pourazowe krwiaki przymózgowe

Similarities and differences between traditional rehabilitation and selected models of PNF concept combined with elements of Bobath method in rehabilitation of patients following surgery of traumatic subdural and epidural hematomas

Grażyna Brzuszkiewicz-Kuźmicka, Stanisław Kuźmicki, Janusz Domaniecki

Grażyna Brzuszkiewicz-Kuźmicka, Stanisław Kuźmicki, Janusz Domaniecki – Similarities and differences between traditional rehabilitation and selected models of PNF concept combined with elements of Bobath method in rehabilitation of patients following surgery of traumatic subdural and epidural hematomas. Fizjoterapia Polska 2008; 8(1); 35-42

Abstract

Background. The main purpose of this work is to determine how early physiotherapy influences the recovery of motor capacity of the upper and lower limb and ability communicate in patients following surgical treatment of traumatic subdural and epidural hematomas. Material and methods. The study group included 84 patients who had undergone surgery due to traumatic subdural and epidural hematomas. The patients were subdivided into two subgroups according to the type of physiotherapy they received. Motor capacity of the lower limb and ability to communicate were assessed according to the Brunnström scale. The Wilcoxon test for dependent data and U-Mann-Whitney test for independent data were used to compare means. Results. The results of the study confirmed a significant improvement of motor capacity of the upper and lower limb as well as the ability to communicate in all patients. However, the recovery of the motor functions in patients subjected to physiotherapy combining selected models of the PNF-concept and the Bobath method occurred significantly faster when compared to patients treated with standard physiotherapy. No differences between the subgroups were recorded with respect to the recovery of the ability to communicate. Conclusions. The results also suggest that the greatest potential for disturbed functions exists in the early postoperative period (Days 1-5).

Key words:

early physiotherapy, PNF concept, Bobath method, traumatic subdural and epidural hematomas, motor capacity

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Functional recovery in patients receiving rehabilitation after operative treatment of post-traumatic extraaxial cerebral haematoma

Grażyna Brzuszkiewicz-Kuźmicka, Stanisław Kuźmicki, Wiesław Tomaszewski

Grażyna Brzuszkiewicz-Kuźmicka, Stanisław Kuźmicki, Wiesław Tomaszewski – Functional recovery in patients receiving rehabilitation after operative treatment of post-traumatic extraaxial cerebral haematoma. Fizjoterapia Polska 2010; 10(4); 271-279

Abstract

The number of patients treated surgically for post-traumatic extraaxial cerebral haematoma is growing every year, thus becoming a significant therapeutic problem. The main aim of the study is to describe changes in functional status, progress in the resolution of neurological deficits and changes in the level of consciousness of patients receiving comprehensive rehabilitation after surgery for a post-traumatic extraaxial cerebral haematoma and to determine differences and similarities in the rate of recovery of these functions. The study involved a group of 43 patients receiving operative treatment of post-traumatic extraaxial cerebral haematoma. The International Muscle Paresis Scale, the Modified Barthel Scale and the Rankin Scale were used to evaluate the severity of the neurological deficit and disability, while the Glasgow Coma Scale was used to assess patients’ level of consciousness. These were standardised in order to allow comparison of the temporal pattern of change and a comprehensive evaluation of the functions under examination. The patients receiving physiotherapy after surgery for post-traumatic extraaxial cerebral haematoma demonstrated significant improvements in all functions under investigation. The quickest recovery was observed in functional performance and the ability to perform activities of daily living. Recovery of the level of consciousness was much slower and pareses resolved the most slowly. 1. Surgery and early post-operative rehabilitation lead to effective functional recovery but the rate of recovery of individual functions may vary. 2. Early rehabilitation of patients after extraaxial cerebral haematoma evacuation increases the possibility of the development of compensatory mechanisms and contributes to positive outcomes of rehabilitation.

Key words:

Craniocerebral Trauma, post-traumatic extraaxial cerebral haematoma, post-operative physiotherapy

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Dynamika powrotu utraconych funkcji u pacjentów poddanych fizjoterapii po operacyjnym leczeniu pourazowych krwiaków przymózgowych

Grażyna Brzuszkiewicz-Kuźmicka, Stanisław Kuźmicki, Zbigniew Śliwiński, Maria Kłoda, Michał Sobstyl, Agata Kuźmicka

Grażyna Brzuszkiewicz-Kuźmicka, Stanisław Kuźmicki,
Zbigniew Śliwiński, Maria Kłoda, Michał Sobstyl, Agata Kuźmicka

G. Brzuszkiewicz-Kuźmicka, S. Kuźmicki, Z. Śliwiński, M. Kłoda, M. Sobstyl, A. Kuźmicka – The dynamics of the return of lost functions in patients undergoing physiotherapy following surgical treatment of post-traumatic paracerebral hematomas. FP 2014; 14(3); 66-75

Streszczenie
Celem pracy jest określenie wpływu wczesnej fizjoterapii na dynamikę powrotu zdolności wykonywania czynności dnia codziennego, poprawę stanu funkcjonalnego i zmniejszenie ubytków neurologicznych oraz zmianę stanu świadomości u chorych po operacyjnym leczeniu pourazowych krwiaków przymózgowych.
Materiał badań stanowiła grupa 86 chorych leczonych operacyjnie z powodu pourazowego krwiaka przymózgowego. Wszystkich pacjentów podzielono na dwie grupy, gdzie podstawowym kryterium różnicującym badanych był rodzaj zastosowanej kinezyterapii.
Do oceny stopnia neurologicznego deficytu i niepełnosprawności wykorzystano Międzynarodową Skalę Niedowładów Mięśni, Zmodyfikowaną Skalę Barthel i Skalę Rankina, natomiast ocenę stanu świadomości dokonano w oparciu o skalę Glasgow Coma Scale.
Powrót utraconych funkcji u chorych usprawnianych wg wybranych wzorców koncepcji PNF i elementów Metody Bobath, w porównaniu do pacjentów poddanych kinezyterapii tradycyjnej, posiadał większą dynamikę, szczególnie w pierwszych dniach i następował w istotnie szybszym tempie. Jednak takiej zależności nie odnotowano w przypadku powrotu stanu świadomości. Największe możliwości uzyskana powrotu utraconych funkcji występują we wczesnym okresie pooperacyjnym (1-5 doba).