Dariusz Białoszewski

Usefulness of manual therapy in the rehabilitation of patients with chronic rotator cuff injuries. Preliminary report.

BACKGROUND Various manual therapy procedures are increasingly more often being used in the treatment of shoulder complex dysfunctions. The objective of the present study was to investigate whether manual therapy can improve the range of motion in the glenohumeral joint and alleviate pain in patients with chronic rotator cuff injuries MATERIAL AND METHODS The participants were randomly assigned to an experimental group and a control group of 15 patients each. Both groups received a standard combination therapy involving TENS, ultrasound therapy and kinesiotherapy. Additionally, the experimental group took part in a treatment programme designed by the authors composed of selected elements of various manual therapy techniques. Outcome evaluation focused on changes in the range of motion in the glenohumeral joint and changes in pain intensity (VAS scale) during the performance of functional tests. The results were subjected to statistical analysis. RESULTS More rapid and more significant pain reduction and more significant improvement in the range of motion of the glenohumeral joint across all movements tested were obtained in the experimental group. CONCLUSION The inclusion of manual therapy in standard comprehensive physiotherapy applied in the rehabilitation of patients with chronic rotator cuff injuries of the glenohumeral joint significantly improves treatment effectiveness.

Activity of ozonated water and ozone against Staphylococcus aureus and Pseudomonas aeruginosa biofilms.

Summary Background The known bactericidal properties of ozone have not been checked in relation to its action on bacterial biofilms. This is especially true of ozonated fluids. The aim of this study was to investigate the bactericidal activity of ozonated water and that of a mixture of ozone and oxygen against biofilms. Material/Methods Eighteen clinical strains of Staphylococcus aureus and Pseudomonas aeruginosa exhibiting various levels of antibiotic sensitivity were investigated. Bacteria were cultured in biofilm form on polystyrene titration plates for periods of 2 to 72 hours. The biofilms formed in this way were exposed to in statu nascendi ozonated water produced in a prototype device that had been tested in clinical conditions, or to a mixture of oxygen and ozone generated in the same device. Live cells in the biofilm were stained with a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium (MTT) bromide solution. The degree of reduction of viable bacteria following ozone exposure was determined. Results Ozonated water was found to be an effective bactericidal agent against biofilms after as little as 30 seconds of exposure, while the bactericidal activity of the ozone-oxygen solution was much lower. Prolongation of the duration of biofilm exposure to the gaseous disinfectant to 40 minutes led to a reduction in the viable cell count, which nevertheless remained high. Conclusions Unlike the ozone-oxygen mixture, ozonated water effectively destroys bacterial biofilms in vitro.

Attitudes of European physiotherapy students towards their chosen career in the context of different educational systems and legal regulations pertaining to the practice of physiotherapy: implications for university curricula

OBJECTIVES Differences in the organisation of educational systems and regulations pertaining to the practice of a profession can influence the attitudes of students towards their chosen career and their perceptions of employment possibilities. The aim of this paper was to discuss the different educational systems and legal regulations pertaining to the practice of physiotherapy in selected countries of the European Union (EU), and to present some conclusions regarding the influence of these differences on the perceptions of first-year physiotherapy students on their chosen career. DESIGN Quantitative questionnaire-based study. SETTING Twenty-one university-level schools in the Czech Republic, Latvia, Malta, Poland, Spain and the U.K. PARTICIPANTS Six hundred and sixty-seven first-year physiotherapy students. RESULTS The mean response rate was 74%. Most students (79%) reported that a personal interest was the main reason why they had decided to study physiotherapy (79%). Most students from Spain and the Czech Republic reported that, on completion of their studies, they would like to work as physiotherapists (61/120, 51% Czech Republic; 140/250, 56% Spain), compared with only 4% of Polish students (P<0.001). Most students from Poland and Spain were not familiar with employment opportunities in their respective countries (202/250, 81% Spain; 212/250, 85% Poland), and claimed that it is difficult to find employment as a physiotherapist in their country. Most students from the Czech Republic, Latvia, Malta, Poland, Spain and the U.K. claimed that it is easy to find a job in other EU countries. CONCLUSION Most physiotherapy students chose their course because of an interest in physiotherapy. They were not familiar with employment possibilities for graduates, and believed that it is easier to find work in other EU countries. Both factors may further aggravate the problem of unemployment among physiotherapists.

