Tag: Jan Talar

Treatment and rehabilitation procedures for patients with Guillain-Barre-Strohl syndrome

Iwona Pyszczek, Jolanta Kujawa, Jan Talar, Robert Jonak

Iwona Pyszczek, Jolanta Kujawa, Jan Talar, Robert Jonak – Treatment and rehabilitation procedures for patients with Guillain-Barre-Strohl syndrome. Fizjoterapia Polska 2001; 1(1); 63-66

Abstract
This article presents the epidemiology and clinical picture of Guillain-Barre-Strohl Syndrome (GBS), along with a review of currently used methods of treatment and rehabilitation for patients with this disorder. A summary is provided of the current state of research on the etiopathogenesis of GBS, its clinical symptoms, and the typical course. The rehabilitation procedures appropriate for the various stages of the disease are described. There is also a presentation of the best kinesitherapeutic and physicotherapeutic methods, with particular attention to electrotherapy and the use of alternating magnetic fields.

Key words:
Guillain-Barre-Strohl, AIDP, Rehabilitation, electrotherapy, alternating magnetic fields

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Clinical neurophysiology and early post stroke neurorehabilitation

Ryszard Kinalski, Jan Talar

Ryszard Kinalski, Jan Talar – Clinical neurophysiology and early post stroke neurorehabilitation. Fizjoterapia Polska 2001; 1(1); 47-50

Abstract
The interest of the neurorehabilitation of the stroke survivors have increased in the Brain Decade. The Helsinborg Declaration and the National Program of the Stroke Prevention and Treatment recommends to organize the stroke units and to start with the physiotherapy since the first day of hospitalization. The authors justifies the usefulness of the verification of the early post stroke rehabilitation effects on the basis of the instrumented tests, that image and quantify the neuromechanisms underlying the behaviour of the movement disorders, more accurately than the stroke scales. The heuristic possibility of the repetitive electrostimulation applicability in the early post stroke neurorehabilitation was discussed.

Key words:
clinical neurophysiology, neurorehabilitation, acute stroke

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Thermovisual evaluation of the behavior of skin surface temperature following cryostimulation of the forearm in healthy adultsThermovisual evaluation of the behavior of skin surface temperature following cryostimulation of the forearm in healthy adults

Zbigniew Śliwiński, Jan Talar

Zbigniew Śliwiński, Jan Talar – Thermovisual evaluation of the behavior of skin surface temperature following cryostimulation of the forearm in healthy adults. Fizjoterapia Polska 2001; 1(2); 155-160

Abstract
Introduction. The authors describe the impact of local cryotherapy on the human organism and the operating principles of the thermoregulation center. The article also contains information on thermovision. The research results presented here involve change in skin suface temperature in the upper limbs following chilling only one forearm by liquid nitrogen vapors for 2 minutes. Material and methods. 18 healthy volunteers (13 women, 5 men) were tested with the consent of the Bioethics Committee at the Bydgoszcz Academy of Medicine. Skin temperature changes were evaluated using an Agema 570 thermovision camera. A KS-1 apparatus manufactured by Hans-Sped (Głogów, Poland) was used for cryostimulation. Results. The results confirm that chilling one limb evokes changes in the other limb also. The temperature in the chilled limb after a two-minute administration did not achieve the initial values 5 minutes after conclusion of cryostimulation. In the limb which did not receive cryostimulation the temperature leveled out within 2 minutes after conclusion of stimulation, despite an initial drop. Intensive perfusion brought about a statistically significant increase in temperature to values higher than initial, in several cases, however, increased temperature was observed after conclusion of cryostimulation. This mechanism is not fully explained. Conclusions. The temperature increase in the untreated arm after conclusion of cryostimulation indicates that the thermoregulatory mechanism is operating properly, defending the organism against heat loss by increasing the blood supply to the limb. Cold reduced the sensitivity of smooth muscles to sympathetic stimuli and the effect of catecholamine, and this facilitates blood supply to the limbs. Cryostimulation to only one limb in healthy persons induces contralateralization of the consensual reflex, as shown by temperature changes on the skin of the limb not subjected to cryotherapy. This would seem to be associated with the arousal of cold thermoreceptors due to the reduction in skin temperature, which in turn leads to bioelectric arousal of the brain by the activating portion of the reticular network in the mesencephalon.

