2014 Vol. XVI No. 1

Rafał Sapuła

Katedra Fizjoterapii Wyższej Szkoły Informatyki i Zarządzania w Rzeszowie Katedra Fizjoterapii Wyższej Szkoły Zarządzania i Administracji w Zamościu Zamojska Klinika Rehabilitacji WSZiA w Zamościu

okladka_2014_1Controversies in using the barthel index in care-treatment ward


Background. Bartel Index is the most commonly used scale to assess performance of activities of daily living (ADL). Bartel Index assesses ten basic activities of daily living.

Objective. Evaluation of the functional status of patients in Care-Treatment Ward and the possibility of using the Barthel Index.

Material and method. The study used a author’s questionnaire and an anonymous question-naire. The questionnaires was conducted in 86 Care-Treatment Wards in Poland. Some of the questions the questionnaires has not responded.

Results. Over 60% of respondents think that the Barthel Index is not an objective tool and does not reflect the correct functional state in patients of Care-Treatment Ward.

Conclusions. Barthel Index does not describe the functional status of patients of Care-Treatment Ward. Barthel Index is dedicated to the functional assessment of patients with neurological diseases ex.: stroke, craniocerebral trauma, brain tumors. Barthel Index makes interpretation problems for medical staff in Care-Treatment Ward.

Keywords: Barthel Index, Care-Treatment Ward


Krzysztof Mataczyński, Mateusz Pelc

Ośrodek Rehabilitacyjno-Terapeutyczny im. Ks. Arcybiskupa Józefa Życińskiego w Krasnymstawie
Wyższa Szkoła Zarządzania i Administracji w Zamościu
SP Szpital Wojewódzki im. Papieża Jana Pawła II w Zamościu

Physical activity of children and adolescents in the selected age groups


Introduction. Physical activity is the fundamental element of the healthy lifestyle. It is important at every stage of human life, however, it plays a crucial role in childhood and adolescence, because it conditions the proper physical, mental and social development. Regular activity has a positive impact on the human body, it allows to keep good fitness and condition, it prevents the development of civilisation diseases, it has a positive effect on the psyche. Despite these advantages resulting from the activity, people often do not undertake it.

Goal. The goal of the paper is the quality and quantity evaluation of the level of physical activity among the students of the primary school, middle school and high school in the area of Lublin and Podkarpackie.

Material and method. The survey was conducted at schools in the towns of Krasnystaw, Zamość and Rzeszów in 2012. The study involved 270 students, 148 girls and 122 boys attending the sixth grade of the primary school, third grade of the middle school and third grade of high school. The research tool was the survey of own design, containing 23 questions.

Results and conclusions. In the study group 95% of students said that physical activity has a significant influence on health of young people. Boys spend more time on physical activity outside the physical education classes. At the turn between the primary and medium school, there was observed a gradual increase of physical activity, while between the medium and high school its decrease. In terms of the time spent on physical activity, they most frequently pointed to 3-6 h and under 3 h a week. Most students, who are active outside physical education classes did several sports at the same time. The most preferred sport was the team sport. People from the urban environment said more often that they have exhausting household chores. The limited activity was explained with the lack of free time mostly as a result of great amount of studying as well as the lack of motivation to exercise. Scoliosis was present in 50% of those who said they have the disadvantage that attitude (21%). Group 29% of all respondents are under the control of the orthopedic clinic. It has been observed that the higher the education level, the less often been used in schools gymnastics. Parents and teachers need to intensively engage in appropriate educational activities designed to motivate young people, especially girls to greater participation in active recreation.

Keywords: physical activity, health promotion, youth




Justyna Leszczak, Andrzej Kwolek, Justyna Podgórska-Bednarz, Justyna Rykała, Anna Siewierska

Instytut Fizjoterapii, Wydział Medyczny, Uniwersytet Rzeszowski

Analysis of risk factors of coronary artery disease in rehabilitated people


Introduction. Diseases of cardiovascular system are a main cause of women’s and men’s deaths in Poland and in the world. In Europe due to cardiac reasons, mainly due to coronary artery disease (CAD) approximately 55% women die. In the USA CAD is the main cause of deaths of women after 50 years of age.

