Efficacy and Safety of Spinal Collagen Mesotherapy in Patients with Chronic Low Back Pain in a Three-Month Follow-Up-Retrospective Study

Background: Low back pain syndrome is associated with muscular and myofascial pain and is linked with muscle overstrain or a lack of regular physical activity as well as a habitual bad posture, which cause the overload of perispinal soft tissues. One of the forms of therapy of LBP is the mesotherapy of the spine, which consists of multi-point micro-injections of drugs or medicine mixtures, which include preparations of collagen type I. The aim of the study was to assess the efficacy and safety of mesotherapy with collagen type I. Methods: A retrospective analysis of the results of the treatment of patients with chronic low back pain syndrome using mesotherapy was performed. A total of 130 patients (83 women and 47 men; mean age: 51 ± 14 years) were divided into two groups: group I (n = 65), treated with collagen type I, and group II (n = 65), treated with lignocaine 1%. Mesotherapy was performed weekly over five weeks. Patients were assessed using the following scales: the VAS, Laitinen Scale, and Revised Oswestry Low Back Pain Disability Scale before the start of the treatment, after five treatments, and at the three-month follow-up visit. Results: A statistically significant improvement was observed after the use of spinal mesotherapy both with collagen type I and lignocaine, with the collagen treatment having better results at the three-month follow-up visit. No adverse effects were observed after the procedures. Conclusions: Spinal mesotherapy using collagen type I and lignocaine seems to be an effective method in the treatment of chronic LBP. Collagen mesotherapy gives better results in the long term. Mesotherapy is a safe form of therapy.

The Effectiveness of Preoperative Outpatient and Home Rehabilitation and the Impact on the Results of Hip Arthroplasty: Introductory Report

A total hip replacement is the treatment of choice for end-stage hip osteoarthritis. Rehabilitation performed before surgery (called prehabilitation) is used to improve the results of surgical treatment. However, the results of studies have not unquestionably confirmed the effectiveness of preoperative rehabilitation and its impact on the outcome of surgery. The aim of this study is to assess the effectiveness of preoperative outpatient and home rehabilitation in relation to a control group not subject to these forms of influence. A total of 61 patients qualified for primary hip arthroplasty were randomly assigned to a group with outpatient rehabilitation before surgery, exercises performed at home, or a group without any intervention before surgery. Three weeks after surgery, the patients were re-qualified and underwent three weeks of outpatient rehabilitation in the day rehabilitation department. The patients from all three groups were evaluated in terms of functionality and pain using point scales upon enrolment in the study, on admission to the day rehabilitation department, and after 3 weeks of rehabilitation in the department. A total of 50 subjects completed the study. The study results did not reveal statistically significant differences between preoperative rehabilitation and no intervention. Patients rehabilitated at home gave up self-therapy more often than those undergoing outpatient rehabilitation.

Changes in Melatonin Concentration in a Clinical Observation Study under the Influence of Low-Frequency Magnetic Fields (Magnetic Stimulation in Men with Low Back Pain)-Results of Changes in an Eight-Point Circadian Profile

The aim of this study was to assess the changes in melatonin concentration under the influence of magnetic stimulation in men with low back pain. A total of 15 men were used in this study, divided into two groups. In Group 1, consisting of seven men, the M1P1 Viofor JPS program was used twice a day for 8 min, at 08:00 and 13:00. In Group 2, consisting of eight men, the M2P2 Viofor JPS program was used once a day for 12 min at 10:00. The application was subjected to the whole body of patients. The treatments in both groups lasted 3 weeks, for 5 days each week, with breaks on weekends. The diurnal melatonin profile was determined the day before exposure and the day after the last treatment, as well as at one-month follow-up. Blood samples were collected eight times a day. In both programs, magnetic stimulation did not reduce the nocturnal peak of melatonin concentration. After exposure, prolonged secretion of melatonin was observed until the morning hours. The impact of the magnetic field was maintained 1 month after the end of the application. The effect of the magnetic field was maintained for 1 month from the end of the application, which confirms the thesis about the occurrence of the phenomenon of biological hysteresis. The parameters of the magnetic fields, the application system, and the time and length of the application may affect the secretion of melatonin.

Why Does Rehabilitation Not (Always) Work in Osteoarthritis? Does Rehabilitation Need Molecular Biology?

Osteoarthritis (OA) is a common disease among the human population worldwide. OA causes functional impairment, leads to disability and poses serious socioeconomic burden. The rehabilitation offers a function-oriented method to reduce the disability using diverse interventions (kinesiotherapy, physical therapy, occupational therapy, education, and pharmacotherapy). OA as a widespread disease among elderly patients is often treated by rehabilitation specialists and physiotherapists, however the results of rehabilitation are sometimes unsatisfactory. The understanding of molecular mechanisms activated by rehabilitation may enable the development of more effective rehabilitation procedures. Molecular biology methods may prove crucial in rehabilitation as the majority of rehabilitation procedures cannot be estimated in double-blinded placebo-controlled trials commonly used in pharmacotherapy. This article attempts to present and estimate the role of molecular biology in the development of modern rehabilitation. The role of clinicians in adequate molecular biology experimental design is also described.

Analgesic Effectiveness of Physical Therapy Combining the Use of Electromagnetic Fields with Light Radiation Emitted by LEDs along with the Use of Topical Herbal Ointment in Patients with Gonarthrosis

(1) Background: The aim of the study is to evaluate the analgesic effectiveness of a physical therapy regimen that combines the use of an electromagnetic field with light radiation emitted by LEDs, along with the use of Traumeel S ointment, in patients with gonarthrosis. (2) Methods: The study included 90 patients with knee osteoarthritis (grade 2 Kellgren and Lawrence osteoarthritis). They were divided into three groups: Group I, 30 patients treated with magnetic stimulation plus LED therapy; Group II, 30 patients treated with Traumeel S ointment; and Group III, 30 patients treated with magnetic stimulation plus LED therapy with Traumeel S ointment. Pain intensity was assessed using the VAS and Laitinen scales before and after a series of treatments. (3) Results: Significant results in terms of pain reduction before and after treatment were obtained in each of the study groups, as there were significant differences in the VAS pain intensity scores before and after the procedures between the groups. In group I, with electromagnetic field and LED light treatment, the difference was 35.5; in group II, which received Traumeel S® ointment, the difference was 18.5; and in group III, with electromagnetic field and LED light treatment as well as Traumeel S ointment, the difference was 26.5. In the Laitinen scale, the differences were insignificant, although the size distribution was similar. (4) Conclusions: The therapy used in this study showed that magnetic stimulation plus LED therapy and the use of Traumeel S ointment gave positive results in terms of pain reduction in each of the study groups. The strongest analgesic factor seems to be magnetic and LED therapies used separately. Traumeel S in magnetoledophoresis does not work synergistically with the magnetic field of LED light, and even worsens the effect of the therapy used.

Chronic-Exposure Low-Frequency Magnetic Fields (Magnetotherapy and Magnetic Stimulation) Influence Serum Serotonin Concentrations in Patients with Low Back Pain-Clinical Observation Study

(1) Background: The influence of serotonin on many regulatory mechanisms has not been sufficiently studied. The use of a physical method, assuming the possibility of its action on increasing the concentration of serotonin, may be the direction of therapy limiting the number of antidepressants used. The aim of the research was to study the effects of low-frequency magnetic fields of different characteristics on the circadian profile of serotonin in men with low back pain. (2) Methods: 16 men with back pain syndrome participated in the study. The patients were divided into two groups. In group 1, magnetotherapy (2.9 mT, 40 Hz, square wave, bipolar) was applied at 10.00 a.m. In group 2, the M2P2 magnetic stimulation program of the Viofor JPS device was used. Treatments in each group lasted 3 weeks, 5 days each, with breaks for Saturday and Sunday. The daily serotonin profile was determined the day before the exposure and the day after the last treatment. Blood samples (at night with red light) were collected at 8:00, 12:00, 16:00, 24:00, and 4:00. The patients did not suffer from any chronic or acute disease and were not taking any medications. (3) Results: In group 1, a significant increase in serotonin concentration was observed after 15 treatments at 4:00. In group 2, a significant increase in serotonin concentration was observed at 8:00 after the end of the treatments. In comparison between magnetotherapy and magnetic stimulation, the time points at which differences appeared after the application of serotonin occurred due to the increase in its concentrations after the application of magnetic stimulation. (4) Conclusions: Magnetotherapy and magnetic stimulation, acting in a similar way, increase the concentration of serotonin. Weak magnetic fields work similarly to the stronger ones used in TMS. It is possible to use them in the treatment of mental disorders or other diseases with low serotonin concentrations.

