Assessment of kinematics of pathological gait after articular cartilage surgery

Andrzej Czamara, Sławomir Winiarski, Zbigniew Jethon, Andrzej Bugajski, Rafał Szafraniec, Andrzej Zaleski, Wiesław Tomaszewski

Andrzej Czamara, Sławomir Winiarski, Zbigniew Jethon, Andrzej Bugajski, Rafał Szafraniec, Andrzej Zaleski, Wiesław Tomaszewski – Assessment of kinematics of pathological gait after articular cartilage surgery. Fizjoterapia Polska 2006; 6(4); 304-309

Abstract
Background. This paper presents a biomechanical assessment of changes in the kinematics of gait of patients following selected types of articular cartilage surgery of the knee joint, examined with a 3D motion analysis system (SIMI Reality Motion Systems GmbH, Germany). Material and methods. The gait of thirty-two patients after articular cartilage surgery of the knee joint was analyzed in the course of 2 out of 4 stages of our original physiotherapy treatment. Monitoring the progress of the rehabilitation programme involved recording of spatial kinematic data of the gait and angle-time characteristics. The first measurement was taken between the 2nd and 3rd week postoperatively, the second was taken between the 6th and 8th postoperative week. The last measurement was taken between the 10th and 14th week postoperatively, when the patient’s gait was fully restored and being improved. Results. Satisfactory individual results in patients undergoing our rehabilitation programme were obtained in test patients compared to the control group between the 10th and 14th postoperative week. The spatial gait parameters: step and stride lengths were significantly increased and the stance-to-swing ratio decreased for the affected limb compared to the first measurement. Gait velocity was also found to have doubled. In addition the range of motion in the joints was increased and the angle characteristics were similar in the test patients and the control group. Conclusions. The extensive surgical and physiotherapeutic management improved gait parameters between the 10th and 14th postoperative week in all patients.

Key words:
gait analysis, pathological gait, articular cartilage, rehabilitation

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Assessment of kinematics of pathological gait after articular cartillage surgery

Andrzej Czamara, Sławomir Winiarski, Zbigniew Jethon, Andrzej Bugajski, Rafał Szafraniec, Andrzej Zaleski, Wiesław Tomaszewski

Andrzej Czamara, Sławomir Winiarski, Zbigniew Jethon, Andrzej Bugajski, Rafał Szafraniec, Andrzej Zaleski, Wiesław Tomaszewski – Assessment of kinematics of pathological gait after articular cartillage surgery. Fizjoterapia Polska 2007; 7(1); 1-9

Abstract

Background. Thirty two male patients with the full-thickness lesion of articular cartilage on the load-bearing surface of the knee joint (Outerbridge Grade III-IV) were involved in the study. The goal of this paper is the biomechanical assessment of changes in the kinematics of gait of patients after selected articular cartilage surgeries of knee joint examined by the 3D motion analysis system (SIMI Reality Motion Systems GmbH, Germany). Material and methods. Gait of thirty two patients with the articular cartilage surgery of knee joint was analyzed while they underwent 2 out of 4 stages of our original physiotherapy treatment. In order to test the progress of the rehabilitation program the spatial kinematic data of the gait was collected and the angle-time characteristics acquired. The first measurement was taken between the 2nd and 3rd week postoperatively, the second was taken between 6th and 8th week postop. The last measurement was taken between 10th and 14th week postoperatively, when the patient’s gait was fully restored and being improved. The values of step and stride lengths (meters), gait velocity (meters per sec.) and the step cadence (steps per sec.) were monitored as well as the stance and swing ratios (percent of the gait cycle) of the affected and unaffected limb. Range of motion in the knee joint was examined in dynamics and the angles at heel-strike and toe-off measured for both lower limbs. Results. As a consequence of our rehabilitation procedure satisfactory results were obtained individually between 10th and 14th week postop. in test patients with reference to the control group. The spatial gait parameters step and stride lengths have significantly increased and the stance to swing ratio have decreased for the affected limb compared to the first measurement. The gait velocity was found to be doubled. In addition an increase in range of motion in the joints was noticed and the angle characteristics was similar to the one of the control group. Conclusions. The extensive surgical and physiotherapeutic procedures applied in the treatment have improved gait parameters between 10th and 14th week postop in all tested patients.

Key words:
biomechanics, gait, gait disorders, articular cartilage, surgery, rehabilitation
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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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Acceptance of illness in patients with rheumatoid arthritis

Rafał Szafraniec, Edyta Szczuka, Anna Pawłowska

Rafał Szafraniec, Edyta Szczuka, Anna Pawłowska – Acceptance of illness in patients with rheumatoid arthritis. Fizjoterapia Polska 2012; 12(1); 39-48

Abstract
The aim of the study was to assess the degree of acceptance of illness (AI) by persons affected by rheumatoid arthritis as related to the disease duration and selected socio-demographic factors. The research group consisted of 22 women and 18 men (average subjects” age was 50.7±14.3 years, and average disease duration – 14.4±7.8 years). In the study Acceptance of Illness Scale (AIS) was used. Men were found to have slightly higher levels of AI (29.06) than women (24.32). AI ratio was the lowest among those who lost their spouse (17.71), the unmarried 23.5, the married 29.84 (p<0.001). The respondents with university degrees, obtained the average AI value of 32.5; the scores obtained from the subjects with secondary; vocational and basic education were 23, 21.86 and 26.64 respectively (p<0.02). The patients with RA aged below 39 years obtained the average AI value of 31.55, those aged from 40-59 years – 27.94, and those over 60 years – 19.67 (p<0.01). Negative correlation was observed between the duration of the disease and its degree of acceptance (r =-0.64, p<0.00001). The long duration of illness has a negative impact on the degree of disease tolerance. Younger, better educated and having their spouse’s support patients find it easier to adapt to functional limitations caused by rheumatoid arthritis. Both gender and place of residence (city or village) does not significantly influence the level of acceptance of the disease in patients with RA.
Key words:
rheumatoid arthritis (RA), acceptance of illness (AI)
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