Author: Marek Woszczak, Katarzyna Syrewicz, Iga Woźniak, Łukasz Goździewicz, Katarzyna Bogacz, Karolina Kossakowska

Comprehensive draining therapy in the treatment of lymphoedema in women after mastectomy

Marek Woszczak, Katarzyna Syrewicz, Iga Woźniak, Łukasz Goździewicz, Katarzyna Bogacz, Karolina Kossakowska

M. Woszczak, K. Syrewicz, I. Woźniak, Ł. Goździewicz, K. Bogacz, K. Kossakowska – Comprehensive draining therapy in the treatment of lymphoedema in women after mastectomy. Fizjoterapia Polska 2019; 19(4); 28-40

Abstract
Introduction. Breast cancer is one of the most dangerous malignancies tumor, and the incidence of this disease is still growing. As a result of treatment and related removal or impairment of lymph node structure, a frequent complication is lymphoedema. There are many methods of treatment, however, the most recommended and currently the most effective is a complex decongestive therapy.
Purpose of this study. The aim of the study was to evaluate the effectiveness of complex decongestive therapy, its influence on the reduction of lymphoedema and the improvement of mobility and strength of the upper limb.
Materials and methods. The study was conducted on a group of 60 women after unilateral mastectomy at the Świętokrzyski Oncology Center in Kielce. The examined patients were divided into two groups: research and control. In the study group consisting of 30 women, KFTU treatments were performed, while other rehabilitation procedures were performed. The therapeutic cycle lasted 10 days. At the beginning and at the end of the treatment, the change in pain severity was assessed on the VAS scale and the range of motion was measured using the goniometric method, the limb circumferences were measured with a centimeter tape and SUR was measured using a dynamometer.
Results. In both groups, after the end of the therapy, all parameters were improved, but in the research group where a complex decongestive therapy was used, the effect was more noticeable. In the study group there was a significant decrease in pain sensation, decreased limb circumference and visible improvement in strength and range of motion.
Conclusions.The use of both methods of treatment brings effects in the form of reduction of lymphatic edema, however, a complex decongestive therapy is a more effective method of improvement.

Key words:
mastectomy, comprehensive draining therapy, lymphoderma

 

 

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Effect of laser puncture on arterial blood gases for mechanically ventilated patients: a randomized controlled trial

Hany Farid Eid Morsy Elsisi, Zeinab Sami Ali Ahmed, Azza Fekry Ismail, Amany Raafat Mohamed, Rania M. El-Sherif

Hany Farid Eid Morsy Elsisi, Zeinab Sami Ali Ahmed, Azza Fekry Ismail, Amany Raafat Mohamed, Rania M. El-Sherif – Effect of laser puncture on arterial blood gases for mechanically ventilated patients: a randomized controlled trial. Fizjoterapia Polska 2019; 19(4); 24-27

DOI: https://doi.org/10.56984/8ZG1A3D62

Abstract
Purpose. To determine the effect of laser puncture on arterial blood gases for mechanically ventilated patients. Design. Single blind randomized controlled trial. Methods. Forty patients participated in the study, they were recruited from the critical care unit in Cairo University hospitals Kasr el Einy hospitals, Cairo, Egypt; their ages ranged from 50-70 years old, through a period of 33 months (from May 2016 to February 2019). Confidentiality was assured. They were assigned randomly into two groups equally in number; 20 patients each: Group (A) patients received both Laser puncture with an output of 5–20 mW, wavelength of 905 nm and frequency of 5000 Hz. laser probe stimulated on each point for 1 min, once daily for 10 days and routine intensive care physical therapy program twice per day. Group (B) patients received a routine intensive care physical therapy program (modified postural drainage, airway clearance techniques, lung expansion techniques and circulatory exercises for lower limbs) twice per day for 10 days. Pre and post Blood gas analysis for assessment of arterial blood gases (PaO2, PaCO2, O2%, and PaO2/FiO2) for all patients. Results. This study revealed improvement in PaO2/FiO2 in group (A), non significant change in PaO2, PaCO2 level, O2% after 10 days in both groups. Conclusion. Laser puncture had a significant effect in PaO2/FiO2, so this study supports the value of laser puncture on arterial blood gases for mechanically ventilated patients.

