The Impact of Thoracic Physiotherapy Procedures on Rehabilitation Outcomes in Patients after Coronary Artery Bypass Grafting

Katarzyna Bogacz, Anna Szczegielniak, Jacek Łuniewski, Bartosz Pańczyszak, Aleksandra Kucińska, Hanna Piekarska, Igor Świerkowski, Jan Szczegielniak

Katarzyna Bogacz et al. – The Impact of Thoracic Physiotherapy Procedures on Rehabilitation Outcomes in Patients after Coronary Artery Bypass Grafting –  Fizjoterapia Polska 2025; 25(5); 26-36

DOI: https://doi.org/10.56984/8ZGA4318Q2M

Abstract
Introduction. Coronary artery bypass grafting performed via median sternotomy frequently leads to postural disturbances, reduced thoracic mobility, and diaphragmatic dysfunction, which may adversely affect pulmonary ventilatory function and exercise tolerance. Supplementing standard cardiac rehabilitation with physiotherapeutic interventions targeted at the thorax and diaphragm may enhance the effectiveness of functional recovery in patients after CABG.
Aim of the Study. The aim of the study was to evaluate the effect of thoracic physiotherapy procedures on body posture, pulmonary ventilatory function, and exercise tolerance in patients after coronary artery bypass grafting.
Material and Methods. The study included 80 patients (28 women and 52 men) after OPCAB surgery, qualified for phase II cardiac rehabilitation. The patients were randomly assigned to an experimental group (I) and a control group (II). Both groups followed a 3-week standard cardiac rehabilitation program, while the experimental group additionally received exercises aimed at improving posture, thoracic mobility, and manual therapy techniques targeting the diaphragm. Before and after physiotherapy, body posture, breathing pattern, spirometric parameters, and exercise tolerance in the 6-minute walk test were assessed. Repeated-measures ANOVA was used for statistical analysis.
Results. After physiotherapy, both groups demonstrated a significant improvement in pulmonary ventilatory function and exercise tolerance (p < 0.05). The experimental group showed a significantly greater magnitude of changes in body posture, diaphragmatic function, spirometric parameters, and MET values in the 6-minute walk test compared with the control group.
Conclusions. Physiotherapeutic interventions targeted at the thorax and diaphragm constitute a valuable adjunct to standard cardiac rehabilitation in patients after coronary artery bypass grafting, contributing to improved respiratory function and exercise tolerance.
Key words
coronary artery bypass grafting, cardiac rehabilitation, respiratory physiotherapy, diaphragm, exercise tolerance, 6MWT
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The effect of local cryotherapy on temperature changes in the ankle joint in individuals with chronic ankle instability

Bartosz Pańczyszak, Katarzyna Bogacz, Łukasz Mączka, Danuta Lietz-Kijak, Jacek Łuniewski, Anna Szczegielniak, Jan Szczegielniak

 

Bartosz Pańczyszak et al. – The effect of local cryotherapy on temperature changes in the ankle joint in individuals with chronic ankle instability –  Fizjoterapia Polska 2025; 25(2); 172-177

DOI: https://doi.org/10.56984/8ZG00E1ON2V

Abstract
Objective. The aim of this study was to evaluate the impact of local cryotherapy on temperature changes in the ankle joint. Additionally, a subjective assessment of joint function was performed in individuals with chronic ankle instability and in healthy controls.
Materials and methods. The chronic ankle instability (CAI) group consisted of 10 participants, while the healthy control group included 22. In both groups, ankle joint temperature was measured at four time points: 10 minutes before testing, immediately before cryotherapy, immediately after the procedure, and 10 minutes post-treatment. Functional status of the ankle joint was assessed using the FADI-Q questionnaire.
Results. The lowest temperature was recorded at the Achilles tendon during the first measurement, and the CAI group showed a higher Achilles tendon temperature before testing began. The experimental group scored lower on the FADI-Q questionnaire than the control group.
Conclusions.
1. The CAI group exhibited higher temperature at the distal insertion of the Achilles tendon before the study began.
2. Ten minutes after the procedure, skin temperature had not returned to baseline values.
3. The FADI-Q questionnaire revealed that the group with chronic ankle instability rated their functional status lower.
Key words
functional status, quality of life, erderly people, institutional care
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Assessment of rehabilitation effectiveness in patients with COPD as part of the project “PulmoRehab – Access to healthcare services through a personalized care system for patients with COPD, including remote monitoring and tele-rehabilitation based on Artificial Intelligence methods”

