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Gait in patients with stroke-related hemiparesis and methods of gait assessment

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Agnieszka Guzik A., Andżelina Wolan-Nieroda A., Katarzyna Walicka-Cupryś K.
Medical Review
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2016
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issue 2
220-224
EN
Cerebral stroke, a serious complication of cardiovascular system disorders, has become an important medical issue in contemporary societies. Gait disorders in patients after stroke constitute a serious clinical challenge - every year, more than ten thousand patients become seriously disabled as a result of stroke. Locomotor disability is one of stroke’s consequences. Patients with stroke-related hemiparesis often show gait disorders. Hemiparetic gait is characterized with a number of disorders, such as a considerable asymmetry of gait phase time, i.e. step length, or limb load – the healthy leg being overloaded. These disorders result in limiting patients’ everyday activity. Therefore, objective methods of gait analysis are currently being researched. Among gait assessment methods there are clinical, or observation methods – which consist of gait description as related to the normal gait patterns; as well as quantitative, or objective methods – which consist of measuring, description and analysis of chosen parameters of human gait. The aim of the study is to characterise gait in patients with stroke-related hemiparesis, as well as to discuss the methods of its assessment.
PL
Udar mózgu, będący dramatycznym powikłaniem chorób układu naczyniowego, stanowi duży problem zdrowotny we współczesnym społeczeństwie. U pacjentów z niedowładem połowiczym po udarze mózgu występuje patologiczny wzorzec chodu. Chód hemiparetyczny cechuje się serią zaburzeń, w tym znaczną asymetrią czasu trwania faz chodu, długości kroku, obciążenia kończyn, polegającą na przeciążaniu kończyny zdrowej. Skutkuje to ograniczeniem aktywności w życiu codziennym. Ze względu na narastające znaczenie społeczne i powszechność udaru mózgu coraz częściej poszukuje się metod w zakresie analizy chodu tej grupy chorych. Wśród metod oceny chodu wyróżnia się metody kliniczne, obserwacyjne polegające na opisie chodu w odniesieniu do wzorca prawidłowego oraz metody ilościowe, obiektywne, polegające na pomiarze, opisie i analizie wybranych parametrów charakteryzujących chód człowieka. Celem pracy jest charakterystyka chodu pacjentów z niedowładem połowiczym po udarze mózgu i metod jego oceny.
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Effects of sensory integration therapy in a 7-year old child with epilepsy following craniocerebral trauma – a case study

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Maria Widelak M., Andżelina Wolan-Nieroda A., Justyna Podgórska-Bednarz J., Agnieszka Guzik A.
European Journal of Clinical and Experimental Medicine
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2020
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issue 1
67-71
EN
Introduction. Post-traumatic epilepsy develops as a complication of a serious craniocerebral trauma, frequently an open head injury, resulting in neurological impairments. Aim. The study was designed to discuss problems associated with sensory integration dysfunction observed in a seven-year old girl with epilepsy which occurred as a result of craniocerebral injury. Description of the case. The case study is based on information gained from the girl’s medical records, an interview with her guardians and a sensory function questionnaire. Additional examinations assessed the girl’s balance control, and her functional performance according to Barthel scale. The girl received a three-week sensory integration therapy which included exercise involving tactile, vestibular and proprioceptive stimulation, as well as balance exercises and self-care training. Conclusions. In this particular case, application of sensory integration therapy produced beneficial results. The findings show improvement in balance, coordination as well as self-care.
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Częstość występowania i czynniki ryzyka urazów na lekcjach wychowania fizycznego u uczniów szkół podstawowych i gimnazjalnych województwa podkarpackiego

