Body mass index, overweight and obesity in married and never married men and women in Poland

The study examined the relationship between marital status and the body mass index (BMI) and the prevalence of overweight and obesity in the Polish population. The sample included 2,266 men and 4,122 women, 25-60 years of age, who were occupationally active inhabitants of Wroclaw, in southwestern Poland. Marital status was defined by two categories: never married and presently married, and two groups in each category were established on the basis of educational level: well-educated (12 or more years in school) and poorly educated (less than 12 years in school). The subjects were also divided into four age groups: 25-30, 31-40, 41-50, and 51-60 years. Height and weight were measured and the BMI was calculated. Three categories of the BMI were established: normal, BMI < 25.0 kg/m(2), overweight, BMI > or = 25 < 30 kg/m(2), and obese, BMI > or = 30 kg/m(2). In each age and educational group, married individuals had a higher BMI than those who were never married. With the exception of well-educated males 51-60 years, differences in the BMI between married and never married individuals increased with age. In general, married men and women were more likely to be overweight and obese than never married individuals. The results indicated a significant association (P < 0.001) between marital status and the BMI in both sexes. After age, marital status was the most important predictor of overweight/obesity among men (P < 0.001), whereas educational level did not have a significant role. Among women, age, marital status, and education were significantly (P < 0.001) related to the BMI.

Marital differences in blood pressure and the risk of hypertension among Polish men

The aim of the study was to evaluate the relationship between marital status and blood pressure, and to assess the risk of hypertension in adult Polish men, after adjustment for BMI. Material comprised the data of 2,271 healthy men, aged 25-60, occupationally active inhabitants of Wroclaw (south-western Poland). Arterial hypertension was diagnosed when systolic blood pressure (SBP) > or =140 mm Hg and/or diastolic blood pressure (DBP) > or = 90 mm Hg. The following categories of marital status and educational level were applied: never married vs. currently married, and well-educated vs. poorly educated, respectively. The data on lifestyle elements were obtained from questionnaires. Multi-factorial analyses of covariance (ANCOVA) were used to compare mean values of SBP and DBP in married vs. never married in subsequent age categories with BMI as a covariate. Independent effects of marital status, life-style variables and body mass index (BMI) on the risk of hypertension in men were analysed using the multifactorial models of logistic regression. In our analysis an interesting epidemiological phenomenon was observed. Never married men had on average higher SBP and DBP than married men. Never married had also a higher risk of hypertension when compared to married men, even when adjusted for different demographic, socio-economic, life-style variables, and even that never married men had lower BMI than married subjects. Marital differences in psychological status (prolonged stress and low social support), dietary intake (mainly sodium and potassium intake) and economic aspects of living alone are suggested as factors, which might explain at least partly the marital diversity in blood pressure and the risk of hypertension in men.

Secular trends in body height and body mass in 19-year-old Polish men based on six national surveys from 1965 to 2010

OBJECTIVES

The aim was to determine whether an intergenerational trend toward increased stature is slowing down, and whether body weight has recently increased among young men in Poland, as it has in Western European countries.

METHODS

Data were taken from six national surveys of 19-year-old Polish male conscripts from cohorts 1965, 1976, 1986, 1995, 2001, and 2010.

RESULTS

The mean stature of this population increased throughout the last 45 years from 170.5 cm in 1965 to 178.3 in 2010. However, the average gain in stature per decade declined from 2.4 cm in the period 1965 to 1976 to 0.8 cm per decade in 1995 to 2001, but increased to 1.0 cm in the last period. The average of body weight increased from 63.2 kg in 1965 to 73.1 in 2010 and body mass index (BMI) rose from 21.73 to 22.94 in the same period. The tempo of increase varied in different periods; between 1965 and 1986 an insignificant increase was observed (of circa 0.12); in 1986 to 1995 there was no increase, whereas the period of 2001 to 2010 witnessed a significant increase (of circa 0.76).

CONCLUSIONS

The trend of body size and stature increase within the Polish population, although decelerating, remained positive and steady during the last 45 years. No significant impact of the past half-century's socioeconomic crises was observed in these measures of growth. We concluded that during the economic crises some effective mechanism protecting the living conditions of the children and youth were operating within the population.

