Tag: endoprotezoplastyka

A biomechanical analysis of gait disturbances in a patient following alloplasty of the hip joint

Wiesław Chwała, Witold Serafin, Anna Marchewka

Wiesław Chwała, Witold Serafin, Anna Marchewka – A biomechanical analysis of gait disturbances in a patient following alloplasty of the hip joint. Fizjoterapia Polska 2007; 7(2), 185-197

Abstract

Background. The physical examination and imaging studies are the diagnostic tools of today’s therapists and physicians. The drawbacks of these methods include a lack of objectivity as the assessment depends on the examiner’s clinical experience and the limited possibilities of the physical examination. As attention is quite often focused on a specific clinical area, biomechanical relations with other structures in the locomotor system are neglected. Three-dimensional analysis of movement is now available to clinicians as a new method of analysis of patient locomotion that can ensure a holistic and precise whole-body diagnosis of biomechanical disturbances. Material and methods. A three-dimensional gait analysis was carried out at the Laboratory of Biokinetics of the University of Physical Education in Cracow, Poland. A 56 year-old woman with right hip coxarthrosis underwent an examination of locomotion before an elective THR at the Department of Neuroorthopedics of the Rydygier Hospital in Cracow, and four months after the sur-gical procedure, following a period of total unloading of the operated right hip, around the time she commenced unsupported ambulation without assistive forearm crutches. Results and Conclusions. Based on the three-dimensional analysis of motion, a number of gait disturbances were detected which had originated from the degenerative changes within the hip joint and were not noticed during the physical examination. A comparison of the pre- and post-operative data showed that the pathologic gait patterns were successfully altered thanks to THR. Specifically, the range of motion within the hip joint was closer to relevant biomechanical reference values. The results of the postoperative examination suggest the presence of persistent disturbances of muscle function that still necessitate compensatory work of the contralateral limb.

Key words:

three-dimensional gait analysis, coxarthrosis, THR

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Physiotherapy in patients with congenital haemorrhagic diathesis in the material of the systemic rehabilitation department

Joanna Bukowska, Agata Pawełczyk, Ireneusz Kotela, Małgorzata Szarota, Paweł Kaminiński, Magdalena Wilk-Frańczuk, Rafał Trąbka

Joanna Bukowska, Agata Pawełczyk, Ireneusz Kotela, Małgorzata Szarota, Paweł Kaminiński, Magdalena Wilk-Frańczuk, Rafał Trąbka – Physiotherapy in patients with congenital haemorrhagic diathesis in the material of the systemic rehabilitation department. Fizjoterapia Polska 2021; 21(2); 6-15

Abstract
Aim. The objective of this study is to present the process and results of physiotherapy in patients suffering from congenital haemorrhagic diathesis, treated at the Inpatient Rehabilitation Department of the Krakow Rehabilitation Centre and Orthopaedics (MSOR). Material. The analysis involved 73 patients treated at the Inpatient Rehabilitation Department between 2014 and 2019. The reason for admission was haemophilic arthropathy in the course of congenital haemorrhagic diathesis. Results. The results prove that early postoperative knee rehabilitation is effective in patients with congenital haemorrhagic diathesis after surgery. Deaver’s functional scale: before rehabilitation, the mean result was 3.65, after rehabilitation it was 2.62. Muscle strength: the assessment of muscle strength according to the Lovett scale showed improvement in 64 patients (87,67%). Range of motion: in the extension test, the condition of 57 patients (78%) improved, the mean result was better by 7.52 degrees. Conclusions. 1. The use of early physiotherapy in patients with haemophilia after knee endoprosthetics results in an improvement in gait function analysed according to Deaver’s scale. 2. Early rehabilitation of patients with haemophilia after endoprosthetics results in an increase in the range of motion of the knee joint and in muscle strength. 3. It was also found that pain in the joint undergoing surgery was reduced thanks to the applied physiotherapy.
Key words:
physiotherapy, haemophilia, endoprosthetics, arthropathy
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Physiotherapy following hip arthroplasty: treatment analysis

