EVALUATION OF THE EFFECTIVENESSOF PHYSIOTHERAPYBASED ON THE LOCATIONTHE JOINTCHANGESIN RHEUMATOID ARTHRITIS

Rheumatoid arthritis (RA) is a chronic connective tissue disease. Typical first signs of diseases are pain and edemas of small hand and foot joint, but sometimes first symptoms regard less typical place like one big joint. Pain became the barrier for normal functioning patients with RA, therefore wide range of physical therapy is needed. The aim of this study was evaluation of pain reduction in physical therapy on diseases changed joint. The study involved 50 patients with RA, where mean of age was 47,5. In this group fallowing physical therapy techniques were used: cryotherapy, ultrasound therapy, laser therapy, electrical stimulation TENS, iontophoresis, diadynamic and magnetic therapy. In studied group first signs of diseases were similar like in literature. The presented results indicate pain reduction on all treatment filled join. Used physical therapy techniques were more effective on hand joints then on foot joints

SACROILIAC JOINT SYNDROME – DESCRIPTION OF PAIN ETIOLOGY

Numerous clinical studies have supported the thesis that sacroiliac (SI) joints constitute one of the causes of spinal pain radiating to the lower limb. The pathology of SI joint has been variously defined. The majority of definitions refer to the joint structure as the potential source of pain.As far as the etiology of SI joint dysfunction is concerned, it has not been disambiguated yet.Among the main causative factors, injuries and strains of the structures surrounding the joint are noted.Joint pathology usually manifests itself by pain occurring within the area of the joint.The causes of pain may be divided into two categories: intra-articular and extra-articular.Pain caused by the SI joint may be nociceptive or neural in nature, whereaspain pattern characteristic of the joint correlates with its innervation (S2 dorsal rami) and is consistent with the localisation of radicular pain to a large extent

RECOMMENDATIONS OF THE ALZHEIMER'S DISEASE INTERNATIONAL CONCERNING THE CARE OF PATIENTS WITH DEMENTIAAND THE SITUATION IN POLAND

According to data of WHO research, there are an estimated 36,5 million people with dementia worldwide. They need long-term care. The nature of this care depends on economic situation of the country - the higher developed it is, the bigger participation of institutions specialized in long-term care and smaller participation of home care. In high income countries around one-third to one-half of people with dementia are cared for in care homes. Alzheimer's Disease International (ADI) predicts that by 2030 number of patients with dementia will double and triple by 2050. This prognosis requires advanced planning, monitoring and coordination actions to improve system of long-term care. To achieve this goal, ADI recommends: promoting broad public awareness of dementia and combating stigma, identifying dementia capable support services at all stages of the disease, assessing and improving the quality of health care, social care and long-term care support and services, assessing availability and access to diagnostic services, promotion of brain health. Caregivers should be valued by society for they demanding and difficult work. Also patients should keep their autonomy and choice. 92% of suffering from dementia patents in Poland are cared at home since beginning of disease until their death. Other 8% stays at different types of home cares. There are also short-term care, daily care and ambulatory care available. The reasons of small participation of those institutions are: maladjusted to growing number of patients with dementia system of care, complicated administrative procedures, lack of money to cover up costs of care and lack of knowledge about dementia in society

The opinion of professional caregivers about the platform understAID for patients with dementia

Clinical research[Abstract] BACKGROUND: The person with dementia should be treated as an unique person regarding symptoms directly associated with dementia, such as problems with memory, hallucinations, and delusions, as well as other physical, mental, or neurological deficits. The symptoms not directly typical of dementia, such as musculoskeletal disorders or depression, should be also be considered in order to improve the quality of life of a person with dementia. That is why professional caregivers have to broaden their current knowledge not only of medical symptoms but also of the patient’s psychosocial condition and increase their inquisitiveness about the individual condition of the patient. The aim of the study was to get to know the opinion of professional caregivers about the UnderstAID platform and its usefulness for informal caregivers. MATERIAL AND METHODS: Participants in the study group consisted of professional caregivers: nurses, sociologists, psychologists, physiotherapists, and occupational therapists, all of whom specialized in geriatrics and had experience in working with people with dementia. All professional caregivers answered 24 questions that refer to positive and negative aspects of the UnderstAID platform. RESULTS: The study group of professional caregivers highly appreciated that the application could give support to caregivers (mean score of 4.78; 5 points means that they totally agreed, and 1 point means that they totally disagreed) and that a wide range of multimedia materials helped the informal caregivers to gain a better understanding of the contents (mean score of 4.78). There was a statistically significant correlation between the age of the professional caregivers and the frequency of positive opinions that the UnderstAID application gave support to caregivers of relatives with dementia (p=0.028) and the opinion that videos, photos, and pictures may help the informal caregivers to gain a better understanding of the contents (p=0.028). CONCLUSIONS: A group of professional caregivers positively assessed the UnderstAID platform. Caregivers, especially older caregivers, highly appreciated the usefulness of videos, photos, and pictures for gaining a better understanding of the contents.European Commission; AAL5/1/2013European Commission; AAL5/2/201

