Zbigniew Śliwiński

Patient-Specific CT-Based Instrumentation versus Conventional Instrumentation in Total Knee Arthroplasty: A Prospective Randomized Controlled Study on Clinical Outcomes and In-Hospital Data.

Total knee arthroplasty (TKA) is a frequently performed procedure in orthopaedic surgery. Recently, patient-specific instrumentation was introduced to facilitate correct positioning of implants. The aim of this study was to compare the early clinical results of TKA performed with patient-specific CT-based instrumentation and conventional technique. A prospective, randomized controlled trial on 112 patients was performed between January 2011 and December 2011. A group of 112 patients who met the inclusion and exclusion criteria were enrolled in this study and randomly assigned to an experimental or control group. The experimental group comprised 52 patients who received the Signature CT-based implant positioning system, and the control group consisted of 60 patients with conventional instrumentation. Clinical outcomes were evaluated with the KSS scale, WOMAC scale, and VAS scales to assess knee pain severity and patient satisfaction with the surgery. Specified in-hospital data were recorded. Patients were followed up for 12 months. At one year after surgery, there were no statistically significant differences between groups with respect to clinical outcomes and in-hospital data, including operative time, blood loss, hospital length of stay, intraoperative observations, and postoperative complications. Further high-quality investigations of various patient-specific systems and longer follow-up may be helpful in assessing their utility for TKA.

Lumbosacral pain in ballet school students. Pilot study.

BACKGROUND The unique biomechanical demands placed on ballet students predispose to injury and pain. The aim of this study was to evaluate the prevalence of lumbosacral pain in ballet school students and to identify possible risk factors for the pain. MATERIAL AND METHODS The study group comprised 71 ballet school students, including 45 females and 26 males, aged 15-18 years (mean 16.5 years). In order to identify possible risk factors for pain, a survey was conducted, the angle of sacral bone inclination was measured using a mechanical inclinometer and the BMI was calculated. A VAS scale was used for a subjective assessment of pain intensity. RESULTS Low back pain was reported by 44 patients (62%). A comparison of sacral inclination angles in a position with the feet placed parallel and in the turnout position showed statistically significant changes in the angle among respondents reporting pain (p <0.05). CONCLUSIONS 1. Compensation in the turnout position by increas ed anterior tilt of the pelvis may increase the risk of low back pain. 2. An angle of sacral bone inclination in turnout above or equal to 30° can increase the intensity of low back pain. 3. A BMI below 18.5 in female ballet school stu dents can increase the risk of lumbosacral pain.

The Influence of Electromagnetic Radiation Generated by a Mobile Phone on the Skeletal System of Rats

The study was focused on the influence of electromagnetic field generated by mobile phone on the skeletal system of rats, assessed by measuring the macrometric parameters of bones, mechanical properties of long bones, calcium and phosphorus content in bones, and the concentration of osteogenesis (osteocalcin) and bone resorption (NTX, pyridinoline) markers in blood serum. The study was carried out on male rats divided into two groups: experimental group subjected to 28-day cycle of exposures in electromagnetic field of 900 MHz frequency generated by mobile phone and a control, sham-exposed one. The mobile phone-generated electromagnetic field did not influence the macrometric parameters of long bones and L4 vertebra, it altered mechanical properties of bones (stress and energy at maximum bending force, stress at fracture), it decreased the content of calcium in long bones and L4 vertebra, and it altered the concentration of osteogenesis and bone resorption markers in rats. On the basis of obtained results, it was concluded that electromagnetic field generated by 900 MHz mobile phone does not have a direct impact on macrometric parameters of bones; however, it alters the processes of bone mineralization and the intensity of bone turnover processes and thus influences the mechanical strength of bones.

The Application of Negative Pressure Wound Therapy in the Treatment of Chronic Venous Leg Ulceration: Authors Experience

The aim of the study was to use negative pressure wound therapy (NPWT) in patients with chronic venous leg ulceration. The authors present their experience in treatment of 15 patients whose average ulceration surface area was 62.6 cm2. In 10 patients, the ulcers healed within 6 weeks and in the remaining patients within 20 weeks. Based on the results obtained, the authors imply that NPWT is an effective method in the treatment of chronic venous leg.

Life satisfaction and risk of burnout among men and women working as physiotherapists.

