Multimodal programmes in the treatment of myofascial pain syndrome (MPS) – a two-step review

Krzysztof Konior, Aleksandra Bitenc-Jasiejko, Danuta Lietz-Kijak, Piotr Skomro, Małgorzata Kowacka, Konrad Kijak, Zbigniew Śliwiński


Krzysztof Konior, Aleksandra Bitenc-Jasiejko, Danuta Lietz-Kijak, Piotr Skomro, Małgorzata Kowacka, Konrad Kijak, Zbigniew Śliwiński – Multimodal programmes in the treatment of myofascial pain syndrome (MPS) – a two-step review. Fizjoterapia Polska 2023; 23(1); 188-202

DOI: https://doi.org/10.56984/8ZG07B914

Abstract
Myofascial pain syndrome (MPS) is one of the most common ailments associated with the human musculoskeletal system, characterised by the presence of the so-called trigger points (TrP – trigger point; MTrPs – myofascial trigger points). The International Association for the Study of Pain indicates that MPS may affect approximately one-third of people with chronic musculoskeletal pain, and that there is a lack of appropriate classification which can be attributed to a misunderstanding and/or misinterpretation of the pathophysiology. Given the diverse causes of pain syndromes in myofascial structures, it is vital to properly select and integrate therapeutic methods. The scientific literature indicates that treatment programmes should include a variety of manual therapy methods and rehabilitation exercises. Trigger point therapies, such as dry needling or dry cupping, are also widely used. At the heart of the success of rehabilitation programmes, in the opinion of the authors of this publication, is their multimodality, i.e. selection of therapeutic methods based on the cause of the pain, providing for measurable, reproducible diagnostic methods in therapy.
Aim of the study. The aim of this study is to analyse and infer conclusions on multimodal myofascial pain therapy programmes.
Material and methods. Given the complex research problem set as the aim, the study was carried out through a literature review in terms of two criteria:
Criterion I (C I): analysis of the literature on the etiology and pathogenesis of myofascial pain (i.e. causes and triggers, symptoms, social and environmental factors determining the onset of MPS), diagnostic procedures (initial diagnosis and ongoing monitoring of treatment outcomes), and therapeutic methods used in the course of MPS.
Criterion II (C II): a literature study of research publications addressing multimodal programmes for myofascial pain therapy, with their qualitative evaluation using the modified PEDro scale, and empirical testing of hypotheses based on the literature study and the analysis made in Part I.
Data sources: PubMed, SCOPUS, Science Direct, MEDLINE, PEDro, Cochrane, Embase, Web of Science Core Collection, Google Scholar electronic databases were searched systematically, restricting the languages to English and German only.
Results. The analysis of the literature showed that the causes, symptoms and associations of myofascial pain have been described in detail. There are also numerous reports on a variety of therapeutic methods, together with a precisely described methodology for their implementation. It is not uncommon to recommend combining methods into multimodal programmes, which unfortunately does not mean that there are many such programmes or that studies on MPS are consistent. The literature study on multimodal treatment programmes for MPS revealed that there is no correlation between its pathogenesis and a purposeful selection of specific therapeutic methods. In a small number of cases, a complex etiopathogenesis led to the formation of multidisciplinary teams. This may be associated with the absence of strict recommendations on the diagnostic methods applicable to the assessment of MPS.
Conclusions. 1. Multimodal programmes for the treatment of musculoskeletal pain, notably MPS and MTrPs, should include a detailed and comprehensive diagnosis (structural, biochemical, psycho-emotional) which should serve as the basis for the formation of interdisciplinary rehabilitation teams. 2. Musculoskeletal diagnosis, in addition to radiological assessment, should include measurable techniques of postural and functional assessment (such as pedobarography, wearable sensors, assisted anthropometry, i.e. photogrammetry, videogrammetry, etc.), aimed primarily at the ongoing assessment of posture. 3. The choice of therapeutic methods and patient education should be based on the causes of the patient’s pain, taking into account systemic diseases, postural defects, lifestyle and psycho-emotional state. 4. Scientific research in multimodal treatment programmes should be carried out in randomised groups, with due attention to the methodologies of diagnostic and therapeutic procedures and group selection.
Keywords
chronic pain, myofascial pain, manual therapy, exercise, multimodal programmes
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Biotensegration of malocclusion and temporomandibular disorders with diseases of the musculoskeletal system and posture defects – a literature review, supported by own observations

