Tag: rehabilitacja

The idea of movement re-education in physiotherapy

Janusz Nowotny

Janusz Nowotny – The idea of movement re-education in physiotherapy. Fizjoterapia Polska 2004; 4(1); 68-74

Abstract

Movement is an inherent part of human life. Unfortunately, congenital abnormalities, disease or perinatal injury can make it difficult to learn normal movement in the earliest stages of life. On the other hand, an injury or acquired disorder in the later periods of life can ruin learned movement skills, leading to temporary or permanent disability. This necessitates movement re-education, which is one of the major goals of medical rehabilitation. In the daily practice of physiotherapy we often observe a mechanistic approach to treatment, directed towards relieving particular symptoms. The functional results of such an approach are difficult to foresee, but they are usually unfavorable. Although the idea of re-education is reflected in some neuro-muscular methods, many therapists see the necessity of using them only in such states (i.e. neuromuscular disorders), and seem to see no need for broadly conceived movement re-education. In the present study, the author attempts to counteract this approach, showing some of the basic premises for restoring lost skills, in the context of re-learning correct movements, including the basic features of various pathological states that can temporarily or permanently disturb motor control and prevent the complete recovery of health. Particular attention is given to controlling the process of compensation in the earliest stages of dysfunction, and to restoring physiological movement patterns or forming the most suitable functional patterns.

Key words:

physiology of movement, pathophysiology, rehabilitation

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The effectiveness of conservative methods of rehabilitation (PT) in treatment of lymphoedema after mastectomy operation

Dorota Hanasz-Sokołowska, Urszula Kaźmierczak, Wojciech Hagner, Magdalena Kaźmierczak

Dorota Hanasz-Sokołowska, Urszula Kaźmierczak, Wojciech Hagner, Magdalena Kaźmierczak – The effectiveness of conservative methods of rehabilitation (PT) in treatment of lymphoedema after mastectomy operation. Fizjoterapia Polska 2006; 6(1); 67-72

Abstract

Background. The aim of our research was to evaluate the effectivness of two methods of treatment of the lymphoedema after mastectomy operation. Method number 1 – classic method in treatment of lymphoedema after mastectomy operation. Treatment by using: lymphatic drainage, pneumatic massage, exercises in series 10/ 3 times a week. Method number 2 – complex methods that helps in restoration of patency: lymphatic drainage, pneumatic massage, exercises, bandaimy the upper limb, where lymphoedema appeared in series 10, 5 times a week. The examination aim was to evaluate subside of pain druing process of decreasing of lymphoedema. Material and methods. In our research we examinated patients with lymphoedema of upper limb after mastectomy operation, who were treated in Wojewódzkie Centrum Onkologii in Gdansk. Patients were devided into two groups of 15 patients each. In first group patients were treated in serie of 10, 3 times a week by classic method used: lymphatic drainage, pneumatic massage, exercises. In second group patients were treated by complex method of treatment, in series of 10, 5 times a week, by using classic treatment and adding the bandainy of upper limb, were lymphoedema appeared after operation. Results. Treatment of lymphoedema by using two methods had influence on our final results. Lymphoedema in group number 1, who were treated by classic method was located on level of forearm and elbow point. Lymphoedema in group number 2, who were treated by complex method was located over decvanon of vinov bone. Conclusions. Our research shows that conservative methods of rehabilitation had influence in process of decreasing lymphoedema, also helped to relieve pain in upper limb. The complex method is very effective treatment in lymphotic restor patency process.

Key words:
mastectomy, lymphoedema, rehabilitation
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Evaluating quality of life in traumatic brain injury patients

Małgorzata Wiśniewska, Wiesław Tomaszewski, Ireneusz M. Kowalski, Teresa Wiśniewska

Małgorzata Wiśniewska, Wiesław Tomaszewski, Ireneusz M. Kowalski, Teresa Wiśniewska – Evaluating quality of life in traumatic brain injury patients. Fizjoterapia Polska 2006; 6(1); 13-21

Abstract

Background. According to the World Health Organization (WHO), quality of life (QOL) depends on how individuals perceive their position in life, in the context of the culture and value system in which they live, taken together with their own individual goals, standards, expectations and fears. As a result of traumatic brain injury (TBI), all aspects of the patient’s QOL undergo change to some extent. Neurosurgical treatment, followed by the long hard work of rehabilitation, speech therapy, psychotherapy – all these factors can contribute to significantly improved QOL, which can be measured using questionnaires developed for this purpose. Material and methods. The clinical material consisted of 30 patients (14 female, 16 male) ranging in age from 11 to 50 years, hospitalized in the Department of Rehabilitation at the UMK Collegium Medicum University Hospital in Bydgoszcz. All these patients filled out two widely used questionnaires pertaining to QOL: the WHOQOL-Bref and the SF-36. Results. Both the women and the men in the study population indicated a high QOL in the context of their immediate environment, but a low QOL in respect to social life. Conclusions. The WHOQOL-Bref is more suitable than the SF-36 for the evaluation of QOL in TBI patients, because the former contains questions pertaining to different aspects of life.

