Correlation between pain and muscle strength in patients with adult scoliosis

INTRODUCTION: In this study, we investigate the possible benefits of two different combinations of ex­ercise-based therapies in the treatment of adult idiopathic scoliosis.MATERIALS AND METHODS: A total of 62 patients (mean age 31.43 years) were selected to participate in the physiotherapy protocol. Pain and trunk muscle strength in patients with scoliosis (mean 10.93°Cobb) were measured in each subject prior to treatment intervention and 6 months following the intervention. The level of pain and trunk muscle strength was analyzed on each test, so pre- and post-comparisons could be made.RESULTS AND CONCLUSION: After 6 months of treatment, the experimental group averaged a 2.75 reduction in their levels of pain according to the visual analogue scale (VAS), and the control group aver­aged 1.88 reduction in their levels of pain. None of the patients had an increase of pain. The trunk muscle strength increased in both groups. The combined use of spinal mobilization and postural therapy appeared to significantly reduce the levels of pain and increase trunk muscle strength in all 62 subjects. These results warrant further testing of this protocol

EFFECTIVENESS OF MANUAL THERAPY ADDED TO CONVENTIONAL PHYSIOTHERAPY PROTOCOL IN PATIENTS WITH SURGICALLY TREATED PROXIMAL HUMERAL FRACTURES

Proximal humerus fractures are the third most common fractures in adult patients. In developed economies, there is a tendency to increase the number of these fractures due to the aging population. Physical therapy is recognized as an important component in the management regardless of the fracture type or treatment protocol. The purpose of this blind, randomized study was to compare the effectiveness of two physical therapy interventions on the shoulder range of motion and function after surgical treatment of proximal humerus fracture: 1) supervised therapeutic exercise only (Control group – CG), 2) supervised therapeutic exercise with manual soft tissue mobilization and massage (Experimental group – EG). Ninty-six subjects diagnosed with proximal humerus fracture treated operatively were randomly assigned to one of these two groups. The rehabilitation included four phases, in each of which the patients underwent ten procedures. Shoulder range of motion was assessed with a universal goniometer for flexion, extension abduction, internal rotation and external rotation. International SFTR method of measuring and recording joint motion was used. The results were analyzed with the statistical program SPSS Statistics 19. At the end of the study, we found statistically significant better results in the EG in flexion (152.8° ± 22.3°), abduction (145.3° ± 24.2°), external (61.1° ± 11.8°) and internal (75.3° ± 11.6°) rotations, compared to CG: flexion (140.7° ± 22.0°), abduction (130.6° ± 24.4°), internal (51.8° ± 15.6°) and external (63.5° ± 14.1°) rotations with statistical significance (p < 0.05). The extension showed improvement in both study groups, within the EG results being 52.9° ± 15.9° and in the CG 49.9° ± 5.5° - with no statistically significant difference between them. The DASH (Disabilities of the Arm, Shoulder, and Hand) scale was used for functional assessment of upper extremity. We established that the application of manual soft tissue mobilization with massage in the postoperative rehabilitation of patients with proximal humerus fractures leads to more effective restoration of shoulder joint function

PHYSIOTHERAPY METHODS FOR PATIENTS WITH ADULT SCOLIOSIS

Spinal deformities are a major demographic health issue among the adult population all over the world. Surgeons are often very conservative in the treatment of adult scoliosis because of the complication rates associated with the surgeries. A prerequisite to surgical interventions is usually failure of all appropriate conservative care. There is currently a lack of consensus on the most efficient conservative treatments for adult scoliosis. The aim of the present study is to investigate the effect of two different methods of exercise-based therapies on the treatment of adult idiopathic scoliosis. The research was done among 62 patients with scoliosis (10.93°Cobb) and back pain. They were randomly divided into two groups, depending on the physiotherapy (PT) protocol. To evaluate the effect of physiotherapy we used the posture assessment, visual analog scale (VAS) for pain, muscle strength test and Functional Rating Index (FRI). The control group – CG (n=37) performed a conventional physiotherapy program, including symmetrical exercises for the trunk muscles, lower and upper limbs, while the experimental group – EG (n=25) performed PT program, additionally including spinal mobilization, muscle energy technique, and postural therapy. The results after 6 months of treatment revealed a statistically significant improvement in the following parameters in the EG: the posture correction, pain index (according to VAS), muscle strength hand quality of live (p < 0.01). In the control group these results did not improve significantly. Conclusion: The combined use of spinal mobilization and postural therapy applied in the EG appears more effective than the conventional physiotherapy program used in the treatment of adult scoliosis