ObjectivesRecently in Poland as a result of the high rate of aging population and high rates of morbidity, a growing demand for the physiotherapist profession is observed. The results of this study can be used to formulate principles for better organization of physiotherapist’s workplace in order to prevent occurrence of burnout. The aim of this study is to investigate the effect of gender on satisfaction with life and burnout among active physiotherapists.Material and MethodsThe survey was anonymous and voluntary, and involved a group of 200 active physiotherapists working in health care units and educational centers in Po?land. The study group was selected randomly and incidentally. Each respondent received a demographic data sheet and a set of self-rating questionnaires (Life Satisfaction Questionnaire, Burnout Scale Inventory).ResultsBurnout among men decreased along with increasing satisfaction with one’s work and occupation, friends, relatives and acquaintances, sexuality, and increased due to greater satisfaction with one’s housing status. Burnout among women decreased along with increasing satisfaction with one’s health, free time and friends, relatives and acquaintances, and increased due to work at a setting other than a health care unit or educational center. Statistical analysis failed to reveal any significant differences with regard to the BSI domains and with regard to the overall burnout index as well as with regard to the assessment of satisfaction with life between female and male physiotherapists.ConclusionsSatisfaction with children, marriage and partnership, with one’s work and occupation, interactions with friends, relatives and acquaintances and sexuality may contribute to reduction of burnout among men. Women who are satisfied with their children, family, health, free time and contacts with friends, relatives and acquaintances are less prone to burnout. Weak financial situation among women and deficiency of free time among men can induce burnout. Improving staff happiness may contribute to decreasing burnout.

Efficacy of physiotherapy for urinary incontinence following prostate cancer surgery.

The study enrolled 81 with urinary incontinence following radical prostate-only prostatectomy for prostatic carcinoma. The patients were divided into two groups. The patients in Group I were additionally subdivided into two subgroups with respect to the physiotherapeutic method used. The patients of subgroup IA received a rehabilitation program consisting of three parts. The patients of subgroup IB rehabilitation program consist of two parts. Group II, a control group, had reported for therapy for persistent urinary incontinence following radical prostatectomy but had not entered therapy for personal reasons. For estimating the level of incontinence, a 1-hour and 24-hour urinary pad tests, the miction diary, and incontinence questionnaire were used, and for recording the measurements of pelvic floor muscles tension, the sEMG (surface electromyography) was applied. The therapy duration depended on the level of incontinence and it continued for not longer than 12 months. Superior continence outcomes were obtained in Group I versus Group II and the difference was statistically significant. The odds ratio for regaining continence was greater in the rehabilitated Group I and smaller in the group II without the rehabilitation. A comparison of continence outcomes revealed a statistically significant difference between Subgroups IA versus IB. The physiotherapeutic procedures applied on patients with urine incontinence after prostatectomy, for most of them, proved to be an effective way of acting, which is supported by the obtained results.

Assessment of the TMJ Dysfunction Using the Computerized Facebow Analysis of Selected Parameters

The Purpose of the Paper. Qualitative and quantitative analysis of selected parameters of mandible movements, electronically registered in patients with temporomandibular joint dysfunction and healthy ones. Material. Function test of the mandible movements was conducted in 175 patients. Gender distribution was 143 women and 32 men, aged 9 to 84. Methods. The studied population, after accurate clinical examination, was divided into age groups with the range of five years. All the patients had Zebris JMA computerized facebow examination done, according to the generally accepted principles and procedures. Results. Mean values of mouth opening calculated to 45.6 mm in healthy group and 37.6 mm in TMJ dysfunction group. Mean length of condylar path amounted to 39 ± 7% of the maximum value of mouth opening in the group of healthy people, 44 ± 11% in the case of muscle-based disorders, and 35 ± 11% with joint-based. The mean value of the condylar path inclination oscillated in the range of 25° to 45°. Conclusions. The ratio of length of the condylar path to the size of mouth opening may be a significant value characterising the type and degree of intensification of the TMJ dysfunctions.

