Psychometric Features of the Polish Version of TSK Heart in Elderly Patients with Coronary Artery Disease.

Background and objectives: Recommendations for the control of stable patients with coronary artery disease (CAD) related to an adequate level of physical activity (PA). Practical experience shows that the PA level in most people with CAD is definitely too low in relation to the guidelines. The cause may be psychological factors and among them the fear of movement-kinesiophobia. The aim of this project was to examine the evaluation of psychometric features of the Polish version of the Tampa Scale for Kinesiophobia Heart (TSK Heart), used in people with CAD. Materials and methods: The study involved 287 patients with stable CAD: 112 women and 175 men. Age: 63.50 (SD = 11.49) years. Kinesiophobia was assessed using TSK Heart, physical activity (PA)-using the International Physical Activity Questionnaire (IPAQ), and anxiety and depression was examined using the Hospital Anxiety and Depression Scale (HADS). The structure of TSK was examined using principal component analysis (PCA), internal cohesion (Cronbach's alpha, AC), and content validity was calculated by linear regression. Results: PCA showed a three-factor TSK structure. One-dimensionality and satisfactory reliability were found: TSK Heart: AC = 0.878. Kinesiophobia as a predictor of PA: R2 = 0.162 (p = 0.000000). Anxiety and depression-TSK: R2 = 0.093 (p = 0.00000). Conclusions: The Polish version of TSK Heart for cardiac patients is characterized by good psychometric features. The use of it can improve the cooperation of rehabilitation teams for patients with CAD.

Risky behaviors of adolescents in the Silesian voivodeship: resistance to stress and physical activity.

BACKGROUND: Movement and physical activity are the natural needs of a living human. Sedentary lifestyle resulting from the development of car communication, improper nutrition, abuse of drugs and addictive substances, constant rush and stress consequently cause destructive health effects. The aim of the study was to analyze risky behaviors among adolescents in the Silesian voivodeship (Poland), taking into account their resistance to stress and physical activity. METHODS: Two hundred eleven people were examined (100%). Among them there were 122 girls (57.82%) and 89 boys (42.18%) aged 16 to 18 years (x=17.3, SD=0.53). The participants were students from upper secondary schools in the Silesian voivodeship. The research tool was an original questionnaire consisting of a metric part, closed questions related to the examined problem and a standardized questionnaire of physical activity (Subjective Experience of Work Load [SEWL]). RESULTS: Most of the girls (47, 38.52%) considered themselves to be medically resistant to stress, while boys (30, 33.71%) believed they were rather resistant to stress. On the other hand, there was no correlation between susceptibility to stress of adolescents in relation to age. From the whole group, up to 203 people (96.21%) have already drunk alcohol. Among them there were 117 girls (95.90%) and 86 boys (96.63%). The first cigarette from the studied group of teenagers was ignited by 137 people (64.93%), including 80 girls (65.57%) and 57 boys (64.04%), while psychoactive substances have been already taken by 51 participants (24.17%). Among them there were 23 girls (18.85%) and 28 boys (31.46%). There was no correlation between the self-esteem of susceptibility to stress and the use of stimulants in both boys and girls. The average value of the Sport Index among girls was 2.75, while among boys was 6.37. CONCLUSIONS: Boys in comparison to girls considered themselves more resistant to stress, while the age in both sexes did not affect self-assessment of vulnerability to stress. Gender of the adolescents did not affect the frequency of stimulants use.

Can the expression of the metalloproteinase 9 gene and its inhibitor be considered as markers of heart failure?

