Post-COVID-19 rehabilitation in the post-hospitalization period – case study

Michał Polawski, Wiktor Obręcki, Magdalena Kościelniak, Rafał Trąbka


Michał Polawski, Wiktor Obręcki, Magdalena Kościelniak, Rafał Trąbka – Post-COVID-19 rehabilitation in the post-hospitalization period – case study. Fizjoterapia Polska 2022; 22(3); 102-115

Abstract
Aim of the research work. The main goal of the research work was to show an author’s plan of physiotherapeutic intervention for people suffering of COVID-19 in the post-acute stage. The therapeutic procedure highlighted pulmonary rehabilitation, aerobic and resistance training and patient’s education.
Case study. The research work was performed on a 62-year old woman, who was diagnosed with infection by SARS-CoV-2 virus. The patient was admitted to ICU with acute ARDS in a heavily severe condition. The medical history showed obesity, chronic ischemic heart disease, arterial hypertension and cardiac arrest (2011). The patient was admitted to the rehabilitation unit in the post-acute stage of infection, and was using passive oxygen therapy with oxygen flow set to 4 l/min. During the qualification for therapy the patient was tested using a questionnaire which consisted of clinical tests such as 6MWT, MRC, 30CST and FIM scale. Furthermore, the lungs were examined using spirometry. Identical measurements were being used every 2 weeks of the therapy process. After 8 weeks of physiotherapeutic procedure there was a significant increase of score in 6-MWT which upgraded by 750%. Systematic improvement was also visible in dyspnoea and fatigue, which completely surceased after finishing the therapeutic process. Functional state of the patient improved considerably which is shown by 30CST score, improved by 380%. Spirometry score analysis shows FVC, FEV1 and Tiffeneau-Pinelli index improve respectively by 40%, 53% and 9.6%.
Summary. The therapeutic program based on pulmonary rehabilitation, aerobic and resistance training and patient’s education looks very promising. Implemented procedure contributed to the patient’s relatively quick recovery to a pre-COVID-19 state. Patient’s physical and pulmonary efficiency were noticed, exertional tolerance increased, dyspnoea and fatigue gave way which all combined led to improved functional efficiency. Pulmonary system function was also enhanced which was demonstrated by spirometry.

Key words:
SARS-CoV-2, COVID-19, physiotherapy, rehabilitation

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Successful public procurement of physiotherapeutic equipment

Damian Durlak


Damian Durlak – Skuteczne zamówienia publiczne na sprzęt fizjoterapeutyczny. Fizjoterapia Polska 2022; 22(2); 54-58

Abstract
Medical facilities purchasing medical equipment under the public procurement procedure are obliged to comply with the regulations specified in legal acts. Due preparation of the specification of the subject of the contract, selection of the appropriate team responsible for the process, and above all, understanding the needs and opinions of physiotherapists who will be using the equipment in the future can significantly affect the success of the entire process. Physiotherapists should be aware of the basics in the field of public procurement in order to be able to support other employees in the adequate preparation of tenders and in the selection of contractors.
Proper cooperation will ensure physiotherapists’ satisfaction working on the suitable equipment, and safe physiotherapeutic conditions for patients.
Key words:
Physiotherapy, public procurement, physiotherapy equipment
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Index assessment of outpatient physiotherapy financed from public funds at the disposal of the National Health Fund provided in 2017–2019 in Poland

Zbigniew Tytko, Dominik Dziurda, Dorota Mańkowska, Agata Bąk, Katarzyna Leoszkiewicz, Katarzyna Kędzior, Piotr Bednarski, Roman Topór-Mądry


Zbigniew Tytko, Dominik Dziurda, Dorota Mańkowska, Agata Bąk, Katarzyna Leoszkiewicz, Katarzyna Kędzior, Piotr Bednarski, Roman Topór-Mądry – Index assessment of outpatient physiotherapy financed from public funds at the disposal of the National Health Fund provided in 2017–2019 in Poland. Fizjoterapia Polska 2022; 22(1); 152-158

