Inpatient post-COVID-19 rehabilitation program featuring virtual reality-Preliminary results of randomized controlled trial.

Background: Numerous recommendations from pulmonary scientific societies indicate the need to implement rehabilitation programs for patients after COVID-19. The aim of this study was to propose an innovative comprehensive intervention based on a hospital-based pulmonary rehabilitation program for individuals with post-acute sequelae of COVID-19. Methods: It was decided to evaluate two forms of hospital rehabilitation: traditional and one provided through virtual reality. Preliminary results are based on a group of 32 patients (20 female and 12 male), of average age 57.8 (4.92) years in the period of 3-6 months after the initial infection. Primary outcomes included analysis of lung function, exercise performance and stress level. A 3-week, high-intensity, five-times per week pulmonary rehabilitation program was designed to compare the effectiveness of a traditional form with a VR-led, novel form of therapy. Results: The analysis of the results showed a statistically significant improvement in both groups with regard to exercise performance expressed as 6MWT distance. Moreover, a statistically significant decrease in dyspnoea levels following the 6MWT was also noted in intergroup comparison, but the between-group comparison revealed non-statistically significant changes with low effect size. Regarding lung function, the analysis showed essentially normal lung function at baseline and a non-statistically significant improvement after the completion of the rehabilitation program. The analysis of the stress level showed a statistically significant improvement in both groups within the inter-group comparison, yet the between-group comparison of deltas values showed a non-significant difference with low effect size. Conclusion: A 3-weeks inpatients pulmonary rehabilitation program led to improvement of the exercise performance of people with post-acute sequelae of COVID-19, but not lung function. Furthermore, the program was shown to reduce patients' stress levels. A comparison of the traditional form of rehabilitation to the novel form using VR, shows similar effectiveness in terms of exercise performance and stress levels.

Excessive Facial Wrinkling Is Associated with COPD Occurrence-Does COPD Damage Skin Beauty and Quality?

The aim of this study was to investigate facial wrinkling in COPD patients, its relationship with lung function parameters, and the differences in wrinkling between COPD patients and smokers without COPD. The study included 56 patients with COPD with smoking history and 84 controls. Wrinkle intensity was measured and classified using Daniell's grading system, and the total length of wrinkles was also estimated. The predominant grades of Daniell's scale were IV-V for COPD patients (89.3% of current and 75.0% of former smokers), III-V for controls who currently smoke (89.2%), and II-III for former (92.9%) and never smokers (100%) controls. These distributions were statistically significantly different, but current and former smokers with COPD and COPD former smokers and control current smokers did not differ. In terms of the total length of wrinkles, the COPD patients possessed significantly longer wrinkles than the control subgroups (all p-values were <0.004). Negative correlations between wrinkle length and lung parameters were found. This phenomenon seems to be independent of smoking, but the length of wrinkles is related to lung function parameters. It seems that not only smoking but also COPD damages skin beauty and quality.

Effectiveness of an Inpatient Virtual Reality-Based Pulmonary Rehabilitation Program among COVID-19 Patients on Symptoms of Anxiety, Depression and Quality of Life: Preliminary Results from a Randomized Controlled Trial.

Forms of rehabilitation for patients after COVID-19 are gaining interest. The purpose of this study was to investigate and compare an innovative in-hospital pulmonary rehabilitation programs augmented with training elements performed in virtual reality. This randomized controlled study included 32 patients enrolled in post-COVID-19 rehabilitation at a Public Hospital in Poland. The rehabilitation models included exercise capacity training on a cycle ergometer, breathing and general fitness workout, resistance training, and relaxation. The forms of training and relaxation differed between the groups: the experimental group employed virtual reality, and the control group used a traditional form of therapy. Exercise tolerance was assessed using a 6 min walk test (6 MWT), while psychological parameters were evaluated using the Hospital Anxiety and Depression Scale (HADS) and the brief World Health Organization Quality of Life Scale (WHOQOL-BRIEF). The analysis of the post-rehabilitation results showed a statistically significant improvement in both groups regarding depression (VR: 6.9 (3.9) vs. 4.7 (3.5), p = 0.008; CG: 7.64 (4.5) vs. 6.6 (4.8), p = 0.017) and anxiety (VR: 8.6 (4.6) vs. 5.6 (3.3), p < 0.001; CG: 9.57 (6.0) vs. 8 (4.8), p = 0.003). No statistically significant improvements in quality of life were noted in both groups. Moreover, the analysis showed a statistically significant improvement in the exercise capacity in both groups after completion of the rehabilitation program, expressed as a distance in the 6 MWT, as well as a statistically significant improvement in dyspnea in the VR group. To conclude, the analysis of the preliminary data revealed that a 3-week hospital-based pulmonary rehabilitation program for COVID-19 patients led to an improvement in exercise tolerance as well as a reduction in the symptoms of anxiety and depression. The virtual reality-based form of training delivery, despite its attractiveness, did not significantly affect patients' performance.

