Return to Work after Primary Total Knee Arthroplasty: The First Polish Pilot Retrospective Study.

(1) Background: Total knee arthroplasty (TKA) performed on working-age patients significantly affects the participation of such patients in social life. A retrospective study was conducted to determine the return to work (RTW) rate after TKA. The goal of this study was to provide reference data for the Polish population and identify the factors impacting patients' decisions to return to or resign from work, relative to their functional performance. (2) Methods: This retrospective study involved 48 patients. An interview related to RTW was carried out to identify the factors impacting a patient's decision to return to or resign from work. Functional performance was assessed using the Knee Outcome Survey-Activities of Daily Living (KOS-ADL) scale. (3) Results: Before TKA, 15 individuals (31.25%) qualified for the study did not work and were receiving welfare benefits. After the surgery, 23 individuals (47.9% of those working prior to TKA) did not return to work. The number of those who did not work after TKA increased to 38 (79.17%), which was a significant change. The mean level of functional performance after TKA assessed using KOS-ADL was 75.89. (4) Conclusions: The findings show that the rate of RTW after TKA in Poland is significantly lower than that in other countries. The reasons for this situation, as shown in the study, may be related to the lack of an occupational rehabilitation system, resulting in a paucity of information about the possibility to return to work and about opportunities for retraining.

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.

Evaluation of Reliability of the Luna EMG Rehabilitation Robot to Assess Proprioception in the Upper Limbs in 102 Healthy Young Adults.

BACKGROUND Proprioception, the body's ability to perceive its own position and movement, is fundamental for motor control and coordination. Reliable assessment tools are essential, particularly for conditions affecting proprioceptive function. This study aimed to evaluate the external and internal compliance of the Luna EMG -multifunction robotic device in assessing proprioception. MATERIAL AND METHODS The study involved 102 healthy students (31 men and 71 women; mean age 22.2±1.46 years), assessing proprioception using the Luna EMG for the upper limbs. Two investigators conducted measurements, which were repeated after 2 weeks under identical conditions. RESULTS Based on the identified values of the interclass correlation coefficient (ICC) (ICC=0.969-0.997), which is a key measure of agreement between 2 assessments, the study shows a high agreement of measurements both between investigators (for right hand: P=0.3484 [Exam 1]; P=1.0000 [Exam 2]; for left hand: P=0.1092 [Exam 1]; P=0.7706 [Exam 2]) and between the examinations (for right hand: 0.1127 [Investigator 1]; 0.2113 [Investigator 2]; for left hand: P=0.0087 [Investigator 1]; P=0.1466 [Investigator 2]). The Bland-Altman analysis showed very small inter-rater deviations, approximately 0.05° in the first examination for the left side and 0.04° for the right side. The highest deviation between the examinations, amounting to 0.08°, was identified for the left side. CONCLUSIONS The study shows that the Luna EMG multifunction robotic device enables a reliable evaluation of upper limb proprioception. Measurements performed using this device show high internal and external consistency in the assessment of the proprioceptive senses of the upper limb in 102 healthy young adults.

Objective assessment of dysarthric disorders in patients with multiple sclerosis depending on sex, age, and type of text read.

Purpose: To assess dysarthric disorders in multiple sclerosis (MS) patients in comparison with healthy individuals and MS patients without dysarthria depending on the patient's sex, age, and the type of text read using an objective tool. Methods: The study was carried out in a group of 72 persons, including 24 with MS presenting dysarthria (study group) and 24 healthy individuals (healthy control group), and 24 with MS without dysarthria (MS control group). Performance (reading) time was evaluated by means of an objective tool created for the purpose of the analysis. Results: The study showed significant statistical differences in the analyzed performance time of: poetry reading, prose reading, and completing a diction exercise, among persons with MS from the study group presenting dysarthria and both control groups (p < 0.05). It took more time to read the poem, and prose and to perform a diction exercise in the study group with dysarthria than in both control groups (with no significant differences between the two) Similarly, the comparison between the groups in terms of sex and age showed disturbances in the above-mentioned parameter in the study group. What was not demonstrated were significant differences in the evaluated speech parameters depending on both sex and age separately in the group of MS patients with dysarthria, and both control groups (p < 0.05). Conclusion: The objective tool created for the purpose of speech analysis is useful in detecting discrepancies in performance (reading) time among MS patients with dysarthria, and healthy individuals, as well as patients with MS without dysarthria and can be used in clinical practice for diagnostic purposes, however, further research is essential to complete its validation.

