Comprehensive Physical Therapy Research Articles

Bridge the Divide: Create Your Connection from Research to Practice

Bridge the Divide: Create Your Connection from Research to Practice

Physiotherapy in hospitalised patients with COVID-19 disease: what we know so far

International Journal of Therapy and RehabilitationVol. 27, No. 3 EditorialPhysiotherapy in hospitalised patients with COVID-19 disease: what we know so farMassimiliano PolastriMassimiliano PolastriCorrespondence to:E-mail Address: [email protected]Medical Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, St Orsola University Hospital, Bologna, ItalySearch for more papers by this authorMassimiliano PolastriPublished Online:10 Apr 2020https://doi.org/10.12968/ijtr.2020.0035AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Ambrosino N, Makhabah DN. Comprehensive physiotherapy management in ARDS. Minerva Anestesiol. 2013;79(5):554–563 Google ScholarBBC News. Virus surges in US as death toll passes 1,000. https://www.bbc.co.uk/news/live/world-52044452 (accessed26 March 2020) Google ScholarChinese Association of Rehabilitation Medicine, Respiratory Rehabilitation Committee of Chinese Association of Rehabilitation Medicine, Cardiopulmonary Rehabilitation Group of Chinese Society of Physical Medicine and Rehabilitation. Recommendations for respiratory rehabilitation of COVID-19 in adults. Chinese Journal of Tuberculosis and Respiratory Diseases. 2020;43(0):E029. https://doi.org/10.3760/cma.j.cn112147-20200228-00206 Google ScholarEuropean Centre for Disease Prevention and Control. Situation update for the EU/EEA and the UK, as of 23 March 2020. 2020. https://www.ecdc.europa.eu/en/cases-2019-ncov-eueea (accessed25 March 2020) Google ScholarHui DS, Chow BK, Chu L et al.. Exhaled air dispersion and removal is influenced by isolation room size and ventilations settings during oxygen delivery via nasal cannula. Respirology. 2011;16(6):1005–1013. https://doi.org/10.1111/j.1440-1843.2011.01995.x Crossref, Google ScholarHui DS, Chow BK, Chu L et al.. Exhaled air dispersion during coughing with and without wearing a surgical or N95 mask. PLoS One. 2012;7(12):e50845. https://doi.org/10.1371/journal.pone.0050845 Crossref, Google ScholarHui DS, Chow BK, Lo T et al.. Exhaled air dispersion during non invasive ventilation via helmets and a total facemask. Chest. 2015;147(5):1336–1343. https://doi.org/10.1378/chest.14-1934 Crossref, Google ScholarLazzeri M, Lanza A, Bellini R et al.. Respiratory physiotherapy in patients with COVID-19 infection in acute setting: position paper of the Italian Association of Respiratory Physiotherapists (ARIR).. Monaldi Arch Chest Dis. 2020;90:1285. https://doi.org/10.408/monaldi.2020.1285 Crossref, Google ScholarLi Q, Guan X, Wu P et al.. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020. https://doi.org/10.1056/NEJMoa2001316 Crossref, Google ScholarSimonds AK, Hanak A, Chatwin M et al.. Evaluation of droplet dispersion during non-invasive ventilation, oxygen therapy, nebuliser treatment and chest physiotherapy in clinical practice: implications for management of pandemic influenza and other airborne infections. Health Technol Assess. 2010;14(46):131–172. https://doi.org/10.3310/hta14460-02 Crossref, Google ScholarWorld Health Organization. Coronavirus disease (COVID-2019) situation reports. 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200322-sitrep-62-covid-19.pdf?sfvrsn=f7764c46_2 (accessed25 March 2020) Google ScholarYang F, Liu N, Wu JY et al.. Pulmonary rehabilitation guidelines in the principle of 4S for patients infected with 2019 novel coronavirus (2019-nCoV). Zhonghua Jie He He Hu Xi Za Zhi. 2020;43(0):E004. https://doi.org/10.3760/cma.j.issn.1001-0939.2020.0004 Google ScholarZhu N, Zhang D, Wang W et al.. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–733. https://doi.org/10.1056/NEJMoa2001017 Crossref, Google Scholar FiguresReferencesRelatedDetailsCited byCOVID-19: emerging challenges in maintaining physical function in patients who have had haematopoietic cell transplantsJaleel Mohammed, Anne Gonzales, Hadeel R Bakhsh, Jayanti Rai, Nnenna Chigbo, Shahrukh K Hashmi2 October 2020 | International Journal of Therapy and Rehabilitation, Vol. 27, No. 9Developing patient information and clinician education resources for venous thromboembolism in a physiotherapy department in response to the COVID-19 pandemicChris Drake, Nicola Hicks, Leanne Atkin2 October 2020 | International Journal of Therapy and Rehabilitation, Vol. 27, No. 9A new way forwardVicki Williams2 October 2020 | International Journal of Therapy and Rehabilitation, Vol. 27, No. 9 2 March 2020Volume 27Issue 3ISSN (online): 1759-779X Metrics History Published online 10 April 2020 Published in print 2 March 2020 Information© MA Healthcare LimitedPDF download

