Postural problems of children with CP based on hemiparesis

Małgorzata Domagalska, Krzysztof Czupryna, Andrzej Szopa, Janusz Nowotny

Małgorzata Domagalska, Krzysztof Czupryna, Andrzej Szopa, Janusz Nowotny – Postural problems of children with CP based on hemiparesis. Fizjoterapia Polska 2008; 8(3); 253-259

Abstract
Background. Injury to the immature brain leads to impaired development of the antigravity mechanism. The adoption of progressively higher body positions is only possible due to compensatory mechanisms. The aim of the study was to diagnose postural disorders in children with CP with respect to the adopted compensatory mechanisms. Material and methods. Eighteen children with advanced hemiparesis, aged from 5 to 14, took part in the study. Objective posturometric measurements were taken while the patients maintained a standing position without assistance. Photogrammetric measurements was used to evaluate the spatial arrangement of individual body segments, with pressure forces on the support base being assessed simultaneously using a baroresistive platform. Results. Patients demonstrated two types of postural patterns: a progravity pattern and an antigravity pattern, which differed mainly in terms of the patient habitually overloading or unloading one of the lower limbs, changing the position of the centre of gravity projection on the support base and a characteristic relation of the shoulder and pelvic lines. Conclusions. The nature of postural disorders in CP children depends on the anti- or progravitational nature of the paresis. The development of postural disorders in CP children is predictable and should therefore be taken into account from the very beginning of rehabilitation
Key words:
cerebral palsy, compensatory antigravity mechanism, postural problems
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The effect of derotation exercises on correction of spinal alignment

Anna Brzęk, Olga Nowotny-Czupryna, Janusz Nowotny

Anna Brzęk, Olga Nowotny-Czupryna, Janusz Nowotny – The effect of derotation exercises on correction of spinal alignment. Fizjoterapia Polska 2008; 8(4); 384-392

Abstract
Background. Scoliosis is a three-plane defect. The correction of scoliosis should therefore be a global process involving all three planes, which, however, is not always the case with postural reeducation. More emphasis, especially in corrective exercises in schools, is placed on the correction of lateral curvatures in the frontal plane, elongation exercises, and exercises to strengthen the postural muscles, while the rotary component is usually ignored. The aim of this paper was to analyse derotation exercises and answer the question whether and how the correction of spinal alignment during derotation exercises results in immediate changes in body posture. Material and methods. 73 persons in two age groups (schoolchildren and adults) were examined. All participants had been diagnosed with scoliosis of the thoracic spine. Posture was assessed photogrammetrically in various free positions, following active spinal correction and during a derotation exercise using the bancho device.Results. There were considerable differences regarding active spinal correction between the children and adults. There was also a statistically significant correlation between age and the ability to actively correct spinal alignment during a derotation exercise. Conclusions. 1. The possibilities of active scoliosis correction are increased if the rotational component is also involved. 2. Derotation exercises are a significant element of corrective gymnastics, particularly in school-age patients.
Key words:
scoliosis, arrangement of body, derotation exercises
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Body posture changes during first six years of school education

Janusz Nowotny, Krzysztof Czupryna, Aleksandra Rudzińska, Olga Nowotny-Czupryna

Janusz Nowotny, Krzysztof Czupryna, Aleksandra Rudzińska, Olga Nowotny-Czupryna – Body posture changes during first six years of school education. Fizjoterapia Polska 2008; 8(4); 378-383

Abstract
Background. Screening examinations undertaken in periods of intensive body growth (growth spurts) and including an assessment of body posture are a basic form of prevention. These examinations help to pick out children at risk of developing faulty postures or with established postural defects so that they can benefit from corrective measures, if necessary. The aim of the work was to examine body postures of adolescents during their second growth spurt and to compare the results with postural data obtained at the age of seven.Material and methods. The study initially involved 116 subjects, of whom 63 were qualified for further assessment. Their posture was examined twice, at the ages of 7 and 13, using a modified scoring system. The results were compared.Results. The results confirmed the presence of postural variability. The posture of a third of the participants did not change. Of the others, improved postures were seen in half of them and postural deterioration in the other half. The second examination did not reveal any severe posture faults, but there were fewer children with normal postures. In the period between the examinations most of the children with faulty postures had attended corrective gymnastics classes once a week at their schools.Conclusions. 1. The results confirmed variability of body posture, leading both to spontaneous improvement and postural deterioration. 2. There are some possibilities for spontaneous improvement but only in children with minor posture faults.
Key words:
body posture, screening examinations, variability of body posture
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Functional testing in physiotherapy

