Thermographic assessment of radiation induced by cryostimulation of both lower limbs and analysis of changes in children with cerebral palsy

Zbigniew Śliwiński, Zdzisław Zagrobelny, Jan Talar, Piotr Płaza, Bartłomiej Halat, Marek Kiljański

Zbigniew Śliwiński, Zdzisław Zagrobelny, Jan Talar, Piotr Płaza, Bartłomiej Halat, Marek Kiljański – Thermographic assessment of radiation induced by cryostimulation of both lower limbs and analysis of changes in children with cerebral palsy. Fizjoterapia Polska 2003; 3(4); 316-330

Abstract

Background. The authors presented the examine of changes temperature results in the children’s with the cerebral palsy legs, which were registrated during treatment in the Rehabilitation Center in Zgorzelec. Material and methods. The changes temperature were checkted by the camera Agema 570 before the treatment and four weeks later. The spastic tension was checked also using the Mionotometer Szirmai and Ashworth test and Brunstrom test. Spontaneous motorial evaluation and the level motorial development were checked using own scale. Results and conclusions. The results shown that the using the cryostimulation in the treatment children with the cerebral palsy decrease the spastic tension in the legs and the spontaneous motorial evaluation was better, the range of motion in joins also were better after treatment. The termal pictures shown that arterial play in the children’s legs was adapted to the cryogenic temperatures.

Key words:
thermoregulation, local cryotherapy, termovision, spastic tension, spontaneous motorial evaluation
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Horizontal electrotherapy in rehabilitation

Aneta Hak, Marcin Oryniak, Jagoda Szner-Dobrowolska, Rafał Kaczmarzyk, Małgorzata Jegier, Zbigniew Śliwiński

Aneta Hak, Marcin Oryniak, Jagoda Szner-Dobrowolska, Rafał Kaczmarzyk, Małgorzata Jegier, Zbigniew Śliwiński – Horizontal electrotherapy in rehabilitation. Fizjoterapia Polska 2004; 4(3); 292-294

Abstract

The use of „horizontal” stimulation makes it possible to achieve a stimulatory effect on the synchronic frequency of stimuli of functional potentials in the stimulated cells, as well as electrobiochemical and electrophysical effects, and, with higher dosages, blockage of nerve conductance, which greatly increases the chances of achieving therapeutic success. The WaDiT device produces all the various kinds of effects needed in selective therapy in terms of an alternating electromagnetic field (medium frequency current in the high tone range from ca. 4000 Hz to 12,000 Hz). This range is characterized by high local systemic tolerance. WaDiT devices operate in a wide range of high tones. This results in especially good modulation in tissue, and consequently many additional effects that are medically and biologically advantageous.

Key words:
„horizontal” stimulation, currents of medium frequency, high tones
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A comparison of conceptions concerning rehabilitation following facial nerve injuries in children

Wojciech Kiebzak, Czesław Szmigiel, Zbigniew Śliwiński, Marek Zięba

Wojciech Kiebzak, Czesław Szmigiel, Zbigniew Śliwiński, Marek Zięba – A comparison of conceptions concerning rehabilitation following facial nerve injuries in children. Fizjoterapia Polska 2006; 6(1); 22-26

Abstract

Background. The authors studied the dynamics of the improvement of facial muscle motor function in children with peripheral facial nerve paresis. The objective of the present investigations is the comparison of the therapeutic effect achieved in children with peripheral facial nerve paresis using neurophysiological stimulation with the effects obtained with laser biostimulation and electrostimulation. Material and methods. 51 children with peripheral damage of the facial nerve symptoms were examined. To assess the function of the above muscles, a „0” to „3” score scale developed by Pietruski was used. The children were divided into three groups: Group 1 (N=17) received laser biostimulation (4-6 J/cm2, 3-4 procedures per week, 20 procedures per series, a CTL-1106 MX 830 nm, 400 mW laser manufactured by Laser Instruments); Group 2 children (N=17) were subjected to a therapy that combined elements of three neurophysiological methods: the reflex therapy developed by Vojta, method PNF and elements of the Castillo-Morales method; Group 3 patients (N=17) were subjected to impulse electrostimulation (an Pulsotronic ST-5D electrostimulator manufactured, with impulse duration of 80 – 180 ms, frequency of 1 – 4 Hz and amplitude of 20 – 60 mA). All the children were subjected to passive, passive-active and active motor exercises of the facial muscles and delicate massage. Results. In the first examination at the beginning of therapy, mimical muscle function was poor and the score low: in Group 1 – 4.2, Group 2 – 4.8 and in Group 3 – 6.2. In consequence of various types of stimulatory treatment, the mean time of muscle function restoration in the investigated patients was as follows: Group 1 – 33.4 days, Group 2 – 22,9 days and Group 3 – 41.7 days. Conclusion. Reflex forms of therapy using the methods of PNF, Castillo-Morales and Vojta constitute an effective and commonly available rehabilitative treatment modality in peripheral damage to the facial nerve. Effectiveness of electrostimulation turn out to be very low that is why using this method in peripheral facial nerve paralysis treatment isn’t crucial.

