Analysis of consistency between temporospatial gait parameters and gait assessment with the use of Wisconsin Gait Scale in post-stroke patients

Introduction Due to the increasing incidence and social effects of stroke there is a growing interest in finding methods enabling gait analysis in this group of patients. Observational techniques are predominantly applied in clinical practice; on the other hand advanced quantitative methods allow in-depth multidimensional gait assessment. The present study was designed to assess the consistency between temporospatial gait parameters acquired through 3-dimensional gait analysis and the results of gait assessment with the use of observational WGS in post stroke hemiparetic patients. Material and method The study was performed in a group of 30 post-stroke patients, over 6 months from the onset of ischaemic stroke, who were able to walk unassisted. Gait assessment based on WGS was performed by an experienced physiotherapist, with the use of video recordings. Assessment of temporospatial parameters was based on gait analysis performed with BTS Smart system. Results The findings show moderate correlation between WGS based gait assessment and gait velocity (r=−0.39; p=0.0316). Similar relationship was identified between gait cycle duration and score in WGS for both unaffected (r=−0.36; p=0.0477) and affected side (r=−0.37; p=0.0426). Higher correlation level was demonstrated for stance phase on the unaffected side and gait assessment based on WGS (r=0.58; p=0.0009). Conclusions Gait assessments with the use of temporospatial parameters and with observational WGS were found to produce moderate and good consistent results. WSG is a useful, simple tool for assessing gait in post stroke hemiparetic patients

Evaluation of the quality of life after surgical removal of lung cancer

Introduction: Morbidity and mortality attributed to lung cancer remain at high levels, especially where men are concerned.The surgery for lung cancer involves removing neoplastic lesions in order to save the largest possible part of the healthy lung.Of importance is also pre- and post-surgical rehabilitation. The aim of this thesis is to gauge the quality of life of the patients whohave had their lung cancer surgically removed. Material and methods: The study was conducted on 72 patients (52 men and 20 women) after surgical removal of lung cancer.The subjects were examined prior to, a week after and six months following surgery. The investigation employed the standardisedquestionnaires to assess the quality of life, i.e. EORTC QLQ-C30 and EORTC QLQ-LC13, as well as the visual analogue pain scale(VAS). Statistical analyses were performed using the Anova Friedman test and Dunna test, and p-value calculated in multiplecomparisons with significance level assumed at p < 0.05. Results: During six months after the operation, the quality of life deteriorated in relation to the one before operation as evidencedby the functioning scale at the level of p < 0.001. Overall symptom scale, as well as symptomatic scale and the VAS scale showedthat some symptoms increased significantly in the early period after surgery p < 0.001, then with the passage of time, thepatients felt improvement, however, some of them, e.g. pain sensations can persist till six months after surgery. Conclusions: Surgical removal of lung cancer is associated with a significant deterioration of the quality of life in the early periodafter surgery and can persist till six months later

Assessment of cervical range of motion in patients after axis fracture

Background Surgical treatment of odontoid fractures with posterior C1/C2 fusion always leads to severe limitations in mobility of the cervical spine and head. Purpose To assess the mobility of the cervical spine in patients treated with various surgical methods after an axis body fracture. Material and methods A group of 61 subjects receiving surgical treatment in a group of 214 subjects treated for odontoid fractures at one ward of neurosurgery at a regional hospital. Studies also included odontoid peg and Hangman fractures. The range of motion of the head was compared to standards by the International Standard Orthopedic Measurements (ISOM) and to head mobility in a control group of 80 healthy subjects without any pathologies or complaints associated with the cervical spine. Ranges of motion were measured with the CROM goniometre with regard to flexion, extension, right and left lateral flexion and right and left rotation. The functional status was evaluated with Neck Disability Index (NDI) standard questionnaires indicated for patients with cervical spine pain. Results Except for flexion and extension, patients after odontoid fractures had a statistically significantly smaller range of motion of the cervical spine in all planes compared to the control group and ISOM standards. Conclusions Odontoid fractures lead to limitations in mobility of the cervical spine even after treatment with methods that in theory should preserve the C1/C2 mobility

