Comparison of selected prooxidant-antioxidant balance and bone metabolism indicators and BDNF levels between older women with different levels of physical activity.

BACKGROUND: Given a lack of studies precisely indicating how many steps elderly people should take daily for their antioxidant defence, bone metabolism, and cognitive abilities to improve, our study set out to compare the selected antioxidant, prooxidant, bone turnover, and BDNF indicators between elderly women differing in physical activity (PA) measured by the daily number of steps. METHODS: The PA levels of 62 women aged 72.1 ± 5.4 years were assessed based on their daily number of steps and then were used to allocate the participants to three groups: group I (n = 18; <5,000 steps a day); group II (n = 22; from 5,000 to 9,999 steps a day); and group III (n = 22; ≥10,000 steps a day). Blood samples were collected from the participants in early morning hours and subjected to biochemical analysis for prooxidant-antioxidant balance indicators (SOD, CAT, GPx, GR, GSH, UA, MDA and TOS/TOC), bone metabolism indicators (Ca, 25-OH vitamin D, osteocalcin, CTX-I, and PTH), and BDNF levels. RESULTS: The groups were not statistically significantly different in the activity of SOD, CAT, GPx, and GR, but their concentrations of GSH (H = 22.10, p < 0.001) and UA (H = 12.20, p = 0.002) proved to be significantly associated with the groups' daily PA. The between-group differences in the concentrations of MDA and TOS/TOC were not significant, with both these indicators tending to take higher values in group I than in groups II and III. Significant differences between the groups were established for the concentrations of 25-OH vitamin D (H = 24.21, p < 0.001), osteocalcin (H = 7.88, p = 0.019), CTX-I (H = 12.91, p = 0.002), and BDNF (H = 14.47, p = 0.001), but not for Ca and PTH. CONCLUSIONS: Significantly higher concentrations of GSH, slightly lower oxidative stress indicators, significantly higher BDNF levels, and moderately better bone turnover indicators and resorption markers in the group taking more than 5,000 steps a day suggest that this level of PA can promote successful aging. More research is, however, needed to confirm this finding.

Are Teachers Working with Visually Impaired Children Prepared to Be Advocates of Oral Health? Pilot Study.

BACKGROUND: Children and adolescents with visual impairment are at increased risk of oral cavity diseases. Pro-health education in their prevention and the role of educators and school counselors are extremely important in this aspect. The aim of the study was to collect information, and compare and analyze the level of pro-health awareness in the field of oral health prevention among teachers working with visually impaired children in Poland and Slovakia. METHODS: The questionnaire survey covered 109 school educators working with visually impaired children. The survey contained general information about participants concerning their knowledge of oral health, basic information about oral hygiene, and children's care needs in this area. The obtained results were statistically analyzed. RESULTS: The level of knowledge about oral health was assessed by the majority of respondents as rather good (60.56%), 28.44% as very good, and 11.01% as middling. Teaching children about oral hygiene at school was declared by a majority of them and over half of the correct answers were given by only 48.42% of the respondents. CONCLUSIONS: It is advisable to intensify the oral cavity diseases prevention training of teachers working with visually impaired children and youth and there is a great need to organize and carry out educational campaigns in schools for them.

The Influence of Various Hydration Strategies (Isotonic, Water, and No Hydration) on Hematological Indices, Plasma Volume, and Lactate Concentration in Young Men during Prolonged Cycling in Elevated Ambient Temperatures.

