Comparative Analysis of Mandibular and Cervical Mobility in Young Adults with Temporomandibular Joint Disorders: A Case-Control Study.

BACKGROUND Temporomandibular joint disorders (TMJD) affect the muscles of the mandible or the temporomandibular joint (TMJ). The objective of this case-control study was to compare mandibular and cervical joint mobility in young adults diagnosed with TMJD to a healthy control group. MATERIAL AND METHODS We enrolled 60 participants aged 18-30 years, split evenly between 30 TMJD patients and 30 healthy controls. We employed a millimeter gauge to measure TMJ mobility and a tape-based tool for assessing the range of cervical mobility. RESULTS Our data revealed that TMJD patients exhibited a significantly reduced range of mobility in both the TMJ and cervical spine compared to controls. Controls demonstrated a greater mean cervical mobility through left and right lateral flexion movements (P<0.01 and P<0.05 respectively), as well as right and left rotations (P<0.05). Additionally, they showed significantly higher mandibular mobility across all tested parameters (P<0.001). Within the TMJD group, we observed a significant correlation between cervical and mandibular mobility (P<0.05). CONCLUSIONS Our findings underline that TMJD patients possess significantly diminished mandibular and cervical mobility, particularly in lateral movements and rotations, compared to those without the disorder. The observed correlation between cervical and mandibular mobility in the TMJD group implies the necessity to consider these interconnected aspects when designing rehabilitation programs, thereby enhancing patient quality of life and impeding further mobility deterioration.

Cryotherapy With Mobilization Versus Cryotherapy With Mobilization Reinforced With Home Stretching Exercises in Treatment of Chronic Neck Pain: A Randomized Trial.

OBJECTIVES: The purpose of this study was to compare the effectiveness of cryotherapy with mobilization (CM) vs cryotherapy with mobilization reinforced with home stretching exercises (CMS) on pain and disability. METHOD: A randomized clinical trial with 2-arm parallel design, concealed allocation, assessor blinding, and intention to-treat analysis. Sixty participants were in 2 groups. Group 1 included cryotherapy with mobilization twice per week for 5 weeks. Group 2 included cryotherapy with mobilization plus home stretching exercises 5 times per week for 5 weeks. The evaluations were at baseline and 2 days posttreatment for the numeric pain rating scale, neck disability index, patient-specific functional scale, and global rating of change. RESULTS: The CM and CMS decreased neck pain and disability (P = .000). The statistical significance between the groups' differences favored the CM in the numeric pain rating scale, patient-specific functional scale, global rating of change (P = .000), and neck disability index (P = .004). CONCLUSION: Cryotherapy with mobilization for subjects in this study was more effective in decreasing disability and neck pain than CMS.

Manual Therapy With Cryotherapy Versus Kinesiotherapy With Cryotherapy for Knee Osteoarthritis: A Randomized Controlled Trial.

CONTEXT: Manual therapy and kinesiotherapy are used for knee osteoarthritis (OA). Yet, a clear evidence of the effects of manual therapy versus kinesiotherapy on knee OA is limited. The addition of cryotherapy to manual therapy or to kinesiotherapy may enhance the health benefits in patients with knee OA. OBJECTIVE: The study intended to evaluate the efficacy of manual therapy combined with cryotherapy versus kinesiotherapy combined with cryotherapy for patients with knee OA. DESIGN: The research team designed a randomized, controlled trial. SETTING: The study occurred in the Physiotherapy Outpatient Department of the Regional Hospital (Sandomierz, Poland). PARTICIPANTS: The participants were 128 females and males with knee OA, aged 40 to 80 y, who were patients in the department at the hospital. INTERVENTION: The participants were randomly assigned to an intervention group that received manual therapy combined with cryotherapy, the MT-C group (n = 64), or to a control group, which received kinesiotherapy combined with cryotherapy, the KIN-C group (n = 64). The participants in both groups received 10 treatments, 2 per wk for 5 wk. OUTCOME MEASURES: The primary outcome was measured using a visual analog scale pain ratings. The secondary outcome measured the quality of life using the Western Ontario and McMaster Universities questionnaire, knee extension, and flexion range of motion using the goniometer, and functional capacity using the 6-min walk test. RESULTS: After the treatments, the intervention group had significantly lower scores than the control group for pain, as well as significantly higher scores for quality of life, range of motion of the affected knee, and functional capacity. CONCLUSION: The patients achieved better health benefits from manual therapy when it was combined with cryotherapy.

