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Demograficzne uwarunkowania stosowania ćwiczeń fizycznych w profilaktyce bólu w chorobie dyskowej odcinka krzyżowo – lędźwiowego kręgosłupa / Demographic determinants of using exercise as the prophlaxis of the cross section of the disk – lumbar spine’s pain

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Turkiewicz-Maligranda A., Rymaszewska J.
Advances in Rehabilitation
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2014
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vol. 28
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issue 4
43-50
EN
Introduction: The disc disease of the lumbosacral spine is frequently occurs whose the main cause is the intervertebral disc degeneration. Pain in the lower back section of the spine and a considerable impairment of physical fitness is the main ailment. It is a chronic disease with periodic recurrent episodes of intense pain. Coping with the disease means, among other things, reinforcement perivertebral muscles through regular physical exercise. It is assumed that sociodemographic factors will be related to undertaking health-promoting actions in the form of physical activity adjusted to the degenerative disc disease of the lumbosacral spine. The aim of the paper was to answer the question whether demographic variables have any connection with undertaking physical activity adjusted to the disease of the lower back section of the spine. Material and methods: The study was a longitudinal type of research (two measurement points at half yearly interval) and it covered 92 people in whom the disc disease of the lumbosacral spine was found by means of MRI scan. The study used an interview (the sociodemographic data), the eleven-point VAS scale, and a questionnaire concerned undertaken phisical activity. Results: The patients showed a low level of physical activity undertaken due to the disease of the spine (M=2.33 SD=2.21). A dependency between younger age (H(2, N=92)=4.5, p<0.08) and higher education (H(3, N=91)=16.62,p=0.001) and undertaking physical activity adjusted to the disease of the lower back section of the spine was noticed. Conclusions: The people who took part in the study undertook little physical activity due to the spine disease. Age and education are related to the undertaking of physical activity adjusted to the disease of the lower back section of the spine.
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Doświadczanie bólu a aktywność fizyczna u osób z chorobą dyskową odcinka krzyżowo – lędźwiowego kręgosłupa/ Experience of pain and physical activity in people suffering from the disc disease of the lumbosacral spine

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Turkiewicz-Maligranda A., Rymaszewska J.
Advances in Rehabilitation
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2015
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vol. 29
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issue 1
21-29
EN
Introduction: Disc disease of the lumbosacral spine is a frequent ailment from which younger and younger people suffer. The main symptom of this disease is severe pain. The disease impairs not only physical condition of patients but also their social and psychological life. It is a chronic illness, therefore it requires changing of one’s unhealthy lifestyle to healthy living on a permanent and regular basis. One of manifestations of a health-promoting attitude in the disc disease is the performance of regular exercise chosen for the ailment in order to reinforce perivertebral muscles. Physical activity is both treatment and prevention in the disc disease of the lumbosacral spine. As there is an opinion that pain experienced by the ill people is the main motivating factor for treating the disc disease of the lumbosacral spine, the authors decided to investigate whether there is a relation between pain felt and physical activity undertaken in people with the disc disease of the lumbosacral spine and whether the relation is modified by sociodemographic variables. Material and methods: The study was a longitudinal type of research (two measurement points at half yearly interval) and it covered 92 people who suffer from disc disease of the lumbosacral spine. The diagnosis was found by MRI scan. The study used an interview (the sociodemographic data), the VAS scale, and a questionnaire on the indicator of healthpromoting attitude in the disc disease specially prepared for the purpose of this project. Results: For the group of people with the disc disease of the lumbosacral spine, no relation was found between the pain felt and the physical activity undertaken. A positive relation between the pain felt and the physical activity was found only for the group of younger patients. Conclusions: The pain felt may be the motivating factor for undertaking regular physical exercise only for the group of the youngest patients examined.
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Drgawki indukowane klozapiną

