Agnieszka Kędra

The Comparison of the Effects of Three Physiotherapy Techniques on Hamstring Flexibility in Children: A Prospective, Randomized, Single-Blind Study

The aim of the study was to evaluate changes in hamstring flexibility in 120 asymptomatic children who participated in a 6-week program consisting of one physiotherapy session per week and daily home exercises. The recruitment criteria included age (10–13 years), no pain, injury or musculoskeletal disorder throughout the previous year, physical activity limited to school sport. Subjects were randomly assigned to one of the three groups: (1) post-isometric relaxation – PIR (n = 40), (2) static stretch combined with stabilizing exercises – SS (n = 40) and (3) stabilizing exercises – SE (n = 40). Hamstring flexibility was assessed with straight leg raise (SLR), popliteal angle (PA) and finger-to-floor (FTF) tests. The examinations were conducted by blinded observers twice, prior to the program and a week after the last session with the physiotherapist. Twenty-six children who did not participate in all six exercise sessions with physiotherapists were excluded from the analysis. The results obtained by 94 children were analyzed (PIR, n = 32; SS, n = 31; SE, n = 31). In the PIR and SS groups, a significant (P<0.01) increase in SLR, PA, FTF results was observed. In the SE group, a significant (P<0.001) increase was observed in the SLR but not in the PA and FTF (P>0.05). SLR result in the PIR and SS groups was significantly (P<0.001) higher than in the SE group. As far as PA results are concerned, a significant difference was observed only between the SS and SE groups (P = 0.014). There were no significant (P = 0.15) differences regarding FTF results between the three groups. Post-isometric muscle relaxation and static stretch with stabilizing exercises led to a similar increase in hamstring flexibility and trunk forward bend in healthy 10–13-year-old children. The exercises limited to straightening gluteus maximus improved the SLR result, but did not change the PA and FTF results.

Epidemiology of Back Pain in Children and Youth Aged 10-19 from the Area of the Southeast of Poland

Objective. The aim of this work was to define the prevalence of back pain in children and youth aged 10–19 from the southeast of Poland. Material and Methods. The cross-sectional study included 1089 students (547 girls and 542 boys) aged 10–19. The prevalence of back pain, its intensity, location, and situations in which it occurred were assessed with a questionnaire. Results. Among 1089 respondents, 830 (76.2%) admitted that they had experienced back pain at various frequencies within the year preceding the study. Back pain was located mainly in the lumbar segment (74.8%). Mild pains were dominant, which was declared by 44.7% of the respondents. Girls experienced back pain significantly more frequently than boys (52.2% versus 47.8%, P < 0.05). Conclusions. The research revealed that back pain is a common phenomenon. The prevalence of back pain in children and youth living in southeast Poland is similar to the frequency of occurrence of such complaints occurring in peers in other countries. It seems significant to monitor the remaining regions of Poland in order to define the scale of the problem and to look for the risk factors of back pain in children and youth to undertake efficient prophylactic actions.

Squat - Rules of Performing and Most Common Mistakes

Squat - Rules of Performing and Most Common Mistakes The squat is an exercise which is commonly applied in sport, recreation and while performing numerous everyday activities [1, 2, 3]. The improper performance of the squat leads to the shaping of an improper movement pattern. In this work the methodology of teaching the squat, which has to be learnt to constitute a significant element in the prophylaxis of the musculoskeletal system overloads, is described.

The Examination of the Musculoskeletal System Based Only on the Evaluation of Pelvic-Hip Complex Muscle and Trunk Flexibility May Lead to Failure to Screen Children for Generalized Joint Hypermobility

Objective The aim of the study was to evaluate whether the clinical assessment of the pelvic-hip complex muscle and trunk flexibility is sufficient for diagnosing generalized joint hypermobility (GJH). Design A cross-sectional study. Setting Center of Body Posture in Olsztyn, North East Poland. Participants The study included 136 females and 113 males aged 10–13 years. Main outcome measures In order to assess muscle flexibility, the straight leg raise (SLR) test (for hamstring) and modified Thomas test for one- (O-JHF) and two-joint (T-JHF) hip flexors were performed. To evaluate trunk flexibility the fingertip-to-floor (FTF) and lateral trunk flexion (LTF) tests were used. The GJH occurrence was assessed with the use of nine-point Beighton scale (threshold value ≥5 points for females, ≥4 for males). The analysis was carried out separately for females and males. Results There were no significant differences between females with versus without GJH, and males with versus without GJH regarding SLR (p = 0.86, p = 0.19 for females and males, respectively), O-JHF (p = 0.89, p = 0.35 for females and males, respectively), T-JHF (p = 0.77, p = 0.4 for females and males, respectively), FTF (p = 0.19, p = 0.84 for females and males, respectively) and LTF (p = 0.58, p = 0.35 for females and males, respectively) tests results. Conclusions Clinical examination of the pelvic-hip complex muscles and trunk flexibility by use of SLR, O-JHF, T-JHF, FTF and LTF revealed to be insufficient in diagnosing GJH in children aged 10–13 years. Thus, the Beighton scale should be considered a standard element of physiotherapeutic examination of the musculoskeletal system in children and youth.

