Year 2012, Issue 1 (ZSiM 35)

Jolanta Zwolińska, Andrzej Kwolek

Introduction. Traditional electrodiagnostic methods are not fully used in diagnosing and monitoring the outcomes of rehabilitation. These are non-invasive methods which are commonly available in all physiotherapy rooms and may be helpful in taking decisions related to therapy.
Purpose. The study aimed at accessing the usefulness of electrodiagnostic parameters in monitoring the process of rehabilitation in patients with carpal tunnel syndrome.
Material and method. The study group included 6 patients referred for physiotherapy due to carpal tunnel syndrome. Altogether 8 hands were analysed: 6 right and 2 left hands. The study applied quantity-based electrodiagnostic methods. Nervous excitability of thenar muscles was assessed. The following values were measured: rheobase, chronaxie, accommodation threshold, and accommodation index. The assessment also included subjective clinical symptoms, and a computer method was used to measure the range of motion in hand joints, and hand grip strength. Examinations were performed before the rehabilitation programme was initiated and after it was concluded. The rehabilitation programme included sonication, whirlpool massage, and neuromobilization of the median nerve.
Results. The study showed statistically significant correlation between the assessment of self-care ability and the value of accommodation index (lower ability coincided with a lower value of accommodation index). None of the electrodiagnostic parameters were significantly changed as a result of the therapy.
Conclusions. Due to the small size of the study group, at this stage of the research the obtained results did not confirm the usefulness of the traditional electrodiagno-stic methods.

Keywords: Carpal tunnel syndrome, elektrodiagnostics, nerve conduction, rheobase, chronaxie.

Full article: Przydatność tradycyjnych metod elektrodiagnostycznych … (PDF)



Adam Topolski, Rafał Sapuła, Marta Topolska, Marta Barbara Topolska, Sebastian Chrzan, Marta Soboń, Krzysztof Marczewski

Background. Clinical studies confirm that depression is a common consequence of pain. Early detection of depression in people with low back pain could contribute to obtaining better results of rehabilitation.
Goal. Evaluation of the prevalence of depression in people with low back pain.
Materials and methods. The study was conducted in the Rehabilitation Clinic of University of Management and Administration in Zamość from August to December 2010. We studied 101 subjects (80 women and 21 men) aged 25 — 75 years (mean age – 54,7 years). The occurrence of depression was examined using Beck Depression Inventory (BDI). Own survey concerned: social history, gender, height, weight, age.
Results. The prevalence of depression in the group was 60.4% (62.5% women and 52.4% men). The average age of people with depression and without depression differed significantly and was respectively 56.59 and 51.63 years (p= 0.015).
Conclusions. Depression applicable 6 in 10 people treated for low back pain. People with low back pain increases the risk of depression with age. People with low back pain should be intensified psychological care.

Keywords: depression, low back pain, Beck Depression Inventory.

Full article: Częstość występowania depresji u osób z zespołem … (PDF)



Sebastian Chrzan, Rafał Sapuła, Marta Topolska, Marta Soboń, Marta Barbara Topolska, Adam Topolski, Krzysztof Marczewski

Backcground. Depression is one of the most severe health issues of the modern medicine. The aim of this study was to evaluate the relationship between depression and neck pain.
Material and method. The study involved 60 patients aged 37-82 years (mean age: 63 ± 10 years) treated for neck pain at the Rehabilitation Department of Zamość University of Management and Administration. Depression symptoms were assessed with a Zung Self-Rating Depression Scale (SDS). It was also used a Acceptance of Illness Scale.
Results. The studied group demonstrated statistically significant decrease of depression after rehabilitation (SDS: p<0,001). The research did not show statistically significant increase of acceptance of illness degree (AIS: p=0,48).
Conclusions. Rehabilitation decreases intensity of depression. In a subjective opinion, rehabilitation has no improvement on acceptance of illness degree.

