Zmiany w równowadze ciała spowodowane narażeniem na urazy – badania wieloośrodkowe

Aleksandra Bitenc-Jasiejko, Krzysztof Konior, Anna Walińska, Kinga Gonta, Elżbieta Szkiler, Milena Kraft, Alina Kirpichnikova, Karolina Trąbska, Anna Parus, Tomasz Kupc, Malwina Waleryn-Sagun, Anna Szadkowska, Rafał Mosur, Kamila Mosur, Damian Szyguła, Nicola Książek, Małgorzata Barszczewska, Patrycja Janta, Aneta Mandrosa, Joanna Jarosławska, Klaudia Smolińska, Marta Szewczyk, Agnieszka Byszewska, Anna Morzyńska, Marzena Tuszkowska, Barbara Wrocławska-Tuszkowska, Marek Gapiński, Tomasz Kowalik, Karolina Adamska, Katarzyna Pawliwiec, Jan Głodowski, Konrad Kijak, Małgorzata Kowacka, Danuta Lietz-Kijak

Aleksandra Bitenc-Jasiejko, Krzysztof Konior, Danuta Lietz-Kijak et al – Changes in body balance due to exposure to trauma – multi-center studies. Fizjoterapia Polska 2023; 23(5); 313-326

DOI: https://doi.org/10.56984/8ZG20Bb3T

Streszczenie
Cel. Celem badania było ocenienie wpływu doświadczonego przez osobę zdarzenia traumatycznego na równowagę posturalną i biomechaniczne parametry chodu.
Metodologia badania. Badanie objęło 31 osób (n = 100%), w tym 22 kobiety (nk% = 70.97%) i 9 mężczyzn (nm% = 29.03), w wieku 29-60 lat. Z badania wykluczono osoby z chorobami i dysfunkcjami wpływającymi na równowagę ciała i wzorzec chodu.
Testy równowagi i chodu przeprowadzono przy użyciu pedobarografii (pedobarograf mod. EPS R2, oprogramowanie Biomech Studio v2). Test równowagi przeprowadzano w pozycji stojącej, przez 20 sekund, z próbkowaniem co 1 ms (milisekundę) – liczba próbek podczas jednego testu wynosi 20,000. Testy oceny równowagi i chodu przeprowadzono dwukrotnie. Test I obejmował testowanie w neutralnych warunkach, Test II obejmował testowanie w warunkach, w których osoba była narażona na doświadczone w przeszłości przez siebie zdarzenie traumatyczne (tzw. ekspozycja na “doświadczone traumy”).
Wyniki. Uzyskane wyniki badań wpływu ekspozycji na doświadczone traumy na równowagę ciała podczas stania wykazały istotne różnice w wahaniach ciała w najważniejszych parametrach oceny stabilometrycznej.
Uzyskane wyniki badań wpływu ekspozycji na traumę na chód osoby nie wykazały istotnych różnic między testem w neutralnych warunkach a testem podczas ekspozycji.
Wnioski. (1) Ekspozycja na doświadczone przez osobę traumy znacząco wpływa na równowagę ciała w pozycji stojącej. (2) Badania nie wykazały wpływu ekspozycji na doświadczone traumy na chód osoby w zakresie czasu kontaktu stóp z podłożem oraz na wartości maksymalnego i średniego ciśnienia; Obszar płaszczyzny, na której stopy są umieszczone na podłożu, zmienia się znacząco przed i po ekspozycji na doświadczone traumy. (3) W badaniach wpływu traumy na postawę ciała należy uwzględnić szczegółowe wyniki badań zakresu fluktuacji COP w każdej płaszczyźnie – badanie wykazało, że analiza tylko średnich wyników może znacząco wskazywać błędny wynik w ocenie równowagi ciała.

Słowa kluczowe
stres, trauma, PTSD, równowaga ciała, chód, stabilometria, pedobarografia

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The gait. Part I – the analysis of the gait biomechanics in the rehabilitation

Mirosław Janiszewski, Beata Rechcińska-Roślak, Joanna Błaszczyk-Suszyńska

Mirosław Janiszewski, Beata Rechcińska-Roślak, Joanna Błaszczyk-Suszyńska – The gait. Part I – the analysis of the gait biomechanics in the rehabilitation. Fizjoterapia Polska 2002; 2(4); 311-318

Abstract
In the article the present state of knowledge regarding the gait of human is described. It has been presented what movements are performed in the upper and lower limbs joints while walking and in what position the centre of human gravity is. In the enclosed figures there is stated what biomechanics of the human is like.

