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In this research work we tried to determine physical therapy effect on thigh – bone, shin and heel – bone muscle power, muscle spread and patirns mobility after acute haematogenous osteomyelitis (AHO). The purpose. To determine patients thigh – bone, shin and heel – bone muscle power changes, during acute haematogenous osteomyelitis 60 days treatment course. Methods. Research was applied Kaunas V. Tumėnienės children sanatorium. In research work took part 30 children, from them 21 boys and 9 girls. Years of age average 11 ± 2 years. Patients for this research were chosen by disorder localisation and divided into 3groups: after thigh – bone AHO (n=10), after shin AHO (n=10), after heel – bone AHO (n=10). Rehabilitation treatment course were 60 days. Every patient from this group had and individual course of physiotherapy twice in a day, but also patients had massage procedure and physiotherapy manipulations. To evaluate the effect of applied treatment couse patients were tested after 30 days and in the end of treatment course period. For – bone, shin and heel – bone muscle spread and muscle functionality evaluation was used Lovett 5 score scale, subjective pain scale and functional mobility test (Keitel index). Results. Forshowed that biggest thigh – bone and shin muscle atrophy is in shin bone AHO. During treatment period in all research groups biggest thigh – bone and shin muscle spread increased, but after 60 days of treatment course it was less comparing with healthy leg... [to full text]

Anksčiau naudotiems čiurnos sąnario operacinio gydymo metodams (koreguojanti blauzdikaulio osteotomija, čiurnos sąnario artrodezė, artroplastika) atsirado alternatyva – čiurnos sąnario pakeitimas endoprotezu. Tačiau ir po pooperacinės reabilitacijos išlieka dalinis čiurnos sąnario funkcijos nepakankamumas, skausmo problema. Apie tai rašoma tiek užsienio tiek ir Lietuvos moksliniuose straipsniuose. Šio darbo tikslas nustatyti kineziterapijos programų efektyvumą po čiurnos sąnario pakeitimo operacijos Tyrimas buvo atliktas Palangos reabilitacijos ligoninėje. Tyrime dalyvavo pacientai po čiurnos sąnario pakeitimo. Visi pacientai buvo operuoti Klaipėdos ligoninėje sąnarių implantacijos centre (SIC), operacijas atliko tas pats ortopedas-traumatologas, visiems buvo implantuotas STAR tipo protezas. Pirmą grupę tiriamųjų sudarė 12 pacientų, visiems buvo taikyta pratimų terapija. Antrą grupę sudarė taip pat 12 pacientų, kuriems buvo atlikta pratimų terapija kartu su minkštųjų audinių atpalaidavimo metodika ir krioterapija. Matavimai buvo atliekami 2 kartus: atvykus į reabilitacijos ligoninę ir išvykstant. Buvo analizuojami bendri visų tiriamųjų rezultatai ir palyginti pirmosios ir antrosios grupių rezultatai. Nustatyta, kad po reabilitacinio gydymo statistiškai reikšmingai pagerėjo visi funkcinės būklės vertinimo rodikliai abiejose grupėse. Po gydymo čiurnos sąnario tiesimo ir lenkimo amplitudės padidėjo antrosios grupės tiriamiesiems. Antrosios grupės tiriamiesiems, taikant pratimų... [toliau žr. visą tekstą] / The surgical treatment methods of ankle joints (adjusting tibial osteotomy, arthrodesis of intertarsal joint, arthroplasty) were used before there appears an endoprosthesis for replacement of ankle joint. Even so, after the surgical rehabilitation there are still a partial insufficiency of ankle joint function and ache problems. Foreign and Lithuanian scientific press write about it equally. The purpose of this research work is to evaluate the physiotherapy influence on the rehabilitation efficiency. The second objective is to compare how the physiotherapy governed by relaxation techniques on soft issues and cryotherapy have had influence on the results. The research was done in Palanga rehabilitation hospital. The patients who have had the implanted ankle joint replacements were engaged in this research work. All patients had surgeries in Center for Joint Replacement (CJR) in Klaipeda hospital. It was done by the same orthopaedist-traumatologist. A STAR prosthesis were implanted into every patient. In first group there are 12 patients who have been applied physiotherapy. The second group consists of 12 patients as well who were treated by physiotherapy governed by relaxation techniques on soft tissues and cryotherapy. The measurements were done twice; arriving at rehabilitation hospital and leaving the hospital. The results of both groups have been studied and also they have been carefully compared. Conclusion. It is certain that after the rehab treatment the functional... [to full text]