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Zwyrtek E., Rymaszewska J.
Psychiatria i Psychologia Kliniczna
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2015
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vol. 15
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issue 2
66-70
EN
Clozapine remains one of the leading antipsychotic medications to date. It is a first-line drug in treatment-resistant schizophrenia, tardive dyskinesia in patients previously receiving other antipsychotics as well as in patients with aggressive behaviour. Furthermore, clozapine therapy significantly reduces suicidal behaviour and improves the quality of life. Clozapine-related adverse effects include, among other things, agranulocytosis and granulocytopenia, seizures, myocarditis, metabolic syndrome, sialorrhea, sedation. Despite the numerous adverse effects, the mortality among clozapine-treated patients is lower compared to the overall schizophrenic population. Clozapine lowers the seizure threshold and induces seizures. The risk of seizures is dose-dependent and is approximately 4.4%. Tonic-clonic seizures are most commonly reported, followed by myoclonus and atonic seizures. Difficulty in speaking, myoclonus and falls during atonic seizures may be signs of approaching tonic-clonic seizures. Although the monitoring of clozapine serum levels and electroencephalography were shown to be an effective aid in the therapy, they failed to show efficacy in assessing the risk of seizures. In the case of combination therapy, potential interactions between clozapine and a number of other drugs should be considered. When a first seizure occurs, it is recommended that the dosage of clozapine be reduced. If a second seizure occurs, an anticonvulsant drug should be initiated. Valproic acid and lamotrigine are first-line anticonvulsants for clozapine-induced seizures. It is worth noting that there is no metabolic interaction between lamotrigine and clozapine and that lamotrigine potentiates the antipsychotic effects of clozapine. Gradual increasing and decreasing clozapine doses is recommended for the prevention of seizures.
PL
Klozapina pozostaje jednym z najskuteczniejszych leków stosowanych w psychiatrii. Jest lekiem pierwszego rzutu w schizofrenii lekoopornej oraz w przypadku późnych dyskinez u pacjentów uprzednio leczonych innymi lekami przeciwpsychotycznymi i uciążliwych zachowań agresywnych. Dodatkowo wyraźnie redukuje ryzyko zachowań samobójczych i poprawia jakość życia. Wśród działań niepożądanych klozapiny wymienia się m.in. agranulocytozę i granulocytopenię, drgawki, zapalenie mięśnia sercowego, zespół metaboliczny, ślinotok, sedację. Pomimo licznych działań niepożądanych śmiertelność wśród osób leczonych klozapiną jest niższa niż wśród ogółu pacjentów chorujących na schizofrenię. Klozapina obniża próg drgawkowy oraz indukuje drgawki. Ryzyko ich wystąpienia zależy od dawki leku i wynosi około 4,4%. Najczęściej opisywane są drgawki toniczno-kloniczne, następnie mioklonie i napady atoniczne. Trudności w mówieniu, mioklonie, upadki w przebiegu napadów atonicznych mogą być zwiastunami drgawek toniczno- -klonicznych. Monitorowanie poziomu klozapiny w surowicy i elektroencefalografia, chociaż pomocne w prowadzeniu terapii, nie wykazały skuteczności w ocenie ryzyka wystąpienia drgawek. W przypadku politerapii warto zwrócić uwagę na możliwość interakcji klozapiny z licznymi lekami. Po pierwszym napadzie drgawek rekomenduje się zmniejszenie dawki klozapiny, a w razie wystąpienia kolejnych napadów – wprowadzenie leku przeciwdrgawkowego. Lekami pierwszego rzutu w leczeniu drgawek indukowanych klozapiną są kwas walproinowy i lamotrygina. Warto zauważyć, że lamotrygina nie wchodzi w interakcje z metabolizmem klozapiny oraz potencjalizuje jej działanie przeciwpsychotyczne. Z myślą o profilaktyce napadów drgawkowych zaleca się stopniowe zwiększanie i stopniową redukcję dawek klozapiny.
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Rehabilitacja dzieci autystycznych oraz z zespołem Downa a poczucie obciążenia opiekunów / Rehabilitation of children with Down Syndrome and autism, and caregivers burden