InteRhemispheric differences in clinical outcome after intravenous thrombolysis

Човешкият мозък се характеризира с функционална асиметрия, включваща междухемисферни, корови и подкорови взаимодействия. Пациентите с ИМИ в лява хемисфера и проведено тромболитично лечение (ТЛ) имат два пъти по-голяма вероятност за благоприятен клиничен изход на третия месец сравнено с дяснохемисферните инфаркти. Женският пол и левостранната локализация са предиктори на значимо подобрение на неврологичния дефицит на 24-я час след ТЛ. От друга страна асоциацията на мъжки пол и дяснохемисферна локализация на инсулта е свързана с по-голяма вероятност за благоприятен клиничен изход отколкото при жените със същата локализация. Също така дяснохемисферната локализация на инсулта при мъжете се свързва с по-добър изход отколкото при локализация налезията в лява хемисфера.The human brain is characterized by functional asymmetry including interhemispheric, cortical and subcortical interactions. Patients with acute ischemic stroke (AIS) in the left hemisphere and conducted thrombolytic therapy (IVT) have a two-fold greater likelihood of favorable clinical outcome of the third month compared with right hemispheric infarcts. Petticoats and left - sided location are predictors of significant improvement in neurological deficit 24 hours after IVT. On the other hand the association of male and right - sided location of stroke is associated with a greater likelihood of favorable clinical outcomes than women with the same location. In men it is associated with a better outcome than left-sided localization of the lesion

Quality indicators in the treatment of acute ischemic stroke

Cerebrovascular diseases are a global medical and social issue because of the high morbidity, disability and mortality they cause. WHO announces 15 million new ischemic strokes per year globally, with 5 million associated deaths and 5 million patients left permanently disabled. Thrombolysis (TL) with tissue plasminogen activator (rt-PA) is currently an approved differentiated pharmacotherapeutic treatment of ischemic stroke (IS) in its acute phase. There is irrefutable evidence of better health results and efficient clinical management of ischemic strokes within an integrated therapeutic approach as a key factor for improving the functional outcome in stroke patients. Quality is one of the most widely discussed issues in the theory and practice of disease management. Strict compliance with the standards for ischemic stroke treatment is an indicator of high quality patient management

An Information Cardiac Platform to Support Healthcare

The article presents a software information platform for storing, processing, researching, and protecting cardiology information obtained during the study of patients with various cardiovascular diseases and a healthy control group. The information platform contains non-confidential data about the research subjects, which is freely available; as well as a confidential part; cardiological data, containing information about the biomedical tests carried out; as well as the parametric and graphical results of the mathematical analyzes obtained based on the registered cardiac data. The created integrated information platform can be used by cardiology specialists to evaluate the results of cardiac examinations and assist cardiologists in making a correct diagnosis and prescribing effective treatment. The platform is a tool with a user-friendly interface and can be useful for cardiac data researchers as well

Methods for Mathematical Analysis of Simulated and Real Fractal Processes with Application in Cardiology

In the article, a comparative analysis is performed regarding the accuracy parameter in determining the degree of self-similarity of fractal processes between the following methods: Variance-Time plot, Rescaled Range (R/S), Wavelet-based, Detrended Fluctuation Analysis (DFA) and Multifractal Detrended Fluctuation Analysis (MFDFA). To evaluate the methods, fractal processes based of Fractional Gaussian Noise were simulated and the dependence between the length of the simulated process and the degree of self-similarity was investigated by calculating the Hurst exponent (H > 0.5). It was found that the Wavelet-based, DFA and MFDFA methods, with a process length greater than 214 points, have a relative error of the Hurst exponent is less than 1%. A methodology for the Wavelet-based method related to determining the size of the scale and the wavelet algorithm was proposed, and it was investigated in terms of the exact determination of the Hurst exponent of two algorithms: Haar and Daubechies with different number of coefficients and different values of the scale. Based on the analysis, it was determined that the Daubechies algorithm with 10 coefficients and scale (i = 2, j = 10) has a relative error of less than 0.5%. The three most accurate methods are applied to the study of real cardiac signals of two groups of people: healthy and unhealthy (arrhythmia) subjects. The results of the statistical analysis, using the t-test, show that the proposed methods can distinguish the two studied groups and can be used for diagnostic purposes