Author: Monika Wolska, Marek Kiljański, Witold Rongies

Selektivna dorzalna rizotomija (SDR – Selective Dorsal Rhizotomy) – neurokirurška metoda liječenja spasticiteta kod cerebralne paralize (CP): trenutno stanje znanja

Monika Wolska, Marek Kiljański, Witold Rongies

M. Wolska, M. Kiljański, W. Rongies – Selective Dorsal Rhizotomy (SDR) – neurosurgical method in treatment of spasticity in CP: the current state of knowledge. Fizjoterapia Polska 2019; 19(2); 66-75

Abstract
Spasticity constitutes one of the main symptoms of Cerebral Palsy (CP), which has a negative influence on children’s activity, their participation in daily life, and it also impacts their functioning in the society. Chronic spasticity leads to the development of structural lesions in the muscles and in the connective tissue, and it contributes to an intensification of atrophy, rigidity, and finally contractures resistant to pharmacological treatment. Worsening comfort of life and problems with taking care of children with CP constitute other aspects, which justify searching for methods of permanent and effective treatment of spasticity.
The selection of an optimal treatment method for every patient depends on the following: location and extent of the injury, clinical symptoms, patient’s age, and available treatment methods. Selective dorsal rhizotomy (SDR) is a method of surgical treatment of spasticity in children with CP. The procedure is irreversible, and it permanently reduces spasticity. There are still many controversies regarding qualification for the procedure, indications, or short-term and long-term effects. Over the years, there are more and more international clinical studies which confirm the beneficial effect of the procedure in terms of improving the functional state of the patients. The purpose of this paper was to gather and systematize the knowledge about the procedure itself, the qualification criteria, the applied research tools, and the post-surgery physical therapy protocols, as well as to present the effects of surgical treatment.

Key words:
Selective Dorsal Rhizotomy, SDR, physical therapy, spasticity, CP

 

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Utjecaj vježbanja disanja ošitnog mišićja i vježbi dna zdjelice na kontrolu toka urina nakon menopauze: randomizirana klinička ispitivanja

Asmaa M. El-Bandrawy, Azza Barmoud Nashed, Hamada Ahmed Hamada, Hassan O. Ghareeb

Asmaa M. El-Bandrawy, Azza Barmoud Nashed, Hamada Ahmed Hamada, Hassan O. Ghareeb – Effect of Diaphragmatic Breathing Exercises and Pelvic Floor Retraining on Postmenopausal Stress Urinary Incontinence: A randomized controlled trial. Fizjoterapia Polska 2019; 19(2); 60-64

DOI: https://doi.org/10.56984/8ZG0DB30A

Abstract
Background. Incontinence in the urine is a common problem. Its prevalence increases as age increasing , especially among older women..Conservative management as its first line treatment is recommended. Physical therapies are the cornerstone of such conservative management, especially pelvic floor muscle exercise.
Objective. Prospective study to evaluate objectively the advantages of pelvic floor exercises for the treatment of urinary stress incontinence associated with breathing exercises.
Materials and Methods. Fifty female elderly patients were selected for this study at age 50-65 diagnosed with urinary stress incontinence (SUI), their body mass index (BMI) was < 30 kg / m2.They were allocated randomly into two groups equally (A and B). they recieved the same treatment which is pelvic floor training but in group (A) the breathing exercise were added to the program For 12 weeks, the treatment program was done twice a week. Evaluation of all subjects for both groups (A and B) was conducted pre and post treatment program during the evaluation of the perineometer change in vaginal squeeze pressure.The revised scale of urinary incontinence (RUIS) was used to assess the alter in symptoms of severe incontinence.
Results. Analysis of the data reported marked improvement in squeezing vaginal pressure and urinary incontinence scale of both groups when comparing their mean values before and after treatment. Significant improvement in the study group, however, was noted when comparing the mean values of the study group after treatment with the control group.
Conclusion. Pelvic floor exercises associated to breathing exercises is an Appropriate and secure way to alleviate postmenopausal stress urinary incontinence.