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Zima J., Kokot M., Rymaszewska J.
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2011
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vol. 19
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issue 3
9-18
EN
Child's upbringing is a major challenge, and in the case of children with a disability additional difficulty is to provide rehabilitation and support during abnormal development. Aim: evaluation of the burden of caregivers of children with Down syndrome and autism. The study was carried out in a group of 33 parents of children with Down Syndrome, 22 parents of autistic children who participated in rehabilitation and 15 parents of autistic children who did not participate in rehabilitation. Results and conclusions: the caregivers of children with Down Syndrome have a lower burden than caregivers of children with autism. Rehabilitation has a beneficial effect on the sense of burden in the caregivers of autistic children.
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Stres i obraz siebie wśród osób chorujących na stwardnienie rozsiane oraz wybrane pozytywne aspekty zmagania się z chorobą

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Neustein J., Pawik M., Rymaszewska J.
Aktualności Neurologiczne
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2018
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vol. 18
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issue 1
34-39
EN
Multiple sclerosis is an inflammatory demyelinating disease of the central nervous system. It is a chronic disease, with an unpredictable course, involving a heterogeneous clinical picture, and is commonly considered life-changing for both the patient and their family. The diagnosis of multiple sclerosis and the reality of living with the condition come as powerful stress to the affected individual, often rapidly altering their previous self-image and self-esteem. The lowered self-esteem contributes to the patient’s suffering, impedes their daily functioning, and affects their ability to perform their social roles. It is not only the diagnosis as such that weighs the patient down, but the increasing toll the disease takes on all areas of life with time. There is a reciprocal correlation between stress and multiple sclerosis flare-ups, with stress being a well-recognised trigger of multiple sclerosis relapses, and relapses, in turn, being extremely stressful to the patient. Any psychological therapy for multiple sclerosis patients must account for the central role of their way of perceiving reality and interpreting stress factors. The patient’s ability to look for and acknowledge good things, positive aspects and favourable circumstances in life may become their shield against the condition’s impact, relieving the negative effects of chronic stress. In the case of multiple sclerosis patients, the increasingly popular positive psychology calls for focus to be placed on exploring the existing assets and resources of one’s situation rather than the deficits in self-image and one’s reality. Studies examining such variables as the willingness for personal growth, or the patient’s levels of optimism, gratitude, sense of meaning, positive orientation, spirituality and satisfaction facilitate the construction of therapies aimed at identifying the positive aspects of life, helping to shift the person’s perspective on the unpleasant experiences associated with their condition.
PL
Stwardnienie rozsiane jest zapalno-demielinizacyjną chorobą ośrodkowego układu nerwowego. To choroba przewlekła, nieprzewidywalna, wielopostaciowa, o różnorodnym obrazie objawów i przebiegu, zmieniająca życie pacjenta, jego rodziny i bliskich. Diagnoza stwardnienia rozsianego oraz następstwa choroby wiążą się z tak silnym stresem, że powodują gwałtowne i niezgodne z dotychczasowym rozwojem zmiany w obrazie siebie. Skutkować to może zaniżeniem samooceny i spadkiem poczucia własnej wartości, co z kolei wpływa zarówno na cierpienie chorego, jak i na jego codzienne funkcjonowanie czy odgrywanie ról społecznych. Źródłem stresu jest nie tylko ustalone rozpoznanie, ale przede wszystkim jego następstwa, które z czasem coraz bardziej uwidaczniają się we wszystkich sferach życia. Należy również mieć na względzie dwukierunkową zależność między stresem a zaostrzeniem choroby, czyli wystąpieniem rzutu: stresory sprzyjają rzutom, rzuty zaś wywołują stres. W szeroko pojętej pracy terapeutycznej z osobami chorymi na stwardnienie rozsiane kluczowe znaczenie wydają się mieć sposób postrzegania rzeczywistości oraz interpretacja czynników stresogennych. Odnajdywanie przez chorego pomyślnych zdarzeń, sprzyjających okoliczności i pozytywnych aspektów codziennego życia z chorobą staje się swoistym buforem i łagodzi negatywne skutki trwałego stresu. Coraz popularniejsza obecnie psychologia pozytywna każe nie tylko skupić się na deficytach w postrzeganiu siebie i rzeczywistości występujących u osób chorych na stwardnienie rozsiane, lecz także eksplorować ich zasoby. Badania nad takimi zmiennymi, jak gotowość do uzyskania wzrostu osobistego czy poziom optymizmu, wdzięczności, poczucia sensu, orientacji pozytywnej, duchowości i satysfakcji, pozwalają konstruować oddziaływania terapeutyczne ukierunkowane na dostrzeganie pozytywnych aspektów życia, co może pomóc w przewartościowywaniu przykrych doświadczeń związanych z chorobą.
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Comparison of the needs of the elderly patients in care-rehabilitation centers in Wroclaw and in Hamburg

