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EN
Inhalations, whose aim is the liquefaction of dense viscous secretions and preparing them for evacuation from the bronchial tree by means of drainage techniques, are standard treatment procedures in cystic fibrosis. Numerous studies showed that during inhalation only a small percentage of the drug was deposited in the bronchi. The use of the so-called elevated positive expiratory pressure, or PEP system, can improve the drug deposition in the lungs and consequently have the effect of increasing the effects of physiotherapy and delay the progression of the disease. The aim of the study was a retrospective evaluation of the applicability of the PEP system in mucolytic drug inhalations in CF patients. Material and Methods: Analysis of the variation of selected spirometry indicators over time: FEV1, FVC, MEF75%, 50%, 25%, performed in two groups of patients with cystic fibrosis: group I using PEP (n 29), group II without PEP (n 38). The analysis of parameter variance in time, as well as of the course taken by the changes and the difference in this respect regarding the PEP and no PEP group of patients was made by means of the analysis of linear regression for correlated data (generalized estimating equation). Results: The use of the PEP system for inhalation in patients with cystic fibrosis had the greatest impact on improving the values of MEF75%, 50%, 25%. After 18 months, observations indicated the improvement of the values by 8.1%, 10.4% and 13% respectively in the group of PEP and reduction by 6%, 4.6% and 4.5% in the group without PEP. The differences in the level of change observed between the two groups proved to be statistically significant (p=0.033, p = 0.019, p=0.006). After 18 months compared to the initial visit, the analysis of variation over time in the PEP group showed significant improvement only in the case of MEF 25% (p=0.024). Conclusions: 1) The PEP system may be applied in inhalations of mucolytic drugs in cystic fibrosis patients. 2) the application of the PEP system for inhalations in cystic fibrosis patients showed the greatest improvement in the values of MEF75%50%25% 3) the use of PEP for inhalation of mucolytic drugs in patients with cystic fibrosis may be one of the factors affecting the delay of progression of functional changes in the lungs. 4) Long-term randomized observation should be carried out in order to confirm the retrospective study results.
PL
Wstęp: Zabiegi inhalacyjne, których celem jest upłynnienie gęstej, lepkiej wydzieliny i przygotowanie jej do ewakuacji z drzewa oskrzelowego przy pomocy technik drenażowych stanowią standardowe leczenie mukowiscydozy. Liczne badania pokazują, że w czasie inhalacji tylko niewielki procent leku deponuje się w oskrzelach. Zastosowanie podwyższonego ciśnienia wydechowego tzw. systemu PEP może zwiększyć depozycję leku w płucach i w konsekwencji mieć wpływ na zwiększenie efektów leczenia fizjoterapeutycznego i opóźnienie progresji choroby. Celem pracy była retrospektywna ocena przydatności systemu PEP w inhalacjach z leków mukolitycznych u chorych na mukowiscydozę. Materiał i metody: Przeprowadzono analizę zmienności w czasie wybranych wskaźników spirome trycznych: FEV1, FVC, MEF75%,50%,25%, w dwóch grupach chorych na mukowiscydozę: grupa I (n 29) – chorzy, którzy stosowali system PEP, grupa II (n 38) − kontrolna. Analizę zmienności badanych parametrów w czasie oraz różnic w przebiegu zmienności pomiędzy grupami pacjentów stosujących PEP i bez PEP zbadano przy pomocy analizy regresji liniowej dla danych powiązanych (uogólnione równanie estymujące, ang. generalized estimating equation). Wyniki: Zastosowanie systemu PEP w inhalacji u chorych na mukowiscydozę miało największy wpływ na poprawę wartości MEF75%,50%,25%. Po 18 miesiącach stwierdzono poprawę wartości wskaźników MEF75%,50%,25% odpowiednio o8,1%, 10,4% i13% wgrupie zPEP iobniżenie o6%, 4,6% i4,5% wgrupie dzieci inhalowanych bez PEP. Różnice w poziomie zmian zaobserwowane między grupami okazały się istotne statystycznie (p=0,033, p=0,019, p=0,006). Analiza zmienności w czasie w grupie stosującej PEP wykazała istotną statystycznie poprawę tylko w przypadku MEF25% po 18 miesiącach w stosunku do badania wyjściowego, (p=0,024). Wnioski: 1) System PEP może mieć zastosowanie w inhalacjach z leków mukolitycznych u chorych na mukowiscydozę. 2) Zastosowanie systemu PEP do inhalacji u chorych na mukowiscydozę miało największy wpływ na poprawę wartości MEF75%,50%,25%. 3) Zastosowanie PEP w inhalacji z leków mukolitycznych u chorych na mukowiscydozę może być jednym z czynników mających wpływ na opóźnienie progresji zmian czynnościowych w płucach. 4) Wymagane jest przeprowadzenie badania randominizowanego, długofalowego, które potwierdziłoby wyniki uzyskane w badaniu retrospektywnym
EN