Proprietary Model of Qualification for In-Hospital Rehabilitation after COVID-19.

BACKGROUND: Since the beginning of the SARS-CoV-2 epidemic in Poland, 6,128,006 people have been diagnosed, of which 116,798 died. Patients who recovered from COVID-19 and require rehabilitation due to varied impairments should be provided an opportunity to participate in an individualized, complex rehabilitation program starting from acute care and being continued in the post-acute and long-term rehabilitation phase. It is recommended to offer out-patient and in-hospital rehabilitation procedures depending on the type and persistence of symptoms and dysfunctions. The aim of this paper is to present the qualification process of post-COVID19 patients for an in-hospital complex rehabilitation program developed on the basis of pulmonary physical therapy. METHODS: The presented qualification program was developed on the basis of clinical experience of over 2000 patients participating in the pilot program of in-hospital rehabilitation launched in September 2020 and based on the Regulation of the Polish Minister of Health of 13 July 2020. RESULTS: The proposed model of patients' qualification rests on well-known and validated tools for functional assessment: exercise tolerance assessment, dyspnea intensity assessment, functional fitness assessment, assessment of arterial blood saturation, lung ventilation function assessment, assessment of long-lasting COVID-19 symptoms, and patient's basic mental health condition. CONCLUSIONS: The proposed qualification model for the post-COVID rehabilitation program allows us to introduce adequate qualifications followed by much needed assessment of the health effects.

Post-COVID-19 rehabilitation - a Polish pilot program.

The current spread of SARS-CoV-2 indicates a long-term fight against the widespread and exponential increase in morbidity and mortality across the globe. A variety of non-pharmacological strategies to mitigate and suppress virus transmission have been investigated and introduced. Currently, emerging studies focus mostly on the management of hospital-treated patients in the acute phase of the disease, including the legitimacy of using physiotherapeutic procedures. However, current literature lacks guidelines for rehabilitation related to maintaining continuity and universality of the therapy after the end of the acute phase of the disease and discharge from hospital. The authors suggest implementing an immediate rehabilitation program in post-infection patients as data from previous epidemics of respiratory-related viral diseases shows that COVID-19 survivors should be expected to have impaired lung ventilation function, and reduced exercise tolerance and muscular weakness, and prolonged return to work and participation. It should be assumed that only the introduction of immediate recommendations for the implementation of rehabilitation procedures based on simple and well-known tests, as well as their obligatory regime, can contribute to the reduction of respiratory disability leading, in a short time, to infections recurrence and, in the long run, to a lower quality of life and socioeconomic burden on the population. This article presents a respiratory rehabilitation program for COVID-19 survivors, recommended by the Polish Society of Physiotherapy. This program was approved by the Polish Minister of Health and implemented as a pilot program at the Hospital of the Ministry of the Interior and Administration in Glucholazy, Poland. Med Pr. 2021;72(5):611-6.

The possibility of the use of Kinesio Taping in internal, oncologic, and neurologic diseases: A systematic review and meta-analysis.

OBJECTIVES: This systematic review aimed to present the current body of knowledge on Kinesio Taping (KT) as a treatment method for patients with internal, oncologic, and neurologic diseases. DATA SOURCES: PubMed, MEDLINE, CENTRAL (Cochrane Library), EMBASE Excerpta Medica, and Google Scholar. STUDY SELECTION: The papers were identified through term searches in digital research databases. Based on the review of the available 152 research articles, 12 papers on internal, oncologic, and neurologic diseases were selected. Two of this review's authors, working independently, selected the papers to be included in the analyzed sample, performed a bias risk assessment and assessed the quality of the evidence for the main effects using the Internal Validity Score (IVS) (PEDro) approach. A simplified version of the Oxford Centre for Evidence-Based Medicine (OCEBM) system was used to evaluate the evidence. DATA EXTRACTION: The full text of each relevant study was read by two independent reviewers to extract data. The collected database was subjected to matrix processing. Variable vectors for individually analyzed categories were designated and used in the meta-analysis. DATA SYNTHESIS: There are few prospective, randomized controlled trials on KT that include a sufficiently large cohort. Only few of the reviewed papers which discuss the principles of KT met the criteria of scientifically rigorous research. CONCLUSIONS: We found some evidence to support the use of KT in clinical practice in patients with neurologic, oncologic, and internal diseases. However, there is a need for further clinical trials on the effectiveness of the use of the KT method.

