Changes in Hand Flexors Spasticity and Strength after Radial Extracorporeal Shock Wave Therapy in Post-Stroke Patients: A Randomized Controlled Trial

Gehan M. Ahmed, Bassam A. Elnassag, Ayman A. Nassif, Ebtesam M. Fahmy, Amira M. El Gohary, Elham N. Salem

Gehan M. Ahmed, Bassam A. Elnassag, Ayman A. Nassif, Ebtesam M. Fahmy, Amira M. El Gohary, Elham N. Salem – Changes in Hand Flexors Spasticity and Strength after Radial Extracorporeal Shock Wave Therapy in Post-Stroke Patients: A Randomized Controlled Trial. Fizjoterapia Polska 2020; 20(4); 34-39

Abstract
Background. Radial Extracorporeal Shock Wave Therapy (rESWT) has been reported to be an alternative, safe and noninvasive treatment for spasticity. Objective. This study aimed to determine its additional effect to a selected physical therapy program on spasticity of wrist and fingers flexors and hand grip strength in patients with stroke. Design. A single blinded, parallel randomized controlled trial. Setting. Faculty of Physical Therapy and Department of Clinical Neurophysiology, Faculty of Medicine, Cairo University, Egypt. Participants. Thirty stroke patients were divided randomly into two equal groups. Interventions. Group (A): received four successive sessions of rESWT as one session/week over flexor carpi ulnaris, flexor carpi radials and hand intrinsic muscles. Control group (B): received sham rESWT and both groups received a selected physical therapy program for stroke over a period of four weeks as three sessions/week. Outcomes measures. The Modified Ashworth’s Scale, Hand grip strength and H/M ratio were performed for all patients before and after treatment. Results. Intervention group showed significant improvements in wrist and fingers flexor muscles’ tone and hand grip strength compared to the control group (p < 0.05). The H/M ratio results revealed statistically non-significant difference between both groups (p > 0.05). Conclusion. Adding rESWT to a selected physical therapy program can increases its effectiveness in reducing spasticity and improving strength of treated muscles in patients with stroke.

Key words:
Radial Extracorporeal Shock Wave Therapy, Wrist and Fingers flexor Spasticity, Stroke
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Assessment of the severity of menopause symptoms and the occurrence of pain in the lumbar spine among women living in the Silesia Voivodeship

Agata Grzyb, Anna Koralewska, Martyna Gruszka, Zuzanna Sobczak, Magdalena Drewnowska

A. Grzyb, A. Koralewska, M. Gruszka, Z. Sobczak, M. Drewnowska– Assessment of the severity of menopause symptoms and the occurrence of pain in the lumbar spine among women living in the Silesia Voivodeship. Fizjoterapia Polska 2020; 20(4); 22-33

Abstract
Introduction. During the menopause, many changes are observed in a woman’s life. These processes have different backgrounds, but mainly they are caused by hormonal changes that have a huge impact on the functioning of the whole organism. These changes may cause, among others: insomnia, mood disorders, weight gain, and indirectly may affect the appearance of back pain.
Aim of the study. The main aim of the study was to recognize the incidence and severity of menopause symptoms, as well as to assess the degree of disability caused by pain in the thoracolumbar spine in the Silesian female population.
Material and method. The material consisted of 150 women between the ages of 40 and 60 from the Śląskie Voivodeship. The study used: the author’s questionnaire, Menopausal Symptom Assessment Scale (MRS) and the Oswestry Questionnaire. The collected material was subjected to statistical analysis.
Results. There was a wide variation in the incidence of menopause symptoms among respondents. Correlation analysis showed that there are statistically significant differences between all menopausal symptoms and lower back pain. Over half of the respondents (56.7%) struggled with excessive body weight. 79% of women have a moderate degree of disability.
Conclusions. The most common symptoms of menopause are psychological symptoms. The respondents have pain in the lumbar spine. The vast majority of women have a moderate degree of disability resulting from pain in the lower spine, the higher the body mass index result, the greater the sensation of somatic and vegetative symptoms and urogenital symptoms. The obtained data encourage a deeper and broader analysis of the phenomenon.