Early physiotherapy is an important part of the comprehensive treatment of patients after major abdominal surgery (MAS). Accelerated mobilization should be safe and requires the use of appropriate techniques. Most of the physiotherapists and surgeons recommends using abdominal belts. Opponents claim that belts have an adverse effect on lungs ventilation. The aim of the study was to determine the effect of abdominal belt on lung ventilation efficiency in the early period after MAS. Material and methods. The study involved 20 patients after MAS. Including 9 women and 11 men, aged between 40 to 90 years (xˉ 66.7). In the scheduled 7 patients and urgent 13. All of them were in the early period after surgery. Dynamic spirometry was performed twice in the postoperative period. For the first time wearing a belt, and then without the belt in the same group. Evaluated the forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF). For the analysis uses the Wilcoxon matched-pairs test and Spearman’s rank correlations. P values <0.05 were considered significant. Results. The value of the ventilation indicators measured wearing abdominal belt were slightly lower than the values evaluated without the belt. The results are shown in percent predicted for age and gender, FEV wearing belt 52%, without belt 53%; FEV1 59% vs 61%; PEF 46% vs 51%. There were no statistically significant differences Conclusions. There were no significant negative influence of abdominal belt on lungs ventilation in early period after MAS. There was no correlations between age, body mass index and changes in ventilation indicators.
EN
Though cervical spine disorders occur less frequently than lumbar spine problems, their course and final results may have severe implications for patients. Despite significant development in operative treatment of cervical spine; patients, if possible, choose conservative methods basing mainly on pharmacotherapy and rehabilitation (physiotherapy). A case report of non-operative treatment with use of selected techniques of manual therapy and physiotherapy is described. Achieved improvement allowed postponing the surgery, but we cannot exclude the necessity of operation in the future.
EN
The aim of this article is to make the assessment of physiotherapy use in the case of swimmers’ regeneration. A diagnostic survey was used as the method. Opinions from the author’s survey were considered and there were 30 high-class swimmers analyzed aged 15–27. The research was conducted in 2012 at the Floating Arena swimming pool in Szczecin. 100% of the surveyed swimmers benefit from regeneration after physical effort. The most common physiotherapist treatment in case of swimmers is dry classic massage – 86.7%. The water bath (63.3%), sauna bath (56.7%), whirl bath (53.3%), water jets/Scotch douche (43.3%) and hydro massages (30%) are the most common types of hydrotherapy. On the other hand, ultrasounds and cryotherapy are the least common treatments when choosing adequate types of regeneration, i.e. respectively 13.3% and 3.3%. The biggest amount of massages is performed shortly before start – 40%. Massage in 60% cases lasts 10 minutes. In 90% of the surveyed group partial massage is being applied, whereas only 3.3% of competitors take the overall massage. In case of 80% of the swimmers, massage is regarded as completely relaxing. For 77% of them it relaxes both physically and mentally. In case of 80% of the surveyed, it is regarded as the most efficient form of biological regeneration. 60% of swimmers say it is helpful to maintain readiness to start and to overcome fever (feeling of annoyance) or apathy.
EN
Background and purpose: Multiple sclerosis (MS) is a demyelinating disease, usually with multifocal symptoms and multiphasic course that is emerging as a result of inflammation and the formation of foci of myelin breakdown in the central nervous system as a consequence of not fully known harmful external factors. The aim of this study was to analyze the results of tests allowing to detect imbalances in patients with multiple sclerosis. Material and Methods: A 38 year old male with MS diagnosed in 2006 was examined. The study used three tests of balance: "Timed Up & Go" test, Tinetti test and Berg Balance Scale. The results of the scale were analyzed, which consisted in a variety of motor tasks assessing balance and gait. Tests were repeated every month for 10 months. Results: The results in each test over 10 months significantly change. Changes in response to the increase of the number of tasks and the difficulty of the test occured. As a consequence of impaired balance control, the number of falls increased. Conclusions: The stability of the patient with multiple sclerosis is getting worse in each test evaluated. The deficit of stability increased in response to increasing the number of tasks and increasing the difficulty of the test. A key role in postural stability in standing plays the pelvis and lumbo-pelvic-hip complex.
