Tag: Aleksandra Bitenc-Jasiejko

The impact of individually selected PORON heel lifts, foot supination, and limb axial alignment on body balance – a multicenter study

Aleksandra Bitenc-Jasiejko, Anna Lubkowska, Ewa Stachowska, Krzysztof Konior, Alina Kirpichnikova, Marcelina Bitenc-Jasiejko, Małgorzata Barszczewska, Dominika Dachtera, Natalia Dąbrowska, Kinga Gonta, Patrycja Janta, Joanna Jarosławska, Beata Klus, Tomasz Kowalik, Marta Krysiak, Wojciech Kuliczkowski, Tomasz Kupc, Aneta Mandrosa, Rafał Michalski, Anna Morzyńska, Rafał Mosur, Natalia Pachulska, Dawid Paradziński, Izabela Plewa, Klaudia Stankowska, Marta Stelmaszczyk, Anna Szewczyk, Marta Szewczyk, Damian Szyguła, Marzena Tuszkowska, Magdalena Walasek, Anna Walińska, Mariola Wawełczyk-Polotzek, Barbara Wrocławska, Krystiana Kijak, Danuta Lietz-Kijak

 

Aleksandra Bitenc-Jasiejko et al. – The impact of individually selected PORON heel lifts, foot supination, and limb axial alignment on body balance – a multicenter study –  Fizjoterapia Polska 2025; 25(2); 317-331

DOI: https://doi.org/10.56984/8ZG00E1CVPM

Abstract
The center of pressure (COP) on the feet is a crucial parameter providing information about structural and postural balance. A disturbance in this global pattern causes or reflects dysfunctions in the distribution of tension within the body. Postural disorders that manifest as an imbalance of the center of gravity in the sagittal plane lead to multisegmental ergonomic disturbances of the musculoskeletal system, resulting in compensations, pain, and, over time, structural overload changes and defects. Early detection of anterior-posterior load imbalances and their correction is of great importance for the prevention and treatment of musculoskeletal disorders.
Objective. To assess the impact of individually selected PORON heel lifts and lower limb correction in the transverse plane on body balance.
Methods. The study included 96 participants (n=100%), including 62 women (nf% = 64.58%) and 34 men (nm% = 35.42%), aged 15 to 80 years. The average weight of the participants was 75 kg (SD = 18.244), their average height was 1.705 m (SD = 0.093), and their average BMI was 24.81 (SD = 5.009). Exclusion criteria. Individuals diagnosed with significant foot and lower limb deformities or conditions significantly affecting body balance. A pedobarographic examination (EPS R2) was conducted while participants stood barefoot. Each test lasted 20 seconds, with a sampling rate of 1 ms (20,000 samples per test). The study included four trials: trial 0 in free standing, trial 1 with a 3 mm PORON heel lift, trial 2 with a 6 mm heel lift, and trial 3 in the lower limb correction test in the transverse plane (rotation).
Results. The study demonstrated a significant effect of using a low PORON offloading heel lift on balancing anterior-posterior pressure distribution on the feet.
The median heel underload in the control test (without correction) was −7.05% (interquartile range [−11.1%; −1.2%]). The greatest change was observed with the 6 mm heel lift (−3.0%; [−7.2%; +3.0%]). The Kruskal–Wallis statistical significance test for comparing all trials showed a significant difference (χ²[3] = 15.47, p=0.001). The Wilcoxon rank sum test, used to analyze statistical significance between individual trials, indicated a significant difference between trial 0 and trial 2 (p = 0.001) and between trial 0 and trial 3 (p = 0.036). The difference between trial 0 and trial 1 was nearly significant (p=0.054). The study found no significant effect of the interventions on lateral (right–left) pressure distribution (χ²[3] = 0.87, p = 0.834). Statistical analysis of 10 body balance parameters showed a significant difference between trials only in parameters describing body oscillations in the sagittal plane. The COP–barycenter angle of the feet significantly decreased (χ²[3] = 15.01, p=0.002), while the mean COP distance along the Y-axis significantly increased (χ²[3] = 10.01, p = 0.018).
Conclusions. For postural disorders that shift the center of gravity forward and affect balance in the sagittal plane, the use of PORON heel lifts is justified. Given that the PORON material used in the study is an offloading material with a hardness of approximately 15 Shore and that our applied interventions were significantly lower than those previously studied, these solutions reduce the undesired effects of heel elevation while increasing comfort and footwear compatibility.
Manual correction of the lower limb in the transverse plane also positively influences anterior–posterior COP balance, shifting weight distribution backward. The combination of heel offloading and correction of foot overpronation has a significant impact on relieving pressure on the forefoot, improving standing posture ergonomics, and promoting postural re-education from a forward-leaning position.
Statistical analysis. Statistical analyses were performed using the R statistical software, version 4.3.0 (The R Foundation for Statistical Computing, Wirtschaftsuniversität Wien, Vienna, Austria). Given the significant non-normality of variable distribution in the trials, the Kruskal–Wallis test was applied. The Wilcoxon rank sum test (also known as the Mann–Whitney–Wilcoxon test), with Bonferroni correction for multiple comparisons, was used to identify trial pairs where significant differences occurred. Results were considered statistically significant at p<0.05.
Key words
PORON heel lifts, postural balance, foot supination, anterior-posterior pressure
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Changes in body balance due to exposure to trauma – multi-center studies