Latest findings for rehabilitation of patients with Parkinson's disease

Parkinson's disease is one of the most common neurodegenerative diseases. Given the progressive course and numerous motor and motor symptoms, this disorder can significantly affect person's functional status, quality of life, and disability.
 Possibility of treatment and prevention of parkinsonism varies depending on the type of Parkinson's disease. Medication, physical therapy and surgical treatment are used. Effective pharmacologic therapy includes comprehensive physical therapy and rehabilitation, starting at the time of diagnosis. It can prevent and treat complications, slow the progression of symptoms, and enhance adaptation to the newly acquired condition. It is necessary to stimulate mechanisms of compensation and neuroplasticity. Experiences show that kinesiotherapy and physical agents are effective in the treatment of pain, walking disorders, postural instability and risk of falls. There are also alternative techniques such as yoga, tai chi, acupuncture, dance therapy, music therapy that have a positive impact on the disease. The efficacy of neurofeedback, art therapy in improving and maintaining cognitive functions has been demonstrated. Occupational therapy is of great importance for empowering the patient with activities of daily living, especially for self-care. Education and support from family and carers, as well as home and workplace adaptation, play an important role in rehabilitation. Rehabilitation and physical therapy for this disease is carried out systematically and for a lifetime. A multidisciplinary approach in treating patients with Parkinson's disease enables the maintenance of quality of life.

Abstract P1-20-22: Evaluating the use of targeted axillary dissection and comprehensive physical therapy to reduce the risk of lymphedema in node-positive breast cancer patients

