Emilia Mikołajewska

Manual Physical Therapists’ Use of Biopsychosocial History Taking in the Management of Patients with Back or Neck Pain in Clinical Practice

Objective. To develop and evaluate process indicators relevant to biopsychosocial history taking in patients with chronic back and neck pain. Methods. The SCEBS method, covering the Somatic, Psychological (Cognition, Emotion, and Behavior), and Social dimensions of chronic pain, was used to evaluate biopsychosocial history taking by manual physical therapists (MPTs). In Phase I, process indicators were developed while in Phase II indicators were tested in practice. Results. Literature-based recommendations were transformed into 51 process indicators. Twenty MTPs contributed 108 patient audio recordings. History taking was excellent (98.3%) for the Somatic dimension, very inadequate for Cognition (43.1%) and Behavior (38.3%), weak (27.8%) for Emotion, and low (18.2%) for the Social dimension. MTPs estimated their coverage of the Somatic dimension as excellent (100%), as adequate for Cognition, Emotion, and Behavior (60.1%), and as very inadequate for the Social dimension (39.8%). Conclusion. MTPs perform screening for musculoskeletal pain mainly through the use of somatic dimension of (chronic) pain. Psychological and social dimensions of chronic pain were inadequately covered by MPTs. Furthermore, a substantial discrepancy between actual and self-estimated use of biopsychosocial history taking was noted. We strongly recommend full implementation of the SCEBS method in educational programs in manual physical therapy.

Integrated IT environment for people with disabilities: a new concept

This article evaluates the authors’ own concept of integrated IT environments for people with disabilities. Increasing numbers of disabled people and elderly people are affected by shortages of medical specialists and limited funding for medical care. Integrated IT environments for people with disabilities — through integration of various technical and medical solutions into one flexible system — are one way to provide increased independence and improved quality of life for disabled, elderly and severely ill people. The aim of this paper is to assess the extent to which the available possibilities in this area are being utilized, including the authors’ own concept. The implications of technological developments are discussed to lay the groundwork for further research.

Non-invasive EEG-based brain-computer interfaces in patients with disorders of consciousness

Disorders of consciousness (DoCs) are chronic conditions resulting usually from severe neurological deficits. The limitations of the existing diagnosis systems and methodologies cause a need for additional tools for relevant patients with DoCs assessment, including brain-computer interfaces (BCIs). Recent progress in BCIs’ clinical applications may offer important breakthroughs in the diagnosis and therapy of patients with DoCs. Thus the clinical significance of BCI applications in the diagnosis of patients with DoCs is hard to overestimate. One of them may be brain-computer interfaces. The aim of this study is to evaluate possibility of non-invasive EEG-based brain-computer interfaces in diagnosis of patients with DOCs in post-acute and long-term care institutions.

The prospects of brain — computer interface applications in children

The restoring of motor functions in adults through brain-computer interface applications is widely studied in the contemporary literature. But there is a lack of similar analyses and research on the application of brain-computer interfaces in the neurorehabilitation of children. There is a need for expanded knowledge in the aforementioned area. This article aims at investigating the extent to which the available opportunities in the area of neurorehabilitation and neurological physiotherapy of children with severe neurological deficits using brain-computer interfaces are being applied, including our own concepts, research and observations.

Cervicogenic somatosensory tinnitus: An indication for manual therapy? Part 1: Theoretical concept

Tinnitus can be evoked or modulated by input from the somatosensory and somatomotor systems. This means that the loudness or intensity of tinnitus can be changed by sensory or motor stimuli such as muscle contractions, mechanical pressure on myofascial trigger points, transcutaneous electrical stimulation or joint movements. The neural connections and integration of the auditory and somatosensory systems of the upper cervical region and head have been confirmed by many studies. These connections can give rise to a form of tinnitus known as somatosensory tinnitus. To date only a handful of publications have focussed on (cervicogenic) somatosensory tinnitus and manual therapy. Broadening the current understanding of somatosensory tinnitus would represent a first step towards providing therapeutic approaches relevant to manual therapists. Treatment modalities involving the somatosensory systems, and particularly manual therapy, should now be re-assessed in the subgroup of patients with cervicogenic somatosensory tinnitus. The conceptual phase of this study aims to uncover underlying mechanisms linking the auditory and somatosensory systems in relation to subjective tinnitus through (i) review of the literature (part 1) and (ii) through design of a pilot study that will explore characteristics of the study population and identify relevant components and outcomes of manual therapy in patients with cervicogenic somatosensory tinnitus (part 2). This manuscript focusses the theoretical concept of (cervicogenic) somatosensory tinnitus, either with or without secondary central tinnitus or tinnitus sensitization.

