Assessment of functional fitness impacted by hospital rehabilitation in post-stroke patients who additionally contracted COVID-19.

Background: The aim of the study was to assess the effects of rehabilitation in post-stroke patients, or post-stroke patients with simultaneous COVID-19 infection, in relation to: improved locomotion efficiency, improved balance, reduced risk of falling as well as the patients' more effective performance in everyday activities. Methods: The study involved 60 patients in the early period (2-3 months) after a stroke. Group I consisted of 18 patients (30.0%) who, in addition to a stroke, also contracted COVID-19. Group II consisted of 42 patients (70%) post-stroke, with no SARS-CoV2 infection. The effects were assessed on the basis of: Tinetti test, Timed Up & Go test and Barthel scale. Results: Both groups achieved a statistically significant improvement in their Barthel score after therapy (p < 0.001). The Tinetti test, assessing gait and balance, showed that participants in Group I improved their score by an average of 4.22 points. ±4.35, and in Group II, on average, by 3.48 points ± 3.45 points. In the Timed Up & Go test over a distance of 3 m, significant improvement was achieved in both groups, as well but the effect was higher in Group I (p < 0.001). Conclusions: Hospital rehabilitation in the early period after stroke improved locomotion efficiency and balance, and reduced the risk of falls in post-stroke patients, both with and without COVID-19 infection.

Differences in Body Balance According to Body Mass Classification among Brazilian Jiu-Jitsu Athletes.

Background: Body weight is an important aspect in the development of components of physical fitness that can affect athletic performance. The purpose of this study was to examine the differences in body balance of Brazilian Jiu-Jitsu (BJJ) athletes according to body mass classification: underweight/normal weight (UW/NW); overweight/obese (OW/OB). Material and Methods: The study was conducted among 69 BJJ athletes (age 23.26 ± 3.53) and 93 non-practicing adults (age 21.73 ± 2.32). This study was based on a quantitative assessment of body balance on the Zebris PDM platform during two tests, i.e., with eyes open and closed. Results: The total path of the center of pressure (COP TTL) was significantly higher in participants with UW/NW compared to those with OW/OB, both in participants from the study group and control group (p < 0.001). COP TTL was significantly lower in UW/NW BJJ athletes than in participants in the control group with the same BMI category (987.4 mm vs. 1238.5 mm and 1080.59 mm vs. 1280.70 mm, respectively) (p < 0.001). Conclusions. BJJ training is associated with a better balance in terms of COP TTL in the case of people with normal or underweight. The presence of excess body weight has a positive effect on lower COP TTL values in both practicing and non-practicing people.

The Level and Factors Differentiating the Physical Fitness of Adolescents Passively and Actively Resting in South-Eastern Poland-A Pilot Study.

Physical activity (PA) is defined as any bodily movement produced by skeletal muscles that requires energy expenditure. Due to civilization's development, we can observe a global decline in physical activity which negatively affects the state of physical and mental health. The physical activity of children and adolescents is a counterpart to their physical fitness. There is also more frequent spending of free time in a passive way rather than actively. The aim of the study was to determine whether there are differences in the physical fitness of young people who rest passively in relation to those who rest actively. In addition, it was checked whether factors, such as age, weight, body height and BMI differentiate the level of fitness in adolescents. Study group: 25 boys and 25 girls declaring active leisure activities. Control group: 25 boys and 25 girls declaring passive leisure activities. Age of the respondents ranged from 11 to 15 years (Me = 13; SD = 1.23). The research used: the author's questionnaire and the Index of Physical Fitness of K. Zuchora. The results were statistically developed. The youth who spend their free time actively were characterised by a higher level of physical fitness than their peers who choose passive recreation. The students with a higher BMI obtained worse results than the children with a lower body mass index. In both groups, slightly better results were obtained by girls. A significant relationship between age and results has been observed in the control group-the results increased with increasing age. The level of physical fitness is higher in active forms of recreation than in passive rest. Physical fitness tends to increase with age but decreases with increasing BMI. Girls are characterised by a higher level of physical fitness than boys.

The Effectiveness of Pelvic Floor Muscle Training in Men after Radical Prostatectomy Measured with the Insert Test.