Abstract Background: Before the advent of neoadjuvant chemotherapy (NC), the standard of care for node-positive breast cancer patients was to undergo complete axillary lymph node dissection (ALND). These patients also generally receive adjuvant radiation (AR), including axillary lymph node radiation. However, ALND and AR have been shown to increase the risk of secondary lymphedema to 20-30%. When treated with NC, resolution of all nodal metastasis to pathologically confirmed node-negative disease occurs in approximately 40% of patients. Such patients are eligible for targeted axillary dissection (TAD), which involves removal of clipped biopsy-positive node and sentinel nodes. TAD patients also receive AR, and their lymphedema rate has been reported at 10-12%. There is considerable variability on recommended protocols for lymphedema prevention in these patients. The goal of this study was to investigate whether TAD in combination with comprehensive physical therapy can further reduce the risk of lymphedema in node-positive breast cancer patients receiving NC. Methods: An IRB-approved retrospective review was conducted of 29 consecutive patients undergoing NC and localization of axillary nodes for their breast cancer surgery between Aug 2016 and Dec 2018. Patients with negative nodes intra-operatively underwent TAD only whereas those with positive nodes underwent ALND. Comprehensive physical therapy program included deep myofascial release, range of motion exercises, and stretching. Patients with ALND were provided prophylactic compression sleeve for 3 months. The main outcome measures were Lymphedema Index (L-DEX) scores (normal range -10 to +10) and range of motion at 1 month post-surgery. Lymphedema was also monitored clinically for a median duration of 7 months post-surgery. Baseline characteristics and outcomes between the TAD and ALND groups were compared. Results: A total of 16 patients underwent TAD whereas 13 underwent ALND (Table 1). Post-NC stages were 11 Stage 0, 3 Stage I, 9 Stage IIB, 5 Stage III A, 1 Stage IIIC. 10 patients completed breast conservation surgery, 13 had mastectomy with implant-based reconstruction (9 nipple-sparing mastectomy, 4 skin-sparing mastectomy), and 6 had mastectomy without immediate reconstruction. The clipped node was localized at a median of 1 day (range 1-35) before surgery, and 100% of the clipped nodes were retrieved. 28/29 (97%) patients underwent AR (1 patient refused). There were no statistically significant differences in pre-op L-DEX and 1-month post-op L-DEX between TAD and ALND groups. At 1-month post-op, 22 patients had full and 7 had limited range of motion. Two ALND patients with BMI of 25.8 and 32.2 kg/m2 developed lymphedema at 9.2 and 16 months respectively after surgery and were successfully managed with physical therapy. None of the 29 patients experienced tumor recurrence after a median follow-up of 7 months. Conclusion: This preliminary study found no evidence of lymphedema in TAD and ALND patients at one month following surgery. After a median follow-up of 7 months, 15% of ALND patients but no TAD patients experienced lymphedema. Prospective studies with large sample sizes are needed to further investigate the role of TAD combined with physical therapy in reducing the risk of lymphedema. Table 1: Comparison of patient characteristics and outcomes between TAD and ALND (N=29)CharacteristicTAD (n=16)ALND (n=13)P-valueMedian age in years49.654.50.28Median BMI in kg/m226.432.20.16Response to NCComplete response10 (62.5)1 (7.7)0.01*Partial response6 (37.5)9 (69.2)No response0 (0)3 (23.1)Median sentinel nodes removed320.02*Median size of clipped node (mm)15200.04*Median follow-up duration in months7.75.80.37Median number of PT visits380.20Median L-DEX score pre-op-1.5-1.30.73Median L-DEX score 1 month post-op-2.72.10.55Median L-DEX score difference (post-op minus pre-op)0.4-0.10.98Range of motion 1 month post-opFull14 (87.5)8 (61.5)0.10Limited2 (12.5)5 (38.5)Deep myofascial release to axilla and breast 1 month post-opYes12 (75)11 (84.6)0.53No4 (25)2 (15.4)Lymphedema during long-term follow-upYes0 (0)2 (15.4)No16 (100)11 (84.6)0.10Values in parentheses are column percentages*P <= 0.05 Citation Format: Miral Amin, Karan Shah. Evaluating the use of targeted axillary dissection and comprehensive physical therapy to reduce the risk of lymphedema in node-positive breast cancer patients [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-20-22.

Effects of a comprehensive physical therapy on moderate and severe obstructive sleep apnea- a preliminary randomized controlled trial

