3D printed orthosis supporting rehabilitation of children with nervous system disorders

Agnieszka Ciukszo, Mateusz Curyło, Katarzyna Placek, Dariusz Lusina, Jan W. Raczkowski


Agnieszka Ciukszo, Mateusz Curyło, Katarzyna Placek, Dariusz Lusina, Jan W. Raczkowski – 3D printed orthosis supporting rehabilitation of children with nervous system disorders. Fizjoterapia Polska 2022; 22(3); 52-58

DOI: https://doi.org/10.56984/8ZG1427jJ

Abstract
The main task of orthoses in neurological diseases is stabilization, correction and improvement of gait function. Orthoses actively support the work of muscles by proper alignment of individual body segments in relation to each other to facilitate the performance of the planned function. During upright standing, the task of the orthosis is to keep the upper ankle in a fixed, intermediate position, usually at an angle of 90°. This increases the base of support provided by the feet flat on the ground. Stabilization in the joints gives a chance to maintain the correct length of the muscles, and thus protects against contractures. Individual orthoses are used during upright standing and to improve the gait function with dedicated footwear. The brace widens the contour of the foot, so the footwear for orthoses is usually wider than the standard one, but it cannot be longer than the brace. One of the leading guidelines in gait analysis used in children with gait disorders are the criteria adopted by the Rancho Los Amigos Hospital. Despite the complexity of the problems with gait that patients report to a physiotherapist, a simple strategy should be adopted when it comes to securing with the orthosis. The role of orthopedic equipment is to support muscle failure by obtaining a stable stance phase.

Key words:
3D printing, 3D orthoses, CP (cerebral palsy), spina bifida, SMA, gait analysis

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Life quality of patients with idiopathic scoliosis treated with Chenêau Brace

Tomasz Urbański, Mateusz Curyło, Karina Rożek, Dariusz Lusina, Katarzyna Placek, Jan W. Raczkowski


Tomasz Urbański, Mateusz Curyło, Karina Rożek, Dariusz Lusina, Katarzyna Placek, Jan W. Raczkowski – Life quality of patients with idiopathic scoliosis treated with Chenêau Brace. Fizjoterapia Polska 2022; 22(2); 136-143

DOI: https://doi.org/10.56984/8ZG0DE0LR

Abstract
Objective. The main objective of this study was to determine the effect of wearing a Chêneau brace on the quality of life of patients with idiopathic scoliosis.
Methodology. The study used a short questionnaire that consisted of 12 questions – 4 questions about demographics and 8 questions about quality of life. The investigated aspects of life included difficulty in performing daily activities, feelings of embarrassment, sleep discomfort, irritability, and patients’ perceived benefits of this treatment procedure. Questionnaires were filled during follow-up visits. The study was conducted on a group of 30 patients aged 9–16 years treated for at least 6 months. Among the respondents there were 22 females and 8 males.
Results. Despite the small study group, the results of the statistical analysis confirmed the hypothesis that the brace significantly affects the quality of life of patients and has a greater impact on the quality of life of the female gender due to the disruption of aesthetics and the associated sense of shame. An association was observed between the sense of shame related to wearing a brace and the desire to “hide” the brace under clothing, as well as the perception of the benefits of wearing a brace and a lower sense of shame.
Conclusion. In the processes of rehabilitation and treatment of the patient with idiopathic scoliosis, a holistic approach that considers not only activities related directly to physiology, but also to patients’ well-being and quality of life is important.
Key words:
idiopathic scoliosis, Chêneau brace, quality of life
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Orthotic management in the rehabilitation of children with plano-valgus foot

Agnieszka Ciukszo, Mateusz Curyło, Ewa Kucharska,Marcin Mikos, Jan W. Raczkowski

Agnieszka Ciukszo, Mateusz Curyło, Ewa Kucharska,Marcin Mikos, Jan W. Raczkowski – Orthotic management in the rehabilitation of children with plano-valgus foot. Fizjoterapia Polska 2021; 21(5); 124-131

