The role of hippotherapy in children rehabilitation

Maria Kłoda, Karen Shahnazaryan, Marzena Gorzkowska, Igor Falkowski, Daniel Malczewski, Dariusz Białoszewski

M. Kłoda, K. Shahnazaryan, M. Gorzkowska, I. Falkowski, D. Malczewski, D. Białoszewski – The role of hippotherapy in children rehabilitation. Fizjoterapia Polska 2021; 21(4); 58-70

Abstract
Hippotherapy is one of the forms of animal therapy (zootherapy). It is defined as a therapeutic action to improve human health and its functioning, with the help of a horse and riding on its back. The aim of the study was to present current reports on hippotherapy, as well as its popularization as a method that supports traditional rehabilitation. The theoretical part of the thesis discusses the mechanism of the horse’s therapeutic impact on humans, including its impact on the physical, emotional, motivation, cognitive and social spheres. The basic assumptions of hippotherapy are also presented – indications, contraindications, choice of a horse, the profession of a hippotherapist and the principles of conducting therapeutic activities with children. In the research part, in order to present up-to-date reports, a review of scientific articles from Poland and around the world, published in 2015-2019, on the effectiveness of hippotherapy activities and their impact on the psychomotor development of children with CPR, ASD and ADHD. These articles were found in the PubMed medical database. Twenty publications were selected that met all the search criteria. Most of the analyzed studies showed a positive effect of hippotherapy on the functioning of ill children. The most common effects are, the improvement of motor functions (including body posture, gait and balance), improvement of behavior, and better social functioning. It was confirmed that hippotherapy can complement comprehensive rehabilitation among children with CPR, ASD and ADHD, as well as motivate to therapy and exercise. On the basis of the discussed data, conclusions were also drawn that further research is needed, which would take into account larger groups of respondents and would show the long-term effects of therapy with the participation of a horse.
Key words:
Hippotherapy, horses, children theraphy with CPR, ASD (autism spectrum disorder) i ADHD (attention-deficit hyperactivity disorder)
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Computer-assisted rehabilitation of aphasia in the assessment of Polish patients – the results of a proprietary survey

Anna Obszyńska-Litwiniec, Dariusz Boguszewski, Monika Lewandowska, Izabela Korabiewska, Maria Kłoda, Andrzej Ochal, Dariusz Białoszewski

A. Obszyńska-Litwiniec, D. Boguszewski, M. Lewandowska, I. Korabiewska, M. Kłoda, A. Ochal, D. Białoszewski – Computer-assisted rehabilitation of aphasia in the assessment of Polish patients – the results of a proprietary survey. Fizjoterapia Polska 2020; 20(1); 188-194

Abstract
Objective. The objective of the study was to determine the general level of acceptance for the use of the AfaSystem computer tool to assist in aphasia rehabilitation among Polish patients, as well as to learn patients’ subjective opinions about the positive and negative aspects of working with the program.
Material and methods. 32 patients covered by 2-month therapy using AfaSystem participated in a proprietary survey concerning the level of satisfaction with the use of software in therapy. In the first part of the survey, patients made an overall assessment of the program on a scale of 1 to 5. In the second part, they indicated the most important advantages of such therapy and the difficulties encountered.
Results. Patients indicated that their level of satisfaction with the use of the program was very high. The most important advantages were the increased motivation to exercise, therapy attractiveness, low rehabilitation costs, as well as the ease of use of the program. The disadvantages included limited possibilities of material individualization, the lack of video material and the lack of interactivity.
Conclusions.
1. The use of the AfaSystem computer tool in the rehabilitation process is accepted by patients with post-stroke aphasia.
2. Patients handle the program well and find it attractive.
3. It is advisable to supplement the functionality of the software with high-quality audiovisual materials, extensive individualization of the exercise material, as well as interactivity.

