Short-term effect (ATR, Kasperczyk's Scale, chest's mobility) of using of physiotherapy method in the treatment of AIS - pilot study.

AIM OF THE STUDY: The assessment of influence physiotherapy (DoboMed) to the chest's mobility and the morphology of the ribcage and the posture in short-term intensive physiotherapy in the Department of Rehabilitation. MATERIAL AND METHODS: Forty five girls with AIS (mean age- 14.9y.; Cobb angle-range 11-40 degree) were examined. The physiotherapy was been continued for 3 weeks. The angle of trunk rotation (ATR) (Bunnell scoliometer), the posture's morphology (Kasperczyk's Scale) and the chest's mobility index were estimated twice- before and after therapy. RESULTS: After therapy values of ATR decreased by 2°, the chest mobility index increased by 1.3 and total point obtained in the Kasperczyk's Scale has decreased by 1.9 point- which indicates the improvement body posture. All differences are statistically significantly. Also, reported correlations between Cobb angle and ATR and the sum of the points obtained by Kapserczyk's Scale in first exam. CONCLUSION: Using of physiotherapeutic method in the treatment of AIS provides to the functionally improvement of the chest's mobility, the angle of trunk rotation and the posture in the short time. A used measurement's tools were practical for PT in everyday's work.

Faulty posture and style of life in young adults.

UNLABELLED: Study was aimed to determine the incidence of postural faults, level of physical activity and their possible relationship in young adults. Material included 100 subjects recruited randomly among students of Medical University of Silesia (54F aged 20-28, mean=22.9, SD=2.11 and 46M aged 20-29, mean=25.1, SD=1.86). Posture was examined according to modified Klapp protocol. For thoracic kyphosis and lumbar lordosis, values of 30 degrees +/-2 were considered as normal. ATR exceeding 5 degrees was considered as scoliosis. Physical activity was evaluated with a questionnaire, admitting 1 point for each hour of physical labour and 2 points for each hour of sport activity per week. Statistical analysis was based on the one-way ANOVA test. Postural faults were widespread in assessed group. Most common was lumbar hypolordosis (71.0%, 48.1%F and 97.8%M) and thoracic hyperkyphosis (58.0%, 53.7%F and 63.0%M). Scoliosis was observed in 54.0% (50%F and 58.7%M). Physical activity in assessed group was high, with 71% of cases (76%F and 62.5%M) within range of mean value +/- 1SD. Level of activity in men was significantly higher than women (mean 20.25 vs. 6.28 points, p<0.05). Significant dependence of postural faults and physical activity was not observed. CONCLUSIONS: Young adults prefer active way of life. Postural faults are widespread among young adults. Correlation between level of physical activity and postural faults was not observed.

Knowledge about idiopathic scoliosis among students of physiotherapy.

The aim of the study was to determine the level of basic knowledge about idiopathic scoliosis (IS) among students of physiotherapy. The study included 37 students of Medical University of Silesia (17F and 20M aged 22-25, mean 22.6), attending the 3(rd) year of a 1(st) degree of physiotherapy. All students had credits in kinesiotherapy, including methods of conservative treatment of IS. Students were examined using a questionnaire, comprising general knowledge of IS, questions related to sagittal plane correction, influence of various physical activities on IS and known methods of conservative treatment. 81 students considered IS as 3-D deformity. 62.2% of those questioned would diagnose IS when the Cobb angle reaches 10 degrees . All students agreed that the aetiology of IS remains unknown. 54.1% considered forcible extensory exercises of back as favourable in IS. Questioned students mostly preferred swimming (94.6%), yoga (73.0%) and martial arts (32.4%) as beneficial to IS. The methods of conservative treatment which were known best were: Lehnert-Schroth-Weiss (94.6%), Klapp (91.9%), Majoch (89.2%) and Dobosiewicz (78.4%). The conclusions indicate that the average level of knowledge of idiopathic scoliosis among students of physiotherapy is unsatisfactory, despite the education programme including the SOSORT guidelines. Education in the field of scoliosis should be comprehensive and meet contemporary guidelines and standards.