Keywords: cervical spine, depression,Zung Self-Rating Depression Scale

Full article: Wpływ rehabilitacji na występowanie depresji … (PDF)



Rafał Sapuła, Iwona Głowacka, Andrzej Lesiak, Wiesław Siwek, Krzysztof Mataczyński

Introduction. Low back pain is a fast-growing disease of civilization. It is estimated that 80-100% of the adult population experiences low back pain. They occur in about 90% of the population after 40.
The aim of study. Evaluation of the effectiveness of rehabilitation in patients with osteoarthritis of spine and concomitant spondylolisthesis based on selected parameters.
Material and method. Studied 37 patients with low back pain with spondyloarth-rosis and with coexisting multi-level discopathy. The study was conducted in Rehabilitation Clinic of Zamość University of Management and Administration, based on the author’s questionnaire and clinical examination. Patients were examined twice, the first day of rehabilitation and second time in the last day of rehabilitation. The rehabilitation program included treatments of physiotherapy, kinesitherapy and mobilizations. The results were statistically analyzed.
Results and conclusions. Physiotherapy for outpatient conditions with low back pain reduce pain and ischias symptoms. Rehabilitation treatment improved mobility of spine. Rehabilitation of the study group did not alter the surface sensation and stretch movement.

Keywords: low back pain, spodylosis lumbalis, spondylarthrosis, discopathy, rehabilitation

Full article: Ocena efektywności rehabilitacji pacjentów … (PDF)



Ewa Kostrzewa-Zabłocka, Grażyna Kierepka

Introduction. „School of Diabetes” is a nationwide educational program aimed it leading a campaign among doctors, nurses and patients to prevent diabetes and romote a proactive approach towards the disease.
purpose of the paper. The paper is to determine the effect of the educational programme „School of Diabetes” on the metabolic control level in people with diabetes, articipating in classes in Chełm.
Material and method. The survey involved 73 patients with diabetes, aged from 3 to 78. The survey was conducted at the Clinic „Zdrowie” which is also the seat if the Diabetes Outpatient Clinic and the Association of Diabetics in Chełm. The urvey was participated by 40 women and 33 men. More than half of the respondents
47%) had secondary education and only 11% elementary education. The majority of urvey participants (46 people) were retired while 15% were working professionals. The BMI of the respondents indicated overweight and levels I and II of obesity. Most people (40 respondents) were diagnosed with diabetes within the last 11 years. Type 2 diabetes was observed in 86% of the people, while type 1 diabetes only in 14%.
Results. Taking into account the specific criteria set by the PTD in 2011, based on the data entered in the questionnaires (patient age, type of diabetes, duration of the disease), it has been found that HbA1c levels were normal in 33% patients and for 67% the results were above normal.
Conclusions. Education is an essential part of diabetes therapy and helps to reduce the number of diabetic complications. Participants of trainings designed at improvement of knowledge on diabetes have better test results, including lower levels of glycosylated hemoglobin (Research in Środa Wielkopolska). Respondents declare their willingness to extend their knowledge and understand the importance of diabetes education in their treatment process.

Keywords: Diabetes, “School of Diabetes”, education diabetes, metabolic control.

Full article: Edukacja w Szkole Cukrzycy w Chełmie (PDF)