Key words:
arterial blood gases, laser puncture, mechanically ventilated patients

 

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Physiotherapy in patients after myocardial infarction

Włodzisław Kuliński, Sylwia Pająk

W. Kuliński, S. Pająk – Physiotherapy in patients after myocardial infarction. Fizjoterapia Polska 2019; 19(4); 6-22

Abstract
Background. Myocardial infarction is a serious social and health problem of modern society. Cardiac rehabilitation is a very important part of management in this group of patients.
Aim. To assess the efficacy of rehabilitation and its effects on cardiovascular and respiratory performance in patients after myocardial infarction.
Materials and methods. The study assessed a group of 30 patients who participated in 3-week day-care cardiac rehabilitation at the District Health Care Institution in Starachowice.
The effectiveness of rehabilitation was analysed using an original study card, divided into two parts (history taking and physical examination). The first part included personal and medical history and a scale for subjective assessment of exertion during daily activities, similar to the Borg scale. The other part included daily blood pressure and pulse measurements taken before and 5 minutes after cycle ergometer training. Dependent variables were verified before rehabilitation and after 15 days of rehabilitation.
Results. After rehabilitation, patients showed permanent cardiovascular adaptation to more intense exercise, reflected by reduced systolic and diastolic blood pressure values and a lower heart rate.
Conclusions. 1. Cardiac rehabilitation helped improve physical performance in patients after myocardial infarction. 2. Systolic pressure was reduced as early as after the first training and permanent cardiovascular adaptation to more intense exercise was seen in study patients, which was reflected by normal blood pressure and pulse values. 3. Rehabilitation had a positive influence on patient functioning in everyday life.

Key words:
myocardial infarction, physiotherapy

 

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Effect of Upright versus Recumbent Positions on Labour Outcomes

Mohamed A Awad, Wafaa M Kamal, Emad Salah

Mohamed A Awad, Wafaa M Kamal, Emad Salah – Effect of Upright versus Recumbent Positions on Labour Outcomes. Fizjoterapia Polska 2019; 19(3); 174-179

Abstract
Aim. This study was to find out the impact of uprighting versus lying down positions on labour outcomes.
Subjects. Sixty women between 37-41 weeks’ gestational ages in active phase of first stage of labour participated in this study. They were selected randomly from Kasre Al-Ainy University Hospital in Cairo, Cairo University. Their ages ranged from 18-35 years old and their BMI were not more than 35 kg/m2. They were with single live fetus and their fetus was in cephalic presentation. They were without any pregnancy or medical complications. participants were indiscriminately allocated into 2 identical groups: Group A (Upright group) composed of thirty women who adopted the upright positions. Group B (Recumbent group) consisted of thirty women who remained in bed (supine or side lying positions).
Methods. Body Mass Index was assessed by weight-height scale. Duration of stages of labour was assessed using stop watch. Labour pain intensity was assessed by using visual analogue scale at 3-5 cm and 7-8 cm of cervical dilatation. Fetal heart rate was assessed by using cardiotocography. Apgar score of the newborns was assessed by using Apgar test at 1 minute and at 5 minutes after birth.
Results. Results of this study revealed that duration of 1st, 2nd and 3rd stage of labour, labour pain and fetal heart rate decreased significantly in upright group than recumbent group. Apgar score of the newborns decreased significantly in recumbent group than upright group. 10% of upright group delivered normal labour with episiotomy while 30% in recumbent group. 6.6% of upright group used forceps delivery while 20% in recumbent group. 20% of upright group delivered cesarean section while 40% in recumbent group.
Conclusion. Upright positions had favorable impact on labor progression through decreasing length of labor course and labour pain and consequently better neonatal outcomes.