Key words:
paresis nervi facialis, methods of physiotherapy, facial muscle
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The effect of Kinesio Taping applications on motor activity in children with developmental defects

Zbigniew Śliwiński, Bartłomiej Halat, Wojciech Kufel, Beata Michalak, Marek Kiljański

Zbigniew Śliwiński, Bartłomiej Halat, Wojciech Kufel, Beata Michalak, Marek Kiljański – The effect of Kinesio Taping applications on motor activity in children with developmental defects. Fizjoterapia Polska 2007; 7(1); 52-62

Abstract

Background. The authors present the results of a study of children with developmental defects who underwent a comprehensive physiotherapeutic treatment with the Kinesio Taping method. The children were aged 18 months to 8 years. All patients took part in a 4-week rehabilitation programme at the Rehabilitation Centre in Zgorzelec. Material and methods. The study included 30 children of both sexes. All patients underwent a medical and physiotherapeutic examination, which was the basis for designing a Kinesio Taping-based rehabilitation plan. The application of Kinesio Taping was preceded by Kinesio Taping screening tests, Vojta’s screening tests and an assessment of spontaneous motor activity. The final stage of the study involved analysis of study results and assessment of the utility of the screening tests. Results. Our observations supported by the test results and their analysis prove that Kinesio Taping is a very useful physiotherapeutic modality. If applied properly, it is a valuable adjunct to therapeutic rehabilitation. Kinesio Taping enables the control of muscle tone, which directly translates into new possibilities of locomotor activity of the patients. This method helps to reduce paraesthesias and oedemas. Conclusions. Kinesio Taping applications influenced muscle and fascia tone in our study. Kinesio Taping can be used in combination with other procedures. There are no absolute contraindications to the use of Kinesio Taping as part of comprehensive physiotherapeutic management.

Key words:
developmental defects, Kinesio Taping screening tests, Kinesio Taping applications
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The importance of quality in the practice of physiotherapy. The case of the Regional Specialised Paediatric Hospital in Kielce

Wojciech Kiebzak, Małgorzata Starczyńska, Zbigniew Śliwiński, Ireneusz M. Kowalski, Lucyna Robak, Marek Kiljański, Marek Woszczak, Magdalena Jaskólska-Pisiewicz

Wojciech Kiebzak, Małgorzata Starczyńska, Zbigniew Śliwiński, Ireneusz M. Kowalski, Lucyna Robak, Marek Kiljański, Marek Woszczak, Magdalena Jaskólska-Pisiewicz – The importance of quality in the practice of physiotherapy. The case of the Regional Specialised Paediatric Hospital in Kielce. Fizjoterapia Polska 2007; 7(2), 133-144

Abstract

Background. The aim of this paper was to show that procedures used within the framework of therapeutic management at the Regional Specialised Paediatric Hospital in Kielce improve the quality of service, which is the main condition for the hospital to remain on the market of health service providers. The high quality of services has been confirmed by the recent conferring of an accreditation certificate which requires that the hospital operate on the basis of a number of documented procedures, instructions and standards. The therapeutic activities of the hospital are based on a set of instructions providing detailed guidelines concerning the management of particular medical conditions. Material and methods. The study included children who were hospitalized or treated on an outpatient basis. Patient management was based on a set of instructions. An anonymous questionnaire concerning the quality of treatment and the level of satisfaction with the service was distributed among the children’s guardians and parents. Results. In the first and the second half of the year 2005, 95% and 86% of parents respectively assessed service quality as very good. 92% of parents gave the rating of very good in the first half of the year 2006 and 79% did so in the second half of the year. These results confirmed the high quality and efficacy of as well as satisfaction with the treatment received by the children. Conclusions. The observance of specified instructions during the therapeutic process improves the quality of service and minimizes the possibility of medical malpractice.

