The importance of systematic rehabilitation over 45 years of a patient with developmental dysplasia of the hip joint (case study)

Eleonora Stefańska-Szachoń, Anna Kubsik-Gidlewska, Marek Krochmalski, Marta Woldańska-Okońska, Marek Kiljański

Eleonora Stefańska-Szachoń, Anna Kubsik-Gidlewska, Marek Krochmalski, Marta Woldańska-Okońska, Marek Kiljański – The importance of systematic rehabilitation over 45 years of a patient with developmental dysplasia of the hip joint (case study). Fizjoterapia Polska 2023; 23(2); 182-194

DOI: https://doi.org/10.56984/8ZG0DF5B2

Abstract

Congenital hip dysplasia is a teratogenic defect and affects 2% of the population; It arises in the fetal period and can be caused by pathological factors from both the mother and the fetus. The hallmark of congenital hip dysplasia is an undeveloped, excessively shallow acetabulum that prevents stabilization of the femoral head, resulting in hip dislocation. In recent years, there has been a shift in understanding of this musculoskeletal defect, based on early clinical and ultrasound findings, to developmental hip dysplasia, which can present as hip subluxation or dislocation. This paper presents the stages of treatment of a patient with developmental hip dysplasia over a 45-year period, the course of rehabilitation, and the effects of improvement after the use of CD34+ stem cells.

 

Key words: congenital hip dysplasia, developmental hip dysplasia, CD34+ stem cells, case stage

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Physiotherapeutic procedure in goose foot inflammation – case study

Radosław Kocent, Marek Kiljański, Joanna Kałuża-Pawłowska

Radosław Kocent, Marek Kiljański, Joanna Kałuża-Pawłowska – Physiotherapeutic procedure in goose foot inflammation – case study. Fizjoterapia Polska 2021; 21(5); 204-210

Abstract
Objective. The article presents a comprehensive rehabilitation procedure in goose foot bursitis. At the beginning, the causes of inflammation and its symptoms were presented.
Material and methods. The study was conducted on a specific case. The article describes the patient’s evaluation and physiotherapy recommendations for the treatment of the disease. In the field of kinesiotherapy, recommendations were made in the form of exercises stretching the shortened muscles that cause the goose foot, as well as strengthening the group of muscles activated to stabilize the knee. An important aspect of working with myofascial techniques is presented. Cryotherapy, laser therapy and sonotherapy procedures are described among the physiotherapy treatments in the rehabilitation of goose foot inflammation. The article also highlights the effectiveness of treatment thanks to the combination of physical therapy, kinesiotherapy, functional massage and re-education of gait and running. The subject of patient education to prevent the recurrence of injuries was also discussed.
Results. Therapy was administered for a period of four weeks. Positions during rest and sleep at home, exercise, walking in a newly learned, correct pattern and avoiding training errors were recommended. After the treatment was completed, pain was completely gone and the patient was fully active again.
Conclusions. Physical therapy, kinesiotherapy, massage and the patient’s compliance with the therapist’s recommendations result in the relief of ailments and a full return to various types of activity.
Key words:
goose foot inflammation, physiotherapy
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The impact of magnetostimulation on the level of urinary incontinence among women after menopause

Robert Kowalski, Joanna Kałuża-Pawłowska, Marek Kiljański

Robert Kowalski, Joanna Kałuża-Pawłowska, Marek Kiljański – The impact of magnetostimulation on the level of urinary incontinence among women after menopause. Fizjoterapia Polska 2021; 21(5); 58-69

Abstract
Urinary incontinence (UI) is according to ICS definition “every uncontrolled urine loss”. Among the broadly understood definition, there are different types of UI: effort, urgent, from overflow, mixed, transitional, bedwetting and other types of UI. The most common type from mentioned is the effort urinary incontinence and the mixed one. Due to the complex nature of UI problem, there are many methods of diagnosis and treatment of incontinence. In conservative treatment, pelvic floor muscle exercises, physical therapy (including magnetic field) and behavioral therapy are commonly used.  The aim of the study.  The aim of work is to evaluate the impact of magnetostimulation and pelvic floor muscle exercises on the level of urinary incontinence among women after menopause. Material and methodology.  The research was conducted among 30 women at the age of 45–67 years old (average ± 56) who were treated because of UI in The Independent Public Health Care Centre named Primate Cardinal Stefan Wyszyński in Sieradz in the rehabilitation ward. The patients were divided into two groups – 15 people each. In the first group participants were tested by magnetostimulation and they were doing pelvic floor muscle exercises. In the second group they were only doing pelvic floor muscle exercises.The patients have been surveyed twice, before and after 3 weeks therapy. In the study two different questionnaires (A and B) were used. They were based on Gaudenza questionnaire. Results. According to the analysis of survey data, these are the following results. In the first group improvement concerned: reduction in the frequency of UI episodes and frequency of urination, less amount of „urine loss” and UI intensity based on daily physical acivity, extending the time of the ability to control urination and better quality of life tested women. In the second group an improvement has been noticed according to subjective patient’s feelings. All data analysis results from questionnaires were not statistically significant.
Conclusions. From the analysis of the results, the following conclusions have been drawn: 1. Combination therapy of magnetostimulation with pelvic floor exercises causes more beneficial effect than applying only exercises. 2. Subjective assessment of participants on how to improve ailments connected with UI, speaks in favour of therapy with the use of magnetic field stimulation. 3. The most common type of incontinence amoung tested women after menopause was the effort one. 4. Therapy with 3–weeks programme of magnetic field stimulation increases the level of satisfaction and improves well-being of poople with UI.
Key words:
urinary incontinence, magnetostimulation, menopause, physiotherapy
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Thermographic assessment of radiation induced by cryostimulation of both lower limbs and analysis of changes in children with cerebral palsy