USING THE SODA SCALE TO ASSESS THE EFFECTIVENESS OF NEUROLOGICAL SPEECH AND LANGUAGE THERAPY ON IMPROVING LANGUAGE FUNCTIONS IN POST-STROKE PATIENTS

OBJECTIVE

The aim: Assess the impact of neurological SLA on improvement of language functions in post-stroke patients.

PATIENTS AND METHODS

Materials and methods: The study covered a total of 82 patients aged 40-80, of both sexes, with stroke-induced cognitive deficits. They were in-patients of the Clinic Of Rehabilitation And Physical Medicine of the "WAM" Teaching Hospital in Łódź. The study comprised two groups. The study group consisted of post-stroke patients with aphasia, who were referred to four-week comprehensive program of neurological SLA therapy earlier (about a month) after experiencing stroke. The group comprised 44 patients. Six months after the stroke, the patients underwent another four weeks of neurological SLA. The control group consisted of post-stroke patients with aphasia. The group comprised 38 patients. The four-week neurological SLA therapy was applied more than six months after stroke ("late therapy"). The patients were ascribed to the groups randomly. Language abilities were evaluated with the Aphasia Dynamics Assessment Scale (Polish: Skala Oceny Dynamiki Afazji, abbrev. SODA).

RESULTS

Results: The study showed that neurological SLA helped patients in both the study and control group to significantly regain their language functions. However, greater improvement was found in the study group, which underwent neurological SLA twice, which proves that duration of the therapeutic process is an important factor.

CONCLUSION

Conclusions: neurological SLA was beneficial for both groups, regardless of the time that elapsed between stroke and start of the therapy. neurological SLA therapy allowed patients to restore part of their language functions, both in the study and control group. The sooner neurological SLA is implemented and the longer its duration, the more beneficial it is to patients.

The effect of smoking on back pain intensity in rehabilitated patients treated conservatively and surgically for discopathy

INTRODUCTION

Back pain is now a very common phenomenon. It is caused by various pathologies in the area of the motor unit of the spine. These changes can cause pressure on the nerve structures within the spinal canal, resulting in various ailments. Pain is the most common symptom. In most cases, patients are qualified for conservative management. In the case of neurological deficits, the patient is qualified for spinal surgery. Unfortunately, surgical treatment is not always 100% effective therapy method. Moreover, many external factors, such as smoking for instance, can affect the process of tissue healing and decide on the time of recovery.

OBJECTIVE

The aim of the study was to assess the impact of smoking on back pain intensity in rehabilitated patients with discopathy treated conservatively and surgically.

MATERIAL AND METHODS

The study included 41 patients after surgical treatment (9 smokers) and 96 patients (20 smokers) undergoing conservative therapy for back pain due to discopathy. All patients underwent a multidirectional rehabilitation programme at the Department of Rehabilitation and Physical Medicine of the Medical University in Łódź.

RESULTS

The Laitinen scale was used to assess the patients' pain. Rehabilitation of patients with back pain due to discopathy had a significant analgesic effect (p <0.0001). Furthermore, there was observed a statistically significant effect of smoking on the level of pain intensity on the Laitinen scale in the group of patients who underwent surgery (p <0.0469). The smokers operated on had significantly worse results.

CONCLUSIONS

1) Complex rehabilitation of patients with back syndrome pain due to discopathy demonstrated significant analgesic effectiveness. 2) Smoking significantly worsens the results of the therapy in patients who underwent surgery.

OVERVIEW OF WELLNESS METHODS FOR PEOPLE PRACTICING SPORTS

The term "wellness" embraces a wide spectrum of methods that impact the human body by restoring its capabilities and functions, which were previously depleted as a result of increased physical and mental activities such, i.e. sport. Judging by the number of amateur, semi-professional, and professional sporting events at local and national levels, societies consider sports a major part of their everyday lives. A growing percentage of the population is exposing their bodies to various strains, which may result in fatigue, overtraining and injuries, and so the market demand for recovery-related services is on the rise. Therefore, this paper is an overview of the most important and the latest wellness systems and methods applied in today's sport. They divide into three areas: pedagogical, psychological and medical-biological. Among the most popular treatments are: light radiation with infrared rays, cryotherapy, electrotherapy, magnetotherapy, ultrasound and laser therapy, as well as a sauna, paraffin compress, mud compress and brine baths. In a broader context, the paper also acknowledges the growing demand for better body recovery methods and the latest developments in the field of sport physiotherapy.

[Stochastic resonance method in physiotherapy - a review of the literature]

Non-linearity is an important feature of many human body structures that may result from deterministic properties of the body and noise. Noise is defined as accidental or irregular fluctuations or disturbances that are not part of the signal. Stochastic resonance (SR), the term originally used in a very specific context, is now widely used to describe any phenomenon in which the presence of noise in a nonlinear system is better for the quality of the output signal than its absence. The conducted research for the needs of physiotherapy consists in assessing the impact of the platform generating forced mechanical vibrations with specific parameters in selected disease entities, sports disciplines, as well as prevention. The aim of the work is to discuss the stochastic resonance method and to analyze the results of the most important works discussing the use and effectiveness of therapeutic impact on the human body. The use of the stochastic resonance method enforces mechanical vibrations, which are characterized by the variability of rhythm, amplitude and direction of vibrations, which enforces postural adjustment regulated by the CNS and response to stimuli that disturb the body's balance. The analysis of the effectiveness of therapeutic impact in the field of body balance disorders, reeducation of locomotion in people with partial spinal cord injury, motor motility and changes in hormonal concentrations was carried out. Stochastic resonance therapy can reduce or eliminate dysfunction in many disease entities, however, further studies are needed to assess the effectiveness of the therapy.

CD34+ Stem Cell Treatment for Knee Osteoarthritis: A Treatment and Rehabilitation Algorithm

Osteoarthritis is a group of multiple overlapping pathological conditions that cause destruction of articular cartilage and other structures of the joint. It is a progressive disease that leads to limitations of physical activity. New forms of treatment are therefore sought to alleviate the clinical symptoms of osteoarthritis and avoid surgery. Stem cell based therapy is an emerging field in orthopaedics. This study describes the treatment of knee osteoarthritis with CD34+ stem cells at the Medical Magnus Outpatient Clinic in Lodz, Poland, together with the treatment and rehabilitation algorithm developed for maximum effectiveness of this procedure. The algorithm includes 3 rehabilitation stages: preoperative, hospitalization and outpatient periods.

[An assessment of the effectiveness of comprehensive neurorehabilitation in patients after ischemic stroke]

OBJECTIVE

Introduction: Comprehensive rehabilitation after stroke is to help the patient recover optimal physical and mental condition. The multidirectional approach to the patient implemented by a multidisciplinary team: physicians, physiotherapists, neurologopedians and neuropsychologists allows the best use of the patient's potential. The aim: To evaluate the effectiveness of comprehensive neurological rehabilitation of patients after ischemic stroke.

PATIENTS AND METHODS

Materials and methods: The 90 patients after ischemic stroke were examined. The first examined group (45 people) consisted of patients rehabilitated at the Department of Rehabilitation and Physical Medicine of the WAM University Hospital in Lodz. The second examined group number (45 people) consisted of patients waiting for admission to the Department of Rehabilitation, who were rehabilitated in environmental conditions. The patients were examined twice: first before the rehabilitation (study I) and then at the end of rehabilitation program (study II). The ADL Index by Barthel was used to assess the functional status of the patients. In addition, speech disorders (SODA scale) and emotional state (Beck Depression Scale) were assessed in patients.

RESULTS

Results: Both individuals after stroke rehabilitated in hospital and those rehabilitated in environmental conditions achieved a significant improvement in activities of daily living and improvement in speech - symptoms of aphasia were withdrawn. However, only stroke patients rehabilitated in hospital conditions achieved a significant improvement in the emotional state.

