The influence of anatomical markers on the precision of body posture measurement in the DIERS Formetric 4D system – intra- and inter-rater analysis

Zuzanna Wiecheć, Arkadiusz Żurawski, Żaneta Wypych, Marek Wiecheć, Zbigniew Śliwiński

Zuzanna Wiecheć, Arkadiusz Żurawski, Żaneta Wypych, Marek Wiecheć, Zbigniew Śliwiński – The influence of anatomical markers on the precision of body posture measurement in the DIERS Formetric 4D system – intra- and inter-rater analysis –  Fizjoterapia Polska 2025; 25(3); 432-440

DOI: https://doi.org/10.56984/8ZG7D193RN5

Abstract
Introduction. Diagnostics in physiotherapy is increasingly based on precise measuring devices; one of the increasingly popular in clinical practice is the DIERS Formetric 4D system. Its effectiveness has been confirmed in many studies, but there is still no assessment of the effectiveness of measurements depending on whether photosensitive anatomical markers were used.
Aim of the study. The aim of the study was to verify the effect of anatomical markers on the results of a photogrammetric examination using the DIERS Formetric system as an example.
Material and methods. The study involved 20 healthy adults. Each subject was examined three times by two independent researchers with two measurement variants – one with anatomical markers and one without markers. Seven body posture parameters were taken into account in the analysis. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC) and Student’s t-test and Wilcoxon test were used to determine the variability and reliability of the measurements (SEM), minimal detectable change (MDC), and Student’s t-test and Wilcoxon test.
Results. Five of the seven parameters showed slight differences. Higher values of thoracic kyphosis and lumbar lordosis angles and lower values of surface rotation and lateral deviation were obtained in measurements using markers (p < 0.05). ICC values ranged from 0.88 to 0.99, showing very high repeatability in both conditions. Slightly lower values of SEM and MDC in the case of markers indicate higher precision of this method.
Conclusions. The use of anatomical landmarks can increase both the accuracy and reliability of body posture assessment using the DIERS Formetric 4D system, which is particularly important in the case of examinations requiring a high level of precision.
Key words
DIERS Formetric 4D, rasterstereography, posture assessment, anatomical markers, repeatability of measurement, measurement accuracy
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Ultrasound-based assessment of voluntary activation of selected stabilizing muscles in healthy young adults

Zuzanna Wiecheć, Arkadiusz Żurawski, Joanna Macierzyńska, Mahitab Mohamed Yosri, Marek Wiecheć, Hoda Zayed A. Mohamed, Zbigniew Śliwiński

Zuzanna Wiecheć et al. – Ultrasound-based assessment of voluntary activation of selected stabilizing muscles in healthy young adults –  Fizjoterapia Polska 2025; 25(3); 221-227

DOI: https://doi.org/10.56984/8ZG7D19GM4Q

Abstract
Introduction. Conscious activation of deep core muscles is a key element of motor control training and rehabilitation for spinal dysfunctions. Learning to effectively engage these muscles can help improve posture and reduce injury risk.
Aim of the study. This study aimed to evaluate the activation potential of selected stabilizing muscles – longus colli, serratus anterior, transversus abdominis, and lumbar multifidus – by comparing their thickness at rest and during contraction using ultrasound imaging.
Material and methods. A total of 109 healthy young adults (42 men and 67 women, aged 19–25) participated in the study. Muscle thickness was measured at rest and during isometric contraction using ultrasound. Paired t-tests and effect sizes (Cohen’s d) were calculated.
Results. A statistically significant increase in thickness was observed only in the transversus abdominis (p = 0.0012; d = 1.48), suggesting effective voluntary activation. The remaining muscles showed no significant changes, with small effect sizes.
Conclusions. Among the tested muscles, only the transversus abdominis showed a clear response to voluntary activation cues, highlighting its importance in core training. Other muscles may require more targeted approaches such as neuromuscular training or biofeedback. Ultrasound proved to be a reliable tool for assessing deep muscle engagement.
Key words
muscle ultrasonography, core stabilization, transversus abdominis, multifidus, muscle activation, motor control
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The impact of mindfulness meditation on changes in brain cortical activity in a competitive swimmer: A case study

Joanna Budzis, Marek Wiecheć, Zbigniew Śliwiński

Joanna Budzis, Marek Wiecheć, Zbigniew Śliwiński – The impact of mindfulness meditation on changes in brain cortical activity in a competitive swimmer: A case study –  Fizjoterapia Polska 2024; 24(5); 334-345

