Tag: udar mózgu

Ocena wpływu fizjoterapii z wykorzystaniem elementów muzykoterapii na subiektywne odczucia i psychologiczne aspekty funkcjonowania pacjenta rehabilitowanego

Weronika Paradowska, Bartłomiej Tarkowski, Klaudia Marek, Elżbieta Miller

Weronika Paradowska, Bartłomiej Tarkowski, Klaudia Marek, Elżbieta Miller – Assessment of the impact of physiotherapy using elements of music therapy on the subjective feelings and psychological aspects of functioning of a rehabilitated patient –  Fizjoterapia Polska 2026; 26(3); 84-94

DOI: https://doi.org/10.56984/8ZG7D1AV7A4

Streszczenie
Cel pracy. Celem pracy była ocena wpływu fizjoterapii z wykorzystaniem elementów muzykoterapii na subiektywne odczucia oraz psychologiczne aspekty funkcjonowania pacjenta rehabilitowanego.
Materiał i metodyka. Do badania zakwalifikowano 30 osób w wieku 42–84 lat, hospitalizowanych w oddziale rehabilitacji neurologicznej, Miejskiego Centrum Medycznego im. dr Karola Jonschera w Łodzi. W badaniu wykorzystano autorskie ankiety oraz kwestionariusze: PROMIS Global Health-10 (PROMIS GH-10), Kwestionariusz Poczucia Stresu (KPS).
Wyniki. W grupie badanej zaobserwowano większą tendencję do poprawy wyników w zakresie psychicznego i ogólnego wymiaru jakości życia ocenianej za pomocą PROMIS GH-10, jednak różnice nie osiągnęły istotności statystycznej. Nie stwierdzono istotnych różnic między grupami w zakresie poziomu stresu mierzonego kwestionariuszem KPS. W analizie przed-po w grupie badanej odnotowano istotny wzrost stresu intrapsychicznego (p = 0,047). Subiektywna ocena procesu rehabilitacji była natomiast istotnie wyższa w grupie badanej niż w grupie kontrolnej (45,73 vs 41,20 pkt; p = 0,048).
Wnioski. Zastosowanie elementów muzykoterapii w fizjoterapii pacjentów po udarze mózgu sprzyjało bardziej pozytywnej ocenie procesu rehabilitacji i mogło korzystnie wpływać na subiektywny odbiór terapii. Nie wykazano natomiast istotnego wpływu na jakość życia ani poziom odczuwanego stresu. Uzyskane wyniki wskazują, że włączenie elementów muzykoterapii może zwiększać satysfakcję i zaangażowanie pacjentów w proces usprawniania, jednak wymaga dalszych badań na większych grupach.
Słowa kluczowe
udar mózgu, muzykoterapia, rehabilitacja, muzykoterapia neurologiczna
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Wpływ spastyczności kończyny dolnej na uwięźnięcie nerwu piszczelowego u pacjentów po udarze mózgu

Hosam Magdy Metwally Abd Alhamid, Mohamed Salah El-Sayed, Ahmed Magdy Alshimy

Hosam Magdy Metwally Abd Alhamid, Mohamed Salah El-Sayed, Ahmed Magdy Alshimy – Impact of lower limb spasticity on tibial nerve entrapment in patients with stroke –  Fizjoterapia Polska 2026; 26(2); 32-37

DOI: https://doi.org/10.56984/8ZG560AT6B1

Streszczenie
Wprowadzenie. Udar mózgu jest najczęstszą przyczyną śmiertelności i jedną z głównych przyczyn chorobowości na świecie. Polineuropatie i neuropatie z uwięźnięcia występują jako powikłania udaru mózgu.
Cel pracy. Celem niniejszego badania była ocena wpływu spastyczności kończyny dolnej na uwięźnięcie nerwu piszczelowego u pacjentów po udarze mózgu.
Materiał i metody. W badaniu wzięło udział stu pacjentów po udarze mózgu w wieku od 55 do 65 lat. Każdą płeć podzielono na dwie równe grupy: grupę A i grupę B. Zgodnie ze zmodyfikowaną skalą Ashwortha stopnie 1 i 1+ wskazywały na łagodną spastyczność w grupie A, natomiast stopnie 2 i 3 wskazywały na umiarkowaną spastyczność w grupie B. Do oceny badanych zastosowano badanie elektrodiagnostyczne, obejmujące prędkość przewodzenia nerwowego, latencję dystalną i amplitudę, oraz badanie kliniczne — test potrójnego ucisku.
Wyniki. Zaobserwowano statystycznie istotne różnice we wszystkich zmiennych (p < 0,001). W szczególności grupa A wykazywała istotnie krótszą latencję dystalną, wyższą amplitudę oraz większą prędkość przewodzenia nerwowego niż grupa B. Wyniki te sugerują, że grupa A charakteryzowała się lepszą funkcją nerwów obwodowych niż grupa B.
Wnioski. W badaniu stwierdzono, że stopień spastyczności wpływał na funkcję nerwu piszczelowego, przy czym umiarkowana spastyczność była związana z większym uszkodzeniem elektrofizjologicznym.
Słowa kluczowe
udar mózgu, spastyczność, uwięźnięcie nerwu piszczelowego, niedowładna kończyna dolna
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Papildomų mentalinių vaizdinių treniruočių poveikis apatinių galūnių funkcijai insultą patyrusiems pacientams, gydomiems virtualios realybės pagalba