Key words:
urinary incontinence; post-menopause, pelvic floor exercises; breathing exercises

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Procjena učinkovitosti masaže u sprezi s ostalim rehabilitacijskim zahvatima tijekom liječenja bolnih sindroma kralježnice

Monika Molga, Damian Durlak

M. Molga, D. Durlak – Evaluation of the effectiveness of massage therapy in combination with other rehabilitation treatments in the treatment of back pain syndrome. Fizjoterapia Polska 2019; 19(2); 46-58

Abstract
Objective. The objective of the study was to evaluate the effectiveness of classic massage therapy in combination with other rehabilitation treatments and its influence on the reduction of pain intensity in people diagnosed with back pain syndrome.
Material and method. The study was conducted using a questionnaire form at the HIPOKRATES clinic in Krakow. The study involved 150 people who underwent massage therapy, and physiotherapy and kinesitherapy treatment recommended by a physician. To assess the effectiveness of massage therapy in combination with other treatments, the degree of pain intensity was determined in all patients using the VAS visual analog scale before and after completed rehabilitation. The questions also concerned the duration of back pain, knowledge of the principles of ergonomics, use of other treatments besides massage therapy, the time after which the pain was reduced and the duration of positive effects, the effects of massage therapy combined with other rehabilitation treatments, and well-being.
Results. On average, in people using rehabilitation, pain symptoms began to decrease after the fourth treatment. After a series of treatments, most of the respondents experienced improved functioning in everyday life, and pain and increased muscle tone decreased. The patients’ well-being improved considerably, and the dose of painkillers taken was reduced.
Conclusions. Massage therapy in combination with kinesiotherapy and physiotherapy is an effective form of therapy for the treatment of back pain syndrome.

Key words:
back pain, massage therapy, rehabilitation

 

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Zdravstvena i regeneracijska svojstva ljekovitog blata – mogućnosti uporabe

Marlena Warowna, Katarzyna Tokarczyk, Anna Hordyjewska, Agnieszka Sobolewska-Samorek, Beata Kręcisz

M. Warowna, K. Tokarczyk, A. Hordyjewska, A. Sobolewska-Samorek, B. Kręcisz – Medicinal and care properties of mud – the review of literature. Fizjoterapia Polska 2019; 19(2); 34-43

Abstract
Mud (peloid, peat) has been used in medicine for many years. It is a natural resource used in Polish spas. The properties of treatments with mud are its thermal, mechanical, chemical, hormonal, immunomodulatory, anti-inflammatory and analgesic. Pores from peat cause local overheating of tissues and thus increase cellular metabolism. Its mineral components such as magnesium sulfate, potassium, aluminum compounds and others, penetrate the skin and accumulate in the stratum corneum and deeper. The content of organic compounds humic acids testify to the therapeutic properties of mud.
The healing and prophylactic properties of peat are widely used in rheumatology, dermatology, cosmetology, urology, ophthalmology, gynecology, gastrology and dentistry. Traditional treatments with peloid are used in the form of complete or partial baths, soaking tubs, wraps, mud tampons or iontophoresis.

Key words:
mud, peloid, healing treatments, humic acid

 

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Utjecaj treninga dišnih mišića na mobilnost ošita i funkcionalni kapacitet starijih osoba: randomizirana klinička ispitivanja

Fatma Aboelmagd M., Hamada Ahmed Hamada, Ibtissam M. Saab

Fatma Aboelmagd M., Hamada Ahmed Hamada, Ibtissam M. Saab – Effect of Inspiratory Muscle Training on Diaphragm Mobility and Functional Capacity in Elderly: A randomized clinical trial. Fizjoterapia Polska 2019; 19(2); 28-32

Abstract
Aim. Aging resulted in decrease in respiratory muscle strength which limits the exercise performance and quality of life. The purpose of this study was to evaluate the clinical and the functional outcomes of inspiratory muscle training in elderly.
Material and methods. 48 nonsmoker’s elderly from both genders aging 60 to 70 years were recruited. They were assigned randomly into two groups of equal number. The study group received training with threshold inspiratory muscle trainer (IMT) at 40% of the PImax measured during the initial evaluation which was readjusted weekly by evaluating the PImax while the control group received training with threshold IMT at the lowest pressure offered by the device, 3 times/week for 10 weeks. Diaphragmatic mobility was measured by ultrasonography, Maximal inspiratory pressure measurement and the functional capacity was measured by 6MWT before and after the end of the training program for both groups.
Results. The diaphragmatic mobility, Maximal inspiratory pressure measurement and the distance walked during 6MWT increased significantly within the study group at the end of the study (p < 0.05) with non-significant change in the control group (p > 0.05). Comparison between both groups at the end of the study revealed significant increase in diaphragmatic mobility and Maximal inspiratory pressure measurement in study group compared with control group (p <0.05) with non-significant difference between both groups regarding the distance walked during 6MWT (p > 0.05).
Conclusion. Inspiratory muscle trainer should be a part in elderly daily routine as it has a positive effect on the clinical outcome measure and there is a tendency to improve the functional outcome.

