Evaluation of the functional outcome and mobility of patients after stroke depending on their cognitive state.

The study aimed to analyze the functional outcome and mobility in stroke patients depending on their cognitive state. 180 patients after first stroke were divided into four groups: 48 patients without symptoms of cognitive impairment (G1); 38 with mild cognitive impairment without dementia (G2); 47 with mild dementia (G3); 47 with moderate dementia (G4). The Mini Mental State Examination (MMSE), Barthel Index (BI), Sitting Assessment Scale (SAS), Berg Balance Scale, Trunk Control Test and Test Up & Go were used. The tests were carried out at the time of admission to the ward (T1) and at the time of discharge (T2). A statistically significant improvement was demonstrated in all parameters in almost all groups. No significant difference was observed only in groups G1 and G4 in SAS head. Statistically significant differences in BI results in T2 between groups G1 and G4 were noted. The lowest change in BI was observed in the G4. Regression analysis showed that MMSE and BI at T1 and MMSE score at T2 explained the functional status at T2. Cognitive dysfunction at the time of admission to the ward and discharge may determining the patient's functional status at the time of discharge from the ward.

Walking Speed and Risk of Falling Patients Operated for Selected Malignant Tumors.

BACKGROUND: A literature review reveals that studies on walking and fall occurrences in the context of cancer have predominantly centered on geriatric patients. Nonetheless, cancer patients of all ages are susceptible to such risks. Both cancer and its treatments contribute to significant risk factors for disturbances in walking and falls, encompassing muscle weakness, impaired balance, reduced proprioception, cognitive impairment, and functional limitations. AIM: to assess walking speed and the risk of falls among patients undergoing surgery for the most common malignancies: breast (BU), lung (P), colorectal (DS), and reproductive organs (G). MATERIAL AND METHODS: An observational study was conducted using a cohort design. A total of 176 individuals participated in the study, including 139 cancer patients, who were divided into four groups: BU (N = 30), P (N = 35), DS (N = 35), and G (N = 39), as well as 37 healthy volunteers in the control group (C, N = 37). All participants underwent an assessment of walking speed using BTS G-WALK® and an evaluation of the number of falls and the risk of falling using a Fall Control Card. RESULTS: There was a significant decrease in walking speed after surgery compared to the time before surgery, from 2.7% in the BU group, through 9.3% in the P group, and 19.2% in the DS group, to 30.0% in the G group. At the same time, for groups G and DS, the average walking speed fell below 1.0 m/s, amounting to 0.84 m/s and 0.97 m/s, respectively, in the measurement after the surgery and 0.95 m/s and 1.0 m/s in the follow-up measurement. Falling occurred in all the groups except for the BU group. The created logistic regression model showed that increasing the walking speed measured after the procedure (study 2) by 1 m/s reduces the risk of falling by approximately 500 times (OR = 0.002). Limitations in daily activity were observed in the follow-up examination (study 3) in 75% of patients. CONCLUSIONS: Surgical intervention has an impact on walking speed, and being part of the study group influences the risk of falling. Further research is needed to determine the precise risk of falls in cancer patients.

Prognostic Relevance of the Lung Ultrasound Score: A Multioutcome Study in Infants with Respiratory Distress Syndrome.

OBJECTIVE: There is growing evidence for the usefulness of the lung ultrasound score (LUS) in neonatal intensive care. We evaluated whether the LUS is predictive of outcomes in infants with respiratory distress syndrome (RDS). STUDY DESIGN: Neonates less than 34 weeks of gestational age were eligible for this prospective, multicenter cohort study. The outcomes of interest were the need for mechanical ventilation (MV) at <72 hours of life, the need for surfactant (SF), successful weaning from continuous positive airway pressure (CPAP), extubation readiness, and bronchopulmonary dysplasia. Lung scans were taken at 0 to 6 hours of life (Day 1), on Days 2, 3, and 7, and before CPAP withdrawal or extubation. Sonograms were scored (range 0-16) by a blinded expert sonographer. The area under the receiver operating characteristic curve (AUC) was used to estimate the prediction accuracy of the LUS. RESULTS: A total of 647 scans were obtained from 155 newborns with a median gestational age of 32 weeks. On Day 1, a cutoff LUS of 6 had a sensitivity (Se) of 88% and a specificity (Sp) of 79% to predict the need for SF (AUC = 0.86), while a cutoff LUS of 7 predicted the need for MV at <72 hours of life (Se = 89%, Sp = 65%, AUC = 0.80). LUS acquired prior to weaning off CPAP was an excellent predictor of successful CPAP withdrawal, with a cutoff level of 1 (Se = 67%, Sp = 100%, AUC = 0.86). CONCLUSION: The LUS has significant predictive ability for important outcomes in neonatal RDS. KEY POINTS: · Lung ultrasound has significant prognostic abilities in neonatal RDS.. · Early sonograms (0-6 h of life) accurately predict the requirement for SF and ventilation.. · Weaning off CPAP is effective when the LUS (range 0-16) is less than or equal to 1..