BACKGROUND: Increased internal body temperature during dehydration can be accompanied by water-electrolyte imbalances, higher levels of lactate during and after physical exertion, and changes in blood volume. Adequate hydration with carbohydrate-electrolyte fluids during physical activity can prevent dehydration and delay the onset of fatigue, allowing for proper biochemical and hematological reactions during exertion. A suitable drinking plan should consider the pre-exercise hydration level as well as the requirements for fluids, electrolytes, and substrates before, during, and after exercise. The objective of this study was to assess the impact of different hydration strategies (isotonic, water, and no hydration) on hematological indicators (hemoglobin concentration, hematocrit number, erythrocyte count, leukocyte count, and mean corpuscular volume) and lactate concentration during prolonged physical exertion in a high-temperature environment in young men. METHODS: The research method was quasi-experimental. The study involved 12 healthy men aged 20.6 ± 0.9 years, who were characterized by a body height (BH) of 177.2 ± 4.8 cm, a body mass (BM) of 74.4 ± 7.6 kg, a lean body mass (LBM) of 61.1 ± 6.1 kg, and a body mass index (BMI) of 23.60 ± 0.48. Measurements were taken of body composition and hematological and biochemical indicators. The main tests consisted of three series of tests separated by a one-week break. During the tests, the men performed a 120 min exercise with an intensity of 110 W on a cycle ergometer in a thermo-climatic chamber at an ambient temperature of 31 ± 2 °C. During exertion, the participants consumed isotonic fluids or water in an amount of 120-150% of the lost water every 15 min. The participants who exercised without hydration did not consume any fluids. RESULTS: Significant differences in serum volume were observed between the use of isotonic beverage and no hydration (p = 0.002) and between the use of isotonic beverage and water (p = 0.046). Immediately after the experimental exercise, hemoglobin values were significantly higher with no hydration than with water (p = 0.002). An even stronger significance of differences in hemoglobin was observed between no hydration and isotonic beverage consumption (p < 0.001). There was a statistically significant difference in the number of leukocytes between the consumption of isotonic beverage and no hydration (p = 0.006). CONCLUSIONS: Each active hydration strategy allows for a better maintenance of water-electrolyte homeostasis during physical exertion in a high-temperature environment, and isotonic beverage consumption had a greater impact on hydrating extracellular spaces with the smallest changes in hematological indicators.

Variability of foot growth in width in relation to length among 3-year-old girls and boys.

PURPOSE: The aim of the study was to analyze the length and width of the feet and the mutual rate of growth of these features in 3-year-old girls and boys classified into age categories taking into account the semi-annual division. METHODS: The study covered 800 children (400 girls and 400 boys) aged 3. The CQ-ST podoscope was applied as the research tool. The data were analyzed based on Student's t-test for independent samples, Mann-Whitney U-test, Wilcoxon test and simple regression. RESULTS: There were statistically significant differences in the width of the right and left feet, for both girls (1st group: p<0.001; 2nd group: p = 0.006) and boys (1st group: p<0.001; 2nd group: p<0.001), in the absence of differences in length. In the regression models created for the results of girls and boys classified into age categories, the coefficients of determination ranged from R2= 0.24 to R2= 0.48. CONCLUSIONS: The right and left feet of the examined girls and boys are characterized by symmetry in terms of length, while in terms of width, the left feet are larger than the right ones. In girls, the width of the foot increases proportionally by about 67-69% of the length, while in boys, the increase in foot width is 49-61% of the growth in length. In boys classified to the 2nd group, the growth of the foot in width in relation to its lenght in length is smaller than in the 1st group.

Effects of Elevated Body Temperature on Selected Physiological Indices and Thermal Stress in Athletes and Non-Athletes.

The purpose of this study was to determine the effects of active and passive overheating. A group of athletes (A) and non-athletic men (N) underwent an exercise stress test at elevated ambient temperature and sauna bathing until an increase in rectal temperature of 1.2°C was observed. It was shown that group A performed physical exercise for a longer period of time, which elicited significantly higher amounts of work performed in the stress test. Both forms of overheating caused a significant decrease in BM and a significant change in plasma volume, while greater dehydration was observed after active overheating. Changes observed in group A were higher than in group N. MCV levels were initially higher in group A. The levels in both groups decreased after sauna bathing, although in non-athletes the decrease was greater. Both forms of overheating increased Hb, HCT, and SBP, while only the non-athletic group showed a decrease in DBP after the exercise stress test. However, a decrease in DBP was observed in both groups after sauna bathing. The PSI increased after both tests, yet to a higher extent after the stress test than after sauna bathing. The PSI was negatively correlated with VO2max in both groups. The increase in cortisol concentration was higher after sauna bathing. There was a correlation between cortisol levels and the work performed during the stress test in group A. Endurance training resulted in more efficient thermoregulatory mechanisms in athletes.

Effect of a six-week times restricted eating intervention on the body composition in early elderly men with overweight.

The main aim of the study was to determine the effectiveness of time-restricted eating (TRE) in reducing body fat and lowering body mass index in early elderly men with overweight (65-74 years). An additional goal was to determine the feasibility of applying TRE for extensive use in elderly men. This study included a group of 46 healthy men (EXP = 23 persons, CON = 23 persons). The six-week intervention in the experimental group involved complete abstinence from food intake for 16 h per day, from 08:00 to 12:00 p.m. After the intervention, the body weight decreased in the EXP group (- 1.92 kg) with a 95% CI (1.14-2.70) compared to the CON group. There was also a decrease in the Visceral fat mass (- 0.64 l) with 95% CI (0.46-0.82) and in the waist circumference (- 3.11 cm) with 95% CI (1.89-4.33) in the EXP group compared to the CON group. The skeletal muscle mass did not change significantly. There was no significant change in the control group, either. The application of TRE in early elderly overweight men resulted in positive changes in body composition and visceral fat. All participants succeed in the prescribed diet plan, which shows that TRE is easy to maintain for early elderly overweight men and may become an essential obesity treatment tool in these age groups.