BackgroundCritically compromised by upper airway anatomical impaired properties, obstructive sleep apnea (OSA) can be categorized into different phenotypic traits, mainly including oropharyngeal muscle dysfunction. The upper airway muscle strength training was targeted on oropharyngeal muscle dysfunction by re-educating the oropharyngeal muscles to maintain the upper airway patency. OSA was characterized with multilevel collapsibility of the upper airway; however, the programs are still inconsistent and the effects are unknown. Therefore, the purpose of this study was to investigate the effects of a comprehensive physical therapy on OSA. MethodsFifteen subjects with newly diagnosed moderate or severe OSA (AHI ≥ 15) were randomized into intervention and control groups. The intervention group underwent a 12-week-intervention of hospital based physical therapy, while the control group was kept on waiting for 12 weeks. Polysomnography (PSG) data, oropharyngeal and respiratory muscle performance were measured before and after intervention. ResultsIn intervention group (n = 8), AHI was significantly improved (from 46.96 ± 19.45 to 32.78 ± 10.78 events/h, p = 0.017); in control group (n = 7), AHI was significantly increased (from 35.77 ± 17.49 to 42.96 ± 17.32 events/h, p = 0.043). While the control group remained no change between pre- and post- intervention, the intervention group demonstrated that other PSG outcomes significantly improved, including arousal index (46.04 ± 18.9 versus 32.98 ± 8.35/h), mean SpO2 (92.88 ± 2.1 versus 94.13 ± 1.46%), and oxygen desaturation index (ODI) (31.13 ± 19.48 versus 20.57 ± 7.83/h). ConclusionThis comprehensive physical therapy can be prescribed for the significant clinical improvement on sleep apnea for the patients with moderate and severe OSA.

Improving the quality of life using physical therapy to correct excess weight in women

The article deals with the problem of overweight women and the measures that can influence it. The actual problem of reducing the quality of life of overweight women and the need to take this indicator into consideration when selecting the measures of physical therapy and assessing the quality of their use are raised. The results of the study of changes in quality of life after using of programs of physical therapy for the correction of excess weight are presented.
 The quality of life of young overweight women was evaluated using the SF-36 survey (physical and mental health). Experimental sample size: 10 females in the main group and 10 females in the control group. Weight loss program and improving the quality of life of young women through physical therapy lasted for 6 months. Programs of physical therapy in the main group was included elements of different directions of aerobics (classical aerobics, power aerobics, aerobics using different tools, aerobics with psycho-regulatory orientation) and nutrition correction. Programs of physical therapy in the control group was also included nutrition correction and fitness workouts with the use of simulators with a focus on strength and cycling.
 According to recent estimates, at least one in three adults in the world is overweight and almost one in 10 is obese. Being overweight is not only an aesthetic problem, it is a health threat that entails a number of illnesses and complications, reducing the quality of life. Not everyone knows that the risk of health problems manifests itself even with a slight overweight, and increases as you gain weight. For greater results in overweight correction, it is best to use aerobic and anaerobic fitness programs.
 A comprehensive physical therapy program has significantly improved the health of young women and has had a positive effect on physical and mental health. We have reason to believe that the overweight correction technique of the main group has proven to be more effective in improving the quality of life of women than the control group program.

Assessment of the Therapeutic Effect of Physiotherapy on Minimizing Imbalances of Geriatric Patients

Introduction: The progressing aging process and comorbidities worsen the efficiency of the balance system in the elderly, which leads to a weakening of stability and, as a consequence, to falls and injuries. The first ones lead to: worsening of functioning, reduced mobility, an increased risk of disease and mortality, therefore systematic physical activity and shaping the balance using physiotherapy, which can prevent dangerous falls is very important. Aim: Assessment of the therapeutic effect of physiotherapy on minimizing imbalances in geriatric patients. M aterial and Methods: The study group consisted of 46 people, including 32 women (69.6%) and 14 men (30.4%); average age of respondents – 72.5 years. They were patients of the Department of Rehabilitation of Poddębice Health Center, Ltd. The researchers used a self-made questionnaire, body mass to height index (BMI) and the Tinetti Test. Results: Patients with an elevated BMI (89.1%), as well as those taking more than 4 medication (78.3%), have had more falls over the past year (respectively 91.4% and 81.4%). After the use of comprehensive therapy, none of the patients achieved a worse result than before the physiotherapy while 91.3% of the respondents had an increase in the number of points scored in the Tinetti Test. The percentage of patients at high risk of falling reduced from 67.4% to 37%. There was also a decrease in the fear of walking (in 58.7%), falling (in 57.7%) and climbing stairs (in 47.9%). According to 78.3% of respondents, physiotherapy positively affected their independence and quality of life. Conclusions: The use of comprehensive physiotherapy reduces the fear of walking, climbing stairs and falling, which can be a good predictor of prevention. Both polypragmasia and an elevated body mass index (BMI) increase the risk of falling. Comprehensive physiotherapy of geriatric patients helps to improve balance and gait stereotype. Physiotherapy for the elderly helps improve the quality of life, independence, minimize imbalances, and thus reduce the risk of falls. Balance exercises play an important role in preventing falls.

