Bensår är en kronisk sjukdom och ger ofta underbensödem vilket gör att såren blir svårläkta. Den viktigaste behandlingsmetoden för att undvika ödem är kompressionsbandage. Många av de patienter som drabbas av bensår tycker att sårläkningsprocessen är svår att acceptera och de har därför problem med att fullfölja kompressionsbehandlingen. Syftet med studien var att undersöka vilka faktorer som hade betydelse för patientens följsamhet vid kompressionsbehandling av bensår. Arbetet har gjorts som en litteraturstudie av vetenskapliga artiklar. Resultatet visar att om distriktssköterskan ser patienten som en enskild individ, har helhetssyn och samarbetar med patienten samt är kunnig och erfaren, har patienterna lättare att tolerera behandling med kompressionsbandage. Kontinuitet i vården, det vill säga att ha en och samma distriktssköterska genom hela behandlingen, är även en viktig faktor för patienters följsamhet. Bättre dokumentation, generella riktlinjer för behandling och mer utbildning i sårvård behövs för att förbättra vården för bensårspatienter. / Leg ulcer is a chronic disease and the patient often gets lower leg oedema  which makes the ulcers difficult to heal. The most important treatment to avoid oedema is compression bandaging. Many patients with leg ulcer find the healing process hard to tolerate and have roblems to comply with compression therapy. The aim of the study was to examine which      factors that influences patients to comply with compression therapy. The study has been done as a literature review of scientific articles. The result shows that if the district nurse sees the patient as an individual, has a holistic approach and work with the patient and is knowlegeable and experienced, patients were more likely to accept treatment with compression bandages. Continuity in care, having the same nurse throughout the treatment, is also an important factor for patient compliance. Better documentation, general guidelines for treatment and more education in wound care is needed to improve care for leg ulcer patients.

Tyrimo objektas. Specialių fizinių pratimų poveikis laikysenai ir „X” kojų deformacijai. Tyrimo subjektas. 5-7metų amžiaus lankantys ikimokyklinę įstaigą ir turintys laikysenos sutrikimų bei kojų „X” deformaciją vaikai. Tyrimo problema. Vaikų su ydinga kūno laikysena ikimokykliniame amžiuje daugėja. Tai aktuali šių dienų problema. Žaidimas kompiuteriu, mažas fizinis aktyvumas turi įtakos raumenų silpnumui, asimetriškumui vystytis, o susilpnėjus raumenims vystosi laikysenos pokyčiai. Ydinga laikysena nagrinėjama daugelyje darbų, o vaikų kojų deformacijai skiriamas menkas dėmesys. Vaikams iki 5 metų pasitaikančios deformacijos yra trumpalaikės, 90 proc. atvejų praeina savaime, o 10 proc. atvejų liga gali progresuoti, deformacijos sunkėti, prognozė blogėti, ypač tai pastebima brendimo laikotarpiu.( Paukštys ir Vasiliauskienė, 2006). Todėl svarbi ankstyva laikysenos diagnostika ir sutrikimų profilaktika. Hipotezė. Vaikams dėl laikysenos sutrikimų ir „X”, kojų deformacijos tikslinga taikyti specialius fizinius pratimus. Tyrimo tikslas: įvertinti ar ugdymas specialiais fiziniais pratimais turi įtakos laikysenos sutrikimų ir „X“ kojų deformacijos korekcijai. Tyrimo uždaviniai: 1) Tyrimo pradžioje įvertinti 5-7 metų vaikų lankančių Kauno Panemunės (pagrindinė grupė) ir „Žiedelis” (kontrolinė grupė) laikysenos sutrikimus ir „X” kojų deformacijas. 2) Įvertinti pagrindinės grupės vaikų laikysenos sutrikimų ir „X” kojų deformacijos pokyčius po penkių mėnesių. 3) Įvertinti... [toliau žr. visą tekstą] / The object of research. The influence of special physical exercise on the carriage and „X” leg deformation. The subject of research. 5-7 year-old preschool children with carriage disorders and „X” leg deformation attending preschool institution. The problem surrounding this investigation. The number of preschool children with carriage disorder are increasing. Nowadays it is an urgent problem. Playing with computer, lack of physical activities result in the weekness of muscles and as development of asymmetry which, in turn, cause changes in the carriage. The carriage disorder has been investigated in many works while the problem of „X” leg deformation is not so widely discussed. Children up to 5 years old have short-term deformations and in 90% cases they disappear without treatment, but in 10% cases the illness may develop, deformation and prognosis become worse, especially in maturation period. ( Paukštys & Vasiliauskienė, 2006). Hypothesis. Special physical exercise should be applied for children with carriage disorders and „X” leg deformation. The aim of research. To evaluate the influence of training children with special physical exercise on the correction of carriage disorders and „X” leg deformation. The tasks of research: 1. To evaluate the carriage disorders and „X” leg deformation 5-7 year-old children in Kaunas Panemunė (main group) and „Žiedelis“ (control group) kindergartens at the beginning of the research. 2. To evaluate the changes in carriage disorders and... [to full text]

