Articles


  • The importance of rehabilitation for women after mastectomy

    2014-09-02
    2014 volume 7(1) pp.11-14

    Authors: Marzena A. Humańska, Małgorzata Gejda, Agata Kosobucka, Mirosława Felsmann, Beata Haor, Danuta Ponczek, Mariola Głowacka, Agnieszka Pluta,

    Abstract

    Introduction: Neoplastic diseases represent the main problem of the modern world. The second most common cause of death among cancers is breast cancer. In addition to prophylaxis and treatment, early, continuous and systematic rehabilitation plays an important role in the oncological treatment.

    The aim of this study is to assess the importance of the rehabilitation of women after mastectomy.

    Material and methods: The study included 52 women who were patients of the Centre of Oncology Bydgoszcz, after mastectomy. A diagnostic survey of own design containing 37 questions was used.  

    Results: The study group comprised 52 women after mastectomy age 46 to 79 years of whom (63.5%) were aged 5675 years. Twenty-five patients (48.1%) were living on pensions 10 (19.2%) were collecting a disability pension and 10 were active. Most of the women of the study group benefited from the exercises (77.4% showed improvement) Rehabilitation treatment resulted in a decrease of pain on the side of the operated limb in 34.6% of the patients. More than half of the group did not elect for treatment and aesthetic prosthetic breast reconstruction

    Conclusions:

    1. Active and comprehensive physical rehabilitation facilitated an easier return to performing activities associated with daily life and vocation.

    2. Rehabilitation applied to respondents resulted in a decrease of pain on the side of the operated limb.

    3. Most respondents better accepted themselves in  their new situation - as a woman after mastectomy.

    More »
    .oncology, mastectomy, rehabilitation, breast cancer
  • The concept of alternative chair massage and an evaluation of its understanding among physiotherapists

    2014-09-02
    2014 volume 7(1) pp.18-20

    Authors: Anna Cabak, Przemysław Kotynia,

    Abstract

    Introduction: One alternative method for the prevention of musculoskeletal pain caused by overloading could be the concept of a massage on a special chair (chair massage), which is relatively little known and promoted in Poland. It can be performed in many sites outside of the specialist massage centre such as the workplace or place of study. However, few studies exist regarding its effectiveness. The aim of this study was to assess the knowledge and opinions about this method among physiotherapists. Materials and methods: The study was conducted on a group of 213 physiotherapists, of which, 180 were Master’s degree students at Warsaw Universities and 33 were qualified physical therapists working in the profession. A questionnaire prepared by the author was applied to 135 women and 79 men. Based on the correct answers given, three levels of knowledge were designated: low, moderate and high. The study was anonymous and all participants gave their consent. Results: The vast majority of respondents (90%) had not heard about the chair massage method or knew just a little about it, but 70% declared a desire to familiarise with it. The main source of knowledge about this method was the Internet and friends. In  total, 32% of respondents showed little knowledge of the technique and approximately 50% showed a moderate degree of knowledge. There were no significant differences between the genders. Second-year Master’s students demonstrated better knowledge of this method than first years (p < 0.05). Conclusions: An alternative form of massage - the chair massage - was not well-known amongst physiotherapists. At the same time the vast majority of respondents expressed a willingness to learn more about it.

    More »
    .back pain, massage, alternative therapy, knowledge assessment, physiotherapists
  • The opinions of undergraduate and postgraduate physiotherapy students about their future profession

    2014-09-02
    2014 volume 7(1) pp.30-38

    Authors: Witold Rekowski, Sylwia Molska,

    Abstract

    Introduction: As with students of other medical faculties, students of Physiotherapy have a vision of the profession they will carry out in the future, which may be of a stereotypical character. Previous studies replicate a one-dimensional picture of these views but fail to differentiate them according to the individual socio-demographic characteristics of respondents. The aim of the study was to establish whether the perception of the profession of Physiotherapy by the student is influenced by socio-demographic profile, and to determine the degree of self-direction – conformism indicated by the respondents in describing the profession.