Computational gait analysis using fuzzy logic for everyday clinical purposes – preliminary findings

Abstract Background: Proper, early, and exact identification of gait impairments and their causes is regarded as a prerequisite for specific therapy and a useful control tool to assess efficacy of rehabilitation. There is a need for simple tools allowing for quickly detecting general tendencies. Objective: The aim of this paper is to present the outcomes of traditional and fuzzy-based analysis of the outcomes of post-stroke gait reeducation using the NeuroDevelopmental Treatment-Bobath (NDT-Bobath) method. Materials and methods: The research was conducted among 40 adult people: 20 of them after ischemic stroke constituted the study group, and 20 healthy people constituted the reference group. Study group members were treated through 2 weeks (10 therapeutic sessions) using the NDT-Bobath method. Spatio-temporal gait parameters were assessed before and after therapy and compared using novel fuzzy-based assessment tool. Results: Achieved results of rehabilitation, observed as changes of gait parameters, were statistically relevant and reflected recovery. One-number outcomes from the proposed fuzzy-based estimator proved moderate to high consistency with the results of the traditional gait assessment. Conclusions: Observed statistically significant and favorable changes in the health status of patients, described by gait parameters, were reflected also in outcomes of fuzzy-based analysis. Proposed fuzzy-based measure increases possibility of the clinical gait assessment toward more objective clinical reasoning based on common use of the mHealth solutions.

Ethical considerations in the use of brain-computer interfaces

Nervous system disorders are among the most severe disorders. Significant breakthroughs in contemporary clinical practice may provide brain-computer interfaces (BCIs) and neuroprostheses (NPs). The aim of this article is to investigate the extent to which the ethical considerations in the clinical application of brain-computer interfaces and associated threats are being identified. Ethical considerations and implications may significantly influence further development of BCIs and NPs. Moreover, there is significant public interest in supervising this development. Awareness of BCIs’ and NPs’ threats and limitations allow for wise planning and management in further clinical practice, especially in the area of long-term neurorehabilitation and care.

Limbic brain structures and burnout—A systematic review

More profound understanding of the relationship between the burnout and the limbic system function can provide better insight into brain structures associated with the burnout syndrome. The objective of this review is to explore all evidence of limbic brain structures associated with the burnout syndrome. In total, 13 studies were selected. Four of them applied the neuroimaging technology to investigate the sizes/volumes of the limbic brain structures of burnout patients. Six other studies were to investigate the hypothalamus-pituitary-adrenal (HPA) axis of burnout patients. Based on the results of the studies on the HPA-axis and neuroimaging of the limbic brain structures, one can see great impact of the chronic occupational stress on the limbic structures in terms of HPA dysregulation, a decrease of BDNF, impaired neurogenesis and limbic structures atrophy. It can be concluded that chronic stress inhibits the feedback control pathway in the HPA axis, causes the decrease of brain-derived neurotrophic factor (BDNF), then impaired neurogenesis and eventually neuron atrophy.

“Clinical biopsychosocial physiotherapy assessment of patients with chronic pain: The first step in pain neuroscience education” by Amarins J Wijma et al., 2016

Department of Manual Therapy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Pain in Motion International Research Group, Vrije Universiteit Brussel, Brussels, Belgium; Department of Public Health and Research, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Methodological Health-Skilled Institute, Beuningen, The Netherlands; Department of Physiotherapy, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland; Neurocognitive Laboratory, Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Toruń, Poland; Department of Nursing Sciences, Faculty of Health, University Witten/Herdecke, Witten, Germany; SOMT Educational Institute for Musculoskeletal Therapy, Amersfoort, The Netherlands; Department Medical Psychology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands

Association of vitamin D status and clinical and radiological outcomes in a treated MS population in Poland

Vitamin D influences the immune system significantly. Previous studies have found that vitamin D deficiency in adolescence can play a significant role in increasing the risk of developing autoimmune diseases including multiple sclerosis. The aim of this study was to investigate the relationship between the vitamin D status in serum and clinical and radiological outcomes in a treated population in Poland.