Standards of competence in the physiotherapist profession

Wojciech Kiebzak, Jan Szczegielniak, Michał Butkiewicz, Bogusław Frańczuk, Małgorzata Starczyńska, Zbigniew Śliwiński

Wojciech Kiebzak, Jan Szczegielniak, Michał Butkiewicz, Bogusław Frańczuk, Małgorzata Starczyńska, Zbigniew Śliwiński – Standards of competence in the physiotherapist profession. Fizjoterapia Polska 2009; 9(1); 84-96

Abstract
Background. Work on standards of professional aualifications was started in Poland in the 1990’s. The standards contain a general description of professional tasks in the context of the particular profession together with an outline of the associated skills and qualifications. A total of 253 qualifica-tions standards had been developed by the end of 2007, including standards for physiotherapists, physiotherapy assistants and massage specialists. Material and methods. Five levels of qualifications have been defined in the National Professional Oualification Standard in accordance with EC provisions, taking under consideration the complexity of work, the difficulty of the skills, the degree of responsibility and the level of professional hierarchy which students are prepared to. The sets of skills, knowledge and psychophysical characteristics were assigned to four groups of qualifications: extra-professional, general-professional, basie professional and specialised professional skills, with indMdual groups differing in terms of scope and degree of generalny. On the basis of the above criteria, a questionnaire was designed and a survey was carried out. The questionnaire, which had over 30 pages, was first tested in a pilot study involving 8 persons and then used in a target study of 40 respondents. Both studies involved active physiotherapists as well as the management of the facility where they were employed. The results of the suney served to develop a preliminary version of the standard, which was later assessed by three evaluators during a session with the authors. Following incorporation of justified comments and emenda-tions, the standard was sent to reviewers, whose remarks were incorporated before the standard was submitted to a relevant committee for approval. Results. The standard of the physiotherapist profession was elaborated, including the legal basis of the profession, a synoptic description of the profession, work place, professional tasks, and a specification of general-professional, basie and specialized qualifications for the profession. Conclusions. 1. The standard is a single document specifying the range of knowledge and skills, professional tasks and the scope of professional responsibility. 2. The standard of the physiotherapist profession can be used by interested persons and institutions for a variety of purposes, e.g. vocational counselling, employment policies, personnel policy of companies and institutions as well as for social insurance related purpos-es to estimate occupational risk and determine insurance premiums accordingly and in jurisprudence and to determine social insurance.
Key words:
physiotherapist, professional tasks, professional competence
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Assessment of gait patiem following Kinesiology Taping application in patients after cerebral stroke

Beata Michalak, Bartłomiej Halat, Wojciech Kufel, Marta Kopa, Jacek Łuniewski, Katarzyna Bogacz, Magdalena Wilk, Marcin Krajczy, Anna Lipińska, Jan Szczegielniak, Zbigniew Śliwiński

Beata Michalak, Bartłomiej Halat, Wojciech Kufel, Marta Kopa, Jacek Łuniewski, Katarzyna Bogacz, Magdalena Wilk, Marcin Krajczy, Anna Lipińska, Jan Szczegielniak, Zbigniew Śliwiński – Assessment of gait patiem following Kinesiology Taping application in patients after cerebral stroke. Fizjoterapia Polska 2009; 9(2); 133-142

Abstract
Background. The authors present an assessment of gait pattern in stroke patients subjected to comprehensive physiotherapy inclu-ding Kinesiology Taping applications. Material and methods. The KT group included 20 patients (13 men and 7 women) who were subjected to Kinesiology Taping. KT applications were not used in the control group, which consisted of 5 women and 15 men. Ali patients underwent physical, neurological and functional examinations, which constituted the basis for designing a rehabilitation program. Results. The analysis of the results indicates that functional KT application to the anterior tibial muscie, ligamentous KT application to the Achilles tendon and muscular KT application to the soleus muscie significantly contributed to improving ankle joint function. Patients treated with KT applications demonstrated improved gait patterns, visible as balanced step length and an extended support phase main-taining the body weight. When learning and analyzing the gait pattern, the midstance phase (fuli loading) is a significant element prece-ding the propulsion phase. This assessment of gait patterns following KT application in stroke patient is an innovative study. Conclusions. Muscular and ligamentous Kinesiology Taping applications reduce the spastic tension of the lower limb muscles para-lyzed as a result of cerebral stroke, The beneficial effect of Kinesiology Taping described by the founders ofthis method reduces the congestive edema of the limbs paralyzed as a result of a cerebral stroke and improve the gait pattern. The rehabilitation program applied in this study increased the gait speed of the stroke patients.
Key words:
Kinesiology Taping, muscular applications, ligamentous applications, corrective applications, cerebral stroke
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Effects of 8 weeks of isometric training on cutaneous microcirculation

