The effects of new methods of physiotherapy in patients with haemophilic arthropathy

Advanced arthropathy mainly of the knee, hip or ankle joint occurs even in young adults with haemophilia. It has been proved that physical training increases isometric muscular strength and proprioceptive performance in haemophilia patients. The aim of this study was to present the new methods of physiotherapy process and their effect in patients with haemophilic arthropathy. Five subjects, aged from 32 to 42 years, with severe haemophilia A or B attended physiotherapy in a outpatient ambulatory setting over a 3-month period. The following treatment modalities were performed: walking on AlterG anti-gravity treadmill, deep penetrating electromagnetic stimulation (Salus Talent), manual physical therapy, mobilization and manipulation techniques, active muscle-strengthening exercises, post isometric relaxation (PIR) muscle energy techniques, as well as exercises for improvement of coordination, postural equilibrium and proprioception exercises using sensorimotor discs. The HJHS (Haemophilia Joint Health Score) has been used to assess the effectiveness of the treatment, VAS scale (Visual Analog Scale) to assess level of pain, TUG test (Timed Up and Go) to assess mobility as well as dynamic and static balance. Strength of the muscles acting on the joints improved, swelling of joints diminished and the level of pain decreased. An improvement of the dynamic and static balance was found as well. The range of motion did not change. Physiotherapy process did not provoke bleeding episodes in patients with haemophilic arthropathy included to the study

The manual treatment of Myofascial Pain Syndrome due to bruxism

Bruxism is thought to be the most often occured parafunctions what means harmful motor reactions of mandible. This dysfunction relies on gnashing and clenching teeth with much force. Many patients don’t realize of presence of this affection because of doing it subconsciously. Non-treated, fixed bruxism becomes the cause of serious disturbances in stomatognathic system. The aim of this article is to present regularity physiotherapeutic methods application in bruxism treatment. In this cause the most important names connected with bruxism for example myofascial pain syndrome or trigger points in muscles of stomatognatic system were described. In next part of this article variety of manual therapy methods were analized due to author’s experiences. In last few decades there was achieved a development of knowledge about bruxism and its followed disorders. Data from the literature indicate that there is a possibility of effective, physiotherapeutic treatment of mentioned active disturbances

Meniscus suture provides better clinical and biomechanical results at 1-year follow-up than meniscectomy

BACKGROUND: Surgery of meniscus tear results in limitation of function. The aim of study was functional assessment of knee 1 year after surgery with two techniques in cases of the medial meniscus tear followed by the same supervised rehabilitation. MATERIALS AND METHODS: A total of 30 patients with good KOSS scores constituted two equal groups after partial meniscectomy or meniscus suture. Measurements of knee extensors and flexors muscles peak torques were performed with angular velocities 60, 180, 240 and 300 s(−1) using Biodex IV system. One-leg-hop and one-leg-rising tests ascertained the function of operated knee. Results of examinations were compared with reference to healthy volunteers. Results of biomechanical and clinical studies were correlated to create complex and objective method evaluating treatment. RESULTS: Extensors peak torque values at 60 s(−1) angular velocity and H/Q coefficient were decreased after meniscectomy more than meniscus suture in comparison to healthy volunteers (P ≤ 0.001; P ≤ 0.05). Analysis of functional tests revealed that patients after meniscectomy showed difference between operated and non-operated knee (P ≤ 0.01) while patients with meniscus suture differed the least to controls (P ≤ 0.05). Extensors peak torque values at 60 s(−1) angular velocity correlated with results of one-leg-rising test. CONCLUSION: Results suggest worse functional effects when meniscectomy is applied which implies modification of the rehabilitative methods in a postoperative period

Zastosowanie manualnych technik osteopatycznych w leczeniu bólu pleców u kobiet w ciąży