Key words:
Elderly, Inspiratory muscle training, diaphragmatic ultrasonography, Six-minute walk test

 

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Primjena fizioterapeutskih zahvata u fibromialgiji

Anna Mickiewicz

A. Mickiewicz – Physiotherapy in the treatment of fibromyalgia. Fizjoterapia Polska 2019; 19(2); 20-26

Abstract
Fibromyalgia is a chronic disorder characterized by pain, sleep disturbances, fatigue, cognitive dysfunction and many other somatic symptoms, negatively influencing functional status and quality of life of the patients.
Non-pharmacological treatment, comprising exercises, physical agents, massage and manual therapy, should be the first-line treatment in patients with fibromyalgia.
The aim of this article is to present the up-to-date findings of the systematic reviews, meta-analyses and randomized controlled clinical trials, describing the efficacy of the physiotherapy treatment in patients with fibromyalgia.
Material and methods. The literature available in the PubMed and PEDro databases was reviewed regarding the possibility of using selected physiotherapy treatments in fibromyalgia. This review includes the results of the latest systematic reviews, meta-analyzes and randomized clinical trials, showing the effectiveness of selected physical exercises, physical agents and massage in patients with fibromyalgia.

Key words:
fibromyalgia, physiotherapy, exercises, physical agents, massage

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Utjecaj masaže na crijevnu peristaltiku

Dagmara Gąbka, Sandra Grzesik, Aleksandra Skomudek, Katarzyna Bogacz, Jan Szczegielniak

D. Gąbka, S. Grzesik, A. Skomudek, K. Bogacz, J. Szczegielniak – The influence of the massage on a bowel movement. Fizjoterapia Polska 2019; 19(2); 6-17

Abstract
Aim. One of the most serious civilisation diseases is constipation. Constipation is an infrequent defecation – lower than two times a week or solid stools extracted with the feeling of incomplete bowels with a large effort put in the process. The aim of the presented dissertation is the evaluation of the one – off abdominal massage influence on reduction of constipation. It was examined whether under the influence of massage the symptoms of constipation was reduced, how long it took to wait for the results and how long the effects lasted.
Materials and methods of survey. The study covered 20 women who suffered from a spastic type of habitual constipation. Among examined women constipation was diagnosed on the basis of the questionnaire that refers to occurrence of constipation. The patients were undergone the one – off massage lasting an hour.
Results. Conducted surveys have shown that the one – off massage has a positive effect in the form of reduced troublesome symptoms and the increase of defecation frequency. The treatment is effective, the results are visible but it is a short – term phenomenon lasting for two weeks.
Conclusions
1. The pain and tension of the abdominal muscles, false tenesmus, intensified thirst, the lack of appetite, bloating, bowel cramps – colic, the feeling of fullness in stomach have been reduced. General weakness and depression have subsided.
2. After a single abdominal massage the improvement of defecation amount has been observed among 85% of patients.
3. The effect of the massage in the form of increased defecation amount has lasted for a week.
4. The difficulties during defecation process after the massage have decreased considerably and systematically.

Key words:
constipation, classic belly massage, physiotherapy

 

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Bol donjeg dijela kralježnice – sažetak Susreta stručnjaka u 2017. godini

Mateusz Wojciech Romanowski, Anna Kostiukow, Łukasz Kubaszewski, Wojciech Romanowski, Marian Majchrzycki, Ernest Wiśniewski, Włodzimierz Samborski

M. W. Romanowski, A. Kostiukow, Ł. Kubaszewski, W. Romanowski, M. Majchrzycki, E. Wiśniewski, W. Samborski – Low back pain – summary of the 2017 Expert Meeting. Fizjoterapia Polska 2019; 19(1); 108-122

Abstract
Low back pain (LBP) is one of the main causes of health problems in developed countries. LBP can lead to a high degree of disability and sometimes involve high costs of treatment. The causes of LBP can be classified into the basic three groups: non-specific pain, pain potentially related to radiculopathy or spinal stenosis, pain potentially related to another specific cause. Treatment of low back pain should be directed to the cause of the disorder, and mainly includes non-invasive treatment, physiotherapy, pharmacotherapy, education. Invasive treatment of LBP includes pharmacological blockade, surgery.

