Piotr Król

Does low output laser stimulation enhance the healing of crural ulceration? Some critical remarks

The objective of the experiment was to evaluate the impact of laser stimulation on crural ulceration healing. Three groups were established at random from patients with crural ulceration: A, B and C. Group A included 21 patients, group B included 22 patients and group C, 22 patients. Patients in all groups were treated with pharmaceuticals and with compressive therapy. The ulcers in group A were additionally irradiated with laser light of wavelength 810 nm, so that a dose of 4 J/cm2 was applied in each procedure. Patients in group B were additionally subjected to a blind test (with placebo in the form of quasi-laser therapy). At the end of the treatment a statistically significant reduction of the area and volume of the ulcers was found in all groups. No statistically significant difference was found between the groups in terms of average rate of change per week of the relative area of ulceration and average rate of change per week of the relative volume of ulceration. Reduction of infected area was observed in all groups, but a significant change was only observed in group C. No significant impact of laser light (lambda=810 nm, P=65 mW, p=4 J/cm2) on any of the stages of ulceration healing was observed.

Early and long-term results of physical methods in the treatment of venous leg ulcers: randomized controlled trial.

Objective To estimate early and long-term results of physical methods in the treatment of venous leg ulcers. Method In group A after surgical operation, 40 patients were treated with the high-voltage stimulation (HVS) (100 µs, 100 Hz, 100 V) and drug therapy. In group B after operation, 37 patients were treated with ultrasound (0.5 W/cm2, 1 MHz) and drug therapy. In group C after operation, 33 patients were treated with low-level laser therapy (LLLT) (810 nm, 65 mW) and drug therapy. In group D after operation, 35 patients were treated with the compression stockings (25–31 mmHg) and drug therapy. In group E after operation, 37 patients were only treated with drug therapy. Group F consisted of 32 patients, conservatively treated with the HVS and drug therapy. Group G consisted of 20 patients, conservatively treated with ultrasound and drug therapy. Group H consisted of 21 patients, conservatively treated with LLLT and drug therapy. Group I consisted of 30 patients, conservatively treated with compression and drug therapy. Group J consisted of 27 patients only treated with drug therapy. Results Both short and long term parameters showed that compression therapy is the most efficient in ulcer healing. The electrical and ultrasound methods are less effective. The laser therapy ared useless. Conclusion Superficial venous surgery in addition to compression therapy is the most efficient treatment of venous leg ulcers. The compression therapy should be continued both surgically and conservatively treated patients with healed ulcers. In special cases after superficial venous surgery (isolated superficial reflux) compression therapy could be applied only to the time of ulcer closure without continuing it longer. HVS and ultrasound therapy are useful methods in conservative treatment of venous leg ulcers. For surgically-treated patients these physical therapies are efficient only in superficial plus deep reflux cases. HVS and ultrasound can be alternative methods, but are less effective in recurrence risk. LLLT is not an efficient physical method in treatment of venous leg ulcers.

The Effect of a Short-Term and Long-Term Whole-Body Vibration in Healthy Men upon the Postural Stability

The study aimed to establish the short-term and long-term effects of whole-body vibration on postural stability. The sample consisted of 28 male subjects randomly allocated to four comparative groups, three of which exercised on a vibration platform with parameters set individually for the groups. The stabilographic signal was recorded before the test commenced, after a single session of whole-body vibration, immediately after the last set of exercises of the 4-week whole-body vibration training, and one week after the training ended. The subjects were exposed to vibrations 3 times a week for 4 weeks. Long-term vibration training significantly shortened the rambling and trembling paths in the frontal plane. The path lengths were significantly reduced in the frontal plane one week after the training end date. Most changes in the values of the center of pressure (COP) path lengths in the sagittal and frontal plane were statistically insignificant. We concluded that long-term vibration training improves the postural stability of young healthy individuals in the frontal plane.

The Effect of a Single Session of Whole-Body Vibration Training in Recreationally Active Men on the Excitability of the Central and Peripheral Nervous System

Abstract Vibration training has become a popular method used in professional sports and recreation. In this study, we examined the effect of whole-body vibration training on the central nervous system and muscle excitability in a group of 28 active men. Subjects were assigned randomly to one of two experimental groups with different variables of vibrations. The chronaximetry method was used to evaluate the effect of a single session of whole-body vibration training on the excitability of the rectus femoris and brachioradialis muscles. The examination of the fusing and flickering frequencies of the light stimulus was performed. An increase in the excitability of the quadriceps femoris muscle due to low intensity vibrations (20 Hz frequency, 2 mm amplitude) was noted, and a return to the initial values was observed 30 min after the application of vibration. High intensity vibrations (60 Hz frequency, 4 mm amplitude) caused elongations of the chronaxy time; however, these differences were not statistically significant. Neither a low intensity vibration amplitude of 2 mm (frequency of 20 Hz) nor a high intensity vibration amplitude of 4 mm (frequency of 60 Hz) caused a change in the excitability of the central nervous system, as revealed by the average frequency of the fusing and flickering of the light stimulus. A single session of high intensity whole-body vibration did not significantly decrease the excitability of the peripheral nervous system while the central nervous system did not seem to be affected.

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.