The Effect of Frankel's Stabilization Exercises and Stabilometric Platform in the Balance in Elderly Patients: A Randomized Clinical Trial.

Background and Objectives: Every year, older people are becoming a larger part of the population. In a couple of years medicine is going to struggle with specific disorders and their consequences, where one of them are falls. Fall prevention involves a use of strengthening exercises, equivalent exercises, stabilometric platforms, and special exercise programs. Almost the entire brain is involved in maintaining correct balance. Reduction of a volume of gray matter negatively affects balance. Single exercise sessions do not significantly improve balance. In order to achieve satisfactory results at least 10 training sessions are required. The aim of this study is to determine if there is a correlation between a risk of falls, gender, and a risk of falls and the age of the subjects. Another reason to conduct that research was to assess the effectiveness of Frankel's exercises and training of using the stabilometric platform in rehabilitation, which aims to reduce the risk of falls among elderly people. Materials and Methods: The study involved 40 elderly patients referred for physiotherapy to a rehabilitation center. The patients were divided into two groups of 20 people. In experimental group 1 (C) Frankel's stabilization exercises were used; in experimental group 2 (E) a stabilometric platform was used. The correlation between the risk of falls and age as well a risk of falling and the gender of the examined persons was taken into consideration. The effect of therapy that uses stabilization exercises and the stabilometric platform on the risk of falls in the examined persons was assessed using the Tinetti scale. Clinical control was performed using the Tinetti scale, before and after a two-week rehabilitation period. Results: The study showed no correlation between the degree of risk of falling and age, and between the risk of falling by the elderly and gender. There were also changes in the results obtained by patients after using the training, both with the use of Frankel's stabilization exercises as well as with the use of the stabilometric platform. Patients using the dynamometric platform obtained higher results in the Tinetti test after treatment. Conclusions: In the examined sample, no correlation was found between the risk of falls and age as well as the risk of falls and gender. Both Frankel's exercises and training with the use of the stabilometric platform were effective in a rehabilitation program aimed at reducing the risk of falls among the elderly.

The effect of programed physical activity measured with levels of body balance maintenance.

Background The aim of the research was an evaluation of 2 training programs covering the same standard physical activity in the initial stage (warm-up) and the main (motor exercises) as well as a separate end part in Program A of stretching and in Programme B of vibration training designed to improve the level of body balance. Material and Methods We tested 40 randomly chosen students of the Academy of Physical Education and Sport in Gdansk, subsequently divided into two 20-person groups: C (average age 21.3±1.2), and E (average age 21.8±1.1). The training of body balance was conducted for 8 weeks: we used in Group C Program A and in group E Program B. The evaluation of body balance was done 3 times: at the beginning, at midway point, and at the end of the experiment. The stabilographic tests with posture-graphical method and the task of 1-leg balance standing with eyes closed was used. Results It was found that in the first examination both groups did not significantly differ in terms of the tested parameters of balance. During the training process we obtained increased time of maintaining balance on 1 leg. This difference was significant between tests 1 and 2 both for Group C (p=0.0002) and for E (p=0.0034), while between the tests 2 and 3 in Group E (p=0.0213) only. Conclusions The training Program B is more effective to maintain balance on 1 leg when compared to Program A.

The effectiveness of selected Tai Chi exercises in a program of strategic rehabilitation aimed at improving the self-care skills of patients aroused from prolonged coma after severe TBI.

