Enhanced Rehabilitation Outcomes of Robotic-Assisted Gait Training with EksoNR Lower Extremity Exoskeleton in 19 Stroke Patients.

BACKGROUND Stroke is a leading cause of long-term disability, often resulting in impaired mobility and gait abnormalities, necessitating effective rehabilitation approaches. Robotic-assisted gait training (RAGT) offers precise control and intensive, task-specific training. The EksoNR exoskeleton shows potential in facilitating gait recovery. This study assesses the efficacy and tolerability of RAGT using EksoNR in the rehabilitation of 19 stroke patients. MATERIAL AND METHODS A prospective nonrandomized, observational study design was employed with a single group convenience sample. The study included 19 individuals post-stroke, who underwent a 4-week rehabilitation program. Baseline and post-rehabilitation assessments were conducted using selected International Classification of Functioning, Disability and Health (ICF) codes, gait exoskeleton parameters (number of steps, walking time, time of verticalization) obtained during the exoskeleton sessions, and the Timed Up and Go Test (TUG). RESULTS The study revealed statistically significant improvements in all analyzed ICF categories, except for D530 Toileting, indicating enhanced functioning. The most notable improvements in activity and participation were observed in the categories of D410 Changing basic body position (-0.84±0.60) and D450 Walking (-0.84±0.60). Additionally, gait analysis demonstrated significant enhancements in the number of steps (difference of 506.79±252.49), walking time (13.02±7.91), and time of verticalization (11.82±9.21) (p>0.001). The TUG test also showed a statistically significant improvement in mobility (p=0.005). CONCLUSIONS This study supports previous findings, demonstrating that RAGT using the EksoNR lower extremity exoskeleton improves gait and functional status in stroke patients, while being well tolerated. The results highlight the potential of this approach for improved rehabilitation outcomes.

The Impact of Physical Exercises with Elements of Dance Movement Therapy on Anthropometric Parameters and Physical Fitness among Functionally Limited Older Nursing Home Residents.

Changes in the composition of the body mass of functionally limited older patients may contribute to a decrease in functional fitness and the development of chronic diseases. This research aimed to assess the differences in anthropometric parameters and physical fitness of older patients, over the age of 65, in a 12-week clinical intervention study. Method: The study participants were nursing home inhabitants aged 65-85 who were functionally limited. Persons meeting the inclusion criteria were assigned to one of the three groups: Group 1-basic exercises/BE group (n = 56); Group 2-physical exercises with elements of dancing/PED group (n = 57); Group 3-control group/CO group (n = 56) routine care. The data were collected at the beginning of the study and at the 12-week mark. The outcome was observed for hand grip strength (HGS), arm curl test (ACT), Barthel Index (BI), Berg Balance Scale (BBS), triceps skin fold (TSF), waist-to-hip-ratio (WHR), and arm muscle area (AMA). Results: The study included 98 women and 71 men. The average age of the participants was 74.40 years. The analysis of the effects of the 12-week exercise program showed the greatest changes in HGS, ACT, and BI in the exercise groups, especially in the PED group compared to the BE group. Statistically significant differences in the examined parameters of the PED vs. BE vs. CO groups were demonstrated in favour of the exercising groups. In conclusion, a 12-week program of group physical exercises, both PED and BE, improves physical fitness indicators and anthropometric indicators.

Single Nucleotide Polymorphism Discovery and Genetic Differentiation Analysis of Geese Bred in Poland, Using Genotyping-by-Sequencing (GBS).

Poland is the largest European producer of goose, while goose breeding has become an essential and still increasing branch of the poultry industry. The most frequently bred goose is the White Koluda® breed, constituting 95% of the country's population, whereas geese of regional varieties are bred in smaller, conservation flocks. However, a goose's genetic diversity is inaccurately explored, mainly because the advantages of the most commonly used tools are strongly limited in non-model organisms. One of the most accurate used markers for population genetics is single nucleotide polymorphisms (SNP). A highly efficient strategy for genome-wide SNP detection is genotyping-by-sequencing (GBS), which has been already widely applied in many organisms. This study attempts to use GBS in 12 conservative goose breeds and the White Koluda® breed maintained in Poland. The GBS method allowed for the detection of 3833 common raw SNPs. Nevertheless, after filtering for read depth and alleles characters, we obtained the final markers panel used for a differentiation analysis that comprised 791 SNPs. These variants were located within 11 different genes, and one of the most diversified variants was associated with the EDAR gene, which is especially interesting as it participates in the plumage development, which plays a crucial role in goose breeding.

