Ultrasound Imaging in Diagnosis and Management of Lower Limb Injuries: A Comprehensive Review.

Medical imaging tests are widely used to diagnose a broad spectrum of lower-limb injuries. Among these modalities, ultrasound (US) imaging has gained significant traction as a valuable diagnostic instrument for assessing conditions primarily affecting muscles, tendons, ligaments, and other soft tissues. However, there are important dilemmas related to the indications and possibilities of US in lower-limb injuries. Conflicting findings and approaches raise questions regarding the validity, accuracy, and usefulness of the US in that area. This narrative review attempts to summarize the current state of knowledge regarding US imaging of lower-limb injuries. The study provides a detailed discussion of the existing literature and contemporary insights on the diagnosis of lower-limb injuries using US examination, and draws attention to the role of the US in interventional procedures and monitoring of the healing process. The characteristics of normal muscles, tendons, and ligaments in US imaging are presented, along with the most commonly documented conditions affecting these tissues. Furthermore, the benefits and justifications for employing US in interventional procedures are discussed, ranging from platelet-rich plasma injections to physiotherapeutic treatments like percutaneous electrolysis. The study was further augmented with US pictures depicting various lower-limb injuries, mainly affecting young athletes. This article aims to review the role of US imaging in the diagnosis and management of common lower-limb injuries.

Psychodiabetology: The Challenge of the Future?

The number of people suffering from diabetes, including type 1, is constantly increasing both in Poland and worldwide. Type 1 diabetes is a chronic disease characterized by uncertain prognosis and relapses, as well as permanent, irreversible, and progressive changes in health status. The ongoing disease results in dysfunction or disability, and the patient requires specialized supervision, care, and rehabilitation. However, the success of therapy does not depend solely on the perfection of treatment, but also on the patient's readiness to change their lifestyle and cooperate with the therapeutic team. The patient's constant alertness in making therapeutic decisions does not always lead to expected treatment results, and the risk of hypoglycemia associated with intensive insulin treatment depletes the patient's motivation for treatment, leading over time to the development of 'therapeutic burnout' and psychiatric disorders. This narrative review is an attempt to summarize the knowledge and possible future solutions in diabetes type 1 in Poland as well as highlight the importance of comprehensive care, including psychological care, which appears fundamental in a chronic disease such as type 1 diabetes. Therefore, the aim of the study was to present generational changes and psychosocial problems of patients with type 1 diabetes and to identify urgent challenges in diabetic care. Attention should be paid to the deteriorating mental condition of the young generations, who, in the course of diabetes, are exposed to additional psychological and psychiatric health problems. The next generation of patients will require more psychological care, which is why the challenge of the future is to create psychodiabetology centers.

Body Posture and Low Back Pain: Differences between Folk and Ballroom Dancers.

(1) Background: Dance is extremely diverse in its styles. Each of them presents different training, dynamics, and figures that may impact the body posture and the occurrence of low back pain. This observational study aimed to compare the sagittal curvatures and the range of motion (ROM) of the spine, as well as the low back pain occurrence and its intensity between folk and ballroom dancers. (2) Methods: Fifty-one participants took part in the study (nineteen folk dancers, fifteen ballroom dancers, and seventeen non-dancers) aged 18-32. Study groups did not differ in anthropometric parameters as well as in dancing experience and training frequency. Study procedures included a self-administered questionnaire and a physical examination of the sagittal spine curvatures and ROM. The questionnaire included questions about epidemiological data and the occurrence of chronic pain and its intensity using a Visual Analogue Scale (VAS). (3) Results: There was a significant difference in thoracic kyphosis angle between study groups (p = 0.02). The greatest angle was found in folk dancers and the lowest in ballroom dancers (40 vs. 33 respectively). We have found no significant differences in spine ROM, low back pain occurrence, and intensity between study groups (p > 0.05). We have found no correlation between low back pain and spine curvatures and ROM in dancers (p > 0.05), however, we found a very strong and negative correlation between thoracic spine range of motion and the pain intensity in non-dancers (R= -0.95, p = 0.003). The analysis also revealed that only in folk dancers, but not in ballroom dancers, the BMI correlates positively with dancing experience (R = 0.67, p = 0.002). (4) Conclusions: There are no differences in low back pain occurrence and pain intensity between folk and ballroom dancers, however, the prevalence of low back pain in dancers is very high. Folk dancers seem to have more flexed body posture compared to ballroom dancers.

Changes in Metabolic Health and Sedentary Behavior in Obese Children and Adolescents.