BACKGROUND: Difficulties in self-care constitute a very common problem for patients recovering from prolonged coma after a severe TBI, and a major factor reducing their quality of life. Effective new rehabilitation programs that would help solve this problem are urgently needed. The purpose of our experiment was to evaluate improvement in this respect in a group of patients aroused from prolonged coma who participated in a goal-oriented rehabilitation program (Rehab-3), enhanced with selected elements of Tai-Chi. MATERIAL/METHODS: We examined 40 patients aroused from prolonged coma after a severe TBI, undergoing long-term rehabilitation according to a standard phased rehabilitation program. These patients were divided into two numerically even groups: a control group treated according to the standard program, and an experimental group, who received an additional goal oriented program enhanced with selected Tai-Chi exercises. The research methods included analysis of documentation (MRI, CT), a structured clinical interview, and the Standard Self-Care Scale. RESULTS: The experimental group achieved significant improvement of self-care skills, whereas in the control group the improvement was slight and not statistically significant. The value of co-efficient j (0.64) indicates a very strong association between the rehabilitation procedure and improved self-care in the experimental group, but not in the control group. CONCLUSIONS: Our results confirmed that a goal-oriented rehabilitation program enhanced with elements of Tai-Chi was more effective than the standard program in improving the performance of activities of daily living.

Effects of Rowing on Rheological Properties of Blood.

The aim of this study was to analyze the selected hematological and rheological indices in female rowers during the competitive season. The study included 10 female rowers (aged 21.2 ± 2.6) and the control group consisted of 10 woman of corresponding age (non-athletes). The examination of athletes took place two times: at the beginning of the season during high endurance low intensity training period in January (baseline) and at the end of the competitive season in October (after). Blood samples taken from all woman were analyzed for hematological and rheological parameters. The training period of rowers during the 10 months resulted in decrease in red blood cell count and RBC deformability, in contrast to an improvement in some rheological functions such a decrease in fibrinogen concentration, plasma viscosity and aggregation index. The training program practice in rowing modulated some hematological and rheological indices. Some of them positively influenced the cardiovascular system and reduced potential risks connected with hard training and dehydration, but others may have followed from overtraining or not enough relaxation time between training units.

Assessment of rehabilitation effects in children with mild intellectual disability.

Research on effectiveness of rehabilitation programmes continues to investigate impact of therapeutic interventions on various motor parameters in children with intellectual disability (ID). This study compared the effectiveness of rehabilitation, reflected by physical fitness, static balance, and dynamic balance measurements, in children with mild ID. A total of 70 children with mild ID were enrolled for the study and were divided into two equal groups based on their body mass index (BMI) percentile, reflecting obesity or normal weight. Physical fitness was assessed using the Eurofit Special Test, whereas balance was evaluated with single-leg stance and timed up and go tests. The examinations were performed twice: At the beginning and at the end of a six-month therapy programme. Improvements were shown in the muscle strength of the upper limbs (p < 0.001) and lower limbs (p = 0.001), flexibility (p = 0.005), and static balance (p < 0.001) for the entire cohort. The effects of rehabilitation did not differ significantly between the children with obesity and those with a normal weight. These results may be important from the viewpoint of clinical practice and preventive measures, as they present evidence showing that rehabilitation is equally effective in both obese and normal weight children with mild ID. Therefore, these findings may be of assistance to those designing therapeutic programmes in special education centres.

The quality of life of persons with TBI in the process of a comprehensive rehabilitation program.

