Characteristics of Factors Influencing the Occurrence of Cleft Lip and/or Palate: A Case Analysis and Literature Review.

INTRODUCTION: Cleft lip with or without cleft palate (CL/P) stands as the most common congenital facial anomaly, stemming from multifactorial causes. OBJECTIVE: Our study aimed to ascertain the prevalence and characteristics of cleft palates, identify associated risk factors to inform prevention and prenatal detection for early intervention, and assess postoperative rehabilitation protocols for cleft palates. DESIGN: This study employs a retrospective descriptive and clinical approach. PATIENTS: The study includes 103 children with cleft palates treated at the Department of Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury. METHODS: We conducted a thorough evaluation of records, considering variables such as sex, cleft type, maternal occupation, parental education, and family history of clefts. Data analysis was carried out using R software version GPL-3 and ordinal logistic regression analyses. RESULTS: Notably, children born to mothers who experienced significant stress during pregnancy exhibited a 9.4-fold increase in the odds of having bilateral cleft palates. Conversely, no substantial evidence was found to support the influence of the child's sex, birth order, body mass, maternal exposure to workplace toxins, infections, or drug toxicity on the dependent variable. CONCLUSIONS: Our findings suggest that children with parents who have a history of clefts and those with less educated mothers are more likely to develop bilateral cleft palates. Additionally, children born to mothers experiencing stress during pregnancy face an increased risk of bilateral cleft palates. It is important to note that there is a paucity of literature on rehabilitation following various cleft palate surgical techniques in children.

Effectiveness of Rehabilitation for Disk Displacement of the Temporomandibular Joint-A Cross-Sectional Study.

(1) Background: Dislocations of articular disk can occur as a result of parafunctions in the Temporo Mandibular Joint (TMJ), which limits the opening of the mandible and other movements. The aim of this study was to evaluate the effectiveness of rehabilitation in patients with disk displacement of the TMJ. A total of 327 subjects with Temporo Mandibular Disorders underwent stomathognatic physiotherapy. (2) Methods: Based on the results obtained by a manual functional analysis, 35 patients who were identified with articular disk locking (disk displacement without reduction) were included in the study. The study group (N = 35) was subjected to passive repositioning of the articular disk, reposition splints, and physiotherapy. The patient's TMJs were then examined before the therapy, immediately after the therapy, and during the follow-up visit 3-6 weeks after the therapy. The Diagnostic Criteria for the Most Common Intra-articular Temporomandibular Disorders was used to evaluate the effects of rehabilitation on the patients' range of motions and the Numeric Pain Rating Scale (NPRS). For the statistical analysis, Pearson's r correlation coefficient test and Wilcoxon signed-rank test were used. (3) Results: The results showed a significant improvement in the range of motion of the mandible movements. The level of improvement was dependent on the time from the incident until undergoing rehabilitation. (4) Conclusions: The stomatognathic physiotherapy applied increased the range of motion of the mandible and reduced pain levels to the expected range.

Life satisfaction, generalized sense of self-efficacy and acceptance of illness in rheumatoid arthritis patients depending on age and severity of the disease.

Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune condition characterized by periods of exacerbation (physical limitations, depressed mood, depressive states and decreased life satisfaction) and remission (hope of health improvement). Our objective was to present social functioning of RA patients taking into consideration their age and employing selected determinants: satisfaction with life, generalized sense of self-efficacy and acceptance of illness. Material and methods: Standardized tools were employed: the Satisfaction with Life Scale, Generalized Self Efficacy Scale and Acceptance of Illness Scale. The study group included 46 RA patients aged 18-45 years and 54 RA patients aged over 60 years. The control group consisted of 24 non-RA subjects in every group. Results: Rheumatoid arthritis patients in the period of disease exacerbation reported low and moderate levels of satisfaction with life, in the patients in remission period the score was moderate, while the control group subjects described their level of satisfaction with life as high and moderate. The level of acceptance of illness was described by the RA patients in the period of disease exacerbation as 20.4/40 points; the patients in remission defined their level of acceptance of illness as 29.38/40 points. The patients with RA exacerbation showed a low sense of self-efficacy, yet a large group of such patients also presented high self-efficacy levels and the majority of the RA subjects in remission reported a high sense of self-efficacy. Conclusions: In the RA patients, satisfaction with life, generalized sense of self-efficacy and acceptance of illness were closely related and affected their general psychosocial functioning.

