The effect of the rehabilitation program on balance, gait, physical performance and trunk rotation in Parkinson's disease

BACKGROUND: Parkinson’s disease (PD) is a progressive, neurodegenerative disease which leads to postural and gait disorders, limitation in mobility, activities of daily living and disability. AIMS: The aim of the study is to assess the effects of the rehabilitation program on balance, gait, motor performance and trunk rotations in PD patients. METHODS: Sixty-four patients with 1.5–3.0 stage PD in the Hoehn and Yahr scale were randomly allocated to rehabilitation and control groups. Sixty-one patients completed the study. Patients were assessed three times, at month intervals. Between the first and second assessments, the rehabilitation group participated in a rehabilitation training program focused on mobility, balance and gait exercises, consisting of 28 sessions. Balance was assessed with tandem stance and the Pastor test (shoulder tug). Gait was assessed with a 10 m walk at preferred speed and 360° turn. Motor performance was evaluated by means of the Physical Performance Test (PPT) and timed motor activities. The trunk rotations were measured in the lumbar and thoraco-lumbar spine with a tape measure. RESULTS: The rehabilitation group significantly improved (p < 0.05) in balance and gait outcomes, PPT score, timed activities and trunk rotations both in comparison to the control group and baseline results. The positive effects of the exercise program maintained for at least 1 month. CONCLUSION: The 4-week rehabilitation training program focused on mobility, balance and gait exercises improved balance, gait, physical performance and trunk rotations in patients with PD

BURNOUT SYNDROME IN PHYSICAL THERAPISTS – DEMOGRAPHIC AND ORGANIZATIONAL FACTORS

Background: Professional burnout results from prolonged exposure to chronic, job-related stressors. According to Christina Maslach, professional burnout is a syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment. Literature includes a number of reports on burnout syndrome within health service, but hardly ever do they make any references to physiotherapists. The purpose of this study is assessment of the level of professional burnout in a group of physiotherapists and investigating relationships between the indices of burnout syndrome and selected demographic as well as organizational variables. Material and Methods: The study group consisted of 151 physiotherapists with at least 3 years of experience, employed in various health service outposts in Krakow, Poland. The Maslach Burnout Inventory (MBI) was used to measure emotional exhaustion, depersonalization and personal accomplishment. A questionnaire for the description of socio-demographic and work characteristics was used as well. Results: Job burnout among the physiotherapists was manifested by an increased emotional exhaustion and decreased sense of personal achievement. Emotional exhaustion was significantly higher among physical therapists working with adults and employed in hospitals, depersonalization was higher among men, hospital workers and employees with seniority from 15 to 19 years, personal accomplishment was decreased among men and less-educated therapists. Conclusions: The study confirmed that indicators of burnout in physiotherapists are significantly associated with selected demographic and organizational variables. It is necessary to undertake a more exhaustive study of burnout in this group of employees, and implement elements of prevention. Med Pr 2014;65(4):453–46

