Opinion of medical students on the role of a physiotherapist in providing health services

Introduction. An extremely important aspect of the efficient work of the therapeutic team is the knowledge of the rights and the range of tasks of each specialist who is part of it. In order to increase the efficiency of the physiotherapist's activity in the treatment and rehabilitation of patients, on September 25, 2015, the Act on the Physiotherapist's profession was passed. Despite the fact that the Act is more than 3 years old, there are no reports on the awareness and opinions of medical circles about it. Objective of the study. The aim of the study was to examine the opinions of future doctors - students of the 4th, 5th and 6th year of the medical faculty on the role of a physiotherapist in providing health services. Material and methods. 225 people from several medical schools in Poland (144 women and 81 men) took part in the survey. The questionnaire was based on the Physiotherapist Act and included questions about the students' opinions on the physiotherapists’ rights, their role and competence in the rehabilitation process. Results. A significant proportion of future doctors do not have full knowledge of some of the physiotherapist's rights and the range of tasks. As many as 48.8% of the respondents disagree or have no opinion on the physiotherapist's possibility to refuse to perform the services ordered by a physician. Almost every third person thinks that physiotherapists do not have enough knowledge to conduct the functional diagnosis of the patient. According to 29.3% of respondents, a physiotherapist can not expect a physician to justify an order for physiotherapy. On the other hand, the vast majority of the study group believes that the physiotherapist should look after the patient from the first day after the surgery and consider the physiotherapist an inseparable part of the therapeutic team. As many as 84% of students want to cooperate with a physiotherapist in the future. Conclusions. 1. A significant percentage of students of medicine estimate the competences and skills of physiotherapists to be lower than guaranteed by the Act on the Profession of Physiotherapy. 2. The awareness of students of medicine regarding the competences of physiotherapists set out by the Act is insufficient, which may decrease the efficiency of a healthcare team. 3. Students of medicine consider the role of physiotherapists in the process of treatment and recovery of patients significant

Physical activity amongst hemodialysed patients – why lack of motivation to exercise is present?

In recent years a great interest in rehabilitation and physical activity amongst hemodialysed patients have developed. Despite having numerous exercise options, adverse effects of a lack of movement still are seen in this group of patients. The reasons of insufficient physical activity amongst hemodialysed patients are complications related to chronic diseases and renal replacement therapy. For patients suffering from kidney failure it is crucial to adhere to recommendations relating to regular physical activity in order to maintain health and good quality of life

An assessment of the impact of physical activity undertaken by patients with gestational diabetes mellitus on neonatal birth weight

Maziarz Agata, Ogonowski Jarosław, Szylińska Aleksandra, Wiatrak Adrian, Turoń-Skrzypińska Agnieszka, Rotter Iwona. An assessment of the impact of physical activity undertaken by patients with gestational diabetes mellitus on neonatal birth weight. Journal of Education, Health and Sport. 2018;8(12):169-183. eISNN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.2064733 http://ojs.ukw.edu.pl/index.php/johs/article/view/6358 https://pbn.nauka.gov.pl/sedno-webapp/works/890559 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 Authors 2018; 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 Share alike. (http://creativecommons.org/licenses/by-nc-sa/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: 18.11.2018. Revised: 25.11.2018. Accepted: 08.12.2018. An assessment of the impact of physical activity undertaken by patients with gestational diabetes mellitus on neonatal birth weight Agata Maziarz1, Jarosław Ogonowski2, Aleksandra Szylińska1, Adrian Wiatrak1, Agnieszka Turoń-Skrzypińska1, Iwona Rotter1 1. Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Poland 2. Autonomous Laboratory for Diseases of Civilization and Obesity Treatment, Pomeranian Medical University in Szczecin, Poland Abstract Background Recent years have seen a growing interest in the physical activity of pregnant patients and its effects on obstetric outcomes. Apart from its positive influence on healthy pregnant patients, moderate physical effort also plays an important role in therapeutic procedures in women diagnosed with gestational diabetes mellitus. The aim of this paper was to assess the link between daily physical activity of patients diagnosed with gestational diabetes mellitus and neonatal birth weight. Material, patients and methods- The study group included 100 patients with gestational diabetes mellitus (GDM) between 26 and 32 weeks’ gestation. Their physical activity was assessed using the International Physical Activity Questionnaire (IPAQ), the Pregnancy Physical Activity Questionnaire (PPAQ) and a pedometer. Results No significant correlation between neonatal birth weight and the parameters describing the type and intensity of physical activity was shown. Neonatal birth weight correlated positively with pregravid BMI of the pregnant patient. A negative correlation was identified between gestational weight gain and pregravid BMI. Conclusion There was no relationship between daily physical activity during pregnancies complicated by diabetes mellitus and neonatal birth weight. Maternal pregravid weight was found to be an important parameter affecting the infant’s weight. Key words: birth weight, physical activity, gestational diabetes mellitu

