnieszka Cichoszewska – Medical massage in dysmenorrhoea. Fizjoterapia Polska 2006; 6(4); 339-343

Abstract
Background. From 40 to 60 % of women aged 20-40 are affected by dysmenorrhoea. Such patients are usually prescribed pain-relieving and spasmolytic drugs. Massage is a non-invasive therapeutic modality whose effects are believed to include reduction of muscle tone. Therefore, the authors attempted to determine the efficacy of medical massage in allevi-ating dysmenorrhoeic pain. Material and methods. The participants of the study were 48 students from the University School of Physical Education, aged 22-25. To evaluate efficacy of medical massage, the researchers elaborated questionnaires. The objectives of the questionnaire were to: 1) select those participants complaining of menstruation-associated pain, and 2) to determine the intensity of the pain at baseline and after a series of massages. A total of 26 women with dysmenorrhea were selected and subsequently subjected to medical massage. Four 10-minute medical massage sessions were performed over the lumbar, sacral and gluteal areas. At the end of each procedure a hot water bottle with 45 degrees Celsius water was applied to the massaged area in order to preserve the changes in blood distribution within the pelvis. Results. Medical massage applied a few days before menstruation reduced dysmenorrhoeic pain in 24 out of the 26 women. Pain was alleviated in 16 women and completely disappeared in a further 8 patients. In 2 patients, the intensity of pain remained the same after application of medical massage. Conclusions. The findings indicate that medical massage can be an easy-to-use adjunctive therapeutic modality for reducing pain in women with dysmenorrhea.

Key words:
massage, dysmenorrhoea, physical therapy

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Ground reaction forces of the gait in patients undergoing physiotherapy after articular cartilage surgeries

Andrzej Czamara, Tadeusz Trzaska

Andrzej Czamara, Tadeusz Trzaska – Ground reaction forces of the gait in patients undergoing physiotherapy after articular cartilage surgeries. Fizjoterapia Polska 2006; 6(4); 289-297

Abstract
Background. The goal of our study was the evaluation of the ground reaction forces (N) of vertical component in flat surface gait in patients undergoing 10 to 14 weeks of physiotherapy after chosen surgeries of the knee joint cartilage. Material and methods. We measured ground reaction forces of the gait in 58 people. 31 patients after the carrier surface of knee joint cartilage surgeries and 27 people with no cartilage injuries were examined. When the patients developed individual gait after 10 to 14 weeks of physiotherapy, we measured ground reaction forces of their gait. The examination was carried on a track with, computer programmed, mtd-balance tensometric platforms. Results and Conclusions. Between 10th and 14th week after the surgery, the patients regained the gait. The values of ground reaction forces of the gait during stance phase for the operated limbs were close to the results of healthy limbs. The results did not differ from the results reached by the people with no cartilage injuries and oscillated between 1,19 to 1,21 of body weight. Moreover, minor asymmetry was reported between left and right limbs in groups with no articular cartilage injuries and in patients which did not exceed 5%.

Key words:
physiotherapy, gait, knee joint cartilage, ground reaction forces

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Diversity of body composition among female students of physiotherapy at the Medical University in Bydgoszcz

Andrzej Lewandowski, Ryszard Grucza

Andrzej Lewandowski, Ryszard Grucza – Diversity of body composition among female students of physiotherapy at the Medical University in Bydgoszcz. Fizjoterapia Polska 2007; 7(2), 171-178

Abstract

Background. Human motor abilities, and particularly occupational physical activity patterns, undergo constant changes in response to the progress of civilisation. A career as a physiotherapist may be associated with adaptation of the body to the increased exertion, leading to the development of particular types of body composition. However, it is also possible that the process of selection of applicants for physiotherapy studies or student identification with the physiotherapist community leads to such adaptation manifesting itself while the student is still at college. Material and methods. Ninety-three female students in their third year of Physiotherapy were examined during the years 2001-2003. The somatic characteristics of the students were determined and analysed using the typology system of Wanke and Kolasa. Results. The female physiotherapy students did not exhibit any characteristic types of body composition. Analysis of somatic characteristics revealed a preponderance of the I element while the contribution of the H element was the smallest. There were insignificant differences regarding somatic characteristics between years of study. Some similarity was detected between the physiotherapy students and female medical students. There were also some differences compared to characteristics shared by the general population of Polish women. Conclusions. The results indicate that the choice of studies and future careers in physiotherapy as well as being a physiotherapy student had little effect on the body composition of the females. There was a trace effect of the general sporting ability test taken at the entrance examination on the somatic composition of the future physiotherapists.