BACKGROUND: The aim of the research was to evaluate the effectiveness of the phased rehabilitation program in patients after traumatic brain injury, one developed by the authors and controlled by the strategic plan, pertaining to their quality of life compared to patients treated according to a standard, phased rehabilitation program. MATERIAL/METHODS: The study included 40 patients of post traumatic brain injury treated at the Rehabilitation Clinic of the L. Rydygier Academy of Medical Sciences in Bydgoszcz and the Department of Medical Rehabilitation of the Cracow Rehabilitation Centre. An experimental group included 20 patients rehabilitated by a strategic approach and a control group consisted of 20 patients treated before the introduction of this approach. In assessing the effectiveness of rehabilitation, a structured interview was used with clinical observation and the Battery of Quality of Life Assessment. The study was conducted twice: before and after eight weeks of rehabilitation. RESULTS: The quality of life of people after brain injury is affected by self-service difficulties, difficulties in meeting the physiological needs and loss of psychophysical comfort, decreased mobility, impaired cognitive functions and executive and social functions. There is no consistency between the stated (subjective) level of quality of life of the patient, and the depth of objectively measured disability resulting from the injury sustained. CONCLUSIONS: A rehabilitation program controlled by a strategic plan, in collaboration with the patient treated subjectively is more effective in improving the quality of life, since the cooperating patient is more motivated to carry out individually designed goals. A rehabilitation program based on a strategic plan is worthy of recommendation for the treatment and improvement of patients after cranio-cerebral trauma.

Social intelligence and adequate self-expression in patients with orbitofrontal cortex injury and in the criminals.

BACKGROUND: The aim of present article is to compare patients with damage to the orbitofrontal cortex and prison inmates in terms of social intelligence and social intelligence monitoring. In addition, personal principles and emotional regulation of behavior will be assessed in both groups. MATERIAL/METHODS: 20 patients with orbitofrontal cortical injury, 20 prisoners and 20 controls answered questions from the Social Interactions Assessment Questionnaire. Then they evaluated their self-disclosure, reported their emotions related to self-disclosure and declared their personal principles concerning conversations with strangers. RESULTS: The patients with damage to the orbitofrontal cortex disclosed themselves to a stranger less appropriately than did other subjects, and did not assess it critically. They also violated their own declared principles, but did not feel embarrassed because of that. The prison inmates spoke out less forthrightly on many topics and felt confused during the whole examination. CONCLUSIONS: Damage to the the orbital part of frontal lobes may result in a disorder of self-disclosure monitoring and impairment of social intelligence in conversations with unknown persons. Prison inmates give information about themselves unwillingly, which may result from their specific experiences during criminal and judicatory procedures and confinement.

Evaluation of a neurotherapy program for a child with ADHD with Benign Partial Epilepsy with Rolandic Spikes (BPERS) using event-related potentials.

BACKGROUND: We hypothesized that there would be a good response to relative beta training, applied to regulate the dynamics of brain function in a patient with benign partial epilepsy with Rolandic Spikes (BPERS), associated with neuropsychiatric deficits resembling the symptoms of attention deficit-hyperactivity disorder (ADHD). CASE REPORT: The patient, E.Z., age 9.3, was suffering from neuropsychiatric symptoms, cognitive dysfunction, especially attention deficits, and behavioral changes, rendering him unable to function independently in school and in many situations of everyday life. He was treated for epilepsy, but only slight progress was made. The patient took part in 20 sessions of relative beta training combined with behavioral training. We used standardized neuropsychological testing, as well as ERPs before the experiment and after the completion of the neurotherapy program. Neuropsychological testing at baseline showed multiple cognitive deficits. Over the course of neurotherapy, E.Z.'s verbal and non-verbal IQ increased significantly. His cognitive functions also improved, including immediate and delayed logical and visual recall on the WMS-III, maintaining attention on the WMS-III, and executive functions, but remained below norms. Physiologically, the patient showed substantial changes after neurotherapy, including fewer spikes and an increased P300 NOGO component. CONCLUSIONS: The cognitive deficits characteristic for ADHD in a child with BPERS may be unresponsive to antiepileptic treatment, but are reversible after a carefully selected neurotherapy program, combined with antiepileptic treatment. Event Related Potentials (ERPs) in the GO/NOGO task can be used to assess functional brain changes induced by neurotherapeutical programs.

Radiological and biomechanical analysis of humeral fractures occurring during arm wrestling.