Key words:
pain, women, menopause

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Fascial Manipulation for Cervicogenic Headache: A Single Blinded Randomized Controlled Trial

Bassam A. El-Nassag, Ahmed Baghdadi

Bassam A. El-Nassag, Ahmed Baghdadi – Fascial Manipulation for Cervicogenic Headache: A Single Blinded Randomized Controlled Trial. Fizjoterapia Polska 2020; 20(4); 16-21

Streszczenie

Background. Cervicogenic Headache (CGH) is a common type of secondary headaches which has a great socioeconomic impact. Several therapeutic approaches have been used for treatment of CGH. Objective. To investigate the effect of Fascial Manipulation (FM) on CGH, cervical range of motion and CGH associated dizziness. Design. Single blinded, parallel randomized controlled trial. Settings. Out-Patient department at Al-Wakra Hospital, Hamad Medical Corporation, Qatar. Participants. 48 patients with Cervicogenic Headache associated with dizziness. Intervention. Patients were randomized to a study (A) (n = 24) and control (B) (n = 24) groups. Over two successive weeks, patients in group (A) received two sessions of FM as one session/week, while group (B) performed low load cervico-scapular endurance training for two weeks as a three sessions/week. Outcomes measures. The six items Headache Impact Test (HIT-6), Neck Disability Index (NDI), Flexion rotation test (FRT) and Dizziness Handicap Inventory (DHI). Results. There was a statistically significant improvement in the HIT-6, NDI, FRT and DHI within and between groups after treatment in favor for the study group (P < 0.05). Correlation between FRT, HIT-6 and DHI post treatment revealed a negative moderate (r = -0.3) to weak (r = -0.24) correlations respectively. Conclusion. Fascial manipulation is an effective therapeutic approach in comparison to exercise program in treating CGH associated with dizziness.

Słowa kluczowe:
Cervicogenic Headache, Dizziness, Fascial Manipulation
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Quality of life of children with ICP as assessed by parents

Artur Marszałek, Zuzanna Płaza, Zbigniew Śliwiński

A. Marszałek, Z. Płaza, Z. Śliwiński – Quality of life of children with ICP as assessed by parents. Fizjoterapia Polska 2020; 20(4); 6-14

Streszczenie

Introduction. Infantile cerebral palsy should not be treated as a separate disease entity. It is a complex of different symptoms resulting from various etiological factors. It is “a permanent, time-changing disturbance of movement or posture, or movement and posture, with dysfunctions, resulting from permanent, non-progressive brain damage at the stage of incomplete development”. It is estimated that the prevalence of cerebral palsy in Poland is 2.0–2.5 per 1,000 live births.
Objective. Assessment of the quality of life of children with ICP based on the opinions of their parents.
Material and methods. The study uses the method of a diagnostic survey. A group of parents of 25 children with infantile cerebral palsy and, as a control group, parents of 25 healthy children were interviewed. For this purpose, the CHQ-PF 50 child health questionnaire was used to measure the parents’ perceptions of their children’s quality of life.
Conclusions. Infantile cerebral palsy, like any other type of disability, reduces the quality of life. ICP has a negative impact on the functioning of children in society, causing them to feel discomfort in various areas of life.

Słowa kluczowe:
cerebral pals, quality of life, physical disability
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Effect of plyometrics, closed kinetic chain versus quadratus lumborum strengthening exercises on vertical jump height in volley ballplayers: A randomized controlled trial

Yasmein M. Mahmoud, Wadeda H. Elsayed, Amira H. Draz

Yasmein M. Mahmoud, Wadeda H. Elsayed, Amira H. Draz – Effect of plyometrics, closed kinetic chain versus quadratus lumborum strengthening exercises on vertical jump height in volley ballplayers: A randomized controlled trial. Fizjoterapia Polska 2020; 20(3); 192-196

