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1

Qualification for prevention of musculoskeletal diseases. Low back pain example.

100%

Wiśniewski E., Zubrzycka A., Wroński Z., Hadamus A.

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issue 4

13-19

EN

Introduction In order to take a correct decision while qualifying for prevention programs, particularly in regard to persons with disability certificate, a detailed physiotherapeutic examination needs to be conducted. Currently practitioners are looking for methods allowing for quick assessment of patients’ health before advising prevention or treatment. This paper examines the Functional Pain Index (FPI), a tool conceived by the authors, and compares the results with the results of the anamnesis and physical examination conducted by a physiotherapist. Material and methods Sample group consisted of 206 workers with disability certificate who have been experiencing low back pain (LBP). Each person went through physiotherapeutic examination, it was concluded by a decision to either qualify them for prevention program or advise LBP treatment. This result was compared with the FPI questionnaire and qualification based on the result produced by the questionnaire. Results The FPI based on three variables embedded in the questionnaire showed no statistically significant difference compared to a similar index based on the documentation produced by physiotherapeutic examination. Following the latter, 87 persons were qualified for prevention programs, with the FPI in this group ranging on average from 31.9 to 36.8 points, depending on the applied FPI variant. 119 persons were advised physiotherapeutic treatment or medical consultation, with the FPI in this group ranging from 51.8 to 57.5 points. It has been also shown that there is a statistically significant correlation between a decision of a physiotherapist to advise LBP prevention program and the FPI score in all its variants (p<0.001). Conclusions High consistency between the FPI based on the questionnaire and the index based on physiotherapeutic examination shows that the questionnaire is highly reliable. The FPI questionnaire can be a good alternative for qualifying patients for prevention programs, with questionnaire-based qualification for prevention program triggered in 0-40% range of the FPI.

2

Assessment of the strength and endurance of the trunk muscle in patients with low back pain

88%

Głodzik J., Chwała W., Marchewka A., Ruchlewicz T., Skura A.

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EN

Introduction: In this study, strength and endurance of the trunk muscles were assessed in patients with spondyloarthrosis of the lower spine. Material and methods: 52 women and 49 men with low back pain syndrome (LBPS) were enrolled into the study. The muscle strength of the flexors and extensors of the trunk was determined by calculation of the maximum (MT) and relative torque (RT) during an isometric contraction. Evaluation of endurance of the extensors used calculation of the regression coefficient of the strength reduction during the testing of maximum strength capability. The obtained results were compared to results obtained in healthy persons. Moreover, the relation of those parameters to age, body-mass index – BMI (describing somatic habitus) and the Oswestry Disability Index – ODI (describing pain intensity during activities of daily living) was assessed. Separate analyses were conducted for the groups of males and females.Results: Based on the conducted study and the performed analyses, it can be stated that in patients with chronic low back pain syndrome there is a marked reduction in trunk muscle strength as compared to healthy persons. For females, the reduction ranged from 45% (flexors) to 48% (extensors) for absolute maximum torque values, while for relative values (RT) – from 51% (flexors) to 56% (extensors). In men, the strength reduction of abdominal and back muscles was smaller and was approximately 40% (for MT and RT). Because of such differences in the strength of the back muscles and methodological reasons, endurance variables were not compared. Reduction in trunk muscle strength is primarily due to the pain syndrome and does not depend on patients’ age or habitus. Lower muscle strength can affect the intensity of spinal pain during every-day activities.Conclusions: Precise determination of strength and endurance of the trunk muscles and the appropriate selection of methods of their reinforcement should constitute one of the principal aims of rehabilitation treatment in patients with low back pain.

3

Influence of physical activity on the psychophysical condition of pregnant women

63%

Chitryniewicz-Rostek J., Kulis A., Kreska-Korus A.

Medical Rehabilitation

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2015

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vol. 19(1)