Results of the use of physical therapy for metabolic syndrome according to anthropometric studies

Purpose: to investigate and determine anthropometric indicators (length and body weight, abdominal circumference, skin fold thickness, calculate body mass index and percentage of adipose tissue) of examined patients with metabolic syndrome, evaluate the effectiveness of our comprehensive physical therapy program based on the study of the dynamics of anthropometric indicators women with metabolic syndrome during the rehabilitation process. Material and methods: 28 women with metabolic syndrome were examined, the main group (MG) (n = 14) and the control group (CG) (n = 14), the average age was in MG- 31.49 ± .71 years, in the CG – 31.06 ± .57 years. Women of the main group studied according to the author’s program of physical therapy, women of the control group - according to the program, used for metabolic syndrome according to the methods of S.M. Popova (2005, 2008), N.A. Beloy (2001). Results: allowed us to analyse the dynamics before the indicators were fully scrutinized by the programs of physical therapy and to separate the results from the main and control groups. Conclusions: the author's program of physical therapy is effective, was carried out in order to normalize body weight and reduce the manifestations of abdominal obesity.

Impact of myofascial mobilization on pain and mobility of the spine in people with pain and increased muscle tone of the cervical spine

<b>Introduction.</b> Manual therapy is a standard method of physiotherapy to deactivate the interfering potential of the trigger points thus eliminate the subsequent tension within the area of the connective tissue. <b>Aims.</b> The aim of the study is the evaluation of the influence of the myofascial trigger points therapy on the increased neck muscle tension, pain and ROM in people who suffer from cervical pain. <b>Material and methods.</b> A diagnostic method was linear measurements of ROM of the cervical spine and a visual analogue scale (VAS) to assess the pain level. The examination included 35 people aged 25-55, performing whitecollar work in sitting position, selected by a neurologist or orthopedist, with identified increased muscle tension in the cervical region. Achieved results were statistically evaluated. To show the importance of the differences in cervical ROM, the intensity of pain and disability level before and after rehabilitation, a non-parametric signedrank test was utilized. The differences were found as significant for p<0,05. <b>Results and conclusions.</b> A comprehensive physiotherapy of myofascial painfull points results in decrease the pain level in patients suffering from pain syndrome of the cervical spine. Proposed physiotherapy plan lead to improved movement of the cervical spine in all directions.

Comparison of the Efficacy of Comprehensive Respiratory Physiotherapy in Children With Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis

Comparison of the Efficacy of Comprehensive Respiratory Physiotherapy in Children With Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis

The impact of comprehensive Physiotherapy with Biofeedback on the functional state of patients with Lumbar Spine pain

<b><br>Introduction:</b></br> Chronic pain in the lumbosacral spine are becoming a problem for younger and younger people and affect the deterioration of the condition functional patients. <b><br>Material and methods:</b></br> Two groups were studied twice, 20 patients (in each group) with lower back pain, attending physiotherapy. In the research group applied comprehensive physiotherapy, and only physical treatments were applied in the control group. To measure effects of therapy were used: the VAS scale, the BPFS Stratford Functional Pain Scale Rating Scale, two weight test, Pressure Bio-Feedback Stabilizer device for muscle activation testing transverse abdomen muscle. Results: In the research group compared to the control group, (p<0.05) a significantly lower level of pain was obtained, assessed on the VAS scale (p=0.003) and in terms of improving functioning significantly (p=0.017) higher level of functional possibilities (by 17.4%). In the research group significantly (p=0.011) more people achieved the correct value of the symmetry of lower limbs, which is in the range of 1- 1.15. All (100%) treated with comprehensive physiotherapy improved transverse abdominal muscle activation TrA. <b><br>Conclusions:</b></br> Using the comprehensive physiotherapy reduces pain and improve functional possibilities. Contributes to an even load on the lower limbs in anteroposterior surface and improve the symmetry index of lower limbs. Comprehensive therapy is more effective form treating patients rather than using physical therapy alone. Training transverse abdomen muscle reduces the severity of pain and increases daily activities.

