2015 Vol. XVII No. 1

Robert Walaszek1, Wojciech Porada2, Anna Marszałek3, Katarzyna Walaszek4, Marcin Burdacki4
1 Katedra Rekreacji i Odnowy Biologicznej Akademii Wychowania Fizycznego w Krakowie
2 Ośrodek Rehabilitacyjny Wichrowe Wzgórze w Siemianowicach Śląskich
3 Publiczna Szkoła Podstawowa Stowarzyszenia Przyjaciół Szkół Katolickich w Hucisku Pewelce
4 Akademia Wychowania Fizycznego w Krakowie, student I roku SUM kierunku Fizjo­terapia


Abstract: Young musicians who keep mastering their instrument playing skills often sit in the same position for many hours a day. These positions are non-physiological and unhealthy in terms of maintaining the proper body posture. zsim-tom-xvii-zeszyt-2Symmetric and asym­metric, static and dynamic overloading of some parts of the motor system during a prolonged musical training may have a negative impact on the quality of motor abilities. This study’s objective was to compare the body posture and, by using appropriate tests to assess motor abilities of women, who played wind and string musical instruments. The subjects of this study were Ą2 female music students of Akademia Muzyczna im. Karola Szymanowskiego in Katowice, aged between 20-25. The study was conducted between 15-20 February 2015. Half of the subjects played string instruments whereas the other half played wind instruments. The scoring method by Kasperczyk was used to assess the body posture, and for the assessment of the motor abilities some selected parts of the Eurofit test were used. The flexibility of the subjects was assessed using the Fingertip-to-Floor (FTF) test. The skills were measured using a special instrument which had been prepared prior to the test. The main statistical measures were used in order to describe the subjects; the arithmetic mean () and standard deviation (s) were calculated. The t-student test was used to analyse the differences between the measured parameters. The tests showed that the women who played wind instruments had a very good body posture, whereas the other women who played string instruments had an average body posture. More specific motor ability tests proved that it was sometimes the women playing dent instruments who achieved better results in the tests, and another time it was the women who played string instruments who performed better.

Keywords: musicians, body posture, postural anomalies, motor abilities



Rafał Sapuła1234, Anna Pietruszka1, Joanna Sapuła5, Marta Wolanin13

1 Wyższa Szkoła Zarządzania i Administracji w Zamościu, Katedra Fizjoterapii
2 Wyższa Szkoła Informatyki i Zarządzania w Rzeszowie, Katedra Fizjoterapii
3 Zamojska Klinika Rehabilitacji WSZiA w Zamościu
4 Centrum Rehabilitacyjno-Medyczne Reh-Mediq w Tyczynie
5 PKP Linia Hutnicza Szerokotorowa Spółka z o.o.


Admission. In recent years, the growing number of patients with pains of the spine determines the fundamental problem not only medical but also social. As many as 50-80% of the population at least once in their life will experience back pain. A very large impact on the formation of low back pain has many hours of work in static and asymmetrical spine position.

Objective. The aim of this study was to analyze the dysfunction of the spine among economically active persons working in static positions. Made study was to evalu­ate the effect of the nature of the work (in a static position standing and sitting) on the felt pain, assess the level of knowledge of the respondents about the ergonomics depending on the nature of the work and assess the impact of the knowledge and observance of the principles of ergonomics to the frequency of symptoms pain.

The method and material. Surveys were carried out on the basis of the author’s sur­vey on the example of randomly selected employees from Glassworks in Krosno from the age group 20 years and above. The study sample included 100 people.

Results. Analysis of the material showed that the nature of the work performed by the subjects significantly affect the incidence of pain, the circumstances in which intensifies the pain and duration. Pain reported more white-collar workers than blue collar workers. The analysis showed that pain occurred more frequently among people spend in a seated position more time. Principles of ergonomics are consid­ered known but are usually observed only partially. Manual workers slightly more often than white-collar workers pointed to the adherence to a certain extent, while white-collar workers more likely to admit to the failure of these principles.

Conclusions. Analyzing the data can be seen, however, that more often on pain complained about people not know the principles of ergonomics. On the incidence of pain in workers glassworks affects knowledge of and adherence to the principles of ergonomics. People honestly adhering to the principles of ergonomics or warn­ing them to some extent rarely complained about pain than those not observing the principles of ergonomics.