Małgorzata Rycyk, Krzysztof Marczewski

Introduction. Pregnancy as a very important period in a woman’s life is also long been interested for men. The modern model of the relationship between parents gave this new dimension, which is reflected in such increasingly common presence of fathers at the birth, or his presence at antenatal courses. Therefore it seemed important to examine the opinion of men about a healthy lifestyle of pregnant women especially that such work does not have excessive much.
The aim of this study was to investigate the opinion of men about indicated and not indicated forms of physical activity during pregnancy
Material and method. The survey was conducted among students of the University of Management and Administration in Zamość, PKP LHS staff and via the Internet (and eBadania GoldenLine portal), from May to October 2010. In total, 1120 questionnaires were sent, received 170 copies. They came from 170 men aged 21 — 60 years (32.1 ± 9.4), of which 76 are not admitted to the experience of fatherhood.
Results. Over half (54%) men, regardless of the personal experience of fatherhood, rated their knowledge about pregnancy as good or very good, and the primary source of information about the pregnancy was the Internet. The vast majority (95%) of respondents positively evaluated the physical activity of pregnant women, while there were large differences between the optimal forms of activity from slow walk (26%) up to very intense exercise (21%). According to respondents, for pregnant women are particularly appropriate swimming (92%), chess (81%) and exercise on a stationary bike (65%). As the effects of a shortage of movement mentioned primarily back pain (81%) and higher striae (75%), slightly less risk of obesity, diabetes and hypertension (65%). However, knowledge of relaxation techniques was small, and as many as 68% of respondents did not performed with his partner even breathing exercises in preparation for childbirth, and 20% performed only exercises in the school childbirth. As many as 64% of respondents stated that a physiotherapist should be involved in preparing for childbirth and postpartum period.
Conclusions. A positive assessment of physical activity of pregnant, made by men in comparison with relevant shortcomings of their knowledge about the recommended exercise indicates the need for better health education. It seems that the role of coach and educator could play properly oriented physiotherapist, who would be accepted by most respondents.

Keywords: pregnancy, physical activity, mens opinion

Full article: Aktywność fizyczna kobiet ciężarnych … (PDF)



Bożena Krupa, Paweł Trzebiński

Introduction. Rehabilitation is a complex process rich in a number of biological, psychological and social conditions. Dimensions that make up the personality type D, in particular, a negative emotional determine the level of satisfaction with life, means that the greater tendency to experience negative emotions- the lower level of satisfaction with life and hence less effects of rehabilitation.
Purpose. the purpose of this study is answering the question: what role the patients assign rehabilitation and therapists and that the evaluation of the effects of rehabilitation is associated with type D personality. In terms of a global analysis of the process of rehabilitation in the context of the biopsychosocial model.
Material and method. Studies using diagnostic survey with questionnaire technique were undertaken on a group of professionally active and inactive adult patients in Zamość Rehabilitation Clinic WSZiA 2011. Two tools were used for measuring: Scale DS-14- in Polish version (N. Ogińska-Bulik, Z. Juczyński and Denollet) to assess personality (scale DS-14 contains fourteen statements, seven of them concern negative emotionality, the other seven social inhibition); Survey’s questionnaire-own authorship.
Results. 1/3 patients have stressed personality (type D). Individuals with type D personality much lower rate their health than those who do not type-D. Sociodemo-graphic variables and personality type does not significantly affect the definition of rehabilitation and do not differentiate between the treatment groups in the context of the location of the line physiotherapy treatment – wellness. Personality type affects the assessment of the effects of rehabilitation. In the group of type D shows the tendency to attribute the positive effects of rehabilitation rather in the physical and non-group D, both physical and mental.
Conclusion. Psychological and social factors should be taken into account and incorporated together with biological variables in the diagnosis of disease and the patient must be considered simultaneously.

Keywords: quality of life, personality, social support, rehabilitation

Full article: Psychospołeczne aspekty zdrowia i rehabilitacji (PDF)



Łukasz Popko, Rafał Sapuła, Janusz Milanowski

Abstact Rehabilitation is an integral part of comprehensive medical impacts over a terminally sick patient. A study of two cases described in article shows that physiotherapy carried out in hospice patients brings relevant results, first of all in terms of improving the quality of life. This description brings us the evolution of social attitudes towards persons with throughout human history, also as a seed of the structures and institutions dealing with human beings in palliative status. Thesis also shows a picture of contemporary hospice health care, principles of functioning and organizational structure.
Keywords: rehabilitation, palliative care, hospice

Full article: Rehabilitacja jako integralna część leczenia paliatywnego … (PDF)



