The frequency of occurrence and risk factors for injuries to primary and junior high schools students from the Podkarpackie Province during Physical Education classes

Wstęp: Zajęcia z wychowania fizycznego to całokształt zabiegów mających na celu wszechstronny rozwój fizyczny organizmu człowieka. Jednakże nie ulega wątpliwości, że ćwiczenia na lekcjach wychowania fizycznego wiążą się z ryzykiem kontuzji lub uszkodzeń ciała. Zagrożenie utraty zdrowia w wymiarze szkolnym stało się obecnie bardzo dużym problemem społecznym. W związku z tym należy zwracać szczególną uwagę na bezpieczeństwo młodzieży zarówno w planowaniu zajęć wychowania fizycznego, jak i w doborze metod i form pracy. Cel pracy: Celem pracy jest ocena częstości występowania urazów uczniów szkół podstawowych i gimnazjalnych województwa podkarpackiego na lekcjach wychowania fizycznego oraz ocena zależności występowania urazów sportowych wśród dzieci i młodzieży szkolnej od wybranych czynników. Materiał i metoda: Badaniem objęto grupę 301 uczniów szkół podstawowych i gimnazjalnych na terenie województwa podkarpackiego. W badanej grupie było 151 chłopców i 150 dziewcząt. Wiek badanych mieścił się w przedziale od 9 do 16 lat (średnia wieku 12,58 lat). Do przeprowadzenia badań wykorzystano oryginalną ankietę. Ankieta była standaryzowana, anonimowa, zawierała 29 pytań. Wyniki: W wyniku przeprowadzonych badań wykazano, iż wśród 301 przebadanych uczniów ponad połowa – 158 (52,5%) doznała urazu na lekcjach wychowania fizycznego. Analizując rodzaj doznanego urazu wykazano, że najczęściej dochodziło do stłuczeń (53,16%), które dotyczyły głównie kończyn dolnych (55,06%). Stwierdzono wysoce istotną statystycznie zależność pomiędzy częstotliwością urazów a wiekiem badanych (p<0,001), środowiskiem zamieszkania (p<0,001), a także rodzajem aktywności ruchowej pozalekcyjnej (p<0,05). Wnioski: Urazy na lekcjach wychowania fizycznego są częstym zjawiskiem wśród uczniów województwa podkarpackiego. Występuje istotna zależność pomiędzy wiekiem, środowiskiem zamieszkania, aktywnością ruchową pozalekcyjną, a częstotliwością występowania urazów na zajęciach wychowania fizycznego.Introduction: The classes of Physical Education include a range of activities aimed at comprehensive physical development of human body. However, there is no doubt that exercises at Physical Education (PE) are associated with the risk of injury or damage to the body. The threat of loss of health in school environment is currently becoming a significant social issue. Therefore, particular attention should be paid to the safety of young people both in course of planning of PE classes and the choice of methods and forms of activity. Aim: The aim of this study was to evaluate the incidence of injuries in primary and secondary schools students during PE classes in the Podkarpackie Province and the assessment of correlation between the incidence of sports injuries among children and adolescents and selected factors. Material and methods: 301 primary and secondary school students from the Podkarpackie Province were included in the study. The study group comprised of 151 boys and 150 girls. Age of the participants ranged from 9 to 16 years of age (mean age 12.58 years). The author’s questionnaire was used to carry out the research. The survey was standardized, anonymous and consisted of 29 questions. Results: The results of the study showed that out of the total of 301 students surveyed, more than a half – 158 (52.5%) suffered occasionally from an injury at PE lessons. The analysis in terms of injury type revealed that contusions were predominant (53.16%), the lower limbs were the most frequently affected (55,06%). There was a highly significant relationship between the frequency of injuries and the age of students (p <0.001), living environment (p <0.001) as well as a kind of after-school physical activity (p <0.05). Conclusions: Injuries at PE classes are common among students in the Podkarpackie Province. There is a significant relationship between the age, living environment, afterschool physical activity and the incidence of injury during physical education classes

Multistage treatment of a patient with developmental dysplasia of the hip: A case study

