Tag: Wojciech Kiebzak

Compensation Mechanism in Treatment of Idiopathic Scoliosis with the FED Method – Preliminary Results

Sandra Trzcińska, Wojciech Kiebzak, Marek Wiecheć, Zbigniew Śliwiński

S. Trzcińska, W. Kiebzak, M. Wiecheć, Z. Śliwiński – Compensation Mechanism in Treatment of Idiopathic Scoliosis with the FED Method – Preliminary Results. FP 2017; 17(2); 6-14

Abstract

Introduction. The idiopathic background of scoliosis makes it difficult to treat the disorder in a cause and effect way. This gives a starting point for creation of many physiotherapy treatment methods, among them the FED method. It is a new, but a very promising way of the conservative treatment for scoliosis.
Research Goal. The assessment of impact of the FED treatment for reducing the angle of the primary curve (KTR P) and the secondary curve (KTR W) rotation, and the overall rotation of the spine (SDR).
Materials and Methods. In the research participated girls 11 to 15 years old (M = 13.5 ±1.4), with the diagnosed double curve scoliosis of the second degree. In all the patients, there were carried out measurements of the angle of trunk rotation in the primary curve, secondary curve, cervical segment and the scoliosis coefficient was measured with a Zebris apparatus. There was also analyzed the sum of two rotations (SDR) parameter. The above examinations were performed before and after the three week treatment with the FED method.
Results. After the application of the FED treatment method, we have observed statistically significant decrease in the average value of the trunk rotation angle at the levels of primary curve, secondary curve and cervical segment. Similar observations were made in the case of the scoliosis coefficient in Zebris examination. All the examined parameters have shown a significant decrease in the average output values (p < 0.001).
Conclusions. Treatment of double curve scoliosis with the application of the FED method, for the period of 3 weeks, leads to reduction of the rotation angle of the trunk. This reduction applies to both, the primary and secondary curve, the overall rotation angle and the cervical segment. The FED therapy improves the total rotation of the whole spine.In the course of treatment, there occurs decrease in the angle of vertebrae rotation in the cervicothoracic segment.

Key words:
idiopathic scoliosis, physiotherapy, FED method, compensation mechanism

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Use of respiratory efficiency therapy in patients with idiopathic scoliosis

Iga Walenda, Sandra Trzcińska, Marek Kiljański, Wojciech Kiebzak

I. Walenda, S. Trzcińska, M. Kiljański, W. Kiebzak – Zastosowanie terapii sprawności oddechowej u pacjentów ze skoliozą idiopatyczną. FP 2013; 13(4); 6-11

Abstract

The aim of this study was to evaluate the effects of the respiratory efficience therapy of patients with 2nd grade idiopathic scoliosis. The study was conducted at the Centre for Orthopaedics and Rehabilitation for Children and Youth in Konstancin-Jeziorno, Mazowieckie’s Rehabilitation Center “STOCER”. The study comprised 60 patients with diagnosed 2nd grade idiopathic scoliosis at the age of 8-17 years. The observation period lasted four weeks. The subjects were divided into two groups, study and control of 30 persons. In both groups implemented kinesiotherapy program, and the study group was additionally applied the efficiency of respiratory therapy. The tests were performed using a spirometer Micro Plus, by means of it was setted three parameters: FVC, FEV1, PEF. Results: In the test group, there was an increase in all parameters, compared to the baseline measurement. In the study group and the control there was a statistical increase in all studied parameters, only PEF’s improvement was not statistically significant. In the study group there was more increase in the level of the analyzed variables than in the case of persons belonging to the control group. Conclusions: Respiratory therapy improves lung function parameters in patients with 2nd grade idiopathic scoliosis becoming an important element in a comprehensive physiotherapy program. The use of respiratory kinesiotherapy in children with 2nd grade idiopathic scoliosis contributes to the improvement of all indicators, including significantly FEV1 and FVC.