Tahir Masood, Tasmiya Asghar, Arshad Nawaz Malik

 

Tahir Masood, Tasmiya Asghar, Arshad Nawaz Malik – Effects of additional mental imagery training on lower limb function in stroke patients treated with virtual reality –  Fizjoterapia Polska 2024; 24(2); 89-93

DOI: https://doi.org/10.56984/8ZG56083OG

Tikslas. Įvertinti, ar insultą patyrę pacientai, kuriems taikomas užduočių orientuotas ir virtualios realybės treniruotės derinys, gali papildomai naudos gauti pridedant motorinių vaizdinių treniruotes, siekiant pagerinti apatinių galūnių sensomotorinę funkciją, pusiausvyrą, eiseną ir kritimo riziką.
Medžiaga ir metodai. Trisdešimt lėtinių insultą patyrusių pacientų (40-60 metų) dalyvavo šiame vieno aklo atsitiktinių imčių kontroliuojamame tyrime, kuris buvo atrinktas pagal patogumo atrankos metodą ir atsitiktinai paskirtas į eksperimentinę grupę arba kontrolinę grupę. Eksperimentinė grupė dalyvavo virtualios realybės treniruotėse kartu su mentalinių vaizdinių treniruotėmis, o kontrolinė grupė – virtualios realybės treniruotėse kartu su įprastiniu gydymu. Abi intervencijos truko 6 savaites, po 3 sesijas per savaitę. Duomenys buvo renkami naudojant Berg pusiausvyros skalę, Fugl-Meyer apatinių galūnių vertinimą, Viskonsino eisenos skalę, laiko iki kėlimo ir vaikščiojimo testą ir 10 metrų vaikščiojimo testą pradiniu momentu ir po 3 bei 6 savaičių.
Rezultatai. Eksperimentinės grupės dalyviai parodė žymiai geresnius rezultatus, palyginti su kontrolinės grupės dalyviais visais tyrimo matavimais (P < 0.05). Be to, abi grupės, palyginti su pradiniais duomenimis, žymiai pagerėjo (P < 0.05).
Išvados. Integruojant motorinių vaizdinių treniruotes į lėtinių insultą patyrusių pacientų, gydomų užduočių orientuotu ir virtualios realybės treniruotėmis, reabilitacijos planus, pacientų rezultatai žymiai pagerėja.
Klinikinių tyrimų registras: NCT05812638

Raktažodžiai: Motoriniai vaizdiniai, insultas, apatinių galūnių funkcija, exergaming, eisena

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Use of the posturography platform as a tool for quantitative assessment of imbalance and postural control in post-stroke patients in chronic phase

Paulina Magdalena Ostrowska, Rita Hansdorfer-Korzon, Rafał Studnicki, Dawid Spychała


Paulina Magdalena Ostrowska, Rita Hansdorfer-Korzon, Rafał Studnicki, Dawid Spychała – Use of the posturography platform as a tool for quantitative assessment of imbalance and postural control in post-stroke patients in chronic phase. Fizjoterapia Polska 2023; 23(1); 142-163