Skapaitė L. Kineziterapijos poveikio įvertinimas po klubo sąnario endoprotezavimo dėl koksartrozės; magistro baigiamasis darbas / mokslinis vadovas doc. A. Kimtys; Kauno medicinos universitetas, Slaugos fakultetas, Reabilitacijos klinika. – Kaunas, 2008. Darbo tikslas buvo įvertinti kineziterapijos poveikį asmenims po klubo sąnario endoprotezavimo dėl koksartrozės antrame reabilitacijos etape. Reabilitacijos kurso trukmė buvo 30 dienų. Tyrime dalyvavo 21 vienos ligoninės Fizinės medicinos ir reabilitacijos skyriaus pacientas po klubo sąnario endoprotezavimo dėl koksartrozės. Tiriamąją grupę sudarė 2 vyrai (9%) ir 19 moterų (91%), kurių amžius 50-70 metų. Pacientai buvo suskirstyti į dvi grupes pagal amžių. Pirmojoje grupėje – 7 pacientai, kurių amžius 50-65 metai (33%), antrojoje grupėje – 14 pacientų, kurių amžius 66-70 metų (67%). Tiriamųjų amžiaus vidurkis buvo 65,9 ± 6,09 metai. Pirmosios grupės pacientų amžiaus vidurkis 58,9 ± 5,96 metai, antrosios grupės pacientų amžiaus vidurkis 69,4 ± 1,01 metai. Pacientai buvo tiriamai du kartus: pirmąjį – tik atvykus į Fizinės medicinos ir reabilitacijos skyrių, antrąjį kartą – prieš išvykstant pacientui iš šio skyriaus. Kineziterapijos poveikiui vertinti buvo atliekami šie tyrimai ir testai: šlaunies raumenų jėga vertinama naudojant Oxford skalę, judesių amplitudės klubo sąnaryje – goniometriniu metodu, paciento mobilumas – pagal modifikuotą Keitel indeksą, skausmas - naudojant vizualinės analogijos skausmo skalę... [toliau žr. visą tekstą] / The aim of the study was to evaluate the effect of physiotherapy in patients after hip replacement in second stage of rehabilitation. Duration of rehabilitation course was 30 days. The study included a group of 21 patients from Rehabilitation department in one hospital after hip replacement because of coxarthrosis. Exploration shows, that more patients were women - 19 (91%), and men – 2 (9%). The age of the patients in this group was from 50 to 70 years. The average age of them was 65,9 ± 6,09 years. Patients was grouped according to age in two groups. In first group – 7 patients who‘s age was from 50 to 65 years (33%) and in second group – 14 patients who‘s age was from 66 to 70 years (67%). The average age of the patients in first group was 58,9 ± 5,96 years, in second group – 69,4 ± 1,01 years. The effect of physiotherapy was performed using the Oxford scale, goniometry technique, Keitel‘s index, Pain Visual Analog Scale, Barthel‘s index. We evaluated these indexes at two times – before rehabilitation course and after rehabilitation course. The muscle strength after rehabilitation course increased in both groups (p<0,05). The range of motions after rehabilitation course increased in both groups (p<0,05). Level of the pain after rehabilitation course decreased in both groups (p<0,05). Keitel‘s index after rehabilitation course increased in both groups (p<0,05). Barthel‘s index after rehabilitation course increased in both groups (p<0,05).

The aim of this study is the investigation and assessment in subsequent treatment of kinezioterapy rehabilitation for after stroke patients. Measures of functional independence, muscle force and balance tests have been used for this purpose. This study has involved 17 after stroke participants: 10 female and 7 male. The obtained results has showed that the use of physiotherapy rehabilitation in subsequent treatment of functional independence, balanse and muscle force has improved or recovered completely.