Impact of the COVID-19 Pandemic on the Level of Anxiety and Depression in Caregivers of Children Benefiting from Neurorehabilitation Services.

INTRODUCTION: At the turn of March and April 2020, due to the occurrence of COVID-19 in Poland, the first restrictions on the provision of rehabilitation services were introduced. Nevertheless, caregivers strived to ensure that their children could benefit from rehabilitation services. AIM OF THE STUDY: To determine which of the selected data presented in the media reflecting the intensity of the COVID-19 epidemic in Poland differentiated the level of anxiety and depression in caregivers of children benefiting from neurorehabilitation services. MATERIAL AND METHODS: The study group consisted of caregivers of children (n = 454) receiving various neurorehabilitation services in the inpatient ward of Neurological Rehabilitation of Children and Adolescents (n = 200, 44%), in the Neurorehabilitation Day Ward (n = 168, 37%), and in the Outpatient Clinic (n = 86, 19%) of the Clinical Regional Rehabilitation and Education Center in Rzeszow. The average age of the respondents was 37.23 ± 7.14 years. The Hospital Anxiety and Depression Scale (HADS) was used to measure the severity of anxiety and depression in caregivers of children. The questionnaires were distributed from June 2020 to April 2021. As a measure of the severity of the COVID-19 epidemic in Poland, the figures presented in the media were adopted. In addition, data on the COVID-19 pandemic presented in the media (Wikipedia, TVP Info, Polsat Nes, Radio Zet) on the day preceding the completion of the survey were analyzed based on statistical analysis methods. RESULTS: 73 of the surveyed caregivers (16.08%) suffered from severe anxiety disorders, and 21 (4.63%) from severe depressive disorders. The average severity of anxiety (HADS) in the subjects was 6.37 points, and the average severity of depression was 4.09 points. There was no statistically significant relationship between the data presented in the media-such as daily number of infections, total number of infections, daily number of deaths, total number of deaths, total number of recoveries, number of hospitalizations, and people under quarantine-and the level of anxiety and depression of the studied caregivers (p > 0.05). CONCLUSIONS: It was not found that the selected data presented in the media, showing the intensity of the COVID-19 epidemic in Poland, significantly differentiated the level of anxiety and depression among caregivers of children using neurorehabilitation services. Their motivation to continue the treatment, caused by concern for their children's health, resulted in less severe symptoms of anxiety and depression during the peak period of the COVID-19 pandemic.

Inter- and intra-rater reliability of new application software for computerised paediatric version of Wisconsin Gait Scale.

The paediatric version of Wisconsin Gait Scale (WGS) is a reliable tool for gait assessment in children with spastic hemiplegic cerebral palsy (CP). We decided to develop a solution which will make it possible to objectify the descriptive paediatric version of the WGS, and which, consequently, will allow researchers/clinicians to more easily perform accurate assessment of gait patterns in patients. The aim of the study was to assess inter- and intra-rater reliability of new application software for computerised paediatric version of the WGS in children with hemiplegic CP. The study involved 31 children with hemiplegic CP. The app was designed using a model based on thematic categories of the paediatric WGS, and utilising auxiliary lines between specific points on the patient's body, and taking into account angular values, duration and length of the specific gait phases, in order to enable acquisition of quantitative data corresponding to the components of the WGS. The gait of the study participants was recorded, in series of videos. These provided material for three independent raters who reviewed the recordings twice and assessed the participants' gait using the app. After the evaluation was completed, the data were retrieved from the software. The new application software for the computerised paediatric WGS presents very good inter- and intra-rater reliability. Intra-class correlation coefficient (ICC) was very high in measurement 1 (ICC > 0.9) and 2 (ICC > 0.8), which reflects a very high degree of agreement between the three examiners; there was also high agreement for the specific examiners, between the two measurements (ICC > 0.9). The observational gait scale, objectified through the new software, and enabling computer-aided use of the paediatric WGS, presents practical advantages for examiners since it facilitates decisions taken in the process of WGS-based assessment in children with spastic hemiplegic CP.

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.

Perceptions of Polish and German physiotherapists about their professional education and development: a cross-sectional nonrandomized questionnaire cohort study.