Chód pacjentów z niedowładem połowiczym po udarze mózgu i metody jego oceny

Cerebral stroke, a serious complication of cardiovascular system disorders, has become an important medical issue in contemporary societies. Gait disorders in patients after stroke constitute a serious clinical challenge - every year, more than ten thousand patients become seriously disabled as a result of stroke. Locomotor disability is one of stroke’s consequences. Patients with stroke-related hemiparesis often show gait disorders. Hemiparetic gait is characterized with a number of disorders, such as a considerable asymmetry of gait phase time, i.e. step length, or limb load – the healthy leg being overloaded. These disorders result in limiting patients’ everyday activity. Therefore, objective methods of gait analysis are currently being researched. Among gait assessment methods there are clinical, or observation methods – which consist of gait description as related to the normal gait patterns; as well as quantitative, or objective methods – which consist of measuring, description and analysis of chosen parameters of human gait. The aim of the study is to characterise gait in patients with stroke-related hemiparesis, as well as to discuss the methods of its assessment.Udar mózgu, będący dramatycznym powikłaniem chorób układu naczyniowego, stanowi duży problem zdrowotny we współczesnym społeczeństwie. U pacjentów z niedowładem połowiczym po udarze mózgu występuje patologiczny wzorzec chodu. Chód hemiparetyczny cechuje się serią zaburzeń, w tym znaczną asymetrią czasu trwania faz chodu, długości kroku, obciążenia kończyn, polegającą na przeciążaniu kończyny zdrowej. Skutkuje to ograniczeniem aktywności w życiu codziennym. Ze względu na narastające znaczenie społeczne i powszechność udaru mózgu coraz częściej poszukuje się metod w zakresie analizy chodu tej grupy chorych. Wśród metod oceny chodu wyróżnia się metody kliniczne, obserwacyjne polegające na opisie chodu w odniesieniu do wzorca prawidłowego oraz metody ilościowe, obiektywne, polegające na pomiarze, opisie i analizie wybranych parametrów charakteryzujących chód człowieka. Celem pracy jest charakterystyka chodu pacjentów z niedowładem połowiczym po udarze mózgu i metod jego oceny

The frequency of occurrence and risk factors for injuries to primary and junior high schools students from the Podkarpackie Province during Physical Education classes