Changes in body posture, musculoskeletal disorders and somatic dysfunctions are frequently observed during pregnancy, especially ligament, joint and myofascial impairment. The aim of the paper is to present the use of osteopathic manipulative treatment (OMT) for back and pelvic pain in pregnancy on the basis of a review of the available literature. MEDLINE and Cochrane Library were searched in January 2014 for relevant reports, randomized controlled trials, clinical and case studies of OMT use in pregnant women. Each eligible source was verified and analyzed by two independent reviewers. OMT procedures appear to be effective and safe for pelvic and spinal pain management in the lumbosacral area in pregnant women.W trakcie ciąży u kobiet zachodzą zmiany w postawie ciała, układzie mięśniowo-szkieletowym oraz zaburzenia somatyczne. Najczęściej dochodzi do dysfunkcji więzadeł, stawów i powięzi. Celem pracy jest przedstawienie wykorzystania bezpiecznych osteopatycznych technik manualnych w leczeniu bólu pleców i miednicy u kobiet w ciąży, na podstawie przeglądu dostępnej literatury naukowej. Przegląd literatury przeprowadzono w bazach danych MEDLINE i Cochrane Library w styczniu 2014 roku. Do analizy wybrano prace poglądowe, randomizowane, kliniczne oraz studium przypadku dotyczące terapii manualnej u kobiet w ciąży. Każda praca była weryfikowana i analizowana przez dwóch niezależnych badaczy. Osteopatyczne techniki manualne (OMT) wydają się być skuteczną i bezpieczną terapią w bólach odcinka lędźwiowo-krzyżowego kręgosłupa i miednicy u kobiet w ciąży

Body balance a few years after total hip replacement

These aim of the study was to conduct a long-term evaluation of whether total hip replacement permanently affects the dynamic body balance. Methods: Twenty-five patients after the unilateral total hip replacement (mean age: 69.9 ± 6.2) and 25 subjects without the total hip replacement (mean age: 68.4 ± 4.8) who matched the age and overall health participated in this study. The force platform and functional tests such as Timed Up and Go, 3m walk test, Functional Reach Test, 30s Chair Stand Test, Step Test and Berg Balance Scale were used to assess dynamic balance. The results obtained in individual trials were compared using the Student’s t-test for independent variables, the Welch test or the non-parametric Mann–Whitney U-test. Results: Subjects from the THR group exhibited significantly increased time and distance in the tests performed on the force platform, compared to the control group. We also observed worse balance and functional test scores in the THR group: Timed Up and Go test ( p < 0.001), 3 m walk test ( p < 0.001), Functional Reach Test ( p < 0.001), 30 s Chair Stand Test ( p = 0.001) and Step Test (operated leg: p < 0.001, non-operated leg: p < 0.001). The results obtained in the Berg Balance Scale tests were not significantly different between the groups ( p = 0.218). Conclusions: We observed significant differences in postural stability and dynamic balance between patients after THR and subjects in the same age without endoprosthesis. Our research shows that total hip replacement permanently impairs patients’ dynamic balance and their functionality in certain lower-extremity activities

The Use of the ICF Classification Sheet to Assess Cognitive-Behavioral Disorders and Verbal Communication in Patients after Ischemic and Hemorrhagic Stroke during Rehabilitation

Background: In patients after experiencing stroke, the cognitive-behavioral deficits and disorders of verbal communication limit the effectiveness of rehabilitation. The key is to diagnose them at an early stage of rehabilitation and to implement appropriate psychological and speech therapy. Objective: Identify differences in the frequency and effectiveness of cognitive-behavioral disorder therapy depending on the clinical type of stroke, assessed before and after rehabilitation treatment, and their presentation using the ICF (International Classification of Functioning, Disability, and Health) classification. Materials and Methods: The study was prospective and included the analysis of cognitive-behavioral and verbal communication disorders. The study consisted of 47 patients after intracerebral hemorrhage (ICH) and 47 patients after an ischemic stroke (IS) before the implementation of rehabilitation and after completing a 4-week rehabilitation. Results: In the group after ICH, psychological therapy significantly reduced the disturbances of consciousness and orientation (p &lt; 0.001) and improved the speed of performing tasks in tests (p &lt; 0.001). In patients after IS and ICH, memory and attention function improved significantly (p &lt; 0.001). Moreover, in patients after ICH, language function deficits decreased significantly (p = 0.018). Mood disturbances were maintained in 17% of patients after ICH and 40% of patients after IS (p = 0.007). Speech therapy reduced speech articulation disorders and aphasia in 85% of patients after ICH (p = 0.001) and in 68% of patients after IS (p = 0.033). Conclusions: The frequency and type of cognitive-behavioral and verbal communication disorders vary depending on the history of ICH or IS. The ICF classification may be useful in assessing and analyzing cognitive-behavioral and verbal communication disorders, which may lead to the implementation of appropriate psychological and speech therapy at an early stage of rehabilitation and increase the effectiveness of the therapy

Assessment of CVD Risk Factors in Secondary Prevention after Ischemic Stroke Using the ICF

