Kinematic parameters after tibial nonunion treatment using the Ilizarov method.

BACKGROUND: Analysis of the outcomes of Ilizarov treatment of tibial nonunion shows functional deficits in the lower limbs of some patients. Biomechanical gait parameters are an important measure for assessing musculoskeletal disorder treatments that aim to restore normal gait. The purpose of our study was to compare the kinematic parameters in patients with tibial nonunion treated using the Ilizarov method and those in a control group of healthy volunteers. METHODS: The study population consisted of 23 patients (age 54.9 ± 16.4 years) who were treated for tibial nonunion using the Ilizarov method, as well as 22 healthy adult controls (age 52.7 ± 10.6 years). Kinematic parameters were measured using a Noraxon MyoMOTION System. We measured hip flexion and abduction, knee flexion, ankle dorsiflexion, inversion, and abduction during walking. RESULTS: Our analysis showed significant differences between the patients' operated limbs (OLs) and the controls' nondominant limbs (NDLs) in the ranges of hip flexion, hip abduction, and knee flexion. We observed no significant differences in knee flexion between the OL and the NOL in patients or between the dominant limb (DL) and NDL in controls. Our evaluation of the kinematic parameters of the ankle joint demonstrated significant differences between the patients' OLs and the controls' NDLs in the ranges of ankle dorsiflexion, ankle inversion, and ankle abduction. There were also significant differences in the range of ankle dorsiflexion and ankle abduction between the patients' NOLs and the controls' DLs. CONCLUSION: Tibial nonunion treatment using the Ilizarov method does not ensure complete normalization of kinematic parameters assessed 24-48 months following the completion of treatment and rehabilitation.

In Patients with Grade I and II Ankle Sprains, Dynamic Taping Seems to Be Helpful during Certain Tasks, Exercises and Tests in Selected Phases of the Rehabilitation Process: A Preliminary Report.

We aimed to investigate changes in postural stability on a stable surface after the application of dynamic tape for patients with inversion ankle sprains. This study enrolled 30 patients (age 25.5 ± 8.0 years) with grade I and II ankle sprains, which occurred 7−21 days before enrolment. Postural stability (balance, coordination, feedback) was assessed before and after the application of dynamic tape using a stabilographic platform. Three 32-s exercises were performed on the stabilographic platform, one with eyes open, one with eyes closed and one with visual feedback. After the application of dynamic tape, an improvement was observed in terms of the mean radius of sway (4.2 ± 1.3 mm vs. 3.4 ± 0.9 mm; p = 0.012) and coordination (48.8 ± 19.2% vs. 59.3 ± 5.8%; p = 0.021). Selected balance parameters did not improve significantly in the tests with open and closed eyes. Asymmetric load improved for all tests, but significant differences were only observed with eyes closed (34.9 ± 24.4 vs. 41.7 ± 30.5; p < 0.01). We concluded that the use of dynamic tape after an ankle sprain significantly improved balance and coordination on a stable surface. The benefits were shown in terms of a significant improvement in the asymmetric load of the injured limb in comparison to the healthy limb during the test with closed eyes and a considerable improvement in the asymmetric load that was evaluated with visual feedback on a stable surface.

Kinematic Parameters Following Pilon Fracture Treatment with the Ilizarov Method.

Background: The purpose of our study was to analyze kinematic parameters following pilon fracture treatment with the Ilizarov method. Methods: Our study assessed kinematic parameters of gait in 23 patients with pilon fractures treated with the Ilizarov method. Patients had completed their treatment 24−48 months prior to measurements. The range-of-motion values in the non-operated limb (NOL) and operated limb (OL) were compared. Kinematic parameters were measured using the Noraxon MyoMOTION System. Results: We observed no significant differences in hip flexion, hip abduction, or knee flection between the OLs and NOLs in patients after treatment with the Ilizarov method. We observed significant differences in the ranges of ankle dorsiflexion, inversion, and abduction (p < 0.001; p < 0.001; p < 0.003, respectively) between the OLs and the NOLs. Conclusion: Following pilon fracture treatment with the Ilizarov method, we observed no differences in terms of knee or hip joint mobility between the OL and the NOL, whereas the range of motion in the ankle joint of the OL was significantly limited. The treatment of pilon fractures with the Ilizarov method does not ensure the complete normalization of ankle joint kinematic parameters. Therefore, intense personalized rehabilitation of the ankle joint is recommended.

