Does Application of Lymphatic Drainage with Kinesiology Taping Have Any Effect on the Extent of Edema and Range of Motion in Early Postoperative Recovery following Primary Endoprosthetics of the Knee Joint?

BACKGROUND: The surgery of knee replacement due to degenerative changes is the last step of the treatment. After surgery, a major problem in patients is pain, swelling, intraarticular hematoma, and the restriction of the mobility of the joint. The aim of this work was to determine the effect of Kinesio Taping (KT) on reducing edema of the subcutaneous tissue and improving the range of motion in the joint. METHODS: 82 patients were qualified for the study. After surgery, 42 patients received postoperative edema treatment with KT bands, and 40 patients did not receive the treatment. The swelling thickness and range of mobility were measured on the third and eighth days after the operation. RESULTS: A statistical difference between the longitudinal measurements of the KT group and the group without KT application was shown at the level of the fibula head, 25 mm below the fibula neck, and 50 mm below the fibular neck. There were no statistically significant differences in the change in knee angle between the applied and non-applied patients. CONCLUSION: The lymphatic application technique KT influences the absorption of subcutaneous edema after primary knee joint replacement surgery but has no influence on mobility.

A Kinesio Taping Method Applied in the Treatment of Postsurgical Knee Swelling after Primary Total Knee Arthroplasty.

Background The knee is one of the joints in the human body that is most susceptible of osteoarthritis (OA). In the case of advanced-stage OA, total knee arthroplasty (TKA) is a treatment of choice. One modern physiotherapeutic method to support the treatment in the early postsurgical period is Kinesio Taping (KT). The aim of this study is to evaluate the efficacy of KT on swollen subcutaneous tissue after TKA. MATERIALS AND METHODS: The studied group consisted of 23 patients who had received TKA. The mean BMI was 30.60 ± 4.91, and KT was applied between the 3rd and 8th day of the early postoperative period. The control group was constituted by 22 patients who had received TKA. The mean BMI was 30.41 ± 6.00, and KT was not applied. On the 3rd and 8th day after TKA, in all patients, the swelling of the shin, range of motions (ROM), and pain were measured using ultrasound, a goniometer, and a VAS scale, respectively. RESULTS: In the KT group, the lateral measurement at the top of the head of the fibula significantly decreased between the 3rd and 8th day (11.47 ± 0.76 vs. 9.76 ± 0.77; p = 0.0004). The knee flexion angle on day 3 was statistically significantly different from that on day 8 (48.61 ± 3.08 vs. 72.74 ± 3.92; p = 0.00004). The evaluation results for severity of pain using the VAS scale on day 3 were statistically significantly higher than those on day 8 (5.74 ± 0.25 vs. 4.30 ± 0.25; p = 0.00006). In the group of patients to whom KT was not applied, the lateral measurement at the top of the head of the fibula on day 3 was not statistically significantly different from that on day 8 (10.323 ± 0.828 vs. 10.273 ± 0.995; p = 0.9227). The knee flexion angle in the group that did not receive KT on day 3 was statistically significantly different from that on day 8 (45.182 ± 3.654 vs. 59.909 ± 4.817; p = 0.0006). The severity of pain evaluated using the VAS scale on day 3 was statistically significantly different from that on day 8 (6.227 ± 0.146 vs. 4.864 ± 0.190; p = 0.0001). CONCLUSIONS: KT is an effective method for improving subcutaneous drainage and decreasing subcutaneous tissue. However, KT does not affect postoperative pain and ROM.

ISCHEMIC SPINAL CORD INJURY FOLLOWING AORTIC STENT GRAFT IMPLANTATION - CASE STUDY.

Morbidity and mortality associated with aortic aneurysm remains high. Aneurysms involving the thoracic and lumbar part of the aorta (TAAA) are particularly burdened with mortality. They are also one of the biggest challenges that vascular surgeons can face. Despite several dozen years of progress in surgical techniques, as well as the constant development of accompanying methods of spinal protection, ischemic spinal cord injury with subsequent paresis or pareresis is still one of the most serious complications of both open and closed surgical treatment of aortic aneurysms. Ischemic complications of the spinal cord occur immediately after the procedure, when the patient wakes up with a neurological deficit (according to some authors within the first day after the procedure) or in a deferred manner. In the case of open surgery, immediate damage is more common, in the case of endovascular surgery - deferred. Factors such as low blood pressure, arrhythmias, cardiovascular failure, sepsis and anemia due to anemia contribute to an increased risk of deferred complications. The rehabilitation of a patient with limb paralysis as a consequence of vascular spinal injury is laborious and requires a comprehensive approach. Proper treatment and prompt intervention in the form of rehabilitation is a great therapeutic challenge. The aim of the paper was to present the importance of the ischemic injuries of spinal cord following aortic stent graft implantation through a case report.