Key words:
Cryostimulation, thermoregulation, thermovision

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The neurorehabilitation of hemispatial neglect in patients with traumatic brain injury

Maria Pąchalska, Bogusław Frańczuk, Jan Talar, Wiesław Tomaszewski, Bruce MacQueen, Kay Neldon

Maria Pąchalska, Bogusław Frańczuk, Jan Talar, Wiesław Tomaszewski, Bruce MacQueen, Kay Neldon – The neurorehabilitation of hemispatial neglect in patients with traumatic brain injury. Fizjoterapia Polska 2001; 1(2); 143-154

Abstract
Background. The purpose of this article is to evaluate the relative effectiveness of differentiated rehabilitation programs for patients with hemispatial neglect subsequent to traumatic brain injury (TBI). In the literature, neglect is classified into two basic types: egocentric (“body-centered”), in which the patient neglect object situated in a given area of his field of vision, and allocentric )”objected-focused”), in which the patient neglects one side of objects presented to him, regardless of their location. The authors’ clinical practice indicates that the visual scanning technique traditionally used in neglect therapy is generally ineffective in patients with egocentric neglect. A spatio-motor training program has therefore been developed by the authors, elaborated on the basic of their program of semantically controlled motion patterns for the rehabilitation of apraxia, whose goal is to reestablish the proper relations between automatic and voluntary movements, to improve interhemisphere cooperation by symmetrical and asymmetrical modeling of motor exercises with both healthy and affected limbs, and to increase patient motivation by establishing clearcut goals and rewarding success. Both programs, visual scanning and spatio-motor training, have been implemented in clinical practice in the represented by the authors. Material and methods. The article describes in detail the rehabilitation of two TBI patients (JK, male, age 27, and AS, female, age 28) treated by the authors in the chronic phase of recovery after automobile accidents, as a result of which both patients were comatose for more than 4 weeks. In neuropsychological testing JK and AS both presented with persistent and significant leftsided hemispatial neglect: allocentric neglect in JK, and egocentric in AS. A modified AB-BA experimental design was used, where A represents spatio-motor training, and B is visual scanning. For patient JK, program A was first applied, followed by B, while for patient AS the reverse sequence was used. Each program included 10 therapy sessions, with a four-week interval between programs. The degree of neglect was measured using standard neuropsychological tests for quantitative and qualitative assessment of neglect, along with the analysis of drawings made during therapy by both patients. The patients were tested four times, before and after each of the two programs. Results. As the authors had hypothesized, patient JK did not show any progress in terms of neglect after conclusion of program A, while after program B he showed virtually no lingering neglect. In the case of patient AS the results were exactly opposite: after concluding program B (which she received first) there was no significant change, while after program A (administered second) there were no signs of neglect.Conclusion. The theoretical and clinical implications of these results for neuropsychological practice are discussed, and a model solution is proposed to explain the basic pathomechanism of both allocentric and egocentric neglect. These two types of neglect are sufficiently different in etiology and symptomatology to necessitate differentiated therapy programs in the course of neurorehabilitation.