Key words:
questionnaire, coma, rehabilitation
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Comparison of motoric activity of American and Polish children with cerebral palsy during rehabilitation

Iwona Kasior-Szerszeń, Wanda Stryła

Iwona Kasior-Szerszeń, Wanda Stryła – Comparison of motoric activity of American and Polish children with cerebral palsy during rehabilitation. Fizjoterapia Polska 2006; 6(1); 7-12

Abstract

Background. Common features of cerebral palsy in children are movement and posture disorders. The most disturbed sphere is motorics. Movement disorders include spastic limb paresis, unvoluntary movements, coordination and balance disturbances. The aim of this report was to compare motor efficiency concerning manual and locomotive functions as well as life activities in Polish and American children. Material and methods. Study material involved 100 Polish children and 107 children from USA. Survey method was used. Results. The results were compared with respect to locomotor and manual functions in Polish and American children. Statistically significant differences were obtained. Conclusions. 1. The level of disability was higher in American children than in Polish children. 2. Manual and locomotive functions in American children were more limited. 3. Everyday child care concerning basic life activities leads to chronic fatigue, frustration, depression and in consequence to disturbances in normal family life.

Key words:
cerebral palsy, rehabilitation, motoric activity
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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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Influence of selected anthropometric features on outcomes of motor rehabilitation of women following radical mastectomy – evaluation of changes in muscle strength

Zbigniew Kopański, Joanna Zyznawska, Robert Suszko, Renata Pięta, Magdalena Michalin

Zbigniew Kopański, Joanna Zyznawska, Robert Suszko, Renata Pięta, Magdalena Michalin – Influence of selected anthropometric features on outcomes of motor rehabilitation of women following radical mastectomy – evaluation of changes in muscle strength. Fizjoterapia Polska 2007; 7(1); 29-37

Abstract

Background. The aim of the study was to determine the usefulness of selected anthropometric features in predicting the development of impairment of the strength of thumb & finger flexors after radical mastectomy. Material and methods. The analysis included 126 women who had undergone a radical operation for breast cancer. The strength of flexors of the fingers & thumb was evaluated before surgery and during 12-month follow-up. The results of muscle strength tests were referred to 15 anthropometric traits. Results. 23.8% of the women did not regain pre-surgery muscle strength, as attested by the results of all muscle strength measurements. There were statistically significant differences in mean body mass and the BM and Quetelet’s indices between women with persistent post-operative impairment of muscle strength and those who regained muscle strength following a radical mastectomy. Conclusions. Impairment of muscle strength below reference values in the finger & thumb flexors was seen in 23.8% of the mastectomy patients. Grasp strength decreases were most strongly correlated with body mass (correlation index 0.67). Post-operative weakening of the hand was significantly correlated with high body mass (>71.1 kg) and high values of the following indices: BMI (>29.8) and Quetelet’s index (>412).

Key words:
radical mastectomy, anthropometric features, muscle strength, 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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Physiotherapy management in geriatrics

Tomasz Pasek, Marcin Kempiński, Jarosław Pasek, Romualda Mucha, Aleksander Sieroń

Tomasz Pasek, Marcin Kempiński, Jarosław Pasek, Romualda Mucha, Aleksander Sieroń – Physiotherapy management in geriatrics. Fizjoterapia Polska 2007; 7(4); 455-464

