Disability and Rehabilitation
Institute of Labor and Social Studies

nr 2 2018


dr Marta Wolanin
Uniwersytet Marii Curie-Skłodowskiej w Lublinie
Paulina Warzocha
Niepubliczny Zakład Opieki Zdrowotnej „Rehamed” w Tomaszowie Lubelskim
Rafał Sapuła
Zamojska Klinika Rehabilitacji Wyższej Szkoły Zarządzania i Administracji w Zamościu, Wyższa Szkoła Informatyki i Zarządzania w Rzeszowie
Adam Topolski
Zamojska Klinika Rehabilitacji Wyższej Szkoły Zarządzania i Administracji w Zamościu
Antoni Wolanin
Oddział Kardiochirurgii, Samodzielny Publiczny Szpital Wojewódzki im. Papieża Jana Pawła II w Zamościu

Background: In Poland, gonarthrosis affects 4-5 million people (Kaniewska 2014, p. 102–108). In Europe, gonarthrosis affects about 4% of people aged 18-24 years, while the in the case of the elderly gonarthrosis occurs in 85% of the population (EULAR 2003, p. 1145–1155). Evaluation of the effects of rehabilitation used in elderly Patients treated for osteoarthritis of the knee.

Materials and metods: Examined 60 people: 30 people in the study group (19 women and 11 men) aged 60 to 85 years (average age 72.5 years) and 30 in the control group (18 women and 12 men) aged 20 - 59 years (average age 39.5 years). All study subjects were diagnosed with gonarthrosis. Posted KOOS questionnaire, VAS and own survey.

Results: According to the questionnaire after the KOOS rehabilitation significant improvement was observed in both test (p <0.0001) and control (p <0.0001) groups. Patients after rehabilitation (by KOOS) in the study group was significantly worse than the control group (p <0.05).

1. The effectiveness of rehabilitation in people over 60 years of age with knee joint degeneration is less than in individuals 60 years of age. Age is a factor in the effect of rehabilitation of people with osteoarthritis of the knee joints.
2. KOOS questionnaire and VAS carried out rehabilitation brought the desired effects and the level of pain decreased significantly in both the test and reference.

Keywords: rehabilitation, gonarthrosis, elderly patients
Lidia Urbanowicz
Zakład Rehabilitacji, Szpital Specjalistyczny w Wejherowie

Introduction and objective of the study: Breast cancer treatment often causes many complications that can be reduced or eliminated through rehabilitation.

The aim of this article is to present complications that can arise after surgical treatment of breast cancer and the possibility of referring patients for rehabilitation. In addition  athering this information in one study can act as a guide.

Brief description of the state of knowledge/ground: Unfavorable consequences in the form of general weakening of the body and reduction of muscle strength, edema, limited mobility or disturbed sensation in the upper limb can occur both after surgical treatment of breast cancer, as well as, after chemotherapy, radiotherapy, brachytherapy or hormonal therapy. The way to prevent and treat these complications is through properly conducted rehabilitation, which should be used at every stage of therapy, both with the participation of a physiotherapist, as well as, independently by the patient at home. Most often, it will be a movement therapy in combination with anti-edema and sensation enhancing treatments. Depending on the indication and the stage of treatment, they can be carried out in an outpatient setting, at home, physiotherapy wards, spa treatment or in Amazons clubs. 

Summary: Thanks to physiotherapeutic procedures, the adverse consequences of surgical breast cancer treatment can be reduced and sometimes even prevented. Targeting patients for rehabilitation is strongly recommended.

Keywords: rehabilitacja, rak piersi, komplikacje po leczeniu onkologicznym, komplikacje pooperacyjne
dr Marta Wolanin
Uniwersytet Marii Curie-Skłodowskiej w Lublinie
Rafał Sapuła
Zamojska Klinika Rehabilitacji Wyższej Szkoły Zarządzania i Administracji w Zamościu, Wyższa Szkoła Informatyki i Zarządzania w Rzeszowie
Adam Topolski
Zamojska Klinika Rehabilitacji Wyższej Szkoły Zarządzania i Administracji w Zamościu
Antoni Wolanin
Oddział Kardiochirurgii, Samodzielny Publiczny Szpital Wojewódzki im. Papieża Jana Pawła II w Zamościu
Ewelina Bednarczyk
Ośrodek Rehabilitacji w Łykoszynie

Background: Pain in the cervical spine occurs in 60-90% of the population and is a serious social and economic problem. The aim of the work was to assess the effects of therapeutic massage in patients with painful ailments of the cervical spine.

Materials and methods: 60 people with cervical spine pain syndrome participated in the prospective study. Patients were divided into two groups: the study group with classic massage applied (30 people) and the control group without the application of the massage (30 people). Physiotherapy and kinesitherapy were performed in each group. The following parameters were used: Neck Disability Index (NDI), visual analogue VAS pain scale and own questionnaire. The measurement of mobility was examined with the help of a sewing centimeter.