Katarzyna Bogacz, Anna Szczegielniak, Łukasz Czekaj, Andrzej Jarynowski, Robert Kitłowski, Stanisław Maksymowicz, Danuta Lietz-Kijak, Bartosz Pańczyszak, Jacek Łuniewski, Edyta Krajczy, Mirosław Lenczuk, Jacek Sahajdak, Krzysztof Kassolik, Szymon Kaliciński, Jan Szczegielniak

 

Katarzyna Bogacz, Anna Szczegielniak, Łukasz Czekaj et al – Assessment of rehabilitation effectiveness in patients with COPD as part of the project “PulmoRehab – Access to healthcare services through a personalized care system for patients with COPD, including remote monitoring and tele-rehabilitation based on Artificial Intelligence methods” –  Fizjoterapia Polska 2024; 24(1); 6-11

DOI: https://doi.org/10.56984/8ZG2EF8D9D

Abstract
Introduction. In the project “PulmoRehab – Access to Healthcare Services through a Personalized Patient Care System for COPD including Remote Monitoring and Tele-rehabilitation Based on Artificial Intelligence Methods,” SP ZOZ Specialized Hospital Ministry of Internal Affairs and Administration in Głuchołazy and 10 partners conducted research on tele-rehabilitation for people suffering from Chronic Obstructive Pulmonary Disease (COPD). The tele-rehabilitation program, based on personalized approach and technology, allowed patients to use therapy at home or a convenient location. The project aimed to reduce social inequalities in healthcare by providing remote access to health services for COPD patients.
Materials and Methods. The study involved 80 patients aged 50 to 76 years, hospitalized at Ministry of Internal Affairs and Administration’s Specialist Hospital of St. John Paul II, meeting specific criteria. Qualification for the tele-rehabilitation program took into account the assessment of exercise tolerance, dyspnea, fatigue, lung ventilatory function, and saturation. The program included exercises adapted to the individual needs of the patients.
Results. Analysis of the results conducted using XLSTAT software 2021.2.2 showed statistically significant differences between spirometric values before and after rehabilitation. Similarly, significant improvement was observed in the results of the 6MWT test and blood saturation. The tele-rehabilitation program proved effective in improving respiratory health parameters in COPD patients.
Conclusions.
1. The tele-rehabilitation program improves lung ventilatory function in people with COPD. It reduces the feeling of dyspnea, decreases fatigue, improves SpO2, and increases exercise tolerance, demonstrating the beneficial effects of the rehabilitation applied.
2. The obtained results encourage further research on a representative group with the use of randomization.
Key words:
Tele-rehabilitation, COPD
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Ultrasonography in physiotherapy and rehabilitation: A physiotherapist’s curriculum introduction.

Dominik Sieroń, Izabella Jabłońska, Maciej Kostrzewa, Dawid Lukoszek, Jan Szczegielniak, Rafał Trąbka, Karol Szyluk, Aleksander Sieroń

 

Dominik Sieroń, Izabella Jabłońska, Maciej Kostrzewa, Dawid Lukoszek, Jan Szczegielniak, Rafał Trąbka, Karol Szyluk, Aleksander Sieroń – Ultrasonography in physiotherapy and rehabilitation: A physiotherapist’s curriculum introduction. Fizjoterapia Polska 2023; 23(2); 104-111

DOI: https://doi.org/10.56984/8ZG0DF2DA

 

Abstract

Ultrasound examination (USG) is becoming more popular among physiotherapists. The term “rehabilitative ultrasound imaging” (RUI) refers to the use of USG in the rehabilitation process. An examination (ultrasound) is used in physiotherapeutic therapy to evaluate the tissue and function of the musculoskeletal system. The real image allows for accurate observation and stimulation of the necessary muscles during kinesiotherapy, while measurements track the treatment’s progress. Furthermore, the ultrasound examination aims to assist the physiotherapist in making an early diagnosis of dysfunctional aspects that may necessitate consultation with another specialty, thereby reducing medical errors. Preparing an educational program and conducting training in accordance with established standards and guidelines will allow physiotherapists to be adequately prepared to perform ultrasound examinations and dispel any doubts about a physiotherapist’s competence and the possibility of performing ultrasound examinations in a medical setting.

