Coxarthrosis as a clinical and social problem. Analysis following hip arthroplasty.

OBJECTIVE: Aim: The aim of this study was to determine how hip arthroplasty contributed to improvements in the clinical condition and quality of life of patients after the procedure. PATIENTS AND METHODS: Materials and Methods: The study included 30 patients who underwent surgery due to hip osteoarthritis at the Department of Endoprostheses of the Healthcare Center Regional Hospital in Busko-Zdroj. The subjective and objective condition of the patients was assessed before and after their arthroplasty procedure. RESULTS: Results: Study patients reported the elimination of pain and showed an increased range of hip mobility. Their physical fitness was considerably improved. CONCLUSION: Conclusions: 1. Coxarthrosis is a difficult clinical problem. 2. Hip arthroplasty resulted in the elimination of pain or its radical reduction. 3. After the procedure, study patients showed a considerably better level of physical fitness as compared to baseline and were able to walk a longer distance without pain. 4. The patients are happy and satisfied with the effects of hip arthroplasty.

PHYSICAL THERAPY IN DISABILITY PREVENTION IN LONG-LIVED PERSONS.

OBJECTIVE: The aim: To evaluate physical therapy in the prevention of disability in long-lived persons. PATIENTS AND METHODS: Materials and methods: The study was conducted over a period of 4 months in a group of 27 patients treated at the Residential Care Facility in Szydlowiec. Most patients were over the age of 90 years (68%), with a mean age of 88 years. They underwent physical therapy cycles and their functional status was doc¬umented. Physical therapy included selected physiotherapy and kinesiotherapy methods adjusted to the physical fitness of each patient. Treatment efficacy was monitored using the standardised ADL and Barthel Index scales, which allowed for functional status assessments. RESULTS: Results: The study found that physical therapy improved physical fitness in study patients after 4 months. Appropriate physical therapy and rehabilitation conducted in this group of patients helped considerably improve their objective and subjective condition, including their functional status and degree of independence. CONCLUSION: Conclusions:1. Chronic musculoskeletal, cardiovascular, nervous system and other disorders are an important aspect of old age. 2. Appropriate physical therapy and rehabilitation in this group of patients helps considerably improve their objective and subjective condition, including their functional status. 3. Providing appropriate care for the elderly is a challenge for healthcare systems.

HIPPOTHERAPY IN CEREBRAL PALSY - SURVEY RESEARCH.

OBJECTIVE: The aim: To assess the effects of a one-year hippotherapy programme on the physical and mental functioning of children with cerebral palsy. PATIENTS AND METHODS: Materials and methods: The study included 15 children with cerebral palsy whose mean age was 9 years. The children participated in hippotherapy ses¬sions at the Rehabilitation Centre in Rusinowice (one-year observation). The clinical presentation was dominated by manifestations of motor and postural abnormalities caused by central nervous system damage. A survey questionnaire was used in the study to collect information about problems associated with everyday life and functioning. RESULTS: Results: The results obtained in this study showed that spastic CP was the most common form of the disorder, affecting 8 out of 15 children (53%). It was followed by mixed CP (40%, 6 children). Among the respondents, 67% (10 people) were already familiar with hippotherapy whereas 33% did not know this method. CONCLUSION: Conclusions: There was a strong correlation between being familiar with effects of hippotherapy and the level of education of the parent/guardian. This result had a moderate influence on the frequency of hippotherapy sessions. Systematic hippotherapy sessions helped improve physical fitness and everyday functioning in children with cerebral palsy.

REHABILITATION IN PATIENTS AFTER MYOCARDIAL INFARCTION: CLINICAL AND SOCIAL ASPECTS.

OBJECTIVE: The aim: To assess the effects of cardiac rehabilitation on the health of myocardial infarction patients, the risk of a relapse and the possibility of restoring full physical fitness. PATIENTS AND METHODS: Materials and methods: The study was conducted in a group of 40 patients after myocardial infarction treated at the Cardiac Rehabilitation Department. The subjective and objective condition of the patients was assessed. Study patients underwent physical therapy and rehabilitation over a period of 3 weeks. RESULTS: Results: The physical therapy and rehabilitation programme conducted in study patients resulted in an improved physical function and a weight reduction. The cholesterol and blood pressure levels were both decreased. Study patients expressed a very favourable opinion about the effects of physical therapy and rehabilitation. CONCLUSION: Conclusions: 1. Myocardial infarction is a clinical and social problem. 2.Physical therapy after myocardial infarction is one of the main elements of treatment of this disorder. 3. Physical therapy should be used more widely in coronary heart disease prevention.

SELECTED PROBLEMS IN THE REHABILITATION OF PATIENTS IN A NURSING AND CARE INSTITUTION.

