The importance of quality in the practice of physiotherapy. The case of the Regional Specialised Paediatric Hospital in Kielce

Wojciech Kiebzak, Małgorzata Starczyńska, Zbigniew Śliwiński, Ireneusz M. Kowalski, Lucyna Robak, Marek Kiljański, Marek Woszczak, Magdalena Jaskólska-Pisiewicz

Wojciech Kiebzak, Małgorzata Starczyńska, Zbigniew Śliwiński, Ireneusz M. Kowalski, Lucyna Robak, Marek Kiljański, Marek Woszczak, Magdalena Jaskólska-Pisiewicz – The importance of quality in the practice of physiotherapy. The case of the Regional Specialised Paediatric Hospital in Kielce. Fizjoterapia Polska 2007; 7(2), 133-144

Abstract

Background. The aim of this paper was to show that procedures used within the framework of therapeutic management at the Regional Specialised Paediatric Hospital in Kielce improve the quality of service, which is the main condition for the hospital to remain on the market of health service providers. The high quality of services has been confirmed by the recent conferring of an accreditation certificate which requires that the hospital operate on the basis of a number of documented procedures, instructions and standards. The therapeutic activities of the hospital are based on a set of instructions providing detailed guidelines concerning the management of particular medical conditions. Material and methods. The study included children who were hospitalized or treated on an outpatient basis. Patient management was based on a set of instructions. An anonymous questionnaire concerning the quality of treatment and the level of satisfaction with the service was distributed among the children’s guardians and parents. Results. In the first and the second half of the year 2005, 95% and 86% of parents respectively assessed service quality as very good. 92% of parents gave the rating of very good in the first half of the year 2006 and 79% did so in the second half of the year. These results confirmed the high quality and efficacy of as well as satisfaction with the treatment received by the children. Conclusions. The observance of specified instructions during the therapeutic process improves the quality of service and minimizes the possibility of medical malpractice.

Key words:

quality, standard, instructions, rehabilitation treatment

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Body equilibrium assessment in patients with degenerative changes after whole-body cryostimulation connected with physiotherapy

Marek Kiljański, Zbigniew Śliwiński, Wojciech Kufel, Wojciech Kiebzak, Marek Woszczak

Marek Kiljański, Zbigniew Śliwiński, Wojciech Kufel, Wojciech Kiebzak, Marek Woszczak – Body equilibrium assessment in patients with degenerative changes after whole-body cryostimulation connected with physiotherapy. Fizjoterapia Polska 2007; 7(3); 286-298

Abstract
Background. The authors present the results obtained in a group of 126 participants. The aim of the study was to determine whether a four-week program of physiotherapy including whole-body cryostimulation, applied in patients with degenerative changes in the spine, influences their body equilibrium and pain sensation. Material and methods. The examined group comprised 66 patients with degenerative changes in the lumbar spine, while the control group consisted of 60 participants. Apart from an individually designed rehabilitation program, each patient participated in 20 sessions of whole-body cryostimulation. The measurement of lumbosacral spine mobility and the assessment of pain sensation using the Visual Analogue Scale (VAS) were performed before the first and after the last session. Moreover, after the first, tenth and twentieth session of general cryostimulation, measurements on a stabilometric platform were conducted. The healthy participants, who were qualified as the control group, underwent tests on the stabilometric platform after one session in the cryogenic chamber. The aim of these tests was to compare the differences in the stabilogram curve in healthy individuals and patients with degenerative changes in the lumbar spine. The effect of cryostimulation procedures on pain sensation and mobility of the lumbosacral spine was assessed. Additionally, the effect of cryogenic temperatures on body equilibrium was studied. Results. The comparison of the results, obtained before the procedure and after completing the therapy indicates that general cryostimulation in a physiotherapeutic program for patients with degenerative changes in the lumbar spine contributes to relaxation of excessively tense muscles. Conclusions. The use of whole body cryostimulation in patients with degenerative changes in the lumbosacral spine, combined with a properly designed and managed physiotherapeutic program, decreases pain sensation in a statistically significant way. The application of cryogenic temperatures, combined with physiotherapeutic program, favourably affect patient body equilibrium.
Słowa kluczowe
physiotherapy, spine, cryostimulation, coordination, stabilometric platform
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Assessment of the efficacy of local cryotherapy in children with cerebral palsy