CONCLUSION

Conclusions: Stroke patients rehabilitated in hospital conditions have significantly improved their functional status and emotional state compared to patients rehabilitated in environmental conditions.

[An assessment of the functional status in the neurorehabilitation of patients after ischemic stroke]

OBJECTIVE

Introduction: In this article, the authors focused on the symptoms of ischemic stroke and the effect of neurorehabilitation methods on the functional status of patients after ischemic stroke. The aim of the study was to evaluate and compare the functional status of patients after ischemic stroke with improved classic kinesiotherapy, classic kinesiotherapy and NDT-Bobath and classic kinesiotherapy and PNF.

PATIENTS AND METHODS

Materials and methods: The study involved 120 patients after ischemic stroke. Patients were treated in the Department of Rehabilitation and Physical Medicine USK of Medical University in Lodz. Patients were divided into 3 groups of 40 people. Group 1 was rehabilitated by classical kinesiotherapy. Group 2 was rehabilitated by classic kinesiotherapy and NTD-Bobath. Group 3 was rehabilitated by classical kinesiotherapy and PNF. In all patient groups, magnetostimulation was performed using the Viofor JPS System. The study was conducted twice: before treatment and immediately after 5 weeks after the therapy. The effects of applied neurorehabilitation methods were assessed on the basis of the Rivermead Motor Assessment (RMA).

RESULTS

Results: In all three patient groups, functional improvement was achieved. However, a significantly higher improvement was observed in patients in the second group, enhanced with classical kinesitherapy and NDT-Bobath.

CONCLUSION

Conclusions: The use of classical kinesiotherapy combined with the NDT-Bobath method is noticeably more effective in improving functional status than the use only classical kinesiotherapy or combination of classical kinesiotherapy and PNF patients after ischemic stroke.

Location of the ischemic focus in rehabilitated stroke patients with impairment of executive functions

BACKGROUND

Executive dysfunctions are part of the clinical symptoms of a stroke and can inhibit the process of rehabilitation. Patients with impaired executive functions may manifest aggression, impulsiveness, impaired thinking and planning.

OBJECTIVES

The aim of this study was to assess the effect of the ischemic focus location on the effectiveness of physiotherapy in improving the executive functions in patients after stroke.

MATERIAL AND METHODS

Ninety patients after unilateral ischemic cerebral stroke were studied. We studied 45 patients treated at the Department of Rehabilitation and Physical Medicine of the WAM University Hospital of Lodz for 5 weeks. The rehabilitation program included: kinesitherapy, physiotherapy, speech therapy, psychological consultations and psychotherapy. The control group consisted of patients who were waiting for admission to the Department of Rehabilitation. The patients in both groups were divided into three subgroups with different locations of stroke: front, back and subcortical. Executive functions were measured by the Wisconsin Card Sorting Test (WCST), the trail making test (TMT - A, TMT - B), the verbal fluency test (VFT).

RESULTS

Patients rehabilitated in the hospital with the front and subcortical lesion location reported improvement in executive functions in terms of a greater number of the analyzed indicators of the Wisconsin Card Sorting Test (WCST) than those with the back lesion location. Patients rehabilitated at home with the subcortical lesion location did not experience a significant improvement in executive functions in any of the analyzed indicators of the Wisconsin Card Sorting Test (WCST). Most of the indicators, with the exception of the total errors of Wisconsin Card Sorting Test (WCST) and TMT B, have not been modified by the location of stroke.

CONCLUSIONS

Executive dysfunction occurs not only in patients with an anterior location of the stroke, but also in the posterior and subcortical locations. Patients with a subcortical location of the stroke require more treatment to mitigate the dysfunction.

Rehabilitation in multiple sclerosis

The aim of the study is to present a strategy of rehabilitation in multiple sclerosis on the basis of the latest developments in the field of physiotherapy. The publications on the problem discuss a wide range of methods of physiotherapy that can be used in order to reduce the degree of disability and alleviate the symptoms associated with the disease. The complexity of the disease, the difficulty in determining the appropriate treatment and a wide range of symptoms require a comprehensive approach to the patient, which would include both pharmacology and neurorehabilitation. Rehabilitation, which includes psychotherapy and symptomatic therapy, is regarded nowadays as the best form of treatment for multiple sclerosis. An indepth diagnostic assessment of functional status and prognosis should be carried out before the start of the rehabilitation process. The prognosis should take into account the mental state, the neurological status and the awareness of the patient. The kinesiotherapy program in multiple sclerosis is based on a gradation of physiotherapy which assumes a gradual transition from basic movements to more complex ones till global functions are obtained. The most appropriate form of treatment is functional rehabilitation combined with physical procedures. Recent reports indicate the need for aerobic training to be included in the rehabilitation program. The introduction of physical activities, regardless of the severity of the disease, will reduce the negative effects of akinesia, and thus increase the functional capabilities of all body systems.

[The impact of dynamic platform exercises on knee joint muscle strength in patients with gonarthrosis treated with microfracture method]

Osteoarthritis is the most common joint disease. Gonarthrosis is one of the most serious diseases the highly developed modern medicine must face. The number of patients suffering from joint pain and progressive disability is growing, especially in economically developed countries. Over the years, the disease has been considered merely as a symptom of aging and the effect of "wear and tear" of the cartilage. At present it is known that the degenerative joint disease is of chronic and progressive nature and its pathogenesis is complex.

AIM

The aim of the study was to determine the impact of dynamic platform exercises on knee joint muscle strength in patients with gonarthrosis treated with microfracture method.

MATERIALS AND METHODS

The study included 120 patients of both sexes, aged 40 to 65 years, height range1.60-1.90 m., weight 50- 100 kg. Patients were divided into two groups. Group I of 60 patients after knee arthroscopy (with performed microfractures on the articular cartilage) who were subjected to physiotherapy with the use of dynamometric platform and to isometric and dynamic exercises of muscles surrounding the knee joint. Group II (control) of 60 patients after knee arthroscopy (with performed microfractures on the articular cartilage), who were subjected only to isometric and dynamic exercises of muscles surrounding the knee joint. The patients underwent rehabilitation according to the same rehabilitation program suggested by the Medical Magnus Clinic in Lodz, which consisted in performing daily exercises in open and closed kinetic chains. All Group I and II patients were examined three times: before the start of the rehabilitation, after 4th week of rehabilitation (on the average 20 days of the procedures) and 3 months afterwards. The clinical examination included the measurement of muscle strength using Lovett test.

RESULTS

It has been demonstrated that the introduction of modern highly specialized physiotherapy contributes to the improvement of the outcome and to the shortening of the treatment duration. A significant improvement was observed in all the examined patients at all stages of rehabilitation in relation to the baseline values.

CONCLUSIONS

The conducted modern physiotherapy has a significant effect on the condition of patients after surgery. Different exercises on dynamometric platform combined with static and dynamic exercises exert a positive impact on the strengthening of muscles surrounding the knee joint, which in time perspective results in better quality of life of the patients.

[The assessment of the impact of rehabilitation on the pain intensity level in patients with herniated nucleus pulposus of the intervertebral disc]

Back disorders are very common phenomena in modern society. One of the methods of spinal pain treatment is performing surgery. Unfortunately, this method is not one hundred percent effective. Some patients show no improvement after surgery, the pain persists and even increases. In these cases, it is reasonable to use the term Failed Back Surgery Syndrome (FBSS), i.e. back pain syndrome after unsuccessful spine surgery.

AIM

The aim of the study is to assess the impact of rehabilitation on the pain intensity level in patients with FBSS.

MATERIALS AND METHODS

The study was conducted in a group of 38 patients aged from 32 to 87 (mean age 61 years), including 20 women and 18 men. All patients were operated for spinal pain syndrome. Afterwards, they underwent rehabilitation because of persisting pain after the surgery. For the pain assessment was used The Visual- Analogue Scale and The Laitinen Modified Questionnaire Indicators of Pain. The results were statistically analyzed.

RESULTS

The study showed the high efficacy of specialized rehabilitation in patients with FBSS.

