Tag: physiotherapy

Efficacy of the PNF method in rehabilitation for activities of daily living in late post-stroke patients

Tomasz Wolny, Edward Saulicz, Rafał Gnat

Tomasz Wolny, Edward Saulicz, Rafał Gnat – Efficacy of the PNF method in rehabilitation for activities of daily living in late post-stroke patients. Fizjoterapia Polska 2009; 9(1); 51-60

Abstract
Background. Our increasing knowledge on the complexity of CNS injuries and mechanisms of neuronal plasticity indicates that the traditional approach to rehabilitation of stroke patients is no longer adequate. Appropriate stimulation of the central nerv-ous system to promote neuromuscular plasticity is crucial for the restoration of normal function. Rehabilitation based on PNF (Pro-prioceptive Neuromuscular Facilitation) significantly improves ADL functional performance of post-stroke patients. Materiał and methods. A total of 64 stroke patients were randomly divided into two groups. ActMties of daily living were eval-uated by means of the ‘Repty’ Functional lndex, which includes: self-service, sphincter control, mobility locomotion and communi-cation. Throughout the study period (their stay at the Neurological Rehabilitation Ward for a mean of 21 days), all patients received comprehensive rehabilitation, with Group A receiving conventional rehabilitation and Group B receMng also indMdual kinesiother-apy based on the PNF method. Results. Analysis of yariance showed significant differences in the following domains of the ‘Repty’ Functional lndex: self-service (p=0.0015), locomotion (p=0.0279), and total score (p=0.0032). No significant differences were found in the remaining domains (sphincter control, mobility and communication). Conclusions. PNF-based rehabilitation of late post-stroke patients significantly improved their ADL functional performance with respect to self-service and locomotion.
Key words:
PNF, physiotherapy, activities of daily-living
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Focused and radial shock wave in orthopedics and physiotherapy

Piotr Król, Andrzej Franek, Wiesław Zinka, Janusz Kubacki, Anna Polak, Ewa Franek

Piotr Król, Andrzej Franek, Wiesław Zinka, Janusz Kubacki, Anna Polak, Ewa Franek – Focused and radial shock wave in orthopedics and physiotherapy. Fizjoterapia Polska 2009; 9(1); 1-20

Abstract
This article aims at presenting current knowledge about shock wave therapy and especially analysing the results of research on the influence of focused and radial shock wave in the treatment of pseudarthrosis, tendinosis calcarea of the shoulder, calcanean spurs, plantar fasciitis, tendinitis and enthesitis, etc. Orthopaedics and physiotherapy have been using focused shock wave therapy for two decades now, but radial shock wave therapy has a history of only several years. As a consequence, there is a dearth of studies corroborating the thera-peutic efficacy of this method, although the available results are very encouraging. Most studies concentrate on presenting the effects of focused shock wave in the treatment of pseudarthrosis, where the shock wave impact is purely destructive. In other conditions, the mechanism of action of both focused and radial shock wave is obscure, although the procedures are very effective. Because the only alternative available to many patients, especially those with tendinosis calcarea of the shoulder and calcanean spurs, is a surgical procedure, the application of shock wave, a low-invasive and highly effective method, is fully justified.
Key words:
focused shock wave, radial shock wave, physiotherapy
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Perception of the physiotherapist profession by first-year students of Polish universities of various educational orientations

Joanna Gotlib, Dariusz Białoszewski, Anna Cabak, Katarzyna Barczyk, Aleksandra Bauer, Wojciech Kułak, Piotr Majcher, Olga Nowotny-Czupryna, Maciej Płaszewski, Janusz Sierdziński

Joanna Gotlib, Dariusz Białoszewski, Anna Cabak, Katarzyna Barczyk, Aleksandra Bauer, Wojciech Kułak, Piotr Majcher, Olga Nowotny-Czupryna, Maciej Płaszewski, Janusz Sierdziński – Perception of the physiotherapist profession by first-year students of Polish universities of various educational orientations. Fizjoterapia Polska 2009; 9(2); 109-121