Background: Patients after undergoing ischemic stroke have a high risk of further cardiovascular disease (CVD) incidents. Monitoring risk factors is critical to prevent the recurrence of CVD. Objective: The aim of the study was to determine differences in the incidence of risk factors for CVD in a post-ischemic stroke patient group (SG) compared to the control group, which had not undergone ischemic stroke (CG), and to characterize them using the ICF (International Classification of Functioning, Disability and Health) classification system. Materials and Methods: The incidence of risk factors for recurrent CVD events were retrospectively analyzed in 55 patients in SG and 55 patients in CG. The results were translated into categories from the ICF classification system. Results: Atrial fibrillation (p = 0.013), carotid artery stenosis &gt; 50% (p &lt; 0.001), LDL &gt; 71 mg/dL (p &lt; 0.001), heart rate &gt; 80/min (p = 0.007), taking NOAC (p = 0.008) and NSAIDs (p &lt; 0.001) as well as nicotinism (p = 0.001) were significantly more common in SG compared to CG. The value of the distribution of the total incidence of CVD risk factors were observed to be higher for SG than for CG. In SG, both for males (p &lt; 0.001) and females (p &lt; 0.001) more risk factors for recurrent CVD incidents were observed compared to CG. Conclusions: Patients in SG differ in the occurrence of risk factors for CVD event compared to CG. The use of a single tool, such as the ICF assessment sheet, can be useful in assessing and analyzing risk factors for recurrent CVD events. This may help to reduce the risk of subsequent CVD events in secondary prevention

Perspectives of Motor Functional Upper Extremity Recovery with the Use of Immersive Virtual Reality in Stroke Patients

Stroke is one of the leading causes of disability, including loss of hand manipulative skills. It constitutes a major limitation in independence and the ability to perform everyday tasks. Among the numerous accessible physiotherapeutic methods, it is becoming more common to apply Virtual Reality "VR”. The aim of this study was to establish whether immersive VR was worth considering as a form of physical therapy and the advisability of applying it in restoring post-stroke hand function impairment. A proprietary application Virtual Mirror Hand 1.0 was used in the research and its effectiveness in therapy was compared to classical mirror therapy. A total of 20 survivors after ischaemic stroke with comparable functional status were divided into a study group (n = 10) and control group (n = 10). Diagnostic tools included 36-Item Short Form Survey “SF-36” and the Fugl-Meyer Assessment Upper Extremity “FMA-UE”. Collected metrics showed a normal distribution and the differences in mean values were tested by the student’s t-test. In both, the study and control groups’ changes were recorded. A statistically significant outcome for FMA-UE and SF-36 measured by the student’s t-test for dependent or independent samples (p > 0.05) were obtained in both groups. Importantly, proven by conducted studies, an advantage of VR proprietary application was subjective sensations amelioration in pain and sensory impressions. Applying Virtual Mirror Hand 1.0 treatment to patients after a stroke appears to be a good solution and definitely provides the opportunity to consider VR applications as an integral part of the neurorehabilitation process. These results give a basis to plan further larger-scale observation attempts. Moreover, the development of the Virtual Mirror Hand 1.0 as an innovative application in physiotherapy may become equivalent to classical mirror therapy in improving the quality and effectiveness of the treatment used for post-stroke patients

The ICF Classification System to Assess Risk Factors for CVD in Secondary Prevention after Ischemic Stroke and Intracerebral Hemorrhage

Background and objectives: Patients with a history of prior stroke have a high risk for subsequent cardiovascular events (CVD). Therefore, the implementation of an effective strategy to reduce risk factors and thereby improve secondary prevention outcomes is crucial in this patient population. The aim of this study was to determine differences in the incidence of risk factors for recurrent CVD events based on clinical type of prior stroke and to characterize them using the ICF (International Classification of Functioning, Disability and Health) classification system. Materials and Methods: The incidence of risk factors for recurrent CVD events were retrospectively analyzed in 109 patients with a history of ischemic stroke (IS) and 80 patients with a history of intracerebral hemorrhage (ICH) within 14 days poststroke. Results: Atrial fibrillation/flutter (p = 0.031), &gt;70% carotid artery stenosis (p = 0.004), blood pressure &gt;140/90 mmHg (p = 0.025), blood HbA1c levels &gt;7% (p = 0.002), smoking (p = 0.026) and NSAID (nonsteroidal anti-inflammatory drug) use (p &lt; 0.001) were significantly more common in patients with a history of ischemic stroke. However, liver function test abnormalities were observed more commonly in patients with a history of hemorrhagic stroke (p = 0.025). Conclusions: The incidence and type of risk factors for recurrent CVD events vary according to the clinical type of prior stroke. The ICF classification system is a useful tool for evaluating these risk factors. This may help reduce the risk of subsequent CVD events