Tag: fizjoterapia

Subjective assessment of the effects of different approaches to rehabilitation of patients after cerebral stroke

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Michał Kuszewski, Andrzej Myśliwiec

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Michał Kuszewski, Andrzej Myśliwiec – Subjective assessment of the effects of different approaches to rehabilitation of patients after cerebral stroke. Fizjoterapia Polska 2009; 9(3); 223-231

Abstract
Background. Paying attention to the individual needs of the patient during treatment planning is becoming an important element of contemporary rehabilitation of post-stroke patients. The patient should not only be the recipient, but also a co-author of the programme of rehabilitation administered to him or her. The study hypothesis was that the type of rehabilitation treatment would influence the patient’s subjective evaluation of the effects of rehabilitation. Material and methods. The study involved a group of 64 stroke patients. All subjects were divided randomly into three groups (A, B and C). Subjective assessment of the efficacy of rehabilitation was based on a specially prepared questionnaire. Patients were followed up for about 21 days, during which period they were administered comprehensive rehabilitation. Group A received traditional post-stroke therapy. The rehabilitation programme for Group B included individual kinesiotherapy based on the PNF method. The programme for Group C comprised individual kinesiotherapy based on the PNF method supplemented with tensing neuromobilisations of peripheral nerves of the paretic upper extremity. Results. Overall, the highest average number of points (x = 11.5394), corresponding to the most marked subjective impro -vement, was recorded in Group C, while the least marked effect was noted in Group A (x = 8.1751). Conclusions. The subjective assessment of the effects of rehabilitation treatment correlated significantly with the type of rehabilitation administered.
Key words:
self-assessment, physiotherapy, stroke, therapeutic effects
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Proposal for a rehabilitation regimen for patients after posterior cruciate ligament reconstruction surgery. A model of biomechanical study ofthe rehabilitation process

Przemysław Lisiński, Agnieszka Gronek, Włodzimierz Samborski, Lechosław B. Dworak

Przemysław Lisiński, Agnieszka Gronek, Włodzimierz Samborski, Lechosław B. Dworak – Proposal for a rehabilitation regimen for patients after posterior cruciate ligament reconstruction surgery. A model of biomechanical study ofthe rehabilitation process. Fizjoterapia Polska 2010; 10(1); 1-11

Abstract
Background. Few rehabilitation problems raise so much controversy as the timing of rehabilitation and the choice of rehabilitation techniąues in patients following posterior cruciate ligament (PCL) reconstruction. PCL damage occurs in almost 37% of injuries to the knee joint. PCL plays a significant role in stabilising the knee joint. As the signs and symptoms of PCL damage are not so clear-cut as in injuries of other ligaments, a correct diagnosis and institution of treatment are often delayed. A key problem in rehabilitation of these patients is the need to protect the graft. Accordingly all rehabilitation procedures should be carefully supervised. Since there are few available publications concerned with the rehabilitation of patients following PCL surgery, the authors decided to present their own model of rehabilitation. The key elements of this scheme, such as the timing and choice of diagnostic and therapeutic procedures are compared to other methodologies presented in the literaturę.Fuli recovery reąuires a long period of rehabilitation that is dwided into several stages. Ultimately the fuli rangę ofmovement and appropriate muscle strength are restored, and the patient regains fuli motor control thanks to the restoration of proprioception. The authors propose a model of biomechanical investigations enabling objective evaluation ofthe rehabilitation process following PCL reconstruction surgery.
Key words:
posterior cruciate ligament, trauma, reconstruction, physiotherapy, biomechanical investigations
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Evaluation of physiotherapeutic management of patients with multi-level cervical discopathy after interbody implant surgery

Włodzisław Kuliński, Wojciech Haładyna, Arkadiusz Wilk, Jan Podgórski, Marzenna Bazan, Józef Mróz, Paweł Leśniewski

Włodzisław Kuliński, Wojciech Haładyna, Arkadiusz Wilk, Jan Podgórski, Marzenna Bazan, Józef Mróz, Paweł Leśniewski – Evaluation of physiotherapeutic management of patients with multi-level cervical discopathy after interbody implant surgery. Fizjoterapia Polska 2010; 10(2); 149-155

