Cardiopulmonary exercise test in patients with congestive heart failure underwent various rehabilitation programs

Aleksandra Kubinyi, Bogumiła Bacior, Wojciech Szot, Kalina Kawecka-Jaszcz

Aleksandra Kubinyi, Bogumiła Bacior, Wojciech Szot, Kalina Kawecka-Jaszcz – Cardiopulmonary exercise test in patients with congestive heart failure underwent various rehabilitation programs. Fizjoterapia Polska 2002; 2(4); 290-299

Abstract
Background. The aim of this study was to assess tolerance of physical exercise in patients with chronic heart failure who were exercised using different model of training. Material and methods. 28 patients (mean age 53.9 ± 9.2) with chronic heart failure (NYHA class II and III) were included into this study. They were divided randomly into three groups, each number 14 patients: group A – patients who were trained according to model with progressive increase of workload, group B – patients who were trained according to interval workload model. Studied groups did not differ among themselves with average age, BMI, NYHA scale, or pharmacological treatment. All patients from groups A and B were rehabilitated during six months time, 3 times per week for 1 hour each time. All patients were submitted to the following examinations before and after six months of training: echocardiography and cardiopulmonary exercise test. Results. In groups A and B we have observed increase in exercise capability, which was more pronounced in group A. This increase was observed as increase in total exercise time when compared to group B (839.1 ± 98.3 sec vs 472.4 ± 39.7 sec, p < 0.0001), and increase in workload (6.28 ± 0.8 MET vs 3.9 ± 0.2 MET p < 0.001). We also observed improve in cardiopulmonary exercise test. After six months we observed significant difference in all parameters of cardiopulmonary exercise test in group A. In group B we observed improvement in parameters VO2peak (15.3 ± 2.1vs 16.5 ± 1.9 ml/kg/min, p < 0.01) and AT (35.8 ± 5.6 vs 44.8 ± 6.6 %, p < 0.01).Conclusions. Systematical exercise training patients with chronic heart failure, especially with the progressive increase of workload exercise model, improve exercise capacity without any negative influence on systolic and diastolic function parameters of left ventricle.

Key words:
rehabilitation, physical training, chronic heart failure, cardiopulmonary exercise test

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Influence of coronary artery bypass grafting (CABG) procedure and inpatient (phase 1) and outpatient (phase 2) cardiac rehabilitation on functional capacity in patients post myocardial infarction (MI) within first 12 months after the procedure

Dorota Fudalej, Zbigniew Nowak, Michał Plewa

Dorota Fudalej, Zbigniew Nowak, Michał Plewa – Influence of coronary artery bypass grafting (CABG) procedure and inpatient (phase 1) and outpatient (phase 2) cardiac rehabilitation on functional capacity in patients post myocardial infarction (MI) within first 12 months after the procedure. Fizjoterapia Polska 2002; 2(4); 285-289

Abstract
Background. The objective of this study was to assess the influence of complex treatment on functional capacity in patients with chronic coronary artery disease (CAD). Treatment consisted of CABG procedure and subsequent inpatient (phase 1) and outpatient (phase 2) cardiac rehabilitation programs.Material and methods. The study group consisted of 46 male patients aged from 36-68 (x = 51 ± 9.4), whose phase 1 rehabilitation program was initiated in 1st day after CABG procedure and lasted for consecutive 7 days. Phase 2 of rehabilitation consisted of group exercise sessions performed at outpatient exercise centre and 16 cycles of interval training performed on cycle ergometer. Results and conclusions. The results of stress test obtained before CABG procedure and 6 and 12 months later were compared. It was found that patients’ functional capacity improved considerably. The adequate tolerance of exercises performed according to proposed program was noted as well.

Key words:
coronary artery bypass graft, cardiac rehabilitation, functional capacity

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Evaluation of the structures of shoulder joint at patients with hemiparesis after the apoplexy during rehabilitation

Andrzej Kwołek, Teresa Pop, Jacek Gwizdak, Krzysztof Kołodziej, Dorota Korab, Grzegorz Przysada

Andrzej Kwołek, Teresa Pop, Jacek Gwizdak, Krzysztof Kołodziej, Dorota Korab, Grzegorz Przysada – Evaluation of the structures of shoulder joint at patients with hemiparesis after the apoplexy during rehabilitation. Fizjoterapia Polska 2002; 2(4); 273-279

Abstract
Background. One of often met complications in rehabilitation of patients after the apoplexy are functional disturbances of the shoulder joint on the side of paresis. Connected with it painfulness and limitation of mobility makes difficult re-education of the extremity’s function. The aim of this work is evaluation of the structures of shoulder joint in the paretic extremity and comparing it with the healthy joint, as well as determination of influence of rehabilitation procedure on improvement of changes of the examined structures. Material and methods. In a group of 40 patients ultrasonographic examination was used to evaluate the shoulder joint. All patients, who in a period since December 2000 to March 2001 were hospitalised at the Rehabilitation Department of the Provincial Hospital No. 2 in Rzeszów, were directed to this examination. This examination was done twice: on the first and last day of the patient’s stay at the Rehabilitation Department. Results and conclusions. Observations during three-four weeks’ stay showed regression of pathological changes in the shoulder joint.