Aim. Evaluation of risk factors of coronary artery disease among people with CAD and people with movement disorders, comparison of risk factors of this disease in both groups.

Material and method. A group of 60 patients were studied. The researched group were people with coronary artery disease and the control group were people with movement disorders. The research was done with the use of diagnostic poll which tool was the author’s own survey. Pearson’s chi-square test and Mann-Whitney U test was used for the statistical analysis.

Results. When comparing the risk of hypertension among patients of both groups depending on BMI, food they eat and the level of physical activity no statistical significance. Conclusions. Researched risk factors of coronary artery disease applied to both groups. Among people with CAD greater number of risk factors of this disease dominated — i.e., greater exposure to stress, increased level of blood pressure and cholesterol, co-existing diseases preconditioning the development of CAD, increased BMI and low physical activity. On the other hand, the group with movement disorders was characterized to a greater degree by such risk factors like smoking, drinking alcohol, bad heating habits. From the conducted research it results that among people with movement disorders there is a comparative number of risk factors of coronary artery disease.

Keywords: coronary artery disease, movement disorders, atherosclerosis, hypertension, life style




Emilia Rymkiewicz, Agata Rękas-Wójcik, Andrzej Prystupa, Grzegorz Dzida, Jerzy Mosiewicz

Katedra i Klinika Chorób Wewnętrznych
Samodzielny Publiczny Szpital Kliniczny Nr 1 w Lublinie

Side effects of nonsteroidal anti-inflammatory drugs


Introduction. Drugs of nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay of treatment for pain in rheumatic diseases. Despite the widespread use of these drugs have several side effects. The most common side effects of NSAIDs include gastritis, stomach ulcers, gastrointestinal bleeding, induction of asthma attacks, heart failure and kidney and liver skin allergy.

Objective. Presentation of the most common complications in the application of the various groups of non-steroidal anti-inflammatory drugs.

Methodology. The article uses the work available in the online databases from the years 1992 to 2007.

Summation. Knowledge of the possible side effects of therapy with an NSAID allows the use of selected classes of drugs in certain patients to prevent possible complications

Keywords: non-steroidal anti-inflammatory drugs, complications, pain management




Aneta Florczak, Jolanta Zwolińska, Andrzej Kwolek, Mariusz Drużbicki

Instytut Fizjoterapii Uniwersytetu Rzeszowskiego

Quality of life of patients with chronic obstructive pulmonary disease


Introduction. Chronic Obstructive Pulmonary Disease is one of the most common diseases of pulmonary system which obstructs the life of people suffering from it. The most common health survey questionnaire assessing the influence the disease has on the quality of life is SF-36.

Aim of thesis. The aim of this thesis is to assess the influence the disease has on the quality of life.

Research method. Research was done among 30 people suffering from chronic obstructive pulmonary disease (the research group) and 30 healthy people (the control group). The research methods comprised the health survey questionnaire SF-36 and my own survey.

Results. The results showed that the quality of physical and mental health among people suffering from the disease is much lower than among the healthy. Additionally, mental disorders and other coexisting diseases were also more common in the research group than in the control group.

Conclusion. Chronic Obstructive Pulmonary Disease has a negative influence on the quality of physical and mental health.

Keywords: Qaulity of life, COPD — Chronic Obstructive Pulmonary Disease, The Short Form 36 health Surrey Questionaire, vitality, social functioning, mental health




Marcin Gniewek1, Kamil Chołuj1, Justyna Chmiel1, Grzegorz Nowicki2, Andrzej Prystupa3, Łukasz Łagód4

1 Zakład Rehabilitacji i Fizjoterapii Katedry Rehabilitacji, Fizjoterapii i Balneoterapii, Uniwersytetu Medycznego w Lublinie
2 Zakład Kwalifikowanej Pomocy Medycznej z Pracownią Ratownictwa Medycznego, Uniwersytet Medyczny w Lubline
3 Katedra i Klinika Chorób Wewnętrznych, Uniwersytet Medyczny w Lublinie
4 Zakład Psychologii Wychowawczej i Psychologii Rodziny, Instytut Psychologii, UMCS w Lublinie

The evaluation of the comprehensive rehabilitation of patients after the surgical treatment of breast cancer


Background. Breast cancer is the most common cause of death among women from 35 to 55 years of age. In nearly all cases, treatment involves the surgical removal of the neoplastic lesion with an edge of healthy tissues, and often also lymph nodes and muscles. The damage to the structures, the cutting of lymphatic vessels or their damage resulting from radiotherapy, frequently leads to the failure of the lymphatic system on the operated side. This leads to a secondary lymphoedema. However, a properly conducted rehabilitation, a good choice of treatments, as well as the patient’s education and discipline can significantly reduce the possibility of a lymphoedema and assist in its therapy.