Abstract
Cervical discopathy is a serious medical and social problem. Displacement of the intervertebral disc into the vertebral canal compresses spinal nerve roots and/or the spinal cord. Cage fusion and the implantation of a mobile disc prosthesis have recently been introduced in surgery. The aim of the study was to assess the effectiveness of physiotherapeutic management of patients with multi-level cervical discopathy treated by microdiscectomy and cage fusion. A group of 23 patients was followed up over six weeks, including 20 patients after two-level surgery (Group A) and 3 after three-level surgery (Group B). The progress of rehabilitation was evaluated on the basis of :- muscle strength (Lovett test), – range of motion, – regression of pain (VAS scale) and paraesthesiae. In Group A, neck pain disappeared in 18 patients, and paraesthesiae in the upper limbs disappeared in 12 patients; 14 patients fully recovered muscle strength in the limbs, and 16 patients recovered the full range of motion in the shoulder joints. In group B, two patients reported regression of the neck pain, one fully recovered muscle strength, and two recovered the full range of motion in the shoulder joints. Conclusions1. The physiotherapy of patients with multi-level cervical discopathies following cage fusion surgery was an effective adjunctive treatment in this group of patients. 2. Early institution of appropriate procedures may result in full motor recovery
Key words:
cervical discopathy, implants, physiotherapy
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Analysis of physiotherapy students’ opinions on curricula in university-level schools of different educational orientations

Dariusz Białoszewski, Joanna Gotlib, Anna Cabak, Katarzyna Barczyk, Andrzej Bugajski, Wojciech Kułak, Piotr Majcher, Olga Nowotny-Czupryna, Maciej Płaszewski, Janusz Sierdziński

Dariusz Białoszewski, Joanna Gotlib, Anna Cabak, Katarzyna Barczyk, Andrzej Bugajski, Wojciech Kułak, Piotr Majcher, Olga Nowotny-Czupryna, Maciej Płaszewski, Janusz Sierdziński – Analysis of physiotherapy students’ opinions on curricula in university-level schools of different educational orientations. Fizjoterapia Polska 2010; 10(2); 136-148

Abstract
Introduction and Objective. Physiotherapy as a university degree programme was first offered in Poland in 1997, with courses including 3-year Bachelor-level and 2-year Master-level programmes. The education of physiotherapists in Poland currently takes place at three types of university-level schools: medical universities (MS), universities of physical education (PE) and university-level schools of orientations not connected with medicine or physical education (OU).This study aims to analyse and compare opinions of MS, PE and OU students on the curricula offered by the three types of university-level schools. Material and methods. The study involved a total of 593 students in their third year of Bachelor programme studies from 10 university-level schools of different educational orientations. Participation in the study was voluntary and anonymous involved completing a questionnaire distributed in March and April 2009. The questionnaire, designed by the authors, consisted of 4 parts and contained a total of 88 questions. The statistical analysis of the survey data (STATISTICA 9.0) was conducted using the Kruskall-Wallis test. Results. The majority of MS students believed the amount of practical classes was appropriate, while PE and OU participants assessed it as insufficient (p=NS). The MS students were satisfied with the amount of time of working directly with patients during clinical classes, while their PE and OU counterparts found the time insufficient. The largest number of MS, PE and OU participants declared that training in special techniques in physiotherapy was insufficient (p=NS). Conclusions. 1. It would be advisable to combine the clinical experience of medical universities with the facilities and teaching staff of specialists in physiotherapy-related courses available in universities of physical education in order to improve the quality of physiotherapy education in Poland.2. In view of the current level of research in physiotherapy, it seems important to provide students with high quality training in state-of-the-art physiotherapy techniques.
Key words:
physiotherapy, students, Bachelor-degree programmes, medical universities, universities of physical education
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Evaluation of the effectiveness of Butler’s neuromobilisations in reducing disorders of stereognosis of impaired upper extremity in late-stage stroke patients

Tomasz Wolny, Edward Saulicz, Rafał Gnat

Tomasz Wolny, Edward Saulicz, Rafał Gnat – Evaluation of the effectiveness of Butler’s neuromobilisations in reducing disorders of stereognosis of impaired upper extremity in late-stage stroke patients. Fizjoterapia Polska 2010; 10(2); 95-102