Wstęp: Zajęcia z wychowania fizycznego to całokształt zabiegów mających na celu wszechstronny rozwój fizyczny organizmu człowieka. Jednakże nie ulega wątpliwości, że ćwiczenia na lekcjach wychowania fizycznego wiążą się z ryzykiem kontuzji lub uszkodzeń ciała. Zagrożenie utraty zdrowia w wymiarze szkolnym stało się obecnie bardzo dużym problemem społecznym. W związku z tym należy zwracać szczególną uwagę na bezpieczeństwo młodzieży zarówno w planowaniu zajęć wychowania fizycznego, jak i w doborze metod i form pracy. Cel pracy: Celem pracy jest ocena częstości występowania urazów uczniów szkół podstawowych i gimnazjalnych województwa podkarpackiego na lekcjach wychowania fizycznego oraz ocena zależności występowania urazów sportowych wśród dzieci i młodzieży szkolnej od wybranych czynników. Materiał i metoda: Badaniem objęto grupę 301 uczniów szkół podstawowych i gimnazjalnych na terenie województwa podkarpackiego. W badanej grupie było 151 chłopców i 150 dziewcząt. Wiek badanych mieścił się w przedziale od 9 do 16 lat (średnia wieku 12,58 lat). Do przeprowadzenia badań wykorzystano oryginalną ankietę. Ankieta była standaryzowana, anonimowa, zawierała 29 pytań. Wyniki: W wyniku przeprowadzonych badań wykazano, iż wśród 301 przebadanych uczniów ponad połowa – 158 (52,5%) doznała urazu na lekcjach wychowania fizycznego. Analizując rodzaj doznanego urazu wykazano, że najczęściej dochodziło do stłuczeń (53,16%), które dotyczyły głównie kończyn dolnych (55,06%). Stwierdzono wysoce istotną statystycznie zależność pomiędzy częstotliwością urazów a wiekiem badanych (p<0,001), środowiskiem zamieszkania (p<0,001), a także rodzajem aktywności ruchowej pozalekcyjnej (p<0,05). Wnioski: Urazy na lekcjach wychowania fizycznego są częstym zjawiskiem wśród uczniów województwa podkarpackiego. Występuje istotna zależność pomiędzy wiekiem, środowiskiem zamieszkania, aktywnością ruchową pozalekcyjną, a częstotliwością występowania urazów na zajęciach wychowania fizycznego.Introduction: The classes of Physical Education include a range of activities aimed at comprehensive physical development of human body. However, there is no doubt that exercises at Physical Education (PE) are associated with the risk of injury or damage to the body. The threat of loss of health in school environment is currently becoming a significant social issue. Therefore, particular attention should be paid to the safety of young people both in course of planning of PE classes and the choice of methods and forms of activity. Aim: The aim of this study was to evaluate the incidence of injuries in primary and secondary schools students during PE classes in the Podkarpackie Province and the assessment of correlation between the incidence of sports injuries among children and adolescents and selected factors. Material and methods: 301 primary and secondary school students from the Podkarpackie Province were included in the study. The study group comprised of 151 boys and 150 girls. Age of the participants ranged from 9 to 16 years of age (mean age 12.58 years). The author’s questionnaire was used to carry out the research. The survey was standardized, anonymous and consisted of 29 questions. Results: The results of the study showed that out of the total of 301 students surveyed, more than a half – 158 (52.5%) suffered occasionally from an injury at PE lessons. The analysis in terms of injury type revealed that contusions were predominant (53.16%), the lower limbs were the most frequently affected (55,06%). There was a highly significant relationship between the frequency of injuries and the age of students (p <0.001), living environment (p <0.001) as well as a kind of after-school physical activity (p <0.05). Conclusions: Injuries at PE classes are common among students in the Podkarpackie Province. There is a significant relationship between the age, living environment, afterschool physical activity and the incidence of injury during physical education classes

Impact of Foehn Wind and Related Environmental Variables on the Incidence of Cardiac Events

In Poland there is no data related to the impact of halny wind and the related environmental variables on the incidence of cardiac events. We decided to investigate the relationship between this weather phenomenon, as well as the related environmental variables, and the incidence of cardiac events in the population of southern Poland, a region affected by this type of wind. We also decided to determine whether the environmental changes coincide with or predate the event examined. We analysed data related to 465 patients admitted to the cardiology ward in a large regional hospital during twelve months of 2011 due to acute myocardial infarction. All the patients in the study group lived in areas affected by halny wind and at the time of the event were staying in those areas. The frequency of admissions on halny days did not differ significantly from the admissions on the remaining days of the year (p = 0.496). No statistically significant differences were found between the number of admissions on halny days and on the remaining days during halny months (p = 0.084). We have identified a difference in the number of admissions between days with no halny and days immediately preceding onset of halny (p = 0.001). However, no effects of the related environmental variables have been observed in the incidence of cardiac events (p = 0.866, F = 0.37). On the days with halny wind, incidence of cardiac events is similar to that on the remaining days of the year

Assessment of the effects of Proprioceptive Neuromuscular Facilitation therapy on the improvement of motor function in a patient after total hip replacement – a case study

Hip osteoarthritis is a serious clinical and social problem. The number of patients who suffer from degenerative changes in the hip joints and require endoprosthesis-plasty is constantly increasing. This paper presents physiotherapeutic activities based on Proprioceptive Neuromuscular Facilitation (PNF) which optimize a patient’s mobilization using the reserves in their body fully to make improvements in movement and to regain lost functions for achieving beneficial therapeutic effects. The aim of the study was to evaluate the influence of PNF therapy on changes in muscle strength, mobility, and gait pattern in patients after Total Hip Arthroplasty. The case described here regards a 63-year-old woman diagnosed with left hip osteoarthritis who had Total Hip Arthroplasty. The patient was examined twice before and after PNF therapy. The range of mobility of hip joints, level of pain, muscular strength and gait were assessed. Applied PNF therapy, including dynamic (eccentric, concentric) and static muscle training, post-isometric relaxation, stabilization and control in the stance phase, resulted in improved hip joint mobility, muscle strength, gait pattern and pain reduction in the patient. The case study demonstrates that a short (two-week) but intensive (over two hours per day) PNF therapy positively influenced selected motor functions after Total Hip Arthroplasty