Marek Woszczak, Zbigniew Śliwiński, Marek Kiljański, Wojciech Kiebzak, Marcin Szczepanik, Wiesław Tomaszewski

Marek Woszczak, Zbigniew Śliwiński, Marek Kiljański, Wojciech Kiebzak, Marcin Szczepanik, Wiesław Tomaszewski – Assessment of the efficacy of local cryotherapy in children with cerebral palsy. Fizjoterapia Polska 2007; 7(3); 275-285

Abstract
Background. The author presents the results of a study of 60 children with infantile cerebral palsy carried out at a rehabilitation centre in the town of Zgorzelec. The study aimed to demonstrate that a 4-week programme of customised kinesiotherapy with cryostimulation of the lower limbs with liquid nitrogen vapour could have a beneficial effect on motor status as well as muscle tone and skin surface temperature in children with infantile cerebral palsy. Material and methods. A group of children of both sexes aged 3-14 with infantile cerebral palsy underwent 4 weeks of customised kinesiotherapy combined with cryostimulation of both lower limbs. Muscle tone was determined with a Szirmai myotonometer using special methodology. The level of spasticity was estimated with the Ashworth test, and motor activity assessment was made before and after the treatment according to a score table designed by the authors. Thermovisual recordings of skin surface temperature in the lower limbs were made immediately before and 5 and 15 minutes after cryostimulation procedures at the beginning and end of the 4-week programme. Results and Conclusions. A comparison of the results of the motor activity assessment, Ashworth test and myotonometry before and after the rehabilitation programme shows that the use of cryostimulation in the rehabilitation of children with infantile cerebral palsy results in a reduction of spasticity in the lower limbs and improvement in motor activity. Thermovisual analysis of skin surface temperature demonstrates full adaptation of the children’s vascular system, i.e. excellent safety of topical cryostimulation.
Key words:
infantile cerebral palsy, spastic muscle tone, local cryostimulation, Ashworth test, motor activity assessment, Szirmai myotonometer, thermovision
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Thermovision recordings of skin surface temperatures following selected physical therapy procedures and comparison of procedure efficacy

Zbigniew Śliwiński, Wojciech Kufel, Marek Woszczak, Grzegorz Śliwiński, Anna Lipińska

Zbigniew Śliwiński, Wojciech Kufel, Marek Woszczak, Grzegorz Śliwiński, Anna Lipińska – Thermovision recordings of skin surface temperatures following selected physical therapy procedures and comparison of procedure efficacy. Fizjoterapia Polska 2009; 9(4); 321-331

Abstract
Background. The results of a thermovision study of the body surface of patients subjected to various physical therapy procedures are presented. Pain intensity is also assessed using a Yisual Analogue Scale (VAS). The aim ofthe paperis to compare the efficacy of these procedures. Material and methods. The study involved 38 patients (15 males and 23 females) aged 19-78 years (mean age 58.1 years) with diagnosed degenerative changes and pain syndromes ofjoints of the lower extremities (13 patients), upper extremities (7 patients) and the vertebral column (18 patients). Ali patients were divided into 4 groups and subjected to NSAID iontophoresis (Group 1), anodę galvanisation (Group 2), galvanisa-tion followed immediately by an NSAID rub-in (Group 3), and NSAID rub-in alone (Group 4). Pain intensity was assessed using a subjective scalę (VAS) on the first, fifth and tenth procedurę day The distribution of temperature in the treated area was also recorded with an Agema 570 thermo-vision camera on the day of the first and last procedure. Results. A subjective reduction in pain intensity was recorded in all groups. Patients from the first group reported 50.2% improvement, patients from Group 2 reported 44.9% improvement, Group 3 reported 62.2% improvement, and Group 4 reported 38.9% improvement over baseline (first day of treatment). Changes in skin surface temperature were also observed but were not significant for Group 4. Conclusions. In the subjective opinion of the patients, the most efficacious procedure was anode galvanization immediately followed by an NSAID rub-in. The superior efficacy of this procedure appears to be related to the higher dose of medication being introduced into the treated area and greater skin hyperaemia compared to iontophoresis alone. Medication rub-in following galvanisation is effective and more cost-effective as the-re are no drug losses due to the drug remaining in the vehicle, as is observed during an iontophoresis procedure.
Key words:
iontophoresis, galvanic current, rub-in, thermovision, linear VAS scale
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腰椎疼痛综合征患者在康复期间中心稳定性改善的功能表现