Aleksandra Bitenc-Jasiejko, Krzysztof Konior, Anna Walińska, Kinga Gonta, Elżbieta Szkiler, Milena Kraft, Alina Kirpichnikova, Karolina Trąbska, Anna Parus, Tomasz Kupc, Malwina Waleryn-Sagun, Anna Szadkowska, Rafał Mosur, Kamila Mosur, Damian Szyguła, Nicola Książek, Małgorzata Barszczewska, Patrycja Janta, Aneta Mandrosa, Joanna Jarosławska, Klaudia Smolińska, Marta Szewczyk, Agnieszka Byszewska, Anna Morzyńska, Marzena Tuszkowska, Barbara Wrocławska-Tuszkowska, Marek Gapiński, Tomasz Kowalik, Karolina Adamska, Katarzyna Pawliwiec, Jan Głodowski, Konrad Kijak, Małgorzata Kowacka, Danuta Lietz-Kijak

Aleksandra Bitenc-Jasiejko, Krzysztof Konior, Danuta Lietz-Kijak et al – Changes in body balance due to exposure to trauma – multi-center studies. Fizjoterapia Polska 2023; 23(5); 313-326

DOI: https://doi.org/10.56984/8ZG20Bb3T

Abstract
Aim. The purpose of the study was to assess the impact of a traumatic event experienced by the subject on postural balance and biomechanical parameters of gait.
Research methodology. The study involved 31 people (n = 100%), including 22 women (nk% = 70.97%), 9 men (nm% = 29.03), aged 29-60. People with diseases and dysfunctions affecting body balance and gait pattern were excluded from the study.
Balance and gait tests were performed using pedobarography (pedobarograph mod. EPS R2, Biomech Studio v2 software). The balance test was performed while standing, for 20 seconds, with sampling every 1 ms (millisecond) – the number of samples during one test is 20,000. The balance and gait assessment tests were performed twice. Test I included testing in neutral conditions, Test II included testing in conditions in which the subject was exposed
to a traumatic event he or she had experienced in the past (so-called exposure to “experienced trauma”).
Results. The obtained results of studies on the impact of exposure to experienced trauma on body balance while standing showed significant differences in body fluctuations in the most important parameters of stabilometric assessment.
The obtained results of research on the impact of exposure to trauma on the subject’s gait showed no significant differences between the test in neutral conditions and the test during exposure.
Conclusions. (1) Exposure to the trauma experienced by the subject significantly affects the body’s balance in a standing position. (2) The research showed no influence of exposure to the experienced trauma on the subject’s gait in the area of the time of contact of the feet with the ground and on the values of maximum and average pressure; The area of the plane where the feet are placed on the ground changes significantly before and after exposure to the trauma experienced by the subject. (3) In research on the impact of trauma on body posture, detailed results of studies on the range of COP fluctuations in each plane should be taken into account – the study showed that the analysis of only average results may significantly indicate an incorrect result in the assessment of body balance.