Children with Rare Nager Syndrome-Literature Review, Clinical and Physiotherapeutic Management.

Nager syndrome is a rare human developmental disorder characterized by craniofacial defects including the downward slanting of the palpebral fissures, cleft palate, limb deformities, mandibular hypoplasia, hypoplasia or absence of thumbs, microretrognathia, and ankylosis of the temporomandibular joint. The prevalence is very rare and the literature describes only about a hundred cases of Nager syndrome. There is evidence of autosomal dominant and autosomal recessive inheritance for Nager syndrome, suggesting genetic heterogeneity. The majority of the described causes of Nager syndrome include pathogenic variants in the SF3B4 gene, which encodes a component of the spliceosome; therefore, the syndrome belongs to the spliceosomopathy group of diseases. The diagnosis is made on the basis of physical and radiological examination and detection of mutations in the SF3B4 gene. Due to the diversity of defects associated with Nager syndrome, patients require multidisciplinary, complex, and long-lasting treatment. Usually, it starts from birth until the age of twenty years. The surgical procedures vary over a patient's lifetime and are related to the needed function. First, breathing and feeding must be facilitated; then, oral and facial clefts should be addressed, followed by correcting eyelid deformities and cheekbone reconstruction. In later age, a surgery of the nose and external ear is performed. Speech and hearing disorders require specialized logopedic treatment. A defect of the thumb is treated by transplanting a tendon and muscle or transferring the position of the index finger. In addition to surgery, in order to maximize a patient's benefit and to reduce functional insufficiency, complementary treatments such as rehabilitation and physiotherapy are recommended. In our study, we describe eight patients of different ages with various cases of Nager syndrome. The aim of our work was to present the actual genetic knowledge on this disease and its treatment procedures.

sEMG and Vibration System Monitoring for Differential Diagnosis in Temporomandibular Joint Disorders.

The stomatognathic system represents an important element of human physiology, constituting a part of the digestive, respiratory, and sensory systems. One of the signs of temporomandibular joint disorders (TMD) can be the formation of vibroacoustic and electromyographic (sEMG) phenomena. The aim of the study was to evaluate the effectiveness of temporomandibular joint rehabilitation in patients suffering from locking of the temporomandibular joint (TMJ) articular disc by analysis of vibrations, sEMG registration of masseter muscles, and hypertension of masticatory muscles. In this paper, a new system for the diagnosis of TMD during rehabilitation is proposed, based on the use of vibration and sEMG signals. The operation of the system was illustrated in a case study, a 27-year-old woman with articular dysfunction of the TMJ. The first results of TMD diagnostics using the k-nearest neighbors method are also presented on a group of fifteen people (ten women and five men). Vibroacoustic registration of temporomandibular joints, sEMG registration of masseter muscles, and functional manual analysis of the TMJ were simultaneously assessed before employing splint therapy with stomatognathic physiotherapy. Analysis of vibrations with the monitoring of sEMG in dysfunctions of the TMJ can lead to improve differential diagnosis and can be an objective way of monitoring the rehabilitation process of TMD.

Different Changes in Adipokines, Lipid Profile, and TNF-Alpha Levels between 10 and 20 Whole Body Cryostimulation Sessions in Individuals with I and II Degrees of Obesity.

Obesity is associated with chronic inflammation. While cold therapy influences the pro/antioxidative status of an individual, by affecting adipokine levels and the lipid profile, the effect of body mass index (BMI) on the response to cold exposure is unclear. We analyzed the link between BMI and the differences in effects of whole-body stimulation, depending on the number of treatments, on specific physiological parameters in men. Twenty-seven non-active men were divided into three groups: N (n = 9, BMI < 24.9), IOb (n = 9, BMI 30.0-34.9), and IIOb (BMI ≥ 35.0). The subjects participated in 20 3-min cryochamber sessions (-120 °C), 1/day, 5 days/week. Body composition was analyzed before and after treatment. Blood adiponectin (ADP), leptin (LEP), and tumor necrosis factor alpha (TNF-alpha) levels, and the lipid profile were analyzed three times: at baseline and up to 2 h after 10 and 20 sessions. The 20 treatments caused significant changes in body composition. Between 10 and 20 whole-body cryostimulation (WBC) sessions, a significant decreased was observed in the LEP and TNF-alpha levels. No significant changes in the lipid profile were noted. However, a positive tendency to regain the metabolic balance in adipose tissue was apparent in the IOb group in the tested period (decreased TG levels, increased HDL levels or the HDL/LDL ratio, and significantly decreased visceral adiposity index levels). Collectively, for people with obesity increasing the number of treatments above the standard 10 should be recommended.