BACKGROUND: The approach to the education and professional advancement of physiotherapists is particularly relevant today. To date, no studies have compared the perceptions of physiotherapists regarding professional issues in geographically close European countries such as Poland and Germany. Therefore, this study's purpose was to compare Polish and German physiotherapists' perceptions related to their profession, entry-level education, and career opportunities. METHODS: We recruited 565 physiotherapists from Poland and 560 physiotherapists from Germany. An opinion polling method based on a questionnaire was applied in the study. The survey was conducted in 48 facilities located throughout the territories of the two countries. The assessment focused on the following three issues: 1) professional education (form and content of educational programs, organizational aspects, and effects of education); 2) professional development and career opportunities; and 3) the relationship between years of service and perceptions of professional education, career satisfaction and advancement opportunities. RESULTS: German respondents rated specific aspects of their education, development opportunities and professional careers more highly than their Polish counterparts (p = 0.001). A highly significant negative correlation was identified in both groups between all the assessed aspects of professional education and years of service (0.9 ≤ |R| < 1, p = 0.001). CONCLUSIONS: Opinions on their professions expressed by physiotherapists from closely neighboring countries, namely, Poland and Germany, were surprisingly disparate. Compared to their Polish colleagues, German physiotherapists viewed their experiences more favorably vis-a-vis entry-level education, career opportunities, and professional status. Further study is needed to establish whether these findings reflect actual differences, sampling bias, or other factors.

Assessment of Functional Performance in Children with Cerebral Palsy Receiving Treatment in a Day Care Facility: An Observational Study.

BACKGROUND The study assessed changes in functional performance of children with cerebral palsy (CP), immediately following treatment and 2 months later, in addition to investigating the relationship between therapy effect and sex, age, or comorbidities. MATERIAL AND METHODS Functional performance of 32 children with spastic diplegia CP, aged 9-16 years, was assessed for: 1) manual function (Box and Block test), motor capacities (Gross Motor Function Measure), sensory capacities (Finger Identification [FI] and Localisation of Tactile Stimuli test [LTC]), and 2) activity and participation, ie, independence in essential and more complex daily activities (Barthel Index; Paediatric Evaluation of Disability Inventory). Measurements were conducted before the start (Month 0), immediately after 6-month rehabilitation program (Month 6), and following a 2-month period with no therapy, ie, 8 months after baseline measurement (Month 8). RESULTS Comparison of Month 0 and Month 6 scores showed significant differences (P<0.001) in all measures. However, Month 8 scores were significantly worse in all the measures, except for sensory capacities assessed using FI and LTC (P<0.001). CONCLUSIONS Functional performance of children with CP was positively affected by 6-month therapy, but 2 months later these effects significantly deteriorated, except for the sensory capacities. This suggests that therapy focusing on functional performance should be included as a permanent component of rehabilitation programs. These findings may be important for clinical practice as they show that therapy of children with CP should be continuous and systematic, and this should be taken into account by those designing therapeutic programs.

Impact of a Rehabilitation Program on the Change in Components of Body Mass of the Upper and Lower Limbs in People After Ischemic Stroke.

BACKGROUND The aim of this study was to evaluate the effects of rehabilitation in terms of changes in the body mass composition in the upper and lower limbs depending on the length of time after stroke and the age of the patient. MATERIAL AND METHODS Eighty-two patients after ischemic stroke were tested 3 times: on admission, after 5 weeks, and 3 months after leaving the hospital (follow-up). During each examination, a segmental analysis of the components of the body mass of the upper limbs and lower limbs was performed, depending on the side of paresis. RESULTS Patients between 7 and 12 months after stroke with right-sided paresis had a reduction of fat (P=0.027) and an increase in muscle tissue in the lower (P=0.030) and upper limbs with paresis (P=0.037), as well as in the healthy upper limb (P=0.034) after rehabilitation. Only in the youngest age group (25-44 years) and in patients with left-sided paresis was there a decrease of adipose tissue in the healthy upper (P=0.012) and paresis limbs (P=0.032) and an increase in the muscle tissue mass in the right upper limb (P=0.010) after rehabilitation. CONCLUSIONS The rehabilitation program had a significant impact on the change in the composition of body mass in upper and lower limbs in people with right-sided paresis, particularly 7 to 12 months after stroke and in the youngest age group (25-44 years). These results may be useful in planning a rehabilitation program for stroke patients to consider the patient's dominant hand and neglect.

Somatic Development Disorders in Children and Adolescents Affected by Syndromes and Diseases Associated with Neurodysfunction and Hydrocephalus Treated/Untreated Surgically.