Key words: ultrasound, rehabilitation, physiotherapy, diagnostics

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Assessment of the body posture of junior high school students in the context of their physical activity

Marta Gołdyn-Pastuszka, Marzena Dorosz, Anna Szczegielniak, Katarzyna Bogacz, Jacek Łuniewski, Jan Szczegielniak


Marta Gołdyn-Pastuszka, Marzena Dorosz, Anna Szczegielniak, Katarzyna Bogacz, Jacek Łuniewski, Jan Szczegielniak – Assessment of the body posture of junior high school students in the context of their physical activity. Fizjoterapia Polska 2023; 23(1); 112-125

DOI: https://doi.org/10.56984/8ZG07B654

Abstract
Introduction. Posture defects constitute a social problem and can cause negative changes in many aspects of our lives – in both physical and mental health. Prophylaxis and an appropriate degree of physical activity, which affects harmonious development, are very important here. Objective. The objective of the study was to assess the body posture of junior high school students and to determine the degree of their physical activity, and then to check whether there is a correlation between them. The study group consisted of 53 people from a junior high school in Wrocław, aged 14 to 17. Material and methods. To assess physical activity, the International Physical Activity Questionnaire (IPAQ) was used, which contains 7 questions regarding activity in the last 7 days. Body posture in the sagittal plane was examined using photogrammetry, and typology classification was based on Wolański’s method modified according to Zeyland-Malawka. Results. The results of the study were subjected to a statistical analysis, which shows that the studied group of adolescents is mostly characterized by a kyphotic type of body posture, while the least common is the balanced type. The level of physical activity of the study group can be described as sufficient, but it is worth noting that only 6% of the respondents are characterized by an insufficient level of physical activity, and only 7.5% are characterized by a high level of physical activity. Conclusions. In further analyses, it was examined whether there is a correlation between body posture and physical activity. It was found that there are no statistically significant differences between these two features in the study group.
Key words:
posture defects, body posture, physical activity, junior high school students
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Impact of the pandemic on the quality of life in the Polish and German population

Daniela Kajda, Jan Szczegielniak, Marzena Dorosz, Marta Gołdyn-Pastuszka, Jacek Łuniewski, Katarzyna Bogacz


Daniela Kajda, Jan Szczegielniak, Marzena Dorosz, Marta Gołdyn-Pastuszka, Jacek Łuniewski, Katarzyna Bogacz – Impact of the pandemic on the quality of life in the Polish and German population. Fizjoterapia Polska 2022; 22(5); 140-153

DOI: https://doi.org/10.56984/8ZG20A6hK

Abstract:

Introduction. Quality of life during the pandemic has taken on a completely different dimension. As a result of the restrictions, it was necessary to reorganize life in every sphere. This could lead to a number of negative consequences, including the deterioration of physical and mental health, as well as disturbances in the ability to establish proper social relationships.
Objective. The objective of the study was to assess the impact of the pandemic on the quality of life in the Polish and German population.
Material and methods. The study was conducted on a group of 200 people, of which 100 people are respondents living in Poland, while the remaining 100 live in Germany. The research tool used in this study was a questionnaire. The questionnaire was created in two language versions: Polish and German. The obtained results are presented in the form of pie charts and bar graphs. Pie charts present the results in percentages, obtained in individual questions included in the questionnaire.
Results and discussion. The results indicate a change in the frequency of undertaking physical activity. The number of respondents undertaking physical activity has significantly decreased, while the respondents who do not undertake physical activity during the pandemic constitute almost half of the respondents from Poland. The situation in Germany is completely different, as the number of people undertaking and not undertaking physical activity has not changed significantly. As a result of the pandemic caused by the SARS-CoV-2 virus, almost half of the respondents from Poland began to feel a little fatigued while performing everyday activities, while the level of fatigue of the German respondents did not change significantly and oscillates around the same limits as before the pandemic. The quality of sleep in Polish respondents definitely decreased from good to moderate as a result of the COVID-19 pandemic, while in German respondents there is no significant decrease in sleep quality.
Conclusions. 1. The COVID-19 pandemic had a negative impact on the mental health of the Polish population to a large extent, while the negative impact of the SARS-CoV-2 virus pandemic on the German population is observed to a much lesser extent.
2. The pandemic situation contributed to a significant deterioration in the quality of life in the case of the Polish population, while in the case of the German population, no significant deterioration in the overall quality of life caused by the COVID-19 pandemic was documented.
3. The COVID-19 pandemic caused a significant decrease in the level of physical fitness and the frequency of undertaking physical activity in the Polish population, while in the case of the German population, the level of physical fitness slightly deteriorated, but no significant decrease in the frequency of undertaking physical activity was observed during the pandemic caused by the SARS-CoV-2 virus.
4. Among the Polish population, the general well-being has clearly deteriorated, however, in the case of the German population, there is no significant decrease in well-being caused by the ongoing COVID-19 pandemic.