Relationships between the Perception of Footwear Comfort and the Fear of Falls in People at the Early Period of Old Age.

Objective: The present study aimed to analyze the relationships between the perceptions of footwear comfort with fear of falls in younger-old women and men. Participants: the population sample involved 100 free-living community dwellers aged 65−74. Design: the Falls Efficacy Scale-International and a visual analogue scale to assess perception of footwear comfort were used as research tools. Results: there were statistically significant differences in the FES-I results in people who suffered a fall in the last year compared to those who did not experience a fall (p < 0.001), as well as in the subjective assessment of mediolateral control in people who have suffered and have not suffered a fall in the last year (p = 0.033). In women, statistically significant relationships were found in the subjective assessment of shoe comfort in terms of arch height (p = 0.025) and material properties of the footwear (p = 0.036) with the results of FES-I. Conclusions: People who have fallen show a higher level of fear of falling. The assessment of footwear comfort in terms of mediolateral control was lower in the younger-old who had experienced a fall in the last year. In women, a worse assessment of arch height and material properties of the footwear is accompanied by greater fear of falling.

Can Frailty Be a Predictor of ICD Shock after the Implantation of a Cardioverter Defibrillator in Elderly Patients?

INTRODUCTION: The aim of the study was to assess the prevalence of frailty among elderly patients who had an implanted cardioverter defibrillator, as well as the influence of frailty on the main endpoints during the follow-up. METHODS: The study included 103 patients > 60 years of age (85M, aged 71.56-8.17 years). All of the patients had an implanted single or dual-chamber cardioverter-defibrillator. In the research, there was a 12-month follow-up. The occurrence of frailty syndrome was assessed using the Tilburg Frailty Indicator scale (TFI). RESULTS: Frailty syndrome was diagnosed in 75.73% of the patients that were included in the study. The mean values of the TFI were 6.55 ± 2.67, in the physical domain 4.06 ± 1.79, in the psychological domain 2.06 ± 1.10, and in the social domain 0.44 ± 0.55. During the follow-up period, 27.2% of patients had a defibrillator cardioverter electric shock, which occurred statistically more often in patients with diagnosed frailty syndrome (34.6%) compared to the robust patients (4%); p = 0.0062. In the logistic regression, frailty (OR: 1.203, 95% CI:1.0126-1.4298; p < 0.030) was an independent predictor of a defibrillator cardioverter electric shock. Similarly, in the logistic regression, frailty (OR: 1.3623, 95% CI:1.0290-1.8035; p = 0.019) was also an independent predictor for inadequate electric shocks. CONCLUSION: About three-quarters of the elderly patients that had qualified for ICD implantation were affected by frailty syndrome. In the frailty subgroup, adequate and inadequate shocks occurred more often compared to the robust patients.

Influence of Frailty Syndrome on Kinesiophobia According to the Gender of Patients after Coronary Artery Bypass Surgery.

(1) Background: Kinesiophobia is associated with fear of movement, general fitness exercises, and physical or mental discomfort. In patients with frailty syndrome, in addition to coexisting conditions, the postoperative recovery period may be longer than in patients without frailty; (2) Methods: The study included 108 people over 60 years of age, qualified for CABG (coronary artery bypass grafting). The Tilburg Frailty Index was used to assess frailty syndrome and the kinesiophobia scale was to assess fear of physical activity; (3) Results: Frailty syndrome was diagnosed among 19.44% of respondents. The social components of frailty were more intense in the group of women p = 0.009. The mean results for the biological and psychological domain on the scale of kinesiophobia were 1.94 and 1.6. The level of kinesiophobia was higher among women than among men taking into account the psychological domain (p = 0.006) and the subdomains: motor skills self-assessment (p = 0.042) and body care (p = 0.011); (4) Conclusions: Frailty syndrome does not affect kinesiophobia among patients after CABG. The level of kinesiophobia was higher among women than among men, taking into account the psychological domain. The greater the energy resources, the lower the level of frailty and its physical components in the group of women.