CONCLUSIONS

The rehabilitation in patients with FBSS has a significant analgesic effect. Rehabilitation should be a gold standard in patients with FBSS.

[The assessment of the impact of rehabilitation on the pain intensity level in patients with herniated nucleus pulposus of the intervertebral disc]

Back pain may be caused by many factors. In many cases it is difficult to unambiguously determine a cause of the pathology, which can involve various structures in the spine. In this paper we will discuss the symptoms associated with the degenerative changes of the intervertebral disc, which involve, among others, its bulging, dislocation and pressure on the surrounding structures. These problems require an adequate clinical and imaging diagnostics in order to implement an appropriate treatment. In the first place, it should be based on the conservative methods (such as: pharmacotherapy, rehabilitation and lifestyle changes). Only in the absence of improvement it is recommended to consider a surgical treatment.

AIM

The aim of the study is to assess the impact of rehabilitation on the pain intensity level in patients with herniated nucleus pulposus of the intervertebral disc.

MATERIALS AND METHODS

The study was performed in 46 patients (age range: 19-85), including 26 women and 20 men. On the basis of imaging, all patients showed the presence of a slipped disc with disc herniation. The patients were treated conservatively. For pain assessment was used the The Laitinen Modified Questionnaire Indicators of Pain and The Visual- Analogue Scale. The results were statistically analyzed.

RESULTS

The results clearly demonstrate the analgesic efficacy of specialized rehabilitation in the spinal pain syndrome in a discopathy with a spinal disc herniation of an intervertebral disc.

CONCLUSIONS

The rehabilitation of patients with a back pain due to the presence of herniated nucleus pulposus has a significant analgesic effect. In the case of a presence of the herniated nucleus pulposus, the rehabilitation should be considered in a first place. If no improvement, a possible surgery should be considered. An important element of a conservative treatment is an effective rehabilitation, which is of vital economic importance, because a therapy including surgery usually requires subsequent rehabilitation and is much more expensive.

[The use of fascial distorsion model (FDM) in patient with limited mobility in the shoulder joint - a case report]

FDM is the anatomical model in which clinical signs in conjunction with the patient's body language allow to diagnose one or more of the six specific distortions of the fascial system described by the creator of the concept of FDM and doctor-osteopath Stephen Typaldos.

AIM

The aim of the study is to present the use of therapy Fascial Distorsion Model to patient with limited mobility in the shoulder joint.

A CASE REPORT

Here we report a 32 year old female patient with painful limitation of motion in the shoulder joint right continuing for three weeks. The patient is an office worker, three times a week swims. Pain appears periodicaly and only in certain ranges of motion of the right upper limb. In the functional study by FDM it is continuum distortion and triggerband distortion. Then the appropriate therapeutic techniques were used.

CONCLUSIONS

The patient regained full range of motion in the shoulder joint after using FDM techniques without pain that prevented her making a move. During the test, the patient performed functional movements in the full range of movement without pain. Techniques of the FDM are an interesting complement workshop therapy which is treating limits in the range of motion and pain in the joints.

[The overall assessment of psychological well - being of patients with multiple sclerosis after the application of physical therapy. Part 2]

INTRODUCTION

Multiple sclerosis is a chronic demyelinating disease of the central nervous system, which results a progressive disability. The disease reduces the quality of life of patients, changes the general health perceptions, and also limits performing social roles because of emotional problems.

THE AIM

Evaluation of the impact of the methods of rehabilitation to improve the mental health of patients with multiple sclerosis, and also to change individual parameters included in the overall assessment of mental health.

MATERIAL AND METHODS

The study was conducted in 2010-2014 at the Department of Physical Medicine and Rehabilitation in Lodz. The study included 120 patients with multiple sclerosis. Patients were classified into 4 test groups: in the first was used the laser, in the second - laser and magnetostimulation, in the third - kinesiotherapy, and in the fourth - magnetostimulation. The tests were carried out three times. To evaluate the quality of life was used Quality of Life Questionnaire (MSQOL-54), analyzed the overall assessment of mental health.

RESULTS

The improvement in a range of parameters, an overall assessment of the quality of mental health has allowed to get a better overall psychological well-being. ,There was oserved a statistically significant difference at the level of p<0.001 between groups in 4/5 investigated parameters, statistically significant differences weren't obserwed at the evaluation of cognitive functions. The greatest improvement was observed in Group II and Group IV.

CONCLUSIONS

In the examination it was confirmed an effectiveness of physical treatment, such a the laser radiation and magnetostimulation. Synergism of both methods in their biological activity, allows for evoke of hysteresis fenomenon, resulting in the maintenance of the treatment effects after cessation of rehabilitation. Applying the classical kinesiotherapy only doesn't allow to get long-term effects.

[New physical methods in osteoarthritis treatment]

Osteoarthritis is a chronic disease in which the pathological processes start from the catabolism of cartilage extracellular matrix and next extend on the whole joint. Therefore, it is important to diagnose the disease and determining treatment, selecting individually for each patient. The main health problems presents by every patients is pain, which decreases the everyday functioning and quality of life. The paper presents the definition of the disease and new therapeutic methods which improve the quality of life, as well as reduce intensity of pain.

[Effectiveness of early physiotherapy treatment for ischaemic stroke patients suffering intercurrently from post-stroke depression and/or hemispatial neglect syndromes]

Wstęp: Depresja poudarowa i zespoł pomijania stronnego są jednymi z szeregu zaburzeń neurologicznych występujących jako konsekwencje incydentu udarowego. Oba zaburzenia uważa się za czynniki negatywnie wpływające na szybszy powrot pacjenta do zdrowia. Zadaniem wczesnej fizjoterapii po incydencie udarowym jest poprawa funkcji motorycznych oraz poprawa jakości życia pacjenta. Materiał i metody: W badaniu wzięło udział 51 pacjentow zakwalifikowanych do wzięcia udziału w "Narodowym Programie Profilaktyki i Leczenia Chorob Układu Sercowo-Naczyniowego na lata 2006-2008 POLCARD". Wyniki badań pacjentow notowano w skali Barthel, NIH oraz Geriatrycznej Skali Oceny Depresji. Analiza statystyczna została wykonana w programie STATISTICA 6PL za pomocą testu Wilcoxona dla prob zależnych. Wyniki: Analiza wynikow wykazała, że osoby z zespołem zaniedbywania osiągnęły większy przyrost punktow w skali Barthel niż osoby bez zespołu pomijania stronnego (p≤0,05). Natomiast badanie osob z depresją poudarową wykazały większy przyrost punktow w skali Barthel niż pacjenci, u ktorych depresja nie została stwierdzona. Wnioski: Skuteczność wczesnej fizjoterapii zależy od ciężkości udaru, stopnia niepełnosprawności oraz czynnikow zaburzających, takich jak m.in. agnozja wzrokowo-przestrzenna lub depresja. Jednakże pacjenci ze wspołistniejącymi zespołami neurologicznymi poddani kompleksowej fizjoterapii we wczesnym okresie po udarze mozgu maja prawdopodobnie większą rezyliencję w zakresie motywacji, zdolności adaptacyjno-kompensacyjnych, czyli generalnie dotyczących plastyczności mozgu.

[The education influence on effects of rehabilitation in patients after stroke]

Patients after stroke face a new situation where some educational and pedagogical actions should be reinitiated. Stroke often causes a break away from the previous lifestyle. It the acute phase it excludes the possibility of employment or performance of household duties that were carried out before or indulging in previously preferred ways of spending free time. Patients often abandon the habits that they developed before stroke, inclusive of hygienic habits. Therefore, it is an important objective of rehabilitation to reinstate in stroke patients behaviours characteristic of their peers, which would mark the beginning of their own care for health. The pedagogic and educational activities should lead to a transformation in the patient. This could be one of the factors in facilitating the patient's return to previous forms of activity.

AIM

The aim of this study was to analyze progress in patient's rehabilitation and satisfaction, to assess impact of health education on higher satisfaction and better knowledge in stroke patients as well as on their recovery. Another aim was to assess the factors that maximize the patients' chances of returning to the labor market.

