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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An interdisciplinary concept for the treatment of Bell’s palsy – a case report

Konrad Kijak, Łukasz Kopacz, Grzegorz Cieślar, Zbigniew Śliwiński, Piotr Skomro, Małgorzata Kowacka, Paweł Berczyński, Danuta Lietz-Kijak


Konrad Kijak, Łukasz Kopacz, Grzegorz Cieślar, Zbigniew Śliwiński, Piotr Skomro, Małgorzata Kowacka, Paweł Berczyński, Danuta Lietz-Kijak –
An interdisciplinary concept for the treatment of Bell’s palsy – a case report. Fizjoterapia Polska 2023; 23(2); 62-69

DOI: https://doi.org/10.56984/8ZG0DF923

Abstract

Background. Bell’s palsy is a spontaneous paralysis of the facial nerve (i.e. cranial nerve VII). It presents with muscle weakness leading to facial asymmetry, with a drooping corner of the mouth, loss of the ability to whistle, blink, close the eyelid, purse lips or grin. The forehead on the affected side becomes smooth and the patient is not able to frown or raise eyebrows.

Objective. The aim of the study was to evaluate the effect of combined electrophysical and physiotherapeutic methods on accelerating recovery from facial nerve palsy.

Material and Methods. The authors describe two cases of Bell’s palsy, treated with simulta-neous application of electrophysical agents, in the form of an extremely low-frequency elec-tromagnetic field (ELF-EMF) and high-energy LED light, and physiotherapy modalities, i.e. proprioceptive neuromuscular facilitation (PNF) and kinesiotaping (KT).

Results. After four weeks of electrophysical and physiotherapeutic treatments, a fully satis-factory and stable therapeutic effect was achieved.

Conclusions. The interdisciplinary therapy using ELF-EMF + LED combined with PNF and KT treatments proved to be effective in accelerating recovery from facial nerve palsy. Further studies are needed to establish appropriate protocols.

Key words: Bell’s palsy, electrophysical agents, physiotherapy, LED light therapy with extremely low frequency electromagnetic field (ELF-MF), proprioceptive neuromuscular facilitation (PNF), kinesiotaping (KT)
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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 review of literature on the possibility of the use of Kinesiology Tape in musculoskeletal diseases. Meta-analysis

Marcin Krajczy, Katarzyna Bogacz, Jacek Łuniewski, Edyta Krajczy, Igor Świerkowski, Aleksandra Skomudek, Ewa Jach, Danuta Lietz-Kijak, Zbigniew Śliwiński, Jan Szczegielniak

Marcin Krajczy, Katarzyna Bogacz, Jacek Łuniewski, Edyta Krajczy, Igor Świerkowski, Aleksandra Skomudek, Ewa Jach, Danuta Lietz-Kijak, Zbigniew Śliwiński, Jan Szczegielniak – The review of literature on the possibility of the use of Kinesiology Tape in musculoskeletal diseases. Meta-analysis. Fizjoterapia Polska 2021; 21(5); 90-103

Abstract
Background. Kinesilogy Tape (KT) is widely used in patients with muscular disorders and pain. Objectives. To present the current body of knowledge on KT as a treatment method in patients with muscular disorders and pain. Design. Systematic review. Population. Patients with musculoskeletal disorders and pain. in whom KT was used.
Methods The papers were identified on the basis of term searches in digital research databases (PubMed, Medline, Cochrane Central Register of Controlled Trials (CCTR), EMBASE Excerpta Medica, and Google Scholar). On the basis of the review of the available 152 research articles, 27 papers on muscular disorders and pain disorders were selected. Two of the authors of this review, working independently, selected the papers to be included in the analyzed sample, isolated the data, performed an assessment of the risk of bias, and assessed the quality of the evidence for the main effects using the IVS internal validity score (PEDro) approach. A simplified version of the Oxford Centre for Evidence-Based Medicine (OCEBM) system was used to evaluate the evidence. Results. There are too few prospective, controlled randomized trials on KT that include a sufficiently large cohort. Only few of the reviewed papers that discuss the principles of KT meet the criteria of scientifically rigorous research. Conclusions. There is a need for further clinical trials on the effectiveness of the use of KT method.
Clinical rehabilitation impact. We found significant quality evidence to support the use of KT in clinical practice in patients with disorders of the musculoskeletal system (and in sports therapy).
Key words:
kinesiotaping, kinesiology taping, kinesiology tape, k/active tape AND medicine, musculoskeletal disorders AND pain
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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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Ocena skuteczności usprawniania pacjentów z dyslordozą szyjną z wykorzystaniem testów neurodynamicznych i zabiegów fizykalnych

Zbigniew Śliwiński, Agnieszka Zamczyk, Danuta Lietz-Kijak, Edward Kijak, Małgorzata Starczyńska

Zbigniew Śliwiński, Agnieszka Zamczyk, Danuta Lietz-Kijak, Edward Kijak, Małgorzata Starczyńska – Ocena skuteczności usprawniania pacjentów z dyslordozą szyjną z wykorzystaniem testów neurodynamicznych i zabiegów fizykalnych. FP 2013; 13(2); 15-21