Key words:
shoulder, rehabilitation, ultrasonographic

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Hospital rehabilitation after implantation of cementless hip endoprosthesis

Ewa Rosa, Wojciech Hagner, Urszula Kazimierczak, Grzegorz Srokowski, Agnieszka Radzymińska

Ewa Rosa, Wojciech Hagner, Urszula Kazimierczak, Grzegorz Srokowski, Agnieszka Radzymińska – Hospital rehabilitation after implantation of cementless hip endoprosthesis. Fizjoterapia Polska 2003; 3(2); 159-163

Abstract
Background. Hip joint alloplasty is a very complicated therapeutic problem. The cooperation of the orthopedic surgeon with they physiotherapist is very important in successful treatment. The aim of current treatment strategies is to restore the function of the hip joint. This article describes the model of rehabilitation treatment we apply in our clinical practice.Material and methods. We examined 18 patients after hip alloplasty using a cementless endoprosthesis, operated in the Orthopedic and Traumatology Clinic of the Medical University of Bydgoszcz, and rehabilitated in the Rehabilitation Clinic of the Medical University of Bydgoszcz. On the basis of differences in limb length, the patients were divided into three subgroups: A) no difference in limb length; B) operated limb shorter; C) operated limb longer.Results. Significant differences among the subgroups were found in terms of the percentage of weight burden on the operated limb.Conclusions. Rehabilitation after hip alloplasty must consider each patient individually. Outcome depends not only on good surgical technique, but also the nature and quality of the rehabilitation program after surgery.

Key words:
Hip Joint, cementless endoprosthesis, rehabilitation

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Satisfaction of life and acceptance for the disease with patients under replacement therapy – kidney transplantation

Monika Lewandowska, Izabela Korabiewska, Dariusz Białoszewski, Leszek Pączek, Joanna Juskowa

Monika Lewandowska, Izabela Korabiewska, Dariusz Białoszewski, Leszek Pączek, Joanna Juskowa – Satisfaction of life and acceptance for the disease with patients under replacement therapy – kidney transplantation. Fizjoterapia Polska 2003; 3(2); 153-158

Abstract
Background. The quality of life of the patients after renal graft transplanted is not only medical, but also a social problem. One of the suggested ways of their treatment is a holistic approach to their rehabilitation, as well as analysis of their evaluation of life conditions. Material and methods. The research involved 20 patients after renal graft transplanted, during the process of physiotherapy. This group has been scrutinized during a questionary examination (incluling SWLS, AIS) and also during a specified standard questionary. The received results have been statistically analysed according to interpretation standard adapted to Polish conditions.Conclusions and Results. The conducted examinations showed, the usefulness of the scrutiny thanks to which high interpreting results have been accomplished. The results show the acceptance of poor health conditions by the patients and low level of life satisfaction caused by the end-stage of their renal failure.

Key words:
Quality of Life, renal graft, rehabilitation

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The thermogram of cervical spinal pain syndrome as an attempt to objectivize pain

Bożena Jasiak-Tyrkalska, Bogusław Frańczuk, Janusz Otfinowski

Bożena Jasiak-Tyrkalska, Bogusław Frańczuk, Janusz Otfinowski – The thermogram of cervical spinal pain syndrome as an attempt to objectivize pain. Fizjoterapia Polska 2003; 3(3); 250-255

Abstract

Background. This paper describes the features of thermovisual images in cervical spinal pain syndrome and their variability over the course of rehabilitation, and makes an effort to specify the interdependence of these characteristics and pain relief. Material and methods. Thermovisual tests were performed on 71 patients in rehabilitation for cervical spine pain syndrome.Results. The thermovisual image of the cervical spinal region in patients with pain syndrome is different from that of healthy persons. It is characterized by considerable asymmetry of temperature and increased hyperthermia in the neck and shoulders. Over the course of rehabilitation a distinct evolution could be seen in the direction of temperature symmetry in this region. Conclusion. There is a significant correlation between pain relief and the features of the thermovisual image.

Key words:
thermovision, pain, rehabilitation
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Evaluation of the structures of shoulder joint at patients with hemiparesis after the apoplexy during rehabilitation

Andrzej Kwolek, Teresa Pop, Jacek Gwizdak, Krzysztof Kołodziej, Dorota Korab, Grzegorz Przysada

Andrzej Kwolek, Teresa Pop, Jacek Gwizdak, Krzysztof Kołodziej, Dorota Korab, Grzegorz Przysada – Evaluation of the structures of shoulder joint at patients with hemiparesis after the apoplexy during rehabilitation. Fizjoterapia Polska 2003; 3(3); 224-230