Background: This study was conducted to evaluate the co-occurrence of hydrocephalus treated/untreated surgically and congenital nervous system disorders or neurological syndromes with symptoms visible since childhood, and with somatic development disorders, based on significant data obtained during admission to a neurological rehabilitation unit for children and adolescents. Methods: The study applied a retrospective analysis of data collected during hospitalization of 327 children and adolescents, aged 4−18 years, all presenting congenital disorders of the nervous system and/or neurological syndromes associated with at least one neurodysfunction that existed from early childhood. To allow the identification of individuals with somatic development disorders in the group of children and adolescents with hydrocephalus treated/untreated surgically, the adopted criteria considered the z-score values for body height, body weight, head circumference, body mass index, and head circumference index. Results: Treated/untreated hydrocephalus was observed in the study group at the rates of 8% and 0.9%, respectively. Among 239 patients with cerebral palsy, 9 (3.8%) had surgically treated hydrocephalus, 17 (70.8%) of 24 patients with neural tube defects also had hydrocephalus treated with surgery, and 3 (12.5%) of 24 patients with neural tube defects had untreated hydrocephalus. This medical condition was a more frequent comorbidity in subjects with neural tube defects compared with those with cerebral palsy (p < 0.001). Subjects with untreated hydrocephalus most frequently presented macrocephaly (p < 0.001), including absolute macrocephaly (p = 0.001), and with tall stature (p = 0.007). Excessive body mass co-occurred more frequently with surgically untreated hydrocephalus, but the relationship was not statistically significant (p = 0.098). Conclusions: Surgically treated hydrocephalus occurred in patients with cerebral palsy and neural tube defects, and untreated hydrocephalus was present only in patients with neural tube defects. Untreated hydrocephalus negatively changed the course of individual development in the studied group of children, in contrast to surgically treated hydrocephalus.

Selected Correlates of Attitudes towards Rape Victims among Polish Medical Students.

Sexual violence against women, including rape, is a serious public health issue in many countries. Rape victims often meet health professionals in medical institutions for a range of health problems. The aim of this research was investigation of attitudes towards rape victims among medical students. METHODS: The study sample consisted of 1183 university students who represented various medical disciplines. The average age of the respondents was 23.3 years. The Attitudes toward Rape Victims Scale (ARVS) was used in this study. RESULTS: Higher scores in men indicate that they held less sympathetic attitudes towards rape victims than women (61.6 vs. 52.6, p = 0.0000). Given the univariate interaction, social environment, and religious commitment did not significantly differentiate the respondents in this respect. Students of the medical faculty obtained the lowest results (medicine 49.7 vs. midwifery and nursing: 54.1, other fields: 54.4, p = 0.0008), showing much understanding and empathy for rape victims. CONCLUSIONS: The surveyed medical students presented moderately positive attitudes towards rape victims, among them men somewhat negative than women who made more pro-victim judgments. Among all medical field of study, medicine was distinguished by higher empathy. Religion and social environment independently do not differentiate respondents in this respect.

Assessment of Agreement Between a New Application to Compute the Wisconsin Gait Score and 3-Dimensional Gait Analysis, and Reliability of the Application in Stroke Patients.

Currently, there are no computerized tools enabling objective interpretation of observational gait assessment based on Wisconsin Gait Scale (WGS), which is a reliable and well-tested tool. The solution envisaged by us may provide a practical tool for assessing gait deviations in patients with hemiparesis after stroke. The present study assessed agreement between a new application software for computerized WGS and 3-dimensional gait analysis (3DGA), and reliability of the application. The study involved 33 individuals with hemiparesis after stroke. The software was developed based on a model designed taking into account components of the WGS and incorporating auxiliary lines passing through the relevant anthropometric points on the patient's body, as well as measurements of angular values, distances and duration of the specific gait phases, which make it possible to substantiate assessment based on this scale. Series of videos were made to record gait of the qualified patients. After the gait evaluation was carried out using the app, the data were retrieved from the software. The gait assessment was performed separately by three independent examiners who reviewed the video recording using the new app twice (two weeks apart). Additionally, 3DGA was carried out for all the subjects, and the results of the app-aided assessment were compared to those acquired using 3DGA. The findings show statistically significant correlations (p < 0.05) between majority of the WGS items measured using the new app, and the relevant spatiotemporal and kinematic parameters identified by 3DGA. Agreement between the scores reported by the three examiners was high in both measurements, as reflected by Cronbach's alpha exceeding 0.8. The findings reflect very good intra-observer reliability (as reflected by kappa coefficients from 0.847 to 1) and inter-observer reliability (as reflected by kappa coefficients from 0.634 to 1) of the new application software for computerized WGS. The opportunities offered by the observational gait scale objectified through our new software for computerized WGS result from the fact that the tool provides a useful low-cost and time-effective feedback to monitor ongoing treatments or formulate hypotheses.

