Trening aerobowy poprawia funkcje poznawcze i funkcjonalne u pacjentów z depresją w stwardnieniu rozsianym. Badanie pilotażowe na podstawie studium przypadku

Marta Niwald, Justyna Redlicka, Elżbieta Miller

M. Niwald, J. Redlicka, E. Miller – Aerobic training enhances cognition and functional status in depressive multiple sclerosis patients. A case-control study-pilot study. Fizjoterapia Polska 2018; 18(2); 96-102

Abstract

Background: The objectives of this study were to assess the effects of aerobic training (AT) on depression, cognition and functional status in 2 groups of multiple sclerosis (MS) patients: with depression syndrome (MS-D) and without depression (MS).
Objectives: a sample of 31 individuals with MS and 28 MS-D performed 30 minutes of AT using lower-extremity ergometer 3×10 min each day, with a 60-minute break for 6 weeks. Both groups were matched for the age and sex.
Material and methods: all examined parameters were assessed before and after AT series with use of Montreal Cognitive Assessment (MoCA), the Beck Depression Inventory (BDI), Activities of Daily Living (ADL) scale and the Expanded Disability Status Scale (EDSS). We analyzed the drop-out rate as a measure of feasibility.
Results: In both groups, the AT session induced a significant improvement in reducing depression (BDI) and cognition impairment (MoCA). However, the changes observed in MS-D patients were significantly greater than those observed in MS patients, especially in BDI and MoCA. There were no statistically significant correlations of EDSS, MOCCA, BDI, ADL, age or gender.
Conclusions: AT appears to be an effective and simple tool for improving cognition and functional status in patients with MS. This study indicates that aerobic training is feasible and could be beneficial for patients with progressive MS.

Key words:
Aerobic training, Multiple Sclerosis (MS), cognition, depression

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Analysis of the effect of comprehensive rehabilitation with stabilometric platform on body balance in patients with multiple sclerosis and after stroke

Justyna Redlicka, Jan Niedzielski, Elzbieta Miller

J. Redlicka, J. Niedzielski, E. Miller – Analysis of the effect of comprehensive rehabilitation with stabilometric platform on body balance in patients with multiple sclerosis and after stroke. FP 2017; 17(4); 18-23

Abstract

Objective. The objective was to evaluate the effect of a comprehensive rehabilitation program on body balance in patients with multiple sclerosis (MS) and after cerebral stroke.
Materials and methods. Tests were performed at the NeurorehabilitationWard of Dr K.Jonscher Municipal Hospital no. 3 in Lodz on randomly selected patients with MS and after stroke. The group included 50 subjects – 30 men and 20 women, aged 32 to 76 years. All the patients were examined twice for body balance with the use of a computerized stabilometric platform. The following parameters were analyzed: the mean number of all sways, the mean number of sways forwards and backwards, as well as to the left and right. All the sway parameters were measured both with eyes closed and open. The results obtained after rehabilitation were compared to those from before the introduction of rehabilitation.
Results. A course of comprehensive rehabilitation of MS patients resulted in a significant reduction of sways with eyes closed (p < 0.001), however less significant with eyes open (p < 0.2). Similarly, a marked improvement was observed in post-stroke patients in the mean number of sways with eyes closed (p < 0.001), whereas with eyes open, the results were not statistically significant (p < 0.02). Conclusions. Comprehensive rehabilitation has a significant effect on the body balance of patients with MS and after stroke. In the trial with the use of a stabilometric platform, better results after a course of rehabilitation were noted inpost-stroke patients. Key words: stabilometric platform, balance, stroke, multiple sclerosis

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The impact of stroke on the power and shortening velocity of the muscles – preliminary report

Joanna Kostka, Andżelika Fajkowska, Elżbieta Miller

J. Kostka, A. Fajkowska, E. Miller – The impact of stroke on the power and shortening velocity of the muscles – preliminary report. FP 2017; 17(2); 16-22