Physiotherapy in women after breast cancer treatment – review

<br/><b>Introduction:</b> Breast cancer is the most common malignant tumor in women in the Polish region. Surgery is a basic method of breast cancer treatment. Surgery often carries a lot of unwanted changes as follows: limitation of mobility in the shoulder joint on the operated side, secondary lymphoedema, post mastectomy pain syndrome (PMPS), reduction of muscle strength or disorders in body posture. Therefore, the implementation of physiotherapeutic activities that are designed to prevent and eliminate postoperative complications seems very important. The main aim of this work was to present physiotherapeutic management in women after mastectomy based on the analysis of available literature. The physiotherapeutic process can be divided into three periods: early hospital, early ambulatory and the late ambulatory period. In the first period, active slow exercises, self-support of the upper limb on the operated side and breathing exercises on the thoracic track are used to prevent circulatory disorders, pulmonary complications, and edema. The early ambulatory period includes corrective exercises, general improvement exercises, stretching and learning of automatic massage of the upper limb of the operated side. The last period should be enriched by recreational methods of physical activity such as swimming, cycling or Nordic walking to maintain physical fitness, proper mobility of the shoulder girdle and improve the patient's psychophysical state. It is very important the patient regular continues the rehabilitation program after curing of breast cancer as well. In the case of secondary lymphoedema of the upper limb, comprehensive rehabilitation physiotherapy is used, consisting of manual lymphatic drainage, healing exercises, compression therapy, and skin care. <br/><b>Conclusions:</b> Physiotherapy in women after breast cancer surgery is a complex and long-term process. Physiotherapeutic methods are effective in treating complications after surgery of breast cancer surgery. It is necessary to constantly update the physio-therapy knowledge in women after breast cancer surgery.

A comprehensive physical therapy evaluation for Male Chronic Pelvic Pain Syndrome: A case series exploring common findings

IntroductionMale Chronic Pelvic Pain Syndrome (MCPPS) is a complex condition and difficult to decipher due to the multifactorial etiologies and system interrelationships. No studies to date have described a movement-based, multisystem assessment including the musculoskeletal, visceral, nervous, lymphatic and vascular systems, as well as manual prostate mobility testing.The purpose of this paper is to demonstrate the importance of a comprehensive physical therapy evaluation to identify predominant mechanical and movement-based dysfunctions related to multiple anatomical structures and their interrelationships. Furthermore, symptoms and potentially confounding psychosocial, and environmental factors linked to MCPPS will be presented, and an overview of prospective treatment will be provided. MethodA retrospective analysis of evaluative findings for ten men was performed. The men, with an average age 35 (range 24–46) were referred to physical therapy for MCPPS. ResultsThis retrospective analysis of ten patients identifies potential contributing pain factors associated with MCPPS. Similarities in clinical presentation among men suffering from MCPPS were identified to include predominant mechanical dysfunctions of the thoraco-lumbar spine, the liver, the kidney, the femoral nerve, the bladder, the prostate, and the pelvic floor. ConclusionThe observations in this retrospective study demonstrate that the use of a multisystem assessment approach in patients with MCPPS is critical for their more effective treatment. On the basis of these findings, and the close mechanical interrelationships of the anatomical elements involved and multisystem MCPPS etiologies, larger-scale research is warranted.

Efficacy of Physiotherapy in Reducing Back Pain and Improve Joint Mobility in Older Women.