Key words:
Upright positions, Recumbent positions, Labour outcomes

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Profile of patients undergoing therapy in the field of therapeutic rehabilitation on the basis of the Act of May 9, 2018 on special solutions supporting persons with severe disability

Karol Wojciechowski, Krzysztof Mirecki, Marek Kiljański, Jan Szczegielniak

K. Wojciechowski, K. Mirecki, M. Kiljański, J. Szczegielniak – Profil pacjentów usprawnianych w zakresie rehabilitacji leczniczej na podstawie ustawy z dnia 9 maja 2018 r. o szczególnych rozwiązaniach wspierających osoby o znacznym stopniu niepełnosprawności. Fizjoterapia Polska 2019; 19(3); 168-172

Abstract
The aim of the study was an attempt to analyze rehabilitation services provided to patients with a severe disability certificate.
The study material consisted of data reported by service providers who have concluded contracts in the field of therapeutic rehabilitation with the Lodz Voivodship Branch of the National Health Fund, providing services within the combined ranges, dedicated to people with a severe degree of disability. Reporting data was prepared by service providers in the period from July 1, 2018 to December 31, 2018.
Data analysis indicated that patients’ condition was most often improved in the field of outpatient physiotherapy for people with a severe degree of disability (45.13% of the total number of respondents); 29.63% of patients constituted the group of patients covered by medical outpatient rehabilitation care and 19.12% of patients underwent physiotherapy at home.
The evaluation of the study material indicated that patients most often undergoing rehabilitation were patients in the 51-84 age group (62.23% of all respondents).
The smallest group consisted of patients from the age group up to 16 years of age and the 85-101 age group (3.26% and 6.04% of all respondents, respectively).
The evaluation indicated that the most common main diagnosis reported by service providers was cerebral palsy (8.65% of all respondents) and hemiplegia (7.71% of all respondents).
The study showed that the most frequently reported billing product was individual work with patients, accounting for 17.06% of all procedures performed.

Key words:
therapeutic rehabilitation, significant degree of disability

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Clinico-hemodynamic and psycho-cognitive parallels of internal picture of health correction in the process of restorative treatment and rehabilitation of patients with ST-segment elevation myocardial infarction

Roxolana Nesterak, Igor Vakalіuk, Jacek Łuniewski, Jan Szczegielniak

R. Nesterak, I. Vakalіuk, J. Łuniewski, J. Szczegielniak – Clinico-hemodynamic and psycho-cognitive parallels of internal picture of health correction in the process of restorative treatment and rehabilitation of patients with ST-segment elevation myocardial infarction. Fizjoterapia Polska 2019; 19(3); 158-166

Abstract
Aim. The aim of this research was to determine the clinical-hemodynamic and psychologic-cognitive parallels of correction of internal picture of health in the process of restorative treatment and rehabilitation of patients with ST-segment elevation myocardial infarction.
Materials and methods. The study included 141 patients with STEMI. They were divided into the following groups: 63 patients with the use of conservative treatment, and 78 patients with invasive treatment tactics – percutaneous coronary intervention (PCI). Depending on the applied methods of restorative treatment and rehabilitation, each group of patients was divided into subgroups. Patients of the first subgroup were given traditional treatment; in the second subgroup of patients, in addition to traditional treatment, the training with optimization of the IPH in the form of the “Program of clinical-psychological rehabilitation of cardiological patients by optimisation of the internal picture of health” was used.
Results. The use of the “Program of clinical-psychological rehabilitation of cardiologic patients by optimization of the internal picture of health” increases the clinical efficacy of post-infarction period management, increases tolerance to physical activity measured in 6MWT, reduces manifestations of myocardial ischemia, and in general, increases the quality of life in patients with ST-segment elevation myocardial infarction.
Conclusions. “Program of clinical-psychological rehabilitation of cardiologic patients by optimization of the internal picture of health” can be effectively used in clinical practice.