MATERIALS AND METHODS

The study involved 30 patients after stroke, 8 women and 22 men, over 40 years of age, who underwent either early or late rehabilitation, the type of which affected the time of treatment. The minimal duration of the patient's stay was 21 days, in which time an individually tailored way of education, rehabilitation, treatment and care was implemented. The study used a questionnaire and the Bartel and the Rankin scales. The subject of the analysis consisted of 22 questions that were based on hypotheses. They assessed the facts, the sources of information, knowledge and subjective feelings of the patients concerning the education carried out by the rehabilitation team and its impact on the patients' rehabilitation.

RESULTS

A highly significant (p<0,01) improvement to patients' health and an increase in their knowledge were observed in the rehabilitation.

CONCLUSIONS

During the rehabilitation patients gained a significant improvement to their health, which resulted in more independence in daily living. The implemented health education has an effect on the scope of the patients' knowledge during and after rehabilitation, which translates into a higher satisfaction from the patient's education. The acquired knowledge and skills increase the chances of the patient to return to activities and participation in social life at a satisfactory level. The members of the rehabilitation team, especially the physicians, play an important role in health education of patients.

[Assessment of degree of functional efficiency patients with the gonarthrosis after applying physiotherapy]

Gonarthrosis is the most important problem of contemporary medicine. Social and economic aspect of this phenomenon caused the World Health Organization gave it the status of "disease of civilization".

AIM

The aim of the study was assessment of the impact chosen models of physiotherapy proceedings on the functional efficiency of patients with the gonarthrosis.

MATERIALS AND METHODS

In the study took part in 120 patients of both sexes divided into 4 groups. Group I - 30 patients with the gonarthrosis who have been applied electrostimulation of Kot'z and static exercises with biofeedback of extensors and flexors of the knee joint. Group II - 30 patients with the gonarthrosis who have been applied electrostimulation of Kot'z and dynamic exercises of muscles working on the knee joint. Group III - 30 patients with the gonarthrosis who have been applied static exercises with biofeedback of extensors and flexors of the knee joint, without electrostimulation. Group IV - 30 patients with the gonarthrosis who have been applied dynamic exercises of muscles working on the knee joint, without electrostimulation. Participants in the project were examined twice (before the starting and after finishing rehabilitation) and the level of the functional efficiency of patients was assessed based on results of the Functional Lequesne Index for knee joints.

RESULTS

Results collected at this work are confirming the dominant role of the model of therapy from the group I (Kot'z electriostimulation and static exercises with biofeedback) in the forming of the functional efficiency of patients with the gonarthrosis. Results of this group, in the statistically significant way differ from of the patients from the group III (only static exercises) and IV (only dynamic exercises). No significant diferences between groups I and II confirm the tkey role in the forming of the result of Kot'z electrostimulation.

CONCLUSIONS

Combination of kinesio exercises and Kot'z electrostimulation influences significally on increasing of the functional efficiency patients with gonarthosis. Out of all analysed models of therapy it turned out that the most effective is combination of "Russian stimulation" and static exercises with biofeedback.

[Assessment of the pain patients with the multiple sclerosis after applying the physiotherapy treatment]

Multiple sclerosis is one of the most common demyelinating disease of the CNS connected with the autoimmune action. The effect of the disease is progressive disability, and one of the symptoms is pain. In relieving pain in the course of MS physical procedures and exercises of physiotherapy are used.

AIM

The aim of the study was assessment of the pain in patients with the multiple sclerosis after applying laser radiation, magnetostimulation and kinesiotherapy.

MATERIALS AND METHODS

The studied material was consisted of 120 patients with multiple sclerosis of both sexes (82 women and 38 men) aged 21-81 years. Patients were randomly divided into 4 treatment groups and the assesment was performed three times. In the first group laser therapy, in the group II laser and magnetostimulation, in the third group kinesiotherapy, in the fourth group magnetostimulation was used. The same program of physiotherapy in all groups was used. All patients were performed the following tests to assess of the pain: The Laitinen Modified Questionnaire Indicators of Pain of and the Visual- Analogue Scale (VAS).

RESULTS

In all treatment groups was observed tends to decrease a result of a point in The Laitinen Modified Questionnaire Indicators of Pain and the Visual-Analogue Scale (VAS). Correlation between groups demonstrated statistically significant result on the level p<0.05 in the group where the laser treatment was applied towards group II assessed with parameter of the Questionnaire of Pain according to Laitinen, as well as towards group II and III assessed with parameter - of the Visual Analogue Scale (VAS). The good result, i.e. the reduction of the spot value, after the III examination towards the preliminary examination were got in the group II.

CONCLUSIONS

Laser radiation is an effective method which has an analgesisc action. The combination of laser radiation and magnetostimulation reduces pain in patients with multiple sclerosis, and also allows to maintain a therapeutic effect even after the cessation of the application of these procedures, which indicates the possibility to elicitation the biological phenomenon of hysteresis in these methods.

Application of laser radiation and magnetostimulation in therapy of patients with multiple sclerosis

BACKGROUND

Multiple sclerosis is one of the most common neurological disorders. It is a chronic inflammatory demyelinating disease of the CNS, whose etiology is not fully understood. Application of new rehabilitation methods are essential to improve functional status.

OBJECTIVE

The material studied consisted of 120 patients of both sexes (82 women and 38 men) aged 21-81 years. The study involved patients with a diagnosis of multiple sclerosis. The aim of the study was to evaluate the effect of laser radiation and other therapies on the functional status of patients with multiple sclerosis.

METHODS

Patients were randomly divided into four treatment groups. The evaluation was performed three times - before the start of rehabilitation, immediately after rehabilitation (21 days of treatment) and subsequent control - 30 days after the patients leave the clinic. The following tests were performed for all patients to assess functional status: Expanded Disability Status Scale (EDSS) of Kurtzke and Barthel Index.

RESULTS

Results of all testing procedures show that the treatment methods are improving the functional status of patients with multiple sclerosis, with the significant advantage of the synergistic action of laser and magneto stimulation. The combination of laser and magneto stimulation significantly confirmed beneficial effect on quality of life. The results of these studies present new scientific value and are improved compared to program of rehabilitation of patients with multiple sclerosis by laser radiation which was previously used.

CONCLUSIONS

This study showed that synergic action of laser radiation and magneto stimulation has a beneficial effect on improving functional status, and thus improves the quality of life of patients with multiple sclerosis. The effects of all methods of rehabilitation are persisted after cessation of treatment applications, with a particular advantage of the synergistic action of laser radiation and magneto stimulation, which indicates the possibility to elicitation in these methods the phenomenon of the biological hysteresis.

[Physiotherapeutic proceeding in symptomatic calcaneal spur treatment]

Calcaneal spur is one of the most common disorders associated with foot pain. According to appearance of pain in each step during the day, it is important to find the most effective method of treatment. This article is a review of medical reports about non-operative treatment method. It shows that ultrasound therapy was the most common physical intervetion used so far, and mostly occurs to be effective. However one of the comparative studies improves higher efficiency of phonopheresis. Another comparative study, shows higher efficiency of combined ultrasound and laser therapy, than exclusive laser therapy. There haven't been found any articles that would evaluate efficacy of electrotherapy and short wave diathermy (electric field) in the treatment of mentioned disorder. Studies that describe the effect of ESWT treatment were also analyzed in this article, and all of them confirm its effectiveness in heel spur therapy, showing no side-effects. Cryotherapy also causes positive effect in treatment of this disorder. However Cryoultrasound therapy that uses the energy of two interconnected terapeutic techniques which is cryotherapy and ultrasounds, proved to be more effective.

[The overall assessment of the quality of the physical health of patients with multiple sclerosis after the application of physical therapy. Part 1]

INTRODUCTION

Multiple sclerosis is one of the demyelinating diseases of the central nervous system. The biggest problem of patients affected by this disease are physical limitations which force many times to changes in employment and dependent on their families.The progressive disability significantly reduces the quality of life of patients with MS.

MATERIAL AND METHODS

The study involved 120 patients with multiple sclerosis at the age of 21 - 81 years. Patients were divided into four groups, and the test was performed three times. In the first group was used laser therapy, group II laser and magnetostimulation, in the third group kinesiotherapy in the fourth group magnetostimulation. In all patients MSQOL (Quality of Life Questionnaire-54) was carried out, this survey analyzed overall assessment of physical health.