Pain of the spine and large appendicular joints may limit the functional mobility of elderly persons and affect their biological fitness. This paper assesses the effects of comprehensive physical therapy in women with lumbar and cervical pain and compares flexibility in the upper and lower body and the range of motion in selected joints. Thirty-three women aged 60-75 years completed a 6-week intervention involving group gymnastics to prevent back pain, relaxation techniques, classic massage, transcutaneous electrical nerve stimulation, and ultrasound therapy to the lumbosacral and cervicothoracic regions. Patient outcomes were assessed by measuring upper and lower body flexibility, upper and lower extremity joint and spinal ROM, and self-reported back pain using a Visual Analogue Scale. Differences in means between successive measurements were calculated with a Student t test for dependent groups, while differences in the range of motion in the joints of the right and left limbs were calculated with the NIR test. The physical therapy significantly improved flexibility of the upper and lower body by increasing the range of motion in selected joints of the limbs and the spine. On completion of the intervention, the intensity of back pain was reduced by 2.9 points in the VAS scale. 1. The 6-week physical therapy programme desig-ned by us constitutes an effective therapy for pain relief in patients with degenerative changes of the spine. 2. The proposed combination of sonotherapy, elec-tro-therapy and classic massage procedures with general fitness exercises in low positions and au-to-genic training contributed significantly to im-provement in flexibility of the upper and lower part of the body and increasing the range of mo-tion in joints of the lower and upper extremities and the spine in women over 60 years of age. 3. The proposed set of procedures and exercises may be used in women over 60 years of age with the aim of improving selected components of biolo-gical fitness.

Evaluation of the Effectiveness of Physiotherapy in Health Resort in the Treatment of Lumbosacral Spine Pain

Introduction: Diseases of the spine are the most common health problem in all population tested, regardless of the country. Pain syndrome of the spine is a major issue because it leads to disability progression and consequently to the deterioration of the quality of life. Physical therapy takes an important place in treating pain syndrome of the spine. The main focus of comprehensive physiotherapy is on dealing with pain and regaining normal range of movement of the spine, as well as obtaining proper stabilization. The aim of this study is to evaluate the effectiveness of spa physiotherapy on treating patients with low back pain. Material and Methods: The study included 50 patients of the “Malwa” Sanatorium in Polanica Zdrój participating in three-week spa therapy because of low back pain. The evaluation was based on the Numerical Rating Scale, Jackson-Moskowitz Scale, the Roland-Morris Disability Questionnaire, and the fingertip-to-floor test. Results: After three weeks of physiotherapy, an average level of pain measured by the Numerical Rating Scale decreased. The range of spine mobility measured by the fingertip-to-floor test improved. The differences between the averages are statistically significant. The patients’ disability concerning everyday tasks, measured by the Roland-Morris Disability Questionnaire decreased. Conclusions: A comprehensive physiotherapy used in health resorts has improved spine mobility among patients with low back pain; it also helped to decrease pain and disability. It seems that a period of three weeks is enough to provide improvement in low back pain.

Successful Surgical Treatment for Dysphagia Secondary to Descending Necrotizing Mediastinitis.

Descending necrotizing mediastinitis (DNM) is a life-threatening disease with a high fatality rate that occurs as a complication of deep neck abscess. DNM complicated by severe dysphagia during the postoperative period has been previously reported, but there have been no published cases of surgical treatment for severe dysphagia secondary to DNM. A 63-year-old man was diagnosed with a deep neck abscess followed by DNM. The patient had dysphagia after incision and drainage of the abscess and drainage for DNM with video-assisted thoracic surgery (VATS). A comprehensive long-term physiotherapy program with a speech and language therapist did not reduce his dysphagia. Thus, the patient underwent laryngeal elevation and cricopharyngeal myotomy, which enabled oral intake. Surgery should be considered for prolonged severe restriction of laryngeal elevation and esophageal introitus opening that is unresponsive to physiotherapy with a speech and language therapist.