Streszczenie
Wstęp. Celem pracy była ocena skuteczności kompleksowego postępowania fizjoterapeutycznego usprawnianie pacjentów dyslordoza szyjną materiał i metody badania objęto grupę 40 osób, u których stwierdzono zmiany zwyrodnieniowe w obrębie szyjnego odcinka kręgosłupa. Grupa badana stanowiąca 20 osób została poddana serii zabiegów fizykalnych (biostymulacja laserowa i galwanizacja) oraz serii zabiegów mobilizacji i poizometrycznej relaksacji mięśni z ćwiczeniami izometrycznym. W grupie kontrolnej pacjenci korzystali tylko zabiegów fizykalnych (laser i galwanizacja). Oceny rezultatów zastosowanych terapii dokonano wykorzystując testy neurodynamiczne. Wyniki. Z przeprowadzonych badań wynika że terapia zabiegami fizykalnymi połączonymi z neuromobilizacją i poizometryczna relaksacją mięśni z ćwiczeniami izometrycznym stanowi ważny element w terapii leczenia dyslordozy szyjnej. Przemawia za tym fakt zmniejszenia się średniego bólu odczuwanego przez pacjentów oraz zwiększenie ruchomości kręgosłupa szyjnego. Wnioski. Terapia dyslordozy szyjnej z wykorzystaniem zabiegów fizykalnych (biostymulacja laserowa i galwanizacja) połączona z neuromobilizacją i poizometryczna relaksacją mięśni daje lepszy efekt terapeutyczny niż usprawnianie tylko z wykorzystaniem metod fizykalnych. Kompleksowe postępowanie fizjoterapeutyczne przyczyniło się do zmniejszenia natężenia bólu oraz do poprawy ruchomości kręgosłupa w odcinku szyjnym.

Słowo kluczowe
dyslordoza szyjna, zabiegi fizykalne, testy neurodynamiczne,, usprawnianie, fizjoterapia, cervical hypolordosis, physical treatments, neurodynamical tests, improving, physiotherapy

Therapeutic value of local cryotherapy in the treatment of patients with gonarthrosis

Łukasz Kopacz, Anna Lubkowska, Iwona Bryczkowska, Piotr Skomro, Elżbieta Kubala, Marek Kiljański, Danuta Lietz-Kijak

Ł. Kopacz, A. Lubkowska, I. Bryczkowska, P. Skomro, E. Kubala, M. Kiljański, D. Lietz-Kijak – Wartość terapeutyczna krioterapii miejscowej w leczeniu pacjentów z gonartrozą. FP 2013; 13(4); 31-36

Streszczenie
Wstęp. Celem przeprowadzonych badań była ocena wpływu zabiegów krioterapii miejscowej na zakres ruchu w stawie kolanowym u pacjentów z chorobą zwyrodnieniową stawów. Dodatkowo analizowano potencjalne zmiany w dolegliwościach bólowych pacjentów. Materiał i metody. Grupa badana liczyła 50-ciu pacjentów i była jednorodna pod względem schorzenia. W badaniu wzięło udział 39 kobiet i 11 mężczyzn. Pacjenci poddani byli 10-ciu codziennym zabiegom krioterapii miejscowej na okolicę stawu kolanowego. Przed przystąpieniem do krioterapii, pacjenci zostali poddani badaniom antropometrycznym oraz wyliczono wskaźniki BMI. Został zebrany wywiad odnośnie chorób współistniejącychi zbadano dolegliwości bólowe według skali VAS. U wszystkich badanych wykonano pomiar zakresu ruchów w stawie kolanowym za pomocą goniometru. Został on wykonany przed rozpoczęciem zabiegów oraz po ich zakończeniu. Wynik. U wszystkich pacjentów, poddanych serii zabiegów można stwierdzić znaczną poprawę w zakresie ruchu zgięcia i wyprostu w stawie kolanowym. Analizując dolegliwości bólowe oceniane za pomocą skali VAS, po zakończeniu serii zabiegów wykazano znaczne zmniejszenie wartości wskazywanych przez badanych. Rozpatrując zakres ruchu zgięcia w stawie kolanowym w obu grupach, zarówno z rozpoznaniem choroby zwyrodnieniowej stawów kolanowych oraz choroby zwyrodnieniowej wielostawowej, po serii zabiegów krioterapii miejscowej ruch znacznie się poprawił, natomiast zakres ruchu wyprostu w stawie kolanowym polepszył się w grupie z rozpoznaniem choroby zwyrodnieniowej wielostawowej. Wnioski. Krioterapia miejscowa jest korzystną metodą, redukującą dolegliwości bólowe oraz wpływającą na poprawę zakresu ruchów w stawie kolanowym u pacjentów z gonartrozą.

Słowa kluczowe:
zimnolecznictwo, gonartroza, leczenie zimnem


Abstract

Introduction. The aim of the study was to evaluate the effect of local cryotherapy treatment for range of motion in the knee joint in patients with osteoarthritis. In addition, analyzed potential changes in symptoms of pain patients. Material and method. The study group consisted of 50 of the patients and was homogeneous in terms of disease. The study involved 39 women and 11 men. Patients were subjected to 10 daily treatments local cryotherapy on the area of the knee. Before cryotherapy, patients were examined anthropometric, and BMI was calculated indicators. Was collected interview regarding comorbidities and examined pain according to VAS. In all patient performed to measure of range of motion in the knee joint using a goniometer. It was made before and after treatment.
Results. All patients who underwent a series of treatments there is a considerable improvement in flexion and extension of the knee. Considering the analysis of pain assessed by VAS in all patients demonstrated a significant reduction in the value indicated by the respondents on the scale after the series of treatments. Considering the range of flexion in the knee joint in both groups, both diagnosed with osteoarthritis of the knee and polyarticular osteoarthritis, after a series of local cryotherapy treatments became significant improvement, while the range of motion in the knee extension improved more in the group diagnosed with polyarticular osteoarthritis. Conclusion. Local cryotherapy is a beneficial effect on the range of motion in the knee joint and reduction of pain in patients with gonarthrosis.

Key words:
cryotherapy, osteoarthritis, knee, cold therapy

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