The aim of the present study was to evaluate the efficacy of kinesitherapy applied to children presented with Legg-Calve-Perthes disease during rehabilitation period. The study was performed at V. Tumenienes Children Rehabilitation Center in Kaunas. 22 children (boys) were examined. The efficacy of kinesitherapy was assessed using movement range and leg musculature extent groups’ measurements. The movement function was evaluated using modified Keitel index. The results showed that the movement range of the affected leg has improved in approximately one year during which kinesitherapy procedures were applied (p<0.0001). Statistically significant difference was observed. During treatment, slight changes regarding calf size were observed (p<0.05). The size of the thigh and the calf increased after kinesitherapy course (p<0.0001). Keitel index raised up to 67.9 ± 4.2% (p<0.0001) at the end of the treatment course. Thus, the movement therapy provided at V. Tumenienes Children Rehabilitation Center was effective.

GENERAL CHARACTERISTIC OF THE DISSERTATION Topicality of the problem Prosthesis in orthopaedic technique are constructions that act as leg function reproduction and for external normal view of the leg. It is a technique giving a possibility to adapt to the society and live a full-fledged life, when one or another limb is lost. By the data, declared by the world health society, people with a disability include 10 % of all world population, among them people over 80 years old. More and more orthopaedic techniques are produced in Lithuania at present. The production, manufactured in our country keeps in step with world design and quality in foreign countries and they are 5–6 times cheaper. The main aim of the designers and constructors of orthopaedic techniques is to design and produce functional and high quality lower limbs prosthesis and apparatus. In the meantime, the same as abroad, in Lithuania the production processes of the prosthesis are automated but not so much to ensure a good quality of the prosthesis. Sometimes it is very hard to make prosthesis of adequate size to a patient that prosthesis implicitly fits just to the patient. Also, it is very hard to adjust it, ensuring the same length as the residual limb which should precisely correspond to the lost limb of the changeable loads chains of the prosthesis periodically are deformed during walking. In other words, the length of the prosthesis changes during gait. Thus, it is very important to set the limits of... [to full text]

The aim of this paper is to identify the influence of the Physical Therapy on patient’s self-sufficiency following the amputation of legs, during the stages of rehabilitation, and a Health Recovering Treatment. There were 30 patients (23 men and 7 women) who participated in this experiment. All the participants where the patients who came back for the Health Recovering Treatment (first time for a definitive prosthetic after the temporary prosthesis) following the amputation of one leg either in a level of thigh, or shin. The average age of male participants was 61 year, while average age of female participants – 68 year. The patient’s abilities to be self-dependant and to take care of himself were analysed while using the Bartel Index. The testees were examined in the early stage of rehabilitation (the preparation for prosthetic and the adaptability of temporary prosthesis), and in the final stage of rehabilitation (30 after starting an experiment); also in the early stage of the Health Recovering Treatment (first time definitive prosthesis was applied after temporary prosthesis), and in the final stage of the Health Recovering Treatment (24 days later). During the rehabilitation stage the patients’ self-sufficiency improved starting from almost complete dependence to an average dependence (by 20,34 points), and during the Health Recovering Treatment stage it improved from average dependence to a little dependence (by 21,40 points). The improvement in walking on a smooth... [to full text]