EN
A person with Parkinson's disease has bigger problems with maintaining the stability than the healthy person. Nordic Walking is a safe kind of physical activity for elderly people. The aim of this study is to present the influence of a 6-month therapy of the Nordic Walking on the imbalance and the risk of falls for 66-years-old patient with Parkinson's disease. On the basis of results of 4 tests, performed both at the beginning and at the end of the Nordic Walking therapy, we have made a comparison of patient’s changes before and after 6 months of rehabilitation. the DGI test, the PD patient received 18 points. After he got 22 points. In the Functional Reach Test ( FR), while attempting to reach forward, reached out for 23 cm before the therapy, and 31 cm after the therapy. In the test and go up the patient got a time of 63 seconds, after therapy the time was reduced to 45 s. Nordic Walking is a safe kind of physical activity for people with Parkinson's disease. It reduces muscle tension, and improves joint function.
EN
Background: Man is exposed to falls performing daily activities, their effects turn out to be more severe especially in the later decades of life. After 60 years, it appears to be a larger number of fractures resulting in the limitation of physical fitness, health complications and life threatening. Therefore, prevention efforts conducted in the form of an in-depth analysis of the falls’ causes which already happened, control of health and proper treatment, conducting systematic, interesting and varied physical activities - in conjunction with education and mental change in a determined way they can and should reduce the risk of falls of the elderly.
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Physiotherapy in the comprehensive treatment of obesity

100%
EN
Background: World Health Organization considers obesity as the most serious health condition in the world today. This concerns not only adults but also children and young people. Obesity is the leading cause of increased morbidity, disabilities, mortality rates and deteriorated quality of life in society. Higher death risk due to cardiovascular diseases and certain cancerous conditions are also attributable to obesity. Some 40% adults in the world today are overweight and 13% are obese. These tendencies have also been observed in Poland. Specific components of comprehensive slimming treatments include dietary treatment, nutrition education, habits modification, increased level of physical activity, pharmacological treatment and surgical interventions. The basis in obesity treatment is to induce a negative energy balance. This status is typically achieved through dietary measures and increased energy expenditure. Helping prepare adequate individual therapeutic programs is a key to success in slimming of the obese patients. Mass reduction programs are prepared individually based on FITT formula, which takes into consideration four aspects of physical activity: frequency, intensity, time and type of physical activity. The role of physiotherapists in this process is essential. Individual therapeutic programs help adjust all the aspects of training to the health status of the obese patients, with respect to coexisting diseases.
EN
Introduction Low-back pain syndromes are a common problem. The authors estimate that this ailment is experienced by more than 80% of populations in developed countries. The treatment of spine pain syndromes is an interdisciplinary issue. Therefore, a proper therapy must be multifactorial and take into consideration all aspects of a patient’s life. The aim of this work was to compare subjective evaluation of the process of rehabilitation of patients suffering from ailments related to lumbar spine pain who received physiotherapy within the health insurance reimbursement in Poland and in France. Material and methods The study included 100 patients who underwent physiotherapy due to lumbosacral spine pain complaints. The study group consisted of 50 participants who received physiotherapy in Poland and 50 subjects who underwent it in France. The authors’ own questionnaire was employed in the study. It was prepared in two language versions, i.e. Polish and French. The questionnaire consisted of 34 questions on demography, pain complaints, the process of physiotherapy and the evaluation of pain on the VAS scale, before and after physiotherapy Results The assessment of the promptness of the employed treatments was statistically higher in the case of the patients in France (p=0.039). The general assessment of the physiotherapy process by the examined patients in Poland and in France was similar. No statistically significant differences were revealed in this respect (p=0.240). The process of the therapy was most often regarded as very good (66%). Conclusions The patients with chronic lumbar spine pain undergoing therapy in France evaluated it higher than the patients in Poland. The effectiveness of physiotherapy in both countries did not vary considerably. France respects the rules of early intervention and extensiveness of physiotherapy to a larger degree than Poland.