BACKGROUND: Arm wrestling has recently become one of the most popular sports among young people, mainly due to its simplicity and spectacularity. Yet, unfortunately it is also injury prone. The aim of the study was to perform a biomechanical analysis of the forces which act during arm wrestling, as well as to explain the mechanism of the occurrence of humeral fractures of a similar topology as observed on X-rays. MATERIAL/METHODS: During the period 2001 to 2008 nine cases of humeral fractures resulting from arm wrestling were consulted and treated at the Clinic. The assessment of the limb condition included an interview and the examination of the fractured extremity. All the patients underwent surgical treatment, using the method of open reduction and internal fixation. The virtual dynamic model of the upper limb was established on the basis of a series of computer tomography scans of the bone, and literature data. The biomechanical analysis was carried out using the Finite Elements Method (FEM). RESULTS: There were five cases of the 12-B1 type in the AO Classification with butterfly fragments in five cases, and four of the 12-A1 type without the butterfly fragment. The maximum bone stress resulting from torsional loading which occurs during arm wrestling amounted to 60 MPa and was located 115 mm above the elbow on the medial - posterior side of the humeral. CONCLUSIONS: The strength analysis carried out during arm wrestling revealed that the forces of the acting muscles significantly exert stresses within the distal third of the humeral.

Physiotherapeutic Methods in the Treatment of Cervical Discopathy and Degenerative Cervical Myelopathy: A Prospective Study.

Spinal dysfunctions are very common in the population. However, there is still a lack of information on how to diagnose and treat them properly. The common causes of spinal dysfunctions are cervical discopathy and degenerative cervical myelopathy. The aims of the study are to examine whether a combination of manual therapy and stabilometer platform exercises can be effective in treating cervical discopathy and degenerative cervical myelopathy, and the possibility of observing the differences between patients suffering from the above diseases. The study involved 40 patients referred for rehabilitation, who formed two groups of 20 people. The first group consisted of patients suffering from cervical discopathy, the second group consisted of patients affected by degenerative cervical myelopathy. During therapy, manual therapy techniques and a stabilometric platform were used. The Neck Disability Index and Pain Numeric Rating Scale were used for clinical evaluation. The correlation between the existing diseases and the results obtained in the Neck Disability Index and Pain Numeric Rating Scale was examined. The distribution of patient responses in questions of the Neck Disability Index was also checked. Clinical evaluation was performed twice, before the start of therapy and after a two-week rehabilitation treatment. The study showed a significant difference between the patients' results before the start of therapy and after the end of the rehabilitation stay in both used questionnaires (p = 0.00). A difference in the distribution of responses between the two groups after therapy was also found in the Neck Disability Index (p = 0.018) and in the Pain Numeric Rating Scale (p = 0.043). The study shows that manual therapy and exercises using the stabilometric platform are effective methods of treating both patients with cervical discopathy and patients with degenerative cervical myelopathy. It was also noted that, when comparing groups of patients, patients with degenerative cervical myelopathy tend to have greater disturbances in concentration-related activities, such as reading, focusing, driving, sleeping, and resting.

An evaluation of the strategic approach to the rehabilitation of traumatic brain injury (TBI) patients.

BACKGROUND: The objective of our study was to evaluate a goal-driven strategic plan for the step-by-step rehabilitation of traumatic brain injury (TBI) patients, with effectiveness measured in terms of quality of life, as compared to patients treated according to a standard, progressive rehabilitation program. MATERIAL/METHODS: We studied 40 patients after TBI awakened from a long-term coma. The patients were divided into two equal groups: a control group (n=20) involving patients treated before the introduction of the strategic approach, and an experimental group (n=20) involving patients rehabilitated under the strategic approach. In evaluating the effectiveness of rehabilitation we used a structured interview with clinical observation and a scale for assessing the quality of life of patients after TBI. RESULTS: The deterioration in the quality of life of TBI patients is mainly related to difficulties in satisfying physiological needs, self-care, reduced mobility and disorders of cognitive, regulatory, and social functions. In both groups, the feature most susceptible to rehabilitation related change was movement, while the least susceptible functions were associated with the use of different means of transport. This change is significantly greater in persons in the experimental group, as compared to controls. CONCLUSIONS: We found that a rehabilitation program controlled by a strategic plan, with the cooperation of the patient, is more effective in improving the quality of life, as the patient is more self-motivated to individually designed objectives.