[Overview of selected tests used to assess the functional status of elderly].

Physical activity is one of the most important element of a healthy lifestyle and determinant of the physical and mental health. According to the WHO, limited physical activity is the fourth most common premature deaths risk factor in the world. Regular sport and active recreation is very important for our health. Physical exercise is the most effective method used by physiotherapists to prevent and slow down the aging process of the body, and consequently, diseases of elderly, such as: osteoporosis, injuries caused by falls, diabetes or hypertension. Physical activity has a positive effect on the quality of life and cognitive functions of elderly. People over 65 years constitute about 40-50% of people who require specialist medical care in the world. Therefore, health and medical professionals dealing with preventive healthcare and treatment of elderly people should have basic knowledge in geriatric rehabilitation, as well as to be able to plan suitable physiotherapy program adequate to the needs of older people. To assess the functional status of the patient, as well as the effectiveness of the training, various types of functional tests are used, specially designed for the elderly. These tests are based on the Comprehensive Geriatric Assessment (COG) considering the state of health, physical and mental fitness as well as socio-environmental conditions. The physiotherapeutic program should be based on functional training involving the entire human body, i.e. nervous, muscular, skeletal, sensory and balance systems.

Postural disorders in the elderly in static assessment.

Physical activity is one of the most important element of a healthy lifestyle and determinant of the physical and mental health. According to the WHO, limited physical activity is the fourth most common premature death risk factor in the world. Regular sport and active recreation is very important for our health. Physical exercise is the most effective method used by physiotherapists to prevent and slow down the aging process of the body, and consequently, diseases of elderly (e.g. osteoporosis, diabetes, hypertension and injuries). Physical activity has a positive effect on the quality of life and cognitive functions of elderly. The physiotherapeutic program should be based on functional training involving the entire human body. To plan and monitor the effectiveness of the training, different types of tests are used to assess the functional status of elderly people. These tests are based on the Comprehensive Geriatric Assessment considering the state of health, physical and mental fitness as well as social and environmental determinants.

Postoperative limb lengthening following Total Hip Arthroplasty (THA) through a posterior approach--a challenge for the orthopaedist or physiotherapist?

BACKGROUND: As coxarthrosis progresses, pain and mobility limitation exacerbate, usually presenting as a progressive flexion-abduction contracture. This, combined with the degradation of articular ends of bones, is responsible for anatomical and functional shortening of the limb. The sensation of postoperative leg length difference is a significant problem both for the patient and the operator. A sense of the operated limb being longer may be due to excessive length of the femoral segment following total hip arthroplasty. It may also result from a postoperative abduction or flexion-abduction contracture. The aim of the study was to review the clinical course of total hip replacement surgeries. The focus was on complaints of leg length discrepancy persisting for more than two weeks after ambulation. MATERIAL AND METHODS: We investigated a series of 210 unilateral THA procedures. Swanson's technique through a posterolateral approach was used in all cases. Twelve patients, including 8 women and 4 men (out of the total of 210 patients - 169 women and 41 men), reported a sensation of operated limb lengthening for more than two weeks after ambulation. We reviewed the process of rehabilitation in this group of patients. RESULTS: The rehabilitation procedure presented in this paper eliminated the sensation of limb length discrepancy in all patients who had reported this problem. CONCLUSIONS: 1. Complaints of leg lengthening following total hip arthroplasty were reported by approx. 5% of the THA patients. 2. Consistent physiotherapy involving muscle energy techniques (MET) helped to eliminate the sensation of limb length inequality.

[Problem and tolerance of leg lengthening after total hip replacement]. / Problem i granica tolerancji wydluzenia konczyn po protezoplastykach stawów biodrowych.

Inevitable sequaelae of predominant number of hip arthritis is shortening of the upper end of the femur due to the destruction of the femoral cartilage and head which is usually accompanied by increasing flexion contracture. The main goal of hip replacement is to restore normal hip biomechanics and appropriate femoral neck lever. As the number of hip arthroplasties increases the patients dissatisfied with the early postoperative result related to the apparent lengthening of the operated limb are becoming more numerous. The authors retrospectively analyzed group of 10 patients complaining of postoperative lengthening limb derived from series of 210 hip replacements. In this group a rehabilitation programme comprising of repeated maneuvers of manipulation aiming at reduction of abduction contracture and obtaining adduction was performed. After a period of one week to six months in all the cases the perception of leg length discrepancy disappeared.