OBJECTIVE: The aim of the study was to assess selected problems in the rehabilitation of patients staying at a nursing and care institution. PATIENTS AND METHODS: Materials and methods: The study included 33 patients aged 55 to 96 years who were staying at the nursing and care institution in Lipsko. Study patients were examined over a period of 3 months using the standardised Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (I-ADL) scores, the Abbreviated Mental Test Score (AMTS) and the Timed Up and Go Test (TUG). RESULTS: Results: Standardised ADL testing showed that a considerable proportion of study patients (60%) aged 66-75 years had moderate disability. Standardised Lawton scale testing showed that the most difficult complex activities were home maintenance (96.97%), shopping (90.91%), cooking (87.88%), cleaning (87.88%) and doing laundry (78.79%). The standardised Timed Up and Go Test showed that a large proportion of study patients (71.43%) aged 66-75 years had considerable functional mobility limitations. The AMTS, which assessed the cognitive function, revealed normal results in 36.36% of study patients. CONCLUSION: Conclusions: 1. Study patients had significant functional disability. 2. The patients' sex did not influence the ability to perform complex activities of daily living. 3. Sociodemographic determinants did not influence cognitive functioning. 4. Physical therapy and rehabilitation in the elderly should be performed on a regular basis and in the entire society.

QUALITY OF LIFE IN WOMEN AFTER MASTECTOMY. CLINICAL AND SOCIAL STUDY.

OBJECTIVE: The aim: To assess the quality of life in women after mastectomy. PATIENTS AND METHODS: Materials and methods: The study included 25 women after mastectomy. The patients were aged 31 to over 50 years and were members of a breast cancer support group at the Holy Cross Cancer Centre in Kielce. During group meetings, the patients underwent rehabilitation and worked with psychologists and social workers. RESULTS: Results: Most women after mastectomy who underwent breast reconstruction or wore breast prostheses reported a better quality of life. Mastectomy affects ipsilateral upper limb function and causes difficulty with activities of daily living, such as cleaning, cooking, brushing hair, bathing, and dressing. CONCLUSION: Conclusions: 1. All women who rated their health as poor experienced such negative emotions as sadness, low mood, dejection. 2. Mastectomy affects ipsilateral upper limb function. 3. Breast reconstruction after mastectomy improves patient-rated quality of life. 4. Pain in the ipsilateral upper limb is considerably more common in women with a limited range of motion. 5. All women who participated in breast cancer support group meetings found support there and the time they spent together resulted in an improved quality of life.

PHYSICAL PROCEDURES IN POST-STROKE PATIENTS. CLINICAL AND SOCIAL PROBLEMS.

OBJECTIVE: The aim: To assess the effects of physical therapy on the general condition of stroke patients and their level of independence with respect to functioning after stroke. PATIENTS AND METHODS: Materials and methods: The study was conducted in patients receiving care and rehabilitation at the "Teczowe Zacisze" centre in Wola Kopcowa. The study group included both residents and out-patients undergoing rehabilitation at the centre. The study assessed a total of 25 patients (14 women and 11 men) aged 50 years and older and analysed the quality of life with respect to activities of daily living and mobility as well as the effects of physical therapy on functioning in stroke patients. RESULTS: Results: The use of comprehensive rehabilitation in study patients improved their mobility with respect to using the stairs and walking on a flat surface, improved their ability to perform self-care activities when using the toilet, and helped them eat meals, get dressed, and bathe unassisted. CONCLUSION: Conclusions: 1. Post-stroke rehabilitation should be comprehensive, complex, and adjusted to the current physical and motor abilities of the patient. 2. The number of patients undergoing early and comprehensive rehabilitation remains too low. It is important to inform the public at large about the possibility of receiving physical therapy after stroke.

EFFECTS OF SENSORY INTEGRATION THERAPY ON SELECTED FITNESS SKILLS IN AUTISTIC CHILDREN.

OBJECTIVE: Introduction: Autism is a pervasive developmental disorder characterised by abnormal development in the first two years of life and impairment with respect to the following three areas: social interactions, communication, and behaviour. The disorder is more common in males than females. The aim: The study was conducted to assess the effects of sensory integration therapy on selected fitness skills in autistic children. PATIENTS AND METHODS: Material and methods: The study assessed a group of 20 children (15 boys and 5 girls) aged 3 to 10 years. All children were diagnosed with autism and underwent 2-year therapy. The children showed impaired sensory modulation with abnormal stimulus reception and processing in the tactile, auditory, vestibular (balance), olfactory, and gustatory sensory systems. The study assessed fitness skills and their correlations with sensory integration therapy used in the children. The assessment used the Sensorimotor Development Questionnaire developed by Zbigniew Przyrowski and selected tests from "Obserwacja Kliniczna" as well as history-taking conducted with the parents. The following aspects were analysed: muscle tone, static balance, dynamic balance, jumping on two legs, jumping on one leg, catching and throwing a ball, and self-care activities, such as putting on shoes. RESULTS: Results: Sensory integration therapy contributed to an improvement in motor, sensory, cognitive, emotional, communication, and social development in the study patients. CONCLUSION: Conclusion: The use of sensory integration effectively supports sensory processes in autistic children.

