Analysis of pain and quality of life in women after radical and sparing mastectomy

Kinga Czaja, Zbigniew Śliwiński, Edyta Dziewisz-Markowska, Kamil Markowski

Kinga Czaja, Zbigniew Śliwiński, Edyta Dziewisz-Markowska, Kamil Markowski – Analysis of pain and quality of life in women after radical and sparing mastectomy. Fizjoterapia Polska 2021; 21(3); 214-225

Abstract
Objective. The objective of the study was to analyse pain and quality of life in women after radical and sparing mastectomy. The quality of life after radical mastectomy compared to sparing mastectomy was characterized, assessing difficulties in everyday life and work, as well as limitations in undertaking various activities caused by pain after the procedure. The study verified whether the type of mastectomy significantly impacted selected aspects of life.
Material and method. The questionnaire-based study was carried out among 100 patients of Holy Cross Cancer Centre, aged 29 to 88 years, after radical and sparing breast cancer treatment. In order to compare the values of quantitative and qualitative variables between the groups, Student’s t-test, chi-square test, Mann-Whitney test and Shapiro-Wilk test were used. A significance level of p <0.05 was adopted in the course of the analysis. Statistical analysis was performed using Statistica 13.1 by StatSoft; the data was collected in Excel 2016.
Results. The analysis showed no statistically significant differences in the level of pain intensity in each analysed area between the groups of women, however, it confirmed a statistically significant correlation between the type of surgery performed and the onset of pain as well as limitations in everyday functioning. The analysis showed no statistically significant differences in pain intensity depending on the treatment period.
Conclusions. The level of pain after radical and sparing mastectomy was similar. After radical mastectomy, the patients’ quality of life was lower than after sparing mastectomy. Rehabilitation reduced pain intensity and improved the patients’ quality of life.
Key words:
radical mastectomy, sparing mastectomy, rehabilitation, quality of life
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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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Thermovisual evaluation of the behavior of skin surface temperature following cryostimulation of the forearm in healthy adults

Zbigniew Śliwiński, Jan Talar

Zbigniew Śliwiński, Jan Talar – Thermovisual evaluation of the behavior of skin surface temperature following cryostimulation of the forearm in healthy adults. Fizjoterapia Polska 2001; 1(2); 155-160

Abstract
Introduction. The authors describe the impact of local cryotherapy on the human organism and the operating principles of the thermoregulation center. The article also contains information on thermovision. The research results presented here involve change in skin suface temperature in the upper limbs following chilling only one forearm by liquid nitrogen vapors for 2 minutes. Material and methods. 18 healthy volunteers (13 women, 5 men) were tested with the consent of the Bioethics Committee at the Bydgoszcz Academy of Medicine. Skin temperature changes were evaluated using an Agema 570 thermovision camera. A KS-1 apparatus manufactured by Hans-Sped (Głogów, Poland) was used for cryostimulation. Results. The results confirm that chilling one limb evokes changes in the other limb also. The temperature in the chilled limb after a two-minute administration did not achieve the initial values 5 minutes after conclusion of cryostimulation. In the limb which did not receive cryostimulation the temperature leveled out within 2 minutes after conclusion of stimulation, despite an initial drop. Intensive perfusion brought about a statistically significant increase in temperature to values higher than initial, in several cases, however, increased temperature was observed after conclusion of cryostimulation. This mechanism is not fully explained. Conclusions. The temperature increase in the untreated arm after conclusion of cryostimulation indicates that the thermoregulatory mechanism is operating properly, defending the organism against heat loss by increasing the blood supply to the limb. Cold reduced the sensitivity of smooth muscles to sympathetic stimuli and the effect of catecholamine, and this facilitates blood supply to the limbs. Cryostimulation to only one limb in healthy persons induces contralateralization of the consensual reflex, as shown by temperature changes on the skin of the limb not subjected to cryotherapy. This would seem to be associated with the arousal of cold thermoreceptors due to the reduction in skin temperature, which in turn leads to bioelectric arousal of the brain by the activating portion of the reticular network in the mesencephalon.