Keywords
stress, trauma, PTSD, body balance, gait, stabilometry, pedobarography

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Effects of upper cervical HVLA manipulation on static and dynamic balance parameters in healthy adults – a systematic literature review

Przemysław Malich, Agata Pasternak, Danuta Lietz-Kijak, Aleksandra Bitenc-Jasiejko, Piotr Skomro, Konrad Kijak, Małgorzata Kowacka, Zbigniew Śliwiński


Przemysław Malich, Agata Pasternak, Danuta Lietz-Kijak, Aleksandra Bitenc-Jasiejko, Piotr Skomro, Konrad Kijak, Małgorzata Kowacka, Zbigniew Śliwiński – Effects of upper cervical HVLA manipulation on static and dynamic balance parameters in healthy adults – a systematic literature review. Fizjoterapia Polska 2023; 23(3); 210-220

DOI: https://doi.org/10.56984/8ZG1436RB

Abstract
Background. Balance is a complex concept that applies not only to tasks with a reduced base of support, but also to everyday activities that require us to maintain a fixed position. Just as the concept itself is broad, the mechanisms for maintaining balance are complex and rely on information received from many regions of the body and organs.
Objective. The aim of this systematic literature review is to analyse whether HVLA manipulation of a blocked C0-C1 segment can affect static and dynamic balance parameters in healthy adults.
Methods. Based on the available literature, accessed via PubMed, Google Scholar, Scopus, EBSCO databases, a detailed search of the electronic literature was performed for 2010–2023. Eligible studies were chosen according to inclusion and exclusion criteria, using keywords: static balance, dynamic balance, manipulation, HVLA. Out of 114 manuscripts, 82 were short-listed for the preliminary review process. Twenty experimental studies were selected for final analysis.
Results. Out of the 20 publications analysed, 14 examined the effect of HVLA manipulation on balance parameters. In most cases, the study groups consisted of people with no dysfunction or complaints and/or people with neck pain. The most commonly studied parameter was static balance in standing: 17 of 20 publications. For the cervical spine, 50% of the studies found a significant improvement in the parameters studied in the immediate assessment, while in the delayed assessment there were as many significant positive results as there were results with no effect on balance. In the analysis of a subset of trials that examined only asymptomatic patients, partial or significant positive effects were observed in both immediate and delayed assessment.
Conclusions. We were not able to identify studies that would provide a clear answer to the research question. Based on the publications included in the review, it can be assumed that HVLA manipulation in the cervical region has the potential to affect balance in healthy adults, but the number of available studies is too small to draw firm conclusions. Further research in this area is therefore warranted.
Keywords
static balance, dynamic balance, manipulation, HVLA, podoscope
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Temperature measurements on facial skin surface as evaluated by infrared thermal cam-era and pyrometer following physiotherapeutic light treatments

Danuta Lietz-Kijak, Piotr Skomro, Roman Ardan, Elżbieta Kubala, Paulina Strzelecka, Małgorzata Kowacka, Konrad Kijak, Aleksandra Bitenc-Jasiejko, Krzysztof Konior, Helena Gronwald, Zbigniew Śliwiński

Danuta Lietz-Kijak, Piotr Skomro, Roman Ardan, Elżbieta Kubala, Paulina Strzelecka, Małgorzata Kowacka, Konrad Kijak, Aleksandra Bitenc-Jasiejko, Krzysztof Konior, Helena Gronwald, Zbigniew Śliwiński – Temperature measurements on facial skin surface as evaluated by infrared thermal cam-era and pyrometer following physiotherapeutic light treatments. Fizjoterapia Polska 2023; 23(2); 148-157