Danuta Lietz-Kijak, Aleksandra Bitenc-Jasiejko, Piotr Skomro, Krzysztof Konior, Konrad Kijak, Małgorzata Kowacka, Zbigniew Śliwiński


Danuta Lietz-Kijak, Aleksandra Bitenc-Jasiejko, Piotr Skomro, Krzysztof Konior, Konrad Kijak, Małgorzata Kowacka, Zbigniew Śliwiński – Biotensegration of malocclusion and temporomandibular disorders with diseases of the musculoskeletal system and posture defects – a literature review, supported by own observations. Fizjoterapia Polska 2023; 23(1); 22-38

DOI: https://doi.org/10.56984/8ZG07B3B3

Streszczenie

Although it enables a quick evaluation, medical diagnostics of the human myofascial-skeletal system is not always used to its full capabilities. This often hampers the objective assessment of a dysfunction and limits treatment options. Dysfunctions of the stomatognathic system, of different aetiology, are becoming more prevalent. Many scientific studies are in to relationships between organs and systems of the human body that can cause dysfunctions of the temporomandibular disorders. Studies investigating correlations between a myofascial-skeletal disorder and temporomandibular disorders are to be found in the literature. To achieve a good understanding of aetiology of these dysfunctions, a holistic view of a patient is advisable, which takes into consideration the fact that the temporomandibular joint is an integral part of the whole body. This study is a review of the literature, supported by own examples on investigating the relationship between myofascial-skeletal disorders and a temporomandibular disorder, which, in the light of current medical knowledge, is attributed to the phenomenon of biotensegrity. A conclusion has been put forward on the basis of 136 scientific reports that a dependency exists between the said dysfunctions.

Słowa kluczowe:
biotensegrity, disorders of the musculoskeletal system, posture defects, dysfunctions of the masticatory system, temporomandibular joint disorder

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Application of non-invasive brain stimulation with the use of repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) in the treatment of dysphagia following an ischemic stroke – analysis of research reports

Karolina Sandecka, Zbigniew Śliwiński


Karolina Sandecka, Zbigniew Śliwiński – Application of non-invasive brain stimulation with the use of repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) in the treatment of dysphagia following an ischemic stroke – analysis of research reports. Fizjoterapia Polska 2022; 22(5); 108-114

DOI: https://doi.org/10.56984/8ZG20ANp0

Streszczenie

Stroke is one of the significant problems and causes of death, in particular in highly developed countries. It is also the most common cause of dysphagia.
This study is devoted to the analysis of publications from the last decade concerning research on the use of non-invasive brain stimulation (TMS, tDCS) in the treatment of dysphagia following an ischemic stroke. The following databases were searched for publications: PUBMED, Polish Scientific Journals Database, EBSCO, ScienceDirect. Out of 358 articles found, only two met all the inclusion conditions.
The studies discussed in this article included patients who had their first unilateral ischemic stroke, followed by dysphagia.
Findings from pilot studies on the effectiveness of the use of tDCS in the treatment of dysphagia following an ischemic stroke were analysed. Fourteen patients aged 50-92 were randomly assigned to two groups. The study group was treated with anodic stimulation, and the control group with sham brain stimulation. The results showed that patients in the study group obtained a statistically significant result, indicating an improvement in the swallowing function as measured by the Dysphagia Score and Severity Scale. The above data may indicate the effectiveness of the use of tDCS in the treatment of dysphagia.
Fifty patients were qualified for the research on the effectiveness of rTMS in the treatment of dysphagia. Three groups were created: the first group treated with high frequency rTMS, where patients received rTMS stimulation – 3Hz; the second group with low frequency rTMS – 1Hz; and the control group. The effectiveness of the therapy used was assessed on the fifth day and after 1, 2 and 3 months. After 5 days the groups where active rTMS stimulation was used showed greater improvement in the swallowing function compared to the sham stimulation group. Improved results in the Standardized Swallowing Assessment were also recorded after 3 months in the 1Hz and 3Hz groups, but this did not apply to the control group. In three groups, the results of the water swallow test and the degree of dysphagia improved after 3 months.
This analysis shows that non-invasive brain stimulation using tDCS and rTMS in the treatment of dysphagia is associated with improved swallowing function. However, the small number of studies conducted in this area does not allow for extrapolation of their results.