Relationship between early puberty and the risk of hypertension/overweight at age 50: evidence for a modified Barker hypothesis among Polish youth

The objective of this paper is to evaluate: (a) the association between BMI in childhood and adolescence and BMI at age 50, and (b) the association between timing of maturation at puberty and BMI at age 50 and the occurrence of high blood pressure. We explore whether differences in somatic and physiological factors observed among children with early or late onset of puberty indicates that this period of life could be critical for appearance of some CVD risk factors later in the life cycle. Our data include 135 males and 148 females, born in 1953, participants in the Wrocław Longitudinal Study. Data pertaining to their growth and several indices of sexual and skeletal maturation were collected yearly between age 8 and 18. Subsequently, their anthropometric traits were measured and cardiovascular health status was assessed at age 50. We find that BMI at distinct stages in the life cycle were positively correlated. Also BMI at 50 were positively associated with blood pressure at 50. Moreover, earlier maturation at puberty is associated with higher values of BMI at age 50. We also find that earlier pubertal maturation is an independent factor that influences the appearance of high blood pressure in adulthood.

SOCIOECONOMIC STATUS DURING CHILDHOOD AND HEALTH STATUS IN ADULTHOOD: THE WROCŁAW GROWTH STUDY

It has been widely observed that socioeconomic status (SES) is associated with frequency of cardiovascular disease. Both men and women of low socioeconomic position have increased risk of cardiovascular disease morbidity and premature death. In this study the relationship between SES in childhood, and health status at the age of 50 years was examined. Socioeconomic status in childhood was measured using objective (father’s educational level and number of children in the family) and subjective (self-assessed SES in childhood declared in early adulthood) indicators. Data from the Wrocław Growth Study were completed when subjects were 50 years old, and information concerning health status was added. The results indicated that the objective, universally used measures of SES in childhood such as father’s educational level and size of family did not show any essential relationships with health outcomes in adulthood, both for men and women. By contrast, retrospective, self-assessed SES (as better, average or worse as compared with peers) in childhood was significantly associated with the appearance of cardiovascular disease among women aged 50 years. Women who at the beginning of their adult life declared better socioeconomic condition in childhood were significantly healthier at the age of 50 years (OR=3·43; p=0·02). Moreover, this appeared to be independent of BMI, SES and life-style in adulthood. For men, retrospective self-assessed SES showed no relation to health status at the age of 50 years. The gender differences in the relationships between self-assessed SES in childhood and health status in adulthood are explained by possible selective premature mortality among men from lower childhood SES and/or sex differences in cognitive abilities.

The negative health consequences of unemployment: the case of Poland

In the 1990s Poland began to make a transition to a free-market economy: a transition accompanied by a variety of negative socio-economic developments, most notably a rise in unemployment. The aim of this study is to shed light on the relationship between occupational status (including unemployment) and the risk of cardiovascular disease (CVD), by examining the experience of 542 men and 572 women between the ages of 40 and 50 of the town of Wroclaw in 2006. The Framingham Risk Score (FRS), which uses certain health and life-style parameters to predict the risk of major coronary problems over a 10-year period, was calculated, and the effect of occupational status on the FRS was assessed. The results showed that the FRS varied according to sex and to occupational status, with the highest FRS rating among unemployed men. Thus governmental policies to counter the adverse effects of unemployment should be developed to remedy the problem.

Social class-specific secular trends in height among 19-year old Polish men: 6th national surveys from 1965 till 2010

The results presented in this study concern the assessment of the secular trend of body height in 10 % a random national sample (N = 134,224) representing all regions of Poland in 8 homogeneous social groups over 45 years in Poland (1965-2010). Very significant political, social and economic changes in Poland occurred in the period studied. The political revolution that began in Poland at the turn of the 1980s and 1990s dramatically changed the picture of social inequalities in the country. It rapidly transformed (in different directions and to a different degree) the economic situation, working conditions, lifestyles and the prestige of particular social classes and professional groups. A positive secular trend was observed in 19-year-old participants in the period analysed in all homogeneous socio-professional groups, however, with different intensity in each group. The highest body height increases in 1965-2010 were observed in the sons of farmers with post-primary father's education (7.77 cm). The lowest were observed among the sons of professionals, only 5.45 cm. Although social distances between extreme socio-economic groups significantly decreased (from 4.89 cm in 1965 to 2.76 cm in 2010), social gradients of body height, despite the improvement in the standards of living of the entire society remained exceptionally stable and unchanged for nearly half a century.