Changes in the scar tissue structure after cesarean section as a result of manual therapy.

BACKGROUND: Available statistical data from 2015 show that 28% of pregnancies in developed countries end in cesarean section (CC). Discomfort associated with the scar after surgery is a common complication. OBJECTIVES: This study aimed to evaluate the changes in the structure of the cesarean scar after the application of a scheme of manual therapy. MATERIAL AND METHODS: The study included 15 women in the treatment group (TG) and 15 in the control group (CG). The scars were evaluated twice at 5-week intervals with the use of quantitative scales: the Vancouver Scar Scale (VSS), the Manchester Scar Scale (MSS) and the Patient and Observer Scar Assessment Scale (POSAS). During each examination, the scar was compared, using the specified criteria, to the physiological skin, i.e., the tissues directly bordering the incision. During therapy, 8 manual techniques were used during a 4-week program consisting of 30-minute sessions 3 times per week. RESULTS: Patients in the TG showed a statistically significant improvement in all of the analyzed characteristics of the scar. A statistically significant difference was also observed between the results obtained during the 2nd examination (after the therapy) in the TG and the CG. CONCLUSIONS: As a result of the therapy, the condition of the scar in the TG significantly improved. Onerous scar-related symptoms were alleviated. The vascularity, hyperpigmentation and distortion of the scar were reduced. The elasticity and pliability of the scar increased, and the height of the scar decreased. The texture, finish and contour of the scar improved. Obtained results suggest that manual therapy of the scar after CC should be a part of the treatment in women during the postpartum period.

Assessment of the Level of Physical Activity and Mood in Students after a Year of Study in a Mixed Mode in the Conditions of Restrictions Resulting from the Pandemic.

The COVID-19 pandemic has forced social isolation affecting all areas of life. It also affected the functioning of schools and universities. Many countries have introduced full or partial distance learning. The aim of the study was to assess the level of physical activity and student mood of the Faculty of Physiotherapy of the Academy of Physical Education in Wroclaw (Poland) and students of the Faculty of Health of the ODISSE University in Brussels (Belgium) after a year of the study conducted in a mixed mode due to contact restrictions resulting from the COVID-19 pandemic and checking which of the analyzed factors increases the risk of depression to the greatest extent. MATERIAL AND METHODS: 297 students from the 2nd to 4th year of full-time studies took part in the observation. The academic year 2020/2021 was assessed. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) recommended for this type of analysis by WHO. The GPAQ questionnaire enables the assessment of activity performed at work, movement, and leisure time and assesses the time of sitting or resting in a supine position. The Beck Depression Inventory was used to assess mental health. The subjects also completed a questionnaire concerning selected somatic features and describing their living conditions in the previous year. RESULTS: In the group of Polish students, classes conducted in a completely remote mode accounted for about 50%, while in the group of Belgian students, about 75%. In the described period, 19% of students from Poland and 22% of students from Belgium were infected with COVID-19. The median of the results of the Beck Depression Scale in both groups was lower than 12 points (7 points in the AWF group and 8 points in the ODISSE group, respectively). A detailed analysis showed that in both study groups, more than 30% of students received results showing a depressed mood. A total of 19% of the surveyed students of the University of Physical Education and 27% of the ODISSE students were characterized by a result indicating mild depression. The results of the GPAQ questionnaire show that the total physical activity, including work/study, recreation, and mobility was 16.5 h a week for students from Poland and 7.4 h a week for students from Belgium. CONCLUSIONS: Both groups of subjects reached all the thresholds recommended by the WHO as a sufficient level of weekly physical activity. A group of students of the Faculty of Physiotherapy of the University of Physical Education in Wroclaw was characterized by more than twice as high (statistically significant) level of weekly physical activity as compared to the group of participants from the ODISSE University in Brussels. In both study groups, more than 30% of students experienced a lowered mood of varying intensity. It is necessary to monitor the mental state of students and, in the event of obtaining control results at a similar level, to implement psychological assistance for willing participants.

