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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.
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Ocena przydatności wybranych skal i metod stosowanych w ocenie równowagi i sprawności fiycznej seniorów – badanie pilotażowe

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Agnieszka Ćwirlej-Sozańska A., Anna Wilmowska-Pietruszyńska A., Agnieszka Guzik A., Agnieszka Wiśniowska A., Mariusz Drużbicki M.
Medical Review
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2015
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issue 1
8-18
PL
Wstęp i cel pracy: Wraz z wiekiem znacząco wzrasta ryzyko upadków. Celem pracy była analiza przydatności wybranych skal i metod stosowanych w ocenie równowagi i sprawności fiycznej seniorów. Materiał i metoda: Badaniem pilotażowym objęto grupę 25 osób w wieku 60–77 lat. Do oceny sprawności funkcjonalnej wykorzystano specjalistyczny test dla osób starszych Fullerton Functional Fitness Test. Do oceny równowagi seniorów wykorzystano testy kliniczne: Up&Go Test, Functional Reach Test, Tandem Stance Test, Tandem Walk Test oraz Tandem Pivot 180° oraz pomiary na platformie stabilometrycznej Cosmogamma. Wyniki: W wyniku przeprowadzonych badań wykazano występowanie relacji pomiędzy wynikami testów klinicznych a pomiarem sprawności funkcjonalnej. Wykazano też zależność pomiędzy wynikami testów klinicznych a wynikami pomiaru długości ścieżki środka pola podparcia na platformie stabilometrycznej w staniu na jednej kończynie dolnej z oczami otwartymi. Pomimo że w literaturze istnieją doniesienia dotyczące badań nad oceną wydolności systemu kontroli równowagi seniorów, brak jest ujednoliconych procedur wskazujących, które testy i metody ilościowe oceny równowagi powinny być analizowane, aby zapewnić wiarygodność badań. Wykazano, że na podstawie wyników jednego ze wskazanych w pracy testów można przewidywać z dość dużą pewnością wyniki dla innego. Wnioski: Zastosowane w pracy testy: Up&Go, Tandem Walk, Tandem Pivot 180° i Functional Reach są wartościowymi narzędziami do jakościowej oceny równowagi w populacji osób powyżej 60 roku życia. Stabilometryczna ocena równowagi seniorów pozostaje w zależności z wynikami testów klinicznych. Konieczne są dalsze badania obejmujące większą grupę osób w celu potwierdzenia wiarygodności uzyskanych wyników.
EN
Introduction and aim: The risk of falls increases signifiantly with age. The aim of the study was to analyze the usefulness of selected scales and methods used in assessing the balance and physical finess in seniors. Material and methods: The study included a pilot group of 25 people aged 60-77 years of age. Fullerton Functional Fitness Test also called the Senior Fitness Test was used to assess the functional capacity. The following clinical tests were used to assess balance in seniors: “Up&Go Test”, Functional Reach Test, Tandem Stance Test, Tandem Tandem Walk, Tandem Pivot 180° and measurements on Cosmogamma stabilometric platform. Results: The studies demonstrated the relationship between the results of clinical tests and the measurement of functional capacity, i.e. the relationship between the results of clinical tests and the results of measurement of path length of centre of pressure on stabilometric platform in standing on one leg with eyes open. Although there are reports in the literature concerning the research on evaluation of usefulness of the control system used to assess balance in seniors, there are no uniform procedures indicating which tests and quantitative methods for assessing the balance should be analyzed to ensure the credibility of the research. It was demonstrated that the results of one of the tests concerned in this paper can be a fairly reliable prediction of the results for another one. Conclusions: The tests: “Up & Go”, Tandem Walk, Tandem Pivot 180° and Functional Reach, which were used in this study, are valuable tools for qualitative assessment of the balance in the population of people over 60 years of age. Stabilometric assessment of the balance in seniors correlates with the results of clinical tests. Further studies are necessary involving a larger group of people in order to confim the reliability of the results.
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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.
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Gait velocity as a tool for evaluating the effects of gait training in patients with chronic stroke