Results: After rehabilitation, the range of motion was significantly greater in the study group: the lateral flexion improved to the right; it increased from 22.4 cm to 25.4 cm (p = 0.0313); lateral flexion to the left increased from 23.3 cm to 26.3 cm (p = 0.0016); mobility when turning to the right increased from 29.7 cm to 32.8 cm (p = 0.0247) and turning to the left - from 29.8 cm to 33.2 cm (p = 0.0055). After rehabilitation there was a statistically significant reduction in pain (according to VAS) in both the study group (from 6.6 to 3.4, p <0.0001) and control (from 5.6 to 3.3, p <0, 0001).

1. The therapeutic massage of the cervical segment influences the increase of the range of mobility of the lateral flexion to the right and to the left and range of motion when turning to the right and left. 
2. In people with cervical spine pain, therapeuthic massage reduced the pain.

Keywords: rehabilitacja, kręgosłup, zakres ruchów, masaż leczniczy
Małgorzata Owsianowska
Studium Doktoranckie Wydziału Nauk o Zdrowiu Pomorskiego Uniwersytetu Medycznego w Szczecinie
Patrycja Sagan
Koło Naukowe przy Zakładzie Podstawowej Opieki Zdrowotnej, Pomorski Uniwersytet Medyczny w Szczecinie
dr hab. n. zdr. Anna Jurczak , prof.
Poznański Uniwersytet Medyczny Zakład Pielęgniarstwa Specjalistycznego, Pomorski Uniwersytet Medyczny w Szczecinie
dr n. med. Sylwia Wieder-Huszla
Zakład Pielęgniarstwa Specjalistycznego, Pomorski Uniwersytet Medyczny w Szczecinie
dr n. zdr. Joanna Owsianowska
Zakład Pielęgniarstwa Specjalistycznego, Pomorski Uniwersytet Medyczny w Szczecinie
dr hab. n. zdr. Jacek Brodowski
Zakład Podstawowej Opieki Zdrowotnej, Pomorski Uniwersytet Medyczny w Szczecinie

Background: Hypertrophic arthritis is one of the most common chronic joint diseasesin persons 60 years and older. In 25% of cases the disease strikes at the knee joints. In advanced stages of the gonarthrosis in order to restore functions of the join, to cushion pain complaints and to improve the quality of life of patients an endoprosthetics treatment is performed. After an alloplasty procedure a rehabilitation is necessary.

Objectives: The aim of research was an assessment of the impact of the physiotherapy treatment on pain complaints of patients after the treatment of the alloplasty of the knee joint and the analysis of factors affecting the effects of the treatment. Material and methods: 100 patients took part in the examination after an endoprosthetics procedure on the knee joint (69% women, 31% men). The age bracket of the examined group was 27 – 97 years, and the average age was64,45. Patients were provided with a comprehensive physiotherapy process at the District Hospital in Drezdenko. The conducted research was based on the author’s questionnaire form. For the evaluation of pain complaints they used the eleven – point visual – analogue VAS scale.  Respondents assessed their pain complaints before and aftertreatment.

Results: The examinations conducted showed that in the assessment of pain problems in the VAS scale before applying the comprehensive rehabilitation, patients had felt pain on average on the level 7.23, and after the rehabilitation the average was 3.17. Results showed the statistical significance. In the case of obese patients a lower effectiveness of treatments was noticed in relation to felt pain. In the case of 99% of examinated patients we could observe reduced pain, for 98% of patients quality of life improved and for 99% the physiotherapy treatment helped them recover their fitness.

1. Comprehensive rehabilitation reduces pain in patients after the endoprosthetics of the knee joint and improves their mobility and quality of life.
2. Age up to 70 years old seems to be a favorable factor for the stronger reduction of pain after rehabilitation. 
3. Excessive body weight reduces the effectiveness of anodyne rehabilitation.

Keywords: choroba zwyrodnieniowa stawów kolanowych, wymiana stawu kolanowego, rehabilitacja pooperacyjna
Effectiveness of stretching frontal muscle and epicranial aponeurosis in assessment of mechanical properties of cervical spine
Paula Tomaszewska
Wydział Nauk o Zdrowiu, Collegium Medicum Uniwersytetu Jagiellońskiego

Introduction: Relaxing the cranial vault muscles is a physiotherapeutic method that helps relieve headaches and increases the mobility of the cervical spine. The objective was to present the beneficial effects of work of the frontal muscle and epicranial aponeurosis and their impact on headaches and the mobility of the cervical segment.