Objective. This article aims at the evaluation of the subjective and objective effectiveness of the comprehensive physiotherapy performed after mastectomy.

Materials and methods. The study involved two 30-person groups of women with II° clinical lymphoedema — all patients of the Rehabilitation Centre of St Johns’ Oncology Centre in Lublin. The measure used was an original survey questionnaire and a measurement of the circumference of their upper limbs.

Conclusions. The application of oedema prevention rules can considerably reduce the development of oedema and the related discomfort. Reduced lymphoedema led to lower pain intensity and less onerous feeling of heaviness and numbness in the affected limb. Patients should regularly take part in comprehensive anti-oedema therapy, and in periods when this is not conducted, follow oedema prevention rules.

Keywords: rehabilitation, mastectomy, swelling



Marta Wolanin1,2,3, Rafał Sapuła1,2,3, Adam Topolski1,2, Antoni Wolanin4, Krzysztof Marczewski2,5

1 Zamojska Klinika Rehabilitacji Wyższej Szkoły Zarządzania i Administracji w Zamościu
2 Katedra Fizjoterapii Wyższej Szkoły Zarządzania i Administracji w Zamościu
3 Wyższa Szkoła Informatyki i Zarządzania w Rzeszowie
4 Oddział Kardiochirurgii Szpitala im. Papieża Jana Pawła II w Zamościu, Polska
5 Oddział Nefrologii, Endokrynologii, Nadciśnienia Tętniczego I Chorób Wewnętrznych Szpitala im. Papieża Jana Pawła II w Zamościu, Polska

Gender as a factor potentially modifying effects of quality of Life and rehabilitation of people with low back pain


Background. In assessing the results of the rehabilitation of patients with low back pain should be taken into account medical indicators, the degree of pain reduction, psychological and psychosocial factors. This make up the overall assessment of the patient’s quality of life.

The aim of this study was to determine the factors that influence the quality of life related to health (HRQOL) and effects of rehabilitation in patients with low back pain.

Material and method. The study of 160 patients with low back pain in age from 28 to 75 years old (80 women and 80 men). We used anonymous questionnaire, which consisted of parts: the personal, the General Assessment of Helth Questionnaire (SF-20) and visual-analog scale of pain (VAS). Before and after the rehabilitation patients anwsered questions from Roland-Morris Disability Questionnaire (RMDQ).

Results. Effects measured by RMDQ significantly improved in the group of women (p < 0,001) and men (p = 0,007). Rehabilitation statistically significant improved the quality of life related with health in both: the men and women (p < 0,001).

Conclusions. Gender does not affect the results of rehabilitation and quality of life of people with low back pain.

Keywords: low back pain, Roland-Morris Dysability Questionnaire, quality of life related to health (HRQOL)




Karol Terlecki1, Paulina Chwil1, Jan Sobstyl1, Paulina Sobstyl1, Lidia Kotuła2, Janusz Kocki2

1 Studenckie Koło Naukowe Genetyki Medycznej przy Zakładzie Genetyki Klinicznej
2 Zakład Genetyki Klinicznej

Rehabilitation in patients after mastectomy


Introduction. Breast cancers account for 20% of all ‘malignant neoplasms in females, in Poland. Prevention forms the basis of overcoming breast cancer. The primary goal is a combined rehabilitation with a supplement of psych-physio-therapy. The implications of mastectomy are: reduced range of motion and muscle strength of the operated limb and a shoulder girdle, as well as lymphoedema. Rehabilitation in women being treated for breast cancer was introduced in Poland in the 1970s.

