Types of prosthesis funnels used after lower limb thigh amputation

Ze względu na komfort i zdrowie pacjenta po amputacji, najważniejszym elementem każdej protezy udowej jest lej protezowy. Kikut umieszczony w leju narażony jest na obtarcia i rany, a także ból i niedogodności związane z ciągłym obciążaniem jednego miejsca. Kształt leja decyduje o możliwości noszenia protezy, osiągnięcia wydolnego i estetycznego chodu i o dobrostanie użytkowania. W niniejszej pracy opisano zalety i wady obecnie używanych lejów protezowych: czworokątnego, owalnego NML i dwuwarstwowego MAS.For person with lower-limb amputation a prosthesis funnel is the most important element of each thigh prosthesis. While using the prosthesis, the stump inserted in the funnel is exposed to sores and wounds, and also to the feeling of pain and discomfort caused by constant pressure on one spot on the stump. The shape of the funnel determines the possibility of wearing the prosthesis, of gaining the efficient and aesthetic gait and the comfort of using it. In the paper the advantages and disadvantages of the prosthesis funnel were described: quadrangular, oval NML and MAS

The assessment of functional fitness and risk of falls in people aged 70 and older

Introduction. One of the key elements of successful aging is to maintain autonomy and independence in daily activities and performance. Aim. The aim of this dissertation is to evaluate the functional capacity of elders. Due to the growing proportion of elderly people in the society, the next objective of the research was to assess the risk of falls in people over 70 years of age. Material and methods. The study included 72 people with an average age of 78.74 years +/- 6.50 years, including 44 women and 28 men. The inclusion criteria for the study group was completing 70 years of age and the result above 23 points obtained in the MMSE test (The Mini Mental State Examination). To evaluate balance, a few tests such as Berg Balance Scale, “get up and go” test, Tinetti Test, and Senior Fitness Test were used. In addition, I used Barthel scale to assess functional capacity. The assessment of the balance was based on the Tinetti test and Berg scale. These tests also assess the seniors’ exposure on downs. Results. The results reflect the occurrence of deficits during gait and in the process to maintain balance. For 72 subjects in the test Tinetti only 17 participants showed minor threat of falling, and in 24, risk was five times higher than in others. Test ‘get up and go’, showed that the increased risk of falls in the study group concerns 28 people, while a high risk of 20 respondents. Conclusions . The dependence between the risk of falls and reduced functional efficiency points to the need of implementing exercises in geriatric care that could improve the efficiency and the body balance

Interaction between risk factors and the evaluation of quality of life in diabetic sufferers in relationship to the introduced therapy

Wstęp: Cukrzyca jest chorobą przewlekłą, prowadzącą do wielu powikłań. Poprzez kompleksową opiekę diabetologiczną i skuteczne postępowanie terapeutyczne można kontrolować i aktywnie stymulować subiektywne poczucie jakości życia. Celem pracy była ocena wpływu czynników ryzyka u chorych na cukrzycę typu 2 na domeny Quality of Life (QoL). Materiał i metody: Badania przeprowadzono wśród 101 pacjentów chorych na cukrzycę typu 2, powi­kłaną miażdżycą tętnic obwodowych (makroangiopatia cukrzycowa) w okresie niedokrwienia II B według klasyfikacji Fontaine’a. Każdy zakwalifikowany do badania pacjent został zbadany według kwestionariusza ogólnej oceny jakości życia SF-36 oraz autorską ankietą, uwzględniającą specyficzność choroby. Do analiz statystycznych wykorzystano elementarne metody statystyczne: test t-Studenta, test Chi-kwadrat, test Wilcoxona, test Kruskala-Wallisa oraz test U Manna-Whitneya. Wyniki: W grupie I analiza wieloczynnikowa predyktorów wpływających na ocenę jakości życia ankie­towanych osób wykazała istotną statystycznie zależność między domenami role-physical (RP), physical functioning (PF) i vitality (VT) a wiekiem, czasem trwania choroby i dolegliwościami bólowymi, domeną mental health (MH) a wiekiem i dolegliwościami bólowymi, oraz domeną social functioning (SF) a dole­gliwościami bólowymi. W grupie II analiza wieloczynnikowa wykazała istotną statystycznie zależność między domenami PF a wie­kiem, czasem trwania choroby i nasileniem bólu, domeną VT a nasileniem bólu, domeną MH a wskaźnikiem body mass index (BMI) oraz wiekiem, wskaźnikiem BMI i czasem trwania choroby w domenie SF. Wnioski: Grupę chorych, którym do leczenia włączono insulinę cechuje gorsza ocena jakości życia, zarówno w obszarze fizycznym, jak i psychicznym. Wybór sposobu leczenia okazał się nie mieć istotnego wpływu na QoL, determinować go mogły czas trwania choroby oraz otyłość.Introduction: Diabetes is a chronic disease that leads to various complications. Through complex diabetic care and effective therapy, it is possible, though, to control and actively influence the sufferers subjective experience and quality of life. The aim of study was an evaluation on influence of the risk factors on domains of quality of life in type 2 diabetes patients. Material and methods: The subjects of the study were 101 diabetic patients suffering from type 2 diabetes, complicated by peripheral arterial disease (diabetic macroangiopathy), at the stage of Fontaine stage II ischemia. Each patients who qualified for the study was evaluated with SF-36 questionnaire evaluating general quality of life and with the authors own survey which takes into consideration the specific nature of the disease. In the statistical analysis basic statistical tests were used, t-Student test, Chi-square test, Wilcoxon test, Kruskal-Wallis and U Mann-Whitney test. Results: In the group I, the multi-factor analysis of predictors influencing evaluation of quality of life of the surveyed patients revealed statistically significant correlation between domains role-physical (RP), physical functioning (PF) and vitality (VT) and age, disease duration and pain, in the mental health (MH) domain with age, pain and in social functioning (SF) it correlated with pain. In the second group, the multi-factoral analysis showed statistically significant correlation between the following domains: PF domain and age, disease duration and pain intensity, VT domain and pain intensity, MH domain and body mass index (BMI) and age, BMI index and disease duration in SF domain. Conclusions: The group of patients treated with insulin evaluated their quality of life lower. The kind of treatment way did not influence on the quality of life. The important determination could be disease duration or obesity