Dynamic Gait Parameters in Patients With Nonunion of the Tibia Following Treatment With the Ilizarov Method.

The purpose of this study was a comprehensive assessment of the dynamic parameters of gait in patients who underwent Ilizarov treatment for nonunion of the tibia. The experimental group consisted of 24 individuals treated with the Ilizarov method for nonunion of the tibia. The control group comprised 31 healthy individuals, matched for BMI, sex, and age. The dynamic gait parameters in patients and in the control group were measured with a Zebris pedobarographic platform. The treatment group and the control group showed statistically significant differences in terms of the following gait parameters: maximum force during braking nonoperated-limb (NOL), time maximum force during braking operated-limb (OL), time maximum force during braking NOL, maximum force during push-off NOL, time maximum force during push-off OL, and maximum force forefoot OL. Most of the evaluated gait parameters were bilaterally similar in patients group. The only significant differences between the operated and nonoperated limb were seen in terms of Time maximum force during push-off and Maximum force forefoot. The most pronounced abnormalities in dynamic gait parameters were observed in the forefoot (maximum force forefoot OL was 13.3% lower than in the control group, maximum force forefoot OL was 12.4% lower than in NOL). The patients treated with the Ilizarov method did not achieve a complete normalization of dynamic gait parameters, as their gait parameters did not equal those measured in the control group. The Ilizarov method for the treatment of tibial nonunion helps restore a symmetrical distribution of gait parameter values between the affected limb and the healthy limb. Patients continue to show the following abnormalities in their dynamic gait parameters after treatment: higher values maximum force during braking NOL, Time maximum force during braking OL, time maximum force during braking NOL, maximum force during push-off NOL, contact time forefoot NOL, contact time midfoot NOL, contact time heel NOL and smaller values of time maximum force during push-off OL.

Assessment of Lower Limb Load Distribution in Patients Treated with the Ilizarov Method for Tibial Nonunion.

BACKGROUND Successful treatment of tibial nonunion should lead to a complete bone union, lack of pain, and pathological mobility of the lower extremity, as well as to the achievement of satisfactory joint mobility and muscle strength, which in turn improves its biomechanics. The objective of this study was to assess the load placed on the lower limbs in patients subjected to treatment with the Ilizarov method due to aseptic tibial nonunion. MATERIAL AND METHODS This research involved 24 participants (average age, 55 years). All were diagnosed with aseptic tibia nonunion and treated with the Ilizarov external fixator between 2000 and 2017. The control group was matched to the treated group in terms of sex and age. This study used pedobarography evaluation to assess lower limb load distribution. RESULTS No differences were found in the distribution of the load over the entire foot or of the forefoot and hindfoot of the treated limb in comparison to the non-dominant limb of the controls, or in the healthy limb of the treated group compared to the dominant limb of the control group. Similarly, differences in load distribution between the operated and healthy limbs of the treated group were insignificant. CONCLUSIONS Patients subjected to treatment with the Ilizarov external fixator for aseptic tibial nonunion show symmetrical load distribution on both lower limbs following treatment, which does not differentiate them in this respect from healthy individuals. Treated patients presented with a symmetrical distribution of the load on the lower extremities over the entire foot surface, including the forefoot and hindfoot. Finally, the Ilizarov external fixator enables restoration of correct static biomechanics of the treated limbs over the period of aseptic tibial nonunion therapy.

Assessment of Gait after Treatment of Tibial Nonunion with the Ilizarov Method.