9-14

PL

Aktywność fizyczna jest nieodłączną sferą w życiu każdego człowieka, stanowiąc genetycznie zaprogramowaną naturalną potrzebą ludzkiego organizmu. Szczególnie istotna wydaje się być u kobiet, które stają w obliczu różnego rodzaju wyzwań życia codziennego, a w sposób wyjątkowy w czasie ciąży, co jest związane między innymi z licznymi zmianami zachodzącymi w ich organizmie. Celem prezentowanych badań była analiza wpływu różnorodnych form aktywności fizycznej na stan psychofizyczny kobiet ciężarnych. Badaniami objęto grupę 166 ciężarnych kobiet. Zostało ono przeprowadzone w formie autorskiego kwestionariusza. Grupę badaną (grupa A, n = 125) stanowiły kobiety, które były aktywne fizycznie podczas ciąży. Grupę kontrolną natomiast stanowiły kobiety, które pomimo braku przeciwwskazań aktywności takiej nie wykazywały (grupa B, n = 41). Przeprowadzone badania pozwoliły ustalić, że aktywność fizyczna kobiet ciężarnych pomaga w zachowaniu dobrego ich samopoczucia, zmniejsza tzw. dolegliwości ciążowe oraz pozwala wzmocnić ciało ciężarnej jako przygotowanie do porodu. Tzw. świadomość ciała i zachodzących w nim zmian podczas ciąży wyraźnie wpływa na zmniejszenie stresu przedporodowego, a w późniejszym okresie zwiększa więź matki z dzieckiem.

EN

Physical activity is an indispensable sphere of every person’s life, a genetically programmed natural need of the human body. It is particularly significant in the case of women, who face challenges in everyday life, maintaining a professional career, taking care of duties at home and, at some point, also enduring pregnancy, which causes numerous changes to a woman’s entire body. The objective of this scientific research was to analyse the influence of various forms of physical activity on the psychophysical condition of pregnant women. The research was conducted among a group of 166 pregnant women. It was performed using the authors’ own questionnaire, which was prepared for this purpose and was anonymous in character. The study group (Group A, n=125) was made up of women who had been active during their pregnancy. The control group, however, were women who, despite the absence of contraindications, did not participate in such activity (Group B, n=41). Engaging in physical activity during pregnancy helps women preserve a positive frame of mind, lessens pregnancy ailments and helps strengthen a pregnant woman’s body. Practicing breathing is an excellent way for a woman to prepare herself for delivery. An increased awareness of the body and the changes that occur throughout pregnancy results in the lessening of stress and enables the mother to sense a stronger bond with the baby.

4

Diagnostic and therapeutic algorithm of proceeding in back pain disorders

63%

Krasuski M.

Medical Rehabilitation

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2005

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vol. 9(3)

19-25

PL

Zespoły bólowe kręgosłupa są wbrew pozorom trudne w diagnozowaniu i leczeniu. Decydują o tym niespecyficzne objawy kliniczne i czasami bardzo bogate w treści badania dodatkowe. Okazuje się też, że czasami zbyt mało mamy informacji dotyczących rzeczywistego działania leczniczego niektórych zabiegów stosowanych w fizykoterapii, stąd pojawia się problem oceny skuteczności prowadzonego leczenia. W pracy przedstawiono propozycję algorytmu diagnostyczno-leczniczego w zespołach bólowych kręgosłupa. Omówiono najistotniejsze zagadnienia związane z diagnostyką i leczeniem bólów kręgosłupa. W algorytmie zwraca się uwagę na kolejność postępowania w zależności od uzyskanych informacji dotyczących diagnostyki, a także wskazano na najczęściej stosowane zabiegi terapeutyczne. Algorytm ma ułatwić postawienie rozpoznania choroby i ograniczyć do minimum błędy wynikające z niewłaściwej diagnozy, a co za tym idzie niewłaściwego leczenia. Obserwacje kliniczne dowodzą, że zbyt często rozpoznanie zespołów bólowych kręgosłupa traktuje się ogólnikowo, nie wnikając w szczegóły dotyczące określenia chorej struktury wywołującej objawy chorobowe.

EN

Back pain is a symptom presented in a broad range of disorders. Blurred or non-specyfic clinical presentation, excessive information from laboratory tests and image techniques, numerous therapeutic options of poor efficiacy evidence, explain difficulties in diagnosing and management of a person with low back pain. According to autor’s clinical observation there is a large number of back pain patients referred to specialized treatment with unrecognized cause and character of main and accompanying disorders. The paper presents an original pattern of diagnostic and therapeutic proceeding with patient apearing with back pain. Important and often neglected aspects of adequate diagnostic and therapeutic proceeding are discussed. The pattern is based on author’s clinical experience and literature review. The algorithm defines a logical consequence of proceeding and validates base for drawing clinical conclusions for an adequate therapeutic program design. Author believes that clinical proceeding according to the presented pattern could facilitate determination of a proper diagnosis and diminish the risk of incorrect treatment consequences.

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Qualification for prevention of musculoskeletal diseases. Low back pain example.

Assessment of the strength and endurance of the trunk muscle in patients with low back pain

Influence of physical activity on the psychophysical condition of pregnant women

Diagnostic and therapeutic algorithm of proceeding in back pain disorders