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Mazurek J., Rymaszewska J., Lurbiecki J.
Advances in Rehabilitation
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2012
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vol. 26
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issue 2
15-21
EN
Introduction: The central issue of geriatrics amounts to determining the hierarchy of problems (whether health related or other) of people at old age. The healthcare offered to elderly people should be oriented at the possibly broadest approach to their needs Aim: The main goal of the research is developing knowledge about the areas of elderly people’s needs on the basis of a sample consisted of patients from two rehabilitation centers, situated in Poland (PL:Wroclaw) and in Germany (DE:Hamburg) respectively. Material and methods: The sample consists of 80 patients of the age 60+, divided into two groups, 40 patients in each. For the research method/technique the interview is chosen and the questionnaire CANE serves as the main research tool. Other tools used are: GDS, MMSE, Barthel Index and Socio-demographical and Clinical questionnaires. Results: Before the patients’ admission to the center the average estimate for their overall needs was: PL 4.33 (SD=3.52), DE 5.12 (SD=3.26), out of which met needs were estimated as: PL 3.35 (SD=1.03), DE 4.47 (SD=2.99), whereas unmet as: PL 0.97 (SD=1.33), DE 0.65 (SD=1.03) respectively. After the patients’ admission to the center the average estimate for overall needs increased both for PL: 8.93 (SD=2.08) and for DE: 6.53 (SD=2.54), out of which met needs amounted to: PL, 7.55 (SD=1.50) and DE, 5.95 (SD=2.37) respectively, whereas not unmet ones to: PL, 1.38 (SD=1.44) and DE, 0.57 (SD=0.96). Conclusions: The patterns of needs /met and unmet/ of the elderly patients from two researched centers were similar before the patients’ admission to the clinics, but after the admission differences were observed between the two groups. Much from the needs both met (e.g. looking after the home, physical health) and unmet (e.g. psychological distress), mentioned before the admission to the clinic remained in the area of needs also after the admission. That observation is valid both for PL group as for DE one.
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Cognitive impairment and dementia - problems of geriatric physiotherapy

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Kowalska J., Szczepańska-Gieracha J., Rymaszewska J.
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2010
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vol. 18
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issue 2
73-80
PL
W artykule przedstawiono podstawowe przyczyny i objawy zaburzeń funkcji poznawczych i zespołów otępiennych oraz proste testy przesiewowe stosowane w celu ich rozpoznania. Jest to niezbędna wiedza, jaką powinien posiadać personel medyczny, w tym fizjoterapeuci pracujący z osobami w podeszłym wieku. Znajomość podstaw z zakresu psychopatologii zaburzeń otępiennych pozwala lepiej zrozumieć i interpretować zachowanie pacjenta, ułatwia komunikowanie się z nim, pozwala dostosować proces usprawniania do możliwości poznawczych seniora oraz zmniejsza natężenie negatywnych emocji ze strony opiekunóow i terapeutów.
EN
The article presents the basic causes and symptoms of cognitive impairment and also simple screening tests used to identify them. This is necessary know-how for medical personnel including physiotherapists working with the elderly. Elementary knowledge of dementia psychopathology allows better understanding and proper interpreting of the patients' behaviour, making communication with the patients easier. Such skills help to adapt the rehabilitation process to the cognitive abilities of the elderly and reduce the severity of negative emotions from caretakers and therapists.
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