Abstract
Introduction. Our study aims to present the state of Polish outpatient physiotherapy covered by the National Health Fund (NHF) based on a set of original indices to parametrise the structure of services and the physiotherapy process.
Materials and methods. The study used the NHF reporting data on outpatient physiotherapy collected between January 2017 and October 2019. The analysis used a set of originally developed indices.
Results. Of all outpatient physiotherapy cycles, generally provided on consecutive working days, 70% lasted 10 days and 84% were provided to patients without a formal confirmation of severe disability. From the patient’s perspective, 41% of the time of services is provided in a one-on-one basis (index of the structure of services), while the kinesiotherapy accounted for 30% of total time of services. The dominant group of services, about 70% in quantitative terms, is physical therapy.
Conclusions. To satisfy the health needs of patients by publicly funded outpatient physiotherapy is still a challenge and creates a perspective to develop a new way of organising and financing outpatient physiotherapy. The proposed indices of service structure and process enable an accurate diagnosis of the current situation, development of optimal system solutions and monitoring their implementation.
Key words:
physiotherapy, index, population-based, real world data
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Possibilities of using physiotherapy after surgical treatment of endometriosis. Case study

Magdalena Dudkowska, Agnieszka Sobierajska-Rek, Zofia Barcikowska

Magdalena Dudkowska, Agnieszka Sobierajska-Rek, Zofia Barcikowska – Possibilities of using physiotherapy after surgical treatment of endometriosis. Case study. Fizjoterapia Polska 2022; 22(1); 108-120

Abstract
Objective of the study. The aim of the study was to present the role of physiotherapy in women with endometriosis after surgical treatment.
Material and methods. A 35 year old women with endometriosis diagnosed by histopathological examination participated in the study. The study program included a examination and therapy. The examination included an interview and filled a questionnairy: „Endometriosis impact questionnaire (EIQ)”. The physical examination included functional tests and palpation the structure. The therapy included work with scar, diaphragm, abdominal muscle, iliopsoas muscle and sacroiliac joint.
Results. Physiotherapy management is an important part of the comprehensive treatment of patients after surgical intervention for endometriosis. It contributes to the reduction of tension and to the alleviation of pain.
Conclusions. Physiotherapy may plays an important role in the complex treatment of women with Endometriosis.
Key words:
endometriosis, chronic pain, physiotherapy
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Physiotherapeutic procedure in goose foot inflammation – case study

Radosław Kocent, Marek Kiljański, Joanna Kałuża-Pawłowska

Radosław Kocent, Marek Kiljański, Joanna Kałuża-Pawłowska – Physiotherapeutic procedure in goose foot inflammation – case study. Fizjoterapia Polska 2021; 21(5); 204-210

Abstract
Objective. The article presents a comprehensive rehabilitation procedure in goose foot bursitis. At the beginning, the causes of inflammation and its symptoms were presented.
Material and methods. The study was conducted on a specific case. The article describes the patient’s evaluation and physiotherapy recommendations for the treatment of the disease. In the field of kinesiotherapy, recommendations were made in the form of exercises stretching the shortened muscles that cause the goose foot, as well as strengthening the group of muscles activated to stabilize the knee. An important aspect of working with myofascial techniques is presented. Cryotherapy, laser therapy and sonotherapy procedures are described among the physiotherapy treatments in the rehabilitation of goose foot inflammation. The article also highlights the effectiveness of treatment thanks to the combination of physical therapy, kinesiotherapy, functional massage and re-education of gait and running. The subject of patient education to prevent the recurrence of injuries was also discussed.
Results. Therapy was administered for a period of four weeks. Positions during rest and sleep at home, exercise, walking in a newly learned, correct pattern and avoiding training errors were recommended. After the treatment was completed, pain was completely gone and the patient was fully active again.
Conclusions. Physical therapy, kinesiotherapy, massage and the patient’s compliance with the therapist’s recommendations result in the relief of ailments and a full return to various types of activity.
Key words:
goose foot inflammation, physiotherapy
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Influence of physiotherapy on exercise tolerance in patients after COVID-19

Klaudia Pompka, Katarzyna Bogacz, Jacek Łuniewski, Krystyna Rasławska, Ewa Jach, Igor Świerkowski, Jan Szczegielniak

Klaudia Pompka, Katarzyna Bogacz, Jacek Łuniewski, Krystyna Rasławska, Ewa Jach, Igor Świerkowski, Jan Szczegielniak – Influence of physiotherapy on exercise tolerance in patients after COVID-19. Fizjoterapia Polska 2021; 21(5); 182-189