Obesity is becoming more common among children and adolescents. As in adults, obesity in the pediatric population is associated with an increased risk of metabolic disorders and diseases. In the related literature, little attention has been devoted to evaluating how metabolic health and sedentary behavior change in the obese pediatric population. Therefore, this study aimed to assess changes in metabolic health and sedentary behavior in obese children aged 7-12 and adolescents aged 13-17. For this single-center hospital-based prospective observational study, we included 202 Polish children and adolescents aged 7-17 years. We performed blood pressure measurements and collected blood samples to assess metabolic health markers. Based on the performed measurements, we also calculated additional indexes and ratios: BMI, WHtR, ABSI, VAI, and HOMA-IR. The analysis of the results showed clear and significant differences between the study groups. The older boys and girls were identified with higher values of anthropometric ratios, blood pressure, time spent sitting, and lower HDL cholesterol values (p < 0.05). The analysis also revealed a strong-to-moderate correlation between age and anthropometric ratios, blood pressure, HDL cholesterol, and sitting time (p < 0.05). Obese children and adolescents included in this study represent poor metabolic health and are at great risk of developing other metabolic diseases such as type 2 diabetes, hypertension, or metabolic syndrome. This risk increases with age; therefore, a number of preventive and therapeutic actions should be taken in overweight and obese children and adolescents to avoid further metabolic complications.

The Relationship between Self-Rated Health and Physical Fitness in Polish Youth.

Self-rated health (SRH) is a tool for assessing a population's health across the lifetime, and seems to be a dynamic assessment of current health status and a strong predictor of cardiovascular disease and mortality, whereas insufficient levels of physical fitness in adolescence are a significant health problem and may contribute to the development of many disorders in adulthood. In this cross-sectional study, we attempted to assess the relationship between SRH and the physical fitness of adolescents. Two hundred and thirty-five adolescents (eighty-five boys and one hundred and fifty girls) aged 16-17 were recruited for this study. The study procedures included a short author questionnaire and physical fitness assessment (Zuchora's Physical Fitness Index). Boys declared better health states and reported less frequent morbidity of seasonal diseases (p < 0.05). No differences were found in physical fitness, the incidence of postural disorders, lower limb malalignments, foot deformities, sleep duration, and perception of physical activity on physical condition and well-being in boys and girls (p > 0.05). The comparison of physical fitness levels in adolescents with different SRH, sleep duration, perceptions of physical activity on physical condition and well-being also showed significant differences (p < 0.05). Positive SRH and perception of physical activity on physical condition and well-being, proper sleep duration (7-8 h/night), and a lack of foot deformities are associated with a better physical fitness in adolescents. Physical fitness seems to be a good predictor of SRH only in Polish boys, but not girls and the entire population. The lack of significance in the entire population could be attributed to the substantial number of girls in the study group. Despite that, it is recommended to encourage adolescents to engage in regular exercises, sleep routines and healthy lifestyles. Further research should be based on a more representative group, with a comparable number of girls and boys in the study group and potential confounders, but also they should be focused on SRH predictors to improve SRH in Polish girls.

ACL Reconstruction: Which Additional Physiotherapy Interventions Improve Early-Stage Rehabilitation? A Systematic Review.

Despite the restoration of the mechanical stability of the knee joint after ACL reconstruction (ACLR), patients often experience postoperative limitations. To our knowledge, there are no systematic reviews analyzing additional physiotherapy interventions implementing standard rehabilitation programs in the early postoperative phase after ACLR. The objective of this study was to analyze the additional physiotherapy interventions implemented in standard rehabilitation programs that improve early-stage ACLR rehabilitation. For this systematic review, we followed the PRISMA guidelines. In March 2022 we conducted a literature review using electronic databases. Primary outcomes were pain, edema, muscle strength, ROM, and knee function. The risk of bias and scientific quality of included studies were assessed with the RoB 2, ROBINS-I and PEDro scale. For the review, we included 10 studies that met the inclusion criteria (total n = 3271). The included studies evaluated the effectiveness of Kinesio Taping, Whole-body vibration, Local Vibration Training, Trigger Point Dry Needling, High Tone Power Therapy, alternating magnetic field, and App-Based Active Muscle Training Program. Most of the additional physiotherapy interventions improved pain, edema, ROM, knee muscle strength, or knee function in early-stage postoperative ACL rehabilitation. Except for one study, no adverse events occurred in the included studies, which demonstrates the safety of the discussed physiotherapy interventions. Further in-depth research is needed in this area.

Impact of mild COVID-19 on balance function in young adults, a prospective observational study.

