GOAL-ORIENTED BREATHING EXERCISES IN ACUTE PERIOD AFTER STROKE

The respiratory function of patients with stroke becomes worse and may lead to restrictive disorders in ventilation and pulmonary complications. The purpose of this study is to establish the ability to influence respiratory disorders through a feedback breathing device in the acute period after a stroke. The research was done among 59 patients who were monitored in the acute period after an ischemic stroke. They were divided into two groups, exercise group (EG) and control group (CG), according to their consent to perform breathing exercises at home. Forced vital capacity (FVC), peak expiratory flow (PEF), forced expiratory volume at 1 s (FEV1) and inspiratory capacity (IC) were measured. There were significant differences in the first month in the PEF and IC between the two groups. All spirometric parameters improved in the EG with significant increase in FEV1 and IC. The conducted study and the results indicate that goal-oriented training by incentive breathing device provides informative feedback on inspiration, facilitates cognitive stage, and positively influences inspiratory capacity among patients with acute ischemic stroke. The self-control during breathing facilitates early involvement of the basic principles of motor learning

Physical Therapy and Functional Motor Recovery in Patient with Guillain-Barré Syndrome - Case Report

Introduction: Guillain-Barré syndrome (GBS) is an autoimmune disease with sudden onset and progressive impairment of the peripheral nerves. Aim: To study the influence of applied physical therapy (PT) on functional recovery in patient with a prolonged complicated course of GBS, Landry ascending paralysis and assisted breathing and 4 months in-hospital stay. Case report: The study was conducted with a 34-year-old woman in subacute stage of GBS, over the course of 2 months in the patient’s home, after discharge. PT sessions were performed 3-4 times per week for 1-hour duration, moderate intensity, without reaching fatigue. Correct positioning in bed, passive-active exercises, analytical exercises, exercises for strength of abdominal muscles, breathing exercises, training balance and coordination of sitting and standing, and massage were applied. PT included correct positioning in bed, passive-active exercises, analytical exercises, exercises for strength of abdominal muscles, breathing exercises, training balance and coordination of sitting and standing, and massage. Tests for bed mobility and transfers, Five Times Sit-To-Stand Test (FTSTS) and 10 Meters Walking Test (10MW) were applied twice in order to monitor the effect of PT. Results and Discussion: The results showed an improvement in the speed of patient’s response for transfers. Time for performing FTSTS decreased 33 sec. Improvement in bed mobility, walking speed and cadence are also observed. Conclusion: After two months of treatment functional mobility of the patient was improved

INFLUENCE OF PHYSIOTHERAPY AND BALNEOTHERAPY IN PATIENTS WITH SPINAL DISC DISEASE

Chronic spinal disc disease has a large socioeconomic impact on the health care system. A lot of researchers confirm that physiotherapy (PT) is an effective choice of treatment for many patients. The aim of the present study is to evaluate the combined effect of physiotherapy and balneotherapy the treatment of lumbar disc disease and to compare the results with those obtained only after physio-therapy. Twenty patients with lumbar disc disease in the chronic period, divided into two groups – experimental and control were studied. The experimental group did exercises in a thermal mineral pool and underwent a general PT program for ten days, while the control group had only general PT program for ten days. The general PT program was the same for both groups. Before and after the treatment the Schober test and the static part of the Kraus-Weber test were conducted. We revealed significant positive changes in the lumbar flexibility, endurance and strength of the back muscles, mm. glutei, abdominal muscles and the hip flexors among the patients from the experimental group, objectified by the increased time to perform the static test positions of Kraus-Weber Test and Schober test. We recommend our program with PT and balneotherapy as appropriate when dealing with patients with chronic lumbar spine disease in balneological resorts and SPA hotels

Influence of Kinesitherapy on Functional Independence in Patients with Supratentorial Unilateral Stroke in Chronic Period