Introduction. Developmental dysplasia of the hip (DDH) concerns about 5 per cent of the newborn population, and congenital hip dislocation (1%) is considered a challenge in child orthopedics due to the risk of further complications.Recently, the occurrence of this illness has been decreasing due to early hip diagnostics in newborns and fast implementation of proper treatment. Aim. To describe multi-annual treatment and multiplicitous complications in a 15 years old patient diagnosed with DDH. Description of the case. Complications occurring, despite the treatment conducted in accordance with accepted standards, induced the necessity of surgical procedures. This paper describes applied surgical techniques, physiotherapy treatment, the functional status of patient during particular stages of treatment as well as current results of gait analyses. Conclusions. In spite of early diagnosis and treatment of DDH, surgical intervention does not always bring the expected result

Multistage treatment of a patient with developmental dysplasia of the hip: A case study

Introduction. Developmental dysplasia of the hip (DDH) concerns about 5 per cent of the newborn population, and congenital hip dislocation (1%) is considered a challenge in child orthopedics due to the risk of further complications.Recently, the occurrence of this illness has been decreasing due to early hip diagnostics in newborns and fast implementation of proper treatment. Aim. To describe multi-annual treatment and multiplicitous complications in a 15 years old patient diagnosed with DDH. Description of the case. Complications occurring, despite the treatment conducted in accordance with accepted standards, induced the necessity of surgical procedures. This paper describes applied surgical techniques, physiotherapy treatment, the functional status of patient during particular stages of treatment as well as current results of gait analyses. Conclusions. In spite of early diagnosis and treatment of DDH, surgical intervention does not always bring the expected result

The Utility of Gait Deviation Index (GDI) and Gait Variability Index (GVI) in Detecting Gait Changes in Spastic Hemiplegic Cerebral Palsy Children Using Ankle–Foot Orthoses (AFO)

Background: Cerebral palsy (CP) children present complex and heterogeneous motor disorders that cause gait deviations. Clinical gait analysis (CGA) is used to identify, understand and support the management of gait deviations in CP. Children with CP often use ankle&ndash;foot orthosis (AFO) to facilitate and optimize their walking ability. The aim of this study was to assess whether the gait deviation index (GDI) and the gait variability index (GVI) results can reflect the changes of spatio-temporal and kinematic gait parameters in spastic hemiplegic CP children wearing AFO. Method: The study group consisted of 37 CP children with hemiparesis. All had undergone a comprehensive, instrumented gait analysis while walking, both barefoot and with their AFO, during the same CGA session. Kinematic and spatio-temporal data were collected and GVI and GDI gait indexes were calculated. Results: Significant differences were found between the barefoot condition and the AFO conditions for selected spatio-temporal and kinematic gait parameters. Changes in GVI and GDI were also statistically significant. Conclusions: The use of AFO in hemiplegic CP children caused a statistically significant improvement in spatio-temporal and kinematic gait parameters. It was found that these changes were also reflected by GVI and GDI. These findings might suggest that gait indices, such as GDI and GVI, as clinical outcome measures, may reflect the effects of specific therapeutic interventions in CP children

Ocena parametrów czasowo-przestrzennych chodu w grupie zdrowych dzieci w wieku 9 lat

