The Opinion of Professional Caregivers About The Platform UnderstAID for Patients with Dementia.

BACKGROUND The person with dementia should be treated as an unique person regarding symptoms directly associated with dementia, such as problems with memory, hallucinations, and delusions, as well as other physical, mental, or neurological deficits. The symptoms not directly typical of dementia, such as musculoskeletal disorders or depression, should be also be considered in order to improve the quality of life of a person with dementia. That is why professional caregivers have to broaden their current knowledge not only of medical symptoms but also of the patient's psychosocial condition and increase their inquisitiveness about the individual condition of the patient. The aim of the study was to get to know the opinion of professional caregivers about the UnderstAID platform and its usefulness for informal caregivers. MATERIAL AND METHODS Participants in the study group consisted of professional caregivers: nurses, sociologists, psychologists, physiotherapists, and occupational therapists, all of whom specialized in geriatrics and had experience in working with people with dementia. All professional caregivers answered 24 questions that refer to positive and negative aspects of the UnderstAID platform. RESULTS The study group of professional caregivers highly appreciated that the application could give support to caregivers (mean score of 4.78; 5 points means that they totally agreed, and 1 point means that they totally disagreed) and that a wide range of multimedia materials helped the informal caregivers to gain a better understanding of the contents (mean score of 4.78). There was a statistically significant correlation between the age of the professional caregivers and the frequency of positive opinions that the UnderstAID application gave support to caregivers of relatives with dementia (p=0.028) and the opinion that videos, photos, and pictures may help the informal caregivers to gain a better understanding of the contents (p=0.028). CONCLUSIONS A group of professional caregivers positively assessed the UnderstAID platform. Caregivers, especially older caregivers, highly appreciated the usefulness of videos, photos, and pictures for gaining a better understanding of the contents.

Delays in Motor Development in Children with Down Syndrome.

BACKGROUND: Children with Down syndrome (DS) present with delays in motor development. The reduced size of the cerebrum, brain maturation disorders, and pathophysiological processes lead to motor development delay. The aim of this study was to examine the gross motor function and estimate what motor abilities are significantly delayed in children with Down syndrome even if they attend physical therapy sessions. Another purpose of the study was to assess the functional balance. MATERIAL AND METHODS: The study group consisted of 79 children with DS (42 boys, 37 girls), average age 6 years and 3 months ± 4 years and 6 months. Participants were divided into 3 groups according to (i) age: <3 years old, 3-6 years old, and >6 years old; and (ii) motor impairment scale: mild (SNR 1), moderate (SNR 2), and severe (SNR 3). Children were assessed using the Gross Motor Function Measure-88 (GMFM-88) and Pediatric Balance Scale (PBS). RESULTS: None of the assessed children developed all the functions included in GMFM-88. The standing position was achieved at the specified age by 10% of children in the first age group (<3 years old) and 95% of children aged 3-6 years. Similarly, the walking ability was performed by 10% of children under 3 years old and by 95% of children aged 3-6 years. The median score of PBS was 50 points (min. 34 p. - max. 56 p.). There was a statistically significant correlation between PBS scores and GMFM-88 scores, r=0.7; p<0.0001, and between balance scores and GMFM - 88 E (walking, running, jumping) (r=0.64; p<0.0001). CONCLUSIONS: Motor development, especially standing position and walking ability, is delayed in children with Down syndrome. Balance and motor functions are correlated with each other, so both aspects of development should be consider together in physical therapy of children with Down syndrome.

Sacroiliac joint pain as an important element of psoriatic arthritis diagnosis.

Psoriatic arthritis (PsA) is a chronic inflammatory disease characterized by the coexistence of arthritis with psoriasis of the skin and nails. The sacroiliac joints were observed in 34-78% of patients with psoriatic arthritis. Due to such a high prevalence of SIJ dysfunction, understanding pathophysiology of pain and the associated pain pattern becomes a very important aspect of PsA diagnosis. As far as the etiology of SI joint dysfunction is concerned, it has not been disambiguated yet. Among the main causative factors, injuries and strains of the structures surrounding the joint are noted. Joint pathology usually manifests itself by pain occurring within the area of the joint. The causes of pain may be divided into two categories: intra-articular and extra-articular. Pain caused by the SI joint may be nociceptive or neural in nature, whereas the pain pattern characteristic of the joint correlates with its innervation and is consistent with S2 dorsal rami.

