The Effectiveness of Preoperative Outpatient and Home Rehabilitation and the Impact on the Results of Hip Arthroplasty: Introductory Report.

A total hip replacement is the treatment of choice for end-stage hip osteoarthritis. Rehabilitation performed before surgery (called prehabilitation) is used to improve the results of surgical treatment. However, the results of studies have not unquestionably confirmed the effectiveness of preoperative rehabilitation and its impact on the outcome of surgery. The aim of this study is to assess the effectiveness of preoperative outpatient and home rehabilitation in relation to a control group not subject to these forms of influence. A total of 61 patients qualified for primary hip arthroplasty were randomly assigned to a group with outpatient rehabilitation before surgery, exercises performed at home, or a group without any intervention before surgery. Three weeks after surgery, the patients were re-qualified and underwent three weeks of outpatient rehabilitation in the day rehabilitation department. The patients from all three groups were evaluated in terms of functionality and pain using point scales upon enrolment in the study, on admission to the day rehabilitation department, and after 3 weeks of rehabilitation in the department. A total of 50 subjects completed the study. The study results did not reveal statistically significant differences between preoperative rehabilitation and no intervention. Patients rehabilitated at home gave up self-therapy more often than those undergoing outpatient rehabilitation.

Why Does Rehabilitation Not (Always) Work in Osteoarthritis? Does Rehabilitation Need Molecular Biology?

Osteoarthritis (OA) is a common disease among the human population worldwide. OA causes functional impairment, leads to disability and poses serious socioeconomic burden. The rehabilitation offers a function-oriented method to reduce the disability using diverse interventions (kinesiotherapy, physical therapy, occupational therapy, education, and pharmacotherapy). OA as a widespread disease among elderly patients is often treated by rehabilitation specialists and physiotherapists, however the results of rehabilitation are sometimes unsatisfactory. The understanding of molecular mechanisms activated by rehabilitation may enable the development of more effective rehabilitation procedures. Molecular biology methods may prove crucial in rehabilitation as the majority of rehabilitation procedures cannot be estimated in double-blinded placebo-controlled trials commonly used in pharmacotherapy. This article attempts to present and estimate the role of molecular biology in the development of modern rehabilitation. The role of clinicians in adequate molecular biology experimental design is also described.

OVERVIEW OF WELLNESS METHODS FOR PEOPLE PRACTICING SPORTS.

The term "wellness" embraces a wide spectrum of methods that impact the human body by restoring its capabilities and functions, which were previously depleted as a result of increased physical and mental activities such, i.e. sport. Judging by the number of amateur, semi-professional, and professional sporting events at local and national levels, societies consider sports a major part of their everyday lives. A growing percentage of the population is exposing their bodies to various strains, which may result in fatigue, overtraining and injuries, and so the market demand for recovery-related services is on the rise. Therefore, this paper is an overview of the most important and the latest wellness systems and methods applied in today's sport. They divide into three areas: pedagogical, psychological and medical-biological. Among the most popular treatments are: light radiation with infrared rays, cryotherapy, electrotherapy, magnetotherapy, ultrasound and laser therapy, as well as a sauna, paraffin compress, mud compress and brine baths. In a broader context, the paper also acknowledges the growing demand for better body recovery methods and the latest developments in the field of sport physiotherapy.

Effect of inhaled N-acetylcysteine on hydrogen peroxide exhalation in healthy subjects.

N-acetylcysteine (NAC) has antioxidant properties and its oral administration decreased H(2)O(2) exhalation in patients with chronic obstructive pulmonary disease. In this study we tested whether inhaled NAC could suppress H(2)O(2) levels in exhaled breath condensate (EBC) of eight healthy subjects that have never smoked (never-smokers). Original NAC solution (ACC vial, 300 mg NAC in 3 ml solvent), NAC-placebo (vehicle), sterile 0.9% NaCl or distilled water were nebulized via the pneumatic De Vilbiss nebulizer once daily every 7 days and H(2)O(2) and thiols exhalation was measured just before, 30 min and 3 h after the end of drug administration. Additional in vitro experiments were performed to evaluate NAC stability during nebulization, reactivity with H(2)O(2) and possible H(2)O(2) generation in aqueous NAC solutions. NAC almost completely abolished H(2)O(2) exhalation 30 min after inhalation (0.02+/-0.04 vs. 0.21+/-0.09 microM, p<0.001). However, 3 h later the H(2)O(2) levels raised 1.8-fold from baseline (p<0.01). Other inhaled solutions did not affect H(2)O(2) levels. Mean thiol concentration in EBC rose (p<0.05) after treatment with NAC and reached 1.03+/-0.48 microM at 3 h. Although, 25 and 50 mM NAC completely inhibited H(2)O(2)-peroxidase-luminol-dependent chemiluminescence, detectable amounts of H(2)O(2) were generated in NAC solutions. It was accompanied by moderate loss of -SH groups. Catalase and ascorbic acid prevented H(2)O(2) formation in NAC solutions. In conclusion inhaled NAC revealed biphasic effect on H(2)O(2) exhalation in healthy subjects, which depends on direct H(2)O(2) scavenging and H(2)O(2) generation related to drug oxidation. The net result of these processes may determine anti- or pro-oxidant action of inhaled NAC.