A commonly used physiotherapeutic method for the treatment of urinary incontinence (UI) after radical prostatectomy (RP) is pelvic floor muscle training (PFMT). The aim of this study was to evaluate the effectiveness of PFMT by enhanced biofeedback using the 1h pad-weighing test. The following factors were taken into consideration in the analysis of PFMT effectiveness: the relevance of the patients' age, time from RP, BMI, mental health, functional state, and depression. A total of 60 post-RP patients who underwent 10-week PFMT were studied. They were divided into groups: A (n = 20) and B (n = 20) (random division, time from RP: 2−6 weeks) and group C (time from RP > 6 weeks). Group B had enhanced training using EMG biofeedback. UI improved in all groups: A, p = 0.0000; B, p = 0.0000; and C, p = 0.0001. After the completion of PFMT, complete control over miction was achieved by 60% of the patients in group A, 85% in group B, and 45% in group C. There was no correlation between the results of PFMT efficacy and patients' age, BMI, time from RP, mental health, functional state, and depression. PFMT is highly effective in UI treatment. The enhancement of PFMT by EMG biofeedback seems to increase the effectiveness of the therapy.

Is There a Link between Balance and Body Mass Composition in Children and Adolescents?

School-age children are particularly prone to disturbances in body composition, because this is a period of intensive growth and a period in which correct habits are shaped, especially in relation to diet. This is why it is so important to diagnose emerging disorders early so as to implement therapeutic or educational activities. The aim of this study was to assess the relationship between the factors of body mass composition and body mass index (BMI), as well as the balance parameters in children and adolescents. The study group consisted of 1137 children aged 7 to 15. There were 559 girls and 578 boys among the subjects. The study used the Tanita 780 body mass composition analyser and the Zebris stabilometric platform. It was found that girls were characterized by a significantly higher content of adipose tissue (24.37% vs. 20.45%), while boys were characterized by a higher content of lean tissue (32.99% vs. 30.43%), muscle tissue (31.23% vs. 28.86%) and water (24.15% vs. 22.28%). Interestingly, the girls had better balance than their peers in all analyzed parameters (COF TTL.-616.72 vs. 661.50; CEArea-73.63 vs. 112.24; COF HD-3.44 vs. 4.23; COF VD-4.52 vs. 5.12). It turned out that among children in adolescence, a higher adipose tissue content and a higher BMI correlated with a smaller surface area (p < 0.05) defined by the center of gravity and smaller deviations of the center of gravity in the horizontal plane (p < 0.05). Sex and adolescence play an important role in differentiating both body composition and body balance. The results of this study allow us to conclude that children with higher BMI values have better balance. Due to the fact that these conclusions are inconsistent with those of other researchers, it will be worth continuing the research (e.g., on a different population group) in order to confirm the results and to draw far-reaching conclusions.

Changes in Children's Body Composition and Posture during Puberty Growth.

The main goal of our study was to determine how the age of children, puberty and anthropometric parameters affect the formation of body composition and faulty body posture development in children. The secondary goal was to determine in which body segments abnormalities most often occur and how gender differentiates the occurrence of adverse changes in children's body posture and body composition during puberty. The study group consisted of 464 schoolchildren aged from 6-16. Body posture was assessed with the Zebris system. The composition of the body mass was tested with Tanita MC 780 MA body mass analyzer and the body height was measured using a portable stadiometer PORTSTAND 210. The participants were further divided due to the age of puberty. Tanner division was adopted. The cut-off age for girls is ≥10 years and for boys it is ≥12 years. The analyses applied descriptive statistics, the Pearson correlation, stepwise regression analysis and the t-test. The accepted level of significance was p < 0.05. The pelvic obliquity was lower in older children (beta = -0.15). We also see that age played a significant role in the difference in the height of the right pelvis (beta = -0.28), and the difference in the height of the right shoulder (beta = 0.23). Regression analysis showed that the content of adipose tissue (FAT%) increased with body mass index (BMI) and decreased with increasing weight, age, and height. Moreover, the FAT% was lower in boys than in girls (beta negative equal to -0.39). It turned out that older children (puberty), had greater asymmetry in the right shoulder blade (p < 0.001) and right shoulder (p = 0.003). On the other hand, younger children (who were still before puberty) had greater anomalies in the left trunk inclination (p = 0.048) as well as in the pelvic obliquity (p = 0.008). Girls in puberty were characterized by greater asymmetry on the right side, including the shoulders (p = 0.001), the scapula (p = 0.001) and the pelvis (p < 0.001). In boys, the problem related only to the asymmetry of the shoulder blades (p < 0.001). Girls were characterized by a greater increase in adipose tissue and boys by muscle tissue. Significant differences also appeared in the body posture of the examined children. Greater asymmetry within scapulas and shoulders were seen in children during puberty. Therefore, a growing child should be closely monitored to protect them from the adverse consequences of poor posture or excessive accumulation of adipose tissue in the body.