Objective. The aim of this study was to present comprehensive information about rehabilitation in patients undergoing mastectomy and an attempt to adapt to existing rehabilitation programs.

Materials and Methods. Based on the available studies an analysis of the rehabilitation programs after mastectomy was conducted.

Results. A major part of improving after mastectomy has prevention of lymphoedema by conducting daily auto-massage. Hospital physiotherapy consists of: antioedema therapy, group activities and kinesitherapy. The next stage is an ambulatory treatment with kinesitherapy. A complement to the ambulatory treatment is hydrotherapy, physical therapy, as well as physical therapy in health resort. After regaining dexterity it is advised to do daily exercise of the upper limb. Satisfactory effects are visible after swimming, Nordic walking and yoga. Suitable psycho-physiotherapy should be applied at every stage of cancer treatment.

Conclusions. On the basis of the study it can be concluded that rehabilitation might improve the patient’s condition undergoing mastectomy. Rehabilitation in a patients is a valuable component of breast cancer treatment, its impact in quality of life is determined by a chance to return to pre-treatment mobility.

Keywords: mastectomy, rehabilitation, breast cancer




Paulina Sobstyl1, Jan Sobstyl1, Paulina Chwil1, Karol Terlecki1, Lidia Kotuła2, Janusz Kocki2

1 Studenckie Koło Naukowe Genetyki Klinicznej przy Zakładzie Genetyki Klinicznej Uniwersytetu Medycznego w Lublinie
2 Zakład Genetyki Klinicznej Uniwersytetu Medycznego W Lublinie

Rehabilitation following subarachnoid hemorrhage as a result of ruptured middle cerebral artery aneurysm — case report


Introduction. Subarachnoid hemorrhage — SAH is a bleeding into the subarachnoid space. Aneurysms are the cause of subarachnoid hemorrhage in 85% of cases. SAH is most common in person ages 20 to 60. It is slightly more common in women than men. The specific locations of intracranial aneurysms are at the middle cerebral artery bifurcation and along the anterior communicating artery.

Objectives. The aim of this review was to assess the improvement quality of life after rehabilitation in patient with the aneurysmal subarachnoid hemorrhage.

Material and Methods. A retrospective analysis in patient with age 57 who was

treated on The Department of Neurological Rehabilitation Independent Public Teaching Hospital No 4 in Lublin. We asses case history, clinical symptoms, comorbid conditions, causes of the hemorrhage, results of radiology tests, complications and result of the therapy. Muscle tone, strength, passive and active movements, range of movement and sensory disturbances were assessed. The Asworth Scale was used to test muscle spasticity.

Results. Some improvement of spasticity and dysarthria was achieved. Result of the rehabilitation was positive.

Conclusions. Significant changes were observed in the functional and health status of the patients. Varied methods of rehabilitation provide satisfying effects.

Keywords: subarachnoid hemorrhage, aneurysm, rehabilitation, Ashworth Scale



Justyna Podgórska-Bednarz, Justyna Drzał-Grabiec, Sławomir Snela, Jutyna Rykała, Justyna Leszczak, Piotr Czarnecki

Instytut Fizjoterapii Uniwersytetu Rzeszowskiego

Effect of trunk Asymmetry on the feet shape


Introduction. Trunk asymmetries are a relatively common phenomenon. Many authors have reported that their number increases with the age of the child. In a large group of children existing asymmetries progress. Moreover, trunk asymmetries can affect on the whole musculoskeletal system.

Aim of the study. The aim of this study was to assess the impact of trunk asymmetries on shape of children’s feet.

Material and methods. The study population included 340 children studying in primary schools located in the Podkarpackie Province. The age range 7-10 years. The occurrence of trunk asymmetries was performed using a photogrammetric method (System Mora 4Genetion). Foot examination has been made using a computer system to test the foot CQ-ST.

Results. Analysis of the data showed no statistically significant differences between the two groups (no trunk asymmetry group, trunk asymmetry group). Higher values of mean differences between the right and left foot for the parameter SZ (width feet) and CL (Clarke’s angle) characterized a group of children with trunk asymmetry. The means differences for the parameters DL (foot length) and W (Wejsflog’s index) were lower in this group.

