Wyniki wyszukiwania - BazTech

1

Gait changes in patients after reconstruction of facial bones with fibula and iliac crest free vascularized flaps

Syczewska M., Krajewski R., Szczerbik E., Kalinowska M.

Acta of Bioengineering and Biomechanics

|

2018

|

Vol. 20, no. 1

185--190

EN

Patients with malignant tumours of the oral cavity require its surgical removal and reconstruction of the bone and soft tissues. The grafts are obtained either from leg (fibula) or pelvis (iliac crest). The removal of grafts from the locomotor apparatus can impair the gait. The aim of this study was to find out how the localization of donor site influences the gait pattern. Methods: Results obtained for 30 patients were analyzed (16 fibula graft, 14 iliac crest graft). Patients underwent instrumented gait analyses three times (VICON system): before surgery, 2–4 month after the surgery, and 4–8 months after the surgery. Results: In both groups several gait parameters were changed. Two parameters changed in both groups: gait speed and cadence. In patients receiving iliac crest graft the changed gait variables were: pelvic rotation, hip range in sagittal plane (operated side), knee range in sagittal plane (operated side), foot dorsiflexion in swing on both sides. In patients receiving fibula flap the changed gait variables were: tilt, range motion of the tilt, minimum hip flexion (operated side), time to maximum knee flexion (non-operated side), GGI (non-operated side) and step length (nonoperated side). Conclusions: The primary gait deviations occurring after surgery, and the compensatory mechanisms which subsequently arise depend on the localization of graft donor site. The results indicate that the patients in whom fibula flap was used have less problems with gait pattern after the surgery than the patients receiving iliac crest graft.

2

Could lower leg Wartenberg test be used as a predictor of restrictions in temporomandibular joint movements in CP patients

Syczewska M., Szczerbik E., Graff K., Olczak-Kowalczyk D., Dąbrowska-Gontarczyk A., Kalinowska M., Jelonek E.

Acta of Bioengineering and Biomechanics

|

2016

|

Vol. 18, no. 2

3--7

EN

Purpose: Patients with spasticity suffer not only from neurological problems but also from various dentistry problems due to spasticity of the jaw muscles. Measurements of motion in temporomandibular joints should reflect the amount of abnormal muscle tone of these muscles. The aim of this study was to find out if the measurements of temporomandibular joint movements performed with the ultrasound Zebris device are different in cerebral palsy patients than in healthy subjects; and to find out if the information on the degree of spasticity in the lower legs provided by the Wartenberg test could be used to predict the degree of spasticty in the jaw muscles. Method: Twenty five healthy subjects and 25 cerebral palsy patients participated in the study. Two types of measurements were performed: temporomandibular movements measured with Zebris device, and instrumented Wartenberg test. Results: The laterotrusion and opening movements are different in CP patients than in healthy subjects. Laterotrusion movement correlates with velocity measured during the Wartenberg test. Conclusion: This finding suggests that high spasticity in the lower legs could indicate jaw movement restrictions in CP patients.

3

The comparison of two physiotherapeutic approaches for gait improvement in sub-acute stroke patients

Krawczyk M., Szczerbik E., Syczewska M.

Acta of Bioengineering and Biomechanics

|

2014

|

Vol. 16, no. 1

11--18

EN

The functional gait problems encountered by stroke patients include impaired balance, abnormal gait pattern with marked asymmetry, pathological trunk and spinal motion. Many different methods of physiotherapy are used to improve functional ability (especially gait) in stroke patients, but their efficacy and outcome are often not objectively assessed. The goal of this paper is to compare two therapeutic programs: one that is traditionally used in our rehabilitation facilities (exercises in lying position, “open chain” exercises, isolated movements of extremities with trunk stabilization) and the new one (exercises in vertical position, sitting or standing, “closed chain” exercises involving whole paretic side of the body). Fifty one stroke patients, aged 34 to 79 years, participated in the study. Patients were randomly allocated to one of the two groups. Patients underwent clinical assessment (Fugl-Meyer, Rivermead Motor Assessment, Berg Balance Scale) and instrumented gait analysis (using six-camera VICON 460 system) simultaneously three times: prior to the beginning of the rehabilitation program, after 6 weeks of the program, and after another 6 weeks of physiotherapy, at the end of rehabilitation program. Results demonstrated that both rehabilitation programs improved the gait function and clinical status in patients suffering from stroke. Despite the differences between the two programs the progress achieved by the patients in locomotor function is similar. Two equivalent physiotherapy programs could be applied during rehabilitation process depending on the patient’s individual preferences and needs, as the amount of functional improvement provided by them is comparable.

4

Ground reaction force analysed with correlation coefficient matrix in group of stroke patients

Szczerbik E., Krawczyk M., Syczewska M.

