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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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Assessment of the effects of manual techniques on neck pain.

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Stępnik J. H., Czaprowski D.
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2018
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vol. 32
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issue 2
33-39
EN
Introduction The research focused on assessing the effects of a set of manual techniques applied in the anterior neck region on pain and ability to perform everyday activities by the study participants. The aim of the study was to assess the influence of selected manual techniques on tissues located in the anterior region of the neck and on an index of disability caused by neck pain. Material and methods The study included 31 individuals (26 females and 5 males) aged 23-53 (mean=35 years) who were randomly divided into 2 groups, i.e. the study group (n=16, 13 females, 3 males) and the control group (n=15, 13 females, 2 males). The participants from the study group underwent a procedure which included five techniques performed on the anterior neck, i.e. superficial cervical fascia stretch, infrahyoid muscle stretch – pretracheal fascia, carotid sheath stretch, deep cervical fascia stretch, suspensory ligament of pleural cupula stretch. The participants from the control group underwent laser therapy on the cervical and thoracic spine with the device switched off. The treatment effectiveness was assessed with the use of the Neck Disability Index (NDI). The measurements were made before and five days after the therapy. Results Compared to the control group, the mean total score in the NDI increased significantly by 8.5 points (17%) (p>0.05) in the study group. Conclusions The study results indicated that performing osteopathic procedures in the anterior neck region reduces neck pain and disability level in patients.
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Rehabilitation protocol of „runner’s knee” (Iliotibial Band Syndrome - ITBS) – a case study

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Biernat R., Czaprowski D.
Advances in Rehabilitation
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2012
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vol. 26
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issue 3
35-40
EN
Introduction:„Runner’s knee”, in other words Iliotibial Band Syndrome (ITBS) is the second, after PFPS, in terms of incidence frequency overuse injury amongst runners - 8.5 %. It is the most common cause of lateral knee pain. It mainly occurs in middle aged athletes, in the second decade of life. Cyclists, skiers, weight lifters, soccer and tennis players are next groups, where this clinical entity occurs. ITBS is typical overuse injury which results from cyclic friction (or compression) of iliotibial band on lateral epicondyle of femur. Training errors are main risk factors. Biomechanical disorders leading to this entity are: weakness of gluteus medius, lack of functional hip mobility, weakness of knee flexors and extensors, shortness of hip adductors, limited hip internal rotation. Improper saddle height, frame size or incorrect pedal position can cause ITBS among cyclists. Case study:Professional cyclist was referred to Rehabilitation Centre, complaining about severe pain located at lateral side of the right knee, lasting from 4 months. The pain was described as burning, sharp, increasing during biking, finally disabling him to continue sports activity. After biomechanical analysis we introduced functional re-education training correcting disbalances, the causes of injury. The role of tri-planar, eccentric exercises rotating the pelvis is underlined. After 7 weeks of aggressive, functional rehabilitation resumed sports activity without pain and functional limitations. Conclusions:An early diagnosis of ITBS allows for shorter rehabilitation time. It’s necessary to precisely determine biomechanical disorders leading to ITBS. 7-week rehabilitation, with functional, three dimensional exercises is effective mean of ITBS treatment. We recommend to continue this kind of exercises for 6-12 months to prevent injury recurrence
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Squat - Rules of Performing and Most Common Mistakes

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Czaprowski D., Biernat R., Kędra A.
Polish Journal of Sport and Tourism
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2012
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vol. 19
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issue 1
3-7
EN
The squat is an exercise which is commonly applied in sport, recreation and while performing numerous everyday activities [1, 2, 3]. The improper performance of the squat leads to the shaping of an improper movement pattern.In this work the methodology of teaching the squat, which has to be learnt to constitute a significant element in the prophylaxis of the musculoskeletal system overloads, is described.
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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
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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.
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Students' Knowledge Concerning the Correct Squat and the Elements of the Methodology of Teaching It