Thermographic of the Microcirculation in Healthy Children Aged 3-10 Months as an Objective and Noninvasive Method of Assessment.

BACKGROUND: The aim of this study was to assess if thermography as an objective and non-invasive research tool is capable of identifying the changes in the surface temperature of the body as a response to muscle stimulation in Vojta therapy. The research group consisted of children aged 3-10 months with slight abnormalities of the motor pattern, subjected to individually selected stimulation elements according to Vojta. METHODS: The Vojta method of spontaneous motor assessment and the thermovision method of assessing the microcirculation properties of muscles were used for the evaluation. RESULTS: In the study group, changes in the microcirculation parameters of the extensor muscles of the back occurred immediately after the therapy at the first examination. CONCLUSIONS: The analysis featuring an objective assessment allows physiotherapists to diagnose local temperature changes based on the effect of microcirculation parameters in the musculofascial structures. TRIAL REGISTRATION: The research was conducted as a pilot study for a scientific project approved by the Commission for Scientific Research of the University of Health and Sport Sciences in Wroclaw No 24/2021. The study is currently in the registration process with the Australian New Zealand Clinical Trials Registry.

Assessment of the Nutritional Status and Quality of Life in Chronic Kidney Disease and Kidney Transplant Patients: A Comparative Analysis.

BACKGROUND: Chronic kidney disease (CKD) can significantly influence a patient's nutritional status, leading to malnutrition. Malnutrition is associated with an increase in morbidity and hospital admissions, as well as a decrease in functional status. All these factors impact emotional, physical, and psychosocial health, leading to a lower quality of life (QOL). The aim of the study was to assess the nutritional status and QOL in patients with CKD compared to patients after kidney transplantation and determine what factors influence nutritional status and QOL in this patient population. METHODS: The study included 167 patients: 39 pre-dialysis patients-group 1; 65 dialysis patients-group 2; 63 kidney transplant patients-group 3. Patients completed the Kidney Disease Quality of Life questionnaire (KDQoL) and the Mini Nutritional Assessment questionnaire (MNA). RESULTS: A comparative analysis of the QOL of patients in the three study groups showed no statistically significant differences in the overall KDQoL scores. Factors that affected quality of life included the designated group, determined by disease status, MNA score, patient age, and WHR. Nearly 1/3 of patients from groups 2 and 3 were at risk of malnutrition. CONCLUSIONS: A systematic assessment of nutritional status and monitoring of QOL should be integrated into the standard management guidelines for CKD patients.

Assessment of Viscoelastic Parameters of Muscles in Children Aged 4-9 Months with Minor Qualitative Impairment of the Motor Pattern after Vojta Therapy Implementation.

The aim of this study was to assess if there are any objective changes in the viscoelastic parameters of the erector spinae muscle after Vojta stimulation. The study involved 22 healthy children at an average age of 7 months and with an Apgar score of 8-10 points, who were referred for rehabilitation due to a slight delay in the phases of psychomotor development. The first group consisted of 11 children with increased muscle tone (IMT) and the second group consisted of 11 children with non-increased muscle tone (nonIMT). All study participants received a one-time Vojta therapy session, which was continued for 4 weeks by parents at home. The viscoelastic parameters of the dorsal extensor muscle were measured three times. In the first study group, changes in the viscoelastic parameters of the extensor muscles of the back occurred immediately after the therapy at the first examination, whereas changes in the supporting and extensor function of the limbs occurred in both groups at the second examination. Analysis featuring an objective assessment allows physiotherapists to diagnose local changes in the viscoelastic parameters after the implementation of therapy. These studies are the first pilot studies to be continued with a 30- or 60-day follow-up.

A Comparative Analysis of Functional Status and Mobility in Stroke Patients with and without Aphasia.

