Physiotherapy in patients with congenital haemorrhagic diathesis in the material of the systemic rehabilitation department

Joanna Bukowska, Agata Pawełczyk, Ireneusz Kotela, Małgorzata Szarota, Paweł Kaminiński, Magdalena Wilk-Frańczuk, Rafał Trąbka

Joanna Bukowska, Agata Pawełczyk, Ireneusz Kotela, Małgorzata Szarota, Paweł Kaminiński, Magdalena Wilk-Frańczuk, Rafał Trąbka – Physiotherapy in patients with congenital haemorrhagic diathesis in the material of the systemic rehabilitation department. Fizjoterapia Polska 2021; 21(2); 6-15

Abstract
Aim. The objective of this study is to present the process and results of physiotherapy in patients suffering from congenital haemorrhagic diathesis, treated at the Inpatient Rehabilitation Department of the Krakow Rehabilitation Centre and Orthopaedics (MSOR). Material. The analysis involved 73 patients treated at the Inpatient Rehabilitation Department between 2014 and 2019. The reason for admission was haemophilic arthropathy in the course of congenital haemorrhagic diathesis. Results. The results prove that early postoperative knee rehabilitation is effective in patients with congenital haemorrhagic diathesis after surgery. Deaver’s functional scale: before rehabilitation, the mean result was 3.65, after rehabilitation it was 2.62. Muscle strength: the assessment of muscle strength according to the Lovett scale showed improvement in 64 patients (87,67%). Range of motion: in the extension test, the condition of 57 patients (78%) improved, the mean result was better by 7.52 degrees. Conclusions. 1. The use of early physiotherapy in patients with haemophilia after knee endoprosthetics results in an improvement in gait function analysed according to Deaver’s scale. 2. Early rehabilitation of patients with haemophilia after endoprosthetics results in an increase in the range of motion of the knee joint and in muscle strength. 3. It was also found that pain in the joint undergoing surgery was reduced thanks to the applied physiotherapy.
Key words:
physiotherapy, haemophilia, endoprosthetics, arthropathy
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A Comparative analysis of early results of surgical treatment of Achilles tendon injuries with the minimally invasive and classic methods – physiotherapy options. A Randomized Controlled Trial

Michał Konik, Ireneusz Kotela, Jacek Lorkowski, Tomasz Chruściak, Emilia Sołtan, Monika Chruściak, Sebastian Zduński

M. Konik, I. Kotela, J. Lorkowski, T. Chruściak, E. Sołtan, M. Chruściak, S. Zduński – A Comparative analysis of early results of surgical treatment of Achilles tendon injuries with the minimally invasive and classic methods – physiotherapy options. A Randomized Controlled Trial. Fizjoterapia Polska 2020; 20(5); 182-191

Abstract
Background. The Achilles tendon is the strongest tendon in the human body. Despite the high incidence of injuries and a well-known problem of treating heel tendon injuries, there has been no consensus on the proper treatment, (both surgical and rehabilitation) in professional literature so far. Choosing an operating method that gives “better” treatment results can facilitate the choice of a more effective treatment. It should also be remembered that a properly conducted rehabilitation process is an extremely important element following the surgery.
Aim of the study. The study aimed to evaluate the effectiveness of the surgical treatment of patients with Achilles tendon injuries using the minimally invasive and classic methods.
Material and Methods. The study material included 62 patients treated surgically for Achilles tendon injury in the Department of Orthopedics and Traumatology of CSK MSW in Warsaw in the years 2011-2016. 31 patients were operated using the minimally invasive method (the study group) and 31 patients using the conventional method (the control group). The research group consisted of 27 men and 4 women. The comparative group consisted of 27 males and 4 females. The following research tools were used to evaluate the treatment results: 1. Author’s questionnaire 2. AOFAS score (American Orthopedic Foot and Ankle Society Score) 3. Measuring instrument for maximum force moments in ankle joint JBA “Staniek” 4. HUR stabilographic platform 5. Ultrasonography.
Results. 4 patients, (12.9%) in the control group re-ruptured the tendon after operative treatment. In the study group, 2 patients (6.5%) experienced a complete heel tendon rupture in the postoperative period. The problem of postoperative wound healing disorders was observed among 2 patients (6.5%) from the study group. In the group treated with the classical technique, 5 (16.1%) patients experienced a delay in the healing of the surgical wound due to bacterial infection. Paresthesia, from the sural nerve was observed in only 1 patient in the MIS (Minimal Invasive Surgery) group. 27 patients (87.1%) returned to their sports activity after percutaneous surgery, and 22 patients (71%) after conventional treatment. On average, patients from both groups needed 6 months to return to sports activities.
Conclusions. 1. The number of renewed ruptures after minimally invasive treatment of a damaged Achilles tendon is low and comparable to that of a group of patients treated with the classic technique. 2. Postoperative wound healing disorders are rare in both groups. 3. Calf nerve injury was reported only in one case, while using a minimally invasive procedure. 4. Patients return to work and sports at the same time after surgery in both groups which is influenced by properly implemented physiotherapy 5. Patients presented a similar balance control on the stabilographic platform in both groups. 6. Similar values of maximum force moments in ankle joint were recorded in both groups. 7. In the ultrasound image, there were no morphological differences in Achilles tendon formation in either study group.
Key words:
Achilles tendon, surgical treatment, injury, rupture, physiotherapy
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Analysis goniometric of selected classes of traffic knee

Jędrzej Płocki, Joanna Banaś,  Dominik Pikuła,
Andrzej Kotela, Ireneusz Kotela

J. Płocki, J. Banaś,  D. Pikuła, A. Kotela, I. Kotela – Analysis goniometric of selected classes of traffic knee. FP 2014; 14(2); 52-59

Abstract

Normal range of motion of joint is an important factor of physical fitness. It’s measurement makes up the basis of evaluation of the skeletal joint system. Analysing the changes in ranges of motion in the function of the time with the use of electrogoniometer provides valuable and meaningful data. The aim of the study was an attempt to determine the dynamics of change and the range of motion of the knee healthy population during going up the step of the dominant limb.
Material and Methods.
75 students of the Department of Medical University of Rzeszow, aged 18-26 were examined. The research was carried out with the use of Noraxon 1400 L system as well as compatible biaxial electrogoniometer. The preliminary process was performed in MS Excel. The statistical analysis was carried out in the Statistica 10.0 program.
Results.
Established normative value for the maximum angle of knee bends during going up the step – 85,12˚ with confidence interval 80,27-88,25˚.
Conclusions.
There is a need for research on a larger, representative sample in order to determine the standards for the maximum angle of knee flexion during the entry level in the studied age group.

Key words:
Electrogoniometer, normative value, knee joint

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The use of pedobarographic examination in children – own experience and review of literature

Jacek Lorkowski, Oliwia Grzegorowska, Ireneusz Kotela

J. Lorkowski, O. Grzegorowska, I. Kotela – The use of pedobarographic examination in children – own experience and review of literature. FP 2014; 14(4); 46-51

Abstract

A non-invasive method, that can be used to describe the underfoot pressure distribution during stance and gait, is pedobarography. This examination helps to describe biomechanics of motor system, especially foot pathologies, among children and adults. It has been used to assess and monitor the progress and effectivness of undergone treatment. In this article we describe chosen issues of pedobarographic examination in diagnostics and treatment of the motor system in children, in whom an appropriate therapy can be more effective than in adults.
In our opinion, pedobarography should be used more often and widely than now. Together with clinical and radiological examination, it can simply complement standard diagnosctics.

Key words:
foot, diagnostics, pressure, gait, children

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