Assessment of the level of static and dynamic balance in healthy people, practicing selected Latin American dances.

PURPOSE: The balance, known as the ability to independently maintain the body in a certain position and return to the starting position, can be divided into static and dynamic balances. Social Latin American dances (salsa, bachata) require dancers to do a characteristic figure, however, they are not trained as intensively as dancing sports. The aim of the study was to assess the static and dynamic balances of dancers, who are regularly dancing those selected Latin American dances, by comparison with those who do not. METHODS: The study was conducted among 34 dancers from a Krakow Dancing School and, 37 students of the Jagiellonian University, aged 21-35. A SIGMA balance platform was used to measure static and, the Y-Balance Test platform to assess dynamic balance. The Student's T-test, Mann- Whitney U-test and Spearman's rank correlation coefficient were used in statistical analysis. RESULTS: There were neither significant differences between right and left lower limbs of dancers, nor between values of tilts on the YBT platform in both investigated groups. Non-dancers, however, showed a slightly higher positive correlation between the deviations in the sagittal and frontal planes and the surface area, as well as between the path length and the surface area on the SIGMA platform when compared to dancers. CONCLUSIONS: The level of dynamic and static balances of dancing people is similar, when compared to non-dancers. The influence of practicing Latin American dances on the sense of balance require further studies.

Body Balance and Physiotherapy in the Aquatic Environment and at a Gym.

The increase in the average age of our society represents a growing medical and social problem, which requires concentration on the issue concerning balance disorders. The aquatic environment has a number of complex properties that have miscellaneous effects on the human body. In the light of the above, water is becoming an ideal environment to learn correct neuromuscular communication, and a properly prepared training session in water helps to practice balance and movement coordination. The objective of the study was to assess the impact of rehabilitation in the aquatic environment on patients' balance and compare the results obtained with patients who received rehabilitation at a gym. The study was carried out among patients hospitalised in the "Krzeszowice" Rehabilitation Centre. It encompassed 137 patients, randomly assigned to either the study group (the aquatic environment) or the control group (the gym). The preliminary examination included general medical history and a test on the stabilometric platform. The patients attended training sessions for 4 weeks, 5 times a week for 30 minutes. It was a single-blinded study wherein the authors did not know which group a given patient had been assigned to. Upon completion of a monthly therapy, the stabilometric test was carried out again. The study revealed that the patients from both groups experienced a significant improvement in balance. However, the improvement was slightly greater in those exercising in the pool. Physiotherapy in the aquatic environment makes a greater contribution to the improvement of body balance compared to physical exercises performed at a gym.

Distribution of feet pressure on ground and maintaining body balance among 8-10-year-old children with and without external load application.

PURPOSE: The aim of this study was to analyse the impact of applying an external load on the distribution of pressure on the plantar side of the foot and maintaining body balance, using the podobarographic platform. METHODS: The study was conducted on 130 school children aged 8-10: girls (n = 68, body mass = 22.8 ± 6.0 kg, body height = 129.3 ± 7.5 cm) and boys (n = 62, body mass = 31.1 ± 6.5 kg, body height 134.4 ± 7.3 cm). The study involved 2 trials. At first, children stood on the platform assuming a natural position. Then, they put on a 5-kg backpack and stood on the platform once more. RESULTS: The results indicate that after backpack loading, for the total research group of girls and boys, statistically significant differences were found in the distribution of foot force on the ground in the left forefoot ( p = 0.008), metatarsus ( p = 0.000) and heel areas ( p = 0.002). While in the right foot, these differences were noted for the forefoot ( p = 0.024) and metatarsus ( p = 0.000). The results of balance testing were also statistically significant. They concerned measurements of the body barycentre area (cop-bars p = 0.003), the barycentre area of the left foot (l-bars p = 0.034) and the parameter comparing distance to surface ratio (cop-lsf p = 0.000). CONCLUSIONS: It may be concluded that prolonged overloading with backpacks affects movement patterns, which may further lead to the acquisition and consolidation of postural defects.

