Changes in the scar tissue structure after cesarean section as a result of manual therapy.

BACKGROUND: Available statistical data from 2015 show that 28% of pregnancies in developed countries end in cesarean section (CC). Discomfort associated with the scar after surgery is a common complication. OBJECTIVES: This study aimed to evaluate the changes in the structure of the cesarean scar after the application of a scheme of manual therapy. MATERIAL AND METHODS: The study included 15 women in the treatment group (TG) and 15 in the control group (CG). The scars were evaluated twice at 5-week intervals with the use of quantitative scales: the Vancouver Scar Scale (VSS), the Manchester Scar Scale (MSS) and the Patient and Observer Scar Assessment Scale (POSAS). During each examination, the scar was compared, using the specified criteria, to the physiological skin, i.e., the tissues directly bordering the incision. During therapy, 8 manual techniques were used during a 4-week program consisting of 30-minute sessions 3 times per week. RESULTS: Patients in the TG showed a statistically significant improvement in all of the analyzed characteristics of the scar. A statistically significant difference was also observed between the results obtained during the 2nd examination (after the therapy) in the TG and the CG. CONCLUSIONS: As a result of the therapy, the condition of the scar in the TG significantly improved. Onerous scar-related symptoms were alleviated. The vascularity, hyperpigmentation and distortion of the scar were reduced. The elasticity and pliability of the scar increased, and the height of the scar decreased. The texture, finish and contour of the scar improved. Obtained results suggest that manual therapy of the scar after CC should be a part of the treatment in women during the postpartum period.

Assessment of the Level of Physical Activity and Mood in Students after a Year of Study in a Mixed Mode in the Conditions of Restrictions Resulting from the Pandemic.

The COVID-19 pandemic has forced social isolation affecting all areas of life. It also affected the functioning of schools and universities. Many countries have introduced full or partial distance learning. The aim of the study was to assess the level of physical activity and student mood of the Faculty of Physiotherapy of the Academy of Physical Education in Wroclaw (Poland) and students of the Faculty of Health of the ODISSE University in Brussels (Belgium) after a year of the study conducted in a mixed mode due to contact restrictions resulting from the COVID-19 pandemic and checking which of the analyzed factors increases the risk of depression to the greatest extent. MATERIAL AND METHODS: 297 students from the 2nd to 4th year of full-time studies took part in the observation. The academic year 2020/2021 was assessed. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) recommended for this type of analysis by WHO. The GPAQ questionnaire enables the assessment of activity performed at work, movement, and leisure time and assesses the time of sitting or resting in a supine position. The Beck Depression Inventory was used to assess mental health. The subjects also completed a questionnaire concerning selected somatic features and describing their living conditions in the previous year. RESULTS: In the group of Polish students, classes conducted in a completely remote mode accounted for about 50%, while in the group of Belgian students, about 75%. In the described period, 19% of students from Poland and 22% of students from Belgium were infected with COVID-19. The median of the results of the Beck Depression Scale in both groups was lower than 12 points (7 points in the AWF group and 8 points in the ODISSE group, respectively). A detailed analysis showed that in both study groups, more than 30% of students received results showing a depressed mood. A total of 19% of the surveyed students of the University of Physical Education and 27% of the ODISSE students were characterized by a result indicating mild depression. The results of the GPAQ questionnaire show that the total physical activity, including work/study, recreation, and mobility was 16.5 h a week for students from Poland and 7.4 h a week for students from Belgium. CONCLUSIONS: Both groups of subjects reached all the thresholds recommended by the WHO as a sufficient level of weekly physical activity. A group of students of the Faculty of Physiotherapy of the University of Physical Education in Wroclaw was characterized by more than twice as high (statistically significant) level of weekly physical activity as compared to the group of participants from the ODISSE University in Brussels. In both study groups, more than 30% of students experienced a lowered mood of varying intensity. It is necessary to monitor the mental state of students and, in the event of obtaining control results at a similar level, to implement psychological assistance for willing participants.

Thermographic of the Microcirculation in Healthy Children Aged 3-10 Months as an Objective and Noninvasive Method of Assessment.

BACKGROUND: The aim of this study was to assess if thermography as an objective and non-invasive research tool is capable of identifying the changes in the surface temperature of the body as a response to muscle stimulation in Vojta therapy. The research group consisted of children aged 3-10 months with slight abnormalities of the motor pattern, subjected to individually selected stimulation elements according to Vojta. METHODS: The Vojta method of spontaneous motor assessment and the thermovision method of assessing the microcirculation properties of muscles were used for the evaluation. RESULTS: In the study group, changes in the microcirculation parameters of the extensor muscles of the back occurred immediately after the therapy at the first examination. CONCLUSIONS: The analysis featuring an objective assessment allows physiotherapists to diagnose local temperature changes based on the effect of microcirculation parameters in the musculofascial structures. TRIAL REGISTRATION: The research was conducted as a pilot study for a scientific project approved by the Commission for Scientific Research of the University of Health and Sport Sciences in Wroclaw No 24/2021. The study is currently in the registration process with the Australian New Zealand Clinical Trials Registry.