Keywords:
pandemic, quaility of life, Polish population, German population

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The impact of body composition disorders on the quality of life of patients with chronic obstructive pulmonary disease

Marzena Dorosz, Katarzyna Bogacz, Marta Gołdyn-Pastuszka, Marcin Krajczy, Anna Szczegielniak, Jacek Łuniewski, Jan Szczegielniak


Marzena Dorosz, Katarzyna Bogacz, Marta Gołdyn-Pastuszka, Marcin Krajczy, Anna Szczegielniak, Jacek Łuniewski, Jan Szczegielniak – The impact of body composition disorders on the quality of life of patients with chronic obstructive pulmonary disease. Fizjoterapia Polska 2022; 22(5); 56-69

DOI: https://doi.org/10.56984/8ZG20AXT7

Abstract

Introduction. COPD is a chronic inflammatory disease that constitutes a significant public health problem. It is characterized by not fully reversible, progressive limitation of airflow through the airways. In addition to the harmful pulmonary effects, COPD manifests itself with complications in other body systems, including body composition disorders, which adversely affects patients’ quality of life and prognosis. The objective of this study was to assess the quality of life of patients with COPD and to assess the factors that will affect its deterioration.
Material and methods. The study included 37 patients of the University Hospital at the Jagiellonian University Medical College in Kraków at 8 Skawińska Street, who were diagnosed with COPD according to the GOLD guidelines. In the study group, a personal questionnaire was conducted, anthropometric data was collected, i.e. the Quetelet index was calculated, thigh circumference and skin folds were measured, and the subjective assessment of the quality of life was examined using the SGRQ-C questionnaire and the CAT Test.
Results. Based on the analysis of the collected materials, it was shown that the average assessment of the quality of life in the study population was at a low level of 61.8 points on the SGRQ-C scale. There was a large variation in the assessment of HRQoL depending on the stage of the disease. The best result, amounting to 23.0 points, was achieved by patients in stage 1, and the worst – 81.6 points. – patients in stage 4 according to GOLD guidelines. Among the main determinants of the quality of life in the study group, in addition to the degree of airway obstruction, there were: high intensity of clinical symptoms, such as cough, shortness of breath or expectoration of secretions, low body weight and the number of comorbidities. Conclusions. It has been shown that the loss of fat-free body mass and systemic complications are factors that significantly reduce the quality of life, and patients with fewer comorbidities and with increased BMI score better on the SGRQ-C scale. It has been proven that the progression of the disease contributes to the exclusion of patients from active social life and causes many mental problems. It was established that patients with COPD should be covered by multidisciplinary care and a special training program in order to prevent or delay the onset of systemic complications, which significantly worsen the patients’ quality of life

Keywords:
COPD, body composition, quality of life

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Efficacy of ultrasound in diagnosis and treatment of the shoulder – A systematic review

Dawid Lukoszek, Dominik Sieroń, Izabella Jabłońska, Jan Szczegielniak, Rafał Trąbka, Karol Szyluk