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2019
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vol. 33
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issue 2
29-35
EN
Introduction The foot plays an important role as a static-dynamic foundation of the skeleton. The process of the most intensive formation of the foot during the posturogenesis falls on the preschool age and early school age. The aim of the study was to characterize the arch of the feet in children at the age of 5 and to look for the dependence of their arching condition on the Cole’s index level. Material and methods Forty-four preschool children took part in the research. The Cole’s index showed an underweight, normal body weight, overweight and obesity. The plantography method was used to assess the arching of the feet Results Over half of the examined children had normal body weight. Underweight was more common in the boys group, while overweight and obesity in girls. Ninety percent of children had abnormal longitudinal and transverse arches in both feet. The varus of the big toe and the valgus of the small toe was observed in both groups. The position of the heel was set correctly in majority of the participants. Conclusions No relationship was found between the Cole’s index and longitudinal arches of the right and left foot in boys, as well as in girls. The results revealed that excessive body weight in girls was correlated with flattening of the transverse arch and incorrect position of the heel in the right foot. No significant correlation was found between the Cole’s index and the assessed parameters of the foot in boys.
EN
Introduction Physiotherapy and education are indispensable after total hip arthroplasty. The aim of the study was to assess the patients' level of knowledge about total hip arthroplasty, physiotherapy and everyday functioning after the surgery and to determine factors which affect this knowledge. Material and methods The study included 31 patients aged 57.03±14.53 years who underwent total hip arthroplasty. The authors' own questionnaire which verified the patients' knowledge about postsurgical procedures was used as a research tool. The questions were prepared on the basis of information provided to patients by physiotherapists and included, inter alia, photos showing correct and incorrect behaviours of patients after the surgery. Results Nearly 30% of the respondents demonstrated a high level of knowledge. The Internet was the most common (43%) source of information regarding the surgery and physiotherapy for patients. As many as 25% of the patients did not search for any information. The results did not correlate with such variables as age, gender, level of education, place of living, BMI or professional activity. Conclusions Patients' first contact with physiotherapeutic procedures takes place when they are admitted to a hospital. They rarely take advantage of out-patient presurgical physiotherapy. Patients should be given a wider access to reliable information regarding arthroplasty and physiotherapy. It may be done by preparing proper materials and making them available as well as encouraging patients to use them. It is necessary to convince patients to engage fully in the treatment process and cooperate with the therapeutic team.
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2018
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vol. 32
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issue 1
39-45
EN
Physiotherapy plays a very important role in cystic fibrosis. Its basic aim is to regularly clear bronchial passages of mucus which is responsible for exacerbation of bronchoalveolar symptoms. Positive Expiratory Pressure (PEP) and Oscillating Positive Expiratory Pressure (OPEP) are among the most commonly used bronchi clearance methods. It is not entirely clear which technique should be applied in what situations and whether these techniques are similar to other drainage techniques in terms of effectiveness. The aim of this study is to review the literature and analyse the effectiveness of both techniques, to summarise the existing evidence and to point to gaps in the knowledge about this issue.
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First Polish Hand Allograft - 6-Month Report

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EN
The transplant recipient is a 32 year-old man who lost his right, dominant upper limb on the level of the midpoint of his forearm in an accident 14 years ago. After a comprehensive pretransplantation evaluation and informed consent process he received a transplant of the right forearm, matched for size and skin tone, of a brain-dead man aged 47. The donor's limb was amputated at the elbow and irrigated with UW solution. We dissected the donor and recepient limbs simultaneously. Appropriate lengths of anatomical structures were matched. Bone fixation was performed with Rush pins, without bony transplants; the muscles were anastomosed in layers and the skin wound was closed without a skin transplant. The cold ischemia time was 10.5 hours. Immunosuppresion included simulect, tacrolimus, mycophenolic acid, and prednisone. Maintanance therapy included tacrolimus (15 ng/ml), mycophenolic acid, and encorton.There were no intraoperative or early postoperative complications. No episodes of rejection were observed. Immunosupression was well tolerated. The intensive physiotherapy led to satisfactory progress of motor function recovery. Reinnervation was excellent, and after 6 months, Tinel's sign was present over 40% of the respective lengths of the median and ulnar nerves. Follow-up included routine post-transplant laboratory tests, skin biopsies, bacteriological tests, and physiotherapy.
EN
Low back-pain is the most common pain syndrome. Radiofrequency facet denervation (RFD) is a minimally invasive method of treatment of chronic low back pain caused by facet joint syndrome. In this procedure electric current with frequency of radio waves are used to cause thermal injury to a small branch nerve that innervates painful facets. There are numerous studies confirming the effectiveness of this therapy. A good outcome of RFD can be sustained by appropriate and regular exercise. The aim of this article is to recommend such a program of exercises focused on strengthening the muscles and improving stabilization of the lumbar spine.
