Tag: Bogusław Frańczuk

Therapy for limb apraxia in a patient with the Melas syndrome

Maria Pąchalska, Bogusław Frańczuk, Tadeusz Gałkowski, Bożena Grochmal-Bach, Henryk Knapik, Ewa Gostyk, Bruce MacQueen, Adam Pąchalski, Piotr Pąchalski, Rafał Stabrawa, Irena Jeleńska-Szyguła

Maria Pąchalska, Bogusław Frańczuk, Tadeusz Gałkowski, Bożena Grochmal-Bach, Henryk Knapik, Ewa Gostyk, Bruce MacQueen, Adam Pąchalski, Piotr Pąchalski, Rafał Stabrawa, Irena Jeleńska-Szyguła – Therapy for limb apraxia in a patient with the Melas syndrome. Fizjoterapia Polska 2001; 1(1); 26-38

Abstract
Introduction. The authors report the results of four years of research and therapy of apraxia occurring in a patient with a mitochondrial cytopathy known as the MELAS syndrome, which causes heterogeneous organic changes in the brain. This is an original contribution, since the clinical literature contains no references to apraxia therapy in MELAS. Slowly progressive apraxia of the upper and lower limbs is described, and the rehabilitative potential of a specially developed authorial program entitled “Semantically Controlled Patterns of Motion” (referred to as “SSWR” from the Polish abbreviation) is measured.Material and methods. The patient, K.S., female age 22, diagnosed with MELAS, is under treatment in the Department of Medical Rehabilitation at the Cracow Rehabilitation Center. The extraordinarily complicated clinical picture of her illness (one of the mitochondrial cytopathies) consists of episodic exacerbation overlaid on a patient of slowly progressive symptoms, including dementia, fluctuating aphasia, tactile agnosia, sensorineural deafness, cortical blindness, and slowly progressive ideomotor apraxia. The holistic therapy program involves the indicated pharmacological treatment and comprehensive neurorehabilitation aimed at the polymodal reintegration of higher cortical functions, including voluntary limb movements. The SSWR program is comprised of an authorial set of patterns of limb motion involving both gross and fine movements, along with descriptive humorous names for the individual patterns, in order to support the process of remembering and recalling, since the patient exhibits cognitive disturbances. The effectiveness of the therapy program developed for this patient was assessed by means of standard neuropsychological tests, including the Boston Test of Praxis and the Test of Activities of Daily Life (ADL). Results. It was found that despite the continued development of the illness as measured by the results of MRI examinations, the patient achieved considerable progress in respect to conscious control of limb movements, as indicated by significant improvement in the results from successive administrations of the Boston Test of Praxis. Improvement in general ability to adapt as well as emotional and social functioning, is indicated by the results from standard neuropsychological tests and from the Test of Activities of Daily Life (ADL). Discussion. The authors present the theoretical foundations of the program. Imitating a movement requires that a mental representation of the intended movement be evoked in the brain, after which a motor program (in the seanse of praxis) is formulated and executed. The significance of this discovery for contemporary physiotherapy will be demonstrated.

Key words:
MELAS syndrome, limb apraxia ideomotor apraxia, patterns of motion, neurorehabilitation

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The neurorehabilitation of hemispatial neglect in patients with traumatic brain injury

Maria Pąchalska, Bogusław Frańczuk, Jan Talar, Wiesław Tomaszewski, Bruce MacQueen, Kay Neldon

Maria Pąchalska, Bogusław Frańczuk, Jan Talar, Wiesław Tomaszewski, Bruce MacQueen, Kay Neldon – The neurorehabilitation of hemispatial neglect in patients with traumatic brain injury. Fizjoterapia Polska 2001; 1(2); 143-154

