Comparative evaluation of the analgesic effectiveness of selected physiotherapeutic methods in the treatment of low back pain syndrome

Jolanta Kujawa, Iwona Pyszczek, Jan Talar, Mirosław Janiszewski

Jolanta Kujawa, Iwona Pyszczek, Jan Talar, Mirosław Janiszewski – Comparative evaluation of the analgesic effectiveness of selected physiotherapeutic methods in the treatment of low back pain syndrome. Fizjoterapia Polska 2001; 1(3); 271-279

Abstract

Background. Low back pain, especially lumbosacral syndrome, is the most frequently encountered pain syndrome in musculoskeletal diseases. In many countries the question of low back pain has become a social problem. The basic task of rehabilitation teams is to make the proper choice of effective physiotherapeutic method. The goal of this study was to evaluate the analgesic effectiveness of selected combined physiotherapeutic methods in patients with low back pain. The results were analyzed for statistically significant differences correlating with the application of particular physical methods.Material and methods. 450 randomly selected patients (319 females, 131 males), age 21-79 (average age 56,53 years +/- 15,34) treated for low back pain syndrome in the Department of Medical Rehabilitation at the Łódź-Śródmieście Municipal Clinic were surveyed. Patients were divided into two groups: Group A received laser biostimulation, while Group B received interferential current instead of laser therapy. All patients studied went through a uniform, typical program of therapeutic exercises.The effectiveness of this combined therapy was evaluated on the basis of subjective pain reported on the modified Laitinen pain questionnaire, taking into account intensity, frequency, use of analgesics and motor activity. A clinical examination was also performed. Results. The investigation indicated that both selected combined physiothearapeutic methods have a measurable analgesic effect in the treatment in low back pain. However, laser therapy applied in combination with therapeutic exercises proved to have greater therapeutic efficiency for such patients compared to interferential current with therapeutic exercises, and this difference was statistically significant.

Key words:
low power laser therapy, Low Back Pain, physiotherapy
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The role of physiotherapy in the treatment, prevention, and rehabilitation of chronic bronchitis

Volodymyr Mizin

Volodymyr Mizin – The role of physiotherapy in the treatment, prevention, and rehabilitation of chronic bronchitis. Fizjoterapia Polska 2001; 1(3); 237-242

Abstract

Background. Within the framework of the Global Initiative for Chronic Obstructive Disease there has been considerable scientific discussion and a search for original, modem approaches to the treatment of chronic bronchitis. The success of these endeavors is conditional upon the precise definition of the goals and the application of the appropriate means to achieve them. A review of the literature shows no reports on the potential of physiotherapeutic methods of treatment in this area. The goal of our research was to evaluate the use of electrostimulation of the torso and dalargin electrophoresis to relieve respiratory distress in patients with chronic bronchitis. Materials and methods. The research on the impact of these procedures on the cardiopulmonary system and immune system involved 67 patients. Respiration, hemodynamics, T- and B-lymphocyte content, and immunoglobulin E levels were tested. A biomechanical model was used to simulate the strength of the erython and the respiratory and cardiac muscles, as well as general physical capacity, minute blood volume, and deviation of these parameters from the optimal values. Simulation and calculation of the coefficients consumption by the cardiopulmonary system and the organism was using a synergetic model of aerobic metabolism. Results. Correlation, regression, and factor analyses show that the effects of electrostimulation and dalargin electrophoresis make a major contribution to the realization of numerous treatment goals, including the relief of respiratory distress. The tested factors increase the fuctional capacity of the cardiopulmonary system to supply the organism with oxygen, improve the equilibrium of the vegetative nervous system and the balance of B- and T-lymphocytes, increase the level of T-lymphocytes and lower the level of IgE. The results of factor analysis suggest that lowering the level of IgE decreases the virulence of inflammatory processes. An increases was observed in oxygen consumption and reserve capacity, and an increase – of particular importance – in the integral coefficient of oxygen metabolism in the organism. Conclusions. The tested procedures of electrostimulation of the torso and dalargin electrophoresis produce effects that are beneficial in achieving many strategic and tactical goals in the treatment and rehabilitation of patients with chronic bronchitis, especially reducing the activity of IgE as a risk factor, countering the effects of respiratory insufficiency, inhibiting inflammatory reactions, and improving the status of the immune system, respiratory functions, and hemodynamics. These procedures bring about improvement in the vegetative nervous system, the metabolic systems, and oxygen consumption. These effects make it possible a comprehensive program to reduce respiratory distress in patients with chronic bronchitis.