Protocol for Multi-Stage Treatment of Temporomandibular Joint Ankylosis in Children and Adolescents.

Treatment of temporomandibular ankylosis is challenging and frequently leads to re-ankylosis, relapse, dangerous complications and, in turn, the need for multiple operations. In this article, we present a protocol for the treatment of ankylosis of the temporomandibular joints that assumes earlier intervention with the assistance of 3D virtual surgical planning (3DVSP) and custom biomaterials for better and safer surgical outcomes. Thirty-three patients were treated due to either uni- or bilateral temporomandibular ankylosis. Twenty individuals received temporomandibular prosthesis, whereas seventeen required simultaneous 3D virtual surgical/planned orthognathic surgery as the final correction of the malocclusion. All patients exhibited statistically significant improvements in mouth opening (from 1.21 ± 0.74 cm to 3.77 ± 0.46 cm) and increased physiological functioning of the mandible. Gap arthroplasty and aggressive rehabilitation prior to temporomandibular prosthesis (TMJP) placement were preferred over costochondral autografts. The use of 3DVSP and custom biomaterials enables more precise, efficient and safe procedures to be performed in the paediatric and adolescent population requiring treatment for temporomandibular ankylosis.

Temporomandibular disorders and their impact on the development of the overloading changes within temporomandibular joints.

TMD is a disease within the masticatory system that increases its reach among the society every year in the third and fourth decade of life. The etiology of TMD is complex and it is often difficult to establish the cause in a specific case. The a i m of the study was to determine the impact of TMD on pathomorphological changes within the temporomandibular joints, evaluated in USG examinations and evaluation the assessment of differences in the number of pathological changes between various forms of TMD. MATERIAL AND METHODS: The study material included a group of 386 patients, both sexes, aged 20 to 46 years, who came for prosthetic treatment due to symptoms of TMD. Ultrasound examination of the temporomandibular joints supplemented the clinical diagnosis of TMD in all the subjects. Axis I of the DC/TMD were used. RESULTS: Group I included 116 women and 89 men, group II consisted of 102 women and 79 men. Pathological morphological changes in the temporomandibular joints were found in all the examined patients. The changes in soft tissue structures were significantly increased in group II, but numerous pathomorphological changes were also present in the group of patients with the muscle form of TMD. CONCLUSION: The results of the conducted studies with the use of USG temporomandibular joints revealed numerous pathomorphological changes within the temporomandibular joints. This indicates the usefulness of the USG examination in additional diagnostic tests in the group of patients with TMD.

The Emergencies in the Group of Patients with Temporomandibular Disorders.

Temporomandibular disorder is a musculoskeletal disease with complex, multifactorial etiology regarding improper functioning of the stomatognathic system (masticatory muscles, temporomandibular joints, and surrounding structures). This article presents medical emergencies occurring among patients treated for temporomandibular disorders, which tend to constitute a severe difficulty for practitioners during their clinical practice. Examples of the most common emergencies of this type are disc displacement without reduction and a sudden contraction of the inferior part of the lateral pterygoid muscle. The latter occurs in cases of uncontrolled and incorrect use of the anterior repositioning splints and the hypertrophy of the coronoid process of the mandible. The sudden attacks of pain of secondary trigeminal neuralgia are also discussed in this article, together with their specific nature, which is significantly different from the nature of the pain of primary trigeminal neuralgia, yet the two types of neuralgia can be easily confused when the primary one takes the painful form. Subsequent emergencies discussed are myofascial pain syndrome, traumatic and inflammatory states of the temporomandibular joints, subluxation, and the consequences of intense occlusive parafunctions. Finally, the recommended therapeutic methods, which are used as part of the treatment in the cases of aforementioned emergencies, are described in this mini-review article, emphasizing that the implementation of the incorrect treatment and rehabilitation for emergencies of temporomandibular disorders may lead to permanent damage to the soft tissue structures of the temporomandibular joints.

