The Role of Rehabilitation after Spinal Mesotherapy in a Three-Stage Treatment Concept.

Sedentary lifestyles, work overload, and lack of regular physical activity are risk factors for spinal pain syndrome. In everyday medical practice, spinal pain syndrome of a muscular or myofascial, or non-neurogenic, nature is diagnosed. This problem affects a large group of patients and reaches about 70-80% of spinal pain cases. Usually, one of the primary treatments is with NSAIDs (Non-steroidal Anti-Inflammatory Drugs). In this case, one treatment method that is safe and has no side effects is spinal mesotherapy. This method consists of performing multi-point intradermal microinjections with the administration of drugs or medical devices. Based on a new perspective on the treatment of spinal pathology-the so-called three-stage treatment concept-it is necessary to deal with the risk factor(s) of spinal pain syndrome and reduce or at least modify them (stage I). This is followed by a broadly understood medical therapy, in this case spinal mesotherapy (stage II), which aims to relax tense tissues, improve mobility in the spine and thus reduce pain. As a result, conditions are created for the necessary process, which is rehabilitation in the broadest sense (stage III). Movement therapy, which is crucial in spinal pain syndrome, is performed with less pain, after obtaining better patient mobility. The purpose of this article is to evaluate the role of rehabilitation of patients after spinal mesotherapy in terms of the three-stage treatment concept for spinal pathology.

Efficacy and Safety of Spinal Collagen Mesotherapy in Patients with Chronic Low Back Pain in a Three-Month Follow-Up-Retrospective Study.

Background: Low back pain syndrome is associated with muscular and myofascial pain and is linked with muscle overstrain or a lack of regular physical activity as well as a habitual bad posture, which cause the overload of perispinal soft tissues. One of the forms of therapy of LBP is the mesotherapy of the spine, which consists of multi-point micro-injections of drugs or medicine mixtures, which include preparations of collagen type I. The aim of the study was to assess the efficacy and safety of mesotherapy with collagen type I. Methods: A retrospective analysis of the results of the treatment of patients with chronic low back pain syndrome using mesotherapy was performed. A total of 130 patients (83 women and 47 men; mean age: 51 ± 14 years) were divided into two groups: group I (n = 65), treated with collagen type I, and group II (n = 65), treated with lignocaine 1%. Mesotherapy was performed weekly over five weeks. Patients were assessed using the following scales: the VAS, Laitinen Scale, and Revised Oswestry Low Back Pain Disability Scale before the start of the treatment, after five treatments, and at the three-month follow-up visit. Results: A statistically significant improvement was observed after the use of spinal mesotherapy both with collagen type I and lignocaine, with the collagen treatment having better results at the three-month follow-up visit. No adverse effects were observed after the procedures. Conclusions: Spinal mesotherapy using collagen type I and lignocaine seems to be an effective method in the treatment of chronic LBP. Collagen mesotherapy gives better results in the long term. Mesotherapy is a safe form of therapy.

The Effectiveness of Preoperative Outpatient and Home Rehabilitation and the Impact on the Results of Hip Arthroplasty: Introductory Report.

A total hip replacement is the treatment of choice for end-stage hip osteoarthritis. Rehabilitation performed before surgery (called prehabilitation) is used to improve the results of surgical treatment. However, the results of studies have not unquestionably confirmed the effectiveness of preoperative rehabilitation and its impact on the outcome of surgery. The aim of this study is to assess the effectiveness of preoperative outpatient and home rehabilitation in relation to a control group not subject to these forms of influence. A total of 61 patients qualified for primary hip arthroplasty were randomly assigned to a group with outpatient rehabilitation before surgery, exercises performed at home, or a group without any intervention before surgery. Three weeks after surgery, the patients were re-qualified and underwent three weeks of outpatient rehabilitation in the day rehabilitation department. The patients from all three groups were evaluated in terms of functionality and pain using point scales upon enrolment in the study, on admission to the day rehabilitation department, and after 3 weeks of rehabilitation in the department. A total of 50 subjects completed the study. The study results did not reveal statistically significant differences between preoperative rehabilitation and no intervention. Patients rehabilitated at home gave up self-therapy more often than those undergoing outpatient rehabilitation.