Bakgrund; 3 % av världens befolkning lider av venösa bensår och de drabbade är främst äldre och kvinnor. Kompressionsbehandling och fysisk aktivitet är de två vanligaste egenvårdsåtgärderna och det ligger ett stort ansvar på sjuksköterskan att motivera patienten till en fungerande egenvård. Syfte; Syftet med denna litteraturstudie var att beskriva patienters svårigheter till följsamhet av egenvård och att belysa betydande aspekter i sjuksköterskans arbete för att kunna motivera patienter till följsamhet av egenvård vid venösa bensår samt att undersöka kvaliteten på urvalsmetoden forskarna till valda artiklar använt sig av. Metod; Denna litteraturstudie har en deskriptiv design och är baserad på tio vetenskapliga artiklar varav fyra är kvalitativa, tre är kvantitativa och tre är kvalitativa/kvantitativa och publicerade mellan 2004-2014. De vetenskapliga artiklarna inhämtades från databasen PubMed. Artiklarnas innehåll granskades utifrån likheter. Kvalitet, likheter och skillnader granskades i den metodologiska aspekten urvalsmetod. Resultat; Sju teman identifierades varav tre berörde patienters svårigheter till följsamhet av egenvård; kunskap och tro på sig själv och behandlingen, patienters svårigheter vid kompressionsbehandling som egenvårdsåtgärd, patienters svårigheter vid fysisk aktivitet som egenvårdsåtgärd och fyra behandlade aspekter i sjuksköterskans motiverande arbete; kunskap och information, patientens inställning, organisationsproblem och relationer. Gällande granskningen av artiklarnas urvalsmetod påvisades en varierande kvalitet. Konklusion; Kunskap och inställning hos både sjuksköterska och patient samt en god relation mellan dessa är av största vikt för få en fungerande egenvård och på så sätt minska prevalensen av venösa bensår. / Background; 3 % of the world’s population suffers from venous leg ulcers. Women and elderly are most affected. Compression therapy and physical activity is the most common self-care treatment for patients with venous leg ulcers and the nurse has a great responsibility to motivate patients to self-care. Aim; The aim of this study was to describe difficulties venous leg ulcer patients’ may experience performing self-care, to describe the nurses essential factors to motivate patients to adhere to self-care and to examine the quality of sampling methods in the studies included. Methods; A descriptive design was used and this study included four qualitative studies, three quantitative studies and three studies with both qualitative and quantitative design and was published between 2004-2014. The scientific articles were found in the database PubMed and the content of the articles was examined of their resemblance. Quality, similarities and differences were examined in the methodological aspect selection method. Results; Seven themes were identified and three of them described patients difficulties to adhere to self-care. Knowledge and belief in the treatment and themselves was found to be essential and the next two themes described patients’ difficulties to adhere to compression therapy and physical activity. The residual themes described the nurses’ essential factors to motivate patients to adhere to self-care, knowledge and information, the patients’ attitude towards self-care, organizational problems and the relationship between the nurse and patient. Regarding the review of the articles selection method, a varying quality was found. Conclusions; There are many factors influencing venous leg ulcer patients’ adherence to self-care. The nurses’ and the patients’ knowledge and attitude towards self-care activities is an important part of a functional self-care needed to reduce the prevalence of venous leg ulcers.

Bakgrund: I vårdandet av personer med svårläkta sår finns det en risk att fokus hamnar på såret i sig, istället för den enskilde individen. En avgörande faktor för framgångsrik sårläkning är att vårdaren intar ett helhetsperspektiv av personen. Tidigare forskning visar att livskvaliteten hos personer med bensår påverkas negativt av olika faktorer såsom smärta, nedsatt rörlighet och sömnstörningar. Sjuksköterskan bör bedöma och se till de faktorer som påverkar livskvaliteten hos varje enskild person, samt agera för att såret skall läka och lindra symtom. Syfte: Att belysa den personliga upplevelsen av att leva med svårläkta bensår ur ett livskvalitetsperspektiv. Metod: En litteraturstudie baserad på tolv studier med kvalitativ ansats. Därefter följer en deduktiv analys av materialet utifrån WHOQOL:s definition av livskvalitet enligt sex olika domäner. Artiklarna hittades via sökningar i databaserna Cinahl, MEDLINE, AMED och Academic Search Elite. Resultat: Livskvaliteten hos personer med bensår påverkades inom de fysiska och psykiska domänerna, liksom i domänerna grad av oberoende, sociala relationer och omgivning och miljö. Ingen påverkan inom domänen andlighet, religion och personlig tro har kunnat påvisas. Slutsats: Personer med bensår upplevde en negativ inverkan på sin livskvalitet. För att kunna upprätthålla och förbättra sin livskvalitet behövde personer med bensår hjälp och stöd i det dagliga livet. / Background: In the care of people with chronic wounds, there is a risk that the focus is placed on the wound itself, rather than on the individual. A crucial factor for successful wound healing is that the caregiver takes a holistic perspective of the person. Previous research shows that the quality of life in people with leg ulcers is adversely affected by various factors such as pain, impaired mobility and sleep disturbances. The nurse should assess and review the factors that affect the quality of life of every individual, and act to heal the wound and alleviate symptoms. Aim: To highlight the personal experience of living with chronic leg ulcers from a quality of life perspective. Method: A study based on twelve studies with a qualitative approach. This is followed by a deductive analysis of the material from WHOQOL's definition of quality of life under six different domains. Articles were found through searches of the databases Cinahl, MEDLINE, AMED and Academic Search Elite. Results: The quality of life in people with leg ulcers was affected in the physical domain, psychological domain, level of independence, social relationships and environment. No influence in the domain spirituality, religion and personal faith has been demonstrated. Conclusion: People with leg ulcers experienced a negative impact on their quality of life. In order to maintain and improve the quality of life for the individuals with leg ulcers, there is a major need for help and support in the daily life.