Using thermal imaging to assess the effect of classical massage on selected physiological parameters of upper limbs

Summary Study aim: the aim of this study was to assess the relationship between classical sport massage of the hand and the forearm and the surface temperature of upper limb muscles, and between hand grip strength and the range of motion in the radiocarpal joint. Material and methods: study participants comprised 35 women not engaging in competitive sport, aged 19–23 years. Thermal images were taken with a Flir A325 camera. Hand grip strength was measured using an analogue dynamometer. The range of motion in the radiocarpal joint was measured using a goniometer. All tests and measurements were performed twice: directly before and after the massage of the hand and the forearm (of the right limb). Classical massage was applied on the dorsal and palmar surfaces of the hand and on the anterior and posterior surfaces of the forearm. Results: after the massage, the temperature of the right limb increased significantly, as did the temperature of the posterior surface of the left limb. However, no change in temperature was observed on the anterior surfaces of the left forearm and the left arm. A significant increase in the range of motion in the right radiocarpal joint (in all planes) was observed. No significant differences in hand grip strength measured with a dynamometer were found before and after the massage. Conclusions: while classical sport massage increases muscle temperature, it does not improve effort capacity, and therefore it is not a sufficient means of preparing an athlete for physical effort. The massage increased the range of motion in the massaged limb, which mostly indicates the relaxing effect of the treatment.

Evaluation of effectiveness of kinesiology taping as an adjunct to rehabilitation following anterior cruciate ligament reconstruction. Preliminary report.

BACKGROUND. Kinesiology Taping (KT) is being increasingly more often used in musculoskeletal rehabilitation. The aim of the study was to assess the effect of Kinesiology Taping on rehabilitation outcomes in patients following anterior cruciate ligament (ACL) reconstruction. MATERIALS AND METHODS. The study enrolled 26 patients (16 women and 10 men) aged between 20 and 41 years. The patients were randomly divided into two groups: an experimental group (Group 1), which received Kinesiology Taping, and a control group (Group 2), which followed the same rehabilitation protocol except for KT. Students t test with a minimum significance level at p<0.05 was used for statistical analysis. RESULTS. All participants demonstrated a significant improvement in the range of knee flexion and extension in the affected limb as soon as the end of the first week of rehabilitation (p˂0.001). This tendency persisted in the following weeks until Day 28. Thigh measurements revealed a faster increase in thigh circumference in Group 1. Significant swelling reduction was found among patients from the experimental group at all consecutive measurements. The greatest difference (p<0.001) was noted at the beginning of the rehabilitation. After 28 days of rehabilitation, pain intensity and pain frequency had significantly decreased in all patients (p<0.001). Patients from the control group used analgesics significantly more often. CONCLUSIONS. 1. The use of KT contributed to a faster improvement of the range of knee motion, reduction of oedema and greater improvement in thigh circumference. 2. A similar reduction in pain intensity was observed in all patients. However, pain significantly less often forced patients from the experimental group to use analgesics or reduced their activity.

Utility of craniosacral therapy in treatment of patients with non-specific low back pain. Preliminary report.

BACKGROUND Non-specific low back pain is an increasingly common musculoskeletal ailment. The aim of this study was to examine the utility of craniosacral therapy techniques in the treatment of patients with lumbosacral spine overload and to compare its effectiveness to that of trigger point therapy, which is a recognised therapeutic approach. MATERIAL AND METHODS The study enrolled 55 randomly selected patients (aged 24-47 years) with low back pain due to overload. Other causes of this condition in the patients were ruled out. The participants were again randomly assigned to two groups: patients treated with craniosacral therapy (G-CST) and patients treated with trigger point therapy (G-TPT). Multiple aspects of the effectiveness of both therapies were evaluated with the use of: an analogue scale for pain (VAS) and a modified Laitinen questionnaire, the Schober test and surface electromyography of the multifidus muscle. The statistical analysis of the outcomes was based on the basic statistics, the Mann-Whitney U test and Wilcoxons signed rank test. The statistical significance level was set at p≤0.05. RESULTS Both groups demonstrated a significant reduction of pain measured with the VAS scale and the Laitinen questionnaire. Moreover, the resting bioelectric activity of the multifidus muscle decreased significantly in the G-CST group. The groups did not differ significantly with regard to the study parameters. CONCLUSIONS 1. Craniosacral therapy and trigger point therapy may effectively reduce the intensity and frequency of pain in patients with non-specific low back pain. 2. Craniosacral therapy, unlike trigger point therapy, reduces the resting tension of the multifidus muscle in patients with non-specific lumbosacral pain. The mechanism of these changes requires further research. 3. Craniosacral therapy and trigger point therapy may be clinically effective in the treatment of patients with non-specific lumbosacral spine pain. 4. The present findings represent a basis for conducting further and prospective studies of larger and randomized samples.