Osteoartrozė – viena dažniausių vyresnio amžiaus žmones varginančių ligų. Progresuojanti liga luošina ligonius, labai nukenčia jų gyvenimo kokybė ir yra viena neįgalumo priežasčių. Ligos gydymas reikalauja ypatingos sveikatos apsaugos sistemos dėmesio ir lėšų. Kadangi ligos paplitimas tiesiogiai susijęs su amžiumi, prognozuojama, kad ateityje, didėjant vyresnio amžiaus žmonių skaičiui, sergamumas osteoartroze dar labiau padidės, atitinkamai didės ir gydymo išlaidos. Gydant ligą, kartu su kitais metodais, taikoma kineziterapija. Sergant kelių sąnarių osteoartroze, ligonių mokymas ir kineziterapijos taikymas mažina skausmo intensyvumą ir gerina funkcines galimybes (Dieppe et al, 2001). Tyrimo metodai ir organizavimas. Tyrime dalyvavo sergantieji kelių sąnarių osteoartroze, savanoriškai sutikę dalyvauti. Jiems taikytas ambulatorinės reabilitacijos gydymo kompleksas. Tiriamieji buvo suskirstyti į dvi skirtingo amžiaus grupes: iki 60 metų (n=12) ir virš 60 metų (n=18). Abiem grupėms taikyta tokia pati kineziterapijos programa. Tiriamiesiems skirtos 5 kineziterapijos procedūros po 30 min. Dėl mažo kineziterapijos procedūrų skaičiaus ir tiriamųjų nesistemingo procedūrų lankymo, rekomenduota kineziterapiją atlikti ir savarankiškai, namuose. Vertintas skausmo stiprumas pagal VAS skalę, funkcinė būklė – pagal modifikuotą Keitel indeksą, kelio sąnario lenkimo judesio amplitudė, blauzdos raumenų – tiesėjų jėga – pagal 5 balų Lovett skalę. Visi tyrimai atlikti per pirmą ir pakartoti per... [toliau žr. visą tekstą] / Osteoarthritis is one the most common illnesses amongst elderly people. An ingravescent illness maims patients, exacerbating quality of their lives and therefore this is one of the causes of their physical disability. Treatment of this illness requires a special attention of the health service system and funds. Since pervasion of the illness is directly related with age, there are some predictions that with an increasing number of the elderly people, morbidity of osteoarthritis will increase also; medical costs will be increasing respectively. This illness, together with the other methods, is being cured by the physiotherapy. If the patients suffer of the kneel joints osteoarthritis, patients training and application of the physiotherapy decreases intensity of the pain and improves functional capabilities. (Dieppe et al, 2001). Methods of the research and organization. Volunteers, having knee joint osteoarthritis, attended this research process. They received an ambulatory treatment complex. Exploratory group was divided into two parts: under 60 years (n =12) and over 60 years (n =18). Both groups received the same type of the program – 5 physiotherapy procedures up to 30 minutes. Due to the little number of the procedures and facultative attendance of the patients, there were made recommendations to perform physiotherapy procedures at home. There were evaluated the following facets – pain intensity according to the VAS scale, functional state according to the modified... [to full text]

Tyrimo tikslas: Veiksnių, įtakojančių kineziterapijos efektyvumą, sergantiesiems GSI, ankstyvuoju ligos laikotarpiu, nustatymas. Kontingentas. Tyrimas buvo atliktas Kauno medicinos universiteto klinikų (KMUK) neurologijos skyriuje. Tyrime dalyvavo 25 ligoniai (17 moterų ir 8 vyrai), kuriems buvo diagnozuotas išeminis galvos smegenų insultas, ūmus ligos laikotarpis. Reabilitologas buvo paskyręs kineziterapiją. Tyrimas buvo atliekamas 2007 m. spalio – 2008 kovo mėn. Pacientai vidutiniškai skyriuje praleido 14 dienų. Tiriamieji buvo suskirstyti į keletą grupių: pagal lytį – vyrai ir moterys, pagal amžių – 50-69 bei 70-87 metų, bei pagal galvos smegenų pusrutulio pažeidimo pusę – kairės ir dešinės. Tyrimo metodai. Reabilitacijos veiksmingumui vertinti pasirinkta paciento bendros funkcinės būklės ( Bartelio indeksas), motorinės funkcijos (Rivermedo judesių įvertinimo skalė), bei pažintinių funkcijų (Trumpas protinės būklės tyrimo testas) pokytis po reabilitacijos. Tyrimo rezultatai parodė, kad ankstyva sergančiųjų galvos smegenų insultu kineziterapija statistiškai reikšmingai pagerino pacientų bendrąją funkcinę būklę, motorinę funkciją bei pažintines funkcijas visose grupėse (pagal amžių, lytį ir galvos smegenų pažeidimo pusę)(p<0,05). Tačiau statistiškai reikšminga lyties, amžiaus, bei galvos smegenų pažeidimo pusės įtaka bendrai funkcinei būklei, motorinei, bei pažintinėms funkcijoms nenustatyta, kaip manoma dėl mažo tiriamųjų skaičiaus. / Aim of the research: Establishment of factors influencing the effectiveness of physiotherapy of people sick with stroke in the early period of illness. Contingent. The research was performed in the Division of Neurology of Kaunas University of Medicine Hospital. 25 patients took part in the research (17 women and 8 men) with the diagnosis of (išeminis) stroke, acute period of the illness. The rehabilitation physician had prescribed physiotherapy. The research was performed in October 2007 – March 2008. The patients spent in the Section on the average 14 days. The exploratory people were divided into several groups: according to the sex – men and women, according to the age – 50-69 and 70-87 years old, and according to the side of the hemisphere of head brains affection – left and right. Methods of the research. In order to evaluate the effectiveness of rehabilitation the alteration of patent’s general state (Barthel Index), motor functions (Rivermead Motor Assessment scale) and cognitive functions (Mini-Mental State Examination) after the rehabilitation were chosen. The results of the research have shown that the early physiotherapy of people sick with stroke statistically significantly improved patients’ general functional state, motor function and cognitive function in all groups (according to the age, sex and the side of the hemisphere of head brains affection) (p<0,05). However statistically significant influence of age, sex and the side of the hemisphere of head... [to full text]