Introduction: Gait analysis can be defined as a measurement, description and assessment of human locomotion. The development of quantitative gait analysis methods and their increasing application to pathological gait assessment in children has created an urgent need for establishing normative data. The spatio-temporal gait parameters must be compared with valid reference data for the appropriate interpretation. Objective: The aim of this study was the assessment of the spatio-temporal gait parameters of 9 years old healthy children, considering the subject’s gender and the potential difference between right and left lower limb. Additional purpose of our study was to develop own reference data for the gait analysis in this age group. Material and methods: 42 healthy, nine years old children (19 girls, 23 boys), participated in this study. 3D gait analysis was performed using the computerized optoelectronic system (BTS Smart, Italy). Basic spatio-temporal gait parameters (percentage share of the stance and swing phase, right and left lower limb step lenght, as well as step frequency and average gait speed, were anylysed. Results: Our research showed no statistically significant influence of gender, and no differences between the right and left lower limbs on most of the gait parameters in the study group.Wprowadzenie: Analizę chodu można zdefiniować jako pomiar, opis i ocenę lokomocji człowieka. Rozwój ilościowych metod analizy chodu oraz ich rosnące zastosowanie w ocenie patologii chodu u dzieci spowodował pilną potrzebę stworzenia danych normatywnych. Najczęściej stosowane parametry czasowo- -przestrzenne chodu muszą być porównywane z wartościowymi danymi referencyjnymi w celu prawidłowej interpretacji. Cel: Celem badań była ocena parametrów czasowo-przestrzennych chodu w grupie zdrowych dzieci w wieku 9 lat, z uwzględnieniem płci badanych oraz ewentualnych różnic pomiędzy prawą i lewą kończyną dolną. Dodatkowym celem naszych badań było opracowanie własnych danych normatywnych dotyczących analizy chodu w grupie zdrowych dzieci w wieku 9 lat. Materiał i metoda: W badaniach udział wzięło 42 zdrowych dzieci (19 dziewczyn, 23 chłopców) w wieku 9 lat, spełnia jących przyjęte kryteria włączenia. Trójwymiarowa analiza chodu została wykonana przy użyciu komputerowego systemu optoelektonicznego BTS Smart (BTS Bioengineering, Włochy). Analizie poddano podstawowe parametry czasowo- -przestrzenne chodu, takie jak udział procentowy fazy podporu i wymachu oraz długość kroku dla prawej i lewej kończyny dolnej, częstość kroków i średnią prędkość chodu. Wyniki: Nasze badania wykazały brak istotnie statystycznego wpływu płci oraz brak różnic pomiędzy prawą i lewą kończyną dolną w odniesieniu do większości rozważanych parametrów chodu w badanej grupie

Functional assessment of patients before and 6 months after total knee replacement

Wstęp. Endoprotezoplastyka jest obecnie najbardziej rozpowszechnioną metodą leczenia zaawansowanych zmian zwyrodnieniowych stawów, w tym stawu kolanowego. Jej głównym celem jest przywrócenie funkcjonalnej niezależności pacjentów w czynnościach dnia codziennego poprzez zmniejszenie natężenia bólu i niepełnosprawności. Cel pracy. Ocena funkcjonalna pacjentów po całkowitej endoprotezoplastyce stawu kolanowego z uwzględnieniem płci, wieku, BMI oraz czasu trwania choroby. Materiał i metoda. W badaniu udział wzięło 70 pacjentów (59 kobiet, 11 mężczyzn), którzy zostali zakwalifikowani do zabiegu całkowitej endoprotezoplastyki stawu kolanowego w wyniku pierwotnych zmian zwyrodnieniowych. Średni wiek pacjentów w badanej grupie wynosił 66,5 roku. Do oceny funkcjonalnej pacjentów posłużono się skalą VAS, skalą Knee Injury and Osteoarthritis Outcome Score, Global Rating Scale, testem Up&Go, testem Five Time Sit to Stand oraz 10-metrowym testem chodu. Dodatkowo wykonano pomiary zakresów ruchu stawu kolanowego w kończynie operowanej i nieoperowanej. Badanie wykonano dwukrotnie; badanie I - tydzień przed zabiegiem operacyjnym i badanie II - 6 miesięcy po nim. Do prezentacji uzyskanych wyników badań posłużono się wartościami średniej, mediany, odchylenia standardowego oraz współczynnikiem korelacji rang Spearmana. W celu analizy statystycznej wykorzystano testy nieparametryczne Wilcoxona i Manna-Whitneya. Poziom istotności statystycznej został określony jako p < 0,05. Wyniki. W okresie 6 miesięcy po zabiegu endoprotezoplastyki stwierdzono poprawę we wszystkich testach i skalach oceny.Introduction. Endoprosthetics is currently most common method of the treatment of advanced osteoarthritis, including knee joint osteoarthritis. Its main goal is to restore patients functional independence in activities of daily living through reducing pain and disability. Objective. The aim of this study was functional assessment of the patients after total knee replacement (TKR) considering subjects age and gender, BMI and mean duration of the disease. Material and methods. 70 patients (59 females and 11 males), qualified for total knee replacement surgery due to the primary knee osteoarthritis (KO), participated in this study. Mean age of the patients in the study group was 66,5 years. Visual Analogue Scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), Global Rating Scale, Up&Go Test, Five Time Sit to Stand Test and 10-meters walking test were used for the functional assessment of the patients. Additionally, the measurement of the range of motion of the operated and non-operated knee joint were performed. The study was performed twice; the first study was conducted one week before the surgery and the second study-six months after. For the purpose of the presentation of the results of this study mean value, median, standard deviation and Spearman’s rank correlation coefficient were used. Non-parametric Wilcoxon and Mann-Whitney test were used for the statistical analysis. The level of statistical significance was assumed at α < 0.05. Results. Within six months after total knee replacement surgery (TKR) statistically significant improvement of the results of all functional tests and scales used in this study were observed