UnderstAID, an ICT Platform to Help Informal Caregivers of People with Dementia: A Pilot Randomized Controlled Study.

Information and communications technology (ICT) could support ambient assisted living (AAL) based interventions to provide support to informal caregivers of people with dementia, especially when they need to cope with their feelings of overburden or isolation. An e-learning platform (understAID application) was tested by informal caregivers from Denmark, Poland, and Spain to explore the technical and the pedagogical specifications, as well as evaluating the impact of its use on the psychological status of the participants. 61 informal caregivers completed the study taking part in the experimental (n = 30) or control (n = 31) groups. 33.3% of the caregivers were satisfied with the application and around 50% of the participants assessed it as technically and pedagogically acceptable. After using understAID the caregivers in the experimental group significantly decreased their depressive symptomatology according to the Center for Epidemiologic Studies Depression scale, but a possible benefit on their feelings of competence and satisfaction with the caring experience was also observed. The low scores obtained for satisfaction were highlighting issues that need to be modified to meet the informal caregivers' needs in national, social, and cultural context. Some possible biases are also considered and discussed to be taken into account in future improvements of understAID application.

Condition of informal caregivers in long-term care of people with dementi.

INTRODUCTION: Caregivers of demented relatives devote their time and attention in order to help the beloved members of the family. Those who are informal caregivers require support in order to avoid being overburdened. Many such caregivers may suffer from chronic health problems, for instance, depression. OBJECTIVE: The aim was to assess the factors of depression in caregivers, and to discover the determinants of depression among informal family caregivers of demented individuals. MATERIALS AND METHOD: Forty-one caregivers in the research group were administered a questionnaire which included the caregivers' demographics. Caregiver's level of depression was measured by the scale of the Centre for Epidemiology Scale for Depression. The relationship between depression and demographic features was analyzed. Data were analyzed using STATISTICA 8.1 (StatSoft). Analysis of the results was performed using the Kolmogorov-Smirnov test of normality. Pearson correlation coefficient was also used. RESULTS: Referring to The Centre for Epidemiology Scale for Depression, the average score in the study group was 18 ± 7.49. There was no statistically significant relationship between the level of depression and such factors as caregiver's age, time of care of demented relative, and type of kinship and pain. CONCLUSIONS: Although there was no relationship between the level of depression and demographic features, the problem with quality of life, worries and grief which may appear, seemed to be sufficient reason for organizing the prevention of depression for all informal caregivers of persons with dementia.

Dysfunctions associated with dementia and their treatment.

International UnderstAID project shows the role of physiotherapist in patients with dementia as divided into two branches: helping to resolve the physical problems and solving the problems related to dementia. The role of physiotherapist in dementia treatment may be divided into two branches: helping to resolve the physical problems and solving the problems related to dementia. The physical problems consider such aspects as musculoskeletal disorders, mobility dysfunction and pain. Referring to musculoskeletal problems, the interventions of physical therapists should included whole-body progressive resistance exercise training, strengthening, "range-of-motion" and stretching exercises and transfer training. Mobility disorders are associated with physical symptoms such as: rigidity, balance problem, shuffling gait. Decreased mobility can be based on unrelieved pain. These are some crucial scales which are designed to detected the pain. For instance, The Pain Assessment in Advanced Dementia. Transcutaneous Electrical Nerve Stimulation, massage or exercises can be provide to reduce the pain in patients with dementia. Physiotherapy in dementia treatment influences not only physical functions but also the maintenance or progression of cognitive abilities of demented elderly subjects.

Motor skills, cognitive development and balance functions of children with Down syndrome.