Changes in Melatonin Concentration in a Clinical Observation Study under the Influence of Low-Frequency Magnetic Fields (Magnetic Stimulation in Men with Low Back Pain)-Results of Changes in an Eight-Point Circadian Profile.

The aim of this study was to assess the changes in melatonin concentration under the influence of magnetic stimulation in men with low back pain. A total of 15 men were used in this study, divided into two groups. In Group 1, consisting of seven men, the M1P1 Viofor JPS program was used twice a day for 8 min, at 08:00 and 13:00. In Group 2, consisting of eight men, the M2P2 Viofor JPS program was used once a day for 12 min at 10:00. The application was subjected to the whole body of patients. The treatments in both groups lasted 3 weeks, for 5 days each week, with breaks on weekends. The diurnal melatonin profile was determined the day before exposure and the day after the last treatment, as well as at one-month follow-up. Blood samples were collected eight times a day. In both programs, magnetic stimulation did not reduce the nocturnal peak of melatonin concentration. After exposure, prolonged secretion of melatonin was observed until the morning hours. The impact of the magnetic field was maintained 1 month after the end of the application. The effect of the magnetic field was maintained for 1 month from the end of the application, which confirms the thesis about the occurrence of the phenomenon of biological hysteresis. The parameters of the magnetic fields, the application system, and the time and length of the application may affect the secretion of melatonin.

Why Does Rehabilitation Not (Always) Work in Osteoarthritis? Does Rehabilitation Need Molecular Biology?

Osteoarthritis (OA) is a common disease among the human population worldwide. OA causes functional impairment, leads to disability and poses serious socioeconomic burden. The rehabilitation offers a function-oriented method to reduce the disability using diverse interventions (kinesiotherapy, physical therapy, occupational therapy, education, and pharmacotherapy). OA as a widespread disease among elderly patients is often treated by rehabilitation specialists and physiotherapists, however the results of rehabilitation are sometimes unsatisfactory. The understanding of molecular mechanisms activated by rehabilitation may enable the development of more effective rehabilitation procedures. Molecular biology methods may prove crucial in rehabilitation as the majority of rehabilitation procedures cannot be estimated in double-blinded placebo-controlled trials commonly used in pharmacotherapy. This article attempts to present and estimate the role of molecular biology in the development of modern rehabilitation. The role of clinicians in adequate molecular biology experimental design is also described.

Analgesic Effectiveness of Physical Therapy Combining the Use of Electromagnetic Fields with Light Radiation Emitted by LEDs along with the Use of Topical Herbal Ointment in Patients with Gonarthrosis.

(1) Background: The aim of the study is to evaluate the analgesic effectiveness of a physical therapy regimen that combines the use of an electromagnetic field with light radiation emitted by LEDs, along with the use of Traumeel S ointment, in patients with gonarthrosis. (2) Methods: The study included 90 patients with knee osteoarthritis (grade 2 Kellgren and Lawrence osteoarthritis). They were divided into three groups: Group I, 30 patients treated with magnetic stimulation plus LED therapy; Group II, 30 patients treated with Traumeel S ointment; and Group III, 30 patients treated with magnetic stimulation plus LED therapy with Traumeel S ointment. Pain intensity was assessed using the VAS and Laitinen scales before and after a series of treatments. (3) Results: Significant results in terms of pain reduction before and after treatment were obtained in each of the study groups, as there were significant differences in the VAS pain intensity scores before and after the procedures between the groups. In group I, with electromagnetic field and LED light treatment, the difference was 35.5; in group II, which received Traumeel S® ointment, the difference was 18.5; and in group III, with electromagnetic field and LED light treatment as well as Traumeel S ointment, the difference was 26.5. In the Laitinen scale, the differences were insignificant, although the size distribution was similar. (4) Conclusions: The therapy used in this study showed that magnetic stimulation plus LED therapy and the use of Traumeel S ointment gave positive results in terms of pain reduction in each of the study groups. The strongest analgesic factor seems to be magnetic and LED therapies used separately. Traumeel S in magnetoledophoresis does not work synergistically with the magnetic field of LED light, and even worsens the effect of the therapy used.

