Search results

1

Possibilities of using outpatient physiotherapy in the process of rehabilitation of people with degenerative disc disease in the lumbosacral spine

100%

Bolach B., Walowska J., Chabraszewska P., Ryterska K., Bolach E.

Central European Journal of Sport Sciences and Medicine

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2021

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vol. 36

27-36

EN

Degenerative disc disease (DDD) in the lumbosacral spine is one of the most common causes of pain and the significant associated limitations in physical activity and daily functioning, with the vast majority of patients requiring long-term physiotherapy. Hence, the significance of proper diagnostics, locating the cause of the ailment, implementation of appropriate therapy and prevention. The aim of the study was to investigate the efficacy of outpatient physiotherapy on reducing pain and improving the function of the lumbosacral spine. The research group comprised 95 people (50 women and 45 men) with an average age of 53 years, all patients with DDD in the lumbosacral spine. They underwent 3 physical treatments: magnetotherapy, laser therapy, and systemic cryotherapy, as well as gymnastic exercises, aimed at improving physical fitness, and strengthening the muscular corset. The research methods included the Schober test, the Thomayer test (finger-ground test), the Visual Analogue Scale scale, Laitinen's pain questionnaire, and calculation of BMI. Physiotherapeutic treatments significantly reduced the patients' pain symptoms, significantly increased the range of motion in the lumbosacral spine and improved physical fitness. Better results of the therapy were observed in patients with lower BMI.

2

Influence of Hamstring Muscles Extensibility on Spinal Curvatures and Pelvic Tilt in Highly Trained Cyclists

88%

Muyor J., Alacid F., López-Miñarro P.

Journal of Human Kinetics

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2011

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vol. 29

15-23

EN

The purpose of this study was to determine the influence of hamstring muscles extensibility in standing, maximal trunk flexion with knees extended and on the bicycle in lower handlebar-hands position of highly trained cyclists. Ninety-six cyclists were recruited for the study (mean ± SD, age: 30.36 ± 5.98 years). Sagittal spinal curvatures and pelvic tilt were measured in the standing position, maximal trunk flexion with knees extended (sit-and-reach test) and while sitting on a bicycle in lower handlebar-hand position using a Spinal Mouse system. Hamstring muscles extensibility was determined in both legs by passive straight leg raise test (PSLR). The sample was divided into three groups according to PSLR angle: (1) reduced extensibility (PSLR < 80º; n = 30), (2) moderate hamstring extensibility group (PSLR = 80º; - 90º; n = 35), and (3) high hamstring extensibility (PSLR = > 90º; n = 31). ANOVA analysis showed significant differences among groups for thoracic (p < 0.001) and pelvic tilt (p < 0.001) angles in the sit-andreach test. No differences were found between groups for standing and on the bicycle position. Post hoc analysis showed significant differences in all pairwise comparisons for thoracic angle (p < 0.01) and pelvic angle (p < 0.001) in the sit-and-reach test. No differences were found in lumbar angle in any posture. In conclusion, the hamstring muscles extensibility influence the thoracic and pelvic postures when maximal trunk flexion with knees extended is performed, but not when cyclists are seated on their bicycles

3

An approximate mathematical model binding the height and position of lumbar vertebrae in the canine spine

88%

Wadowska I., Dzierzęcka M., Paśko S., Barszcz K., Bartyzel B. J., Wadowska I., Dzierzęcka M., Paśko S., Barszcz K., Bartyzel B. J.

Polish Journal of Veterinary Sciences

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2020

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vol. 23

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issue 2

4

Flexibility of the hamstring muscles and the position of the trunk in boys training football

88%

Smoła E., Wódka K., Bibro M. A., Jankowicz-Szymańska A.

