Rehabilitation In Poland Research Articles

Influence of Risk Factors on Exercise Tolerance in Patients after Myocardial Infarction-Early Cardiac Rehabilitation in Poland.

(1) Background: Prognosis in patients with cardiovascular diseases is significantly influenced by lifestyle and the control of risk factors. Patients after myocardial infarction require special care and promptly introduced cardiac rehabilitation. The primary aim of this study was to identify risk factors and their influence on exercise tolerance before and after cardiac rehabilitation (CR) provided under the Coordinated Specialist Care Programme—Infarct (CSC-Infarct). (2) Methods: The study was carried out at the Cardiac Rehabilitation Centre of Slupsk Specialist Hospital on a group of 112 patients aged 35–87 (62.78 ± 10.09 years) after myocardial infarction (MI), participating in CSC-Infarct. An exercise test (treadmill ECG test), the 6 min walk test (6MWT), echocardiography, blood test (total cholesterol, HDL, LDL, TG), measurement of diastolic pressure ratio (DPr), waist-to-hip ratio (WHR), and BMI were performed in participants on the first and last day of CR. Rating of perceived exertion was assessed with Borg’s scale. (3) Results: The overweight variable had the strongest effect on the increased value of initial: HR rest, HR max, and HR 1 min after exercise compared to subjects with normal BMI. DPr values before and after CR were also higher in overweight patients. Scores of 6MWT were higher in smokers compared to non-smokers. The final MET value was significantly higher in non-diabetic subjects. Hyperlipidaemia was associated with a higher initial HR max and initial HR 1 min after exercise. DPr before CR was also higher. The initial and final MET values were lower in hypertensive patients. Borg’s rating of perceived exertion measured after the final exercise test was also higher in hypertensive patients. Hypertension influenced the initial and final 6MWT scores, which were significantly higher in normotensive patients. (4) Conclusions: CR within CSC-infarction in patients after myocardial infarction improves exercise tolerance. Exercise tolerance in post-MI patients with concomitant risk factors is lower compared to post-MI patients without risk factors.

The Work of Janina Sikorska-Tomaszewska, Associate Professor of Medical Sciences, Towards the Development of Rehabilitation in Poland in the Years 1948-1978.

Based on an analysis of archival materials from the private collections of Janina Sikorska-Tomaszewskas family, the Document Repository of Wiktor Dega Memorial Orthopedics and Rehabilitation Hospital in Pozna, articles from daily press and some publications, the authors present the work of Janina Sikorska-Tomaszewska (19111998), Associate Professor of Medical Sciences, towards the development of rehabilitation in Poland in the years 19481978. Her organizational, educational and scientific activity in the early years of the development of rehabilitation medicine in our country contributed significantly to the establishment of the Polish school of rehabilitation. The 30 years of her activity allow Janina Sikorska-Tomaszewska to be counted among the pantheon of founders of rehabilitation in Poland.

Niewykorzystany kapitał. Pomoc międzynarodowa a początki rehabilitacji zawodowej w Polsce po II wojnie światowej

Unused Assets. International Aid and the Birth of Vocational Rehabilitation in Poland after the Second World War In 1946, at the request of the Polish government, UNRRA sent in two British experts in vocational rehabilitation to help establish the national framework of helping people with disabilities. During numerous meetings with government representatives, medical doctors, and social workers, as well as by trainings, lectures, and screenings of instructional films, they tried to familiarise Poles with the British model of rehabilitation. The model assumed close integration of medical and vocational rehabilitation and aimed at placing the disabled workers in the industry alongside those without disabilities. Initially, officials from the Polish Ministry of Labour and Social Welfare seemed to be keen to adopt such an approach, but in 1949, they turned toward the Soviet solutions. One of the main effects of this shift was moving away from employing the disabled in the industry. They were encouraged to join cooperatives instead, which, in the end, proved to be unfavorable to their social rehabilitation. The article reconstructs the activity of the British experts in Poland and analyses their observations from the encounters. By situating these events in a broader context of political and social conditions, I argue that replacing the progressive British model with Soviet solutions stemmed from the ongoing process of the Sovietization of Poland.