Key words:
aphasia, speech rehabilitation, computer program

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Progressive spastic four-limb paresis. Suspected Strumpell-Lorrain disease. Case study

Maria Kłoda, Grażyna Brzuszkiewicz-Kuźmicka, Marcin Jelitto, Izabela Korabiewska, Karen Shahnazaryan, Dariusz Białoszewski

M. Kłoda, G. Brzuszkiewicz-Kuźmicka, M. Jelitto, I. Korabiewska, K. Shahnazaryan, D. Białoszewski – Progressive spastic four-limb paresis. Suspected Strumpell-Lorrain disease. Case study. Fizjoterapia Polska 2020; 20(1); 150-159

Abstract
Strumpell–Lorrain disease is a rare progressive disease also called hereditary spastic paraplegia. It is a genetic neurological disorder with a diverse course, characterized by usually very severe progressive spastic paresis of the lower limbs. It is one of the neurodegenerative diseases of the motor neuron.
The subject of the study was a 27-year-old woman with suspected hereditary spastic tetraplegia.
The subject experienced the first symptoms of the disease at the age of six. The patient’s parents observed toe walking and frequent falls due to improper foot placement.
Physiotherapeutic procedures were aimed at improving stability of the torso and functional improvement of the patient, including daily activities along with the extension of the time spent outside the bed. Improvement of her motor functions, including faster performance of activities in a shorter time.
Physiotherapy has a significant role in the treatment of patients with neuromuscular disorders. It applies to functional, physical, psychological and social aspects. Patients with this type of disease are very often lonely and unhappy, which affects their mental health. The possibility of participating in physiotherapeutic procedures means that such a person not only improves his/her physical condition; it also strongly affects mental health and improves functioning in society.

Key-words:
Strumpell–Lorrain disease, hereditary spastic paraplegia

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以计算机辅助语言康复治疗对中风后失语症患者命名能力的影响

Anna Obszyńska-Litwiniec, Monika Lewandowska, Dariusz Boguszewski, Izabela Korabiewska, Maria Kłoda, Dariusz Białoszewski

Anna Obszyńska-Litwiniec, Monika Lewandowska, Dariusz Boguszewski, Izabela Korabiewska, Maria Kłoda, Dariusz Białoszewski – Impact of computer-assisted speech therapy on naming skills in patients with post-stroke aphasia . Fizjoterapia Polska 2019; 19(4); 156-161

摘要
研究目的。此项研究的目的在确定强化的计算机辅助语言障碍康复治疗对中风后失语症患者命名能力改善的影响。
材料和方法。该项研究涵盖73名失语症患者,住院后患者被分入实验组(n = 36)或对照组(n = 37)。两组均使用波士顿命名测验(BTN)来进行诊断测试,实验组患者接受为期2个月的AfaSystem强化康复计划,对照组患者则接受标准语言治疗,治疗结束后所有患者均再度接受波士顿命名测验,然后在干预结束前后将所取得的结果进行比较,以统计分析评估结果。
结果。为期2个月的计算机辅助治疗结束后,实验组在波士顿命名测验量表上获得的命名能力改善比对照组的患者显著,其差异p = 0.0044具统计学意义。
结果。1. 使用Afasystem 工具进行强化康复治疗可改善中风后失语症患者的命名能力。2. 使用失语症计算机辅助治疗工具可提供高强度的康复治疗,为有效治疗语言障碍的必要条件。

关键词:
失语症、语言治疗、计算机计划、失范状态

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Diagnostics of Balance and Gait Disorders in Patients with Parkinson’s Disease

Maria Kłoda, Grażyna Brzuszkiewicz-Kuźmicka, Edyta Smolis-Bąk, Izabela Korabiewska, Monika Lewandowska, Dariusz Białoszewski

M. Kłoda, G. Brzuszkiewicz-Kuźmicka, E. Smolis-Bąk, I. Korabiewska, M. Lewandowska, D. Białoszewski – Diagnostics of Balance and Gait Disorders in Patients with Parkinson’s Disease. FP 2017; 17(2); 122-131

Abstract

Parkinson’s disease is a chronic, progressing affliction of the human central nervous system. It is one of degenerative diseases and affects mainly the extrapyramidal system, and in particular the substantia nigra of the midbrain.  Along with the axial symptoms of Parkinson’s disease, the other most important ones would include abnormalities of posture and gait. The improper posture has an impact on future problems with locomotion and self-service functions.
Prior to introducing any physiotherapy, there should be carried out a number of tests, which will allow both, quantitative and qualitative assessment the patient’s gait and his or her posture. These tests include among others: gait analysis performed on a treadmill of the ”Zebris” FDM-TDM type, which uses the WinFDM-T data base system, Vicon 460 system for the three-dimensional assessment of gait, Timed Up & Go, 10 MWT or Tinetti tests.
Demographic data indicate the increasing incidence of the Parkinson’s disease, which seems to be due to the gradual lengthening of a human life span. This makes it very important to properly rehabilitate and care for the patients.
As the disease progresses, patients begin to experience discomfort during their daily activities, and in locomotion, and thus their quality of life is being reduced. Here comes the great importance of implemented physiotherapy treatments, which are supposed to maintain, for as long as possible, the patients’ mobility at the level sufficient to enable their independent functioning. Introduced early enough physiotherapy procedures significantly improve gait parameters in patients with the Parkinson’s disease, thus delaying progression of the disease.