BACKGROUND: Heart failure (HF) is a major cause of mortality in developed countries. Its formation is associated with a change in the transcriptional activity of many genes. The aim of the study was to select, from the group of genes related to coronary atherosclerosis and heart failure, genes differentiating patients with coronary heart disease and heart failure on the basis of myocardial ischemia from healthy people, and then genes differentiating patients with various stages of heart failure. METHODS: The study was carried out using the oligonucleotide microarray technique HG-U133A (Affymetrix, Santa Clara, CA, USA). Cluster analysis showed a homogeneous division of the study group into patients with heart failure and healthy patients with excluded coronary artery disease and patients with heart failure depending on the size of the left ventricle ejection fraction. RESULTS: The study showed that genes differentiating the group of patients from healthy people were: TGF-ß1, TIMP-1 and MMP-9. The analysis also showed that genes differentiated patients with advanced heart failure in the course of coronary disease and left ventricular ejection fraction (LVEF) 20% and patients from the group with 40% LVEF were MMP-9 and TIMP-1. CONCLUSIONS: Extracting from the group of genes related to coronary atherosclerosis and cardiac failure: MMP-9, TGF-ß1 and TIMP-1 differentiating patients with heart failure on the basis of myocardial ischemia in varying degrees of severity from healthy people may indicate their significant contribution to disease development. Also increased expression of the metalloproteinase gene 9 (MMP-9) with a simultaneous decrease in the expression of its tissue inhibitor 1 (TIMP-1) in the studied group of patients with ischemic heart failure differing in left ventricular ejection fraction LVEF makes them the markers of progression in failure.

Fear of movement (kinesiophobia) - an underestimated problem in Polish patients at various stages of coronary artery disease.

INTRODUCTION: The importance of the problem of reduced motor activity in the prophylaxis and treatment of many diseases has resulted in numerous adaptations of a diagnostic tool, both for the disease and for linguistic and cultural versions. This also applies to cardiovascular diseases. The significance of the problem, and encouraging results of several studies, have led to a wider use of this tool. This also applies to people suffering cardiologically in Poland, where this problem is poorly understood. This was the inspiration to undertake research on the explanation of the reasons for the limitation in the activation of cardiac patients. OBJECTIVE: The aim of the study was to determine the level of kinesiophobia in patients with CAD, and to assess its possible association with physical activity (PA), socio-demographic determinants and morbidity. MATERIAL AND METHODS: The study was cross-sectional and included 217 hospitalized patients with CAD: 94 women and 123 men; aged 67.39 years. PA was assessed using the short version of IPAQ, and kinesiophobia was assessed using TSK Heart in Polish adaptation. TSK HeartIPAQ correlations were found. RESULTS: More than 70% of the patients revealed high levels of kinesiophobia (TSK>37 points). There were no TSK associations with gender, BMI, socio-demographic variables, other conditions and duration of cardiovascular disease. The disease is the main cause of kinesiophobia and regardless of its nature, negatively affects the level of PA. CONCLUSIONS: The quality of life of patients with CAD at various stages and the effectiveness of cardiolog-ical rehabilitation are conditioned by PA.

Body posture and physical activity in children diagnosed with asthma and allergies symptoms: A report from randomized observational studies.

Asthma and body posture abnormalities in children and young people are major epidemiological problems worldwide. Asthma among children and adolescents, its relations with physical activity (PA) and PA relations with body posture were and are still being investigated.The aim of this study was to investigate how body posture is shaped in children diagnosed with asthma symptoms and whether body posture is associated with PA. The study involved 192 children. The main group consisted of 90 children diagnosed with asthma and allergies symptoms age 9 to 12 years old (x = 10.75 ±â€Š1.08). The control group included 102 healthy children at the similar age (x = 10.64 ±â€Š1.1). The level of activity has been assessed on the basis of a questionnaire and body posture assessments were done using a plumb line, pediscoliometer, digital inclinometer.Comparison of percentage of respondents fitting into body posture norms clearly indicates higher value in the group classified as active. In the group of participants diagnosed with asthma, percentage differences of participants with good body posture (without postural defects) were statistically significant. Among healthy children, percentages of the participants were higher in active children than in inactive children.Body posture is directly related to PA and the lack of activity affects disturbances within posturometric parameters. Prevention of body posture abnormalities is worth promoting in groups of children, also with various diseases including asthma and allergies symptoms.

The relationship between physical fitness and health self-assessment in elderly.