Regional Variability in the Access to Cardiac Rehabilitation in Poland.

Equitable access to cardiological rehabilitation services is one of the important elements in the effectiveness of the treatment of cardiovascular diseases as cardiological rehabilitation is an important part of circulatory system disease prevention and treatment. However, in many countries among others, Poland suffers from the underutilization of cardiac rehabilitation services. Cardiovascular diseases are the worldwide number one cause of mortality, morbidity, and disability and are responsible for the substantial increase in health care costs. Thus, the aim of the research was the analysis of geographical accessibility to cardiac rehabilitation services in Poland. Perkal’s method was employed in this research. The conducted research allowed to recognize the regional variation, but also made it possible to classify Polish voivodeships in terms of the level of availability achieved. This enables the identification of voivodeships that provide a good, or even very good, access to cardiology rehabilitation services and those characterized by low, or very low access. It was found that there was a slight regional variability in the access to cardiological rehabilitation services. However, the sufficient development of a rehabilitation infrastructure has been also recognized.

Wpływ epidemii choroby Heinego-Medina na rozwój rehabilitacji w Polsce.

<p><strong>ABSTRACT</strong><br />The work presents pioneering activities of Polish orthopedists in the interwar period who were the first to propose methods of surgical and physical treatment of the effects of poliomyelitis. It also discusses the activities undertaken by the Ministry of Health and the National Rehabilitation Specialist, prof Wiktor Dega, in the early 1950s in order to fight the effects of the Heine-Medin disease epidemic in Poland. They worked on the creation of a network of rehabilitation centres throughout the country, training of medical personnel, development of uniform procedures that would provide the patient with appropriate treatment in the acute state of the disease and during the following years of its consequences. In addition to treating, it was possible for the sick children to get a profession that would allow them to start working. The authors show that dealing with the effects of Heine-Medin disease had a significant impact on the development of rehabilitation in Poland.</p> <p><strong>STRESZCZENIE</strong><br />Praca przedstawia prekursorskie działania ortopedów polskich w okresie międzywojennym, którzy jako pierwsi zaproponowali metody leczenia operacyjnego i fizykalnego skutków poliomyelitis. Omawia także działania podjęte przez Ministerstwo Zdrowia i Krajowego Specjalistę ds. Rehabilitacji prof. Wiktora Degę na początku lat 50. XX w. w celu walki ze skutkami epidemii choroby Heinego-Medina w Polsce. Dotyczyły one powstania sieci ośrodków rehabilitacyjnych na terenie całego kraju, szkolenia personelu medycznego, wypracowania jednolitej metody powstępowania, zapewniającą choremu właściwe leczenie usprawniające w ostrym stanie choroby oraz w ciągu trwającego wiele lat jej następstw. Poza leczeniem, chorym dzieciom stworzono możliwość zdobycia zawodu umożliwiającego podjęcie pracy zawodowej. Autorzy wykazali, że leczenie skutków choroby Heinego-Medina wpłynęło w znaczący sposób na rozwoju rehabilitacji w Polsce.</p>

Świadczenia rehabilitacji medycznej w Polsce w czasie pandemii COVID-19. Zagadnienia regulacyjne i organizacyjne

Medical rehabilitation in Poland during the COVID-19 pandemic. Regulatory and organizational issues The medical rehabilitation system in Poland includes various rehabilitation services, financed by various institutions, including the NFZ, ZUS, KRUS, PFRON and local governments. The aim of the study is to identify the most important problems and limitations of this system, especially in the context of the COVID-19 pandemic. The most important issues to be solved and proposed reforms of the medical rehabilitation system in Poland presented in recent years were identified. The impact of the COVID-19 pandemic on this system, providing rehabilitation services and problems related to the im­plementation of further legal regulations in the first months of the pandemic were discussed. One of the most important recommended changes is the implementation of the comprehensive care model and the activities aimed at coordinating various elements and levels of rehabilitation.