Zmiany w hemodynamice przepływu krwi w kończynach dolnych na przykładzie pomiarów termograficznych

Introduction. The flow of blood in the arterial and venous vessels of various organs is holds according to the difference of the value of systolic and diastolic pressures and is dependent from many factors connected with the control of the change of the vessel diameter. Arteriosclerosis can make difficult the access of the blood in the essential way to organs laid distally. Available diagnostic methods can increase in the essential way to the quicker intervention in the inhibition of the morbid process.The valuation of usability of method of thermography to rating of haemodynamics changes of blood flow in lower limbs at persons with ischaemia in II period according to Fontaine’a is the aim of study. Material and methods. Fifty persons was qualified to surveys in II period of the ischaemia of lower limbs, waiting on the endovascular intervention and 49 persons without the affirmed arteriosclerosis of lower limbs, with diseases coexisting characteristic for this aged group. The measurement of the temperature of lower limbs, was made with termographic camera Trotec IR 060. Results. The assessment of the temperature of lower limbs at persons with their ischaemia showed sig­nificant differences in average values in the comparison with healthy persons (35,4 vs. 36,5°C). The time of duration of the disease moreover was factor determining the evaluation of the changes of the value of the temperature — they diminished together with outflow of time of duration of the disease from 35,8 on 35,1°C in the studied group. Conclusions. Conducted studies let certify, that morbid process in the character of the ischaemia of lower limbs found reflection in the average values of the temperature on the skin surface of limbs in studied groups carrying out 1.1°C ± 0.7. The results of the examination with the thermographic camera confirmed dependence between the time of duration of the disease and the changes of the temperature of lower limbs. The registration of the range of the flow blood in the arteries of lower limbs made using the thermal photography can provide many interesting information to the valuation of the changes of the circulation in the indicated area.  Wstęp. Przepływ krwi w naczyniach tętniczych i żylnych różnych narządów odbywa się zgodnie z różnicą wartości ciśnień naczyniowych skurczowych i rozkurczowych oraz jest zależny od wielu czynników związanych z regulacją zmiany średnicy naczynia. Proces chorobowy, jakim jest miażdżyca, może w sposób istotny utrudniać dostęp krwi do narządów położonych dystalnie. Dostępne metody diagnostyczne mogą w sposób istotny przyczynić się do szybszej interwencji służącej zahamowaniu procesu chorobowego. Praca bada przydatność metody termografii do oceny zmian w hemodynamice przepływu krwi w kończynach dolnych u osób z niedokrwieniem II stopnia według Fontaine’a. Materiał i metody. Do badań zakwalifikowano 50 osób z niedokrwieniem kończyn dolnych II stopnia, czekających na zabieg endowaskularny oraz 49 osób bez stwierdzonej miażdżycy kończyn dolnych, z cho­robami współistniejącymi charakterystycznymi dla tej grupy wiekowej. Pomiar temperatury kończyn dolnych wykonano kamerą termowizyjną Trotec IR 060. Wyniki. Ocena temperatury kończyn dolnych u osób z ich niedokrwieniem wykazała istotne różnice w średnich wartościach w porównaniu z osobami zdrowymi (35,4 vs. 36,5°C). Ponadto czynnikiem deter­minującym ewaluację zmian wartości temperatury był czas trwania choroby — w badanej grupie malały one wraz z upływem czasu trwania choroby z 35,8 do 35,1°C. Wnioski. Przeprowadzone badania pozwoliły stwierdzić, że proces chorobowy w postaci niedokrwienia kończyn dolnych znalazł odzwierciedlenie w średnich wartościach temperatury skóry kończyn w badanych grupach, wynoszących 1,1°C ± 0,7. Wyniki badania kamerą termowizyjną potwierdziły zależność między czasem trwania choroby a zmianami temperatury kończyn dolnych. Rejestracja przepływu krwi w tętnicach kończyn dolnych wykonana za pomocą kamery termowizyjnej może wnieść wiele interesujących informacji służących ocenie zmian krążenia we wskazanym obszarze.