DOI: https://doi.org/10.56984/8ZG209371

Abstract
Plano-valgus foot is a common three-plane deformity that appears at developmental age. It is characterized by the eversion of the calcaneus in relation to the tibia, foot pronation and lowering of the medial longitudinal arch under load. Joint hypermobility and significant body weight are believed to increase the prevalence of plano-valgus foot at all ages. There is no consensus on the proper management of flat feet. This disagreement is primarily due to the fact that there is no clear-cut approach to distinguishing pathological or physiological flat feet and to determining who needs treatment. One of the methods of supporting foot correction is the use of orthopaedic equipment in the form of shoe insoles or SMO/RING orthoses. The introduction of repositioning in the lower ankle joint is intended to restore the natural foot support system and to reduce the compensation at higher levels in the joints of the lower limbs, in the pelvis and torso.
Key words:
plano-valgus foot, posture defect, orthopaedic insole, orthosis
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Medical records in the practice of a physiotherapist. Legal and administrative aspects

Tomasz Pęcherz, Mateusz Curyło, Marcin Mikos, Marlena Rynkiewicz-Andryśkiewicz, Ewa Kucharska, Jan W. Raczkowski

T. Pęcherz, M. Curyło, M. Mikos, M. Rynkiewicz-Andryśkiewicz, E. Kucharska, J. W. Raczkowski – Medical records in the practice of a physiotherapist. Legal and administrative aspects. Fizjoterapia Polska 2021; 21(4); 226-228

DOI: https://doi.org/10.56984/8ZG20AZF1

Abstract
Medical records are very often treated by medical staff as an additional, unpleasant and unnecessary duty. However, it is currently the basic, undeniable source of defence against all claims of patients, both formal, regarding the correctness of the records, and substantive, related to the allegations of medical malpractice during the provision of medical services.
Key words:
medical records, malpractice, patient rights, GDPR, responsibilities of a physiotherapist
Article only in Polish language

Comparison of early and late surgical outcomes of patients after total hip arthroplasty in terms of the type of surgical approach and assessment of the level of fitness

Paweł Zieliński, Rafał Trąbka, Jarosław Amarowicz, Mateusz Curyło, Paweł Kamiński, Magdalena Wilk-Frańczuk, Tomasz Maicki

P. Zieliński, R. Trąbka, J. Amarowicz, M. Curyło, P. Kamiński, M. Wilk-Frańczuk, T. Maicki – Comparison of early and late surgical outcomes of patients after total hip arthroplasty in terms of the type of surgical approach and assessment of the level of fitness. Fizjoterapia Polska 2021; 21(4); 190-203

Abstract
Osteoarthritis is the most common form of human joint pathology. It is estimated that it affects about 6% of the world’s population. In addition to the hand and knee joints, the hip joint is one of the most common joints affected by OA.
The study included 59 randomly selected patients (from a group of over 600 people operated in a similar period) of the Orthopaedics and Rehabilitation Department of the Centre for Rehabilitation and Orthopaedics in Krakow, who underwent THA due to advanced degenerative changes using a cementless prosthesis.
The objective of the study was to compare the early and late outcomes of the procedure (patient’s fitness level and subjective assessment) using the anterolateral (according to Watson-Jones) and lateral (McFarland and Osborne as modified by Hardinge) approach.
The obtained results confirm better outcomes in terms of the abduction strength scale (SO%), HHS, VAS, frequency of the Trendelenburg sign and partially mobility (external rotation) in relation to short-term follow-up (especially after 6 and 12 weeks), but not long-term follow-up (after 24 weeks and 11-12 years).
It was found that people who underwent surgery using the lateral approach (according to Hardinge) recover faster than people who underwent surgery with the use of the anterolateral approach (according to Watson-Jones).
Key words:
arthroplasty, osteoarthritis, hip joint
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Non-invasive treatment of plagiocephaly with the use of corrective helmets in infants