All researchers agree that aphasia is a serious consequence of a stroke, but they also report contradictory data regarding the functional outcome. The aim of this study was, therefore, to assess the functional outcomes of stroke patients with and without aphasia, who were undertaking a regular rehabilitation programme. MATERIALS AND METHODS: The study group consisted of 116 post-stroke patients, including 54 patients without aphasia (G1) and 62 patients with aphasia (G2). The following tests were used before (T1) and after (T2) rehabilitation measurement points: Barthel Index (BI), Sitting Assessment Scale (SAS), Berg Balance Scale (BBS), Trunk Control Test (TCT), Test Up & Go (TUG) and the Timed Walk Test (TWT). RESULTS: The group of post-stroke patients with aphasia had a significantly longer time since a stroke on admission, a significantly longer length of stay in the ward and significantly worse SAS and TCT scores at T2, compared to patients without aphasia. Both groups achieved significant improvement in all studied parameters (SAS, TCT, BI, BBS, TUG and TWT). Aphasia was a predictor of functional status in the stroke patients group, but only at the time of admission to the ward. CONCLUSIONS: Patients with and without aphasia have an equal likelihood of improving their functional status and returning to independence. Aphasia should not be an absolute factor that excludes stroke patients from research studies on their functional status.

The Occurrence of the Sensory Processing Disorder in Children Depending on the Type and Time of Delivery: A Pilot Study.

Over recent years, the concept of Sensory Integration has become more popular. Knowledge about Sensory Processing Disorder (SPD) also has grown, and it is often discussed in scientific research. Sensory disturbances can cause problems in learning and behaviour of children in whom no medical diagnosis has been made. These are healthy children regarding the environment, but their behaviour is often described as strange in the meaning not appropriate/not adequate to the situation. The aim of the study was to analyse if there is a correlation between occurrence of SPD and the time or the way of delivery. Participants were 75 children, ages 5-9 years old. Children born prematurely (n = 25), and children delivered by caesarean section (C-section) (n = 25) were compared to the ones born on time by natural means (n = 25). Research was based on a questionnaire filled by children's parents. Descriptive results and percentage calculations were compared. SPD were detected among 84% of pre-borns and among 80% of children delivered by C-section and it is statistically significant. Both groups are at higher risk of Sensory Processing Disorder than those delivered on time by vaginal birth. Due to the results, the time and the way of the delivery are the factors that affect Sensory Processing Disorder.

Changes in Skin Microcirculation Resulting from Vibration Therapy in Women with Cellulite.

BACKGROUND: Cellulite is a cosmetic defect that affects over 80% of post-pubertal women. One of its pathomechanisms involves microvascular dysfunction. It has been suggested that vibration is a physical stimulus that may improve circulation in the skin and muscles. The aim of this study was to evaluate the effect of local vibration on cutaneous microcirculation and on eliminating the symptoms of cellulite in women. METHODS: A total of 57 healthy women with at least grade 1 cellulite were recruited and divided into four groups differing by treatment time (30' or 60') and position (sitting or lying) during the vibration treatments. Participants took part in 15 vibrotherapy sessions. Body composition, selected circumferences, cellulite grade, and thermographic images of buttocks and thighs were recorded. RESULTS: Significant changes in skin temperature were observed in both studied areas after the first and last treatments in each group. A significant decrease in cellulite grade was observed after a series of treatments. The strongest effects were observed for the sitting position with a treatment time of 60 min. CONCLUSION: Vibration treatment improves microcirculation in cellulite-affected areas. Over time, no adaptation was observed, and subsequent treatments maintained the beneficial effects. Extending the treatment time increased its influence on the microcirculation in the skin.

Superficial temperature distribution patterns before and after physical activity in school children are indicative for personalized exercise coaching and disease prevention.