Efficacy of immediate physiotherapy after surgical release of zygomatico-coronoid ankylosis in a young child: A case report.

BACKGROUND: Temporomandibular joint ankylosis (TMJ ankylosis) manifests itself as a locked jaw and reduced mouth opening. We hypothesized that the efficacy of TMJ ankylosis surgery in a child may largely depend on physiotherapeutic management. CASE DESCRIPTION: In this case report, we present the treatment of a girl between 1 and 4 years of age, who was unable to open her jaws immediately after birth. Congenital ankylosis was diagnosed. INTERVENTION: Two models of therapeutic management were presented, with a surgical procedure to release bone fusion adopted as a starting point. In the first model, the rehabilitation procedure started 21 days after surgery. OUTCOMES: Despite rehabilitation, no clinical improvement was achieved (i.e. the child was still unable to open her jaws). In the second model, rehabilitation started from the day after surgery and management according to the second model allowed for obtaining therapeutic benefits. After therapy, the girl was able to abduct the mandible to a degree allowing for improved speech and the ability to crush food. CONCLUSIONS: This clinical case shows that the efficacy of surgical procedures may depend on the type of postoperative management. It was demonstrated that physiotherapy started immediately after the procedure to release the ankylosis improved the mandible mobility outcomes for this child.

The Effectiveness of Physical Therapy in Patients with Generalized Joint Hypermobility and Concurrent Temporomandibular Disorders-A Cross-Sectional Study.

Temporomandibular disorders (TMD) consist of a group of symptoms such as: pain of temporomandibular joints, masticatory muscles or surrounding tissues, dysfunctions of TMJs' mobility, and crepitation. The Hypermobility Joint Syndrome (HJS) manifests in the flaccidity of joint structures, an increase in the range of joint motion, and occurs more often in the young and women. The aim of this study was to present the occurrence of HJS among patients with myogenic TMD and disc displacement with reduction. The secondary goal was to assess the effectiveness of physiotherapy directed to TMD with coexisting HJS. The study involved 322 patients with symptoms of TMD. HJS was diagnosed using the Beighton Scale, which confirmed its occurrence in 26 cases. 79 subjects (7 males and 72 females; mean age, 33.9 ± 10.4 years) were selected and divided into two groups: HJS + TMD (n = 26; 2 males and 24 females; mean age, 27.1 ± 9.4 years) and TMD (n = 53; 5 males and 48 females; mean age, 37.4 ± 9.2 years). These patients completed 3-week physiotherapy management. Before and after physiotherapy, the myofascial pain severity on Numeric Pain Rating Scale, linear measurement of maximum mouth opening, and opening pattern, were assessed. To demonstrate differences between the results, the level of significance for statistical analysis was set at α = 0.05. A statistically significant improvement was obtained in decreasing myofascial pain in both groups. Coordination of mandibular movements was achieved in both groups. Generalized joint hypermobility occurred among patients with TMD. Physiotherapy directed to TMD was effective in reducing myofascial pain and restoring TMJ's coordination also in patients with HJS.

[The Polish physiotherapists' state of knowledge about the act on the profession of physiotherapist]. / Wiedza polskiego srodowiska fizjoterapeutycznego dotyczaca regulacji prawnych w swietle ustawy o zawodzie fizjoterapeuty.

BACKGROUND: Work on the Act on the Profession of Physiotherapist had been conducted since the 1990s. However, it was not until October 2015 that the legal regulations were eventually introduced, following which physiotherapists gained professional independence and became a profession of public trust. The aim of the study was to assess the factors influencing the knowledge of these legal regulations among physiotherapists. MATERIAL AND METHODS: The study involved 399 physiotherapists and physiotherapy students (28.8±5.9 years old) who completed an anonymous questionnaire, in the form of a knowledge test, consisting of 24 questions on the general aspects of the reference Act. RESULTS: Overall, 30.3% of the respondents proved to have a significant knowledge about the rights and obligations resulting from the Act. The physiotherapists who were entered into the National Register of Physiotherapists (2.6 times) and residents of large cities (1.8 times) had a greater knowledge of the Act. There was a correlation between seniority and gender, and the knowledge of legal regulations. CONCLUSIONS: The main factors influencing the state of knowledge about the Act are the entry to the National Register of Physiotherapists, the place of residence and seniority. This proves better access to up-to-date information in cities and a greater interest in the Act among those people who have obtained the right to practice their profession. Med Pr. 2021;72(4):407-14.