Keywords: back pain, risk factors, ergonomics, physiotherapy



Rafał Sapuła1234, Sylwia Myszak1, Joanna Sapuła5, Marta Wolanin13

1 Wyższa Szkoła Zarządzania i Administracji w Zamościu, Katedra Fizjoterapii
2 Wyższa Szkoła Informatyki i Zarządzania w Rzeszowie, Katedra Fizjoterapii
3 Zamojska Klinika Rehabilitacji WSZiA w Zamościu
4 Centrum Rehabilitacyjno-Medyczne Reh-Mediq w Tyczynie
5 PKP Linia Hutnicza Szerokotorowa Spółka z o.o.


Admission. Physical activity is one of the most important factors determining the health status of the population. Nordic Walking can be a common form of such ac­tivity.

Objective. The main objective of the study was to evaluate the effect of training Nordic Walking for health-promoting effects in people with locomotor dysfunctions.

Material and methods. The study was conducted among 59 people with various dysfunctions of motion, using diagnostic survey using a proprietary questionnaire. In addition to the assessment of pain used numerical scale (NRS – Numerical Rating Scale). The results were statistically analyzed.

Results. Among the most commonly observed positive effects of Nordic Walking for Health surveyed respondents mentioned improvement in oxygenation of the body, faster removal of by-products of metabolic processes, improve the perception of physi­cal fitness habit of a simple silhouette. Respondents also pointed to the analgesic effect of exercise with sticks.

Conclusions. Training Nordic Walking has a positive effect on the health effects of many of the body, improves mood, increases physical performance. Nordic Walking is low kontuzjogenną form of daily activity. The march technique Nordic Walking has analgesic effect in patients with locomotor dysfunctions.

Keywords: physical activity, Nordic Walking, pain, musculoskeletal dysfunction



Małgorzata Słomian1, Paweł Podsiadło2, Michał Słomian13, Krzysztof Marczewski1,3,4

1 Odział Nefrologii, Endokrynologii Nadciśnienia Tętniczego i Chorób Wewnętrznych SP Szpitala Wojewódzkiego im Papieża Jana Pawła II w Zamościu
2 Odział Kardiologii SP Szpitala Wojewódzkiego im. Papieża Jana Pawła II w Zamościu
3 Szpitalny Odział Ratunkowy SP Szpitala Wojewódzkiego im. Papieża Jana Pawła II w Zamościu
4 Wydział Nauk o Zdrowiu Wyższej Szkoły Ekonomii i Innowacji w Lublinie


Introduction. Nowadays Emergency Departments have become not only admission rooms but also departments, which initially treat patients and stabilize their vital functions. Often, a condition of patients admitted to ED is serious and despite treat­ment patients die in EDs. However, potentially very important in terms of public health, analyses of mortality among ED’s patients are rarely published.

Aim of study. Analysis of causes of death in ED’s — one year period.

Materials and Methods. Retrospective analysis of data on the basis of death certificates filled according to ICD 10 classification among patients who died during hospitalization in ED at Voivodship Hospital John Paul II in Zamość. Age differ­ence, gender difference, and dynamic of deaths during 2015 year were taken into consideration.

Results. In 2015 a total of 33 deaths out of 19559 patients hospitalized in EDs were registered, including 23 males (69,7%) and 10 females (30,3%). The average age of de­ceased was 68,5y. Deceased males were on average about 10 y. younger than deceased females (65,3 vs 75,8).Cardiovascular diseases , carcinoma and injuries were the most often basic causes of death. Patients who died in ED were younger than deceases on the other departments, mostly significant difference among males (more than 6y.)

Conclusions. Cardiovascular diseases are still the main reason of deaths. Men die younger than women. There is a need of further analysis of lower average age among deceased in ED’s.

