Sacro-lumbar orthosis in lower back pain syndromes – literature review

Mateusz Curyło, Tomasz Urbański, Agnieszka Ciukszo, Katarzyna Placek, Dariusz Lusina, Marcin Mikos, Jan W. Raczkowski


Mateusz Curyło, Tomasz Urbański, Agnieszka Ciukszo, Katarzyna Placek, Dariusz Lusina, Marcin Mikos, Jan W. Raczkowski – Sacro-lumbar orthosis in lower back pain syndromes – literature review. Fizjoterapia Polska 2022; 22(3); 164-168

Abstract
Purpose of study. The purpose of this study is to analyze the effect of sacral-lumbar orthoses on the occurrence of pain in patients with low back pain (LBP) and the effects of these orthoses on the muscles that stabilize the trunk based on the available literature.
Methods. For the purpose of this study, the following databases were searched: Pubmed, Scopus, ScienceDirect, Medline, and others using the Google Scholar search engine using the following keywords: low back pain, lbp exercise, low back pain epidemiology, low back pain orthosis, low back pain therapy, LBP treatment, lumbar sacral orthosis.
Results. 26 of the 92 articles searched by the above method were analyzed in relation to the subject of the use of sacral-lumbar orthoses in patients with spinal pain syndrome. The analysis did not show that wearing a corset negatively affects muscle strength. Most current studies recommend using a corset in combination with exercise and/or pharmacotherapy for LBP.
Conclusion. There are not enough studies to conclusively determine the effect of lumbar sacral orthoses on the sensation of pain in the lumbar spine. Among the main limitations of the analyzed studies are difficulty in measuring pain, as pain is a subjective sensation, and the significant number of possible causes of LBP, which are sometimes difficult to specify.

Key words:
sacral-lumbar orthosis, spinal pain syndrome, lower back pain

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3D printed orthosis supporting rehabilitation of children with nervous system disorders

Agnieszka Ciukszo, Mateusz Curyło, Katarzyna Placek, Dariusz Lusina, Jan W. Raczkowski


Agnieszka Ciukszo, Mateusz Curyło, Katarzyna Placek, Dariusz Lusina, Jan W. Raczkowski – 3D printed orthosis supporting rehabilitation of children with nervous system disorders. Fizjoterapia Polska 2022; 22(3); 52-58

Abstract
The main task of orthoses in neurological diseases is stabilization, correction and improvement of gait function. Orthoses actively support the work of muscles by proper alignment of individual body segments in relation to each other to facilitate the performance of the planned function. During upright standing, the task of the orthosis is to keep the upper ankle in a fixed, intermediate position, usually at an angle of 90°. This increases the base of support provided by the feet flat on the ground. Stabilization in the joints gives a chance to maintain the correct length of the muscles, and thus protects against contractures. Individual orthoses are used during upright standing and to improve the gait function with dedicated footwear. The brace widens the contour of the foot, so the footwear for orthoses is usually wider than the standard one, but it cannot be longer than the brace. One of the leading guidelines in gait analysis used in children with gait disorders are the criteria adopted by the Rancho Los Amigos Hospital. Despite the complexity of the problems with gait that patients report to a physiotherapist, a simple strategy should be adopted when it comes to securing with the orthosis. The role of orthopedic equipment is to support muscle failure by obtaining a stable stance phase.

Key words:
3D printing, 3D orthoses, CP (cerebral palsy), spina bifida, SMA, gait analysis

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Life quality of patients with idiopathic scoliosis treated with Chenêau Brace

Tomasz Urbański, Mateusz Curyło, Karina Rożek, Dariusz Lusina, Katarzyna Placek, Jan W. Raczkowski


Tomasz Urbański, Mateusz Curyło, Karina Rożek, Dariusz Lusina, Katarzyna Placek, Jan W. Raczkowski – Life quality of patients with idiopathic scoliosis treated with Chenêau Brace. Fizjoterapia Polska 2022; 22(2); 136-143

Abstract
Objective. The main objective of this study was to determine the effect of wearing a Chêneau brace on the quality of life of patients with idiopathic scoliosis.
Methodology. The study used a short questionnaire that consisted of 12 questions – 4 questions about demographics and 8 questions about quality of life. The investigated aspects of life included difficulty in performing daily activities, feelings of embarrassment, sleep discomfort, irritability, and patients’ perceived benefits of this treatment procedure. Questionnaires were filled during follow-up visits. The study was conducted on a group of 30 patients aged 9–16 years treated for at least 6 months. Among the respondents there were 22 females and 8 males.
Results. Despite the small study group, the results of the statistical analysis confirmed the hypothesis that the brace significantly affects the quality of life of patients and has a greater impact on the quality of life of the female gender due to the disruption of aesthetics and the associated sense of shame. An association was observed between the sense of shame related to wearing a brace and the desire to “hide” the brace under clothing, as well as the perception of the benefits of wearing a brace and a lower sense of shame.
Conclusion. In the processes of rehabilitation and treatment of the patient with idiopathic scoliosis, a holistic approach that considers not only activities related directly to physiology, but also to patients’ well-being and quality of life is important.
Key words:
idiopathic scoliosis, Chêneau brace, quality of life
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Orthotic management in the rehabilitation of children with plano-valgus foot