Abstract
Background: A review of contemporary literature indicates that the rehabilitation of stroke patients is chiefly based on reeducation and compensation techniques addressing motor deficits, even though pure motor hemiparesis occurs very rarely. We assumed that tensional neuromobilisations of the impaired upper extremity in late-stage post-stroke patients influence disorders of stereognosis (tactile perception of natural objects)Material and method: The study involved a group of 64 stroke patients. The subjects were divided randomly into two subgroups (A and B). To assess tactile perception, all patients had to identify 10 commonly used objects by touch. During the 21-day follow-up, all patients were subjected to comprehensive rehabilitation. The therapeutic programme for Group A included selected physical modalities and individual kinesiotherapy based on the PNF method. The treatment in Group B additionally included tensional neuromobilisations of peripheral nerves of the impaired upper extremity. Results: Analysis of variance showed significant variation only for the test measurement factor (p <0.01), which was due to significant intra-group differences in Group B (p<0.05; Tukey test).Conclusions: The greatest improvement in the assessment of the tactile perception of everyday objects was obtained in the group which received PNF therapy supplemented with neuromobilisations of peripheral nerves of the impaired upper extremity.
Key words:
stereognosis, physiotherapy, stroke, therapeutic effects
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Poststroke physiotherapy of the patient with pusher syndrome – case study

Jakub Stolarski, Jan Kochanowski, Joanna Trochimiuk, Sebastian Wójtowicz

Jakub Stolarski, Jan Kochanowski, Joanna Trochimiuk, Sebastian Wójtowicz – Poststroke physiotherapy of the patient with pusher syndrome – case study. Fizjoterapia Polska 2010; 10(4); 317-323

Abstract
Postural disturbances in stroke patients may present as pusher syndrome. The aim of the study was to describe the treatment process and outcomes of physiotherapy of a post-ischaemic stroke patient with co-existing pusher syndrome. We describe a 78-year-old patient (S.L.) with left hemiplegia and pusher syndrome. Magnetic Resonance Imaging (MRI) revealed an ischaemic focus with a small haemorrhage in the posterior thalamus and posterior limb of the internal capsule. The patient underwent physiotherapy based on Proprioceptive Neuromuscular Facilitation (PNF). The pusher syndrome, which was diagnosed in the late stage of hospitalisation, was measured with the Scale for Contraversive Pushing (SCP), in which the patient scored 3.75 pts. Intensive rehabilitation started in the early post-stroke phase helped the patient achieve independence in changing position and sitting without assistance or support. The pushing behaviour did not improve in spite of appropriate therapy and verbal instructions. After 33 days of hospitalisation and physiotherapy at a Neurology Department, the patient was transferred to a Neurorehabilitation Unit for further rehabilitation. The pusher syndrome slowed down the recovery and reduced possibilities for applying rehabilitation in high positions (sitting and standing) in the early stage of post-stroke physiotherapy.
Key words:
physiotherapy, Stroke, pusher syndrome, PNF
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Effectiveness of PNF method in improving symmetry of lower extremity loading in late-stage post-stroke patients

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Andrzej Myśliwiec, Michał Kuszewski

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Andrzej Myśliwiec, Michał Kuszewski – Effectiveness of PNF method in improving symmetry of lower extremity loading in late-stage post-stroke patients. Fizjoterapia Polska 2010; 10(4); 263-270

Abstract
Early comprehensive multidisciplinary rehabilitation is crucial for achieving satisfactory results in the conservative management of post-stroke patients. Gait re-education is a major goal in post-stroke rehabilitation regardless of how much time has elapsed since the stroke. The study hypothesis was that therapy based on PNF (Proprioceptive Neuromuscular Facilitation) would significantly improve loading symmetry of the lower limbs, thus enabling faster restoration of the support and locomotor function and improving gait efficiency in post-stroke patients. A total of 64 stroke patients were randomly divided into two groups. A Loading Symmetry Index (LSI) of the lower limbs was calculated basing on data recorded in the ‘two-scales’ test. Patients were followed up for a mean of 21 days (during which they stayed at a Neurological Rehabilitation Ward). Group A received conventional rehabilitation while Group B also received individual kinesiotherapy based on the PNF method. Analysis of variance showed significant differences in LSI values (interaction: group x measurement – p=0.0075). Post hoc Tukey test revealed significant intra-group differences in Group B (p=0.0002). There were no significant intra-group differences in Group A or significant differences between the groups. PNF-based rehabilitation of late-stage post-stroke patients significantly improved loading symmetry of the lower extre – mities.
Key words:
PNF, physiotherapy, symmetry, Locomotion
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Functional benchmarks of musculoskeletal fitness following knee joint anterior cruciate ligament reconstruction

