Influence of Nordic Walking Training on Vitamin D Level in the Blood and Quality of Life among Women Aged 65-74.

INTRODUCTION: Demographic forecasts indicate the progressive aging process of societies in all countries worldwide. The extension of life span may be accompanied by deterioration of its quality resulting from a decrease in physical activity, mental or even social performance, and a deficit in certain chemical compounds responsible for proper functioning of the body. AIM: The aim of the study was to evaluate the influence of a 12-week Nordic walking (NW) training intervention on the level of vitamin D in the blood and quality of life among women aged 65-74 years. MATERIALS AND METHODS: The study comprised 37 women aged 65-74 (x = 68.08, SD = 4.2). The subjects were randomly assigned to 2 groups: experimental group (NW), which consisted of 20 women who underwent an intervention in the form of Nordic walking training for 12 weeks, and the control group (C), including 17 women who underwent observation. In the experimental group, training sessions were held 3 times a week for 1 h. At that time, the C group was not subject to any intervention. The SF-36 questionnaire was used to measure quality of life. Vitamin D was assessed based on the results of biochemical blood tests. The analysed parameters were assessed twice-before and after the completed intervention or observation. RESULTS: Comparison of the results regarding trials 1 and 2 allowed to note statistically significant improvement in quality of life for all health components and factors in the NW group. Analysis of vitamin D levels demonstrated a statistically significant increase in the NW group. In group C, no significant changes in the analysed parameters were observed. CONCLUSIONS: Regularly undertaking Nordic walking training significantly influences the improvement of self-evaluation regarding the components of physical and mental health, as well as the concentration of vitamin D in women aged 65-74 years.

Computational models and motor learning paradigms: Could they provide insights for neuroplasticity after stroke? An overview.

Computational approaches for modelling the central nervous system (CNS) aim to develop theories on processes occurring in the brain that allow the transformation of all information needed for the execution of motor acts. Computational models have been proposed in several fields, to interpret not only the CNS functioning, but also its efferent behaviour. Computational model theories can provide insights into neuromuscular and brain function allowing us to reach a deeper understanding of neuroplasticity. Neuroplasticity is the process occurring in the CNS that is able to permanently change both structure and function due to interaction with the external environment. To understand such a complex process several paradigms related to motor learning and computational modeling have been put forward. These paradigms have been explained through several internal model concepts, and supported by neurophysiological and neuroimaging studies. Therefore, it has been possible to make theories about the basis of different learning paradigms according to known computational models. Here we review the computational models and motor learning paradigms used to describe the CNS and neuromuscular functions, as well as their role in the recovery process. These theories have the potential to provide a way to rigorously explain all the potential of CNS learning, providing a basis for future clinical studies.

The effect of the rehabilitation program on balance, gait, physical performance and trunk rotation in Parkinson's disease.

BACKGROUND: Parkinson's disease (PD) is a progressive, neurodegenerative disease which leads to postural and gait disorders, limitation in mobility, activities of daily living and disability. AIMS: The aim of the study is to assess the effects of the rehabilitation program on balance, gait, motor performance and trunk rotations in PD patients. METHODS: Sixty-four patients with 1.5-3.0 stage PD in the Hoehn and Yahr scale were randomly allocated to rehabilitation and control groups. Sixty-one patients completed the study. Patients were assessed three times, at month intervals. Between the first and second assessments, the rehabilitation group participated in a rehabilitation training program focused on mobility, balance and gait exercises, consisting of 28 sessions. Balance was assessed with tandem stance and the Pastor test (shoulder tug). Gait was assessed with a 10 m walk at preferred speed and 360° turn. Motor performance was evaluated by means of the Physical Performance Test (PPT) and timed motor activities. The trunk rotations were measured in the lumbar and thoraco-lumbar spine with a tape measure. RESULTS: The rehabilitation group significantly improved (p < 0.05) in balance and gait outcomes, PPT score, timed activities and trunk rotations both in comparison to the control group and baseline results. The positive effects of the exercise program maintained for at least 1 month. CONCLUSION: The 4-week rehabilitation training program focused on mobility, balance and gait exercises improved balance, gait, physical performance and trunk rotations in patients with PD.

The effects of physiotherapy with PNF concept on gait and balance of patients with Huntington's disease - pilot study.

BACKGROUND AND PURPOSE: Huntington's disease (HD) is a neurodegenerative, progressive disorder of the central nervous system which causes significant gait and balance disturbances. This is a pilot study which aims to determine the effects of a physiotherapy programme with use of Proprioceptive Neuromuscular Facilitation (PNF) on gait and balance in HD patients. MATERIAL AND METHODS: 30 HD patients aged 21-60 with genetically confirmed diagnosis participated in the study. Participants followed a 3-week-long PNF-based physiotherapy programme. Gait and balance were evaluated twice in each participant: first at baseline and then after the course of physiotherapy. The following methods were used for gait disturbances: Tinetti Gait Assessment Tool, Up and Go Test, Timed Walking Tests for 10m and 20m (TWT10m, TWT20m). Balance was assessed with use of Berg Balance Scale, Pastor Test and Functional Reach Test. RESULTS: There was a significant improvement in all measures of balance and gait. CONCLUSION: PNF-based physiotherapy is effective and safe in HD patients.

Burnout syndrome in physical therapists - demographic and organizational factors.

