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Physiotherapy Based on PNF Concept for Elderly People After Conventional Colon Surgery

100%
Czyżewski P., Szczepkowski M., Domaniecki J., Dąbek A.
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vol. 85
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issue 9
475-482
EN
Aging population, increases the number of major abdominal surgery (MAS) performed in the elderly. Main goal of physiotherapy after that surgery is prevention postoperative complications and reduction of functional limitation. The aim of the study was to asses functional status elderly people after MAS during early postoperative physiotherapy. Material and methods. In a prospective randomized study involved 34 patients scheduled for elective MAS, aged 65+. Patients were randomly assigned to receive PNF or conventional physiotherapy. The study included forced spirometry (FVC, FEV1, PEF) and functional tests (gait speed, up&go). Measurements were performed before surgery and the fourth day after surgery. Also analyzed age, sex, BMI and the level of postoperative independence (postoperative independence scale SAP). Kolmogorow- Smirnow test was used to check normal distribution, t-Student was used to check whether two sets of data differ significantly, and r-Pearsons for correlations testing. p values <0.05 were considered significant. Results. After surgery the time of gait speed test and up and go test was significant longer in comparison to preoperative value. FVC%, FEV1%, PEF% values was decrease. In the PNF group was found significantly higher postoperative independence(SAP) and shorter length of stay in hospital compared to conventional physiotherapy group. Results of SAP and functional tests were significantly positive correlated. Conclusions. Major abdominal surgery decrees efficiency of walking and lung ventilation after 65 year old in early postoperative period. Some techniques of the PNF concept used in improving older patients after the MAS may favourably affect the postoperative increase independence and reduce the time of hospitalization.
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The Influence of Physical Activity on Physiotherapy Effects After Abdominal Surgery in Elderly People

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Czyżewski P., Domaniecki J., Dąbek A., Kopytiuk R.
Advances in Rehabilitation
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2013
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vol. 27
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issue 3
1-8
EN
Introduction: Elderly people are at the higher risk of colon cancer. Most of them request surgery. Main goal of physiotherapy after major abdominal surgery (MAS) is prevention postoperative complications and reduction of functional limitation. Physical activity level and functional status are close connected for 65+ patients. Daily activity independence, mental efficiency and well-being depend on physical activity level of elderly people. The aim of this study was to determine the correlations between physical activity level, functional status and lung function of elderly people in early postoperative physiotherapy period. Material and methods : Prospective randomized study involved 34 patients scheduled for elective MAS, aged 65+. Patients were randomly assigned to receive PNF or conventional physiotherapy. The study included forced spirometry (FVC, FEV1, PEF) and functional tests (gait speed, up&go). Measurements were performed before surgery and the fourth day after surgery. Also analyzed age, sex, BMI and the level of postoperative independence (postoperative independence scale SAP). Training intensity and capacity was the same in both groups. Kolmogorow-Smirnow test was used to check normal distribution, t-Student was used to check whether two sets of data differ significantly, and r- Pearsons for correlations testing. P values <0.05 were considered significant. Results: After surgery the time of gait speed test and up and go test was significant longer in comparison to preoperative value. FVC%, FEV1%, PEF% values decreased. Level of physical activity had influence on results in evaluated tests of walking and lung ventilation. There was no significant changes after surgery to preoperative value for these measurements in high physical activity group. High active group had better results on SAP scale than low and middle activity group. Conclusions: MAS decrees efficiency of lung ventilation and walking after 65 year old in early postoperative period. High physical activity level patients scheduled for major abdominal surgery had positive impact on postoperative lung ventilation, ability and independence in walking in hospital period.
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Zaburzenia Czucia w Obszarze Unerwianym Przez Nerw Pośrodkowy u Pacjentów z Okołoporodowym Uszkodzeniem Splotu Ramiennego (Ousr). / Dysesthesia in Innervated Area by Median Nerve in Obstetric Brachial Plexus Injuries (Obpi)