Abstract
Background. In Poland at present, physiotherapy studies are offered at three types of school: medical universities, universities of physical education, and schools not specialising in either the medical sciences or physical education. The aim was to compare the perception of the physiotherapist profession by first-year students of different types of universities. Material and methods. The study sample comprised 1145 1st year BA programme students from eleven schools in Poland. The study utili-sed the diagnostic poll method – a questionnaire, which comprised three parts. The Kruskal-Wallis test was used along with the median test and the Chi-squared test (p<0.05). Results. Most students stated that the professional status of physiotherapists is lower than that of doctors (above 52%), but is higher than that of nurses (above 70%). 92% of the students believed that physiotherapists and physicians should work together as partners (p=NS). The vast ma-jority (70%) of the students believed that the physiotherapist profession is related to medicine rather than physical education. Conclusions. 1. The educational orientation of the university did not influence first-year students’ perception of their futurę profession in this study with most of the surveyed stating that physiotherapist is a medical profession. 2. In the light of the findmgs of foreign authors, there is a ne-ed to carry out a study in Poland that would address the issue of the position of the physiotherapist in the therapeutic team in relation to the doctor and the team nurse as well as the other members of the team: dietitian, psychologist and occupational adviser.
Key words:
medical education, physiotherapy, type of university, perception of the profession
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Motivations for studying physiotherapy and familiarity with employment situation among physiotherapy students at variously oriented university-level schools in Poland

Joanna Gotlib, Dariusz Białoszewski, Anna Cabak, Katarzyna Barczyk, Aleksandra Bauer, Wojciech Kułak, Piotr Majcher, Olga Nowotny-Czupryna, Maciej Płaszewski, Janusz Sierdziński

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Michał Kuszewski, Andrzej Myśliwiec – Motivations for studying physiotherapy and familiarity with employment situation among physiotherapy students at variously oriented university-level schools in Poland. Fizjoterapia Polska 2009; 9(3); 232-244

Abstract
Background. There is considerable interest in studying physiotherapy in Poland and in many countries of the European Union. The objective was to identify the factors that motivate applicants to choose Physiotherapy studies and find out what students know about working in Poland and other EU countries. Material and methods. The study sample comprised 954 1st year BA students from eleven universities: medical sciences (MS), physical education (PE), and other universities (OU). The statistical analysis was based on questionnaires obtained from : 211 MS, 118 PE and 625 OU. Results. Students relied on advice of active physiotherapists when choosing a study programme: 62% ME, 57% PE and 68% OU. Respondents would like to study for the Master’s degree and take up work: 55% PM, 56% PWF and 62% IP. Students were not familiar with employment opportunities: 87% MS, 91% PE and 73%. The most important factors aiding in finding a job are knowledge and skills: 43% MS, 42% PE and 45% OU. Conclusions. 1. The respondents did not choose studies by accident but based their decision on stereotypes. 2. Universities should set great store by their teaching standards as applicants decide to choose a university on the basis of opinions about the particular university. 3. There is a need to develop a professional information service on study opportunities in physiotherapy in Poland that would necessarily include objective information regarding employment opportunities for physiotherapists in EU countries and in the world.
Key words:
employment situation, motivation, European Union, physiotherapy, type of university
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Subjective assessment of the effects of different approaches to rehabilitation of patients after cerebral stroke

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Michał Kuszewski, Andrzej Myśliwiec

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Michał Kuszewski, Andrzej Myśliwiec – Subjective assessment of the effects of different approaches to rehabilitation of patients after cerebral stroke. Fizjoterapia Polska 2009; 9(3); 223-231

Abstract
Background. Paying attention to the individual needs of the patient during treatment planning is becoming an important element of contemporary rehabilitation of post-stroke patients. The patient should not only be the recipient, but also a co-author of the programme of rehabilitation administered to him or her. The study hypothesis was that the type of rehabilitation treatment would influence the patient’s subjective evaluation of the effects of rehabilitation. Material and methods. The study involved a group of 64 stroke patients. All subjects were divided randomly into three groups (A, B and C). Subjective assessment of the efficacy of rehabilitation was based on a specially prepared questionnaire. Patients were followed up for about 21 days, during which period they were administered comprehensive rehabilitation. Group A received traditional post-stroke therapy. The rehabilitation programme for Group B included individual kinesiotherapy based on the PNF method. The programme for Group C comprised individual kinesiotherapy based on the PNF method supplemented with tensing neuromobilisations of peripheral nerves of the paretic upper extremity. Results. Overall, the highest average number of points (x = 11.5394), corresponding to the most marked subjective impro -vement, was recorded in Group C, while the least marked effect was noted in Group A (x = 8.1751). Conclusions. The subjective assessment of the effects of rehabilitation treatment correlated significantly with the type of rehabilitation administered.
Key words:
self-assessment, physiotherapy, stroke, therapeutic effects
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Proposal for a rehabilitation regimen for patients after posterior cruciate ligament reconstruction surgery. A model of biomechanical study ofthe rehabilitation process

Przemysław Lisiński, Agnieszka Gronek, Włodzimierz Samborski, Lechosław B. Dworak