Słowa kluczowe:
dysphagia, transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS)

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Psychophysical condition of a child during the COVID-19 pandemic

Miłosz Opuchlik, Anna Opuchlik, Arkadiusz Żurawski, Marek Wiecheć, Małgorzata Biskup, Kamil Markowski, Zbigniew Śliwiński


Miłosz Opuchlik, Anna Opuchlik, Arkadiusz Żurawski, Marek Wiecheć, Małgorzata Biskup, Kamil Markowski, Zbigniew Śliwiński – Psychophysical condition of a child during the COVID-19 pandemic. Fizjoterapia Polska 2022; 22(5); 6-19

DOI: https://doi.org/10.56984/8ZG20A7jJ

Streszczenie

The aim of this article is to present the effects of the COVID-19 pandemic on the psychophysical state of a child. The diagnostic survey method and questionnaire technique were used for the study. The survey was conducted online among elementary school students. The empirical material collected shows the evaluation of remote education and its impact on the changes that occurred in children during the pandemic. The changes that occurred during remote learning include increased stress, isolation, lack of contacts with peers, exhaustion, long hours of work in front of a screen and decreased physical activity.

Słowa kluczowe:
COVID-19, remote education, mental development of children, psysical development, social development

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The review of literature on the possibility of the use of Kinesiology Tape in musculoskeletal diseases. Meta-analysis

Marcin Krajczy, Katarzyna Bogacz, Jacek Łuniewski, Edyta Krajczy, Igor Świerkowski, Aleksandra Skomudek, Ewa Jach, Danuta Lietz-Kijak, Zbigniew Śliwiński, Jan Szczegielniak

Marcin Krajczy, Katarzyna Bogacz, Jacek Łuniewski, Edyta Krajczy, Igor Świerkowski, Aleksandra Skomudek, Ewa Jach, Danuta Lietz-Kijak, Zbigniew Śliwiński, Jan Szczegielniak – The review of literature on the possibility of the use of Kinesiology Tape in musculoskeletal diseases. Meta-analysis. Fizjoterapia Polska 2021; 21(5); 90-103

Abstract
Background. Kinesilogy Tape (KT) is widely used in patients with muscular disorders and pain. Objectives. To present the current body of knowledge on KT as a treatment method in patients with muscular disorders and pain. Design. Systematic review. Population. Patients with musculoskeletal disorders and pain. in whom KT was used.
Methods The papers were identified on the basis of term searches in digital research databases (PubMed, Medline, Cochrane Central Register of Controlled Trials (CCTR), EMBASE Excerpta Medica, and Google Scholar). On the basis of the review of the available 152 research articles, 27 papers on muscular disorders and pain disorders were selected. Two of the authors of this review, working independently, selected the papers to be included in the analyzed sample, isolated the data, performed an assessment of the risk of bias, and assessed the quality of the evidence for the main effects using the IVS internal validity score (PEDro) approach. A simplified version of the Oxford Centre for Evidence-Based Medicine (OCEBM) system was used to evaluate the evidence. Results. There are too few prospective, controlled randomized trials on KT that include a sufficiently large cohort. Only few of the reviewed papers that discuss the principles of KT meet the criteria of scientifically rigorous research. Conclusions. There is a need for further clinical trials on the effectiveness of the use of KT method.
Clinical rehabilitation impact. We found significant quality evidence to support the use of KT in clinical practice in patients with disorders of the musculoskeletal system (and in sports therapy).
Key words:
kinesiotaping, kinesiology taping, kinesiology tape, k/active tape AND medicine, musculoskeletal disorders AND pain
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Emotional condition of children in eastern Ukraine