Conclusions. Small degree of trunk asymmetry did not affect the foot shape in the group taking part in this study. Children diagnosed with abnormalities of the parameters characterizing the posture and feet shape should be refer to therapeutic treatment.

Keywords: trunk asymmetry, feet shape, photogrammetric method



Grzegorz Mizerski1, Paweł Kiciński1,2, Andrzej Prystupa2, Sylwia Przybylska-Kuć2, Andrzej Jaroszyński1

1 Katedra i Zakład Medycyny Rodzinnej Uniwersytetu Medycznego w Lublinie
2 Katedra i Klinika Chorób Wewnętrznych Uniwersytetu Medycznego w Lublinie

Influence of physiotherapy on blood pressure in patients with type 2 diabetes and concomitant arterial hypertension


Introduction. Regular physical effort is an important method of therapy of type 2 diabetes mellitus (DM t.2). It positively regulates glycemia, reduce body mass, positively acts on blood pressure (BP) and level of lipids.

The aim of this study was define the role of physical effort in sanatorium as a factor changing blood pressure at patient with DM t.2 and hypertension.

Matherial and methods. There were studied 142 patient with DM t.2 and hypertension, staying at Sanatorium for Farmers in Nałęczów in years 2009-2011. Eighty six persons (including 46 men) in age 59,4 ± 7,7 years, having exertions with physical effort were test group, and 56 persons (including 30 men) in age 60,5 ± 7,2 without effort were control group. There were no statistically differents between the both groups for the sake of sex ( p = 0,99) and age ( p = 0,55). The patients with modified pharmacological therapy of hypertension were excluded from the study. Blood pressure was measured in all paients at the beginning and 21st day of staying.

Results. The final blood pressure decrease in patients having physical exercises was 10,3 ± 5,9/6,6 ± 2,7 mm Hg an was significantly lower than in patients without physical activity (8,3 ± 2,7/3,5 ± 2,5 mm Hg; p = 0,02 for systolic BP and p < 0,000001 for diastolic BP).

Conclusions. Decrease of BP in all patients might be explained by microclimate of Nałęczów and regular using of drugs in sanatorium. Additional physical effort promotes higher reduce of BP.

Keywords: hyprtension, diabetes mellitus, physical activity



Justyna Wyszyńska, Grzegorz Przysada, Justyna Podgórska-Bednarz, Justyna Leszczak, Teresa Pop, Sylwia Szeliga, Mariusz Drużbicki

Instytut Fizjoterapii, Wydział Medyczny, Uniwersytet Rzeszowski

Low back pain in a group of professional truck drivers


Introduction. Low back painis a frequentlyoccurringdiseaseof modern civilization. The problem also relates to professional truck drivers. Factors contributing to the emergence ofpainin drivers include:prolongeddriving,oftenon bumpy roads, staying at one, forcedpostures, often onuncomfortableandvibratingseat.

The aim ofthis study was toevaluate the prevalence oflow back pain amongprofessional drivers.The following factors were examined: age, years of serviceanddaily working time. It was examinedwhether thesefactors influence the incidence ofpainand theextent to which thepainmakes it difficult toperformactivities of daily living.

Materials and methods. 80 professional truck drivers participated in the study.

For the analysis were used a modified Laitinen pain indicator questionnaire and indicator of low back pain “Oswestry Disability Index — ODI”.

Дesults. Low back pain was observed in 57 respondents (71%). Mild pain occurred more frequently (71%), severe pain was observed in 4% of patients. Length of service in the group of respondents with pain was 16.02 years, while in the group without pain was 10.78. Oswestry Disability Index — ODI showed that in 68% of respondents appeared minimal disability, and in 4% — serious disability. Among the drivers, 47% did not use painkillers, and 39% used drugs occasionally.

Conclusions. The age of respondentshad a negative impactonactivities of daily living, such asself-reliance, walking, sleeping, social life andsexual activity, as well as onfrequency ofpain.The longerlength of serviceadversely affects theself-reliance, walking, sleeping, social life, sexual activity andtraveling,as well asthe intensityof pain,frequency ofpain anduse ofanalgesics.A longerdaily working time had a negativeeffect onwalkingand sleeping.

