Purpose: The patients expect optimal knee function after Total Knee Arthroplasty. It is necessary to apply appropriate surgical technique and supervised physical therapy. The optimal management of posterior cruciate ligament remains controversial. Both implant designs, i.e., cruciate retaining and posterior substituting, allow the orthopedic surgeon to achieve excellent clinical outcomes, as measured by commonly used questionnaires. Such methods of assessment may poorly reflect the functional status of patients. Therefore, three-dimensional gait analysis is recommended to evaluate the outcomes of surgical intervention. This study sought to determine differences in kinematic gait parameters and Knee Society Score between cruciate-retaining and posterior-substituting patients. Methods:23 individuals after cruciate-retaining total knee arthroplasty and 19 individuals after posterior-substituting total knee arthroplasty were subjected to gait analysis using three-dimensional motion capture system BTS Smart DX 7000. In addition, gait was assessed in 21 patients with knee osteoarthritis and in 30 healthy individuals. Results: The study did not reveal differences between cruciate-retaining and posterior-substituting groups, both in terms of Knee Society Score and kinematic gait parameters. There were also no differences in kinematic gait parameters between patients from the knee osteoarthritis group and total knee arthroplasty groups. The analyzed parameters in all of the groups differed significantly from those found in healthy individuals. Conclusions: Surgical technique and implant design do not affect values of kinematic gait parameters evaluated under natural walking speed. Several months after surgery the patients still demonstrated alterations in gait pattern, similar to those recorded in patients with knee osteoarthritis.
Purpose: The aim of the study was to evaluate the effects of a 6-week sEMG-biofeedback-assisted pelvic floor muscle training program on pelvic floor muscle activity in young continent women. Methods: Pelvic floor muscle activity was recorded using a vaginal probe during five experimental trials. Biofeedback training was continued for 6 weeks, 3 times a week. Muscle strenghtening and endurance exercises were performed alternately. SEMG (surface electromyography) measurements were recorded on four different occasions: before training started, after the third week of training, after the sixth week of training, and one month after training ended. Results: A 6-week sEMG-biofeedback-assisted pelvic floor muscle training program significantly decreased the resting activity of the pelvic floor muscles in supine lying and standing. The ability to relax the pelvic floor muscles after a sustained 60-second contraction improved significantly after the 6-week training in both positions. SEMG-biofeedback training program did not seem to affect the activity of the pelvic floor muscles or muscle fatigue during voluntary pelvic floor muscle contractions. Conclusions: SEMG-biofeedback-assisted pelvic floor muscle training might be recommended for physiotherapists to improve the effectiveness of their relaxation techniques.
Purpose: The experiment was designed to evaluate and compare the efficacy of focused shockwave and radial shockwave in symptomatic heel spur treatment. Postural balance tests were used to ensure the objectivity of evaluations. Methods: Forty three patients with symptomatic heel spur were divided into two comparative groups that received respectively focused shockwave therapy (the FSWT group; 2000 impulses, 4 Hz, 0.4 mJ/mm2 ) and radial shockwave therapy (the RSWT group; 2000 impulses, 8 Hz, 5 bars + 2000 impulses, 8 Hz, 2.5 bars). Each patient received 5 treatments at weekly intervals. Before therapy started and 1, 3, 6 and 12 weeks after it ended, the intensity of pain experienced by the patients was assessed and static balance tests were performed on a force platform. Results: Successive measurements showed that the intensity of all kinds of pain under consideration was decreasing gradually and statistically significantly in both groups. The percentage reduction in pain intensity was similar between the groups. The standard deviation of the COP in the anterior-posterior and medial-lateral directions, 95% confidence ellipse area and COP velocity kept varying throughout the experiment, but in none of the groups changes were statistically significant. Conclusions: Focused shockwave therapy and radial shockwave therapy improve the well-being of patients with symptomatic heel spur significantly and comparably. Posturography cannot deliver unambiguous data for tracking changes that the two therapies induce in these patients.
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Celem przeprowadzonego badania była ocena efektu cieplnego wybranych zabiegów fizykalnych stosowanych w leczeniu owrzodzeń żylnych goleni. 32 chorych z owrzodzeniami żylnymi goleni zakwalifikowano losowo do grup porównawczych 1,2 i 3. Do grupy 1. włączono 12 chorych, do 2. - 10 chorych, do 3. - 10 chorych. Wszyscy chorzy byli poddani miejscowej terapii farmakologicznej. U osób z grupy 1. wykonano zabiegi sono-terapii. Natomiast u osób z grupy 2. wykonano elektro-stymulację wysokonapięciową. U osób z grupy 3. owrzodzenia poddano biostymulacji laserowej. Oceniano, w jakim stopniu metody fizykalne wpływają na średnią i maksymalną temperaturę w obrębie ubytku. Po zakończeniu leczenia stwierdzono, że sonoterapia wywołuje istotny, choć krótkotrwały efekt cieplny. Natomiast nie zauważono efektu cieplnego w przypadku elektrostymulacji wysokonapięciowej i biostymulacji laserowej.
EN
The aim of the study was to evaluate the thermal effect of sonotherapy, high voltage electrostimulation and laser biostimulation in treatment of venous leg ulcers. Three comparative groups - 1,2 and 3 - were random-i ly chosen from 32 patients with venous leg ulcers. The I group 1 consisted of 12 patients, the group 2 of 10 pa-I tients, the group 3 of 10 patients. The patients in all comparative groups were treated pharmacologically. Ulcerations at the patients in the group 1 were additionally treated with the sonotherapy. In the group 2 high voltage electrostimulation was applied. Ulcerations at the patients in the group 3 were treated with the laser biostimulation. After therapy we concluded that ultrasound had significant thermal effect, however short. No significant effects of high voltage electrostimulation and laser biostimulation were observed.
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