Zastosowanie tańca w rehabilitacji pacjentów z chorobą Parkinsona

Parkinson’s disease (PD) is a progressive, neurodegenerative disease leading to the occurrence of movement disorders, postural instability, gait disorders, falls, non-motor symptoms and disability. Rehabilitation is an important component of multidisciplinary treatment in PD. The aim of the study is to present the benefits and effects of using dance in the rehabilitation of patients with PD. Dance can have a beneficial influence on the physical, psychological, emotional, intellectual, aesthetic, cultural and social spheres of human life. Positive effects, which can be obtained through regular dance classes, in particular when they accurately correspond to the therapeutic goals of rehabilitation in PD. Patients with PD benefit from dance training in the way other dancing individuals do. Dance training includes various postural, balance and gait exercises performed to rhythm and music. It uses strategies naturally used in dance which are particularly useful in the therapy of patients with PD: concentration on movement performed to music, imagination of movement before its execution, multisensory stimulation and using sensory cues. Music and dance facilitate the initiation of movement and its performance at a proper speed and amplitude. In the limited studies concerning the effects of dance rehabilitation programs on PD, positive results were obtained in balance, gait, functional status and the quality of patient life . The authors used various forms of dance: the elements of classical ballet, jazz dance, ballroom dancing, Argentine tango, group dances, folk dances, contemporary dance, contact improvisation, elements of choreography dance theatre. Dance in various forms can be the tool for multidisciplinary rehabilitation, joining the elements of physiotherapy, art therapy (dance and music therapy), rhythmic auditory stimulation as well as social integration.Choroba Parkinsona (PD) jest postępującą chorobą neurodegeneracyjną, która prowadzi do wystąpienia zaburzeń ruchowych, niestabilności postawy, zaburzeń chodu, upadków, zaburzeń pozaruchowych i niesprawności. Rehabilitacja jest istotnym elementem kompleksowego leczenia chorych na PD. Celem pracy jest przedstawienie korzyści oraz efektów zastosowania tańca w rehabilitacji chorych na chorobę Parkinsona w oparciu o dostępne piśmiennictwo. Taniec wpływa korzystnie na sferę fizyczną, psychiczną, emocjonalną, intelektualną, estetyczną, kulturalną i społeczną człowieka. Pozytywne efekty, które można uzyskać poprzez regularne zajęcia taneczne szczególnie trafnie korespondują z celami terapeutycznymi rehabilitacji ruchowej w PD. Pacjenci z PD korzystają z treningu tanecznego, jak inne tańczące osoby. Trening taneczny obejmuje różnorodne ćwiczenia postawy, równowagi i chodu wykonywane do rytmu i muzyki. Wykorzystuje strategie naturalnie stosowane w tańcu i szczególnie przydatne w usprawnianiu chorych z PD, m.in.: koncentrację na ruchu do muzyki, wyobrażenie ruchu przed jego wykonaniem, wielosensoryczną stymulację i wskazówki sensoryczne. Muzyka i taniec ułatwiają rozpoczynanie ruchu i wykonywanie go z odpowiednią szybkością i amplitudą. W nielicznych badaniach dotyczących skuteczności tanecznych programów rehabilitacyjnych w PD uzyskano pozytywne efekty w zakresie równowagi, chodu, stanu funkcjonalnego i jakości Ŝycia chorych. Autorzy stosowali różne style i formy taneczne: elementy baletu klasycznego, jazz dance, taniec towarzyski, tango argentyńskie, tańce integracyjne, ludowe, taniec współczesny, kontaktową improwizację taneczną, teatr tańca oraz pantomimę. Taniec może być narzędziem kompleksowej rehabilitacji w PD, który łączy elementy fizjoterapii, terapii sztuką (tańcem i muzyką), rytmicznej stymulacji dźwiękowej i integracji społecznej

