Aleksandra Truszczyńska

A comparative analysis of static balance between patients with lumbar spinal canal stenosis and asymptomatic participants.

OBJECTIVE The aim of this study was to assess static balance in patients with lumbar spinal canal stenosis who qualified for surgical decompression of associated neural structures and compare them with asymptomatic participants. METHODS This case-controlled study evaluated a sample of 50 patients with spinal canal stenosis (stenosis group) and 48 participants with no history of clinical symptoms of back pain. Static balance was assessed by conducting quantitative analysis of balance reaction parameters in quiet standing with the eyes closed. RESULTS Higher values were observed in total length of center of pressure (COP) path, length of COP path in the anterior-posterior plane, mean amplitude of COP projection in the anterior-posterior plane, maximal amplitude between the 2 most distant points in the anterior-posterior plane, mean COP velocity, and sway area marked by the moving COP in the stenosis group compared with the asymptomatic group. CONCLUSIONS This study showed statistically significant differences in static balance parameters between patients with spinal canal stenosis compared with the asymptomatic group.

Recurrence of tuberculosis after hip replacement 58 years after primary infection.

The paper presents the case of a 73-year-old patient with a history of tuberculosis of the hip in childhood who received an Exeter total hip prosthesis. Tuberculosis recurred 58 years after primary infection and 9 years after THA. The authors analyzed the available literature, which described only a few case reports, because Mycobacterium tuberculosis infections of a joint implant after THA are extremely rare. They are frequently the result of local reactivation of the pathogen or, less commonly, an overlooked diagnosis of tuberculosis at the time of endoprosthesis implantation. Proper diagnostic work-up of infection is particularly difficult because synovial fluid cultures are usually negative. In addition, a coexisting Staphylococcus aureus infection may obscure the clinical presentation. In post-THA patients, complete anti-TB treatment is recommended. Particular caution should be observed in patients from regions with high TB morbidity or with a history of pulmonary and operated joint tuberculosis.

Back pain in Polish military helicopter pilots

ObjectivesLow back pain in pilots of military helicopters is widely discussed in the world literature. Vibrations and improper seat configuration cause that cervical, thoracic and lumbar spine might be exposed to overloading. The aim of the study was to determine the incidence and intensity of pain in the spine as well as to identify subjective risk factors of back pain and its effect on the pilot’s actions while flying a helicopter.Materials and Methods112 pilots, aged 25–56 years (mean age: 34.8±6.3 years), actively flying helicopters, participated in the questionnaire survey. The questionnaire containing five groups of questions, elaborated by the authors, was used.Results70% of the pilots reported pain complaints. Pain was localized in different parts of the spine. Uncomfortable body posture during prolonged flights resulting from the lack of lumbar support exerted the highest effect on pain provocation.ConclusionsThis questionnaire survey enabled to determine the prevalence of pain, its type and intensity. Knowledge on low back pain imposes the necessity to eliminate the negative environmental effect on helicopter pilotage. Elimination of risk factors is possible through appropriate physical exercises and adjustment of pilots’ seats. The authors plan to conduct — in the future — detailed annual examinations among pilots with back pain and, based on the results, to elaborate a prophylactic program containing simple forms of isometric and isotonic training involving paravertebral and deep abdominal muscles designed specifically for pilots of military helicopters.

Influence of the Weight of a School Backpack on Spinal Curvature in the Sagittal Plane of Seven-Year-Old Children

The aim of the paper was to determine a correlation between the weight of a childs backpack, their body weight, and certain features of their body posture. Material and Methods. The study group consisted of 109 children, all aged seven years. The parameters of body posture were determined using the Zebris Ultrasonic System. Results. The number of children carrying a school backpack in accordance with recommendations was 44 subjects (40.37%). Statistically significant changes were found in the total length of the spine (Z = 2.223, p = 0.026) and between backpack weight and changes in the following parameters: the total length of the spine (r s = −0.3999, p = 0.017), the length and the angle of the lumbar lordosis (r s = −0.3352, p = 0.049), the angle of the lumbar lordosis (r s = −0.5065, p = 0.002), and the sacral angle (r s = −0.4279, p = 0.010). Conclusions. Wearing a backpack heavier than 10% of ones body weight can cause shallowing of the lumbar lordosis and a tendency towards a vertical position of the sacrum. Monitoring the weight of childrens school backpacks and enabling them to leave books and notebooks at school would probably be beneficial in reducing the daily burden put on childrens spines.

