根据2017年蒂黑省立医院新生儿科中住院的新生儿医疗文献分析所得,导致婴儿髋关节发育不全的主要因素

Magdalena Kiecoń, Jarosław Madowicz, Paulina Głowacka, Renata Szczepaniak

M. Kiecoń, J. Madowicz, P. Głowacka, R. Szczepaniak – The main factors determining the occurrence of developmental dysplasia of the hip in infants based on the analysis of medical history of newborns staying in the neonatal ward of the Szpital Wojewódzki in Tychy in 2017. Fizjoterapia Polska 2019; 19(1); 98-107

摘要
研究目的。检查新生儿髋关节发育不全的频率,并区分导致其出现的主要因素。
材料及方法。针对位于蒂黑省立专科医院Megrez Sp. z o.o. 新生儿科中1591名病患的病历进行研究。
结果。女孩出现髋关节发育不全的频率比男孩高,普遍出现在右关节。研究中未发现髋关节发育不良的出现率与分娩的类型、孕周、孕期及新生儿出生体重间的显著相关性。然而,发现生理学上关节的发育不全和新生儿出生体重间具统计学上的显著相关性。
结果。1. 2017年在蒂黑省立医院新生儿科住院的新生儿中髋关节发育不全的发生率为2.7%,低于文献记录。2. 女孩出现髋关节发育不全的机率高于男孩。3. 髋关节发育不全出现于右关节的几率在统计学上显然较高。4. 确认在根据格拉夫量表的IIa型变异出现及新生儿体重之间存在显著相关性。5. 髋关节发育不良与分娩的类型、孕周、孕期及新生儿出生体重间未发现显著相关性。

关键词:
DDH、髋关节发育不全、儿科、新生儿、髋关节

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DKK设备在物理治疗中的应用。适用症和禁忌症

Wojciech Kaczmarek, Paweł Łęgosz, Renata Szczepaniak, Anna Lipińska, Krzysztof Mucha

W. Kaczmarek, P. Łęgosz, R. Szczepaniak, A. Lipińska, K. Mucha – The new Dynamic Spine Correction (DSC) device: indications and contraindications. Fizjoterapia Polska 2018; 18(4); 62-72

摘要
治疗中使用动态脊椎矫正设备;经过后来修正,根据Wojciech Kaczmarek专利编号PL 229766及编号US 9,949,884 B2。设备在欧盟动态脊椎矫正器(DKK)及新理疗法项目框架下,由Bio.morph Sp. z_o.o.公司开发和制造。DKK设备可在物理治疗师监控下独立进行康复,也可在脊椎关节阻塞的动态生理性关节内动作恢复时持续控制脊椎的活动。借助新的诊断系统可将脊椎健康状态可视化、记录患者的工作参数并记录结果,并对当前患者状态及理疗进展进行客观评估。
新诊断解决方案及动态脊椎矫正和神经肌肉姿势再训练等新方法的使用(以下简称DKK),可以有效治疗功能性障碍且结合疼痛综合症的脊椎疾病,同时降低病患因使用特定治疗技术、具过度毒性和低特异性的材料及药物所带来的健康风险。其设计可消除因未受控制的治疗等为病患所带来的健康风险。

关键词:
脊椎功能性障碍的物理治疗、脊椎动态矫正和活动化、神经肌肉的姿势再训练。

 

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工作疗法的功能面

Jerzy Rottermund, Joanna Szymańska, Aneta Warmuz-Wancisiewicz, Renata Szczepaniak

Jerzy Rottermund, Joanna Szymańska, Aneta Warmuz-Wancisiewicz, Renata Szczepaniak – The functional aspects of occupational therapy. Fizjoterapia Polska 2018; 18(3); 78-85

 