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.

Validity of the Gait Deviation Index in children and adolescents with juvenile idiopathic arthritis.

PURPOSE: Effectiveness of the Gait Deviation Index (GDI) in patients with juvenile idiopathic arthritis (JIA) is unknown. The aim of this study was to investigate the validity of the GDI as an outcome measure of gait disturbance children with JIA. METHODS: Fifty children and adolescents with JIA were included into the study. The control group included 50 healthy children without gait disorders, matched for age and gender. The kinematic gait parameters were measured using a 3D movement analysis system. Walking speed, walking distance, cadence, step length and single support time were also evaluated. RESULTS: The findings show a statistically significant difference between the values of GDI for the right leg in the study group and the controls ( p = 0.036). The individuals included in the study group achieved significantly lower values in this parameter (mean 94.92 ± 8.38 vs. mean 100.00 ± 10.00). The GDI value for right and left leg and the mean GDI value showed low (0.3 ≤ |R| <0.5, p <0.005) to moderate (0.5 ≤ |R| <0.7, p<0.001) correlations with the other gait parameters and measures. CONCLUSIONS: The GDI scores were lower in individuals with JIA compared to controls. This difference in the GDI values was only significant for the right leg. The GDI values showed low to moderate correlations with other gait parameters.

Establishing the Minimal Clinically Important Differences for Sagittal Hip Range of Motion in Chronic Stroke Patients.

Many researchers have pointed out that decreased sagittal range of motion (ROM) in the affected hip joint is a common consequence of stroke, and it adversely affects walking performance and walking speed. Nevertheless, the minimal clinically important differences (MCID) in hip-related kinematic gait parameters post-stroke have not yet been determined. The present study aimed to define MCID values for hip ROM in the sagittal plane i.e., flexion-extension (FE), for the affected and unaffected sides at a chronic stage post-stroke. Fifty participants with hemiparesis due to stroke were enrolled for the study. Four statistical methods were used to calculate MCID. According to the anchor-based approach, the mean change in hip FE ROM achieved by the MCID group on the affected/unaffected side amounted to 5.81°/2.86° (the first MCID estimate). The distribution-based analyses established that the standard error of measurement in the no-change group amounted to 1.56°/1.04° (the second MCID estimate). Measurements based on the third method established that a change of 4.09°/0.61° in the hip ROM corresponded to a 1.85-point change in the Barthel Index. The optimum cutoff value, based on ROC curve analysis, corresponded to 2.9/2.6° of change in the hip sagittal ROM for the affected/unaffected side (the fourth MCID estimate). To our knowledge, this is the first study to use a comprehensive set of statistical methods to determine the MCID for hip sagittal ROM for the affected and unaffected sides at a chronic stage post-stroke. According to our findings, the MCID of the hip FE ROM for the affected side amounts to 5.81° and for the unaffected side to 2.86°, in patients with chronic stroke. This indicator is extremely important because it allows clinical practitioners to assess the effects of interventions administered to patients, and to interpret the significance of improvements in sagittal kinematic parameters of the hip; ultimately, it may facilitate the process of designing effective gait reeducation programs.

Determinants of health-related quality of life in patients with fracture of the axis vertebrae.

The study is designed to evaluate quality of life and functional performance in patients with type II and III odontoid fracture treated with anterior odontoid screw fixation. We investigated the relationship between quality of life and: (1) the range of axial rotation of the cervical spine, (2) neck pain intensity, and (3) level of disability in these patients. The study involved 60 patients operated on for type II and III fractures with the use of direct osteosynthesis of the dens. Quality of life and functional performance were assessed using SF-36 Questionnaire and Neck Disability Index (NDI). The range of axial rotation was examined with the use of the Zebris ultrasound system while the intensity of pain with the use of the VAS Visual Analog Pain Scale. The subjects' quality of life was poorer with respect to the mental dimension (32.3%) compared to the physical dimension (22.7%). Based on the NDI survey, the rate representing the patients' functioning in daily life amounted to 13.7% which reflects mild limitations in functional abilities. It was shown that the range of axial rotation (both to the right and the left) was not related to the degree of disability of patients as measured by the NDI questionnaire. The model of regression was statistically significant for overall quality of life (F = 48.24 p < 0.001), as well as physical dimension (F = 45.1 p < 0.001). Quality of life indicators in SF-36 are decreased in patients operated for type II and III odontoid fracture and the mental dimension of the quality of life is significantly poorer than the physical one. More than half of the patients operated for type II and III odontoid fracture regained normal functioning, as assessed with the NDI questionnaire.