Some evidence for health-related marriage selection

OBJECTIVES

Married people live longer and are healthier than unmarried people. This can be explained in terms of marriage protection and marriage selection. The aim of the present study was to examine the direct effect of marriage selection on health status.

METHODS

Data were collected from the archives of the Lower Silesian Medical Center (DOLMED) in Wrocław, Poland. The sample consisted of 2,265 adult (never married or currently married) men. Subjects were assigned to categories for selected variables, including age, level of education, military category upon conscription, height, hearing acuity, and visual acuity. Military category, objective data gathered upon military conscription at age 18, was used to assess initial health status. To identify any relationships between marital status and health status, generalized linear models with binomially distributed dependent variable were used.

RESULTS

The never-married subjects were more likely to have been assigned to lower military categories, which indicates that their health status at age 18 was inferior to those conscripts who would later marry. Hearing acuity and visual acuity were generally worse in never-married subjects than in married subjects. Never-married subjects were also more likely to be short and less likely to be tall.

CONCLUSIONS

The results provide evidence for direct health-related marriage selection in men between 25 and 60 years of age. Poor health status reduces the likelihood of marriage.

Effect of husbands' education on fatness of wives

The aim of the study was to examine the relationship between social position of females achieved by marriage and level of fatness and relative fat distribution. The data of 588 healthy, occupationally active, married women, age 21-62 years, with 12 years of education (completed secondary school) were used. The body mass index (BMI, kg/m(2) ), triceps and subscapular skinfold thicknesses, and summed skinfold thicknesses were used as indicators of fatness. The waist-hip ratio, the waist-thigh ratio, and waist, hip, and thigh circumferences were used as indicators of fat distribution. According to the educational level of husbands, women were grouped as 1). moving up the social scale (spouse with complete university education), 2). stable (equal level of education), and 3). moving down the social scale (spouse who never passed beyond the level of basic vocational school, i.e., skilled and unskilled manual workers). The two opposite groups were analyzed, i.e., moving up and moving down. Women with secondary schooling who married up were consistently leaner than women who married down. A similar pattern was observed for fat distribution. Women marrying down had more abdominal body fat compared to women marrying up.

Secular trends in BMI and the prevalence of obesity in young Polish males from 1965 to 2010

BACKGROUND

Obesity is a serious public health problem, the prevalence of which is increasing dramatically all over the world. The aim of this study was to examine trends in body mass index (BMI) and the proportion of overweight and obese individuals among 19-year-old Polish males reporting for mandatory military fitness exams from 1965 to 2010.

METHODS

Height, weight and BMI [weight (kg)/height (m(2))] in five 10% nationwide random samples of 19-year-old conscripts examined in 1965, 1986, 1995, 2001 and 2010 were analysed.

RESULTS

From 1965 to 2010, mean BMI in 19-year-old Polish males increased from 21.7 to 22.9. The rate of change was not uniform, with a rapid increase in mean BMI from 1995 to 2010. Beginning in 1965, the proportion of men with a BMI over 25 has been steadily increasing from one decade to the next, and was four times higher in 2010 than it was in 1965. The rate of increase per decade was twice as high from 2001 to 2010 than it was from 1995 to 2001. In 2010, only 70.8% of young men were of ideal weight.

CONCLUSION

Increase in obesity can be attributed to the social and economic changes brought about by the transformation of the country from a communist to a free-market economy in 1989. The challenges of the obesity epidemic for public health services and its impact on morbidity and life expectancy are also discussed.

Evaluation of factors related to bone disease in Polish children and adolescents with cystic fibrosis

PURPOSE

The aim of the study was to evaluate factors related to bone formation and resorption in Polish children and adolescents with cystic fibrosis and to examine the effect of nutritional status, biochemical parameters and clinical status on bone mineral density.

MATERIALS AND METHODS

The study group consisted of 100 children and adolescents with cystic fibrosis with a mean age 13.4 years old. Anthropometric measurements, included body height, body mass and body mass index (BMI); bone mineral densitometry and biochemical testing were performed. Bone mineral density was measured using a dual-energy X-ray absorption densitometer. Biochemical tests included serum calcium, phosphorus, parathyroid hormone and vitamin D concentrations, as well as 24-h urine calcium and phosphorus excretion. Pulmonary function was evaluated using FEV1%, and clinical status was estimated using the Shwachman-Kulczycki score.