Abstract
Patients after severe COVID-19 need effective treatment and full medical care. An important aspect of a successful recovery is the implementation of comprehensive rehabilitation. Rehabilitation for convalescents is primarily aimed at restoring or improving the proper functioning of the respiratory system, reducing the severity of the symptoms of the disease and disorders related to comorbidities, as well as increasing the physical efficiency of the body. Objective. The objective of the study was to assess the effect of endurance training on exercise tolerance using the 6-minute walk test in patients with a history of COVID-19.
Material and methods. Thirty patients after COVID-19 were examined, including 12 women (40%) and 18 men (60%) aged 35 to 75 years. The mean age in the study group was 55 years, SD = 10.9.
Before rehabilitation, all patients underwent a 6-minute walk test (6MWT) in order to qualify for the appropriate rehabilitation model. The following parameters were analysed: test time, distance travelled, systolic pressure, diastolic pressure, heart rate, and the reasons for the termination of the test. All COVID-19 patients are covered by the rehabilitation program for patients after COVID-19, which came into force on the basis of the Regulation of the Minister of Health of July 13, 2020 (Journal of Laws, item 1246) on a pilot program in the field of therapeutic rehabilitation for patients after COVID-19.
The distance in the 6-minute walk test in the entire group after rehabilitation increased by an average of 11.8% (from 531.7 ± 97 m to 601.2 ± 86.4 m). Analysing the presented results of studies describing the effect of endurance training on exercise tolerance in patients after COVID-19, no statistically significant differences were found between the age group <55 and the age group ≥ 55.
Conclusions. 1. A 3-week rehabilitation program after COVID-19, the basis of which was endurance training based on exercise on a cycle ergometer, has a positive effect on exercise tolerance in patients measured on the basis of the distance walked during the 6-minute walk (6MWT). 2. In the analysed study, a significant improvement was observed in patients aged ≥ 55 who achieved the shortest distance during the initial 6MWT test.
Key words:
COVID-19, physiotherapy, exercise tolerance
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The impact of magnetostimulation on the level of urinary incontinence among women after menopause

Robert Kowalski, Joanna Kałuża-Pawłowska, Marek Kiljański

Robert Kowalski, Joanna Kałuża-Pawłowska, Marek Kiljański – The impact of magnetostimulation on the level of urinary incontinence among women after menopause. Fizjoterapia Polska 2021; 21(5); 58-69

Abstract
Urinary incontinence (UI) is according to ICS definition “every uncontrolled urine loss”. Among the broadly understood definition, there are different types of UI: effort, urgent, from overflow, mixed, transitional, bedwetting and other types of UI. The most common type from mentioned is the effort urinary incontinence and the mixed one. Due to the complex nature of UI problem, there are many methods of diagnosis and treatment of incontinence. In conservative treatment, pelvic floor muscle exercises, physical therapy (including magnetic field) and behavioral therapy are commonly used.  The aim of the study.  The aim of work is to evaluate the impact of magnetostimulation and pelvic floor muscle exercises on the level of urinary incontinence among women after menopause. Material and methodology.  The research was conducted among 30 women at the age of 45–67 years old (average ± 56) who were treated because of UI in The Independent Public Health Care Centre named Primate Cardinal Stefan Wyszyński in Sieradz in the rehabilitation ward. The patients were divided into two groups – 15 people each. In the first group participants were tested by magnetostimulation and they were doing pelvic floor muscle exercises. In the second group they were only doing pelvic floor muscle exercises.The patients have been surveyed twice, before and after 3 weeks therapy. In the study two different questionnaires (A and B) were used. They were based on Gaudenza questionnaire. Results. According to the analysis of survey data, these are the following results. In the first group improvement concerned: reduction in the frequency of UI episodes and frequency of urination, less amount of „urine loss” and UI intensity based on daily physical acivity, extending the time of the ability to control urination and better quality of life tested women. In the second group an improvement has been noticed according to subjective patient’s feelings. All data analysis results from questionnaires were not statistically significant.
Conclusions. From the analysis of the results, the following conclusions have been drawn: 1. Combination therapy of magnetostimulation with pelvic floor exercises causes more beneficial effect than applying only exercises. 2. Subjective assessment of participants on how to improve ailments connected with UI, speaks in favour of therapy with the use of magnetic field stimulation. 3. The most common type of incontinence amoung tested women after menopause was the effort one. 4. Therapy with 3–weeks programme of magnetic field stimulation increases the level of satisfaction and improves well-being of poople with UI.
Key words:
urinary incontinence, magnetostimulation, menopause, physiotherapy
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Assessment of training heart rate in patients with chronic obstructive pulmonary disease (COPD)