DOI: https://doi.org/10.56984/8ZG0DF529

Abstract
Any clinical procedure in dentistry, especially one that involves a breach of tissue integrity, carries the risk of complications, which can occur in any speciality. These include: postopera-tive wound pain, tissue swelling, bleeding, redness, elevated temperature, trismus, decreased sensation as a result of nerve damage. Postoperative patient care aims to minimise the risk of complications and to treat those which have developed. To this end, we can resort to physical therapy, one of the modalities of which is light therapy, using electromagnetic wave ranges of red, infrared, yellow and ultraviolet light. Yet, it remains unclear which wavelength should be used to treat any specific disease entity and which form of therapeutic light should be used in the rehabilitation of a specific complication following dental procedures? In this study, we used the Cason CA380 infrared digital pyrometer with a laser pointer and the Fluke Ti 400 thermal imaging camera. On the basis of the tests and statistical analysis, it can be concluded that the application of light significantly increases the temperature of the irradiated facial skin surface. Irrespective of the type of light used, each was associated with an increase in temper-ature. A more pronounced increase in temperature on the facial skin surface after a given ap-plication suggests that the effect of light therapy is shallow, which is relevant to the choice of a specific light wavelength to be applied in a particular disease entity or dental complication.
Key words: temperature measurement, light therapy, pyrometer, thermal imaging
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Multimodal programmes in the treatment of myofascial pain syndrome (MPS) – a two-step review

Krzysztof Konior, Aleksandra Bitenc-Jasiejko, Danuta Lietz-Kijak, Piotr Skomro, Małgorzata Kowacka, Konrad Kijak, Zbigniew Śliwiński


Krzysztof Konior, Aleksandra Bitenc-Jasiejko, Danuta Lietz-Kijak, Piotr Skomro, Małgorzata Kowacka, Konrad Kijak, Zbigniew Śliwiński – Multimodal programmes in the treatment of myofascial pain syndrome (MPS) – a two-step review. Fizjoterapia Polska 2023; 23(1); 188-202