RESULTS

Standardized body height, body mass and BMI were significantly lower than in the reference population. Mean serum vitamin D concentration was decreased. Pulmonary disease was generally mild, with a mean FEV1% of 81%. Multivariate linear regression revealed that the only factors that had a significant effect on bone marrow density were BMI and FEV1%. There were no significant correlations between bone mineral density and the results of any of the biochemical tests performed.

CONCLUSIONS

Nutritional status and bone mineral density were significantly decreased in children and adolescents with cystic fibrosis. In spite of abnormalities in biochemical testing, the factors that were found to have the strongest effect on bone mineral density were standardized BMI and clinical status.

Biological condition of adult migrants and nonmigrants in Wrocław, Poland

Human migration and its economic, social, and demographic effects can lead to health consequences for individuals and populations. In the present study, we estimated differences in health status between migrant (those who had come to Wrocław at the age of > or =16 years) and nonmigrant (those who had lived in Wrocław since birth or had come with their parents) inhabitants of Wrocław, Poland. Three hundred and sixty seven males and 496 females aged 40 and 50 underwent medical examination, and were asked to fill out a questionnaire comprising social, demographic, and life style information. Health status was assessed by blood pressure, heart rate, fasting lipid profile, glucose, height, and measures of fatness (BMI, WHR, sum of skinfolds). Comparisons were made based on Borkan's and Norris's profiles. Student's t-test showed significant differences in diastolic blood pressure, heart rate, total cholesterol, and glucose levels between two groups of males, in favor of migrants. Male migrants were also significantly taller than their peers born in Wrocław. In females, migrants had significantly lower blood pressure and heart rate than nonmigrants. In interpreting the results two possible, not mutually exclusive, mechanisms are proposed: selective spatial mobility, and changes toward healthier life style as an adaptation to new urban environment.

Life satisfaction and cardiovascular disease risk in Poland

INTRODUCTION

Cardiovascular disease is the most common cause of death. Life satisfaction is a predictor of morbidity and mortality, irrespectively of objective measures of health status. The aim of the study was to evaluate the relationship between life satisfaction (LS) and cardiovascular disease risk (CVD) assessed with the Framingham Risk Score (FRS) in Polish adults.

MATERIAL AND METHODS

Past, present and projected LS were estimated. The FRS reflecting 10-year CVD risk was calculated from health indices and lifestyle parameters. Relationships between LS and FRS were tested by two-way analysis of variance in 489 men and 591 women, 40-50 years of age.

RESULTS

Subjects with a reduction in LS over time had a higher FRS compared to peers with an improvement in LS. The relationship between current LS and FRS had a J-shape in men; FRS was lowest in men with an LS of 5-7 (average LS), slightly higher in men with an LS of 8-10 (highest LS), and highest in men with an LS of 1-4 (lowest LS). Among women, there was an inverse linear relationship between LS and FRS: the higher the LS, the lower FRS. There was a strong linear relationship between predicted LS and CVD risk. Highest risk was evident in subjects with low LS in whom low LS was predicted over the next five years.

CONCLUSIONS

Low LS (dissatisfaction) thus has a long-term negative effect on CVD risk in Polish adults of both sexes.

Protocol for Multi-Stage Treatment of Temporomandibular Joint Ankylosis in Children and Adolescents

Treatment of temporomandibular ankylosis is challenging and frequently leads to re-ankylosis, relapse, dangerous complications and, in turn, the need for multiple operations. In this article, we present a protocol for the treatment of ankylosis of the temporomandibular joints that assumes earlier intervention with the assistance of 3D virtual surgical planning (3DVSP) and custom biomaterials for better and safer surgical outcomes. Thirty-three patients were treated due to either uni- or bilateral temporomandibular ankylosis. Twenty individuals received temporomandibular prosthesis, whereas seventeen required simultaneous 3D virtual surgical/planned orthognathic surgery as the final correction of the malocclusion. All patients exhibited statistically significant improvements in mouth opening (from 1.21 ± 0.74 cm to 3.77 ± 0.46 cm) and increased physiological functioning of the mandible. Gap arthroplasty and aggressive rehabilitation prior to temporomandibular prosthesis (TMJP) placement were preferred over costochondral autografts. The use of 3DVSP and custom biomaterials enables more precise, efficient and safe procedures to be performed in the paediatric and adolescent population requiring treatment for temporomandibular ankylosis.

