The aim of this study is to evaluate the influence of implementation of the BFR training on the hypertrophy and strength of the lower limb muscles in combat sports fighters, using common and easy to perform both training and control methods. Design as a randomized control trial (RCT). The study included 30 men, MMA fighters since at least a year. They were divided into two groups: (A, a control group; B, men with the BFR training). The training lasted 8 weeks (3 times a week) and consisted of performing a set of specific exercises with a load of 20% 1RM. The Wilcoxon analyzing test showed important changes in muscle girth (P<0.01) and lower limb muscular strength (P<0.05). These changes were to be seen in the tested group only, not in the control group. Occlusion training is effective in increasing strength and hypertrophy of lower limb muscles in martial arts fighters.
Voice diseases occupy the third place among all of the diagnosed occupational disorders in Poland. There still exists the necessity to implement effective and economical methods of the primary and secondary prevention of voice disorders in teachers. The aim of this study was to assess the effectiveness of comprehensive voice rehabilitation in teachers, conducted within a health resort hospital. The results of comprehensive voice rehabilitation in 100 teachers with job seniority of 10-30 years (M = 17 years), conducted during 24-day-long staying in a sanatorium, are presented in this research. Phoniatrical and laryngological examinations (maximum phonation time [MPT], perceptual assessment of voice in GRBAS scale, laryngovideostroboscopy, and acoustic analysis of voice), self-assessment of voice (the Voice Handicap Index - VHI), logopedical estimation and audiometry were conducted during the first and the last day of the sanatorium stay. The therapeutic program included educational workshops on vocal hygiene, voice therapy, physiotherapy and psychotherapy. The inpatient therapy effects were also described by the teachers using a questionnaire. Improvements of objective acoustic parameters, a perceptual assessment of voice, and a self-assessment of VHI and MPT were observed. Phonation style changes were confirmed in the laryngovideostroboscopic examination. Phonation closure improved significantly in 30% of the examined teachers. Moreover, 97% of the participants confirmed in the questionnaire the effectiveness and purposefulness of periodic recurrence of such rehabilitation courses. The results of this research as well as the positive feedback from the participants of inpatient rehabilitation confirmed the effectiveness of occupational voice disorder rehabilitation in sanatorium (inpatient) conditions. Treatment and rehabilitation in a stationary form should aim to achieve voice improvement and job continuation. Such a procedure may contribute to reducing the financial outlays related to treatment, health leaves and occupational pensions. Med Pr. 2021;72(4):399-405. Schorzenia narządu głosu zajmują 3 miejsce wśród rozpoznawanych chorób zawodowych w Polsce. Nadal istnieje potrzeba wdrażania skutecznych i ekonomicznych metod prewencji pierwotnej i wtórnej zaburzeń głosu u nauczycieli. Celem pracy była ocena skuteczności kompleksowej rehabilitacji głosu u nauczycieli prowadzonej w warunkach szpitala uzdrowiskowego. Przedstawiono wyniki kompleksowej rehabilitacji głosu przeprowadzonej podczas 24-dniowego turnusu sanatoryjnego u 100 nauczycielek ze stażem pracy 10–30 lat (M = 17 lat). W pierwszym i ostatnim dniu turnusu wykonano badania laryngologiczne i foniatryczne [czas fonacji (maximum phonation time – MPT), ocenę percepcyjną głosu w skali GRBAS, badanie laryngowideostroboskopowe, analizę akustyczną głosu], wypełnienie Kwestionariusza samooceny głosu (Voice Handicap Index – VHI), ocenę logopedyczną i audiometrię tonalną. W zakres programu terapeutycznego wchodziły: zajęcia edukacyjne dotyczące higieny głosu, terapia głosu, fizjoterapia i psychoterapia. Efekty rehabilitacji sanatoryjnej pacjenci oceniali również w badaniu ankietowym. Stwierdzono poprawę obiektywnych parametrów akustycznych, oceny percepcyjnej głosu, samoceny głosu VHI i MPT. Zmiany w sposobie fonacji potwierdzono w badaniu laryngowideostroboskopowym, w którym obserwowane zwarcie fonacyjne poprawiło się znamiennie u 30% badanych. W ankiecie oceniającej korzyści z sanatoryjnej rehabilitacji głosu 97% uczestników potwierdziło skuteczność i celowość okresowego powtarzania takiej rehabilitacji. Wyniki przedstawionych badań i pozytywne oceny uczestników rehabilitacji sanatoryjnej potwierdzają skuteczność sanatoryjnej terapii zawodowych zaburzeń głosu. Leczenie i rehabilitacja w formie stacjonarnej powinny zmierzać do poprawy głosu oraz kontynuacji pracy zawodowej. Tak ukierunkowane postępowanie może przyczynić się do zmniejszenia nakładów finansowych związanych z leczeniem, urlopami dla poratowania zdrowia i rentami zawodowymi. Med. Pr. 2021;72(4):399–405.