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

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

Role of body mass category in the development of faulty postures in school-age children from a rural area in south-eastern Poland: a cross-sectional study.

OBJECTIVE: The aim of the study was to assess the relationship between body mass index (BMI) and the incidence of abnormalities in selected parameters measured in the trunk area. DESIGN: Cross-sectional studies. SETTING: The research was conducted in a primary school in the Trzebownisko Municipality, a rural area in south-eastern Poland. PARTICIPANTS: A group of 464 children, ranging in age from 6 to 16 years (234 boys and 230 girls), was recruited to participate in the study. OUTCOME MEASURES: The examination of their body postures was conducted with the use of the Zebris system. Body mass was determined using a body mass analyser Tanita MC-780 MA. BMI was calculated based on the acquired data. RESULTS: It was noticed that the children with overweight and obesity tended to have an incorrect position of the shoulders and pelvis in comparison to children with normal body weight. It was found that greater body mass (higher BMI) coincided with a larger distance of the scapulae from the frontal plane (p=0.009). CONCLUSIONS: Increase in children's BMI produces adverse effects in the position of the shoulder blades, reflected by their greater distance from the frontal plane. Increase in BMI is not significantly related to the position of the shoulder joints or pelvis; however, the subjects with overweight or obesity presented a greater difference in the position of the shoulder joints and pelvis.

Translation, cross-cultural adaptation and validation of the polish version of the Oxford Shoulder Score in patients undergoing arthroscopic rotator cuff repair.

BACKGROUND: The Oxford Shoulder Score (OSS) is a simple and reliable, joint-specific, self-reported outcome measure. It can be applied in patients with shoulder disease other than instability. The purpose of this study was to perform a translation, cultural adaptation of the Polish version of the OSS and to evaluate its selected psychometric properties in patients after arthroscopic rotator cuff repair. METHODS: Sixty-nine subjects participated in the study, with a mean age 55.5 (ranging from 40 to 65 years). The OSS has been translated using the widely accepted guidelines. All patients completed the Polish version of OSS (OSS-PL), the short version of the Disabilities of Arm, Shoulder and Hand Questionnaire (QuickDASH), the Short Form-36 v. 2.0 (SF-36) and the 7-point Global Rating of Change Scale (GRC). RESULTS: High internal consistency of 0.96 was found using Cronbach's alpha coefficient. Reliability of the OSS resulted in Intraclass Correlation Coefficient (ICC) = 0.99, Standard Error of Measurement (SEM) = 1.14 and Minimal Detectable Change (MDC) = 3.15. The validity analysis showed a moderate (General health r = 0.34) to high (Physical role functioning r = 0.82) correlation between the OSS-PL and SF-36 and a high correlation between the OSS-PL and the QuickDASH (r = - 0.92). CONCLUSIONS: The Polish version of OSS is a reliable and valid, self-reported questionnaire, which can be applied in patients with a rotator cuff tear undergoing reconstruction surgery. The very good psychometric properties of the Polish version of the OSS indicate that it can be used in clinical practice and scientific research.

The Influence of Body Mass Composition on the Postural Characterization of School-Age Children and Adolescents.