Prof. Eugeniusz Piasecki’s Contribution to the Development of Polish Physiotherapy

Based on source materials, this article presents the activity of Prof. Eugeniusz Piasecki towards the development of physiotherapy in Poland. After completing his studies at the Faculty of Medicine of Jagiellonian University and a pedagogical course in physical education for gymnastics teachers at secondary schools and teacher training centres, he went to Vienna to deepen his knowledge of medical gymnastics and hydrotherapy. During a scientific trip to Sweden, he became acquainted with Pehr Henrique Ling's method. In the years 1900-1916, E. Piasecki ran a healing gymnastics, orthopaedics and massage facility in Lviv. He was also active in the "Sokol" Gymnastic Society and worked in the gymnasiums owned by his father Wenanty Piasecki in Cracow and Zakopane. At the University of Lviv he taught school hygiene, theory of physical education as well as conducting research and teaching in the physiology of exercise. There he also obtained his habilitation in 1909. His overarching objective was to eliminate German gymnastics, which he considered harmful, from schools in Galicia. Instead, he advocated Swedish gymnastics, based on scientific evidence and anatomo-physiological analysis of each movement. His research focused, among others, on the effect of various physical exercises on the cardio-respiratory and osteo-articular systems in children. The results of E. Piasecki's studies were the basis for a critical evalu-ation of the irrational strength exercises of German gymnastics. He endeavoured to promote physical education as much as possible, adapting it to the specific needs of schools, hospitals and spas. As head of the Department of Theory of Physical Education and School Hygiene (since 1919) and then the Institute of Physical Education (since 1924) at Poznan University, together with Prof. Ireneusz Wierzejewski, Dr Wiktor Dega,Ph.D., and Dr Franciszek Raszej, Ph.D., he laid the foundations of rehabilitation in Poland. Thanks to him, the Poznan centre carried out research in medical gymnastics and massage, preparing specialists in the area of corrective exercises and, later, physiotherapy in Poland.

Rehabilitation specialty nursing in Poland – is it justified?

Nurses enjoy a special status in the treatment teams due to their most intimate and frequent relations to the patients, both ambulatory and stationary ones. Hence, appropriate nursing care serves vast rehabilitation purposes and helps to prevent undesired events improving patient’s quality of life. Particularly important is rehabilitation performed by nurses during care of the disabled and aged persons with co-morbidities. In light of the fact that the population is aging, it is essential to introduce the appropriate rehabilitation learning programs as part of the nursing faculty. Although some of these practical treatment aspects are defined by the Polish law, nurses still cannot obtain a specialization degree in the field of rehabilitation in Poland. Yet, it is well established and developed in other countries, like Canada which could serve as a model.

Antoni marian gabryszewski as a pioneer of orthopaedics and rehabilitation in poland.

This article describes the work of Dr. Antoni Marian Gabryszewski, orthopaedic surgeon, associate professor at Lvov University, towards the development of orthopaedics and rehabilitation in Poland before World War I. It is based on archival materials, publications in medical journals and articles from the daily press of that time. The author presents little-known facts concerning Dr. Gabryszewski's occupational and academic activity and his work at the Surgery Dept. of Lvov University as well as his habilitation dissertation, regarded as the first attempt to position orthopaedics as distinct from surgery in Poland. The article also describes his long-term work at the private Orthopaedic Facility established in 1898 in Lvov which later incorporated the Zander Institute in 1908. The Zander Institute was the first in Galicia to offer exercise machines designed by Dr. Gustav Zander, imported from Stockholm and enjoying an extraordinary popularity in the world. Dr. Gabryszewski's practice as a spa doctor, which he pursued in Iwonicz Zdrój in the summer months, is also presented. Dr. A. Gabryszewski introduced comprehensive rehabilitation to the treatment of orthopaedic patients both at the Surgery Dept. of Lvov University and at his Orthopaedic Facility. He used therapeutic gymnastics (particularly mechanotherapy), therapeutic massage, physical therapy and orthopaedic aids. Analysis of the source materials leads to unequivocal conclusions attesting to Dr. A. Gabryszewski's pioneering role and significant contribution to the development of orthopaedics and rehabilitation in Poland.