Abstract
Background. The purpose of this article is to evaluate the relative effectiveness of differentiated rehabilitation programs for patients with hemispatial neglect subsequent to traumatic brain injury (TBI). In the literature, neglect is classified into two basic types: egocentric (“body-centered”), in which the patient neglect object situated in a given area of his field of vision, and allocentric )”objected-focused”), in which the patient neglects one side of objects presented to him, regardless of their location. The authors’ clinical practice indicates that the visual scanning technique traditionally used in neglect therapy is generally ineffective in patients with egocentric neglect. A spatio-motor training program has therefore been developed by the authors, elaborated on the basic of their program of semantically controlled motion patterns for the rehabilitation of apraxia, whose goal is to reestablish the proper relations between automatic and voluntary movements, to improve interhemisphere cooperation by symmetrical and asymmetrical modeling of motor exercises with both healthy and affected limbs, and to increase patient motivation by establishing clearcut goals and rewarding success. Both programs, visual scanning and spatio-motor training, have been implemented in clinical practice in the represented by the authors. Material and methods. The article describes in detail the rehabilitation of two TBI patients (JK, male, age 27, and AS, female, age 28) treated by the authors in the chronic phase of recovery after automobile accidents, as a result of which both patients were comatose for more than 4 weeks. In neuropsychological testing JK and AS both presented with persistent and significant leftsided hemispatial neglect: allocentric neglect in JK, and egocentric in AS. A modified AB-BA experimental design was used, where A represents spatio-motor training, and B is visual scanning. For patient JK, program A was first applied, followed by B, while for patient AS the reverse sequence was used. Each program included 10 therapy sessions, with a four-week interval between programs. The degree of neglect was measured using standard neuropsychological tests for quantitative and qualitative assessment of neglect, along with the analysis of drawings made during therapy by both patients. The patients were tested four times, before and after each of the two programs. Results. As the authors had hypothesized, patient JK did not show any progress in terms of neglect after conclusion of program A, while after program B he showed virtually no lingering neglect. In the case of patient AS the results were exactly opposite: after concluding program B (which she received first) there was no significant change, while after program A (administered second) there were no signs of neglect.Conclusion. The theoretical and clinical implications of these results for neuropsychological practice are discussed, and a model solution is proposed to explain the basic pathomechanism of both allocentric and egocentric neglect. These two types of neglect are sufficiently different in etiology and symptomatology to necessitate differentiated therapy programs in the course of neurorehabilitation.

Key words:
hemispatial neglect, traumatic brain injury, rehabilitation

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Continous passive motion as a method of kinesitherapy in the treatment of brachialgia

Bogusław Frańczuk, Wojciech Szwarczyk, Magdalena Wilk, Maciej Kasparek, Janusz Otfinowski

Bogusław Frańczuk, Wojciech Szwarczyk, Magdalena Wilk, Maciej Kasparek, Janusz Otfinowski – Continous passive motion as a method of kinesitherapy in the treatment of brachialgia. Fizjoterapia Polska 2001; 1(2); 123-126

Abstract
Background. The purpose of this article is to describe the treatment outcomes for patients with bracchialgia who received, in addition to standard rehabilitation, treatment by continuous passive movement (CPM) as well. Material and methods. The research involved 55 patients under treatment in the Clinic of Traumatology at the Jagiellonian University’s Collegium Medicum, in accordance with the standard approach to rehabilitation. In 25 these cases (group II), CPM treatment was applied additionally. In order to evaluate rehabilitation outcome, the Visual Analogue Scale (VAS) was applied to assess pain symptoms, the range of active movements was tested in the humeral joint (especially painful abduction), and a two-degree self evaluation scale was applied to measure satisfaction with the state of health: satisfactory (the limb can be used with relative facility) or unsatisfactory (major limitations in the functions of the upper limb). The patients were tested twice: once before treatment and again after its completion. Conclusion. The results obtained justify the conclusion that patients with post-traumatic brachialgia, when subjected to rehabilitation obtain a reduction in pain symptoms, an increase in joint mobility, and improvement in the subjective evaluation of the state of health. Greater improvement is obtained by patients when continous passive motion (CPM) is added to the program. CPM can be recommended as a method for kinesitherapy in the rehabilitation of bracchialgia.

