Treatment and rehabilitation procedures for patients with Guillain-Barre-Strohl syndrome

Iwona Pyszczek, Jolanta Kujawa, Jan Talar, Robert Jonak

Iwona Pyszczek, Jolanta Kujawa, Jan Talar, Robert Jonak – Treatment and rehabilitation procedures for patients with Guillain-Barre-Strohl syndrome. Fizjoterapia Polska 2001; 1(1); 63-66

Abstract
This article presents the epidemiology and clinical picture of Guillain-Barre-Strohl Syndrome (GBS), along with a review of currently used methods of treatment and rehabilitation for patients with this disorder. A summary is provided of the current state of research on the etiopathogenesis of GBS, its clinical symptoms, and the typical course. The rehabilitation procedures appropriate for the various stages of the disease are described. There is also a presentation of the best kinesitherapeutic and physicotherapeutic methods, with particular attention to electrotherapy and the use of alternating magnetic fields.

Key words:
Guillain-Barre-Strohl, AIDP, Rehabilitation, electrotherapy, alternating magnetic fields

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An evaluation of the effectiveness of electroanalgesia using the Stiwell method in the rehabilitation of patients with lumbar back pain syndrome

Mirosław Janiszewski, Maciej Chyliński

Mirosław Janiszewski, Maciej Chyliński – An evaluation of the effectiveness of electroanalgesia using the Stiwell method in the rehabilitation of patients with lumbar back pain syndrome. Fizjoterapia Polska 2001; 1(1); 45-46

Abstract
Background. Pain symptoms in the lumbar segment of the spine constitute a problem that is not only medical, but also social and economic. The goal of this article is to evaluate the therapeutic effectiveness of electroanalgesis in treating this disorder. Material and method. The experimental group consisted of 80 patients aged 40-60, who underwent a two-month rehabilitation program using the Stiwell electroanalgesic method. The control group included 80 patients who received a traditional rehabilitation program. Results. A significant reduction in pain symptoms was discovered in the experimental group, as compared to the control group.Conclusion. The Stiwell electroanalgesic method serve to improve the ultimate outcome of the patients with lumbar back pain syndrome.

Key words:
electroanalgesia, lumbar back pain syndrome, Rehabilitation

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The role of the visual apparatus in the early diagnostics and rehabilitation of disorders of the central nervous system

Zofia Prusiecka, Ludmiła Sadowska, Zbigniew Śliwiński

Zofia Prusiecka, Ludmiła Sadowska, Zbigniew Śliwiński – The role of the visual apparatus in the early diagnostics and rehabilitation of disorders of the central nervous system. Fizjoterapia Polska 2001; 1(1); 43-44

Abstract
The authors present various symptoms that may indicate developmental disorders of the visual apparatus in connection with associations of the neuronal pathway with the sometimes very complicates reflex arches. The Direct Light Stimulation method (DLS) is presented, which may be helpful in the stimulation and rehabilitation of children with damage to the central nervous system.

Key words:
Vision, CNS injury, diagnositics, Rehabilitation

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An evaluation of the effectiveness of magnetotherapy as a factor supporting rehabilitation on the basis of selected biomechanic and psychotechnical indices

Mirosław Janiszewski, Anna Błaszczyk

Mirosław Janiszewski, Anna Błaszczyk – An evaluation of the effectiveness of magnetotherapy as a factor supporting rehabilitation on the basis of selected biomechanic and psychotechnical indices. Fizjoterapia Polska 2001; 1(1); 39-42

Abstract
The aim of this study was to examine the impact of longterm magnetic field stimulation on the rehabilitation of post-stroke patients and to determine how quickly these patients gain locomotor efficiency. A group of 180 patients 50-70 years old after stroke received rehabilitation and low frequency magnetic field stimulation. As a criterion for evaluation purposes the authors used selected biomechanical and psychotechnical indices. The study shows that magnetotherapy in post-stroke patients undergoing rehabilitation has a positive effect in the improvement of muscle function, motor coordination indices, and some biomechanical parameters (strength under dynamic and static circumstances).