Assessment of the effects of dysphagia therapy in patients in the early post-stroke period: a randomised controlled trial.

AIM: This study aimed to evaluate the effects of dysphagia therapy in patients in the early post-stroke period. CLINICAL RATIONALE: Dysphagia can be one of the consequences of stroke. This problem often leads to complications in the early stages of stroke, including aspiration pneumonia. Although individual reports on dysphagia exist in the literature, no comprehensive guidelines for dysphagia therapy are available. MATERIAL AND METHODS: This randomised controlled trial included 60 patients with swallowing difficulties after ischaemic stroke (30 each in the study and control groups; age range: 55-65 years) who were admitted to a hospital stroke subunit. Patient rehabilitation period covered 15 days (seven days a week), with therapy for the first 10 days provided during patient hospitalisation and then outpatient physiotherapy during the subsequent five days. The procedure, including providing education about safe food and liquid consumption to patients and their caregivers, was performed in both patient groups. An original dysphagia treatment method was employed in the study group. Statistical average, standard deviation, and statistical error before and after therapy were determined in the study and control groups. The significance of differences in results between the study and control groups was assessed using the Mann-Whitney U test. RESULTS: The applied therapy for dysphagia improved the swallowing function and selected motor functions of patients after stroke. In the study group, ineffective (delayed) and absent swallowing reflex was observed in 13 patients (44%) before therapy and in one patient (3%) after therapy. The rate of effective swallowing reflex increased from 57% to 97%. Statistically significant differences in swallowing reflex were observed between the study and control groups after therapy (p = 0.00001). CONCLUSIONS: A comprehensive therapy for dysphagia is effective and can reduce serious complications of swallowing disorders in clinical practice. CLINICAL IMPLICATIONS: The results of this study could improve the clinical treatment of dysphagia.

Evaluation of Drug Susceptibility of Microorganisms in Odontogenic Inflammations and Dental Surgery Procedures Performed on an Outpatient Basis.

Bacterial infections are the most common cause of purulent soft tissue inflammations in the head and neck area. These bacteria are also responsible for the majority of inflammatory complications after third molar removal. The key to success of antibacterial treatment in both cases is the use of an appropriate antibacterial agent. The aim of the study was to evaluate the susceptibility profile of bacteria isolated from material collected from patients with intraoral odontogenic abscesses. The test material consisted of swabs taken from the odontogenic abscesses, after their incision and drainage. Another swab was collected from the lesion area, 10 days after the initial visit. Results were compared with an identical study conducted on a control group of healthy patients, who had undergone third molar removal. Bacteria identified in this study consisted of aerobic and anaerobic strains, both Gram-positive and Gram-negative. According to the EUCAST guidelines, none of the tested antibiotics was recommended for all identified bacteria. The percentage of bacterial strains sensitive to amoxicillin and clavulanic acid was 78.13% and 81.48% in the study and control groups, respectively, whereas, the percentage of those sensitive to clindamycin was 96.43% and 80.00%, respectively. For Gram-negative aerobic bacteria, gentamicin and ciprofloxacin were among medications affecting all cultured species. 100.00% of strains were found to be susceptible to these antibiotics. Statistically significant relationship between the presence of Gram-negative aerobic strains and the occurrence of complications was found. In the case of the most frequently occurring bacteria in the study, amoxicillin with clavulanic acid and clindamycin were shown to be very effective. In cases of severe purulent odontogenic inflammations, it is recommended to use a combination of antibiotics. Amoxicillin with ciprofloxacin and clindamycin with cefuroxime seem to be the proper choices based on the results of this study.

The role of MMP-12 gene polymorphism - 82 A-to-G (rs2276109) in immunopathology of COPD in polish patients: a case control study.