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Guzik A., Katarzyna Bazarnik-Mucha K., Andżelina Wolan-Nieroda A.
Medical Review
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2014
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issue 4
355–364
PL
Wstęp: Zajęcia z wychowania fizycznego to całokształt zabiegów mających na celu wszechstronny rozwój fizyczny organizmu człowieka. Jednakże nie ulega wątpliwości, że ćwiczenia na lekcjach wychowania fizycznego wiążą się z ryzykiem kontuzji lub uszkodzeń ciała. Zagrożenie utraty zdrowia w wymiarze szkolnym stało się obecnie bardzo dużym problemem społecznym. W związku z tym należy zwracać szczególną uwagę na bezpieczeństwo młodzieży zarówno w planowaniu zajęć wychowania fizycznego, jak i w doborze metod i form pracy. Cel pracy: Celem pracy jest ocena częstości występowania urazów uczniów szkół podstawowych i gimnazjalnych województwa podkarpackiego na lekcjach wychowania fizycznego oraz ocena zależności występowania urazów sportowych wśród dzieci i młodzieży szkolnej od wybranych czynników. Materiał i metoda: Badaniem objęto grupę 301 uczniów szkół podstawowych i gimnazjalnych na terenie województwa podkarpackiego. W badanej grupie było 151 chłopców i 150 dziewcząt. Wiek badanych mieścił się w przedziale od 9 do 16 lat (średnia wieku 12,58 lat). Do przeprowadzenia badań wykorzystano oryginalną ankietę. Ankieta była standaryzowana, anonimowa, zawierała 29 pytań. Wyniki: W wyniku przeprowadzonych badań wykazano, iż wśród 301 przebadanych uczniów ponad połowa – 158 (52,5%) doznała urazu na lekcjach wychowania fizycznego. Analizując rodzaj doznanego urazu wykazano, że najczęściej dochodziło do stłuczeń (53,16%), które dotyczyły głównie kończyn dolnych (55,06%). Stwierdzono wysoce istotną statystycznie zależność pomiędzy częstotliwością urazów a wiekiem badanych (p<0,001), środowiskiem zamieszkania (p<0,001), a także rodzajem aktywności ruchowej pozalekcyjnej (p<0,05). Wnioski: Urazy na lekcjach wychowania fizycznego są częstym zjawiskiem wśród uczniów województwa podkarpackiego. Występuje istotna zależność pomiędzy wiekiem, środowiskiem zamieszkania, aktywnością ruchową pozalekcyjną, a częstotliwością występowania urazów na zajęciach wychowania fizycznego.
EN
Introduction: The classes of Physical Education include a range of activities aimed at comprehensive physical development of human body. However, there is no doubt that exercises at Physical Education (PE) are associated with the risk of injury or damage to the body. The threat of loss of health in school environment is currently becoming a significant social issue. Therefore, particular attention should be paid to the safety of young people both in course of planning of PE classes and the choice of methods and forms of activity. Aim: The aim of this study was to evaluate the incidence of injuries in primary and secondary schools students during PE classes in the Podkarpackie Province and the assessment of correlation between the incidence of sports injuries among children and adolescents and selected factors. Material and methods: 301 primary and secondary school students from the Podkarpackie Province were included in the study. The study group comprised of 151 boys and 150 girls. Age of the participants ranged from 9 to 16 years of age (mean age 12.58 years). The author’s questionnaire was used to carry out the research. The survey was standardized, anonymous and consisted of 29 questions. Results: The results of the study showed that out of the total of 301 students surveyed, more than a half – 158 (52.5%) suffered occasionally from an injury at PE lessons. The analysis in terms of injury type revealed that contusions were predominant (53.16%), the lower limbs were the most frequently affected (55,06%). There was a highly significant relationship between the frequency of injuries and the age of students (p <0.001), living environment (p <0.001) as well as a kind of after-school physical activity (p <0.05). Conclusions: Injuries at PE classes are common among students in the Podkarpackie Province. There is a significant relationship between the age, living environment, afterschool physical activity and the incidence of injury during physical education classes.
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Assessment of the effects of Proprioceptive Neuromuscular Facilitation therapy on the improvement of motor function in a patient after total hip replacement – a case study

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Agnieszka Guzik A., Anna Szpitman (, Mariusz Drużbicki M., Justyna Wyszyńska J., Andżelina Wolan-Nieroda A.
European Journal of Clinical and Experimental Medicine
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2017
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issue 3
287–294
EN
Hip osteoarthritis is a serious clinical and social problem. The number of patients who suffer from degenerative changes in the hip joints and require endoprosthesis-plasty is constantly increasing. This paper presents physiotherapeutic activities based on Proprioceptive Neuromuscular Facilitation (PNF) which optimize a patient’s mobilization using the reserves in their body fully to make improvements in movement and to regain lost functions for achieving beneficial therapeutic effects. The aim of the study was to evaluate the influence of PNF therapy on changes in muscle strength, mobility, and gait pattern in patients after Total Hip Arthroplasty. The case described here regards a 63-year-old woman diagnosed with left hip osteoarthritis who had Total Hip Arthroplasty. The patient was examined twice before and after PNF therapy. The range of mobility of hip joints, level of pain, muscular strength and gait were assessed. Applied PNF therapy, including dynamic (eccentric, concentric) and static muscle training, post-isometric relaxation, stabilization and control in the stance phase, resulted in improved hip joint mobility, muscle strength, gait pattern and pain reduction in the patient. The case study demonstrates that a short (two-week) but intensive (over two hours per day) PNF therapy positively influenced selected motor functions after Total Hip Arthroplasty.
5
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The assessment of the impact of myofascial training on postural control – a case study