Facilities of early rehabilitation after stroke in Poland 2010

The aim of this work was to survey the contemporary facilities for early poststroke rehabilitation in Poland. The main research questions were as follows: what is the availability of inpatient rehabilitation for poststroke patients in neurological departments and in rehabilitation departments? The growing costs of healthcare are encouraging healthcare planners to look for new organizational solutions of services that could enable rehabilitation as early as possible after disease onset. Early poststroke rehabilitation includes many elements that provide for early-onset rehabilitation and its continuation after discharge from the stroke unit. Two questionnaires evaluating neurorehabilitation of individuals who had stroke were designed and distributed: the first questionnaire was distributed to 221 neurological wards and the second questionnaire was distributed to 154 rehabilitation departments in Poland. We obtained information about delay before admission from neurological wards to rehabilitation departments, the number of sessions per day, the time duration of one session, the number of sessions per week, the average length of stay in department, the methods of outcome measurement, etc. We sent out 375 questionnaires and received 129 (35%) responses, 78 from neurological wards and 51 from rehabilitation departments. Only 25% of all patients were moved from neurological wards to the rehabilitation department after stroke (15% directly). Of those moved to rehabilitation departments, only 54% were treated early after stroke; that is, within 3 months of stroke. Considering that about half of stroke survivors will require rehabilitation (30 days after stroke onset), the current facilities of early poststroke rehabilitation in Poland cannot meet this need. We should do our best to introduce rehabilitation services such as early home-supported discharge after stroke, which is currently not available in Poland. Although we have focused on resources in Poland, we anticipate that similar patterns may be found in other countries in the region.

Development of early comprehensive stroke inpatient rehabilitation in Poland – current status and future requirements

Background and purposeEvery stroke patient should undergo early rehabilitation. We aimed to evaluate accessibility, development and needs in early stroke inpatient rehabilitation in Poland. Material and methodsA questionnaire evaluating rehabilitation departments was prepared and sent (in 2004 and 2008) to rehabilitation wards in Poland, where stroke patients are treated and undergo early rehabilitation. We divided departments into classes: class A – having comprehensive rehabilitation (physiotherapy minimum 60 minutes/day, speech therapy minimum 30 minutes/5 days/week, rehabilitation of other cognitive impairments minimum 30 minutes/5 days/week, group physiotherapy); B – having the possibility of all types of therapy, but done less frequently; C – physiotherapy and speech therapy; D – physiotherapy and cognitive rehabilitation; E – only physiotherapy. ResultsIn 2004, we obtained responses from 115 of 172 (66.9%) rehabilitation departments. According to prespecified criteria there were 11 class A, 31 class B, 28 class C, 4 class D, and 41 class E wards. In 2008, we received response from 89 of 149 (59.7%) rehabilitation departments. According to prespecified criteria there were 17 class A, 40 class B, 22 class C, 0 class D, and 10 class E wards. In 2004, 159 beds and in 2008, 294 beds in class A departments were available for stroke patients. The minimal number of needed but lacking beds was 604 in 2004 and 469 in 2008. ConclusionsDevelopment of departments providing early comprehensive stroke rehabilitation from 2004 to 2008 is marked, but still insufficient. In 2008, 19% of rehabilitation departments could provide comprehensive stroke rehabilitation and this was 38.5% of beds actually needed.

Psychiatric rehabilitation in Poland — Current condition and perspectives of development

Psychiatric rehabilitation in Poland — Current condition and perspectives of development

Rehabilitation in Poland

Rehabilitation in Poland