Influence of footwear fitting on feet morphology in 9 year old girls.

BACKGROUND: The human foot is shaped throughout all life in a way that is individual for every human being. Footwear fitting in the process of foot development is the issue covered by a limited range of empirical studies. This prompted the authors to undertake this subject of the study aimed at the influence of fitting of regularly worn inside the school footwear on feet morphology in primary schoolgirls. METHODS: The study group comprised 100 girls aged 9. Feet characteristics were recorded by CQ-ST podoscope. The footwear fitting to the feet of the examined girls was tested using the Clevermess device. The data were analyzed based on the Student's t test, Wilcoxon test and regression analysis. RESULTS: Appropriately fitted right indoor footwear was worn by 48% of the subjects while the left one by 43% of the group. Appropriate fitting in relation to the left and right foot width was noted in 23% of the group. The statistically significant combined effect of predictors characterizing footwear on the value of Wejsflog index of the right (p < 0.001) and left (p < 0.001) foot and influence of the length excess on the heel angle of the left foot (p = 0.006) were found. CONCLUSIONS: Most examined girls wear poorly fitted indoor footwear. The length excess of the indoor footwear has connections with the Wejsflog index of the right and left foot and the heel angle of the left foot. The larger the length excess, the lower the transverse arch. In the production of indoor footwear the differences in the feet width should be taken into account.

Comprehensive Decongestive Therapy as a Treatment for Secondary Lymphedema of the Lower Extremity and Quality of Life of Women After Gynecological Cancer Surgery.

BACKGROUND Lymphedema is a clinical manifestation of lymphatic system failure, caused by an imbalance between the transport capacity of the lymphatic system and the volume of the produced lymph. Lymphedema is complication and significantly worsens quality of life (QoL). MATERIAL AND METHODS There were 50 patients diagnosed with secondary lymphedema of the lower extremities after gynecological cancer followed by radiotherapy included in this study. The average age was 57.76 years (standard deviation±10.08). Patients were treated at the Department of Physiotherapy, Balneology and Medical Rehabilitation, in hospital NsP in Bardejov. During therapy, we applied manual lymphatic drainage, instrumental lymphatic drainage, multilayer bandage, vascular gymnastics (with loaded external compression), hydrotherapy, and patient education on the adjustment necessary for a life-long regimen. The circumference of the limb was measured using the Kuhnkes disk method, QoL was assessed using the LYMQOL LEG questionnaire, and for assessment of pain the Visual Analogue Scale (VAS) was used. RESULTS After treatment, we found a reduction in lymphedema (P<0.001), an increase in QoL (P<0.001), and a reduction in pain (P<0.001). We found a significant relationship between QoL change and pain in the domains of symptoms, function, and overall QoL (P<0.005). The results showed that reduction of lymphedema was not a significant predictor of QoL (P>0.001). CONCLUSIONS We found a positive effect in the treatment of secondary lymphedema of the lower extremity on the QoL of women after uterine cancer surgery, and also found that reduction of lymphedema and age were not predictors of improvement in QoL.

Impact of footwear fitting on foot shape in primary schoolgirls.

PURPOSE: The study aimed to analyze the footwear fitting and its impact on foot construction features in primary schoolgirls. METHODS: The study group was comprised of 100 girls aged 9 years. The study relied on the CQ-ST podoscope and the Clevermess device for pertinent measurements. The data were analyzed based on the Mann-Whitney U-test, multiple regression analysis and simple regression. RESULTS: Too short right footwear had 37% of the girls and the left - 38% of the girls, while too long shoes were worn respectively by: 14% of the girls and 15% of the girls. Too wide footwear in relation to the right foot width had 45% of the group and in relation to the left foot: 41% of the group. Too narrow right shoes had 23% of the group and the left - 32% of the group. Statistically significant influence of the excess of outdoor footwear width was found on the Clarke's angle values ( p = 0.041), the fifth toe setting of the right foot ( p = 0.015) and Wejsflog index of the left foot ( p = 0.036). CONCLUSIONS: Most 9-year-old girls wear poorly fitted outdoor footwear. Appropriately selected footwear in terms of the width facilitates the formation of foot architecture, but wearing too wide footwear increases the risk of hollow feet and the varus deformity of the fifth toe.

Exposure to ticks and undertaking Lyme borreliosis prevention activities among students from Poland and Slovakia.