Key words:
respiratory efficience therapy, idiopathic scoliosis, spirometer Micro Plus

Assessment of potential risk factors for falls in osteoporotic elderly versus individual mobility considerations

Marek Żak, Szymon Krupnik, Wojciech Kiebzak, Agnieszka Stopa, Joanna Czesak

M. Żak, S. Krupnik, W. Kiebzak, A. Stopa, J. Czesak – Assessment of potential risk factors for falls in osteoporotic elderly versus individual mobility considerations. FP 2014; 14(1); 36-40

Abstract

Background. Incidental falls are anxiously perceived by an increasing number of elderly persons as a clear symptom of ageing, potentially leading to permanent care-dependency.
Methods. The study population comprised 72 patients recruited from respective university clinic geriatric wards (aged 81- 95). A Timed UP & GO test (TUG) was applied (in line with Tinetti POMA protocol), to assess an individual risk of fall. Group I comprised the patients (48 women; x=84 years) who scored 14 seconds or more; Group II – the patients who scored 13.5 seconds or less (24 women; x=82 years).
Results.  When completing Tinetti (POMA) test, Group I women (TUG test scores of 14 seconds and more) ultimately scored below 19 points, i.e. their risk of fall was assessed as 5-fold greater than in their Group II peers (TUG test scores of 13.5 seconds and less).
Consequently, statistical significance of the correlation coefficients between the TUG and Tinetti (POMA) test scores was established as p < 0.05. In Group I (TUG > 14 s) this correlation coefficient was negative and equaled r = -0.74, whereas in Group II (TUG < 13.5 s) it was (r = -0.62).
Conclusions. The TUG test makes up an effective diagnostic instrument for assessing a potential risk of fall (i.e. identify potential fallers) and may therefore be applied as an effective screening test for this group of patients. Community dwellers of higher functional capabilities, despite the risks related to osteoporosis, are far less likely to sustain an accidental fall.

Key words:
geriatrics, falls, osteoporosis, functional capabilities, Timed UP & GO test

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Muscle energy techniques after total hip replacement

Maria Mazepa, Renata Szczepaniak, Wojciech Kiebzak,
Zofia Śliwińska, Zbigniew Śliwiński

M. Mazepa, R. Szczepaniak, W. Kiebzak, Z. Śliwińska, Z. Śliwiński – Muscle energy techniques after total hip replacement. FP 2014; 14(1); 18-26

Abstract

Introduction.  Surgical procedure involving total hip alloplasty is a common consequence of the absence of progress of rehabilitation in patients with significant degenerative lesions accompanied by severe pain and significantly limited mobility. An individual program for patient rehabilitation is established during the first 24 hours after the procedure. This is of particular importance as proper planning and implementation of physiotherapy allows to relieve pain and to achieve full functional joint mobility as well as to strengthen the muscles. We make sure that the proper muscle control and stability within the joint will restore patient’s locomotion and self-care both at the initial and later stages of rehabilitation. There are many ways and methods to improve the above mentioned parameters. Muscle energy techniques, which represent a non-invasive therapy in patients with total hip replacement, are one of these methods. These techniques, including poizometric relaxation of contracted muscles as well as active relaxation of hip joint muscles, myofascial techniques, also in combination with elements of PNF techniques, allow for effective treatment and rehabilitation of patients. Aim. The aim of the study was to compare the effects of standard physiotherapy in patients after cemented hip arthroplasty with those of physiotherapy using muscle energy techniques.
Materials and Methods. A total of 66 patients with advanced degenerative arthritis of the hip, who received surgical treatment in the form of endoprosthetics, were qualified for the study between 2013 and 2014. The patients were divided into two groups  (group I and II), 33 subjects each. Pain level, the range of hip motion as well as muscle strength were assessed in each patient. Group I received muscle energy techniques, including poizometric relaxation of muscles, active muscle relaxation and elements of PNF method. Also, myofascial techniques targeting muscles with different strengths and direction of pressure were used. Group II received standard physiotherapy.
Results. Significant improvement of pain, an increase in the range of functional motion as well as a significant improvement of muscle control of the joint were observed in the group receiving muscle energy treatment, which had beneficial effects on the locomotion of patients.
Conclusions. Muscle energy techniques had significant effects on the improvement of muscle function and stabilization in the pelvic girdle of the joint with endoprosthesis. Poizometric relaxation combined with elements of the PNF method as well as myofascial techniques effectively improved balance, coordination and gait pattern. In conclusion, physiotherapy using muscle energy techniques was shown to be a more effective method in the treatment of hip osteoarthritis as compared to the method based on standard rehabilitation program.

