Disability of Dialysis Patients and the Condition of Blood Vessels.

The number of elderly hemodialysis patients is constantly increasing worldwide. This population has a high burden of comorbid conditions, which impair daily activities. The aim of the study was to analyze problems of disability in hemodialysis patients in the context of cardiovascular (CV) complications and vascular condition. In this cross-sectional study, 129 patients (mean age 64.5) were enrolled. The degree of disability in Barthel index (Bi) and 10-year cardiovascular risk (QRISK®3) were assessed. A Mobil-O-Graph monitor was used for measuring hemodynamic parameters. Only 6.2% of patients were professionally active, 19% used a wheelchair for transport, and 16% used crutches. More than half (51%) were independent in everyday activities reaching 80-100 points on Bi. The rest, with Bi < 80, were considered as dependent. The most common causes of disability were CV complications. The independent group (80-100 points) was characterized by significantly lower pulse wave velocity (PWV) and lower QRISK®3 compared to dependent patients. The degree of disability negatively correlated with age, PWV, and QRISK®3. Multivariate logistic regression revealed that disability (Bi < 80) was independently associated with CV events in the past adjusted odds ratio (adj.OR) 4.83 (95% confidence interval (95% CI): 1.74-13.41) and higher PWV adj.OR 1.45 (95% CI: 1.15-1.82). Our results indicate that CV diseases are the most important cause of functional impairment.

Analysis of the Structure of the Torso in the Frontal Plane in Girls with Rett Syndrome Taking into Account Their Functional Status.

BACKGROUND: Rett syndrome is a rare developmental disorder with a genetic background, and scoliosis is one of its many complications. The aim of the present study was to assess the structure of the torso in the frontal plane in RTT. It was assumed that asymmetry of the structure of the torso in the frontal plane would be smaller in girls who are able to maintain a vertical body position. MATERIAL AND METHODS: The study included 14 girls previously diagnosed with RTT aged between 3 and 15 years, who were divided into 2 groups. Group 1 comprised 5 girls who were not able to maintain a vertical position. Group 2 comprised 9 girls who were able to maintain a vertical position. Body mass and weight were measured with an electronic scales and a height measuring device. The Body Mass Index was calculated. Photogrammetry was used to assess the structure of the torso in the frontal plane. The study results were subjected to a statistical analysis involving the calculation of the arithmetic mean (x), standard deviation (sd), coefficient of variation (v%) and significance of differences (p). RESULTS: Left-sided asymmetries were most common in both groups. All angles and linear values were higher in Group 1. 80% of the subjects in Group 1 demonstrated significant asymmetry of the pelvic tilt angle (PTA). There were no statistically significant differences between Group 1 and 2 regarding all study indices. CONCLUSIONS: 1. The study demonstrated that asymmetry of the torso in the frontal plane was common in the girls with RTT. 2. Torso asymmetry was more pronounced in girls with a poorer functional status. 3. Analysis of BMI values demonstrated a poor nutritional status of the girls.

Body posture of women after breast cancer treatment.

INTRODUCTION: Human body posture changes in the course of ontogenesis. The changes are brought about by both internal factors (illness) and external factors (injury). The negative consequences of a medical condition such as breast cancer, together with the treatment process, undoubtedly contribute to disturbance of body posture. The aim of this paper was to evaluate the type of body posture in women after treatment of breast cancer on the basis of anteroposterior spinal curves. MATERIAL AND METHOD: The study involved a group of 51 (Group 1) women following treatment of breast cancer and a group of 37 healthy women (Group 2). The average age of the women in Group 1 was 61 years, and the average age of the healthy women was 58 years. All participants underwent a photogrammetric examination of body posture. Postural types were defined on the basis of the value of a compensation index (µ) as kyphotic, balanced, and lordotic. The following subtypes were distinguished within these three categories, depending on the shape of the spinal curves: kyphotic subtype I, II, III; balanced subtype I, II, III; and lordotic subtype I, II, III. RESULTS: The post-mastectomy group and the control group did not differ with regard to age (p=0.09), making it possible to continue the analysis of postural differences, which revealed significant differences at p=0.00008. In the group of women after treatment of breast cancer, 82.3% demonstrated a faulty body posture, compared to only 35.1% of the controls. There was no significant relationship between the quality of body posture and oncological treatment. CONCLUSION: A significantly higher incidence of faulty body postures was observed among women after treatment of breast cancer.

The influence of corrective exercises in a water environment on the shape of the antero-posterior curves of the spine and on the functional status of the locomotor system in children with Io scoliosis.

