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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

100%
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.
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Hip joint arthroscopy in professionally active patients with osteoarthritis

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Drobniewski M., Synder M., Skrzypek M., Pstrągowski K., Polguj M., Borowski A.
International Journal of Occupational Medicine and Environmental Health
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2018
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vol. 32
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issue 1
115-120
EN
Objectives The primary endpoints of the study were to assess the effectiveness of hip joint arthroscopy in the treatment of femoroacetabular impingement (FAI) in patients with joint gap stenosis and to determine if and how quickly patients were able to return to work and physical activity. Material and Methods The prospective study of patients undergoing hip joint arthroscopy due to pain in FAI has been conducted. They were divided into 2 groups depending on the degree of the radiological examination. The criterion was the width of the joint gap. The study group involved 47 patients with hip joint gap of 2–3 mm, identified by means of the standardized X-ray examination. The control group consisted of 45 patients with hip joint gap > 3 mm. The post-operative follow-up period of the patients lasted at least 2 years. In addition, the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire together with Harris Hip Score (HHS) were applied. The patients were also evaluated for the post-operative time period enabling return to work. Results All the patients after hip joint arthroscopy returned to normal physical activity within 12 weeks after operation, enabling their return to work. However, it should be noted that during the post-operative follow-up, pain sensations either recurred or did not regress in 37 patients in the study group and 12 patients in the control group after treatment. The nearly equal results of the WOMAC questionnaire and HHS before operation significantly vary between both groups in the last follow up. In the study group they did not change expressively. Conclusions Despite the little invasiveness, hip joint arthroscopy in patients with joint gap stenosis brings about the far from satisfactory results. This procedure is not worth considering. Despite unsatisfactory pain relief, patients decided to returned to work, due to their occupational position and for fear of losing the job due to long absenteeism. Int J Occup Med Environ Health. 2019;32(1):115–20
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Czynniki wpływające na utrzymanie aktywności zawodowej w okresie 2–3 lat po zabiegu całkowitej endoprotezoplastyki stawu biodrowego

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Pop T., Bejer A., Baran J., Szymczyk D.
Medycyna Pracy
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2018
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vol. 69
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issue 2
191-198
EN
Background The purpose of this paper was to assess the occupational activity in patients after hip replacement over a 2–3-year post operational period and to analyze the effect of selected factors (age, gender, body mass index (BMI), functional state and self-assessed health status) on this activity. Material and Methods In the research 107 people (56 women and 51 men) participated. The average age of the subject’s was 55.1 years. A standardized author’s survey questionnaire, including questions about personal and clinical data, occupational activity and self-assessment of health status, was applied. The body mass and height were measured and the BMI index was calculated. The 100 points Harris Hip Score (HHS) was used to assess the functional state in the respondents. Results After the operation about 60% of the patients were not occupationally active; 44 (41.1%) respondents received the state health benefit, 18 (16.8%) respondents were eligible for pension benefit, and 2 (1.9%) respondents were unemployed with benefit. No one unemployed before the operation undertook work afterwards. Neither gender nor the character of the job or BMI exerted statistically significant effect on the occupational activity after the operation. Significant differences were noted in undertaking the occupational activity after the operation in patients with different level of functional efficiency assessed with the use of HHS (p = 0.0350) and different level of self-assessed health statuse (p = 0.0057). Conclusions More than half of the respondents have not returned to work after total hip replacement, while people doing intellectual work most frequently returned to occupation after surgery. Age, functional efficiency, and self-assessed health status of the patient had a significant influence on their return to work. Med Pr 2018;69(2):191–198
PL
Wstęp Celem pracy była ocena statusu zawodowego osób po całkowitej endoprotezoplastyce stawu biodrowego w okresie 2–3 lat od zabiegu oraz analiza wpływu takich czynników, jak wiek, płeć, BMI (body mass index – wskaźnik masy ciała), sprawność funkcjonalna i samoocena stanu zdrowia na utrzymanie aktywności zawodowej. Materiał i metody W badaniu wzięło udział 107 osób, w tym 56 kobiet i 51 mężczyzn. Średni wiek badanych wynosił 55,1 roku. Zastosowano wystandaryzowany autorski kwestionariusz, który zawierał pytania dotyczące danych osobowych i klinicznych, aktywności zawodowej oraz samooceny stanu zdrowia. Dokonano pomiaru masy ciała i wzrostu i wyliczono wskaźnik BMI. Wykorzystano także 100-punktową skalę Harrisa (Harris Hip Score) do oceny sprawności funkcjonalnej badanych. Wyniki Po zabiegu endoprotezoplastyki stawu biodrowego ok. 60% pacjentów nie było aktywnych zawodowo – świadczenia rentowe pobierały 44 (41,1%) osoby, świadczenia emerytalne – 18 (16,8%) osób, a zasiłek dla bezrobotnych – 2 (1,9%) osoby. Nikt z badanych niepracujących przed zabiegiem (z powodu renty) nie podjął pracy po zabiegu. Płeć badanych nie miała istotnego statystycznie wpływu na podjęcie aktywności zawodowej po zabiegu, podobnie jak rodzaj wykonywanej pracy i BMI. Stwierdzono natomiast statystycznie istotne zależności między podejmowaniem aktywności zawodowej po zabiegu a poziomem sprawności funkcjonalnej ocenianej skalą Harrisa (p = 0,0350) i samooceną stanu zdrowia (p = 0,0057). Wnioski Ponad połowa badanych nie podjęła pracy po całkowitej endoprotezoplastyce biodra w okresie 2–3 lat od zabiegu. W grupie osób pracujących umysłowo przed zabiegiem do pracy powróciło stosunkowo najwięcej osób spośród wszystkich badanych. Istotny wpływ na powrót do pracy miały wiek, sprawność funkcjonalna i samoocena stanu zdrowia. Med. Pr. 2018;69(2):191–198
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