ASSESSMENT OF MORBIDITY AND EFFECTIVENESS OF MEDICAL REHABILITATION OF CHILDREN WITH CHRONIC DISEASES OF THE RESPIRATORY SYSTEM IN CLINIC

The data obtained in the study of incidence in children, reflect the results of the children’s clinic. Analysis of the incidence was carried out according to the analysis of medical records. In the structure of general and chronic morbidity in children, the leading places belong to respiratory diseases, among which chronic diseases of adenoids and tonsils prevail (67.7%). Therefore, prevention and timely effective treatment of diseases of the respiratory system will reduce the overall incidence, and, consequently, improve the performance of a children’s clinic. To determine the role of medical rehabilitation, a group of children aged 3 to 14 years with chronic respiratory diseases was recruited in the amount of 127 children (68 boys and 59 girls). In the main group (n=78), treatment without exacerbation included 3 courses of comprehensive medical rehabilitation, including physiotherapy, reflexology, and physical therapy; in the control (n=49) treatment was carried out only in the period of exacerbation. The total duration of observation in both groups was 12 months. The effectiveness of treatment was assessed by the dynamics of the frequency and duration of colds and exacerbations of chronic diseases during the year. In the main group, the average frequency of colds for the year decreased by 2 times (p

Clinical effect of mandibular manipulation combined with comprehensive physical therapy for treatment of acute anterior disc displacement without reduction

Clinical effect of mandibular manipulation combined with comprehensive physical therapy for treatment of acute anterior disc displacement without reduction

Застосування та вплив комплексної програми фізичної терапії на стан серцево-судинної та вегетативної нервової систем жінок молодого віку, хворих на аліментарне ожиріння

Purpose: to investigate the dynamics of the types of reaction of the cardiovascular system to the dosed physical load using the Martine-Kushelevsky test and determine the functional state of the autonomic nervous system (ANS) using the Kerdo index of young women suffering from alimentary obesity under the influence of the developed comprehensive physical therapy program. Material & Methods : study was based on the clinical and functional examination of 50 women aged from 18 to 30 years old, patients with alimentary obesity I–II degree. Results: conducted and analyzed the state of the cardiovascular system on the dosed exercise with the help of the Martine-Kushelevsky and vegetative nervous system tests according to the Kerdo index. Conclusion: use of a physical therapy program, which includes a low-calorie diet, massage, therapeutic gymnastics with elements of sports-oriented aerobics, dosed walking in combination with breathing exercises taking into account the activity of the ANS, helps to normalize the functional state of the cardiovascular and autonomic nervous system.

INFLUENCE OF COMPLEX PHYSIOTHERAPY ON THE FUNCTIONAL CONDITION OF THE SPINE IN OLDER PEOPLE

The aim of the present study was to assess the impact of 21-days comprehensive physiotherapy program on the functional condition of the spine and severity of pain in older people. To achieve this goal, physiotherapeutic procedures were performed on 100 elderly patients suffering from spinal disorders. The comprehensive therapy program consisted of: general improvement exercises, individual exercises with a physiotherapist, exercises in water and physical therapy treatments such as: TENS currents, galvanic current, iontophoresis, laser stimulation, magnetic field on the lumbar spine and hydro massage or mud compresses. Prior and post the therapy program: the Schober’s test - 1 (forward flexion), Schober’s test - 2 (extension), Ott’s test, fingertip-to-floor (FTF) test, pain Visual Analogue Scale (VAS) and the modified Oswestry low back pain questionnaire were evaluated. Statistically significant improvement (p0.001) in all tested parameters was shown at the end of therapy program. Age, height, body weight and body mass index (BMI) has no impact on results before and after the physiotherapy program in respective tests. In conclusion, the conducted study has shown the effectiveness of applied comprehensive physiotherapy program on the functional condition of the spine and improvement of the quality of life of the treated patients, regardless of their somatic conditions.