Bartosz Wnuk

A Controlled Trial of the Efficacy of a Training Walking Program in Patients Recovering from Abdominal Aortic Aneurysm Surgery.

BACKGROUND Major surgical procedures as well as general anesthesia contribute to muscle weakness and posture instability and may result in increased postoperative complications and functional disorders resulting from an elective operation. OBJECTIVES We aim to state the significance of backward walking as a form of interval march training with patients after abdominal aortic aneurysm surgery. MATERIAL AND METHODS Sixty-five patients were randomly divided into three subgroups and three various models of physiotherapy were applied. The participants were males, aged 65-75 years, with stable cardiologic status, absence of neurological disorders, and non-symptomatic aneurysm - non-ruptured, no pain complaints and no motor system impairments. The control group had only routine physiotherapy, since therapeutic groups I and II also had walking exercises, forward in group II and backward in group I. Both experimental groups were applied interval training. The patient data analyzed was as follows: hospitalization period-days; 6-min walking test-distance (m), training heart rate (1/min), mean speed (km/h), MET; spirometry test-FVC(L), FEV1(L), FEV1/FVC and PEF(L/s). RESULTS The hospital stay period in all groups did not vary significantly. Statistical analysis showed that patients with backward walking had a statistically significantly lower reduction of walking distance in the corridor test when compared to the control group (p < 0.05). After the operation, a significant reduction of mean speed in the control group was noted in comparison with both the forward and backward walking groups (p < 0.05). No significant differences were noted between the experimental groups in average walking speed as well as in heart rate in all observed groups. CONCLUSIONS Physical training applied to patients after major abdominal aortic aneurysm surgery influences sustaining the level of exercise tolerance to a small extent. Both backward and forward walking seem to be alternative methods when compared to classic post-surgery physiotherapy.

The Impact of the Derotational Mobilization of Manual Therapy According to Kaltenborn-Evjenth on the Angle of Trunk Rotation in Patients with Adolescent Idiopathic Scoliosis--Pilot Study, Direct Observation.

BACKGROUND The use of manual therapy in the treatment of scoliosis has been controversial. Scientific reports do not clearly indicate its effectiveness or harmfulness. The aim of this study was to determine the effectiveness of passive and active derotation techniques of manual therapy according to Kaltenborn-Evjent on the reduction of the angle of trunk rotation in patients with idiopathic scoliosis. MATERIAL AND METHODS The study enrolled 33 female patients from the Department of Rehabilitation who were diagnosed with adolescent idiopathic scoliosis. The patients were divided into two groups according to the curve location (SRS classification). Group A consisted of 17 women, aged 14.±2.4 years, with single-curve scoliosis in the thoracolumbar segment and group B was composed of 16 women, aged 15±2.24 years, with double-curve scoliosis in the thoracic and lumbar segments. In both groups, the angle of trunk rotation, the magnitude of thoracic kyphosis and lumbar lordosis were measured twice, before and after each session of derotation techniques. RESULTS Both groups demonstrated a positive impact of active and passive derotation techniques on the angle of trunk inclination. The greatest difference was observed after a session of active derotation in the patients with lumbar scoliosis. The angle of trunk rotation decreased on average by 4.5°±1.14°. No correlations were found between the curve angle values and the degree of thoracic derotation after the application of these techniques. CONCLUSION Derotational mobilization techniques may be a valuable complement to scoliosis treatment methods as they increase their effectiveness.

Focused and Radial Shock Wave Therapy in the Treatment of Tennis Elbow: A Pilot Randomised Controlled Study

Abstract The purpose of this article was to evaluate and compare the efficacy of radial and focused shock wave therapies applied to treat tennis elbow. Patients with tennis elbow were randomized into two comparative groups: focused shock wave therapy (FSWT; n=25) and radial shock wave therapy (RSWT; n=25). Subjects in the FSWT and RSWT groups were applied with a focused shock wave (3 sessions, 2000 shocks, 4 Hz, 0.2 mJ/mm2) and a radial shock wave (3 sessions, 2000 + 2000 shocks, 8 Hz, 2.5 bar), respectively. The primary study endpoints were pain relief and functional improvement (muscle strength) one week after therapy. The secondary endpoint consisted of the results of the follow-up observation (3, 6 and 12 weeks after the study). Successive measurements showed that the amount of pain patients felt decreased in both groups. At the same time grip strength as well as strength of wrist extensors and flexors of the affected extremity improved significantly. Both focused and radial shock wave therapies can comparably and gradually reduce pain in subjects with tennis elbow. This process is accompanied by steadily improved strength of the affected extremity.