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Czaprowski D., Kędra A., Biernat R.
Baltic Journal of Health and Physical Activity
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2012
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vol. 4
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issue 2
124-131
EN
Background: A squat is one of the exercises commonly applied in sport, in school physical education classes, among amateurs practising recreational sport as well as in rehabilitation of children and elderly people. The role of the preventive effect of the correctly performed squat on the musculo-skeletal system is particularly highlighted, while threats posed by an incorrect performance of the exercise are simultaneously indicated.The aim of the work was to define the knowledge of students concerning the methodology of teaching the correct squat and to present methodological fundamentals in this field.Material/Methods: The research involved 412 students of physical education and of a special course for personal trainers. The diagnostic poll method with the use of two techniques, i.e. a questionnaire and knowledge test, was applied. The collected data were analysed statistically with the use of the Excel packet.Results: Over a half of the students examined in the test admit that they do not know what the correct squat looks like. The subjects also indicate the lack of knowledge concerning the methodology of teaching it. Over 86% of the respondents admit that during classes included in the studies curriculum they had no opportunity to observe the methodology of teaching the squat. Simultaneously, nearly 71% of the students indicate that an incorrect performance of this exercise may bring about negative effects in the musculo-skeletal system of a person practising sport.Conclusions: The knowledge of students concerning the methodology of teaching the correct squat is insufficient.
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Physiotherapy in the treatment of idiopathic scoliosis - current recommendations based on the recommendations of SOSORT 2011 (Society on Scoliosis Orthopaedic and Rehabilitation Treatment)

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Czaprowski D., Kotwicki T., Durmała J., Stoliński Ł.
Advances in Rehabilitation
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2014
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vol. 28
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issue 1
23-29
EN
SOSORT to międzynarodowe towarzystwo naukowe zajmujące się deformacjami kręgosłupa, w tym skoliozą idiopatyczną (SI). Jednym z podstawowych zadań towarzystwa jest dostarczanie wszystkim profesjonalistom zaangażowanym w zachowawcze leczenie chorych z SI rekomendacji diagnostyczno-terapeutycznych. W ramach leczenia skolioz wyróżnia się leczenie zachowawcze oraz leczenie operacyjne. Podstawowym celem leczenia zachowawczego jest zatrzymanie progresji skrzywienia. Celem terapii są również poprawa jakości życia, estetyki oraz wydolności fizycznej. Istotnym elementem leczenia zachowawczego jest fizjoterapia, która może być stosowana jako samodzielny środek leczniczy, a także jako wspomaganie leczenia gorsetowego i operacyjnego. SOSORT rekomenduje stosowanie fizjoterapii w postaci specyficznej fizjoterapii ambulatoryjnej (PSE) oraz stacjonarnej intensywnej rehabilitacji (SIR). PSE stosowana u chorych z SI musi mieć potwierdzoną zgodnie z wymogami Medycyny Opartej na Dowodach Naukowych skuteczność. Ponadto terapia powinna być dobierana indywidualnie i obejmować: (1) trójpłaszczyznową autokorekcję deformacji, (2) trening w czynnościach dnia codziennego, (3) stabilizację skorygowanej postawy ciała oraz (4) edukację chorego i jego rodziców. SIR polegająca na 3-4 tygodniowych pobytach dziecka w warunkach szpitalnych lub sanatoryjnych rekomendowana jest przede wszystkim w początkowym okresie leczenia. Fizjoterapeuta podejmujący się pracy z dziećmi z SI powinien: (1) posiadać kwalifikacje w posługiwaniu się PSE, (2) mieć odpowiednie doświadczenie w fizjoterapii w ortopedii dziecięcej, (3) posiadać umiejętność analizy zmienności postawy ciała w ontogenezie, (4) posiadać umiejętność doboru ćwiczeń w zależności od etapów kształtowania się cech motorycznych oraz (5) pracować w zespole terapeutycznym, któremu przewodzi lekarz nadzorujący proces leczenia.
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Zmiana kąta rotacji tułowia u dzieci i młodzieży ze skoliozami idiopatycznymi poddanych intensywnej fizjoterapii prowadzonej w oparciu o koncepcję Funkcjonalnej Intensywnej Terapii Skolioz (FITS) / Changing the angle of trunk rotation in children and adolescents with idiopathic scoliosis undergoing intensive physiotherapy carried out based on the Concept of FITS - Functional Intensive Therapy of Scoliosis