RESULTS

In all test groups was observed tends to decrease as a result of a point in Quality of Life Questionnaire MSQOL-54 and continuation in this relationship even after cessation of use of these therapies. The correlation between the two groups showed a statistically significant result at the level of p <0.001 in the group I and II in relation to group III and IV.

CONCLUSIONS

Synergic action of laser radiation and magnetic stimulation, causing a plurality of changes at the cellular and tissue level, has a beneficial effect on improving functional status, and thereby improves the quality of life of patients with multiple sclerosis. Thanks to physical therapy, it is possible to achieve long-term effects of therapy, which proves the biological hysteresis phenomenon. Such results can not be achieved with using monotherapy only - by kinesiotherapy.

[Comparison of the effects of rehabilitation in stroke patients rehabilitated in stationary conditions and the home]

Rehabilitation after stroke is to help the patient recover optimal physical condition, psychosocial and vocational. Standard of care is to ensure comprehensiveness and continuity of the rehabilitation process.

THE AIM OF THE STUDY

Was to compare the effects of rehabilitation in stroke patients rehabilitated in the hospital and at home.

MATERIAL AND METHODS

The 90 patients after ischemic stroke were examined. The first examined group (45 people) consisted ofpatients rehabilitated at the Department of Rehabilitation and Physical Medicine of the WAM University Hospital in Lodz. The second examined group number (45 people) consisted of patients waiting for admission to the Department of Rehabilitation, who were rehabilitated in environmental conditions. The patients were examined twice: first before the rehabilitation (study I) and then at the end of rehabilitation program (study II). Functional status was examined with the Barthel ADL Index and the Brunnstrom scale.

RESULTS

Both individuals after stroke rehabilitated in hospital and those rehabilitated in environmental conditions achieved a significant improvement in functional of paretic limbs and improving independence in activities of daily living. However, the improvement observed in the hospital group was significantly higher. Better positive effects in patients included hospital rehabilitation is achieved through the implementation of comprehensive treatment of the involvement in the therapeutic process the entire interdisciplinary team.

CONCLUSIONS

The comprehensive stationary rehabilitation significantly affected on improving the functional ability of stroke compared to those rehabilitated in environmental conditions. Rehabilitation at home, even though it is associated with certain restrictions is an important element in the overall process of rehabilitation.

[The influence of high-tone power therapy on the functional status of patients with multiple sclerosis]

Multiple sclerosis is a chronic, inflammatory, demyelinating disease of the central nervous system, which is characterized by diverse symptomatology. Most often affects people at a young age gradually leading to their disability. Looking for new therapies to alleviate neurological deficits caused by the disease. One of the alternative methods of therapy is high - tone power therapy. The article is a comparison of high-tone power therapy and kinesis in improving patients with multiple sclerosis. The aim of this study was to evaluate the effectiveness of high-tone power therapy and exercises in kinesis on the functional status of patients with multiple sclerosis.

MATERIAL AND METHODS

The study involved 20 patients with multiple sclerosis, both sexes, treated at the Department of Rehabilitation and Physical Medicine in Lodz. Patients were randomly divided into two groups studied. In group high-tone power therapy applied for 60 minutes, while in group II were used exercises for kinesis. Treatment time for both groups of patients was 15 days. To assess the functional status scale was used: Expanded Disability Status Scale of Kurtzke (EDSS), as well as by Barthel ADL Index. Assessment of quality of life were made using MSQOL Questionnaire-54. For the evaluation of gait and balance using Tinetti scale, and pain VAS rated, and Laitinen. Changes in muscle tone was assessed on the basis of the Ashworth scale.

RESULTS

Both group I and II improved on scales conducted before and after therapy. In group I, in which the applied high-tone power therapy, reported statistically significant results in 9 out of 10 tested parameters, while in group II, which was used in the exercises in kinesis an improvement in 6 out of 10 tested parameters. Correlating the results of both the test groups in relation to each other did not show statistically significant differences.

CONCLUSIONS

High-Tone Power Therapy beneficial effect on the functional status of patients with multiple sclerosis. Obtaining results in terms of number of tested parameters allows for the use of this therapy in the comprehensive improvement of patients with multiple sclerosis. Exercises from the scheme kinesis favorable impact on the functional status of patients with MS and are essential in the rehabilitation of these patients. In any group, no adverse effects were observed.

[The use of Saunders lumbar traction in physiotherapy of patients with chronic lower back pain]

Pain of the lower back is one of the most common ailments in modem society. Such frequent occurrence of back pain syndromes is a serious medical and social problem. Despite numerous attempts, there have not been comprehensive or decisive publications on the therapeutic standard for back pain syndromes that would cover all the aspects of the ailment. Partial report can change the attitude and shed new light on the treatment of these syndromes. The aim of this study was to evaluate the use of Saunders lumbar tractions in patients with chronic lower back pain in comparison with the group of patients undergoing pharmacological treatment.

MATERIAL AND METHODS

The study included 140 patients with chronic lower back pain who were divided into two groups. Each group consisted of 70 persons of mixed gender (the age mean value was 45). Group I were treated with the use of Saunders lumbar traction and Group II (control group) were treated pharmacologically. The following scales were used to assess pain and mobility of the lumbar part of the vertebral column (before treatment, in-treatment, right after treatment and 30 days after treatment): Laitinen, VAS, Rolland-Morris questionnaire and Schober functional test. The statistical analysis was performed with Greenhouse-Geisser test of within-subjects effects.

RESULTS

In both the groups, a significant analgesic action and an improvement to spinal mobility were observed. Significantly better results were obtained in Group I where the patients had been treated with the use of Saunders lumbar traction.

CONCLUSIONS

The pharmacological treatment applied in Group II showed an analgesic action and influenced positively the functional parameters of the patients. The effects, however, were much worse than in Group 1 where axial Saunders traction was applied to the lumbar part of the vertebral column.

[The effect of neurorehabilitation on the functional state and muscle tone of upper limb in patients after ischaemic stroke]

Rehabilitation of upper limb in patients after ischemic stroke is a major challenge for modern neurorehabilitation. Function of upper limb of patients after ischemic stroke returns on the end of the rehabilitation comparing with another parts of the body. Below presents two groups of patients after ischemic stroke who were rehabilitated with use of the following methods: kinesiotherapy combined with NDT- Bobath method and kinesiotherapy only. The aim of this study was to assess the impact of kinesiotherapy only and NDT- Bobath method combined with kinesiotherapy on the functional state and muscle tone of upper limb in patients after ischemic stroke.

MATERIAL AND METHODS

The study involved a group of 40 patients after ischemic stroke with motor control and muscle tone problems of upper limb. Patients were divided into two groups, each of them included 20 people. Upper limb in group I was rehabilitated with the use of kinesiotherapy exercise however group II with the use of kinesiotherapy exercise combined with NDT- Bobath method (Neurodevelopmental Treatment Bobath). To evaluate the patients before and after rehabilitation muscle tone Asworth scale was used and to assess functional status Rivermead Motor Assessment (RMAIII) scale was used.

RESULTS

After 5 weeks of rehabilitation in group II in majority patients were observed decrease of muscle tone and improvement in upper limb functional status. In group I the muscle tone were also decreased and functional status were better but in smaller impact than in II group.

CONCLUSIONS

Classical kinesiotherapy combined with the NDT-Bobath method gives better results in neurorehabilitation of upper limb than the use of kinesiotherapy exercises only in patients after ischemic stroke.

[Evaluation of early physiotherapy in patients after surgical treatment of cruciate ligament injury by bone-tendon-bone method]

Anterior cruciate ligament (ACL) is one of the most important structures of the knee joint. It has a stabilizing function and causes sliding movement between the articular surfaces. Most frequently there comes to the anterior cruciate ligament injury during practicing sports such as skiing, football, sports which require sudden turns and those which are associated with jumps for height like basketball and volleyball. The aim of study was to evaluate of the outcomes of complex physiotherapy after reconstruction of anterior cruciate ligament by bone -tendon-bone (BTB) method.