Agnieszka Ciukszo, Mateusz Curyło, Ewa Kucharska,Marcin Mikos, Jan W. Raczkowski

Agnieszka Ciukszo, Mateusz Curyło, Ewa Kucharska,Marcin Mikos, Jan W. Raczkowski – Orthotic management in the rehabilitation of children with plano-valgus foot. Fizjoterapia Polska 2021; 21(5); 124-131

Abstract
Plano-valgus foot is a common three-plane deformity that appears at developmental age. It is characterized by the eversion of the calcaneus in relation to the tibia, foot pronation and lowering of the medial longitudinal arch under load. Joint hypermobility and significant body weight are believed to increase the prevalence of plano-valgus foot at all ages. There is no consensus on the proper management of flat feet. This disagreement is primarily due to the fact that there is no clear-cut approach to distinguishing pathological or physiological flat feet and to determining who needs treatment. One of the methods of supporting foot correction is the use of orthopaedic equipment in the form of shoe insoles or SMO/RING orthoses. The introduction of repositioning in the lower ankle joint is intended to restore the natural foot support system and to reduce the compensation at higher levels in the joints of the lower limbs, in the pelvis and torso.
Key words:
plano-valgus foot, posture defect, orthopaedic insole, orthosis
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Medical records in the practice of a physiotherapist. Legal and administrative aspects

Tomasz Pęcherz, Mateusz Curyło, Marcin Mikos, Marlena Rynkiewicz-Andryśkiewicz, Ewa Kucharska, Jan W. Raczkowski

T. Pęcherz, M. Curyło, M. Mikos, M. Rynkiewicz-Andryśkiewicz, E. Kucharska, J. W. Raczkowski – Medical records in the practice of a physiotherapist. Legal and administrative aspects. Fizjoterapia Polska 2021; 21(4); 226-228

Abstract
Medical records are very often treated by medical staff as an additional, unpleasant and unnecessary duty. However, it is currently the basic, undeniable source of defence against all claims of patients, both formal, regarding the correctness of the records, and substantive, related to the allegations of medical malpractice during the provision of medical services.
Key words:
medical records, malpractice, patient rights, GDPR, responsibilities of a physiotherapist
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Non-invasive treatment of plagiocephaly with the use of corrective helmets in infants

Agnieszka Ciukszo, Mateusz Curyło, Marcin Mikos, EwaKucharska, Jan W. Raczkowski

A. Ciukszo, M. Curyło, M. Mikos, E. Kucharska, Jan W. Raczkowski – Non-invasive treatment of plagiocephaly with the use of corrective helmets in infants. Fizjoterapia Polska 2021; 21(4); 32-41

Abstract
The use of skull correction is controversial, and treatment recommendations and reporting of results vary. The most commonly observed deformities of the skull are: plagiocephaly, brachycephaly and scaphocephaly. Treatment includes repositioning, physical therapy, and orthotic treatment with an adapted cranial remoulding orthosis (CRO). Positional plagiocephaly should be differentiated from torticollis, which is also one of the main causes of this deformity. Cranial remoulding orthosis yields better and faster results in younger patients, with age the degree of correction slows down with age. CRO is most effective when initiated before the 5th month of age. Apart from positioning therapy, physiotherapy and the use of a CRO shortens the treatment time and improves the results in severe cases of head asymmetry.
Key words:
plagiocephaly, brachycephaly, corrective helmets, infant rehabilitation
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Long-term evaluation of the quality of life of patients with osteoarthritis treated conservatively and surgically

Marcin Świątczak, Aneta Nowicka, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski

Marcin Świątczak, Aneta Nowicka, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski – Long-term evaluation of the quality of life of patients with osteoarthritis treated conservatively and surgically. Fizjoterapia Polska 2021; 21(3); 198-204

Abstract
Introduction. Osteoarthritis of the hip joint is one of the most common chronic diseases of the locomotor system. Total hip replacement (THR) is a treatment option of choice alongside conservative treatment. The aim of the study was the long-term assessment of the quality of life of patients after total hip replacement surgery and after conservative treatment.
Material and methods. The study group consisted of 35 patients diagnosed with many years of osteoarthritis of the hip who underwent THR with posterolateral surgical approach. The assessment was carried out at the Department of Orthopedics and Traumatology of the University Teaching Hospital WAM – CSW in Łódź. The control group consisted of 15 patients with long-term osteoarthritis of the hip, treated conservatively. Medical data were obtained from the history of the disease and the author’s questionnaire, while the World Health Organization Quality OF Life (WHOQOL) – BREF questionnaire was used to assess the quality of life.
The obtained results were statistically analyzed with the use of MS Office and the Student’s T-test, considering the results below p <0.05 as statistically significant.
Results. The assessment of domains was similar in both groups, the greatest dissonance was observed in the assessments of the somatic and social domains. Based on WHOQOL-BREF questionnaire, the majority of patients in the study group rated the quality of life from 60% to 70% of the maximum value, the highest psychological sphere, the least somatic. In the control group, the social domain obtained 78% of the maximum value, other domains – 74% of the maximum value.
Conclusions. Patients treated conservatively assessed their quality of life higher in all domains than patients who underwent THR. In both studied groups, the “positive” variant of the answer was the most frequently chosen in the WHOQOL-BREF questionnaire.
Key words:
quality of life, osteoarthrotic hip disease, alloplasty
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Legal protection of the physiotherapist as a profession of public trust