Age and Sex in Back Pain Intensity-Retrospective Study of Conservatory vs. Surgical Discopathy Treatment.

(1) Background: The frequency of back pain diagnosis and treatment has markedly increased in recent years. Back pain may be caused by many factors and discopathy is one of them. The aim of the study was to assess the impact of age and sex on back pain intensity in rehabilitated patients with discopathy treated conservatively and surgically; (2) Methods: The study included 137 patients: 96 undergoing conservative therapy and 41 after back surgery due to discopathy. VAS and the Laitinen scale were used for pain assessment. All patients underwent a multidirectional rehabilitation program at the Department of Rehabilitation and Physical Medicine of the Medical University in Lódz; (3) Results: No statistically significant effect of age and sex was observed on the level of pain intensity on VAS and the Laitinen scale; (4) Conclusions: Age and sex do not seem to affect back pain intensity in rehabilitated patients treated conservatively and surgically for discopathy. The problem requires further research on a larger group of patients.

Chronic-Exposure Low-Frequency Magnetic Fields (Magnetotherapy and Magnetic Stimulation) Influence Serum Serotonin Concentrations in Patients with Low Back Pain-Clinical Observation Study.

(1) Background: The influence of serotonin on many regulatory mechanisms has not been sufficiently studied. The use of a physical method, assuming the possibility of its action on increasing the concentration of serotonin, may be the direction of therapy limiting the number of antidepressants used. The aim of the research was to study the effects of low-frequency magnetic fields of different characteristics on the circadian profile of serotonin in men with low back pain. (2) Methods: 16 men with back pain syndrome participated in the study. The patients were divided into two groups. In group 1, magnetotherapy (2.9 mT, 40 Hz, square wave, bipolar) was applied at 10.00 a.m. In group 2, the M2P2 magnetic stimulation program of the Viofor JPS device was used. Treatments in each group lasted 3 weeks, 5 days each, with breaks for Saturday and Sunday. The daily serotonin profile was determined the day before the exposure and the day after the last treatment. Blood samples (at night with red light) were collected at 8:00, 12:00, 16:00, 24:00, and 4:00. The patients did not suffer from any chronic or acute disease and were not taking any medications. (3) Results: In group 1, a significant increase in serotonin concentration was observed after 15 treatments at 4:00. In group 2, a significant increase in serotonin concentration was observed at 8:00 after the end of the treatments. In comparison between magnetotherapy and magnetic stimulation, the time points at which differences appeared after the application of serotonin occurred due to the increase in its concentrations after the application of magnetic stimulation. (4) Conclusions: Magnetotherapy and magnetic stimulation, acting in a similar way, increase the concentration of serotonin. Weak magnetic fields work similarly to the stronger ones used in TMS. It is possible to use them in the treatment of mental disorders or other diseases with low serotonin concentrations.

USING THE SODA SCALE TO ASSESS THE EFFECTIVENESS OF NEUROLOGICAL SPEECH AND LANGUAGE THERAPY ON IMPROVING LANGUAGE FUNCTIONS IN POST-STROKE PATIENTS.