Health Promotion & Physical Activity

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2021

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vol. 15

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issue 2

9-14

EN

Introduction: The objective of the study was to assess the flexibility of the hamstring muscles and their relationship with the position of the spine, shoulder and pelvic girdles in individual planes in boys training football.Material and methods: The study included 28 boys aged 10-14, training football 3 times a week for at least 2 years. The subjects were divided into two groups: correct bilateral flexibility of the hamstring muscles, bilateral shortening of the hamstring muscles. Body height and weight were measured and BMI was calculated. The three-dimensional position of the trunk was examined using the Zebris pointer ultrasound system. The passive straight-leg-raising test was used to assess the flexibility of the hamstring muscles.Results: 32% of people were diagnosed with the correct length of both hamstring muscles, 57% had shortened muscles in both limbs. Mean values determining the depth of thoracic kyphosis indicated its deepening in each of the groups, however, lower values were recorded in boys with reduced flexibility of the hamstring muscle mass. This group was also characterised by a better balance of the trunk in the sagittal plane. The average depth of lumbar lordosis in both groups was within the normal range. In the frontal plane, in both groups of footballers there was a tendency to lift the left shoulder (more frequent in the group with normal flexibility), the pelvis on the left side and shift the trunk to the right.Conclusion: Shortening of the hamstring muscles is common in boys who train football, but no evidence of a relationship between the limited flexibility of these muscles and the position of the trunk was found.

5

INFLUENCE OF FENCING TRAINING (TECHNICAL AND TACTICAL) ON SELECTED FEATURES OF SHAPE OF THE SPINE AND PELVIS UNDER LOAD

88%

Kaiser A., Sokołowski M., Mrozkowiak M.

Central European Journal of Sport Sciences and Medicine

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2017

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vol. 18

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issue 2

33-40

EN

The aim of the research was to assess influence of a 90-minute specialist fencing training on selected features of the spine and pelvis under a vertical load in a group of young competitors. The research was carried out in 2015 among 23 fencers (mean ± SD, age: 16 ±1.20 years; body height: 168.4 ±4.68 cm; body weight: 54.7 ±8.26 kg). The method involved measurement of thirty features, describing spatially pelvis and physiological spinal curvature under a vertical load, constituting 1/3 of the body weight before and after specialist training. Statistically significant disturbances in vertically overstretched posture occurred after the training among examined boys within the following features: increase in length of left side scoliosis, progression of lumbar lordosis and lumbosacral spine, increase of the trunk extension angle and shoulder asymmetry. Among examined girls statistically significant changes occurred only within pelvis area: increase of left pelvic tilt in the coronal plane, decrease of right pelvic tilt in the horizontal plane. Adjustment in deficiencies within hip joints movement, increase pelvis and lower limbs muscle strength in girls’ training is necessary. What is recommended for all competitors is prophylaxis of the spinal pain syndrome and expanding endurance shaping exercises during a training unit.

6

Body Posture in Young Women Involved in Regular Aerobic Exercise

88%

Drzał-Grabiec J., Truszczyńska A.

Human Movement

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2014

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vol. 15

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issue 4

195-198

EN

Purpose. The aim of the study was an assessment of posture in women who regularly perform aerobic exercise. Methods. The study group consisted of 50 women actively participating in aerobics classes (mean: age 28.64 ± 5.3 years, body mass 59.83 ± 6.7 kg, height 167.75 ± 4.9 cm, BMI 21.24 ± 3.6 m/kg2) and a control group of 50 women not involved in any regular physical activity (mean: age 28.55 ± 5.05 years, body mass 62.47 ± 10.5 kg, height 167.74 ± 4.8 cm, BMI 22.26 ± 4.8 m/kg2). All participants were subjected to a photogrammetric assessment of posture. Results. Statistically significant differences in posture were identified between the two groups for lumbarosacral and thoracolumbar spinal curvatures. Conclusions. Women who regularly perform aerobic exercise present greater thoracic kyphosis and shoulder asymmetry than women not involved in aerobics.

7

Acute Effects of Hamstring Stretching on Sagittal Spinal Curvatures and Pelvic Tilt

88%

López-Miñarro P., Muyor J., Belmonte F., Alacid F.

Journal of Human Kinetics

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2012

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vol. 31

69-78

EN

The aim of this study was to determine acute effects of hamstring stretching in thoracic and lumbar spinal curvatures and pelvic tilt. Fifty-five adults (29.24 ± 7.41 years) were recruited for this study. Subjects performed a hamstring stretching protocol consisting of four exercises. The session consisted of 3 sets of each exercise and subjects held the position for 20 seconds with a 30-second rest period between sets and exercises . Thoracic and lumbar spinal angles and pelvic tilt were measured with a SpinalMouse in relaxed standing, sit-and-reach test and Macrae & Wright position. Hamstring extensibility was determined by active straight leg raise test and sit-and-reach score. All measures were performed before and immediately after the hamstring stretching protocol. Active straight leg raise angle and sit-and-reach score significantly improved immediately after the stretching protocol (p<0.001). Greater anterior pelvic tilt (p<0.001) and lumbar flexion (p<0.05) and a smaller thoracic kyphosis in the sit-and-reach (p<0.001) were found after the stretching protocol. However, stretching produced no significant change on spinal curvatures or pelvic tilt in standing and maximal trunk flexion with knees flexed. In conclusion, static stretching of the hamstring is associated to an immediate change in the sagittal spinal curvatures and pelvic position when performing trunk flexion with knees extended, so that allowing for greater lumbar flexion and anterior pelvic tilt and lower thoracic kyphosis. Hamstring stretching is recommended prior to sport activities involving trunk flexion with the knees straight.