Key words:
chronic bronchitis, Stress, physiotherapy, electrostimulation, Electrophoresis, dalargin
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The straight leg raising test: its value in differential diagnosis and choice of therapy

Ger Plaatsman, Edward Saulicz, Ewa Żmudzka-Wilczek

Ger Plaatsman, Edward Saulicz, Ewa Żmudzka-Wilczek – The straight leg raising test: its value in differential diagnosis and choice of therapy. Fizjoterapia Polska 2001; 1(4); 414-417

Abstract
Since 2800 BC, when ancient doctors suggested that extension of the leg should be used to examine sprained vertebrae, many authors have given opinion on how to examine disorders in the hip, pelvic and lumbar region by movements of the leg. This article does not attempt to offer yet another interpretation of the Straight Leg Raising test (SLR), but rather a review of several interpretations and differences in the test. Further, we describe the sequence of “diagnosis by treatment” using SLR as a device for differential diagnosis, and how it can help in the choice of technique for therapy.

Key words:
SLR test, physiotherapy, discopathy

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The impact of inpatient physiotherapy on parameters of acid-base equilibrium after corrective surgery of congential heart defects in children age 0-2

Piotr Dominiak

Piotr Dominiak – The impact of inpatient physiotherapy on parameters of acid-base equilibrium after corrective surgery of congential heart defects in children age 0-2. Fizjoterapia Polska 2001; 1(4); 361-365

Abstract
Background. Congenital heart defects constitutes the most significant problem in pediatric cardiology, occupying second place among the causes of infant death in Poland. One can observe a constant lowering of the indicated age for surgery in order to prevent secondary structural changes in and around the heart, and negative psychological effects on parents and children. The goal of this article is to evaluate the effectiveness of the author’s own method of physiotherapy during inpatient care of children aged 0-2 years following total surgical correction of the most commonly occurring congenital heart defects. Material and methods. Ina group of 32 patients recovering from total corrections of ASD II, VSD, PDA and CoA, age 0-2 years, 384 tests were performed on arterialized capillary blood during the first the days after surgery. The tests were performed before, immediately after, and 30 minutes after physiotherapy, and then results were compared. The patients were divided into two sub-groups: subgroup I consisted of 20 patients after total correction of ASD II and VSD, in whom 270 tests were performed, while subgroup II included 12 patients after total correction of PDA and CoA, in whom 114 tests were performed. Results. The results indicated that a postero-lateral thoracotomy produces a leftward shift in acid-base equilibrium; under the influence of physiotherapy, however, the direction of change is identical in both sub-groups. Extracorporeal circulation did not exchange in the lungs (a statistically significant increase in pO2 and SO2 30 minutes after physiotherapy). Conclusion. The physiotherapy program here applied, including elements of he Vojta method, can be used beginning in the first days after surgery.

Key words:
congenital heart defects, surgical treatment, physiotherapy, Acid-Base Equilibrium

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Ultrasonic wave-induced damage to human red blood cells

Iwona Pyszczek, Jan Talar, Jolanta Kujawa, Leu Zavodnik, Ewa Kilańczyk

Iwona Pyszczek, Jan Talar, Jolanta Kujawa, Leu Zavodnik, Ewa Kilańczyk – Ultrasonic wave-induced damage to human red blood cells. Fizjoterapia Polska 2002; 2(2); 134-139

Abstract
Background. The aim of this study was to evaluate the response of human red blood cells to physiotherapeutic ultrasound (1 MHz). Material and methods. The susceptibility of erythrocytes to ultrasonic wave-induced damage was indicated by cell hemolysis, changes in the electrochemical properties of cell membranes, and membrane-bound acetylcholinesterase activity. Results. Exposure of erythrocytes to ultrasound resulted in dose-dependent hemolysis, significant activation of membrane acetylcholineterase due to an increase in substrate affinity, slight membrane depolarization due to nonselective pore formation, and activation of membrane lipid peroxidation. Conclusions. These results show the significant biomodulation effect of the ultrasonic waves used in medical practice on human erythrocytes at the membrane and cellular level.

Key words:
physiotherapy, Hemolysis, acetylcholinestrerase

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The atteration of the value of muscle forces in the programme of physiotherapy after the reconstruction of anterior cruciate ligaments

Andrzej Czamara

Andrzej Czamara – The atteration of the value of muscle forces in the programme of physiotherapy after the reconstruction of anterior cruciate ligaments. Fizjoterapia Polska 2002; 2(4); 263-272