Key words:
arthroplasty, rehabilitation, muscle energy techniques

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Quality of life in patients with lumbar spinal pain

Zbigniew Śliwiński, Malwina Śliwa, Małgorzata Starczyńska, Wojciech Kiebzak

Z. Śliwiński, M. Śliwa, M. Starczyńska, W. Kiebzak – Quality of life in patients with lumbar spinal pain. FP 2014; 14(2); 26-39

Abstract

In recent years, increasing attention has been drawn to the need of a holistic approach to patients. Studies involving the measurement of the quality of life and taking into consideration not only the physical, but also emotional and spiritual aspects of well-being, have been conducted with increasing intensity over the last few decades. In case of disorders as common as spinal pain syndromes, the measurement of the intensity of pain is particularly important, as these diseases are a scourge for the developing societies. The goal of this study was to present and popularize data on the quality of life. The study included 38 subjects (23 females and 15 males) complaining of lumbar spinal pains. The study group was diverse in many aspects, including age distribution. The studies revealed different levels of quality of live impairment depending on the degree of impairment as the result of the disease. Conclusions based on the survey demonstrate the need to include the quality of life in the rehabilitation process. Measurements of the quality of life provide much information on the patient, their attitude to the disease as well as the rehabilitation process.

Key words:
quality of life, Roland-Morris low back pain questionnaire, low back pain, Oswestry Disability Index, Ferrans and Powers Quality of Life Index

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Evaluation of the pressure pain threshold using an algometer

Iwona Wilk, Tomasz Matuszewski, Magdalena Tarkowska, Wojciech Kiebzak

I. Wilk, T. Matuszewski, M. Tarkowska, W. Kiebzak – Evaluation of the pressure pain threshold using an algometer. FP 2015; 15(1); 16-23

Abstract

Introduction. Measurement methods are a_very important element in physiotherapy diagnostics to ensure measurement accuracy, repeatability, availability and they should be relatively easy. Properly performed diagnostics allows proper selection of therapy, ensures higher efficacy of the undertaken activities and allows to obtain the desired effects. The measurement of the pressure pain threshold with the use of an algometer is one of the methods applied more and more frequently by therapists. The method provides an objective, accurate and reproducible assessment.
Material and methods. The study included 20 healthy, young subjects, aged 20 to 30 years. They were subjected to classical massage of the back, which involved selected superficial and deep muscles. The procedure took 20 minutes. Before the massage and immediately afterwards, with the use of an algometer there was measured the pressure pain threshold of the selected back muscles at the site of bone attachments.
Results. After classical massage application, there were noted increased values of pressure pain threshold of selected back muscles attachments. Statistically significant differences were obtained in the case of the trapezius muscles – descending and transverse part.
Conclusions. The measurement of pressure pain threshold with the use of an algometer is an objective method which allows imaging of the effects of the applied therapy, in this case the effect of massage on the pressure pain threshold.