8

The influence of various sport activities on the degeneration of intervertebral discs

88%

Rapčan R., Poliak Ľ., Rapčanová S., Lenčéš P., Buriánek M., Vašková J., Kočan L.

Polish Journal of Sports Medicine

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2020

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vol. 36(3)

115-121

EN

Excessive physical activity is one of the main risk factors in the formation of degenerative changes of the intervertebral discs. Recreational and elite sport also represents a repeated increased physical load, and based on the type of sport, a more intense and sometimes less intense action of direct forces on the intervertebral discs. On the other hand, sport and training is in general regarded as beneficial for our health. Many doctors also regards sport as a form of prevention against back injuries. The authors analyze numerous sporting activities with different types of direct forces acting on the spine, with the goal to inform on realistic scientific facts regarding the impact of these activities on the degeneration of the intervertebral disc. They inform about the available facts, which confirm the positive effects of a certain type of sport load on the degeneration of the intervertebral disc, and its correlation with the clinically manifested back pain.

9

The shape of the sagittal curvatures of the spine in a high-level acrobatic gymnasts – comparison by sex

75%

Polak E., Gardzińska A., Walicka-Cupryś K.

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vol. 44

79-94

EN

Specific loads on the spine and the very young age at which acrobatic gymnastics training is undertaken require monitoring the shape of the spine curvatures in gymnasts to detect possible postural abnormalities. The aim of this descriptive study was to assess and compare the shape of the spine in the sagittal plane in acrobatic gymnasts of both sexes and their associations with demographic and somatic variables. The study group included 159 acrobatic gymnasts aged 12-19 (106 females and 53 males) from 16 European countries. The study was designed as a survey and measurements of somatic variables and the angles of inclination (using the Baseline Bubble inclinometer) at four topographic points of the spine: S1, L5/S1, Th12/L1, C7/Th1. Based on the angles of spinal inclination, the sizes of the sacral slope (SS), lumbar lordosis (LL), and thoracic kyphosis (TK) were calculated. Body posture was assessed based on Wolański’s modified typology. The angles of SS and LL were significantly higher in females, and TK did not differ between sexes. Training experience positively correlated only with the size of the SS in both sexes. Age and somatic variables were significantly correlated with the size of the sagittal curvatures, mainly in females. The majority of gymnasts had a normal angle of SS and TK and a flattened LL. The equivalent and lordotic types of body posture were more frequent in females, and the kyphotic type in males. The incorrect body posture was noted in 19.8% of females and 43.4% of males. We concluded that acrobatic gymnasts are not at risk of increasing the size of spinal curvatures in the sagittal plane, but males show a tendency toward flattened LL and kyphotic type of body posture.

10

Sagittal Spinal and Pelvic Postures of Highly-Trained Young Canoeists

75%

López-Miñarro P., Muyor J., Alacid F.