Aim: The aim of the study is to evaluate the effect of the specialized kinesitherapeutic (KT) methodology (SKTM) on functional independence in patients with supratentorial unilateral stroke in the chronic period (SUSChP). Material and Methods: The study was conducted with 67 patients with SUSChP (56 patients included in the experimental group - 32 men and 24 women, with duration of the disease 7.8 ± 2.0 months, and 11 patients in the control group - 9 men and 2 women, with duration of the disease 7.3 ± 1.5 months). To evaluate the changes in functional independence, test for Functional Independence Measure (FIM) was used. Patients in the experimental group were treated with a specialized 10-day KT, which later continued to be performed as an adapted exercise program at home for a period of one month. Control patients perform a regular 10-day KT. This was done using SKTM principles of modern neurorehabilitation and motor learning as opposed to usual kinesitherapy. Results: After applying SKTM, the highest trend towards the improvement of functional independence was established after the 1st month with a level of significance during treatment p<0.001. Conclusion: In conclusion, the enclosed SKTM in the experimental group continued later as an adapted exercise program at home. It significantly improves the functional independence in patients with supratentorial unilateral stroke in the chronic period (SUSChP) compared  with the usual kinesitherapeutic methodology applied in the control group

Errata Corrige. Orthostatic Reactivity in Patients with Ischemic Stroke in the Chronic Period. http://dx.doi.org/10.3889/oamjms.2015.090

[See http://dx.doi.org/10.3889/oamjms.2015.090 and http://dx.doi.org/10.3889/oamjms.2015.094]AIM: This study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on orthostatic reactivity in patients with ischemic stroke in the chronic period (ISChP).MATERIAL AND METHODS: An active orthostatic test is used for the evaluation of the orthostatic reactions. The arterial blood pressure and heart rate were defined in the 10 minutes of supine position, before and after 1, 5 and 10 minutes of active upright position. The orthostatic autoregulation is evaluated four times - at the beginning of the study, on the 10th day, on the 1st month and three months after the start of the KT. The classification by Thulesius was used to separate the patients into two groups depending on the type of their orthostatic reactivity.RESULTS: At the beginning of the study of infringements symptomatic type orthostatic reactivity (SOR) was observed in 24 patients and hypertensive type orthostatic reactivity (HOR) was observed in the remaining 32 patients. Once applied SKTM establish improvement of orthostatic autoregulation for the groups SOR and HOR at the 10th day and the 1st month with a level of significance p <0.05.CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as an adapted exercise program at home, has significantly improved the orthostatic reactivity in patients with orthostatic dysregulation due to the ISChP

Influence of Kinesitherapy on Balance Reactions in Patients with Ischemic Stroke in the Chronic Period

AIM: The study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on balance reactions in patients with ischemic stroke in the chronic period (ISChP).MATERIAL AND METHODS: A prospective, multicenter study with 56 patients with ISChP. Evaluation of balance reactions using Berg Balance Scale - BBS, includes implementation of 14 tasks with increasing difficulty reflecting the usual activities of everyday life. The first 5 assignments are used to assess the main balance potential and the remaining 9 (6th to 14th task) include more sophisticated balance tasks.RESULTS: The patients were found with a significant improvement in balance opportunities, according to the scale of Berg. Compared to initial data there is a significant increase in the number of points in the measured indicators for functional and static balance. In absolute terms, positive change is most pronounced during the 1st month with a level of significance of p <0.001. CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as adapted exercise program at home, and significantly improved equilibrium reactions in patients with postural disorders because of ischemic stroke and is with a supportive prolonged exposure

PHYSICAL THERAPY AND SWIMMING INFLUENCE ON FEMALE TYPE OF ADIPOSE DEPOSITION AND CELLULITE

Cellulite is a very common problem with women of all ages, and many of them try to solve it using various methods. To evaluate the effect of swimming and physiotherapy on subcutaneous fat in overweight women with female type of adipose deposition. The research was done among 38 women aged between 22 and 48 years, with gynoid accumulation of fat and cellulite II, III-A and III-B classes. For one month, a com-plex of fifteen procedures was applied every other day. The procedures included a combination of the following methods: free style intermittent swimming for 20 min in a pool, a vacuum massage - 30 min, a lymphatic press massage - 20 min, a manual massage with anti-cellulite creams - 20 min. The combination of exercises for the muscles of the abdominal wall, hip muscles and thighs had to be performed at home daily. Five circumferences and ten skin folds were measured before and after the treatment. We found out that a total of ten skin folds was an integral indicator of the nutritional obesity degree and level of subcutaneous fat. At the end of the study, subcutaneous fat was reduced from 222.4 mm to 209.9 mm (10.34%). The reduction of the skin folds, typical for gynoid type deposition of fat and cellulites, was the most pronounced in the following zones: a fold over anterior superior iliac spine, a fold over the patella, a fold in the popliteal fossa and a fold on the medial side of the cruris. The results of the complex therapeutic approach revealed a reduction in the examined indicators within the first month. It is suitable to apply swimming and physiotherapy in the comprehensive treatment of cellulite with women who have female type of adipose deposition

