Rehabilitation management in Parkinson's disease - review of the variety of forms

Introduction: Parkinson's disease is one of the most common central nervous system diseases. Despite many studies and the use of many different forms of drug treatment, it is still not possible to completely regress the disease. Drug treatment can effectively reduce the severity of stiffness, slow motion or tremor, but does not affect non-dopaminergic symptoms such as postural and gait stability disorders which can result in numerous falls. Materials and methods: Analysis of selected and available literature and scientific articles available in the Google Scholar and Pubmed search engine database. Keywords were used for this purpose: Parkinson's disease, Rehabilitation, and Therapy Results: The most common symptoms of a neurodegenerative disease, which is Parkinson's disease, include slow motion, increased muscle tone, resting tremor, and balance disorders. The etiopathogenesis of Parkinson's disease is still not fully understood, and for this reason a simple algorithm was still created for the diagnosis of the disease and possible further treatment. Kinesitherapy, which is individually tailored to the patient's needs, is the basic form of rehabilitation in Parkinson's disease. For this purpose, muscle stretching exercises, autogenic training, exercises improving efficiency, respiratory therapy or progressive muscle relaxation by the Jacobson method are used. In the case of physical therapy, which is complementary to rehabilitation, hydrotherapy, magnetotherapy and iontophoresis are used. In addition to the above-mentioned forms of rehabilitation, deep therapeutic stimulation of the brain, subcutaneous administration of apomorphine, basic forms of occupational therapy and speech therapy exercises are also used for therapeutic purposes. Conclusions: Despite the large amount of research and published results, there is still a great need for further work on the problems of people with Parkinson's disease

Assessing the risk of falls of older people using specialized diagnostic tests

Background: The phenomenon of population aging, resulting in an increase in the number of elderly people in need of medical assistance, necessitated the development of geriatric medicine. Its key assumption is to improve the quality of life of older people through early recognition, prevention and treatment of diseases of old age. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: geriatrics, aging process, falls Results: The fall belongs to a group of great geriatric problems contributing to the phenomenon of senile disability. The result of disturbances in the balance and problems associated with the weakening of the musculoskeletal system is a fall, which has very serious consequences for the health and functioning of an older person. The most important diagnostic tests related to falls of older people include: Timed Up & Go Test (TUG), Dynamic Gait Index (DGI), The Step Test, Stop Walking When Talking (SWWT), Four Square Step Test (FSST) Conclusions: Falling older people is statistically one of the biggest problems of this age group, and at the same time causing a huge number of complications in the lives of geriatric patients, which is why their prevention is so important. There is a further need for research and discussion on the effectiveness of forms of diagnostic to prevent the falls of older peopl

Review of the methodology of lower limb prosthesis

Background: The replacement of inefficient or lost organs, especially in the case of lower ends, is associated with a huge experience for the patient, especially in emotional terms. However, with the development of medicine and technology, they allow patients, with properly conducted rehabilitation, to achieve satisfaction with the obtained effects of the treatment. The variety of forms of lower limb prosthesis depends primarily on the location of the prosthesis. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: Prosthesis, Lower limb, Amputation Results: The lower limb prosthesis is built from a funnel that matches the stump, the mechanism of the knee joint, shin and the foot. Pours that are used at the lower extremities include: a quadrangular funnel, an ICS longitudinal oval or a CAD-CAM, a full-contact hip funnel, a residual femoral funnel or vacuum syphilis used in people with neoplastic amputations. In the case of knee joints, the distinction is made based on the number of axes around which the movement takes place. So we distinguish uniaxial and multi-axis joints. As important as the other parts is the construction of the prosthetic foot, because it is responsible for supporting the limb stabilizers through passive control of the ankle bending. Conclusions: With the new generation of lower limbs prostheses, the patient can lead an active professional life, as well as practice various sports disciplines. However, this does not change the fact that there is still a great need for research, and holistic cooperation to increase the efficiency and satisfaction of life of amputees in the lower limbs

Rehabilitation of patients with paraplegia - a review of the diversity of forms

Abstract: Background: Damage to the spinal cord most often occurs as a result of spine injury, often causing the disability. In every patient with paraplegia, complications may occur in the form of: sensory disorders, bedsores, contractures, urinary and stool incontinence, paresis or limb paralysis, as well as sexual problems. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: Rehabilitation, Paraplegia, Neurology Results: Losing the function of locomotion and self-care in everyday activities is a great psychological burden, both for the sick person and his family. Rehabilitation proceeding should include physical, psychological and social aspects. For paraplegics, the introduction of early and appropriately targeted treatment may reduce the risk of onerous complications and allow for maximum self-empowerment in basic activities. For a person with disability, it is a chance to achieve self-acceptance and return to a dignified life in society. Conclusions: Problems of patients with paraplegia, despite the fact that they were described in many books and articles, should still be considered in studies that would use the latest news from the world of science. Patients struggling with this problem still expect further measures to improve their quality of life