Acta of Bioengineering and Biomechanics

|

2014

|

Vol. 16, no. 2

3--9

EN

Stroke is the third cause of death in contemporary society and causes many disorders. Clinical scales, ground reaction force (GRF) and objective gait analysis are used for assessment of patient’s rehabilitation progress during treatment. The goal of this paper is to assess whether signal correlation coefficient matrix applied to GRF can be used for evaluation of post-stroke patients status. Group of patients underwent clinical assessment and instrumented gait analysis simultaneously three times. The difference between components of patient’s GRF (vertical, fore/aft, med/lat) and normal ones (reference GRF of healthy subjects) was calculated as correlation coefficient. Patients were divided into two groups (“worse and better”) based on the clinical functional scales tests done at the beginning of rehabilitation process. The results obtained by these two groups were compared using statistical analysis. Increase of median value of correlation coefficient is observed in all components of GRF, but only in non-paretic leg. Analysis of GRF signal can be helpful in assessment of post-stroke patients during rehabilitation. Improvement in stroke patients was observed in non-paretic leg of the “worse” group. GRF analysis should not be the only tool for objective validation of patient’s improvement, but could be used as additional source of information.

5

The influence of knee marker placement error on evaluation of gait kinematic parameters

Szczerbik E., Kalinowska M.

Acta of Bioengineering and Biomechanics

|

2011

|

Vol. 13, no. 3

43-46

EN

Vicon motion system is an accurate equipment for objective gait analysis. According to clinical experience the most important source of errors in kinematics is marker misplacement. It seems that knee marker placement is especially important because of its direct influence on two body segments: thigh and shank. There is little data in the literature on how the misplacement of knee marker determines the changes of kinematic parameters. Therefore the aim of this study was to collect the kinematic data of subjects with different knee pathologies (one with knee flexion contracture, the second with knee hyperextension) while knee marker position was changed in a systematical way. They were walking with their natural, preferred speed. The data were collected using VICON460 motion system, the Helen Hayes marker set and Plug-In-Gait model. Then they were processed based on Polygon software. The results of both subjects showed the changes of kinematics, depending on the knee marker misplacement. The assessed joint ranges of angle change were: in knee, 18° in sagittal plane and 20° in frontal plane; in hip, 10° in sagittal plane and 24° in transversal plane; in ankle, 10° in sagittal plane and 25° in transversal plane. This paper presents the detailed data which could help the users of such systems to interpret the kinematic data.

6

Does the gait pathology in scoliotic patients depend on the severity of spine deformity? Preliminary results

Syczewska M., Graff K., Kalinowska M., Szczerbik E., Domaniecki J.

Acta of Bioengineering and Biomechanics

|

2010

|

Vol. 12, no. 1

25-28

EN

The gait pattern in scoliotic patients differed from the gait pattern of the healthy subjects. The aim of the present paper was to describe the dependence of the gait pathology on the severity of the spinal deformity. Thirty five patients with confirmed scoliosis participated in the study. All patients underwent the clinical examination (X-ray and anthropometric measurements) as well as the objective gait analysis. Based on clinical examination the patients were divided into subgroups according to six different criteria. The gait parameters were compared between these subgroups. Most of the assessed variables do not depend on the clinical variables, describing the severity of the spinal deformity. The two gait parameters which depend on the clinical variables are pelvic obliquity and step length. The results show that the obliquity increases with the Cobb angle. The step length decreases with the increasing Cobb angle and with the sum of angles describing the spinal deformity in sagittal and frontal planes. The evaluation of the gait pattern of scoliotic patients and the establishment of its dependence on the spinal deformity are of importance for the treatment of these subjects.

7

Functional outcome following the implantation of the modal/bipolar radial head endoprosthesis. Preliminary results

Syczewska M., Skalski K., Pomianowski S., Szczerbik E.

Acta of Bioengineering and Biomechanics

|

2008

|

Vol. 10, nr 2

43-49

EN

Radial head fractures constitute 33% of all elbow fractures. In cases of unreconstructible fractures, the resection of the head was advocated. Radial head arthroplasty is an alternative way of the treatment. As the implantation could end up with complications, thus new and better designs are constantly looked for. One of such designs is modal/bipolar radial head endoprosthesis. The aim of this paper is to assess the functional outcome following the implantation of this endoprosthesis using movement analysis system. Seven patients participated in the study: 5 after implantation of endoprosthesis and 2 after surgical reconstruction of the radial head. The upper extremity movements with EMG were assessed during gait and pronation/supination movements with and without the external load. The functional abilities of patients with radial head endoprosthesis do not differ from those of the patients after the elbow reconstruction. This allows the patients normal, daily activity, with no restrictions and pain.