INTRODUCTION AND OBJECTIVES: Motor and cognitive development of children with Down syndrome (DS) is delayed and inharmonic. Neuro-muscular abnormalities, such as hypotonia, retained primary reflexes, and slow performance of volitional reaction, result in difficulties with body balance. The aim of the presented study is to assess the global motor functions and body balance of children with DS in relation to age and mental development. MATERIAL AND METHODS: The study group consisted of 79 children with DS (42 boys, 37 girls), average age 6 years and 3 months ± 4 years and 6 months. Participants were divided according to age range into 3 groups: < 3 years old, 3-6 years old, > 6 years old. Children were assessed using Gross Motor Function Measure-88 (GMFM-88) and Paediatric Balance Scale (PBS). Psychological diagnosis served to determine the degree of mental development using the Brunet-Lezine Scale for children younger than 3 years old, and the Wechsler Intelligence Scale for Children (WISC) for those who are older than 3 years. Nine children in research group had not been diagnosed by psychologists, which is the reason why the analysis referring to mental development was performed in 70 children (34 girls, 36 boys), with an average age of 4 years and 6 months. RESULTS: GMFM-88 scores were significantly lower in children with moderate psychomotor delay than in children with mild psychomotor delay, or normally developed children, p=0.043. GMFM-88 scores in children with profound mental impairment were lower than in children with mild or moderate mental impairment. There was a statistical significant correlation between GMFM-88 scores and the PBS scores, r= 0.7, p<0.0001. CONCLUSIONS: Motor development of children with Down syndrome from towns and villages in the Greater Poland region is associated with cognitive development, especially in the first three years of life, with the balance functions being closely related to motor skills.

[Assess of patients' functional condition with rheumatoid arthritis before and after physical therapy treatment]. / Ocena stanu funkcjonalnego chorych na reumatoidalne zapalenie stawów przed i po zastosowaniu fizykoterapii.

UNLABELLED: The aim of this study was to assess the impact of duration of disease and age on the functional condition of patients and also healing effectiveness in different duration of disease and age. MATERIAL AND METHODS: The study involved 31 patients with rheumatoid arthritis aged 40-70 years, with duration of disease 5-20 years. In this group was used following physical therapy technique: cryotherapy, ultrasound therapy, laser therapy, electrical stimulation TENS, iontophoresis, diadynamic and magnetic therapy. Before and after the treatment motor capacity was estimated using Health Assessment Questionnaire (HAQ). RESULTS: The presented results indicate improvement of measured parameters and increasement of patients independence after therapy, especially with duration of disease 5-10 years aged 60-70 years. CONCLUSIONS: Susceptibility of anti pain treatment using physical therapy increase with increasing duration of disease. Therapy influence on functional condition of patient decreasing with duration of disease.

[The Polish model of physiotherapeutic conduct in rheumatoid arthritis and recommendation of Ottawa Panel]. / Polskie podejscie fizjoterapeutyczne usprawniania w reumatoidalnym zapaleniu stawów a zalecenia Panelu Ottawskiego.

THE AIM: The aim of the research was to evaluate how the suggestions of the Ottawa Panel are implemented with regard to the patents suffering from rheumatoid arthritis in Poland. MATERIAL AND METHOD: in the research there was a test group of 41 people (33 women and 8 men) with rheumatoid arthritis. The criterion that was decisive in this study was the phase of reemission of the illness and whether the patient was taking part in physiotherapeutic treatment. The age of the subjects varied from 25 and 79 (the average age was 53.11). The average duration of the illness was 12.17 years. The research was conducted from November 2006 until September 2007 in Wiktor Dega Orthopedic-Rehabilitation Clinical Hospital (O-RSK4) in Poznan and in 22nd Military Rehabilitation Hospital in Ciechocinek. RESULTS: It was shown in the tested group there was a deep correlation between the joints with movement restrictions and the ones that caused most pain (r = 0.6086 for sum of painful joints with those with movement restrictions). Any link between the presence of deformation within the lower limb and exercising the suggested elements of gait during rehabilitation has not been found. Similarly, there was no dependence between the presence of deformations in the upper limb and the appropriate physiotherapeutic treatment. However, only in one patient the physical treatment recommended by the Panel was not used at all. CONCLUSIONS: The majority of the Ottawa Panel recommendations is implemented in the Polish model. A big part of patients has access to rehabilitation and usually the physical treatment techniques that proved to be the most beneficial are used. However, certain changes should be introduced to kinesis therapy, which tends to be focused more on joint deformation than on global work on the improvement of functionality and thus--the quality of patient's life.