针对不同部位以深度电磁刺激治疗腰椎骶部疼痛的有效性评估

Agnieszka Przedborska, Małgorzata Kilon, Agnieszka Leszczyńska, Małgorzata Misztal, Jan W. Raczkowski

A. Przedborska, M. Kilon, A. Leszczyńska, M. Misztal, J. W. Raczkowski – Assessment of the effectiveness of deep electromagnetic stimulation in the treatment of low back pain depending on the area of application. Fizjoterapia Polska 2019; 19(2); 148-156

摘要
简介。与骨盆底肌肉张力降低相关的中枢稳定机制紊乱有可能是腰椎疼痛综合征产生的原因。研究目的在评估对脊椎疼痛妇女的腰椎骶部或骨盆底肌肉进行深度电磁刺激的效用。
材料和方法。共109名脊椎骨关节炎女性患者参与研究,分为两组进行。研究组中有45名女性,治疗周期包括对骨盆底肌肉进行10次的深度电磁刺激。对等组中有64名女性,其治疗应用部位在腰部周围。以VAS量表为基础评估治疗的有效性及运动功能和自理能力的评估。
结果。观察到两组均在以VAS量表为基础的脊椎疼痛上显著降低 – Me(IQR)为:研究组在治疗前5 (4-7)及治疗后2 (1-3),而对等组在治疗前6 (4-7)及治疗后3 (2-4)。移动和日常活动能力也获得显著改善,然而获得的治疗效果不持久,研究组中半数患者的镇痛效果最多维持2个月(IQR: 1-4),对等组则最多4个月(IQR: 2-6)。
结论。无论应用的部位为何,深度电磁刺激可减轻患腰椎骶骨综合症女性的疼痛并改善其步态功能和自理能力。2. 对腰椎骶骨周围施以治疗将使镇痛时间持续较久。

关键词:
腰椎疼痛、骨关节炎、骨盆底肌肉、电磁刺激

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影响髋关节内置假体患者功能敏捷的因素

Małgorzata Kilon, Agnieszka Przedborska, Joanna Kostka, Agnieszka Leszczyńska, Jan W. Raczkowski

M. Kilon, A. Przedborska, J. Kostka, A. Leszczyńska, J. W. Raczkowski – Factors influencing functional performance of patients after hip joint arthroplasty. Fizjoterapia Polska 2019; 19(2); 122-128

摘要
研究目的。研究目的在评估影响单侧髋关节成形术对患者功能状态的影响因素。
平衡和步态功能评估由下列测试进行:Tinetti、起立测试(Timed Up and Go, TUG)及以两种量表为基础计算的对称性指数(WS)。在平坦表面和楼梯行走时的疼痛感度及僵硬程度以李克特量表评估。进行简单和复杂日常活动能力评估时使用ADL Katz(Activities of Daily Living)和IADL Lawton(Instrumental Activities of Daily Living)量表,并以数值标示方式进行自我生活质量评估,此外也计算体重指数(BMI)。
材料和方法。共50名29至88岁间(平均年龄66.7 + 13岁)有单侧髋关节假体的患者(其中33名女性、17名男性)参与研究。
结果。患者年龄、疼痛及僵硬程度决定了大多数的测试结果和功能量表。疾病数量多的患者在Tinetti测试中的结果较差,只有上下楼梯时的强烈疼痛影响WS的结果。提出有较强烈疼痛和晨起僵硬的患者对其生活质量有较差评价。
结论。
年龄、晨起疼痛和僵硬对单侧髋关节假体患者的功能状态和生活质量有影响。BMI和手术后所经过的时间对患者状态无影响。

关键词:
髋关节成形术、生活质量、功能状态

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高频电流在膝关节骨性关节炎患者治疗中的应用

Agnieszka Przedborska, Ewa Pomorska, Marcin Świątczak, Małgorzata Staniszewska, Małgorzata Misztal, Jan W. Raczkowski

A. Przedborska, E. Pomorska, M. Świątczak, M. Staniszewska, M. Misztal, J. W. Raczkowski – Application of high frequency currents in treatment of patients with knee osteoarthritis. Fizjoterapia Polska 2018; 18(4); 112-121