INTRODUCTION AND OBJECTIVE: The incidence of Lyme borreliosis (LB) is increasing in many countries in Europe, including Poland and Slovakia. The aim of the study was to analyze the exposure to tick bites and undertaking LB prevention activities among students of medical fields of studies in Poland (PL) and Slovakia (SK). MATERIAL AND METHODS: The study was conducted among 611 students from Poland (296 students) and Slovakia (315 students). The applied research tool was the questionnaire. It consisted of questions about exposure to ticks (occurrence of an episode of tick bites, bite site, methods used for tick removal) and the frequency of undertaking preventive actions (using repellents, checking the body after returning from green areas). Pearson Chi-square statistics were calculated to assess significant differences between students from the study countries PL/SK and gender in each country. RESULTS: Among surveyed students the episode of a tick bite was reported by 352 persons (57.6%). Students from PL most frequently removed ticks with tweezers with a swift, steady movement (26.6%), while students from SK removed the tick by applying a fatty substance so that it would come off by itself (30.1%). Most of the surveyed students, being outdoors, did not apply ticks repellents (34.7%) or used them rarely (48.9%). At the same time, 49.4% of students stated that they always checked the body to search for any attached tick after returning from green areas. CONCLUSIONS: Considering the fact that the surveyed people were the students of medical fields of studies, and in the future became qualified medical personnel, the frequency of using the analyzed methods of prophylaxis of LB appears to be too small. The results obtained can help in the education of students of medical fields.

Muscle and intestinal damage in triathletes.

The aim of the paper was to assess indicators of muscle and intestinal damage in triathletes. The study involved 15 triathletes whose objective for the season was to start in the XTERRA POLAND 2017 event (1,500-m swimming, 36-km cycling, and 10-km mountain running). Before the 14-week preparatory period, the competitors' body composition was measured, aerobic capacity was tested (graded treadmill test) and blood samples were collected to determine markers showing the level of muscle and intestinal damage. Subsequent tests for body composition were carried out before and after the competition. Blood samples for biochemical indicators were collected the day before the competition, after the completed race, and 24 and 48 hours later. A significant decrease in body mass was observed after completing the race (-3.1±1.5%). The mean maximal oxygen uptake level among the studied athletes equalled 4.9±0.4 L·min-1, 58.8±4.5 mL·kg-1·min-1. The significant increase in concentrations of cortisol, c-reactive protein and myoglobin after the competition, significantly correlated with the significant increase in zonulin concentration (post 1h: r = 0.88, p = 0.007, r = 0,79, p = 0.001, r = 0.78, p = 0.001, and post 12h: r = 0.75, p = 0.01, r = 0.71, p = 0.011, r = 0.83, p = 0.02). No significant changes in the concentration of tumour necrosis factor alpha among the examined competitors were noted at following stages of the study. The results of our research showed that in order to monitor overload in the training of triathletes, useful markers reflecting the degree of muscle and intestinal damage include cortisol, testosterone, testosterone to cortisol ratio, c-reactive protein, myoglobin and zonulin. Changes in muscle cell damage markers strongly correlated with changes in zonulin concentration at particular stages of the study. Thus, one can expect that the concentrations of markers depicting the level of muscle cell damage after an intense and long-lasting effort will significantly influence the level of the intestinal barrier.

Temporal and dynamic changes in plantar pressure distribution, as well as in posture during slow walking in flat and high-heel shoes.

PURPOSE: The aim of the study was to assess the differences in plantar pressure distribution and in posture during slow and very slow walking on the treadmill in flat and high-heeled shoes. METHODS: The Pedar-X® (Novel, Munich, Germany) measuring insoles were used to measure the plantar pressure distribution and to assess temporal parameters during walking on the treadmill with the speed v1 = 0.97 ms-1 and v2 = 0.56 ms-1 in flat shoes (FS) and HH. For postural measurement, the SonoSens Monitor Analyzer (Gefremed, Chemnitz, Germany) was used. Thirty healthy females who only occasionally wear HH volunteered to participate in the study (age: 21.8 ± 2.09 years, weight: 55.7 ± 4.05 kg, height: 1.66 ± 0.03 m). For statistical analysis the ANOVA, and paired t-test were used. RESULTS: Significant differences in walking in HH were detected in temporal and plantar pressure variables, compared to FS. The walking speed influenced the temporal variables, but not the measured dynamic parameters, in either shoes. In the sagittal plane, significant differences in all sections of the spine were identified for v1 and v2. While walking in HH, lordosis at lumbar spine decreased significantly as well as at cervical spine, and kyphosis increased in the thoracic spine. In HH statistically significant differences between the walking speeds were observed particularly in the thoracic spine. CONCLUSIONS: Walking in high heels caused a plantar pressure changes and curvature of the spine, and the slowing of walking speed did not prevent these changes.