BACKGROUND: Thermoregulation is highly individual and predictive for potentially cascading pathologies. Altered and deficient thermoregulation is considered an important diagnostic indicator which can be of great clinical utility for specialized screening programs and individualized prediction and prevention of severe pathologies triggered early in life. WORKING HYPOTHESIS: Individual thermoregulation can be objectively assessed by thermovision camera before and after exercises in school children stratified by age and gender that may be of great clinical utility for personalized training early in life in the framework of 3P medicine. STUDY DESIGN: In this study, 60 female and male primary school children were exposed to physical exercises in the form of 45-min general fitness training. The subjects under examination were stratified by age: group 1 (7-year-olds), group 2 (9-year-olds), and group 3 (12-year-olds). Superficial body temperature patterns were measured by means of thermovision camera before and immediately after exercises, as well as after the 15-min recovery time. Temperature patterns were analyzed in 12 areas of the body front and back, covering trunk and upper and lower limbs. RESULTS: The obtained results revealed an individual and age-depended difference in response of the body to exercises. The first measurement prior to exercise (measurement 1) revealed no statistically significant differences in the mean surface temperature of all analyzed areas between 7- and 9-year-old children. Further, 7- and 9-year-old children did not differ significantly in the mean temperature recorded in the trunk compared to the 12-year-old children. However, in 12-year-old children, statistically significant higher values of the mean temperature of the upper and lower limbs, were observed compared to the group of 7-year-olds and significantly higher values of the mean temperature of the lower limbs compared to the group of 9-year-olds. Immediately after exercises (measurement 2), a statistically significant decrease in the temperature was noted in all groups and in all areas of the body. The greatest temperature change was observed in 12-year-olds, while the least one was measured in the youngest subjects. The statistically significant relation between the average trunk temperature of 7-year-old and 12-year-old children was observed: lower values of the mean temperature of the front and back of the trunk were noted in the group of 12-year-old children compared to the group of 7-year-olds. A significantly lower average temperature of the back of the trunk compared to the youngest group was also recorded in 9-year-old children. The study performed after the 15-min recovery time (measurement 3) showed an increase in the average temperature of all analyzed areas. In all subjects, the mean temperature recorded in measurement 3 did not differ significantly from the initial ones (measurement 1, prior to exercises). Only the mean temperature of the trunk back of 12-year-old children was significantly lower after the rest period compared to the initial examination. In all groups, the temperatures after exercises followed by a 15-min recovery returned to the initial ones, except of the trunk backs of 12-year-old children, where the temperature was lower than before exercises. CONCLUSIONS AND EXPERT RECOMMENDATIONS IN THE FRAMEWORK OF 3PM: Thermovision analysis is an effective tool to assess individual thermoregulation and to stratify school children for personalized exercise coaching. Body exercise-based disease prevention early in life is effective when tailored to the person: multi-parametric guidance for prescribing exercises individually is needed. Contextually, proposed individualized training approach should be adapted to the age-dependent particularities and individual thermoregulation.

Assessment of the Strength Parameters of the Quadriceps Femoris Muscles in Polish University Students after a 3-Week Program of Neuromuscular Electrical Stimulation Using the RSQ1 Method.

A rehabilitative program for patients who lose strength and muscle mass along with the ability to perform intensive exercises is lacking. We developed a 3-week training program based on neuromuscular electrical stimulation (NMES) using a RSQ1 device (modulated current resulting from the overlapping of two-component currents) for RSQ1 electrostimulation to improve strength parameters of the quadricep femoris muscles and compare its effectiveness to isometric training. Nineteen university students were randomly divided into the NMES group (10 sessions) and the control group who trained. We measured the circumference of the thigh, as well as peak torques of the flexor and extensor muscles before and after the start and after the end of the training program. Both tested training programs gave similar results. Differences between measured parameters were not significant except for differences in the peak torques of the knee flexors (9.9% for left limb; p = 0.2135 vs. 7.8% for rift limb; p = 0.2135) and the circumference of the left thigh-2% for both (left p = 0.5839 and right p = 0.1088). Comparable results of the tested training programs suggest that NMES is a good alternative for people who cannot perform exercises, but want to maintain or improve their physical fitness.

Assessment of Depression and Anxiety in Patients with Chronic Kidney Disease and after Kidney Transplantation-A Comparative Analysis.

Depression and anxiety are common among chronic kidney disease (CKD) patients but are rarely diagnosed and treated. Furthermore, the fraction of patients with depression is greater among hemodialyzed patients. The aim of the study was to assess the prevalence of depression symptoms, anxiety and assess the level of life satisfaction in three groups of patients based on the stage of CKD. The study group consisted of 283 patients-130 females and 153 males, mean aged was 54.7 (±15.3) with stage III-V chronic kidney disease and after kidney transplantation. The Beck Depression Inventory (BDI), the Satisfaction with Life Scale (SWLS), and the State-Trait Anxiety Inventory (STAI) were used. The highest percentage of patients with depressive symptoms was recorded in the group of dialysis patients with stage V CKD. The lowest percentage of patients with high satisfaction with life was noted in the pre-dialysis group. There was a significant relationship between BDI and STAI, SWLS in all groups while a significant relationship between BDI and handgrip strength was observed in dialysis and kidney transplantation patients. Anxiety as a trait was found to be the factor most significantly associated with depressive symptoms in each of the three patient groups. Screen testing and monitoring of the emotional state of patients with CKD are needed, regardless of the stage of the disease and treatment, including patients after kidney transplantation.