Przemysław Lisiński, Agnieszka Gronek, Włodzimierz Samborski, Lechosław B. Dworak – Proposal for a rehabilitation regimen for patients after posterior cruciate ligament reconstruction surgery. A model of biomechanical study ofthe rehabilitation process. Fizjoterapia Polska 2010; 10(1); 1-11

Abstract
Background. Few rehabilitation problems raise so much controversy as the timing of rehabilitation and the choice of rehabilitation techniąues in patients following posterior cruciate ligament (PCL) reconstruction. PCL damage occurs in almost 37% of injuries to the knee joint. PCL plays a significant role in stabilising the knee joint. As the signs and symptoms of PCL damage are not so clear-cut as in injuries of other ligaments, a correct diagnosis and institution of treatment are often delayed. A key problem in rehabilitation of these patients is the need to protect the graft. Accordingly all rehabilitation procedures should be carefully supervised. Since there are few available publications concerned with the rehabilitation of patients following PCL surgery, the authors decided to present their own model of rehabilitation. The key elements of this scheme, such as the timing and choice of diagnostic and therapeutic procedures are compared to other methodologies presented in the literaturę.Fuli recovery reąuires a long period of rehabilitation that is dwided into several stages. Ultimately the fuli rangę ofmovement and appropriate muscle strength are restored, and the patient regains fuli motor control thanks to the restoration of proprioception. The authors propose a model of biomechanical investigations enabling objective evaluation ofthe rehabilitation process following PCL reconstruction surgery.
Key words:
posterior cruciate ligament, trauma, reconstruction, physiotherapy, biomechanical investigations
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Evaluation of physiotherapeutic management of patients with multi-level cervical discopathy after interbody implant surgery

Włodzisław Kuliński, Wojciech Haładyna, Arkadiusz Wilk, Jan Podgórski, Marzenna Bazan, Józef Mróz, Paweł Leśniewski

Włodzisław Kuliński, Wojciech Haładyna, Arkadiusz Wilk, Jan Podgórski, Marzenna Bazan, Józef Mróz, Paweł Leśniewski – Evaluation of physiotherapeutic management of patients with multi-level cervical discopathy after interbody implant surgery. Fizjoterapia Polska 2010; 10(2); 149-155

Abstract
Cervical discopathy is a serious medical and social problem. Displacement of the intervertebral disc into the vertebral canal compresses spinal nerve roots and/or the spinal cord. Cage fusion and the implantation of a mobile disc prosthesis have recently been introduced in surgery. The aim of the study was to assess the effectiveness of physiotherapeutic management of patients with multi-level cervical discopathy treated by microdiscectomy and cage fusion. A group of 23 patients was followed up over six weeks, including 20 patients after two-level surgery (Group A) and 3 after three-level surgery (Group B). The progress of rehabilitation was evaluated on the basis of :- muscle strength (Lovett test), – range of motion, – regression of pain (VAS scale) and paraesthesiae. In Group A, neck pain disappeared in 18 patients, and paraesthesiae in the upper limbs disappeared in 12 patients; 14 patients fully recovered muscle strength in the limbs, and 16 patients recovered the full range of motion in the shoulder joints. In group B, two patients reported regression of the neck pain, one fully recovered muscle strength, and two recovered the full range of motion in the shoulder joints. Conclusions1. The physiotherapy of patients with multi-level cervical discopathies following cage fusion surgery was an effective adjunctive treatment in this group of patients. 2. Early institution of appropriate procedures may result in full motor recovery
Key words:
cervical discopathy, implants, physiotherapy
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Analysis of physiotherapy students’ opinions on curricula in university-level schools of different educational orientations

Dariusz Białoszewski, Joanna Gotlib, Anna Cabak, Katarzyna Barczyk, Andrzej Bugajski, Wojciech Kułak, Piotr Majcher, Olga Nowotny-Czupryna, Maciej Płaszewski, Janusz Sierdziński

Dariusz Białoszewski, Joanna Gotlib, Anna Cabak, Katarzyna Barczyk, Andrzej Bugajski, Wojciech Kułak, Piotr Majcher, Olga Nowotny-Czupryna, Maciej Płaszewski, Janusz Sierdziński – Analysis of physiotherapy students’ opinions on curricula in university-level schools of different educational orientations. Fizjoterapia Polska 2010; 10(2); 136-148