The Effect of Pulmonary Rehabilitation in Mountain Environment on Exercise Capacity and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease (COPD) and Chronic Bronchitis.

BACKGROUND We aimed to test the effectiveness of the pulmonary rehabilitation in a mountain environment on the pulmonary function, physical performance, dyspnea, affective factors, and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD) and chronic bronchitis (CB), as well as to determine predictors of clinical improvement. MATERIAL AND METHODS 128 consecutive patients (90 diagnosed with COPD and 38 diagnosed with CB) underwent comprehensive pulmonary rehabilitation for a duration of 3 weeks in one of 3 mountain health resorts in the High Tatras. The examination included spirometry (FEV1 and FEV1/FVC), 6-minute walk test (6MWT), Borg scale of dyspnea, and assessment of depression (Zung score), anxiety (Beck score), and QoL using the SF-36 scales. RESULTS After the study intervention, all patients in both monitored groups demonstrated significant improvements in objective measurements in which large treatment effect was achieved (for FEV1 η²=0.218, for 6MWT η²=0.771). Similarly, in subjective measurements a large effect was achieved (for the Beck score: η²=0.599, for the Zung score: η²=0.536). QoL improved after the intervention in all the monitored SF-36 scales in both groups (P<0.001 for all). In patients with COPD, the improvement of exercise capacity was positively correlated with baseline 6MWT and FEV1, and negatively with the Beck anxiety score and the Borg dyspnea score, whereas, only improvement in the mental summary component of QoL was negatively correlated with baseline 6MWT and FEV1 (P<0.05 for all). CONCLUSIONS Rehabilitation in a mountain environment has proven to be effective in both the reported diagnoses of COPD and CB. Improvements in both functional and subjective indicators were observed. These findings support the use of this treatment modality.

Effect of Rehabilitation on Fatigue Level in Patients with Multiple Sclerosis.

BACKGROUND The objective of this study was to evaluate the effect of a rehabilitation program in changing the perception of fatigue in patients with multiple sclerosis. MATERIAL AND METHODS The study involved 65 respondents/patients with clinically confirmed multiple sclerosis (54 women, 11 men, average age 46.49 years). The evaluation of the effects of fatigue on the physical, psychological, and psychosocial aspects of life was assessed using the Modified Fatigue Impact Scale (MFIS). To test the effectiveness of the neurorehabilitation program, we enrolled 2 groups: the experimental group (EG, n=32, 29 women, 3 men, Expanded Disability Status Scale (EDSS) 4.8 average, SD±1.77, min. 1.5 max 8.0) participated in the intervention and rehabilitation program over a period of 12 weeks and the control group (CG, n=33, 25 women, 8 men. EDSS average 5.12±1.74 SD, min. 2.0 max. 8.0). Each group of patients was divided into 3 sub-groups according to the severity of EDSS: a) 1-3.5, b) 4-6, and c) 6.5-8. For the statistical evaluation of the significance of the observed changes, the MANOVA/ANOVA model was used. RESULTS Between the input and output assessment of the MFIS individual areas questionnaire between the EG and the CG, there existed a statistically significant in the physical area (p<0.000), psychological area (p<0.000), and psychosocial area (p=0.002). CONCLUSIONS Our results support the importance of an active approach in patients with multiple sclerosis using individualized rehabilitation intervention programs.

A Model of the Action of the Shockwave Generated by a Multichannel Discharge on the Union of Bone Tissue with Bone Cement.

BACKGROUND: In reoperation of femoral prostheses, there is a higher percentage of complications associated with the extraction of bone cement from the femoral channel, which is technically and time consumingly tedious. Shockwaves have been used in medicine for years, particularly in urology for the destruction of concretions and orthopaedics, as a method of treating pain in patients with calcifying enthesopathy. MATERIALS AND METHODS: We studied the use of shockwaves generated by a new source based on the multichannel discharge principle in facilitating extraction of bone cement. Femurs of experimental minipigs were chosen as models. We implanted bone cement into the femoral channel and subsequently applied shockwaves. We then measured the force necessary to extract bone cement. RESULTS: The results indicate that the force necessary for extracting cement was consistently statistically significantly lower in the group treated with multichannel discharge shockwaves compared to that for the controls.