Janusz Nowotny, Olga Nowotny-Czupryna, Krzysztof Czupryna

Janusz Nowotny, Olga Nowotny-Czupryna, Krzysztof Czupryna – Functional testing in physiotherapy. Fizjoterapia Polska 2009; 9(3); 245-257

Abstract
Apart from clinical signs and symptoms, a trauma or disease will often give rise to a dysfunction that impairs the performance of activities of daily living. An optimal rehabilitation program should be based on a thorough understanding of the patienfs basie problems, including functional difficulties. This is madę possible not only by routine clinical examinations, but also by special tests and recently introduced functional evaluations using professional apparatus. The results of these examinations also enable evaluation of treatment progress. The aim of the paper was to review the issue of functional testing with respect to basie problems of disability and the planning and monitoring of rehabilitation. The consecutive parts of the paper discuss functional testing on the basis of examples of common postural and locomotor problems (impairments and limitations). Emphasis is placed on the need of objective examinations and possibilities for quantifying test results. Attention is also drawn to the ability to place various manifestations of disease within cause-and-effect chains and the necessity of appropriate interpretation of test results.
Key words:
handicaps, disabilities, functional evaluation, treatment planning
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Base of support in babies with central origin movement disorders

Krzysztof Czupryna, Grzegorz Serkies, Janusz Nowotny

Krzysztof Czupryna, Grzegorz Serkies, Janusz Nowotny – Base of support in babies with central origin movement disorders. Fizjoterapia Polska 2011; 11(2); 107-114

Abstract
The development of infantile cerebral palsy (IPC) precedes movement disorders of central origin (MDCO). In early rehabilitation of the children at risk of IPC, not only early diagnosis, but also the assessment of posture and movement patterns in these children is essential. The purpose of this study was to assess the load distribution in the base of support in infants with MDCO while assuming the supine and prone position, in the context of suspension response evaluation in these infants.The sample included 14 infants with MDCO and 8 healthy infants. The size and arrangement of the base of support was studied on the special platform, in the infants assuming the prone and supine positions. The values of the size of the base of support as the percentage of the front or back body surface as well as load distribution in the right, left, upper and lower body were calculated.In younger infants, the arrangement of the support base of in recumbent position was found to be asymmetric. The asymmetry was more pronounced in the supine position and definitely larger in MDCO infants. Also a bigger load applied on the lower body was observed, especially in the prone position.Bigger asymmetry in both positions was noted in MDCO infants as compared to healthy infants; in the supine position, the tendency to apply bigger load on the lower body was observed.
Key words:
movement disorders of central origin, base of support, Vojta
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The efficiency of mechanism regulating body posture among children and teenagers with low degree scoliosis

Wojciech Cieśla, Tomasz Cieśla, Janusz Nowotny

Wojciech Cieśla, Tomasz Cieśla, Janusz Nowotny – The efficiency of mechanism regulating body posture among children and teenagers with low degree scoliosis. Fizjoterapia Polska 2011; 11(4); 317-326

Abstract
Background. Maintenance of correct body posture requires, among other factors, efficient functioning of the mecha­nism regulating equilibrium of the body, whereas incorrect structure of the body, e.g. in patients with scoliosis, changes conditions of balancing the body thus affecting the function of postural control mechanisms. This study was undertaken to find out when and in what way the regulation of posture begins to be less effective and whether a low degree scoliosis is a cause of negative changes in this area.Material and methods. 138 children, aged from 7 to 15 years were selected for the study. The main group consisted of 88 subjects – children with low degree scoliosis. 50 children without any postural problems constituted the control group. Photogram­metry and stabilometric measurements were carried out simultaneously with the subjects’ eyes open and closed in order to evaluate posture parameters and the projection and pathway of the center of gravity (COG) of the human body.Results. Such factors as scoliosis and gender do not affect COG projection on the X axis. Evaluation of the differences in COG behavior revealed that the subjects’ age and visual control were significant factors.Conclusions. In children and teenagers with scoliosis, the behavior and the position of the COG projection does not change significantly compared to children and teenagers without scoliosis. Effectiveness of the mechanisms regulating body posture improve with age and in children and teenagers with low degree scoliosis these processes are not significantly disturbed.
Key words:
body posture, low degree scoliosis, Photogrammetry, stabilography, equilibrium reactions
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