Keywords: emergency department, statistic of deaths, causes of deaths, cardiovascu­lar deaths



Ewa Kostrzewa-Zabłocka1, Zofia Piękna2, Krzysztof Marczewski3

1 Samodzielny Publiczny Wojewódzki Szpital Specjalistyczny. Poradnia Diabetologiczna w Chełmie
2 Absolwentka Wydziału Pielęgniarstwa Wyższej Szkoły Zarządzania i Administracji w Zamościu
3 Oddział Nefrologii, Endokrynologii, Nadciśnienia Tętniczego i Chorób Wewnętrznych Wojewódzkiego Szpitala Specjalistycznego im. Papieża Jana Pawła II w Zamościu


Introduction. Health resort medical services deal with many chronic diseases, while at the same time intensifying or supplementing the methods previously used in other health care institutions. Balneophysical methods used at health resorts facilitate reduction of symptoms in many diseases and improvement of the treated patients’ life quality. One of the key objectives satisfied by the health resort medical services is the health education, which provides an opportunity to reduce the incidence of many lifestyle diseases and mortality among relatively young people. All patients staying at a health resort should be concurrently treated and competently educated.

Purpose of the paper. Patients’ assessment of the quality of nursing care provided to patients at the sanatorium in Horyniec Zdrój.

Material and methods. The study involved 70 people staying at the sanatorium in Horyniec Zdrój. The study used a research tool in the form of a questionnaire comprising 12 questions.

Results. In the study 70 patients were questioned, of which 60% were aged above 55 and 40% were aged 46-55. The study population of patients was similar in terms of the sex of respondents. The questionnaire was completed by a similar number of women (55,7% ) and men (44,2% ). The vast majority of respondents admitted that their health condition was bad (50%) or poor (41,4%). Only 8,5% of respondents felt that their health was good. Patients were most satisfied with the quality of daily treatments. The 24-hour nursing care received slightly worse rating. As many as 41,4% of respondents felt that they were satisfied with it at a sufficient level. The daily nursing rounds were the least rated activities (22,8%). The respondents highly rated the educational activities of the nursing staff (59,9%). Despite the relatively poor assessment of the work quality of the nursing staff at the health resort, the ma­jority of respondents (74,2%) confirmed their satisfaction with the stay. The great majority of patients who expressed their dissatisfaction with the stay at the health resort were women.

Conclusions. Patients assessed the efficiency of the sanatorium nursing staff’s work in a varied manner, whereas the educational activities were among the most highly rated, while the daily rounds had the lowest score. This demonstrates the need for development of new work plans for the nursing staff employed at the health resort, with particular emphasis on patient education programmes in line with their expectations and interests.

Keywords: sanatorium treatment, sanatorium nursing care, education of patients



Katarzyna Wójcik1, Krzysztof Marczewski12

1 Oddział Chorób Wewnętrznych i Gastrologii SP Wojewódzkiego Szpitala Specjalistyczne­go im Papieża Jana Pawła II w Zamościu
2 Wydział Nauk o Zdrowiu Wyższej Szkoły Ekonomii i Innowacji w Lublinie


Abstract: Self-catheterization is a recognized method of treatment of patients with disorders of urine outflow. Sometimes, however, the special situation of psychosocial leads to dangerous health a modification of such proceedings. Viewing the story of 75 year old patient, which is more than the infection was afraid of contact with the health service.

Keywords: self-catheterization, self-healing, infection



Łukasz Szurlej1, Agnieszka Wiśniowska2, Andrzej Kwolek2

1 Szpital Specjalistyczny im. Św. Rodziny w Rudej Małej
2 Instytut Fizjoterapii, Wydział Medyczny, Uniwersytet Rzeszowski


Introduction. The pain in the lower back are the most common human problems associated with the disorder of the structure and function of the musculoskeletal system. Complaints lead to temporary loss of earning capacity, and to participate actively in society.

Objective. The main objective of the study was to evaluate the effect of rehabilita­tion within the framework of pension prevention by the Social Insurance on the func­tional state of the administrative staff— office pain syndrome of the lumbar spine.

Material and methods. The study group consisted of 53 administrative employ­ees — office outpatients at the Provincial Hospital No. 2 in Rzeszów. The study in­cluded patients with a diagnosis of pain syndrome of the lower spine. Patients were covered by physiotherapy and education in the field of ergonomics, work and leisure. The study questionnaire used by its own and Oswestry Disability Questionnaire, and Schober test, VAS pain scales that were made at the beginning and end of the treatment.

Results. There was a statistically significant improvement in the subjective experi­ence of pain and mobility of the lower spine. Patients at the end of treatment showed greater independence and efficiency in performing activities of daily living as mea­sured by the Oswestry questionnaire.