Assessment of Serum Neopterin as a Biomarker in Peripheral Artery Disease.

Neopterin (NPT), a pyrazino-pyrimidine compound mainly produced by activated macrophages, has been regarded as a proinflammatory and proatherosclerotic agent. The study was designed to evaluate NPT level and its interaction with conventional peripheral artery disease (PAD) biomarkers and vascular regenerative potential in severe PAD. The study included 59 patients (females n = 17, males n = 42) aged 67.0 ± 8.2 years classified into two groups based on ankle-brachial index (ABI) measurements (ABI ≤ 0.9 n = 43, ABI ≤ 0.5 n = 16). A total of 60 subjects aged 70.4 ± 5.5 years (females n = 42, males n = 18) with ABI > 0.9 constituted a reference group. NPT concentration reached values above 10 nmol/L in patients with PAD, which differed significantly from reference group (8.15 ± 1.33 nmol/L). High levels of CRP > 5 mg/L, TC > 200 mg/dL as well as lipoproteins LDL > 100 mg/dL and non-HDL > 130 mg/dL were found in the same group, indicating the relationship between NPT and conventional atherogenic markers. The endothelial progenitor cells (EPCs) tended toward lower values in patients with ABI ≤ 0.5 when compared to reference group, and inversely correlated with NPT. These findings indicate a crucial role of NPT in atheromatous process and its usefulness in monitoring PAD severity. However, the role of NPT in chronic PAD needs further studies including relatively high number of subjects.

Assessment of the Psychophysical Sphere and Functional Status of Women Aged 75-90 Living Alone and in Nursing Homes.

Aim: To assess the psychophysical sphere and functional status of women aged 75-90 living alone and in nursing homes. Methods: 23 women living in nursing homes (NH) and 20 living alone (HOME) underwent the following tests: Up and Go Test, Chair Stand Test, assessment of daily physical activity levels using pedometers, Mini-Mental State Examination, Groningen Activity Restriction Scale, Geriatric Depression Scale, and WHOQOL-Bref. Results: It was shown that the subjects living by themselves performed a greater amount of daily physical activity, although there was not significant difference between the two groups in the Up and Go Test result. There were not statistically significant differences in the self-assessment of the mental sphere, but significant differences were found in the self-evaluation of the physical sphere. In the NH group, subjects with and without depression did not differ in terms of the amount of daily physical activity and functional test results. Women with depression from the HOME group were less physically active and had worse functional fitness. Conclusions: Women living alone performed a greater amount of daily physical activity, but the functional status of women in both groups did not differ in a statistically significant way. The groups didn't differ statistically significantly in terms of psychological self-assessment.

Evaluation of Psychophysical Factors in Individuals with Frailty Syndrome Following a 3-Month Controlled Physical Activity Program.

BACKGROUND: The aim of the study was to compare the emotional state and strength-velocity parameters of patients with frailty and pre-frailty syndrome undertaking a 12-week training programme. METHODS: The study was completed by 36 individuals, including 17 with frailty syndrome (FS) and 19 with pre-frailty syndrome (PFS). The age of the subjects ranged from 63 to 89 years, with a mean 69.2 years (±5.0). The Beck Depression Inventory (BDI), Spielberg's State-Trait Anxiety Inventory (STAI), and Satisfaction with Life Scale (SWLS) were used. The strength of knee muscles was evaluated. The above tests were conducted at two time points: before the training sessions (T1); and after 12 weeks of regular training sessions (T2). RESULTS: After completion of the training programme, statistically significant differences in BDI were observed between the PFS and FS groups (especially in somatic symptoms). Following the training, BDI values in the PFS group were significantly lower (fewer depressive symptoms) than in the FS group. The parameter values describing strength capacities of the lower limbs, both at T1 and T2, proved to be higher in the PFS group. CONCLUSIONS: In individuals with pre-frailty and frailty syndrome, the 3-month physical training programme improved the strength parameters of lower limb muscles. An improvement in mood and reduction in depressive symptoms were only observed in the group of subjects with pre-frailty syndrome. Rehabilitation programmes for people with frailty syndrome should include psychotherapeutic activities in addition to physical training in order to improve the psychophysical condition of patients.

Effects of Physical Rehabilitation on Spatiotemporal Gait Parameters and Ground Reaction Forces of Patients with Intermittent Claudication.