Key words:
Gait, Biomechanics, Rehabilitation

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Ground reaction forces of the gait in patients undergoing physiotherapy after articular cartilage surgeries

Andrzej Czamara, Tadeusz Trzaska

Andrzej Czamara, Tadeusz Trzaska – Ground reaction forces of the gait in patients undergoing physiotherapy after articular cartilage surgeries. Fizjoterapia Polska 2006; 6(4); 289-297

Abstract
Background. The goal of our study was the evaluation of the ground reaction forces (N) of vertical component in flat surface gait in patients undergoing 10 to 14 weeks of physiotherapy after chosen surgeries of the knee joint cartilage. Material and methods. We measured ground reaction forces of the gait in 58 people. 31 patients after the carrier surface of knee joint cartilage surgeries and 27 people with no cartilage injuries were examined. When the patients developed individual gait after 10 to 14 weeks of physiotherapy, we measured ground reaction forces of their gait. The examination was carried on a track with, computer programmed, mtd-balance tensometric platforms. Results and Conclusions. Between 10th and 14th week after the surgery, the patients regained the gait. The values of ground reaction forces of the gait during stance phase for the operated limbs were close to the results of healthy limbs. The results did not differ from the results reached by the people with no cartilage injuries and oscillated between 1,19 to 1,21 of body weight. Moreover, minor asymmetry was reported between left and right limbs in groups with no articular cartilage injuries and in patients which did not exceed 5%.

Key words:
physiotherapy, gait, knee joint cartilage, ground reaction forces

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Assessment of kinematics of pathological gait after articular cartillage surgery

Andrzej Czamara, Sławomir Winiarski, Zbigniew Jethon, Andrzej Bugajski, Rafał Szafraniec, Andrzej Zaleski, Wiesław Tomaszewski

Andrzej Czamara, Sławomir Winiarski, Zbigniew Jethon, Andrzej Bugajski, Rafał Szafraniec, Andrzej Zaleski, Wiesław Tomaszewski – Assessment of kinematics of pathological gait after articular cartillage surgery. Fizjoterapia Polska 2007; 7(1); 1-9

Abstract

Background. Thirty two male patients with the full-thickness lesion of articular cartilage on the load-bearing surface of the knee joint (Outerbridge Grade III-IV) were involved in the study. The goal of this paper is the biomechanical assessment of changes in the kinematics of gait of patients after selected articular cartilage surgeries of knee joint examined by the 3D motion analysis system (SIMI Reality Motion Systems GmbH, Germany). Material and methods. Gait of thirty two patients with the articular cartilage surgery of knee joint was analyzed while they underwent 2 out of 4 stages of our original physiotherapy treatment. In order to test the progress of the rehabilitation program the spatial kinematic data of the gait was collected and the angle-time characteristics acquired. The first measurement was taken between the 2nd and 3rd week postoperatively, the second was taken between 6th and 8th week postop. The last measurement was taken between 10th and 14th week postoperatively, when the patient’s gait was fully restored and being improved. The values of step and stride lengths (meters), gait velocity (meters per sec.) and the step cadence (steps per sec.) were monitored as well as the stance and swing ratios (percent of the gait cycle) of the affected and unaffected limb. Range of motion in the knee joint was examined in dynamics and the angles at heel-strike and toe-off measured for both lower limbs. Results. As a consequence of our rehabilitation procedure satisfactory results were obtained individually between 10th and 14th week postop. in test patients with reference to the control group. The spatial gait parameters step and stride lengths have significantly increased and the stance to swing ratio have decreased for the affected limb compared to the first measurement. The gait velocity was found to be doubled. In addition an increase in range of motion in the joints was noticed and the angle characteristics was similar to the one of the control group. Conclusions. The extensive surgical and physiotherapeutic procedures applied in the treatment have improved gait parameters between 10th and 14th week postop in all tested patients.

Key words:
biomechanics, gait, gait disorders, articular cartilage, surgery, rehabilitation
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The influence of external loading on weight compensatory changes and pelvic behaviour during walking in scoliotic children

Olga Nowotny-Czupryna, Krzysztof Czupryna, Anna Brzęk, Małgorzata Domagalska, Andrzej Szopa

Olga Nowotny-Czupryna, Krzysztof Czupryna, Anna Brzęk, Małgorzata Domagalska, Andrzej Szopa – The influence of external loading on weight compensatory changes and pelvic behaviour during walking in scoliotic children. Fizjoterapia Polska 2008; 8(4); 436-444