Physical therapy of temporomandibular disorder in a child with arthrogryposis multiplex congenita: A case report and literature review.

Background: Arthrogryposis multiplex congenita (AMC) is a rare congenital disorder characterized by the occurrence of polyarticular contractures. Temporomandibular disorders (TMD) affect 25% of patients with arthrogryposis.Clinical Presentation: In this case report, the authors describe rehabilitation of a child between 8 and 24 months of age with AMC accompanied by Pierre-Robin Sequence. Physiotherapy directed to the TMJ included manual therapy, food intake training, and sensory training.Conclusion: Increase in the mobility of the TMJ and improvement in food intake, swallowing, speech, and breathing were achieved. Further research is necessary for investigating the effects of the proposed protocol of physiotherapy on a larger number of children with AMC and co-occurrence of TMD.

Physiotherapy in hypomobility of temporomandibular joints.

INTRODUCTION: Temporomandibular disorders (TMD) are the second most common cause of chronic pain in the human musculoskeletal system. The triad of symptoms of TMD includes: pain within the temporomandibular joint (TMJ), limitation of its mobility and capitations. The aim of the study was to present the methods of physiotherapy and to assess its effectiveness in patients with hypomobility of temporomandibular joints. MATERIAL AND METHODS: 44 patients (40.2 ± 10.6 years) were examined for signs of TMD using the Manual Functional Analysis of masticatory system (MFA) questionnaire due to DC/TMD. In the above group, 20 patients showed hypomobility of TMJs and myofascial pain. They underwent a 3-week physiotherapy consisting of manual therapy and exercises. In the study group, linear measurements of TMJs mobility and palpation of selected masticatory muscles were performed. Pain was assessed before and after 3 weeks of therapy according to Numerical Rating Scale (NRS). Statistical processing of the data was done with STATISTICA 13 and was conducted considering significance at a p-value <0.05. RESULTS: Significant improvement in TMJ's mobility, which increased on average by 6.6 mm (p = 0.0005) and reducing of pain, a decrease of 3 points on average on the NRS Scale (p = 0.00002) were achieved. CONCLUSIONS: The applied physiotherapy algorithm, including manual therapy and exercises of masticatory muscles, is effective in the case of improvement TMJ's range of motion and reduction of pain in patients with hypomobility of TMJ's.

Disbalance and fatigue of the spinal extensors as one of the causes of the overload disease of the lumbar spine.

PURPOSE: The aim of the study was to find out whether among young active people - the future healthcare professionals - there is a risk of developing lumbar spine overload disease depending on the occurrence of the disbalance of paravertebral muscles and to assess the fatigue of the examined muscles depending on the body position during the work. METHODS: The study involved 50 randomly selected students of physiotherapy and emergency medical services of a mean age of 21 years. The surface electromyography (sEMG) was used to measure the activity level of spinal extensors of the cervical and lumbar spine. The statistical analysis of the results was made using the RStudio software. RESULTS: Study shows that the majority of the examined students had a slight asymmetry between the bioelectric activity of the right- and left-side dorsal extensor bands, both in the cervical and lumbar sections (right side 118.6 Hz / left side 115.7 Hz / extension and 98.6 Hz / 95.5 Hz /flexion). Depending on the position, significant fatigue in the examined muscles was found (p < 0.05). CONCLUSIONS: The experiment showed a slight disbalance in the average bioelectromyographic activity in the area of spinal extensors during their symmetrical work. This can be the basis for the development of the overload disease in the weaker muscle parts, which generate more fatigue during the activity. It is worth to carry out similar tests in a much greater group, taking the longer-lasting muscular effort into account.

[Contraction of the tensor fasciae latae muscle of the fascia of the broad thigh and flexion of the knee joint in the runners].