Conclusions. Rehabilitation in the context of prevention of lowered Social Security to improve the functional status of people with pain syndrome of the lower section of the spine. Resulted in improved movable lumbar spine, reducing the severity of the pain and the centralisation of symptoms of pain.

Keywords: back pain, functional state, physiotherapy, work sitting, prevention



Krzysztof Żaba, Marta Ząbek, Justyna Wojtala

Akademia Wychowania Fizycznego w Krakowie im. Bronisława Czecha


Abstract: Osteoarthritis is the most common of the diseases of the musculoskeletal system, as­sociated with old age. It is becoming a problem among younger and younger people, which is also caused by sedentary lifestyle, limited physical activity in childhood, untreated posture problems in overweight consumer society. The most significant action of the whole-body cryotherapy has proven positive effects against pain. Cryo-therapy induces a temperature decrease, which might downregulate several mediators involved in joint inflammation and destruction like cytokines, cartilage-degrad­ing enzymes, proangiogenic factors. Cryotherapy should be included in degeneration therapeutic strategies such as an adjunct therapy, with potential corticosteroid and nonsteroidal anti-inflammatory drug dose-sparing effects. While exercise and regu­lar physical activity participation are both recommended and beneficial for OA and obesed population, our current understanding of optimal strategies to improve func­tion and health status in those who have both OA and obesity is limited. The devel­opment of gonarthrosis (GA) involves inflammatory processes; the role of reactive oxygen species (ROS) is being increasingly mentioned. The body is protected from oxidative damage by the antioxidative barrier with fundamental role being played by antioxidative enzymes, such as superoxide dismutase (SOD), catalase (CAT) and en­zymes involved in glutathione transformations, particularly glutathione peroxidase (GPx). The methods of treatment of cartilage depend on the disease advancement, patient’s reactions to pain, disease-related impairment in daily activities, as well as the age and overall health of the patient. These assays for “markers” of joint tissue turnover provide the possibility of sensitive correlations with clinical and radiologi­cal assessment of joint damage.

Keywords: osteoarthritis, whole-body cryotherapy, rehabilitation exercises, biochemistry and degeneration, rheology and degeneration



Anna Pańczuk1, Maria Kozioł-Montewka2

1 Zakład Fizjoterapii, Państwowa Szkoła Wyższa w Białej Podlaskiej
2 Zakład Pielęgniarstwa, Państwowa Szkoła Wyższa w Białej Podlaskiej


Abstract: Lyme borreliosis is the most common tick-borne disease in Europe and North Amer­ica. In Poland, during the years 1999-2013, the incidence of Lyme borreliosis in­creased from 2,3 to 33,1 per 100 000 inhabitants. The purpose of this study was to understand the effects of the Lyme disease in daily life. The study group consisted of people diagnosed with Lyme borreliosis, patients of the infectious disease ward of the Provincial Hospital in Biała Podlaska. The study group included 56 persons aged 12-74 years. In most cases, Lyme disease was identified within the last year (60,7%) and, most often, it was Lyme arthritis (83,9%). The research tool used in this group involved the anonymous survey. The analysis of self-assessment of the impact of symptoms associated with Lyme disease on performing selected everyday activities showed that difficulties were very frequently connected with kneeling (64,3%), walk­ing up the stairs (51,8%), bending (51,8%), standing (48,2%) and cleaning (46,4%). Frequent or very frequent symptoms associated with the impact of disease on work performance was reported by 57,4% of respondents.

Keywords: Lyme borreliosis, patients, everyday activities



Ewa Wawak1, Paweł Basiński2, Krzysztof Marczewski123

1 Oddział Chorób Wewnętrznych i Gastroenterologii, Szpital im. Papieża Jana Pawła II w Zamościu
2 Oddział Nefrologii, Endokrynologii Nadciśnienia Tętniczego i Chorób Wewnętrznych, Szpital im. Papieża Jana Pawła II w Zamościu
3 Wydział Medyczny Wyższej Szkoły Ekonomii i Innowacji w Lublinie