Assessment of Viscoelastic Parameters of Muscles in Children Aged 4-9 Months with Minor Qualitative Impairment of the Motor Pattern after Vojta Therapy Implementation.

The aim of this study was to assess if there are any objective changes in the viscoelastic parameters of the erector spinae muscle after Vojta stimulation. The study involved 22 healthy children at an average age of 7 months and with an Apgar score of 8-10 points, who were referred for rehabilitation due to a slight delay in the phases of psychomotor development. The first group consisted of 11 children with increased muscle tone (IMT) and the second group consisted of 11 children with non-increased muscle tone (nonIMT). All study participants received a one-time Vojta therapy session, which was continued for 4 weeks by parents at home. The viscoelastic parameters of the dorsal extensor muscle were measured three times. In the first study group, changes in the viscoelastic parameters of the extensor muscles of the back occurred immediately after the therapy at the first examination, whereas changes in the supporting and extensor function of the limbs occurred in both groups at the second examination. Analysis featuring an objective assessment allows physiotherapists to diagnose local changes in the viscoelastic parameters after the implementation of therapy. These studies are the first pilot studies to be continued with a 30- or 60-day follow-up.

The Occurrence of the Sensory Processing Disorder in Children Depending on the Type and Time of Delivery: A Pilot Study.

Over recent years, the concept of Sensory Integration has become more popular. Knowledge about Sensory Processing Disorder (SPD) also has grown, and it is often discussed in scientific research. Sensory disturbances can cause problems in learning and behaviour of children in whom no medical diagnosis has been made. These are healthy children regarding the environment, but their behaviour is often described as strange in the meaning not appropriate/not adequate to the situation. The aim of the study was to analyse if there is a correlation between occurrence of SPD and the time or the way of delivery. Participants were 75 children, ages 5-9 years old. Children born prematurely (n = 25), and children delivered by caesarean section (C-section) (n = 25) were compared to the ones born on time by natural means (n = 25). Research was based on a questionnaire filled by children's parents. Descriptive results and percentage calculations were compared. SPD were detected among 84% of pre-borns and among 80% of children delivered by C-section and it is statistically significant. Both groups are at higher risk of Sensory Processing Disorder than those delivered on time by vaginal birth. Due to the results, the time and the way of the delivery are the factors that affect Sensory Processing Disorder.

Changes in Skin Microcirculation Resulting from Vibration Therapy in Women with Cellulite.

BACKGROUND: Cellulite is a cosmetic defect that affects over 80% of post-pubertal women. One of its pathomechanisms involves microvascular dysfunction. It has been suggested that vibration is a physical stimulus that may improve circulation in the skin and muscles. The aim of this study was to evaluate the effect of local vibration on cutaneous microcirculation and on eliminating the symptoms of cellulite in women. METHODS: A total of 57 healthy women with at least grade 1 cellulite were recruited and divided into four groups differing by treatment time (30' or 60') and position (sitting or lying) during the vibration treatments. Participants took part in 15 vibrotherapy sessions. Body composition, selected circumferences, cellulite grade, and thermographic images of buttocks and thighs were recorded. RESULTS: Significant changes in skin temperature were observed in both studied areas after the first and last treatments in each group. A significant decrease in cellulite grade was observed after a series of treatments. The strongest effects were observed for the sitting position with a treatment time of 60 min. CONCLUSION: Vibration treatment improves microcirculation in cellulite-affected areas. Over time, no adaptation was observed, and subsequent treatments maintained the beneficial effects. Extending the treatment time increased its influence on the microcirculation in the skin.

Superficial temperature distribution patterns before and after physical activity in school children are indicative for personalized exercise coaching and disease prevention.