Balance is of essential importance in human life. The aim of the study is to examine the incidence of balance impairments in young adults who have recovered from mild COVID-19. The study involved 100 subjects, divided into two groups: the study group (50 individuals) comprised subjects who had recovered from mild COVID-19, and the control group (50 individuals) consisted of healthy subjects matched for gender and age. Balance was assessed using a force platform and clinical tests such as: timed up and go test, 15-s step test, sit-to-stand test and 6-min walk test. The assessment on the platform showed greater balance impairments in the trials with eyes closed; more specifically, compared to the controls, in trials with double-leg support the subjects from the study group acquired significantly higher scores in X average (lateral coordinates) (p < 0.05), Path length, V average (average Centre of Foot Pressure Velocity) (p < 0.05) and Area circular (p < 0.01), with even more significant results in trials with single-leg support in X average (p < 0.001), Y average (anterior-posterior coordinates) (p < 0.001) and Path length (p = 0.004). Higher scores in the timed up and go test were found in the study group (p = 0.013). The control group had higher scores in the remaining tests. The current findings show that mild COVID-19 may lead to balance impairments in young adults. Statistically significant differences in balance were found between the subjects in the study group and the healthy controls. Further studies in this area should take into account more age groups, and patients recovered from severe COVID-19, and should investigate long-term consequences of COVID-19 reflected by balance problems.

Body Composition and Physical Fitness: Does This Relationship Change in 4 Years in Young Adults?

(1) Background: There are few studies investigating the relationship between physical fitness and body composition in young adults and, to our knowledge, there are no such reports focusing specifically on physiotherapy students. This observational study aimed to assess the relationship between physical fitness and selected anthropometric measurements as well as body composition in Polish students in the first year and in the final year of a university course in physiotherapy. (2) Methods: A group of 100 randomly selected individuals were recruited among first- and fifth-year students of physiotherapy (50% women), who were assigned to two groups: A (aged 19 years) and B (aged 23 years). Body composition was assessed using a Tanita TBF-300 Analyzer, and physical fitness was measured using Zuchora's Physical Fitness Index. (3) Results: A higher level of general fitness was identified in students from Group B (p = 0.0261), and lower values of the fat mass index was found in Group A (p = 0.0441). Group A was found with correlations between general level of physical fitness and the following indexes: fat% (R = -0.4; p = 0.0018), FM (R = -0.3; p = 0.0310), FFM (R = 0.3; p = 0.0229) and TBW (R = 0.4; p = 0.0024), whereas Group B was found with correlations between general physical fitness and BMI (R = 0.3; p = 0.0308) as well as FM index (R = 0.3; p = 0.0431). (4) Conclusions: The findings show significant differences between the groups in physical fitness, body composition and selected anthropometric measurements. Older students presented higher level of general fitness, whereas younger students were found with a lower mean value of fat index.

[Overview of selected tests used to assess the functional status of elderly].

Physical activity is one of the most important element of a healthy lifestyle and determinant of the physical and mental health. According to the WHO, limited physical activity is the fourth most common premature deaths risk factor in the world. Regular sport and active recreation is very important for our health. Physical exercise is the most effective method used by physiotherapists to prevent and slow down the aging process of the body, and consequently, diseases of elderly, such as: osteoporosis, injuries caused by falls, diabetes or hypertension. Physical activity has a positive effect on the quality of life and cognitive functions of elderly. People over 65 years constitute about 40-50% of people who require specialist medical care in the world. Therefore, health and medical professionals dealing with preventive healthcare and treatment of elderly people should have basic knowledge in geriatric rehabilitation, as well as to be able to plan suitable physiotherapy program adequate to the needs of older people. To assess the functional status of the patient, as well as the effectiveness of the training, various types of functional tests are used, specially designed for the elderly. These tests are based on the Comprehensive Geriatric Assessment (COG) considering the state of health, physical and mental fitness as well as socio-environmental conditions. The physiotherapeutic program should be based on functional training involving the entire human body, i.e. nervous, muscular, skeletal, sensory and balance systems.

Postural disorders in the elderly in static assessment.

Physical activity is one of the most important element of a healthy lifestyle and determinant of the physical and mental health. According to the WHO, limited physical activity is the fourth most common premature death risk factor in the world. Regular sport and active recreation is very important for our health. Physical exercise is the most effective method used by physiotherapists to prevent and slow down the aging process of the body, and consequently, diseases of elderly (e.g. osteoporosis, diabetes, hypertension and injuries). Physical activity has a positive effect on the quality of life and cognitive functions of elderly. The physiotherapeutic program should be based on functional training involving the entire human body. To plan and monitor the effectiveness of the training, different types of tests are used to assess the functional status of elderly people. These tests are based on the Comprehensive Geriatric Assessment considering the state of health, physical and mental fitness as well as social and environmental determinants.