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Impact of timing and regularity of rehabilitation on gait disturbances in patients after a stroke

100%

Kijowski S., Świat M., Opala G.

Medical Rehabilitation

2010

vol. 14(1)

9-15

Introduction: The increasing stroke incidence due to demographic changes in society leads to a growing numbers of patients requiring post-stroke rehabilitation. Effective post-stroke rehabilitation should lead to improvement in motor functions. Pedography allows for an objective assessment of improvement in gait disturbances and thus the effectiveness of the treatment. The aim of the study was to estimate the impact of timing and regularity of treatment on gait disturbances assessed with pedography.Material and Methods: One hundred and twenty consecutive patients (44 women, 76 men, average age 76) were included. All were hemiparetic after stroke (95 ischemic; 25 hemorrhagic). During 4 weeks of the treatment period intensive rehabilitation, 5 days a week, was provided. Ninety patients received treatment regularly, while 30 patients had interruptions in the treatment. Gait parameters were measured with the use of a pedography platform. Pedography was performed before and after the treatment. Improvement after treatment was recognized when asymmetry in the gait parameters between the paretic and healthy limb disappeared. The effects of the treatments were compared depending on the regularity of the treatment and the time from the stroke event i.e. less then 6 months, between 6 and 12 months and more then one year.Results: Significant asymmetry in gait parameters was found in the first measurements before the treatment. After 4 weeks of rehabilitation sessions the asymmetry in recorded parameters disappeared only in systematically treated patients. The best results were found in the subgroup of patients in which the rehabilitation program had been introduced within 6 months after the stroke event. Conclusions: The regularity of the treatment is essential to obtain an improvement in gait disturbances after stroke. The rehabilitation program should be introduced as soon as possible after a stroke to obtain the best effects of the treatment. Pedography is a useful tool for assessment of the effectiveness of the rehabilitation program in stroke patients.

Nordic Walking w rehabilitacji choroby Parkinsona

76%

Szefler-Derela J., Suszyński K., Doroniewicz I., Kowalczyk A., Opala G., Kwiek S. J.

Annales Academiae Medicae Silesiensis

2014

vol. 68

issue 5

361-367

INTRODUCTION Parkinson's disease is neurodegenerative disease of the elderly, for which to this day an effective cure has not been found. Besides pharmacotherapy and Deep Brain Stimulation in PD, an increasingly supplementary treatment is exercise therapy like Nordic Walking (NW). MATERIAL AND METHODS 40 patients with PD taking part in the survey were divided into two equal groups in terms of gender and stage of the disease (II and III stage of the Hoehn and Yahr scale); the study group was subjected to 6 weeks of Nordic Walking training. The control group consists of persons without physical activity for 6 weeks. RESULTS In the NW group there was a statistically significant better improvement of the test parameters. CONCLUSIONS After the 6 week rehabilitation period, major improvement in terms of patient mobility functionality and gait parameters is visible.

WSTĘP Choroba Parkinsona ( Parkinson’s disease – PD) jest neurozwyrodnieniową chorobą wieku podeszłego, na którą do dziś nie wynaleziono skutecznego lekarstwa. Oprócz stosowanej farmakoterapii coraz częściej uzupełnieniem leczenia jest terapia ruchowa, w tym trening metodą Nordic Walking (NW). MATERIAŁ I METODY Badaniem objeto 40 pacjentów z PD, których podzielono na dwie równe grupy pod względem płci oraz stopnia zaawansowania choroby (II i III stopień skali Hoehn&Yahr). Grupę badawczą poddano 6-tygodniowemu treningowi metodą NW . Grupę kontrolną stanowiły osoby bez aktywności fizycznej przez 6 tygodni. W Y N I K I W grupie NW stwierdzono znamiennie statystycznie lepszą poprawę badanych parametrów. W N I O S K I Po 6-tygodniowym okresie usprawniania widoczna jest znaczna poprawa w zakresie funkcjonalności ruchowej pacjentów oraz parametrów chodu.

Wpływ terapii PNF na proces poprawy motorycznej u pacjentów po niedokrwiennym udarze mózgu zlokalizowanym w lewej półkuli w okresie ostrym rehabilitacji

64%

Kaniewski O., Suszyński K., Górka D., Kania D., Szelfer J., Dudek J., Doroniewicz I., Opala G., Kwiek S. J.

Annales Academiae Medicae Silesiensis

2014

vol. 68

issue 5

294-301

AIM The aim of the work was to examine the influence of PNF-therapy (proprioceptive neuromuscular facilitation therapy) based rehabilitation on the improvement process of motor impairment in patients after ischemic stroke located in the left hemisphere. Our study was carried out in K. Gibiński Central Clinic Hospital of the Medical University of Silesia in Katowice-Ligota. MATERIALS AND METHODS The research subjects were represented by a group of 20 patients (15 female and 5 male) aged 49–86 years, hospitalized in the abovementioned facility. Physical therapy in a stroke department begins (in the first 24 h) withcomprehensive evaluation of motor function, mobility, balance, coordination, sensation, and proprioception. Tests used to measures them include: Lovett scale, Brunnstom scale, Rankin scale, Up and Go Test and the Functional Reach Test. Goals that are measurable and realistic were set by the doctors and rehabilitation team, and were reevaluated in the last 24 h before discharge. RESULTS AND CONCLUSIONS The results of our study indicate that a PNF-therapy based rehabilitation program helps in promoting the recovery of muscle strength, preventing complications due to disabilities and improves adapting to activities of dailyliving.

WSTĘP Celem pracy było sprawdzenie wpływu postępowania rehabilitacyjnego z zastosowaniem koncepcji PNF (proprioceptive neuromuscular facilitation) na proces usprawniania motorycznego pacjentów po niedokrwiennym udarze mózgu zlokalizowanym w lewej półkuli. Badania przeprowadzono w Samodzielnym Publicznym Centralnym Szpitalu Klinicznym SUM w Katowicach Ligocie (SPCSK SUM). MATERIAŁ I METODY Materiał badawczy stanowiła grupa 20 hospitalizowanych pacjentów (15 kobiet i 5 mężczyzn) w wieku od 49 do 86 lat. Do weryfikacji procesu badawczego wykorzystano skale: Brunnstom, Rankina i Test Lovetta oraz testy funkcjonalne: Up and Go Test i Functional Reach Test. Badania przeprowadzono w ciągu pierwszych 24 godzin po zakwalifikowaniu pacjenta na Pododdział Udarowy Oddziału Neurologii SP CSK SUM oraz w ciągu ostatnich 24 godzin przebywania badanych na oddziale, po przeprowadzonym procesie usprawniania motorycznego. WYNIKI Wszystkie przeprowadzone testy wykazały poprawę zarówno w zakresie siły mięśniowej, napięcia mięśniowego, jak i odzyskania sprawności w codziennych czynnościach.

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2 Annales Academiae Medicae Silesiensis

1 Medical Rehabilitation

2 2014

1 2010

3 Opala G.

2 Doroniewicz I.

2 Kwiek S. J.

2 Suszyński K.

1 Dudek J.

1 Górka D.

1 Kania D.

1 Kaniewski O.

1 Kijowski S.

1 Kowalczyk A.

1 Szefler-Derela J.

1 Szelfer J.

1 Świat M.

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Impact of timing and regularity of rehabilitation on gait disturbances in patients after a stroke

Nordic Walking w rehabilitacji choroby Parkinsona

Wpływ terapii PNF na proces poprawy motorycznej u pacjentów po niedokrwiennym udarze mózgu zlokalizowanym w lewej półkuli w okresie ostrym rehabilitacji