Key words:
diagnostics, Parkinson’s disease, balance disorders, gait disorders

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The dynamics of the return of lost functions in patients undergoing physiotherapy following surgical treatment of post-traumatic paracerebral hematomas

Grażyna Brzuszkiewicz-Kuźmicka, Stanisław Kuźmicki,
Zbigniew Śliwiński, Maria Kłoda, Michał Sobstyl, Agata Kuźmicka

G. Brzuszkiewicz-Kuźmicka, S. Kuźmicki, Z. Śliwiński, M. Kłoda, M. Sobstyl, A. Kuźmicka  – The dynamics of the return of lost functions in patients undergoing physiotherapy following surgical treatment of post-traumatic paracerebral hematomas. FP 2014; 14(3); 66-75

Abstract

The objective of this study is to determine the impact of early physiotherapy on the dynamics of the recovery of the ability to perform daily activities, improvement in functional status, reduction in neurological deficits and change in the consciousness status in patients following surgical treatment of post-traumatic paracerebral hematomas.
The study material consisted of 86 patients undergoing surgical treatment of post-traumatic paracerebral hematomas. All patients were divided into two groups with the type of kinesitherapy performed as the main differentiating factor.
The grade of neurological deficit was assessed by the International Scale of Muscle Weakness, modified Barthel Index, and Rankin Scale, while consciousness was assessed on the basis of the Glasgow Coma Scale.
The return of lost function in patients undergoing rehabilitation according to selected PNF patterns and elements of Bobath therapy as compared to patients subjected to conventional kinesitherapy was characterized by better dynamics, particularly within the initial days, and progressed at a significantly higher rate. However, no relationship of this kind was observed for the recovery of consciousness. Patients have the highest potential for the return of lost functions in the early postoperative period (days 1-5).

Key words:
early physiotherapy, post-traumatic paracerebral hematomas, kinesitherapy

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The assessment of the attitude towards physical activity among the Physiotherapy students of Warsaw Medical University (WMU) and the students of Physical Education Academy (PEA)

Edyta Smolis-Bąk, Agnieszka Szymańczuk, Hanna Rymuza,
Ilona Kowalik, Maria Kłoda, Grażyna Brzuszkiewicz-Kuźmicka

E. Smolis-Bąk, A. Szymańczuk, H. Rymuza, I. Kowalik, M. Kłoda, G. Brzuszkiewicz-Kuźmicka – The assessment of the attitude towards physical activity among the Physiotherapy students of Warsaw Medical University (WMU) and the students of Physical Education Academy (PEA). FP 2016;16(4);30-39

Abstract

Physical activity is a key integrating element of a healthy lifestyle. Physical Fitness determines the resourcefulness in various life situations, its high level may facilitate work, broaden the capabilities and contribute to a healthy lifestyle. Studies show that physical therapists are particularly predisposed to promote a healthy lifestyle among the medical patients. On the other hand, due to the nature of their work, they are at risk of muscular and skeletal injuries.
The objective was to assess the Warsaw Medical University (WMU) and the Academy of Physical Education (APE) Physiotherapy Students’ attitude toward physical activity and physical fitness.
Methodology. Examined was a group of 90 students (37 females, 9 males from WMU and 22 females, 22 males from PEA) of the age 22.7 on average ±2.0 years. Prepared questionnaire designed to assess attitudes toward physical activity was used. The level of physical fitness of the investigated students was examined with International Physical Fitness Test.
Results. The number of physical activity hours is significantly lower at the Medical University (1.6 ±1.5) than PE Academy (3.6 ±1.7), p<0,001. Very high (80%) interest in physical activity during leisure time has been demonstrated, with higher tendency among Physiotherapy PEA students than the WMU students (p = 0.07). A significantly lower level of physical fitness among WMU students, as compared to PEA students, was also found.
Conclusions. 1. Very high interest in physical activity during leisure time, in both groups, should be taken advantage of and developed in educational process. 2. Medical University students presented a much lower fitness level than PEA students, which may have resulted from fewer hours of physical activities at the Medical University of Warsaw (WMU). 3. Due to higher expectations in case of physiotherapists, it seems that physical fitness should be one of the recruitment process criteria at Medical University of Warsaw.

