Rehabilitation in scoliosis - an overview of the most important procedures

Introduction: Scoliosis is defined as deformation of the spine and torso in three dimensions. Study show that scoliosis affects 68% of healthy individuals over 65 years of age with no low back pain. The aim of this article is to review the available scoliosis rehabilitation methods, including the newest physical rehabilitation trends. Material and methods: Articles in the Google Scholar, Pub Med database have been analysed using keywords: scoliosis, deformation of the spine and torso, modern methods of rehabilitation, older people. Results: After skeletal maturity, curves less than 30°do not progress, however most curves greater than 50°continue to progress with approximate change of 1°per year. Bracing is one of the most popular options of scoliosis treatment. Braces usage aims to slow the progression of the curve. However, complications resulting from the physical changes caused by the compression of the body and/or psychological effects due to the disturbance of the appearance while wearing the brace may occure. The Lehnert-Schroth three-plane corrective breath method principles are: a proper breathing technique where the ribs are used as levers and the breath is directed to the unstretched parts of lungs allowing correction of the curvature of the spine, and secondly activation of non-working muscles on the side of the concave curvature. Nevertheless, surgical procedure is advised for curves greater than 45° in immature patients and greater than 50° in mature patients. Conclusions: Scoliosis, defined as spinal and torso deformity in three planes. 80% of all cases of this postural defect are juvenile idiopathic scoliosis (AIS). However, degenerative scoliosis developed during the patient’s life due to the degeneration of the discs of the spine is frequent in people over the age of 65. It often limits daily functioning and can cause severe pain that requires medical intervention. It has been proven that properly selected systematic rehabilitation may lead to significant improvement in the spinal alignment. Nevertheless, in severe cases surgical treatment may be necessary

Changes seen in the body of an elderly patient suffering from diabetes

Background: Diabetes is a foreign disease today. This is a chronic, metabolic disease that is characterized by elevated blood glucose levels. There are many types of disease. Each of them has different characteristics. The key in the fight against the disease is to perform appropriate laboratory tests to diagnose diabetes and to introduce appropriate treatment to prevent many complications, e.g. impairment of: vision, kidneys, cardiovascular system or hearing. Material and methods: A proper review of the literature was used, which identifies risk factors, complications and proper management in diagnosing diabetes. Results: The growing problem of diabetes forces us to find the most accurate way to treat the disease. Performing reliable diagnostics is crucial. The reference method (IDMS) and methods used in routine diagnostics, oxidase hexokinase are the basic and necessary laboratory tests used in the diagnosis of diabetes. Conclusions: In the coming years, the number of patients suffering from diabetes will continue to grow. Diagnosis and treatment of this disease is extremely important, because neglecting the disease can have many serious consequences for healthy physical and mental functioning. The basis is the performance of correct tests, which allows for proper treatment

Multiple sclerosis and dizziness in the elderly

Background:The essence of sclerosis disseminated, characteristics of the symptoms of this disease and familiarization with the main difficulties that sick people face. Material and methods:The methods used to treat balance disorders and dizziness are pharmacotherapy, vestibular rehabilitation, lifestyle changes and surgical treatment. Results: The results are not very optimistic, treatment is not too easy symptoms are manifested in motor dysfunction leading to even disability Conclusions:Multiple sclerosis is a disease affecting the nerve center of unknown etiology which makes treating difficult. The onset of the disease is often dizziness or headache

Sexual dysfunction in elderly men and women

Background: The aging process of the body is inexorable and affects all areas of geriatric patient's life, including the quality of his sex life. In this case, however, also psychological and environmental problems must be taken into account in the case of diagnostics. The sexuality of elderly patients has been neglected by the medical community for many years, and even recognized by some doctors as unnecessary or bad. Currently, there is a slow change in this position, also due to the patients themselves who are looking for help in specific situations. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: Sexuality, Geriatrics, Dysfunctions Results: Statistics on the sexuality of the elderly give a clear picture of how great a problem this sphere of life is. The main risk factors for sexual dysfunction of the above-mentioned patients include, among others, abnormal lifestyle and urinary tract infections. In the patients' lifestyle the most important aetiological factors are incorrect diet or lack of physical activity. Men of all ages are exposed to problems, however, in the epidemiology of this dysfunction, a drastic jump after the age of 50 is noticed. It is connected with the weakening of the function of the nervous system and microcirculation in the urinary tract and the reduction of the number of hormones responsible for the functioning of sexual organs. In women, this menopause is the period that most destructively affects the quality of sexual life. Here, as in the case of men, a reduced amount of hormones has a negative effect, among others, by a reduced sexual desire or the presence of pain during intercourse. In the treatment of the above-mentioned disorders, mainly pharmacology has the largest field of action. In the treatment of sexual dysfunction, we mainly use 2 compounds and these are sildenafil and tadalafil. Conclusions: Human sexuality, especially in the case of older people, can not be a neglected subject, and dysfunctions and problems of patients treated like any other. The need to integrate interdisciplinary mode in dealing with this type of problems is more necessary. All this is connected with the fact that there is a definite deficit in publications and research on this subject, which creates a wide range of possibilities for the medical community