BACKGROUND: Major symptoms of chronic obstructive pulmonary disease (COPD) are chronic bronchitis and emphysema leading from lung tissue destruction, that is an effect of an imbalance between metalloproteinases (MMPs) and their tissue inhibitors activity. As potential factor involved in this COPD pathogenesis, MMP-12 is considered. We investigated the role of genetic polymorphism and protein level of MMP-12 in the COPD development among Poles. METHODS: We analyzed - 82 A > G SNP in the promoter region of MMP-12 gene (rs2276109) among 335 smoked COPD patients and 309 healthy individuals, including 110 smokers. Additionally, 60 COPD patients and 61 controls (23 smokers) were tested for serum levels of MMP-12 using ELISA. All subjects were analyzed for lung function using spirometry (FEV1% and FEV1/FVC parameters). RESULTS: We observed that -82G allele and -82GG homozygous genotype frequencies of the SNP rs2276109 were significantly lower in COPD patients than in controls (12.5% vs 16.9%, respectively; χ2 = 4.742, p = 0.02 for allele and 0.5% vs 3.9%, respectively; χ2 = 9.0331, p = 0.01 for genotype). Moreover, -82G allele was more frequent in controls smokers than in non-smokers (22.3% vs 14.1%, χ2 = 6.7588, p = 0.01). Serum level of MMP-12 was significantly higher in COPD patients than in controls groups (6.8 ng/ml vs 3.3 ng/ml, respectively; F = 7.433, p < 0.0001), although independently of analyzed gene polymorphisms. Additionally, no correlation between parameters of lung function (FEV1% and FEV1/FVC) and protein level was found. CONCLUSIONS: We found that -82G allele of SNP rs2276109 was associated with reduced risk of COPD, and COPD patients released more MMP-12 than healthy individuals, but independently on this SNP.

Evaluation of applying Kinesio taping in children with urinary incontinence.

INTRODUCTION: Physiotherapeutic methods, used in patients with urinary incontinence, are recommended and acknowledged treatment methods. They include pelvic floor muscle exercises, electrical stimulation, magnetic field, acupuncture, and biofeedback. However, the influence of Kinesio taping (KT) applications is not known. The aim of this work was to assess the influence of the KT method on the number of incontinence incidents in children. Additionally, children included in the research were given a depression level test to assess their mental state and how it is influenced by incontinence. MATERIAL AND METHODS: The study included 62 children (37 boys and 25 girls), aged 7-14 years, diagnosed as having night urinary incontinence and frequent daytime incontinence (daytime wetting). Study participants were randomly allocated to the research group, in which KT was applied, or the control group in which a placebo was used. The main outcome measure was the number of incontinence incidents. RESULT: The analysis of study results indicated that there was a statistically significant decrease (p < 0.001) in the number of incontinence incidents after KT was applied among children in the research group compared with those in the control group. After 4 days of KT application the number decreased by half within 24 h (Figure). DISCUSSION: As can be seen from the analysis of the literature on urinary incontinence therapy, several physiotherapeutic methods are described. They are not merely based on a single strategy but include combinations of methods. To our knowledge, the method described in our work is a pioneer method, previously not applied on its own. It is, however, limited by a relatively small number of research participants, although it took 29 months to gather the group for the research. Additionally, the research based on the principle that children with up to threw incontinence episodes per day were given KT applications every 3 days (72 h per session), whereas children with more frequent incontinence episodes were given KT applications every day (24 h per session). It seems that the principle should be that all children are given KT applications with the same frequency. Perhaps it could be interesting to compare the effects between groups with different frequency. Nevertheless, we believe that the results obtained in this research are of interest in the context of possibility to use KT for urinary incontinence in children. CONCLUSION: The KT method may serve as an effective complementary form of physiotherapy for children with urinary incontinence.

The Impact of the Use of Kinesio Taping Method on the Reduction of Swelling in Patients After Orthognathic Surgery: A Pilot Study.