Key words:
pressure pain threshold, classical massage, algometer

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Application of the Polysensory Stimulation and the General Movement Patterns in Patients with the Serious Traumatic Brain Injury

Wojciech Kiebzak, Anna Wysocka, Arkadiusz Żurawski, Marek Kiljański, Justyna Pogorzelska

W. Kiebzak, A. Wysocka, A. Żurawski, M. Kiljański, J. Pogorzelska – Application of the Polysensory Stimulation and the General Movement Patterns in Patients with the Serious Traumatic Brain Injury. FP 2015; 15(2); 6-20

Abstract

Introduction. Traumatic brain injuries are among the major causes of disabilities and deaths in children. They cause motor performance disorders and neuropsychological dysfunctions. All the above require the maximum reduction of any iatrogenic effects.
Goal. The goal of this paper is to present a rehabilitation program for the patient after severe traumatic brain injury.
Case Study. As the result of a traffic accident, the 15 years old boy had suffered a severe overall trauma, including the traumatic brain injury. He was deeply unconscious, his score in the Glasgow Coma Scale – 4 points. The patient had undergone a 2 months rehabilitation program, while hospitalized. The polysensory stimulation and elements of the following methods had been applied: Vojta method (Reflex locomotion), NDT-Bobath, PNF, Castillo-Morales and Kinesiology Taping. A high degree of the patient’s self-reliance had been achieved, including the ability to walk, with only a slight support.
Discussion. Within the recent – dozen or so – years, numerous studies regarding the physiotherapy treatment in patients with the traumatic brain injury have been published. More often than not, success of the rehabilitation process depends on the early start and the proper orientation of the rehabilitation treatment. Still, in available research, there is very few studies dedicated to the formalized early treatment methods. Hence the need to define the best possible physiotherapy procedures.
Conclusions. The most important issue in the physiotherapy treatment, in patients after the traumatic brain injury, is the interdisciplinary rehabilitation, based on the polysensory stimulation and on the general movement patterns, which combines the techniques of the various methods. Planning of a physiotherapy program should be founded on the basic principles of continuity, comprehensiveness and regularity, but most of all – on the early start of the rehabilitation process. The competent physiotherapy treatment plays an important role in restoration of the cognitive-emotional functions and an achievement of the optimum level of the patient’s psychomotor performance.

Key words:
traumatic brain injury, craniocerebral injury, physiotherapy treatment, polysensory stimulation, general movement patterns

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Methodology of Assessing Certain Statements Regarding the Formation of Attitudes in Students of Physiotherapy, on the Basis of Metaethics

Wojciech Kiebzak, Michał Kosztołowicz, Magdalena Rusin, Marek Kiljański, Małgorzata Kiebzak

W. Kiebzak, M. Kosztołowicz, M. Rusin, M. Kiljański, M. Kiebzak – Methodology of Assessing Certain Statements Regarding the Formation of Attitudes in Students of Physiotherapy, on the Basis of Metaethics. FP 2016;16(4);62-70

Abstract

Introduction. In physiotherapy, just like in the other medical professions, in addition to acquiring the actual knowledge and gaining the professional skills, the professional ethics is of major importance.
Aim of the Study. The aim of the study was to verify statements made by the physiotherapy students, regarding the humanities (academic disciplines), which should have an impact on formation of their ethical attitudes.
Materials and Methods. In the study participated a group of 141 persons who, at the time, were physiotherapy students. The study was carried out at the turn of 2015 and 2016. The research tool applied was a questionnaire. To interpret the results of the study, the chi-square test (χ2) was used.
Results. The results of the survey show, that there is an average dependency between the humanistic disciplines and their impact on the attitude. Psychology, as well as interpersonal communication, have gained a high level of recognition among the physiotherapy students. Hence, the cause which testifies to the lack of impact of the humanistic disciplines on the formation of attitudes of the physiotherapy students toward their patients, is the lack of interpersonal communication, interchangeable, and therefore no emphasis on the knowledge of psychology during the process of communication.