Abstract
Background. Compensatory changes in the spatial arrangement of body segments are a characteristic sign of the development of scoliosis. Additional external loads may lead to intensification of existing signs in both static and dynamic conditions. The manner of carrying heavy objects on a daily basis is a key factor here. The aim of this paper was to assess some changes in static and dynamic parameters associated with carrying the school pack in children with scoliosis.Material and methods. Thirty-six children aged 8-15 years with low-grade scoliosis were examined. Foot pressure in static conditions was recorded using a force platform without additional loading, and with a 4 kg external load carried in a symmetric or asymmetric manner. Three-dimensional gait analysis was also performed using a Zebris® system. Parameters were registered during walking without and with the external load.Results. Signs of asymmetric foot pressures were observed that intensified during external loading of spine (both symmetric and asymmetric). These changes were not clearly related to body posture parameters. There were also signs of gait asymmetry that intensified during walking with asymmetrical external loading. The most marked changes were observed with respect to pelvis-related gait determinants. The magnitude of changes was related to the manner of carrying the school pack rather than to body posture parameters. Conclusions. External loads intensify the asymmetry of foot pressure distribution as a result of spontaneous and unpredictable compensatory dislocations. The manner of carrying the school pack is not irrelevant in children with scoliosis.
Key words:
scolioses, foot pressure, gait, locomotion, external loading, gait determinants
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PNF method of gait analysis in patients after ischemic stroke

Piotr Lutowski, Łukasz Sielski, Katarzyna Lutowska

Piotr Lutowski, Łukasz Sielski, Katarzyna Lutowska – PNF method of gait analysis in patients after ischemic stroke. Fizjoterapia Polska 2011; 11(2); 143-154

Abstract
Cerebral stroke is one of the most common diseases of the nervous system. Paresis or hemiparesis are the main consequences of this diseases. For patients and their carers, such disorders are burdensome as they affect multiple aspects of everyday life. The study was a research project aimed at determining the effect of gait reeducation using PNF approach in patients with the history of ischemic cerebral stroke.he sample comprised 23 patients with the history of ischemic cerebral stroke, admitted to the rehabilitation unit. The patients were qualified for the study based on Berg Balance Scale, informed consent and the value of weight bearing symmetry index for the lower limbs.The study consisted of:• tandem balance test used to calculate weight bearing symmetry index for the lower limbs,• walk test at a distance of 20 m. to determine gait velocity and step length,• Subjective assessment of individual gait phases based on observation,• Berg Balance Scale.Improvement in all the studied parameters was noted in the studied sample.Proprioceptive Neuromuscular Facilitatiobn (PNF) is an effective method of rehabilitation for patients with the history of ischemic cerebral stroke. It contributes to improvement in the qualitative and quantitative parameters of gait.
Key words:
cerebral stroke, Rehabilitation, PNF method, Gait
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Body Weight Support Treadmill Training – a systematic review of meta-analyses

Marcin Błaszcz, Beata Stach

M.Błaszcz, B. Stach – Body Weight Support Treadmill Training – a systematic review of meta-analyses. Fizjoterapia Polska 2020; 20(1); 66-77

Abstract
Aim. Although the effectiveness of Body Weight Support Treadmill Training has already been confirmed in various patients, its superiority over other physiotherapeutic interventions is unclear. The aim of this review was to compare the effectiveness of BWSTT in relation to other methods in various patients group.
Material and methods. A systematic review of meta-analyses was performed with: Cochrane Database of Systematic Reviews, MEDLINE and PEDro from the beginning until January 2019. 1775 publications were identified, of which 4 metaanalyses and one systematic review were included.
Results. BWSTT was more effective than other physiotherapeutic interventions in short-term increasing gait endurance and speed in stroke patients walking independently, and in improving functionality after hip replacement. In terms of: increasing the chance of independent walking, improving gait endurance and speed in dependent stroke patients; increasing walking distance and speed after a spinal cord injury and increasing the walking speed and cadence and stride length in Parkinson’s disease BWSTT was not more effective than standard physiotherapy.
Conclusion. The use of BWSTT may be beneficial for stroke patients who walk independently and at people after hip replacement. In the other areas, insufficient evidences were found.