BACKGROUND: Professional burnout results from prolonged exposure to chronic, job-related stressors. According to Christina Maslach, professional burnout is a syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment. Literature includes a number of reports on burnout syndrome within health service, but hardly ever do they make any references to physiotherapists. The purpose of this study is assessment of the level of professional burnout in a group of physiotherapists and investigating relationships between the indices of burnout syndrome and selected demographic as well as organizational variables. MATERIAL AND METHODS: The study group consisted of 151 physiotherapists with at least 3 years of experience, employed in various health service outposts in Krakow, Poland. The Maslach Burnout Inventory (MBI) was used to measure emotional exhaustion, depersonalization and personal accomplishment. A questionnaire for the description of socio-demographic and work characteristics was used as well. RESULTS: Job burnout among the physiotherapists was manifested by an increased emotional exhaustion and decreased sense of personal achievement. Emotional exhaustion was significantly higher among physi cal therapists working with adults and employed in hospitals, depersonalization was higher among men, hospital workers and employees with seniority from 15 to 19 years, personal accomplishment was decreased among men and less-educated therapists. CONCLUSIONS: The study confirmed that indicators of burnout in physiotherapists are significantly associated with selected demographic and organizational variables. It is necessary to undertake a more exhaustive study of burnout in this group of employees, and implement elements of prevention.

The effectiveness of reinforced feedback in virtual environment in the first 12 months after stroke.

BACKGROUND AND PURPOSE: Reinforced feedback in virtual environment (RFVE) therapy is emerging as an innovative method in rehabilitation, which may be advantageous in the treatment of the affected arm after stroke. The purpose of this study was to investigate the impact of assisted motor training in a virtual environment for the treatment of the upper extremity (UE) after stroke compared to traditional neuromotor rehabilitation (TNR), studying also if differences exist related to the type of stroke (haemorrhagic or ischaemic). MATERIAL AND METHODS: Eighty patients affected by a stroke (48 ischaemic and 32 haemorrhagic) that occurred at least 1 year before were enrolled. The clinical assessment comprising the Fugl-Meyer UE (F-M UE), modified Ashworth (Bohannon and Smith) and Functional Independence Measure scale (FIM) was administered before and after the treatment. RESULTS: A statistically significant difference between RFVE and TNR groups (Mann-Whitney U-test) was observed in the clinical outcomes of F-M UE and FIM (both p < 0.001), but not Ashworth (p = 0.053). The outcomes of F-M UE and FIM improved in the RFVE haemorrhagic group and in the TNR haemorrhagic group with a significant difference between groups (both p < 0.001), but not for Ashworth (p = 0.651). Comparing the RFVE ischaemic group to the TNR ischaemic group, statistically significant differences emerged in F-M UE (p < 0.001), FIM (p < 0.001), and Ashworth (p = 0.036). CONCLUSIONS: The RFVE therapy in combination with TNR showed better improvements compared to the TNR treatment only. The RFVE therapy combined with the TNR treatment was more effective than the TNR double training, in both post-ischaemic and post-haemorrhagic groups. We observed improvements in both groups of patients: post-haemorrhagic and post-ischaemic stroke after RFVE training.

Causes and risk factors of falls in patients with Parkinson's disease.

BACKGROUND AND PURPOSE: Falls are a common and serious problem among Parkinson's disease (PD) patients. However, knowledge about the causes and risk factors of falls is limited. There have been a few attempts to classify the causes of falls. The classification suggested by Olanow seems to be the most comprehensive one. The aim of this study was to analyze retrospectively the causes of falls and risk factors of falls in PD patients. MATERIAL AND METHODS: One hundred and four patients with moderately advanced PD were included in the study. The patients were asked to describe the circumstances and consequences of falls which occurred during 12 months preceding the examination. The falls were classified according to the Olanow classification of causes of falls. RESULTS: Fifty-two patients (50%) reported at least one fall during the previous year with a mean number of 1.5 falls per year. The most common causes of falls were environmental factors, sudden falls and postural instability. There were no falls caused by severe dyskinesia, drugs or cardiovascular disorders. The only independent risk factors of the recurrent falls identified in this study were UPDRS part II score (OR 1.17, 95% CI: 1.02-1.37) and Mini Mental State Examination score (OR 0.85, 95% CI: 0.72-0.99). CONCLUSIONS: Considering these results we may be able to prevent most falls by means of the education of patients about environmental factors and using adequate rehabilitation techniques concentrating on postural stability and gait.

[The effect of the complex rehabilitation on posture and gait in Parkinson disease]. / Wplyw kompleksowego programu rehabilitacji na równowage i chód u chorych na chorobe Parkinsona.

UNLABELLED: Rehabilitation plays an important role in treatment of Parkinson's disease (PD). The influence of rehabilitation on balance and gait in PD hasn't been widely investigated. There is general agreement about positive influence of rehabilitation on postural instability and prevention of falls, but therapeutic program prevention of falls hasn't been worked out. Ambiguous results of studies indicate necessity of further investigations. MATERIAL AND METHODS: 61 patient were included (H&Y 1, 5-3) and randomly assigned to two groups with and without rehabilitation. The balance test battery included: Functional Reach Test, Balance Performance-Oriented Mobility Assessment (Tinetti), assessment on force platform of quiet standing and active standing with Rhythmic Weight Shifts Test and dynamic task (reaction time, number of hitted targets). Gait was assessed with: timed Up&Go test, 10 m walk, locomotion test and 360 degrees turn. Patients were assessed 3 times, at month intervals. Between 1 and 2 assessment, exercising group took part in 1 month complex rehabilitation, consist of the 28 therapeutic sessions. RESULTS: The group, which took part in rehabilitation significantly improved in quiet standing with closed eyes after rehabilitation in comparison with initial status. All of the rest variables significantly improved in exercising group after rehabilitation both in comparison between evaluations and in comparison with the nonexercising group. CONCLUSIONS: Rehabilitation significantly influences balance and gait of patients with PD.