Journal of Human Kinetics

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2011

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vol. 29

41-48

EN

The objective of this study was to determine the sagittal spinal curvatures and pelvic position in standing and kneeling in the canoe in young canoeists. Forty-four young highly-trained canoeists (mean age: 15.11 ± 0.61 years) were recruited. Thoracic and lumbar curvatures and pelvic inclination were evaluated with a Spinal Mouse system in standing position and in the base position (kneeling on one knee in the canoe) and catch phase of the stroke. The mean thoracic kyphosis, lumbar lordosis and pelvic inclination in standing were 44.66 ± 8.80º, -30.34 ± 8.31º, and 14.20 ± 7.32º, respectively. In the canoe, the thoracic, lumbar and pelvic angles were 39.66 ± 9.52º, -24.32 ± 6.79º, and 15.18 ± 4.34º, respectively, for the base position (p<0.001 with respect to standing, except for pelvic inclination), and 28.93 ± 10.45º, -13.45 ± 10.60º, and 37.61 ± 6.27º, respectively, for the catch phase of the stroke (p<0.001 with respect to standing and base position). A higher percentage of hyperkyphotic postures in standing than in the canoe was found, while thoracic hypokyphosis increased in the catch phase of the stroke. In regards to the lumbar curve, the percentage of hypolordosis postures in the base position was higher than when standing. Lumbar kyphotic postures were detected in the catch phase of the stroke. In conclusion, the standing thoracic hyperkyphosis in young canoeists may be related to factors other than the posture and movement in the canoe. The canoeists adopted a lumbar flexed posture at the catch phase of the stroke, although this position may not affect the sagittal configuration of lumbar spine in standing. Postural training should be included in the training program of canoeists to improve the thoracic posture in the standing position.

11

Perceived changes in the university students' health behavior after participating in the study on wearing high-heeled shoes

75%

Gajdos M., Jandova S., Lenkova R., Vadasova B., Cuj J., Mikulakova W., Nechvatal P.

Physical Activity Review

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2020

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vol. 1

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issue 8

104-112

EN

Wearing high-heeled shoes (HH) is a wide-spread practice among Western women, maintaining popularity despite its harmful potential. We examined the main motivation behind wearing HH in female students, as well as the possible change to wearing HH among the research participants. Methods: Thirty university students (N=30 females, age 21.8±2.09 years; weight: 55.7±4.05 kg, height: 1.66±0.03 m, BMI: 20.34±1.41 kg.m-2, shoe size: EU 36-38), who rarely wore HH. The participants wore HH for no longer than 6 hours per month during the period two past years. The SonoSens Monitor Analyzer system (Gefremed, Chemnitz, Germany) was used to observe participants' posture when walking and movements in individual sections of their spines. In a comparative experiment, the correlation between variables recorded when walking in two types of shoes was identified. The first pair of shoes (HH) had 7 cm heels whereas the second were flat sport shoes (FS). Results: The evaluation of participants' spines and posture when walking in HH and FS revealed significant differences (p < 0.05). The evaluation of the initial and follow-up surveys indicates that the main motivation for wearing HH among the test group was to increase their attractiveness and respond to social expectations. After participating in the research and becoming aware of its outcomes and issues, the test group's attitude to wearing HH has changed. Conclusions: In regards to good posture and spinal health, this study has raised some awareness amongst its participants, and has therefore proved to be a significant positive influence.

12

Czy istnieje „idealna” pozycja siedząca? / Does „ideal” sitting position exist?

63%

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.

13

Wpływ pracy zawodowej na występowanie zespołów bólowych kręgosłupa na przykładzie pielęgniarek pracujących w oddziałach szpitalnych

63%

Terpiłowska J.

Innowacje w Pielęgniarstwie i Naukach o Zdrowiu

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2021

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vol. 6

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issue 1

22-36

EN

Introduction. Back pain syndromes are a disease that affects people at an increasingly younger age. On factors that affect many, such as: age, gender, genetic predisposition, life systems, and the type and length of work. The caregiver is a dangerous personnel who may expose us to the musculoskeletal side due to the activity of the work activities. Exactly to, among others lifting people, technical equipment, architectural overcoming, carrying, lifting, forced position work, long-term maintenance, walking or sitting. Objective of the work. The aim of the study was to determine the influence of professional work of back pain syndromes in the group of nurses working in hospital departments. Material and methods. The paper uses the method of a diagnostic survey. The research technique was surveying. The tools used in the work are: the original questionnaire. Results. In the survey, all respondents (100%) experience back pain syndromes. However, the vast majority (84%) indicate that it is pain in the lumbar region. Conclusions. Back pain syndromes in the group of respondents differ significantly depending on such sociodemographic variables as: age, seniority, education, place of residence. Taking action by the respondents in the field of prophylaxis of back pain syndromes significantly differs depending on sociodemographic variables such as: education and place of residence.