Key words:

quality, standard, instructions, rehabilitation treatment

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Kinesiotaping application in children with scoliosis

Zbigniew Śliwiński, Wojciech Kufel, Bartłomiej Halat, Beata Michalak, Jan Szczegielniak, Wojciech Kiebzak, Tomasz Senderek

Zbigniew Śliwiński, Wojciech Kufel, Bartłomiej Halat, Beata Michalak, Jan Szczegielniak, Wojciech Kiebzak, Tomasz Senderek – Kinesiotaping application in children with scoliosis. Fizjoterapia Polska 2007; 7(3); 370-375

Abstract
Background. Scoliosis is still a serious problem, despite numerous therapeutic methods. Kinesiotapping (KT) is one of the methods, which can prove helpful in scoliosis treatment. Using proper applications, we can affect alteration of stability line and achieve balance of the spine. Material and methods. The studies were conducted in Zgorzelec Rehabilitation Centre. The participants were 18 children, who stayed there for rehabilitation, including 16 girls and 2 boys. The mean age was 12 years in this group. Changes in the waist angle were evaluated before and after KT application. Results. The obtained results indicate that application of KT in the examined group results in waist angle change, on average by 4 degrees. For left waist angle this mean value is 5.27 degrees, while for the right waist angle it is 2.58 degrees. The highest value for correction was 11.2 degrees. Conclusions. Selected KT techniques result in changes in stability line course, which is also manifested by waist angle change. Due to muscular and fascial tone normalization, the posture of a child with scoliosis changes in the frontal and sagittal plane. KT as a new method, using multiple forms and techniques, seems helpful in carrying out rehabilitation programme for children with scoliosis.
Key words:
scoliosis, KT application, angle of waist
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Early post stroke rehabilitation after heart transplantation

Elżbieta Miller, Zbigniew Śliwiński, Anna Cabak

Elżbieta Miller, Zbigniew Śliwiński, Anna Cabak – Early post stroke rehabilitation after heart transplantation. Fizjoterapia Polska 2007; 7(3); 351-354

Abstract
Brain stroke is the leading cause of disability, and usually affects people after 60. At this age, the risk of concomitant diseases, affecting not only the cardiovascular system is high. The number and intensity of the diseases are often contraindications for early post stroke rehabilitation. Patients after brain stroke and heart transplantation are rare cases. The aim of the study was to present the effectiveness of early post-stroke rehabilitation in case of the 53-year-old man who underwent heart transplantation in 2000, due to congestive cardiomyopathy. The patient was examined 4 times during the 3rd, 6th, 9th and 15th week after the stroke. The test examined muscle strength in Lovett scale and the grade of muscle tone in Ashworth scale. A functional test was performed in Barthel scale and the extent of requiring care and attention — in Rankin scale. The paper presents an individual diagram of physiotherapeutic procedures divided into two stages: the early stage (0-6 weeks) and the transient stage (6-9 weeks), adjusted to the patient’s actual neurological and cardiological state. Basic recovery after physiotherapeutic treatment was obtained before the 9th week. Patients after heart transplantation can be successfully treated by rehabilitation. A substantial progress in medicine obligates to exchange information about rehabilitation treatment of patients with untypical concomitant diseases.
Key words:
brain stroke, heart transplantation, post stroke rehabilitation
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Kinesiotaping after thoracosurgeries

Jan Szczegielniak, Marcin Krajczy, Katarzyna Bogacz, Jacek Łuniewski, Zbigniew Śliwiński

Jan Szczegielniak, Marcin Krajczy, Katarzyna Bogacz, Jacek Łuniewski, Zbigniew Śliwiński – Kinesiotaping after thoracosurgeries. Fizjoterapia Polska 2007; 7(3); 344-350

Abstract
In 2005 there were about 15 000 operations carried out in Thoracosurgery Units in Poland. The majority of these involved lobectomy due to structural changes resulting from cancer. It is worth mentioning that the majority of patients were operated on during their first or second stages of the disease, which shows improvement in methods used for diagnostic purposes qualifying for surgical operations. However, the patients treated in the third stage of their disease might reach even 40%. Application of physiotherapy in these patients is a complex problem due to the disease, their overall condition and post-operative complications. The treatment aims at improving the efficiency, strengthening the respiration mechanism, increasing thoracic flexibility and pain relief – which finally leads to improvement of the patient’s well-being. In case of possible lymphatic swelling, drainage and antiedema treatment are also very important. In case of the patients, who underwent surgery, not connected with cancer, physical treatment and massage are valuable complementation to kinesitherapy, which is the basis of physiotherapeutic treatment. They are mainly used in order to stabilize the muscle tone, decrease swelling and pain perception. However, because of the main disease, they could not be applied in most of patients. Under limited possibility of using physiotherapeutic treatment, kinesiotaping (KT) is a safe method stimulating post—operative scar healing, improving muscle activity and helping to decrease swelling and pain.
Key words:
kinesiotaping, physiotherapy, thoracosurgery
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Body equilibrium assessment in patients with degenerative changes after whole-body cryostimulation connected with physiotherapy