Keywords:

Physiotherapy, ethics, interpersonal communication, psychology, humanistic education

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Cultural Good as the Basis of Culture and Ethics

Wojciech Kiebzak, Michał Kosztołowicz, Magdalena Rusin, Marek Kiljański, Małgorzata Kiebzak

W. Kiebzak, M. Kosztołowicz, M. Rusin, M. Kiljański, M. Kiebzak – Cultural Good as the Basis of Culture and Ethics. FP 2016;16(4);48-60

Abstract

Introduction. The ethical culture of physiotherapists encompass their attitudes and ethical beliefs, at every stage of their education and the actual job performance. The professional culture may be created by introducing the adequate ethics program. Both culture and ethics complement each other, and they reinforce the new principles and attitudes of people. The culture plays an important role in the daily life of every professional group, providing a common language and a shared way of behavior.
Aim of the Study. The aim of the study is to find a method allowing to formulate the definition of cultural good based on the results of used questions.
Materials and Methods. In the study participated a group of 141 persons who, at the time, were physiotherapy students. The study was carried out at the turn of 2015 and 2016. The research tool applied is a questionnaire. The method used to evaluate the results is the chi-squared test (χ2).
Results. The results have shown, that the physiotherapy students considered the following as cultural goods: esteem for health, propriety, tact, kindness, and responsibility, however these values are poorly related to the satisfaction derived from the fact of studying the physiotherapy.
Conclusion. The cultural good serves people, in a positive sense, through existence of the ethical triad, which should lead to the effective, positive man-to-man interaction.

Keywords:

movement, physical fitness, physical activity, endurance, physiotherapists

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How to Help Persons with Disabilities to Improve Their Everyday Life? – Report from Study with the Rational Behavior Therapy Application

Aleksandra Sierant, Monika Łętocha, Paweł Grzybek, Kamila Pytowska, Anna Wiśniewska-Małek, Marek Kiljański, Wojciech Kiebzak

A. Sierant, M. Łętocha, P. Grzybek, K. Pytowska, A. Wiśniewska-Małek, M. Kiljański, W. Kiebzak – How to Help Persons with Disabilities to Improve Their Everyday Life? – Report from Study with the Rational Behavior Therapy Application. FP 2016;16(4);40-46

Abstract

Introduction. People with disabilities face in their everyday life many challenges / difficult experiences / incidents of stress. Disability status is often accompanied by the lack of employment and by social isolation, moreover, the architectural barriers significantly hamper the lives of the people with disabilities, and reduce the life’s quality. Disabled persons are particularly vulnerable to depression and to suicidal thoughts, and therefore a_special care should be devoted to them. Thus, there is the need to establish methods and support system, which would be effective in the therapeutic work with this group of persons. Proven effectiveness in the treatment of critical situations, including the mental disorders, as well as coping with the everyday life stress, have the cognitive-behavioral methods.  The Rational Behavior Therapy is a_cognitive-behavioral method of therapy developed by Professor Maxie Maulsby  for patients with mental disorders and those, who have experienced crisis situations.  The aim of this method is to reformulate a_person’s thinking to more adaptive model, which should result in reduction in severity of the negative emotions and the undesirable behavior.
Aim. The aim of this study is to evaluate the RBT method, while working with disabled persons.
Materials and Methods. In the study participated 13 persons with disabilities, belonging to professionally active age group – 30 to 52 years old, with mean age of 41 years, and standard deviation of 6.13. Using a_distress thermometer, we measured stress level and the dispositional optimism, before and after two days of the RBT workshops. During workshops, the persons received useful information about mechanism in which emotions function, and about methods for coping with stress, and then, they performed exercises under the supervision of experienced therapists, and the whole session has been complemented by the presentation of films, illustrating the introduced materials.
Results. A_significant reduction in the average level of stress has been determined, from 7.54 before the RBT workshops, to 2.62 after the workshops. The average incidence rate of all tested problems (practical, family, emotional, physical) has been reduced. After application of the therapy, a_significant increase in the level of optimism has been noted.
Conclusion. The obtained results confirm the initial usefulness of the RBT method, in assisting the people with disabilities. There are, however, further multicenter longitudinal studies required, which would confirm the effectiveness of such intervention.

Keywords:

Stress, cognitive-behavioral therapy, RBT, disability, emotional problems, cognitive restructuring

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