摘要
工作疗法的基本目的在减低或完全除去功能限制,并依照所具的身心能力努力达到自立、自给自足和独立。研究目的在将工作疗法作为提高日常活动所需功能健全性的措施。

医学中的功能性意味的是生理的活动或众多过程,对整个身体的运作至关重要。工作疗法中“功能”一词是指治疗参与者所能够进行的一连串活动。本文介绍并谈论工作治疗师在其专业工作中应列入考虑的恢复运动功能的条件。

关键词:
工作疗法、功能健全、功能障碍

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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

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High-tone power therapy as an alternative to walking training in people with intermittent claudication

Joanna Szymańska, Krzysztof Czupryna, Olga Nowotny-Czupryna, Renata Szczepaniak

J. Szymańska, K. Czupryna, O. Nowotny-Czupryna, R. Szczepaniak. High-tone power therapy as an alternative to walking training in people with intermittent claudication. FP 2017; 17(3); 112-120

Abstract

Introduction. The main symptom of the CLEI impairing walking ability and functioning of the patient is intermittent claudication. The predominant form of the physical therapy during this ischaemic period is physical training, which, due to the frequent occurrence of co-morbidities, can only be taken by 25-50% of patients. Therefore, other ways of relieving symptoms associated with the CLEI have been sought. Perhaps, an alternative method might be may the high-tone power therapy, which can start the muscle pump without negative effects of contraindicated for physical exertion.
The aim of the study was to determine whether the high-tone power therapy could be an alternative for walking training on a treadmill, especially for people with contraindication for intensive physical activity.
Material and methodology 68 patients diagnosed with CLEI in the age of 40-70 were examined in 2 groups: A-main and B-control. Functional possibilities were evaluated in the area of the walking distance and the maximum walking distance in a standard treadmill test. The results obtained were compared with the literature on the increment of these distance after the physical training. Group A patients were subjected to a series sessions of high-tone power therapy; group B patients had those treatments simulated.
Results In group A, patients significantly prolonged the claudication distance and maximal walking distance. Also, significant reduction in pain duration was noticed after discontinuation of the treatment.
Conclusions The high-tone power therapy may be an alternative to walking training for patients with the CLEI, especially in those patients with a very short claudication distance and in those whose greater effort is not indicated.

Key words:

high-tone power therapy (HiToP), chronic lower extremity ischaemia (CLEI), intermittent claudication, walking training, chronic lower limb ischaemia

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Improvement in the quality of life of persons with chronic lower extremity ischaemia after high-tone power therapy

Joanna Szymańska, Olga Nowotny-Czupryna, Krzysztof Czupryna, Renata Szczepaniak

J. Szymańska, O. Nowotny-Czupryna, K. Czupryna, R. Szczepaniak – Improvement in the quality of life of persons with chronic lower extremity ischaemia after high-tone power therapy. FP 2017; 17(3); 64-73

Abstract

Introduction.The CLEI results in decreased walking ability, which is limiting physical activity due to pain. This is the main factor adversely influencing the quality of life observed in these patients. For these reasons, the most important target of physiotherapists is to reduce physical fitness loss caused by a very low level of physical activity over many years.
The aim of the study was to investigate whether the high-tone power therapy can improve functional abilities patients with CLEI in the gait, and thereby improve their self-assessed quality of life.
Material and methods The study involved 68 patients aged 40-70, who were assigned to one of two groups: the A – main, group and B – control group. Their functional abilities in gait were assessed with the use of the WIQ-Walking Impairment Questionnaire, which evaluated 4 domains: claudication distance, walking speed, claudication capacity, ability to walk steps. A group patients were subjected to a series of high-tone power therapy while in B group all the treatments were simulated.
Results Certain differences were noticed in each domain of the WIQ questionnaire, but significant ones were solely in A group. The most noticeable changes were in pain and cramps of the calf; smaller changes were related to walking distance and speed. The smallest changes were reported in the ability to walk steps. Some changes were also reported in the control group, but they were less conspicuous and only affected some domains of the WIQ questionnaire.
Conclusions The high-tone therapy results in subjective improvement in functional locomotion capacity in all domains of self-assessment of patients. Improving the function of lower extremities is conditioned by the presence of additional factors, which are kind of disorder risk factors.