Wybrane czynniki ryzyka instytucjonalizacji poszpitalnej
Igor Perehubka, Mariola Rębisz, Krzysztof Marczewski

Abstract Institutionalization is the concept of a wider as exercising the care of persons who are not capable of independent operation. The work includes observation of medium size hospital and the review of the literature that describes the risk factors of institutionalization. On the basis of data from the first half of 2011 and 2012, it has been demonstrated that the risk of finding themselves in a social assistance is greater for men and increases in the age. The main reason for this state of affairs is likely socio-economic factors Our results are slightly different from the known in other countries, which shows the regional variability problem of social support.. Further studies are needed that will help somewhat more accurately determine the risk factors listed above, so on the one hand can be useful in the prevention of institutionalization and, on the other hand, reduced to waiting time for people most in need of this type of provision.

Keywords: Institutionalization, social support end of life, sex

Full article: Wybrane czynniki ryzyka instytucjonalizacji poszpitalnej (PDF)



H. Michałkiewicz, J. Wróbel

Abstract Human aging is a physiological and irreversible process, occurring in many areas of human life: biological, psychological, social. In planning and implementing health care for the elderly the knowledge of the health problems of old age is necessary. In the article we present the influence of the so-called the great geriatric problems on physical fitness, needs and possibilities of rehabilitation of older people. The role of a comprehensive geriatric assessment in the process of medical treatment, including physiotherapy was also discussed. Attention was drawn to the functional tests used in geriatrics as a useful tool in assessing individual health needs of older people. Our goal was to show that a comprehensive geriatric care can not be done without physiotherapist.

Keywords: geriatrics, great geriatric problems, functional tests, physiotherapy

Full article: Całościowa ocena geriatryczna … (PDF)



Monika Biskup, Krzysztof Marczewski

Abstract Chronic back pain is a common condition occurring population, which results in significant economic consequences as well as the individual costs. In the treatment of back pain often exercises are used, sometimes as the only form of treatment. While the damage may be subject to significant structures of the spine, including discs, facet joints, ligaments, and vertebral bodies, however, the impact of exercise interventions include core muscles. The need to protect damaged tissues by the exercises that will help reduce the load on structures damaged as a result of the expected trigger muscle response, have become a topic of discussion in the literature. In the literature, there are many statements that say that keeping the spine in a neutral position, and stabilization of the body are extremely important factors in the prevention of damage to our spine, which is an axial structure, conditioning the ability to move. There are a number of tests including spinal mobility Schober test, test, fingers-floor, sign Otto.

Keywords: Schober test, finger-floor test, OTTo sign.

Full article: Jak mierzyć skuteczność fizjoterapii? … (PDF)



Dorota Boniek-Poprawa, Bogdan Obszański, Andrzej Kleinrok

Abstract Cardiovascular diseases such as coronary heart disease, heart failure and arterial hypertension are now one of the leading causes of hospitalization and disability of patients. It is estimated that in Poland hypertension suffer from 24% to 50% people. In addition to medication to treat high blood pressure can also be used balneothera-py, both peloidotherapy and baths in the mineral waters. They both have the effect of short-term and long-term as the blood pressure.

Keywords: hypertension, peloidoterapia, baths in the mineral waters

Full article: Zabiegi balneoterapii u pacjentów z nadciśnieniem tętniczym. (PDF)



Człowiek niepełnosprawny w mediach w opinii dziennikarzy i fizjoterapeutów
Monika Popławska, Krzysztof Marczewski

Abstract It isn’t a subject of controversy that the media- radio, television, Internet, newspapers, books, have a great impact on us, fulfilling the role of the „Kantian” glasses through which we view the world. Disability, until recently treated stereotypically and hermetically media devote more attention. The image of disabled people is constantly changing, being shaped by the environment of skilled and specialized. Therefore it seemed important to examine and compare the opinions of physiotherapists and journalists on the subject, including journalists with disabilities. The aim of this study was to identify the opinions of journalists and physical therapists on the perception of the image of a disabled person in the media.