DOI: https://doi.org/10.56984/8ZG07B914

Abstract
Myofascial pain syndrome (MPS) is one of the most common ailments associated with the human musculoskeletal system, characterised by the presence of the so-called trigger points (TrP – trigger point; MTrPs – myofascial trigger points). The International Association for the Study of Pain indicates that MPS may affect approximately one-third of people with chronic musculoskeletal pain, and that there is a lack of appropriate classification which can be attributed to a misunderstanding and/or misinterpretation of the pathophysiology. Given the diverse causes of pain syndromes in myofascial structures, it is vital to properly select and integrate therapeutic methods. The scientific literature indicates that treatment programmes should include a variety of manual therapy methods and rehabilitation exercises. Trigger point therapies, such as dry needling or dry cupping, are also widely used. At the heart of the success of rehabilitation programmes, in the opinion of the authors of this publication, is their multimodality, i.e. selection of therapeutic methods based on the cause of the pain, providing for measurable, reproducible diagnostic methods in therapy.
Aim of the study. The aim of this study is to analyse and infer conclusions on multimodal myofascial pain therapy programmes.
Material and methods. Given the complex research problem set as the aim, the study was carried out through a literature review in terms of two criteria:
Criterion I (C I): analysis of the literature on the etiology and pathogenesis of myofascial pain (i.e. causes and triggers, symptoms, social and environmental factors determining the onset of MPS), diagnostic procedures (initial diagnosis and ongoing monitoring of treatment outcomes), and therapeutic methods used in the course of MPS.
Criterion II (C II): a literature study of research publications addressing multimodal programmes for myofascial pain therapy, with their qualitative evaluation using the modified PEDro scale, and empirical testing of hypotheses based on the literature study and the analysis made in Part I.
Data sources: PubMed, SCOPUS, Science Direct, MEDLINE, PEDro, Cochrane, Embase, Web of Science Core Collection, Google Scholar electronic databases were searched systematically, restricting the languages to English and German only.
Results. The analysis of the literature showed that the causes, symptoms and associations of myofascial pain have been described in detail. There are also numerous reports on a variety of therapeutic methods, together with a precisely described methodology for their implementation. It is not uncommon to recommend combining methods into multimodal programmes, which unfortunately does not mean that there are many such programmes or that studies on MPS are consistent. The literature study on multimodal treatment programmes for MPS revealed that there is no correlation between its pathogenesis and a purposeful selection of specific therapeutic methods. In a small number of cases, a complex etiopathogenesis led to the formation of multidisciplinary teams. This may be associated with the absence of strict recommendations on the diagnostic methods applicable to the assessment of MPS.
Conclusions. 1. Multimodal programmes for the treatment of musculoskeletal pain, notably MPS and MTrPs, should include a detailed and comprehensive diagnosis (structural, biochemical, psycho-emotional) which should serve as the basis for the formation of interdisciplinary rehabilitation teams. 2. Musculoskeletal diagnosis, in addition to radiological assessment, should include measurable techniques of postural and functional assessment (such as pedobarography, wearable sensors, assisted anthropometry, i.e. photogrammetry, videogrammetry, etc.), aimed primarily at the ongoing assessment of posture. 3. The choice of therapeutic methods and patient education should be based on the causes of the patient’s pain, taking into account systemic diseases, postural defects, lifestyle and psycho-emotional state. 4. Scientific research in multimodal treatment programmes should be carried out in randomised groups, with due attention to the methodologies of diagnostic and therapeutic procedures and group selection.
Keywords
chronic pain, myofascial pain, manual therapy, exercise, multimodal programmes
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Biotensegration of malocclusion and temporomandibular disorders with diseases of the musculoskeletal system and posture defects – a literature review, supported by own observations

Danuta Lietz-Kijak, Aleksandra Bitenc-Jasiejko, Piotr Skomro, Krzysztof Konior, Konrad Kijak, Małgorzata Kowacka, Zbigniew Śliwiński


Danuta Lietz-Kijak, Aleksandra Bitenc-Jasiejko, Piotr Skomro, Krzysztof Konior, Konrad Kijak, Małgorzata Kowacka, Zbigniew Śliwiński – Biotensegration of malocclusion and temporomandibular disorders with diseases of the musculoskeletal system and posture defects – a literature review, supported by own observations. Fizjoterapia Polska 2023; 23(1); 22-38

DOI: https://doi.org/10.56984/8ZG07B3B3

Streszczenie

Although it enables a quick evaluation, medical diagnostics of the human myofascial-skeletal system is not always used to its full capabilities. This often hampers the objective assessment of a dysfunction and limits treatment options. Dysfunctions of the stomatognathic system, of different aetiology, are becoming more prevalent. Many scientific studies are in to relationships between organs and systems of the human body that can cause dysfunctions of the temporomandibular disorders. Studies investigating correlations between a myofascial-skeletal disorder and temporomandibular disorders are to be found in the literature. To achieve a good understanding of aetiology of these dysfunctions, a holistic view of a patient is advisable, which takes into consideration the fact that the temporomandibular joint is an integral part of the whole body. This study is a review of the literature, supported by own examples on investigating the relationship between myofascial-skeletal disorders and a temporomandibular disorder, which, in the light of current medical knowledge, is attributed to the phenomenon of biotensegrity. A conclusion has been put forward on the basis of 136 scientific reports that a dependency exists between the said dysfunctions.