Andrzej Czamara

Andrzej Czamara – Functional benchmarks of musculoskeletal fitness following knee joint anterior cruciate ligament reconstruction. Fizjoterapia Polska 2010; 10(4); 247-262

Abstract
The study presents five functional benchmarks (FBs) corresponding to various levels of knee function and physical fitness (from basic locomotion to sports-level performance) in patients undergoing physiotherapy (rehabilitation) after reconstruction of the anterior cruciate ligament (ACL). The FBs presented in the paper complement clinical evaluation of the outcomes of a comprehensive treatment plan for post-ACL reconstruction patients. We introduce our own classification of functional benchmarks (FBs) and propose examination methods which allow fairly objective assessment of the fitness level of the musculoskeletal system at a particular stage of rehabilitation. The following FBs are described: clinical (CFB), minimal (MFB), standard (SFB), optimal (OFB) and sports (SPFB). Two criteria are assumed separately for the sports benchmark, namely an amateur sports benchmark and a professional sports benchmark. The paper presents the author’s experience as well as a review of the literature basing on the experience of other authors.
Key words:
Functional Benchmarks (FBs), anterior cruciate ligament (ACL), physiotherapy, ACL injuries
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Motivations for studying physiotherapy and familiarity with employment situation – differences between female and male students of physiotherapy at university-level schools in Poland

Katarzyna Barczyk, Joanna Gotlib, Aleksandra Bauer, Dariusz Białoszewski, Piotr Majcher, Maciej Płaszewski, Anna Cabak, Olga Nowotny-Czupryna, Wojciech Kułak, Janusz Sierdziński

Katarzyna Barczyk, Joanna Gotlib, Aleksandra Bauer, Dariusz Białoszewski, Piotr Majcher, Maciej Płaszewski, Anna Cabak, Olga Nowotny-Czupryna, Wojciech Kułak, Janusz Sierdziński – Motivations for studying physiotherapy and familiarity with employment situation – differences between female and male students of physiotherapy at university-level schools in Poland. Fizjoterapia Polska 2010; 10(4); 307-316

Abstract
Background. The present paper analyses and compares the factors that motivate female and male students of physiotherapy to take up these studies and examines students awareness of the employment situation in their future profession.
Material and methods. The diagnostic poll method (anonymous and voluntary question naire). The study sample comprised 1st year Bachelor programme students from eleven university-level schools. The statistical analysis was based on question naires obtained from 954 students. The survey was carried out in 2006, at the beginning of the 1st semester of the Bachelor’s programme. Outcome measures The Mann–Whitney U test was used at a significance level of p<0.05. Results. Personal interest was the only factor that influenced the decision to study physiotherapy and differentiated between the male and female students. For a significantly higher percentage of the female students (p<0.001), studying physiotherapy had been a life-long ambition. The vast majority of the students stated that they were not familiar with all opportunities for finding employment as physiotherapists. The vast majority of the students believed that it is easy to find employment as a physiotherapist in other European Union countries, with female students stating so significantly more frequently (p<0.05) than their male counter parts
Conclusion. Men and women share similar expectations of their future job and motivations
Key words:
sex differences, physiotherapy, education, occupations, perception, students
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Evaluation of the process of physiotherapists training in Poland

Małgorzata Starczyńska, Wojciech Kiebzak, Zbigniew Śliwiński

Małgorzata Starczyńska, Wojciech Kiebzak, Zbigniew Śliwiński – Evaluation of the process of physiotherapists training in Poland. Fizjoterapia Polska 2011; 11(1); 75-87

Abstract
A sense of professional identity, the perception of the profession in society are important factors of professional development, provide the motivation to remain in this occupation. In the paper systemisation of the knowledge concerning the development of the profession of physiotherapist in Poland has been attempted. Analysis of the available archival texts and national literature allowed to identify the test group in the context of the formation of its professional identity. The following processes were tracked formation of the first training centres for the motor rehabilitation and creating an teaching standards, program of specialisation for physiotherapists. Introduction of the term „physiotherapy in place of the functioning of the term „motor rehabilitation has initiated changes within the domain of legislative activities. In accordance with the Bologna Declaration new levels of education were created, which resulted in the acquisition of certain skills and professional titles. The changes also affected the area associated with specialization. This level of training is being actively undertaken by physiotherapists. Currently 26 centers have been accredited in which the specialization program is carried out by about 400 physiotherapists.
Key words:
physiotherapy, learning standards, professional development, history
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