    Materials and methods: A group of 100 undergraduate students and 92 postgraduate students took part (54.7% were women). A semantic differential method was used to collect the research material, which was subjected to factor analysis. This analysis resulted in the production of relatively independent interpreted factors.

    Results: The overall image of the profession in the research group was described in three dimensions: autotelic values ​​associated with its practice, psycho-social gratification and external, formal characteristics.

    Conclusion: During studies, opinions about the profession change and its description becomes more realistic. The image of the profession is significantly differentiated based on the socio-demographic characteristics of the respondents. The way the profession is perceived can influence the way it is practiced and the relationships with patients.

    More »
    .opinions about profession, socio-demographic characteristics, multidimensional approach, physiotherapy students.
  • Treadmill training as a form of rehabilitation in children and adolescents with cerebral palsy: a literature review

    2014-09-02
    2014 volume 7(1) pp.50-60

    Authors: Jakub Gąsior, Mariusz Pawłowski, Piotr Jeleń, Marcin Bonikowski, Janusz Błaszczyk,

    Abstract

    The aim of this article was to review the existing literature on the effectiveness and safety of treadmill training in children and adolescents with cerebral palsy (CP). Medical databases were searched using the keyword sequence: cerebral palsy and treadmill training. Of 23 search results, 17 publications met our inclusion criteria. The literature review outcomes are presented according to the International Classification of Functioning, Disability and Health at three levels: structure, activity and participation. The studies indicate that treadmill training in children and adolescents with CP may be effective. Statistical significance was demonstrated in 12 out of 17 studies. The authors reported improvement in gait parameters and in the quality of life of the patients undergoing the treadmill training. No side effects were observed. The analyzed studies differed in the treadmill training methodology as well as in patient groups – volunteers undergoing the training exhibited various severities of symptoms. It still remains necessary to determine the characteristics of patients who could benefit the most and to develop individually-designed training protocols, which would allow maximum therapeutic benefit to be achieved from the treadmill training.

    More »
    .cerebral palsy, treadmill training, strength training, progressive strength training, resistance training, rehabilitation, physiotherapy
  • Changes in bone mineral density in patients with spinal cord injury during the acute phase after injury, measured through dual-energy X-ray absorptiometry

    2014-06-06
    2013 volume 6(4) pp. 11-14

    Authors: Muhammad Ikram, Saeed Bin Ayaz, Khalil Ahmad, Zaheer Ahmed Gill, Sumeera Matee,

    Abstract

    Objective: To compare the mean change in bone mineral density between initial presentation and after three months during the acute phase of spinal cord injury, and correlate it with age, gender, neurological level and severity of injury.

    Materials and methods: After permission from the hospital ethics committee, traumatic spinal cord injury patients presenting within one month of injury were recruited, and those suffering from diabetes mellitus, hypo/hyperthyroidism, renal or hepatic disease, rheumatoid arthritis and heterotopic ossification were excluded. With written informed consent, information was gathered through oral interviews and review of the medical management charts of the subjects. Patients were then examined and classified based on severity and level of injury (in relation to T6) as per the American Spinal Injury Association scoring system. Dual energy X-ray absorptiometry scans were performed at admission and after three months, while taking bone mineral density measurements at the lumbar spine and femoral neck, which were expressed as T-scores. The data was analyzed with SPSS V 20. The paired sample t-test was applied to determine the mean change in bone mineral density in the whole sample. Pearson’s correlation analysis was used to correlate age with the reduction in bone mineral density, controlled for level and severity of injury. A univariate analysis of covariance using a general linear model controlled for age was applied to compare the mean reduction in bone mineral density score amongst groups based on different categorical variables. A p-value < 0.05 was considered significant.