Key words:
Cryostimulation, thermoregulation, thermovision

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The use of a Szirmal myotonometr to evaluate spastic tension in the lower limbs of children with cerebral palsy

Zbigniew Śliwiński, Bartłomiej Halat

Zbigniew Śliwiński, Bartłomiej Halat – The use of a Szirmal myotonometr to evaluate spastic tension in the lower limbs of children with cerebral palsy. Fizjoterapia Polska 2001; 1(3); 261-267

Abstract

Background. The authors present the results of their research on the behavior of spastic muscle tension in the lower limbs of children with cerebral palsy. Material and method. The experiment was conducted with a group of children undergoing treatment at the Zgorzelec Rehabilitation Center. During a month-long hospitalization, an individualized rehabilitation program was developed and realized for each child. The children whose muscle tension was tested received cryostimulation in both lower limbs twice daily for 10 days of therapy. The value of the muscle tone was checked on the surface of the muscle belly of the quadriceps and biceps of the thigh and the triceps of the calf, with measurements made before cryostimulation, 10 minutes afterwards, and again 20 minutes after the conclusion of the procedure. The tests were repeated before the beginning of the rehabilitation program, after the fifth day, and after the tenth day. Muscle tension was measured using a Szirmai myotonometer. Results. A statistically significant difference occurred in the spastic tension at the level of the muscle belies of the quadriceps. There is an observable, though smaller difference in the thigh and the triceps of the calf. The trend line as an average reveals a tendency to markedly reduced spastic tension in the lower limbs after the application of the appropriate rehabilitation program. Conclusion. In the authors’ opinion, the Szirmai myotonometer is a useful tool enabling the objective evaluation of muscle tone.

Key words:
pediatric cerebral palsy, Szirmai myotonometr, spastic tension
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The application of laser biostimulation in the treatment of maxillary and frontal sinuses

Beata Ufniak, Jerzy Przybylski, Zbigniew Śliwiński, Zdzisław Zagrobelny

Beata Ufniak, Jerzy Przybylski, Zbigniew Śliwiński, Zdzisław Zagrobelny – The application of laser biostimulation in the treatment of maxillary and frontal sinuses. Fizjoterapia Polska 2001; 1(4); 346-353

Abstract
Background. This article describes the application of laser biostimulation in the treatment of maxillary and frontal sinusitis. The symptoms of the disease are described, along with the treatment protocols for both acute and chronic sinusitis. The article also describes the operating principles of laser radiation and the exposure techniques, which the authors have divided into two types: contact and non-contact. Material and methods. Our research involved 50 patients, 30 with maxillary sinusitis and 20 with frontal sinusitis, who had previously been treated only pharmacologically. The laser used in therapy was an LBK 2 apparatus manufactured by Amber, which emits invisible radiation with a wavelength of 980 nm and a power density of 35 mW/cm2. The radiation dose did not exceed 5 J/cm2. Treatment was administered in two stages. The first included 10 procedures, while the second began after a 2-3 week break, and included 3-6 procedures (once every two days). Of the 50 patients who commenced laser therapy, 20 had very severe symptoms, 20 had severe symptoms, and 8 had mild symptoms. Results. 86% of the patients completed treatment with excellent results, i.e. disappearance of edema and inflammatory exudates, remission of inflammation, and subsidence of pain. 12% of the patients reported good results, i.e. incomplete remission of symptoms. 2% of the patients finished treatment without any reaction. Conclusions. Laser therapy is effective in the majority of cases of maxillary and frontal sinusitis, in both acute and chronic forms, eliminating edema, pain, and inflammation of the mucous membrane of the nose. Laser biostimulation can be more effective in some cases than pharmacological treatment, and in combination with other physical agents gives excellent therapeutic outcomes in the treatment of laryngological patients.

Key words:
acute sinositis, chronic sinusitis, infrared light, therapeutic dose, laser contraindications, contact and non-contract laser procedures

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Thermovisual evaluation of vascular behavior in the paretic upper limb after local cryostimulation in stroke patients

Zbigniew Śliwiński, Piotr Plaza

Zbigniew Śliwiński, Piotr Plaza – Thermovisual evaluation of vascular behavior in the paretic upper limb after local cryostimulation in stroke patients. Fizjoterapia Polska 2002; 2(2); 112-117

Abstract
Background. Stroke is the third most common cause of death, one of the most common causes of handicap, and the most common cause of disability among persons older than 40. Each year 4.6 million people around the world die from strokes, including 3.2 million in developing countries and 1.2 million in highly industrialized countries. In view of the high morbidity rate and the serious consequences of stroke, in the form of limb paresis, the authors decided to use a thermovision camera to check vascular reactions in the paretic limb by evaluating temperature changes on the skin subsequent to cryostimulation by liquid nitrogen vapors. Material and methods. Our research involved 28 patients with an average age of 61.3 years. The procedure was performed on the forearm of the paretic upper limb, which was cooled for 6 minutes (from the hand to the elbow cavity, the dorsal surface and the palm surface). Thermovision images were made 5 times for each patient. Results. The authors observed that as a result of the procedure the temperature of the cooled limb went down 12°C, and 2.6°C in the other limb. Conclusions. The results cannot be easily interpreted. In the authors’ opinion, the temperature reduction in the limb that was not cooled results from contralateralization of the consensual reflex. The present study is a preliminary report describing the phenomenon we observed.