Bakgrund: Venösa bensår är ett växande problem som orsakar smärta, begränsad rörlighet och minskad livskvalitet. Genom att främja egenvård till patienter med venösa bensår kan sårläkning förbättras. Egenvård är en hälso- och sjukvårdsåtgärd som legitimerad yrkesutövare har bedömt att personen kan utöva själv eller med hjälp av någon annan. Sjuksköterskors nyckelroll är att främja och optimera följsamhet av egenvård. Patientdelaktighet leder till att målen med vård och behandling uppfylls bättre. Syfte: Syftet med denna studie var att belysa distriktssköterskors erfarenheter av att främja egenvård hos patienter med venösa bensår. Metod: Data analyserades genom kvalitativ innehållsanalys med en induktiv ansats. Tio intervjuer med distriktssköterskor genomfördes. Resultat: Ur analysen av datamaterialet framträdde fyra kategorier med elva underkategorier; Involvera patienten i behandlingen, Skapa samsyn till förändring, Samarbeta kring patienten och Beakta patientens bristande medverkan. Konklusion: Studiens resultat visade att egenvårdsråd främjas till patienter med venösa bensår men att distriktssköterskorna saknade gemensamma riktlinjer. Genom att distriktssköterskorna tar sig tid och främjar egenvård kan patienten få ökad insikt till varför egenvård behövs för att främja sårläkning. / Background: Leg ulcers are a growing problem causing pain, limited mobility and reduced quality of life. Through promotion of self-care for patients with venous leg ulcers, wound healing can be improved. Self-care is a health measure that qualified professionals can decide a person can exert him or herself or with assistance from others. Nurses’ key role is to foster and optimize adherence to self-care. Patient participation leads to better fulfillment of the goals for the care and treatment. Purpose: The purpose of this study was to elucidate the district nurses’ experiences of promoting self-care in patients with venous leg ulcers. Method: Data were analyzed using qualitative content analysis and an inductive approach. Ten interviews with district nurses were conducted. Results: Analysis of the data produced four categories with eleven sub-categories; Involve the patient in treatment, Create consensus for change, Collaborate with the patient and Observe the patient's lack of participation. Conclusion: Our results showed that self-care is promoting to patients with venous leg ulcers, but that the district nurses lacked common guidelines. The district nurses can by taking the time to promote self-care advice give the patient a greater understanding why self-care is needed to promote wound healing.

The purpose of this study was to determine the jump landing impact absorption kinematic and kinetic characteristics of the four subject groups: a) male high school athletes, b) female high school seasonal athletes, c) female high school year-round athletes, and d) female college athletes who train year-round. Subjects dropped onto a force platform from a height of 40 centimeters. Variables analyzed were flexibility, strength, Fz, Fy, and Fx force, free moment, range of motion, contact and maximum angles, time to maximum angle, contact and maximum angular velocities, and time to maximum angular velocity. Significant differences among subject groups were determined through use of a factorial analysis of variance and Scheffe' post hoc test.A difference was noted in the landing patterns of males and females. Male subjects exhibited a significantly longer time to first vertical peak force. This longer time may allow for greater initial force attenuation; however, the male athletes had a significantfy greater second peak force. Males also differed significantly from females in anteroposterior and mediolateral force.The differences in method of force attenuation may be due to significantly greater ankle eversion shown by the males and greater knee flexion used by the females. Additionally, the males had significantly greater leg strength, which may have allowed them to increase the time to first peak.The year round female high school athletes were found to use the best biomechanical landing method. They had a greater range of motion in the knee and ankle, and subsequently produced the lowest amount of vertical and anterio-posterior force. / School of Physical Education

The impact forces at landing are predominately absorbed by the hip, knee and ankle joints. Fatigue has been shown to increase the amount of work performed by the ankle and to reduce the work performed by the knee during landings. The purpose of this study was to assess the kinematic lower extremity motion and kinetic patterns during landings to fatigue, with and without ankle brace usage. Nine recreationally active males (n = 7) and females (n = 2) performed repetitive drop jumps to fatigue for an un-braced and braced condition. Kinematic and kinetic variables were assessed during the first 100 ms after ground impact. Due to the high skill level of the participants, none of the individuals reached a fatigued state. No significant main effect of fatigue was demonstrated on ankle work (p= 0.260). There was no significant main effect due to fatigue on the hip (p= 1.000), knee (p= 1.000) or ankle (p= 0.636) relative work contributions. Fatigue caused a shift toward a more erect landing position at initial ground contact (IGC). No significant main effect of the brace on hip (p= 0.437), knee (p= 0.283) or ankle (p= 0.314) angles was observed at IGC angles. The use of Ankle Stabilizing Orthosis® (ASO) ankle braces caused a shift toward greater knee contribution in a fatigued state. Plantar flexion angles were decreased the most during the braced un-fatigued condition. There was an inverse relationship between knee and hip angles as compared to ankle angles at IGC. When the hip and knee joint displayed less flexion at IGC, the ankle balanced the positions out by landing in more plantar flexion. / School of Physical Education, Sport, and Exercise Science