Ewa Jach, Igor Świerkowski, Piotr Kęsicki, Katarzyna Bogacz, Marcin Krajczy, Krystyna Rasławska, Jacek Łuniewski, Jan Szczegielniak

Ewa Jach, Igor Świerkowski, Piotr Kęsicki, Katarzyna Bogacz, Marcin Krajczy, Krystyna Rasławska, Jacek Łuniewski, Jan Szczegielniak – Assessment of training heart rate in patients with chronic obstructive pulmonary disease (COPD). Fizjoterapia Polska 2021; 21(5); 6-12

Abstract
Objective. The objective of the study was to evaluate the training heart rate in patients with chronic obstructive pulmonary disease.
Material and methods. The study was carried out at the John Paul II Specialist Hospital of the Ministry of Interior and Administration in Głuchołazy at the pulmonary rehabilitation department. Two hundred and five people participated in the study. Each patient included in the study was diagnosed with chronic obstructive pulmonary disease. The group consisted of 100 women and 105 men. Rehabilitation models A and B were used in the study. 155 people were included in model B, and 50 people in model A. The average age was 55. The patients underwent a 6-minute walk test before and after rehabilitation. The following data was included in the study: walk test maximum heart rate, the patient’s maximum heart rate and resting heart rate.
Results. Before rehabilitation, 121 patients achieved a result of over 70% of the values determining the correlation between the 6MWT test heart rate and the submaximal heart rate, which constitutes 60% of all patients. However, the mean value of this correlation among all patients was 74.69%. After rehabilitation, 143 patients achieved a result of more than 70% of the values determining the correlation between the 6MWT test heart rate and the submaximal heart rate, which is 70% of all patients. However, the mean value of this correlation among all patients was 79.19%. Before rehabilitation, 205 patients achieved a result of more than 70% of the values determining the correlation between the 6MWT test heart rate and the submaximal heart rate, which constitutes 99.51% of all patients. While, the mean value of this correlation among all patients was 92%. The number of patients who, before rehabilitation, achieved more than 70% of the values determining the correlation between the 6MWT test heart rate and the submaximal heart rate, was 100% of all patients. The mean value of this correlation among all patients was 90.15%.
Conclusions. 1. The maximum heart rate achieved by patients during the 6-minute walk test corresponds to the maximum heart rate before rehabilitation in 60% of patients, and after rehabilitation in 70% of patients.
2. The maximum heart rate achieved by patients during the 6-minute walk test corresponds to the training heart rate before rehabilitation in 95% of patients, and after rehabilitation in 100% of patients.
3. It seems the maximum heart rate achieved by patients during the 6-minute walk test can be used in determining the patient’s load during exercise.
Key words:
COPD, pulmonology, exercise heart rate, physiotherapy
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Evaluation of the effects of Super Inductive Stimulation in physiotherapy after SARS-CoV-2 infection

Piotr Kęsicki, Igor Świerkowski, Ewa Jach, Krystyna Rasławska, Jacek Łuniewski, Katarzyna Bogacz, Jan Szczegielniak

P. Kęsicki, I. Świerkowski, E. Jach, K. Rasławska, J. Łuniewski, K. Bogacz, J. Szczegielniak – Evaluation of the effects of Super Inductive Stimulation in physiotherapy after SARS-CoV-2 infection. Fizjoterapia Polska 2021; 21(4); 6-17

Abstract
Objective. The objective of the study was to assess the effectiveness of Super Inductive Stimulation in respiratory therapy in patients after SARS-CoV2 infection.
Material and methods. The study was carried out in the specialist hospital of the Ministry of the Interior and Administration in Głuchołazy, in the pulmonary department. Fifteen men aged 35 to 63 and fifteen women aged 32 to 69 participated in the study. Each patient underwent ten sessions of Super Inductive Stimulation.
Results. The use of Super Inductive Stimulation resulted in the reduction of moderate cough, chest pain, shortness of breath, severe cough with phlegm/sputum, sweating, headache, nausea, diarrhoea, muscle pain, lack of appetite, problems with concentration, problems with thinking and sleeping, and fatigue.
Conclusions. Analysis of the results showed a positive effect of the applied therapy. Taking into account the answers given before and after rehabilitation, the condition of the respondents improved by 20.18%. The largest differences in the results were observed in the case of headache, diarrhoea, and sleeping problems, being 39.85%, 30.91% and 28.57%, respectively. The comparison of the study results showed that the patients’ quality of life improved.
Key words:
pulmonology, super inductive stimulation, COVID-19, physiotherapy
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