Complications associated with hospitalization after spinal cord injury

Abstract: Background: Spinal cord injuries are a traumatic phenomenon not only for the physical sphere, but equally affect the human psyche. The patient ceases to be independent in his actions, he must face a completely new situation for himself and the environment. Particularly difficult is the first period after injury, associated with hospitalization. That is why it is so important to prevent the most common complications of spinal injuries during this period. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: Spinal Cord, Injury, Trauma, Complications Results: The most common complications associated with the hospital stay of patients with spinal cord injury include: complications in the respiratory system (including pneumonia, atelectasis and respiratory failure), decubitus ulcers, periarticular neurogenic ossification, autonomic dysreflexia, spasticity or disorders in the functioning of the urinary tract. Decubitus ulcers due to their nature are a huge problem for hospitalized patients, in epidemiological studies it was estimated to occur at nearly 20 per cent. Spasticity is one of the most serious complications hindering the effective rehabilitation process of post-traumatic persons. In the case of disorders associated with the urinary system, it is important to classify dysfunctions based on the neurogenic evaluation of the sphincter muscles and detrusor. Conclusions: Due to the increasing number of spinal cord and spinal cord injuries and the serious nature of their complications, this topic should continue to be an area of very intensive scientific research, both theoretical and clinical. The given issues should be familiar not only to the medical community but also to the family and the patient's environment

Dysfunctions of the immune system associated with age

Abstract Background: The human immune system consists of innate and adaptive responses. Innate immune response is the first line of the body's defense, while the adaptive response eliminates pathogens in later stages of infection. Cooperation between innate and adaptive immune response is important to effectively eliminate pathogens. An integral part of the aging of the human body is the aging of the immune system, which results in functional disorders directly affecting the deterioration of health. Abnormal functioning of the immune system is a predisposing factor to the occurrence of old-age diseases, as well as reduces the effectiveness of protective vaccination especially recommended to geriatric patients. Material and Methods: The current state of knowledge on age-related immune dysfunctions has been reviewed. The analysis concerned publications in English and Polish language published in the years 2003-2018, which were collected in the PubMed and Google Scholar database. Particular attention was paid to publications presenting the results of research conducted on a group of geriatric people in order to analyze the facts from the research. The publications were searched on the basis of key phrases, among others: the immune system of the elderly, chronic inflammation, innate immunity and adaptive immunity. Results: A review of current knowledge showed the seriousness of the problem of the aging of the immune system. In addition to reducing the efficiency of the immune system, special attention should be paid to chronic inflammation that predisposes to old-age diseases, as well as to reduce the effectiveness of immunization, which is a serious threat. Conclusion: Analyzing the sources of chronic inflammation in the elderly, particular attention was paid to the phenotype of aging cells, changes in the intestinal microflora of the elderly, the role of adipose tissue in the process of inflammation and changes in the levels of steroid hormones. Public awareness of the etiology of the problem is an excellent method of counteracting the negative effects of immunodeficiency. One of the recommendations is physical activity as part of the elimination of adipose tissue capable of securing an infinite number of pro-inflammatory cytokines

Degeneration of the lumbar intervertebral discs as a cause of root discomfort in the lumbar spine

Background: The change in the lifestyle of modern man and the related lack of physical activity caused that pain in the spine has become a civilization problem, covering an increasing population regardless of latitude. Degenerative changes of the spine, also in the lumbar region, are the most frequently diagnosed cause of patients' dysfunction. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: lumbar spine, degenerative changes, dysfunctions Results: Currently, in addition to injuries and mechanical loads, the causes of lumbar spine dysfunction also include abnormal spinal nutritional composition and genetic factors, with the greatest emphasis on genes encoding type 1 collagen. During diagnostics, apart from X-ray imaging, computed tomography and resonance imaging methods should not forget about properly conducted interviews and functional tests. Kinesitherapy assisted by physical treatment methods such as laser therapy or ultrasound should play a major role in rehabilitation. Kinesitherapy should be tailored to the individual patient, and exercises selected so that the patient can also do them at home. Conclusions: In the prevention of degenerative changes of the lumbar spine, there should be a much greater emphasis on patient education related to risk factors or learning ergonomic work. Despite much work on this topic, there is still a need to improve public awareness and further research on prevention

Usefulness of the Polish versions of the Montreal Cognitive Assessment 7.2 and the Mini-Mental State Examination as screening instruments for the detection of mild neurocognitive disorder

Introduction. Screening tests are a key step in the diagnosis of dementia and should therefore be highly sensitive to the detection of mild neurocognitive disorders (NCD). The Mini Mental State Examination (MMSE) is the most commonly used screening method. The Montreal Cognitive Assessment (MoCA) is a newer and less well-known screening tool, which has none of the limitations of the MMSE.Aim. The aim of this study was to analyse the reliability of the Polish versions of MoCA 7.2 vs MMSE in the detection of mild NCD among people aged over 60.Material and methods. The study was carried out at the Department and Clinic of Geriatrics from September 2014 to March 2017. The study included 281 participants, 91 of whom were assigned to the group without NCD. The other 190 had been diagnosed with mild NCD.Results. In the analysis of the ROC curve of the MoCA 7.2 results, the AUC was 0.925 (p < 0.001). The optimal cut-off point for mild NCD was 23/24 points, with sensitivity and specificity of 83.2% and 79.1%. In the ROC curve of MMSE results, the AUC was 0.847 (p < 0.001). The optimal cut-off point for mild NCD was 27/28 points, with sensitivity and specificity of 75.8% and 66.7%. The difference between AUC MoCA 7.2 and MMSE was 0.078 (p = 0.036).Conclusions. MoCA 7.2 detects mild NCD with more sensitivity than MMSE. We recommend using the cut-off point for MoCA of 23/24 points, because this is characterised by a higher sensitivity than the previously recommended cut-off point of 25/26 points. For the MMSE, the recommended cut-off point should be 27/28, which gives greater diagnostic accuracy than the previously recommended 25/26 points