[Amiodarone for long term treatment of arrhythmia in children]. / Amiodaron w przewleklym leczeniu zaburzen rytmu serca u dzieci.

Amiodarone was used in 37 pediatric subjects aging 1 day--16 years. Very high efficiency of long-term treatment (mean 8 months) was found in the cases of supraventricular as well as ventricular tachyarrhythmias (paroxysmal and nonparoxysmal) including complex life-threatening ones. The treatment was not effective only in three subjects. In the other cases normal heart rhythm was achieved or duration time and number of tachycardia attacks was reduced. The class of arrhythmia improved. It was often recommended to use amiodarone together with digitalis preparation in order to obtain its antiarrhythmic activity. Our usual amiodarone dose was 10-20 mg/kg of body mass/24 h intravenously (in order to interrupt the attack) or 10 mg/kg/24 h per os in saturation period. Then the daily dose was reduced to the mean equal 5 mg/kg. Amiodarone side effects were observed in rather high percentage of subjects (24%) during long-term treatment. There were abnormal laboratory tests or laboratory and clinical abnormalities of thyroid function observed in 3 cases. In 4 other ones amiodarone deposits in cornea were found. They disappeared in 2 cases after drug dose reduction. In 1 child the symptoms of lung fibrosis and in the other one of sunshine hypersensitivity were observed. Thus, because of side effects treatment had to be interrupted in 7 cases (19%). It is concluded that amiodarone is exceptionally effective antiarrhythmic drug, very useful also in the youngest pediatric patients. On the other hand it is concluded, that the treated subjects must remain under careful medical control because of high rate of amiodarone side effects.

[Physical fitness of children after cardiosurgical correction of an atrial septal defect type II]. / Wydolnosc fizyczna dzieci po leczeniu kardiochirurgicznym ubytku w przegrodzie miedzyprzedsionkowej serca typu II.

Physical fitness of 17 children aged 8-12 years being 4-7 years after cardiosurgical correction of interatrial defect of the heart (ASD II) was studied. The results were compared with the ones obtained in 14 healthy children of the same age. The parameters of gas exchange, gasometry, heart rate, ECG, arterial blood pressure were determined during supervised physical fitness test. The power of the children and so called anaerobic threshold (according to Beavers method) were evaluated during the exercise test performed on mechanical treadmill, as well. No significant differences of the studied classical physical fitness parameters between both studied groups were observed. On the other hand, the use of a log-log transformation method indicated that the children after cardiosurgical correction achieved the anaerobic threshold at lower exercise intensity. This fact is connected with lower physical performance of these children as compared to the control group.

7th SOSORT consensus paper: conservative treatment of idiopathic & Scheuermann's kyphosis.

UNLABELLED: : Thoracic hyperkyphosis is a frequent problem and can impact greatly on patient's quality of life during adolescence. This condition can be idiopathic or secondary to Scheuermann disease, a disease disturbing vertebral growth. To date, there is no sound scientific data available on the management of this condition. Some studies discuss the effects of bracing, however no guidelines, protocols or indication's of treatment for this condition were found. The aim of this paper was to develop and verify the consensus on managing thoracic hyperkyphosis patients treated with braces and/or physiotherapy. METHODS: The Delphi process was utilised in four steps gradually modified according to the results of a set of recommendations: we involved the SOSORT Board twice, then all SOSORT members twice, with a Pre-Meeting Questionnaire (PMQ), and during a Consensus Session at the SOSORT Lyon Meeting with a Meeting Questionnaire (MQ). RESULTS: There was an unanimous agreement on the general efficacy of bracing and physiotherapy for this condition. Most experts suggested the use of 4-5 point bracing systems, however there was some controversy with regards to physiotherapeutic aims and modalities. CONCLUSION: The SOSORT panel of experts suggest the use of rigid braces and physiotherapy to correct thoracic hyperkyphosis during adolescence. The evaluation of specific braces and physiotherapy techniques has been recommended.