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Grodner M. R., Lewandowska M., Domaniecki J.
Advances in Rehabilitation
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2011
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vol. 25
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issue 2
5-10
EN
Introduction Obstetric brachial plexus injuries (OBPI) are a lesion peripheral nervous system. For this injury motor and autonomic dysfunctions are typical but also sensory disorders appear. Up till now the main research considered the treatment of motor dysfunction within the upper extremity. The dysfunction of the sensory was not the centre of scientists’ attention because of their theoretically minor meaning. Sensory impairments are invisible but extremely important for the functions. A lot of patients with OBPI have a spatial neglect syndrome due to or lack on sensation within the lesion upper extremity. The aim of this study was to examine sensory dysfunction in the area of innervated by median nerve at children and teenagers with OBPI , then to analyze these disorders with relation to the type of the injury, the functional of the hand and past reconstruction of the nerves. Material and methods Research involved the group of 32 patients (aged 6-17 years) with OBPI, improved in Pediatric Hospital in Dziekanów Leśny near of Warsaw and Rehabilitation Centre for Children and Teenagers “STOCER” in Konstancin. Patients were divided in two groups with and without reconstruction of the nerves or muscles. Five types of sensibility were tested (vibration, placement, touch, pain and temperature) on the palmer side of the 2nd finger of the healthy hand and than on the other hand on the side of the lesion. To these analysis were classified ed exclusively patients without disorders of the sensibility in the healthy side, because of the possibility of the exclusion sensory dysfunction consequent from other reasons than OBPI. Results More often appear pain and temperature paraesthesia (superiorly pain paraesthesia). We can observe less degree of dysesthesia of pain and temperature sensibility when the hand in the side lesion is more functional. The higher degree of dysfunction of the temperature paraesthesia appears among patients with nerves reconstruction than among those withou nerves reconstruction or with muscle transfer. Physiotherapy should consider stimulations of the different kind of sensibility within the lesion extremity at patients with OBPI.
4
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Effect of Kinesiology Taping method on pain reduction after rib broken – initial report

88%
Czyżewski P., Hałas I., Kopytiuk R., Domaniecki J., Szczepkowski M.
Advances in Rehabilitation
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2012
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vol. 26
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issue 1
29-35
EN
Introduction: The rib broken are most frequent damages of chest. They cause strong pain, and make difficulties in breathing and changing position of body. Uncomplicated breakdowns are cured by analgesics drugs. One of physical methods for pain decreasing in musculoskeletal dysfunctions is kinesiotaping. The aim of this study was assessment of effectiveness Kinesiology Taping method after rib broken and their influence on pain reduction and breathing parameters. Material and methods : In this study take part 14 patients after broken one or few ribs from General and Colorectal Surgery Clinic Bielanski Hospital in Warsaw. Breathing parameters was controlled by forced vital capacity(FVC), forced expiratory voluntary in first second(FEV1) and peak expiratory flow (PEF). Pain was asses by visual analogue scale (VAS) separately for three situations: deep breathing, provoked coughing and changing body position from supine to seating. Next K-Active Tape® apply on skin over the broken rib. After 15 minutes breathing parameters and pain level assessing was repeated. Results: There were difference between pain level before and after K-Active Tape® apply in three different situations. It shown difference in value of average points VAS in changing body position from supine to seating (p= 0,015), provoked coughing (p= 0,022) and deep breathing (p= 0,023). It means that pain was significantly decrees. Analysis of average value breathing parameters indicate upward trend FVC, FEV1 and PEF after Kinesiology Taping application, but it wasn’t statistically significant. Conclusions: Kinesiology Taping is safety, supplementary method for heeling posttraumatic ribs condition. Apply lymphatic and ligament techniques using K-Active Tape® could be effectiveness method of reduction pain after ribs broken. It’s necessary to continue research on effectiveness Kinesiology Taping after ribs broken with extend methodology.
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