DOI: https://doi.org/10.56984/8ZG07B4A3

Abstract
Background. Imbalance during standing, which is usually observed as an asymmetry in the weight shifting toward to the unaffected side of the body, is one of the most common factors affecting the independence and quality of life of post-stroke patients. Clinical assessment of imbalance in post-stroke patients is often conducted by visual observation using standardised tools (balance tests). However, quantitative analysis, using a posturographic platform, is more accurate and provides more information about the patient’s functional status. The TYMO® device, used in this study, is a portable posturography platform that measures tilts of the body’s center of mass and reports the results of the rehabilitation process. It enables an objective, direct and quantitative assessment of the patient’s functional status. Such an assessment can contribute to significant effectiveness of physiotherapy and consequently improve the patient’s quality of life and shorten the period of abstinence from work. Objective. Quantitative assessment of imbalance and postural control using a posturography platform (TYMO®) in patients after ischaemic stroke, in the chronic phase, as an important component of the functional diagnosis process and rehabilitation programme design. To emphasise the role of the posturography platform (TYMO®) as a tool for measuring static balance – symmetry of body weight distribution, and a tool for monitoring and reporting the results of physiotherapy treatment. Methods. In the current study, before and after two weeks of rehabilitation, quantitative measurements of balance on the TYMO® platform were made in a group of subjects (n = 60: adults, after ischemic stroke – first stroke episode, in chronic phase – up to 5 years after the stroke incident occurred) undergoing therapy using neurophysiological methods (PNF – Proprioceptive Neuromuscular Facilitation and NDT-Bobath – Neurodevelopmental Treatment according to the Bobath concept) and the SPIDER system (Strengthening Program for Intensive Developmental Exercises and activities for Reaching health capability). Measurements included: the distance marked by the patient’s center of mass while performing the test, the medial-lateral and anterior-posterior tilts of the subject’s body, the area of movement marked by the body’s center of mass, the average speed at which the patient performed the movement to maintain the required position, and the distribution of the subject’s weight. Based on the posturographic results obtained before therapy, it was possible to design a targeted rehabilitation programme. The magnitude of the difference in measurements before and after rehabilitation made it possible to assess the impact of the therapy on the patient’s balance. In addition, it was a specific indicator of the accuracy of the selection of physiotherapeutic treatment (a large difference in the mean results before and after therapy reflected an improvement in the parameters of postural control, hence the effectiveness of the therapy) and determined the direction of the future rehabilitation programme. Results and conclusions. The parameters measured by the TYMO® platform are crucial in assessing the functional status of post-stroke patients, especially with regard to postural control or balance disorders. The results described confirm the validity of using quantitative assessment, using the posturography platform, as an important component of the functional diagnostic process and designing an rehabilitation programme. The TYMO® platform itself is a useful tool for measuring, monitoring and reporting the effects of physiotherapeutic treatment in post-stroke patients.
Key words:
stroke, body weight distribution, balance, quantitative assessment, posturographic platform
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An evaluation of the effectiveness of magnetotherapy as a factor supporting rehabilitation on the basis of selected biomechanic and psychotechnical indices

Mirosław Janiszewski, Anna Błaszczyk

Mirosław Janiszewski, Anna Błaszczyk – An evaluation of the effectiveness of magnetotherapy as a factor supporting rehabilitation on the basis of selected biomechanic and psychotechnical indices. Fizjoterapia Polska 2001; 1(1); 39-42

Abstract
The aim of this study was to examine the impact of longterm magnetic field stimulation on the rehabilitation of post-stroke patients and to determine how quickly these patients gain locomotor efficiency. A group of 180 patients 50-70 years old after stroke received rehabilitation and low frequency magnetic field stimulation. As a criterion for evaluation purposes the authors used selected biomechanical and psychotechnical indices. The study shows that magnetotherapy in post-stroke patients undergoing rehabilitation has a positive effect in the improvement of muscle function, motor coordination indices, and some biomechanical parameters (strength under dynamic and static circumstances).

Key words:
Stroke, magnetic fields, Rehabilitation

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Thermovisual evaluation of vascular behavior in the paretic upper limb after local cryostimulation in stroke patients

Zbigniew Śliwiński, Piotr Plaza

Zbigniew Śliwiński, Piotr Plaza – Thermovisual evaluation of vascular behavior in the paretic upper limb after local cryostimulation in stroke patients. Fizjoterapia Polska 2002; 2(2); 112-117