MATERIAL AND METHODS

The study involved 41 patients, 8 women and 33 men, aged 20 to 45 years, body height 1.60-1.90 cm and body weight 50-100 kg. The patients were divided into two groups. Group I included 26 patients (3 women and 23 men) after arthroscopic ACL reconstruction. Group II--control-group included 15 patients (5 women and 10 men) after ACL injury but not subjected to the ligament reconstruction. The patients from both groups underwent rehabilitation according to the same rehabilitation program suggested by the Medical Magnus Clinic in Lodz, which consisted in performing daily exercises in open and closed kinetic chains. All group I and II patients were examined three times: after surgery (before the start of the rehabilitation), in the sixth week of rehabilitation and 12 weeks afterwards. The clinical examination included: measurement of the range of movement in the knee joint, the measurement of musculoskeletal strength with Lovett scale, knee pain assessment using Visual Analog Scale (VAS), transpatellar anthropometric measurement of the knee joint, linear measurements of the thigh and shin (at two points: 5 and 10 cm above the patellar apex and at two points: 5 and 10 cm below the patellar base).

RESULTS

Introduction of early highly specialized physiotherapy has been demonstrated to contribute to the improvement of the rehabilitation outcomes and to the shortening of the therapy. A statistically significant improvement has been obtained in all examined patients after anterior cruciate ligament reconstruction by bone - tendon - bone method at every stage of rehabilitation in relation to the initial values.

CONCLUSIONS

Early motor physiotherapy has a significant impact on the condition of patients treated both surgically and conservatively. The differences observed between the groups in the range of the measurement of movement in the knee joint, the measurement of musculoskeletal strength, severity of pain in the knee joint, transpatellar anthropometric measurement of the knee joint and linear measurements of the thigh and shin were caused by necessary surgery which leads to the conclusion that the therapeutic rehabilitation should be longer in the investigated group. In this group introduction of physical therapy with analgesic effects is also of importance. Taking into account good results observed in patients from the control group, who were treated conservatively, the possible indications for surgery should be carefully considered.

[Influence of toxin botulin on walk stereotype of children with juvenile cerebral palsy. The functional examination performed by BTS, comprehensive movement analysis system. A preliminary report]

INTRODUCTION

Juvenile Cerebral Palsy--is caused by damage of the motor control centers of the developing brain (cerebral refers to the cerebrum, which is the affected area of the brain, although the disorder probably involves connections between the cortex and other parts of the brain and palsy refers to disorder of movement). The clinical symptoms of juvenile cerebral palsy are very diversified and include gross and fine motor-coordination disorders, manual ability, locomotion, perception and response, speech, psychomotor retardation, emotional disorders. The primary therapeutic problem in children with cerebral palsy is learning to move in a lower position and learning to walk. The aim of this research is evaluation the action of the botulinum toxin on gait pattern of children with cerebral palsy. Application of a comprehensive BTS analysis of gait will get accurate, consistent EBM (Evidence Base Medicine) results.

MATERIAL AND METHODS

The children with pyramidal syndrome of juvenile cerebral palsy have been included in the examinations. The children have been divided into 2 random groups: group I--children treated with standard therapy a neurodevelopmental rehabilitation and classic kinesiotherapy, group II--hildren treated with standard therapy --eurodevelopmental rehabilitation, classic kinesiotherapy and a botulinum toxin. The children were examined three times: before the therapy, after 6 weeks of treatment and after 3 months of treatment. In the research BTS comprehensive motion analysis system have been used where influence of toxin botulin on walk stereotype of children was assessed.

RESULTS

The treatment connected with standard rehabilitation and using botulinum toxin brings quicker walk improvement. Comparing the above treatment methods of influence on the walk stereotype of children with juvenile cerebral palsy, we can confirm, that standard treatment brings regular improvement, still, it requires longer period of time, often even 3 months. Using botulinum toxin brings quicker walk improvement, after 6 weeks only, which is a clear, but short-term result.

CONCLUSIONS

Botulinum toxin has a positive effect on gait parameters in children, especially until 3 months, after this time parameters are not better..Concomitant treatment with standard therapy and botulinum toxin should be used becouse it is possitive treatment for locomotion of children with cerebral palsy.

[The effect of standard kinesiotherapy combined with proprioceptive neuromuscular facilitation method and standard kinesiotherapy only on the functional state and muscle tone in patients after ischaemic stroke]

The ischemic stroke is a disease of the central nervous system. Up until today there have been very few scientific findings concerning the most effective methods of patients rehabilitation. The authors of this article present two groups of patients after ischemic stroke who were rehabilitated with use of the following methods: kinesiotherapy combined with PNF (proprioceptive neuromuscular facilitation) method and kinesiotherapy only. The aim of this study was to assess the impact of kinesiotherapy only and PNF method combined with kinesiotherapy on the functional state and muscle tone in patients after ischaemic stroke.

MATERIAL AND METHODS

The study involved a group of 30 patients after ischaemic stroke. Patients were divided into two groups, each of them comprising 15 people. Group I was rehabilitated with the use of kinesiotherapy exercise and group II with the use of kinesiotherapy exercise combined with PNF method. To evaluate the patient before and after rehabilitation muscle tone Asworth scale was used and to assess functional status Rivermed Motor Assessment (RMA) scale was used.

RESULTS

Both in group I and II an improvement in muscle tone and functional status were noted. Better results were observed in group II in which patients were rehabilitated with the use of kinesiotherapy exercise combined with PNF method. All results in group I and II displayed a statistically significant improvement in functional status and muscle tone.

CONCLUSIONS

The use of the classical kinesiotherapy only had a noticeably smaller impact on improvement of functional status and muscle tone in patients from group I than the use of both: classical kinesiotherapy and PNF method which were employed in group II.

[The use of transdermal therapeutic systems in physical therapy]

Methods of the transdermal administration of drugs have long been sought in the medical field in order to ensure the noninvasive and painless transmission of the medicine. Such methods include the TTS (transdermal therapeutic system). It is a method, or rather a set of methods that allows the introduction of the drug to the sites of pathologically changed areas without the pharmacological burdening of the whole body. An important aspect of this treatment is that the substance can be introduced passively (even to unconscious or sanity-limited patients) or actively, i.e. exactly at the point of the pathological changes, thus avoiding contraindications for applications in the general purpose and discomfort of the patient. The transdermal therapeutic system can be found in various areas of medicine. It is also increasingly beginning to act as an alternative to a number of other areas such as pharmacotherapy, physical therapy, and cosmetology; as a precognitive application, hormonal substitution, nutritious, analgesic, anti-inflammatory, or anti-swelling application; an application for the treatment of scars, delayed fracture healing, the neuromuscular stimulation, trophy of tissues; or a bacteriostatic application. Further research in this area seems to have a great practical significance.

Evaluation of the effectiveness of vibroacoustic therapy treatment of patients with so-called "heel spur". A preliminary report

BACKGROUND

The so-called "heel spur" is a radiological term referring to adaptive bone growth as a result of chronic overload enthesopathy of the proximal attachment of the plantar fascia. The main cause of the pain is continued localised pressure on the surrounding soft tissues. Vibroacoustic wave therapy is a relatively new method gaining popularity among doctors, physiotherapists and patients. The aim of this study was to confirm the clinical efficacy of vibroacoustic therapy compared to laser and ultrasound therapy.

MATERIAL AND METHODS

The study enrolled 60 patients treated for plantar heel spurs who were divided into a study group of 40 patients who underwent vibroacoustic therapy and a control group of 20 patients treated with ultrasound and laser therapy. The outcome measure for evaluating the effectiveness of physiotherapy was a subjective assessment of pain intensity by VAS and the modified short-form McGill Pain Questionnaire.

RESULTS

The mean pain intensity score in patients undergoing vibroacoustic therapy decreased by about 2.6 points according to the VAS scale and 17 points according to the McGill questionnaire, compared to reductions of 0.6 and 6 points, respectively, in the ultrasound and laser therapy group. The correlation between subjective assessment of pain according to the VAS scale and palpation-based assessment of pain was significantly positive between the two groups, demonstrating similarity of the two scales, with a slight dominance of the group undergoing laser and ultrasound therapy.

CONCLUSIONS

These results represent a tentative confirmation of analgesic effectiveness of the vibro-acoustic method in musculoskeletal overload conditions. 2. In order to confirm its effectiveness, it is necessary to conduct further prospective randomized studies with blinding and evaluate the long-term results.