INTRODUCTION: In recent years a significant increase in the percentage of children with postural problems has been observed. It is necessary to focus on preventing the phenomenon and on analysis of existing postural defects. AIM: The aim of this work was to assess the potential relationship between body mass composition and body posture in school-age children. MATERIAL AND METHODS: 464 school-age children ranging from 6 to 16 years (234 boys and 230 girls) were qualified for the study. Body mass composition was assessed using the analyzer Tanita MC 780 MA. Assessment of body posture was performed using Zebris system. All the results were analyzed with statistical methods. The accepted level of significance was p<0.05. RESULTS: Analyses of the disparities between the girls and the boys showed statistically significant differences in all of the body mass components and in obliquity of the pelvis/shoulder. The boys were characterized by higher contents of muscle tissue (p<0.001), bone tissue (p<0.001), fatless tissue (p<0.001), and body water (p<0.001) as well as a greater obliquity angle (p=0.018). The girls, on the other hand, were found with higher content of fatty tissue (p<0.001). The children with lower content of muscle tissue (p=0.030), fatless tissue (p=0.030), water (p=0.030), and higher content of fatty tissue measured in kg (p=0.027) were characterized by greater pelvic obliquity. CONCLUSION: The current study shows evidence that sex, as a strongly differentiating factor, determines body mass composition and the occurrence of suboptimal postures only in the pelvic area. Body mass composition differentiates body posture of the study group. The content of fatty tissue influences the occurrence of suboptimal postures in the scapula and pelvic area in the frontal plane. The content of muscle tissue is associated with faulty postures in the scapula and pelvic area in the frontal plane.

The Assessment of Static Balance in Patients after Total Hip Replacement in the Period of 2-3 Years after Surgery.

INTRODUCTION: The aim of this study was to assess static balance of patients after Total Hip Replacement (THR) compared with the age-matched, asymptomatic control group, considering the subject's gender and the time since the surgery. MATERIALS AND METHODS: The Total Hip Replacement (THR) group consisted of 55 subjects (mean age: 56.3 ± 8.7 years) and the control group consisted of 48 subjects (mean age: 58 ± 6.2 years). For the assessment of static balance, a stabilometric force platform was used. All subjects performed two 30-second trials in the double-leg stance position with eyes opened and closed. In the study group, the stabilometric assessment was performed once within the period of 24 to 36 months after the surgery. RESULTS: Subjects from the study group had significantly increased mediolateral COP velocity in the test with eyes opened, as well as the values of most of the COP parameters (excluding COP path area) in the test with eyes closed, compared to the control group. Higher values of the selected COP parameters were observed in the male subjects from the study group. CONCLUSION: In contrast to a number of papers, our study revealed some deficits in static balance in patients after THR up to 2-3 years after surgery.

[Factors affecting the maintenance of occupational activity over a 2-3-year period after total hip replacement]. / Czynniki wplywajace na utrzymanie aktywnosci zawodowej w okresie 2­3 lat po zabiegu calkowitej endoprotezoplastyki stawu biodrowego.

BACKGROUND: The purpose of this paper was to assess the occupational activity in patients after hip replacement over a 2-3-year post operational period and to analyze the effect of selected factors (age, gender, body mass index (BMI), functional state and self-assessed health status) on this activity. MATERIAL AND METHODS: In the research 107 people (56 women and 51 men) participated. The average age of the subject's was 55.1 years. A standardized author's survey questionnaire, including questions about personal and clinical data, occupational activity and self-assessment of health status, was applied. The body mass and height were measured and the BMI index was calculated. The 100 points Harris Hip Score (HHS) was used to assess the functional state in the respondents. RESULTS: After the operation about 60% of the patients were not occupationally active; 44 (41.1%) respondents received the state health benefit, 18 (16,8%) respondents were eligible for pension benefit, and 2 (1.9%) respondents were unemployed with benefit. No one unemployed before the operation undertook work afterwards. Neither gender nor the character of the job or BMI exerted statistically significant effect on the occupational activity after the operation. Significant differences were noted in undertaking the occupational activity after the operation in patients with different level of functional efficiency assessed with the use of HHS (p = 0.0350) and different level of self-assessed health statuse (p = 0.0057). CONCLUSIONS: More than half of the respondents have not returned to work after total hip replacement, while people doing intellectual work most frequently returned to occupation after surgery. Age, functional efficiency, and self-assessed health status of the patient had a significant influence on their return to work. Med Pr 2018;69(2):191-198.