Abstract

Aim: The aim of the study was to determine the difference in power and muscles shortening velocity in patients with a history of stroke and those who have not undergone a stroke as well as to evaluate the determinants of the power and muscles shortening velocity.
Material and Methods: A total of 62 people were enrolled in the study, including 31 patients (9 women and 22 men) after stroke hospitalized in Neurological Rehabilitation Department and 31 people matched for age and sex who did not suffer a stroke. Personal, anthropometric and diseases related data were collected. Muscle power (Pmax) and optimal shortening velocity of the muscles (Vopt) were evaluated by performing two 8-second tests on a Monark type bicycle ergometer.
Results: A significant difference in Pmax and Vopt between groups (p < 0.001) was noted. The average Pmax score in stroke patients was 211.22 W ±134.12, and in the control group 378.76 W ±167.52, and Vopt respectively 58.48 ±18.53 and 78.41 ±17.8 rep./ min. Relationship between age and Pmax as well as Vopt was also obtained. Conclusions: Stroke reduces power and muscle shortening velocity. Power deficit in relation to people who have not suffered a stroke is over 44%, and velocity rate over 25%. The Pmax and Vopt level are affected by age. Key words: hemiplegia, muscles, power, shortening velocity

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Zindywidualizowna terapia polem magnetycznym niskich częstotliwości na przykładzie zespołu de Quervaina / Individualised low frequency magnetic field therapy, using the example of the de Quervain syndrome

Marcin Machnia, Natalia Cichoń, Elżbieta Miller

FP 2015;15(4);116-122

Streszczenie:
W pracy przedstawiono przypadek leczenia zespołu de Quervaina polem elektromagnetycznym niskich częstotliwości (PEMF) według odmiennej procedury od dotychczas stosowanych. Pacjentka z rozpoznanym zespołem de Querwaina lewej dłoni była leczona przez kilka miesięcy w typowy sposób (unieruchomienie, farmakoterpia, fizykoterpia, kinezyterpia) bez znaczącej poprawy.
Z powodu braku oczekiwanego efektu terapeutycznego w zakresie sprawności manualnej jak i zmniejszenia dolegliwości bólowych chora została poddana terapii PEMF z wykorzystaniem biofeedbacku do określenia parametrów terapii. Procedura terapii polegała na użyciu aparatu ONDAMED generującego impuls imitujący potencjał czynnościowy komórek nerwowych z płynną regulacją parametrów (indukcja, częstotliwość, czas) umożliwiających zastosowanie biofeedbacku tętna mierzonego na tętnicy promieniowej. Zastosowana procedura diagnostyczno-terapeutyczna przyniosła po 4 tygodniach poprawę funkcji dłoni oraz ustąpienie dolegliwości bólowych. Wynik leczenia i sposób terapii opisany w pracy skłania do dalszych badań oddziaływania impulsów magnetycznych zbliżonych kształtem do potencjału czynnościowego komórek nerwowych oraz wykorzystania biofeedbacku w celowanej magnetoterapii.
Badania końcowe wykazały znaczną poprawę  ruchomości pasywnej, aktywnej oraz szybkości ruchów badanej ręki. W badaniach wykazano także zmniejszenie poziomu subiektywnych odczuć bólowych chorego oraz powrót funkcji  nerwu łokciowego.

Słowa kluczowe:
zespól de Quervaina, pole elektromagnetyczne niskich częstotliwości, biofeedback, magnetoterapia, ONDAMED

Abstract
Background. The paper presents a case of treatment of the de Quervain syndrome with low frequency electromagnetic field (PEMF), following a procedure different from those applied to date. A patient with de Quervain syndrome diagnosed in her left hand, had been treated in the typical fashion for several months (immobilisation, pharmacotherapy, physiotherapy, kinesitherapy) without any significant improvement.
Due to the absence of the expected therapeutic effect in terms of manual skills, or abatement of pain, the patient was subjected to PEMF therapy with the use of biofeedback, in order to determine the parameters of the therapy. The therapeutic procedure involved using the ONDAMED device, generating an impulse imitating the functional potential of neural cells with a smooth adjustment of parameters (induction, frequency, time), allowing the use of biofeedback of pulse measured on the radial artery. The diagnostic and therapeutic procedure resulted, after 4 weeks, in an improvement of hand function and cessation of pain. The result of treatment and manner of treatment described in the paper encourage further study into the effect of magnetic impulses of waveforms similar to the functional potential of neural cells and the use of biofeedback in targeted magnetotherapy.

Key words:
PEMF, biofeedback, ONDAMED, magnetotherapy, tendovaginitis

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