Keywords: low back pain, professional drivers




Katarzyna Napieraj, Justyna Kubiak, Paulina Limanowska

Studentki Wydziału Nauk o Zdrowiu, Uniwersytet Medyczny we Wrocławiu

The importance of diet in the treatment of gout


Gout (diathesis urica) is a disease associated with renal excretion of uric acid crystals which are deposited in the joints causing inflammation and degeneration. It is estimated that the disease may affect 1-2% of the population, and that its incidence increases with age. This condition is often accompanied by obesity, diabetes, hypertension. The goal of treatment is to minimize gout acute attacks of the disease. In addition to rehabilitation is important lifestyle changes and proper diet to limit intake of purines. Numerous studies have shown that the level of serum uric acid rises after ingestion of meat, seafood and alcohol. Attention is also drawn to limit the intake of sugars and the appropriate quantity and quality of fat in the diet. Patients are advised to use a vegetarian diet.

Keywords: gout, uricaemia, diet, food pyramid, vegetarianism




Agnieszka Budny, Ewelina Dziaduch, Katarzyna Golec, Natalia Ścirka, Andrzej Prystupa

Department of Internal Medicine, Medical University in Lublin, Poland

Anemia as a manifestation of colitis ulcerosa and celiac disease


Anaemia may be considered as a reduction in haemoglobin concentration, haematocrit or red cell count. The causes of anaemia are reduced red cell production, increased red cell destruction and blood loss. Anemia is also a coexisting syndrom of many chronic diseases. In our case, there were many causes of anemia development, such as: ulcerative colitis, celiac disease, vegetarian diet and Graves-Basedow disease. In the study we presented a case of women with anemia caused by ulcerative colitis and celiac disease. All factors mentioned above interact together in the creation of anemia. In summary, this case is an unique combination of many factors which create a picture of a difficult to treat anemia. In this case, it is necessary for physicians representing certain branches of medicine to cooperate together. Only the control of all mentioned diseases can improve the patient’s state and cure anemia.

Keywords: anemia, celiac disease, Graves- Basedow disease, colitis ulcerosa, urticaria, skin manifestations, Reynaud syndrome



Kamil Chołuj1, Justyna Chmiel1, Marcin Gniewek1, Grzegorz Nowicki2, Andrzej Prystupa3

1 Zakład Rehabilitacji i Fizjoterapii Katedry Rehabilitacji, Fizjoterapii i Balneoterapii, Uniwersytetu Medycznego w Lublinie
2 Zakład Kwalifikowanej Pomocy Medycznej z Pracownią Ratownictwa Medycznego, Uniwersytet Medyczny w Lubline
3 Katedra i Klinika Chorób Wewnętrznych, Uniwersytet Medyczny w Lublinie

Kinesio taping — a method which uses the body’s self-healing processes (assisted rehabilitation)


Kinesio Taping® (KT) is a therapeutic method developed by Dr. Kenzo Kase. It has seen increasing global popularity since 1963. The method involves using special adhesive tapes called ,KINESIO TEX’ that are applied directly on the skin. This results in myofascial tone normalisation, blood and lymph flow enhancement, pain reduction and motor activity improvement. Furthermore, the application of KT tapes reduces pain intensity and enhances the functionality of patients. Due to this, the method may be classified as being supplementary to physiotherapy. However, further observation and an appropriate research methodology is necessary to allow the verification of its effectiveness. This article aims at presenting the mechanisms in which the elastic Kinesio Tex affects the skin, the subcutis, the muscles, and the tendons. It describes a methodology for performing treatments and selected applications in assisting the process of rehabilitation in certain dysfunctions and diseases.

Keywords: Kinesio Taping ®, rehabilitation, improvement




Justyna Chmiel1, Kamil Chołuj1, Marcin Gniewek1, Grzegorz Nowicki2, Andrzej Prystupa3, Patryk Rzońca2

1 Zakład Rehabilitacji i Fizjoterapii Katedry Rehabilitacji, Fizjoterapii i Balneoterapii, Uniwersytetu Medycznego w Lublinie
2 Zakład Kwalifikowanej Pomocy Medycznej z Pracownią Ratownictwa Medycznego, Uniwersytet Medyczny w Lubline
3 Katedra i Klinika Chorób Wewnętrznych, Uniwersytet Medyczny w Lublinie