The impact of physical exercises with elements of dance movement therapy on the upper limb grip strength and functional performance of elderly wheelchair users living in nursing homes - a randomized control trial.

INTRODUCTION: Over the last few decades, the quality of care and the quality of life of nursing home (NH) residents have significantly improved, but insufficient physical activity and social involvement still represent substantial challenges in modern nursing facilities. The main aim of this research was to assess the influence of physical exercises with dance movement therapy (DMT) elements on strength and other fitness components of the upper limbs and the overall functional performance of NH residents in wheelchairs compared to standard exercise programmes and usual care. METHOD: The study participants were persons aged 68-85 who lived in NH and used manual wheelchairs as a primary means of mobility. Individuals meeting the inclusion criteria were assigned to one of the three groups: Group 1, basic exercise/BE group (n = 55); group 2, physical exercises with elements of dance movement therapy/PED group (n = 55); and group 3, control group, usual care/CO group (n = 55). The intervention for both exercising groups consisted of a 30-min session, two times a week, for 12 weeks in total. Outcome assessments were performed at baseline, 12 weeks after baseline (immediately after the intervention) and 24 weeks after baseline (12 weeks after the intervention). The main outcome was observed for hand grip strength (HGS), while secondary outcomes for box and block test (BBT), arm curl test (ACT), back scratch test (BS), chair sit-and-reach (CSR), peak expiratory flow (PEF), Barthel Index (BI), Berg Balance Scale (BBS) and the range of motion of the shoulder. RESULTS: Prior to the start of the exercise programmes, all the tested groups were homogeneous. After 12 weeks the PED group presented higher statistically significant scores in HGSL, BBT, ACT, BS, CSR, BI, BBS: p < 0.001 and HGSR: p = 0.01, compared to the BE group. After 24 weeks from the beginning of the intervention the comparison between the PED group and the BE group showed statistically significant differences (p < 0.001) in favour of PED group in almost all areas: HGSR, HGSL, BBT: ACT, PEF, BS, CSR, BI. After 12 and 24 weeks both intervention groups performed better than the CO in all measures except for Katz ADL and shoulder extension. CONCLUSION: Twelve weeks of physical exercises had beneficial effects on the strength and fitness of the upper limbs and overall functional performance in both exercise groups. This study demonstrated that group performing physical exercises with elements of DMT obtained statistically better scores in the majority of analysed domains than other groups. TRIAL REGISTRATION: The study was registered in the Sri Lanka Clinical Trials Registry (Registration Number - SLCTR/2018/014 - Date of Registration 16/05/2018. Accessed on https://slctr.lk/trials/1045 ).

Psychophysical Health Factors and Its Correlations in Elderly Wheelchair Users Who Live in Nursing Homes.

Background: The aging is a multi-faceted process comprising both-the physical and mental alterations. Thus, the aim of the study was to evaluate the variables affecting the psychophysical state of the elderly people using wheelchairs and living in nursing homes (NH). Methods: 165 older wheelchair users were included in the study after meeting the inclusion criteria and expressing written consent. The assessment involved cognitive functioning, depression, body balance and flexibility, lung capacity and upper limbs dexterity, strenght and endurance. The results showed negative correlation between depression and balance, upper limb dexterity and endurance and shoulder flexion. A positive correlation between cognitive functioning and balance, upper limb dexterity, strenght and endurance, lung capacity and joint mobility was determined. Also, the study proved positive correlation between daily functioning and functional fitness, muscle strength and endurance, body flexibility, joint mobility. The regression analysis showed that better scores in balance test and joint mobility implied with higher scores in cognitive functioning. The most important determinants of functional fitness were balance, hand grip strenght and joint mobility. Conclusion: The future study should be focused on developing interventions aimed at senior wheelchair users living in NHs to prevent the deterioration of their mental and physical fitness.

Comparison of selected body composition parameters in women using DXA and anthropometric method.