OBJECTIVE: The aim: Assess the impact of neurological SLA on improvement of language functions in post-stroke patients. PATIENTS AND METHODS: Materials and methods: The study covered a total of 82 patients aged 40-80, of both sexes, with stroke-induced cognitive deficits. They were in-patients of the Clinic Of Rehabilitation And Physical Medicine of the "WAM" Teaching Hospital in Lódz. The study comprised two groups. The study group consisted of post-stroke patients with aphasia, who were referred to four-week comprehensive program of neurological SLA therapy earlier (about a month) after experiencing stroke. The group comprised 44 patients. Six months after the stroke, the patients underwent another four weeks of neurological SLA. The control group consisted of post-stroke patients with aphasia. The group comprised 38 patients. The four-week neurological SLA therapy was applied more than six months after stroke ("late therapy"). The patients were ascribed to the groups randomly. Language abilities were evaluated with the Aphasia Dynamics Assessment Scale (Polish: Skala Oceny Dynamiki Afazji, abbrev. SODA). RESULTS: Results: The study showed that neurological SLA helped patients in both the study and control group to significantly regain their language functions. However, greater improvement was found in the study group, which underwent neurological SLA twice, which proves that duration of the therapeutic process is an important factor. CONCLUSION: Conclusions: neurological SLA was beneficial for both groups, regardless of the time that elapsed between stroke and start of the therapy. neurological SLA therapy allowed patients to restore part of their language functions, both in the study and control group. The sooner neurological SLA is implemented and the longer its duration, the more beneficial it is to patients.

OVERVIEW OF WELLNESS METHODS FOR PEOPLE PRACTICING SPORTS.

The term "wellness" embraces a wide spectrum of methods that impact the human body by restoring its capabilities and functions, which were previously depleted as a result of increased physical and mental activities such, i.e. sport. Judging by the number of amateur, semi-professional, and professional sporting events at local and national levels, societies consider sports a major part of their everyday lives. A growing percentage of the population is exposing their bodies to various strains, which may result in fatigue, overtraining and injuries, and so the market demand for recovery-related services is on the rise. Therefore, this paper is an overview of the most important and the latest wellness systems and methods applied in today's sport. They divide into three areas: pedagogical, psychological and medical-biological. Among the most popular treatments are: light radiation with infrared rays, cryotherapy, electrotherapy, magnetotherapy, ultrasound and laser therapy, as well as a sauna, paraffin compress, mud compress and brine baths. In a broader context, the paper also acknowledges the growing demand for better body recovery methods and the latest developments in the field of sport physiotherapy.

The effect of smoking on back pain intensity in rehabilitated patients treated conservatively and surgically for discopathy.

INTRODUCTION: Back pain is now a very common phenomenon. It is caused by various pathologies in the area of the motor unit of the spine. These changes can cause pressure on the nerve structures within the spinal canal, resulting in various ailments. Pain is the most common symptom. In most cases, patients are qualified for conservative management. In the case of neurological deficits, the patient is qualified for spinal surgery. Unfortunately, surgical treatment is not always 100% effective therapy method. Moreover, many external factors, such as smoking for instance, can affect the process of tissue healing and decide on the time of recovery. OBJECTIVE: The aim of the study was to assess the impact of smoking on back pain intensity in rehabilitated patients with discopathy treated conservatively and surgically. MATERIAL AND METHODS: The study included 41 patients after surgical treatment (9 smokers) and 96 patients (20 smokers) undergoing conservative therapy for back pain due to discopathy. All patients underwent a multidirectional rehabilitation programme at the Department of Rehabilitation and Physical Medicine of the Medical University in Lódz. RESULTS: The Laitinen scale was used to assess the patients' pain. Rehabilitation of patients with back pain due to discopathy had a significant analgesic effect (p <0.0001). Furthermore, there was observed a statistically significant effect of smoking on the level of pain intensity on the Laitinen scale in the group of patients who underwent surgery (p <0.0469). The smokers operated on had significantly worse results. CONCLUSIONS: 1) Complex rehabilitation of patients with back syndrome pain due to discopathy demonstrated significant analgesic effectiveness. 2) Smoking significantly worsens the results of the therapy in patients who underwent surgery.

[Stochastic resonance method in physiotherapy - a review of the literature].