Agnieszka Ciukszo, Mateusz Curyło, Marcin Mikos, EwaKucharska, Jan W. Raczkowski

A. Ciukszo, M. Curyło, M. Mikos, E. Kucharska, Jan W. Raczkowski – Non-invasive treatment of plagiocephaly with the use of corrective helmets in infants. Fizjoterapia Polska 2021; 21(4); 32-41

DOI: https://doi.org/10.56984/8ZG20A36D

Abstract
The use of skull correction is controversial, and treatment recommendations and reporting of results vary. The most commonly observed deformities of the skull are: plagiocephaly, brachycephaly and scaphocephaly. Treatment includes repositioning, physical therapy, and orthotic treatment with an adapted cranial remoulding orthosis (CRO). Positional plagiocephaly should be differentiated from torticollis, which is also one of the main causes of this deformity. Cranial remoulding orthosis yields better and faster results in younger patients, with age the degree of correction slows down with age. CRO is most effective when initiated before the 5th month of age. Apart from positioning therapy, physiotherapy and the use of a CRO shortens the treatment time and improves the results in severe cases of head asymmetry.
Key words:
plagiocephaly, brachycephaly, corrective helmets, infant rehabilitation
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Legal protection of the physiotherapist as a profession of public trust

Marcin Mikos, Mateusz Curyło, Marlena Rynkiewicz-Andryśkiewicz, Tomasz Pęcherz, Ewa Kucharska, Jan. W. Raczkowski

Marcin Mikos, Mateusz Curyło, Marlena Rynkiewicz-Andryśkiewicz, Tomasz Pęcherz, Ewa Kucharska, Jan. W. Raczkowski – Legal protection of the physiotherapist as a profession of public trust. Fizjoterapia Polska 2021; 21(3); 194-196

DOI: https://doi.org/10.56984/8ZG1411DD

Abstract
Physiotherapists are regarded as one of the medical professions of public trust. The Act on Physiotherapist Occupation establishes physiotherapists as a medical occupation of public trust. Medical professions of public trust, such as doctors, nurses, and paramedics, have special legal protection not available to physiotherapists. The Act on Physiotherapists has not defined the physiotherapist as a civil servant. It directly deprives physiotherapists of special legal protection that is assigned to civil servants.
Key words:
Physiotherapist – medical profession of public trust, legal protection of physiotherapist, civil servant, the danger of practising physiotherapy
Only Polish version

Hand and wrist injuries occurring in regular sport climbers

Marta Schmidt, Aleksandra Krupa, Agnieszka Ciukszo, Arkadiusz Fiedor, Ewa Kucharska, Jan W. Raczkowski, Mateusz Curyło

Marta Schmidt, Aleksandra Krupa, Agnieszka Ciukszo, Arkadiusz Fiedor, Ewa Kucharska, Jan W. Raczkowski, Mateusz Curyło – Hand and wrist injuries occurring in regular sport climbers. Fizjoterapia Polska 2021; 21(3); 86-92

DOI: https://doi.org/10.56984/8ZG141A10

Abstract
In the recent years sport climbing has become more and more popular. As an extreme sport, it is prone to a high degree of injury risk. A particular body part exposed to injuries is the upper extremity.
The aim of this study was to assess the number and types of hands and/or wrists injuries in regular sport climbers. The study was conducted on a group of 468 climbers. The criterion for inclusion was the regularity of conducted trainings, training internship of at least 1 year and the minimum difficulty of covering the distance at the level of VI.1. A proprietary questionnaire was used as a research tool.
As a result of climbing training 84% of examined climbers experienced pain in their palm/wrist area, whereas 67% of respondents suffered hand/wrist damage. The most common hand injuries occurred on the annular ligaments of the fingers (N = 97). It was observed a correlation between annular pulley injury and injuries occurring in the proximity of the III finger (rs = 0.513, p < 0.001) as well as between carpal tunnel syndrome and training experience (rs = 0.355, p < 0.05).
Musculoskeletal system damage and pain is a common problem for climbers. The analysis of the collected data indicated that the longer the training experience is, the higher the injury risk. The third and fourth fingers were the most injured, whereas the most frequent injuries were suffered in annular finger ligament. The collected data indicated the need to educate climbers in prevention and treatment of these specific injuries.
Key words:
sport climbing, sport injuries, hand injuries, climbing training
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Rheumatoid arthritis and rheumatoid foot in physiotherapy