BACKGROUND: An excessive accumulation of the adipose tissue in women's organism is a frequent and important medical problem which should be monitored. The aim of this study was to explore correlations between the selected parameters of body composition assessed using DXA and anthropometric methods. MATERIALS AND METHODS: The study group consisted of 50 women aged 51-85. Both adipose mass and fat-free mass were assessed with the DXA method, and the nutritional status of the participants was evaluated with the anthropometric methods. RESULTS: The mean body mass index (BMI) value assessed with the DXA method amounted to 28.4 (±5.12). The Spearman's Rho correlation indicated the presence of a moderate association (0.27-0.50) between: (1) right arm lean and the circumference of the arm (P = 0.020), forearm (P = 0.011), and transverse cross-section of the arm (P = 0.020), (2) right leg fat and circumference of the thigh (P = 0.003), shin (P = 0.009), and also the musculature index of the lower extremity (P = 0.034), (3) visceral adipose tissue (VAT) mass and BMI (P = 0.050), Waist to HeightRatio (WtHR) (P = 0.031), (4) Android fat and WHtR (P = 0.044), and (5) gynoid fat and Skerlj index (P = 0.025). CONCLUSION: The selected parameters assessed with DXA were significantly correlated with the selected parameters assessed with anthropometric methods. WHtR anthropometric parameter is significantly correlated with DXA parameters: VAT mass, gynoid region % fat and android region % fat.

Sedentary behaviors in children and adolescents with type 1 diabetes, depending on the insulin therapy used.

Assessment of sedentary behaviors in children and adolescents with type 1 diabetes (T1D), relative to the method of insulin therapy used, and in comparison to healthy controls.The study group consisted of 215 children with T1D, including 109 (50.7%) insulin pen and 106 (49.3%) insulqsain pump users. The control group comprised 115 healthy children. The subjects' sedentary time was measured with a tri-axial accelerometer ActiGraph GT3X+, used continuously for 7 days.The diabetes group was characterized by a significantly higher "% in sedentary time" score (P = .024) and a lower "mean daily breaks in sedentary time" result (P = .007), which means that they spent much more time on sedentary activities compared to the control group. There were no significant differences between the children using insulin pump and insulin pen in the "% in sedentary time" score (P = .294) and "mean daily breaks in sedentary time" (P = .251).The T1D is a serious encumbrance, leading to longer duration of sedentary time, in comparison to healthy controls. The type of insulin therapy did not significantly affect the percentage of the wear-day spent in sedentary time and mean daily breaks in sedentary time.

The influence of pelvis reposition exercises on pelvic floor muscles asymmetry: A randomized prospective study.

OBJECTIVE: The assessment of pelvis reposition exercise efficacy in the treatment of pelvic floor muscles (PFM) asymmetry. The hypothesis was that PFM asymmetry may have a functional reason related to lumbopelvic complex misalignment. DESIGN: A parallel group trial with follow-up METHODS:: Thirty young women were divided into 2 groups: experimental (n = 15) and control (n = 15). In experimental group one, a 15-minute trial of pelvis reposition exercise was carried out. Ober test, the Thomas test, and transabdominal PFM ultrasound measurements were performed in both groups. RESULTS: In the experimental group both the Ober and Thomas tests were positive at baseline in most subjects. After the exercise, improvement was noted in Ober test (P = .005; d = 0.75 on the right side, P = .005; d = 0.78 on the left side) and in the Thomas test (P = .005; d = 0.66 on the right side, P = .005; d = 0.67 on the left side). At baseline, the ultrasonographic evaluation of PFM performed during resting and during voluntary pelvic muscles contraction showed the right-left length asymmetry. The return of symmetrical PFM work after pelvis reposition exercise was observed in the experimental group. There were no statistically significant changes in the control group.s CONCLUSIONS:: We suggest that after reposition exercises, the pelvis was more symmetrically aligned in relation to body axis; therefore, the muscles of the pelvic floor have functional length and did not shorten or lengthen due to pelvis rotation. In this study, for the first time, it was presented that PFM asymmetry visible in ultrasonography may be corrected by this specific exercise. Further analysis of the causes of this asymmetry may lead to more accurate treatment of PFM dysfunctions.

Physical activity in children and adolescents with type 1 diabetes and contem-porary methods of its assessment.

Exercise is a determinant of people's well-being, and it contributes to the prevention and treatment of numerous diseases of affluence, e.g. diabetes and obesity. The rapid pace of economic development is affecting human functioning to such a degree that the need for physical activity, which has always been recognised as a biological and natural need, has been significantly reduced. Consequently, to-day public health related problems occurring globally are connected with the increasing incidence of cardiovascular, neoplastic, and met-abolic diseases. These problems are manifested not only in adults, but they also increasingly affect children and adolescents worldwide. In the case of children with type 1 diabetes, physical activity is of particular importance because it contributes to the child's normal de-velopment and to positive effects of therapies. The paper discusses health-related benefits of physical activity in children and adolescents with type 1 diabetes, it presents recommendations related to physical activity published in Poland and abroad, and reviews contemporary methods of its assessment.