摘要

前言。内源性热源于膝关节骨性关节炎患者治疗中广泛使用,技术的发展促成高频电流新方法的应用。
研究目的在评估治疗膝关节骨性关节炎患者的各种应用方法中,使用高频电流的有效性。
材料及方法。该研究针对111名膝关节骨性关节炎患者进行,将其分为二组,研究组中有61名,他们接受使用Thermo TK 设备的高频电流治疗。对照组中有50人,他们接受短波透热治疗。疗效根据VAS量表、莱蒂宁量表、膝关节周长和活动范围进行评估。
结果。两组经治疗后均确认根据莱蒂宁量表(治疗前后的中数(四分位间距IQR):研究组:7(6-8)分对3(2-6)分,对照组:8(6-10)分对3.5(2-7)分)所测量的疼痛减轻具统计学意义(p<0.0001)。此外,在研究组中观察到具统计学意义(p=0.0031)的止痛药使用频率降低。治疗后,两组根据VAS量表测量在平坦表面行走和上楼梯时的疼痛症状缓和具统计学意义(p<0.0001),膝关节周长也减少(p<0.0001),而屈曲运动范围却显著增加(p<0.0001)。两组的镇痛效果持续时间类似。 结论。1. 无论何种类型的应用,高频电流都能减轻骨性关节炎患者的疼痛并改善其膝关节运动范围。2. 两组治疗的镇痛效果均不持久。 关键词: 膝关节、骨关节炎、高频电流  

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用选定量表和测试评估脑瘫儿童的功能状态

Małgorzata Kilon, Martyna Ruszkiewicz, Jan W. Raczkowski

M. Kilon, M. Ruszkiewicz, J. W. Raczkowski – Evaluation of functional status of children with cerebral palsy using selected scales and tests. Fizjoterapia Polska 2018; 18(4); 86-93

摘要
研究目的。研究目的在使用选定的量表和测试,以评估脑瘫儿童(MPD)的功能状态并分析影响结果的因素。
材料和方法。有33名4至18岁间被诊断出患有MPD的儿童参与研究,他们在特定的罗兹省康复中心就诊,研究工具为原创问卷及用于评估粗大运动机能测量(GMFM)的大肌动活动及粗大运动机能分类系统(GMFCS),用于手动能力分类系统的小肌动活动。
在统计分析中,变量对等级结果的影响是根据皮尔逊和斯皮尔曼的相关系数确定的,具体取决于分布。定性变量对儿童体适能的影响评估中使用ANOVA方差分析或克-瓦单因子变易数分析。
结果。7名儿童显示出零或非常低的体适能,他们是患有四肢瘫痪的儿童,测试结果受怀孕时间长短、出生体重、年龄及身高和语言逻辑接触的影响。性别及伴随癫痫等定性变量之间没有关系,能动性大小之间则有强相关性。
结论:在所使用的量表和测试中,受试儿童呈现出不同程度的体适能,其获得的分数与MPD类型紧密相关。语言逻辑接触佳的儿童在评估量表中取得更好的分数,父母对儿童体适能的客观评估与测试结果符合。

关键词:
小儿脑瘫、MACS、GMFM、GMFCS

 

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骨盆底肌肉的深层电磁刺激对压迫性尿失禁患者腰骶部不适的影响

Agnieszka Przedborska, Małgorzata Kilon, Małgorzata Misztal, Jan W. Raczkowski

Agnieszka Przedborska, Małgorzata Kilon, Małgorzata Misztal, Jan W. Raczkowski – The effect of deep electromagnetic stimulation of pelvic floor muscles on low back pain in female patients with stress urinary incontinence. Fizjoterapia Polska 2018; 18(3); 46-54

摘要
研究目的。研究目的在评估骨盆底肌肉的深层电磁刺激对压迫性尿失禁女性患者腰骶部不适的影响。
材料及方法。该研究针对85名患慢性腰骶部疼痛综合征及尿失禁的女性进行,施以10次疗程系列的骨盆底深层电磁刺激,治疗的有效性评估以VAS量表、日常生活功能评估及尿失禁症状的严重程度变化为基础。
结果。治疗后可发现以VAS – Me(IQR) 量表为基础的脊柱疼痛严重程度在统计上显著减少,治疗前为5(4-7),治疗后为3(1-4),其移动能力及日常活力在统计上也有显著改善。尿失禁发生的频率在统计上显著减少且尿量也减少。所获得的疗效不具持久性,半数女性患者在止痛效果和尿失禁症状改善上只持续最多两个月(腰骶部疼痛的IQR:1-3个月,尿失禁症状的IQR:1-2个月)。
结论。1. 骨盆底肌肉的深层电磁刺激对腰椎骶椎部疼痛的缓和及压迫性尿失禁症状减少具有影响。2. 改善效果并不持久。