Abstract

Background. Functional disorder of the shoulder joint on the paretic side is among the more common post-stroke complications. Rehabilitation can be hindered by the associated pain, limited joint mobility, and muscle distension during the period of flaccid paresis (or plegia). The purpose of our study was to evaluate certain shoulder joint structures in post-stroke patients in inpatient rehabilitation, to compare the structural image of the shoulder joint in the affected and healthy limbs, and to identify the impact of rehabilitation on the tested joint structures. Material and methods. In a group of 40 post-stroke patients we performed ultrasonographic examination of the shoulder joints. The study group included patients who were hospitalized from December 2000 to March 2001 in the Department of Rehabilitation at Voivodeship Hospital no. 2 in Rzeszów, Poland. Examinations were performed on the first and last day of hospitalization. Results. Pathological changes were found in the shoulder joints. Over a 3-4-week rehabilitation period some improvement was noted. Conclusions. Changes in shoulder joint structure in post-stroke patients with hemiparesis occur more often on the paretic side (esp. thinning of the rotator cone, the deltoid muscle, and the tendon of the long head of the shoulder biceps, calcification, subluxation in the shoulder joint, and fluid in the bursae). Comprehensive hospital rehabilitation has a positive impact on the tested shoulder joint structures. Ultrasonography is a good method for evaluation of the anatomical structures of the shoulder joint in patients with hemiparesis.

Key words:
Shoulder Joint, Rehabilitation, Ultrasonography
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Rehabilitation outcome after surgical reconstruction of the anterior crucial ligament of the knee

Wojciech Hagner, Gabriela Stec, Jan Talar

Wojciech Hagner, Gabriela Stec, Jan Talar – Rehabilitation outcome after surgical reconstruction of the anterior crucial ligament of the knee. Fizjoterapia Polska 2003; 3(4); 331-336

Abstract

Background. Injury to the ligaments and capsule of the knee joint, especially the anterior crucial ligament, leads to joint instability, manifested functionally by unsatisfactory joint mobility and a tendency for the tibial plateau to give way under load. Surgical treatment generally restores stability but the outcome is determined by rehabilitation, focused on recovery of function. The aim of our research was to evaluate outcome one year after surgical reconstruction of the anterior crucial ligament. Material and methods. We tested 20 randomly selected patients under treatment in the Department of Orthopedics and Traumatology of the Motor Apparatus in 2001 after post-traumatic surgical reconstruction of the anterior crucial ligament. The research involved a patient interview that included the pathomechanism of the injury, and a subjective evaluation of the rehabilitation outcome. Results. The most common cause of this injury proved to be sport. Two-thirds of the subjects evaluated the outcome of rehabilitation after surgical reconstruction as good or excellent. Conclusions. The program described here gives good effects in the rehabilitation of patients recovering from surgical reconstruction of the anterior crucial ligament.

Key words:
anterior crucial ligament tears, reconstruction operation, rehabilitation
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Analysis of changes in the strength of muscles acting on the hip joint in patients recovering from hip arthroplasty

Magdalena Wilk, Bogusław Frańczuk

Magdalena Wilk, Bogusław Frańczuk – Analysis of changes in the strength of muscles acting on the hip joint in patients recovering from hip arthroplasty. Fizjoterapia Polska 2003; 3(4); 309-315

Abstract

Background. Observed changes in muscle strength are the basis for selecting therapeutic exercises and assessing rehabilitation outcome. The Lovett Scale is a subjective measure, so we attempted to objectivize the results using tensometric tests and objective measurement of muscle strength based on the method of Wotyczek and Zembaty.Material and methods. We studied 98 patients operated for degenerative changes in the hip joint. These patients were randomly divided into two groups: Group 1, rehabilitated over the first 7 days using a continuous passive motion device (CPM), and Group 2, which received standard rehabilitation. After 7 days the two groups received the same rehabilitation. Muscle strength was measured with the Lovett scale preoperatively and on the 3rd, 7th, and 11th days post-operatively, and again 1, 3, and 6 months later. At 6 months post-operatively we conducted tensometric measurements in a group of 20 patients.Results. The course of changes in muscle strength was similar in both groups. On Day 3 post-operatively decreased strength was noted in all tested muscles. In subsequent testing muscle strength increased, but for the first three months the increase was significantly higher in Group 1 (with CPM). These differences disappeared at 6 months post-operatively. The results from the Lovett scale were compared to tables with the results of tensometric measurements according to the Wojtyczek-Zembaty method. No statistically significant differences were noted.Conclusions. After hip arthroplasty using total prostheses muscle strength is restored to physiological norms within 6 months.

Key words:
hip replacement, Lovett muscle strength scale, rehabilitation
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Prevention and rehabilitation in osteoporosis

Anna Mika, Piotr Mika

Anna Mika, Piotr Mika – Prevention and rehabilitation in osteoporosis. Fizjoterapia Polska 2004; 4(1); 79-85

Abstract

Osteoporosis is a systemic bone disorder, which primarily effects postmenopausal women. The prevention of osteoporosis involves two components: building up high peak bone mass and reducing the rate of bone loss during menopause and aging. Rehabilitation must include pain relief, maintenance of proper posture, rebuilding normal muscle force, and maintaining normal motion range, improvement in bone mineral density, and increasing activity in daily living, in order to stimulate the skeletal system. The aim of the present study is to present, on the basis of literature and our own experience, the importance of physiotherapy in osteoporosis prophylaxis and treatment.

Key words:

rehabilitation, spine, osteoporosis

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