Dawid Lukoszek, Dominik Sieroń, Izabella Jabłońska, Jan Szczegielniak, Rafał Trąbka, Karol Szyluk – Efficacy of ultrasound in diagnosis and treatment of the shoulder – A systematic review. Fizjoterapia Polska 2022; 22(4); 56-73

DOI: https://doi.org/10.56984/8ZG1A6k5q

Abstract
Objectives. The aim of this study was to provide an overview of the scientific evidence base on the use of ultrasonography in physiotherapy and rehabilitation of the shoulder.
Methods. The PubMed / Medline database was reviewed using the following keywords: shoulder ultrasonography AND rehabilitation; shoulder ultrasound imaging AND physiotherapy; shoulder ultrasound imaging AND rehabilitation; Rehabilitative Ultrasound Imaging AND Shoulder. Only full-text, open-access studies in English published before 15 May 2022 were included in the analysis.
Results. 51 articles (out of 748 identified) were included in the analysis. Of all the studies, 3 studies were randomized, 5 were not randomized, the rest were cross-sectional or case studies. The most common study group were patients with hemiplegia (in 13 out of 51 reviewed works). 12 papers out of 51 concerned orthopedic conditions of the shoulder with varying diagnoses. Ultrasound imaging was used mainly to assess echogenicity and measure structures of the shoulder.
Conclusion. There are many studies demonstrating the utility of ultrasound in various aspects of the physiotherapist’s practice, including but not limited to diagnostic purposes, assessment of treatment effectiveness, monitoring treatment progress, and referring the patient to another specialist.

Key words:
ultrasonography, ultrasound, imaging, ultrasonography, rehabilitation, physical therapy, physiotherapy, diagnosis, shoulder, pain, treatment

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Influence of physiotherapy on exercise tolerance in patients after COVID-19

Klaudia Pompka, Katarzyna Bogacz, Jacek Łuniewski, Krystyna Rasławska, Ewa Jach, Igor Świerkowski, Jan Szczegielniak

Klaudia Pompka, Katarzyna Bogacz, Jacek Łuniewski, Krystyna Rasławska, Ewa Jach, Igor Świerkowski, Jan Szczegielniak – Influence of physiotherapy on exercise tolerance in patients after COVID-19. Fizjoterapia Polska 2021; 21(5); 182-189

Abstract
Patients after severe COVID-19 need effective treatment and full medical care. An important aspect of a successful recovery is the implementation of comprehensive rehabilitation. Rehabilitation for convalescents is primarily aimed at restoring or improving the proper functioning of the respiratory system, reducing the severity of the symptoms of the disease and disorders related to comorbidities, as well as increasing the physical efficiency of the body. Objective. The objective of the study was to assess the effect of endurance training on exercise tolerance using the 6-minute walk test in patients with a history of COVID-19.
Material and methods. Thirty patients after COVID-19 were examined, including 12 women (40%) and 18 men (60%) aged 35 to 75 years. The mean age in the study group was 55 years, SD = 10.9.
Before rehabilitation, all patients underwent a 6-minute walk test (6MWT) in order to qualify for the appropriate rehabilitation model. The following parameters were analysed: test time, distance travelled, systolic pressure, diastolic pressure, heart rate, and the reasons for the termination of the test. All COVID-19 patients are covered by the rehabilitation program for patients after COVID-19, which came into force on the basis of the Regulation of the Minister of Health of July 13, 2020 (Journal of Laws, item 1246) on a pilot program in the field of therapeutic rehabilitation for patients after COVID-19.
The distance in the 6-minute walk test in the entire group after rehabilitation increased by an average of 11.8% (from 531.7 ± 97 m to 601.2 ± 86.4 m). Analysing the presented results of studies describing the effect of endurance training on exercise tolerance in patients after COVID-19, no statistically significant differences were found between the age group <55 and the age group ≥ 55.
Conclusions. 1. A 3-week rehabilitation program after COVID-19, the basis of which was endurance training based on exercise on a cycle ergometer, has a positive effect on exercise tolerance in patients measured on the basis of the distance walked during the 6-minute walk (6MWT). 2. In the analysed study, a significant improvement was observed in patients aged ≥ 55 who achieved the shortest distance during the initial 6MWT test.
Key words:
COVID-19, physiotherapy, exercise tolerance
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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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