The paper presents current news on the possibilities of conducting rehabilitation of patients suffering from lung cancer. It presents the principles of conducting and contraindications for pulmonary rehabilitation for these patients according to current guidelines of American College of Sport Medicine. The methods of measuring exercise capacity for patients with lung cancer have been discussed. The value of ergospirometrial test with maximum oxygen consumption (VO(2peak)) in predicting not only the survival of patients with lung cancer, but also assessing the possibility of pulmonary rehabilitation programs has been highlighted. In the part devoted to physical training for patients before a surgery for lung cancer, current research results have been presented- these show that even a short, high intensity program of pulmonary rehabilitation for patients with lung cancer before surgery is effective and increases the safety of both- the safety of the surgery and extends survival time after operation for lung cancer. The paper describes difficulties in the implementation of rehabilitation programs after surgery conducted on patients with lung cancer resulting from dysfunction of cardiovascular and muscle atrophy - both skeletal and respiratory. The issue of patients with inoperable lung cancer treated with chemotherapy has been discussed so far in only one paper published in 2007. The results shown in it have been discussed as well. The authors demonstrated a significant improvement in the efficiency of respiratory-circulatory system assessed by six-minute walk test, although the rehabilitation program was graduated by small number of patients (44%). It was noted that patients with inoperable lung cancer now account for a large group of patients who use this type of medical intervention and can significantly improve the quality of life and the method shows positive impact on the survival rate.
The choice of an appropriate approach to the treatment of idiopathic scoliosis is considerably complicated owing to the lack of a clear-cut aetiology of this condition. Idiopathic scoliosis impairs the body's biomechanical balance and adversely affects body statics. The muscle torques of the flexor and extensor muscles of the hip joints were assessed in 123 children (96 girls and 27 boys) aged from 8 to 16 with the I degrees scoliosis. Statistically significant differences (p>0.05) were revealed. The primary lumbar scoliosis was to the left in 109 patients (Group 1) and to the right in 14 patients (Group 2). All children participated in a 6-month exercise programme to strengthen the weakened muscle groups. Torque measurements were performed twice: immediately after the child joined the rehabilitation programme and on completion of the programme. The strength of the weakened muscles was seen to increase to a statistically non-significant level (p>0.05). 1. Exercises strengthening weakened muscles of the hip joint improve the posture of scoliotic children and can be helpful in treating idiopathic scoliosis. 2. Differences in the strength of the flexors and extensors of the hop joint impair body statics and may constitute one of the causes of idiopathic scoliosis in children.
The article reviews the latest interventions in cognitive rehabilitation for patients with schizophrenia. Studies referring to cognitive rehabilitation for people with schizophrenia from the last three years, found in the PubMed database, are presented. The authors categorised cognitive rehabilitation trainings in terms of targeted cognitive spheres - neurocognitive training, social cognition training, emotion perception training and combined training - and present current trends within this approaches. Cognitive function improvements after cognitive remediation are specific to the rehabilitation target and there are no clear differences between training types in the way they influence other cognitive domains or symptoms. There is a need to heighten transfer of gained / enhanced cognitive skills to functional ones. Therefore new methods of cognitive remediation are explored . The future direction in cognitive rehabilitation is to enhance benefits by combining various forms of cognitive remediation and by emphasizing patient specificity in planning and conducting cognitive interventions.