Oleg Panchenko, Anastasiia Kabantseva, Zbigniew Śliwiński

Oleg Panchenko, Anastasiia Kabantseva, Zbigniew Śliwiński – Emotional condition of children in eastern Ukraine. Fizjoterapia Polska 2021; 21(4); 184-188

Abstract
Aim of the study. diagnosis and prognosis of mental disorders of preschool children who live in eastern Ukraine during armed conflict. Materials and methods. 1308 children aged 5–7 years old of Donetsk region were studied in the period of 2014–2018 years. Observation, conversation, psychodiagnostics and statistical methods were used. Results. Most respondents had fears of different nature (61.2%), anxiety, concern, worry (53.2%), manifestations of aggression (36.7%) and low self-esteem (18.4%). The dynamics of these indicators over the years remained at a high level. Also, the emotional state of parents and family atmosphere affected on the state of children’s health. Fathers’ neglect causes the need for additional attention (r = 0.305; p ≤ 0.01), while mothers’ neglect causes anxiety (r = 0.322; p ≤ 0.01) and neurotic states (r = 0.331; p ≤ 0.01). Conclusions. Armed conflict, social and legal difficulties in Ukraine demoralize society and pose a threat to the full children’s development. The results of the research emphasize the importance of organizing dynamic diagnostics of children’s mental health, as well as regulating appropriate measures for the prevention and elimination of negative emotional manifestations among children through the implementation of the medical-psychological and pedagogical system accompanying them.
Key words:
children, emotional disturbances, aggression, anxiety, war, Donbass, Ukraine
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Collaboration of specialists in the rehabilitation of spine pathology

Oleg Panchenko, Zbigniew Śliwiński, Anastasiia Kabantseva, Nataliia Tsapro

O. Panchenko, Z. Śliwiński, A. Kabantseva, N. Tsapro – Collaboration of specialists in the rehabilitation of spine pathology. Fizjoterapia Polska 2021; 21(4); 96-102

Abstract
To study the influence of the negative psychological state of children and adolescents living on the territory of hostilities, on the formation and course of spinal pathology. The sample consisted of 1467 people aged 5–18-year-old, whose parents had no complaints of the child’s spinal pathology, i.e. “relatively healthy children in respect of spinal pathology.” The growth of pathology of the spine during periods of intensive growth of the child was confirmed: in the 5–7-year-old age group for 3.49% of children, in the 8-10-year-old age group for 13.78%, in the 10-14-year-old age group for 17.89%, in the 15–17-year-old age group for 25.15% respectively. An increase in the prevalence of scoliosis in the Donetsk oblast (excluding the temporarily occupied territories) at the level of 28.26 cases per 1,000 schoolchildren, which is more than in other regions of Ukraine. The similarity of the pathogenesis of scoliosis, stress, and hypercalciuria was determined, which explains the data obtained by us on the prevalence of scoliosis in the ATO area, actually 95.89 cases per 1000 children, and 251.53 cases per 1000 adolescents aged 15-18-year-old. The manifestations of autonomic disturbances (rs = 0.34, p ≤ 0.01), sleep disturbances (rs = 0.43, p ≤ 0.01), anxiety (rs = 0.43, p ≤ 0.01) is increased among children with significant fear of war. There is a need to consider scoliosis as a stressor, and therefore children with scoliosis should get psychological rehabilitation and expert advice.
Key words:
scoliosis, stress, hypercalciuria, children, adolescents, rehabilitation
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Analysis of pain and quality of life in women after radical and sparing mastectomy

Kinga Czaja, Zbigniew Śliwiński, Edyta Dziewisz-Markowska, Kamil Markowski

Kinga Czaja, Zbigniew Śliwiński, Edyta Dziewisz-Markowska, Kamil Markowski – Analysis of pain and quality of life in women after radical and sparing mastectomy. Fizjoterapia Polska 2021; 21(3); 214-225

