Health Education Test in a survey of awareness of health issues in lower limb amputees

Piotr Tederko, Katarzyna Dmitruk, Krzysztof Wasiak, Jerzy Kiwerski

Piotr Tederko, Katarzyna Dmitruk, Krzysztof Wasiak, Jerzy Kiwerski – Health Education Test in a survey of awareness of health issues in lower limb amputees. Fizjoterapia Polska 2008; 8(2); 189-196

Abstract
Background. Education is part and parcel of comprehensive rehabilitation. With regard to limb amputees, education involves not only locomotion techniques and prosthesis application, but also includes prophylaxis and recognition of early signs of common stump problems. In this preliminary study we report the results of experimental application of a Health Education Test (HET) in an inquiry investigating the level of health education in lower limb amputees. Material and methods. 40 subjects admitted to Rehabilitation Department (6 women, 34 men), mean age 60.6 years (SD=12.8) who underwent unilateral lower limb amputation (26 above-knee and 14 below-knee amputees). 33 patients underwent amputation for vascular complications. The HET consisted of 4 open and 46 detailed questions inquiring about patients’ knowledge of the causes, prophylaxis and symptoms of popular stump problems, hygiene and health issues after lower limb amputation. Results. We noted a negative correlation between age and HET results (Pearson coefficient 0.6, p<0.01). Residents of localities above 20.000 inhabitants gave significantly better responses (Mann-Whitney test; p<0.05). HET results did not correlate with general education, reason and level of amputation. Participants reported shortage of suitable information and educational materials for lower limb amputees and difficulty obtaining expert advice outside of specialist centers. Conclusions. Health education concerning prophylaxis of stump problems should be commenced about the time of amputation, maintained during the hospital stage of rehabilitation, and continued in the outpatient setting. The programs and forms of education should be age-specific and be available regardless of the patient’s place of residence.
Key words:
amputation, rehabilitation, health education
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Analgesic effect of static magnets – efficacy according to evidences

Piotr Tederko, Marek Krasuski

Piotr Tederko, Marek Krasuski – Analgesic effect of static magnets – efficacy according to evidences. Fizjoterapia Polska 2011; 11(4); 289-301

Abstract
Alternative and complimentary modes of treatment gain popularity and compete with evidence based therapies. Deve­lopment of alternative methods is enhanced by the demands of the market of medical devices designed for home treatment without need of a physician’s consultation. Application of devices with static magnets is advertised as a safe and effective pain therapy. The purpose of the paper is to analyze scientific evidence of efficacy and safety of static magnetic fields (SMF) applied as therapeutic modality for pain. Survey of peer-reviewed scientific publications resulted in identification of 45 papers including 40 primary publications and 5 meta-analyses. 4 original studies were excludes as uncontrolled trials or case studies. One paper was disqualified because of simultaneous application of alternating magnetic field. Among randomized controlled trials on clinical applications of SMF against pain 10 support hypothesis of analgesic effect of SMF, 9 neither confirm nor exclude therapeutic efficacy of SMF, and 16 give the evidence against SMF superiority over placebo. Frequent failure to blind the study, small sample sizes, short follow-up period limit evidence value of the analyzed results. Expectations resulting from frequent sponsorship of studies by manufacturers of SMF equipment appear to influence the objectivity of several conclusions. SMF of inductances within the range of those used in analyzed devices are not classifiable due to their potential risk of chronic exposure by inconclusive evidence. According to theoretical deliberations, pregnancy, infancy, pacemakers, ferromagnetic implants and application of electronic devices regulating life functions are considered contraindi­cations for the use of therapeutic devices emitting SMF. The current state of knowledge does not allow for unambiguous confirmation of SMF therapeutic efficacy. Devices for therapy with SMF should not be sold as analgesic modalities before evidence of efficacy and safety in each particular indication is confirmed.
Key words:
static magnets, medical devices, Pain, Analgesia
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