Abstract
Purpose. To compare the effects of plyometrics, closed kinetic chain with quadratus lumborum strengthening exercises on vertical jump height in volley ball players.
Design. Pre-post measurement randomized controlled trial.
Methods. Two hundred volleyball players were recruited from Cairo and Kafer El Sheikh University, Egypt. 140 volleyball players met the inclusion criteria and were randomly assigned into four equal groups. Group (A) consisted of 35 volley ball players with mean body mass index (BMI) value of 21 ± 3.76 kg/m2 and received plyometric exercise (Counter Movement jump (CMJ). Group (B) consisted of 35 volley ball players with mean BMI value of 21.44 ± 1.681 kg/m2 and received closed kinetic chain (CKC) exercise (double limp squat free weights), Group (C) consisted of 35 volley ball players with mean BMI value 22.17 ± 1.8 kg/m2 and received quadratus lumorum strengthening exercise (isotonic hip hiking), group (A), (B) and (C) received the exercises two times per week for eight weeks. Group (D) consisted of 35 volley ball players with mean BMI value of 22.01 ± 1.69 kg/m2 and received no exercise (control group).
Results. Statistical analysis revealed that there was significant difference (p < 0.05) in favour to group A, B and C in compared to group D. while there were no significant differences (p > 0.05) among groups (A, B and C).
Conclusion. Plyometrics (CMJ), CKC (Double limb squat free weights), and quadratus lumborum strengthening exercise (Hip hiking) yield an improvement on vertical jump height.
Key words:
plyometrics, CKC, vertical jump, strengthening exercise
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Could it be a New Complementary Intervention in Management of Peripheral Arterial Disease?

Abeer Ahmad Farghaly, Hesham Mostafa, Hasnaa Ahmed Abdel-Aziz, Hamada A. Hamada

Abeer Ahmad Farghaly, Hesham Mostafa, Hasnaa Ahmed Abdel-Aziz, Hamada A. Hamada – Laser Acupuncture: Could it be a New Complementary Intervention in Management of Peripheral Arterial Disease? Fizjoterapia Polska 2020; 20(3); 184-190

Abstract
Laser acupuncture has produced promising results in the management of many medical conditions; it has been used as a non-invasive therapy with no puncture pain which represents a major advantage over traditional acupuncture or electroacupuncture. The research question of this study is: Does the Aluminum Gallium Arsenide (AlGaAs) LASER acupuncture affect the lower limb blood supply and functional walking ability in patients with peripheral arterial disease (PAD)? Thirty male patients’ diagnosis with PAD were recruited from Kasr El-ainy Hospital, and were randomly divided into two equal groups: study group and control group. Both groups received the routine medical treatment whereas study group received laser acupuncture therapy twice weekly for five weeks. Ankle brachial pressure index (ABPI), six-minute walk test (6MWT), and rating of perceived exertion using modified Borg scale were measured. The 2×2 mixed design MANOVA showed that laser acupuncture has induced highly statistically significant improvements in all the measured outcomes (p < 0.05). However, results revealed no significant difference between the two groups except for modified Borg scale. It was concluded that, AlGaAs Laser acupuncture could be an effective non-pharmacological intervention for improving circulation and functional walking performance in PAD patients and may be recommended as a complementary therapy in the management protocols of PAD.
Key words:
Laser acupuncture, peripheral arterial disease, Ankle brachial pressure index, six-minute walk test
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Medical devices prescribed in the practice of physiotherapy

Mateusz Curyło, Marlena Rynkiewicz-Andryśkiewicz, Marcin Mikos, Marek Kiljański, Zbigniew Śliwiński, Jan W. Raczkowski

M. Curyło, M. Rynkiewicz-Andryśkiewicz, M. Mikos, M. Kiljański, Z. Śliwiński, J. W. Raczkowski – Wyroby medyczne wydawane na zlecenie w praktyce fizjoterapeuty. Fizjoterapia Polska 2020; 20(3); 180-183