Abstract
Objective. The objective of the study was to analyse pain and quality of life in women after radical and sparing mastectomy. The quality of life after radical mastectomy compared to sparing mastectomy was characterized, assessing difficulties in everyday life and work, as well as limitations in undertaking various activities caused by pain after the procedure. The study verified whether the type of mastectomy significantly impacted selected aspects of life.
Material and method. The questionnaire-based study was carried out among 100 patients of Holy Cross Cancer Centre, aged 29 to 88 years, after radical and sparing breast cancer treatment. In order to compare the values of quantitative and qualitative variables between the groups, Student’s t-test, chi-square test, Mann-Whitney test and Shapiro-Wilk test were used. A significance level of p <0.05 was adopted in the course of the analysis. Statistical analysis was performed using Statistica 13.1 by StatSoft; the data was collected in Excel 2016.
Results. The analysis showed no statistically significant differences in the level of pain intensity in each analysed area between the groups of women, however, it confirmed a statistically significant correlation between the type of surgery performed and the onset of pain as well as limitations in everyday functioning. The analysis showed no statistically significant differences in pain intensity depending on the treatment period.
Conclusions. The level of pain after radical and sparing mastectomy was similar. After radical mastectomy, the patients’ quality of life was lower than after sparing mastectomy. Rehabilitation reduced pain intensity and improved the patients’ quality of life.
Key words:
radical mastectomy, sparing mastectomy, rehabilitation, quality of life
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The role of the visual apparatus in the early diagnostics and rehabilitation of disorders of the central nervous system

Zofia Prusiecka, Ludmiła Sadowska, Zbigniew Śliwiński

Zofia Prusiecka, Ludmiła Sadowska, Zbigniew Śliwiński – The role of the visual apparatus in the early diagnostics and rehabilitation of disorders of the central nervous system. Fizjoterapia Polska 2001; 1(1); 43-44

Abstract
The authors present various symptoms that may indicate developmental disorders of the visual apparatus in connection with associations of the neuronal pathway with the sometimes very complicates reflex arches. The Direct Light Stimulation method (DLS) is presented, which may be helpful in the stimulation and rehabilitation of children with damage to the central nervous system.

Key words:
Vision, CNS injury, diagnositics, Rehabilitation

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Thermovisual evaluation of the behavior of skin surface temperature following cryostimulation of the forearm in healthy adults

Zbigniew Śliwiński, Jan Talar

Zbigniew Śliwiński, Jan Talar – Thermovisual evaluation of the behavior of skin surface temperature following cryostimulation of the forearm in healthy adults. Fizjoterapia Polska 2001; 1(2); 155-160

Abstract
Introduction. The authors describe the impact of local cryotherapy on the human organism and the operating principles of the thermoregulation center. The article also contains information on thermovision. The research results presented here involve change in skin suface temperature in the upper limbs following chilling only one forearm by liquid nitrogen vapors for 2 minutes. Material and methods. 18 healthy volunteers (13 women, 5 men) were tested with the consent of the Bioethics Committee at the Bydgoszcz Academy of Medicine. Skin temperature changes were evaluated using an Agema 570 thermovision camera. A KS-1 apparatus manufactured by Hans-Sped (Głogów, Poland) was used for cryostimulation. Results. The results confirm that chilling one limb evokes changes in the other limb also. The temperature in the chilled limb after a two-minute administration did not achieve the initial values 5 minutes after conclusion of cryostimulation. In the limb which did not receive cryostimulation the temperature leveled out within 2 minutes after conclusion of stimulation, despite an initial drop. Intensive perfusion brought about a statistically significant increase in temperature to values higher than initial, in several cases, however, increased temperature was observed after conclusion of cryostimulation. This mechanism is not fully explained. Conclusions. The temperature increase in the untreated arm after conclusion of cryostimulation indicates that the thermoregulatory mechanism is operating properly, defending the organism against heat loss by increasing the blood supply to the limb. Cold reduced the sensitivity of smooth muscles to sympathetic stimuli and the effect of catecholamine, and this facilitates blood supply to the limbs. Cryostimulation to only one limb in healthy persons induces contralateralization of the consensual reflex, as shown by temperature changes on the skin of the limb not subjected to cryotherapy. This would seem to be associated with the arousal of cold thermoreceptors due to the reduction in skin temperature, which in turn leads to bioelectric arousal of the brain by the activating portion of the reticular network in the mesencephalon.

Key words:
Cryostimulation, thermoregulation, thermovision

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