Abstract: According to Kirkwood, ageing is defined as the normal, physiological, progressive loss of function accompanied by decreasing fertility and increasing mortality. Sta­tistics says, that in Poland live almost 10% people over 65 years. There is prediction that in 2050 it will be 10% less people in Poland, but twice time ‘more elderly popu­lation. This situation attribute Poland to ageing society, what indicates new tasks for medical department. Higher incidence, more frequent medical advises, more physiotherapy, rehabilitation, nursing, polypharmacy and simultaneous diseases are typical for geriatric medicine. Because of the clinical implications of changes in pharmacokinetic and pharmacodynamic of drugs it is quite easy to make a mistake during therapy. 1/3 reported problems in geriatric medicine are iatrogenic geriatric syndromes, which are corollary with fluoroquinolones treatment. Those antibacte­rial agents are wide spectrum, which is appropriate for infection diseases in elders, so are commonly prescribed. By knowing and being awareness and caution to pos­sible fluoroquinolones-related adverse events it has an impact on protect on avoid patients from under recognize and misdiagnose those symptoms as typical, associ­ated with ageing.

Keywords: fluoroquinolones, cognitive functions, neurotoxicity



Agnieszka Kleinrok-Krupa

Oddział Chorób Wewnętrznych i Gastroenterologii, SPSW im. Papieża Jana Pawła II w Zamościu


Abstract: Type 1 diabetes is a disease where requireing insulin delivery. The recommended method of treatment is intensive insulin therapy using: multiple daily injection or continuous subcutaneous insulin infusion by insulin pump. The last one allows for the precise and individual dosage of insulin and adjustment of hourly doses of insulin to current needs of the patient. Moreover it causes fewer episodes to the hypoglycemia, increases quality of life and metabolic balance. Special care should be undertaken during diagnostic procedures (x-ray examinations) as well as physio­therapy treatment application. It is necessary to take into concideration potentialy dangerous influence of electromagnetic field on insulin pump engine.

Keywords: type 1 diabetes, intensive insulin therapy, personal insulin pump



Małgorzata Molenda, Mariusz Molenda, Agnieszka Drosdzol-Cop

Zakład Patologii Ciąży, Katedra Zdrowia Kobiety, Wydział Nauk o Zdrowiu, Śląski Uni­wersytet Medyczny w Katowicach


Abstract: Urinary incontinence constitutes one of the most frequent chronic diseases in wom­en. At least half of women undergoing a standard treatment still suffer from incon­tinence, therefore science research is being conducted to determine whether alterna­tive therapies, including acupuncture, are effective in urinary incontinence. The purpose of the following paper is to present the efficiacy of acupuncture for urinary incontinence in women on the basis of the academic literature. The research shows that acupuncture combined with moxibustion or combined with moxibustion and pelvic floor training, as well as acupressure and electropuncture are effective thera­pies for stress urinary incontinence in women. The analysed works also proved the efficiacy and safety of acupuncture for overactive bladder and for urge and mixed urinary incontinence. Therefore, the studies suggest that acupuncture is an effective and safe therapy for stress, urge and mixed incontinence in women. It benefits both the physiology and mental wellbeing of the patients. Although the reviews confirm the beneficial effects of acupuncture, they also suggest the lack of sufficient evidence for its statistically significant efficiacy. Further studies of better size and quality are therefore warranted.

Keywords: acupuncture, acupressure, urinary incontinence, overactive bladder



Ewa Wawak1, Krzysztof Marczewski123

1 Oddział Chorób Wewnętrznych i Gastroenterologii, Szpital im. Papieża Jana Pawła II w Zamościu
2 Oddział Nefrologii, Endokrynologii Nadciśnienia Tętniczego i Chorób Wewnętrznych, Szpital im. Papieża Jana Pawła II w Zamościu
3 Wydział Medyczny Wyższej Szkoły Ekonomii i Innowacji w Lublinie


Abstract: Oral cavity hygiene is critical point of palliative medicine, also a part of complex medical system at the intensive care unit, especially during mechanical ventilation. Dry mouth symptom is mostly attached with patients during oncological therapy and mechanical ventilation. This problem is increasing due to commonly prescribed medi­cations which quite often induce this subjective feeling of dryness in mouth. In pa­tients opinion this symptom produce serious negative effects on theirs quality of life, decreasing it. According to development of physical medicine the management of dry mouth might providing relief of symptoms should be started from non-pharmacological therapy, including different stimulations. Unless they occur ineffective then reach chemical agents, such as saliva substitutes or pilocarpine. When starting treatment for management of xerostomia with pharmacological agents we should consider poten­tial benefits for individual patient vs possible side effects after treatment, which might accelerate and intensify decrease of health-related quality of life, already sick patient.