Keywords: disability, disabled person, image media, physiotherapy, journalist, media

Full article: Człowiek niepełnosprawny w mediach w opinii dziennikarzy … (PDF)



Elżbieta Rutkowska

Abstract Physical activity is an important part of a healthy lifestyle. Proper physical training shapes the body’s many functions. Exercise should be done: he regularly (2-3 times per week) for at least 15 minutes, cause an increase in heart rate to 130-150 beats and activate the muscles different from those which are used in routine activities. Assessment of physical activity is an important element of the subjective examination. Allows to evaluate this element in the lifestyle -and then plan an effective and accurate health education. The article presents the principles of training for health conditions (by revives papers) and discusses the principles of construction of the interview on physical activity. Standardized interview allows you to compare the behavior of people at certain intervals — which can be used to assess the effectiveness of health education. It also allows for the detection of many diseases, therefore the quality and quantity of usual physical activity. Research subjective of physical activity can significantly supplement or translate the objective results of clinical trials.

Keywords: physical activity, subjective testing, health education

Full article: Ocena aktywności fizycznej w badaniach podmiotowych (PDF)



Aleksandra Ochota, Małgorzata Mroczek

Abstract The aim of this study was to compare the knowledge and health-seeking behaviour of women over 40 years old and the physiotherapy students on osteoporosis. The study group is characterized by high knowledge of the factors affecting osteoporosis and the basic symptoms. Women over the age of 40 more often have problems with mention of the symptoms than students. We should increase the educational activities in symptoms and prevention of osteoporosis as well as the promotion of physical activity.

Key words: osteoporosis, risk factors, physical activity, health education

Full article: Porównanie wiedzy kobiet po 40 roku życia i studentek … (PDF)



Edward Przychodaj

Abstract The paper presents the situation of persons with disabilities in Poland with special emphasis on.its legal, financial and employment aspects. The analysis focuses on the present condition but certain elements of the social situation of that particular group of people are described from the historical perspective, from the perspective of the past, present and future. References to legal regulations of these problems applied in the European Union also constitute the integral thread of the considerations shown in the paper. That approach enabled the presentation of tendencies and basic circumstances in the field as well as the presentation of the relatively complex evaluation of the protection of rights of the disabled. The paper discusses only some problems of the social environment of the disabled, but from the point of view of the author the most important ones. Their recognition was not an easy task due to multiplicity, diversity and variability with time of data characterizing the situation of the persons with disabilities. Equally important issues connected with their social and professional rehabilitation as well as prevention are also to be the subject of further interest.

Key words: persons with disabilities, Convention on the Rights of Persons with Disabilities, rights of persons with disabilities, employment of the disabled, sheltered workshop, open labour market, social and professional rehabilitation of the disabled, integrated social policy of the European Union, social assistance, education and social integration

Full article: Ochrona osób niepełnosprawnych w Polsce (PDF)



Józef Bergier, Dorota Tomczyszyn, Wiesław Romanowicz

Abstract: The purpose of this article is to determine how disabled people living in rural areas spend their leisure time. The basic method of gathering research material was diagnostic survey, in which the author’s questionnaire was used. The study was conducted in 2010. The material presented relates to the research group, made up of 800 people with disabilities living in rural areas of the Lublin province. It turned out that disabled people have 5–6 hours of leisure time a day, with women having more free time on weekdays, and men having more free time on holidays. Among the active forms of leisure both men and women prefer walking and practicing various forms of sport and recreation. Passive rest in both groups means listening to music, watching TV and using the computer and the Internet. Sports and recreation forms popular among both men and women include walking, cycling and gymnastics.

Keywords: free time, forms of leisure, people with disabilities, rural areas

Full article: Wykorzystanie czasu wolnego osób niepełnosprawnych … (PDF)