Zbigniew Śliwiński, Zdzisław Zagrobelny, Jan Talar, Piotr Płaza, Bartłomiej Halat, Marek Kiljański

Zbigniew Śliwiński, Zdzisław Zagrobelny, Jan Talar, Piotr Płaza, Bartłomiej Halat, Marek Kiljański – Thermographic assessment of radiation induced by cryostimulation of both lower limbs and analysis of changes in children with cerebral palsy. Fizjoterapia Polska 2003; 3(4); 316-330

Abstract

Background. The authors presented the examine of changes temperature results in the children’s with the cerebral palsy legs, which were registrated during treatment in the Rehabilitation Center in Zgorzelec. Material and methods. The changes temperature were checkted by the camera Agema 570 before the treatment and four weeks later. The spastic tension was checked also using the Mionotometer Szirmai and Ashworth test and Brunstrom test. Spontaneous motorial evaluation and the level motorial development were checked using own scale. Results and conclusions. The results shown that the using the cryostimulation in the treatment children with the cerebral palsy decrease the spastic tension in the legs and the spontaneous motorial evaluation was better, the range of motion in joins also were better after treatment. The termal pictures shown that arterial play in the children’s legs was adapted to the cryogenic temperatures.

Key words:
thermoregulation, local cryotherapy, termovision, spastic tension, spontaneous motorial evaluation
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Medical massage as a rational treatment following facial skeleton surgery

Krzysztof Kassolik, Henryk Kaczkowski, Hanna Wojtoń, Waldemar Andrzejewski, Piotr Zachariasiewicz, Ewa Trzęsicka, Marek Kiljański

Krzysztof Kassolik, Henryk Kaczkowski, Hanna Wojtoń, Waldemar Andrzejewski, Piotr Zachariasiewicz, Ewa Trzęsicka, Marek Kiljański – Medical massage as a rational treatment following facial skeleton surgery. Fizjoterapia Polska 2007; 7(1); 87-92

Abstract

The main aim of postoperative management following surgery of the facial skeleton is to prevent potential postoperative complications. As a result of disruption of the continuity of tissue, there is swelling within the operated area, as well as subcutaneous extravasation of blood and hyperaesthesia of facial skin. The authors have developed an approach to reduce or completely eliminate those inconveniences and thus shorten convalescence time using medical massage. Initially, normal superficial sensitivity of facial skin is restored by stroking from the medial line of the face towards the ear concha, starting from the lower jaw line and ending in the forehead. Next, the peristaltic movement in lymphatic vessels diverting lymph within the head and neck is stimulated by moving the skin over deeper lying tissues within the physiological range of skin mobility. Circular movements are made with a brush for 2-4 min., and slight pressure is applied to the skin over the haematoma area in order to accelerate the resorption of subcutaneous discoloration ensuing from extravasation of blood. The last stage of the treatment is aimed at reducing pain and tenderness in the operated area. We use vibration of < 1 mm amplitude and frequency of 50-100 Hz, which guarantees analgesia for 2-3 hours. The treatment reduces postoperative discomfort afflicting patients already during the first 24 hours after surgery.