Key words:
continous passive motion, bracchialgia

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The application of high-tone power therapy in the rehabilitation of patients with soft-tissue damage to the knee joint

Magdalena Wilk, Wojciech W. Fibiger, Bogusław Frańczuk

Magdalena Wilk, Wojciech W. Fibiger, Bogusław Frańczuk – The application of high-tone power therapy in the rehabilitation of patients with soft-tissue damage to the knee joint. Fizjoterapia Polska 2002; 2(2); 118-121

Abstract
Background. This article presents the preliminary results from the treatment of patients with traumatic knee injuries using high-tone power therapy (HiToP). Material and method. The research involved 10 patients treated in the Traumatic Surgery, Orthopedics, and Rehabilitation Clinic of the Jagiellonian University’s Collegium Medicum in Cracow. The device used for the procedures was a high-tone power therapy apparatus of German manufacture – HiToP – which has been approved for use in European Union countries. The patients received a series of 10 procedures (45 min. each) performed every other day. Results. Improvement was obtained in all patients. Conclusions. The preliminary treatment results for traumatic knee injuries are encouraging.

Key words:
high-tone power therapy, medium frequency current, knee injury

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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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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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Outcome of early rehabilitation with continous passive motion for patients recovering from surgical reconstruction of the knee due to degenerative changes. A preliminary report

Magdalena Wilk, Bogusław Frańczuk, Rafał Trąbka, Wojciech Szwarczyk

Magdalena Wilk, Bogusław Frańczuk, Rafał Trąbka, Wojciech Szwarczyk – Outcome of early rehabilitation with continous passive motion for patients recovering from surgical reconstruction of the knee due to degenerative changes. A preliminary report. Fizjoterapia Polska 2004; 4(2); 163-166

Abstract

Background. Due to the increasing number of surgical knee constructions, there is a constant search for new solutions in surgical techniques and rehabilitation methods. The goal of rehabilitation is to enable the patient to return to normal activities of daily living and recover functional independence as soon as possible. Continuous passive motion (CPM) is one of the methods currently used for patients recovering from surgical reconstruction of the knee. Material and methods. Our research involved 60 patients who had received total endoprostheses due to degenerative changes in the knee, divided at random into two groups. Both groups received the same rehabilitation program except for CPM, which was applied only in group I. All patients were examined twice (before and after surgery) to measure body mass, range of movement in the knee joints (using a Sanders digital inclinometer), and muscle strength in the femoral quadriceps. Results. The outcome was more favorable in group I, where CPM was used, both in terms of the average range of movement and on the VAS scale. The patients in group I also reported greater satisfaction. CPM applied in early rehabilitation for this patients accelerates the recovery process. Conclusions. The introduction of CPM in the early post-surgery period contributes to shortening recover time, increases the range of movement in the operated knee, reduces pain and tension in soft tissues, facilitates healing, and accelerates the resorption of hematomas.

Key words:
total endoprosthesis, range of movement, muscle strength
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An evaluation of the effectiveness of two different thermal therapy procedures in the rehabilitation of patients with degenerative changes in the knee joint

Bożena Jasiak-Tyrkalska, Bogusław Frańczuk, Jolanta Jaworek, Daniela Mosurska

Bożena Jasiak-Tyrkalska, Bogusław Frańczuk, Jolanta Jaworek, Daniela Mosurska – An evaluation of the effectiveness of two different thermal therapy procedures in the rehabilitation of patients with degenerative changes in the knee joint. Fizjoterapia Polska 2004; 4(2); 157-162

Abstract

Background. The aim of our research was to evaluate and compare the analgesic effectiveness of thermal therapy in conjunction with magnetotherapy and active exercises without weight load to improve the functional efficiency of the knee joint with degenerative changes. Material and methods. The level of pain, range of movement, and strength of muscle groups in the knee joint were tested before and after rehabilitation in 48 patients, divided randomly into two groups of 24 people. Results. In both groups there was a reduction in the average level of reported pain, and in the flexion deficit in the knee joint. No changes were noted in the increase of average muscle strength in the flexors and extensors of the knee. Conclusions. In respect to analgesic action and improvement of function in a knee with degnerative changes, a rehabilitation program that includes local cryotherapy proved to be more effective that a program using Sollux lamp irradiation.