Abstract
Introduction and Objective. Physiotherapy as a university degree programme was first offered in Poland in 1997, with courses including 3-year Bachelor-level and 2-year Master-level programmes. The education of physiotherapists in Poland currently takes place at three types of university-level schools: medical universities (MS), universities of physical education (PE) and university-level schools of orientations not connected with medicine or physical education (OU).This study aims to analyse and compare opinions of MS, PE and OU students on the curricula offered by the three types of university-level schools. Material and methods. The study involved a total of 593 students in their third year of Bachelor programme studies from 10 university-level schools of different educational orientations. Participation in the study was voluntary and anonymous involved completing a questionnaire distributed in March and April 2009. The questionnaire, designed by the authors, consisted of 4 parts and contained a total of 88 questions. The statistical analysis of the survey data (STATISTICA 9.0) was conducted using the Kruskall-Wallis test. Results. The majority of MS students believed the amount of practical classes was appropriate, while PE and OU participants assessed it as insufficient (p=NS). The MS students were satisfied with the amount of time of working directly with patients during clinical classes, while their PE and OU counterparts found the time insufficient. The largest number of MS, PE and OU participants declared that training in special techniques in physiotherapy was insufficient (p=NS). Conclusions. 1. It would be advisable to combine the clinical experience of medical universities with the facilities and teaching staff of specialists in physiotherapy-related courses available in universities of physical education in order to improve the quality of physiotherapy education in Poland.2. In view of the current level of research in physiotherapy, it seems important to provide students with high quality training in state-of-the-art physiotherapy techniques.
Key words:
physiotherapy, students, Bachelor-degree programmes, medical universities, universities of physical education
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Evaluation of the effectiveness of Butler’s neuromobilisations in reducing disorders of stereognosis of impaired upper extremity in late-stage stroke patients

Tomasz Wolny, Edward Saulicz, Rafał Gnat

Tomasz Wolny, Edward Saulicz, Rafał Gnat – Evaluation of the effectiveness of Butler’s neuromobilisations in reducing disorders of stereognosis of impaired upper extremity in late-stage stroke patients. Fizjoterapia Polska 2010; 10(2); 95-102

Abstract
Background: A review of contemporary literature indicates that the rehabilitation of stroke patients is chiefly based on reeducation and compensation techniques addressing motor deficits, even though pure motor hemiparesis occurs very rarely. We assumed that tensional neuromobilisations of the impaired upper extremity in late-stage post-stroke patients influence disorders of stereognosis (tactile perception of natural objects)Material and method: The study involved a group of 64 stroke patients. The subjects were divided randomly into two subgroups (A and B). To assess tactile perception, all patients had to identify 10 commonly used objects by touch. During the 21-day follow-up, all patients were subjected to comprehensive rehabilitation. The therapeutic programme for Group A included selected physical modalities and individual kinesiotherapy based on the PNF method. The treatment in Group B additionally included tensional neuromobilisations of peripheral nerves of the impaired upper extremity. Results: Analysis of variance showed significant variation only for the test measurement factor (p <0.01), which was due to significant intra-group differences in Group B (p<0.05; Tukey test).Conclusions: The greatest improvement in the assessment of the tactile perception of everyday objects was obtained in the group which received PNF therapy supplemented with neuromobilisations of peripheral nerves of the impaired upper extremity.
Key words:
stereognosis, physiotherapy, stroke, therapeutic effects
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Poststroke physiotherapy of the patient with pusher syndrome – case study

Jakub Stolarski, Jan Kochanowski, Joanna Trochimiuk, Sebastian Wójtowicz

Jakub Stolarski, Jan Kochanowski, Joanna Trochimiuk, Sebastian Wójtowicz – Poststroke physiotherapy of the patient with pusher syndrome – case study. Fizjoterapia Polska 2010; 10(4); 317-323

Abstract
Postural disturbances in stroke patients may present as pusher syndrome. The aim of the study was to describe the treatment process and outcomes of physiotherapy of a post-ischaemic stroke patient with co-existing pusher syndrome. We describe a 78-year-old patient (S.L.) with left hemiplegia and pusher syndrome. Magnetic Resonance Imaging (MRI) revealed an ischaemic focus with a small haemorrhage in the posterior thalamus and posterior limb of the internal capsule. The patient underwent physiotherapy based on Proprioceptive Neuromuscular Facilitation (PNF). The pusher syndrome, which was diagnosed in the late stage of hospitalisation, was measured with the Scale for Contraversive Pushing (SCP), in which the patient scored 3.75 pts. Intensive rehabilitation started in the early post-stroke phase helped the patient achieve independence in changing position and sitting without assistance or support. The pushing behaviour did not improve in spite of appropriate therapy and verbal instructions. After 33 days of hospitalisation and physiotherapy at a Neurology Department, the patient was transferred to a Neurorehabilitation Unit for further rehabilitation. The pusher syndrome slowed down the recovery and reduced possibilities for applying rehabilitation in high positions (sitting and standing) in the early stage of post-stroke physiotherapy.
Key words:
physiotherapy, Stroke, pusher syndrome, PNF
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