The use of Kinesiology Taping in physiotherapy practice: a systematic review of the literature

Wojciech Kiebzak, Ireneusz M.Kowalski, Mariusz Pawłowski, Jakub Gąsior, Katarzyna Zaborowska-Sapeta, Olga Wolska, Zbigniew Śliwiński 1 Wy dział Na uk o Zdro wiu, Uni wer sy tet Hu ma ni stycz no -Przy rod ni czy Ja na Ko cha now skie go, Kiel ce 2 Od dział Fi zjo te ra pii, Wo je wódz ki Spe cja li stycz ny Szpi tal Dzie cię cy, Kiel ce 3 Za kład Re ha bi li ta cji, Wy dział Na uk Me dycz nych, Uni wer sy tet War miń sko -Ma zur ski, Olsz tyn 4 Wy dział Re ha bi li ta cji, Aka de mia Wy cho wa nia Fi zycz ne go Jó ze fa Pił sud skie go, War sza wa 5 Stu denc kie Ko ło Na uko we Fi zjo te ra pii, War szaw ski Uni wer sy tet Me dycz ny 6 Cen trum Me dycz no Re ha bi li ta cyj ne Krio so nik, War sza wa 1 Fa cul ty of He alth Scien ces, The Jan Ko cha now ski Uni ver si ty of Jan Ko cha now ski, Kiel ce 2 De part ment of Phy sio the ra py, Chil dren’s Ho spi tal, Kiel ce 3 De part ment of Re ha bi li ta tion, Fa cul ty of Me di cal Scien ces, Uni ver si ty of War mia and Ma zu ry, Olsz tyn 4 Di vi sion of Re ha bi li ta tion, Jó zef Pił sud ski Uni ver si ty of Phy si cal Edu ca tion, War saw 5 Stu dent Scien ti fic So cie ty at Di vi sion of Re ha bi li ta tion, Me di cal Uni ver si ty of War saw 6 Me di cal and Re ha bi li ta tion Cen ter Krio so nik, War saw, Po land

The use of physiotherapy in the regeneration of periapical bone structures of the teeth, prepared to load the prosthetic.

The aim of this work was to investigate whether the use of magnetoledotherapy will accelerate the elimination of osteolytic lesions of the dental periapical area, and provide for prosthetic treatment. What impact on time of healing does the inflammatory change location, type of treatment or patients age have? 69 patients underwent the examination. The problem of osteolytic lesions in the course of protracted or protracted acute dental periapical tissue inflammation was determined. Patients were divided into two research groups: group L - treated with magnetoledotherapy and group K - treated without the support of magnetoledotherapy. In the first group we applied the electromagnetic field, generated using the Viofor JPS Clinic apparatus. Our studies have confirmed the effectiveness of magnetoledotherapy in the accelerated decommissioning of the osteolytic lesion. This provides evidence of the appropriateness of this method in the treatment of protracted dental periapical tissue inflammation, in teeth qualified for prosthetic load. Magnetostimulation combined with LED energy is an adjunctive procedure, adopted in order to eliminate osteolytic inflammatory changes of dental periapical tissues. It can be used in all age groups with the same good result. After applying magnetoledotherapy, in the course of the dental periapical tissue repair process of tooth treated endodontically for the first time as well as reendodontically, no differences were found. This shows the opportunity of using magnetoledotherapy in all cases of protracted periapical tissue inflammation.

Role of the physiotherapist in the orthopaedic trauma department in the context of National Health Fund funding of medical procedures.

BACKGROUND The present paper aims to demonstrate that physiotherapy in orthopaedic and trauma departments is part and parcel of a comprehensive treatment plan. MATERIAL AND METHODS Hospital records of 66 patients treated in three orthopaedic trauma departments in 2011 were analysed. Basing on the requirements of the National Health Fund (Narodowy Fundusz Zdrowia--NFZ), reports were generated on the number of physiotherapy procedures provided. RESULTS The mean age of the patients was 70.26 (SD=12.08) years. Sixty-two of them (93.94%) had undergone hip replacement and the remaining 4 (6.06%) had undergone knee replacement procedures. The patients spent a mean of 13 days in hospital (SD=3.66, range 9-30 days). The following physiotherapy procedures were applied: mobilisation in 48 subjects (72.73%), seating in 47 (71.21%), gait training in 48 (72.73%), exercises of the affected leg in 46 (69.70%), upper limb exercises in 38 (57.58%) and breathing exercises in 28 (42.42%). According to the NFZ regulations, the maximum number of patients per one physiotherapist in an orthopaedic department is 10, which requirement was met in only one of the three hospitals involved. CONCLUSIONS 1. Arthroplasty procedures along with long bone fracture fixation are the most common causes of hospitalisation in orthopaedic trauma departments. 2. The departments involved in this study do not provide pre-operative rehabilitation. Physiotherapy begins at 3 days post surgery. 3. Most of the departments involved do not comply with the NFZs requirement regarding the therapist-to-patient ratio.