Key words:
high-tone power (HiToP), quality of life, chronic lower extremity ischemia (CLEI), chronic lower limb ischemia

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Muscle energy techniques after total hip replacement

Maria Mazepa, Renata Szczepaniak, Wojciech Kiebzak,
Zofia Śliwińska, Zbigniew Śliwiński

M. Mazepa, R. Szczepaniak, W. Kiebzak, Z. Śliwińska, Z. Śliwiński – Muscle energy techniques after total hip replacement. FP 2014; 14(1); 18-26

Abstract

Introduction.  Surgical procedure involving total hip alloplasty is a common consequence of the absence of progress of rehabilitation in patients with significant degenerative lesions accompanied by severe pain and significantly limited mobility. An individual program for patient rehabilitation is established during the first 24 hours after the procedure. This is of particular importance as proper planning and implementation of physiotherapy allows to relieve pain and to achieve full functional joint mobility as well as to strengthen the muscles. We make sure that the proper muscle control and stability within the joint will restore patient’s locomotion and self-care both at the initial and later stages of rehabilitation. There are many ways and methods to improve the above mentioned parameters. Muscle energy techniques, which represent a non-invasive therapy in patients with total hip replacement, are one of these methods. These techniques, including poizometric relaxation of contracted muscles as well as active relaxation of hip joint muscles, myofascial techniques, also in combination with elements of PNF techniques, allow for effective treatment and rehabilitation of patients. Aim. The aim of the study was to compare the effects of standard physiotherapy in patients after cemented hip arthroplasty with those of physiotherapy using muscle energy techniques.
Materials and Methods. A total of 66 patients with advanced degenerative arthritis of the hip, who received surgical treatment in the form of endoprosthetics, were qualified for the study between 2013 and 2014. The patients were divided into two groups  (group I and II), 33 subjects each. Pain level, the range of hip motion as well as muscle strength were assessed in each patient. Group I received muscle energy techniques, including poizometric relaxation of muscles, active muscle relaxation and elements of PNF method. Also, myofascial techniques targeting muscles with different strengths and direction of pressure were used. Group II received standard physiotherapy.
Results. Significant improvement of pain, an increase in the range of functional motion as well as a significant improvement of muscle control of the joint were observed in the group receiving muscle energy treatment, which had beneficial effects on the locomotion of patients.
Conclusions. Muscle energy techniques had significant effects on the improvement of muscle function and stabilization in the pelvic girdle of the joint with endoprosthesis. Poizometric relaxation combined with elements of the PNF method as well as myofascial techniques effectively improved balance, coordination and gait pattern. In conclusion, physiotherapy using muscle energy techniques was shown to be a more effective method in the treatment of hip osteoarthritis as compared to the method based on standard rehabilitation program.

Key words:
arthroplasty, rehabilitation, muscle energy techniques

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The rehabilitation of patients after the cerebral stroke including socio-demographic factors

Marzena Kobylańska, Bartosz M. Wójcik, Renata Szczepaniak, Zbigniew Śliwiński

M. Kobylańska, B. M. Wójcik, R. Szczepaniak, Z. Śliwiński – The rehabilitation of patients after the cerebral stroke including socio-demographic factors. FP 2016;16(4);82-97