Darbo aktualumas: Osteoartritas (OA) senstančioje visuomenėje darosi vis svarbesnė problema. Daugumai žmonių OA – tai sindromas, kurį sudaro sąnarių skausmo, sustingimo ir dėl to prastėjančių funkcijų simptomai ir kuris daro didelę įtaką gyvenimo kokybei (Conaghan & Sharma, 2009). Sergantiems osteoartritu ligoniams pažeidžiamos daugelis gyvenimo sričių: apsitarnavimas, namų ruoša, darbas, laisvalaikis, judėjimas, miegas (Thorstenson, 2007; Sunden et al. ,2007). Siekiant sumažinti skausmą bei pagerinti funkciją pacientams, sergantiems kelių sąnarių osteoartritu, analizavome, kaip skirtingos kineziterapijos programos veikia pacientų skausmą, pusiausvyrą ir šlaunies raumenų jėgą. Tyrimo objektas: skausmo, pusiausvyros ir raumenų jėgos pokyčiai, taikant skirtingas kineziterapijos programas – kineziterapiją vandenyje bei kelių sąnarių mobilizaciją ir kineziterapiją salėje bei TENS. Tyrimo tikslas: Nustatyti skirtingų kineziterapijos programų efektyvumą ligoniams, sergantiems kelio sąnario osteoartritu. Tyrimo uždaviniai: 1. Nustatyti klinikinio rodiklio – kelių sąnarių skausmo stiprumo – kaitą, taikant skirtingas kineziterapijos programas; 2. Nustatyti funkcinių rodiklių: statinės ir dinaminės pusiausvyros bei blauzdą tiesiančių raumenų jėgos kaitą, taikant skirtingas kineziterapijos programas; 3. Nustatyti, kuri kineziterapijos programa veiksmingesnė, mažinant skausmą ir didinant funkciją – pusiausvyrą bei blauzdą tiesiančių raumenų jėgą. Tyrimo hipotezė: Manome, kad taikydami... [toliau žr. visą tekstą] / Problem of study: Osteoarthritis (OA), in an aging society is becoming increasingly important problem. OA, for the majority of people - is a syndrome consisting of joint pain, stiffness and function because of deteriorating symptoms and who have a significant impact on the quality of life (Conaghan & Sharma, 2009). Patients ill with osteoarthritis are vulnerable to many disabilities in different areas of life: self-service, household chores, work, leisure, movement, sleep (Thorstenson, 2007; Sunden e al. 2007). In order to reduce pain and improve function in patients with knee osteoarthritis, we examined how different physical therapy programes are affecting the pain, balance and strength of the thigh muscles of the patients.. Object of study: changes in pain, balance and muscle strength while applying different physical therapy programs - physical therapy in water, knee joint mobilization, physical therapy room and TENS. Aim of study: to determine the effectiveness of various physical therapy programs for patients with knee osteoarthritis. Goals of study: 1. Establish a clinical indicator – change in the intensity of knee pain with different physical therapy programs; 2. Identify the functional characteristics: static and dynamic balance and change in force of the extensor muscles of the thigh, with different physical therapy programs; 3. To establish which physical therapy program is more effective in reducing pain and improving function - balance and power of the extensor... [to full text]

<p>Background: Practice knowledge exists as a complex relationship between questions and answers in a context of meaning that is often intuitive and hidden from the novice practitioner. Physiotherapy education, which aims to develop patterns of thinking, reflection and reasoning as part of practice knowledge, is often based on didactic teaching methods that emphasise the learning of facts without highlighting the relationships between them. In order to improve health outcomes for patients, clinical educators must&nbsp / consider redesigning the curriculum to take into account the changing and complex nature of physiotherapy education. There is some evidence that a blended approach to&nbsp / teaching and learning may facilitate the development of graduates who are more capable of reflection, reasoning and critical thinking, and who can adapt and respond to the&nbsp / complex clinical environment. The purpose of this study was to develop principles that could be used to guide the design of blended learning environments that aim to develop&nbsp / capability in undergraduate physiotherapy students. Method: The study took place in a university physiotherapy department in the Western Cape in South Africa, among&nbsp / undergraduate students. Design research was used as a framework to guide the study, and included a range of research methods as part of that process. The problem was&nbsp / identified using a systematic review of the literature and a survey of