Effects of cognitive exercise therapy on upper extremity function in stroke patients – A case study

Joanna Pawełczyk, Katarzyna Adamczewska, Jacek Lewandowski

J. Pawełczyk, K. Adamczewska, J. Lewandowski – Effects of cognitive exercise therapy on upper extremity function in stroke patients – A case study. FP 2017; 17(4); 70-75

Abstract

Purpose. The purpose of this study was to evaluate the effects of cognitive exercise therapy on upper extremity function in a female stroke patient.
Materials and methods. The study was conducted on a 76-year-old female patient who suffered an ischemic stroke and exhibited severe left-sided hemiparesis. The patient underwent a 6-week therapy regimen based on the cognitive exercise treatment method, with 3 therapy session each week. Therapy progress was evaluated every two weeks using the Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES).
Results. The patient showed motor function improvement on all MESUPES subscales. The overall progress was 31%. The highest rate of improvement (45%) was recorded on the first part of the scale (MESUPES I), which evaluated general movements. In the second part, the patient showed a 25% improvement in joint mobility and a 17% improvement in coordination.
Conclusion. The cognitive exercise therapy proved to be an effective treatment for improving upper extremity function of the patient.

Key words:
neurorehabilitation, stroke, Perfetti method, cognitive exercise therapy

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Angle of trunk rotation in 10-year-old primary school children in Poznań

Katarzyna Adamczewska, Marzena Wiernicka, Łukasz Michałowski, Lech Furmaniuk, Magdalena Goliwąs, Marta Flis-Masłowska, Jacek Lewandowski

K. Adamczewska, M. Wiernicka, Ł. Michałowski, L. Furmaniuk, M. Goliwąs, M. Flis-Masłowska, J. Lewandowski – Angle of trunk rotation in 10-year-old primary school children in Poznań. FP 2017; 17(3); 96-102

Abstract

Introduction. Changes in spinal geometry should be assessed in three planes, and accounting for the movement of spinous processes. An assessment of the angle of trunk rotation allows for early and non-invasive detection of scoliosis and its prevention.
Purpose. The purpose of this study was to assess the angle of trunk rotation (ATR) in the population of 10-year-old primary school children in Poznań.
Materials and methods. The participants included 1533 children aged 10 years (759 girls and 774 boys). The ATR was measured with the Bunnell scoliometer at three levels of the spine: Th1-Th4, Th5-Th12, Th12-L4. On the basis of the measurements conducted in this study, a group of children with ATR at 0, 1-3˚, 4-6˚ and ≥ 7˚ (including rotation to the left and to the right) was identified.
Results: The lowest values of ATR in both groups (boys and girls) were found at the level of Th1-Th4 with ATR ≥ 7˚ occurring in 0.2% of the participants. 4% of all participants also presented with a clinical suspicion of lateral curvature of the spine. Values of the ATR measured at the Th5-Th12 and Th12-L4 levels increased considerably. At the Th level of the spine, 10% of the participants presented with a clinical suspicion of scoliosis, and the diagnosis was confirmed for 2.5% of all primary school children. At the lowest level of the spine, 9% of the participants were identified as being at an increased risk of scoliosis, and 2.7% of children exhibited an ATR ≥ 7˚.
Conclusions:
1. The highest angle of trunk rotation (ATR ≥ 7˚) was found in girls at the Th5-12.level of the spine. Both genders exhibited primarily rotation to the right.
2. Scoliosis poses a significant diagnostic challenge in a school environment. If left untreated, it increases the risk of pathological changes in the trunk and disease progression.
3. The Bunnell scoliometer allows for early and non-invasive assessment of the angle of trunk rotation, and should be permanently included in screening procedures.
4. Using appropriate instruments for posture assessment is necessary for diagnosing musculoskeletal disorders accurately.

Key words:

angle of trunk rotation, scoliometer, scoliosis, posture in children

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