Włodzisław Kuliński, Rafał Pilichowski

W. Kuliński, R. Pilichowski – Physiotherapy following hip arthroplasty: treatment analysis. Fizjoterapia Polska 2020; 20(5); 30-42

Abstract

Background. Hip osteoarthritis (HOA) is an important clinical and social problem and is considered a civilisation disease. HOA is a chronic condition causing joint cartilage damage. Its symptoms increase slowly, resulting in considerable limitations in hip joint mobility and severe pain. Advanced degenerative changes constitute one of the main indications for arthroplasty.
Aim. To assess the effects of hip arthroplasty and physiotherapy on patient functioning.
Material and methods. The study was conducted in a group of 30 patients after arthroplasty procedures at the Regional Polyclinical Hospital in Kielce in 2019. The patients completed WOMAC survey questionnaires twice, before and after rehabilitation.
Results. All patients showed a considerable improvement in physical performance and reported resolution of pain during everyday activities.
Conclusions. Arthroplasty and comprehensive rehabilitation performed in the study patients improved the ranges of motion in the hip joints, which contributed to improvements in gait, functioning, and physical performance, and to a significantly better quality of life.

Key words:
hip osteoarthritis, arthroplasty, physiotherapy
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Implementation of manual physiotherapeutic activities as an important element of supporting surgical treatment in congenital malformations of the bite and temporomandibular joints – case report

Szymon Tyszkiewicz, Marta Tyndorf, Krzysztof Dowgierd

S. Tyszkiewicz, M. Tyndorf, K. Dowgierd – Implementation of manual physiotherapeutic activities as an important element of supporting surgical treatment in congenital malformations of the bite and temporomandibular joints – case report. Fizjoterapia Polska 2019; 19(3); 38-45

Abstract
Introduction. Surgical procedures used to treat congenital craniofacial malformations may give rise to complications, resulting in impaired function of the stomatognathic system. Reconstructive correction of subsequent defects may require multi-disciplinary skills, including those of maxillofacial and microsurgery, orthodontics, speech therapy and physiotherapy. The purpose of reconstruction to restore function can be divided into two stages: firstly the establishment of correct anatomical relationships in the facial skeleton and secondly the restoration of function of individual structures of the stomatognathic system, together with the stabilisation of both function and appearance. The latter is fundamentally associated with supportive physiotherapy.
Aim of the study. The aim of the study was to determine the effectiveness of physiotherapy in the process of restoring motor functions in the stomatognathic system in a patient treated for disorders of the masticatory apparatus.
Material and methods. The article presents an account of supportive physiotherapy utilised in the healing process. The case study presented is that of a patient with congenital ankylosis of the temporomandibular joints. The patient presented in the maxillofacial department for surgical joint treatment and with associated in activity in the musculature of this region. Initial treatment involved bilateral arthroplasty with prosthetic arthroplasy, after which it was possible to proceed to restoration of functional speech. The provision of physiotherapy over a timescale of six months achieved reduction of oedema, development of the expected range of movement, reduction of pain and the achievement of deglutition.
Results. Results were maintained through continuation of therapeutic procedures, since periods of reduced activity are associated with loss of function. In order to increase functional capacity and achieve stability, the patientis to undergo microtransplantation (cable grafts) and orthodontic treatment to achieve full centricocclusion. Speech therapy and physiotherapy will also be continued.
Conclusions: Supportive physiotherapy should be a key element of treatment of patients after maxillofacial procedures, regardless of whether this is due to injury, congenital malformation ororthognathic procedures.

Key words:
arthroplasty, ankylosis, dental physiotherapy, temporomandibular joint

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Muscle energy techniques after total hip replacement

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

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

Abstract

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

Key words:
arthroplasty, rehabilitation, muscle energy techniques

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