Key words:
Stroke, magnetic fields, Rehabilitation

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The neurorehabilitation of hemispatial neglect in patients with traumatic brain injury

Maria Pąchalska, Bogusław Frańczuk, Jan Talar, Wiesław Tomaszewski, Bruce MacQueen, Kay Neldon

Maria Pąchalska, Bogusław Frańczuk, Jan Talar, Wiesław Tomaszewski, Bruce MacQueen, Kay Neldon – The neurorehabilitation of hemispatial neglect in patients with traumatic brain injury. Fizjoterapia Polska 2001; 1(2); 143-154

Abstract
Background. The purpose of this article is to evaluate the relative effectiveness of differentiated rehabilitation programs for patients with hemispatial neglect subsequent to traumatic brain injury (TBI). In the literature, neglect is classified into two basic types: egocentric (“body-centered”), in which the patient neglect object situated in a given area of his field of vision, and allocentric )”objected-focused”), in which the patient neglects one side of objects presented to him, regardless of their location. The authors’ clinical practice indicates that the visual scanning technique traditionally used in neglect therapy is generally ineffective in patients with egocentric neglect. A spatio-motor training program has therefore been developed by the authors, elaborated on the basic of their program of semantically controlled motion patterns for the rehabilitation of apraxia, whose goal is to reestablish the proper relations between automatic and voluntary movements, to improve interhemisphere cooperation by symmetrical and asymmetrical modeling of motor exercises with both healthy and affected limbs, and to increase patient motivation by establishing clearcut goals and rewarding success. Both programs, visual scanning and spatio-motor training, have been implemented in clinical practice in the represented by the authors. Material and methods. The article describes in detail the rehabilitation of two TBI patients (JK, male, age 27, and AS, female, age 28) treated by the authors in the chronic phase of recovery after automobile accidents, as a result of which both patients were comatose for more than 4 weeks. In neuropsychological testing JK and AS both presented with persistent and significant leftsided hemispatial neglect: allocentric neglect in JK, and egocentric in AS. A modified AB-BA experimental design was used, where A represents spatio-motor training, and B is visual scanning. For patient JK, program A was first applied, followed by B, while for patient AS the reverse sequence was used. Each program included 10 therapy sessions, with a four-week interval between programs. The degree of neglect was measured using standard neuropsychological tests for quantitative and qualitative assessment of neglect, along with the analysis of drawings made during therapy by both patients. The patients were tested four times, before and after each of the two programs. Results. As the authors had hypothesized, patient JK did not show any progress in terms of neglect after conclusion of program A, while after program B he showed virtually no lingering neglect. In the case of patient AS the results were exactly opposite: after concluding program B (which she received first) there was no significant change, while after program A (administered second) there were no signs of neglect.Conclusion. The theoretical and clinical implications of these results for neuropsychological practice are discussed, and a model solution is proposed to explain the basic pathomechanism of both allocentric and egocentric neglect. These two types of neglect are sufficiently different in etiology and symptomatology to necessitate differentiated therapy programs in the course of neurorehabilitation.

Key words:
hemispatial neglect, traumatic brain injury, rehabilitation

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Sport training as an alternative form of rehabilitation for heart transplant patients

Dominika Batycka, Grzegorz Mańko, Michał Stachnik

Dominika Batycka, Grzegorz Mańko, Michał Stachnik – Sport training as an alternative form of rehabilitation for heart transplant patients. Fizjoterapia Polska 2001; 1(2); 111-116