Tomasz Łosień, Krzysztof Banasiak, Katarzyna Kniaziew-Gomoluch, Marek Woszczak, Beata Kita

T. Łosień, K. Banasiak, K. Kniaziew-Gomoluch, M. Woszczak, B. Kita – Functional symptoms of core stability improvement in rehabilitation of patients with low back pain syndrome. Fizjoterapia Polska 2019; 19(4); 142-148

摘要
研究目的。此项研究的目的在评估深部躯干肌肉练习的有效性及其对腰椎疼痛综合征患者的影响。
材料和方法。实验组由46人组成,其中30名女性及16名男性,他们都有腰椎疼痛的状况。受试者的年龄在32至62岁之间,平均年龄为47岁,实验工具为国际问卷《Revised Oswestry Low Back Pain Disability》,内容包含10个有关进行日常活动时的疼痛感问题,及包含6个问题的自编制表格,其中1个问题涉及疼痛感程度。问卷完成后,受试者接受为期30天的康复计划,使用加强躯干深层肌肉的强化练习。依该计划每周会面3次,患者将于会面中就设定方案进行30分钟练习,完成计划的最后一个周期后,受试者必须再度填写问卷和表格。
结果。训练周期后的病痛水平为7.91,与训练周期前的水平23.59相比较,在统计学上呈显著下降,差异为15.67。
研究包含的结果明确显示出接受分析患者的疼痛感降低,进行完整的每月治疗后以视觉模拟量表测得的平均疼痛感降低2.2点,成为3.67点。
结论。进行的研究显示出以深层肌肉锻炼为周期的治疗可显著降低受试者间的主观疼痛感,记录显示康复治疗对体适能的整体水平有助益,研究结果显示,使用躯干肌肉紧身胸衣的强化治疗为治疗腰椎疼痛的有效形式。

关键词:
腰椎疼痛综合症、功能训练、躯干肌肉紧身胸衣、视觉模拟量表

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进行乳房切除术后妇女的淋巴水肿全疏通治疗

Marek Woszczak, Katarzyna Syrewicz, Iga Woźniak, Łukasz Goździewicz, Katarzyna Bogacz, Karolina Kossakowska

M. Woszczak, K. Syrewicz, I. Woźniak, Ł. Goździewicz, K. Bogacz, K. Kossakowska – Comprehensive draining therapy in the treatment of lymphoedema in women after mastectomy. Fizjoterapia Polska 2019; 19(4); 28-40

摘要
简介。乳癌为最危险的恶性肿瘤之一,该疾病的发病率持续增加中。因治疗和与之相关的淋巴结结构去除或破坏后的最常见并发症为淋巴水肿,改善状况的方法之一为实施综合疏通治疗(KTU)。
研究目的。该研究的目的在评估综合疏通治疗疗效,及其对淋巴水肿和活动性与紧握力的影响。
材料与方法。该实验在克尔采的圣十字肿瘤中心进行,对象为进行单侧乳房切除术后的60名妇女,她们被分入实验组和对照组两组。实验组中的30名女性接受KTU疗程,而另一组则接受改善治疗。疗程持续10天,在改善治疗前后以测角术测量运动范围,并以厘米胶带评估四肢周长并使用测力计测量SUR。
结果。疗程结束后两组的研究参数均获改善,然而实施综合疏通治疗的组效果更为明显,实验组的四肢周长缩小且紧握力及活动范围均有改善。
结论。所使用的两种治疗方法都能有效减少淋巴水肿,然而综合疏通治疗KTU为更有效的治疗方法。