Renata Szyguła, Jan Szczegielniak

Renata Szyguła, Jan Szczegielniak – Effects of 8 weeks of isometric training on cutaneous microcirculation. Fizjoterapia Polska 2010; 10(4); 281-288

Abstract
The effect of resistance exercises on peripheral circulation is poorly documented. Reports about the impact of such exercises on the vascular endothelium are conflicting. Similar controversy surrounds the response of systemic and cutaneous microcirculation to resistance training. A study was therefore conducted to assess the impact of 8-week isometric training of forearm muscle on cutaneous microcirculation. Eight weeks of isometric training was applied to 34 healthy men. Cutaneous microcirculation was measured using a Perifluks 4001 (Perimed) laser Doppler flowmeter. Laser Doppler flowmeter signal frequency within the 0.01-2 Hz range was also analyzed during basal flow. After 8 weeks of isometric exercises to forearm and hand, forearm circumference increased from 27.6±1.23 to 28.31±1.33 cm (p=0.02). Resting flow improved from 10.29±2.36 PU before the training to 13.04±1.16 PU after the training (p=0.0000). The remaining cutaneous microcirculation parameters examined in the study did not change significantly after the resistance training period.8-week isometric exercises of the non-dominant forearm and hand improved the resting perfusion of cutaneous microcirculation. The resistance training did not influence the capacity and efficiency of the cutaneous vascular bed in the study group, which may indicate lack of a cardioprotective effect of local isometric exercises.
Key words:
isometric training, cutaneous microcirculation, laser Doppler flowmetry
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Effect of an inpatient Active Rehabilitation programme on functional performance of patients following a cervical spinal cord injury

Piotr Józefowski, Rafał Szafraniec, Jan Szczegielniak

Piotr Józefowski, Rafał Szafraniec, Jan Szczegielniak – Effect of an inpatient Active Rehabilitation programme on functional performance of patients following a cervical spinal cord injury. Fizjoterapia Polska 2011; 11(1); 21-29

Abstract
The study aimed to evaluate the effectiveness of a single administration of an inpatient programme of Active Rehabilitation on the functional performance of people with high spinal cord injury. The study involved 23 men between the ages of 17 and 30 years with tetraplegia due to spinal cord injury in the cervical segment. Group 1 was composed of patients with damage at the level of C6 (n = 22), and Group II consisted of patients with damage at the level of C7 (n = 11). Patients were evaluated immediately before the beginning of the programme (TEST I) and on its completion (TEST II) using the Spinal Cord Independence Measure (SCIM) scale.Mean SCIM increased from 32.8 to 43.5 in the C6 group, and from 43.7 to 53.9 in the C7 group. Improved SCIM scores were noted in both groups in all of the domains surveyed: self-care, respiration and sphincter management, and indoor and outdoor mobility.A fourteen-day inpatient programme of Active Rehabilitation appeared to have a significant impact on improving functional performance in the patients after spinal cord injury at the C6 and C7 level in all aspects examined, even when the damage had occurred 14-17 months before the treatment began.
Key words:
spinal cord injury, Active Rehabilitation, functional performance, SCIM
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The effect of Kinesiology Taping application on the result of 100 meter walking test in patients after cerebrovascular stroke

Jan Szczegielniak, Dariusz Banik, Jacek Łuniewski, Katarzyna Bogacz, Zbigniew Śliwiński

Jan Szczegielniak, Dariusz Banik, Jacek Łuniewski, Katarzyna Bogacz, Zbigniew Śliwiński – The effect of Kinesiology Taping application on the result of 100 meter walking test in patients after cerebrovascular stroke. Fizjoterapia Polska 2012; 12(1); 71-75