Słowa kluczowe:
biotensegrity, disorders of the musculoskeletal system, posture defects, dysfunctions of the masticatory system, temporomandibular joint disorder

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The use of pedobarography in physiotherapeuticprocedures – analysis of educationstandards, fields of application – and reality; part 2

Aleksandra Bitenc-Jasiejko, Krzysztof Konior, Monika Brzózka, Andrzej Garstka, Marek Kiljański, Danuta Lietz-Kijak

A. Bitenc-Jasiejko, K. Konior, M. Brzózka, A. Garstka, M. Kiljański, D. Lietz-Kijak – The use of pedobarography in physiotherapeuticprocedures – analysis of educationstandards, fields of application – and reality; part 2. Fizjoterapia Polska 2020; 20(4); 122-136

Abstract

Diagnosis of human body posture and assessment of functionality, in physiotherapeutic procedures, is mainly carried out by viewing methods and by photogrammetric or videogrammetric methods, which do not provide angular measurements, anthropometric, time-space measurements, etc. Highly specialized imaging tests are medical procedures, which significantly affects their availability. Also, in terms of their economics, application and invasiveness. Thus, their purpose is significantly limited in the initial diagnostics process, and in particular in current physiotherapeutic assessment.
In the world, for over 30 years, gait, balance, selected biomechanics parameters and body functionality have been evaluated by pedobarography. However, other scientific studies of the authors indicate that the method is very little known in Poland by medical staff. Despite the fact that it has been included in the list of guaranteed benefits since 2011, no procedures for its implementation have been specified. An important aspect of pedobarography is the consistency of its directions of use with the standards of training the profession of a physiotherapist. The obvious and logical conclusion is that the lack of knowledge in the area of the method does not allow its development. An important issue is to assess whether education standards are directly consistent with the directions of pedobarography in the rehabilitation process.

Key words:

rehabilitation, physiotherapy, posture tests, gait tests, feet, foot defects, pedobarography, orthopedics, rehabilitation, neurology

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Availability and application of pedobarography within services offered by the guaranteed healthcare benefits fund and private sector — possibilities and limitations; part 1

Aleksandra Bitenc-Jasiejko, Krzysztof Konior, Katarzyna Kordus, Monika Brzózka, Andrzej Garstka, Marek Kiljański, Danuta Lietz-Kijak

A. Bitenc-Jasiejko, K. Konior, K. Kordus, M. Brzózka, A. Garstka, M. Kiljański, D. Lietz-Kijak – Availability and application of pedobarography within services offered by the guaranteed healthcare benefits fund and private sector — possibilities and limitations; part 1. Fizjoterapia Polska 2020; 20(2); 160-176

Abstract
Changes resulting from incorrect plantar foot pressure distribution can lead to degenerative changes of hard and soft tissues. Especially clear connection can be noticed between excessive pressure on feet and occurrence of ulcers and chronic wounds, especially those secondary to diabetes and motor and sensory neuropathy. Pedobarography is widely used to assess the value as well as time and space parameters of pressure when standing and walking. This means that this procedure can prove useful in many fields, including orthopaedics, rehabilitation, orthopaedic appliances as well as in traumatology and treating bad posture.
Pedobarography is a diagnostic procedure that is not highly specialist (besides physicians, it can be performed by non-physician practitioners) that is why it can be used by specialists of many fields. In most countries where prophylactics of feet disorders, especially the diabetic foot syndrome, is highly developed, pedobarography is one of the basic diagnostic procedures of the guaranteed healthcare services. In Poland, it is included in the list of guaranteed healthcare benefits of the National Health Found since 2011. However, there are grounds to think that pedobarography is not commonly used, mainly due to insufficient knowledge of medical staff on this method. Considering the fact that this diagnostic procedure plays an important role in preventing disorders resulting from incorrect pressure migration, it is crucial to analyse directions of its application and factors influencing its development. The aim of this paper was to assess availability of pedobarography and to analyse factors facilitating and limiting its development.

Key words:
pedobarography, orthopaedics, rehabilitation, traumatology, bad posture, ulcerations, Charcot’s neuro-osteoarthropathy, custom-made orthopaedic insoles

 

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