关键词:
乳房切除术、综合疏通治疗、淋巴水肿

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Evaluation of combination therapy with the use of low-frequency magnetic field and ultraphonophoresis for patients with chronic osteoarthrits of the knee

Marek Woszczak, Kacper Kucz, Marek Kiljański, Marta Woszczak

M. Woszczak, K. Kucz, M. Kiljański, M. Woszczak – Ocena terapii skojarzonej polem magnetycznym niskiej częstotliwości i ultrafonoforezy u pacjentów z przewlekłą chorobą zwyrodnieniową stawów kolanowych. FP 2013; 13(3); 48-54

Summary
The aim of the study was to evaluate the combination therapy involving low-frequency magnetic field and phonophoresis applied lo patients suffering from osteoarthritis (ICD – M 77).
The assessment of physical condition was made through 6 climbs of a patient onto a 17 centimeire step within 30 seconds, the first step was made with less aching leg.
Thanks to this test the group of patients qualified to the study was homogeneous. The study involved 62 people (47 women, 75 men) aged 41-86, randomly assigned to two comparative groups. The patients’ health was assessed by means of WOMAC scale, Pain Assessment Scale VAS and functional kneeling test. The examination was conducted twice: before the beginning of the treatment and after a series of physiotherapeutic sessions. Group A was treated with the combination therapy including magnetic field and ultraphonophoresis
Group B was treated with low frequency magnetic field in addition, both groups were abo subjected To kinesiotherapy strengthening the four-headed muscle of the femur. For the statistical analysis of the research the Statistical Package for Social Sciences was employed (PASW 78). To check the effectiveness of the therapy in group A the Test of Relevant Statistical Differences t-siudent for paired data was applied.

Key words
osteoarthritis of the knee, low-frequency magnetic field, phonophoresis

 

 

Ocena poziomu wydolności fizycznej u licealistów klas I i II

Marek Woszczak, Katarzyna Bogacz, Marcin Szczepanik, Sławomir Jandziś,Karolina Kossakowska, Magdalena Józefowicz-Korczyńska

M. Woszczak, K. Bogacz, M. Szczepanik, S. Jandziś,K. Kossakowska, M. Józefowicz-Korczyńska – Assessment of physical endurance in students of the 1st and 2nd grade of secondary school. Fizjoterapia Polska 2018; 18(2); 70-82

Abstract

Introduction. Physical endurance is a very important element of everyone’s health. It is a health aspect comprising the factors which may affect the level of physical endurance. That is why it is important to know what allows to keep it as high as possible.
Objective. The purpose of this study was to demonstrate the differences in the levels of physical endurance of students of 1st and 2nd grade of secondary school.
Materials and methods. The studies were conducted on secondary school students. It covered 70 students, including 37 women and 33 men. The physical endurance level was examined using the Harvard Step-Up Test. The study included analysis of the effects of sex, age, place of residence and BMI on the level of physical endurance.
Results and conclusions. The research results allowed to draw the conclusions that sex, place of residence or BMI are not statistically significant for the level of physical endurance of the persons studied. As for age, the research results may indicate that at 5% significance level, age is statistically relevant for the level of physical endurance – older students demonstrate more good and very good fitness results, while the number of average and poor physical endurance results decreases.