Key words:
Body Weight Support Treadmill Training, gait, body weight support, systematic review, meta-analysis

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Wpływ odciążenia masy ciała poprzez system Parestand na kinematykę chodu – badanie pilotażowe

Beata Stach, Marcin Błaszcz

B. Stach, M. Błaszcz – Influence of body weight support via Parestand system on gait kinematic — a pilot study; Fizjoterapia Polska 2018; 18(1); 84-94

Abstract

Background. Many studies have recently confirmed the effectiveness of the Body Weight Support (BWS) Treadmill Training in healthy subjects and various clinical conditions. It is rarely practised method in Poland. No study about influence of Polish Parestand system on kinematic parameters of gait have been reported to date.
Material and Methods. The kinematics of the right lower limb of a healthy woman was analysed, while walking on the treadmill without support (0%) and with 25% and 50% BWS via the body weight support system Parestand at velocity of 3; 4 and 5 km/h in the initial contact (IC), loading response (LR), terminal stance (TSt) and mid swing (MSw) phase. The joint angle parameters were collected using the Noraxon system and then subjected to statistical analysis.
Results. BWS via Parestand (25% and 50%) significantly changed hip kinematics at each velocity. Knee kinematics significantly differed at 25% BWS in IC and LR, and at 50% BWS in IC, LR, TSt and MSw at each velocity. Ankle angular values did not differ significantly at 25% BWS at any velocity, and at 50% BWS were significantly different only at 3 km/h in all tested phases.
Conclusions. Increasing of BWS changes gait kinematic in a bigger extent. Even a 25% of body weight support via Parestand could change hip kinematics during gait. 25% BWS via Parestand could change knee kinematic in the early gait phases without modifying the ankle kinematics. A study in this area should be carried out on a larger number of subjects.

Key words:

gait, body weight support, Gait Kinematic, Body Weight Supported Treadmill Training

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The use of pedobarographic examination in children – own experience and review of literature

Jacek Lorkowski, Oliwia Grzegorowska, Ireneusz Kotela

J. Lorkowski, O. Grzegorowska, I. Kotela – The use of pedobarographic examination in children – own experience and review of literature. FP 2014; 14(4); 46-51

Abstract

A non-invasive method, that can be used to describe the underfoot pressure distribution during stance and gait, is pedobarography. This examination helps to describe biomechanics of motor system, especially foot pathologies, among children and adults. It has been used to assess and monitor the progress and effectivness of undergone treatment. In this article we describe chosen issues of pedobarographic examination in diagnostics and treatment of the motor system in children, in whom an appropriate therapy can be more effective than in adults.
In our opinion, pedobarography should be used more often and widely than now. Together with clinical and radiological examination, it can simply complement standard diagnosctics.

Key words:
foot, diagnostics, pressure, gait, children

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Body Weight Supported Treadmill Training with Parestand system as walking therapy of patients early after stroke: a pilot study

Beata Stach, Marcin Błaszcz, Aleksandra Bober, Mariola E. Wodzińska, Joanna Zyznawska

B. Stach, M. Błaszcz, A. Bober, M. E. Wodzińska, J. Zyznawska – Body Weight Supported Treadmill Training with Parestand system as walking therapy of patients early after stroke: a pilot study. FP 2016;16(2);54-63

Abstract

Background. Body Weight Supported Treadmill Training (BWSTT) is high intensive and task-specific gait therapy for stroke patients. Effectiveness of BWSTT is repeatedly proven, however superiority of that training over overground walking is often contested. It is rarely practised and investigated method in Poland.
Patients and Methods. 20 patients in the early post-stroke rehabilitation phase able to walk. All patient participated in traditional physiotherapy based on Bobath and PNF concepts. Experimental group (10 people) additionally received Body Weight Supported Treadmill Training. Control group (10 people) additionally received overground walking. Baseline and postintervention assessments included Berg Balance Scale, Timed Up & Go, 10 m Time Walking Test and 6 Minute Walk Test.
Results. Both groups showed statistically significant improvement in all outcome measures (P<0,05). Group BWSTT increased distance by 108,4±75,7 m and control grouop by 57±51,3 m in 6 Minute Walk Test. Difference between the groups was not statistically significant (p=0,28). Group BWSTT shortened time in Timed Up & Go by 9±1,4 seconds and control group by 2,7±1,1 seconds. Difference between the groups was not statistically significant (p=0,63). Group BWSTT improved by 7,0±3,7 points, and control group by 6,6±4,4 points in Berg Balance Scale. Difference between the groups was not statistically significant (p=0,88). Group BWSTT increased gait velocity by 0,25±0,13 m/s, and control group by 0,28±0,13 m/s. Difference between the groups was not statistically significant (p=0,96).
Conclusions. Either Body Weight Supported Treadmill Training or overground walking could improve balance, reduce risk of falls, increase endurance and velocity of gait in walking subacute stroke patients. BWSTT could have tendency to more effective increasing gait endurance.

Key words:
stroke, hemiparesis, physiotherapy, rehabilitation, gait

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