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Development of veterinary physiotherapy in Poland

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PL
Wstęp: fizjoterapia zwierząt w Polsce jest dziedziną bardzo młodą i stosunkowo mało popularną. Jednak w ostatnich latach obserwuje się wzrost zainteresowania zarówno właścicieli zwierząt, jak i lekarzy weterynarii wykorzystaniem zabiegów fizjoterapeutycznych w weterynarii. Obserwując trendy światowe, można się spodziewać, że w najbliższym czasie dojdzie do znacznego rozszerzenia usług fizjoterapeutycznych w leczeniu zwierząt. Cel pracy: celem pracy była ocena popularności i rozwoju fizjoterapii zwierząt w Polsce. Materiał i metody badań: badania przeprowadzono w placówkach weterynaryjnych, w których w leczeniu zwierząt wykorzystuje się przynajmniej jedną metodę fizjoterapii i które odpowiedziały na rozesłaną ankietę. Ankietę wypełniło 16 placówek, w tym: kliniki, przychodnie, lecznice i gabinety weterynaryjne z rejonu całej Polski. Wnioski: w Polsce wykorzystanie fizjoterapii w leczeniu zwierząt jest jeszcze niewielkie. Jednakże obserwuje się wzrost zainteresowania fizjoterapią zwierząt wśród lekarzy i klientów przychodni weterynaryjnych. Według polskich terapeutów rehabilitacja zwierząt przynosi bardzo dobre rezultaty. Fizjoterapia zwierząt najczęściej stosowana jest w przypadku schorzeń kręgosłupa, dyskopatii, zwyrodnieniach stawów, po urazach, wypadkach, dysplazji stawów biodrowych. Terapeuci wykazują zainteresowanie podnoszeniem kwalifikacji w pracy ze zwierzętami poprzez specjalistyczne szkolenia.
EN
Introduction: in Poland animal physiotherapy is a very young discipline and it is still not very popular. However, in recent years animal owners and veterinary surgeons have become more and more interested in the use of physiotherapeutic procedures in veterinary medicine. Observing world trends, it may be expected that the nearest future will bring about significant expanding of physiotherapeutic services in the treatment of animals. Aim: the aim of the research was to assess the popularity and development of animal physiotherapy in Poland. Material and methods: the research was carried out in veterinary institutions in which at least one physiotherapeutic method is used in the treatment of animals and which completed a questionnaire. Sixteen institutions completed the questionnaire, and they included: veterinary departments, clinics, surgeries from all over Poland. Conclusions: in Poland the use of physiotherapy in treatment of animals is still limited. However, an increase has been observed in animal physiotherapy among veterinary surgeons and clients of veterinary clinics. According to Polish therapists rehabilitation of animals brings about very good results. Animal physiotherapy is used most frequently in diseases of the spine, discopathy, joint degeneration, aftertraumas, accidents and in hip dysplasia. Therapists are eagerto improve their qualifications by attending specialist training courses.
EN
Discogenic back pain is an increasing problem in the modern world. Conservative treatment of discopathy is comparatively popular and may be an alternative to surgery. The authors describethe case of a 32 year old male with acute back pain, sciatica and numbness in the left lower leg. On the base of MRI imagesL4-L5 and L5-S1 two-level disc herniation was diagnosed. The patient did not decide on surgery, so complex conservative treatment was applied, including pharmacology and rehabilitation techniques. The symptoms resolved with permanent improvement in one year of follow up. Additionally, the patient was encouraged to apply “healthy habits” in physical activity. Conservative treatment in some cases of massive lumbar disc herniation may be successful.