[Evaluation of the effectiveness of rehabilitation in patients after stroke with executive dysfunction]

INTRODUCTION

Executive dysfunction (DES) in the form of disturbances of conscious and flexible programming, organization and control of their own actions as part of the clinical picture of stroke. impairment of the executive mechanism may reduce the efficacy of treatment of patient. The aim of this study was to assess the impact of rehabilitation on improving executive functions in patients after stroke.

MATERIAL AND METHODS

The study involved 90 patients after a stroke. The study group comprised 45 patients, resident in the Department of Rehabilitation and Physical Medicine USK of Medical University in Lodz, which was implemented in 5 week rehabilitation program including: kinesiotherapy, physiotherapy, speech therapy classes and psychological consultation and psychotherapy. The control group consisted of patients waiting for admission to the Department of Rehabilitation. The study was conducted twice: the first time, before the start of rehabilitation, the second time at the end of five weeks of the rehabilitation process. Executive functions were assessed by means of: Test of Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT-A, TMT-B), Verbal Fluency Test (VFT).

RESULTS

In patients after stroke rehabilitation in the hospital was significantly greater improvement in executive function compared to those rehabilitated in environmental conditions.

CONCLUSIONS

Comprehensive rehabilitation in the hospital has a significant impact on improving executive functions in patients after stroke.

[Application of laser therapy in the physiotherapy of patients with multiple sclerosis]

Multiple sclerosis is a chronic disease of the nervous system, which main manifestations are disseminated demyelinated the changes in the central nervous system. The pathogenesis of this disease is still not known, the curative treatment is not possible. In connection with the alleged autoimmune genesis of MS patients are administered immunomodulatory drugs. Patients with multiple sclerosis suffer from a number of symptoms associated with this disease. The aim of this article is to present the main clinical symptoms characteristic of MS and to present biological effects of low-energy lasers used in the treatment of multiple sclerosis.

[NDT-Bobath method used in the rehabilitation of patients with a history of ischemic stroke]

Ischemic stroke is the third leading cause of death and disability in human. The vitally important problem after ischemic stroke is hemiparesis of the body. The most common methods used in improving the mobility of patients after ischemic stroke is a Bobath-NDT (Neuro-Developmental Treatment - Bobath), which initiated the Berta and Karel Bobath for children with cerebral palsy. It is a method designed to neurophysiological recovery of these vital functions that the patient was lost due to illness, and wants it back.

[Analgesic efficacy of magnetoledotherapy in patients with low back pain syndromes]

INTRODUCTION

Low back pain syndromes most often occur due to overloading of the musculoskeletal system. The cause is a frequent, improper lifting of heavy objects, most commonly by those working physically, with repetitive movements of bending and straightening of the trunk (turning and bending with load). This problem affects not only adults but also children and adolescents. There is a growing interest in new forms of analgesic therapy nowadays, especially in those that exhibit synergistic therapeutic effects. The aim of this work is to evaluate the analgesic efficacy of magnetoledotherapy in patients with lumbar--sacrum spinal pain syndromes caused by joints degenerative changes.

MATERIAL AND METHODS

The examination was carried out in 66 patients of both sexes aged 30 to 76 (average 54.7 +/- 13.8) with low back pain syndrome caused by spinal degenerative changes. The patients were divided into three groups according to the applied analgesic therapy (magnetoledotherapy, magnetostimulation, TENS currents). Level of pain has been evaluated four times in all patients--before the start of therapy and after 5, 10 and 15 applications with the use of the modified Laitinen Questionnaire and Visual-Analoque Scale (VAS).

RESULTS

Post therapy levels of pain in the studied patients decreased significantly. According to Laitinen questionnaire, the greatest improvement was observed in the group treated with magnetoledotherapy and TENS currents and the smallest improvement was observed in the group treated with magnetostimulation.

CONCLUSIONS

1. Magnetoledotherapy shows significant analgesic efficacy in patients with low back pain syndrome and shows no side effects. 2. Concurrent application of both the infrared radiation generated by LED's and magnetostimulation synergistically reinforces analgesic effect in patients with low back pain syndrome, especially in level of pain and frequency of its occurrence, which results in the increase of movement activity and decrease in administration of analgesics.

[Effect of low frequency magnetic fields used in magnetotherapy and magnetostimulation on the rehabilitation results of patients after ischemic stroke]

New methods of rehabilitation should be introduced in order to reduce disability resulting from stroke. During the twelve months of follow-up, effect of low frequency magnetic field (If mf) on the course of patient rehabilitation following ischemic stroke was evaluated on in-patient (acute and subacute period of the stroke) and outpatient (chronic period) basis with the use of Mathew et al's and Barthel's scales. Lf mf (20 procedures of 20-min. duration) of magnetotherapy (I group--placebo, II--group 5.6 mT induction, 10 Hz frequency and sinusoidal shape, III group--2.8 mT induction, 10 Hz frequency and sinusoidal shape) and magnetostimulation (IV group--M1P1 program of Viofor JPS system, 16 min a day) was applied as early as in the subacute period of the stroke (1-8 weeks). The data obtained were presented in the form of percentage changes in the pain levels as well as in the form of the arithmetical mean and standard deviation (X +/- SD). The ANOVA test was used for a statistical evaluation of the data obtained in the tests. The results obtained indicate beneficial effects of If mf in the III and IV group of patients in the Barthel's scale and Mathew scale, which were observed during the examination 12 months after the stroke. The recommended doses of If mf seem to be adequate to obtain therapeutic effects and may be used in the early period of rehabilitation. The neurological and functional improvement persisted for a long-period of the out-patient treatment, which was confirmed during the control examination 12 months after the ischemic stroke. As no adverse effects (which could be attributed to If mf), were observed, this method of physical therapy can be recognized as a safe one and worth making popular in clinical practice.

[Evaluation of magnetostimulation effectiveness in physiotherapy--questionnaire research]

The anonymous questionnaires which had been filled in by patients were analysed after the end of the magnetostimulation applied with Viofor JPS. The applicator in form of a mattress with maximum induction 45 microT was used. In the analysed group of 1742 patients, 5% of patients suffered from rheumatoid arthritis, 16% from central nervous system illnesses, 9% from injuries, 1.5% from allergies, 2% from infections, 5.4% from vessel illnesses, 1% from skin illnesses. 0.5% of the patients used monotherapy. 8% suffered from radicular symptoms, 30.7% from pseudoradicular symptoms, 17.4% from arthrosis, and 3.4% patients suffered from migraines and headaches. The complete abatement of complaints or the improvement was noted in 95.5% of patients, no improvement in 4.3% and 0.2% of patients became worse--82% of deteriorated patients were the ones that suffered from infections. The strongest analgesic action and the most frequent abatement were noted in patients after injuries and patients with headaches.

[Biological effects produced by the influence of low frequency electromagnetic fields on hormone secretion]

The article discusses the role of (electro)magnetic fields in hormone secretion in humans and animals. The best known hormone whose secretion may be disturbed by magnetic field is melatonin. The level of serotonin positively reacts to the presence of magnetic field in the environment-its level is raised. The effect of magnetic fields on other hormones has not as yet been described. It seems necessary to continue experimental and epidemiological research on living organisms (their hormone secretion) to standardise the norms of exposure with the aim of diagnostic and therapeutic application.

[Evaluation of the prognostic value of general motor activity for rehabilitation of patients after cerebral stroke]

Following cerebral stroke motor activity of the patient is dependent on the extensiveness of brain ischemia. Evaluation of this activity may be an exponent of brain ischemia extent. It can be used for the determination of predictability of patient survival and results of rehabilitation. Using Mathew and Barthel scales effectiveness of treatment and rehabilitation was evaluated four times during 12-month follow-up in patients of General Motor Activity Clinical Group II i III. The results obtained may be evidence of significant prognostic importance of evaluation of general motor activity of the organism in the initial period of treatment and rehabilitation only, i.e. within 3 months following cerebral stroke. However, it is no importance for evaluation of remote results (one year following cerebral stroke). The evaluation of general activity cannot be used to predict the dynamics of the improvement of neurological and functional status of patients undergoing rehabilitation following cerebral stroke.