Comparison of the Effectiveness of Shockwave Therapy with Selected Physical Therapy Procedures in Patients with Tennis Elbow Syndrome.

Wstep. Lokiec tenisisty jest to zespól bólowy tkanek miekkich okolicy nadklykcia bocznego kosci ramiennej. Celem pracy bylo porównanie skutecznosci terapii radialna fala uderzeniowa (RSWT) z zabiegami laseroterapii i ultradzwieków w badanej grupie. Material i metody. Badania przeprowadzono na grupie 77 pacjentów, których poddano terapii radialna fala uderze-niowa (RSWT; grupa pierwsza - 40 osób) vs laser i ultradzwieki (grupa druga - 37 osób). Do pomiaru efektów terapii wy-ko--rzystano testy funkcjonal-ne Milla i Thomsona, kwestionariusz EQ-5D-5L do ogólnej oceny stanu zdrowia oraz specy-ficz-ny kwestiona-riusz Patient - Rated Tennis Elbow Ewaluation (PRTEE) oceny funkcjonalnej pacjentów z "lokciem tenisisty'. Wyniki. Zarówno w pomiarze testem Thomsona i Milla odnotowano istotna statystycznie poprawe wyników w oby-dwu gru-pach. Efekty leczenia istotnie statystycznie róznily sie pomiedzy grupami w pomiarze testem Milla (p=0,006). Efekty terapii mie-rzone w skali PRTEE istotnie statystycznie róznily sie w dwóch badanych grupach w kazdej z kategorii (p<0,001) na korzysc grupy leczonej RSWT. W skali EQ-5D-5L wieksza statystycznie poprawe zaobserwowano w grupie leczonej RSWT jedynie w kategorii samoobslugi (p=0,024). Wnioski. 1. Zarówno leczenie z zastosowaniem laseroterapii i ultradzwieków jak i radialnej fali uderzeniowej istotnie wplywaja na zmniejszenie dolegliwosci bólowych, a tym samym na poprawe funkcji konczyny górnej oraz jakosci zycia osób z zespolem lokcia tenisisty. 2. Wykazano wieksza krótkotrwala skutecznosc terapii z zastosowaniem radialnej fali uderzeniowej w porównaniu do laseroterapii i ultradzwieków w eliminowaniu bólu oraz poprawie funkcji konczyny górnej. 3. Fala uderzeniowa wydaje sie byc skuteczna terapia dla pacjentów z zespolem lokcia tenisisty, niemniej nalezy prowadzic dalsze badania dotyczace dlugotrwalych efektów prezentowanej metody leczenia.

Occupational Activity in Patients 10 Years after Hip Replacement Surgery.

BACKGROUND: Advanced hip osteoarthritis requires total joint replacement surgery to improve daily activity, including occupational activity. The purpose of this study was to evaluate employment status among patients 10 years after hip replacement surgery. MATERIAL AND METHODS: A total of 63 patients who underwent total hip replacement surgery at the Department of Orthopedics and Traumatology between 2003 and 2005 were enrolled in the study. At the time of the study (2014), all patients from the study group were of working age. Ultimately, 32 patients participated in the study. Each participant completed a questionnaire with questions about the place of residence, age, type of endoprosthesis, employment status, type of work performed, reason for arthroplasty, postoperative course of rehabilitation and subjective health status. Functional capacity was evaluated using Harris' 100-point scale. RESULTS: 88% of the respondents had been employed prior to surgery, compared to only 46% one year after surgery and only 40% at 10 years after surgery. A positive outcome was that 17% of the respondents receiving a disability pension prior to surgery were able to return to work after surgery. CONCLUSIONS: 1. Hip replacement surgery may affect the employment status of patients. 2. The most significant factors influencing cessation of work were a high BMI, living in a rural environment and being female.

The influence of Kinesiology Taping on the reduction of lymphoedema among women after mastectomy - preliminary study.