Key words:
massage therapy, oedema, hypersensitivity
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The effect of Kinesio Taping applications on motor activity in children with developmental defects

Zbigniew Śliwiński, Bartłomiej Halat, Wojciech Kufel, Beata Michalak, Marek Kiljański

Zbigniew Śliwiński, Bartłomiej Halat, Wojciech Kufel, Beata Michalak, Marek Kiljański – The effect of Kinesio Taping applications on motor activity in children with developmental defects. Fizjoterapia Polska 2007; 7(1); 52-62

Abstract

Background. The authors present the results of a study of children with developmental defects who underwent a comprehensive physiotherapeutic treatment with the Kinesio Taping method. The children were aged 18 months to 8 years. All patients took part in a 4-week rehabilitation programme at the Rehabilitation Centre in Zgorzelec. Material and methods. The study included 30 children of both sexes. All patients underwent a medical and physiotherapeutic examination, which was the basis for designing a Kinesio Taping-based rehabilitation plan. The application of Kinesio Taping was preceded by Kinesio Taping screening tests, Vojta’s screening tests and an assessment of spontaneous motor activity. The final stage of the study involved analysis of study results and assessment of the utility of the screening tests. Results. Our observations supported by the test results and their analysis prove that Kinesio Taping is a very useful physiotherapeutic modality. If applied properly, it is a valuable adjunct to therapeutic rehabilitation. Kinesio Taping enables the control of muscle tone, which directly translates into new possibilities of locomotor activity of the patients. This method helps to reduce paraesthesias and oedemas. Conclusions. Kinesio Taping applications influenced muscle and fascia tone in our study. Kinesio Taping can be used in combination with other procedures. There are no absolute contraindications to the use of Kinesio Taping as part of comprehensive physiotherapeutic management.

Key words:
developmental defects, Kinesio Taping screening tests, Kinesio Taping applications
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The importance of quality in the practice of physiotherapy. The case of the Regional Specialised Paediatric Hospital in Kielce

Wojciech Kiebzak, Małgorzata Starczyńska, Zbigniew Śliwiński, Ireneusz M. Kowalski, Lucyna Robak, Marek Kiljański, Marek Woszczak, Magdalena Jaskólska-Pisiewicz

Wojciech Kiebzak, Małgorzata Starczyńska, Zbigniew Śliwiński, Ireneusz M. Kowalski, Lucyna Robak, Marek Kiljański, Marek Woszczak, Magdalena Jaskólska-Pisiewicz – The importance of quality in the practice of physiotherapy. The case of the Regional Specialised Paediatric Hospital in Kielce. Fizjoterapia Polska 2007; 7(2), 133-144

Abstract

Background. The aim of this paper was to show that procedures used within the framework of therapeutic management at the Regional Specialised Paediatric Hospital in Kielce improve the quality of service, which is the main condition for the hospital to remain on the market of health service providers. The high quality of services has been confirmed by the recent conferring of an accreditation certificate which requires that the hospital operate on the basis of a number of documented procedures, instructions and standards. The therapeutic activities of the hospital are based on a set of instructions providing detailed guidelines concerning the management of particular medical conditions. Material and methods. The study included children who were hospitalized or treated on an outpatient basis. Patient management was based on a set of instructions. An anonymous questionnaire concerning the quality of treatment and the level of satisfaction with the service was distributed among the children’s guardians and parents. Results. In the first and the second half of the year 2005, 95% and 86% of parents respectively assessed service quality as very good. 92% of parents gave the rating of very good in the first half of the year 2006 and 79% did so in the second half of the year. These results confirmed the high quality and efficacy of as well as satisfaction with the treatment received by the children. Conclusions. The observance of specified instructions during the therapeutic process improves the quality of service and minimizes the possibility of medical malpractice.

Key words:

quality, standard, instructions, rehabilitation treatment

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Body equilibrium assessment in patients with degenerative changes after whole-body cryostimulation connected with physiotherapy

Marek Kiljański, Zbigniew Śliwiński, Wojciech Kufel, Wojciech Kiebzak, Marek Woszczak

Marek Kiljański, Zbigniew Śliwiński, Wojciech Kufel, Wojciech Kiebzak, Marek Woszczak – Body equilibrium assessment in patients with degenerative changes after whole-body cryostimulation connected with physiotherapy. Fizjoterapia Polska 2007; 7(3); 286-298

