Rehabilitation in locked-in-syndrome – a case study

Grabowska Anna, Zgórzyńska Justyna, Wesołowska Monika, Wójcicki Marcin, Nicpoń-Nożewska Klara, Podhorecka Marta, Zukow Walery. Rehabilitation in locked-in-syndrome – a case study. Journal of Education, Health and Sport. 2017;7(3):427-437. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.344963 http://ojs.ukw.edu.pl/index.php/johs/article/view/4301 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 12.02.2017. Revised 23.02.2017. Accepted: 28.02.2017. Rehabilitacja w zespole zamknięcia – opis przypadku Rehabilitation in locked-in-syndrome – a case study Anna Grabowska1, Justyna Zgórzyńska1, Monika Wesołowska1, Marcin Wójcicki2 Klara Nicpoń-Nożewska3, Marta Podhorecka3, Walery Zukow4 1. Katedra i Klinika Rehabilitacji Szpital Uniwersytecki nr 1 w Bydgoszczy, Collegium Medicum UMK, Toruń 2. Oddział Kliniczny Anestezjologii i Intensywnej Terapii 10 WSK , Bydgoszcz 3. Katedra i Klinika Geriatrii, Collegium Medicum UMK, Toruń, Bydgoszcz 4. Instytut Kultury Fizycznej, Uniwersytet Kazimierza Wielkiego, Bydgoszcz Słowa kluczowe: zespół zamknięcia, proces rehabilitacji, udar, logopedia Keywords: locked-in-syndrome, rehabilitation process, stroke, speech therapy Streszczenie Wstęp: Zespół zamknięcia to schorzenie neurologiczne powstające najczęściej w wyniku udaru pnia mózgu, który powoduje, iż pacjent jest w pełni przytomny, ma zachowane podstawowe funkcje poznawcze, występuje afonia lub ciężka hipofonia, a także niedowład lub porażenie czterokończynowe. Zachowane są ruchy pionowe lub boczne gałek ocznych oraz mruganie, które służą jako środek umożliwiający komunikację. Choroba ta prowadzi do całkowitej niepełnosprawności fizycznej danej osoby, przy zachowanej sprawności psychicznej. Opis przypadku: Celem niniejszej pracy jest przedstawienie opisu przypadku osoby z zespołem zamknięcia, który był wynikiem udaru niedokrwiennego w obrębie mostu i lewej półkuli móżdżku. Zespół zamknięcia jest schorzeniem, którego rokowanie poprawy jest złe. Stwarza to konieczność przystosowania się chorego do nowej, trudnej sytuacji, która będzie mu towarzyszyć prawdopodobnie do końca życia. Świadomość tego, że powrót do wcześniejszej aktywności jest niemożliwy stanowiła dla badanego czynnik frustrujący. W pracy przedstawiono proces terapeutyczny od momentu zachorowania poprzez rehabilitację ruchową, terapię neurologopedyczną oraz neuropsychologiczną do powrotu chorego do domu. Proces ten wymaga cierpliwości oraz zaangażowania zarówno ze strony pacjenta, terapeutów, jak i członków rodziny. Wnioski: Prowadzenie badań w tym zakresie ma pomóc w planowaniu współpracy całego zespołu medycznego, lekarzy, pielęgniarek, rehabilitantów, pracowników socjalnych, logopedów i neuropsychologów. Interdyscyplinarne postępowanie może w znacznym stopniu pomóc osiągnąć chociaż minimalny stopień samodzielności i autonomii. Summary Introduction: The locked-in syndrome is a neurological condition which occurs most often as a result of brainstem stroke, characterized by the presence of sustained eye opening, aphonia or severe hypophonia, quadriplegia or quadriparesis, preserved cognitive functioning, and a primary and elementary code of communication using vertical eye movements or blinking. This illness leads to complete physical disability of the person, accompanied with fully retained mental capability. Case study: The goal of the hereby work is to present a description of a case of a person with the locked-in syndrome, caused by ischemic stroke of the pons and left cerebellar hemisphere. The prognosis of improvement in LIS is bad. The patient has to adapt to the new, difficult situation that will probably accompany him for whole life. The article presents the therapeutic process from the onset through physical rehabilitation, speech therapy and psychological therapy until return home. The process requires patience from the patient and therapists and family members. Conclusion: Research in this area is supposed to help in planning of cooperation the entire medical team of doctors, nurses, physiotherapists, social workers, speech therapists and neuropsychologists. Interdisciplinary proceedings can greatly help to achieve even a minimal degree of independence and autonomy

The Effects of Wearing a Medical Mask on the Masticatory and Neck Muscle Activity in Healthy Young Women

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New Opportunities for Oil and Gas Exploration in Poland—A Review

Reserves totaling ~142 BCM (5 TCF) of natural gas trapped in 306 fields and ~22 MTOE (~157 MMBOE) of crude oil in 87 fields have been discovered. The prospection, exploration, and production of hydrocarbons are licensed: an entity interested in these kinds of activities needs to have concession, which is granted by the Polish Ministry of Climate and Environment for 10 to 30 years according to one of two independent ways—international tender or open door procedure. In this review, the most prospective areas for oil and gas exploration in Poland, selected by the Polish Geological Survey, and announced as dedicated for the next 6th tender round, planned in the second half of 2022, are described. These are: Block 413–414, Block 208, Cybinka–Torzym, Zielona Góra West, and Koło areas. The main exploration target of these tender areas is related to conventional and unconventional accumulations of gas and oil in the Carpathian basement, Carpathian Foredeep, and Outer Carpathians (Block 413–414), as well as in the Carboniferous, Permian Rotliegend, Zechstein Main Dolomite (Block 208, Cybinka–Torzym, Zielona Góra West), and in the Mesozoic of the Polish Lowlands (Koło). The second way of granting concession in Poland is the so-called open door procedure, in which an entity may apply for a concession for any other area selected on its own

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This study aims to examine the correlations between masticatory and neck muscle thickness and activity versus eyeball length, retinal thickness, choroidal thickness, and intraocular pressure in healthy women versus women with myopia. The study group consisted of 21 women aged 24 years and a control group of 19 women (mean age 23 years). For bioelectrical activity analysis within the temporalis anterior, the superficial part of the masseter muscle, the middle part of the sternocleidomastoid muscle, and the anterior belly of the digastric muscle, an eight-channel BioEMG III electromyograph were used. An M-Turbo ultrasound machine was used to analyze masticatory and neck muscle thickness. The eyeball length was examined by IOL Master 500; choroidal and retinal thickness by Optovue Angiovue; and intraocular pressure by Tono-Pen XL. Refractive errors are related to differences in muscle thickness and electromyographic activity. Bioelectrical activity within the temporalis anterior seems to be associated with ocular length, retinal thickness, and choroidal thickness in women with myopia

Prospection and exploration of oil and gas fields in Poland : 6th tender round

On June 30, 2021 the Polish Minister of Climate and Environment announced the boundaries of five areas dedicated for the next, 6th tender round for hydrocarbon concessions in Poland, planned for the second half of 2022. These are: Block 413-414, Block 208, Cybinka-Torzym, Zielona Góra West, and Koto tender areas. The main exploration target of these areas is related to conventional and unconventional accumulations of gas and oil in the Carpathian basement, Carpathian Foredeep and Outer Carpathians (Block 413-414), as well as in the Carboniferous, Permian Rotliegend, Zechstein Limestone, and Main Dolomite (Block 208, Cybinka-Torzym, Zielona Góra West) and in the Mesozoic of the Polish Lowlands (Koto). The other way of granting hydrocarbon concessions in Poland is the open door procedure, in which an entity may apply for concessions for any other area