Abstract
Background. The goal of this study was to evaluate „sports training” as an alternative to the traditional forms of cardiac rehabilitation for patients in advanced recovery from heart transplant surgery. Sports training is a good, diversified form of therapy, and at the same time plays an additional role in social integration and relief of psychological stress. Material and method. The effectiveness of “sports training” was evaluated in a natural clinical experiment involving 34 patients undergoing rehabilitation in the Cardiovascular Surgery and Transplantation Clinic at the Jagiellonian University’s Collegium Medicum in Cracow. The patients were divided into a control group (K), including 17 patients (15 men and 2 women) who underwent rehabilitation before the implementation of “sports training”, using the traditional form of rehabilitation, and an experimental group (E), also including 17 patients matched by age and sex, who received “sports training”. Results. An analysis of the results obtained demonstrated no statistically significant difference between the outcome under traditional rehabilitation and in “sports training”, including respiratory parameters. Nothing in the results pointed to increased risks associated with sports training. Conclusion. Sports’ training is a good alternative to traditional forms of exercises for patients who are well advanced in recovery from heart transplant surgery.

Key words:
Heart Transplant, sport training, rehabilitation

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Long-term respirotherapy, dishabituation from the respirator, and the rehabilitation process in a patient with marfan syndrome subsequent to surgery on an aortal aneurysm

Dominika Batycka, Grzegorz Mańko, Michał Stachnik, Donata Kołacz

Dominika Batycka, Grzegorz Mańko, Michał Stachnik, Donata Kołacz – Long-term respirotherapy, dishabituation from the respirator, and the rehabilitation process in a patient with marfan syndrome subsequent to surgery on an aortal aneurysm. Fizjoterapia Polska 2001; 1(3); 292-296

Abstract

The purpose of this article is to present the case of a patient with the Marfan syndrome who underwent surgery to repair an aortal aneurysm and his early rehabilitation, with particular emphasis on respiratory therapy. A 32-year-old patient with the Marfan syndrome was admitten to the Cardiovascular Surgery and Transplantology Clinic at the Jagiellonian University’s Collegium Medicum in Cracow, Poland, with suspected delamination of an aneurysm in the ascending aorta. Computer tomography revealed supravalvular dilatation of the ascending aorta along a 5-6 cm segment. Emergency surgery was performed using the Bental de Bono Composite Graft St. Jude Medical 25A method and ingrafting a venous bypass to the RCA. After surgery the patient was “suppressed” for 7 days in a drug-induced coma (low arterial blood pressure must be maintained initially in a patient with a surgically implanted prosthesis to prevent damage to the graft site). On the 8th day an attempt was made to extubate the patient. After ca. 14 hours of spontaneous respirator the patient was reintubed due to respiratory and circulatory insufficiency. On the 13th day when it proved impossible to terminate mechanical ventilation of the patient, a tracheotomy was performed. On the 19th day a successful effort was made to disconnect the patient from the respirator. At present the patient is breathing independently and is undergoing rehabilitation in the Department of Surgery. The article describes the program of early rehabilitation for this patient. The significance of the case for physiotherapy practice will be discussed.

Key words:
mechanical ventilation, Rehabilitation, Marfan Syndrome
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Problems in physico- and physiotherapy of patients in the course of HIV infection and AIDS infection

Włodzisław Kuliński, Anna Muszyńska, Jerzy Kruszewski

Włodzisław Kuliński, Anna Muszyńska, Jerzy Kruszewski – Problems in physico- and physiotherapy of patients in the course of HIV infection and AIDS infection. Fizjoterapia Polska 2002; 2(1); 68-70