PL

Wstęp. Zespoły bólowe kręgosłupa są schorzeniem, które dotyka osób w coraz młodszym wieku. Na występowanie tej dolegliwości ma wpływ wiele czynników, takich jak: wiek, płeć, predyspozycje genetyczne, styl życia oraz rodzaj i staż wykonywanej pracy. Personel pielęgniarski jest grupą szczególnie narażoną na dolegliwościami ze strony układu mięśniowo-szkieletowego ze względu na czynności wykonywane w pracy zawodowej. Jest to m.in. dźwiganie pacjentów, sprzętu medycznego, pokonywanie barier architektonicznych, przenoszenie, podnoszenie, praca w wymuszonej pozycji, długotrwałe stanie, chodzenie lub siedzenie. Cel pracy. Celem pracy było określenie wpływu pracy zawodowej na występowanie zespołów bólowych kręgosłupa w grupie pielęgniarek pracujących w oddziałach szpitalnych. Materiał i metody. W pracy została zastosowana metoda sondażu diagnostycznego. Techniką badawczą było ankietowanie. Narzędzia użyte w pracy to autorski kwestionariusz ankiety. Wyniki. W przeprowadzonym badaniu wszyscy respondenci (100%) doświadczają zespołów bólowych kręgosłupa. Zdecydowana większość (84%) wskazuje, że jest to ból w okolicy lędźwiowej. Wnioski. Zespoły bólowe kręgosłupa w grupie badanych istotnie różnią się w zależności od takich zmiennych socjodemograficznych jak: wiek, staż pracy, wykształcenie, miejsce zamieszkania. Podejmowanie działań przez badanych w zakresie profilaktyki zespołów bólowych kręgosłupa istotnie różni się w zależności od zmiennych socjodemograficznych takich jak: wykształcenie oraz miejsce zamieszkania.

14

Comparison of the effectiveness of two physiotherapy programs for female patients with lumbar spine discopathy

63%

Puszczałowska-Lizis E., Dziedzic P., Jandziś S.

Medical Rehabilitation

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2017

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vol. 21(3)

43-50

PL

Wstęp. Schorzenia dolnej części kręgosłupa należą do najczęściej występujących u człowieka problemów związanych z zaburzeniem struktury i funkcji narządu ruchu. Stanowią wyzwanie dla współczesnej fizjoterapii, której celem jest obniżenie lub w miarę możliwości wyeliminow-anie dolegliwości bólowych, przywrócenie sprawności umożliwiającej funkcjonowanie w życiu codziennym, a także zapobieganie nawrotom. Cel pracy stanowiło porównanie dwóch programów usprawniania w aspekcie obniżenia natężenia dolegliwości bólowych, poprawy ruchomości lędźwiowej i piersiowo-lędźwiowej części kręgosłupa oraz sprawności funkcjonalnej u kobiet z dyskopatią lędźwiową. Materiał i metody. Badaniami objęto 100 kobiet w wieku 45-50 lat z dyskopatią lędźwiową, usprawnianych w warunkach ambulatoryjnych. Pacjentki podzielono na dwie 50-osobowe grupy, w zależności od zaaplikowanego programu. Program fizjoterapii pacjentek z grupy I obejmował: masaż klasyczny, kinezyterapię i prądy interferencyjne, a w grupie II zastosowano: masaż klasyczny, kinezyterapię i ultradźwięki. Narzędzie badawcze stanowiła numeryczna skala natężenia bólu (NRS), kwestionariusz Rolanda-Morrisa (RMDQ) i pomiary zakresów ruchu lędźwiowej i piersiowo-lędźwiowej części kręgosłupa. Do analiz wykorzystano testy: U Manna-Whitneya i Wilcoxona. Wyniki. Po zakończeniu usprawniania kobiety z grupy I odznaczały się istotnie niższym poziomem dolegliwości bólowych (p=0,037) i wyższą sprawnością funkcjonalną (p=0,001). Zakres poprawy, oceniany różnicą wyników uzyskanych w badaniu II i III, był istotnie większy w przypadku kobiet z grupy II (p=0,002). Po miesiącu od zakończenia postępowania terapeutycznego stwierdzono brak statystycznie istotnych międzygrupowych różnic (p=0,169, p=0,067). Wnioski. Zastosowanie prądów interferencyjnych w fizjoterapii osób z dyskopatią lędźwiową w porównaniu do terapii z wykorzystaniem ultradźwięków pozwala na uzyskanie większej poprawy w kwestii obniżenia natężenia dolegliwości bólowych, zwiększenia ruchomości lędźwiowej i piersiowo-lędźwiowej części kręgosłupa oraz sprawności funkcjonalnej. Skuteczność ultradźwięków wzrasta w miarę upływu czasu od zakończenia terapii i dopiero po miesiącu w przypadku obu programów fizjoterapii można zaobserwować zbliżone efekty.