Abstract
Background. Stroke is the third most common cause of death, one of the most common causes of handicap, and the most common cause of disability among persons older than 40. Each year 4.6 million people around the world die from strokes, including 3.2 million in developing countries and 1.2 million in highly industrialized countries. In view of the high morbidity rate and the serious consequences of stroke, in the form of limb paresis, the authors decided to use a thermovision camera to check vascular reactions in the paretic limb by evaluating temperature changes on the skin subsequent to cryostimulation by liquid nitrogen vapors. Material and methods. Our research involved 28 patients with an average age of 61.3 years. The procedure was performed on the forearm of the paretic upper limb, which was cooled for 6 minutes (from the hand to the elbow cavity, the dorsal surface and the palm surface). Thermovision images were made 5 times for each patient. Results. The authors observed that as a result of the procedure the temperature of the cooled limb went down 12°C, and 2.6°C in the other limb. Conclusions. The results cannot be easily interpreted. In the authors’ opinion, the temperature reduction in the limb that was not cooled results from contralateralization of the consensual reflex. The present study is a preliminary report describing the phenomenon we observed.

Key words:
Stroke, Cryostimulation, thermovision, vascular behavior

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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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Early post stroke rehabilitation after heart transplantation

Elżbieta Miller, Zbigniew Śliwiński, Anna Cabak

Elżbieta Miller, Zbigniew Śliwiński, Anna Cabak – Early post stroke rehabilitation after heart transplantation. Fizjoterapia Polska 2007; 7(3); 351-354

Abstract
Brain stroke is the leading cause of disability, and usually affects people after 60. At this age, the risk of concomitant diseases, affecting not only the cardiovascular system is high. The number and intensity of the diseases are often contraindications for early post stroke rehabilitation. Patients after brain stroke and heart transplantation are rare cases. The aim of the study was to present the effectiveness of early post-stroke rehabilitation in case of the 53-year-old man who underwent heart transplantation in 2000, due to congestive cardiomyopathy. The patient was examined 4 times during the 3rd, 6th, 9th and 15th week after the stroke. The test examined muscle strength in Lovett scale and the grade of muscle tone in Ashworth scale. A functional test was performed in Barthel scale and the extent of requiring care and attention — in Rankin scale. The paper presents an individual diagram of physiotherapeutic procedures divided into two stages: the early stage (0-6 weeks) and the transient stage (6-9 weeks), adjusted to the patient’s actual neurological and cardiological state. Basic recovery after physiotherapeutic treatment was obtained before the 9th week. Patients after heart transplantation can be successfully treated by rehabilitation. A substantial progress in medicine obligates to exchange information about rehabilitation treatment of patients with untypical concomitant diseases.
Key words:
brain stroke, heart transplantation, post stroke rehabilitation
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The effect of early rehabilitation on locomotor function in post-stroke patients – preliminary report

Emil Domański, Magdalena Wilk, Wojciech Kiebzak, Zbigniew Śliwiński

Emil Domański, Magdalena Wilk, Wojciech Kiebzak, Zbigniew Śliwiński – The effect of early rehabilitation on locomotor function in post-stroke patients – preliminary report. Fizjoterapia Polska 2008; 8(1); 83-95

Abstract
Background. Cerebral stroke is defined by the WHO as sudden onset of rapidly developing clinical signs of focal disturbance of cerebral function, with symptoms lasting longer then 24h, or leading to death, caused by changes in the arterial or vascular system of the brain. The aim of this study was to assess the effect to early rehabilitation on the locomotor function in stroke patients. Material and method. A group of 30 patients with hemiparesis within 24h after the onset of stroke and after 14 days of rehabilitation. The locomotor assessment was carried out according to the PNF functional status of muscles and gait patterns. Activities of daily living were evaluated according to the Repty Functional Index (RFI) and the Simple Chart of Locomotor Activities (PKCM). The level of disability was graded to the Rankin scale. For logistic reasons, the study did not include a control group, so that the paper is treated as a preliminary report.Results. Locomotor improvement was achieved in 40% of patients, with reduction in disability in 50%. Improved locomotor function led to urinary function improvement in 50% of patients. Motor dysfunction of the upper limb was reduced thanks to physiotherapy in 40% of patients. Conclusions. Early rehabilitation leads to improved function as defined by the functional status of muscles and hait patterns. The adopted rehabilitation programme resulted in improved functional indepedence evaluated on the basis of the Repty Functional Index (WFR) and Simple Chart of Activities (PKCM). The locomotor improvement resulted in urinary improvement in 50% of patients. Early rehabilitation improved the locomotor function of the paretic upper limb. The conclusions need to be verified in further studies with control groups.
Key words:
cerebral stroke, hemiparesis, early rehabilitation, functional status
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