The influence of elongation exercises on the anterior-posterior spine curvatures.

Summary Introduction: Elongation exercises are designed to reduce existing pathological or increased physiological curvatures of the spine. The aim of the study was to evaluate the changes occurring in the parameters describing the anterior-posterior spinal curvatures during the performance of symmetric elongation exercises. Material and methods: The study included 150 children aged 7-10 years: 82 girls and 68 boys. It was performed in June 2012, following prior parental and the subjects’ consent. The study design was approved by the Bioethical Committee of the Medical Faculty of Rzeszow University (number 05/07/2012). In each subject, an examination of the body posture was performed twice - first in a relaxed position and second during an elongation exercise. The Wilcoxon pair sequence test was used for statistical analysis. Results: The lumbosacral angle was significantly higher during the performance of an elongation exercise (p < 0.001), and so was the thoracolumbar angle (p < 0.001). The angle of the upper thoracic spine (p < 0.01) was significantly reduced. In the case of parameters describing thoracic kyphosis, a significant increase was observed both for the thoracic kyphosis angle (p < 0.01) and the depth of this part of the spine. As for the parameters describing lumbar lordosis, both the lordosis angle and its depth were significantly reduced (p < 0.001 and p < 0.001). Conclusions: 1. Elongation exercises reduce the depth of lumbar lordosis. 2. During elongation exercises thoracic kyphosis becomes deeper

Transient Peripartum Osteoporosis of the Femoral Head in First and Third Pregnancy

The aim of this article was to present transient peripartum femoral head osteoporosis. This very rare condition occurred twice in our patient-a woman in her 30s. The cases described in the literature were mostly unilateral, with bilateral hip involvement noted much less frequently. In our patient, transient osteoporosis occurred in the third trimester of her first pregnancy in the right hip, her second pregnancy was uncomplicated, and in the third trimester of the patients third pregnancy, osteoporotic changes were noted in the left hip joint. The patient breastfed her first and third babies only 3 wk each. She breastfed her second baby for 4 mo. The diagnostic workup was based on the clinical examination and radiographic/magnetic resonance imaging, which revealed bone marrow edema, and the dual-energy X-ray absorptiometry scans. The treatment consisted in core decompression of the femoral head (foragé), unloading of the hip using crutches as well as administration of calcitonin and calcium supplements. Complete recovery of the femoral heads was achieved. The follow-up time was 7 yr.

Assessment of postural stability in patients with lumbar spine chronic disc disease

PURPOSE The pain, motor and sensory deficits are common symptoms of the lumbar disc disorder, and they can significantly affect human postural control. The aim of this study was to assess postural stability in patients with severe symptoms of lumbar spine disc disease qualifying them for surgical treatment and to compare them with a control group. METHODS The study involved 103 subjects: 54 patients and 49 healthy subjects. Patients mean age was 46.4 ± 11.3 years, mean body height 172.2 ± 10.3 cm, mean body mass 83.1 ± 18.9 kg, and mean body mass index (BMI) was 27.9 ± 5.2 kg m-2. The mean time of their recent pain episode was 9.7 ± 8.5 months. RESULTS We found statistically significant differences between postural stability in patients with lumbar spine disc disease and the control group. The measurements taken with eyes closed, as compared with the clinical control group, revealed higher and statistically significant values of the mean amplitude of COP, mean amplitude of COP on sagittal plane, and maximal sway in sagittal plane parameters. The analysis of pressure value differences between the right and left lower limbs in both groups revealed statistical significance. In the study population the difference was significantly greater in comparison to the control group. The patients had significantly greater asymmetry of lower limb load. CONCLUSIONS 1. Patients with lumbar spine discogenic pain had decreased postural control. 2. The patients had significant asymmetry in foot pressure resulting from pain radiating to a lower limb.