Abstract

Introduction. According to the World Health Organization, cerebral stroke constitutes the third largest cause of death just after heart disease and cancer. It is estimated that every year 4.6 million people die due to stroke, including 3.2 in developing countries and 1.2 in developed ones. It has been observed that the effectiveness of physiotherapy in patients after a stroke depends on biological factors but also on their socio-economic condition.
The dissertation goal. The goal of this dissertation is to analyze the role of socio-demographic factors in the process of physiotherapy for patients after a cerebral stroke.
Materials and methods. The research has been carried out at the neurological rehabilitation ward of the Wrocław Center for Rehabilitation and Sports Medicine. The research group consisted of 120 patients after cerebral stroke. The examination was conducted at two time intervals – on the first day of the patient’s treatment at the neurological rehabilitation ward, and after three weeks of rehabilitation. All the patients participated in the systematic physiotherapy, which is a standard procedure at the neurological rehabilitation ward, where they had a defined schedule of frequency and time of rehab. A full research cycle lasted for three weeks for every patient. The following methods were used in the research: Barthel Scale (Barthel Index, BI), Lawton Scale (Instrumental Activity of Daily Living (IADL), Rivermead Mobility Index (RMI), Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Generalized Self – Efficacy Scale (GSES), Acceptance of Illness Scale (AIS), and Visual Analogue Scale (VAS).
Results. Factors regarding the biological nature of the patient’s condition such as age, time since the stroke, type of stroke, and number of coexisting diseases have a definite impact on the low effectiveness of the physiotherapy conducted at the neurological rehabilitation ward. Socio-demographic factors, marital status, professional activity, and kind of job, also have an impact on the low effectiveness of the conducted physiotherapy.
Conclusions. Comprehensive rehabilitation of neurological patients after the cerebral stroke, taking into account socio-demographic factors is essential to achieve high effectiveness of physiotherapy.

Keywords:

stroke, physiotherapy, socio-demographic factors

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Possible applications of dynamic taping in women after the removal of lymph nodes because of breast cancer

Anna Lipińska, Magdalena Lipińska-Stańczak, Paweł Macek, Renata Szczepaniak, Sławomir Jandziś, Zbigniew Śliwiński

A. Lipińska, M. Lipińska-Stańczak, P. Macek, R. Szczepaniak, S. Jandziś, Z. Śliwiński: Possible applications of dynamic taping in women after the removal of lymph nodes because of breast cancer. FP 2015;15(4);16-31

Abstract
Introduction. In Poland and in the world breast cancer is the most frequent malignancy among women. Complications occurring after the applied therapy lower the quality of patients’ life. One of the many adverse effects of breast cancer treatment is lymphedema. Removal of lymph nodes and damage to lymphatic vessels make the transport of high-molecular proteins difficult, and at the same time, they have an influence on an increase in the colloid-osmotic pressure, water retention in the inter-tissue space, the loss of lymphatic vascular tone and reduction of the hydrostatic pressure. If not treated, lymphedema causes ailments in the form of recurrent inflammatory conditions of the skin, lymphatic vessels, which greatly reduces the patients’ psychophysical efficiency and promotes the development of lymphosarcoma of the upper limb on the side of mastectomy. One of the methods of lymphedema treatment is Kinesiology Taping. In Poland, the term dynamic taping is more and more frequently used. Application of this method causes that healing processes occur in the patient in a painless and natural way.
Aim. To present the possibilities of using lymphatic techniques of dynamic taping in women after mastectomy and to assess the impact of the applications on the secondary lymphedema.  The author decided to verify the main objective through the following research hypotheses:
1.Applications of dynamic taping reduce lymphedema in women after mastectomy.
2.Techniques of the Kinesiology Taping method influence the change of motion ranges in the joints of the upper limb.
Material and research methods. The study was performed in the Department of Rehabilitation of Holycross Cancer Centre in Kielce. The study group consisted of 73 patients after mastectomy diagnosed with secondary lymphedema of the upper limb. The volume of upper limbs was measured with the use of a measuring cylinder filled with water. Measurements of motion ranges in the joints of upper limbs were performed with the use of a goniometer.
Results and conclusions. Analysis of the results shows that the employed lymphatic applications reduce lymphedema, increase the range of motion in the joints of the upper limb on the operated side and promote healing processes, contributing to the improvement of physical efficiency and the quality of life.

Key words:
breast cancer, lymphedema, dynamic taping, Kinesiology Taping

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