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Physiotherapy in women with diastasis of the rectus abdominis muscles

100%
Bobowik P. Ż., Dąbek A.
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2018
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vol. 32
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issue 3
11-17
EN
Background Diastasis of the rectus abdominis muscles (DRAM) is the separation of the two rectus abdominis muscles more than 2 cm wide. It often arises as a result of android obesity, dysfunctional abdominal cramp and pregnancy. Untreated diastasis may lead to dangerous heath consequences such as.: abdominal hernia, lower back pain or disorders in pelvis’s area. The aim of this study was to determinate the effectiveness of novel physiotherapeutic program in women with diastasis of the rectus abdominis muscles. Material and methods The study was conducted on a group of 40 women between 20-45 years old (mean 32,32+5,9 year). They all were qualified in obstetric ward of Szpital Bielański in Warsaw. All of them were in the postpartum between 0-3 days after labor and have DRAM greater than 2 cm (measured by palpation on the umbilicus height, 4,5 cm above and below umbilicus). In research group (included 20 women) applied novel physiotherapeutic program aimed at reduction of DRAM. In controlled group (20 women) there was no therapy but only observation of spontaneous reduction of diastasis. The study took 6 weeks. Results Data analysis had shown 95% effectiveness of novel physiotherapeutic program. Chi-square test has confirmed the difference in DRAM size in both groups (p<0,0001). A statistically significant correlation was demonstrated between width of diastasis and growth of the mother’s weight gain in pregnancy, waist-to-hip ratio, BMI, number of delivery and mother’s physical activity before and during pregnancy (p<0,05). There wasn’t clear correlation between width of diastasis and mother’s age or infant’s mass (p>0,05). Conclusions It seems that spontaneous reduction of diastasis of the rectus abdominis muscles is very rare. New physiotherapeutic program is an effective method in DRAM’s reduction. The research should be continued in larger group of women and after effectiveness confirmation, program should be introduced in obstetric wards.
2
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The influence of physical activity on climacteric symptoms

81%
Dąbek A., Adamiec A., Rekowski W., Czyżewski P.
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2020
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vol. 30
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issue 1
27-32
EN
Introduction The menopausal syndrome affects 85-87% post-menopausal women. Typical symptoms include: hot flashes, heavy sweats, dizziness, increased body temperature, heart palpitations, depression, mood swings, distorted concentration, distorted memory and interrupted sleeping patterns. The literature on effects of physical activity on menopausal symptoms seems to be inconsistent. The aim of this study was to determine the relationship between intensified menopausal syndrome and undertaking physical activity. Material and methods We studied 105 healthy menopausal women (aged 45 to 65). Their mean age was 52 SD 5.2. We used the survey method. The research tools were: questionnaire we devised, Kupperman index and Borg scale. Additionally, we devised: physical effort intensity index and physical activity variety index. To conduct the statistical analysis, we used STATISTICA programme. We set statistical significance at p<0.05. Results We found a statistically significant relationship between the frequency of undertaking physical activity and the intensity of menopausal syndrome. More than a half of the subjects (54.3%) did physical exercise "often" or "regularly", and they did not suffer from the "severe" form of menopausal syndrome. We found a significant relationship between the BMI and intensity of menopausal symptoms (p=0.04) and between the waist size and menopausal symptoms (p=0.001). Conclusions The more intense, varied and frequent physical activity, the less intense menopausal symptoms. The subjects with normal BMI and waist narrower than 80cm had less difficult menopause. Physical activity reduces physical and psychological changes experienced in the climacteric.
3
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Physiotherapy Based on PNF Concept for Elderly People After Conventional Colon Surgery

81%
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.
4
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The Influence of Physical Activity on Physiotherapy Effects After Abdominal Surgery in Elderly People

81%
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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