Orthostatic Reactivity in Patients with Ischemic Stroke in the Chronic Period

[This article has been corrected.  See http://dx.doi.org/10.3889/oamjms.2015.094 and http://dx.doi.org/10.3889/oamjms.2015.095] AIM: This study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on orthostatic reactivity in patients with ischemic stroke in the chronic period (ISChP).MATERIAL AND METHODS: An active orthostatic test is used for the evaluation of the orthostatic reactions. The arterial blood pressure and heart rate were defined in the 10 minutes of supine position, before and after 1, 5 and 10 minutes of active upright position. The orthostatic autoregulation is evaluated four times - at the beginning of the study, on the 10th day, on the 1st month and three months after the start of the KT. The classification by Thulesius was used to separate the patients into two groups depending on the type of their orthostatic reactivity.RESULTS: At the beginning of the study of infringements symptomatic type orthostatic reactivity (SOR) was observed in 24 patients and hypertensive type orthostatic reactivity (HOR) was observed in the remaining 32 patients. Once applied SKTM establish improvement of orthostatic autoregulation for the groups SOR and HOR at the 10th day and the 1st month with a level of significance p <0.05.CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as an adapted exercise program at home, has significantly improved the orthostatic reactivity in patients with orthostatic dysregulation due to the ISChP

Feasibility of interactive video games for influence on balance in institutionalized elderly people

Purpose: The purpose is related to the assumption that the application of interactive video games will positively affect the functional balance reactions in institutionalized older individuals. Material and Methods: Ten institutionalized elderly people with an average age of 80.6 years ± 7.25, two men and eight women were included. All of them had to meet the inclusion and exclusion criteria. The intervention program included interactive video games, for 5 days per week, for one month. Berg Balance Scale, Timed Up and Go and Mini Mental State Examination tests were considered. Results: Including commercial games in physical therapy sessions have a positive effect on dynamic postural control and functional ability in institutionalized elderly. Application of virtual reality possibly maintains cognitive function. Comparison between initial and final measurement revealed statistically significant differences for Berg Balance Scale and Mini Mental State Examination (p<0.005) and for Timed Up and Go (p<0.001). Conclusion: The application of virtual reality (including commercial video games) is feasible in institutionalized elderly people. Suitable selection of computer games may improve balance and maintain cognitive function. Key Words: physical therapy, virtual reality, geriatr

Effect of kinesitherapy on physical activity in patient with Guillain-Barré syndrome

Introduction: Guillain-Barré syndrome is an autoimmune disease characterized by sudden onset and progressive impairment of peripheral nerves. It is a rare disorder in which weakness and tingling in the extremities are usually the first symptoms. Aim: To study the influence of the applied kinesitherapy in a patient with Guillain-Barré syndrome with severe and protracted course of the disease by deterioration with Landry ascending paralysis and assisted breathing. Material and Methods: The study was conducted with a female, 34 years old in the subacute stage within two months at home. The kinesitherapy sessions are performed 2-3 times per week with 1-hour duration, moderate intensity, more breaks between exercises without reaching fatigue. We applied correct positioning in bed and seating, passive-active exercises, analytical exercises for upper and lower limbs, breathing exercises, training balance and coordination of sitting and standing and massage techniques. To monitor the effect of kinesitherapy the patient performed twice tests for transfers (turning from lying on his back to the left and right side; lying to sitting and sitting to standing). We use also the test "Five Times Sit To Stand" which is appropriate to assess the possibilities for transfer. Results and Discussion: The results showed an improvement in the speed of response of the patient for changing the body position and transfer due to systematic applying of various therapeutic exercises including exercises for strength of lower limbs and abdominal muscles. The time for performing the test "Five Times Sit To Stand" decreased with 33 sec, which is indicative of the strength of the lower limbs and a big step towards the independence of the patient. The correct position of the body and speed is essential. If the speed of movement of the trunk is less, then it will be a greater loading of the lower extremities. The test also aims to establish coordination and consistency of movements between the trunk and lower limbs. Conclusion: After a two-month kinesitherapy an improvement of functional status of the patient was observed. Key words: Guillain-Barré syndrome, kinesitherapy, physical mobilit