INTRODUCTION: Kinesiology Taping is a method that assists healing processes and improves the physical efficiency. THE AIM OF THE STUDY: The aim of the study was to assess the influence of Kinesiology Taping on the lymphoedema reduction among women after mastectomy. MATERIAL AND METHODS: The subject of the research included 44 women underwent single mastectomy along with the removal of lymph nodes. The examination was carried out from the 4(th) of January to the 4(th) of February, 2013. The traditional taping method was implemented among 22 women, whereas the own taping method was used among the other 22 women. The therapy took 21 days, during which the tapes were applied three times every 7 days. The measurements were made before every application and at the end of the therapy. In the study, a questionnaire was used and it included questions concerning basic demographic, epidemiological data as well as the evaluation of the therapy effectiveness. The linear measurements of the upper limbs, the measurements of the range of joints' motion in the upper limb were taken as well as grip strength was made. RESULTS: The reduction of the volume of lymphoedema of 55% was reported in the study group, whereas the oedema reduced by 27% in the clinical control one. CONCLUSIONS: In the reduction of lymphoedema, the greater effectiveness of the own taping method in comparison to the traditional one was reported. Kinesiology Taping exerted an influence on the improvement of the upper limb's joints movability and the grip strength.

Change in anthropometric parameters of the posture of students of physiotherapy after three years of professional training.

INTRODUCTION AND AIM: A physiotherapist's occupation requires high physical fitness and a properly functioning neuromuscular system. Working with patients is not always performed in accordance with the rules of work ergonomics. The aim of this paper was to verify the possible changes in the posture of students of physiotherapy after three years of professional training. MATERIAL AND METHODS: The sample group consisted of 30 randomly chosen students of physiotherapy. Each person was examined twice (at the age of 20 and at the age of 23). Both examinations were performed by the same researcher. The ultrasound system ZEBRIS Pointer was used for the examination; 17 parameters were analyzed in sagittal projection, frontal projection, and transversal projection. RESULTS: Statistical analysis revealed positive correlations between the 10 parameters in examination 1 and examination 2 which means that a person with a relatively higher level of obliquity in examination number 1 also had slightly different values in an examination conducted three years later. CONCLUSION: Studying physiotherapy and physical work with patients resulted in a considerable worsening of the students' posture. It is advisable to educate students on ergonomics and the rules of safety and hygiene while working as a physiotherapist in order to protect the therapists' health.

Subluxation of the shoulder joint in stroke patients and the influence of selected factors on the incidence of instability.

BACKGROUND: The aim of the study was to evaluate the incidence of shoulder subluxation in stroke patients and the impact of rehabilitation and presence/absence of fluid in the subhumeral and subdeltoid bursae on the occurrence of instability. MATERIALS AND METHODS: The study group was composed of 182 patients after stroke, with 108 men and 74 women. 156 of the patients had suffered an ischemic stroke whereas 26 had experienced a hemorrhagic stroke; 90 patients had right-sided paresis and 92 left-sided paresis. The study variables were evaluated by performing, on two occasions, an ultrasound examination of the shoulder and an assessment of upper limb functional capacity using the Brunnström scale. 182 patients of the study group participated in an exercise programme according tothe PNF concept. RESULTS: There was no subluxation of the shoulder on the healthy side, while on the paretic side, subluxation occurred in 25.3% of the patients. Bursal fluid was seen more frequently on the paretic side (12.6%). A statistically significant reduction of the subluxation and bursal fluid was achieved after the rehabilitation. Subluxation occurred more frequently in patients with a known presence of fluid in the bursae and in those with poorer functional capacity of the upper limb. CONCLUSIONS: 1. The clinical symptoms of stroke are the cause of subluxation in the shoulder joint. 2. Subluxation occurs more frequently in patients with a known presence of fluid in the subhumeral and subdeltoid bursae and in patients with reduced functional capacity. 3. The reduction of subluxation and bursal fluid was influenced by the exercise program and improved functional capacity.

Effect of TENS on pain relief in patients with degenerative disc disease in lumbosacral spine.