Knee arthroplasty in the elderly

Background: One of the many problems related to geriatric patients are degenerative changes in joints. In this article authors discuss about the knee joint endoprosthesis. During preparations of this publishment special attention was paid to the following aspects: role and the meaning of preventing actions, explanation the clue and main goal of the surgery intervention, and it’s simplified course. Subsequently there are short description of the knee joint with its most relevant to the fallowing subject structures. Furthermore the quantity of respective surgical procedure was given to approximate the scale of subject. Next paragraphs explaining why endoprothesis is the best way for dealing with this kind of problems, and the significance of the physiotherapist in whole process both before, and after surgery. Materials and methods: Analysis of available literature and articles in PubMed, ResearchGate and other scientific platforms related to discussed subject, using words: geriatrics, endoprothesis, knee arthroplasty, knee joint. Results: Gonarthrosis is a significant social problem. Endoprosthesis plastic surgery is performed on those patients who struggle badly in activities of daily living because of advanced articulations disorders. The main diagnoses underlying the primary knee replacement were primary bilateral gonarthrosis and other primary gonarthrosis accounted. The analysis of sources devoted to these issues includes people after 65 years old (mostly women) which occurs a low level of physical activity, the burden of metabolic disease such as diabetes (type 2). Authors demonstrated a correlation between excessive body weight, and insufficient production of synovial fluid, it’s damage and in the final phase lost which is a direct reason for pain. The following thesis was proven based on the source material: thanks to arthroplasty the patients quality of life as improved by around 90 percent. When the physiotherapist is involved in the whole process, both in the pre- and post-surgery phase it is possible to obtain much better therapeutic effects. Conclusions: Knee arthroplasty can help restore independence to patients in their daily activities. The introduction of artificial foreign bodies into the pond to replace the damaged leads to an improvement in the quality of life of sick patients. The introduction of intensive rehabilitation, patient education and pharmacological treatment after arthroplasty allows for reduction of pain and faster recovery. There are many types of rehabilitation after knee replacement surgery, so the therapy plan has to be adapted to the individual patient

A rehabilitation approach to the falls of geriatric patients

Abstract: Background: Falls of the elderly are not only in themselves one of the most common problems of geriatric patients, but also the cause of many complications that affect permanently or for a shorter period of time affect the quality of life of people over 65 years of age. These changes affect not only the efficiency and motility of the elderly but also may reduce self-esteem, limit social life or cause loss of self-confidence. Material and methods: Analysis of available literature, articles in the Google Scholar database and PubMed using keywords: falls, geriatrics, aging process, problem Results: In clinical practice, many tests and scales are used to prevent the fall of older people and related complications. These include: Timed Up & Go (TUG), Tinetti scale, Dynamic Gait Index (DGI), One Leg Standing (OLS), Four Square Step Test (FSST), Berg test or Functional Reach (FR). Preventing falls can primarily be achieved by the use of appropriate rehabilitation methods, which include, among others, kinesitherapy and properly selected orthopedic equipment. The aim of individually selected kinesitherapy is to restore or maintain the patient's full fitness through the use of physical exercises to improve the balance, increasing mobility and efficiency. In the case of orthopedic supplies, the most common are baby walkers (without wheels, walker with wheels, using a triangular and quadrangular base) and orthopedic balls. Conclusions: Prophylaxis to prevent destructive effects of falls of geriatric patients should be carried out in a comprehensive manner and cover a wide range of activities. There is a further need for research and discussion on the effectiveness of forms of rehabilitation to prevent the falls of older peopl

Degeneration of the lumbar intervertebral discs as a cause of root discomfort in the lumbar spine