Dysfunctions associated with dementia and their treatment

[u]International UnderstAID project shows[/u] the role of physiotherapist in patients with dementia as divided into two branches: helping to resolve the physical problems and solving the problems related to dementia. The role of physiotherapist in dementia treatment may be divided into two branches: helping to resolve the physical problems and solving the problems related to dementia. The physical problems consider such aspects as musculoskeletal disorders, mobility dysfunction and pain. Referring to musculoskeletal problems, the interventions of physical therapists should included whole-body progressive resistance exercise training, strengthening, “range-of-motion” and stretching exercises and transfer training. Mobility disorders are associated with physical symptoms such as: rigidity, balance problem, shuffling gait. Decreased mobility can be based on unrelieved pain. These are some crucial scales which are designed to detected the pain. For instance, The Pain Assessment in Advanced Dementia. Transcutaneous Electrical Nerve Stimulation, massage or exercises can be provide to reduce the pain in patients with dementia. Physiotherapy in dementia treatment influences not only physical functions but also the maintenance or progression of cognitive abilities of demented elderly subject

UnderstAID, an ICT platform to help informal caregivers of people with dementia: a pilot randomized controlled study

[Abstract] Information and communications technology (ICT) could support ambient assisted living (AAL) based interventions to provide support to informal caregivers of people with dementia, especially when they need to cope with their feelings of overburden or isolation. An e-learning platform (understAID application) was tested by informal caregivers from Denmark, Poland, and Spain to explore the technical and the pedagogical specifications, as well as evaluating the impact of its use on the psychological status of the participants. 61 informal caregivers completed the study taking part in the experimental (n=30) or control (n=31) groups. 33.3% of the caregivers were satisfied with the application and around 50% of the participants assessed it as technically and pedagogically acceptable. After using understAID the caregivers in the experimental group significantly decreased their depressive symptomatology according to the Center for Epidemiologic Studies Depression scale, but a possible benefit on their feelings of competence and satisfaction with the caring experience was also observed. The low scores obtained for satisfaction were highlighting issues that need to be modified to meet the informal caregivers’ needs in national, social, and cultural context. Some possible biases are also considered and discussed to be taken into account in future improvements of understAID application.European Commission; AAL-2012-5-10

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

Fizjoprofilaktyka w osteoporozie

Osteoporoza, zgodnie z definicją Światowej Organizacji Zdrowia (WHO, World Health Organization), jest chorobą charakteryzującą się obniżeniem masy kostnej oraz zaburzeniami w mikroarchitekturze tkanki kostnej. Zarówno profilaktyka, jak i leczenie osteoporozy powinny być działaniem kompleksowym, zawierającym oprócz farmakoterapii postępowanie usprawniające oraz modyfikację stylu życia — fizjoprofilaktykę.Zależnie od okresu choroby oraz objawów klinicznych fizjoprofilaktykę w osteoporozie można wdrożyć jako fizjoprofilaktykę pierwotną, wtórną lub kliniczną. Fizjoprofilaktyka osteoporozy powinna rozpoczynać się już u osób młodych i opieraćsię na uzyskaniu możliwie najwyższego poziomu szczytowej masy kostnej oraz sprawności fizycznej. Główne cele w fizjoprofilaktyce osteoporozy to stymulacja biosyntezy tkanki kostnej oraz zapobieganie upadkom i ich powikłaniom. W zależności od oczekiwanego efektu należy odpowiednio przeprowadzić edukację pacjenta i dobrać formę treningu: oporowy,siłowy, wytrzymałości lub równowagi. Dane z literatury wskazują na wysoką skuteczność fizjoprofilaktyki w zapobieganiu objawom i powikłaniom osteoporozy

Wpływ ćwiczeń mięśni dna miednicy na dysfunkcję stawów krzyżowo-biodrowych.

Staw krzyżowo-biodrowy stanowi połączenie kości krzyżowej i talerza biodrowego, które ustabilizowane jest przez więzadło oraz struktury mięśniowo-powięziowe. Jednym z elementów stanowiących wewnętrzną stabilizację obręczy biodrowej są mięśnie dna miednicy. Osłabienie lub niewystarczające pobudzenie mięśni dna miednicy upośledza mechanizm tak zwanego ryglowania wymuszonego stawu krzyżowo-biodrowego, a w konsekwencji przyjmowanie strategii kompensacyjnych przez pacjenta. Przeciążenia w obszarze tkanki miękkiej otaczającej staw krzyżowo-biodrowy prowadzą do powstawania zablokowania lub nadruchomości stawu. Osłabienie siły mięśniowej pierścienia dna miednicy będzie tylko pogłębiało niestabilność w stawach krzyżowo-biodrowych, prowokując ból w tych okolicach oraz prowadząc do powstania choroby zwyrodnieniowej wtórnej. Aby zapobiegać tym zmianom, w procesie rehabilitacji kładzie się nacisk na przywrócenie siły, wytrzymałości i odpowiedniej koordynacji pobudzenia mięśni dna miednicy

Efektywność masażu klasycznego u chorych z zesztywniającym zapaleniem stawów kręgosłupa

W pracy przedstawiono przypadek 64-letniego pacjenta aktywnego zawodowo z rozpoznanym w 1979 roku zesztywniającym zapaleniem stawów kręgosłupa, aktualnie poddanego leczeniu biologicznemu. Celem badania była ocena efektywnośćmasażu klasycznego u chorego z zesztywniającym zapaleniem stawów. U pacjenta zastosowano fizjoterapię w postaci serii 6 masaży wykonywanych w czasie 3 tygodni z 3-dniową przerwą pomiędzy zabiegami.Do oceny postępów terapii wykorzystano wizualną skalę analogową (VAS), kwestionariusz wskaźników bólu według Laitinena, pomiar ruchomości kręgosłupa goniometrem, skale BASDAI i BASFI.Przeprowadzona terapia doprowadziła do poprawy ruchomości poszczególnych odcinków kręgosłupa. Po terapii badany lepiej radził sobie z codziennymi czynnościami zgodnie z wynikami skal BASDAI i BASFI