OBJECTIVE: Introduction: The illustration of the ranges of bending the limb during the outflow allowed to divide the study group into two parts. In the majority of respondents, the initial flexion prevailed over the final one. The researchers focused on finding the reasons for the advantage of the final bend over the initial one in 30% of the subjects. The aim: The analysis of the dynamic stride under the control of the MVN Biomech system in the bending of the knee joint of the lateral limb, comparing the preparation to the leg (initial bending) and its ending (final). PATIENTS AND METHODS: Materials and Methods: 18 right-handed 25 to 35 year old runners were selected after the following exclusion criteria were applied: polyarticular hypermobility, systemic diseases, Rheumatoid arthritis, osteoarthritis, post-traumatic instability. The MVN Biomech system assessed the three-dimensional movements of the joints of the free part of the lower limb and pelvis, and the flexibility of the muscles was subject to physiotherapeutic assessment. RESULTS: Results: In 55% of respondents dominated the pattern in which the initial flexion exceeded by min. 10° final bend in both limbs (decreasing type). The researchers focused on finding the reasons for the smaller difference or the advantage of the final bending on both sides in 30% of respondents (mixed type). The comparison of physiotherapeutic examination results and measurements of MVN Biomech showed functional contractures of the tensor fasciae latea muscles in 5 subjects with a mixed type (83% of subjects with a mixed type). CONCLUSION: Conclusions: Contraction of the tensor fasciae latae constrained the initial flexion of the knee joint of the lateral limb, and also increased bilateral visitation of the hip joints during the dynamic mixed-type twitch. The remaining muscles of the lower limbs show no statistically significant differences in elasticity compared to the type of the leg.

Lateral instability of the knee joint and disorder of the ankle joint extension disorder in men.

OBJECTIVE: Introducion: The flexion of the knee joints in the movement of the squat may be accompanied by physiological varus deformity that increases smoothly with the lowering of the center of gravity, followed by a return to the starting position. Observing the disturbances of the physiological movement of the knee joints in the frontal plane, the authors correlated them with the mobility of the ankles in the sagittal plane. The aim: To show the relationship of knee joint motion disorders in the frontal plane with the movement of the ankle joints in the sagittal plane in the movement of the squat. The authors asked themselves about the number of subjects with the physiological mobility of both joints in the given planes and in what part of the subjects there are disorders and whether they relate to the ipsi or the contralateral part of the body. There was also the question of whether and in which group there are deviations not meeting the above criteria. PATIENTS AND METHODS: Materials and methods: 20 healthy right-handed men aged 25-35 were examined with physiological mobility of lower limb joints, confirmed in a physiotherapeutic study. Exclusion criteria included: polyarticular laxity, systemic diseases, rheumatoid arthritis, osteoarthritis. The subjects performed a three-time squat after putting in the Biomech measuring system inertial sensors on the lower limbs and the pelvis. Assessment was related to the movement of the knee joint in the frontal plane with the movement of the ankle joint in the sagittal plane. RESULTS: Results: Alternating deformity with right knee valgus occurred in 16 people in the right knee joint (80% of subjects) and in 6 men in the left knee joint (30% of subjects). Three subjects (15%) had a degenerative disorder in both knee joints. The others presented physiological mobility or single (not correlating) disturbances in the mobility of selected joints. CONCLUSION: Conclusions: The tests confirmed that the ankle joint is functionally connected to the dysfunctional knee joint on the opposite side, despite various surfaces of mutual movement. Dysfunction of the knee joint is about 10 ° reduction of varus deformity during squat during maximum flexion of the knee joint and again varus deformation when lifting the center of gravity, which ends in distortion until the starting position. These deflections are accompanied by a decrease in the opposite ankle extension at the time of knee valgus deformity in the maximum flexion. The above dysfunctions occurred in 100% instability of the non-dominant knee joint, and on the dominant side in 63%.

Comparative studies of physical properties of kinesiotapes.

BACKGROUND: Nowadays we observe growing popularity of kinesiotaping as a supportive method in physiotherapy. In documents available on kinesiotaping we can find that mechanical properties of tapes are similar to the ones of a human skin, but usually there is hardly any numerical data characterizing these properties. OBJECTIVE: Therefore, testing and comparing physical properties of commercially available kinesiotapes seems to be important. METHODS: Physical properties of five commercially available kinesiotapes were examined. Strain vs. stress data was collected up to 15 N. Program Origin 9.0 was used for data analysis. RESULTS: The obtained results show that up to about 2 N the strain vs. stress characteristics of the tested tapes are similar while for greater stress they differ essentially. CONCLUSIONS: An alternative, to commonly used, way of defining relative strain is proposed. This definition could be more suitable in those cases when desired tape tensions are higher than 50% i.e. in ligament and tendon techniques.