Key words:
physical endurance, Harvard Step-up Test, physical endurance index

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Professor Andrzej Zembaty

Sławomir Jandziś, Marek Woszczak, Marek Kiljański, Renata Szczepaniak

S. Jandziś, M. Woszczak, M. Kiljański, R. Szczepaniak – Profesor Andrzej Zembaty. FP 2013; 13(4); 57-59

Abstract

The 50th anniversary of the organized activity of physiotherapists in Poland is an opportunity to present the figure of one of the eminent representatives of our profession, prof. Andrzej Zembaty, PhD. He was born on April 21, 1935 in Jasło to an intelligentsia family. The mother was a teacher, my father graduated from the Jagiellonian University law department and worked as a judge in Jasło and then Sanok. Andrzej Zembaty, after passing the final exams at the high school in Sanok, he began studies at the University of Physical Education in Warsaw, which he graduated in 1958. In 1960, he started working as a physiotherapist at the Metropolitan Rehabilitation Center for Motion Disorders in Konstancin and in 1964 as a teacher of the profession at the Medical Vocational College in Konstancin. In 1972, at the request of prof. Marian Weiss, director of STOCER and curator of the Rehabilitation Department at the University of Physical Education in Warsaw, was employed as a senior assistant at the same facility. He returned to the university, with whom he associated most of his professional life. He held the following function: 1979 – head of the Department of Movement Rehabilitation, 1982 – Rector’s representative for the appointment of the Rehabilitation Department, 1983 – deputy director. Institute of Biological Sciences, 1984 – 1987 – vice-dean for student and organizational affairs at the newly appointed Faculty, 1987 – 1990 – vice-dean for didactics. The last place of professional and didactic activity before retiring in 1999 was the University of Physical Education in Katowice, where the Professor headed the Kinesitherapy Unit.

Key words:
Therapeutic rehabilitation, physiotherapists, rehabilitation history

Eligibility of COPD patients for physiotherapy based on a six minute walk test and treadmill test

Katarzyna Bogacz, Marek Woszczak, Jacek Łuniewski, Marcin Krajczy, Bartosz Pańczyszak, Jan Szczegielniak, Marek Kiljański

K. Bogacz, M. Woszczak, J. Łuniewski, M. Krajczy, B. Pańczyszak, J. Szczegielniak, M. Kiljański – Eligibility of COPD patients for physiotherapy based on a six minute walk test and treadmill test; Fizjoterapia Polska 2018; 18(1); 96-106

DOI: https://doi.org/10.56984/8ZG0768F5

Abstract

Objective. The aim of the paper was to assess the results of physiotherapy of COPD patients whose elgibility for the relevant rehabilitation model was assessed with the help of the 6-MWT test and the treadmill test according to the modified Bruce protocol.
Materials and methods. 80 individuals suffering from COPD treated as in-patients at the MSWiA Specialist Hospital in Głuchołazy between May 2017 and September 2017 were examined. After a 3-week comprehensive physiotherapy, the exercise stress test, spirometry test and dyspnoea assessment on the modified 10-point Borg scale were repeated in both groups of COPD patients.
Results. Calculations were performed using the IBM SPSS software. In order to assess consistency between the distribution of the results with the normal distribution, the Kolmogorov-Smirnov test was used. As the distribution differed from the normal distribution, nonparametric methods were used for further analysis. In order to assess the significance of differences between the two groups in terms of quantitative variables, Mann-Whitney tests were used, while Wilcoxon tests were used for dependent samples to assess the significance of changes over time in the same patients (bound pairs). The statistical significance threshold was set at p < 0.001.
Conclusions
1. A significant improvement was noticed in the level of exercise stress tolerance after physiotherapy both among patients assessed according to the modified Bruce test and patients assessed with the 6-minute walk test.
2. A significant improvement was shown in the values of spirometric indicators after physiotherapy both among patients assessed according to the modified Bruce test and patients assessed with the 6-minute walk test.
3. A significant decrease was shown in the level of dyspnoea after physiotherapy both among patients assessed according to the modified Bruce test and patients assessed with the 6-minute walk test.

Key words:

COPD, modified Bruce protocol, 6-MWT test, physiotherapy

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