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2018
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vol. 32
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issue 3
11-17
EN
Background Diastasis of the rectus abdominis muscles (DRAM) is the separation of the two rectus abdominis muscles more than 2 cm wide. It often arises as a result of android obesity, dysfunctional abdominal cramp and pregnancy. Untreated diastasis may lead to dangerous heath consequences such as.: abdominal hernia, lower back pain or disorders in pelvis’s area. The aim of this study was to determinate the effectiveness of novel physiotherapeutic program in women with diastasis of the rectus abdominis muscles. Material and methods The study was conducted on a group of 40 women between 20-45 years old (mean 32,32+5,9 year). They all were qualified in obstetric ward of Szpital Bielański in Warsaw. All of them were in the postpartum between 0-3 days after labor and have DRAM greater than 2 cm (measured by palpation on the umbilicus height, 4,5 cm above and below umbilicus). In research group (included 20 women) applied novel physiotherapeutic program aimed at reduction of DRAM. In controlled group (20 women) there was no therapy but only observation of spontaneous reduction of diastasis. The study took 6 weeks. Results Data analysis had shown 95% effectiveness of novel physiotherapeutic program. Chi-square test has confirmed the difference in DRAM size in both groups (p<0,0001). A statistically significant correlation was demonstrated between width of diastasis and growth of the mother’s weight gain in pregnancy, waist-to-hip ratio, BMI, number of delivery and mother’s physical activity before and during pregnancy (p<0,05). There wasn’t clear correlation between width of diastasis and mother’s age or infant’s mass (p>0,05). Conclusions It seems that spontaneous reduction of diastasis of the rectus abdominis muscles is very rare. New physiotherapeutic program is an effective method in DRAM’s reduction. The research should be continued in larger group of women and after effectiveness confirmation, program should be introduced in obstetric wards.
EN
Introduction Diastasis recti abdominis is a pathological condition at the linea alba in which rectus abdominis muscles separate. It occurs mainly in pregnant and postpartum women. Changes in the linea alba area are caused by stress to the tissue and pregnancy induced hormonal changes which lead to the loosening of abdominal connective tissue. This pathological condition is not manifested with any pain symptoms but the effects which may develop as a result of diastasis recti abdominis may cause pain. This literature review study discusses the non-surgical methods of treating diastasis recti abdominis by reducing the distance between the two parts of the rectus abdominis muscle. Material and methods Scientific literature on physiotherapy, surgical treatment and diagnostics of diastasis recti abdominis in pregnant and postpartum women from the last 15 years was analysed. Such databases as Google Scholar, PubMed, ScienceDirect, Ebsco and MedLine were used in the analysis and 11 publications were considered. Results Having analysed the available literature, it was concluded that abdominal exercises can prevent or reduce diastasis recti abdominis. However, the analysis did not reveal which method of treatment was the most effective. Conclusions This review of the literature revealed that there is not currently a gold standard method of treating diastasis recti abdominis. However, abdominal exercises during pregnancy reduce the risk of this condition postpartum. Diastasis recti abdominis may be reduced even a few years after childbirth by implementing appropriate treatment including a special training programme focusing on strengthening anterior abdominal wall and learning to maintain a proper body posture during activities of daily living.
EN
The Human immunodeficiency virus (HIV) is a lentivirus that causes HIV infection, and over time, Acquired Immunodeficiency Syndrome (AIDS). HIV infection (simply called HIV at its early stage and AIDS at its later stage) is a very prevalent global disease condition affecting about 36.7 million people, both young and old. Sadly, HIV/AIDS affects almost all the systems in the body (particularly the neurological and musculoskeletal systems), which may result into physical disability. Physiotherapists are known to play important roles in the management of physical disability. In this paper, the authors provide information on the clinical and epidemiological features of HIV/AIDS, as well as the treatment modalities for the neurological and musculoskeletal problems experienced by people living with HIV/AIDS.
EN
Aging population, increases the number of major abdominal surgery (MAS) performed in the elderly. Main goal of physiotherapy after that surgery is prevention postoperative complications and reduction of functional limitation. The aim of the study was to asses functional status elderly people after MAS during early postoperative physiotherapy. Material and methods. In a prospective randomized study involved 34 patients scheduled for elective MAS, aged 65+. Patients were randomly assigned to receive PNF or conventional physiotherapy. The study included forced spirometry (FVC, FEV1, PEF) and functional tests (gait speed, up&go). Measurements were performed before surgery and the fourth day after surgery. Also analyzed age, sex, BMI and the level of postoperative independence (postoperative independence scale SAP). Kolmogorow- Smirnow test was used to check normal distribution, t-Student was used to check whether two sets of data differ significantly, and r-Pearsons for correlations testing. p values <0.05 were considered significant. Results. After surgery the time of gait speed test and up and go test was significant longer in comparison to preoperative value. FVC%, FEV1%, PEF% values was decrease. In the PNF group was found significantly higher postoperative independence(SAP) and shorter length of stay in hospital compared to conventional physiotherapy group. Results of SAP and functional tests were significantly positive correlated. Conclusions. Major abdominal surgery decrees efficiency of walking and lung ventilation after 65 year old in early postoperative period. Some techniques of the PNF concept used in improving older patients after the MAS may favourably affect the postoperative increase independence and reduce the time of hospitalization.
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