Short-term effects by using additional methods in DOBOMED preparation phase for AIS double major patients – pilot study

Materials and methods Thirty-five girls with AIS double major (mean Cobb’s angle – Th=27o±7,5; L=24o±5,6) were divided for two randomized groups. In group A was applied only standard DoboMed [1]. In-group A-plus was applied triple method (DoboMed + OMT Kaltenborn-Evjenth + Dynamic Brace System – Meditrac). The derotation manual therapy techniques and Meditrac were used in DoboMed preparation phase. Meditrac was used only in the part of lumbar spine once a day during 30 minutes. The stationary intensive rehabilitation for both groups have been continued during 3 weeks. Before and after observation have been analyzed: the respiratory system function (spirometry-VC, FEV1, PEF), the strength of respiratory muscles (maximal inspiration and expiratory pressuresMIP,MEP), the trunk morphology and function (kyphosis and range of spine motion by V-plurimeter; the trunk rotation angle-ATR by Bunnell’s scoliometer).

Influence of active and passive derotation techniques of OMT Kalternborn-Evjenth manual therapy on trunk morphology of adolescents with idiopathic scoliosis – pilot studies

Methods This is a prospective, randomized, and double blind study. 17 in-patient adolescents with idiopathic scoliosis treated with DoboMed (DM) were studied for trunk morphology (surface topography – ATR, Hump Sum, absolute rotation, total rotation, POTSI and clinical examination – ATR by scoliometer, kyphosis and lordosis by plurimeter). Measurements were taken in the morning, before (first study), and after (second study) mobilizations, lasting 10 minutes. They were used as a preparatory phase for a series of DoboMed exercises. On the first day, no mobilization was performed – manual therapy was simulated (placebo group). In the second and third day, (for a random order of individual patients – 8 group vs. 9 group) we used passive derotation mobilization techniques (“passive” group) or active (“active” group) only in the area of lumbar curvature. Derotation mobilization techniques were implemented, in accordance with the concept of OMT KalternbornEvjenth, in a sitting position. Clinical examination of the lumbar spine was performed in a standing position. Surface topography examination was performed in a sitting position. Statistical analysis was performed using nonparametric tests. Results After performing mobilization techniques, there was a statistically significant reduction in the parameters values (absolute values) (scoliometer ATR, surface topography – ATR, Hump Sum, absolute rotation, total rotation) only in the active and passive group (first study vs second study). Improvement (as a percentage of patients with improvement = relative values) was observed in all measured parameters between the group of mobilization (passive and active) and the placebo group. Only in the POTSI case, improvement was registered (insignificant) only in the active group; and in the case of the lordosis value, there were no statistically significant changes. Better percentage improvement was observed (not statistically significant) for most parameters in the active vs. passive group.

Cervical Pain in Young Professional Musicians - Quality of Life.

BACKGROUND The education of young musicians requires teaching them appropriate prophylaxis in order to avoid spinal overload and the development of postural defects. The aim of the study was to assess the quality of life of young musicians with cervical pain. MATERIAL AND METHODS The study involved a group of 45 young musicians divided into three subgroups depending on the musical instrument they played, namely the violin, cello and piano. The total follow-up period was 18 weeks. The patients were tested at 6-week intervals using the NDI, SF-36 and a VAS scale to assess pain intensity. RESULTS The degree of disability was moderate in all the groups. The level of general physical health was the lowest in the cello group. Pain intensity was also moderate in all the groups. CONCLUSIONS 1. Short-term follow-up revealed no changes in the quality of life of young musicians playing various instruments. 2. Prophylaxis should be implemented particularly in cellists.

The direct impact of derotation techniques (omt-kalternborn-evjenth) on the trunk morphology and the possibility of the autocorrection in girls with AIS - pilot studies

Background Conservative treatment of idiopathic scoliosis is a difficult and complex therapeutic process, witch not always is finished successfully. It seems that manual therapy may be used as an element in the preparatory phase for active 3D specific exercises. A systematic review of the literature (which is rather poor) performed by Romano and Negrini show, that manual therapy is not support in the treatment of the idiopathic scoliosis.

Short-term effects of simultaneous using of two physiotherapeutic methods in the treatment of adolescent idiopathic scoliosis – continuation of study?

Material and methods Forty girls with AIS (range of Cobb angle 15-35 degree) were examined. The group was divided into two randomized subgroups “D”(N=18) and “DK” (N=22). DoboMed was applied in group “D” (only). DoboMed and manual therapy was applied in the group “DK”. Derotational stretch mobilization techniques in selected segments of thoracic spine were used as preparation for DoboMed’s exercises. Physiotherapy has been continued for 3 weeks. The spirometry, maximal inspiration and expiratory pressures (MIP, MEP), kyphosis and the angle of trunk rotation (ATR-Bunnell) in thoracic spine have been estimated before and after therapy.