Nutritional Disorders in a Group of Children and Adolescents with Syndromes or Diseases Involving Neurodysfunction.

A study of the literature shows the lack of data on a comprehensive analysis of eating disorders in children with neurodysfunction, which constitute a clinical subgroup with an increased risk of abnormalities in this area. Therefore, the aim of this study was to determine the relationship between the coexistence of nutritional disorders and diseases or syndromes associated with neurodysfunction based on data collected during hospitalization at a rehabilitation center for children and adolescents. A retrospective analysis was carried out in a group of 327 children and adolescents aged 4-18 years. The study group covered various types of diseases or syndromes involving damage to the central nervous system. A retrospective analysis of baseline data (age, sex, main and additional diagnosis and Body Mass Index-BMI) was performed. Two assessment criteria of nutritional status were taken into account (z-score BMI and other previously published normative values). In the study group, malnutrition was found more frequently (18.0% of the respondents) than obesity (11.3% of the subjects). Hypothyroidism coexisting with malnutrition was identified in the study group (N% = 43.8%, p = 0.011) and malnutrition with tetraplegia in the subgroup of spastic cerebral palsy (N% = 34.2 %, p = 0.029).

Microsomic and macrosomic body structure in children and adolescents affected by syndromes or diseases associated with neurodysfunction.

In Poland the issue of microsomic body structure (micro-SBS) and macrosomic body structure (macro-SBS) has so far been overlooked. Up until now only a small amount of data have been published, most often as an overview of the problem. The current study was designed to investigate the co-occurrence of microsomic/macrosomic body structure (micro/macro-SBS) and congenital nervous system disorders or neurological syndromes with symptoms visible from infancy, based on essential data acquired during admission procedures at a neurological rehabilitation ward for children and adolescents. The study applied a retrospective analysis of data collected during hospitalization of 327 children and adolescents, aged 4-18 years who had been affected since infancy by congenital disorders of the nervous system and/or neurological syndromes associated with a minimum of one neurodysfunction. To identify subjects with microsomic or macrosomic body structure in the group of children and adolescents, the adopted criteria took into account z-score values for body height (z-score Ht), body weight (z-score Wt), head circumference (z-score HC), BMI (z-score BMI) and head circumference index (z-score HCI). The rates of micro/macro-SBS in the study group amounted to 7.3% and 0.6%, respectively. The findings show a more frequent co-occurrence of, as well as statistically significant correlations between, micro/macro-SBS and type of spasticity (cerebral palsy) (p = 0.024) as well as hydrocephalus not treated surgically (p < 0.001). Macro-SBS was found to more frequently co-occur with hemiplegia and hydrocephalus not treated surgically.

Abnormal cranium development in children and adolescents affected by syndromes or diseases associated with neurodysfunction.

Microcephaly and macrocephaly can be considered both cranial growth defects and clinical symptoms. There are two assessment criteria: one applied in dysmorphology and another conventionally used in clinical practice. The determination of which definition or under which paradigm the terminology should be applied can vary on a daily basis and from case to case as necessity dictates, as can defining the relationship between microcephaly or macrocephaly and syndromes or diseases associated with neurodysfunction. Thus, there is a need for standardization of the definition of microcephaly and macrocephaly. This study was designed to investigate associations between abnormal cranial development (head size) and diseases or syndromes linked to neurodysfunction based on essential data collected upon admission of patients to the Neurological Rehabilitation Ward for Children and Adolescents in Poland. The retrospective analysis involved 327 children and adolescents with medical conditions associated with neurodysfunction. Two assessment criteria were applied to identify subgroups of patients with microcephaly, normal head size, and macrocephaly: one system commonly used in clinical practice and another applied in dysmorphology. Based on the results, children and adolescents with syndromes or diseases associated with neurodysfunction present abnormal cranial development (head size), and microcephaly rarely co-occurs with neuromuscular disease. Macrocephaly frequently co-occurs with neural tube defects or neuromuscular diseases and rarely with cerebral palsy (p < 0.05); microcephaly frequently co-occurs with epilepsy and hypothyroidism (p < 0.001). Traditional classification facilitates the identification of a greater number of relationships and is therefore recommended for use in daily practice. There is a need to standardize the definition of microcephaly and macrocephaly and to include them in 'Human Phenotype Ontology' terms.