EN

Background. Lower back pain is one of the most common problems in the human body relat-ed to the disturbances of the motor organ’s structure and function. It challenges contemporary physiotherapy which aim is to reduce or, when possible, eliminate pain, restore fitness for eve-ryday life and prevent recurrences. The aim of the study was to compare two physiotherapy programmes in terms of lowering pain intensity, improvement of lumbar and thoracolumbar spine mobility, as well as functional ability in females with lumbar spine discopathy. Material and methods. The study included 100 women aged 45-50 with lumbar spine disco-pathy being treated in outpatient conditions. The patients were divided into two 50-subject groups depending on the programme used. The physiotherapy programme for group I patients included classic massage, kinesiotherapy and interferential currents, and in group II: classic massage, kinesiotherapy and ultrasound. The research tool was the Numeric Pain Rating Scale (NRS), the Roland Morris Disability Questionnaire (RMDQ) and measurements of lumbar and thoracolumbar spine mobility. The Wilcoxon and Mann-Whitney U tests were used for the analysis. Results. After completion of the physiotherapy programme, the women in group I experi-enced significantly lower pain (p=0.037) and higher functional efficiency (p=0,001). The range of improvement, assessed by the difference in the results of study II and III, was signif-icantly higher for the II group of women (p=0,002). One month after completion of therapeu-tic treatment, there were no statistically significant differences between the groups (p=0,169, p=0,067). Conclusions. The use of interferential currents in the physiotherapy of individuals with lum-bar spine discopathy compared to ultrasound therapy allows for greater improvement in reduc-ing pain intensity, lumbar and thoracolumbar spine mobility, as well as higher functional effi-ciency. The effectiveness of ultrasound had increased over time since the end of therapy and only after one month in the case of both physiotherapy programmes, similar effects could be observed.

15

Ryzyko wystąpienia choroby zwyrodnieniowej kręgosłupa lędźwiowego wśród piłkarzy nożnych

63%

Siwecka G., Wodka-Natkaniec E., Niedźwiedzki Ł., Niedźwiedzki T.

Polish Journal of Sports Medicine

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2018

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vol. 34(1)

27-33

EN

Background. Football is the most popular sport discipline among men. Due to its high dynamics and multiple motor features, which are necessary to obtain good results, considering the risk connected with involvement in this sport is essential. The aim of this study was the assessment of mobility and low back pain among football players in terms of the risk of degenerative changes. Material and methods. The sample comprised 50 males aged 16-20 years. The study group included 25 football players whose mean age was age: 17.5 and mean BMI value BMI: 21.5 and the control group included 25 non-training males with the corresponding parameters: age: 18.3 and BMI: 22.3. Lumbar spine mobility was measured using Schöber teat. Besides, hyperextension test was performed as well as anamnesis for the history of contusions, injuries and pain episodes. Results. A lower average value of Schöber’s test was obtained in the group of footballers as compared with the average result obtained from the control group. The anamnesis revealed pain in the lumbar spine in 8% of the footballers while the hyperextension test revealed pain in 12% of participants. No low back pain symptoms were found in the control group. Conclusions. Schöber’s sign and pain in the lumbar spine indicate muscle overload and/or overload of other spinal and adjoining structures and thus, a higher risk of the development of degenerative changes in the lower spine among footballers.

PL

Wstęp. Piłka nożna jest najpopularniejszą dyscypliną sportową wśród mężczyzn. W związku z dużą dynamiką i mnogością cech motorycznych istotnych dla uzyskania dobrych wyników, konieczne jest zwrócenie uwagi na ryzyko jakie niesie ze sobą ten sport. Celem pracy jest ocena ruchomości i występowania bólu kręgosłupa w odcinku lędźwiowym wśród piłkarzy nożnych w aspekcie ryzyka zmian zwyrodnieniowych. Materiał i metody. Badaniami objęto 50 mężczyzn w wieku 16-20 lat. Grupę badaną stanowiło 25 piłkarzy nożnych w wieku: 17,5 i BMI: 21,5, natomiast grupę kontrolną 25 osób nietrenujących w wieku: 18,3 i BMI: 22,3. W badaniu przeprowadzono pomiar ruchomości kręgosłupa lędźwiowego testem Schöbera. Wykonano także test przeprostu oraz zebrano informacje o przebytych kontuzjach, obrażeniach i bólu. Wyniki. U badanych zaobserwowano niższy wynik testu Schöbera w grupie piłkarzy nożnych w porównaniu do grupy kontrolnej. Podczas wywiadu odnotowano ból w odcinku lędźwiowym kręgosłupa u 8% piłkarzy nożnych, a w czasie testu przeprostu stwierdzono go u 12%. Nie stwierdzono objawów bólowych kręgosłupa lędźwiowego w grupie kontrolnej. Wnioski. Objaw Schöbera i ból w odcinku lędźwiowym świadczą o przeciążeniu mięśni i/lub innych struktur kręgosłupa i jego okolic, a zatem większym ryzyku rozwoju zmian zwyrodnieniowych w dolnym odcinku kręgosłupa u piłkarzy nożnych.