Zagrożenia zdrowotne wśród dzieci i młodzieży. T. 3

Praca recenzowana / Peer-reviewed pape

Primitive Reflex Factors Influence Walking Gait in Young Children: An Observational Study

Background: Primitive reflexes (PRs) are observed as an automatic response to a specific stimulus. They are vivid from intrauterine life to 6 months postnatal. The reactions are inhibited with the growing maturation of the central nervous system (CNS). In some cases, when the natural process of development is incorrect, PRs manifest later. The analysis of differentiation in gait parameters in children with persistent PRs is important for better understanding their specific behaviour and movement. This study’s aim was to investigate the influence of active PRs on the gait parameters of preschool children. Methods: There were 50 children examined, 30 girls and 20 boys. They were 3.5–6 years old. The children had persistent PRs in the trace form. Each child was examined by S. Goddard’s Battery Test. The acquisition of the spatial-temporal gait parameters was performed using a BTS G-SENSOR measurement instrument. Participants walked barefoot, in the most natural way for them, at a self-selected speed on a 5 m walkway, then turned around and went back. They performed this twice. Results: The reflex activity influences gait cycle duration (p = 0.0099), the left step length (p = 0.0002), the left double support phase (p = 0.0024), the right double support phase (p = 0.0258) and the right single phase. Difficulties in recreating the crawling pattern and GRASP reflex influence gait cadence (p < 0.05). The left GRASP reflex corresponds to step length (p < 0.05). The activeness of the symmetrical tonic neck reflex correlates with the right single support (p < 0.05). Conclusion: The presence of PRs affect walking gait in preschool children

Spine pain in the firefighter profession

Background Musculoskeletal disorders mainly affecting the spine constitute one of the major social problems. Frequently, they constitute the cause of prolonged absence at work. Working in a fire brigade is specific because of the physical strain, working time under adverse conditions or stress related to rescue operations. Material and Methods The study group comprised 61 firefighters, 60 men (98.36%) and 1 woman (1.64%). The age of examined firefighters ranged 20–56 years old. The average age of the examined persons was 33.77 years old and the average working service in a fire brigade was 9.59 years. The following research instruments were applied as the study methods: own survey, the Numerical Rating Scale, the International Physical Activity Questionnaire (IPAQ) – long version and the Oswestry Disability Index (ODI) questionnaire. The Pearson correlation coefficient at significance level of p < 0.05 was used for determining the dependencies among the variables. Results Knowledge of ergonomic lifting and handling principles concerning heavy loads was reported by 84% of the group, the remaining 16% declared ignorance of such rules. The dependence of pain on the length of service of the examined was insignificant and amounted to 0.281 Pearson’s r. The results of the ODI questionnaire did not significantly change statistically with age. Conclusions The IPAQ confirmed the high level of physical activity of the study population. Even though the study group was small, the results of ODI showed a minor degree of disability. Med Pr 2018;69(4):365–37

Assessment of Changes in the Hemoglobin Level under the Influence of Comprehensive Spa Therapy Using Therapeutic Radon-Sulfur Waters and Its Correlation with Free Radical Reactions

Introduction. Hemoglobin is a protein present in erythrocytes of higher organisms. Its main function is to transport oxygen from the lungs to tissues and carbon dioxide from tissues to the lungs. Hemoglobin contains Fe2+, catalyzes free radical reactions, and may initiate oxidation reactions by enzymatic and nonenzymatic degradation. The aim of the study was to evaluate the effect of balneophysiotherapy on the hemoglobin level in osteoarthritis patients and to try to assess the association of those metabolic changes with free radical reactions. Materials and Methods. The study was conducted in Przerzeczyn-Zdrój spa resort. It included patients receiving spa treatment over 21-day sessions. The studied group consisted of n = 122 patients with joint and back pain due to osteoarthritis or disc herniation. Their age ranged between 32 and 67 years with a mean age of 53.5. Blood samples were collected before treatment and after 21 days at the spa. Standard tests were used. The results were statistically analyzed using the sign test and the Wilcoxon test. Results. In the study group, we observed a drop in the hemoglobin level following spa treatment. Before treatment, the mean hemoglobin level was 14.1549 g%, and after treatment, it was 14.0008 g%. Conclusions. (1) In the study, we concluded that balneophysiotherapy in osteoarthritis patients resulted in a decrease in the mean hemoglobin level. (2) The decrease in the mean hemoglobin level in osteoarthritis patients treated at the spa resort may indicate an association with free radical reactions. This trial was registered with NCT03405350