Three-dimensional analysis of gait in children and adolescents with juvenile idiopathic arthritis

The paper aimed to assess the gait pattern in children and adolescents with juvenile idiopathic arthritis (JIA) treated at the rehabilitation center and to assess changes in this pattern after the end of treatment and 9 months later. Methods: 50 children with JIA were enrolled into the study. 35 healthy volunteers were enrolled into the study for a comparison. Spatiotemporal and kinematic gait parameters were obtained using a movement analysis system. The Gait Deviation Index (GDI) was calculated. The assessment was performed three times: on the day of admission to the rehabilitation center, after the end of a 4-week treatment period and 9 months later. Results: With regard to the majority of spatiotemporal and kinematic parameters, differences in their distribution were highly statistically significant between the study group and the control group ( p &lt; 0.001). In two subsequent tests, differences were less significant when compared to the control group ( p &lt; 0.01). In the study group, ranges of motion in the sagittal plane in the hip ( p &lt; 0.01), knee ( p &lt; 0.001) and ankle joints ( p &lt; 0.01) increased significantly between tests 1 and 2, and 1 and 3. A significantly lower value of GDI was observed in the study group (right limb; p = 0.036). Conclusions: The gait pattern of children with JIA is significantly different from the one observed in healthy children. A rehabilitation program significantly improved gait in children with JIA, but differences compared to healthy children were still observed, and it indicates that the abnormal gait pattern became permanent in this group of subjects

The paediatric version of Wisconsin gait scale, adaptation for children with hemiplegic cerebral palsy: a prospective observational study

Abstract Background In clinical practice there is a need for a specific scale enabling detailed and multifactorial assessment of gait in children with spastic hemiplegic cerebral palsy. The practical value of the present study is linked with the attempts to find a new, affordable, easy-to-use tool for gait assessment in children with spastic hemiplegic cerebral palsy. The objective of the study is to evaluate the Wisconsin Gait Scale (WGS) in terms of its inter- and intra-rater reliability in observational assessment of walking in children with hemiplegic cerebral palsy. Methods The study was conducted in a group of 34 patients with hemiplegic cerebral palsy. At the first stage, the original version of the ordinal WGS was used. The WGS, consisting of four subscales, evaluates fourteen gait parameters which can be observed during consecutive gait phases. At the second stage, a modification was introduced in the kinematics description of the knee and weight shift, in relation to the original scale. The same video recordings were rescored using the new, paediatric version of the WGS. Three independent examiners performed the assessment twice. Inter and intra-observer reliability of the modified WGS were determined. Results The findings show very high inter- and intra-observer reliability of the modified WGS. This was reflected by a lack of systematically oriented differences between the repeated measurements, very high value of Spearman’s rank correlation coefficient 0.9 ≤ |R|  0.9, and low value of CV < 2.5% for the specific physical therapists. Conclusions The new, ordinal, paediatric version of WGS, proposed by the authors, seems to be useful as an additional tool that can be used in qualitative observational gait assessment of children with spastic hemiplegic cerebral palsy. Practical dimension of the study lies in the fact that it proposes a simple, easy-to-use tool for a global gait assessment in children with spastic hemiplegic cerebral palsy. However, further research is needed to validate the modified WGS by comparing it to other observational scales and objective 3-dimensional spatiotemporal and kinematic gait parameters. Trial registration anzctr.org.au, ID: ACTRN12617000436370. Registered 24 March 2017