Key words:
hemispatial neglect, traumatic brain injury, rehabilitation

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A contribution to the meta-analysis of the results of evoked potentials examinations performed in acute patients

Ryszard Kinalski, Jan Talar, Małgorzata Łukowicz

Ryszard Kinalski, Jan Talar, Małgorzata Łukowicz – A contribution to the meta-analysis of the results of evoked potentials examinations performed in acute patients. Fizjoterapia Polska 2001; 1(2); 131-134

Abstract
Background. This article presents a selective meta-analysis of published case studies from the years 1988-1999 describing the results of somatosensory tests and evoked motor potentials conducted in the acute phase of stroke. Material and methods. The publications were selected from among those in the MEDLINE data base whose titles were returned by a search for the key words “acute stroke” and “evoked potentials”. A review was also conducted of the regular issues and supplements of Neurologia i Neurochirurgia Polska this same 10-year period. Conclusions. The articles found and analyzed were published in 23 reports from 12 different countries around the world. The tests were often performed within the first 24 hours after the onset of stroke symptoms. The parameters most often evaluated included the amplitudes, latencies, and central conductivity of evoked potentials. The purpose of these examinations was most often to localize the brain lesion, identify early and delayed neuroplasticity, and develop an early prognosis for the recovery of voluntary movements and functional improvement.

Key words:
Evoked Potential, sacute stroke, meta-analysis

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A program of motor rehabilitation for patients in the early phase after cardiac surgery

Jan Talar, Grzegorz Mańko, Dominika Batycka

Jan Talar, Grzegorz Mańko, Dominika Batycka – A program of motor rehabilitation for patients in the early phase after cardiac surgery. Fizjoterapia Polska 2001; 1(2); 105-110

Abstract
Background. This article describes a program of rehabilitation for patients recovering from cardiac surgery (including coronary by-passes, surgical repair of valve defects, and heart transplants) currently in use at the Cardiovascular Surgery and Transplantation Clinic at the Jagiellonian University’s Collegium Medicum in Cracow. Physiotherapeutic procedures implemented preand post-operatively are presented, with particular emphasis on respiratory and motor rehabilitation and an educational program intended to improve the patient’s sense of cognitive control. Material and methods. The effectiveness of this program was evaluated in a natural clinical experiment involving 42 patients who underwent rehabilitation after cardiac surgery. The patients were divided into two groups, matched by age and sex: a control group (K), consisting of 21 patients treated prior to the implementation of the new physiotherapy program, using traditional respiratory exercises, and an experimental group (E), also including 21 patients, who received the new program. The results were obtained from clinical observation, and from the evaluation of the patients’ scores on the Self-Evaluating Clinical Scale of cognitive, emotional, vegetative, and neurobehavioral disturbances and the Self-Evaluating Quality of Life Scale, as pertains to the patient’s health image, pain management, and the feeling of security. The patients were tested twice: once before rehabilitation (before the cardiosurgical operation), and again 7 days into the program. Results. The results obtained by these patients clearly indicated that the program here proposed is more effective than traditional programs in terms of patient satisfaction with the course of rehabilitation, increased motivation to exercise, and faster attainment of independence by the patient. The authors discuss the possible significance if brain hypoxia in the etiology of the cognitive and emotional deficits displayed by virtually all the patients. Conclusion. The rehabilitation program for patients recovering from cardiac surgery should be implemented even prior to surgery. It should include respiratory therapy and physiotherapy, with elements or patient education. The program described in this article supports improvement in the physical and psychological status of the patients in the early phase post-surgery, which leads to a better quality of life.

Key words:
cardias surgery, motor rehabilitation, respiratory exercises

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Kinesitherapy in compression fractures of the spine in the eveloping years: an authorial modification of exercises

Halina Protasiewicz, Ireneusz Kowalski, Jan Talar, Adam Buciński

Halina Protasiewicz, Ireneusz Kowalski, Jan Talar, Adam Buciński – Kinesitherapy in compression fractures of the spine in the eveloping years: an authorial modification of exercises. Fizjoterapia Polska 2001; 1(3); 286-291