Marcin Mikos, Mateusz Curyło, Marlena Rynkiewicz-Andryśkiewicz, Tomasz Pęcherz, Ewa Kucharska, Jan. W. Raczkowski

Marcin Mikos, Mateusz Curyło, Marlena Rynkiewicz-Andryśkiewicz, Tomasz Pęcherz, Ewa Kucharska, Jan. W. Raczkowski – Legal protection of the physiotherapist as a profession of public trust. Fizjoterapia Polska 2021; 21(3); 194-196

Abstract
Physiotherapists are regarded as one of the medical professions of public trust. The Act on Physiotherapist Occupation establishes physiotherapists as a medical occupation of public trust. Medical professions of public trust, such as doctors, nurses, and paramedics, have special legal protection not available to physiotherapists. The Act on Physiotherapists has not defined the physiotherapist as a civil servant. It directly deprives physiotherapists of special legal protection that is assigned to civil servants.
Key words:
Physiotherapist – medical profession of public trust, legal protection of physiotherapist, civil servant, the danger of practising physiotherapy
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Comparative analysis of the functional status of women with osteoarthritis of the hip or knee joint

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

Małgorzata Kilon, Agnieszka Przedborska, Joanna Kostka, Jan W. Raczkowski – Comparative analysis of the functional status of women with osteoarthritis of the hip or knee joint. Fizjoterapia Polska 2021; 21(3); 134-142

Abstract
Objective. The objective of the study was to compare the level of functional efficiency and factors influencing it in women after the age of 50 with advanced osteoarthritis of the hip (coxarthrosis) or knee (gonarthrosis) joint.
Material and methods. The study included 70 women aged 50–90 years with coxarthrosis (n = 35) or gonarthrosis (n = 35), stage 3 according to the Kellegren-Lawrence scale.
The functional status was assessed based on the Tinetti test and the Two-scales test. The Likert scale rated pain, stiffness, and the difficulty of getting up and putting on socks. The quality of life was assessed using a 100-point scale.
Results. Women with coxarthrosis achieved worse results in the Tinetti test in the part concerning gait (p < 0.01) and balance (p < 0.05). Pain and stiffness determined the results of most tests. Patients with gonarthrosis had greater problems with walking on flat surfaces and with getting up from a chair (p < 0.001). Pain determined difficulties when walking and putting on socks, and stiffness influenced difficulties in walking, standing up, putting on socks, and the results of the Tinetti test.
Conclusions.
1. Stiffness and pain deteriorate functional efficiency in women with coxarthrosis and gonarthrosis.
2. Greater problems with gait and balance occur in women with coxarthrosis, while women with gonarthrosis have greater difficulties with walking on flat surfaces and getting up from a chair.
Key words:
osteoarthritis, hip joints, knee joints, functional efficiency, Tinetti test
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The effectiveness of rehabilitation by exercising central stability of the cervical spine in cognitive phase in patients with neck pain (pilot study)

Marcin Świątczak, Rafał Janiak, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski

Marcin Świątczak, Rafał Janiak, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski – The effectiveness of rehabilitation by exercising central stability of the cervical spine in cognitive phase in patients with neck pain (pilot study). Fizjoterapia Polska 2021; 21(3); 102-112

Abstract
Introduction. In present times, vast majority of patients with back ailments complain about pain in cervical spine area. The use of  exercises based on biofeedback as well as  patient’s full engagement and focus  are designed to restore sufficient control to deep stabilizers of the cervical spine, where  vestibular system plays a crucial role.  The following method is appropriate for patients who experience different types of pain since it will not inflict further damage or exacerbate existing degeneration in that segment.
Purpose of the study. The purpose of this study is to analyze how central stabilization exercises influence stability of the neck in cognitive phase and whether they minimize neck pain, correct and restore overall motor control to effectively improve everyday physical activity and activities of daily living.
Measures and test methods. The subject of this research were patients with neck pain syndrome. The group of participants took part in a three-week program, which involved exercising central stability of the neck. The test measures were: Numeric Rating Scale (NRS), measures of neck mobility, Neck Disability Index, repositioning to neutral spot, as well as The Dartmouth Coop Functional and Health Status Measures for Adults. The patients were examined before and after completing the program.
Results. The study has shown that neck pain decreased by 1.7 points in 80% of the respondents. It has been observed that after the program patients had experienced increased neck mobility by 1 centimeter on average in all ranges of motion. They have also reported improved everyday physical activity and greater physical fitness.
Conclusions. Exercising central stability of the cervical spine in cognitive phase are beneficial for: restoring motor control, relieving neck pain, increasing range of motion of the head, and improving everyday physical activity.
Key words:
central stability, cervical spine, cognitive
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