Abstract
Foot drop is one of the most serious problems, encountered during rehabilitation of patients with the history of cerebrovascular stroke, since it significantly contributes to gait quality deterioration. Traditional orthopaedic equip­ment may, to some degree, compensate this defect. Alternative rehabilitation forms for patients with foot drop include corrective application of Kinesiology Taping. The goal of this paper is to evaluate the effect of corrective positioning of the foot using Kinesiology Taping on the result of 100 metre walk test in patients with the history of cerebrovascular stroke. 30 randomly selected patients (15 males and 15 females) with the history of cerebrovascular stroke participated in the study. The subjects underwent treatment at the Medical Centre in Brzeg from January to December 2009. The subjects’ age ranged from 53 to 70 years (the mean age = 58.7 years). All the subjects underwent standard neurological physio­therapy. They performed a 100 metre walk test before the application, an hour after the application and 24 hours after the appli­cation of Kinesiology Tape, aimed at foot drop correction. A statistically significant (p<0.05) reduction in the results obtained from the test was observed in the subjects after Kinesiology Tape application.The results suggest the usefulness of corrective application of Kinesiology Taping, supporting neurological physiotherapy in patients after cerebrovascular stroke.
Key words:
Kinesiology Taping, Cerebrovascular stroke, foot drop
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Assessment of effectiveness of short-lived physiotherapy procedure on selected functional parameters of the respiratory system in patients with COPD Chronic Obstructive Lung Disease (COLD)

Krystyna Rożek, Jan Szczegielniak, Marta Majewska-Pulsakowska, Anna Dor, Monika Bartczyszyn

Krystyna Rożek, Jan Szczegielniak, Marta Majewska-Pulsakowska, Anna Dor, Monika Bartczyszyn – Assessment of effectiveness of short-lived physiotherapy procedure on selected functional parameters of the respiratory system in patients with COPD Chronic Obstructive Lung Disease (COLD). Fizjoterapia Polska 2012; 12(2); 119-128

Abstract
Background. The objective of the study of short-lived physiotherapy procedure on selected functional parameters of lungs, parameters of arterial blood gas (ABG) and of physical capacity patients with advanced COPD was to assess its effectiveness. Material and methods. examinations were carried out on 40 of the hospitalized men with COPD. Patients were divided in two research groups. Group I -23 men observed a week rehabilitation program based on physiotherapy aimed at raising physical fitness of the patients, group II-control was made of 17 patients in which only pharmacological curing was employed. Functional examinations of the lungs were made with the help of apparatus of German Erich Jaeger FLOWSCREEN equipment. All patients underwent the following examinations: ABG, 6MWT (Six Minutes Walking Test), measurement of BMI (Mass Index Body) and a range of chest mobility. Results. Subjects from Group I, after completion of improvement process, were able to overcome a longer walking distance in a 6-minute walking test, this distance became, however, even shorter, compared to exit results, in the control group patients. However, the average walking speed as well as MET values calculated from the formulae increased in both groups. Parameter FVC significantly increased in group I patients. A significant improvement was also observed amongst studied ABG parameters: pO2 and SaO2 in the experimental group, and a decrease, after the same number of days, in the control group.Conclusions. 1. As a result of the weekly special physiotherapy program the walking distance covered during a 6-minute walking test increased. 2. Among lung function parameters only forced vital capacity increased significantly. 3. After a week of exer­cise pO2 and SaO2 significantly increased in the experimental group.
Key words:
COPD, pulmonary rehabilitation, respiratory function, Exercise Tolerance, POChP
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根据2018年5月9日关于支持严重残疾人的特殊解决方案的法案,在治疗康复领域接受治疗的患者概况

Karol Wojciechowski, Krzysztof Mirecki, Marek Kiljański, Jan Szczegielniak

K. Wojciechowski, K. Mirecki, M. Kiljański, J. Szczegielniak – Profil pacjentów usprawnianych w zakresie rehabilitacji leczniczej na podstawie ustawy z dnia 9 maja 2018 r. o szczególnych rozwiązaniach wspierających osoby o znacznym stopniu niepełnosprawności. Fizjoterapia Polska 2019; 19(3); 168-172