Key words:
gonarthrosis, pain, magnetotherapy, cryotherapy
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Osteoporosis risk factors vs. BMD in post-menopausal women

Bożena Jasiak-Tyrkalska, Jolanta Jaworek, Bogusław Frańczuk

Bożena Jasiak-Tyrkalska, Jolanta Jaworek, Bogusław Frańczuk – Osteoporosis risk factors vs. BMD in post-menopausal women. Fizjoterapia Polska 2006; 6(2); 126-132

Abstract

Background. It is commonly known that the main characteristic feature of osteoporosis is bone brittleness, whose complications include fractures. Consequently the most important treatment objective is to prevent fractures by maintaining or increasing bone mass, to prevent falls and injuries, to reduce acute and chronic conditions and to improve physical, and psychosocial functions. The significance of increased physical activity as one of the protective factors that prevent bone fractures in an elderly age needs to be underscored. Osteoporosis becomes a not only a medical challenge, but also a social and economic problem. Such a dynamically growing problem is the reason behind the present paper whose aim is to show if and to what extent selected factors, such as age, body mass and physical activity influence bone mineral density (BMD) in post-menopausal women. Material and methods. 54 women participated in the study, median age 66.8 years. Bone mineral density was determined on the basis of a densitometric test, which was then juxtaposed with osteoporosis risk factors and correlations were analysed. On the basis of body mass and height of study participants the body mass index was calculated (BMI). Data concerning physical activity over the last dozen years or so was obtained during an interview. The level of physical activity was assessed using a four-grade scale developed by the author. Results. A statistically significant negative correlation was shown between BMD and the age of women participating in the study (p<0,01). A similar correlation was observed (p<0,01) between (BMD) an the BMI. A very high correlation (p<0,001) was shown between BMD and physical activity of women participating in the study. Conclusions. An important factor in osteoporosis prevention is physical activity. Age is not necessarily a risk factor in osteoporosis. Moderate overweight has a positive impact on BMD level.

Key words:
osteoporosis, body mass index, physical activity
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Efficacy of two different physiotherapeutic procedures in comprehensive therapy of plantar calcaneal spur

Bożena Jasiak-Tyrkalska, Jolanta Jaworek, Bogusław Frańczuk

Bożena Jasiak-Tyrkalska, Jolanta Jaworek, Bogusław Frańczuk – Efficacy of two different physiotherapeutic procedures in comprehensive therapy of plantar calcaneal spur. Fizjoterapia Polska 2007; 7(2), 145-154

Abstract

Background. A plantar calcaneal spur causes pain in the area of the medial process of the calcaneal tuber. The pain is caused by localised pressure in the region of the plantar aponeurosis attachment to the calcaneal bone. Plantar calcaneal spurs are principally treated by physiotherapy techniques, with ultrasound as the most popular procedure. At present, phonophoresis is more and more frequently used. Phonophoresis is an ultrasound treatment in which the substance between the transducer and the skin is replaced with a medicine in gel form. The aim of this paper is to assess the efficacy of and compare ultrasound- and phonophoresis-based therapeutic procedures for calcaneal spur. Materials and methods. 40 patients treated for plantar calcaneal spur participated in the study. The patients were randomised into two groups: Group A was treated by phonophoresis and group B received an ultrasound treatment. The patients were between 35 and 80 years of age (mean age 57.3 years). The enrolment criteria for the study were: absence of concomitant systemic disease or generalised inflammatory conditions and no history of recent injuries. The following criteria of physiotherapeutic treatment efficacy were adopted for the study: subjective pain intensity using the VAS scale, the range of plantar flexion and supination as well as the strength of muscle groups of the longitudinal arch of the foot. In order to provide better insight, taking into account the risk factors for the calcaneal spur, the BMl as well as Bogdanov’s ankle bone angle, which determines the length of the longitudinal arch of the foot, were determined in both groups. Results. Plantar calcaneal spur patients are usually overweight and suffer from slight longitudinal flatfootedness. A significant reduction of pain intensity was observed in group A (at p<0.001), and in group B (p<0.01). There was also an improvement in both foot flexion and supinetion at p<0.001. The strength of foot flexors and supinators increased significantly in both groups, at p<0.001 in group A and p<0.05 in group B. Conclusions. The clinical profile of calcaneal spur patients mostly includes overweight and slight longitudinal flatfootedness. Phonophoresis is a significantly more effective physiotherapeutic procedure than ultrasound in the physiotherapeutic management of plantar calcaneal spurs.

Key words:

calcaneal spur, treatment, efficacy

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