Key words:
Stroke, Cryostimulation, thermovision, vascular behavior

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The efficacy of early neurostimulation of development in the Wroclaw Model of Rehabilitation for Down’s syndrome children, as measured by bio-electric examinations of the brain

Witold Pilecki, Ludwika Sadowska, Monika Mysłek, Zbigniew Śliwiński

Witold Pilecki, Ludwika Sadowska, Monika Mysłek, Zbigniew Śliwiński – The efficacy of early neurostimulation of development in the Wroclaw Model of Rehabilitation for Down’s syndrome children, as measured by bio-electric examinations of the brain. Fizjoterapia Polska 2002; 2(2); 99-107

Abstract
Material and methods. Brainstem auditory evoked potentials (BAEP) and visual evoked potentials (VEP) were examined in two groups of small children with Down syndrome (DZ), one group rehabilitated since birth in the Wrocław Model of Rehabilitation (WMU), and the other not rehabilitated. The findings were compared with an homologous control group of healthy children. Results. During the BAEP examinations, the latency of deflection I was analyzed, where delayed latency indicates reduced sensitivity to sound. The examinations showed a significantly higher percentage of poor results in the group of DS. children who were not rehabilitated (33.3% in the first examination and 27.3% during the control examination). In the group of children with DS rehabilitated since birth, the percentage was 5 times lower (5.4% at the beginning of rehabilitation and 3.8% after several months of rehabilitation), similar to the results achieved in the control group (3.3%). In the VEP examinations, the percentage of normal results after stimulation with a flash of light was low in the group of children not rehabilitated (34% on the first examination). In the group of rehabilitated children, 53% achieved completely normal results. In the control examination, in the group of children not rehabilitated, normalization was observed in only one case (of 5 examined children), whereas in the rehabilitated group normalization occurred in 6 out of 13 cases with previously abnormal results. Ultimately, normal results were achieved by 38% of the children not rehabilitated and 68% of the rehabilitated children. In the control group, 84% of the results were normal. Conclusion. In the case of children with Down’s Syndrome, the activity of the examined analyzers differs from healthy children. On the other hand, the improvement observed over time indicates that some normalization of function does occur in these analyzers, particularly in children subjected to neurostimulation since the first months of life.

Key words:
Down, brain evoked potentials, Wroclaw Model of Rehabilitation

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The role of nitric oxide in the modulation of arterial smooth muscle contraction evoked by activation of adrenoreceptors during laser biostimulation

Magdalena Mackiewicz-Milewska, Jan Talar, Grzegorz Grześk, Leszek Szadujkis-Szadurski, Irena Bułatowicz, Zbigniew Śliwiński

Magdalena Mackiewicz-Milewska, Jan Talar, Grzegorz Grześk, Leszek Szadujkis-Szadurski, Irena Bułatowicz, Zbigniew Śliwiński – The role of nitric oxide in the modulation of arterial smooth muscle contraction evoked by activation of adrenoreceptors during laser biostimulation. Fizjoterapia Polska 2002; 2(2); 89-98

Abstract
Introduction. The mechanisms of action of laser biostimulation on tissue continues to be the object of scientific investigation. The positive impact of laser radiation of low and medium power on inhibiting vascular contraction has been proven. It remains unknown, however, exactly how this takes place. We investigated the role of nitric oxide in this process.Material and methods. An in vitro experiment was performed on isolated tail arteries of male Wistar rats. The arteries were first subjected to the effect of noradrenalin (NA) and phenylephrine (PHE), and then to the effect of laser radiation (10, 30 and 100 mW), Then an inhibitor of nitric oxide synthase was added to the incubation fluid, along with methylene blue, and the effects of laser radiation in these conditions were observed.Results. Laser radiation of 10, 30, and 110mW inhibits the vascular contraction reaction induced by NA and PHE. The addition of a nitric oxide inhibitor or a guanyl cyclase inhibitor (methylene blue) to the incubation fluid cancels the inhibitory effect of laser biostimulation on contraction. Conclusion. Our results imply that the inhibitory effect of laser biostimulation on vascular contraction is mediated by nitric oxide and its secondary transmitter, guanyl cyclase.