Non-linearity is an important feature of many human body structures that may result from deterministic properties of the body and noise. Noise is defined as accidental or irregular fluctuations or disturbances that are not part of the signal. Stochastic resonance (SR), the term originally used in a very specific context, is now widely used to describe any phenomenon in which the presence of noise in a nonlinear system is better for the quality of the output signal than its absence. The conducted research for the needs of physiotherapy consists in assessing the impact of the platform generating forced mechanical vibrations with specific parameters in selected disease entities, sports disciplines, as well as prevention. The aim of the work is to discuss the stochastic resonance method and to analyze the results of the most important works discussing the use and effectiveness of therapeutic impact on the human body. The use of the stochastic resonance method enforces mechanical vibrations, which are characterized by the variability of rhythm, amplitude and direction of vibrations, which enforces postural adjustment regulated by the CNS and response to stimuli that disturb the body's balance. The analysis of the effectiveness of therapeutic impact in the field of body balance disorders, reeducation of locomotion in people with partial spinal cord injury, motor motility and changes in hormonal concentrations was carried out. Stochastic resonance therapy can reduce or eliminate dysfunction in many disease entities, however, further studies are needed to assess the effectiveness of the therapy.

[An assessment of the functional status in the neurorehabilitation of patients after ischemic stroke].

OBJECTIVE: Introduction: In this article, the authors focused on the symptoms of ischemic stroke and the effect of neurorehabilitation methods on the functional status of patients after ischemic stroke. The aim of the study was to evaluate and compare the functional status of patients after ischemic stroke with improved classic kinesiotherapy, classic kinesiotherapy and NDT-Bobath and classic kinesiotherapy and PNF. PATIENTS AND METHODS: Materials and methods: The study involved 120 patients after ischemic stroke. Patients were treated in the Department of Rehabilitation and Physical Medicine USK of Medical University in Lodz. Patients were divided into 3 groups of 40 people. Group 1 was rehabilitated by classical kinesiotherapy. Group 2 was rehabilitated by classic kinesiotherapy and NTD-Bobath. Group 3 was rehabilitated by classical kinesiotherapy and PNF. In all patient groups, magnetostimulation was performed using the Viofor JPS System. The study was conducted twice: before treatment and immediately after 5 weeks after the therapy. The effects of applied neurorehabilitation methods were assessed on the basis of the Rivermead Motor Assessment (RMA). RESULTS: Results: In all three patient groups, functional improvement was achieved. However, a significantly higher improvement was observed in patients in the second group, enhanced with classical kinesitherapy and NDT-Bobath. CONCLUSION: Conclusions: The use of classical kinesiotherapy combined with the NDT-Bobath method is noticeably more effective in improving functional status than the use only classical kinesiotherapy or combination of classical kinesiotherapy and PNF patients after ischemic stroke.

CD34+ Stem Cell Treatment for Knee Osteoarthritis: A Treatment and Rehabilitation Algorithm.

Osteoarthritis is a group of multiple overlapping pathological conditions that cause destruction of articular cartilage and other structures of the joint. It is a progressive disease that leads to limitations of physical activity. New forms of treatment are therefore sought to alleviate the clinical symptoms of osteoarthritis and avoid surgery. Stem cell based therapy is an emerging field in orthopaedics. This study describes the treatment of knee osteoarthritis with CD34+ stem cells at the Medical Magnus Outpatient Clinic in Lodz, Poland, together with the treatment and rehabilitation algorithm developed for maximum effectiveness of this procedure. The algorithm includes 3 rehabilitation stages: preoperative, hospitalization and outpatient periods.

[An assessment of the effectiveness of comprehensive neurorehabilitation in patients after ischemic stroke].

OBJECTIVE: Introduction: Comprehensive rehabilitation after stroke is to help the patient recover optimal physical and mental condition. The multidirectional approach to the patient implemented by a multidisciplinary team: physicians, physiotherapists, neurologopedians and neuropsychologists allows the best use of the patient's potential. The aim: To evaluate the effectiveness of comprehensive neurological rehabilitation of patients after ischemic stroke. PATIENTS AND METHODS: Materials and methods: The 90 patients after ischemic stroke were examined. The first examined group (45 people) consisted of patients rehabilitated at the Department of Rehabilitation and Physical Medicine of the WAM University Hospital in Lodz. The second examined group number (45 people) consisted of patients waiting for admission to the Department of Rehabilitation, who were rehabilitated in environmental conditions. The patients were examined twice: first before the rehabilitation (study I) and then at the end of rehabilitation program (study II). The ADL Index by Barthel was used to assess the functional status of the patients. In addition, speech disorders (SODA scale) and emotional state (Beck Depression Scale) were assessed in patients. RESULTS: Results: Both individuals after stroke rehabilitated in hospital and those rehabilitated in environmental conditions achieved a significant improvement in activities of daily living and improvement in speech - symptoms of aphasia were withdrawn. However, only stroke patients rehabilitated in hospital conditions achieved a significant improvement in the emotional state. CONCLUSION: Conclusions: Stroke patients rehabilitated in hospital conditions have significantly improved their functional status and emotional state compared to patients rehabilitated in environmental conditions.