Nordic Walking as a safe form of rehabilitation with numerous applications. a review of the latest studies


Nordic walking is an activity recognised as being one of the newer forms of rehabilitation. It owes its popularity and attractiveness to the fact that it is based on the natural pattern of walking and can be practised regardless of age and fitness. It is characterised by high effectiveness, as the dynamic and forceful marching with poles improves fitness by strengthening and stretching the appropriate muscle groups. Research shows that Nordic walking involves the use of about 90% of the body’s muscles, particularly those of the lower limbs and the lower girdle, abdomen and chest, spinal stabilisation muscles, shoulder girdle and upper limbs. Moreover, study results show that regular Nordic walking can reduce blood pressure by as much as 9 mmHg. Indeed, regular training leads to lower BMI, as the level of adipose tissue becomes reduced. Research also shows that cervical spine pain is diminished. Nordic walking is a safe form of activity, as the use of poles reduces the load on the motor system up to 30% and improves the balance and stability when walking on difficult surfaces. Furthermore, Nordic walking contributes to improved aerobic capacity, which results in better physical fitness, enhanced quality of life, and reduced risk of diseases and dysfunctions caused by hypokinesia. Regular Nordic walking training is one of the many forms of motor rehabilitation used mainly to enrich the previously prescribed fitness improvement programmes. Nordic walking is used in e.g. cardiac, orthopaedic, neurological, pulmonary, psychiatric and geriatric rehabilitation.

Keywords: Nordic Walking, rehabilitation, cardiology training




Rafał Sapuła1,2,3, Bożena Bury2, Adam Topolski2,3

1 Katedra Fizjoterapii Wyższej Szkoły Informatyki i Zarządzania w Rzeszowie
2 Katedra Fizjoterapii Wyższej Szkoły Zarządzania i Administracji w Zamościu
3 Zamojska Klinika Rehabilitacji w Zamościu

The presence of defects in the foot in children and their parents


Background. Feet are the link between the surface on which we are moving and our body. There is no conclusive studies to confirm the cause of the pathology of the foot.

The aim of this study was to analyze the dependence of foot defects in children and their parents.

Material and method. The study included a total of 150 people, including 50 children under school age (5-6 years) and their both parents. The study was conducted in the Local Government Kindergarten in Przedmieście Dubieckie and Local Kindergarten in Dubieck. Study group consisted of 27 girls and 23 boys with their parents. The basic research method was plantografia.

Results. Statistical analysis showed a significant correlation between the child’s feet and mother’s and father’s foot (p = 0,001 and p = 0,006). Construction defects in child’s foot depend on the construction defects in parent’s foot.

Conclusions. It was observed the relationship between child’s feet and parent’s foot. The transverse arch in child’s feet increase or decrease in the increases or decreases a transverse arch in parent’s feet.

Keywords: defects of feet, children, parents




Agnieszka Paterska1, Piotr Dziemidok2, Krzysztof Marczewski1

1 Oddział Nefrologii, Endokrynologii, Nadciśnienia Tętniczego i Chorób Wewnętrznych, Samodzielny Publiczny Szpital Wojewódzki im. Papieża Jana Pawła II w Zamościu

Mefformin and cancer risk and mortality


Metformin is the longest known oral hypoglycemic factor used in the treatment of type 2 diabetes. One of the known mechanisms of action is activation of AMP acivated proteinkinase (AMPK) with the inhibition of m TOR activity. AMPK is a key energy sensor and regulates cellular metabolism to maintain energy homeostasis. It is one of the possible mechanisms of influence of the metformin treatment on cancer cells development in humans. The effect was already noticed among patients with breast cancer, also non diabetic patients receiving neoadjuvant chemotherapy. The strong relationship between receiving of metformin and reduction of incidence of cancer in a case of pancreatic and colorectal cancers was also described among diabetic patients. Authors analyse the influence of metformin treatment in different types of cancer and the possible mechanisms of action. Numerous clinical trials are currently performed to investigate metformin’s potential to prevent an array of cancers, including breast cancer, colorectal, prostate, and others.

Keywords: metformin, AMPK, diabetes, chemotherapy, breast cancer, cancer