Key words:
laser biostimulation, vascular endothelium, Nitric Oxide, adrenoreceptors

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Hippotherapy as one of the elements of comprehensive pediatric rehabilitation at the Zgorzelec Rehabilitation Center

Zbigniew Śliwiński, Anna Morawska, Bartłomiej Halat

Zbigniew Śliwiński, Anna Morawska, Bartłomiej Halat – Hippotherapy as one of the elements of comprehensive pediatric rehabilitation at the Zgorzelec Rehabilitation Center. Fizjoterapia Polska 2002; 2(3); 250-256

Abstract
The hyppotherapy is one of the form rehabilitation in the ICP. This manner of treat used only one kind of horse’s walk which name is walk. The horse riding normalizes the tension of muscles . It is connected with the correct position on horse , the rhythmic movement of rider, alternately flex and relax of muscle and the temperature of horse. The horse riding for children who don’t walk to let the felling the location own body in air space. In the hyppotherapy the authors distinguish ; therapeutic horse riding, horse’s rehabilitation, therapy by the contact with horse, pedagogic and therapeutic bareback riding, the horse riding for disabled people. The authors presented the indication to the horse riding- neurological syndromes, faulty posture genetic illness eg Down’ syndrome, myelomeningocele. They described also the contraindication eg. mental handicap, epilepsy, osteoporosis, injures on the of skin, retinodialises, injures or column, rethrolisteses and allergy to horse’s fur, sweat or odour. The authors presented also the rules comprehensive rehabilitation for children with ICP which is used in the Rehabilitation Center in Zgorzelec.

Key words:
ICP, hipotherapy form, idication and contridication

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Evaluating the motor development of infants using Vojta’s method, with particular attention to risk factors, in clinical material from a Rehabilitation Center for Children with Cerebral Palsy

Aleksandra Deljewska-Starykow, Zbigniew Śliwiński, Wanda Różyło

Aleksandra Deljewska-Starykow, Zbigniew Śliwiński, Wanda Różyło – Evaluating the motor development of infants using Vojta’s method, with particular attention to risk factors, in clinical material from a Rehabilitation Center for Children with Cerebral Palsy. Fizjoterapia Polska 2002; 2(3); 216-228

Abstract
Background. The author described child’s physical and mental development in the first year his live in Theodor Hellbrige’s opinion. They presented new definitions how „high-risk pregnancy, „high-risk birth, „high-risk child” They talked over risk factors and among of them there is of great importence famillie’s relations connected with the Rh factor, main blood groups, famillie’s enzynopathy and chromosome aberration also mather’s ilnneses during the her pregnancy. They payed special attention to the gestosis, diabetes, tyroid’s ilnneses, obesity, anemia, passed infectius and bleeding. The authors rated negative factors among low height of mather, low weigth of mather befor her pregnancy and no hygienic live. The period shorter than 6 months between the pregnancies is health risk also, and like how the inflammatory proceeses of the Central Nervous System, generalized cyanosis, low evaluation in the Apgar Scale, acidosis, hiperbilirubinamy, infantile convulsions, neonatal asphyxia, the children born after different complications related to labour.The aim of examine.• The neurophysiology analysis of the development newborn from the group high-risk pregnancy, high-risk birth, especially children which was born before 37 weeks lasting pregnancy – premature baby- and children which was born in normal labor but the size those newborn was too small to fetal age- dystrophy child• The paying attention to early diagnosis of the neurodeveloping disturbances and starting the treatment quickly.Material and methods. 32 premature baby was examine , it was the children were born between 28-37 weeks of the pregnancy and 13 dystrophy child which weight were 2 500 g. and 1 child was born after 37 weeks pregnancy. The examine was done in the Rehabilitation Center in Zgorzelec. Results and conclusions. On the basis of examine the authors drown following conclusions: 1. The Vojty’s development neurokinesiology diagnostic is good screening for children from risk groups, is simply to do and let to evaluate early child’s disturbances in psychomotorial development. 2. The bigger worth of the Vojtys diagnostic and therapy is possible right development of children from high-risk birth groups. The results which are presented prove to early start to diagnos and treat give children chance to right development. 3. The age of the child is of great importance for results and time of therapy. 4. The low weigth of labor and relative shorter time of live the child during the pregnancy have the influence for efficiency CNS and the level of disturbances central neurvous coordination. The low weigth and shorter pregnancy live the higher level disturbances central neurvous coordination is presented. 5. The risk factor has influence for time therapy to moment reached the normalization. The intermural dystrophy is worst than premature baby. The premature baby quicklier and large number reache the normal psychomotorial development.

Key words:
infantum Cerebral Palsy, Vojta, child physical and mental development

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