BACKGROUND Orthognathic surgery (OGS) is associated with extensive surgical intervention within the soft and hard tissues of the facial region of the skull leading to inflammatory reactions. The presence of postoperative swelling indicates the accumulation of exudate or transudate; both these fluids occur in surgery. Massive swelling is a significant problem, because the tension of tissues intensifies pain sensations. The aim of the study was to evaluate the effectiveness of the kinesio taping method (KT) in patients after orthognathic surgery in the area of the facial skull in terms of eliminating postoperative swelling. MATERIAL AND METHODS The study of the impact of kinesiology tape applied after orthognathic surgery to the craniofacial area on the elimination of swelling was performed in sixteen patients who suffered from this complication after bilateral sagittal split osteotomy. RESULTS The swelling was shown to be reduced after KT; within the same study the differences were statistically significant between the left and right sides and for the same side (p<0.05). The application of the lymphatic kinesio taping method led to the reduction of tension in the affected area and restoration of proper lymphatic circulation in the region covered by swelling. This allows for the improvement of the blood and lymph microcirculation and activation of self-healing processes. CONCLUSIONS The analysis of the impact of the practical use of the lymphatic KT on complications after orthognathic surgery revealed that it had a beneficial effect on the reduction of swelling. The use of the KT method seems promising because it is simple to carry out, not traumatic, economical and rarely causes undesirable allergies.

A study on nonlinear estimation of submaximal effort tolerance based on the generalized MET concept and the 6MWT in pulmonary rehabilitation.

BACKGROUND: The six-minute walk test (6MWT) is considered to be a simple and inexpensive tool for the assessment of functional tolerance of submaximal effort. The aim of this work was 1) to background the nonlinear nature of the energy expenditure process due to physical activity, 2) to compare the results/scores of the submaximal treadmill exercise test and those of 6MWT in pulmonary patients and 3) to develop nonlinear mathematical models relating the two. METHODS: The study group included patients with the COPD. All patients were subjected to a submaximal exercise test and a 6MWT. To develop an optimal mathematical solution and compare the results of the exercise test and the 6MWT, the least squares and genetic algorithms were employed to estimate parameters of polynomial expansion and piecewise linear models. RESULTS: Mathematical analysis enabled to construct nonlinear models for estimating the MET result of submaximal exercise test based on average walk velocity (or distance) in the 6MWT. CONCLUSIONS: Submaximal effort tolerance in COPD patients can be effectively estimated from new, rehabilitation-oriented, nonlinear models based on the generalized MET concept and the 6MWT.

Impact of Matrix Metalloproteinase 9 on COPD Development in Polish Patients: Genetic Polymorphism, Protein Level, and Their Relationship with Lung Function.

Chronic obstructive pulmonary disease (COPD) is characterized by a decline of lung function and symptoms such as chronic bronchitis and emphysema leading from lung tissue destruction. Increased activity of matrix metalloproteinases (MMPs) and an imbalance between MMPs and their tissue inhibitors (TIMPs) are considered as factors influencing the pathogenesis of COPD. We investigated the role of genetic polymorphism and expression level of MMP-9 and concentration of its complexes with TIMPs in the development of COPD among Polish patients. We analyzed SNP in the promoter region of MMP-9 gene (rs3918242) using PCR-RFLP method among 335 COPD patients and 309 healthy individuals. Additionally, 60 COPD patients and 61 controls were tested for copy number variants (CNV) of MMP-9 (by quantitative real-time PCR) and serum levels of MMP-9 and its complexes with TIMP1 and TIMP2 (using ELISA). All subjects were analyzed for lung function using spirometry (FEV1% and FEV1/FVC parameters). We observed that allele and genotype frequencies of the SNP rs3918242, as well as the number of gene copies, were similar in COPD patient and controls groups. Serum levels of MMP-9 and MMP-9/TIMP1 complex were significantly higher in COPD patients in comparison to controls groups, although independently of analyzed gene polymorphisms. Additionally, the significant inverse relationships between parameters of lung function (FEV1% and FEV1/FVC) and proteins level were found in ridge regression models, especially we found that FEV1% decreased when MMP-9 level increased in controls and patients with COPD group. In conclusion, we found that COPD patients were predisposed to produce more MMP-9 and MMP-9/TIMP1 complex than healthy individuals. This phenomenon is probably associated with the disease-related lung environment but not with genetic features of the MMP-9.

The influence of Kinesio Taping on the effects of physiotherapy in patients after laparoscopic cholecystectomy.