BACKGROUND: The process of population aging inclines to seek determinants of the quality of life in the older people. Health self-assessment is the one of the main elements of the quality of life. In the older people it is associated with functional efficiency. The aim of the study was to determine correlations of physical fitness and health self-assessment. METHODS: The study group included 123 people aged 60 to 86 years. Physical fitness was evaluated using the Senior Fitness Test (SFT). Self-esteem of health was assessed by the SF-36 questionnaire. RESULTS: The analysis included sex factor and the occurrence of chronic diseases. When comparing with healthy participants, people suffering from chronic diseases revealed a lower level of physical fitness (P < .05) and health self-assessment (P < .05). The results of a significant percentage of study participants were worse than norms proposed as standards. The percentage of people below norms varied depending on sex, age, and SFT assessment and ranged from 0 to 89.5%. CONCLUSION: Physical fitness and health self-assessment among elderly may be strongly determined by cultural conditions, for example, habits, lifestyle in various regions. The application of conclusions suggests that the key element of rehabilitation programs among elderly should be focused on improving coordination and locomotor capabilities. Assessment of the elderly is more clearly associated with physical fitness in women than in men and also more in patients chronically ill than in healthy person. Comprehensive assessment of physical fitness according to standardized values does not indicate the diversity by sex.

Body posture in children with obesity - the relationship to physical activity (PA).

INTRODUCTION: The modern world of electronic devices offers children and young people various forms of leisure activities, while reducing the need for natural movement, necessary for normal psychomotor development. Sedentary life contributes to an increased body weight and, thereby, to the development of body posture abnormalities. The aim of the study was to evaluate body posture, leisure activities, and the number of hours spent using electronic devices among children with obesity. MATERIAL AND METHODS: The study involved 51 children with obesity (BMI above 95 percentile) - A group, and 69 children with normal body weight at the age of 9-13 years (10.98 ± 1.29) - B group (control). Body posture has been evaluated with the scoliometer, the digital inclinometer and the plumb line. The hump ratio has been calculated on the basis of SOSORT recommendations. Time spent in front of electronic devices based on a questionnaire results has also been calculated. RESULTS: Children with obesity have more body posture defects in the sagittal plane than children with normal z-scores (p<0.001). 46.8% of children in group A have distorted depth of the two curvatures of the spine. In the control group, the majority of deviations have been observed in the evaluation of the ATR (Angle Trunk Rotation) at the lumbar spine (p<0.05), while in group A, at the level of the thoracic spine (40.42% vs. 23.07%). Both groups of respondents use electronic devices at least 3 days a week (p>0.05). Obese children often use mobile devices, while children with normal body weight often use desktop equipment. CONCLUSIONS: Definitely more body posture abnormalities are found in the group of obese children. Children use electronic devices regardless of weight. It is worth to expand educational activities with programs that improve the quality of body posture through a daily change of abnormal patterns.

Effect of a nonsurgical treatment program on the gait pattern of idiopathic toe walking: a case report.

BACKGROUND: Recent studies have reported many possibilities for the treatment of idiopathic toe walking (ITW); however, none of them have been sufficiently documented. The purpose of this case study was to document the evolution of the gait pattern of a child with severe ITW using the Gillette Gait Index before and after the third and sixth weeks, a nonsurgical treatment program and then every 3 months to 1 year from the start of the treatment. This is significant because the case study shows that a nonsurgical treatment program can be an alternative treatment method for children with severe ITW. CASE DESCRIPTION: The case study involved a 5-year-old boy diagnosed with severe ITW. An orthopedist recommended a surgical treatment, but his parents refused to provide consent. INTERVENTION: The subject participated in a 12-week nonsurgical treatment program that used tone-inhibiting casts (TICs) combined with physiotherapy based on neurodevelopmental treatment principles. The treatment protocol included the following: 1) precast preparation; 2) TICs with treatment; and 3) post-cast treatment to improve the gait pattern. OUTCOMES: After treatment with TICs, the range of motion of ankle dorsiflexion during stance had increased, resulting in an almost normalized gait. The patient stopped toe walking for at least 1 year. DISCUSSION: This study demonstrates that nonsurgical treatment should be considered first, with surgical options reserved for resistant cases; however, further research is required given the current lack of knowledge about treatment outcomes using TICs and the wide use of this treatment modality in children with ITW.