    Results: Out of 70 patients, 62 (88.6%) were male and 8 (11.4%) were female. The mean age was 33 ± 7 (range: 22–48 years). The majority had a complete injury (71.4%) with the level of spinal cord injury being at or above T6(54.3%). Considering the whole sample, the mean T-score was significantly reduced after three months at both the lumbar spine (p < 0.001) and the femoral neck (p < 0.001). On comparing different variables, the mean T-score was significantly reduced at the lumbar spine in patients with a complete injury (p < 0.001) and neurological level above T6  (p <0.001), and at the femoral neck in patients with a complete injury (p = 0.003) . Age and gender did not significantly affect the loss in bone mineral density.

    Conclusion: The bone mineral density is decreased following spinal cord injury at the lumbar spine and femoral neck in the acute phase following injury. The loss at the lumbar spine is higher in patients with a complete injury and neurological level above T6, while the loss at the femoral neck is higher in patients with a complete injury. The age and gender do not significantly affect the loss in bone mineral density in spinal cord injury patients.

    More »
    .spinal cord injury, dual-energy X-ray absorptiometry, bone mineral density
  • Conversion disorder – a case study with recurrent mouth deviation causing facial asymmetry

    2014-06-06
    2013 volume 6(4) pp.31-33

    Authors: Zaheer Ahmed Gill, Saeed Bin Ayaz, Sumeera Matee, Muhammad Ikram,

    Abstract

    The study presents a rare case of facial asymmetry due to conversion disorder. The patient was a 24-year-old unmarried teacher who presented with a history of three episodes of facial asymmetry over the past three months. Two previous episodes were resolved after taking oral prednisolone for the first and acyclovir for the second. She had a history of disturbed sleep and abnormal behaviour and reported to be under psychological stress from being unmarried. On examination, she had facial asymmetry with prominent right sided deviation of the lower jaw. The Bell’s palsy was absent and the sensory assessment for facial nerve was normal. Magnetic resonance imaging of brain, electrodiagnostic evaluation of the right facial nerve, assessment for C-reactive protein, erythrocyte sedimentation rate and relevant serological evaluation did not reveal any abnormality. An appropriate referral to a psychiatrist resulted in a diagnosis of conversion disorder. She was given antidepressants and psychotherapy sessions and her parents were counselled to find an appropriate partner for her life. The patient responded well and is now under the care of a psychiatrist.

    More »
    .conversion disorder, facial paralysis, psychiatrist
  • Medicinal leech therapy in the treatment of Complex Regional Pain Syndrome Type I (CRPS-I) – a case study

    2014-06-06
    2013 volume 6(4) pp. 38-41

    Author: Aleksandra Szabert,

    Abstract

    Complex regional pain syndrome (CRPS) known before as a Sudeck’s disease is a group of changes occurring in the upper or lower limb as a consequence of sympathetic nervous system pathological reaction. The most common CRPS symptoms are: amplified pain, swelling, vasomotor dysfunction, increased sweating, restricted movement. So far no credible treatment scheme for CRPS has been validated. Hirudotherapy which is a therapy with medicinal leeches, was one of the main treatments used from antiquity until the mid-XIX century.

    A 62-years old woman with CRPS–I after a fracture of distal radius bone of the right upper limb. After two ineffective series of physiotherapy patient underwent hirudotherapy. Four leeches from the species Hirudo verbana were used at once. The effects of the therapy were apparent already during the procedure. In less than 24 hours after the leech therapy significant improvements were observed: reduction of swelling and pain and significant increase in mobility of joints (wrist and fingers).

    Medicinal leech therapy (MLT) combined with physical therapy may be an effective treatment for CRPS-I.

