Continous passive motion as a method of kinesitherapy in the treatment of brachialgia

Bogusław Frańczuk, Wojciech Szwarczyk, Magdalena Wilk, Maciej Kasparek, Janusz Otfinowski

Bogusław Frańczuk, Wojciech Szwarczyk, Magdalena Wilk, Maciej Kasparek, Janusz Otfinowski – Continous passive motion as a method of kinesitherapy in the treatment of brachialgia. Fizjoterapia Polska 2001; 1(2); 123-126

Abstract
Background. The purpose of this article is to describe the treatment outcomes for patients with bracchialgia who received, in addition to standard rehabilitation, treatment by continuous passive movement (CPM) as well. Material and methods. The research involved 55 patients under treatment in the Clinic of Traumatology at the Jagiellonian University’s Collegium Medicum, in accordance with the standard approach to rehabilitation. In 25 these cases (group II), CPM treatment was applied additionally. In order to evaluate rehabilitation outcome, the Visual Analogue Scale (VAS) was applied to assess pain symptoms, the range of active movements was tested in the humeral joint (especially painful abduction), and a two-degree self evaluation scale was applied to measure satisfaction with the state of health: satisfactory (the limb can be used with relative facility) or unsatisfactory (major limitations in the functions of the upper limb). The patients were tested twice: once before treatment and again after its completion. Conclusion. The results obtained justify the conclusion that patients with post-traumatic brachialgia, when subjected to rehabilitation obtain a reduction in pain symptoms, an increase in joint mobility, and improvement in the subjective evaluation of the state of health. Greater improvement is obtained by patients when continous passive motion (CPM) is added to the program. CPM can be recommended as a method for kinesitherapy in the rehabilitation of bracchialgia.

Key words:
continous passive motion, bracchialgia

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The thermogram of cervical spinal pain syndrome as an attempt to objectivize pain

Bożena Jasiak-Tyrkalska, Bogusław Frańczuk, Janusz Otfinowski

Bożena Jasiak-Tyrkalska, Bogusław Frańczuk, Janusz Otfinowski – The thermogram of cervical spinal pain syndrome as an attempt to objectivize pain. Fizjoterapia Polska 2003; 3(3); 250-255

Abstract

Background. This paper describes the features of thermovisual images in cervical spinal pain syndrome and their variability over the course of rehabilitation, and makes an effort to specify the interdependence of these characteristics and pain relief. Material and methods. Thermovisual tests were performed on 71 patients in rehabilitation for cervical spine pain syndrome.Results. The thermovisual image of the cervical spinal region in patients with pain syndrome is different from that of healthy persons. It is characterized by considerable asymmetry of temperature and increased hyperthermia in the neck and shoulders. Over the course of rehabilitation a distinct evolution could be seen in the direction of temperature symmetry in this region. Conclusion. There is a significant correlation between pain relief and the features of the thermovisual image.

Key words:
thermovision, pain, rehabilitation
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Constraint-induced movement therapy in the rehabilitation of stroke patients

Janusz Otfinowski, Bożena Jasiak-Tyrkalska, Agnieszka Bogunia, Beata Buda

Janusz Otfinowski, Bożena Jasiak-Tyrkalska, Agnieszka Bogunia, Beata Buda – Constraint-induced movement therapy in the rehabilitation of stroke patients. Fizjoterapia Polska 2004; 4(1); 19-24

Abstract

Background. This article presents some preliminary results from the rehabilitation of patients with impaired hand function after stroke. The basis for therapy was the method introduced by Taub, known as Constraint-Induced Movement Therapy (CIMT), which involves the temporary constraint of the healthy upper limb, with simultaneous intensive motor rehabilitation of the dysfunctional limb. Material and methods. Our research involved 10 patients treated in the Rehabilitation Clinic at the Jagiellonian University College of Medicine for post-stroke hemiparesis. There were 5 men and 5 women in this group, ranging in age from 57 to 77 years (ave. 66.5). The time since onset ranged from 1 to 50 months (ave. 11.4 months). CIMT was used in all patients. Results. After 2 weeks of rehabilitation all the patients required less time to perform manual tests, and showed marked functional improvement in the affected hand. Conclusions. The CIMT method is effective in the rehabilitation of patients with post-stroke hemiparesis.

Key words:
Stroke, rehabilitation of the hand, CIMT
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Selected demographic and clinical factors and the efficacy of the Constraint-Induced Movement Therapy (CIMT) of the hand after stroke

Bożena Jasiak-Tyrkalska, Janusz Otfinowski, Beata Buda

Bożena Jasiak-Tyrkalska, Janusz Otfinowski, Beata Buda – Selected demographic and clinical factors and the efficacy of the Constraint-Induced Movement Therapy (CIMT) of the hand after stroke. Fizjoterapia Polska 2007; 7(1); 21-28

Abstract

Background. The authors attempted to evaluate the effect of selected demographic and clinical factors on the efficacy of Constraint-Induced Movement Therapy (CIMT) in improving the mobility of a paretic hand following cerebral stroke. The analysis focussed on factors such as age, gender, side of paresis and time elapsed since stroke. It is commonly known that post-stroke rehabilitation is relatively difficult and poses a challenge not only to the therapeutic team, but also to the patient’s family. Despite activities geared towards improved mobility, satisfactory effects cannot always be achieved. Until recently, physiotherapy was mainly geared towards the compensation of deficits rather than functional restoration. Nowadays, specialised neurological rehabilitation centres introduce novel methods based on the concept of brain adaptability, aimed primarily at functional restoration. The CIMT method is being used more and more frequently. It can be succinctly defined as a strategy for the activation of paretic parts of the body through constraining or totally preventing the use of their healthy counterparts. Material and methods. The study group comprised 21 persons (11 women and 10 men) following cerebral stroke. Mean patient age was 65 years. The efficacy end-point for the rehabilitation approach was time required to carry out 10 basic everyday activities using the affected hand. This assessment was carried out four times: at baseline, after two weeks of intensive exercise in a hospital rehabilitation ward as well as at 4 and 12 weeks of independent practice at home. Results. The therapeutic programme lead to a highly significant (p<0.001) improvement of the performance of the motor function impaired hand. Subgroup analysis did not demonstrate any significant influence of individual factors on the efficacy of the method used to improve hand motor function after cerebral stroke. Conclusions. Regardless of the age and gender of cerebral stroke patients, the CIMT method demonstrated significant efficacy in improving hand motor function. Time elapsed since stroke has no impact on the improvement of the paretic hand using the C1MT method. Regardless of the affected side, the method activates the motor functions of the paretic hand.

Key words:
stroke, improvement of hand mobility, CIMT
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