Abstract
The important role of the physiotherapy in the treatment of elderly patients was recognized in the second part of the 21st century. Physiotherapy facilitates adaptation to the problems of the old age. Physiotherapeutic management includes the development of motor programmes which help elderly people to function normally and independently. Aging is a natural part of human life. Man’s role is to make it as comfortable as possible. Geriatric rehabilitation is concerned with treating elderly patients and keeping them fit, helping them to avoid some of the symptoms of chronic old age ailments. Nowadays age 65 is regarded as the beginning of old age. Some of the most characteristic features of this part of life are: difficulties in maintaining homoeostasis in the presence of stress stimuli, lower capability to carry out activities of daily living and reduced physical activity. In fact, elderly people are increasingly dependent on the help of others. Therefore there is a great need for preventative rehabilitation, whose purpose is to prepare for a physiological and healthy old age. This article describes problems connected with rehabilitation of the elderly. Currently employed physiotherapeutic and kinesitherapeutic methods are described together with state-of-the-art treatment options in physical therapy. The latter include magnetic field stimulation, which is remarkably useful in the treatment of depression, injuries and other musculoskeletal conditions and magneto-LED-therapy, a novel combination of fluctuating magnetic field and visible light irradiation possessing anti-inflammatory, antibacterial and analgesic effects.
Key words:
geriatrics, physical medicine, elderly, rehabilitation
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Rehabilitation of laryngectomized patients – evaluation of physical fitness and capacity

Urszula Kaźmierczak, Wojciech Hagner, Jan Talar

Urszula Kaźmierczak, Wojciech Hagner, Jan Talar – Rehabilitation of laryngectomized patients – evaluation of physical fitness and capacity. Fizjoterapia Polska 2007; 7(4); 431-437

Abstract
Background. Patients after total laryngectomy are usualy less physically active than other groups of patients treated for cancer. The limitation of physical activity after laryngectomy is the result of the inability to control the sensation of apparent dyspnoea and inability to communicate by means of articulate speech, fear of recurrence and of not being accepted by the family or other relations. Early rehabilitation is very important after surgery for cancer, especially when the treatment cripples the patient. Laryngectomy leads to severe disability, depriving the patients of their speech organ, and is associated with various functional postoperative complications. Material and methods. A total of 30 radical laryngectomy patients (4 women and 26 men) aged 48-74 years (mean 61 years) were enrolled for a rehabilitation programme. During the rehabilitation programme, patients were subjected to the Harvard Step Test modified by Szyszko-Wydra. Results. After the rehabilitation treatment, patients in all age groups demonstrated improvement in physical fitness (see figure in text). The level of physical capacity before the treatment was very low, improving to average or good as a result of rehabilitation. Conclusions. The results of the study show that the rehabilitation programme was instrumental in effecting a significant improvement of the patients’ overall physical capacity. Group rehabilitation of patients suffering from the same condition increases the likelihood of achieving a higher level of physical capacity. This is attributable to the positive effect of the daily exercises, especially respiratory exercises to strengthen the diaphragm, which are helpful in making sonorous burps and learning oesophageal speech. Exercise also helps to eliminate the feeling of embarrassment and promotes full acceptance and emotional support within the group.
Key words:
rehabilitation, laryngectomy, evaluation of physical fitness
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Physiotherapeutic aspect of facial nerve function recovery after cerebellopontine angle tumour surgery

Sebastian Szajkowski, Stanisław Kwiek, Krzysztof Suszyński, Wojciech Ślusarczyk, Hanna Doleżych, Monika Buczma, Jerzy Widuchowski, Piotr Bażowski

Sebastian Szajkowski, Stanisław Kwiek, Krzysztof Suszyński, Wojciech Ślusarczyk, Hanna Doleżych, Monika Buczma, Jerzy Widuchowski, Piotr Bażowski – Physiotherapeutic aspect of facial nerve function recovery after cerebellopontine angle tumour surgery. Fizjoterapia Polska 2007; 7(4); 419-424

Abstract
Background. Facial nerve is particularly susceptible to damage in the course of cerebellopontine angle tumour surgery. For several years neurosurgeons from the Neurosurgery Department in Katowice have been able to preserve anatomical continuity of this nerve during surgery in almost all patients. However, we have observed various degrees of facial nerve paresis and rarely paralysis in the early post-operative period. These problems prompted us to investigate if rehabilitation can significantly influence long-term functional outcomes in regard to the facial nerve. Material and methods. The study group consisted of 133 patients operated for cerebellopontine angle tumours at the 1st Department of Neurosurgery, Silesian Medical University in Katowice, between 1990 and 2006. The House-Brackman scale was used for evaluation of facial nerve function in all patients. A period of 18 months after surgery was chosen as the time of final clinical assessment. Results. The study showed that rehabilitation has a statistically significant beneficial effect on long-tern assessment of facial nerve function. At the same time, tumour size and type significantly affected facial nerve function both in the early post-operative period and in long-term assessment. Conclusions. Early rehabilitation results in better long-term therapeutic outcomes. Intraoperative monitoring contributes to reducing the incidence of functional impairment of the facial nerve.
Key words:
facial nerve, intraoperative monitoring, rehabilitation, cerebellopontine angle tumour
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