16

Evaluation of mechanisms of therapeutic impact of joint manipulation based on the results of experimental studies

51%

Szajkowski S., Dwornik M., Pasek J., Cieślar G.

Medical Rehabilitation

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2019

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vol. 23(4)

47-53

PL

Manipulacje stawów kręgosłupa to forma leczenia bólu kręgosłupa o różnej etiologii. Najpowszechniejszą formą jest: HVLA (High Velocity Low Amplitude); (ICD-9 nr 93.62), która znajduje powszechne zastosowanie w codziennej praktyce klinicznej. HVLA wykorzystuje bodziec mechaniczny który charakteryzuje duża prędkość, krótki czas trwania i mała amplituda przemieszczenia względem siebie powierzchni stawowych. Pomimo długiej historii stosowania, mechanizmy biologicznego oddziaływania nadal pozostają niewystarczająco wyjaśnione. W pracy przeglądowej dokonano weryfikacji hipotez dotyczących mechanizmu leczniczego oddziaływania HVLA na podstawie analizy doniesień naukowych dostępnych w bazie PubMed przedstawiających wyniki badań doświadczalnych na modelach zwierzęcych. Do celów wyszukiwania użyto następujących słów kluczowych: HVLA, manipulacja kręgosłupa, badania doświadczalne, leczenie osteopatyczne. Szczególną uwagę skupiono na pracach badających podstawowe mechanizmy biologiczne. Analiza doniesień naukowych ostatnich lat wykazała, że brak jest bezpośrednich dowodów wskazujących na konieczność uzyskania zjawiska kawitacji podczas wykonywania zabiegów HVLA. Ponadto badania na modelu zwierzęcym dowodzą, że HVLA są procedurami bezpiecznymi i nieinwazyjnymi z punktu widzenia biomechaniki. Hamują one rozwój hiperalgezji i allodynii, co potwierdziły liczne badania immunohistochemiczne. Badania doświadczalne wykazały jednoznacznie, że więcej niż jeden mechanizm biologiczny jest odpowiedzialny za uzyskiwane efekty terapeutyczne HVLA a reakcje pacjenta na terapię są złożone i osobniczo zmienne.

EN

Spine joint manipulation is a form of osteopathic treatment for spinal pain with various aetiologies. The most common form of these manoeuvres is HVLA (High Velocity Low Amplitude); (ICD-9 No. 93.62), which is widely used in everyday clinical practice by qualified physiotherapists and osteopaths. HVLA utilises a mechanical manipulative stimulus characterised by high speed, short duration and low amplitude of displacement of joint surfaces with respect to each other. Despite the long history of its usage, the mechanisms of their biological impact are still insufficiently explained. In this review, hypotheses concerning the therapeutic mechanism of HVLA impact were verified based on the analysis of scientific reports available in the PubMed and Medline databases. Reports have been discussed presenting theoretical mechanisms of the influence of HVLA techniques and experimental work taking up the issues of manipulation carried out on animal materials. Particular attention was focused on research examining basic biological mechanisms being the basis for explaining the observed clinical effects. The analysis of scientific reports in recent years has shown that there is no direct evidence pointing to the need for obtaining the phenomenon of cavitation during HVLA procedures. Moreover, research on animal models proves that HVLA are safe and non-invasive procedures from the point of view of biomechanics. They inhibit the development of hyperalgesia and allodynia as confirmed by immunohistochemical studies. Previous experimental studies have clearly shown that more than one biological mechanism is responsible for the obtained effects of HVLA therapy, and the patients' reactions to therapy are complex and individually variable.

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