Key words:

body structure, physiotherapy, typology, gender differentiation, social environment

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The effect of a multi-modality therapy including active exercises, classic massage, cryotherapy and a combination of ultrasound and electrical stimulation on rotator cuff injuries

Ewa Grymel-Kulesza, Anna Polak, Janusz Kubacki, Bronisława Skrzep-Poloczek, Piotr Król

Ewa Grymel-Kulesza, Anna Polak, Janusz Kubacki, Bronisława Skrzep-Poloczek, Piotr Król – The effect of a multi-modality therapy including active exercises, classic massage, cryotherapy and a combination of ultrasound and electrical stimulation on rotator cuff injuries. Fizjoterapia Polska 2007; 7(2), 107-123

Abstract

Background. The study assessed the effectiveness of a multi-modality therapy for shoulder rotator cuff injuries. The treatment included kinesitherapy, classic massage therapy, cryotherapy and ‘the combination treatment’ (ultrasound plus electrical stimulation). The effects of cryotherapy and the combination treatment for rotator cuff injuries were compared. Materials and methods. The study involved 30 patients with confirmed chronic symptoms of rotator cuff injury. The patients were assigned at random to two groups. Exercises and classic massage of the shoulder area (according to a uniform program) were used in both groups. Additionally, one group (Group A) was exposed to a combination treatment comprising ultrasound and electric stimulation of trigger points in the rotator cuff muscles, whereas Group B was treated with cryotherapy of the shoulder area. Criteria for assessing treatment effectiveness included changes in mobility of the shoulder joint, strength of the rotators, and the presence and intensity of pain. Results and Conclusions. The treatment produced significant and positive effects in both groups. Treatment effects were somewhat better in Group A than in Group B, with statistically significant between-group differences with respect to pain reduction and improved mobility and strength of some muscles. Multi-modality physiotherapy including kinesitherapy and the combination therapy (ultrasound and TENS) is an effective method for treating the sequelae of rotator cuff injuries. Direct combination therapy of myofascial trigger points offers somewhat better results than cryotherapy.

Key words:

injuries of rotator cuff, physiotherapy, ultrasound, electrical stimulation, cryotherapy, combination treatment

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The pediatric physical therapy intervention using kinesiotaping in Estonia

Hille Maas, Reet Koort, Valentin Sander

Hille Maas, Reet Koort, Valentin Sander – The pediatric physical therapy intervention using kinesiotaping in Estonia. Fizjoterapia Polska 2007; 7(3); 355-361

Abstract
Kinesiotaping is based on the philosophy aiming at giving free range of motion in order to allow the body’s muscular sys-tem to heal itself bio-mechanically. This attitude makes it extremely effective for pediatric patients with neurological impairment [1]. Based on this concept, Kinesio Taping fastens motor learning process, avoids using compensatory patterns and confirms child’s normal movement patterns daily using, facilitated by a physiotherapist or parents. Kinesio Taping increases interstitial space and, due to this pressure and irritation, caused by muscle and ligament tightness, the neural and sensory receptors are taken off. This effect significantly decreases uncomfortness of gait in toddler children, and improves their stability, resulting in better balanced reciprocal stance phase of gait. For upper extremity dysfunctions, caused either by central nervous damage or peripheral injuries, improvement is also possible using proximal Kinesio Taping location as it guarantees better stability of the trunk and facilitates, via better balance, also more selective hand functions. Kinesio Taping applied to pediatric patients with neurological impairment should be based on regular and adequate physical therapy assessment procedures and tools, as the changes may occur in motor learning process level and movement patterns in children due to using kinesiotaping rapidly and in order to guarantee permanent progress. There is a constant need to reevaluate and reassess kinesiotaping location and amount.
Key words:
Kinesio Taping, physiotherapy
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Kinesiotaping after thoracosurgeries

