Introduction The aim of the study is to present the evaluation of the functional capacity of elderly patients with osteoarthritis of the knee before and after the endoprosthesis procedure. Material and methods The research was carried out after obtaining the consent of the Bioethical Committee at the Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz in the period from 27/05/2018 to 27/05/2019 in the 10th Military Clinical Hospital with the Polyclinic in Bydgoszcz of the Department of Traumatology and Orthopedics. The research material consisted of 100 patients aged 65+ (62 women and 38 men) qualified to undergo knee endoprosthesis surgery. Results In general, the highest increase in the quality of life was recorded among rural residents – 21.21 points, in the age of 71 76 – 14.95 points and in the age of 68 70 – 14.81 points. The lowest, however, in the 50-67 age group – 12.28 points, for city residents over 100,000. – 9.38 points and 15-49 thousand among the city’s inhabitants – 9.03 points. Conclusions The conducted studies found a statistically significant improvement in the functional efficiency of patients, as well as a reduction in pain in the knee joint and improvement in the quality of life of patients after surgery for knee replacement – endoprosthesis.
Objectives: To evaluate changes in Pulmonary Function Test (PFT) parameters in individuals with paraplegia following Partial Body Weight Supported Treadmill Training (PBWSTT). Design: Randomized controlled trial Setting: Inpatient rehabilitation facility Participants: Adults with chronic SCI (n = 42). Intervention: Patients were randomly allocated in CR group (N= 20) receiving Conventional Rehabilitation or in PBWSTT group (N=22) receiving both Conventional Rehabilitation and PBWSTT for 4 weeks. Main outcome measure(s): Changes in % predicted PFT parameter for the subject’s age, sex and BMI. Results: With PBWSTT, significant PFT changes were VC (P =.009), PEF (p = .001) and ERV (p = .032). In complete SCI, PEF (p = .026) improved, while in incomplete SCI VC (p = .005), ERV (p = .029), PEF( p = .001) improved with PBWSTT. In upper neurological level of injury (NLI) (T6-T11), PBWSTT improved PEF (p = .004) alone while in lower NLI (T12-L2), with PBWSTT both ERV (p = .016) and PEF (p = .035) improved. Conclusions: With added PBWSTT most parameters including Vital Capacity, the global measure of PFT, improved significantly, especially in Lower NLI and incomplete SCI. The positive role of this noninvasive exercise based intervention in improving lung functions comes as an added benefit to the usual benefit of locomotion. This may encourage researchers to design future larger studies to validate it aiming the inclusion of PBWSTT in routine SCI rehabilitation protocols.
Stroke is still the most common cause of disability in Poland and in western countries. As many as 80% of patients report reduced upper limb function in the acute phase after stroke. It is estimated that only 5% to 20% of patients experience full functional recovery of an upper limb. In clinical practice, paretic upper limb stimulation after stroke is usually treated as of secondary importance. However, it constantly poses a challenge to physical therapists. The existing procedures do not provide detailed guidelines regarding upper limb rehabilitation model particularly in the first four weeks after stroke. It is hard to predict biological limitations and the effectiveness of upper limb rehabilitation. The aim of this work is to make an attempt at reviewing the knowledge of the current state of early upper limb physiotherapy, its intensity and strategy type as well as neurobiological foundations of the improvement process. Ample scientific evidence confirms that early post-stroke rehabilitation is crucial. There are relatively few foreign (and virtually no Polish) reports related to early upper limb rehabilitation that would take into account the type of exercises and their therapeutic dose. There are still no solid foundations for determining optimal intensity and type of upper limb rehabilitation (including physical and occupational therapy). There is a scarcity of extensive and uniform (in terms of research groups and tools) multicentre investigations aimed at defining an optimal model of upper limb rehabilitation at an early stage after stroke. Thus, a number of questions still remain unanswered.
PL
Udar mózgu nadal pozostaje główną przyczyną niepełnosprawności w Polsce i krajach zachodnich. Aż 80% pacjentów ma obniżoną sprawność kończyny górnej w fazie ostrej po udarze mózgu. Szacuje się, że tylko 5% do 20% pacjentów osiąga pełną poprawę funkcjonalną kończyny górnej. Stymulowanie niedowładnej kończyny górnej po udarze mózgu w praktyce klinicznej jest zwykle traktowane jako drugoplanowe. Stanowi to nadal wyzwanie dla współczesnej fizjoterapii. Istniejące standardy postępowania nie opisują szczegółowo modelu usprawniania kończyny górnej, zwłaszcza w okresie pierwszych 4 tygodni po udarze mózgu. Trudno ocenić, jakie są granice możliwości biologicznych i jaka może być efektywność poprawy sprawności kończyny górnej. Celem tej pracy jest próba podsumowania dotychczasowej wiedzy na temat obecnego stanu wczesnej fizjoterapii kończyny górnej, jej intensywności i rodzaju strategii oraz neurobiologicznego podłoża procesu poprawy. Wiele naukowych dowodów potwierdza, że rehabilitacja we wczesnej fazie poudarowej jest istotna. Stosunkowo mało jest światowych wiarygodnych doniesień, a polskich właściwie barak, odnoszących się do wczesnej fizjoterapii kończyny górnej uwzględniających rodzaj zastosowanych ćwiczeń i ich dawkę terapeutyczną. Nadal brakuje wystarczających przesłanek, aby określić optymalną intensywność i rodzaj stosowanej rehabilitacji kończyny górnej w tym fizjoterapii i terapii zajęciowej. Brakuje dużych, ujednoliconych pod względem grup i narzędzi badawczych wieloośrodkowych badań dla określenia optymalnego modelu rehabilitacji kończyny górnej we wczesnej fazie po udarze mózgu. Zatem nadal wiele pytań pozostaje bez odpowiedzi.
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