Extracorporeal shockwave therapy vs. kinesiotherapy for osteoarthritis of the knee: A pilot randomized controlled trial.

BACKGROUND: Osteoarthritis (OA) of the knee is a degenerative, painful pathology, needing conservative treatment for symptoms' relief. OBJECTIVE: Comparing the effects of Extracorporeal shockwave therapy (ESWT) and Kinesiotherapy (KIN) on perceived health and range of motion (ROM) of the affected knee. METHOD: A pilot randomized controlled trial with concealed allocation, assessor blinding, intention-to-treat analysis. Forty participants, aged 40-75 with OA of the knee were randomized to an ESWT and a KIN groups. The ESWT group completed 5 interventions for 5 weeks, the KIN group completed the same number of interventions. All evaluations were performed at baseline and after the treatment for: perceived health (Western Ontario and McMaster Universities questionnaire - WOMAC), range of motion (ROM). RESULTS: After the intervention the statistical significant between groups differences favoring the ESWT were found in the WOMAC with regard to pain (p< 0.000), stiffness (p= 0.018), physical function (p< 0.000), total score (p< 0.000), extension and flexion of the affected knee (p= 0.015, p< 0.000) respectively. CONCLUSIONS: ESWT improves WOMAC and ROM better then KIN on the affected knee in patients with OA of the knee.

Neurofeedback training for peak performance.

AIM: One of the applications of the Neurofeedback methodology is peak performance in sport. The protocols of the neurofeedback are usually based on an assessment of the spectral parameters of spontaneous EEG in resting state conditions. The aim of the paper was to study whether the intensive neurofeedback training of a well-functioning Olympic athlete who has lost his performance confidence after injury in sport, could change the brain functioning reflected in changes in spontaneous EEG and event related potentials (ERPs). CASE STUDY: The case is presented of an Olympic athlete who has lost his performance confidence after injury in sport. He wanted to resume his activities by means of neurofeedback training. His QEEG/ERP parameters were assessed before and after 4 intensive sessions of neurotherapy. Dramatic and statistically significant changes that could not be explained by error measurement were observed in the patient. CONCLUSION: Neurofeedback training in the subject under study increased the amplitude of the monitoring component of ERPs generated in the anterior cingulate cortex, accompanied by an increase in beta activity over the medial prefrontal cortex. Taking these changes together, it can be concluded that that even a few sessions of neurofeedback in a high performance brain can significantly activate the prefrontal cortical areas associated with increasing confidence in sport performance.

An evaluation of health-related quality of life of patients aroused from prolonged coma when treated by physiotherapists with or without training in the 'Academy of Life' programme.

OBJECTIVE: To evaluate the health-related quality of life (HRQOL) in patients aroused from prolonged coma after a severe traumatic brain injury (TBI) treated by physiotherapists trained in the 'Academy of Life' programme. It was assumed that physiotherapists who acquired this knowledge and experience would create a better therapeutic milieu, and would be more effective than physiotherapists who had not received this training. MATERIAL AND METHODS: 40 patients who had suffered a severe TBI in a motor vehicle accident and had been aroused from prolonged coma were examined. All the patients underwent long-term rehabilitation according to a standard, phased programme. They were divided into two numerically even groups: an experimental group, treated by therapists trained in the 'Academy of Life' programme, and a control group, treated by physiotherapists who were not trained in this programme. The research instruments included an analysis of documentation, a structured clinical interview, and the Quality of Life Scale. RESULTS: As hypothesized, the experimental group showed significant improvement in HRQOL, whereas in the control group improvement was statistically non-significant. CONCLUSIONS: The patients from the experimental group, treated by physiotherapists trained in the 'Academy of Life', obtained a significantly greater improvement in physical and social functioning, and thus in HRQOL, than patients from the control group.