Prevalence of Internet use indicates, that introducing internet to people with mental disorders might have a positive impact on their social integration. There are concerns about negative effects of dealing with virtual reality on the mental health of Internet users. Evaluation of the ICAR program--"Internet communication and active rehabilitation for people with mental disorders" concerning its utility in psychiatric rehabilitation. 22 participants of the ICAR programme and 22 controls (people with mental disorders not participating in the programme) were investigated before and after the completion of the programme. There following were compared: their computer and Internet use skills, social functioning (Birchwood Scale), self-estimation of the mental health (Frankfurt Scale FBS), self-reported quality of life (WHO QOL BREV) and number of psychiatric hospitalisations during 11 months of the observation period. Among participants, their reported skills and motivation increased significantly following the programme. During 11 months of the observation there were less hospitalisations (1 fulltime and 1 daily) in the study group than in the control group (3 and 1). An increase of symptoms was observed in the Frankfurt Scale in 10 participants and 13 controls. The level of social functioning and severity of symptoms was not significantly different and did not change during observation. The self-reported quality of life increased in both groups during this period. ICAR training programme for the mentally ill, increases participants skills and motivation towards computer and Internet use, as well as their self-reported quality of life. The participation in the programme doesn't have any significant effect on the overall social functioning and number of psychiatric hospitalisations during the 11 months of observation. A positive effect of the ICAR programme on the quality of life, as well as some activating effect leading to exacerbation of the psychopatological symptoms--has an unspecific character and is therefore similar to the other community rehabilitation programmes. Wider spreading of computer training workshops similar to the ICAR programme might have a positive effect on social integration of people with mental disorders.
The prefrontal brain injury may impair several cognitive and emotional functions. In our article we present typical features of these impairments. The current studies present a different therapeutic approach to the dysexecutive syndrome.
This report describes a case of a 40 year-old woman with implanted aortic prosthetic valve, who experienced thrombo-embolic complication in a form of ischaemic stroke in 15 week of pregnancy. At the beginning of the event, the patient suffered from mixed aphasia, right-side paresis and depressive syndrome. Thanks to cooperation of many specialists, especially rehabilitation team, she restored overall physical efficiency, speaking ability, delivered a healthy child, and returned to normal family and social activity. Problems of anti-thrombotic therapy during pregnancy in patients with prosthetic valves are discussed.
Amputations of bottom limbs are serious problem. Loss of leg causes always heavy psychical injury, it makes life more difficult, as well as moving and self-service. The change of appearance and shape of body demands adaptations of patient and his neighbourhood. Every amputation is not only heavy physical injury but also violent and long-lasting psycho-emotional and social stress. Most of patients are afraid of unknown, so it's necessary to decrease their fear, they expect our help in solving their social and domestic problems. The aim of investigations is to show the process of adapting to normal life of people after amputation of bottom limb on example of their rehabilitation. The following investigative methods were used: steered observation, interview, Polish version of questionnaire RNL (reintegration to normal living) in small modification and inquiry. Investigations were conducted in two hospital wards and the rehabilitation centre. The group consisted of 82 patients--59 men (72% of group) and 23 women (28%). The numerous group (43%) were people between 50-69 years old. Only a few patients after amputation go to special out-patients' department. The main reason of it is the lack of rehabilitation centre in the neighbourhood. 1/5 of the group regularly uses rehabilitation at expert, however most patients over 70s do not use any rehabilitation. Frequent form of activity at studied people is morning exercises and easy exercises of stump. Lack of physical activity is typical for 1/3 of group. Physically active are only 12 patients (15%). Near half of the group uses artificial limbs, but 1/5 of group does not want to have it. Most of them is over 70 years old. Results of investigation show the need of opening the larger quantity of rehabilitation centres to make the rehabilitation more common and accessible. Essential meaning has also bigger motivation of patients to physical activity as well as using artificial limbs, which do facilitate functioning in everyday life and improve the mood of patients after amputation.
The aim of the work was to review the current literature on the sacral-lumbar spine pains and on the factors that might be responsible for their incidence. The authors present the selection of therapeutic methods and the evaluation of their efficacy with special reference to sickness absence from work.