Keywords: dry mouth, xerostomia, pilocarpine, palliative medicine



Andrzej Kierzek1, Małgorzata Paprocka-Borowicz2, Jadwiga Kuciel-Lewandowska2, Krzysztof Tuszyński3

1 Sekcja Historyczna Polskiego Towarzystwa Otorynolaryngologów — Chirurgów Głowy i Szyi
2 Katedra i Zakład Bezpieczeństwa i Higieny Pracy oraz Profilaktyki Lekarskiej Wyższej Szkoły Logistyki w Poznaniu


Abstract: Balneoclimatic therapy as a medical treatment that makes use of minerals waters of health resort Szkło near Lvov goes back to the 16th century, when people started to use those waters for medical purposes. The richness of this health resort were sulfur-containing mineral water. The Szkło’s springs are described accurately. Indications and contraindications for their use are also presented. The conditions of lodgings, baths attractions and curiosities in this health resort are presented widely. The methods of use of bathing and drinking cures are analyzed in details.

Keywords: history of health resorts, history of physical medicine and balneology, histo­ry of the south-eastern borderland of the Second Polish Republic



Sylwia Dyczewska-Wójtowicz

Melius Centrum Rehabilitacji w Suwałkach


Abstract: Juvenile idiopathic arthritis is an autoimmune disease that occurs before the age of 16 on each joint. In the course of the disease are noticeable different degrees of destruction of joint structures, osteoporosis, impaired joint function with the pos­sibility of severe disability, stunted growth and developmental disorders. Due to the lack of knowledge of the exact etiology of juvenile idiopathic arthritis, the treatment of this disease cannot be causal treatment. Therapy must be adjusted individually. Rehabilitation of patients with juvenile idiopathic arthritis should be carried out from the very beginning of the disease. The aim of physiotherapy for children with the disorder is primarily to prevent the consequences resulting from the disruptive changes in the organ motion and therefore the investigation physiotherapy should be based on appropriate methods and technology affecting the patterns of movement, reduce pain and shorten the time dysfunctions.

Keywords: juvenile arthritis, physiotherapy, kinesiology taping, JIA treatment



Małgorzata Molenda, Mariusz Molenda, Agnieszka Drosdzol-Cop

Zakład Patologii Ciąży, Katedra Zdrowia Kobiety, Wydział Nauk o Zdrowiu


Abstract: Classical acupuncture constitutes a part of Chinese medicine, a system of healing with five thousand years history. Modern science explains acupuncture mechanisms by neurobiological concepts based on clinical evidence. According to the WHO the term acupuncture describes a group of procedures involving a stimulation of points with specific anatomical location to produce clinical effects. Studies show that acu­puncture affects the nervous system but its effects cannot be explained by a single mechanisms, therefore different models and hypotheses are proposed for different clinical applications. Indications for acupuncture treatment have been stated by the WHO on the basis of clinical trials and they include a vast array of states and diseases. Studies prove that properly performed acupuncture is a safe and non-toxic therapy with marginal side effects.

Keywords: acupuncture, acupuncture point, acupressure, pain



Sylwia Dyczewska-Wójtowicz

Melius Centrum Rehabilitacji w Suwałkach


Abstract: The concept of stabilization center (core stability) refers to the efficiency of the deep muscles of the trunk, whose role is to control the center of our body in static and dynamic situations. Is a concept with an extremely wide range of applications, m. Al. in rehabilitation, professional sports and fitness industry. From an anatomical point of view of stabilization of the center of the human body is a cylindrical space limited by the outline of the front of the abdominal muscles, back through the para-spinal muscles and a gluteal from the top through the membrane, while the bottom of the pelvic floor muscles. Before starting deep muscle training is important to adopt a neutral position of the body, often through early correction of the defective pose, so that as soon as possible and more efficiently utilize the mobility of the body to its stability. Patients stroke, multiple sclerosis and cerebral palsy more frequently in order to stabilize based on the Centaur units 3D and 3D Spacecurl.

Keywords: physiotherapy, stabilization of the central, deep muscle control