Hormone concentration, metabolic disorders and immunoexpression of androgen and estrogen-alpha receptors in men with benign prostatic hyperplasia and testosterone deficiency syndrome

Introduction. A slight decrease in blood testosterone level in men is a physiological state associated with the aging. The aim of our study was to evaluate the occurrence of hormone and metabolic disorders, as well as the immunolocalization and immunoexpression of androgen receptors (AR) and estrogen-alpha receptors (ERa) in the prostates of men with benign prostatic hyperplasia (BPH) and coexisting testosterone deficiency syndrome (TDS). Material and methods. The study involved 150 men, diagnosed with and receiving pharmacological treatment for BPH. Concentrations of glucose, total cholesterol (TCh), high-density lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides (TG) were determined in blood serum. Serum concentrations of total testosterone (TT), free testosterone (FT), estradiol (E2), luteinizing hormone (LH), insulin (I), sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), and insulin-like growth factor 1 (IGF-1) were measured by ELISA. The number of AR-positive cells and ERa-positive cells were measured in prostate sections of men with BPH. Results. Patients eligible for transurethral resection of the prostate and TDS were significantly more likely to have higher abdominal circumference and higher serum levels of insulin and IGF-1 as well as lower levels of FT and SHBG than control subjects with BPH and no TDS. Quantitative analysis revealed 35.8% AR-positive colum­nar epithelial cells and 24.3% AR-positive stromal cells in prostates of BPH patients with TDS and 30.5% and 23.0%, respectively, in BPH patients without TDS. However, the differences between the study and the control groups were statistically not significant. In prostates of BPH patients with TDS the immunoexpression of ERa was observed in 2.88% of the columnar epithelial cells and 0.39% of stromal cells. In BPH patients without TDS ERa-positive cells were only found in 0.04% of columnar epithelial cells and 0.62% of prostatic stromal cells. Conclusions. Considering the statistically significantly higher levels of I and IGF-1 and larger abdominal circumference of men with BPH and TT deficiency, it can be supposed that visceral obesity and carbohydrate disorders may contribute to the reduction of testosterone concentration. The results of our study indicate a relationship between TT concentration in the plasma of patients with BPH and the percentage of AR-positive cells in the prostate.

The effect of smoking and physical activity level on exercise capacity in older adults

Introduction: Exercise capacity is highly age-dependent and influenced by factors such as physical activity level and smoking. The aim of the study was to analyze the relationship between physical activity level, smoking and exercise capacity in people over 60 years of age. Materials and methods: The study involved 100 participants (50 female and 50 male) over 60 years of age (mean age 68.2 years). Based on the answers provided to a questionnaire about smoking and physical activity level, participants were divided into four groups: exercising non-smokers, exercising smokers, non-exercising non-smokers, and non-exercising smokers. Each group consisted of 25 subjects. Exercise capacity was measured using the 6-minute walk test and the Borg scale. Results: Intergroup comparison showed statistically significant differences between the average results of each group, both in the 6-minute walk test (p=0.010) and on the Borg scale (

Articulation disorders and duration, severity and l-dopa dosage in idiopathic Parkinson's disease

Background Parkinson's disease (PD) is one of the most common diseases of the central nervous system (CNS). It is frequently heralded by speech disturbances, which are one of its first symptoms. Aim The aim of this paper is to share our own experience concerning the correlation between the severity of speech disorders and the PD duration, its severity and the intake of l-dopa. Material and methods The research included 93 patients with idiopathic PD, aged 26–86 years (mean age 65.1 years). Participants were examined neurologically according to the Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr Scale. They were also assessed by Frenchay Dysarthria Assessment. Results Considerable and severe disorders were concurrent with impairments in the mobility of the tongue, lips, the jaw as well as the pitch and loudness of the voice. The strongest correlation but at a moderate level was found to exist between the severity of labial impairment, voice loudness and the length of the disease. There was also a positive correlation between lip movement while the motions were being diversified, lip arrangement while speaking and the intake of l-dopa. Conclusions As PD progresses a significant decline in vocal articulation can be observed, which is due to reduced mobility within the lips and the jaw. Exacerbation of articulation disorders resulting from progression of the disease does not materially influence the UPDRSS scores. l-dopa has been found to positively affect the mobility of the lips while the patient is speaking and their arrangement at rest