Material and methods: The presented research results concerned 10 people - 5 women and 5 men, aged 27-55. These people were divided into two groups based on gender. During  the session, the epicranial aponeurosis was being relaxed in women and the frontal muscle in men. Mobility measurements in cervical spine were done before and after each session. The therapy was divided into 3 sessions, with each one being done every 7 days.

Results: Each attempt in both groups had positive effects in the form of increasing the mobility and subjective reduction of headaches. The technique of stretching the epicranial aponeurosis has produced better results compared to the stretching of the frontal muscle.

Conclusions: The proposed treatment contributes to the reduction of pain in the head and cervical spine. The introduction of the technique contributes to the improvement of the mobility in the cervical segment. The technique of stretching the frontal muscle and epicranial aponeurosis is a valuable addition to comprehensive rehabilitation.

Keywords: fizjoterapia, ruchomość kręgosłupa, odcinek szyjny, mięsień czołowy, rozcięgno naczaszne
Rehabilitation of the upper limb after fracture of the larger humerus bone, damage of the bracholar-clavicular syndesmosis and rupture of the supraspinous muscle tendon. A case report.
prof. dr hab. Zbigniew Szot
Sekcja Polska Międzynarodowego Stowarzyszenia Motoryki Sportowej (IASK)
dr Tomasz Szot
Akademia Wychowania Fizycznego i Sportu w Gdańsku

The paper discusses exercises and their application in rehabilitation of acromioclavicular joint in a 78-year old person. The available literature suggests that therapy of elderly people is slow and it is not certain if the application of exercises would restore the arm to the state from before the accident. A hypothesis was formulated: after the application of a large number of repeated exercises, the joint with contusions will achieve significant motion ability in a relatively short time. The obtained results confirmed the hypothesis - after intensive exercises and physiotherapy, a significant progress in limb mobility can be achieved.

Keywords: rehabilitacja, kończyna górna, staw barkowo-obojczykowy
Dorota Domaniewska - Murawska
Szpital Uniwersytecki nr 1 im. dr. A. Jurasza w Bydgoszczy
prof. dr hab. n. med. WOJCIECH HAGNER
Klinika Rehabilitacji Szpitala Uniwersyteckiego nr 1 im. dr. Antoniego Jurasza w Bydgoszczy Katedra i Klinika Rehabilitacji CM UMK w Bydgoszczy.

Speech plays a significant role in communication. It allows for the expression of various emotions, needs and thoughts. Unfortunately, these abilities can be lost or impaired due to sickness or injuries. In such a case, a patient may no longer be able to communicate verbally.

It is known that science and technology evolve rapidly, and the Cyber-Eye is a great example of that progress. For people, who suffer from speech disorders, that device becomes a gate to the external world. It is important to highlight, that the Cyber-Eye is a bidirectional communication channel with the patient and allows them to articulate their needs. It is a great help in a process of speech therapy and rehabilitation. C-Eye system works great in communicating with patients that have emerged from a coma, patients with dysfunction of the central nervous system, and patients recovering after a stroke. The Cyber-Eye system

Keywords: mowa, Cyber-Oko, rehabilitacja logopedyczna, komunikacja pozawerbalna
dr hab. MARCI N BIAŁAS, prof. nadzw.
Zakład Terapii Zajęciowej, Wydział Rehabilitacji i Kinezjologii Akademia Wychowania Fizycznego i Sportu im. Jędrzeja Śniadeckiego w Gdańsku

The birth of a child with a disability is often linked with a traumatic event which is experienced by the parents. It causes disorders in functioning of the family as a system, and also has influence on health of the parents. Chronic stress which is experienced by the parents, leaves an imprint, especially, on the health of the mother. The mother becomes overwhelmed by responsibilities resulting from care and rehabilitation of her disabled child, burdened by an unjustified feeling of guilt for its condition, living in constant fear, exhibits symptoms which reveal the status of her condition. In-validusof a child, in this case, emerges as a constant stressor which causes a high level of permanent and chronic stress that is experienced by the mother. In such situations, an adequate support offered to the mother of a child with disability, must not be only limited to medical and psychological care. Because, if the problem of a mother affects her spiritual sphere, also this therapeutic aspect is needed to be taken into account. This fact justifies applying logotherapy treatment, which main aim is to help the mother of a child with disability to distance herself from the problems, make changes in her value system, neutralize any applied medication, control the stress, set new goals – find the sense of her own existence. In this meaning, logotherapy treatment as a complement of medical and psychological care, seems to be justified because it broadens the spectrum of support dedicated to a mother of a child with disability, by adding a spiritual aspect to her treatment, which constitutes a foundation for an adequate and efficient therapy and its success.

Keywords: dziecko z niepełnosprawnością, stres, trauma, logoterapia, wsparcie duchowe