Abstract
In 1989, the first case was diagnosed of the disease later called acquired immune deficiency syndrome (AIDS). According to WHO data, by the end of 1998 over 30 million persons around the world were known to be infected by the human immunodeficiency virus (HIV); every day 16,000 new cases of HIV infection are reported, and several million people have died of AIDS. In Poland, by the end of 1999 several thousand persons had been infected with HIV, of whom several hundred had been diagnosed with AIDS. From the moment of infection to the full development of the disease takes about ten years. AIDS is spreading on an epidemic scale. Pharmalogical treatment is imperfect and only serves to slow the progress of the infection and delay the onset of AIDS. In the development of the disease we observe the appearance of changes in the central and peripheral nervous systems, caused directly by the action of the virus and by the worsening impairment of cell immunity. Multi-focal leukoencephalopathy is found in the brain, and in the peripheral nervous system there are symptoms of sensory polyneuropathy, followed by demyelinating neuropathy and symptoms of damage to multiple peripheral nerves. In practice, peripheral neuropathy occurs in conjection with subacute encephalitis and paresis of the cranial nerves, primarily V, VII and VIII. Lesions in the vicinity of the spinal cord cause weakening of muscle strength, sphincter disorders, and progressive plegia of the limbs. In many patients we also observe symptoms in the joints. In the physico- and physiotherapeutic treatment of these patients we recommend variable low-frequency magnetic fields for subacute encephalitis with involvement of the cranial nerves (the article specifies the parameters for the procedures and the exposure time, also for patients with symptoms of peripheral neuropathy and limb plegia). The possibilities of selective physicotherapy by other means is discussed. Physical therapy procedures are also presented in the course of joint disorders, and kinesitherapeutic procedures are discussed. In the balance of the article the detailed rules for personal hygiene in handling these patients are discussed. The risk of transmitting HIV infection during physio- and physiotherapeutic procedures has been estimated at 5-10%. We have not had much experience in Poland with managing this group of patients. This article should be regarded as an attempt to raise problems which should be solved in cooperation.

Key words:
Physical Medicine, rehabilitation, prevention

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Local experience in the treatment of low back pain using the McKenzie method

Tadeusz Guranowski, Włodzimierz Kuliński, Zbigniew Lipiec

Tadeusz Guranowski, Włodzimierz Kuliński, Zbigniew Lipiec – Local experience in the treatment of low back pain using the McKenzie method. Fizjoterapia Polska 2002; 2(3); 185-193

Abstract
Background. The goal of our study was to evaluate the value of the McKenzie program in reducing pain symptoms in patients with low back pain. Material and methods. The research involved a group of 25 patients (12 men and 13 women) ranging in age from 23 to 74 years. The patients were referred for treatment on the basis of subjective complaints, neurological and functional physical examinations, additional tests, and a test sheet developed by McKenzie, according to which the so-called „functional degree of damage” to the intervertebral disk was assessed on a scale from 1 to 7. The group included both inpatients in neurological and neurosurgical departments and outpatients. After preliminary examination all these patients were included in the group of persons with structural disturbances. The patients were treated under the McKenzie program for 10 days in the Rehabilitation Department (second examination). For the next three weeks the patients continued the program at home. In addition, they were instructed as to the proper manner of performing activities of daily living. A follow-up test was performed after 30 days (third examination). The effectiveness of the program was evaluated on the basis of the clinical status of the patients, evaluated both subjectively and objectively.Results. An analysis of the results indicates that the McKenzie Method we used had a favorable impact on reducing pain complaints and improving the patients’ functioning. In the experimental group 23 patients reported subjective improvement; Lasseque’s sign disappeared in 9 of 15 patients; pain complaints were reduced and nerve root pain radiation was eliminated in 13 patients; in 2 cases the application of the program did not lead to improvement. Conclusions. The McKenzie Method used in the conservative treatment of low back pain deserves particular attention. The transparent and rapid diagnostic methods and high effectiveness confirm the advisability of its application in the therapy of patients with low back pain.

Key words:
McKenzie method, lumbar spine, rehabilitation

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The gait. Part I – the analysis of the gait biomechanics in the rehabilitation

Mirosław Janiszewski, Beata Rechcińska-Roślak, Joanna Błaszczyk-Suszyńska

Mirosław Janiszewski, Beata Rechcińska-Roślak, Joanna Błaszczyk-Suszyńska – The gait. Part I – the analysis of the gait biomechanics in the rehabilitation. Fizjoterapia Polska 2002; 2(4); 311-318

Abstract
In the article the present state of knowledge regarding the gait of human is described. It has been presented what movements are performed in the upper and lower limbs joints while walking and in what position the centre of human gravity is. In the enclosed figures there is stated what biomechanics of the human is like.

Key words:
Gait, Biomechanics, Rehabilitation

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