The follow-up posturography in rehabilitation after total hip arthroplasty.

PURPOSE: Presentation of the results of clinical study on new supplementary method applied in the physical rehabilitation of patients who underwent total hip arthroplasty. The standard rehabilitation program was supplemented with the lower limb loading symmetry training based on the follow-up posturography with an adaptively modified visual biofeedback, performed on a double plate posturographic platform. METHODS: The research involved 60 randomly selected patients included in prospective and comparative clinical study in the scheme of the parallel groups. The subjects were divided into two groups comprised of 30 patients each. In both groups a conventional 21-day rehabilitation was carried out. Additionally, in experimental group the limb loading symmetry restoration training based on the follow-up posturography with an adaptively modified biofeedback was implemented. The biofeedback coefficient reflected the distribution of loading exerted on a given patient's legs and was evaluated during the static posturography examinations carried out before each symmetry training session. RESULTS: The eyes-open static posturography examinations indicated significant improvement in the lower limb loading symmetry in 29 (97%) patients from the experimental group ( p = 0.000003). In the control group, such an improvement was observed in 20 (67%) patients ( p = 0.034796). In the eyes closed examinations correction in the limb loading symmetry was evident in 23 (77%) patients from the experimental group ( p = 0.000247) and 18 (60%) patients from the control group ( p = 0.043327). CONCLUSIONS: Significant improvement in the lower limb loading symmetry was observed in patients who underwent rehabilitation supplemented with the herein discussed training method.

The effects of mirror therapy on arm and hand function in subacute stroke in patients.

The aim of this study was to evaluate the effect of mirror therapy on arm and hand function in subacute stroke in patients. The study included 60 hemiparetic right-handed patients after ischemic stroke 8-10 weeks after onset. They underwent stationary comprehensive rehabilitation in the rehabilitation centre. They were divided into two randomly assigned groups: mirror (n=30) and control (n=30). For both groups, two subgroups were created: one that included patients with right arm paresis (n=15) and the other that included patients with left arm paresis (n=15). The mirror group received an additional intervention: training with a mirror for 5 days/week, 2 sessions/day, for 21 days. Each single session lasted for 15 min. The control group (n=30) underwent a conventional rehabilitation program without mirror therapy. To evaluate self-care in performing activities of daily living, the Functional Index 'Repty' was used. To evaluate hand and arm function, the Frenchay Arm Test and the Motor Status Score were used. Measurements were performed twice: before and after 21 days of applied rehabilitation. No significant improvement in hand and arm function in both subgroups in Frenchay Arm Test and Motor Status Score scales was observed. However, there was a significant improvement in self-care of activities of daily living in the right arm paresis subgroup in the mirror group measured using the Functional Index 'Repty'. Mirror therapy improves self-care of activities of daily living for patients with right arm paresis after stroke.

Facilities of early rehabilitation after stroke in Poland 2010.

The aim of this work was to survey the contemporary facilities for early poststroke rehabilitation in Poland. The main research questions were as follows: what is the availability of inpatient rehabilitation for poststroke patients in neurological departments and in rehabilitation departments? The growing costs of healthcare are encouraging healthcare planners to look for new organizational solutions of services that could enable rehabilitation as early as possible after disease onset. Early poststroke rehabilitation includes many elements that provide for early-onset rehabilitation and its continuation after discharge from the stroke unit. Two questionnaires evaluating neurorehabilitation of individuals who had stroke were designed and distributed: the first questionnaire was distributed to 221 neurological wards and the second questionnaire was distributed to 154 rehabilitation departments in Poland. We obtained information about delay before admission from neurological wards to rehabilitation departments, the number of sessions per day, the time duration of one session, the number of sessions per week, the average length of stay in department, the methods of outcome measurement, etc. We sent out 375 questionnaires and received 129 (35%) responses, 78 from neurological wards and 51 from rehabilitation departments. Only 25% of all patients were moved from neurological wards to the rehabilitation department after stroke (15% directly). Of those moved to rehabilitation departments, only 54% were treated early after stroke; that is, within 3 months of stroke. Considering that about half of stroke survivors will require rehabilitation (30 days after stroke onset), the current facilities of early poststroke rehabilitation in Poland cannot meet this need. We should do our best to introduce rehabilitation services such as early home-supported discharge after stroke, which is currently not available in Poland. Although we have focused on resources in Poland, we anticipate that similar patterns may be found in other countries in the region.

Quality of life of post-stroke patients and their caregivers.

With improvements in health care, more people survive stroke but many have to cope with the physical, psychological, social and functional sequelae, resulting in increased personal and public costs. Cerebral stroke causes a significant deterioration of the patient's functioning and worsening of her/his quality of life. Long-term disability caused by stroke is a common problem in all countries and its incidence increases markedly with advancing age. The assessment of the Quality of Life could be as well the evaluator of sequelae of stroke as an indicator of the effectiveness of the post-stroke rehabilitation. In this review article, the contemporary state of art in assessment of the post-stroke Quality of Life has been presented. The emphasis was placed on participation in terms of personal factors and environmental factors of post-stroke persons and their caregivers.

Quality of life in multiple sclerosis.

An overall aim of treatment in multiple sclerosis is to lower the negative impact of the disease on functioning and quality of life of patients. Therefore, a measurement of functioning and quality of life should be included in the evaluation of the effectiveness of treatment. The most commonly used quality of life questionnaires, either generic or specific, were presented in this paper,. Information about clinical and functional status is useful in the interpretation of the quality of life assessment results. Because of that, instruments for the assessment of depression, cognitive functions, functional ability and fatigue in multiple sclerosis were also described.

[Questionnaire impact on participation and autonomy (IPA)]. / Kwestionariusz wplywu na uczestnictwo i autonomie--impact on participation and autonomy (IPA).

There are many problems which can decrease the quality of life of disabled persons. It means either social condition, family life, education, vocational status, sport, recreation and psychological implications. The Impact on Participation and Autonomy Questionnaire (IPA) is a valid, reliable and acceptable measure of participation and autonomy in people with a range of conditions, especially with multiple sclerosis, spinal cord injury and rheumatoid arthritis. The psychometric properties of IPA are promising and indicate that IPA has potential to be developed further. Most respondents believe that the IPA items are easy or very easy to understand, relevant and not embarrassing. In review report the own translation of IPA into Polish language has been presented.