Key words:
myocardial infraction, rehabilitation, psychology

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Evaluation of the effectiveness of manual techniques and dynamic taping in the reduction of postoperative complications after surgical treatment of orthognathic defects

Szymon Tyszkiewicz, Marcin Kozakiewicz, Marta Tyndorf, Dorota Kościelniak

S. Tyszkiewicz, M. Kozakiewicz, M. Tyndorf, D. Kościelniak – Evaluation of the effectiveness of manual techniques and dynamic taping in the reduction of postoperative complications after surgical treatment of orthognathic defects. Fizjoterapia Polska 2019; 19(3); 146-157

Abstract
Aim of the study. Evaluation of the effectiveness of manual techniques and dynamic taping in the reduction of postoperative complications after surgical treatment of orthognathic defects.
Material and methods.50 people were qualified for the tests. These people were between the ages of 16 and 39. They were rehabilitated as a result of the surgical treatment of orthognathic defects. These patients were hospitalized due to postoperative complications such as tissue contractures, adhesions and scars, disturbances in joint mobility of the temporomandibular region and the cervical spine, lymphatic edema and nerve conduction disorders in the facial area. In a few people, additional blood bruising was found.
Dynamic taping was performed for two weeks postoperatively, treatments with massage and manual therapy twice a week (45-60 min. – time of a particular visit) for a period of 3 months, starting from the first week after surgery. The results of the therapy were supported by patients performing the recommended exercises. The rate and amount of edema reduction were assessed. Changes in the movement of temporomandibular joints and complex movement of the cervical spine were measured. The rate and extent of reinnervation and the level of pain were controlled. The Pietruski’s, House and Brackmann’s scales, VAS and linear measurements were used for the assessment.
Results.The average range of mobility in the field of temporomandibular joints and the cervical spine was improved in all examined spatial axes. The edema was significantly reduced, remaining after 3 months of therapy only at the averaged value of 8% of the baseline value.Sensory as well as motor fibers in the reinnervation process regained their functions. Their average state described by Pietruski’s scale results is about 26 points, which in the descriptive assessment corresponds to a small paresis.Post-operative haematomas were absorbed within two weeks of the operation.Pain in patients decreased from 7 points at the beginning of therapy, to 3 points after three weeks (average values). The total reduction occurred on average after 5 weeks.
Conclusions. The therapeutic process carried out had a significant influence on the results achieved. These data are comparable with the results presented in the scientific literature, describing similar issues. The results achieved are statistically significant (p <0.05), referring them to the results of people in the comparative group. As a result of the implemented comprehensive therapy, biomechanics and mobility in temporomandibular joints and spine joints were restored to physiological conditions. The performance of the lymphatic system has increased. The pain sensations have been reduced. There were no significant disturbances in the area of facial expressions and the work of sensory branches on the face. Fascial adhesions and scars have been released, to a condition that does not hinder the return to normal daily activity.

Key words:
orthognathic defects, dental physiotherapy, manual therapy, dynamic taping

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Treadmill weight-bearing exercise versus electromagnetic field on bone mineral density in women with osteoporosis secondary to aromatase inhibitors: A randomized controlled trail

Haidy Nadi Ashem, Amira Hussein Draz, Amr Almaz Abdel-aziem, Marwa Esmael Hasanin, Mohamed Abdelrahman

Haidy Nadi Ashem, Amira Hussein Draz, Amr Almaz Abdel-aziem, Marwa Esmael Hasanin, Mohamed Abdelrahman – Treadmill weight-bearing exercise versus electromagnetic field on bone mineral density in women with osteoporosis secondary to aromatase inhibitors: A randomized controlled trail. Fizjoterapia Polska 2019; 19(3); 138-143