    More »
    .hirudotherapy, rehabilitation, complex regional pain syndrome, pain
  • Application of constraint-induced movement therapy for children with cerebral palsy –current state of knowledge

    2014-06-06
    2013 volume 6(4) pp.22-27

    Authors: Mariusz Pawłowski, Jakub Gąsior, Marcin Bonikowski, Janusz Błaszczyk,

    Abstract

    The aim of the study is to present the current state of knowledge on the CIMT and to summarize the up to date research. In order to carry out the literature review the MEDLINE, Embase, PEDro and Cochrane databases were searched using the keywords: “constraint induced movement therapy” in combination with “cerebral palsy”. The results of selected studies are shown in the domain of structure and function, activity and participation. Literature review shows that rehabilitation based on the concept of CIMT may play a significant role in reducing functional limitations of daily life, which affect children with cerebral palsy due to dysfunction of the upper limb.

    More »
    .cerebral palsy, constraint-induced movement therapy
  • Robotic walking assistance: assessment of hip and knee range of motion in post-stroke patients

    2013-12-23
    2013 volume 5(3) pp.13-18

    Authors: Francois Haro, Sophie Tasseel-Ponche, Laurence Damamme, Eloise Szmatula, Thierry Albert, Alain P. Yelnik,

    Objective: To study the ranges of motion developed during walking by post-stroke patients on an electromechanical gait trainer, the Lokohelp®.

    Materials and Method: Ten patients were equipped with electronic goniometers during 10-minute sessions. Data was collected at the 2nd minute (M2), the 5th minute (M5) and the 8th minute (M8). Hip and knee extension and flexion were measured on the paretic and the healthy sides.  Reproducibility was studied by the evolution of data over time.

    Results: The highest rate for a patient within the standards was 60%. On the paretic side, joints tended to remain flexed, only 37% of patients had a physiological hip extension, 27% had normal knee extension and 23% had normal hip flexion. The amplitudes of the healthy side were more physiological, 57% of patients had hip extension within the norms and 53% had normal knee extension. Knee recurvatum was observed only on the healthy side.  The amplitudes between the two sides were not different, except for the hip extension (M2 p: 0.06, M5 p: 0.06 and M8 p: 0.03). Reproducibility was good except for the healthy knee.

    Discussion/Conclusion: These results can be explained by insufficient body weight support, a lack of active participation by the patient (especially on the paretic side), uncontrolled pelvis movements and two characteristics of the device: ankle immobilization in orthoses and the fixed length step. Nevertheless, these results call into question the relationship between the efficacy of these assistive walking devices and the ranges of motion actually induced.

    More »
    .assistive walking device, stroke, range of motion, gait
  • Wheelchair athletes discuss everyday manual wheelchair setup

    2013-12-23
    2013 volume 5(3) pp. 26-31

    Author: Margaret Stran,

    Aim: the aim of this study was to gather wheelchair athletes’ opinions regarding the setup of their everyday manual wheelchair as well as discover the impact of wheelchair sport on their everyday manual wheelchair setup.

    Materials and Methods: twenty-one wheelchair athletes from four different countries, ranging in age from 20 to 58 participated in this study. Participants were invited to take part based on their using a manual wheelchair as their main mode of ambulation. Data was collected via one 20–60 minute interview which was audiotaped and transcribed.  Data was divided into themes, categories, and subcategories by using a combination of the analytic induction and constant comparison techniques and the computer program QSR. Credibility and trustworthiness were established by a search for negative cases throughout the analysis process 

    Results: over time, all participants made changes in manual wheelchair weight, width, and accessories (arm rests, push handles, wheelie bars and brakes), moving from wide, heavy manual wheelchairs with many accessories to light, narrow manual wheelchairs with one or no accessories.  According to participants, involvement in wheelchair sports was the catalyst for changing wheelchairs and/or removing accessories. 

    Discussion: participants did not reference an existing study when discussing the changes they made to their wheelchair setup, but the changes they made support the robust body of literature regarding the best types of wheelchairs and set up for ease of propulsion, comfort, and maneuverability. 

    Conclusions: learning participants’ opinions regarding everyday manual wheelchair setup reflects the importance of a correctly fitting wheelchair on everyday life. 

    More »
    .wheelchair, community, athletes, wheelchair set up
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