Effects of sensory integration therapy in a 7-year old child with epilepsy following craniocerebral trauma – a case study

Introduction. Post-traumatic epilepsy develops as a complication of a serious craniocerebral trauma, frequently an open head injury, resulting in neurological impairments. Aim. The study was designed to discuss problems associated with sensory integration dysfunction observed in a seven-year old girl with epilepsy which occurred as a result of craniocerebral injury. Description of the case. The case study is based on information gained from the girl’s medical records, an interview with her guardians and a sensory function questionnaire. Additional examinations assessed the girl’s balance control, and her functional performance according to Barthel scale. The girl received a three-week sensory integration therapy which included exercise involving tactile, vestibular and proprioceptive stimulation, as well as balance exercises and self-care training. Conclusions. In this particular case, application of sensory integration therapy produced beneficial results. The findings show improvement in balance, coordination as well as self-care

The assessment of the impact of myofascial training on postural control – a case study

Introduction. A sedentary lifestyle with lack of physical activity contributes to deteriorated balance among healthy young people. Physical activity is import_ant since it stimulates neuromuscular junctions that control body posture, especially at younger age, when greater postural sway may be observed in stabilography compared to adults. Proper work of individual muscle groups is import_ant to maintain proper balance. Abnormal muscle tone can lead to dysbalances that make it difficult o maintain a stable posture in a variety of conditions. Aim. The aim of the study was to evaluate the effect of a training cycle consisting of stretching of the ilopsoas, rectus femoris, gluteus maximus, hamstring and rectus abdominis, and eccentric training of the above mentioned muscles to improve static and dynamic balance. Methods. Oobjective and qualitative-subjective were used to assess the results in a man aged 22 yrs. Postural control was tested twice in the patient with the Neurocom International Inc. SMART EquiTest device under static conditions without visual control and with dynamic visual surrounding and unstable support surface. Automatic postural reflexes were also evaluated. In addition, clinical tests were performed. Results. Myo-fascial training, which included eccentric training combined with lower limb and trunk stretching improved the postural control in the subject

Impact of mild COVID-19 on balance function in young adults, a prospective observational study

Abstract Balance is of essential importance in human life. The aim of the study is to examine the incidence of balance impairments in young adults who have recovered from mild COVID-19. The study involved 100 subjects, divided into two groups: the study group (50 individuals) comprised subjects who had recovered from mild COVID-19, and the control group (50 individuals) consisted of healthy subjects matched for gender and age. Balance was assessed using a force platform and clinical tests such as: timed up and go test, 15-s step test, sit-to-stand test and 6-min walk test. The assessment on the platform showed greater balance impairments in the trials with eyes closed; more specifically, compared to the controls, in trials with double-leg support the subjects from the study group acquired significantly higher scores in X average (lateral coordinates) (p < 0.05), Path length, V average (average Centre of Foot Pressure Velocity) (p < 0.05) and Area circular (p < 0.01), with even more significant results in trials with single-leg support in X average (p < 0.001), Y average (anterior–posterior coordinates) (p < 0.001) and Path length (p = 0.004). Higher scores in the timed up and go test were found in the study group (p = 0.013). The control group had higher scores in the remaining tests. The current findings show that mild COVID-19 may lead to balance impairments in young adults. Statistically significant differences in balance were found between the subjects in the study group and the healthy controls. Further studies in this area should take into account more age groups, and patients recovered from severe COVID-19, and should investigate long-term consequences of COVID-19 reflected by balance problems