BACKGROUND: Tibial nonunion is a common bone union disorder leading to abnormal gait, and thus reducing quality of life in the social dimension. RESEARCH QUESTION: The aim of our work was to comprehensively assess gait parameters of patients who had undergone Ilizarov treatment for tibial nonunion compared to a control group of healthy individuals. METHODS: This study evaluated patients treated for aseptic tibial nonunion with the Ilizarov method. 24 patients with a mean age of 55.0 years were included in the study. The control group consisted of 32 healthy volunteers with no significant medical history who were selected to match the gender and age of patients in the study group so that the groups were homogeneous. A Zebris Medical GmbH pedobarographic platform was used to assess the gait parameters. RESULTS: For all gait parameters examined, force forefoot max, force backfoot max, step length, stance phase, swing phase and step time, we observed statistically significant differences between the group that had undergone treatment and the control group. In the group of patients, statistically significant differences between the operated lower limb and the non-operated limb were only observed for the force forefoot max and step time parameters (p = 0.029 and p = 0.045, respectively). Patients presented a longer loading of the operated limb (0.720 s) than the non-operated limb (0.635 s). For the stride time, step cadence and gait velocity parameters, healthy subjects achieved much better results during locomotion, and these differences were statistically significant at p < 0.001. SIGNIFICANCE: Treatment of tibial nonunion with the Ilizarov method did not restore normal gait parameters in our group of patients. In fact, the gait parameters of patients were significantly worse than the healthy individuals in the control group. Furthermore, gait parameters following treatment were not symmetrical, and the dynamics of the musculoskeletal system remained impaired.

Assessment of the quality of life in patients with varying degrees of equalization of lower limb length discrepancy treated with Ilizarov method.

BACKGROUND: Inequalities in leg length result in functional disorders, as they impair the biomechanics of the musculoskeletal system, significantly reducing the quality of life (QoL). This study used the WHOQoL-BREF questionnaire in patients with varying degrees of lower leg shortness who had undergone treatment by the Ilizarov method, compared to a healthy control group. METHODS: Fifty-eight patients treated with the Ilizarov method for discrepancies in lower limb length were grouped by degree of limb equalization (group 1, 37 treated individuals with limb length discrepancy < 1 cm; group 2, 21 individuals with discrepancy ≥ 1 cm but not more than 4 cm). The control group 3 contained 61 healthy individuals. Patient quality of life (QoL) was assessed using a shortened version of the WHOQoL-BREF questionnaire, at least 24 months after the end of Ilizarov therapy. RESULTS: Control subjects obtained higher scores in all domains than subjects in both treatment groups, as well as significantly higher self-assessed QoL, and health, in the physical, psychological, social, and general lifestyle domains, as compared to those with inequalities ≥ 1 cm. Furthermore, patients with inequalities ≥ 1 cm had higher odds ratios of low self-assessment (3.28 times; p = 0.043), low self-assessment of health (4. 09 times; p = 0.047), and low physical and psychological domains (respectively 6.23 times; p = 0.005 and 8.46 times, p = 0.049) compared with patients with inequality < 1 cm. The shortened version of the WHOQoL questionnaire was used. CONCLUSIONS: After at least 24 months of treatment with the Ilizarov method, patients with limb length discrepancy < 1 cm did not differ significantly from healthy individuals in the WHOQoL self-assessment of mental functioning, social, or life satisfaction.

Evaluation of mood, stress levels and sense of coherence in future physiotherapists.

BACKGROUND: Researchers suggest that physiotherapists are highly exposed to both the physical and the mental strains. OBJECTIVE: The aim of this study was to assess mood and the level of stress as well as a sense of coherence among future physiotherapists studying at the Department of Physiotherapy. METHODS: The study included 249 students, 181 women and 68 men. The Beck Depression Inventory (BDI), the Sense of Coherence Questionnaire (SOC-29) and the Perceived Stress Questionnaire (PSQ) were used. RESULTS: The examined group had an average level of sense of coherence and a low level of stress. One out of four students exhibited mood disorders. The factors associated with the prevalence of mood disorders among studied students were as follows: female (gender), lack of regular physical activity, poor financial situation, lack of friend to talk to in case of problems, dissatisfaction with the chosen field of study, and being inadequately prepared to work as a physiotherapist. CONCLUSIONS: The results of the study indicate an increased prevalence of mood disorders among students of physiotherapy. It is suggested that this situation may require the implementation of effective psychoprophylactic activities during the course of studies and broadly understood education about the psychophysical wellbeing of students, especially as they will work in an environment that requires high resistance to stress and support for other people in a crisis situation.