DOI: https://doi.org/10.56984/8ZG020CZP48

Abstract Mindfulness techniques have a beneficial impact on mental health and everyday functioning, including reducing anxiety and stress and improving emotional regulation. Research methods that examine brain activity as well as functional and structural changes contribute to the understanding of the mechanisms behind mindfulness techniques, which are also applicable in sports. EEG studies and quantitative QEEG analysis, used to measure cortical activity, can be applied in assessing the effectiveness of various forms of mental training and their long-term effects on high-performance athletes. In the conducted experiment, a 19-point QEEG study showed changes in values of selected brain waves at specific points of the cerebral cortex, measured before and after completing a 7-day mindfulness meditation training. The presented case study of a swimmer from the Polish National Team (18 years old) shows changes in values of Sensorymotor Rhythm (SMR), Beta, and Beta2 waves in the temporal, frontal, and central areas of the brain’s cortex after the meditation training, which may have had a positive impact on better emotional regulation and stress management during the European Junior Championships. The presented training forms and measurements of their effectiveness can form the basis for preparing athletes for competitions. Further research in this direction is, however, necessary to confirm these observations.
Key words EEG, QEEG, mindfulness, brainwaves, mental traning, self-regulation, sports, swimming
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Temporomandibular joint (TMJ) function on selected postural variables with analysis of changes in equivalent reactions

Zuzanna Broczkowska, Arkadiusz Żurawski, Zbigniew Śliwiński

Zuzanna Broczkowska, Arkadiusz Żurawski, Zbigniew Śliwiński – Temporomandibular joint (TMJ) function on selected postural variables with analysis of changes in equivalent reactions –  Fizjoterapia Polska 2024; 24(5); 267-278

DOI: https://doi.org/10.56984/8ZG020CBV25

Abstract Introduction. The position and tensions in the temporomandibular joint directly affect the cervical spine by changing the position of the cervical lordosis through a direct connection between the TMJ joint and the C0-C1 segment. According to the theory of tensegrity occurring in the human body, a change in the position in one segment can affect the other areas of the body. Changes in the tension of the structures in the joint can therefore affect the parameters of the equilibrium reactions. In the current literature review, there is little research on the relationship between the temporomandibular joint and balance. Study aim. The aim of the study was to analyze the influence of the temporomandibular joint position on the parameters of cervical spine lordosis depth, body posture and balance reactions in a group of young adults. Methods and materials. A total of 43 people aged 18-26 were examined. The tests were conducted in a static form using the DIERS posture lab system in three settings: TMJ joint in a neutral position, TMJ with maximum jaw tension and opening in maximum possibilities. People with orthodontic appliances and people whose jaw opening range was limited (less than the width of their four fingers) were excluded from the study. Parameters used for analysis: Depth of cervical lordosis [mm], Amount of head protraction [mm], Trunk inclination, Depth and angle of lumbar lordosis, Pelvic inclination, pelvic rotation, and variables defining parameters of equivalent reactions and variables defining parameters of equivalent reactions: Left foot load [%], Right foot load [%], Forefoot load [%], Heel load [%], Maximum left foot pressure [N], Maximum right foot pressure [N], Left foot contact area [cm2], Right foot contact area [cm²], Lateral movement COP (max) [mm], Total lateral movement COP [mm], Total front/back movement COP [mm], COP area. Statistica program was used for statistical analysis. Tests for normality distribution (Shapiro-Wilk), Chi-square test were performed, and correlations were examined with Spearman’s test. Results. Studies conducted on a group of young adults may suggest the influence of the temporomandibular joint position on changes in equivalent changes. The results of descriptive statistics show significant changes in the average results, including around foot load or COP surface. The highest average results were observed in the case of opening the TMJ joint, where deviations in the area of equivalent reaction changes showed the highest average results. The results of both descriptive statistics and correlations did not show significant differences between the joint position and trunk variables. The differences between the was minimal. Conclusions. Changes in the position and tension of the temporomandibular joint affect the position of the cervical spine and balance parameters. For the position with open TMJ positioning, there is a correlation with the variables of the contact area of the right and left foot with the ground. There are no changes in body posture. It cannot be stated that the position of the temporomandibular joint significantly affects the variables of body posture.
Key words temporomandibular joint, spine, balance, DIERS
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Internal snapping hip on ultrasound

Artur Marszałek, Ewelina Marszałek, Agata Michalska, Zbigniew Śliwiński, Marcin Bugajski

 

Artur Marszałek, Ewelina Marszałek, Agata Michalska, Zbigniew Śliwiński, Marcin Bugajski – Internal snapping hip on ultrasound –  Fizjoterapia Polska 2024; 24(3); 278-284

DOI: https://doi.org/10.56984/8ZG020A52K

 