摘要
研究目的在试图分析针对具严重残疾证者所提供的康复服务。
研究材料包括与国家健康基金会罗兹分会签订医疗康复合同的服务提供机构所提供的报告数据,其针对具严重残疾证明者提供合并范围内的服务,报告中的数据由服务提供者于2018年7月1日至2018年12月31日间编制。
根据数据分析显示,严重残疾者(占受访者总数45.13 %)最常接受门诊物理治疗,29.63%的患者接受门诊康复护理,19.12% 的患者在家中接受理疗。
研究材料的评估显示出最常接受康复治疗的患者年龄在51-84岁之间(占受访者总数62.23 %),最小的患者组为年龄在16岁以下及85-101岁间的患者(分别占受访者总数3.26% 及 6.04%)。根据评估显示,服务提供者所提供报告中最常见的主要诊断为小儿脑瘫(占总受访者总数8.65%)及偏瘫(占总受访者总数7.71%)。
该研究显示报告中最常处理的结算项目为与处理患者的个别工作,占所有程序的17.06 %。

关键词:
治疗康复,残疾程度显着

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ST段抬高心肌梗死患者恢复治疗和康复过程中健康矫正内部图像的临床血流动力学和心理认知相似性

Roxolana Nesterak, Igor Vakalіuk, Jacek Łuniewski, Jan Szczegielniak

R. Nesterak, I. Vakalіuk, J. Łuniewski, J. Szczegielniak – Clinico-hemodynamic and psycho-cognitive parallels of internal picture of health correction in the process of restorative treatment and rehabilitation of patients with ST-segment elevation myocardial infarction. Fizjoterapia Polska 2019; 19(3); 158-166

摘要
目的。本研究的目的在确认ST段抬高型心肌梗死患者在恢复治疗和康复过程中内部健康状况校正的临床血液动力学和心理认知的相似性。
材料和方法。该研究纳入141名ST段抬高型心机梗死患者,他们被分入以下各组:其中63名患者采保守治疗,78名采经皮冠状动脉介入治疗(PCI)的侵入性治疗策略。根据应用和采取恢复治疗和康复方法的不同,每组患者又分成亚组,第一亚组患者接受传统治疗,第二亚组除了传统治疗外还接受通过健康内部图谱优化心脏病患者的临床心理康复计划”的形式优化IPH的训练。
结果。使用通过健康内部图谱优化心脏病患者的临床心理康复计划”提高了梗死后期管理的临床疗效,增加了以6MWT测量的体能活动的耐受性,减少心肌缺血的症状,且总的来说提高了ST段抬高型心肌梗死患者的生活质量。
结论。“通过健康内部图谱优化心脏病患者的临床心理康复计划“可有效用于临床实践。

关键词:
心机梗塞, 康复, 心理学

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慢性阻塞肺病患者的康复模型

Jan Szczegielniak, Jacek Łuniewski, Marcin Krajczy, Katarzyna Bogacz

J.Szczegielniak, J. Łuniewski, M. Krajczy, K. Bogacz – Rehabilitation models for patients with COPD. Fizjoterapia Polska 2019; 19(3); 126-137

摘要
康复计划包括A、B、C、D、E等模式,特定类型分级的基本标准为运动耐力、肺通气受损(FEV1指数)、呼吸困难程度及体适能等方面的评估。
患者评估时考虑的其他标准还包括年龄、呼吸困难程度及体适能等。对运动测试有禁忌症或出现循环或呼吸功能衰竭者将被分类为E型,其他类型测试涵盖自行车测功计、呼吸和一般运动训练、阻力训练或站立训练、步行、吸入、引流和有效咳嗽、胸部轻拍、物理治疗和按摩等。

关键词:
康复计划、慢性阻塞肺病、康复模式

 

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用於慢性阻塞性肺病患者物理治療的運動耐量試驗

Jan Szczegielniak, Katarzyna Bogacz, Marcin Krajczy, Jacek Łuniewski

Jan Szczegielniak, Katarzyna Bogacz, Marcin Krajczy, Jacek Łuniewski – Exercise tolerance tests used in physiotherapy for COPD patients. Fizjoterapia Polska 2019; 19(3); 24-30

摘要
慢性阻塞肺病的物理治疗计划基础为耐力训练,然而要准确确定每位患者的负荷值就必须进行运动测试,经过运动测试可正确规划能力训练并评估其有效性,同时它们也是评估康复益处的可靠工具。运动测试可用于物理治疗分级、训练计划制定、检测限制运动的症候、物理治疗程序控制及物理治疗效果评估等方面。

关键词:
运动测试、慢性阻塞肺病

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