Evaluation of stomatognathic problems in children with osteogenesis imperfecta (osteogenesis imperfecta - oi) - preliminary study.

According to epidemiological data, muscular dysfunctions of the masticatory system occur in 15-23% of the population. Preventive examinations of functional disorders of the stomatognathic system are, therefore, of particular importance. A distinct group of patients exposed to dysfunctions in the area of the masticatory organ locomotor apparatus comprises those with genetic diseases characterised by disorders in collagen formation. One of such diseases is osteogenesis imperfecta (OI) and dentinogenesis imperfecta that usually goes together with the former. AIM: The objective of this work was to evaluate the frequency with which particular disorders of the masticatory organ locomotor apparatus occur within the group of patients with osteogenesis imperfecta. MATERIAL AND METHODS: The study was performed on patients of the Orthopaedic Clinic of the Polish-American Paediatric Institute in Kraków. The mean age of the children was 7.9 years. In all the cases, a genetic diagnosis of OI has been confirmed. The research methods were based on an in-depth interview on family diseases, pregnancy, postnatal period, feeding, subjective assessment of dysfunctions in the stomatognathic system. An examination of the deformations in the stomatognathic system and the skeleton was conducted, as well as an examination of the trauma and tone of the jaw. The relationship between breastfeeding and swallowing and speech disorders was also evaluated. The impact of intubation on mandibular ranges was investigated. RESULTS: The results obtained were subjected to statistical analysis on the basis of which conclusions were drawn concerning disorders in the stomatognathic system which tend to occur in children with OI. The renunciation of breastfeeding significantly contributes to sucking and swallowing disorders, rumen disorders, as well as biomechanical disorders in the temporomandibular joint. A significant dependence between breastfeeding and swallowing problems was found, whereas there was no such dependence with respect to speech impediments. CONCLUSIONS: The results of the research conducted led to the following conclusions: 1. Among pediatric patients with OI there are disorders in the stomatognathic system. The most common dysfunctions are: abdominal, swallowing and sucking disorders, abnormal muscle structure of the rumen and biomechanical disorders in the temporomandibular joints. Breastfeeding significantly contributes to swallowing disorders. 2. The therapeutic process involving children with OI requires the cooperation of specialists in orthopedics, pediatrics, physiotherapy, orthodontics and neurologopedics to carry out comprehensive diagnostics and treatment tailored to the individual needs of the patient. 3. In order to draw final conclusions, there is a need for more research by means of objective tools, such as EMG and a condensate recorder.

Analysis of pain and painless symptoms in temporomandibular joints dysfunction in adult patients.

Recent years have shown an increase in the number of patients reporting for treatment of pain due to musculoskeletal joint, associated with temporomandibular joint dysfunction. Therefore, studies were undertaken, aimed at analyzing the symptoms of the dysfunction, because of which patients come to the prosthetic treatment. Aim of the thesis: The aim of the study was a retrospective analysis of symptoms of temporomandibular joint dysfunction reported by patients diagnosed with this problem. MATERIAL AND METHODS: The research material was a retrospective medical records of 120 patients, aged 19 to 45 years who have taken prosthetic treatment due to temporomandibular joint dysfunction in the Consulting Room in Prosthetics Department in Kraków, from June 2015 to December 2016. During the test patients, in addition to interviewing a physician, completed a personal survey in their own study. The material has been divided into I group of patients who reported pain form of dysfunction and II group, who had no symptoms of pain within the stomatognatic system. The analysis covered type of symptoms, the share of local factors (para-functions) and systemic, as well as the time a er which the patients reported for the treatment of functional disorders since the appearance of the first symptoms. RESULTS AND CONCLUSIONS: Analysis of the research material showed that the main reason for reporting patients was pain in one or both temporal joints of significant intensity (5 to 8 in VAS scale,) accompanied by acoustic symptoms. A large group of questioners reported problems with the range of jaw movement and head and face pain, as well as subjective symptoms from the auditory, sight, neck, neck and shoulder areas.