Abstract

The authors have developed a two-stage kinesitherapeutic model for the conservative rehabilitation of compression fractures of the spine in children and youth. The first phase, called the “hospitalization phase”, lasts 4-6 weeks, while the second, the “ambulatory phase”, lasts from the 2nd to the 12th month after injury.The orientation in medical rehabilitation presented by the authors of this article combines elements typical for conservative treatment reinforced by Kempf exercises with elements of periodic application of prostheses, in the form of light orthopedic corsets. The best results are achieved by creating an autogenic muscle girdle, which simultaneously protects the spine against flexion movements by forcing extension of the spine, and by using correctional and hypercorrectional positions in the orthoses used, especially in multiple fractures. The primary purpose of kinesitherapy is to strengthen the muscle girdle and to shape the strength and endurance of the postural muscles, using positions that relieve pressure on the spine. The isometric exercises in the pressure-relieving position lead to a systematic increase in the strength of the postural muscle. Other important elements of kinesitherapy include learning to feel one’s own body, proper protection of the spine, and shaping the correct body posture. Full recovery was attained in 70% of cases after one year of modified therapy. In the control group – traditional therapy – positive results were obtained in 56%.

Key words:
compression fractures of the spine, kinesitherapy, conservative treatment, developing years
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Comparative evaluation of the analgesic effectiveness of selected physiotherapeutic methods in the treatment of low back pain syndrome

Jolanta Kujawa, Iwona Pyszczek, Jan Talar, Mirosław Janiszewski

Jolanta Kujawa, Iwona Pyszczek, Jan Talar, Mirosław Janiszewski – Comparative evaluation of the analgesic effectiveness of selected physiotherapeutic methods in the treatment of low back pain syndrome. Fizjoterapia Polska 2001; 1(3); 271-279

Abstract

Background. Low back pain, especially lumbosacral syndrome, is the most frequently encountered pain syndrome in musculoskeletal diseases. In many countries the question of low back pain has become a social problem. The basic task of rehabilitation teams is to make the proper choice of effective physiotherapeutic method. The goal of this study was to evaluate the analgesic effectiveness of selected combined physiotherapeutic methods in patients with low back pain. The results were analyzed for statistically significant differences correlating with the application of particular physical methods.Material and methods. 450 randomly selected patients (319 females, 131 males), age 21-79 (average age 56,53 years +/- 15,34) treated for low back pain syndrome in the Department of Medical Rehabilitation at the Łódź-Śródmieście Municipal Clinic were surveyed. Patients were divided into two groups: Group A received laser biostimulation, while Group B received interferential current instead of laser therapy. All patients studied went through a uniform, typical program of therapeutic exercises. The effectiveness of this combined therapy was evaluated on the basis of subjective pain reported on the modified Laitinen pain questionnaire, taking into account intensity, frequency, use of analgesics and motor activity. A clinical examination was also performed. Results. The investigation indicated that both selected combined physiothearapeutic methods have a measurable analgesic effect in the treatment in low back pain. However, laser therapy applied in combination with therapeutic exercises proved to have greater therapeutic efficiency for such patients compared to interferential current with therapeutic exercises, and this difference was statistically significant.

Key words:
low power laser therapy, Low Back Pain, physiotherapy
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The impact of low-power laser radiation (IR, λ = 810 nm) on ATP-ASE activity and the cell membrane structure of erythrocytes

Jolanta Kujawa, Iwona Pyszczek, Leu Zavodnik, Ilya Zavodnik, Vyacheslav Buko, Ewa Kilańczyk, Maria Bryszewska, Jan Talar

Jolanta Kujawa, Iwona Pyszczek, Leu Zavodnik, Ilya Zavodnik, Vyacheslav Buko, Ewa Kilańczyk, Maria Bryszewska, Jan Talar – The impact of low-power laser radiation (IR, λ = 810 nm) on ATP-ASE activity and the cell membrane structure of erythrocytes. Fizjoterapia Polska 2001; 1(3); 248-253