Sclerostin - a potential new marker of exercise influence on vascular calcification and mineral and bone disorder in hemodialysed adults

Chronic Kidney Disease (CKD) is defined as abnormalities of kidney structure or function, present for >3 months, with implications for health. Amongst CKD complications the most fatal is cardiovascular disease, which together with Chronic Kidney Disease Mineral and Bone Disorder (CKD-MBD) share a possible origin in Wnt signaling pathway disturbances. Sclerostin, a potent Wnt signaling inhibitor may possibly be used as a potential new marker of exercise influence on vascular calcification and mineral and bone disorder in hemodialysed adults

Evaluation of effort tolerance in diabetic and non-diabetic patients undergoing cardiac rehabilitation after cardiac surgery

Introduction: Complex cardiac rehabilitation is a basic procedure of therapeutic treatment for patients after cardiac surgeries. The course of operations depends on many factors. The aim of this article is to investigate connections between type 2 diabetes and results of 6-minute walk test among patients after cardiac surgery. Materials and methods: This research was conducted among 111 patients who had cardiac surgery. Those patients were qualified to stay at a stationary cardiac rehabilitation facility. They were divided into two groups: patients with and without diabetes. In the analysis, patients’ medical data and 6-minute walk test results before and after complex rehabilitation were taken into consideration. Results: On the basis of our analysis it was found that patients who have diabetes achieve worse results of 6-minute walk test before (OR=0.995; p=0.005) and after (OR=0.994, p=0.006) complex cardiac rehabilitation in comparison with patients without diabetes. Conclusions: Type 2 diabetes has impact on physical effort tolerance among patients after cardiac surgery. Despite improvement of 6-minute walk test results thanks to complex cardiac rehabilitation, patients with type 2 diabetes walked shorter distance than patients without diabetes

Immunoexpression of aromatase cytochrome P450 and 17β-hydroxysteroid dehydrogenase in women’s ovaries after menopause

BACKGROUND: Menopause results in a lack of regular menstrual cycles, leading to the reduction of estrogen production. On the other hand, ovarian androgen synthesis is still present at reduced levels and requires expression of several steroidogenic enzymes. METHODS: This study was performed on 104 postmenopausal women hospitalized due to uterine leiomyomas, endometriosis, and/or a prolapsed uterus. Patients were divided into three groups depending on the time from menopause. Group A patients experienced menopause 1–5 years before enrollment in the study (42 women). Group B included women who had their last menstruation 5–10 years before the study (40 women). Group C consisted of 22 women who were more than 10 years past menopause. Hysterectomy or removal of the uterine corpus with adnexa was performed during laparotomy. We evaluated the expression of aromatase cytochrome P450 (CYP 19) and 17β-hydroxysteroid dehydrogenase (17β HSD) by employing immunohistochemistry. RESULTS: Activity of 17β-HSD and CYP19 was demonstrated in the cytoplasm of stromal cells of postmenopausal ovaries, epithelium cells coating the ovaries, vascular endothelial cells, and epithelial inclusion cysts. However, overall expression of both 17β-HSD and CYP 19 decreased with time after menopause. CONCLUSION: Demonstration of the activity of the key enzymes of ovarian steroidogenesis, CYP 19 and 17β-HSD, confirms steroidogenic activity in the ovaries of postmenopausal women. Nevertheless, ovarian steroidogenic activity decreases with time, and its significant decrease occurs 10 years after menopause

The influence of physical activity on the mood of people subjected to standard rehabilitation after cardiac surgery

Introduction: The aim of this study was to assess the correlation between standard post-operational early rehabilitation and compare the differences between mood before and after rehabilitation. Materials and methods: 51 people were examined. The study group included patients from the Department of Cardiac Surgery, SPSK No. 2, PUM in Szczecin. The data was collected using a standardized UMACL scale and an original survey to collect basic data. On the UMACL scale, there are three mood determinants: Hedonic Tone (HT), Tense Arousal (TA) and Energy Arousal (EA). A high level of Hedonic Tone and Energy Arousal as well as low Tense Arousal are considered a good mood. The respondents first filled the UMACL scale questionnaire, then proceeded to a 10-minute drive on the rotor. After completing physical activity, they again completed the same UMACL scale. The obtained results were subjected to statistical analysis. Results: Energy Arousal and Hedonic Tone values increased, and Tense Arousal values decreased in post-operative patients. Conclusions: Even short, one-off physical activity has a positive effect on the mood in cardiac surgery patients