关键词:
腰椎疼痛、尿失禁、骨盆底肌肉、电磁刺激

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The impact of BMI value on the Wejsflog index, and the foot pain assessment

Mateusz Curyło, Magdalenna Wilk-Frańczuk,
Marlena Rynkiewicz-Andryśkiewicz, Jan W. Raczkowski

M. Curyło, M. Wilk-Frańczuk, M. Rynkiewicz-Andryśkiewicz, J. W. Raczkowski – The impact of BMI value on the Wejsflog index, and the foot pain assessment. FP 2014; 14(3); 22-34

Abstract

Introduction. The foot is not only the organ having great stability and overload endurance, but also one being a dynamic spring and, due to this feature, functioning as a shock absorber.
Aims of the work
1. Determining if there exists a correlation between Wejsflog index and the body mass of patient;
2. Determining if the body mass is a risk factor for the transverse arch lowering;
3. Determining if the body mass and the structure of the transverse foot arch influence the appearance of the foot pain ailment.
Material and methods. The research was carried out in Krakow in 2012-2013 period. The examined group of the research consisted of 249 patients, including 178 women and 71 men, aged 21-88 (average age of 52 years).
Results. P-value of the chi-square test is less than 0.05, thus the value of Wejsflog index significantly depends on the BMI: the higher the BMI, the more frequently the transverse arch lowering occurs. P-value of the Mann-Whitney test is greater than 0.05, thus the evaluation of the pain strength is statistically not dependent on the Wejsflog index.
Conclusions
1. The influence of the correlation between the body mass index (BMI) and the frequency of occurrence of the transverse foot arch lowering measured by the Wejsflog index has been proven.
2. Increased body mass defined by the body mass index (BMI) as overweight and obesity is a significant risk factor for the transverse foot arch lowering.
3. Increased body mass index as well as the transverse foot arch lowering measured by the Wejsflog index have no influence on the occurrence of the foot pain ailment.

Key words:
body mass index (BMI), Wejsflog index, transverse arch of the foot

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Evaluation of the therapeutic effects in the patients with the glenohumeral joint dysfunction treated according to Brian Mulligan concept and with the pectoral girdle muscle tapping as well as circumarticular injections

Mateusz Curyło, Katarzyna Cienkosz, Jan W. Sosnowski, Andrzej Szczygieł, Irena Szczepańska, Piotr Wróbel, Magdalena Wilk-Frańczuk,  Jan W. Raczkowski

M. Curyło, K. Cienkosz, J. W. Sosnowski, A. Szczygieł, I. Szczepańska, P. Wróbel, M. Wilk-Frańczuk,  J. W. Raczkowski – Evaluation of the therapeutic effects in the patients with the glenohumeral joint dysfunction treated according to Brian Mulligan concept and with the pectoral girdle muscle tapping as well as circumarticular injections. FP 2017; 17(1); 116-124

Abstract

Introduction. Sedentary lifestyle connected with the civilizational development and the work in sitting position cause glenohumeral joints dysfunction, most often in the form of overload-pain ailments.
Purpose of this study. The purpose of this study was to compare the physiotherapeutic effects with the application of mobilization with motion according to Brian Mulligan and the pectoral girdle muscle tapping, and the used circumarticular injections.
Material and Methods. The research included 27 patients. The first group (16 persons) was treated with the circumarticular injections of medicines of the corticosteroids group. In the second group (11 persons) the manual therapy according to Brian Mulligan’s concept and the muscle tapping were used. The examinations were performed before the therapy and after three weeks. The used measurements included the shoulder pain and disability index SPADI, provocative tests HIN, HIB, POP, Job, “painful arc” (70°-120°), “belly–press”, goniometric measurement and the subjective pain feeling at the night time. In order to check if the used therapy type had any effect on the upper limb function improvement, the statistical analysis was made in the variance with a_mixed scheme, where the inter-group factor was the type of therapy, and the intra-group factor was the measurement moment: before and after completion of the therapy. Data were processed using Microsoft Excel and Statistica software.
Results. The applied therapy methods influenced improvement of the glenohumeral joint movement range in both groups. The group 2 had better results in reduction of periodic pain ailments and sleep disturbances.
Conclusions. Both used therapeutic programs improves functioning and reduce pain ailments in the investigated group, however the use of 2 therapeutic techniques in the group 2, according to Mulligan’s concept and the muscle tapping, brought significantly greater improvement in the clinical condition evaluation and in the patients’ subjective assessment.