Assessment of body balance of patients treated with the Ilizarov method for tibial nonunion.

PURPOSE: The biomechanics of the musculoskeletal system in patients after tibial nonunion treatment using the Ilizarov method have not yet been fully explored. From the orthopaedic and patient point of view, after the treatment, an assessment should be carried out of the biomechanics of the musculoskeletal system. The aim of this study was to assess the body balance of patients treated with the Ilizarov method for tibial nonunion. METHODS: The research group included 24 individuals with a mean age of 55 years, who were treated for aseptic tibial nonunion with the Ilizarov method. The control group was matched to the study group in terms of gender and age, and consisted of 32 subjects with a mean age of 50.5 years and no significant medical history. This study evaluated the balance of patients with the use of pedobarography. RESULTS: In the control group, a statistically significantly shorter path of centre of gravity was observed. There were no statistical differences between the study and control groups for the field area of the centre of gravity. There were no statistical differences between the study and control groups for the minor axis length or major axis length of the centre of gravity. There was a relationship between the centre of pressure path length and the age of the participants in both the control group and the study group. CONCLUSIONS: Treatment of patients with tibial nonunion with the Ilizarov fixator achieves similar balance to healthy volunteers. In the pedobarographic evaluation, patients treated for tibial nonunion using the Ilizarov method had similar statics of the musculoskeletal system to healthy volunteers.

The effectiveness of whole-body cryotherapy and physical exercises on the psychological well-being of patients with multiple sclerosis: A comparative analysis.

BACKGROUND: Due to the chronic character of multiple sclerosis (MS), non-pharmacological treatment can be applied. These therapies can be a good complementation to standard pharmacological treatment. OBJECTIVES: The aim of the study was to evaluate the effectiveness of whole-body cryotherapy (WBC) and physical exercise training on the psychological and general well-being of patients with MS. MATERIAL AND METHODS: The study was carried out on 60 patients, who were divided into 3 groups: cryotherapy (Cryo), physical exercise training (Gym) and cryotherapy with physical exercise training (CryoGym). The Psychological General Well-Being Index, the Hospital Anxiety and Depression Scale and the Rivermead Mobility Index were used at 2 points in time: T1 - before the first therapy session and T2 - after 14 days of therapy. RESULTS: Statistically significant differences in the psychosocial well-being were found in the Gym and CryoGym group. Reduction of depressive symptoms and improved functional status was noted in Cryo group. The most significant improvement was observed in the group using WBC with exercise training (CryoGym). CONCLUSIONS: Whole-body cryotherapy with physical exercise training was an effective therapy for patients with MS. The introduction of WBC into the standard physiotherapy protocol for patients with MS is fully justified.

Evaluation of a Home-Based Pulmonary Rehabilitation Program for Older Females Suffering from Bronchial Asthma.