Return to work after spinal stenosis surgery and the patient’s quality of life

IntroductionThe return to work of patients who undergo spinal surgery poses important medical and social challenge.Objectives1) To establish whether patients who undergo spinal stenosis surgery later return to work. 2) To establish the patient’s attitude towards employment. 3) To assess the quality of life of the patients and its influence on their attitude to work.Materials and MethodsThe study population consisted of 58 patients aged from 21 to 80 years (the mean age was 52.33±14.12). There were 29 women (50%) and 29 men (50%) in the group. The patients’ quality of life was measured by the use of the WHOQOL-BREF instrument. Individual interviews were conducted 3 to 8 months (a mean of 5.72 months ±1.6) after the surgery.Results1) Although 13 patients (22.3%) returned to work, 44 (75.9%) did not, these being manual workers of vocational secondary education. 2) Almost half of the patients (27 patients, i.e. 44%) intend to apply for disability pension, 16 patients (27.6%) consider themselves unfit to work, 22 patients (37.9%) do not feel like working again. 3) The quality of life of the patients decreased. Domain scores for the WHOQOL-BREF are transformed to a 0-100 scale. The mean physical health amounted to 60.67 (±16.31), the mean psychological health was 58.78 (±16.01), while the mean social relations with family and friends were 59.91 (±20.69), and the mean environment 59.62 (±12.48).Conclusions1) A total of 75% of the patients operated for lumbar spinal stenosis do not return to their preoperative work. Difficulties in returning to work and decreased quality of life are associated with female sex, lower-level education, hard physical work and low income. 2) Physical health, psychological health, social relations and environment decreased to the mean of approximately 60. 3) The quality of life of the patients who did return to work was similar to that of healthy people.

Comparison of Parameters Characterizing Lumbar Lordosis in Radiograph and Photogrammetric Examination of Adults

OBJECTIVE The purpose of this study was to test validity of photogrammetry compared with radiography as a method of measuring the Cobb angle and the size of anterior-posterior spine curvatures in adults. METHODS The study included 50 volunteers, 23 men and 27 women whose mean age was 52.6 years. The average weight of the subjects was 81.3 kg, average body height was 172.0 cm, and the average body mass index was 27.4. Based on radiologic examination, the length and depth of lumbar lordosis were determined and the size of the Cobb angle of lumbar scoliosis. After the radiologic examination, a photogrammetric test was performed for each subject with the projection moire phenomenon. RESULTS The Pearson correlation found statistically significant associations concerning the length of lordosis (P < .001) and the Cobb angle (P < .001). Correlation of the depth of lordosis indicated a strong trend (P = .063). CONCLUSIONS This study found that the moire method of photogrammetric measurement produced similar findings to radiographic measurements in determining size of the Cobb angle and the length of lumbar lordosis.

Balance assessment in hearing-impaired children.

According to the scientific reports the postural stability is inseparably associated with hearing organs correct functioning. The aim of the study was to evaluate the degree of disorders occurring in balance reactions in this group of children with profound hearing loss compared to their healthy peers. The study worked with a total of 228 children, including 65 who are deaf (DCH) and 163 subjects without any hearing deficits (CON) in the control group. Stabilometric measurements were performed with the use of a force distribution platform. The results indicate statistically significant differences in terms of one parameter (the total path length) recorded in the test with the eyes open and a whole range of parameters recorded when the subjects had their eyes closed (the width, height, and area of the ellipse, the total path length, and the horizontal and vertical sway). The study results showed better values of the static balance parameters in deaf children as compared to their peers without hearing disorders and the differences were particularly evident in the test with the subjects eyes closed. The results suggest significantly better processing of sensory stimuli in postural reactions particularly from propioception, and to a lesser extent, from the vision system observed in the subjects as compared to their peers in the control group.