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Agnieszka Guzik A., Bartłomiej Chwaszcz B., Mariusz Drużbicki M., Andżelina Wolan-Nieroda A., Justyna Wyszyńska J.
European Journal of Clinical and Experimental Medicine
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2017
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issue 1
71-77
EN
Introduction. A sedentary lifestyle with lack of physical activity contributes to deteriorated balance among healthy young people. Physical activity is import_ant since it stimulates neuromuscular junctions that control body posture, especially at younger age, when greater postural sway may be observed in stabilography compared to adults. Proper work of individual muscle groups is import_ant to maintain proper balance. Abnormal muscle tone can lead to dysbalances that make it difficult o maintain a stable posture in a variety of conditions. Aim. The aim of the study was to evaluate the effect of a training cycle consisting of stretching of the ilopsoas, rectus femoris, gluteus maximus, hamstring and rectus abdominis, and eccentric training of the above mentioned muscles to improve static and dynamic balance. Methods. Oobjective and qualitative-subjective were used to assess the results in a man aged 22 yrs. Postural control was tested twice in the patient with the Neurocom International Inc. SMART EquiTest device under static conditions without visual control and with dynamic visual surrounding and unstable support surface. Automatic postural reflexes were also evaluated. In addition, clinical tests were performed. Results. Myo-fascial training, which included eccentric training combined with lower limb and trunk stretching improved the postural control in the subject.
6
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Cervical spine injuries in Poland – epidemiology, divisions, and causes

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Andżelina Wolan-Nieroda A., Andrzej Maciejczak A., Agnieszka Guzik A., Grzegorz Przysada G., Justyna Wyszyńska J., Ewa Szeliga E.
European Journal of Clinical and Experimental Medicine
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2017
|
issue 1
66-70
EN
Aim. The aim of the study was to review the literature on the prevalence of cervical spine injuries divided between the level of the injury and the causes of fractures. Material and methods. A review of Polish and foreign literature was performed. The following databases were searched: PubMed, Medline, Science Direct, Termedia, and Polish Medical Bibliography. Literature analysis. In Poland the incidence of spinal injuries, including damage to the cord, is estimated at the level of 25–35 persons per one million of the population, half of these being cervical spine injuries. More than one in three of all spinal injuries affect the atlantoaxial and occipital area. It is estimated that axis fractures occur in up to 40% of the cases involving cervical spine injury. Odontoid fractures constitute 10–15% of all cervical spine fractures. Hangman fractures account for 20% of vertebral fractures. Cervical spine injuries more frequently occur in males than in females, and the relevant rates for males are from 1.5 to 2.7 times higher. The most common causes of cervical spine injuries include road traffic accidents, accounting for 33 to 75% of the cases, falls from heights (15–44%) and sports injuries (4–18%). Cervical spine injuries are most often diagnosed in subjects over thirty years of age. Such injuries most commonly are related to the second, fifth and sixth cervical vertebrae. On the other hand damage to the first and second cervical vertebrae is often observed in the same patients who are found with injury to lower cervical vertebrae (approx. 9% of the cases). In the group of advanced age subjects the most frequent cervical spine injuries are axial fractures and they are diagnosed in 15% of adult patients with cervical spine fractures.
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Assessment of manual abilities in children with infantile cerebral palsy

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Grzegorz Przysada G., Agnieszka Guzik A., Andżelina Wolan-Nieroda A., Magdalena Przybyło M., Mariusz Drużbicki M., Artur Mazur A.
European Journal of Clinical and Experimental Medicine
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2019
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issue 2
136-141
EN
Introduction. Cerebral palsy (CP) is a problem presenting multiple issues and the prevalence of this condition is quite significant. CP risk factors are mainly observed in prematurely born children as well as those affected by complications around the time of birth or during the period of mother’s pregnancy. Quite frequently CP is manifested by abnormal muscle tone, contractures and deformities, and consequently impaired fine and gross motor functions. Aim. The study was designed to examine the level of hand function, i.e. fine motor skills and to investigate whether there is a correlation between development of fine motor and gross motor functions. Material and methods. The study group included 80 children with infantile CP. In the group there were 24 cases with spastic diplegia, 36 with spastic hemiplegia, and 20 with bilateral hemiplegia. During the study the children performed Box and Blocks test, and their parents filled in Manual Ability Classification System (MACS) describing the level of fine motor function development in their children. The children were additionally asked to perform two motor tasks. The first one involved an attempt to assume position on all fours, and the other one checked the ability to assume and maintain standing position. Results. The best scores in the conducted tests were found in children with CP taking the form of spastic diplegia, and the poorest scores in MACS, Box and Blocks test as well as in motor tasks assessing gross motor function were observed in children with bilateral hemiplegia. Conclusion. The form of infantile CP affects the level of manual abilities. There is a correlation between the level of gross motor and fine motor functions development.
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