Tag: Wiesław Tomaszewski

Functional recovery in patients receiving rehabilitation after operative treatment of post-traumatic extraaxial cerebral haematoma

Grażyna Brzuszkiewicz-Kuźmicka, Stanisław Kuźmicki, Wiesław Tomaszewski

Grażyna Brzuszkiewicz-Kuźmicka, Stanisław Kuźmicki, Wiesław Tomaszewski – Functional recovery in patients receiving rehabilitation after operative treatment of post-traumatic extraaxial cerebral haematoma. Fizjoterapia Polska 2010; 10(4); 271-279

Abstract
The number of patients treated surgically for post-traumatic extraaxial cerebral haematoma is growing every year, thus becoming a significant therapeutic problem. The main aim of the study is to describe changes in functional status, progress in the resolution of neurological deficits and changes in the level of consciousness of patients receiving comprehensive rehabilitation after surgery for a post-traumatic extraaxial cerebral haematoma and to determine differences and similarities in the rate of recovery of these functions. The study involved a group of 43 patients receiving operative treatment of post-traumatic extraaxial cerebral haematoma. The International Muscle Paresis Scale, the Modified Barthel Scale and the Rankin Scale were used to evaluate the severity of the neurological deficit and disability, while the Glasgow Coma Scale was used to assess patients’ level of consciousness. These were standardised in order to allow comparison of the temporal pattern of change and a comprehensive evaluation of the functions under examination. The patients receiving physiotherapy after surgery for post-traumatic extraaxial cerebral haematoma demonstrated significant improvements in all functions under investigation. The quickest recovery was observed in functional performance and the ability to perform activities of daily living. Recovery of the level of consciousness was much slower and pareses resolved the most slowly. 1. Surgery and early post-operative rehabilitation lead to effective functional recovery but the rate of recovery of individual functions may vary. 2. Early rehabilitation of patients after extraaxial cerebral haematoma evacuation increases the possibility of the development of compensatory mechanisms and contributes to positive outcomes of rehabilitation.
Key words:
Craniocerebral Trauma, post-traumatic extraaxial cerebral haematoma, post-operative physiotherapy
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Computer-Based Medical Decision Support Systems – history, development, comparison of systems in selected European countries and the United States

Wiesław Tomaszewski, Grzegorz Bliźniuk, Roman Bronowski, Andrzej Czamara, Wojciech Widuchowski, Krzysztof Klukowski

Wiesław Tomaszewski, Grzegorz Bliźniuk, Roman Bronowski, Andrzej Czamara, Wojciech Widuchowski, Krzysztof Klukowski – Computer-Based Medical Decision Support Systems – history, development, comparison of systems in selected European countries and the United States. Fizjoterapia Polska 2011; 11(2); 91-106

Abstract
The world is facing many challenges connected with the need to increase health care effectiveness globally. One of the reasons behind the need to improve and optimise healthcare systems is change in the population age structure, which manifests as an increase in the elderly population of the compared to the population before and of productive age. It is thus absolutely necessary to find technical and organisational means to increase the effectiveness of health care, as well as optimise it and reduce the associated costs. Implementing information technologies in health care systems is now an absolute necessity, mainly due to the systematically growing amount of information on patient’s health status, number of diagnosable diseases and implementable treatments, diversity of pharmaceuticals and their effects, as well as the need to store and update this kind of data.The analysis presented in this work deals with issues and problems concerning health care systems in developed countries, including Poland. It was carried out on the basis of the authors’ research experience in analysing IT systems suppoiting the Polish health care system, gained by participating in the implementation of several projects, backed with direct contact with experts, mainly from the Scandinavian countries and the USA, who were involved in the development of information technologies to be used in health care systems in those countries, and an analysis of materials and experts’ reports available in the literature and online.
Key words:
information technologies in medicine, Guidelines, clinical pathways, computer-based decision support systems
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Nerve root tests results for diagnosis and prognosis of the pain syndromes in the lumbar spine area treated under spa conditions

Przemysław Minta, Wiesław Tomaszewski, Monika Sobolak

Przemysław Minta, Wiesław Tomaszewski, Monika Sobolak – Nerve root tests results for diagnosis and prognosis of the pain syndromes in the lumbar spine area treated under spa conditions. Fizjoterapia Polska 2012; 12(1); 21-27

Abstract
Disorders associated with low back pain (lbp) are the result of not only affliction of nerve roots, but also nocireceptive innervated structures of the ligaments and joint capsules. The objective of this study was to determine the prevalence of selected nerve root tests in people selected by the Social Insurance Board (SIB) and the National Health Fund (NHF) for spa treatment due to lbp, and their usefulness for diagnosis and prognosis.The study involved a group of 400 people (200 people recommended by SIB and 200 by the NHF). In questionnaires, beside the basic personal characteristics, the following were taken into consideration: disease duration, pain location and radiation, results of imaging tests, employment status and type of work performed. The questionnaires also carried results of some nerve roots tests carried out. Positive nerve root tests occurred more frequently in people recommended by the SIB for prevention of disability pension award, and their frequency increased with duration of illness and PIT taxable allowance period. SIB patients were recommended for treatment as a result of a disease that was at a more advanced stage than patients from NHF. Analysis of obtained data showed that nerve root tests, in both groups were present in only a quarter of the tested patients, hence this points to their limited diagnostic and prognostic value.
Key words:
Low Back Pain, nerve root tests, spa treatment, prevention of disability pension award
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