Evaluating the motor development of infants using Vojta’s method, with particular attention to risk factors, in clinical material from a Rehabilitation Center for Children with Cerebral Palsy

Aleksandra Deljewska-Starykow, Zbigniew Śliwiński, Wanda Różyło

Aleksandra Deljewska-Starykow, Zbigniew Śliwiński, Wanda Różyło – Evaluating the motor development of infants using Vojta’s method, with particular attention to risk factors, in clinical material from a Rehabilitation Center for Children with Cerebral Palsy. Fizjoterapia Polska 2002; 2(3); 216-228

Abstract
Background. The author described child’s physical and mental development in the first year his live in Theodor Hellbrige’s opinion. They presented new definitions how „high-risk pregnancy, „high-risk birth, „high-risk child” They talked over risk factors and among of them there is of great importence famillie’s relations connected with the Rh factor, main blood groups, famillie’s enzynopathy and chromosome aberration also mather’s ilnneses during the her pregnancy. They payed special attention to the gestosis, diabetes, tyroid’s ilnneses, obesity, anemia, passed infectius and bleeding. The authors rated negative factors among low height of mather, low weigth of mather befor her pregnancy and no hygienic live. The period shorter than 6 months between the pregnancies is health risk also, and like how the inflammatory proceeses of the Central Nervous System, generalized cyanosis, low evaluation in the Apgar Scale, acidosis, hiperbilirubinamy, infantile convulsions, neonatal asphyxia, the children born after different complications related to labour.The aim of examine.• The neurophysiology analysis of the development newborn from the group high-risk pregnancy, high-risk birth, especially children which was born before 37 weeks lasting pregnancy – premature baby- and children which was born in normal labor but the size those newborn was too small to fetal age- dystrophy child• The paying attention to early diagnosis of the neurodeveloping disturbances and starting the treatment quickly.Material and methods. 32 premature baby was examine , it was the children were born between 28-37 weeks of the pregnancy and 13 dystrophy child which weight were 2 500 g. and 1 child was born after 37 weeks pregnancy. The examine was done in the Rehabilitation Center in Zgorzelec. Results and conclusions. On the basis of examine the authors drown following conclusions: 1. The Vojty’s development neurokinesiology diagnostic is good screening for children from risk groups, is simply to do and let to evaluate early child’s disturbances in psychomotorial development. 2. The bigger worth of the Vojtys diagnostic and therapy is possible right development of children from high-risk birth groups. The results which are presented prove to early start to diagnos and treat give children chance to right development. 3. The age of the child is of great importance for results and time of therapy. 4. The low weigth of labor and relative shorter time of live the child during the pregnancy have the influence for efficiency CNS and the level of disturbances central neurvous coordination. The low weigth and shorter pregnancy live the higher level disturbances central neurvous coordination is presented. 5. The risk factor has influence for time therapy to moment reached the normalization. The intermural dystrophy is worst than premature baby. The premature baby quicklier and large number reache the normal psychomotorial development.

Key words:
infantum Cerebral Palsy, Vojta, child physical and mental development

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Normal function of the pelvis is a precondition for success in scoliosis therapy

Zbigniew Śliwiński, Dariusz Milko

Zbigniew Śliwiński, Dariusz Milko – Normal function of the pelvis is a precondition for success in scoliosis therapy. Fizjoterapia Polska 2002; 2(4); 327-337

Abstract
The symmetry is the characteristic of human body in evolution. It is way the asymmetry is departure in the correct development. Sollmann claims that 97% of the population suffer from the scoliosis and the first symptoms can be observed in the baby’s age. Coenen noticed that block of the atlanto-occipital joint can formed faulty posture in children. Lohse- Buscha described the blocking of axis in the rotation is accompanying the restriction his side bending. The authors claims the process of creation idiopathic scoliosis is possible to understand after the understanding biomechanical of the pelvis. They described the changes of the location of hip bones and sacral bone between themselves caused appeared of the seeming leg’s short which can bring about the spondylolisthesis and pathological muscles tonus. The other changes of the location of hip bones and sacral bone between themselves caused also slanting position of lumbar vertebra. The author claims the using manual’s techniques to treat and functional assessment of the pelvis which can be disturbing, is necessary,

Key words:
Scoliosis, block of the atlanto-occipital joint, aferentation, nutation, kontrnutation

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Electrostimulation as an improved physical therapy treatment of lymphoedema