BACKGROUND: Thermoregulation is highly individual and predictive for potentially cascading pathologies. Altered and deficient thermoregulation is considered an important diagnostic indicator which can be of great clinical utility for specialized screening programs and individualized prediction and prevention of severe pathologies triggered early in life. WORKING HYPOTHESIS: Individual thermoregulation can be objectively assessed by thermovision camera before and after exercises in school children stratified by age and gender that may be of great clinical utility for personalized training early in life in the framework of 3P medicine. STUDY DESIGN: In this study, 60 female and male primary school children were exposed to physical exercises in the form of 45-min general fitness training. The subjects under examination were stratified by age: group 1 (7-year-olds), group 2 (9-year-olds), and group 3 (12-year-olds). Superficial body temperature patterns were measured by means of thermovision camera before and immediately after exercises, as well as after the 15-min recovery time. Temperature patterns were analyzed in 12 areas of the body front and back, covering trunk and upper and lower limbs. RESULTS: The obtained results revealed an individual and age-depended difference in response of the body to exercises. The first measurement prior to exercise (measurement 1) revealed no statistically significant differences in the mean surface temperature of all analyzed areas between 7- and 9-year-old children. Further, 7- and 9-year-old children did not differ significantly in the mean temperature recorded in the trunk compared to the 12-year-old children. However, in 12-year-old children, statistically significant higher values of the mean temperature of the upper and lower limbs, were observed compared to the group of 7-year-olds and significantly higher values of the mean temperature of the lower limbs compared to the group of 9-year-olds. Immediately after exercises (measurement 2), a statistically significant decrease in the temperature was noted in all groups and in all areas of the body. The greatest temperature change was observed in 12-year-olds, while the least one was measured in the youngest subjects. The statistically significant relation between the average trunk temperature of 7-year-old and 12-year-old children was observed: lower values of the mean temperature of the front and back of the trunk were noted in the group of 12-year-old children compared to the group of 7-year-olds. A significantly lower average temperature of the back of the trunk compared to the youngest group was also recorded in 9-year-old children. The study performed after the 15-min recovery time (measurement 3) showed an increase in the average temperature of all analyzed areas. In all subjects, the mean temperature recorded in measurement 3 did not differ significantly from the initial ones (measurement 1, prior to exercises). Only the mean temperature of the trunk back of 12-year-old children was significantly lower after the rest period compared to the initial examination. In all groups, the temperatures after exercises followed by a 15-min recovery returned to the initial ones, except of the trunk backs of 12-year-old children, where the temperature was lower than before exercises. CONCLUSIONS AND EXPERT RECOMMENDATIONS IN THE FRAMEWORK OF 3PM: Thermovision analysis is an effective tool to assess individual thermoregulation and to stratify school children for personalized exercise coaching. Body exercise-based disease prevention early in life is effective when tailored to the person: multi-parametric guidance for prescribing exercises individually is needed. Contextually, proposed individualized training approach should be adapted to the age-dependent particularities and individual thermoregulation.

Assessment of the Psychophysical Sphere and Functional Status of Women Aged 75-90 Living Alone and in Nursing Homes.

Aim: To assess the psychophysical sphere and functional status of women aged 75-90 living alone and in nursing homes. Methods: 23 women living in nursing homes (NH) and 20 living alone (HOME) underwent the following tests: Up and Go Test, Chair Stand Test, assessment of daily physical activity levels using pedometers, Mini-Mental State Examination, Groningen Activity Restriction Scale, Geriatric Depression Scale, and WHOQOL-Bref. Results: It was shown that the subjects living by themselves performed a greater amount of daily physical activity, although there was not significant difference between the two groups in the Up and Go Test result. There were not statistically significant differences in the self-assessment of the mental sphere, but significant differences were found in the self-evaluation of the physical sphere. In the NH group, subjects with and without depression did not differ in terms of the amount of daily physical activity and functional test results. Women with depression from the HOME group were less physically active and had worse functional fitness. Conclusions: Women living alone performed a greater amount of daily physical activity, but the functional status of women in both groups did not differ in a statistically significant way. The groups didn't differ statistically significantly in terms of psychological self-assessment.

Effect of Core Stabilizing Training on Young Individuals Presenting Different Stages of Degenerative Disc Disease-Preliminary Report.

The aim of this study was to assess the efficacy of stabilizing training for the deep core muscles of the lumbar spine in subjects with degenerative disc disease. This study was conducted on 38 participants. The participants were divided into two groups: the extrusion group (EXT, n = 17) and the protrusion group (PRO, n = 21). All the subjects underwent a four-week-long core stability exercise-based treatment (five sessions/week). Clinical outcome measures were assessed pre-intervention (pre), post-intervention (post) and four weeks after the intervention (follow-up). The primary outcome measures were the spinal range of motion (ROM; Spinal Mouse® device) and the Oswestry Disability Index (ODI). In the PRO group, the ROM decreased from 88.52° pre-intervention to 83.33° post-intervention and to 82.82° at follow-up (p = 0.01), while the ODI decreased from 16.14 points pre-intervention to 6.57 points post-intervention, with 9.42 points at follow-up (p < 0.01). In the EXT group, the ROM decreased from 81.00° pre-intervention to 77.05° post-intervention, then increased to 77.94° at follow-up (p = 0.03), while the ODI decreased from 22.58 points pre-intervention to 15.41 points post-intervention and to 14.70 points at follow-up (p < 0.001). Although the stabilizing exercise sessions improved the clinical outcomes in each group, we cannot make conclusions as to whether the type of intervertebral disc damage significantly affects the results of stabilizing exercise-based treatment.