Keywords:

physical activity, assessment of physical fitness, physiotherapy students

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The Pathogenesis of Parkinson’s Disease Related Balance Disorders. The Balance Disorders Evaluation Methods. Review Article

Maria Kłoda, Renata Kowalska-Taczanowska, Grażyna Brzuszkiewicz-Kuźmicka, Andrzej Friedman

M. Kłoda, R. Kowalska-Taczanowska, G. Brzuszkiewicz-Kuźmicka, A. Friedman – The Pathogenesis of Parkinson’s Disease Related Balance Disorders. The Balance Disorders Evaluation Methods. Review Article. FP 2016;16(1);82-87

Abstract
Basis of the Parkinson’s disease are the chronic neurodegenerative changes, manifesting themselves in the asymmetric bradykinesia, the muscular rigidity and the resting tremor (the so-called triad of symptoms). Along with the advancement of the disease, there occur symptoms within the autonomic nervous system, speech and swallowing disorders, dementia, cognitive function disorders. The neurodegenerative process caused by the dopamine deficiency in the brain, leads to the gradual loss of movements coordination, which is worsening along with the development of the disease. Slowness of movements, characteristic for the patients with Parkinson’s disease, is in turn the leading cause of the locomotion disability. This symptom, together with the coexisting postural instability, are qualified as the main causes of the balance disorders accompanying the disease in question.  The implementation of the proper procedures for diagnosis of the balance disorders, in this group of patients, actually helps to reduce the number of falls.Currently the most popular tool for evaluating the posture stability disorders are the clinical tests of balance. Very popular for the evaluation of the balance disorders are the simple motor ability tests, allowing to assess a given motor skill in the quantitative and the half-quantitative manner. The actual usefulness of the balance assessment on the stabilometric platforms has been proved in the numerous clinical studies. The efficacy of the described method has been demonstrated in the research of the probability of falls due to Parkinson’s disease. Meaningful are also the reports of the superiority of the posturography over the other methods for the balance assessment. Unfortunately, the application of the posturography tests in balance analyses, in patients with Parkinson’s disease, is still being limited to the selected centers. This is mainly due to the relatively high cost of the purchase of the posturography platform.

Key words:
Parkinson’s disease, posturography tests, balance assessment

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Prevalence of feet defects in preschool-aged children

Maria Kłoda, Grażyna Brzuszkiewicz-Kuźmicka, Maria Drajczyk, Piotr Drajczyk, Janina Grzegorzewska, Edyta Smolis-Bąk

M. Kłoda, G. Brzuszkiewicz-Kuźmicka, M. Drajczyk, P. Drajczyk, J. Grzegorzewska, E. Smolis-Bąk – Prevalence of feet defects in preschool-aged children. FP 2016;16(1);36-46

Abstract
Introduction and study aim. Childhood is known to be a very important period of life when the foot is gradually determining in order to become a strong support of the human body. The aim of the study is to assess the frequency of appearance of foot defects in preschool children.
Material and methods. The study group consisted of 143 preschool children, in which the following parts of examination were evaluated: orthopedic measurements, antropometric measurements, plantoconturographical examination and podoscopic examination. Parents were asked to fill out the questionnaire regarding to the development of their child’s feet, defects as well as their child’s habits and sports in which they participate.
Results. The analysis of Clarke’s angular indicator revealed that flat foot was the most frequent defect in the study group (146/286 feet, circa 50%), and diminished foot was the second frequent problem in the examined group of children (102/286). The normal foot was established to be present in 37 cases. There was also 1 elevated foot due to Clarke’s assessment. No statistical significance was observed between body sides and foot defects. Gender of patient was not statistically correlated to the examined children’s defects besides flat foot, which was observed to be more frequently present in males: 42 males (36%) vs 19 females (11%), p<0,05.
Conclusions. The flat foot was observed to be the most frequently present defect of foot in preschool children. On the other hand, cored foot has been demonstrated to be the most rarely present defect in the study group. Percentage of children who participate in sport activities and wear comfortable shoes in order to prevent foot defects, is unsatisfactory. Motor activity should be more efficiently promoted among parents and caregivers of preschool children.

Key words:
foot defect, angular indicator, plantoconturography

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