Mateusz Curyło, Marlena Rynkiewicz-Andryśkiewicz, Agnieszka Ciukszo, Damian Szubski, Ewa Kucharska, Jan Czernicki, Jan W. Raczkowski

Mateusz Curyło, Marlena Rynkiewicz-Andryśkiewicz, Agnieszka Ciukszo, Damian Szubski, Ewa Kucharska, Jan Czernicki, Jan W. Raczkowski – Rheumatoid arthritis and rheumatoid foot in physiotherapy. Fizjoterapia Polska 2021; 21(2); 172-183

DOI: https://doi.org/10.56984/8ZG0DD753

Abstract
Rheumatic diseases are not fatal, but they result in shorter life expectancy of the patients suffering from them. This applies to all inflammatory rheumatic diseases, especially rheumatoid arthritis (RA). Rheumatic diseases, in which most of all the joint inflammatory process develops with progressive joint damage, are the cause of patients’ disability, prevent patients from working and everyday functioning, also at home, and affect all aspects of social life. The objective of rehabilitation in RA is to relieve pain, reduce or inhibit inflammation, and maintain the proper functioning of the locomotor system while slowing down or ceasing structural lesions in the joints.
Key words:
Rheumatoid arthritis, RA, rheumatoid foot, disability, orthopaedic equipment
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Assessment of the impact of prosthetic foot support flexibility on gait in a patient after lower limb amputation at thigh level

Mateusz Curyło, Agnieszka Ciukszo, Marcin Zaczyk, Damian Szubski, Łukasz Strzępek, Bolesław Karwat, Jan W. Raczkowski

Mateusz Curyło, Agnieszka Ciukszo, Marcin Zaczyk, Damian Szubski, Łukasz Strzępek, Bolesław Karwat, Jan W. Raczkowski – Assessment of the impact of prosthetic foot support flexibility on gait in a patient after lower limb amputation at thigh level. Fizjoterapia Polska 2021; 21(2); 56-63

DOI: https://doi.org/10.56984/8ZG0DDEF8

Abstract
Objective. The article presents the results of experimental studies, the main objective of which was to determine how the degree of flexibility of the lower limb prosthesis support system impacts the pattern of secondarily learned gait in a patient after amputation. Material and methods. The study was carried out on a patient (35-year-old man) after lower limb amputation at the level of 1/3 of the proximal femur, who followed a previously planned walking path. Inclusion criteria: gender F and M, amputation at 1/3 of the proximal femur, age below 40, traumatic amputation, average level of activity, use of a prosthesis for at least one year. Exclusion criteria: age over 40, amputations below 1/3 of the proximal femur, amputations for vascular reasons, activity level below average, use of a prosthesis for under one year. During the study, the patient was equipped with three support systems corresponding to three degrees of flexibility of the prosthetic foot (soft, medium, hard). Biomechanical data during gait was collected using FlexinFit by Sensor Medica for assessing the pressure between the foot and the inside of the shoe. Results. In the entire gait cycle, the support phase on the healthy limb was the longest. The hard support system generates the greatest asymmetry of the transferred loads between the limbs. In this support variant, the difference in load between the healthy limb and the amputated limb was 1,330 kg/m2, which represented an asymmetry of 21%. In terms of load distribution, the best support was medium support – medium support flexibility, for which the difference in load between the healthy limb and the amputated limb was 770 kg/m2, which was an asymmetry of 12%. Conclusions. When designing a prosthesis for people after lower limb amputation, it is crucial to correctly adjust its features to the individual needs of each patient (adjusting prosthesis kinematics, adjusting support system stiffness), so that gait is possibly closest to normal with low energy demand.
Key words:
lower limb amputation, gait analysis, prosthetic gait, prosthetic rehabilitation
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