The relationship between: occupational status, biological condition and androgen hormone level among Polish adult men: the Wroclaw Male Study

Population health and its determinants are one of the major challenges to social and economic policy. The aim of this study was to investigate the relationship between occupational activity and biological condition in adult working Polish men. The participants of the study were 300 men (30-65 years), healthy inhabitants of the city of Wroclaw, Poland. Seventeen measures of biological condition were examined. The subjects were divided into three different occupational groups: professionals, soldiers and skilled workers. A comparison of biological age profiles of three occupational groups showed that in the majority of characteristics, professionals had the youngest biological age, whereas skilled workers had the highest biological age. The results for soldiers were not as unambiguous, but biological parameters were generally closer to those for professionals. Inborn biological predispositions and long-term impact of the working environment can influence on the biological condition of various professional groups. Knowledge of the determinants of biological condition might result in efficient use of predisposition to work or may be of help in extending their time of work ability.

Body balance analysis of children and youth with intellectual disabilities

BACKGROUND

Children and adolescents with intellectual disabilities (IDs) are an identified group with postural disturbances resulting from a lack of integration among the visual, vestibular and proprioceptive systems. The insufficient level of maturity of the sensory systems is at least partly responsible for disturbances in maintaining body balance. More sway can increase the risk of falls and body injuries. The aims of the study were (1) to compare the ability to maintain the body balance of children and youth with a varying degree of ID, both with the eyes open and closed, and (2) to determine to what extent factors such as sex, level of ID, visual stimulus and body height independently affect the ability to maintain body balance in children and adolescents with ID.

METHOD

The study involved 131 people aged 13-21 years (65 girls and 66 boys). The participants were classified as (1) with mild disability (42 girls and 47 boys) and (2) with moderate disability (23 girls and 19 boys), based on IQ test results. Sway measures were collected with the Zebris platform, with the eyes open and closed. Sway path, sway path in anterio-posterior and medio-lateral directions and sway area were analysed.

RESULTS

Boys with moderate ID were characterised by a significantly more sway indicating their worse postural balance ability than boys with mild ID, both in the trials with open eyes and closed ones. The type of test (eyes open/eyes closed) to a small extent had influenced the body balance of the examined children with ID. Results of analyses of covariance had showed that all analysed factors (sex, level of ID, type of the test performance and body height), irrespectively from direction of sway (sway path in anterio-posterior and medio-lateral directions), worked independently influencing body balance.

CONCLUSIONS

It could be assumed that lower height, moderate disability and male sex are factors significantly reducing ability of maintenance of balance of children and youth with ID.

Biological costs of economic transition: Stress levels during the transition from communism to capitalism in Poland

At the end of the 1980s, Poland began the transformation from an essentially one-party communist system to a politically pluralistic democratic system. These political and economic changes had major social consequences, among others unemployment and a sharp decrease in real personal income. The aim of the study was to investigate the possible relationship between stress in adult men, measured by the Allostatic Load, and the socio-economic deterioration during the first part of the economic transition. The Allostatic Load included eleven markers assessing adverse nutritional intake, cardiovascular activity, inflammatory processes, and lung, hepatic and renal functions. The results indicate a significantly higher risk of metabolic dysregulation in men examined after 1990, compared to men from previous years. After adjustment for socioeconomic variables and lifestyle variables, men examined in 1991 had a 31% greater risk of higher Allostatic Load compared with men examined in 1985 (OR=1.31; p=0.0541), in 1992, this risk was 50% greater (OR=1.50; p<0.01), and in 1993, the risk was 66% greater (OR=1.66; p<0.05). The conclusion is drawn that significantly more stressogenic factors for men were those directly connected with the financial situation of their families, than a sudden but short increase of prices for goods and services.

Hypertension among Polish males during the economic transition

In the late 1980s and early 1990s Polish society experienced deep political, economic and social changes. The aim of the study is to investigate whether changes that occurred in Poland during the transformation significantly influenced the risk of hypertension among adult men. We find that irrespective of age, marital status, education, degree of urbanization, lifestyle variables (smoking, drinking alcohol, and physical activity), and BMI the risk of hypertension after 1989 was higher than before transformation (odds ratio=1.45, p<0.001). Psychosocial factors are proposed as factors which might at least partly explain the higher risk of hypertension during the first years of economic transition in Poland.