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

Jan Szczegielniak, Marcin Krajczy, Katarzyna Bogacz, Jacek Łuniewski, Zbigniew Śliwiński – Kinesiotaping after thoracosurgeries. Fizjoterapia Polska 2007; 7(3); 344-350

Abstract
In 2005 there were about 15 000 operations carried out in Thoracosurgery Units in Poland. The majority of these involved lobectomy due to structural changes resulting from cancer. It is worth mentioning that the majority of patients were operated on during their first or second stages of the disease, which shows improvement in methods used for diagnostic purposes qualifying for surgical operations. However, the patients treated in the third stage of their disease might reach even 40%. Application of physiotherapy in these patients is a complex problem due to the disease, their overall condition and post-operative complications. The treatment aims at improving the efficiency, strengthening the respiration mechanism, increasing thoracic flexibility and pain relief – which finally leads to improvement of the patient’s well-being. In case of possible lymphatic swelling, drainage and antiedema treatment are also very important. In case of the patients, who underwent surgery, not connected with cancer, physical treatment and massage are valuable complementation to kinesitherapy, which is the basis of physiotherapeutic treatment. They are mainly used in order to stabilize the muscle tone, decrease swelling and pain perception. However, because of the main disease, they could not be applied in most of patients. Under limited possibility of using physiotherapeutic treatment, kinesiotaping (KT) is a safe method stimulating post—operative scar healing, improving muscle activity and helping to decrease swelling and pain.
Key words:
kinesiotaping, physiotherapy, thoracosurgery
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Body equilibrium assessment in patients with degenerative changes after whole-body cryostimulation connected with physiotherapy

Marek Kiljański, Zbigniew Śliwiński, Wojciech Kufel, Wojciech Kiebzak, Marek Woszczak

Marek Kiljański, Zbigniew Śliwiński, Wojciech Kufel, Wojciech Kiebzak, Marek Woszczak – Body equilibrium assessment in patients with degenerative changes after whole-body cryostimulation connected with physiotherapy. Fizjoterapia Polska 2007; 7(3); 286-298

Abstract
Background. The authors present the results obtained in a group of 126 participants. The aim of the study was to determine whether a four-week program of physiotherapy including whole-body cryostimulation, applied in patients with degenerative changes in the spine, influences their body equilibrium and pain sensation. Material and methods. The examined group comprised 66 patients with degenerative changes in the lumbar spine, while the control group consisted of 60 participants. Apart from an individually designed rehabilitation program, each patient participated in 20 sessions of whole-body cryostimulation. The measurement of lumbosacral spine mobility and the assessment of pain sensation using the Visual Analogue Scale (VAS) were performed before the first and after the last session. Moreover, after the first, tenth and twentieth session of general cryostimulation, measurements on a stabilometric platform were conducted. The healthy participants, who were qualified as the control group, underwent tests on the stabilometric platform after one session in the cryogenic chamber. The aim of these tests was to compare the differences in the stabilogram curve in healthy individuals and patients with degenerative changes in the lumbar spine. The effect of cryostimulation procedures on pain sensation and mobility of the lumbosacral spine was assessed. Additionally, the effect of cryogenic temperatures on body equilibrium was studied. Results. The comparison of the results, obtained before the procedure and after completing the therapy indicates that general cryostimulation in a physiotherapeutic program for patients with degenerative changes in the lumbar spine contributes to relaxation of excessively tense muscles. Conclusions. The use of whole body cryostimulation in patients with degenerative changes in the lumbosacral spine, combined with a properly designed and managed physiotherapeutic program, decreases pain sensation in a statistically significant way. The application of cryogenic temperatures, combined with physiotherapeutic program, favourably affect patient body equilibrium.
Słowa kluczowe
physiotherapy, spine, cryostimulation, coordination, stabilometric platform
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