DOI: https://doi.org/10.56984/8ZG14054B

Abstract
The act on the profession of physiotherapy was a long-awaited legal regulator regulating the profession of physiotherapy. Physiotherapy became not only an independent medical profession, but also a profession of public trust.
The provisions of the act on the profession of physiotherapy have resulted in the introduction of further legislative changes, including those regarding the possibility of prescribing medical devices.
In practice, this regulation filled the gaps in the scope of competences of physiotherapists. Pursuant to the new regulations, the list of medical devices that can be prescribed by physiotherapists with the right to independently provide physiotherapeutic services has been extended, with simultaneous differentiation of competences in this area for masters of physiotherapy and specialists in the field of physiotherapy.
Key words:
medical devices, act on the profession of physiotherapy, competences of physiotherapists, list of medical devices
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Wzorzec chodu osób po złamaniach bliższej nasady kości udowej leczonych chirurgicznie – doniesienie wstępne

Beata Kita, Tomasz Ridan, Tomasz Łosień, Katarzyna Kniaziew-Gomoluch, Joanna Szymańska

B. Kita, T. Ridan, T. Łosień, K. Kniaziew-Gomoluch, J. Szymańska – Gait pattern of people after fractures of proximal femoral epiphysis treated surgically. Preliminary report. Fizjoterapia Polska 2020; 20(3); 164-170

Streszczenie
Wprowadzenie. Szacuje się, że ponad 50% pacjentów, którzy dobrze funkcjonowali przed złamaniem bliższej nasady kości udowej, nie jest w stanie powrócić do aktywności sprzed urazu. Co więcej, umieralność w tej grupie chorych szacowana jest na ponad 21% w ciągu pierwszego roku od złamania, a w ciągu następnych 5 lat liczba ta rośnie do 59%. Zauważono, że pacjenci tracą zdolność do niezależnego funkcjonowania bez pomocy z zewnątrz, pogarsza się ich mobilność, co w konsekwencji prowadzi do obniżenia jakości życia. Wśród ograniczeń zgłaszanych przez pacjentów wymieniano pogorszenie parametrów chodu. Celem pracy jest analiza wpływu przebytego złamania bliższego końca kości udowej leczonego chirurgicznie na wybrane parametry chodu.
Materiał i metody. Przebadano 51 osób, w tym 40 kobiet i 11 mężczyzn. Średni wiek badanych wynosił 73 lata. W grupie badanych osoba najmłodsza miała 50 lat, a najstarsza 92 lata. Wszystkie zakwalifikowane do badania osoby były po przebytym złamaniu bliższej nasady kości udowej, które było leczone chirurgicznie. Osoby te mogły chodzić samodzielnie bez użycia pomocy ortopedycznych w postaci kul, lasek, chodzików. W badaniu wykorzystano następujące narzędzia badawcze: wywiad, analiza dokumentacji medycznej i badanie chodu na platformie tensometrycznej.
Wyniki. W grupie wiekowej 50-64 lata czas cyklu chodu wśród badanych osób wyniósł średnio: u kobiet 1,51 sek. i 1,35 sek. u mężczyzn. W grupie wiekowej 65-80 lat wśród kobiet i mężczyzn wynosi 1,37 sek. Wnioski. Wzorzec chodu osób po złamaniu bliższej nasady kości udowej jest zmieniony i  odbiega  od założeń normy.  W badanej grupie długość cyklu chodu zarówno u kobiet, jak i mężczyzn w grupie wiekowej 50-64. r.ż., jak i 65-80. r.ż. jest znacząco krótsza w stosunku do założeń normy. Badanie nie wykazało istotnych różnic w długości kroku (step length) po stronie operowanej i nieoperowanej we wszystkich grupach wiekowych, zarówno u kobiet, jak i u mężczyzn. Czas cyklu chodu (stride time) w grupie wiekowej 54-64. r.ż. i 65-80. r.ż. wśród badanych mężczyzn mieści się górnej granicy normy. Natomiast wśród badanych kobiet w wymienionych grupach wiekowych czas cyklu chodu w sposób znaczący przekracza górną granicę normy.
Słowa kluczowe:
wzorzec chodu, złamania bliższej nasady kości udowej, zaburzenia chodu, osoby starsze
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