Knee arthroplasty in the elderly

Background: One of the many problems related to geriatric patients are degenerative changes in joints. In this article authors discuss about the knee joint endoprosthesis. During preparations of this publishment special attention was paid to the following aspects: role and the meaning of preventing actions, explanation the clue and main goal of the surgery intervention, and it’s simplified course. Subsequently there are short description of the knee joint with its most relevant to the fallowing subject structures. Furthermore the quantity of respective surgical procedure was given to approximate the scale of subject. Next paragraphs explaining why endoprothesis is the best way for dealing with this kind of problems, and the significance of the physiotherapist in whole process both before, and after surgery. Materials and methods: Analysis of available literature and articles in PubMed, ResearchGate and other scientific platforms related to discussed subject, using words: geriatrics, endoprothesis, knee arthroplasty, knee joint. Results: Gonarthrosis is a significant social problem. Endoprosthesis plastic surgery is performed on those patients who struggle badly in activities of daily living because of advanced articulations disorders. The main diagnoses underlying the primary knee replacement were primary bilateral gonarthrosis and other primary gonarthrosis accounted. The analysis of sources devoted to these issues includes people after 65 years old (mostly women) which occurs a low level of physical activity, the burden of metabolic disease such as diabetes (type 2). Authors demonstrated a correlation between excessive body weight, and insufficient production of synovial fluid, it’s damage and in the final phase lost which is a direct reason for pain. The following thesis was proven based on the source material: thanks to arthroplasty the patients quality of life as improved by around 90 percent. When the physiotherapist is involved in the whole process, both in the pre- and post-surgery phase it is possible to obtain much better therapeutic effects. Conclusions: Knee arthroplasty can help restore independence to patients in their daily activities. The introduction of artificial foreign bodies into the pond to replace the damaged leads to an improvement in the quality of life of sick patients. The introduction of intensive rehabilitation, patient education and pharmacological treatment after arthroplasty allows for reduction of pain and faster recovery. There are many types of rehabilitation after knee replacement surgery, so the therapy plan has to be adapted to the individual patient

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

Abnormal muscle tension as one of the main problems after a stroke

Background: Stroke is a growing problem in an aging society. According to WHO data, it is the second most common cause of death. An increase in the number of strokes causes an increase in the number of patients struggling with its consequences. People who have suffered a stroke are dealing with various neurological defects. One of them is abnormal muscle tension. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: stroke, muscle tension, spasticity. Results: The problem of disturbed tension is common in people who have had a stroke. Spasticity, i.e. increased muscle tone in response to stretching, results from damage to the central nervous system. Direct and indirect methods are used to assess spasticity. In the fight against destroyed muscle tension, it is important to implement treatment as soon as possible. It is based on the use of various forms of therapy: pharmacotherapy and physiotherapy. Physiotherapy and kinesitherapy treatments as well as specialized rehabilitation methods, such as PNF. The rehabilitation process should be supplemented with appropriate pharmacological treatment. Equally important is the implementation of stroke prevention. These activities are associated with the promotion of a healthy lifestyle, for example, regular exercise and stress reduction. Conclusion: Muscle tension disorder, including spasticity, is a problem affecting many patients who have had a stroke. A timely diagnosis is important to get the right therapy. Treatment should have a holistic dimension and combine different methods. The goal of therapy is to normalize muscle tone and thus improve the patient's quality of life

Sciatica - radiating pain affecting an increasing part of society

Introduction: Sciatica is a current and more common problem affecting normal functioning. Along with the development of civilization, the lifestyle has also changed, contributing to spend a large amount of time in a sitting position. Material and Methods: Review of literature data available in the Pubmed, Cochrane and Google Scholar databases. Results: Both in a standing and sitting position, the pressure exerted on the intervertebral discs increases leading to a hernia which, pressing on the roots of the L4-S1 nerves, lead to symptoms characterized by pain in the lumbar region, back of the buttock, thigh, calf, foot and paresthesia of these areas. Due to the progressive changes associated with aging, the frequency of sciatica increases with age. The basis for the diagnosis of sciatica is a carefully collected interview and examination of the patient, while imaging and neurophysiological tests can be helpful in determining the degree of compression on nerve structures. Treatment of sciatica is dependent on the cause and can be both conservative and surgical. Conclusions: Due to the increasing number of cases of sciatica, it seems necessary to expand the knowledge on the diagnostic and therapeutic possibilities of this disease

Dizziness and balance disorders in the elderly

Background: Patients in the geriatric age are characterized by the presence of degenerative changes, significantly affecting their daily functioning. One of the most common symptoms accompanying the elderly include dizziness and balance disorders. This is an extremely important issue, because even every third patient can report such ailments. Often, especially in the group of geriatric patients, these problems are related to disorders in the circulatory system, and more specifically to orthostatic hypotension. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: geriatrics, dizziness, balance disorders. Results: In the treatment of dizziness and disorders of the balance we distinguish pharmacological and non-pharmacological methods where kinesitherapy (exercises) looms large. In the case of pharmacological treatment, attention should be focused on causal therapy because symptomatic treatment can cause side effects and should therefore be used as soon as possible. In many cases, pharmacological treatment can be fully replaced by normal and individually conducted physiotherapeutic procedures. Training to which a patient is subjected should consist of many elements, which, however, will be adapted to the conditions that can meet a patient in everyday life. In diagnostics of the above-mentioned problems, research on stabilometric platforms is becoming more and more important. Increasingly, also in the rehabilitation of patients with a problem with equilibrium, modern technology in the form of virtual reality is used. Conclusions: Dizziness and balance disorders can result in many problems, which is why correct diagnosis and effective treatment are so important, especially because it is a problem for more and more people. Greater importance should be attached to prevention. Although modern forms of fighting these disorders are being introduced, there is still a need for further research on their effectiveness

Sarcopenia as a problem of old age - a form of rehabilitation

Background: Sarkopenia as a disease has relatively recently become the object of research and the work of the academic community. Despite this, sarcopenia is an increasingly serious social problem, it can be seen in a large number of statistics and epidemiological studies. Among geriatric patients, along with their multiformity and the associated use of a large amount of medicines, it causes many negative effects related to the functioning of the whole organism as well as the quality of life of the patient himself. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: sarcopenia, geriatrics, rehabilitation, loss of muscle mass. Results: Among the studies and recommendations concerning sarcopenia, a continuous lack of clear, transparent and confirmed diagnostic criteria can be stated. At the diagnosis of this disease, an X-ray or a bioelectrical impedance analysis is used. Other methods used are functional tests, including a six-minute walk test or "Timed-Up and Go" test (TUG). In the case of rehabilitation of people with sarcopenia, the most effective form of kinesitherapy is individually selected resistive training, which has a positive effect not only on muscle mass growth, but also the body's protein metabolism and the improvement of the endocrine system. Physiotherapy is the most commonly used method of physical therapy, among other methods of rehabilitation there are also therapeutic massage, aqua aerobics, vibratory training, and Nordic Walking and diet supplementation. Conclusions: Sarcopenia in geriatric patients, especially with ineffective treatment and rehabilitation, has a destructive impact on both the physical and mental sphere of the patient. There is a great need for more extensive research, both on the whole disease process and the effectiveness of forms of assistance to patients