BACKGROUND: Asthma is a disease that affects people of all ages worldwide. OBJECTIVES: The aim of the study was to evaluate the effectiveness of a home-based pulmonary rehabilitation program, with one supervised session a week, for improvement of respiratory function, inspiratory muscle strength and physical fitness in older women suffering from asthma. MATERIAL AND METHODS: The study involved 10 female patients (mean age 70.8) with diagnosed bronchial asthma in the slight and moderate stage. Before the program started, all the patients were in a stable phase of the disease. All the patients carried out a respiratory function test based on measurement of the flow/volume loop assessing FVC, FEV1, FEV1/FVC, PEF, MEF50 and MEF25/75. An inspiratory muscle strength test (PImax) was also performed. Agility was assessed by the Fullerton Functional Fitness test, which consists of sitting down on/standing up from a chair, bicep curls with weights, upper and lower body flexibility trials, a complex coordination trial and a six minute walk test (6MWT) to assess the patients' exercise capacity. To evaluate health-related quality of life, the Saint George Respiratory Questionnaire (SGRQ) was completed, and the Hospital Anxiety and Depression Scale was used to diagnose any signs of anxiety or depression. The main part of the program consisted of eight two-minute whole body exercises separated by one-minute intervals. Statistical significance was determined by the Wilcoxon test. RESULTS: Almost all the respiratory function parameters, PImax, exercise tolerance, lower body flexibility trial and 6MWT improved significantly after following the program for eight weeks. Among the parameters measured by the questionnaires and scales, only the component of the SGRQ related to symptoms of the disease has significantly improved. CONCLUSIONS: The home-based pulmonary rehabilitation program significantly improved all respiratory function parameters. The patients' PImax scores also significantly improved. Among the physical fitness parameters, the 6MWT and lower body flexibility trials significantly improved. The home-based pulmonary rehabilitation program can be used effectively in patients suffering from bronchial asthma.

Evaluation of a short-term group psychotherapy used as part of the rehabilitation process in nursing home patients.

PURPOSE: The aim of this study was to assess the impact of a 4-week group psychotherapy on the efficacy of physiotherapy in patients rehabilitated in a nursing home (NH). MATERIALS AND METHODS: The study was performed on 28 women, aged 77.1 (±5.6) years. Thirty-six percent were rehabilitated due to orthopaedic injuries, 36% had undergone a stroke, 28% suffered from chronic diseases of old age. Subjects were divided into two groups: experimental (n = 13) and control (n = 15). In the experimental group, a short-term, goal-focused group psychotherapy was used. To assess cognitive impairment, mood and functional status the Mini Mental State Examination (MMSE), the Geriatric Depression Scale (GDS-15) and the Barthel Index (BI) were used. RESULTS: In the experimental group a four times greater improvement in mood was observed and two times greater physiotherapy efficacy (PE) in the first month of stay in an NH as compared to the control group. The effects of psychotherapy were independent of the type of disease, the patients' age, number of comorbidities and cognitive status (ranging from 15 to 30 points on the MMSE). CONCLUSIONS: Short-term group psychotherapy can be an effective method of supporting the process of rehabilitating older, disabled people rehabilitated in an NH. IMPLICATIONS FOR REHABILITATION: Psychotherapy can improve the efficacy of treatment and rehabilitation in different somatic illnesses despite the advanced age of respondents, high disability rate, and the presence of cognitive impairments. Even short-term (4 weeks) group psychotherapy can provide effective support for the rehabilitation in the elderly.

Mental state and quality of life after 10 session whole-body cryotherapy.

The aim of this study was to evaluate the impact of a whole-body cryotherapy (WBCT) on various parameters of the mental state of patients depending on their age, gender, and diagnosed illness. The study included 55 subjects - 43 women and 12 men aged from 20 to 70 years. Based on the diagnosed illness, the patients were divided into two diagnostic groups. The first group consisted of patients with spinal pain syndromes (n = 34). The second group comprised patients with peripheral joint disease (n = 21). All patients underwent 10 WBCT sessions. The subjects completed a survey at two time points: before the first WBCT treatment (T1) and after completing the tenth treatment (T2). The World Health Organization Quality of Life-Bref (WHOQOL-Bref) questionnaire and the Psychological General Well-Being Index (PGWBI) questionnaire were used in the study. After a series of WBCT treatments, the WHOQOL-Bref and PGWBI scores significantly improved (p = .005161, p = .000862, respectively). WBCT proved to be more effective in enhancing the mood and well-being of the patients than in improving their quality of life. WBCT has a significant influence on improving the well-being and mood of patients (in terms of both psychological and somatic aspects) and consequently leads to an improvement in their quality of life. The worse the mental state of the patients is prior to the cryotherapy, the stronger its effect. The observed effectiveness of cryotherapy was the strongest in women, patients with spinal pains and in patients with severe depressive symptoms.