Tag: Włodzisław Kuliński

Physiotherapy in patients with an implanted cardiac pacemaker

Włodzisław Kuliński

W. Kuliński – Physiotherapy in patients with an implanted cardiac pacemaker. FP 2017; 17(3); 28-36

 

Abstract

Background. In Poland, the number of patients with an implanted cardiac pacemaker equals over 100,000 and many of them undergo physical therapy and rehabilitation due to co-morbidities.
Material and methods. Sample electrocardiograms of various pacemaker pacing modes are presented. Cardiac pacemakers are sensitive to high-strength magnetic fields and electromagnetic fields generated by devices used in physical therapy.
Results. Short-wave diathermy may cause interference if the source of waves is located near the pacemaker site. Procedures using diathermy may inhibit pacemaker activity and cause heat damage to the generator (due to increased temperature). When a pulsed low-frequency magnetic field is used, the metal parts do not overheat, but there is a possibility of disturbances in the pacemaker function and thus it is recommended not to perform such procedures on the chest. The use of galvanic current, iontophoresis, and low and medium frequency currents is possible outside the area of the chest. There are no contraindications to light therapy and heat therapy. Electrical stimulation in patients with peripheral neuron damage may be used as long as special safety measures are followed.
The paper shows sample Holter monitor readings obtained when patients underwent various physical therapy procedures.
It also presents difficult cases of patients with an implanted cardiac pacemaker who require physical therapy and rehabilitation.
Conclusions. Most physical therapy procedures may be performed in patients with a pacemaker, but on condition that appropriate safety principles are followed.

Key words:
cardiac pacemaker, physiotherapy

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Stroke as a civilisation-scale problem – physical treatment analysis

Ewelina Czerczak, Włodzisław Kuliński

E. Czerczak, W. Kuliński – Stroke as a civilisation-scale problem – physical treatment analysis. FP 2016;16(1);24-35

Abstract
Introduction. Stroke is one of the most common forms of damage to the central nervous system. In Poland, approximately 60,000 people suffer from stroke every year. Disorders resulting from stroke require the implementation of long-term care and rehabilitation. The main objective of physiotherapy is to restore patient independence in daily living and improve the quality of life of the patient. Aim of study. The aim of the study was to evaluate the effect of physiotherapy on the functional status and quality of life of patients after stroke. Material and Methods. The study comprised 30 patients after stroke (24 patients after ischemic stroke and 6 patients after hemorrhagic stroke) staying at the neurological rehabilitation ward in the St. Luke Specialist Hospital in Końskie. During 8 weeks of hospitalization, the patients underwent intensive rehabilitation. They were examined twice, namely on admission and on the day of discharge. The examination included completing a questionnaire assessing the quality of life on a scale of 1 to 10 points, an assessment of the functional status using the Barthel Index and an assessment of muscle spasticity of the upper and lower limb with the modified Ashworth scale. The results of functional status assessment were compared according to the type of stroke, time from stroke to rehabilitation and the number of concomitant diseases. Moreover, the effect of the comprehensive rehabilitation on the assessment of independence in daily living was studied after treatment, as was the influence of rehabilitation on the degree of spasticity and the use of orthopedic aids. Results and Conclusion. The functional status improved in all patients. Better final results were obtained in patients after ischemic stroke and suffering from fewer comorbidities. The results were better in those whose rehabilitation commenced earlier. The quality of life was significantly higher than before rehabilitation. The degree of spasticity was significantly reduced and the use of orthopaedic aids was improved.

Key words:
stroke, treatment, physiotherapy

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