Marek Kiljański, Zbigniew Śliwiński, Wojciech Kufel, Wojciech Kiebzak, Marek Woszczak

Marek Kiljański, Zbigniew Śliwiński, Wojciech Kufel, Wojciech Kiebzak, Marek Woszczak – Body equilibrium assessment in patients with degenerative changes after whole-body cryostimulation connected with physiotherapy. Fizjoterapia Polska 2007; 7(3); 286-298

Abstract
Background. The authors present the results obtained in a group of 126 participants. The aim of the study was to determine whether a four-week program of physiotherapy including whole-body cryostimulation, applied in patients with degenerative changes in the spine, influences their body equilibrium and pain sensation. Material and methods. The examined group comprised 66 patients with degenerative changes in the lumbar spine, while the control group consisted of 60 participants. Apart from an individually designed rehabilitation program, each patient participated in 20 sessions of whole-body cryostimulation. The measurement of lumbosacral spine mobility and the assessment of pain sensation using the Visual Analogue Scale (VAS) were performed before the first and after the last session. Moreover, after the first, tenth and twentieth session of general cryostimulation, measurements on a stabilometric platform were conducted. The healthy participants, who were qualified as the control group, underwent tests on the stabilometric platform after one session in the cryogenic chamber. The aim of these tests was to compare the differences in the stabilogram curve in healthy individuals and patients with degenerative changes in the lumbar spine. The effect of cryostimulation procedures on pain sensation and mobility of the lumbosacral spine was assessed. Additionally, the effect of cryogenic temperatures on body equilibrium was studied. Results. The comparison of the results, obtained before the procedure and after completing the therapy indicates that general cryostimulation in a physiotherapeutic program for patients with degenerative changes in the lumbar spine contributes to relaxation of excessively tense muscles. Conclusions. The use of whole body cryostimulation in patients with degenerative changes in the lumbosacral spine, combined with a properly designed and managed physiotherapeutic program, decreases pain sensation in a statistically significant way. The application of cryogenic temperatures, combined with physiotherapeutic program, favourably affect patient body equilibrium.
Słowa kluczowe
physiotherapy, spine, cryostimulation, coordination, stabilometric platform
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Assessment of the efficacy of local cryotherapy in children with cerebral palsy

Marek Woszczak, Zbigniew Śliwiński, Marek Kiljański, Wojciech Kiebzak, Marcin Szczepanik, Wiesław Tomaszewski

Marek Woszczak, Zbigniew Śliwiński, Marek Kiljański, Wojciech Kiebzak, Marcin Szczepanik, Wiesław Tomaszewski – Assessment of the efficacy of local cryotherapy in children with cerebral palsy. Fizjoterapia Polska 2007; 7(3); 275-285

Abstract
Background. The author presents the results of a study of 60 children with infantile cerebral palsy carried out at a rehabilitation centre in the town of Zgorzelec. The study aimed to demonstrate that a 4-week programme of customised kinesiotherapy with cryostimulation of the lower limbs with liquid nitrogen vapour could have a beneficial effect on motor status as well as muscle tone and skin surface temperature in children with infantile cerebral palsy. Material and methods. A group of children of both sexes aged 3-14 with infantile cerebral palsy underwent 4 weeks of customised kinesiotherapy combined with cryostimulation of both lower limbs. Muscle tone was determined with a Szirmai myotonometer using special methodology. The level of spasticity was estimated with the Ashworth test, and motor activity assessment was made before and after the treatment according to a score table designed by the authors. Thermovisual recordings of skin surface temperature in the lower limbs were made immediately before and 5 and 15 minutes after cryostimulation procedures at the beginning and end of the 4-week programme. Results and Conclusions. A comparison of the results of the motor activity assessment, Ashworth test and myotonometry before and after the rehabilitation programme shows that the use of cryostimulation in the rehabilitation of children with infantile cerebral palsy results in a reduction of spasticity in the lower limbs and improvement in motor activity. Thermovisual analysis of skin surface temperature demonstrates full adaptation of the children’s vascular system, i.e. excellent safety of topical cryostimulation.
Key words:
infantile cerebral palsy, spastic muscle tone, local cryostimulation, Ashworth test, motor activity assessment, Szirmai myotonometer, thermovision
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