Abstract

Background. The biostimulatory and therapeutic effects of laser radiation at different wavelengths, power levels, and doses are well known, but the mechanisms underlying these effects are still not completely understood. The aim of our research was to investigate the effect of laser radiation on the function and structure of the cell membranes of human erythrocytes.Material and methods. Isolated erythrocyte cell membranes were irradiated with laser light (λ = 810 nm) of varying surface density of light energy and power. The activity of Na+, K+, and Mg2+, ATPases was used as the marker characterizing structural and functional changes in the cell membrane.Results. Laser radiation of wavelength λ = 810 nm was found to change the activity of the sodium-potassium pump in the cell membrane of human erythrocytes, while the nature of the changes turned out to be dependent on the radiation energy and power dose. The results obtained also indicate that laser irradiation induces an increase of lipid bilayer fluidity. No changes were observed in such parameters as cell stability, the level of lipid peroxidation products, reduced intracellular glutathione, or reduced oxyhemoglobin level.Conclusions. Our results indicate that laser radiation of wavelength λ = 810 nm, depending on power level and energy dosage, induces structural and functional changes in the cell membranes of human erythrocytes.

Key words:
biostimulation, ion pump, cell stability, Lipid Peroxidation, glutahione, Oxyhemoglobin
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The modulating effects of laser radiation on the extra- and intracellular Ca2+ store and vascular resistance in the perfused tail artery of the rat

Leszek Szadujkis-Szadurski, Jan Talar, Krzysztof Wiśniewski, Wiesław Tomaszewski, Małgorzata Łukowicz, Rafał Szadujkis-Szadurski

Leszek Szadujkis-Szadurski, Jan Talar, Krzysztof Wiśniewski, Wiesław Tomaszewski, Małgorzata Łukowicz, Rafał Szadujkis-Szadurski – The modulating effects of laser radiation on the extra- and intracellular Ca2+ store and vascular resistance in the perfused tail artery of the rat. Fizjoterapia Polska 2002; 2(1); 11-20

Abstract
Background. Low-level laser radiation modulates many cell functions, but the operating mechanism of its effects has not been sufficiently explained. Our research indicates that these effects are closely with impact on the cellular signaling system, where the ion receptors and channels play a central role.Material and method. The research involved perfused rat tail arteries based on two independent experimental models: model I, in which only the intracellular Ca2+ ion store is ised in the contraction reaction of arterial smooth muscle tissue, and model II, in which the extracellular poor is used. In model I only phenylephrine (an agonist of the alpha-1-adrenergic receptor) elicits contraction, whereas in model II both phenylephrine and BAY K8644 elicit contractions. These models were used to study the impact of low-power laser radiation (10-110 mV).Results. Our research indicated that phenylephrine causes an increase in perfusion pressure as a result of mobilizing the both the intracellular and extracellular stores of Ca2+ ions. The increased perfusion pressure obtained in this way is maintained for ca. 20-30 minutes. The exposure of arteries to laser radiation (10-110 mV) in a manner dependent on the radiation power reduces this reaction. BAY K8644, acting directly on the L-type Ca2+ ion channels, under these conditions does not cause an increase in perfusion pressure. After the intracellular store of Ca2+ ions is emptied, the increased perfusion pressure reactions to phenylephrine and BAY K8644 can be triggered by supplementing the missing CaCl2 in EGTA-Krebs fluid without Ca2+. The exposure of arteries to similar laser radiation reduces the reactions of arteries to phenylephrine and has no impact on the reactions triggered by BAY K8644. The L-NAME inhibitor NO – synthase effectively protects the arteries against the modulating effect of laser radiation.Conclusions. The results obtained here confirmed the association between the effect of laser radiation the contraction reaction of arteries triggered by phenylephrine and NO synthesis. A comparison to the effect of phenylephrine with BAY K8644 suggests that the effect of modulating the arteries’ reactions is conditioned by binding of G protein with the receptor. This suggestion is consistent with the fact that is no inhibiting action of laser radiation on the direct effect of BAY K8644.

Key words:
Phenylephrine, perfusion pressure, BAY K 8644, NO synthesis

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