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Agnieszka Guzik A., Mariusz Drużbicki M., Andrzej Kwolek A., Grzegorz Przysada G., Agnieszka Brzozowska-Magoń A.
Medical Review
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2016
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issue 2
183-192
EN
Background. Gait velocity is a simple but very essential parameter which may be applied as an indicator of functional efficiency. Gait of stroke patients is characterized by reduced speed. As a result, the patients have significantly limited functioning capabilities, including walking independently outside home. The study was designed to assess selected temporal gait parameters, including gait velocity, stride velocity and swing phase velocity in patients with chronic stroke following a rehabilitation program with the use treadmill. Material and method. The study was conducted in a group of 50 patients with hemiparesis in the late period after stroke. Temporal gait parameters such as: gait velocity, stride velocity and swing velocity were examined. Additionally, 10-metre walk test was measured. Results. While analyzing 10-metre walk test results it was shown that after rehabilitation gait velocity increased by an average of 0.15 m/s (p = 0.0000). Similar results were obtained in terms of gait velocity which had been assessed using a 3-dimensional gait analysis, the average gait velocity increased by 0,14m/s (p = 0.0000). Analyzing stride velocity, both the paretic and non-paretic side it was noted that after rehabilitation this particular parameter increased by an average of 0.05 m/s (p = 0.0019) and 0.06 m/s (p = 0.0052). Similar results were achieved in terms of swing velocity of the paretic side - p = 0.0017. Conclusions. It was demonstrated that rehabilitation program with the use of treadmill enabled significant improvement in gait velocity, stride velocity and swing phase velocity in patients with chronic stroke. Gait velocity is a practical and simple tool to be applied for monitoring of progress in rehabilitation and for assessing effects of gait re-education in patients with hemiplegia in a chronic stage after stroke.
PL
Wstęp. Prędkość chodu jest prostym, a zarazem bardzo istotnym parametrem, który może być stosowany jako wyznacznik sprawności funkcjonalnej. Chód pacjentów po udarze mózgu charakteryzuje się zmniejszoną prędkością. W efekcie pacjenci mają znacznie ograniczone możliwości funkcjonowania, w tym samodzielnego chodu poza domem. Celem pracy jest ocena wybranych czasowych parametrów chodu, w tym prędkości chodu, prędkości cyklu chodu oraz prędkości fazy przenoszenia u pacjentów w okresie późnym po udarze mózgu, po programie rehabilitacji z wykorzystaniem bieżni ruchomej. Materiał i metoda. Badanie przeprowadzono w grupie 50 pacjentów z niedowładem połowiczym w okresie późnym po udarze mózgu. Analizowano czasowe parametry chodu: prędkość chodu, prędkości cyklu chodu oraz prędkości fazy przenoszenia. Dodatkowo wykonano test drogi na 10 metrach. Wyniki. Analizując wyniki testu drogi wykazano, że po zakończeniu programu rehabilitacji prędkość chodu wzrosła średnio o 0,15 m/s (p = 0,0000). Podobne wyniki uzyskano w zakresie prędkości chodu ocenionej z wykorzystaniem 3-wymiarowej analizy chodu, średnia prędkość chodu wzrosła o 0,14m/s (p = 0,0000). Analizując prędkość cyklu chodu zarówno po stronie niedowładnej jak i zdrowej zanotowano, iż w wyniku rehabilitacji nastąpił wzrost tego parametru średnio o 0,05 m/s (p = 0,0019) i 0,06 m/s (p = 0,0052). Zbliżone wyniki uzyskano również w zakresie prędkości fazy przenoszenia po stronie niedowładnej – p = 0,0017. Wnioski. Program rehabilitacji z wykorzystaniem bieżni ruchomej wpłynął na istotną poprawę w zakresie prędkości chodu, prędkości cyklu chodu oraz prędkości fazy przenoszenia u pacjentów w okresie późnym po udarze mózgu. Prędkość chodu jest przydatnym narzędziem umożliwiającym ocenę efektów reedukacji chodu pacjentów z niedowładem połowiczym w okresie późnym po udarze mózgu.
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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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Assessment of relation between gait and static balance in children with cerebral palsy

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Joanna Majewska J., Magdalena Szczepanik M., Mariusz Drużbicki M., Sławomir Snela S., Wojciech Rusek W., Grzegorz Sobota G., Ewelina Nowak E., Jacek Durmała J., Marcin Bonikowski M.
European Journal of Clinical and Experimental Medicine
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2017
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issue 1
24–31
EN
Introduction. Cancer, after cardiovascular disease, is the second most common cause of death both in Poland anIntroduction. In children with cerebral palsy, gait and balance assessment allows for an objective gait pattern evaluation as well as for therapy planning and assessment. It was hypothesised that asymmetry of the lower limbs load in a standing position causes asymmetry of spatiotemporal gait parameters. Material and methods. 19 children with spastic diplegia and 20 healthy children participated in this study. 3D gait analysis was performed using the BTS Smart optoelectronic system. Stabilometric evaluation was performed using the Zebris Force Plate. Additionally, the Symmetry Index for selected gait and balance parameters was calculated. Results and conclusion. It was shown that symmetry of gait parameters and lower limb load in standing position differs significantly between the study and control groups. There was no correlation confirmed between lower limbs symmetry in standing position and symmetry of gait parameters. It was shown that 80% of children with cerebral palsy had asymmetrical gait patterns. It has also been shown that asymmetry of lower limbs load in a standing position correlates with an asymmetry of spatiotemporal gait parameters. The majority of children with spastic diplegia present asymmetrical gait patterns and asymmetrical balance parameters, but it has no influence on gait symmetry.
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