Age, Education, and Stress Affect Ageing Males' Symptoms More than Lifestyle Does: The Wroclaw Male Study

An increasing number of subjects are affected by health problems related to the advanced involutional processes. It is extremely important to identify the determinants of the rate of occurrence of physiological, psychological, and social manifestations of aging. The aim was to determine how factors such as lifestyle, level of education, or severity of stressful life events indicate the appearance of aging symptoms in adult men. The material consisted of data of ethnically homogeneous group of 355 men (32−87 years), invited to the study as a part of the Wroclaw Male Study research project. The analyzed features included (1) socioeconomic status: age, educational level, marital status, and having children; (2) elements of lifestyle: alcohol drinking, cigarette smoking, and physical activity; (3) major and most important stressful life events—the Social Readjustment Rating Scale; (4) symptoms related to male aging—the Aging Males’ Symptoms. The backward stepwise regression models, the Kruskal−Wallis test, and multiple comparisons of mean ranks were used. Noncentrality parameter δ (delta), two-tailed critical values of the test, and test power with α = 0.05 were calculated. Among the analyzed variables, age was most strongly associated with the intensity of almost all groups of andropausal symptoms in men (p = 0.0001), followed by the level of education (p = 0.0001) and the intensity of stressful life events (p = 0.0108). Selected lifestyle elements turned out to be much less important (p > 0.01). Preventive actions aimed at slowing down the intensification of involutional processes, including teaching strategies for coping with stressful life events, should be implemented in groups of men with specific risk factors from an early age.

Influence of neurophysiological hippotherapy on the transference of the centre of gravity among children with cerebral palsy

BACKGROUND

The aim of the study was to present the influence of neurophysiological hippotherapy on the transference of the centre of gravity (COG) among children with cerebral palsy (CP).

MATERIAL AND METHODS

The study involved 19 children aged 4-13 years suffering from CP who demonstrated an asymmetric (A/P) model of compensation. Body balance was studied with the Cosmogamma Balance Platform. An examination on this platform was performed before and after a session of neurophysiological hippotherapy. In order to compare the correlations and differences between the examinations, the results were analysed using Student's T-test for dependent samples at p ≤ 0.05 as the level of statistical significance and descriptive statistics were calculated.

RESULTS

The mean value of the body's centre of gravity in the frontal plane (COG X) was 18.33 (mm) during the first examination, changing by 21.84 (mm) after neurophysiological hippotherapy towards deloading of the antigravity lower limb (p ≤ 0.0001). The other stabilographic parameters increased; however, only the change in average speed of antero - posterior COG oscillation was statistically significant (p = 0.0354).

CONCLUSION

1. One session of neurophysiological hippotherapy induced statistically significant changes in the position of the centre of gravity in the body in the frontal plane and the average speed of COG oscillation in the sagittal plane among CP children demonstrating an asymmetric model of compensation (A/P).

Efficacy of immediate physiotherapy after surgical release of zygomatico-coronoid ankylosis in a young child: A case report

BACKGROUND

Temporomandibular joint ankylosis (TMJ ankylosis) manifests itself as a locked jaw and reduced mouth opening. We hypothesized that the efficacy of TMJ ankylosis surgery in a child may largely depend on physiotherapeutic management.

CASE DESCRIPTION

: In this case report, we present the treatment of a girl between 1 and 4 years of age, who was unable to open her jaws immediately after birth. Congenital ankylosis was diagnosed.

INTERVENTION

: Two models of therapeutic management were presented, with a surgical procedure to release bone fusion adopted as a starting point. In the first model, the rehabilitation procedure started 21 days after surgery.

OUTCOMES

: Despite rehabilitation, no clinical improvement was achieved (i.e. the child was still unable to open her jaws). In the second model, rehabilitation started from the day after surgery and management according to the second model allowed for obtaining therapeutic benefits. After therapy, the girl was able to abduct the mandible to a degree allowing for improved speech and the ability to crush food.

CONCLUSIONS

: This clinical case shows that the efficacy of surgical procedures may depend on the type of postoperative management. It was demonstrated that physiotherapy started immediately after the procedure to release the ankylosis improved the mandible mobility outcomes for this child.