Stroke as a civilization disease

Background: Stroke is one of the three leading causes of death in the world. Young people are also more and more affected. The reasons for this phenomenon are divided into two categories, modifiable and non-modifiable. The former include: hypertension, dyslipidemia, diabetes or cardiovascular disease. Factors that can not be modified include age, gender, race, as well as genetic predispositions and previous impacts. Behind the main principles of primary prevention means: regular monitoring of blood pressure, treatment of metabolic disorders, carotid angioplasty, and most important lifestyle change. The secondary principles of prophylaxis include antiplatelet therapy, anticoagulant therapy as well as surgical treatment. The aim of the study was to present stroke as a disease of civilization, with particular regard to its possible pathogenesis and prevention. Materials and methods: The literature was reviewed from the medical databases PubMed, Google Scholar and EBSCO. We adopted as key words: stroke, prevention, cerebral infarction, civilization disease. Results: Stroke has become a civilization disease. It is more and more often the cause of deaths in Poland and in the world. Epidemiology of this phenomenon has been thoroughly known. Risk factors for the incidence of stroke have been grouped, as well as methods for preventing and treating this phenomenon. Conclusions: The stroke affects more and more people. Its causes have been known. These include risk factors that can be modified by, for example, changing lifestyle

Pretraživanje tradicionalnih europskih ljekovitih biljaka na inhibiciju acetilkolinesteraze i butirilkolinesteraze

Acetylcholinesterase (AChE) inhibitors are widely used for the symptomatic treatment of Alzheimer’s disease (AD) to enhance central cholinergic transmission. On the other hand, butyrylcholinesterase (BuChE) inhibitors were reported to produce significant increases in brain extracellular AChE without triggering severe peripheral or central side-effects. In the present study, we selected twelve plants used in traditional European medicine to treat different central nervous system (CNS) disorders or to improve memory. Methanolic and hexane extracts of these plants were tested for the AChE and BuChE inhibitory activity using Ellman’s colorimetric method. The most potent AChE and BuChE inhibition was observed in the hexane extracts of the flowers of Arnica chamissonis Less. susb. foliosa and Ruta graveolens L. herb at a concentration of 400 μg mL1. However, methanolic extracts of the flowers of Arnica chamissonis Less. susb. foliosa and the Hypericum perforatum L. herb demonstrated at the same concentration, selective inhibition only against AChE but not against BuChE. The other extracts did not show any significant AChE or BuChE inhibitory activity. Our results show that further investigations of the extracts of arnica, rue and St. John’s Wort are needed to identify the compounds responsible for the AChE and BuChE inhibitory activityInhibitori acetilkolinesteraze (AChE) povećavaju kolinergičku transmisiju u mozgu, pa se koriste za simptomatsko liječenje Alzheimerove bolesti (AD). S druge strane, inhibitori butirilkolinesteraze (BuChE) značajno povećavaju ekstracelularnu količinu AChE u mozgu, a da pri tome ne uzrokuju snažne nuspojave ni u središnjem ni i perifernom živčanom sustavu. Galantamin, jedan od odobrenih AChE inhibitora, alkaloid iz lukovica narcisa, pokazuje da su biljke značajni izvor novih potencijalnih AChE- i BuChE- inhibitora. U ovom radu, ispitivali smo učinak dvanaest biljaka koje se koriste u tradicionalnoj europskoj medicini na različite poremećaje središnjeg živčanog sustava i na poboljšanje pamćenja. Pomoću Ellmanove kolorimetrijske metode praćen je inhibitorni učinak metanolnih i heksanskih ekstrakata tih biljaka na AChE i BuChE. Najjači inhibitorni učinak pokazali su heksanski ekstrakti cvjetova Arnica chamissonis Less. susb. foliosa i nadzemnih dijelova Ruta graveolens L. u koncentraciji od 400 μg mL1. Međutim, metanolni ekstrakti cvjetova Arnica chamissonis Less. susb. foliosa i nadzemnih dijelova Hypericum perforatum L. u istim koncentracijama pokazuju selektivnu inhibiciju samo na AChE. Ostali ekstrakti bili su nedjelotvorni. Rezultati ukazuju na potrebu daljnjih ispitivanja ekstrakata arnike, rute i gospine trave da se utvrdi koji su sastojci ekstrakata odgovorni za inhibiciju AChE i BuChE