Changes in Skin Microcirculation Resulting from Vibration Therapy in Women with Cellulite.

BACKGROUND: Cellulite is a cosmetic defect that affects over 80% of post-pubertal women. One of its pathomechanisms involves microvascular dysfunction. It has been suggested that vibration is a physical stimulus that may improve circulation in the skin and muscles. The aim of this study was to evaluate the effect of local vibration on cutaneous microcirculation and on eliminating the symptoms of cellulite in women. METHODS: A total of 57 healthy women with at least grade 1 cellulite were recruited and divided into four groups differing by treatment time (30' or 60') and position (sitting or lying) during the vibration treatments. Participants took part in 15 vibrotherapy sessions. Body composition, selected circumferences, cellulite grade, and thermographic images of buttocks and thighs were recorded. RESULTS: Significant changes in skin temperature were observed in both studied areas after the first and last treatments in each group. A significant decrease in cellulite grade was observed after a series of treatments. The strongest effects were observed for the sitting position with a treatment time of 60 min. CONCLUSION: Vibration treatment improves microcirculation in cellulite-affected areas. Over time, no adaptation was observed, and subsequent treatments maintained the beneficial effects. Extending the treatment time increased its influence on the microcirculation in the skin.

Intermittent Claudication in Physiotherapists' Practice.

Intermittent claudication is a symptom of atherosclerosis of the lower limbs (peripheral arterial disease (PAD)) and is characterized by pain and cramps of lower limb muscles during exercise. Claudication leads to a reduction in physical activity of patients. PAD is a systemic disease. Atherosclerotic lesions located in the arteries of the lower limbs not only pose the risk of the ischemic limb loss, but above all, they are an important prognostic factor. Patients with claudication are at significant risk of cardiovascular complications such as infarcts or strokes. Comprehensive rehabilitation of patients with intermittent claudication based on the current TASC II (Inter-Society Consensus for the Management of Peripheral Arterial Disease) guidelines, ESC (European Society of Cardiology) guidelines, and AHA (American Heart Association) guidelines includes supervised treadmill training, training on a bicycle ergometer, Nordic Walking, resistance exercises of lower limb muscles, and exercises of upper limbs. A trained, educated, and motivated patient has a chance to improve life quality as well as life expectancy.

The role of selected variables in the diagnosis of cervical derangement syndromes.

BACKGROUND: The study analyzed correlations between selected variables in cervical derangement syndromes. MATERIAL AND METHODS: We analyzed data from 63 patients regarding pain (VAS, McGill Pain Questionnaire), mobility (CROM goniometer), dizziness, nausea, the duration of the current episode, and the number of previous episodes (history). Student's t and chi(2) tests and Pearson's r correlation were used. RESULTS: Overall pain intensity correlated positively with the indexes of the McGill Pain Questionnaire, the duration of the current episode, intensity of the proximal and distal symptoms and negatively with protraction or extension. Headache correlated positively with neck pain and negatively with retraction. Neck pain cor-related negatively with multiple cervical movements and positively with intensity of the distal symptoms. A positive relationship between shoulder and upper limb pain was observed. Patients with higher overall pain intensity or lower shoulder pain intensity experienced dizziness more often. The duration of the current episode correlated positively with the number of previous episodes, the frequency of nausea, limited extension and limited protraction. Nausea coexisted with dizziness and reduced protraction. The degree of flexion restriction correlated positively with the number of previous episodes. CONCLUSIONS: 1. Overall and proximal pain intensity, mobility of the cervical spine, the duration of the current episode and dizziness are useful in diagnosis of cervical derangement syndromes. 2. Intensity of the distal symptoms, the number of previous episodes and nausea should be particularly monitored.

Comparison of radiological results of conservative and operative treatment by Salter osteotomy in severe cases of Perthes' disease.

Background. The goal of treatment in Perthes' disease is the creation of best conditions for good hip reconstruction. The aim of this work was the comparison of radiological results of conservative and operative treatment by Salter osteotomy in Perthes' disease. Material and methods. 193 hips with severe Perthes' disease were analyzed (Catterall group III, IV), 105 hips were treated conservatively, 88 - were operated. Minimal follow-up time was 5 years. Following data were evaluated: Wiberg angle, acetabular angle, acetabulum-head index, acetabular and epiphyseal index. Additionally, head sphericity according to Mose, results estimation according to Stulberg and presence of arthritic changes were evaluated. Results. In conservative treatment group, Mose good result was achieved in 25 hips (23,8%), fair result - in 54 (51,4%), and poor result - in 26 (24,8%). According to Stulberg classification, class I was in 25 hips (23,8%), class II - 37 (35,2%), class III - 28 (26,7%), class IV - 9 (8,6%), class V - 6 (5,7%). In operative treatment group, Mose good result was achieved in 45 hips (51,2%), fair result - in 19 (21,6%), and poor result - in 24 (27,2%). According to Stulberg classification, class I was in 39 hips (44,3%), class II - 26 (29,5%), class III - 13 14,7%), class IV - 8 (9,1%), class V - 2 (2,3%). Radiological parameters of femoral head coverage were better after operative treatment. The amount of arthritic changes after conservative treatment were greater than after surgery. Conclusions. 1. Operative treatment by Salter osteotomy creates better conditions for spherical femoral head reconstruction. 2. Patients with III and IV Catterall group should be treated surgically.

Long-term results of conservative treatment in Perthes' disease.

Background. Legg-Calvé-Perthes disease, due to its frequency and impact on hip function, is an important orthopedic issue. The goal of this research was to assess long-term outcome after conservative treatment in Perthes' disease. Material and methods. We studied 123 patients (135 hips), 105 males and 18 females, average follow-up 19.5 years (range 10-34), average age at onset 6.4 years. Conservative treatment involved non-weight bearing, abduction casts, orthoses and rehabilitation. The average treatment duration was 2.9 years. The range of hip motion, pelvic stability, limb length, pain, limping and physical activity were estimated. The patients were classified according to Catterall's criteria and age of onset. In x-rays the risk factors, Wiberg angle, and acetabulum-head index were measured. Outcome was assessed according to Mose and Stulberg, and arthritic changes were noted. Results. At follow-up there was full physical activity in 50 cases (40.7%). Limping was observed in 38 patients (30%), limb shortening in 27 (22%). The range of motion was limited in 37 hips (27%), and 13 hips were unstable (9.6%). There was a good Mose outcome in 36 hips (26.7%), fair in 70 (51.8%), and poor in 29 (21.5%). By Stulberg's classification, 35 hips were in class I (25.9%), 49 in class II (36.3%), 31 in class III (23%), 11 in class IV (8.1%), and 9 in class V (6.7%). Arthrotic changes were noted in 51 hips (37.8%). Conclusions. Twenty years after onset only 25% of the evaluated hips were normal. This suggests low effectiveness of treatment.