Abstract
Introduction. The aim of this research was the analysis of the alteration of the value of forces of the extensors and flexors of knee joints in the 13th week and the 6th month of physiotherapy of the patients after the reconstruction of anterior cruciate ligaments. Material and method. The research involved 46 patients, 25 of whom were women. 39 patients, 19 of whom were women, who had undergone at least a six-month physiotherapy were qualified for the analysis of the alteration of the value of forces. The author offered a four-step physiotherapy programme. In the 13th week and then at the beginning of the 6th month the moment of forces was measured and the analysis of the balance of the moment of forces of the flexors to extensors of knee joints was made. Results. A statistically essential increase of the moment of forces of traumatic limbs, both in a group of men and women, was reached in the 6th month as compared to the 13th week of physiotherapy. No statistically important differences were noted in a men’s group at the beginning of the 6th month. The results in the traumatic limbs were comparable the value of the moment of forces of healthy limbs. At the same time a women’s group got, in the traumatic limbs, about 80-90% of the value of the moment of forces of the muscle groups of healthy limbs. Some essential statistic differences were noted. The value of the balance of the moments of forces of the operated limbs’ muscles altered approaching in the 6th month the values of healthy limbs. Conclusions. The increase of the mean value of the moment of forces in traumatic limbs was reached in the treated groups. The dynamics of the increase of the value of the moment of forces proved better in men. It appears that the analysis of the changes of balance of flexors to extensors may prove useful in the monitoring of the process of physiotherapy.

Key words:
Anterior Cruciate Ligament, physiotherapy, moment of forces

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Physiotherapeutic technics used in Yalta health resorts in the treatment of chronic bronchitis

Volodymyr Mizin

Volodymyr Mizin – Physiotherapeutic technics used in Yalta health resorts in the treatment of chronic bronchitis. Fizjoterapia Polska 2003; 3(2); 197-204

Abstract
A review of the literature in Poland shows no reports on the treatment potential of the physiotherapeutic techniques used in the treatment of chronic bronchitis in the health resorts of Yalta (in Crimea). The goal of this article is to present the current picture of this treatment. The clinical goals and tasks for prevention, resort treatment and rehabilitation in chronic bronchitis are discussed. The effects and doses for the physiotherapeutic factors used in Yalta health resorts are described, including aerotherapy, inhalation, aromatotherapy, electrotherapy, light therapy, magnetotherapy, ultra sound therapy, acupuncture, massage, gymnastics, physical training, climatotherapy, thalassotherapy, balneology, heat therapy and phytotherapy

Key words:
chronic bronchitis, physiotherapy, resort treatment

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Physiotherapy following surgical repair of knee cartilage

Andrzej Czamara

Andrzej Czamara – Physiotherapy following surgical repair of knee cartilage. Fizjoterapia Polska 2003; 3(4); 401-411

Abstract

This article presents a four-stage physiotherapy program for use after certain surgical operations on knee joint cartilage, adapted to the dynamics of tissue healing and reconstruction. In the first stage, the load-bearing time of the operated lower limb in vertical configuration is differentiated, depending on the degree and site of damage and the surgical technique, as well as the patient’s own goals and personal characteristics. Physical agents are also used, along with passive movement of the knee joint without load on CPM devices. Isometric and co-contraction exercises are also used. The patient is taught to walk while relieving the operated limb with crutches. In the second phase of rehabilitation, in addition to routine methods, we use gradual loading on the limb in vertical position, using objective measurements obtained from tensometric platforms. In the third phase standard rehabilitation methods are used. In addition we have implemented monitoring of gradually increased loads, with the goal of restoring limb function, i.e. walking on a level surface and at a variable grade, and basic motor characteristics. The fourth stage is intended for persons whose goal is to return to sport or other professional work requiring a high level of physical activity.

Key words:
knee joint cartilage, knee joint cartilage injuries, physiotherapy, rehabilitation program
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An original method for analyzing thermo-images as an objective supplement to diagnosis outcome evaluation in knee pain syndrome

Jolanta Kujawa, Jarosław Oborzyński, Kamila Gworys, Mirosław Janiszewski, Małgorzata Łukowicz

Jolanta Kujawa, Jarosław Oborzyński, Kamila Gworys, Mirosław Janiszewski, Małgorzata Łukowicz – An original method for analyzing thermo-images as an objective supplement to diagnosis outcome evaluation in knee pain syndrome. Fizjoterapia Polska 2003; 3(4); 375-383

Abstract

Background. This article presents a technique for analyzing thermovision images by calculating the knee-limb temperature index (KLTI). The usefulness of this technique for diagnosis and outcome evaluation is assessed. Material and methods. 41 patients with knee pain syndrome in 67 joints were examined, along with 30 healthy controls. The intensity of knee joint dysfunction was evaluated on a 0-30 point scale according to a specially developed test the sheet. Results. In the control group, the KLTI was in the range from -1.4°C to -0.2°C; the range from -1.31°C to -0.5°C was the norm for 90% of the population. In the experimental group, the KLTC place from -0.5°C to +1.8°C. The differences between the KLTI values in the two groups was statistically significant. There was also correlation between the intensity of dysfunction and the KLTI. In the experimental group the values were lower after treatment. Conclusions. The KLTI is a highly specific and sensitive instrument for evaluating knee pain syndrome. The technique described here is a valuable diagnostic supplement, objectivizing outcome evaluation in these patients.

Key words:
thermovision, knee pain syndrome, physiotherapy
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