Childhood obesity: knowledge, attitudes, and practices of European pediatric care providers.

OBJECTIVE: To determine and compare attitudes, skills, and practices in childhood obesity management in 4 European countries with different obesity prevalence, health care systems, and economic situations. METHODS: A cross-sectional survey was distributed to primary health care providers from France, Italy, Poland, and Ukraine. The questionnaire was returned by 1119 participants with a response rate of 32.4%. RESULTS: The study revealed that most of the primary health care providers were convinced of their critical role in obesity management but did not feel sufficiently competent to perform effectively. The adherence to recommended practices such as routine weight and height measurements, BMI calculation, and plotting growth parameters on recommended growth charts was poor. Most primary health care providers recognized the need for continuing professional education in obesity management, stressing the importance of appropriate dietary counseling. CONCLUSIONS: The study underlines insufficient implementation of national guidelines for management of obesity regardless of the country and its health system. It also makes clear that the critical problem is not elaboration of guidelines but rather creating support systems for implementation of the medical standards among the primary care practitioners.

A comparison of the perceptions and aspirations of third-year physiotherapy students trained in three educational settings in Poland.

OBJECTIVES: In Poland, physiotherapy is offered at three types of school: medical universities, universities of physical education, and schools that do not specialise in either the medical sciences or physical education. This study explored the knowledge of students who were completing their physiotherapy studies about working in Poland and other countries of the European Union (EU), and about their vocational plans. Students were asked, through self-assessment, about aspects of the professional skills they had gained. DESIGN: Quantitative questionnaire-based study of students in three university settings. SETTING: Eleven university-level schools in Poland offering studies in physiotherapy and representing three orientations: medical sciences (MS), physical education (PE) and other universities (OU). PARTICIPANTS: The study sample comprised of 954 third-year Bachelor programme students. RESULTS: The differences in university profiles did not influence the vocational plans of the students, with more than 70% (668/954) declaring that they would look for work outside Poland: 76% (725/954) in the UK and 69% (658/954) in Germany. Most students stated that finding work as a physiotherapist is difficult in Poland (686/954,72%) and easy in other EU countries (763/954, 80%). Differences in university profiles had an effect on the students' assessments of their professional skills, as students from universities without a long-standing tradition of training in physiotherapy declared that they were less well prepared to work as physiotherapists; the difference was statistically significant for 12 of the 16 domains examined (P<0.05). CONCLUSIONS: In the light of these results, an increased influx of Polish physiotherapists, trained according to European standards, into EU countries, especially the UK and Germany, is to be expected in the near future. The physiotherapists will predominantly be graduates of medical and sports-oriented state universities. It appears advisable to launch, under the auspices of an EU programme, an integrated employment information system for physiotherapists that would offer updated information on current demand in individual EU countries.

[Factors determining the quality of life of residents in homes for the aged--preliminary report]. / Ocena czynników determinujacych jakosc zycia mieszkanców domów pomocy spolecznej--doniesienie wstepne.

In 1997 people over 60 constituted 16.2% of Poland's population and their percentage will rise to 22.4 by 2020 according to the General Statistics Office (GUS). The increasing number of the elderly entails the need for new demographic, social, economical and health solutions. Thus, the need to create various centres, such as old people's homes. This is where the elderly live for years, often until their death, therefore it is so important to ensure them appropriate living conditions. Over the last years, it has been stressed that improvement in symptoms and lifespan lengthening are not the only important issues for patients but it is also, and even most of all, the improvement of their life's quality. The aim of the paper was to evaluate the factors determining the Quality of life (QoL) of the inhabitants of old people's homes. The study encompassed 80 inhabitants of an old people's home in Podkarpacie region. The Nottingham Health Profile and the Self Evaluation Scale of professor J. Tylka were used to assess the QoL. Both questionnaires were complemented by questions about chronic diseases and rehabilitation procedure applied. Results of the analysis are preliminary. So far the research has shown a significant dependence of the QoL on physical efficiency, pain and depression. It has been also demonstrated that, in spite of a suitable rehabilitation base, too little importance is still attached too a comprehensive rehabilitation in the old people's homes.