Abstract:
Introduction. The aim of this study is to assess the usefulness of ultrasonography in diagnosing internal extra-articular snapping hip syndrome. Internal extra-articular snapping hip syndrome involves the snapping of the iliopsoas tendon over the iliopectineal eminence, accompanied by a characteristic audible or palpable snap. In some individuals, the snap is accompanied by discomfort or groin pain, which over time may lead to kinesiophobia (fear of movement). Using an ultrasound machine, the snapping of the iliopsoas tendon was evaluated in asymptomatic young individuals.
Methods. A total of 60 hip joints in 30 young individuals (20 women, 10 men) aged 23-25 years, who reported no pain or history of hip surgery, were examined twice. The study was repeated after 6 weeks. The SonoScape Exp 2 ultrasound machine was used according to a previously established protocol. Both examinations were performed by the same person.
Results. The presence of internal snapping hip syndrome (ISHS) was observed in 55 (91%) hips during the first examination and in 54 (90%) during the follow-up. No pain was reported during the ultrasound-observed snapping, but discomfort was noted in 36.1% of cases, and kinesiophobia in 10% of the examined hips.
Conclusion. The correlation between the ultrasound image and the audible or palpable snap in the groin was confirmed in the examined patients. The high prevalence of ISHS in asymptomatic individuals and the occurrence of discomfort in over 30% of examined hips suggests the need for further research on this topic.

Keywords:
snapping hip, ultrasonography, iliopsoas muscle, kinesiophobia

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Analysis of lumbar lordosis on selected balance parameters in men

Zuzanna Broczkowska, Arkadiusz Żurawski, Kamil Markowski, Zbigniew Śliwiński

 

Zuzanna Broczkowska, Arkadiusz Żurawski, Kamil Markowski, Zbigniew Śliwiński– Analysis of lumbar lordosis on selected balance parameters in men –  Fizjoterapia Polska 2024; 24(3); 158-167

DOI: https://doi.org/10.56984/8ZG020AB2L

Abstract:
Introduction. Scientific research indicates the impact of increased lumbar lordosis on selected parameters of static foot load and changes in balance reactions in different age groups. According to the authors, pelvic displacement towards nutation directly influences the increase in lumbar lordosis, thereby affecting the previously mentioned parameters.
Aim. The aim of the study was to analyze selected balance parameters in a group of men based on the relationship with their lumbar lordosis depth.
Materials and Methods. The study was conducted from January to October 2023 at the Collegium Medicum of the Jan Kochanowski University in Kielce. The study group consisted of students from the Collegium Medicum, aged 18‑26 years. A total of 81 men were examined. The study was carried out in a static form using the Diers Posture Lab system. The parameters included in the statistical analysis were: “Lordosis angle,” “Pelvic inclination,” “Lateral movement (max.) CoP,” “Total lateral movement CoP,” “COP area,” “Total front/back movement CoP.” The analysis also considered Harzmann parameters: “Lateral deviation VP‑DM (rms),” “Surface rotation (rms),” “Pelvic obliquity,” “Pelvic twist,” “Torso deviation from vertical VP‑DM,” as well as parameters determining foot load: “Rear force distribution [%],” “Front force distribution [%],” “Left side force distribution [%],” “Right side force distribution [%],” “Maximum left side pressure [N],” “Maximum right side pressure [N],” “Left foot contact area [cm2],” “Right foot contact area [cm2]” in a group of young adults (students of medical and health sciences). Statistical analysis was performed using Statistica Stat Soft 21. Normality tests (Shapiro‑Wilk) and correlation tests using Spearman’s test were conducted.
Results. No statistically significant correlation was found between the lordosis angle and balance reactions, as well as pelvic inclination in the group of young adult men.
Conclusions. Increased lumbar lordosis in young adult men does not directly affect the examined parameters of balance reactions.

Keywords:
lumbar lordosis, balance, pelvis

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The swallowing process in the perspective of physiological consequences of aging

Karolina Sandecka, Zbigniew Śliwiński

Karolina Sandecka, Zbigniew Śliwiński – The swallowing process in the perspective of physiological consequences of aging. Fizjoterapia Polska 2023; 23(5); 234-239

DOI: https://doi.org/10.56984/8ZG20B2sK

Abstract
In an aging society, recognizing the needs of seniors is extremely important. As a result of the physiological aging process progressing with age, we observe increasing limitations in the daily functioning of individuals. For caregivers of the elderly, it is important to be aware of these changes. Disturbances in the swallowing process also intensify with age. Choosing appropriate swallowing therapy methods for the elderly and providing proper instructions for feeding food and drinks can limit the risk of negative health consequences and improve the comfort of life for seniors.

Key words:
swallowing, presbyphagia, senior

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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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