Abstract
Background and objective. Aromatase inhibitor therapy for postmenopausal women with breast cancer is associated with a decrease in bone mineral density (BMD). Both Pulsed electromagnetic fields (PEMFs) and treadmill walking exercises have a positive effect on bone osteoporosis. So, this study aimed to evaluate the effect of PEMFs and treadmill weight bearing exercises on the BMD of the lumbar spine in women with osteoporosis secondary to adjuvant hormonal treatment with aromatase inhibitor.
Methods. A total of 45 female breast cancer patients with osteoporosis secondary to adjuvant aromatase inhibitor were randomly assigned into three equal groups. The control group received only pharmacological treatment (Bisphosphonates, Calcium and Vitamin D). In the other 2 groups, the same drug therapy was consolidated by a program of treadmill weight bearing exercises (treadmill exercise group; 30 min/session, 3 sessions/week), and PEMFs (PEMFs group; 30 min/session, 3 sessions/week). The BMD of the spinal vertebrae was assessed before and after 3 months of intervention by using the Dual energy X-rays (DEXA).
Results, The post value of the PEMFs group was significantly higher than those of the treadmill exercise group and the control group (p = 0.002, 0.001 respectively), and the post value of the treadmill exercise group was significantly higher than that of the control group (p= 0.001), The post values of the three groups were higher than pre values (p = 0.001).
Conclusion. Both treadmill weight bearing exercises and PEMFs were effective in improving the BMD. Moreover, the BMD response to PEMFs was better than treadmill weight bearing exercise.

Key words:
Bone mineral density, weight bearing exercise, pulsed electromagnetic field, breast cancer, aromatase inhibitors

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Biofeedback Electromyography Training Versus Botulinum Toxin A on Synkinesis and Facial Asymmetry in Bell’s Palsy

Sarah G. Mohamed, Gehan M. Ahamed, Walaa M. Abd El Aziz, Amr M. Al-Said, Abeer Elwishy

Sarah G. Mohamed, Gehan M. Ahamed, Walaa M. Abd El Aziz, Amr M. Al-Said, Abeer Elwishy – Biofeedback Electromyography Training Versus Botulinum Toxin A on Synkinesis and Facial Asymmetry in Bell’s Palsy. Fizjoterapia Polska 2019; 19(3); 118-125

Abstract
Objective. To compare the effect of biofeedback electromyography training versus botulinum toxin A versus selected program of exercise on Synkinesis and facial asymmetry in Bell’s palsy. Methods. 45 patients with moderate facial synkinesis were divided randomly into three groups. All participants were evaluated using Sunnybrook facial grading system (FGS) and House Brackmann scale. The first group consisted of fifteen patients were received EMG biofeedback training for facial muscles. Second group consisted of fifteen patients were received a single dose of BTX-A injection for the management of synkinesis. And third group consisted of fifteen patients were received selected program of exercise for facial synkinesis.
Results. There was a significant increase of FGS measurement was in all the three groups between pre and post measurements but first group showed the more evidence of improvement. There was significant decrease HBS measurement of was in all the three groups between pre and post measurements while there was no significant difference between the three groups according to HBS measurement.
Conclusion. EMG biofeedback training therapy is as effective as the botulinum toxin A injection in reducing synkinesis and recovery of facial symmetry in Bell’s palsy. Our results may support interrelation between biofeedback training and improvement of voluntary movement of facial muscle and synkinasis. And also may support interrelation between BTX-A injection and facial symmetry.

Key words:
Bell’s palsy, EMG Biofeedback, Botulinum toxin, Synkinesis

 

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Rehabilitation models for patients with COPD

Jan Szczegielniak, Jacek Łuniewski, Marcin Krajczy, Katarzyna Bogacz

J.Szczegielniak, J. Łuniewski, M. Krajczy, K. Bogacz – Rehabilitation models for patients with COPD. Fizjoterapia Polska 2019; 19(3); 126-137

Abstract
Rehabilitation program includes models A, B, C, D and E. Key criteria in qualifying patients for adequate rehabilitation models include assessment of exercise tolerance, degree of lung ventilation dysfunction (FEV1 index), dyspnea level and physical function level.
The other criteria considered in the qualification include age, dyspnea and physical function. Patients with contraindications for exercise test and patients with cardiopulmonary insufficiency are qualified for model E. Individual models include cycle ergometer training (up to training heart rate), breathing and general exercises, resistance training or station training, walking, inhalations, postural drainage and effective coughing exercises, as well as chest percussion, physical therapy and massage.

Key words:
rehabilitation program, COPD, rehabilitation models

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