Background: The change in the lifestyle of modern man and the related lack of physical activity caused that pain in the spine has become a civilization problem, covering an increasing population regardless of latitude. Degenerative changes of the spine, also in the lumbar region, are the most frequently diagnosed cause of patients' dysfunction. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: lumbar spine, degenerative changes, dysfunctions Results: Currently, in addition to injuries and mechanical loads, the causes of lumbar spine dysfunction also include abnormal spinal nutritional composition and genetic factors, with the greatest emphasis on genes encoding type 1 collagen. During diagnostics, apart from X-ray imaging, computed tomography and resonance imaging methods should not forget about properly conducted interviews and functional tests. Kinesitherapy assisted by physical treatment methods such as laser therapy or ultrasound should play a major role in rehabilitation. Kinesitherapy should be tailored to the individual patient, and exercises selected so that the patient can also do them at home. Conclusions: In the prevention of degenerative changes of the lumbar spine, there should be a much greater emphasis on patient education related to risk factors or learning ergonomic work. Despite much work on this topic, there is still a need to improve public awareness and further research on prevention

Abnormal muscle tension as one of the main problems after a stroke

Background: Stroke is a growing problem in an aging society. According to WHO data, it is the second most common cause of death. An increase in the number of strokes causes an increase in the number of patients struggling with its consequences. People who have suffered a stroke are dealing with various neurological defects. One of them is abnormal muscle tension. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: stroke, muscle tension, spasticity. Results: The problem of disturbed tension is common in people who have had a stroke. Spasticity, i.e. increased muscle tone in response to stretching, results from damage to the central nervous system. Direct and indirect methods are used to assess spasticity. In the fight against destroyed muscle tension, it is important to implement treatment as soon as possible. It is based on the use of various forms of therapy: pharmacotherapy and physiotherapy. Physiotherapy and kinesitherapy treatments as well as specialized rehabilitation methods, such as PNF. The rehabilitation process should be supplemented with appropriate pharmacological treatment. Equally important is the implementation of stroke prevention. These activities are associated with the promotion of a healthy lifestyle, for example, regular exercise and stress reduction. Conclusion: Muscle tension disorder, including spasticity, is a problem affecting many patients who have had a stroke. A timely diagnosis is important to get the right therapy. Treatment should have a holistic dimension and combine different methods. The goal of therapy is to normalize muscle tone and thus improve the patient's quality of life

Sciatica - radiating pain affecting an increasing part of society

Introduction: Sciatica is a current and more common problem affecting normal functioning. Along with the development of civilization, the lifestyle has also changed, contributing to spend a large amount of time in a sitting position. Material and Methods: Review of literature data available in the Pubmed, Cochrane and Google Scholar databases. Results: Both in a standing and sitting position, the pressure exerted on the intervertebral discs increases leading to a hernia which, pressing on the roots of the L4-S1 nerves, lead to symptoms characterized by pain in the lumbar region, back of the buttock, thigh, calf, foot and paresthesia of these areas. Due to the progressive changes associated with aging, the frequency of sciatica increases with age. The basis for the diagnosis of sciatica is a carefully collected interview and examination of the patient, while imaging and neurophysiological tests can be helpful in determining the degree of compression on nerve structures. Treatment of sciatica is dependent on the cause and can be both conservative and surgical. Conclusions: Due to the increasing number of cases of sciatica, it seems necessary to expand the knowledge on the diagnostic and therapeutic possibilities of this disease

Dizziness and balance disorders in the elderly

Background: Patients in the geriatric age are characterized by the presence of degenerative changes, significantly affecting their daily functioning. One of the most common symptoms accompanying the elderly include dizziness and balance disorders. This is an extremely important issue, because even every third patient can report such ailments. Often, especially in the group of geriatric patients, these problems are related to disorders in the circulatory system, and more specifically to orthostatic hypotension. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: geriatrics, dizziness, balance disorders. Results: In the treatment of dizziness and disorders of the balance we distinguish pharmacological and non-pharmacological methods where kinesitherapy (exercises) looms large. In the case of pharmacological treatment, attention should be focused on causal therapy because symptomatic treatment can cause side effects and should therefore be used as soon as possible. In many cases, pharmacological treatment can be fully replaced by normal and individually conducted physiotherapeutic procedures. Training to which a patient is subjected should consist of many elements, which, however, will be adapted to the conditions that can meet a patient in everyday life. In diagnostics of the above-mentioned problems, research on stabilometric platforms is becoming more and more important. Increasingly, also in the rehabilitation of patients with a problem with equilibrium, modern technology in the form of virtual reality is used. Conclusions: Dizziness and balance disorders can result in many problems, which is why correct diagnosis and effective treatment are so important, especially because it is a problem for more and more people. Greater importance should be attached to prevention. Although modern forms of fighting these disorders are being introduced, there is still a need for further research on their effectiveness