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Rehabilitation after fractures of upper limb is very complicated and should be coordinated with orthopedic procedures. A choice of method and schema is depended on general health status of patient and used orthopedic treatment. This process should start immediately after surgeon's intervention. An aim of rehabilitation is improvement of range movement, straight of muscles and acceleration of callus formation. It is very important to restore proprioception in a region of trauma. An intensity and velocity of rehabilitation is the greatest after extra bone consolidation and the slowest after conservative tutor management.
Comparison the voice quality of patients after total laryngectomy using the Provox 2 voice prosthesis and patients with esophageal speech and to discuss difficulties and complications related with its implantation. The study group consists of 39 patients after total laryngectomy and Provox puncture. 36 patients underwent primary puncture, 3 patients - secondary puncture. 32 patients underwent radiotherapy. The time starting of speech learning was approx the 9th day after total laryngectomy and 1st-3th day after secondary implantation. The authors subjectively and objectively analyzed voice of 34 patients with fistular speech and it compared with esophageal speech of 10. The spectrograms analysis of the voice was based on Remacle's scale. The study showed juxtaposition of early and late complications of patients with voice prostheses. 90% of patients (35 patients) learned the fistular speech. The speech was louder and more intelligible than esophageal voice in subjective estimation. The fistular voice had higher of mean volume (61,1 dB vs. 59 dB), mean longer maximum phonation time (9,5 s vs. 2,2 s), mean higher base frequency FO (108 Hz vs. 87Hz) and smaller variability of FO based on mean Jitter ratio (3,8% vs. 6,6%), mean Shimmer ratio (23,18% vs. 23,52%) and mean HPQ ratio (127,34 vs. 141,73) than esophageal voice in objective estimation. Mean range of frequency of the speech was smaller but it was in higher frequencies. The most frequent type of spectrogram was 3th type in experimental group and 2nd type in control group. The mean lifetime of prostheses was 295 days. The most common cause of replacement of the prosthesis was leakage associated with mycosis infection (26 cases). Early complications were observed. The most frequent of them was infection around the fistula during supplementary radiotherapy (7 cases after primary puncture). The most frequent of later complications was widening of fistula and leakage around prosthesis (4 cases). Rehabilitation of patients after total laryngectomy is better using Provox system than learning esophageal speech (according to voice quality aspect). Using of voice prostheses in patients after total laryngectomy can combine with appearance of complications.
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Vestibular receptor impairment causes symptoms called vestibular organ peripheral lesion syndrome. Subjective and objective symptoms of vestibular lesion diminish gradually in the process of vestibular compensation. Stimulating a patient to action is a basic factor that influences on the compensation process. The aim of our studies was an evaluation of treatment results in patients with vertigo of peripheral origin with the use of gingko biloba extract together with kinezytherapy. Ginkgo biloba extract shows vasoactive, rheologic, metabolic and neural effects. We have examined 45 persons aged between 35 and 48 years (38 on average, 35 female, 13 male) with clinical symptoms of peripheral vestibular lesion. In each case we performed as follows: ORL physical examination, pure tone audiometry, suprathreshold audiometry, electronystagmography (eyes open and closed nystagmus, cervical tests, caloric tests according to Hallpike), static and dynamic posturography. In all of the cases vestibular rehabilitation originally programmed in our Clinic was applied. N 23 cases (17 female and 6 male) chosen at random, kinezytherapy together with gingko biloba in tablet was applied: 2 tablets twice a day for 3 months. Control examination were performed on 30, 60 and 90 days of treatment. Treatment results evaluation was based on anamnesis, electronystagmography, static and dynamic posturography. 1. In almost all of the cases with peripheral lesion of vestibular organ, after 30 days of application of gingko biloba extract together with kinezytherapy and without gingko biloba there was vestibular compensation confirmed in electronystagmography but there were disturbances in static and dynamic posturography. 2. Control examination in the course of treatment revealed gradual improvement in vestibular tests in both group (with and without biloba extract). But in patients treated with gingko biloba extract the improvement was more clear and faster an dynamic posturography. It implies central effect of gingko biloba extract that allows to gain full vestibular compensation sooner.
The authors have presented methods of treatment in patients with recurrent laryngeal nerve paralysis after thyroid surgery including pharmacology, physiotherapy, phoniatric rehabilitation and phonosurgery.
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