BACKGROUND: The study sought to evaluate the impact of long-term TENS therapy on pain relief in patients with degenerative disc disease in the lumbosacral spine. MATERIAL AND METHOD: The study involved 39 patients with lumbosacral pain who were receiving treatment in the Regional Hospital No 2 in Rzeszów and in Winsen Hospital. The experimental group consisted of 16 patients who were fitted with L-S orthoses with a built-in OmniTens plus mini-device for long-term application (3 times a day, for 20 minutes) of TENS currents with a frequency of 35 Hz and impulse duration of 150µsec. The control group consisted of 23 patients who received conventional TENS therapy once a day for 20 minutes, with a frequency of 35 Hz and impulse duration of 150 µsec. The results were assessed with the Oswestry Questionnaire, a visual analogue scale (VAS), as well as Schober's Test. Tests were performed before and on completion of the therapy. RESULTS: All participants reported pain relief and improved spinal function and mobility. Statistically significant differences were obtained in the group of patients treated with low frequency pulsed TENS currents administered via the orthosis. CONCLUSIONS: 1. TENS therapy contributed to pain relief and improvement of function and mobility of the lumbosacral spine 2. Representing an appropriate and effective technique, TENS stimulation via an orthosis should be more commonly prescribed.

The dynamics of physical activity in palliative care patients.

BACKGROUND: Active and passive physical exercises in patients under palliative (long term) care in palliative wards and home hospices are a necessary means of prevention or reduction of pulmonary complications, disorders of respiratory function, vascular complications, disorders of lymphatic and venous function, and musculoskeletal dysfunction. The goal of this study was to assess the dynamics of physical activity in patients under long term care. MATERIAL AND METHOD: The study group consisted of 60 patients staying in a palliative care ward or a home hospice. The dynamics of physical ability was assessed with the Karnofsky Performance Scale, and the quality of life was evaluated using the 6-point scale of the Rotterdam Symptom Checklist. The study was conducted over eight weeks, with patient information recorded once a week. RESULTS: Over consecutive weeks, physical activity increased by 10-20% in 20% of the participants, did not change in 36% of the participants, and 44% of the study group showed a decrease in activity. We found an increase in the quality of life in the consecutive weeks of the study and a correlation with the physical activity level. A higher score on the Karnofsky Scale corresponded with a higher quality of life measured in the six-point scale of the Rotterdam Symptom Checklist. Significant correlations were found both for specific weeks and for the entire study period. CONCLUSIONS: 1. The rehabilitation of palliative care patients resulted in a significant improvement in the quality of life. 2. The results indicate that there is a need to provide palliative patients with optimum rehabilitation regardless of their pre-rehabilitation clinical status. 3. The Karnofsky Performance Scale and the Rotterdam Symptom Checklist are strongly correlated with each other, which makes them robust investigative instruments for evaluating palliative patients.

Problems in the rehabilitation of patients following total shoulder replacement surgery - case study.

BACKGROUND: There are a number of indications for total joint replacement surgery, mainly degenerative changes with limited function, rheumatoid arthritis, post-traumatic changes, arthropathy accompanying rotator cuff injuries. Problems in the rehabilitation of patients following partial or total shoulder joint replacement surgery result from the anatomy and biomechanics of the shoulder, including extensive joint mobility range, relatively weak muscle stabilization and a frequent need to reconstruct the rotator muscles and joint capsule. The aim of this paper is to present problems in the rehabilitation of a patient following total shoulder replacement surgery. DESCRIPTION OF A CASE: A female patient (St. G., 69) was involved in a traffic accident and, immediately after the accident, underwent surgery with stabilisation of the bone fragments with Kirschner wires. Five years following the operation, the patient was qualified for total shoulder replacement surgery on account of pain, limited mobility and muscle weakness. One year later, the patient was admitted to the Rehabilitation Department at the Regional Hospital No. 2 in Rzeszów for rehabilitation. The main goals of the rehabilitation were improvement of neuromuscular control of the scapula, reduction of pain, restoration of the function of muscles supplying the glenohumeral joint, and improvement of the range of joint mobility. SUMMARY AND DISCUSSION: Total shoulder replacement is a difficult operative procedure and its outcomes are often unsatisfactory to the patient. Pain reduction and improvement of limb function are good postoperative outcomes. A satisfactory result of total shoulder replacement depends on the experience of the operator, physiotherapist and an appropriate rehabilitation programme. CONCLUSION: Rehabilitation following partial shoulder replacement should be designed not only to increase shoulder joint mobility, but also to restore the entire stabilization mechanism, and improve upper limb function.