[Effectiveness of early physiotherapy treatment for ischaemic stroke patients suffering intercurrently from post-stroke depression and/or hemispatial neglect syndromes].

Wstep: Depresja poudarowa i zespol pomijania stronnego sa jednymi z szeregu zaburzen neurologicznych wystepujacych jako konsekwencje incydentu udarowego. Oba zaburzenia uwaza sie za czynniki negatywnie wplywajace na szybszy powrot pacjenta do zdrowia. Zadaniem wczesnej fizjoterapii po incydencie udarowym jest poprawa funkcji motorycznych oraz poprawa jakosci zycia pacjenta. Material i metody: W badaniu wzielo udzial 51 pacjentow zakwalifikowanych do wziecia udzialu w "Narodowym Programie Profilaktyki i Leczenia Chorob Ukladu Sercowo-Naczyniowego na lata 2006-2008 POLCARD". Wyniki badan pacjentow notowano w skali Barthel, NIH oraz Geriatrycznej Skali Oceny Depresji. Analiza statystyczna zostala wykonana w programie STATISTICA 6PL za pomoca testu Wilcoxona dla prob zaleznych. Wyniki: Analiza wynikow wykazala, ze osoby z zespolem zaniedbywania osiagnely wiekszy przyrost punktow w skali Barthel niz osoby bez zespolu pomijania stronnego (p≤0,05). Natomiast badanie osob z depresja poudarowa wykazaly wiekszy przyrost punktow w skali Barthel niz pacjenci, u ktorych depresja nie zostala stwierdzona. Wnioski: Skutecznosc wczesnej fizjoterapii zalezy od ciezkosci udaru, stopnia niepelnosprawnosci oraz czynnikow zaburzajacych, takich jak m.in. agnozja wzrokowo-przestrzenna lub depresja. Jednakze pacjenci ze wspolistniejacymi zespolami neurologicznymi poddani kompleksowej fizjoterapii we wczesnym okresie po udarze mozgu maja prawdopodobnie wieksza rezyliencje w zakresie motywacji, zdolnosci adaptacyjno-kompensacyjnych, czyli generalnie dotyczacych plastycznosci mozgu.

[The overall assessment of psychological well - being of patients with multiple sclerosis after the application of physical therapy. Part 2].

INTRODUCTION: Multiple sclerosis is a chronic demyelinating disease of the central nervous system, which results a progressive disability. The disease reduces the quality of life of patients, changes the general health perceptions, and also limits performing social roles because of emotional problems. THE AIM: Evaluation of the impact of the methods of rehabilitation to improve the mental health of patients with multiple sclerosis, and also to change individual parameters included in the overall assessment of mental health. MATERIAL AND METHODS: The study was conducted in 2010-2014 at the Department of Physical Medicine and Rehabilitation in Lodz. The study included 120 patients with multiple sclerosis. Patients were classified into 4 test groups: in the first was used the laser, in the second - laser and magnetostimulation, in the third - kinesiotherapy, and in the fourth - magnetostimulation. The tests were carried out three times. To evaluate the quality of life was used Quality of Life Questionnaire (MSQOL-54), analyzed the overall assessment of mental health. RESULTS: The improvement in a range of parameters, an overall assessment of the quality of mental health has allowed to get a better overall psychological well-being. ,There was oserved a statistically significant difference at the level of p<0.001 between groups in 4/5 investigated parameters, statistically significant differences weren't obserwed at the evaluation of cognitive functions. The greatest improvement was observed in Group II and Group IV. CONCLUSIONS: In the examination it was confirmed an effectiveness of physical treatment, such a the laser radiation and magnetostimulation. Synergism of both methods in their biological activity, allows for evoke of hysteresis fenomenon, resulting in the maintenance of the treatment effects after cessation of rehabilitation. Applying the classical kinesiotherapy only doesn't allow to get long-term effects.