Low Back Pain and Everyday Functioning of Students.

INTRODUCTION The aim of the study was to determine the frequency of low back pain episodes (over a period of 12 months) and everyday functioning of students suffering from it. MATERIAL AND METHODS The study enrolled 1321 students of the 1st, 2nd and 3rd year of Bachelor-level programmes in Physical Education, Physiotherapy, Pedagogics, and Tourism and Recreation at 4 universities in Poland. An original questionnaire was used. A 10-point VAS scale was used to assess pain intensity. The reliability of the questionnaire had been assessed before commencing the study by administering it twice at a months interval to a group of 20 people. No significant differences were noted between the results obtained in the two tests (p<0.05). RESULTS Our analysis of the frequency of low back pain episodes showed that the respondents who experienced pain rarely (1-2 episodes per year) constituted the biggest group. With regard to pain intensity, mild pain, reported by 43.4% of the respondents, was most common. Over 20% of the subjects reported severe pain. A considerable percentage of the respondents (over 20%) limited their physical activity because of low back pain and 4.4% had to give up physical activity altogether. Nearly 60% of the subjects reported that the low back pain made it difficult for them to sit for prolonged periods, while nearly 50% had difficulty standing. CONCLUSIONS 1. This study of a group of students from eastern Poland revealed that low back pain is common. 2. Low back pain interferes with or limits daily activities of the students, such as sitting, standing or physical activity.

The Influence of the “Straighten Your Back” Command on the Sagittal Spinal Curvatures in Children with Generalized Joint Hypermobility

Objectives. The aim of the study was to assess the change of sagittal spinal curvatures in children with generalized joint hypermobility (GJH) instructed with “straighten your back” command (SYB). Methods. The study included 56 children with GJH. The control group consisted of 193 children. Sacral slope (SS), lumbar lordosis (LL), global thoracic kyphosis (TK), lower thoracic kyphosis (LK), and upper thoracic kyphosis (UK) were assessed with Saunders inclinometer both in spontaneous positions (standing and sitting) and after the SYB. Results. Children with GJH after SYB presented the following: in standing, increase in SS and decrease in TK, LK, and UK (P < 0.01), with LL not significantly changed; in sitting: decrease in global thoracic kyphosis (35.5° (SD 20.5) versus 21.0° (SD 15.5), P < 0.001) below the standards proposed in the literature (30–40°) and flattening of its lower part (P < 0.001). The same changes were observed in the control group. Conclusions. In children with generalized joint hypermobility, the “straighten your back” command leads to excessive reduction of the global thoracic kyphosis and flattening of its lower part. Therefore, the “straighten your back” command should not be used to achieve the optimal standing and sitting positions.

The influence of self-stretch based on post-isometric relaxation, static stretch combined with stabilization exercises and stabilization exercises only on hamstring, one-joint and two-joints hip flexors flexibility and finger-to-floor test results

Methods 94 children (46 boys and 48 girls) aged 10-13 years (11.5 ±0.5), were randomly divided into 3 groups. Each group underwent a 6-week therapeutic programme aiming to correct muscles flexibility. The first group-GI (31 children) realized the programme of post isometric muscle relaxation (PIR), the second one-GII (31 children) performed static stretching with stabilization exercises, the third group-GIII (32 children) realized only stabilization exercises. The shortening of hamstring, one-joint and two-joint hip flexors was assessed clinically according to Kendall. The straight leg raise (SLR test) angle and the popliteal angle were measured for hamstrings, the angle in sagittal plane in hip for one-joint and the knee flexion was measured for twojoint hip flexors. Fingertips-to-floor distance (FTF test) in trunk flexion was also noted. The examination was conducted twice – before therapy and a week after its completion, by the blinded observers.