Tango argentyńskie w rehabilitacji pacjentów z chorobą Parkinsona

Parkinson’s disease (PD) is a progressive, neurodegenerative disease leading to disability. Parkinson’s disease causes the occurrence of movement disorders, such as bradykinesia, hipokinesia, rigidity, tremor, postural instability, gait disorders and falls as well as non-motor symptoms. Rehabilitation is an important part of treatment in Parkinson’s disease and the Argentine tango is one of the suggested, more attractive forms of physical activity. The aim of the study is to present the effects and possibilities of using the Argentine tango in the rehabilitation of patients with Parkinson’s disease on the basis of the overviewed literature. A review of literature was conducted. The MEDLINE (PubMed) database was searched using the key words: “tango” and “Parkinson’s disease”. The study was based on titles and abstracts, and then on full texts, original papers with and without control groups as well as case studies. Ten out of twelve publications were included in the analysis. Most studies evaluating the effects of Argentine tango dancing were performed in patients with mild to moderate Parkinson’s disease severity. Long-term as well as short, intensive tango dancing programs were used. One of the studies compared the effects of Argentine tango dancing to the effects of waltz and foxtrot dancing. One paper compared partnered to individual tango dancing. Studies indicate that the Argentine tango decreases the severity of Parkinson’s disease symptoms and improves: balance, gait, spatial cognition, everyday activities as well as social integration and participation in patients with Parkinson’s disease. The Argentine tango can be an attractive, useful and effective form of rehabilitation in Parkinson’s disease. Cite this article as: Stożek J., Pustułka-Piwnik U., Curyło M. Argentine tango in rehabilitation of patients with Parkinson’s disease. Med Rehabil 2016; 20(1): 33-38.Wstęp: Choroba Parkinsona (PD) jest postępującą chorobą neurodegeneracyjną, która prowadzi do niesprawności. W przebiegu PD występują zaburzenia ruchowe, m.in. bradykinezja, hipokineza, sztywność mięśni, drżenie, niestabilność postawy, zaburzenia chodu i upadki oraz objawy pozaruchowe. Rehabilitacja jest istotnym elementem leczenia w chorobie Parkinsona, a jedną z proponowanych atrakcyjnych form aktywności ruchowej jest tango argentyńskie. Celem pracy jest przedstawienie efektów i możliwości zastosowania tanga argentyńskiego w rehabilitacji chorych na chorobę Parkinsona na podstawie piśmiennictwa. Metody: Przegląd piśmiennictwa. Źródła informacji: Przeszukiwano bazę danych MEDLINE (PubMed), stosując słowa kluczowe: „tango” i „Parkinson’s disease”. Wybór badań: Na podstawie tytułów, a następnie streszczeń i pełnych tekstów publikacji, do analizy włączano prace oryginalne z grupą kontrolną i bez oraz studium przypadku. Wyniki: Spośród 12 odnalezionych prac 10 włączono do analizy. Większość badań dotyczących oceny efektów tańczenia tanga argentyńskiego przeprowadzono u pacjentów z niewielkim i umiarkowanym nasileniem choroby Parkinsona. Stosowano zarówno długotrwałe, jak i krótkie, intensywne programy tańczenia tanga. W jednej z prac porównano efekty tańczenia tanga argentyńskiego z wynikami tańczenia walca i fokstrota, a w kolejnej tańczenie tanga w parze i bez. Badania wskazują, że tango argentyńskie poprawia wyniki oceny nasilenia choroby, równowagę, chód, postrzeganie przestrzenne, jakość życia i codzienną aktywność oraz integrację społeczną i partycypację u pacjentów z chorobą Parkinsona. Wnioski: Tango argentyńskie może być atrakcyjną, przydatną i skuteczną formą usprawniania pacjentów z chorobą Parkinsona

Burnout syndrome in physical therapists – Demographic and organizational factors

Background: Professional burnout results from prolonged exposure to chronic, job-related stressors. According to Christina Maslach, professional burnout is a syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment. Literature includes a number of reports on burnout syndrome within health service, but hardly ever do they make any references to physiotherapists. The purpose of this study is assessment of the level of professional burnout in a group of physiotherapists and investigating relationships between the indices of burnout syndrome and selected demographic as well as organizational variables. Material and Methods: The study group consisted of 151 physiotherapists with at least 3 years of experience, employed in various health service outposts in Krakow, Poland. The Maslach Burnout Inventory (MBI) was used to measure emotional exhaustion, depersonalization and personal accomplishment. A questionnaire for the description of socio-demographic and work characteristics was used as well. Results: Job burnout among the physiotherapists was manifested by an increased emotional exhaustion and decreased sense of personal achievement. Emotional exhaustion was significantly higher among physical therapists working with adults and employed in hospitals, depersonalization was higher among men, hospital workers and employees with seniority from 15 to 19 years, personal accomplishment was decreased among men and less-educated therapists. Conclusions: The study confirmed that indicators of burnout in physiotherapists are significantly associated with selected demographic and organizational variables. It is necessary to undertake a more exhaustive study of burnout in this group of employees, and implement elements of prevention. Med Pr 2014;65(4):453–46