Location of the ischemic focus in rehabilitated stroke patients with impairment of executive functions.

BACKGROUND: Executive dysfunctions are part of the clinical symptoms of a stroke and can inhibit the process of rehabilitation. Patients with impaired executive functions may manifest aggression, impulsiveness, impaired thinking and planning. OBJECTIVES: The aim of this study was to assess the effect of the ischemic focus location on the effectiveness of physiotherapy in improving the executive functions in patients after stroke. MATERIAL AND METHODS: Ninety patients after unilateral ischemic cerebral stroke were studied. We studied 45 patients treated at the Department of Rehabilitation and Physical Medicine of the WAM University Hospital of Lodz for 5 weeks. The rehabilitation program included: kinesitherapy, physiotherapy, speech therapy, psychological consultations and psychotherapy. The control group consisted of patients who were waiting for admission to the Department of Rehabilitation. The patients in both groups were divided into three subgroups with different locations of stroke: front, back and subcortical. Executive functions were measured by the Wisconsin Card Sorting Test (WCST), the trail making test (TMT - A, TMT - B), the verbal fluency test (VFT). RESULTS: Patients rehabilitated in the hospital with the front and subcortical lesion location reported improvement in executive functions in terms of a greater number of the analyzed indicators of the Wisconsin Card Sorting Test (WCST) than those with the back lesion location. Patients rehabilitated at home with the subcortical lesion location did not experience a significant improvement in executive functions in any of the analyzed indicators of the Wisconsin Card Sorting Test (WCST). Most of the indicators, with the exception of the total errors of Wisconsin Card Sorting Test (WCST) and TMT B, have not been modified by the location of stroke. CONCLUSIONS: Executive dysfunction occurs not only in patients with an anterior location of the stroke, but also in the posterior and subcortical locations. Patients with a subcortical location of the stroke require more treatment to mitigate the dysfunction.

Rehabilitation in multiple sclerosis.

The aim of the study is to present a strategy of rehabilitation in multiple sclerosis on the basis of the latest developments in the field of physiotherapy. The publications on the problem discuss a wide range of methods of physiotherapy that can be used in order to reduce the degree of disability and alleviate the symptoms associated with the disease. The complexity of the disease, the difficulty in determining the appropriate treatment and a wide range of symptoms require a comprehensive approach to the patient, which would include both pharmacology and neurorehabilitation. Rehabilitation, which includes psychotherapy and symptomatic therapy, is regarded nowadays as the best form of treatment for multiple sclerosis. An indepth diagnostic assessment of functional status and prognosis should be carried out before the start of the rehabilitation process. The prognosis should take into account the mental state, the neurological status and the awareness of the patient. The kinesiotherapy program in multiple sclerosis is based on a gradation of physiotherapy which assumes a gradual transition from basic movements to more complex ones till global functions are obtained. The most appropriate form of treatment is functional rehabilitation combined with physical procedures. Recent reports indicate the need for aerobic training to be included in the rehabilitation program. The introduction of physical activities, regardless of the severity of the disease, will reduce the negative effects of akinesia, and thus increase the functional capabilities of all body systems.

[New physical methods in osteoarthritis treatment].

Osteoarthritis is a chronic disease in which the pathological processes start from the catabolism of cartilage extracellular matrix and next extend on the whole joint. Therefore, it is important to diagnose the disease and determining treatment, selecting individually for each patient. The main health problems presents by every patients is pain, which decreases the everyday functioning and quality of life. The paper presents the definition of the disease and new therapeutic methods which improve the quality of life, as well as reduce intensity of pain.