Cerebral palsy: clinical and social problems.

OBJECTIVE: Introduction: Cerebral palsy / MPD/is a motor and postural disorder caused by permanent brain damage that occurred at an early stage of development. Cerebral palsy is the most common cause of disability in children. The aim: To present cerebral palsy as a clinical problem and to outline the importance of physiotherapy in the treatment of cerebral palsy patients. PATIENTS AND METHODS: Materials and methods: The study included 67 children with cerebral palsy (mean age was 9 years) treated and followed up for 6 months at the "Górka" Orthopaedic and Rehabilitation Hospital in Busko Zdrój. The clinical presentation was dominated by manifestations of motor and postural abnormalities resulting from upper motor neuron and corticospinal tract damage. A diagnostic survey was used as the research method. The physiotherapy and rehabilitation used in the patients consisted of kinesiotherapy (usually Bobath/NDT) and physical therapy procedures (magnetic stimulation, laser therapy, LED light therapy). The study used a survey questionnaire that collected information about problems with everyday life and functioning of cerebral palsy patients and opinions about their rehabilitation programme. RESULTS: Results: Follow-up data were analysed in patient groups, which were created based on the method of ambulation in children with cerebral palsy. The results emphasise the role of physiotherapy in the rehabilitation of cerebral palsy patients. Systematic motor rehabilitation contributed to an improved physical fitness and better everyday functioning. Parents of children walking with aids reported having problems with access to specialist healthcare, which resulted from the fact that they did not live close enough to an appropriate centre. Parents of non-ambulatory patients reported that they lacked financial means and parents of children who were able to walk unassisted complained of long waiting times for rehabilitation. CONCLUSION: Conclusions: 1. MPD is a difficult clinical and social problem. 2. Physical improvement procedures is an essential element in the treatment of this group of patients.

Long-term follow-up of a Schwartz-Jampel syndrome case.

Schwartz-Jampel syndrome (SJS) is a rare genetic disorder characterised by myotonia and bone dysplasia. It is inherited as an autosomal recessive trait and caused by mutations in the perlecan-encoding gene HSPG2. Its symptoms include muscular stiffness and hypertrophy. The aim of the study was to analyse the clinical presentation as well as the physical therapy and rehabilitation in a patient with SJS. A 20-year-old male patient with SJS was followed up by the authors for the past 3 years. The paper assesses the physical therapy and rehabilitation conducted at home and presents the possibilities of an extended programme that can be implemented at the multi-field Division of Physical Medicine. Patients with SJS represent an extremely difficult clinical and therapeutic problem.

Evaluation of the effects of physical therapy on everyday functioning in stroke patients.

OBJECTIVE: Introduction: Stroke is one of the most important health problems of our time. The aim: The aim of the study was to assess the functional status of stroke patients and the effects of physical therapy on patient functioning. PATIENTS AND METHODS: Material and methods: The study included 28 patients (10 women, 18 men) after ischaemic stroke. The patients underwent kinesitherapy , verticalisation, gait training, and physical therapy. RESULTS: Results: 1. After treatment, patients showed functional improvements in all the activities of daily living assessed in the study. 2. The improvement depended on the time from stroke, with the most dynamic changes occurring in the first 3 months after stroke. CONCLUSION: Conclusions: 1. Appropriate patient-specific physical therapy plays an extremely important role in rehabilitation. It may prevent a number of complications and reduce disability. 2. Physical therapy and rehabilitation constitute the basis for stroke patient treatment.

Clinical image of anterior longitudinal ligament syndrome - an interdisciplinary problem.

INTRODUCTION: Approximately 1.5-2.5% of all patients treated due to discopathy have anterior longitudinal ligament lesions. An intervertebral disc moving under the anterior longitudinal ligament causes ligament displacement and irritation of the autonomic nervous system structures, resulting in a disturbed function of the organs controlled by this system. Clinical image: Increased sympathetic system activity in the thoracic section may cause symptoms that mimic coronary heart disease while irritation of the autonomic structures in the lumbosacral section of the spine results in a clinical presentation similar to that of gastrointestinal or gynecological disorders. The clinical image of the most common disorders is presented. The diagnosis may be formulated with the use of magnetic resonance imaging. TREATMENT: pharmacotherapy is ineffective. Physiotherapy and rehabilitation constitute a method of choice in the treatment of this syndrome.