BACKGROUND: There has been a growing interest in studies examining the importance of the aquatic environment in non-invasive treatment of scoliosis. The water environment is an important element in the correction of body posture abnormalities. The aim of this paper is to evaluate the influence of corrective exercises in a water environment on the shape of the antero-posterior curves of the spine and on the functional status of the locomotor system of children with Io scoliosis. MATERIAL AND METHODS: The study involved a group of 94 children aged 8-13 years with Cobb Io scoliosis. Computer-aided photogrammetry was used to analyse the shape of the antero-posterior curves of the spine. The functional evaluation of the children's musculoskeletal system involved several functional tests: the Dega wall test, Thomas test, Lasegue test, and Kraus-Weber test. The tests were carried out twice: before a 6-month programme of corrective exercises in a water environment, and immediately on completion of the rehabilitation programme. The programme included swimming and corrective exercises in water. RESULTS: A statistical analysis of the dimensions of the anterio-posterior curves of the spine revealed a significant increase in the total length of the spine and the length of thoracic kyphosis. Besides, the bending angle of the trunk, the angle of thoracic kyphosis and the angle of lumbar lordosis were reduced. The analysis also showed an increase in the bending angle of the upper spine. Shoulder mobility also increased significantly following the programme of corrective aquatic exercises. CONCLUSIONS: 1. The programme of corrective exercises had an influence on the length and angle of thoracic kyphosis. 2. The muscle strength of the lower part of the erector spinae also increased, as did shoulder mobility measured by the Dega test.

Bioelectric activity of selected muscle groups in people with impingement syndrome.

The aim of this study was to assess the changes of the bioelectric activity of the selected muscles and their impact on the functioning of the shoulder joint in people with impingement syndrome. The study covered 58 subjects aged between 24 and 85, who were treated for impingement syndrome in the years 2004-2006. The average duration of the disease was 40 months. The following muscles were tested for bioelectric activity using surface myography: deltoid, supraspinatus, infraspinatus, latissimus dorsi, greater pectoral and biceps brachii on the healthy and the diseased sides. A significant drop in activity of the deltoid and the infraspinatus muscles on the diseased side was observed. The following muscles showed comparable activity on both sides: the supraspinatus, latissimus dorsi and the greater pectoral muscle. The activity of the biceps brachii muscles grew during resisted movements. The drop in the activity of the deltoid and the infraspinatus muscles on the affected side is an important factor responsible for changes of the active mobility of the shoulder and for the development of instability of the shoulder joint. A similar activity of the latissimus dorsi, greater pectoral and biceps brachii muscles on both sides indicates a development of the compensatory mechanisms and the role of those muscles in the dynamic stabilisation of the shoulder joint.

Principles of physiotherapeutic management of shoulder impingement syndrome.

BACKGROUND: The study aimed to assess changes in shoulder joint mobility and symmetry as well as changes in the bioelectrical activity of selected muscles important for the functioning of the shoulder complex in order to determine optimal physiotherapeutic management in patients with shoulder impingement syndrome. MATERIAL AND METHOD: The study involved 58 persons aged 24-85 years treated for shoulder impingement syndrome from 2004 to 2006. Symptoms had been present for 40 months on average. The examination of patients included in each case measurement of active mobility ranges using the SFTR method, photogrammetry-based assessment of shoulder symmetry and an examination of the bioelectrical activity of muscles using surface electromyography. RESULTS: The results demonstrated that the degree of limitation of external rotation, which considerably affects the other motion ranges, is the most important index of shoulder joint dysfunction. The decrease in the bioelectrical activity of the deltoid muscle is caused by pain avoidance, with high activity of the pectoralis major and latissimus dorsi muscles indicating the development of compensatory mechanisms. A spatial displacement of the scapula referred to as a wing-like position impairs the scapulobrachial rhythm. CONCLUSIONS: Therapeutic management should firstly aim to eliminate pain, then to restore shoulder joint stability by instructing the patient on how to properly centre the humeral head, and, subsequently, to restore normal movement patterns and the scapulobrachial rhythm, and finally to gradually increase the range of active mobility, in particular of external rotation.

Analysis of three-dimensional motion of the glenohumeral joint in impingement syndrome.

INTRODUCTION: Impingement syndrome (IS) is one of the most common causes of progressive dysfunctions of the shoulder joint. The aim of the study was to evaluate the changes in the joint's mobility in patients with IS and to find correlations between the angular values of particular motion ranges. MATERIAL AND METHOD: The study involved 58 people aged 24-85 years, treated for IS from 2004 to 2006. The average duration of the disease was 40 months. A comparative examination of active mobility on the healthy and affected side was carried out according to the SFTR method. RESULTS: A comparison of mean values of the motion ranges indicated significant limitations of active mobility in the affected shoulder. The greatest mobility deficit was found in the external rotation range. Moreover, there was a statistically significant correlation between the angular values of internal rotation and the values of the remaining motion ranges. CONCLUSIONS: Impingement syndrome.

Posture in people with shoulder impingement syndrome.

BACKGROUND: The posture of people with shoulder impingement syndrome (SIS) is a result of adaptive defensive posturing to decrease the intensity of pain in the affected joint. The aim of this work is to characterise trunk and shoulder girdle positioning in patients with SIS. MATERIAL AND METHOD: The study involved 58 patients treated for SIS in the years 2004-2006. Symptoms had been present for 40 months on average. A photogrammetric study was performed with the use of a MORA 4G system. It consisted in measuring lordosis and kyphosis, as well as the symmetry of some selected anthropometric points in the frontal plane. RESULTS: Changes in posture presenting as an increased angle of trunk inclination in the sagittal plane and in the frontal plane were observed in all patients. There was asymmetry of bony points as regards the position of the scapula and the waist triangles. CONCLUSIONS: The impingement syndrome is associated with displacement of all bony points analysed. Changes in posture are a result of adaptive mechanisms. Trunk asymmetry is secondary to changes in the spatial position of the scapula.