Kinesitherapy in sural nerve and Achilles tendon damage

Purpose: To monitor the influence of kinesitherapeutic agents on functional disorders in patients with damage to the sural nerve due to rupture of the Achilles tendon. Contingent and methods: The study examined 9 patients with with damage to the sural nerve due to rupture of the Achilles tendon in functional period, who agreed to kinesitherapy at home for a period of 1 month. Exercises are included for: pain reduction, to stimulate proprio- and exteroreceptors, normalization of muscle imbalance; for an analytical effect on muscle strength; to improve the mobility of movement in the ankle area, to gradually adapt the musculoskeletal system; to improve normal postural mechanisms. Functional examinations are manual muscle test, centimetry and goniometry. Results: The study showed that the applied kinesitherapy for 1 month has a positive effect (p<0,001), reducing pain, improves trophic, muscle tone, sensitivity and mobility of movement in the ankle area.. Conclusion: Prolonged use of kinesitherapeutic agents has a positive effect in patients with with damage to the sural nerve due to rupture of the Achilles tendon, which leads to an improvement in the activities of daily life of the patients. Key words: sural nerve, rupture of the Achilles tendon, kinesitherap

Orthostatic Reactivity in Patients with Diabetic Neuropathy

AIM: The purpose of the study was to assess the effect of a structured physical therapy (PT) programme on the orthostatic reactivity in patients with diabetic neuropathy (DNP).MATERIAL AND METHODS: The study was performed in 90 patients with DNP (34 male and 56 female, mean ages 60.8 ± 7.8 years) of lower extremities. The orthostatic autoregulation was evaluated using an active orthostatic test. The arterial blood pressure and the heart rate were determined after 10 minutes of rest in lying position before and after 1, 5 and 10 minutes of active standing.RESULTS: At the start of the study a normotonic orthostatic reactivity (NOR) was observed in 32 patients. Abnormal sympathicotonic type of orthostatic reactivity (SOR) was found in 18 patients and asympaticotonic type of orthostatic reactivity (AOR) was established in the remaining 40 patients. After the PT treatment a significant improvement of the orthostatic autoregulation in the groups with SOR and AOR was not found – NOR was observed in 66 patients with DNP (80.3%) at 6 weeks after the start of PT.CONCLUSION: The applied structured PT, later continued as a home exercise programme, significantly improved the orthostatic reactivity in patients with orthostatic dysregulation due to DNP

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&lt;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

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

EFFECTIVENESS OF INDIVIDUALIZED APPROACH FOR PHYSIOTHERAPY OF CHRONIC SHOULDER PAIN AND PHYSICAL FUNCTIONING IN ELITE ATHLETES WITH PHYSICAL DISABILITIES

ABSTRACT Objective: Тo study the potential effectiveness of individual physiotherapy program for wheelchair athletes with shoulder girdle persistent pain and dysfunctions. Materials and methods: Thirteen athletes, members of the Bulgarian National Teams in wheelchair basketball and track and field athletics, with mean age 40.6 ± 10.9 participated in the study. The studied athletes had had a history of persistent pain and shoulder girdle dysfunctions for more than 6 months. Individual physiotherapy programs were applied to the participants for a period of two weeks. The selection of techniques was based on the initial assessment and evaluation. The participants were evaluated before treatment, after the first week of treatment, and at the end of the period with the use of the following specific questionnaires and tests: Goniometry of shoulder flexion and horizontal adduction, Apley’s Scratch test, Active compression test of O’Brien (ACT), Athletic shoulder outcome rating scale and Wheelchair User’s Shoulder Pain Index (WUSPI). Results: Post-treatment effects demonstrated a significant (p<0.05) increase in shoulder flexion (14.6° for the right and 12.7° for the left) and horizontal adduction (21.9° for the right and 18.8° for the left). A corresponding increase in the scores for the Athletic shoulder outcome rating scale was found with 10.92 points difference to the initial score (p<0.05). The WUSPI demonstrated a non-significant improvement of 0.69 points. The results of ACT and Apley scratch test showed a non-significant decrease of 23.1% for the right shoulder and, 15.4% decrease for the left shoulder after 7 days of treatment. Those results remained unchanged in post-treatment testing. Conclusion: This study showed that the individual physiotherapy programs are effective in the management of wheelchair athletes with chronic shoulder pain. The involvement of Mulligan’s manual therapy techniques combined with other types of exercises for the shoulder and the trunk are beneficial for wheelchair athletes with chronic shoulder pain

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

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 &lt;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 &lt;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

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 &lt;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

Практични насоки на неврорехабилитацијата после мозочен инсулт

Неврорехабилитацијата се базира на ориентирано дефинирање на целите и обезбедување на интервенции за враќање на изгубената функција или за компензирање на изгубена функција, кога таа неможе да биде вратена, но најважно е да се помогне на поединецот да одржува оптимален квалитет на живот. Широко прифатено е дека моторното тренирање и вежбање се од суштинско значење ("користете ги или никогаш нема да се повратите") за различни пациенти со невролошки проблем. Правилата за вежбање се исти за секој вид на метода, но мора да бидеме реални во своите очекувања (поради присуството на мозочно оштетување и намалените нивоа на добра состојба). Од истата причина не треба да ги потценуваме напорите кои се неопходни, за повторно да се научат пациентите на моторна активност и да се адаптираат на зачестеноста и времетраењето на вежбите и периодите на возобновување на соодветен начи