The effect of sport massage on the mental disposition in kickboxing and judo competitors, reducing their body mass prior to competitions

to competition. The goal of the study was to establish the relationships between sport massage procedures and mental disposition of the athletes being prepared for the competition. Material and methods. The sample included 16 females and 32 males – kickboxers and judokas. The study used Spielberger State Trait Anxiety questionnaire and a tailored questionnaire. The differences between variables were studied using Wilcoxon signed rank test. The minimal significance level was set at p<0.05. Results. Among the competitors qualified for the study, 48% reduced their body mass (Body Mass Reduction – BMR) before each start. They most often started reducing their body mass 10 days before the start by a doing a more intense physical exercise (on average 9.55 days and 9.5 days prior to the start for the female and male subjects respectively) and exercised wearing special clothes triggering sweat glands to release perspiration (8.14 days and 6.56 days for the female and male subjects respectively). Most of competitors (94% of the females and 72%of the males ) experienced negative consequences of BMR. The most frequently mentioned side effect was worsening of general feeling (70% of females and 86% of males). Besides, over a half (56%) of the female competitors complained of a decrease in endurance. The obtained results indicate that among the body mass reducing competitors the level of anxiety significantly increases before the start in competition. The differences, however, were only significant in the control group (p=0.021 in the females and p=0.002 in the males). This indicates a favourable effect of massage on the mental state in the competitors being prepared for the competition. Conclusions. A large group of athletes reducing their body mass obtain results below their expectations. Therefore, they should be subjected to physician’s, physiotherapist’s or sport psychologist’s care. The massage resulted in low levels of anxiety in the athletes before competitions. Physical disposition is of key importance in start preparation of combat athletes, thus the studies on the application of physiotherapeutic approaches among these athletes should be continued

The evaluation of health-related behaviours between the physically active and non-active women

Abstract Introduction. In the face of the more and more general threat with civilization diseases the promotion of healthy lifestyle should be one of main activities of educational and medical institutions. Aim. The aim of the work was comparison of chosen elements of healthy lifestyle between the young physically active women and non-sports ones. Material and methods. The survey was carried out on 156 women aged 18-35 years, divided into two groups. Persons physically active were classified into Group 1 (n=72), whereas into Group 2 - non-active ones (n=84). The investigative tool was the Inventory of Health-Related Behaviours by Juczyński (where health-related behaviours were rated in four categories: proper nutrition habits, prophylaxis behaviours, and positive attitude and health practices). Differences between the data were qualified with the t-student test for independent groups; level p≤0.05 was accepted as of minimum significance. Results. The results show that physically active persons pay greater attention to healthy lifestyle than non-sports people. The general indicator of health-related behaviours was noticeably higher in Group 1 (p=0.007). Greatest differences (p=0.008) were noted within the range of nutritional habits, and the least significant ones - in positive attitude (p=0.546). Conclusion. The positive influence of the physical activity on other aspects of the healthy lifestyle has been proven. It seems legitimate to promote physical activity among women of every age

The estimation of health-related behaviours of male judokas

Combat sports are a discipline of sport in which the rivalry consists of direct encounter of two sportsmen, in the form of immediate influence on the body of the competitor with the purpose of the documentary evidence of one’s own superiority. The sports-fight relies among other things on the infliction of knocks (boxing, kick boxing, taekwondo), or the usage of throwing or grappling (wrestling, judo) [1,2]. The identity of combat sports and martial arts consists of the integration of three specific factors: pragmatic, utilitarian and mental. They influence on the psychophysical and moral education of a man. Therefore, sports and martial arts are much more than disciplines of sport. They are the form of the physical education, the civil (defensive) education and the philosophy [3]. Judo is modified form of the old Japanese martial art – jujitsu. The goal of the creator of judo – Jigoro Kano, was the creation of wholly developmental, utilitarian system of exercises, applied in the physical education of children and young people, the defensive instruction of policeand military formations, and also disciplines of sport in the Olympian dimension and recreational one. Judo can be practiced by men in every age, of different physique and different fitness level. For Jigoro Kano, judo was not only the martial art, but also the kind of specific philosophy. Students of his school were obliged to obey strict regulations instituted by the master. The word ‘judo’ in the literal translation from Japanese means ‘the way’ (a rule, manner) of gentleness (agility, compliance). The idea of judo according to his creator had to be the fight with the utilization of the opponent’s power [4,5]. In the judo train-

The Effect of Kinesiology Taping and Muscle Fatigue on Movement Control in the Shoulder Joint - Preliminary Report

OBJECTIVES Methods, that can reduce rehabilitation time after shoulder injuries and improve its effi cacy, include those serving to improve proprioception in the shoulder joint. Sensorimotor control of the shoulder joint, especially during 45-60o abduction, relies on the deltoid muscle. The aim of this study was to assess the effect of Kinesiology Taping application and muscle fatigue to the deltoid on movement control in the shoulder joint.