students. The design of the blended intervention that aimed to address the problem was informed by a&nbsp / narrative review of theoretical frameworks, two pilot studies that evaluated different aspects of blended learning, and a Delphi study. This process led to the development of a set&nbsp / of design principles which were used to inform the blended intervention, which was implemented and evaluated during 2012. Results: The final results showed that students had undergone a transformation in how they thought about the process and practice of learning as part of physiotherapy education, demonstrating critical approaches towards&nbsp / knowledge, the profession and authority. These changes were brought about by changing teaching and learning practices that were informed by the design principles in the&nbsp / preliminary phases of the project. These principles emphasised the use of technology to interact, articulate understanding, build relationships, embrace complexity, encourage&nbsp / creativity, stimulate reflection, acknowledge emotion, enhance flexibility and immerse students in the learning space. Discussion: While clinical education is a complex undertaking with many challenges, evidence presented in this study demonstrates that the development of clinical reasoning, critical thinking and reflection can be enhanced through the intentional use of technology as part of a blended approach to teaching and learning. The design principles offer clinical educators a framework upon which to construct learning environments where the affordances of technology can be mapped to the principles, which are based on a sound pedagogical foundation. In this way, the use of technology in the learning environment is constructed around principles that are informed by theory. However, clinical educators who are considering the integration of&nbsp / innovative strategies in the curriculum should be aware that students may initially be reluctant to engage in self-directed learning activities, and that resistance from colleagues&nbsp / may obstruct the process. Conclusion: The development of clinical reasoning, critical thinking and reflection in undergraduate physiotherapy students may be enhanced through&nbsp / the intentional use of appropriate technology that aims to fundamentally change teaching and learning practices. Design research offers a practical approach to conducting&nbsp / research in clinical education, leading to the development of principles of learning that are based on theory. <br /> iii</p>

Introduction: Balance dysfunction, particularly in standing, is a devastating sequel to stroke since the ability to balance is one of the most critical motor control factors in daily life. Physiotherapists use a variety of balance and stability techniques as a part of treatment programmes to improve functional independence in patients following a stroke. However more scientific evidence for the effectiveness of these techniques or programs is required. Purpose: The purpose of this study was to quantify the effect of a balance and stability training program on stability, balance and functional independence in stroke patients. Method: The aims of this study were achieved using a randomised controlled trial. A questionnaire allowed the collection of demographic data from fifty participants who had suffered the first stroke, regardless of gender or race. The Postural Assessment Scale for Stroke patients (PASS), Berg Balance Scale (BBS), Barthel Index (BI) and questionnaire were administered to all fifty participants on the first and last weeks of a twelve week physiotherapy program. For ten weeks twenty five randomly assigned participants in each of the control and experimental groups underwent either normal physiotherapy or stability and balance intervention exercise program respectively. Data Analysis: The raw data was normalized by calculating percent changes for each item for each participant and the pooled data subjected to Wilcoxon signed ranks testing, paired samples signed tests and Pearson’s correlations. Results: PASS, BBS and BI scores increased significantly from pre-test to post-tests in both groups, with greater changes noted in the experimental group, showing improvements in stability, balance and function. In addition a strong and significant correlation between stability scores and balance scores suggested that stability is important to improve balance. Similarly a strong and significant correlation between stability and balance scores with function scores confirms the value of stability and balance in improving function. It was further noted that in addition to a certain degree of spontaneous recovery, traditional physiotherapy programs also result in improvement in stability, balance and function but not to the same extent as with the program of treatment which emphasizes stability and balance exercises. Conclusion: A significant improvement in the stability, balance and function in stroke patients was achieved with the balance and stability intervention program. Conventional physiotherapy methods also improved stability, balance and function, but to a lesser extent than the balance and stability training. / Thesis (M.Physio.)-University of KwaZulu-Natal, Westville, 2012.