Krzysztof Gieremek, Jolanta Rojczyk-Chmarek, Zbigniew Śliwiński

Krzysztof Gieremek, Jolanta Rojczyk-Chmarek, Zbigniew Śliwiński – Electrostimulation as an improved physical therapy treatment of lymphoedema. Fizjoterapia Polska 2002; 2(4); 300-305

Abstract
Introduction. Morphological and electrophysiologic properties of unstriated muscles of lymphatic vessels were outlined in the present study. The most common disordes observed in lymphatic system, as well as the mechanism of lymphoedema were discussed. Well known and commonly applied means of physical therapy treatment such as external pressure, pneumatic compression, pressure-massage, manual drainage and therapeutic exercises were reviewed in this paper. Material and methods. The main subject of the present study is the orginal method of electrostymulation of unstriated muscles, which takes into consideration individual character of electrophysiological proper-tiesof muscles located in lymphatic vessels. Types of electrical impulses used in this treatment, programme modes (therapy and prophylactic mode), as well as methodology of the treatment were discussed in details. The examples of protocols used in treatment of particular conditions and their clinical aplication were presented as well.Conoclusion. The presented apparatus for application of described methods of electrostimulation in the first construction of this type, wich considers individual structure and function of lymphatic system. This method of stymulation would be probably useful in variety of medical conditions, where lymphoedema is a major therapeutic problem.

Key words:
Lymphatic System, lymphoedema, physical therapy treatment, electrostymulation

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An analysis of pain symptoms in patients with chronic spinal syndrome under treatment in health resorts

Zbigniew Śliwiński, Kamila Kasperek-Konopnicka

Zbigniew Śliwiński, Kamila Kasperek-Konopnicka – An analysis of pain symptoms in patients with chronic spinal syndrome under treatment in health resorts. Fizjoterapia Polska 2003; 3(1); 38-47

Abstract
Background. Pain in the lower segment of the lumbar spine and the lumbo-sacral transition constitutes a major challenge for all those involved in the individual’s treatment: physicians, physiotherapists, psychologists, psychotherapists. The goal of the present study was to determine which structures are the most common source of pain symptoms in patients with chronic spinal syndrome treated in health resorts. Material and methods. We examined 52 patients complaining of pain in the lower lumbar spine, the lumbo-sacral transition, the hip joint, and the lower extremities. The research methods included patient history, analysis of existing patient documentation, x-ray, MRI, CT, measurement of reobasis and chronaxis for the anterior tibial muscle in the left and right leg (using a PHYSIOTER D-50), and manual examination. A medical rehabilitation program was developed on the basis of the research and the medical indications. Test results were recorded twice: before the beginning of treatment and after its completion. Results. Laseque’s sign occurred most often in patients with ischialgia and discopathy. Irritation of the pelvic ligaments was particularly often seen in patients with discopathy, degenerative changes in the spine, and ischialgia. Changes in the sensibility of the sciatic nerve were found in discopathy patients. Conclusions. The most frequently diagnosed disorder in the patients we examined was discopathy. Laseque’s sign occurring before therapy resolved in the majority of cases after health resort treatment. The results from Patric’s test point to improvement of hip and spine function, not only in patients with degenerative changes, but also in discopathy patients. The muscles from the sciatic-crural group, the calf muscles, and the femoral-lumbar muscles were most often of abnormal length in this group of patients. These parameters can produce false results in the Laseque test and the tension test for the sciatic nerve.

Key words:
pain back, Patric, Muscle, acomadation, Irritation by pressing, tension test SLR, Slump Test

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Correlation between motor development and brainstem auditory evoked potentials (BAEP) in children after bacterial meningitis

Witold Pilecki, Teresa Szawrowicz, Małgorzata Micał-Strąk, Zbigniew Śliwiński

Witold Pilecki, Teresa Szawrowicz, Małgorzata Micał-Strąk, Zbigniew Śliwiński – Correlation between motor development and brainstem auditory evoked potentials (BAEP) in children after bacterial meningitis. Fizjoterapia Polska 2003; 3(2); 137-145

Abstract
Background. Bacterial meningitis may lead to various sequelae, especially damage to the central motor neuron. Brainstem auditory evoked potentials enable early detection of CNS dysfunction, and may be helpful in making the decision to start rehabilitation. Material and methods. BAEPs and assessment of motor development were performed on 38 children (from 1 month to 14 years in age) who had survived bacterial meningitis. 24 of them had motor development dysfunction. Results. All the tested children with motor development dysfunction had abnormalities of IPL I-V. Over 50% of those children were additionally affected by dysfunction in transmission, both peripheral and brainstem. Conclusions. There is a strong correlation between the results of BAEP testing and motor development dysfunction.