Key words:
painful shoulder syndrome, manual therapy, physiotherapy

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Evaluation of the lumbar spine pain syndromes frequency of occurrence among office and physical workers

Mateusz Curyło, Alicja Bielańska,  Jan W. Raczkowski

M. Curyło, A. Bielańska,  J. W. Raczkowski – Evaluation of the lumbar spine pain syndromes frequency of occurrence among office and physical workers. FP 2017; 17(1); 28-36

Abstract
Purpose of this study. The purpose of this study was to investigate frequency of the lumbar spine pain syndromes in the group of persons that perform office work and physical work. The pain effect on the investigated everyday lives was also evaluated.
Material and methods. The research was conducted using the Revised Oswestry Low Back Pain Disability Scale. The questions included in the questionnaire concerned everyday life activities. The questioned persons also subjectively assessed the pain intensity and the intensity change.
Conclusions. The ailments relating to the lumbar spine section appear in different occupations and they affect the workers’ everyday lives. More difficulties in the everyday life appear among the office workers, where the pain restricts their walking, lying or sleeping. Implementation of some physical activity reduces the ailments.

Key words:
lumbar spine section, physical work, office workers

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Rehabilitation treatment of 11-years-old boy with Pierre Robin Syndrome – a case study

Izabela Wilmańska, Jan W. Raczkowski

I. Wilmańska, J. W. Raczkowski – Rehabilitation treatment of 11-years-old boy with Pierre Robin Syndrome – a case study. FP 2017; 17(1); 6-13

Abstract

Goal. The aim of the study was to describe a patient with Pierre Robin Syndrome (PRS), with delayed psychomotor development and evaluation of the patient after the physiotherapy procedure.
Materials and Methods. The authors describe an 11-year-old patient suffering for Pierre Robin syndrome with muscle weakness and severe perinatal loads. The patient postural strength was evaluated by testing the antigravity muscles. The gait effectiveness was measured by using a 10 m walk test and physical performance using Ruffie’s test.
Results. Intensive rehabilitation, well-chosen exercises and accurately set of kinesitherapeutic objectives have well affected the condition of a patient with developmental deficits, which is a Pierre Robin syndrome.
Conclusions. In supporting children with rare disorders such as Pierre Robin syndrome it is necessary to take the earliest possible rehabilitation. Patient care should be long-term and should be interdisciplinary.

Key words:
Pierre Robin syndrome, psychomotor retardation, muscular weakness

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Evaluation of body balance in patients with transverse flat foot and the related falls

Sylwia Czesna, Jan W. Raczkowski

S. Czesna, J. W. Raczkowski – Evaluation of body balance in patients with transverse flat foot and the related falls. FP 2015; 15(3); 90-96

Abstract

Introduction. Transverse flat foot is a very often occurring foot defect, the most common in women wearing high-heeled shoes. It is the most common cause of musculoligamentous foot failure, which increases the risk of falls, threatening the efficiency of adults and the elderly. The ability to maintain a balance results from proper functioning of the so-called deep sensation of the human body, psychophysical coordination and strong muscles. Muscle weakness especially of lower limbs increases the risk of imbalance, thereby jeopardizing the fall. Improper passing burden on a flat foot makes it more difficult to maintain balance.
Material and methods. The study included 28 patients with transverse flat foot and 21 patients with normal foot arch at the age of 52±11.5
Results. Analysis of the tested parameters revealed that disturbances to maintain the balance with the transverse flat foot occurs in 68% (n= 9) subjects, and only 32% (n=9) of the test was within the normal range. In contrast, in patients with a normal arch feet imbalance occurs in 29% (n=6) subjects and 71% (n=15) subjects were in the standard range.
Conclusions. In this study it was we demonstrated that imbalance in patients with transverse flat foot is of 2:1 higher than in patients with normal arch feet. The results show that people with the transverse flat foot are more vulnerable to imbalances which result in falls.

Key words:
transverse flat foot, balance, motor coordination

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