Using Thermography in the Diagnostics of Lymphedema: Pilot Study.

Purpose: The aim of the study was to evaluate the usefulness of thermography in the diagnosis of lymphedema. Methods: The study included 43 women after axillary dissection caused by breast cancer, whose mean age was 64.4 ± 7.8 years. The subjects were divided into two groups, with the criterion for division being the appearance of secondary lymphedema. The size of lymphedema was verified by Limb Volumes Professional 5.0; body surface temperatures were registered using a thermal camera. Results: In the control group, the difference in the volume of the limb on the operated side and the contralateral limb was 7.5 ± 77.7 mL (3.6%). The temperature on the nonoperated side tended to be higher than on the opposite side. In the test group, the difference in size between the limbs was 54.5 ± 312.7 mL (29.3%). In the case of mild or moderate edema, a reverse tendency was observed. While measuring the difference in the mean surface temperatures of both limbs belonging to two groups, a significance of differences at the level of p = 0.04 was observed. Moreover, a negative Spearman correlation coefficient (-0.34) was observed between the size of secondary lymphedema and the surface temperature. Conclusion: Noninvasive thermography can provide a valuable supplementary tool in the diagnostics of secondary lymphedema.

Evaluation of changes in selected skin parameters under the influence of extremely low temperature.

The aim of the work was to evaluate changes in selected skin parameters under the influence of low temperature. The tests were conducted on a group of 20 women using whole-body cryotherapy. The average age of participants was 58.7 ±â€¯7.54 years; the average body weight 77.84 ±â€¯16.01 kg, the mean BMI 30.14 ±â€¯5.81, and the average body height 160.7 ±â€¯6.48 cm. The tested parameters included hydration, lubrication, temperature, and pH of the skin. The skin measurements were made on the first and tenth treatment days, before and after leaving the whole-body cryo-chamber. To assess the data collected before and after the experiment, the measurement taken at each time point were compared. After a series of ten treatment sessions, the greatest decrease was observed in skin hydration and skin temperature. No significant differences were noted for lubrication and skin pH. The analysis showed statistically significant differences in skin parameters between all measurement locations; the upper and lower limbs responded more significantly to cold than other parts of the body. It was also found that the facial skin was more lubricated and hydrated compared to other measuring locations. We conclude that varies skin parts respond differently to low temperature. Cryotherapy causes a significant decrease in temperature and hydration of the skin whereas differences in pH and lubrication of the skin remain insignificant.

Effectiveness of Traction in Young Patients Representing Different Stages of Degenerative Disc Disease.

BACKGROUND: Low back pain (LBP) currently ranks among the most frequent musculoskeletal pathologies, and the average age of those affected is constantly decreasing. One of the causes of LBP is lumbar disc herniation (LDH). If untreated, it causes disability and leads to socio-economic problems. Traction techniques are a popular method of treating this condition. The stage of LDH (protrusion, extrusion) in young people appears to determine patients' clinical status, necessitating diversification of treatment methods with regard to the type of damage. MATERIAL AND METHODS: The study enrolled 37 people aged 22-35. The subjects underwent radiological evalu-ation (MRI), which constituted the basis for assigning them to one of two groups: a protrusion group (PRO) or an extrusion group (EXT). During the experiment, the patient was in the supine position while the therapist administered three-dimensional traction using a manual therapy belt. The Oswestry questionnaire, MRC scale, NRS, SLR test, PLE test and measurements of lumbar segment mobility were used for clinical evaluation. Statistica 12.5 was used to perform statistical calculations. RESULTS: An analgesic effect was noted with regard to the following two parameters in both groups: ODI (PRO 28 → 14 and EXT 30 → 28, p <0.01) and NRS (PRO 6 → 2 and EXT 6 → 3, p <0.01). The subjects improved clinically, with regard to PLE (EXT 22% → 0%, p <0.04) and SLR (PRO 100% → 29%, p <0.01, and EXT 100% → 57%, p <0.01). CONCLUSIONS: 1. The type of intervertebral disc damage determines the functional status of young people with degenerative disc disease. 2. The study demonstrated and confirmed a positive effect of traction on the functional status of subjects with lumbar disc herniation. 3. Traction techniques are safe and can be successfully used in the treatment of LDH.