Key words:
bacterial meningitis, motor development, brainstem auditory evoked potentials

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A new type of cervical traction generating mechanical pulsations (vibration) in the comprehensive treatment of patients with cervical spondylosis

Krzysztof Gieremek, Edward Saulicz, Zbigniew Śliwiński, Monika Grygorowicz, Aleksander Socha, Janusz Kubacki

Krzysztof Gieremek, Edward Saulicz, Zbigniew Śliwiński, Monika Grygorowicz, Aleksander Socha, Janusz Kubacki – A new type of cervical traction generating mechanical pulsations (vibration) in the comprehensive treatment of patients with cervical spondylosis. Fizjoterapia Polska 2003; 3(2); 99-105

Abstract
Background. The objective of the present study was to evaluate the therapeutic effectiveness of a new type of vibration traction (Glisson type) as compared to traditional cervical traction (Glisson type) in patients diagnosed with degenerative disc disease or spondylarthrosis of the cervical spine. Material and methods. Two groups of ambulatory patients treated for spondylosis of the cervical spine were included in this study. The study group (n=35) and the control group (n=33) were subjected to the standard comprehensive treatment (massage therapy, short wave diathermy, infrared therapy, electrotherapy using Bernard’s current, ultrasound therapy). The cervical traction set used in the study group was additionally equipped with a device generating vibration (frequency 100 Hz, amplitude 0,2 mm), installed just above the cervical loop. Results. The statistical analysis (Chi2 = 9,672, for a = 0,046) revealed considerable correlation between the type of cervical traction used and the results of the treatment, indicating higher effectiveness of vibration traction. Statistical analysis also proved increased range of motion in the cervical spine in the all planes, as well as improved left and right hand grip function. Conclusions. The study proved that the treatment of cervical traction (Glisson type) equipped with additional vibration device was well tolerated by patients. The use of this type of traction resulted in sooner subsidence of existing symptoms such as pain, increased muscle tone and hypersensitivity to touch of cervical spine musculature.

Key words:
Glisson traction, wibration massage, cervical spondylosis

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Research on the occurrence of nerve root symptoms in hernia of the L5-S1 nucleus pulposus

Przemysław Minta, Zbigniew Śliwiński, Andrzej Permoda, Natalia Szapowałow

Przemysław Minta, Zbigniew Śliwiński, Andrzej Permoda, Natalia Szapowałow – Research on the occurrence of nerve root symptoms in hernia of the L5-S1 nucleus pulposus. Fizjoterapia Polska 2003; 3(3); 256-260

Abstract

Background. The number of patients pathological changes in the lumbo-sacral spine is rising rapidly. It is still a common practice to implement treatment in lumbo-sacral pain syndrome based on the results of nerve root tests. The goal of the present study was to identify codependencies between the occurrence of certain positive nerve root tests on sex, age, and time since onset. Material and methods. Four nerve root tests were performed on 400 patients treated at the authors’ health resort for pain due to hernia of the L5-S1 nucleus pulposus, confirmed by CT or MRI. Results. The co-occurrence of L5-S1 hernia and various other pathological changes in the spine was found in 88.5% of the subjects. These included pathologies of the intervertebral disks on the higher levels, degeneration of bony elements and intervertebral joints and yellow ligaments. The frequency of co-occurrence of hernia with degenerative changes rose with age, regardless of sex. Positive nerve-root tests were found in 51.5% of the subjects. Inactive nerve root syndromes affected nearly half the subjects, while the frequency of occurrence rose with age and time since onset. Conclusions. In our patient population no simple dependence was found between the results of objective imaging tests and the occurrence of nerve root symptoms. The frequency of occurrence of positive nerve root tests decreased with the increasing age of the subjects and the time since onset. The Bragard and Hoover nerve root tests do not guarantee a sufficient degree of diagnostic confidence.