Key words:
lower back pain, low back pain, non-specific lower back pain

 

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Glavni čimbenici koji uzrokuju pojavljivanje displazije kukova kod dojenčadi na temelju analize dokumentacije Neonatološkog odjela Županijske bolnice grada Tichy iz 2017 godine

Magdalena Kiecoń, Jarosław Madowicz, Paulina Głowacka, Renata Szczepaniak

M. Kiecoń, J. Madowicz, P. Głowacka, R. Szczepaniak – The main factors determining the occurrence of developmental dysplasia of the hip in infants based on the analysis of medical history of newborns staying in the neonatal ward of the Szpital Wojewódzki in Tychy in 2017. Fizjoterapia Polska 2019; 19(1); 98-107

Abstract

Aim. To investigate the frequency of occurrence of Developmental Dysplasia of the Hip in newborns and to distinguish the main factors causing its occurrence.
Material and methods. The research included medical documentation in the form of the medical history of 1591 patients in the neonatological ward of the Provincial Specialist Hospital of Megrez Sp. z o.o. in Tychy.
Results. The incidence of DDH was higher among girls than among boys, and predominantly in the right joints. The study did not detect any significant relationship between the occurrence of DDH and the type of delivery, week of pregnancy, multiplicity of pregnancy and birth weight of newborns. However, a statistically significant relationship was detected between the occurrence of physiologically immature joints and the birth weight of newborns.
Conclusions. 1. The frequency of occurrence of DDH among newborns staying in the neonatal ward of the Provincial Hospital in Tychy in 2017 was 2.7% and was lower than the literature gives. 2. The occurrence of DDH was more frequent among girls than among boys. 3. DDH occurred more frequently in a statistically significant way in the right joint. 4. A significant relationship was found between the occurrence of type IIa variations according to the Graf scale and the birth weight of the newborn. 5. There were no significant relationships between the occurrence of DDH and the type of delivery, week of pregnancy, multiplicity of pregnancy and birth weight of newborns.

Key words:
DDH, developmental hip dysplasia, pediatrics, newborns, hip joint

 

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Procjena utjecaja kompleksne ljekovite terapije s primjenom radonske vode na razinu hemoglobina – uvodna ispitivanja

Jadwiga Kuciel-Lewandowska, Łukasz B. Lewandowski, Agata Trafalska, Wojciech Laber, Krzysztof Szarejko, Joanna Kuć, Krzysztof Aleksandrowicz

J. Kuciel-Lewandowska, Ł. B. Lewandowski, A. Trafalska, W. Laber, K. Szarejko, J. Kuć, K. Aleksandrowicz – Assessment of the influence of comprehensive spa therapy with therapeutic radon waters on hemoglobin levels: preliminary study. Fizjoterapia Polska 2019; 19(1); 86-96

Abstract
Introduction. Balneotherapy is a complex therapeutic treatment. Radon treatment is a widely used procedure in musculoskeletal disorders. Clinical evaluation proves this form of therapy to be very beneficial for health. The evaluation of metabolic changes resulting from the influence of balneo treatments with radon waters is difficult to interpret and gives rise to many controversies.
Aim. The aim here was to evaluate changes in the hemoglobin level in patients undergoing complex spa treatment, and the effect of low doses of ionizing radiation from radon waters.
Materials and methods. The study group was comprised of patients undergoing complex spa treatment with radon water, peloid therapy, exercise therapy and kinezytherapyduring a twenty-one day rehabilitation stay. Hemoglobin levels were measured prior to therapy and after eighteen days of treatment. Research was comprised of n = 35 patients (24 female and 11 male) suffering from peripheral and spinal joint pain caused by degenerative disease or disc herniation. Age ranged from 47 – 63 years, and the mean age was 56.5. The control group consisted of fifteen subjects (9 male and 6 female) between the ages of 50 and 62 and the mean age of 54.2. Both groups were subject to the same inclusion and exclusion criteria and test procedures.
Results. There were no statistically significant changes between the research and control group in regard to hemoglobin levels. The results were not statistically significant when compared between the two study groups.
Conclusions. 1. The comprehensive spa treatment with peloid therapy, exercise therapy, kinezytherapy and low doses of ionizing radiation from radon waters did not affect the concentration of hemoglobin. 2. Future research should investigate a larger population and separate the elements of spa therapy.

Key words:
DDH, developmental hip dysplasia, pediatrics, newborns, hip joint

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