Chronic ischemia of the lower extremities often presents as intermittent claudication characterized by lower limb pain which subsides after a short break. This study aimed to provide an assessment of the spatiotemporal parameters of gait and ground reaction forces in patients with PAD participating in three forms of supervised physical training. A total of 80 subjects completed a three-month supervised physical rehabilitation program with three sessions per week. The subjects were assigned to one of three programs: group 1-standard walking training on a treadmill (TT); group 2-Nordic walking (NW) training; group 3-strength and endurance training comprised of NW with isokinetic resistance training (NW + ISO). Gait biomechanics tests (kinematic and kinetic parameters of gait) and a six-minute walk test were carried out before and after three months of physical training. Nordic walking training led to the greatest improvements in the gait pattern of patients with PAD and a significant increase in the absolute claudication distance and total gait distance. Combined training (NW + ISO) by strengthening the muscles of the lower extremities increased the amplitude of the general center of gravity oscillation to the greatest extent. Treadmill training had little effect on the gait pattern. Nordic walking training should be included in the rehabilitation of patients with PAD as a form of gait training, which can be conducted under supervised or unsupervised conditions.

Influence of the Physical Training on Muscle Function and Walking Distance in Symptomatic Peripheral Arterial Disease in Elderly.

INTRODUCTION: A typical symptom of chronic lower-limb ischaemia is lower-limb pain, which occurs during walking forcing the patient to stop, intermittent claudication (IC). Exercise rehabilitation is the basic form of treatment for these patients. AIM: The aim of this study was to compare the effectiveness of three types of physical training programmes conducted over a 12-week period in patients with chronic lower-limb arterial insufficiency. MATERIALS AND METHODS: Ninety-five people qualified for the 3-month supervised motor rehabilitation programme, conducted three times a week. The respondents were assigned to three types of rehabilitation programmes using a pseudo-randomization method: Group I (TW), subjects undertaking treadmill walking training; Group II (NW), subjects undertaking Nordic walking training; Group III (RES+NW), subjects undertaking resistance and Nordic walking training. Treadmill test, 6 Minute Walk Test (6MWT), and isokinetic test were repeated after 3 months of rehabilitation, which 80 people completed. RESULTS: Combined training (RES+NW) is more effective than Nordic walking alone and supervised treadmill training alone for improving ankle force-velocity parameters (p<0.05) in patients with intermittent claudication. Each of the proposed exercise rehabilitation programmes increased walking distance of patients with intermittent claudication (p<0.05), especially in 6MWT (p=0.001). Significant relationships of force-velocity parameters are observed in the maximum distance obtained in 6MWT, both in Group III (RES + NW) and in Group II (NW) at the level of moderate and strong correlation strength, which indicates that if the lower limbs are stronger the walking distance achieved in 6MWT is longer. CONCLUSIONS: Given both the force-velocity parameters and the covered distance, the training RES + NW gives the most beneficial changes compared to training TW alone and NW alone. All types of training increased walking distance, which is an important aspect of the everyday functioning of people with IC.

Peripheral arterial disease decreases muscle torque and functional walking capacity in elderly.

OBJECTIVES: The aim of this study is to compare values of force-velocity and functional walking capacity in elderly patients with intermittent claudication with respect to the control group. MATERIALS AND METHODS: The study involved 135 individuals: 85-peripheral arterial disease (PAD) group diagnosed with stage II chronic lower limb ischemia, according to Fontaine's classification, and 50-control group. The studies included an assessment of walking capacity using a six-minute walk test (6MWT) and measurement of force-velocity parameters (peak torque-PTQ, total work-TW, average power-AVGP) of the lower limbs obtained by means of a functional dynamometry under isokinetic conditions. RESULTS: The peripheral arterial disease group is characterized by significantly lower values of force-velocity parameters compared to the control group (p<0.005). Walking capacity in this group is significantly reduced due to significant differences in the distance covered (p<0.0001), walking speed (p<0.01), and its intensity (p<0.01). Further, a positive correlation was found between the maximum distance specified in the six-minute walk test and lower limb muscle strength in the isokinetic test. CONCLUSIONS: Mean values of all force-velocity parameters and walk distance were significantly higher in the control group than in the peripheral arterial disease group. In the PAD group, in both men and women, the value of the agonist/antagonist ratio of both lower limbs are lower in men and women comparing to the control group. A rehabilitation program for patients with intermittent claudication must consider exercises improving strength, exercise capacity, and endurance in patients with PAD.