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Wczesne wyniki leczenia zachowawczego pacjentki z progresywną skoliozą idiopatyczną – opis przypadku / Early results of conservative treatment of patient with progressive idiopathic scoliosis – a case study

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Leszczewska J., Czaprowski D.
Advances in Rehabilitation
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2014
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vol. 28
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issue 3
29-35
EN
Introduction:According to SOSORT, conservative treatment of idiopathic scoliosis (IS) includes physiotherapy and bracing. The main goal of treatment is to prevent of progression of the curvature as well as improvement the appearance. The aim of the study is to present the results of conservative treatment of girls aged 12 years with progressive idiopathic scoliosis. A case study: The first diagnostic was performed in March 2010 due to asymmetry of scapulas observed by the mother. The girl was referred to an orthopedist for a more detailed diagnostics. The radiographic assessment found: the right-sided curvature in the thoracic (Th6-Th11, 30°) and left-sided in the thoraco-lumbar (Th11-L4, 30°). The Risser sign was determined (0). It was recommended Cheneau brace (23 hours per day) as well as intensive physiotherapy. In the conversation with parents and girl, it was established that they failed to comply the recommendation. The control radiographic exam (September, 2010) revealed the progression of the right thoracic curve (Th6-Th11, 36°). It was recommended more systematic wearing the brace and exercises. The X-ray performed in June 2011 showed decrease of the Cobb angle (Th6-Th11, 18° right and Th11-L4, 14° left). Risser sign value was (1). The menarche occurred in November 2011. The patient continued the treatment with the brace and physiotherapy. In September 2013 performed the control X-ray exam (Th5- Th11, 15°, Th11-L4, 11°). The Risser sign was determined (4).The physician decided by the end of treatment with Chenenau brace and recommended the continuation of physiotherapy to improve the appearance. Summary and conclusion: The conservative treatment (Cheneau brace and physiotherapy) can lead to decrease the Cobb angle in children with IS.
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Czy istnieje „idealna” pozycja siedząca? / Does „ideal” sitting position exist?

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Czaprowski D., Leszczewska J., Sitarski D.
Advances in Rehabilitation
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2014
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vol. 28
|
issue 3
47-54
EN
Sedentary behavior is often mentioned as a factor of posture disorders and low back pain. Despite this fact modern man spends most of time in sitting position. Therefore, physiotherapists and physicians recommends many different sitting positions to prevent and treat negative effects of prolonged sitting in poor posture. Lack of unified guidelines of the best sitting posture is a topic of discussions. Because of negative consequences of sitting in slump posture such as stretched supraspinal ligaments and low back pain some recommendations suggest lordotic lumbar posture that decreases nucleus pulposus pressure, lesser compression load of anterior part of intervertebral disc and provides better shock absorption during movement. However, this position can be related to higher compression of intervertebral joints, increased back muscles activity and back discomfort. Therefore, several studies suggests sitting with slight flexion of the lumbar spine as it lead to even load distribution on intrvertebral disc and decreased compression of intervertebral joints. The analisys of many different studies and contradictory opinions shows that one ideal sitting posture doesn’t exist. Sitting position should be chosen individually in regard to the inter-individual characteristics of musculoskeletal system. It worth also noting that every position (lordotic or kyphotic) maintained for a prolong time leads to discomfort and soft tissue symptoms.
3
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Inter-Examiner, Within-Session and Between-Session Repeatability of Kinematic Gait Parameters Among Adult Subjects

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Leszczewska J., Czaprowski D., Pawłowska P., Oponowicz A.
Human Movement
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2012
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vol. 13
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issue 4
337-343
EN
Purpose. This research aimed to assess the repeatability of results obtained when analysing gait by means of a system designed for objective gait analysis in a single laboratory setting by a single examiner within-session and between-sessions. Methods. For the purpose of this research, the BTS Smart-D movement analysis system, produced by Capture Motion System of Italy, was used. Four healthy adults were examined. The subjects took part in three gait analysis testing sessions, with each session separated by a two-day break. During each session, two sets of measurements were taken for each subject. Statistical analysis was performed with StatSoft’s Statistica 7.1 software. Results. Within each session, all examined temporal and spatial parameters were found to be repeatable. Only in hip and knee joint rotation was repeatability not confirmed within session. Between the sessions, repeatability was confirmed in pelvic rotation, abduction/adduction of the knee joint and for all foot kinematic parameters. Conclusions. Conducting gait analysis by one researcher does not guarantee obtaining repeatable results for all measured kinematic parameters, either within one session or between sessions; caution ought to be exercised when interpreting results. Among the studied parameters, hip and knee joint rotation provided the most difficulty in obtaining repeatable results. For this reason, diagnostic and therapeutic decisions based on such data require the utmost consideration.
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