Key words:
hernia of the nucleus pulposus, nerve root tests, Lasegue test, Kernig test, Bragard test, Hoover test
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High-tone therapy in the comprehensive rehabilitation of children with cerebral palsy

Zbigniew Śliwiński, Bartłomiej Halat, Krzysztof Gieremek, Beata Ufniak, Jolanta Chmarek-Rojczyk

Zbigniew Śliwiński, Bartłomiej Halat, Krzysztof Gieremek, Beata Ufniak, Jolanta Chmarek-Rojczyk – High-tone therapy in the comprehensive rehabilitation of children with cerebral palsy. Fizjoterapia Polska 2003; 3(3); 231-242

Abstract

Background. This article describes the possibilities of using high-tone therapy in the comprehensive rehabilitation of children with cerebral palsy (CP). This device stimulates nerves and muscles with an electrical current at a frequency corresponding to acoustic vibrations, from 4400 to 12300 Hz. High-tone therapy produces many desirable effect; it disperses foci of pain and inflammation, intensifies metabolism, increases local blood supply, promotes cellular diffusion, improves tissue nutrition, accelerates resorption of edema, rebuilds original tissue structure (including muscles), and reduces tension in transversely striated muscle. Material and methods. We studied 19 children with CP-related spastic tetraplegia, age 4-17, inpatients at the Pediatric and Adult Rehabilitation Center in Zgorzelec, Poland. Manual dexterity was tested, as well as range of movement in the radiocarpal and ankle joints. The circumference of the hands and feet was measured and the gait stereotype assessed before and after treatment. The therapeutic program included a 30-minute procedure with the hoSti-Scan program, using a WaDiT-12 apparatus, followed by stimulation of the muscles responsible for dorsal flexion of hands and feet. Results. The evaluation of manual dexterity using the Munich Functional Developmental Diagnosis program indicated that a 4-week rehabilitation program combined with high-tone hterapy had a significant impact on improvement in the manual function of the hands in the subject children. All the children tolerated high-tone therapy very well. Conclusions. In view of the improvement in manual dexterity, radiocarpal and ankle mobility, and gait stereotype, hightone therapy is useful in the rehabilitation of children with spastic cerebral palsy.

Key words:
high tone therapy, methodology of procedure, determinants of gait, Munich Functional Developmental Diagnosis
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Thermographic assessment of radiation induced by cryostimulation of both lower limbs and analysis of changes in children with cerebral palsy

Zbigniew Śliwiński, Zdzisław Zagrobelny, Jan Talar, Piotr Płaza, Bartłomiej Halat, Marek Kiljański

Zbigniew Śliwiński, Zdzisław Zagrobelny, Jan Talar, Piotr Płaza, Bartłomiej Halat, Marek Kiljański – Thermographic assessment of radiation induced by cryostimulation of both lower limbs and analysis of changes in children with cerebral palsy. Fizjoterapia Polska 2003; 3(4); 316-330

Abstract

Background. The authors presented the examine of changes temperature results in the children’s with the cerebral palsy legs, which were registrated during treatment in the Rehabilitation Center in Zgorzelec. Material and methods. The changes temperature were checkted by the camera Agema 570 before the treatment and four weeks later. The spastic tension was checked also using the Mionotometer Szirmai and Ashworth test and Brunstrom test. Spontaneous motorial evaluation and the level motorial development were checked using own scale. Results and conclusions. The results shown that the using the cryostimulation in the treatment children with the cerebral palsy decrease the spastic tension in the legs and the spontaneous motorial evaluation was better, the range of motion in joins also were better after treatment. The termal pictures shown that arterial play in the children’s legs was adapted to the cryogenic temperatures.

Key words:
thermoregulation, local cryotherapy, termovision, spastic tension, spontaneous motorial evaluation
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Horizontal electrotherapy in rehabilitation

Aneta Hak, Marcin Oryniak, Jagoda Szner-Dobrowolska, Rafał Kaczmarzyk, Małgorzata Jegier, Zbigniew Śliwiński

Aneta Hak, Marcin Oryniak, Jagoda Szner-Dobrowolska, Rafał Kaczmarzyk, Małgorzata Jegier, Zbigniew Śliwiński – Horizontal electrotherapy in rehabilitation. Fizjoterapia Polska 2004; 4(3); 292-294

Abstract

The use of „horizontal” stimulation makes it possible to achieve a stimulatory effect on the synchronic frequency of stimuli of functional potentials in the stimulated cells, as well as electrobiochemical and electrophysical effects, and, with higher dosages, blockage of nerve conductance, which greatly increases the chances of achieving therapeutic success. The WaDiT device produces all the various kinds of effects needed in selective therapy in terms of an alternating electromagnetic field (medium frequency current in the high tone range from ca. 4000 Hz to 12,000 Hz). This range is characterized by high local systemic tolerance. WaDiT devices operate in a wide range of high tones. This results in especially good modulation in tissue, and consequently many additional effects that are medically and biologically advantageous.

Key words:
„horizontal” stimulation, currents of medium frequency, high tones
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