Abstract
Background. The authors present the results obtained in a group of 126 participants. The aim of the study was to determine whether a four-week program of physiotherapy including whole-body cryostimulation, applied in patients with degenerative changes in the spine, influences their body equilibrium and pain sensation. Material and methods. The examined group comprised 66 patients with degenerative changes in the lumbar spine, while the control group consisted of 60 participants. Apart from an individually designed rehabilitation program, each patient participated in 20 sessions of whole-body cryostimulation. The measurement of lumbosacral spine mobility and the assessment of pain sensation using the Visual Analogue Scale (VAS) were performed before the first and after the last session. Moreover, after the first, tenth and twentieth session of general cryostimulation, measurements on a stabilometric platform were conducted. The healthy participants, who were qualified as the control group, underwent tests on the stabilometric platform after one session in the cryogenic chamber. The aim of these tests was to compare the differences in the stabilogram curve in healthy individuals and patients with degenerative changes in the lumbar spine. The effect of cryostimulation procedures on pain sensation and mobility of the lumbosacral spine was assessed. Additionally, the effect of cryogenic temperatures on body equilibrium was studied. Results. The comparison of the results, obtained before the procedure and after completing the therapy indicates that general cryostimulation in a physiotherapeutic program for patients with degenerative changes in the lumbar spine contributes to relaxation of excessively tense muscles. Conclusions. The use of whole body cryostimulation in patients with degenerative changes in the lumbosacral spine, combined with a properly designed and managed physiotherapeutic program, decreases pain sensation in a statistically significant way. The application of cryogenic temperatures, combined with physiotherapeutic program, favourably affect patient body equilibrium.
Słowa kluczowe
physiotherapy, spine, cryostimulation, coordination, stabilometric platform
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Assessment of the efficacy of local cryotherapy in children with cerebral palsy

Marek Woszczak, Zbigniew Śliwiński, Marek Kiljański, Wojciech Kiebzak, Marcin Szczepanik, Wiesław Tomaszewski

Marek Woszczak, Zbigniew Śliwiński, Marek Kiljański, Wojciech Kiebzak, Marcin Szczepanik, Wiesław Tomaszewski – Assessment of the efficacy of local cryotherapy in children with cerebral palsy. Fizjoterapia Polska 2007; 7(3); 275-285

Abstract
Background. The author presents the results of a study of 60 children with infantile cerebral palsy carried out at a rehabilitation centre in the town of Zgorzelec. The study aimed to demonstrate that a 4-week programme of customised kinesiotherapy with cryostimulation of the lower limbs with liquid nitrogen vapour could have a beneficial effect on motor status as well as muscle tone and skin surface temperature in children with infantile cerebral palsy. Material and methods. A group of children of both sexes aged 3-14 with infantile cerebral palsy underwent 4 weeks of customised kinesiotherapy combined with cryostimulation of both lower limbs. Muscle tone was determined with a Szirmai myotonometer using special methodology. The level of spasticity was estimated with the Ashworth test, and motor activity assessment was made before and after the treatment according to a score table designed by the authors. Thermovisual recordings of skin surface temperature in the lower limbs were made immediately before and 5 and 15 minutes after cryostimulation procedures at the beginning and end of the 4-week programme. Results and Conclusions. A comparison of the results of the motor activity assessment, Ashworth test and myotonometry before and after the rehabilitation programme shows that the use of cryostimulation in the rehabilitation of children with infantile cerebral palsy results in a reduction of spasticity in the lower limbs and improvement in motor activity. Thermovisual analysis of skin surface temperature demonstrates full adaptation of the children’s vascular system, i.e. excellent safety of topical cryostimulation.
Key words:
infantile cerebral palsy, spastic muscle tone, local cryostimulation, Ashworth test, motor activity assessment, Szirmai myotonometer, thermovision
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Physiotherapist Ethical Code in Polish Republic

Wojciech Kiebzak, Krzysztof Gieremek, Marian Florczyk, Marek Kiljański

Wojciech Kiebzak, Krzysztof Gieremek, Marian Florczyk, Marek Kiljański – Physiotherapist Ethical Code in Polish Republic. Fizjoterapia Polska 2009; 9(3); 266-272

Abstract
Work is what differs human beings from other creatures. A man as a subjective existence is capable of intentional and methodical actions. A man aims at finding self-fulfillment; he decides about his own future and the future of others. Work is being done with others and for others. Work has a common naturę. The concern for a human dignity and common good re-quires obsen/ance ofcrucial values and ethical norms as well as adopting certain attitudes resulting from them. Showing re-lations between a physiotherapist and a patient, the Ethical Code of Physiotherapist outlines professional and ethical beha-viors in those relations. The Code is not limited only to those special relations, it also includes the obligations of a physiotherapist towards society doctors and associales. Among seven chapters, there are those which determine ways ofrespon-sible preparation for this profession and constant training. Therefore, the code deserves the highest recognition. Its first sen-tence, reffering to phisiotherapisfs life and work.: „to honor rights and dignity of every human being is the soul and the ve-ry fundamenta! thought of this code. This code should be extremely helpful for students as well. Deontology as professional ethics expects from aplicants for the university to make not only free but will be responsible for the well-being of men. Therefore, bearing in mind his future professional duties, he should primum non nocere!!!
Key words:
Physiotherapist Ethical Code
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