Physiotherapy in patients after laparoscopic cholecystectomy (CHL) is impeded by postoperative pain which causes a decline in patients' activity, reduces respiratory muscles' function, and affects patients' ability to look after themselves. The objective of this work was to assess the influence of Kinesio Taping (KT) on pain level and the increase in effort tolerance in patients after CHL. The research included 63 patients after CHL. Test group and control group included randomly selected volunteers. Control group consisted of 32 patients (26 females, 6 males), test group consisted of 31 patients (22 females, 9 males). Both groups were subjected to complex physiotherapy, and control group had additional KT applications. Before surgery, during and after physiotherapy, patients were given the following tests: 100-meter walk tests, subjective pain perception assessment, and pain relief medicines intake level assessment. The level of statistical significance for all tests was established at P < 0.05. Statistical analysis showed a significant decrease in the time required to cover a 100-meter distance and a decrease in pain perception presented by significantly lower painkillers' intake in the test group in comparison with the control group. The improvement in clinical condition observed in the research indicates the efficiency of KT as a method complementing physiotherapy in patients after laparoscopic cholecystectomy.

The use of kinesiology taping method in patients with rheumatoid hand--pilot study.

BACKGROUND: Rheumatoid arthritis (RA) most frequently affects smaller joints in the hands and feet. Among the most common deformations resulting from the progression of the disease are ulnar deviation, Boutonniere deformity, swan neck deformity, contractures and limited range of movement in the hand and wrist joints, muscular atrophy of long and short muscles. The topic of this article is the influence of using Kinesiology Taping method on the functioning of the hand of the patient suffering from rheumatoid arthritis. MATERIAL AND METHODS: The research involved 20 patients suffering from rheumatoid arthritis (16 women, 4 men), treated in the Hospital in Kup. Average age of patients was 62.2. Research subjects, apart from pharmacological treatment in the hospital ward, received standard physiotherapy. In case of 10 patients additional K-Active Tape applications were used to correct ulnar positioning of the hand and improve hand functioning. Prior to physiotherapy, all patients were given a hand functioning test and a dynamometer measurement was made. The tests were repeated after the 2-week rehabilitation process has been completed. The results were subjected to statistical analysis with the use of the Wilcoxon test and the U Mann-Whitney test. The assessment of the correlation between analysed parameters was made with the use of linear correlation test. RESULT: In the group where Kinesiology Tape applications were used, hand muscle strength increased significantly (p<0.05) in comparison with the group treated with standard physiotherapy. Hand muscle strength increase correlated with the tempo of carrying out the hand functioning test (r>0.8). CONCLUSION: Results suggest Kinesiology Taping method useful for physiotherapy of rheumatoid hand.

[The influence of physiotherapy on the concentration of interleukin-8 in patients suffering from chronic obstructive pulmonary disease]. / Wplyw fizjoterapii na stezenie interleukiny-8 u chorych na przewlekla obturacyjna chorobe pluc.

BACKGROUND: Interleukin-8 (IL-8, CXCL8), chemokine produced by macrophages and epithelium cells, plays a major role in activating neutrophils and eosinophils in the airways of patients with COPD and might act as a stimulator of inflammatory process. The aim of the research was to assess whether pulmonary physiotherapy influences the concentration of IL-8 in the induced sputum of patients with COPD. MATERIAL AND METHODS: The study included 44 patients (21 males, 23 females, average age 56.47 ± 9.52) with COPD treated in Physiotherapy Department of MSWiA Hospital in Glucholazy, with unchanged pharmacological treatment for the duration of the therapy. Before treatment, efficiency treadmill test by Bruce modified protocol and dyspnea assessment with the modified 20-point Borg scale was given to qualify each patient for physiotherapy. All patients participated in a 3-week multi-treatment pulmonary physiotherapy programme based on efficiency training on a cycloergometer. The physical workload was determined individually for each patient based on the assessment of individual exercise tolerance. Standard physiotherapy programme also included respiratory muscles' training with particular emphasis on training of abdominal muscles and diaphragm, inhalations with isotonic saline, drainage, chest clapping, relaxations and walking. IL-8 concentration in each patient's induced sputum was collected prior to complex physiotherapy, and after it has been completed. IL-8 concentration was determined with the use of the ELISA test. RESULTS: It was found that the concentration of IL-8 was significantly lower in patients with COPD after a 3-week physiotherapy programme. It fell from 18.91 ± 25.2 to 9.69 ± 14.06 ng/ml (p = 0.0215). The most significant IL-8 concentration decrease was observed in patients with the highest initial level of IL-8. CONCLUSIONS: The study shows that multi-treatment pulmonary physiotherapy causes decrease of IL-8 level in the induced sputum in patients with COPD, what can suggest decrease activity of neutrophils, which may be one of the factors leading to the improvement in patients' clinical condition.