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Czaprowski D., Stoliński Ł., Białek M.
Advances in Rehabilitation
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2011
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vol. 25
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issue 3
13-17
EN
Background: In accordance with the SOSORT consensus, in non-invasive treatment for scoliosis, brace and various methods of kinesitherapy supplemented with physical treatments are currently used. Taking into account the fact that opinions on the effectiveness of non-invasive treatment for idiopathic scoliosis are divided, it is important to take action to verify its effectiveness. The aim of this study was to determine the effectiveness of intensive physiotherapy, which was based on the FITS concept, expressed through change in angle of trunk rotation (ATR), among children and adolescents who suffer from idiopathic scoliosis and underwent two-week rehabilitation course. Material and methods: The study included 57 children and adolescents aged 11-18 (on ave- rage 14.6±1.6) afflicted by idiopathic scoliosis. All children were assessed twice with angle of trunk rotation. The first measurement was conducted at the beginning, the second - at the end of two-week rehabilitation course, during which intensive physiotherapy, based on the FITS concept, was carried out. Results: The analysis of the collected results showed significant decrease of Angle of Trunk Rotation, where all the scoliotic curvatures were regarded (9,1±5,0 vs 6,8±3,7, p=0,000). Considerable decrease of ATR was shown both in the case of single-curve (p=0,026), and double-courve scoliosis (p=0,000). Similar observations concerned both the thoracic (p=0,000) and lumbar (p=0,013) curvature in double-curve scoliosis. Conclusions: Multifaceted impact on the child with idiopathic scoliosis used in functional intensive physiotherapy of scoliosis (FITS) leads during the two weeks to a significant reduction in the angle of trunk rotation. As a result of the therapy achieved reduction angle of trunk rotation around bending both thoracic and lumbar spine as.
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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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Using smartphones in the evaluation of spinal curvatures in a sagittal plane

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Waś J., Sitarski D., Ewertowska P., Bloda J., Czaprowski D.
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2020
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vol. 30
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issue 4
29-38
EN
Introduction In physiotherapeutic diagnostic processes, various tools and methods may be used. However, price and availability may limit their daily use in clinical practice. Therefore, the suggestion that smartphones with specific applications may be useful as diagnostic tools can be found in the literature. However, before using them in clinical practice, it is important to verify their reliability. The aim of the study was to evaluate the consistency of measurements of the curvatures in the sagittal plane performed with the Saunders digital inclinometer and a smartphone application. Material and methods The study included 40 subjects aged 22-39 years (23.0 ± 3.7). All subjects had sagittal spinal curvatures (sacral slope - SS, lumbar lordosis - L, thoracic kyphosis - K, upper thoracic kyphosis - K1, lower thoracic kyphosis - K2) measured in both standing and sitting positions with the Saunders digital inclinometer and a smartphone application. Results In measurements performed with the use of the Saunders inclinometer and the smartphone, no significant differences were found between the size of the curvatures of the spine in a standing position (SS 19o ±8.2 vs. 17o ±8.4 p=0.3; L 32o ±11.1 vs. 29o ±10.3 p=0.2; K 43o ±8.4 vs. 41o ±8.1 p=0.2; K1 31o ±7.2 vs. 29.0 o ±7.3; K2 11o ±7.4 vs. 11.0 o ±6.7) and a sitting position (SS 3.75o ±8.9o p=0.8; L 5.8o ±9.06 vs. 5.2o ±8.5 p=0.75; K 40.0o ±8.1 vs. 36.7o ±7.9 p=0.6; K1 25.8o ±7.1 vs. 24.9 o ±7.1; K2 14.5o ±9.9 vs. 11.5 o ±9.4). Conclusions The examination of spinal curvatures in the sagittal plane using Saunders digital inclinometer and a smartphone application allows researchers to obtain reliable results. Therefore, smartphones can be used for an objective evaluation of the musculoskeletal system in daily clinical practice.
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